Hospital

UOFL HEALTH - SHELBYVILLE HOSPITAL

Shelbyville, KY · CCN 180016 · Rates published

25,343 distinct procedures filed

23 distinct payers

1,264,976 rate rows

2026-05-22 last MRF observed

Data quality

1,262,098 of 1,264,976 rate rows are consumer-grade (99.8%)

2,878 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
placeholder amount (≤ $0.02) — excluded from medians	2,436
percent-of-charges filed in the dollar field — excluded from medians	234
per-diem day rate — not a per-procedure price	188
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	20

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://uoflhealth.org/wp-content/uploads/2026/04/843196350_UofL-Health-Shelbyville-Hospital_standardcharges1.zip
Found on page	https://uoflhealth.org/price-transparency/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	5c0f9a2c890db03e… · 4,774,277 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
J3391 OTHER	Inj Atidarsagene Autotemcel	8	$4,377,500.00	$4,730,250.00	$4,505,000.00	nat. median $4,505,000 1.0× median
J1414 OTHER	Inj Beqvez Per Tx Dose	1	$3,675,000.00	$3,710,000.00	$3,710,000.00	nat. median $3,710,000 1.0× median
C9172 OTHER	Inj- Beqvez- Per Tx Dose	4	$3,424,750.00	$4,506,250.00	$3,695,125.00	nat. median $3,675,000 1.0× median
J1411 OTHER	Inj Hemgenix Per Tx Dose	13	$3,489,255.00	$4,969,916.00	$3,685,266.67	nat. median $3,685,267 1.0× median
J1413 OTHER	Inj Delandistrogene Mox Rokl	14	$3,159,182.02	$4,675,409.45	$3,325,454.76	nat. median $3,327,860 1.0× median
J3394 OTHER	Inj Lovotibeglogene Autotem	12	$3,121,700.00	$4,222,979.44	$3,261,355.00	nat. median $3,286,000 1.0× median
J3393 OTHER	Inj Betibeglogene Autotemce	12	$2,819,600.00	$3,829,462.00	$2,950,686.67	nat. median $2,968,000 1.0× median
J3399 OTHER	Inj Onase Abepar-xioi Treat	13	$2,231,250.00	$4,299,505.61	$2,455,110.61	nat. median $2,472,216 1.0× median
J3392 OTHER	Inj Exagamglogene Autotem	9	$2,332,000.00	$3,031,600.00	$2,332,000.00	nat. median $2,332,000 1.0× median
Q2057 OTHER	Afamitresgene Autoleucel	9	$770,620.00	$1,001,806.00	$770,620.00	nat. median $770,620 1.0× median
Q2042 OTHER	Tisagenlecleucel Car-pos T	14	$502,733.22	$952,547.15	$591,726.20	nat. median $591,726 1.0× median
Q2056 OTHER	Ciltacabtagene Car-pos T	14	$500,767.26	$948,822.17	$565,868.95	nat. median $583,076 1.0× median
Q2054 OTHER	Lisocabtagene Mara Car Pos T	14	$490,889.78	$930,106.94	$562,538.19	nat. median $562,538 1.0× median
Q2055 OTHER	Idecabtagene Vicleucel Car	14	$500,258.21	$947,857.66	$557,317.93	nat. median $558,082 1.0× median
Q2041 OTHER	Axicabtagene Ciloleucel Car+	14	$464,983.16	$881,020.73	$533,230.17	nat. median $533,230 1.0× median
Q2053 OTHER	Brexucabtagene Car Pos T	14	$437,503.88	$828,954.72	$489,304.61	nat. median $489,720 1.0× median
Q2058 OTHER	Obecbtge Autol Up To 400 Mil	9	$270,375.00	$361,725.00	$278,250.00	nat. median $281,111 1.0× median
MS-018 OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	15	$232,863.73	$424,344.43	$266,639.12	nat. median $309,559 0.9× median
J3403 OTHER	Revakinagene Per Implant	9	$257,500.00	$334,750.00	$257,500.00	nat. median $265,000 1.0× median
MS-612 OTHER	Neonate- Birth Weight <750 Grams- Discharged Alive	1	$217,286.57	$217,286.57	$217,286.57	nat. median $272,926 0.8× median
510020263 OTHER	Vutrisiran 25 Mg/0.5 Ml Syringe	16	$56,794.15	$424,153.51	$212,076.76	nat. median $212,077 1.0× median
J3402 OTHER	Inj. Remestemcel-l-rknd/ Td	9	$205,640.00	$267,332.00	$205,640.00	nat. median $205,640 1.0× median
510020266 OTHER	Lumasiran 94.5 Mg/0.5 Ml Inj	16	$54,568.67	$407,533.02	$203,766.51	nat. median $203,767 1.0× median
MS-636 OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- With Mu…	1	$199,388.70	$199,388.70	$199,388.70	nat. median $183,596 1.1× median
MS-633 OTHER	Neonate- Birth Weight 1000-1499 Grams- With Significant O.r. Procedures- Dischar…	1	$179,138.52	$179,138.52	$179,138.52	nat. median $297,836 0.6× median
0114 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	$176,428.56	$176,428.56	$176,428.56	nat. median $125,206 1.4× median
MS-631 OTHER	Neonate- Birth Weight 750-999 Grams- Discharged Alive	1	$174,511.45	$174,511.45	$174,511.45	nat. median $197,901 0.9× median
MS-001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	16	$20,000.00	$415,432.83	$173,483.88	nat. median $224,278 0.8× median
5833 OTHER	Neonate With Ecmo	1	$162,247.62	$162,247.62	$162,247.62	nat. median $252,069 0.6× median
5834 OTHER	Neonate With Ecmo	1	$162,247.62	$162,247.62	$162,247.62	nat. median $372,748 outlier · 0.4×
5831 OTHER	Neonate With Ecmo	1	$152,626.88	$152,626.88	$152,626.88	nat. median $139,037 1.1× median
5832 OTHER	Neonate With Ecmo	1	$152,626.88	$152,626.88	$152,626.88	nat. median $152,272 1.0× median
0024 OTHER	Heart andOR Lung Transplant	1	$147,504.23	$147,504.23	$147,504.23	nat. median $235,636 0.6× median
MS-927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	15	$125,326.07	$1,105,675.44	$141,719.49	nat. median $175,322 0.8× median
5884 OTHER	Neonate Bwt 1500g W Major Procedure	1	$141,703.04	$141,703.04	$141,703.04	nat. median $243,175 0.6× median
MS-003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	15	$124,590.57	$274,117.55	$135,502.60	nat. median $169,886 0.8× median
6314 OTHER	Neonate Birthwt 2499g W Other Major Procedure	1	$131,839.30	$131,839.30	$131,839.30	nat. median $163,675 0.8× median
1614 OTHER	Implantable Heart Assist Systems	1	$129,112.29	$129,112.29	$129,112.29	nat. median $194,298 0.7× median
0056U OTHER	Hem Aml DNA Gene Reargmt	1	$50.00	$251,560.00	$125,805.00	nat. median $2,641 outlier · 47.6×
5883 OTHER	Neonate Bwt 1500g W Major Procedure	1	$111,984.02	$111,984.02	$111,984.02	nat. median $163,694 0.7× median
Q0480 OTHER	Driver Pneumatic Vad Rep	13	$72,648.53	$195,676.14	$109,316.30	nat. median $109,316 1.0× median
0044 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	$109,115.53	$109,115.53	$109,115.53	nat. median $138,863 0.8× median
MS-681 OTHER	Neonate- Birth Weight >2499 Grams- With Significant O.r. Procedures- With Multip…	1	$102,819.68	$102,819.68	$102,819.68	nat. median $119,200 0.9× median
0113 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	$102,798.61	$102,798.61	$102,798.61	nat. median $92,292 1.1× median
0053U OTHER	Onc Prst8 Ca Fish Alys 4 Gen	1	$50.00	$203,000.00	$101,525.00	nat. median $2,030 outlier · 50.0×
510020195 OTHER	Tebentafusp-tebn 100 Mcg/0.5 Ml Inj	16	$25,962.84	$193,897.27	$96,948.64	nat. median $96,949 1.0× median
5914 OTHER	Neonate Birthwt 500749g Wo Major Procedure	1	$93,807.13	$93,807.13	$93,807.13	nat. median $149,152 0.6× median
0074 OTHER	Allogeneic Bone Marrow Transplant	1	$92,412.49	$92,412.49	$92,412.49	nat. median $147,645 0.6× median
5934 OTHER	Neonate Birthwt 750999g Wo Major Procedure	1	$90,542.33	$90,542.33	$90,542.33	nat. median $129,842 0.7× median
0014 OTHER	Liver Transplant andOR Intestinal Transplant	1	$90,110.39	$90,110.39	$90,110.39	nat. median $147,828 0.6× median

Other procedures at this hospital

Browse this hospital's 25,343 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J3391	OTHER	Inj Atidarsagene Autotemcel	24	8	—	—	$4,377,500.00	$4,730,250.00	$4,505,000.00	2026-05-22
J1414	OTHER	Inj Beqvez Per Tx Dose	8	1	—	—	$3,675,000.00	$3,710,000.00	$3,710,000.00	2026-05-22
C9172	OTHER	Inj- Beqvez- Per Tx Dose	8	4	—	—	$3,424,750.00	$4,506,250.00	$3,695,125.00	2026-05-22
J1411	OTHER	Inj Hemgenix Per Tx Dose	40	13	—	—	$3,489,255.00	$4,969,916.00	$3,685,266.67	2026-05-22
J1413	OTHER	Inj Delandistrogene Mox Rokl	42	14	—	—	$3,159,182.02	$4,675,409.45	$3,325,454.76	2026-05-22
J3394	OTHER	Inj Lovotibeglogene Autotem	34	12	—	—	$3,121,700.00	$4,222,979.44	$3,261,355.00	2026-05-22
J3393	OTHER	Inj Betibeglogene Autotemce	34	12	—	—	$2,819,600.00	$3,829,462.00	$2,950,686.67	2026-05-22
J3399	OTHER	Inj Onase Abepar-xioi Treat	42	13	—	—	$2,231,250.00	$4,299,505.61	$2,455,110.61	2026-05-22
J3392	OTHER	Inj Exagamglogene Autotem	26	9	—	—	$2,332,000.00	$3,031,600.00	$2,332,000.00	2026-05-22
Q2057	OTHER	Afamitresgene Autoleucel	26	9	—	—	$770,620.00	$1,001,806.00	$770,620.00	2026-05-22
Q2042	OTHER	Tisagenlecleucel Car-pos T	44	14	—	—	$502,733.22	$952,547.15	$591,726.20	2026-05-22
Q2056	OTHER	Ciltacabtagene Car-pos T	44	14	—	—	$500,767.26	$948,822.17	$565,868.95	2026-05-22
Q2054	OTHER	Lisocabtagene Mara Car Pos T	44	14	—	—	$490,889.78	$930,106.94	$562,538.19	2026-05-22
Q2055	OTHER	Idecabtagene Vicleucel Car	44	14	—	—	$500,258.21	$947,857.66	$557,317.93	2026-05-22
Q2041	OTHER	Axicabtagene Ciloleucel Car+	44	14	—	—	$464,983.16	$881,020.73	$533,230.17	2026-05-22
Q2053	OTHER	Brexucabtagene Car Pos T	44	14	—	—	$437,503.88	$828,954.72	$489,304.61	2026-05-22
Q2058	OTHER	Obecbtge Autol Up To 400 Mil	26	9	—	—	$270,375.00	$361,725.00	$278,250.00	2026-05-22
MS-018	OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	50	15	—	—	$232,863.73	$424,344.43	$266,639.12	2026-05-22
J3403	OTHER	Revakinagene Per Implant	20	9	—	—	$257,500.00	$334,750.00	$257,500.00	2026-05-22
MS-612	OTHER	Neonate- Birth Weight <750 Grams- Discharged Alive	2	1	—	—	$217,286.57	$217,286.57	$217,286.57	2026-05-22
510020263	OTHER	Vutrisiran 25 Mg/0.5 Ml Syringe	54	16	$424,153.51	$161,178.33 62% off	$56,794.15	$424,153.51	$212,076.76	2026-05-22
J3402	OTHER	Inj. Remestemcel-l-rknd/ Td	20	9	—	—	$205,640.00	$267,332.00	$205,640.00	2026-05-22
510020266	OTHER	Lumasiran 94.5 Mg/0.5 Ml Inj	54	16	$407,533.02	$154,862.55 62% off	$54,568.67	$407,533.02	$203,766.51	2026-05-22
MS-636	OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- With Mu…	2	1	—	—	$199,388.70	$199,388.70	$199,388.70	2026-05-22
MS-633	OTHER	Neonate- Birth Weight 1000-1499 Grams- With Significant O.r. Procedures- Dischar…	2	1	—	—	$179,138.52	$179,138.52	$179,138.52	2026-05-22
0114	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	1	—	—	$176,428.56	$176,428.56	$176,428.56	2026-05-22
MS-631	OTHER	Neonate- Birth Weight 750-999 Grams- Discharged Alive	2	1	—	—	$174,511.45	$174,511.45	$174,511.45	2026-05-22
MS-001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	52	16	—	—	$20,000.00	$415,432.83	$173,483.88	2026-05-22
5834	OTHER	Neonate With Ecmo	2	1	—	—	$162,247.62	$162,247.62	$162,247.62	2026-05-22
5833	OTHER	Neonate With Ecmo	2	1	—	—	$162,247.62	$162,247.62	$162,247.62	2026-05-22
5831	OTHER	Neonate With Ecmo	2	1	—	—	$152,626.88	$152,626.88	$152,626.88	2026-05-22
5832	OTHER	Neonate With Ecmo	2	1	—	—	$152,626.88	$152,626.88	$152,626.88	2026-05-22
0024	OTHER	Heart andOR Lung Transplant	2	1	—	—	$147,504.23	$147,504.23	$147,504.23	2026-05-22
MS-927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	52	15	—	—	$125,326.07	$1,105,675.44	$141,719.49	2026-05-22
5884	OTHER	Neonate Bwt 1500g W Major Procedure	2	1	—	—	$141,703.04	$141,703.04	$141,703.04	2026-05-22
MS-003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	52	15	—	—	$124,590.57	$274,117.55	$135,502.60	2026-05-22
6314	OTHER	Neonate Birthwt 2499g W Other Major Procedure	2	1	—	—	$131,839.30	$131,839.30	$131,839.30	2026-05-22
1614	OTHER	Implantable Heart Assist Systems	2	1	—	—	$129,112.29	$129,112.29	$129,112.29	2026-05-22
0056U	OTHER	Hem Aml DNA Gene Reargmt	4	1	—	—	$50.00	$251,560.00	$125,805.00	2026-05-22
5883	OTHER	Neonate Bwt 1500g W Major Procedure	2	1	—	—	$111,984.02	$111,984.02	$111,984.02	2026-05-22
Q0480	OTHER	Driver Pneumatic Vad Rep	42	13	—	—	$72,648.53	$195,676.14	$109,316.30	2026-05-22
0044	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	2	1	—	—	$109,115.53	$109,115.53	$109,115.53	2026-05-22
MS-681	OTHER	Neonate- Birth Weight >2499 Grams- With Significant O.r. Procedures- With Multip…	2	1	—	—	$102,819.68	$102,819.68	$102,819.68	2026-05-22
0113	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	1	—	—	$102,798.61	$102,798.61	$102,798.61	2026-05-22
0053U	OTHER	Onc Prst8 Ca Fish Alys 4 Gen	4	1	—	—	$50.00	$203,000.00	$101,525.00	2026-05-22
510020195	OTHER	Tebentafusp-tebn 100 Mcg/0.5 Ml Inj	54	16	$193,897.27	$73,680.96 62% off	$25,962.84	$193,897.27	$96,948.64	2026-05-22
5914	OTHER	Neonate Birthwt 500749g Wo Major Procedure	2	1	—	—	$93,807.13	$93,807.13	$93,807.13	2026-05-22
0074	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$92,412.49	$92,412.49	$92,412.49	2026-05-22
5934	OTHER	Neonate Birthwt 750999g Wo Major Procedure	2	1	—	—	$90,542.33	$90,542.33	$90,542.33	2026-05-22
0014	OTHER	Liver Transplant andOR Intestinal Transplant	2	1	—	—	$90,110.39	$90,110.39	$90,110.39	2026-05-22
MS-004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	52	15	—	—	$62,558.44	$158,990.76	$86,387.82	2026-05-22
MS-635	OTHER	Neonate- Birth Weight 1000-1499 Grams- Died	2	1	—	—	$84,974.31	$84,974.31	$84,974.31	2026-05-22
1613	OTHER	Implantable Heart Assist Systems	2	1	—	—	$83,350.94	$83,350.94	$83,350.94	2026-05-22
1612	OTHER	Implantable Heart Assist Systems	2	1	—	—	$83,331.59	$83,331.59	$83,331.59	2026-05-22
0112	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	1	—	—	$82,976.94	$82,976.94	$82,976.94	2026-05-22
1611	OTHER	Implantable Heart Assist Systems	2	1	—	—	$82,318.94	$82,318.94	$82,318.94	2026-05-22
5881	OTHER	Neonate Bwt 1500g W Major Procedure	2	1	—	—	$82,259.54	$82,259.54	$82,259.54	2026-05-22
5882	OTHER	Neonate Bwt 1500g W Major Procedure	2	1	—	—	$82,259.54	$82,259.54	$82,259.54	2026-05-22
MS-007	OTHER	Lung Transplant	52	16	—	—	$20,000.00	$185,000.00	$81,528.69	2026-05-22
0023	OTHER	Heart andOR Lung Transplant	2	1	—	—	$81,282.42	$81,282.42	$81,282.42	2026-05-22
MS-634	OTHER	Neonate- Birth Weight 1000-1499 Grams- Without Significant O.r. Procedures- Disc…	2	1	—	—	$80,655.19	$80,655.19	$80,655.19	2026-05-22
510018653	OTHER	Tagraxofusp-erzs (Elzonris) 1000 Mcg Inj	54	16	$160,681.65	$61,059.03 62% off	$21,515.27	$160,681.65	$80,340.82	2026-05-22
MS-014	OTHER	Allogeneic Bone Marrow Transplant	52	16	—	—	$20,000.00	$147,421.45	$77,174.71	2026-05-22
MS-613	OTHER	Neonate- Birth Weight <750 Grams- Died	2	1	—	—	$77,067.16	$77,067.16	$77,067.16	2026-05-22
MS-453	OTHER	Combined Anterior/posterior Spinal Fusion W Mcc	6	3	—	—	$71,748.67	$87,340.74	$73,858.93	2026-05-22
6094	OTHER	Neonate Bwt 15002499g W Major Procedure	2	1	—	—	$70,877.49	$70,877.49	$70,877.49	2026-05-22
MS-002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	52	16	—	—	$20,000.00	$123,993.66	$70,707.54	2026-05-22
6024	OTHER	Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom	2	1	—	—	$69,929.73	$69,929.73	$69,929.73	2026-05-22
MS-209	OTHER	Kidney And Urinary Tract Signs And Symptoms Age 0-17	34	12	—	—	$3,693.82	$128,966.41	$69,889.75	2026-05-22
L8702	OTHER	Ewhf S/d Uprt Micro Sensor	42	13	—	—	$62,578.15	$120,740.26	$69,165.33	2026-05-22
MS-212	OTHER	Testes Procedures Age 0-17	52	15	—	—	$7,190.96	$123,899.50	$68,212.16	2026-05-22
MS-426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	48	15	—	—	$11,906.58	$125,575.55	$68,052.17	2026-05-22
510013649	OTHER	Ustekinumab 45 Mg/0.5 Ml Inj	54	16	$135,292.05	$51,410.98 62% off	$18,115.61	$135,292.05	$67,646.02	2026-05-22
510013713	OTHER	Ustekinumab 90 Mg/1 Ml Inj	54	16	$135,291.91	$51,410.93 62% off	$18,115.59	$135,291.91	$67,645.96	2026-05-22
1604	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	2	1	—	—	$66,951.91	$66,951.91	$66,951.91	2026-05-22
0022	OTHER	Health Insurance - Prospective Payment System (hipps) - Skilled Nursing Facility…	2	1	—	—	$66,841.49	$66,841.49	$66,841.49	2026-05-22
510020157	OTHER	Loncastuximab Tesirine-lpyl 10 Mg Inj	54	16	$132,168.06	$50,223.86 62% off	$17,697.30	$132,168.06	$66,084.03	2026-05-22
MS-005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	52	16	—	—	$20,000.00	$164,320.00	$65,665.09	2026-05-22
MS-215	OTHER	Other Heart Assist System Implant	52	15	—	—	$58,446.95	$119,212.69	$64,987.22	2026-05-22
6304	OTHER	Neonate Birthwt 2499g W Major Cardiovascular Procedure	2	1	—	—	$64,803.32	$64,803.32	$64,803.32	2026-05-22
440080914	OTHER	Gen Pulse V Insp 3150	54	16	$129,600.00	$49,248.00 62% off	$17,353.44	$129,600.00	$64,800.00	2026-05-22
MS-632	OTHER	Neonate- Birth Weight 750-999 Grams- Died	2	1	—	—	$64,772.71	$64,772.71	$64,772.71	2026-05-22
510020127	OTHER	Lanreotide 90 Mg Syringe	54	16	$127,939.44	$48,616.99 62% off	$17,131.09	$127,939.44	$63,969.72	2026-05-22
0054	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	2	1	—	—	$63,880.82	$63,880.82	$63,880.82	2026-05-22
J9029	OTHER	Instill Adstiladrin Tx Dose	44	14	—	—	$60,187.03	$114,038.59	$63,688.03	2026-05-22
440077063	OTHER	Lead Stim Insp 4063-45cm	54	16	$126,750.00	$48,165.00 62% off	$16,971.82	$126,750.00	$63,375.00	2026-05-22
6074	OTHER	Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom	2	1	—	—	$62,566.87	$62,566.87	$62,566.87	2026-05-22
0094	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	1	—	—	$62,431.22	$62,431.22	$62,431.22	2026-05-22
MS-216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	52	15	—	—	$57,424.41	$111,465.22	$62,394.75	2026-05-22
0073	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$61,489.01	$61,489.01	$61,489.01	2026-05-22
A9543	OTHER	Y90 Ibritumomab Rx	42	14	—	—	$56,824.55	$117,857.84	$59,665.78	2026-05-22
510017501	OTHER	Ribavirin 6,000 Mg Inhalation Powder	54	16	$118,815.50	$45,149.89 62% off	$15,909.40	$118,815.50	$59,407.75	2026-05-22
0021	OTHER	Heart andOR Lung Transplant	2	1	—	—	$59,406.60	$59,406.60	$59,406.60	2026-05-22
510016295	OTHER	Alemtuzumab (Lemtrada) 12 Mg/1.2 Ml Inj	54	16	$115,660.70	$43,951.07 62% off	$15,486.97	$115,660.70	$57,830.35	2026-05-22
Q2043	OTHER	Sipuleucel-t Auto Cd54+	44	14	—	—	$52,264.47	$99,027.41	$57,348.24	2026-05-22
38240	OTHER	Transplt Allo Hct/donor	44	14	—	—	$1,242.31	$90,986.16	$56,272.82	2026-05-22
0043	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	2	1	—	—	$55,840.60	$55,840.60	$55,840.60	2026-05-22
440059540	OTHER	Genrtr Nrstm 49.5x55.5m 3660ans	54	16	$111,450.00	$42,351.00 62% off	$14,923.16	$111,450.00	$55,725.00	2026-05-22
MS-429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	46	15	—	—	$51,500.37	$102,655.38	$55,631.22	2026-05-22
MS-850	OTHER	Acute Leukemia With Other Procedures	46	15	—	—	$50,830.71	$103,652.30	$55,073.56	2026-05-22
0072	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$54,798.99	$54,798.99	$54,798.99	2026-05-22
440077062	OTHER	Gen Pulse IV Insp 3028	54	16	$109,350.00	$41,553.00 62% off	$14,641.96	$109,350.00	$54,675.00	2026-05-22
5933	OTHER	Neonate Birthwt 750999g Wo Major Procedure	2	1	—	—	$54,565.07	$54,565.07	$54,565.07	2026-05-22
510018575	OTHER	Inotuzumab Ozogamicin 0.9 Mg Inj	54	16	$108,442.37	$41,208.10 62% off	$14,520.43	$108,442.37	$54,221.18	2026-05-22
MS-231	OTHER	Coronary Bypass With Ptca With Mcc	52	15	—	—	$49,482.97	$96,050.28	$54,133.84	2026-05-22
MS-459	OTHER	Spinal Fusion Except Cervical With Mcc	6	3	—	—	$39,966.76	$55,279.59	$53,700.17	2026-05-22
MS-456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	52	15	—	—	$47,959.32	$95,748.34	$52,869.61	2026-05-22
510017356	OTHER	Pegloticase 8 Mg/1 Ml Inj	108	16	$106,093.21	$40,315.42 62% off	$8,923.10	$145,546.42	$52,526.88	2026-05-22
0815	OTHER	N/a	2	1	—	—	$52,500.00	$52,500.00	$52,500.00	2026-05-22
MS-361	OTHER	Cardiac Defibrillator Implant With Mcc	2	1	—	—	$52,473.56	$52,473.56	$52,473.56	2026-05-22
8504	OTHER	Procedure With Diagnosis Of Rehabilitation Aftercare Or Other Contact With Heal	2	1	—	—	$52,127.35	$52,127.35	$52,127.35	2026-05-22
MS-647	OTHER	Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…	2	1	—	—	$52,095.87	$52,095.87	$52,095.87	2026-05-22
440081416	OTHER	Generat Wavewrit 16 Sc-1216	54	16	$103,800.00	$39,444.00 62% off	$13,898.82	$103,800.00	$51,900.00	2026-05-22
440059084	OTHER	Sensor MRI Intellis 97715	54	16	$101,640.00	$38,623.20 62% off	$13,609.60	$101,640.00	$50,820.00	2026-05-22
MS-020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	52	15	—	—	$46,189.35	$90,837.88	$50,530.65	2026-05-22
1624	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	2	1	—	—	$50,327.10	$50,327.10	$50,327.10	2026-05-22
8514	OTHER	Gender Related Procedures	2	1	—	—	$49,861.86	$49,861.86	$49,861.86	2026-05-22
6023	OTHER	Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom	2	1	—	—	$49,747.80	$49,747.80	$49,747.80	2026-05-22
3034	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$49,570.91	$49,570.91	$49,570.91	2026-05-22
MS-454	OTHER	Combined Anterior/posterior Spinal Fusion W Cc	6	3	—	—	$47,811.23	$50,978.78	$49,522.24	2026-05-22
0013	OTHER	Liver Transplant andOR Intestinal Transplant	2	1	—	—	$49,313.89	$49,313.89	$49,313.89	2026-05-22
MS-219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	52	15	—	—	$45,071.13	$87,486.55	$49,307.33	2026-05-22
MS-233	OTHER	Coronary Bypass With Cardiac Catheterization With Mcc	52	15	—	—	$44,876.83	$87,950.13	$49,094.77	2026-05-22
440063210	OTHER	Stim Nrv Wavewriter Sc-1416	54	16	$97,800.00	$37,164.00 62% off	$13,095.42	$97,800.00	$48,900.00	2026-05-22
L7181	OTHER	Electronic Elbo Simultaneous	42	13	—	—	$37,858.44	$87,052.69	$48,632.79	2026-05-22
510017419	OTHER	Porfimer 75 Mg Inj	54	16	$97,232.52	$36,948.36 62% off	$13,019.43	$97,232.52	$48,616.26	2026-05-22
MS-957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	52	15	—	—	$44,728.33	$86,821.14	$48,427.57	2026-05-22
440080893	OTHER	Spyral Den Cath Rdn016	54	16	$96,000.00	$36,480.00 62% off	$12,854.40	$96,000.00	$48,000.00	2026-05-22
6334	OTHER	Neonate Birthwt 2499g W Major Anomaly	2	1	—	—	$47,510.45	$47,510.45	$47,510.45	2026-05-22
5932	OTHER	Neonate Birthwt 750999g Wo Major Procedure	2	1	—	—	$47,389.23	$47,389.23	$47,389.23	2026-05-22
J9226	OTHER	Supprelin La Implant	44	14	—	—	$43,082.71	$81,630.40	$46,812.38	2026-05-22
0062	OTHER	Pancreas Transplant	2	1	—	—	$46,800.53	$46,800.53	$46,800.53	2026-05-22
0064	OTHER	Pancreas Transplant	2	1	—	—	$46,800.53	$46,800.53	$46,800.53	2026-05-22
0063	OTHER	Pancreas Transplant	2	1	—	—	$46,800.53	$46,800.53	$46,800.53	2026-05-22
MS-646	OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- Without…	2	1	—	—	$46,719.69	$46,719.69	$46,719.69	2026-05-22
0053	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	2	1	—	—	$46,512.41	$46,512.41	$46,512.41	2026-05-22
MS-019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	50	15	—	—	$41,879.65	$89,197.98	$46,256.42	2026-05-22
0084	OTHER	Autologous Bone Marrow Transplant	2	1	—	—	$46,186.44	$46,186.44	$46,186.44	2026-05-22
0083	OTHER	Autologous Bone Marrow Transplant	2	1	—	—	$46,025.19	$46,025.19	$46,025.19	2026-05-22
V2790	OTHER	Amniotic Membrane	2	1	—	—	$45,176.00	$45,176.00	$45,176.00	2026-05-22
6093	OTHER	Neonate Bwt 15002499g W Major Procedure	2	1	—	—	$45,106.97	$45,106.97	$45,106.97	2026-05-22
MS-275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	52	15	—	—	$40,848.29	$81,243.78	$44,688.21	2026-05-22
MS-427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	48	15	—	—	$11,460.72	$82,248.73	$44,572.40	2026-05-22
MS-870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	52	15	—	—	$40,571.82	$78,753.05	$44,385.14	2026-05-22
6124	OTHER	Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond	2	1	—	—	$44,351.21	$44,351.21	$44,351.21	2026-05-22
MS-010	OTHER	Pancreas Transplant	52	16	—	—	$20,000.00	$89,712.20	$44,307.51	2026-05-22
MS-928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	52	15	—	—	$37,136.45	$81,725.74	$44,288.99	2026-05-22
510018667	OTHER	Polatuzumab Vedotin-piiq 140 Mg Inj	54	16	$88,103.08	$33,479.17 62% off	$11,797.00	$88,103.08	$44,051.54	2026-05-22
0266T	OTHER	Implt/rpl Crtd Sns Dev Total	40	14	—	—	$10,917.00	$74,434.96	$43,871.74	2026-05-22
33276	OTHER	Insj Phrnc Nrv Stim Sys	40	13	—	—	$26,103.48	$74,434.96	$43,871.74	2026-05-22
510018741	OTHER	Fluocinolone Acetonide Intravitreal 0.59 Mg Implant	54	16	$86,870.00	$33,010.60 62% off	$11,631.89	$86,870.00	$43,435.00	2026-05-22
6114	OTHER	Neonate Birthwt 15001999g W Major Anomaly	2	1	—	—	$43,232.92	$43,232.92	$43,232.92	2026-05-22
MS-955	OTHER	Craniotomy For Multiple Significant Trauma	52	15	—	—	$39,511.13	$98,561.68	$43,224.75	2026-05-22
MS-268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	52	15	—	—	$13,047.47	$78,366.79	$42,848.68	2026-05-22
510018748	OTHER	Teprotumumab-trbw (Tepezza) 500 Mg Inj	54	16	$85,307.05	$32,416.68 62% off	$11,422.61	$85,307.05	$42,653.52	2026-05-22
6092	OTHER	Neonate Bwt 15002499g W Major Procedure	2	1	—	—	$42,551.98	$42,551.98	$42,551.98	2026-05-22
5913	OTHER	Neonate Birthwt 500749g Wo Major Procedure	2	1	—	—	$42,365.74	$42,365.74	$42,365.74	2026-05-22
8634	OTHER	Neonatal Aftercare	2	1	—	—	$41,993.68	$41,993.68	$41,993.68	2026-05-22
6214	OTHER	Neonate Bwt 20002499g W Major Anomaly	2	1	—	—	$41,988.10	$41,988.10	$41,988.10	2026-05-22
MS-217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	52	15	—	—	$38,596.59	$78,193.17	$41,843.68	2026-05-22
6091	OTHER	Neonate Bwt 15002499g W Major Procedure	2	1	—	—	$41,410.33	$41,410.33	$41,410.33	2026-05-22
MS-447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	46	15	—	—	$39,220.56	$76,130.15	$41,399.25	2026-05-22
MS-207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	52	15	—	—	$37,771.28	$73,316.97	$41,321.37	2026-05-22
MS-317	OTHER	Endovascular Cardiac Valve Replacement With Mcc	48	15	—	—	$38,198.92	$76,185.98	$41,286.87	2026-05-22
MS-218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	52	15	—	—	$36,734.91	$74,918.97	$41,209.24	2026-05-22
MS-573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	52	15	—	—	$38,024.79	$74,646.65	$41,059.46	2026-05-22
L2006	OTHER	Kaf Sng/dbl Swg/stn Mcpr Cus	42	13	—	—	$35,816.41	$69,105.31	$39,586.55	2026-05-22
MS-969	OTHER	HIV With Extensive O.r. Procedures With Mcc	52	15	—	—	$35,931.64	$71,161.02	$39,368.60	2026-05-22
L7180	OTHER	Electronic Elbow Sequential	42	13	—	—	$25,912.94	$70,183.07	$39,208.42	2026-05-22
6022	OTHER	Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom	2	1	—	—	$39,097.10	$39,097.10	$39,097.10	2026-05-22
9504	OTHER	Extensive Procedure Unrelated To Principal Diagnosis	2	1	—	—	$39,095.74	$39,095.74	$39,095.74	2026-05-22
4404	OTHER	Kidney Transplant	2	1	—	—	$38,936.02	$38,936.02	$38,936.02	2026-05-22
MS-232	OTHER	Coronary Bypass With Ptca Without Mcc	52	15	—	—	$35,587.07	$69,077.26	$38,931.88	2026-05-22
MS-266	OTHER	Endovascular Cardiac Valve Replacement W Mcc	52	15	—	—	$35,973.32	$69,826.99	$38,908.36	2026-05-22
3033	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$38,890.26	$38,890.26	$38,890.26	2026-05-22
6073	OTHER	Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom	2	1	—	—	$38,589.90	$38,589.90	$38,589.90	2026-05-22
0214	OTHER	Open Craniotomy Except Trauma	2	1	—	—	$38,382.34	$38,382.34	$38,382.34	2026-05-22
MS-276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	52	15	—	—	$31,382.58	$69,699.39	$38,224.85	2026-05-22
5893	OTHER	Neonate Bwt 500g Or Ga 24 Weeks	2	1	—	—	$38,000.63	$38,000.63	$38,000.63	2026-05-22
5894	OTHER	Neonate Bwt 500g Or Ga 24 Weeks	2	1	—	—	$38,000.63	$38,000.63	$38,000.63	2026-05-22
MS-028	OTHER	Spinal Procedures With Mcc	52	15	—	—	$33,400.31	$68,458.57	$37,875.52	2026-05-22
4403	OTHER	Kidney Transplant	2	1	—	—	$37,845.97	$37,845.97	$37,845.97	2026-05-22
4402	OTHER	Kidney Transplant	2	1	—	—	$37,762.12	$37,762.12	$37,762.12	2026-05-22
4401	OTHER	Kidney Transplant	2	1	—	—	$37,704.07	$37,704.07	$37,704.07	2026-05-22
MS-235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	52	15	—	—	$34,448.31	$66,866.83	$37,686.07	2026-05-22
MS-457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	52	15	—	—	$35,003.02	$67,943.56	$37,567.76	2026-05-22
MS-820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	52	15	—	—	$34,426.00	$66,823.53	$37,523.90	2026-05-22
MS-016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	52	16	—	—	$20,000.00	$94,583.75	$37,490.96	2026-05-22
MS-455	OTHER	Combined Anterior/posterior Spinal Fusion Without Cc/mcc	6	3	—	—	$34,801.36	$38,387.24	$37,290.46	2026-05-22
510016458	OTHER	vinCRIStine Liposome 5 Mg/31 Ml Kit	54	16	$74,552.83	$28,330.08 62% off	$9,982.62	$74,552.83	$37,276.42	2026-05-22
MS-608	OTHER	Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period	2	1	—	—	$37,076.11	$37,076.11	$37,076.11	2026-05-22
MS-023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	52	15	—	—	$33,636.49	$65,291.04	$36,716.28	2026-05-22
MS-790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome- Neonate	52	15	—	—	$5,463.16	$112,272.96	$36,699.09	2026-05-22
1634	OTHER	Cardiac Valve Procedures Wo Ami Or Complex Pdx	2	1	—	—	$36,692.40	$36,692.40	$36,692.40	2026-05-22
MS-461	OTHER	Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc	52	15	—	—	$32,419.66	$69,050.15	$36,660.35	2026-05-22
9124	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	2	1	—	—	$36,472.19	$36,472.19	$36,472.19	2026-05-22
1674	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	2	1	—	—	$36,326.66	$36,326.66	$36,326.66	2026-05-22
5891	OTHER	Neonate Bwt 500g Or Ga 24 Weeks	2	1	—	—	$36,259.18	$36,259.18	$36,259.18	2026-05-22
5892	OTHER	Neonate Bwt 500g Or Ga 24 Weeks	2	1	—	—	$36,259.18	$36,259.18	$36,259.18	2026-05-22
9114	OTHER	Extensive Abdominalthoracic Procedures For Mult Significant Trauma	2	1	—	—	$36,203.72	$36,203.72	$36,203.72	2026-05-22
510018281	OTHER	Lanreotide 120 Mg Syringe (J1932/nonpreferred)	108	16	$69,159.61	$26,280.65 62% off	$6,399.03	$90,529.58	$36,036.09	2026-05-22
3004	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	2	1	—	—	$35,863.70	$35,863.70	$35,863.70	2026-05-22
MS-648	OTHER	Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…	2	1	—	—	$35,817.67	$35,817.67	$35,817.67	2026-05-22
MS-463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	52	15	—	—	$33,349.34	$64,940.10	$35,720.37	2026-05-22
MS-430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	46	15	—	—	$33,778.48	$65,710.34	$35,609.88	2026-05-22
MS-834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	52	15	—	—	$32,225.36	$66,388.46	$35,254.20	2026-05-22
MS-213	OTHER	Splenectomy Age 0-17	34	12	—	—	$13,686.10	$65,024.42	$35,238.17	2026-05-22
9104	OTHER	Craniotomy For Multiple Significant Trauma	2	1	—	—	$35,220.33	$35,220.33	$35,220.33	2026-05-22
L8701	OTHER	Ewh S/d Uprt Micro Sensor	42	13	—	—	$31,806.86	$61,369.15	$35,154.95	2026-05-22
0224	OTHER	Ventricular Shunt Procedures	2	1	—	—	$35,043.46	$35,043.46	$35,043.46	2026-05-22
MS-405	OTHER	Pancreas- Liver And Shunt Procedures With Mcc	52	15	—	—	$32,111.48	$62,330.88	$34,994.12	2026-05-22
MS-008	OTHER	Simultaneous Pancreas/kidney Transplant	52	16	—	—	$20,000.00	$61,223.26	$34,941.65	2026-05-22
MS-017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	52	16	—	—	$20,000.00	$67,915.95	$34,884.32	2026-05-22
MS-011	OTHER	Tracheostomy For Face- Mouth And Neck Diagnoses Or Laryngectomy With Mcc	52	15	—	—	$32,015.22	$62,144.02	$34,835.63	2026-05-22
1654	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	2	1	—	—	$34,824.67	$34,824.67	$34,824.67	2026-05-22
MS-428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	48	15	—	—	$9,066.86	$64,057.07	$34,713.94	2026-05-22
MS-234	OTHER	Coronary Bypass With Cardiac Catheterization Without Mcc	52	15	—	—	$32,065.70	$62,242.00	$34,617.59	2026-05-22
MS-278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	52	15	—	—	$29,346.83	$63,421.28	$34,369.39	2026-05-22
0071	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$34,320.66	$34,320.66	$34,320.66	2026-05-22
440061030	OTHER	Pump Synch Iii 20ml 8667-20	54	16	$68,610.00	$26,071.80 62% off	$9,186.88	$68,610.00	$34,305.00	2026-05-22
MS-021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	52	15	—	—	$31,074.27	$71,277.25	$34,225.49	2026-05-22
6034	OTHER	Neonate Birthwt 10001249g W Or Wo Other Significant Condition	2	1	—	—	$34,132.55	$34,132.55	$34,132.55	2026-05-22
MS-220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	52	15	—	—	$31,303.19	$60,761.92	$34,128.33	2026-05-22
MS-653	OTHER	Major Bladder Procedures With Mcc	52	15	—	—	$30,502.54	$62,725.40	$34,055.79	2026-05-22
0111	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	1	—	—	$33,611.16	$33,611.16	$33,611.16	2026-05-22
6033	OTHER	Neonate Birthwt 10001249g W Or Wo Other Significant Condition	2	1	—	—	$33,339.20	$33,339.20	$33,339.20	2026-05-22
0620T	OTHER	Evasc Ven Artlz Tibl/prnl Vn	40	14	—	—	$11,288.00	$55,719.77	$33,302.32	2026-05-22
MS-466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	52	15	—	—	$30,555.36	$59,679.41	$33,068.06	2026-05-22
MS-270	OTHER	Other Major Cardiovascular Procedures With Mcc	52	15	—	—	$3,544.16	$60,118.16	$32,929.31	2026-05-22
440068540	OTHER	Stimulator Neuro Int 97800	54	16	$65,820.00	$25,011.60 62% off	$8,813.30	$65,820.00	$32,910.00	2026-05-22
MS-450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	46	15	—	—	$31,284.41	$60,725.46	$32,908.47	2026-05-22
0012	OTHER	Liver Transplant andOR Intestinal Transplant	2	1	—	—	$32,829.81	$32,829.81	$32,829.81	2026-05-22
0093	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	1	—	—	$32,822.81	$32,822.81	$32,822.81	2026-05-22
MS-677	OTHER	Neonate- Birth Weight 2000-2499 Grams- Without Significant O.r. Procedures- With…	2	1	—	—	$32,617.51	$32,617.51	$32,617.51	2026-05-22
MS-691	OTHER	Urinary Stones W Esw Lithotripsy W Cc/mcc	2	1	—	—	$32,581.47	$32,581.47	$32,581.47	2026-05-22
MS-576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	52	15	—	—	$28,769.73	$60,707.92	$32,532.99	2026-05-22
5912	OTHER	Neonate Birthwt 500749g Wo Major Procedure	2	1	—	—	$32,506.92	$32,506.92	$32,506.92	2026-05-22
MS-362	OTHER	Cardiac Defibrillator Implant Without Mcc	2	1	—	—	$32,398.11	$32,398.11	$32,398.11	2026-05-22
1784	OTHER	External Heart Assist Devices	2	1	—	—	$32,392.76	$32,392.76	$32,392.76	2026-05-22
6814	OTHER	Other Or Procedures For Lymphatichematopoieticother Neoplasms	2	1	—	—	$32,328.70	$32,328.70	$32,328.70	2026-05-22
8633	OTHER	Neonatal Aftercare	2	1	—	—	$32,119.16	$32,119.16	$32,119.16	2026-05-22
MS-326	OTHER	Stomach- Esophageal And Duodenal Procedures With Mcc	52	15	—	—	$29,275.72	$57,148.91	$32,027.32	2026-05-22
0042	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	2	1	—	—	$31,859.36	$31,859.36	$31,859.36	2026-05-22
MS-228	OTHER	Other Cardiothoracic Procedures With Mcc	52	15	—	—	$29,040.92	$56,370.68	$31,770.46	2026-05-22
6123	OTHER	Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond	2	1	—	—	$31,717.13	$31,717.13	$31,717.13	2026-05-22
MS-853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	52	15	—	—	$28,989.27	$56,274.63	$31,713.94	2026-05-22
MS-239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	52	15	—	—	$28,890.06	$56,675.20	$31,605.42	2026-05-22
2994	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	2	1	—	—	$31,579.92	$31,579.92	$31,579.92	2026-05-22
MS-396	OTHER	Major Head And Neck Procedures With Mcc	2	1	—	—	$31,551.05	$31,551.05	$31,551.05	2026-05-22
5931	OTHER	Neonate Birthwt 750999g Wo Major Procedure	2	1	—	—	$31,468.80	$31,468.80	$31,468.80	2026-05-22
2993	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	2	1	—	—	$31,463.82	$31,463.82	$31,463.82	2026-05-22
MS-221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	52	15	—	—	$28,357.75	$57,428.04	$31,460.88	2026-05-22
6344	OTHER	Neonate Birthwt 2499g W Resp Dist Syndoth Maj Resp Cond	2	1	—	—	$31,437.15	$31,437.15	$31,437.15	2026-05-22
0344	OTHER	Nuclear Medicine - Therapeutic Radiopharmaceuticals	4	1	—	—	$29.50	$62,806.00	$31,417.75	2026-05-22
1834	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$31,301.68	$31,301.68	$31,301.68	2026-05-22
33264	OTHER	Rmvl & Rplcmt Dfb Gen Mlt Ld	44	14	—	—	$13,051.74	$54,342.00	$31,257.37	2026-05-22
33270	OTHER	Ins/rep Subq Defibrillator	44	14	—	—	$26,103.48	$54,342.00	$31,257.37	2026-05-22
33231	OTHER	Insrt Pulse Gen W/mult Leads	44	14	—	—	$13,051.74	$54,342.00	$31,257.37	2026-05-22
0408T	OTHER	Insj/rplc Cardiac Modulj Sys	40	14	—	—	$28,054.00	$51,849.13	$31,257.37	2026-05-22
33249	OTHER	Insj/rplcmt Defib W/lead(s)	44	14	—	—	$13,051.74	$54,342.00	$31,257.37	2026-05-22
6954	OTHER	Chemotherapy For Acute Leukemia	2	1	—	—	$31,058.52	$31,058.52	$31,058.52	2026-05-22
MS-837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	52	15	—	—	$28,200.93	$56,341.01	$31,032.96	2026-05-22
MS-471	OTHER	Cervical Spinal Fusion With Mcc	52	15	—	—	$28,344.16	$55,018.21	$31,008.21	2026-05-22
0915T	OTHER	Insj Perm Ccm-d Sys Pg&eltrd	26	9	—	—	$30,055.17	$49,324.40	$30,956.82	2026-05-22
0571T	OTHER	Insj/rplcmt Icds Ss Eltrd	42	14	—	—	$26,103.48	$51,849.13	$30,956.82	2026-05-22
0204	OTHER	Open Craniotomy For Trauma	2	1	—	—	$30,929.35	$30,929.35	$30,929.35	2026-05-22
6804	OTHER	Major Or Procedures For Lymphatichematopoieticother Neoplasms	2	1	—	—	$30,865.43	$30,865.43	$30,865.43	2026-05-22
69930	OTHER	Implant Cochlear Device	44	14	—	—	$3,957.76	$52,850.56	$30,770.65	2026-05-22
3044	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	2	1	—	—	$30,649.98	$30,649.98	$30,649.98	2026-05-22
2604	OTHER	Major Pancreas Liver And Shunt Procedures	2	1	—	—	$30,605.37	$30,605.37	$30,605.37	2026-05-22
MS-981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	52	15	—	—	$27,540.57	$53,490.88	$30,129.08	2026-05-22
6072	OTHER	Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom	2	1	—	—	$30,102.51	$30,102.51	$30,102.51	2026-05-22
2004	OTHER	Cardiac Structural And Valvular Disorders	2	1	—	—	$30,061.78	$30,061.78	$30,061.78	2026-05-22
MS-826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	52	15	—	—	$27,458.39	$53,733.93	$30,039.18	2026-05-22
5911	OTHER	Neonate Birthwt 500749g Wo Major Procedure	2	1	—	—	$29,939.82	$29,939.82	$29,939.82	2026-05-22
MS-245	OTHER	Aicd Generator Procedures	52	15	—	—	$26,781.00	$54,986.27	$29,877.08	2026-05-22
MS-267	OTHER	Endovascular Cardiac Valve Replacement Without Mcc	52	15	—	—	$3,357.66	$54,244.56	$29,837.26	2026-05-22
MS-006	OTHER	Liver Transplant Without Mcc	52	16	—	—	$20,000.00	$57,117.08	$29,716.51	2026-05-22
0268T	OTHER	Implt/rpl Crtd Sns Dev Gen	40	14	—	—	$10,917.00	$48,938.44	$29,709.22	2026-05-22
MS-277	OTHER	Other Major Cardiovascular Procedures With Mcc	52	15	—	—	$27,110.30	$52,623.19	$29,658.38	2026-05-22
MS-460	OTHER	Spinal Fusion Except Cervical Without Mcc	6	3	—	—	$28,262.35	$30,488.25	$29,617.16	2026-05-22
MS-329	OTHER	Major Small And Large Bowel Procedures With Mcc	52	15	—	—	$26,981.16	$52,372.52	$29,502.18	2026-05-22
MS-823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	52	15	—	—	$26,912.48	$52,653.73	$29,441.97	2026-05-22
MS-363	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	2	1	—	—	$29,440.07	$29,440.07	$29,440.07	2026-05-22
33287	OTHER	Rmv&rplcmt Phrnc Nrv Stim Pg	42	13	—	—	$25,828.62	$48,938.44	$29,423.55	2026-05-22
0674T	OTHER	Laps Insj Nw/rpcmt Prm Isdss	30	10	—	—	$4,641.00	$46,881.39	$29,423.55	2026-05-22
MS-799	OTHER	Splenic Procedures With Mcc	52	15	—	—	$26,584.35	$53,501.01	$29,360.96	2026-05-22
L5856	OTHER	Elec Knee-shin Swing/stance	42	13	—	—	$17,323.21	$52,155.62	$29,137.22	2026-05-22
MS-650	OTHER	Neonate Birthwt 1500-1999g Without Signif O.r. Proc With Other Prob	50	15	—	—	$16,746.00	$51,841.34	$29,029.55	2026-05-22
L6880	OTHER	Elec Hand Ind Art Digits	42	13	—	—	$22,574.88	$51,909.43	$28,999.68	2026-05-22
63685	OTHER	Ins/rplc Spi Npg/rcvr Pocket	44	14	—	—	$1,728.79	$48,938.44	$28,995.05	2026-05-22
64568	OTHER	Opn Impltj Crnl Nrv Nea&pg	44	14	—	—	$13,051.74	$48,938.44	$28,995.05	2026-05-22
64582	OTHER	Opn Mpltj Hpglsl Nstm Ary Pg	44	14	—	—	$16,088.00	$48,938.44	$28,995.05	2026-05-22
61886	OTHER	Implant Neurostim Arrays	44	14	—	—	$1,728.79	$48,938.44	$28,995.05	2026-05-22
MS-025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	52	15	—	—	$26,688.84	$51,805.10	$28,956.12	2026-05-22
L6700	OTHER	Ue Add Ext Power Myoel	26	9	—	—	$28,931.56	$51,787.49	$28,931.56	2026-05-22
510020107	OTHER	Leuprolide (Lupron) 6 Month 45 Mg IntraMuscular	54	16	$57,792.92	$21,961.31 62% off	$7,738.47	$57,792.92	$28,896.46	2026-05-22
510016642	OTHER	Brentuximab Vedotin 50 Mg Inj	54	16	$57,758.41	$21,948.20 62% off	$7,733.85	$57,758.41	$28,879.20	2026-05-22
MS-163	OTHER	Major Chest Procedures With Mcc	52	15	—	—	$26,307.88	$51,862.72	$28,780.53	2026-05-22
1814	OTHER	Lower Extremity Vascular Procedures	2	1	—	—	$28,777.64	$28,777.64	$28,777.64	2026-05-22

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