Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

UNIVERSITY OF LOUISVILLE HOSPITAL

Louisville, KY · CCN 180141 · Rates published

104,326 distinct procedures filed
25 distinct payers
6,390,515 rate rows
2026-07-17 last MRF observed
Data quality

6,376,479 of 6,390,515 rate rows are consumer-grade (99.8%)

14,036 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 — reasonRows
placeholder amount (≤ $0.02) — excluded from medians 7,978
percent-of-charges filed in the dollar field — excluded from medians 5,071
per-diem day rate — not a per-procedure price 381
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 359
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 186
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 49
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://uoflhealth.org/wp-content/uploads/2026/04/611293786_UofL-Health-UofL-Hospital_standardcharges2.zip
Found on page https://uoflhealth.org/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-11
Content fingerprint 7996ec2d0168345d… · 20,047,261 bytes · first seen 2026-05-14

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
HCPCS 		Inj Atidarsagene Autotemcel 9 $4,377,500.00 $4,730,250.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj Beqvez Per Tx Dose 2 $3,710,000.00 $3,792,600.00 $3,710,000.00 nat. median
$3,508,750
1.1× median
J1411
HCPCS 		Inj Hemgenix Per Tx Dose 17 $3,489,255.00 $4,969,916.00 $3,697,633.33 nat. median
$3,685,267
1.0× median
C9172
HCPCS 		Inj- Beqvez- Per Tx Dose 16 $3,424,750.00 $4,686,500.00 $3,605,000.00 nat. median
$3,675,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 17 $3,159,182.02 $4,675,409.45 $3,343,579.94 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj Lovotibeglogene Autotem 17 $3,121,700.00 $4,271,800.00 $3,286,000.00 nat. median
$3,248,446
1.0× median
J3393
HCPCS 		Inj Betibeglogene Autotemce 17 $2,819,600.00 $3,858,400.00 $2,968,000.00 nat. median
$2,968,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 17 $2,231,250.00 $4,299,505.61 $2,455,110.61 nat. median
$2,455,111
1.0× median
0891
RC 		Pharmacy - Extension Of 025x And 063x - Special Processed Drugs - Fda Approved C… 11 $29.50 $3,476,250.00 $2,433,375.00 —
J3392
HCPCS 		Inj Exagamglogene Autotem 11 $2,332,000.00 $3,031,600.00 $2,332,000.00 nat. median
$2,332,000
1.0× median
474223557
OTHER 		Car-t Product Carvykti 16 $629,721.96 $3,748,345.00 $1,874,172.50 —
474223559
OTHER 		Car-t Product Breyanzi 16 $602,551.32 $3,586,615.00 $1,793,307.50 —
474223558
OTHER 		Car-t Product Abecma 16 $599,106.31 $3,566,109.00 $1,783,054.50 —
474287975
OTHER 		Amtagvi Lifileucel 73776-0001-11 16 $584,010.00 $3,476,250.00 $1,738,125.00 —
474223556
OTHER 		Car-t Product Tecartus 16 $523,908.00 $3,118,500.00 $1,559,250.00 —
474223555
OTHER 		Car-t Product Yescarta 16 $423,467.86 $2,520,642.00 $1,260,321.00 —
Q2057
HCPCS 		Afamitresgene Autoleucel 11 $770,620.00 $1,001,806.00 $770,620.00 nat. median
$813,967
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 17 $471,442.34 $952,547.15 $591,726.20 nat. median
$621,313
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 17 $500,767.26 $948,822.17 $565,768.67 nat. median
$599,737
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 17 $461,013.08 $930,106.94 $562,538.19 nat. median
$579,571
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 17 $471,350.20 $947,857.66 $557,317.93 nat. median
$574,037
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 25 $448,137.18 $2,520,642.00 $533,230.17 nat. median
$562,501
0.9× median
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $507,687.00 $507,687.00 $507,687.00 nat. median
$2,313,353
outlier · 0.2×
Q2053
HCPCS 		Brexucabtagene Car Pos T 17 $437,503.88 $828,954.72 $489,304.61 nat. median
$513,770
1.0× median
5884
APR_DRG 		Neonate Bwt 1500g W Major Procedure 1 $382,914.09 $382,914.09 $382,914.09 nat. median
$286,698
1.3× median
24
APR_DRG 		Heart andOR Lung Transplant 1 $345,547.17 $345,547.17 $345,547.17 nat. median
$225,531
1.5× median
1614
APR_DRG 		Cardiac Defibrillator And Heart Assist Implant 1 $334,078.59 $334,078.59 $334,078.59 nat. median
$202,242
1.7× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 11 $270,375.00 $361,725.00 $278,250.00 nat. median
$286,598
1.0× median
440015774
OTHER 		Gammatile 18/brchy Ther Gt-18 16 $92,736.00 $552,000.00 $276,000.00 —
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 17 $208,375.86 $424,344.43 $267,009.17 nat. median
$168,055
1.6× median
J3403
HCPCS 		Revakinagene Per Implant 10 $257,500.00 $334,750.00 $265,225.00 nat. median
$264,195
1.0× median
440015773
OTHER 		Gammatile 17/brchy Ther Gt-17 16 $87,696.00 $522,000.00 $261,000.00 —
14
APR_DRG 		Liver Transplant andOR Intestinal Transplant 1 $251,928.85 $251,928.85 $251,928.85 nat. median
$136,566
1.8× median
440015772
OTHER 		Gammatile 16/brchy Ther Gt-16 16 $82,656.00 $492,000.00 $246,000.00 —
74
APR_DRG 		Allogeneic Bone Marrow Transplant 1 $233,255.25 $233,255.25 $233,255.25 nat. median
$149,836
1.6× median
440015771
OTHER 		Gammatile 15/brchy Ther Gt-15 16 $77,616.00 $462,000.00 $231,000.00 —
44
APR_DRG 		Tracheostomy W Mv 96 Hours W Extensive Procedure 1 $228,791.89 $228,791.89 $228,791.89 nat. median
$135,630
1.7× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 1 $227,527.75 $227,527.75 $227,527.75 nat. median
$152,792
1.5× median
5914
APR_DRG 		Neonate Birthwt 500749g Wo Major Procedure 1 $222,706.73 $222,706.73 $222,706.73 nat. median
$171,497
1.3× median
612
MS_DRG 		Neonate- Birth Weight <750 Grams- Discharged Alive 1 $217,286.57 $217,286.57 $217,286.57 nat. median
$21,586
outlier · 10.1×
440015770
OTHER 		Gammatile 14/brchy Ther Gt-14 16 $72,576.00 $432,000.00 $216,000.00 —
855220263
OTHER 		Vutrisiran 25 Mg/0.5 Ml Syringe 16 $71,257.79 $424,153.51 $212,076.76 —
510520263
OTHER 		Vutrisiran 25 Mg/0.5 Ml Syringe 16 $71,257.79 $424,153.51 $212,076.76 —
510420263
OTHER 		Vutrisiran 25 Mg/0.5 Ml Syringe 16 $71,257.79 $424,153.51 $212,076.76 —
510020263
OTHER 		Vutrisiran 25 Mg/0.5 Ml Syringe 16 $71,257.79 $424,153.51 $212,076.76 —
510320263
OTHER 		Vutrisiran 25 Mg/0.5 Ml Syringe 16 $71,257.79 $424,153.51 $212,076.76 —
835220263
OTHER 		Vutrisiran 25 Mg/0.5 Ml Syringe 16 $71,257.79 $424,153.51 $212,076.76 —
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 10 $205,640.00 $267,332.00 $211,809.20 nat. median
$207,733
1.0× median
6094
APR_DRG 		Neonate Bwt 15002499g W Major Procedure 1 $211,045.75 $211,045.75 $211,045.75 nat. median
$198,578
1.1× median
835220266
OTHER 		Lumasiran 94.5 Mg/0.5 Ml Inj 16 $68,465.55 $407,533.02 $203,766.51 —

Other procedures at this hospital

Browse this hospital's 104,326 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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 HCPCS Inj Atidarsagene Autotemcel 26 9 — — $4,377,500.00 $4,730,250.00 $4,505,000.00 2026-05-22
J1414 HCPCS Inj Beqvez Per Tx Dose 10 2 — — $3,710,000.00 $3,792,600.00 $3,710,000.00 2026-05-22
J1411 HCPCS Inj Hemgenix Per Tx Dose 68 17 — — $3,489,255.00 $4,969,916.00 $3,697,633.33 2026-07-17
C9172 HCPCS Inj- Beqvez- Per Tx Dose 26 16 — — $3,424,750.00 $4,686,500.00 $3,605,000.00 2026-07-17
J1413 HCPCS Inj Delandistrogene Mox Rokl 70 17 — — $3,159,182.02 $4,675,409.45 $3,343,579.94 2026-07-17
J3394 HCPCS Inj Lovotibeglogene Autotem 58 17 — — $3,121,700.00 $4,271,800.00 $3,286,000.00 2026-07-17
J3393 HCPCS Inj Betibeglogene Autotemce 58 17 — — $2,819,600.00 $3,858,400.00 $2,968,000.00 2026-07-17
J3399 HCPCS Inj Onase Abepar-xioi Treat 72 17 — — $2,231,250.00 $4,299,505.61 $2,455,110.61 2026-07-17
0891 RC Pharmacy - Extension Of 025x And 063x - Special Processed Drugs - Fda Approved C… 21 11 $3,476,250.00 $834,300.00 76% off $29.50 $3,476,250.00 $2,433,375.00 2026-07-17
J3392 HCPCS Inj Exagamglogene Autotem 30 11 — — $2,332,000.00 $3,031,600.00 $2,332,000.00 2026-05-22
474223557 OTHER Car-t Product Carvykti 60 16 $3,748,345.00 $899,602.80 76% off $629,721.96 $3,748,345.00 $1,874,172.50 2026-05-22
474223559 OTHER Car-t Product Breyanzi 60 16 $3,586,615.00 $860,787.60 76% off $602,551.32 $3,586,615.00 $1,793,307.50 2026-05-22
474223558 OTHER Car-t Product Abecma 60 16 $3,566,109.00 $855,866.16 76% off $599,106.31 $3,566,109.00 $1,783,054.50 2026-05-22
474287975 OTHER Amtagvi Lifileucel 73776-0001-11 60 16 $3,476,250.00 $834,300.00 76% off $584,010.00 $3,476,250.00 $1,738,125.00 2026-05-22
474223556 OTHER Car-t Product Tecartus 60 16 $3,118,500.00 $748,440.00 76% off $523,908.00 $3,118,500.00 $1,559,250.00 2026-05-22
474223555 OTHER Car-t Product Yescarta 60 16 $2,520,642.00 $604,954.08 76% off $423,467.86 $2,520,642.00 $1,260,321.00 2026-05-22
Q2057 HCPCS Afamitresgene Autoleucel 30 11 — — $770,620.00 $1,001,806.00 $770,620.00 2026-05-22
Q2042 HCPCS Tisagenlecleucel Car-pos T 75 17 — — $471,442.34 $952,547.15 $591,726.20 2026-07-17
Q2056 HCPCS Ciltacabtagene Car-pos T 74 17 — — $500,767.26 $948,822.17 $565,768.67 2026-07-17
Q2054 HCPCS Lisocabtagene Mara Car Pos T 75 17 — — $461,013.08 $930,106.94 $562,538.19 2026-07-17
Q2055 HCPCS Idecabtagene Vicleucel Car 75 17 — — $471,350.20 $947,857.66 $557,317.93 2026-07-17
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 88 25 $2,520,642.00 $604,954.08 76% off $448,137.18 $2,520,642.00 $533,230.17 2026-07-17
C9098 HCPCS Ciltacabtagene Car Pos T 1 1 — — $507,687.00 $507,687.00 $507,687.00 2026-07-17
Q2053 HCPCS Brexucabtagene Car Pos T 75 17 — — $437,503.88 $828,954.72 $489,304.61 2026-07-17
5884 APR_DRG Neonate Bwt 1500g W Major Procedure 1 1 — — $382,914.09 $382,914.09 $382,914.09 2026-07-17
24 APR_DRG Heart andOR Lung Transplant 1 1 — — $345,547.17 $345,547.17 $345,547.17 2026-07-17
1614 APR_DRG Cardiac Defibrillator And Heart Assist Implant 1 1 — — $334,078.59 $334,078.59 $334,078.59 2026-07-17
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 30 11 — — $270,375.00 $361,725.00 $278,250.00 2026-05-22
440015774 OTHER Gammatile 18/brchy Ther Gt-18 60 16 $552,000.00 $132,480.00 76% off $92,736.00 $552,000.00 $276,000.00 2026-05-22
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 83 17 — — $208,375.86 $424,344.43 $267,009.17 2026-07-17
J3403 HCPCS Revakinagene Per Implant 22 10 — — $257,500.00 $334,750.00 $265,225.00 2026-05-22
440015773 OTHER Gammatile 17/brchy Ther Gt-17 60 16 $522,000.00 $125,280.00 76% off $87,696.00 $522,000.00 $261,000.00 2026-05-22
14 APR_DRG Liver Transplant andOR Intestinal Transplant 1 1 — — $251,928.85 $251,928.85 $251,928.85 2026-07-17
440015772 OTHER Gammatile 16/brchy Ther Gt-16 60 16 $492,000.00 $118,080.00 76% off $82,656.00 $492,000.00 $246,000.00 2026-05-22
74 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $233,255.25 $233,255.25 $233,255.25 2026-07-17
440015771 OTHER Gammatile 15/brchy Ther Gt-15 60 16 $462,000.00 $110,880.00 76% off $77,616.00 $462,000.00 $231,000.00 2026-05-22
44 APR_DRG Tracheostomy W Mv 96 Hours W Extensive Procedure 1 1 — — $228,791.89 $228,791.89 $228,791.89 2026-07-17
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $227,527.75 $227,527.75 $227,527.75 2026-07-17
5914 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 1 1 — — $222,706.73 $222,706.73 $222,706.73 2026-07-17
612 MS_DRG Neonate- Birth Weight <750 Grams- Discharged Alive 3 1 — — $217,286.57 $217,286.57 $217,286.57 2026-07-17
440015770 OTHER Gammatile 14/brchy Ther Gt-14 60 16 $432,000.00 $103,680.00 76% off $72,576.00 $432,000.00 $216,000.00 2026-05-22
510020263 OTHER Vutrisiran 25 Mg/0.5 Ml Syringe 60 16 $424,153.51 $101,796.84 76% off $71,257.79 $424,153.51 $212,076.76 2026-05-22
510520263 OTHER Vutrisiran 25 Mg/0.5 Ml Syringe 60 16 $424,153.51 $101,796.84 76% off $71,257.79 $424,153.51 $212,076.76 2026-05-22
510420263 OTHER Vutrisiran 25 Mg/0.5 Ml Syringe 60 16 $424,153.51 $101,796.84 76% off $71,257.79 $424,153.51 $212,076.76 2026-05-22
835220263 OTHER Vutrisiran 25 Mg/0.5 Ml Syringe 60 16 $424,153.51 $101,796.84 76% off $71,257.79 $424,153.51 $212,076.76 2026-05-22
510320263 OTHER Vutrisiran 25 Mg/0.5 Ml Syringe 60 16 $424,153.51 $101,796.84 76% off $71,257.79 $424,153.51 $212,076.76 2026-05-22
855220263 OTHER Vutrisiran 25 Mg/0.5 Ml Syringe 60 16 $424,153.51 $101,796.84 76% off $71,257.79 $424,153.51 $212,076.76 2026-05-22
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 22 10 — — $205,640.00 $267,332.00 $211,809.20 2026-05-22
6094 APR_DRG Neonate Bwt 15002499g W Major Procedure 1 1 — — $211,045.75 $211,045.75 $211,045.75 2026-07-17
510020266 OTHER Lumasiran 94.5 Mg/0.5 Ml Inj 60 16 $407,533.02 $97,807.92 76% off $68,465.55 $407,533.02 $203,766.51 2026-05-22
510520266 OTHER Lumasiran 94.5 Mg/0.5 Ml Inj 60 16 $407,533.02 $97,807.92 76% off $68,465.55 $407,533.02 $203,766.51 2026-05-22
510420266 OTHER Lumasiran 94.5 Mg/0.5 Ml Inj 60 16 $407,533.02 $97,807.92 76% off $68,465.55 $407,533.02 $203,766.51 2026-05-22
855220266 OTHER Lumasiran 94.5 Mg/0.5 Ml Inj 60 16 $407,533.02 $97,807.92 76% off $68,465.55 $407,533.02 $203,766.51 2026-05-22
510320266 OTHER Lumasiran 94.5 Mg/0.5 Ml Inj 60 16 $407,533.02 $97,807.92 76% off $68,465.55 $407,533.02 $203,766.51 2026-05-22
835220266 OTHER Lumasiran 94.5 Mg/0.5 Ml Inj 60 16 $407,533.02 $97,807.92 76% off $68,465.55 $407,533.02 $203,766.51 2026-05-22
440015769 OTHER Gammatile 13/brchy Ther Gt-13 60 16 $402,000.00 $96,480.00 76% off $67,536.00 $402,000.00 $201,000.00 2026-05-22
636 MS_DRG Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- With Mu… 3 1 — — $199,388.70 $199,388.70 $199,388.70 2026-07-17
22 APR_DRG Heart andOR Lung Transplant 1 1 — — $199,358.88 $199,358.88 $199,358.88 2026-07-17
21 APR_DRG Heart andOR Lung Transplant 1 1 — — $199,358.88 $199,358.88 $199,358.88 2026-07-17
23 APR_DRG Heart andOR Lung Transplant 1 1 — — $199,358.88 $199,358.88 $199,358.88 2026-07-17
5934 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 1 1 — — $199,067.82 $199,067.82 $199,067.82 2026-07-17
5833 APR_DRG Neonate W Ecmo 1 1 — — $188,848.59 $188,848.59 $188,848.59 2026-07-17
5834 APR_DRG Neonate W Ecmo 1 1 — — $188,848.59 $188,848.59 $188,848.59 2026-07-17
5831 APR_DRG Neonate W Ecmo 1 1 — — $188,848.59 $188,848.59 $188,848.59 2026-07-17
5832 APR_DRG Neonate W Ecmo 1 1 — — $188,848.59 $188,848.59 $188,848.59 2026-07-17
440015768 OTHER Gammatile 12/brchy Ther Gt-12 60 16 $372,000.00 $89,280.00 76% off $62,496.00 $372,000.00 $186,000.00 2026-05-22
6314 APR_DRG Neonate Birthwt 2499g W Other Major Procedure 1 1 — — $180,897.42 $180,897.42 $180,897.42 2026-07-17
633 MS_DRG Neonate- Birth Weight 1000-1499 Grams- With Significant O.r. Procedures- Dischar… 3 1 — — $179,138.52 $179,138.52 $179,138.52 2026-07-17
6304 APR_DRG Neonate Birthwt 2499g W Major Cardiovascular Procedure 1 1 — — $178,935.22 $178,935.22 $178,935.22 2026-07-17
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 74 17 — — $153,264.94 $316,949.71 $178,476.56 2026-07-17
631 MS_DRG Neonate- Birth Weight 750-999 Grams- Discharged Alive 3 1 — — $174,511.45 $174,511.45 $174,511.45 2026-07-17
440015767 OTHER Gammatile 11/brchy Ther Gt-11 60 16 $342,000.00 $82,080.00 76% off $57,456.00 $342,000.00 $171,000.00 2026-05-22
C1825 HCPCS Barostim Neo Sys 100062-202 27 10 $199,500.00 $47,880.00 76% off $17.28 $210,000.00 $168,000.00 2026-07-17
5881 APR_DRG Neonate Bwt 1500g W Major Procedure 1 1 — — $167,639.30 $167,639.30 $167,639.30 2026-07-17
5882 APR_DRG Neonate Bwt 1500g W Major Procedure 1 1 — — $167,639.30 $167,639.30 $167,639.30 2026-07-17
5883 APR_DRG Neonate Bwt 1500g W Major Procedure 1 1 — — $167,639.30 $167,639.30 $167,639.30 2026-07-17
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
64 APR_DRG Pancreas Transplant 1 1 — — $161,856.30 $161,856.30 $161,856.30 2026-07-17
6114 APR_DRG Neonate Birthwt 15001999g W Major Anomaly 1 1 — — $160,959.68 $160,959.68 $160,959.68 2026-07-17
5933 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 1 1 — — $157,910.93 $157,910.93 $157,910.93 2026-07-17
440015766 OTHER Gammatile 10/brchy Ther Gt-10 60 16 $312,000.00 $74,880.00 76% off $52,416.00 $312,000.00 $156,000.00 2026-05-22
5832 OTHER Neonate With Ecmo 2 1 — — $152,626.88 $152,626.88 $152,626.88 2026-05-22
5831 OTHER Neonate With Ecmo 2 1 — — $152,626.88 $152,626.88 $152,626.88 2026-05-22
54 APR_DRG Tracheostomy W Mv 96 Hours Wo Extensive Procedure 1 1 — — $148,627.78 $148,627.78 $148,627.78 2026-07-17
0024 RC Heart andOR Lung Transplant 2 1 — — $147,504.23 $147,504.23 $147,504.23 2026-05-22
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 77 17 — — $128,624.16 $266,928.95 $146,480.23 2026-07-17
6024 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 1 1 — — $142,325.55 $142,325.55 $142,325.55 2026-07-17
5884 OTHER Neonate Bwt 1500g W Major Procedure 2 1 — — $141,703.04 $141,703.04 $141,703.04 2026-05-22
440015765 OTHER Gammatile 9/brchy Ther Gt-09 60 16 $282,000.00 $67,680.00 76% off $47,376.00 $282,000.00 $141,000.00 2026-05-22
72 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $140,783.91 $140,783.91 $140,783.91 2026-07-17
73 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $140,783.91 $140,783.91 $140,783.91 2026-07-17
71 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $140,783.91 $140,783.91 $140,783.91 2026-07-17
6074 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 1 1 — — $138,533.12 $138,533.12 $138,533.12 2026-07-17
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 77 17 — — $120,583.89 $241,839.93 $136,302.84 2026-07-17
6214 APR_DRG Neonate Bwt 20002499g W Major Anomaly 1 1 — — $132,042.19 $132,042.19 $132,042.19 2026-07-17
6314 OTHER Neonate Birthwt 2499g W Other Major Procedure 2 1 — — $131,839.30 $131,839.30 $131,839.30 2026-05-22
6023 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 1 1 — — $131,516.80 $131,516.80 $131,516.80 2026-07-17
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $131,304.67 $131,304.67 $131,304.67 2026-07-17
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $131,304.67 $131,304.67 $131,304.67 2026-07-17
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 1 1 — — $131,304.67 $131,304.67 $131,304.67 2026-07-17
1614 OTHER Implantable Heart Assist Systems 2 1 — — $129,112.29 $129,112.29 $129,112.29 2026-05-22
4404 APR_DRG Kidney Transplant 1 1 — — $127,826.73 $127,826.73 $127,826.73 2026-07-17
440015764 OTHER Gammatile 8/brchy Ther Gt-08 60 16 $252,000.00 $60,480.00 76% off $42,336.00 $252,000.00 $126,000.00 2026-05-22
E0766 HCPCS Elec Stim Cancer Treatment 1 1 — — $125,257.00 $125,257.00 $125,257.00 2026-07-17
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $121,967.26 $121,967.26 $121,967.26 2026-07-17
441078483 OTHER Ribfix Bdge 23mm Pst 323.1013 60 16 $243,000.00 $58,320.00 76% off $40,824.00 $243,000.00 $121,500.00 2026-05-22
440078483 OTHER Ribfix Bdge 23mm Pst 323.1013 60 16 $243,000.00 $58,320.00 76% off $40,824.00 $243,000.00 $121,500.00 2026-05-22
3034 APR_DRG Dorsal And Lumbar Fusion Proc For Curvature Of Back 1 1 — — $121,471.46 $121,471.46 $121,471.46 2026-07-17
8634 APR_DRG Neonatal Aftercare 1 1 — — $118,654.58 $118,654.58 $118,654.58 2026-07-17
C1824 HCPCS Generator Ipg 10-b411-3xx 14 10 $138,000.00 $33,120.00 76% off $17.28 $138,000.00 $113,850.00 2026-07-17
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 1 1 — — $112,862.94 $112,862.94 $112,862.94 2026-07-17
41 APR_DRG Tracheostomy W Mv 96 Hours W Extensive Procedure 1 1 — — $112,340.01 $112,340.01 $112,340.01 2026-07-17
42 APR_DRG Tracheostomy W Mv 96 Hours W Extensive Procedure 1 1 — — $112,340.01 $112,340.01 $112,340.01 2026-07-17
43 APR_DRG Tracheostomy W Mv 96 Hours W Extensive Procedure 1 1 — — $112,340.01 $112,340.01 $112,340.01 2026-07-17
440018481 OTHER Stim Nrv Wavewriter Sc-1432 60 16 $224,016.00 $53,763.84 76% off $37,634.69 $224,016.00 $112,008.00 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
6091 APR_DRG Neonate Bwt 15002499g W Major Procedure 1 1 — — $111,027.77 $111,027.77 $111,027.77 2026-07-17
6092 APR_DRG Neonate Bwt 15002499g W Major Procedure 1 1 — — $111,027.77 $111,027.77 $111,027.77 2026-07-17
6093 APR_DRG Neonate Bwt 15002499g W Major Procedure 1 1 — — $111,027.77 $111,027.77 $111,027.77 2026-07-17
440015763 OTHER Gammatile 7/brchy Ther Gt-07 60 16 $222,000.00 $53,280.00 76% off $37,296.00 $222,000.00 $111,000.00 2026-05-22
61 APR_DRG Pancreas Transplant 1 1 — — $110,987.07 $110,987.07 $110,987.07 2026-07-17
63 APR_DRG Pancreas Transplant 1 1 — — $110,987.07 $110,987.07 $110,987.07 2026-07-17
62 APR_DRG Pancreas Transplant 1 1 — — $110,987.07 $110,987.07 $110,987.07 2026-07-17
Q0480 HCPCS Driver Pneumatic Vad Rep 72 17 — — $72,648.53 $195,676.18 $109,316.28 2026-07-17
0044 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 2 1 — — $109,115.53 $109,115.53 $109,115.53 2026-05-22
440059301 OTHER Generator Sentiva Implt 1000 60 16 $216,664.00 $51,999.36 76% off $36,399.55 $216,664.00 $108,332.00 2026-05-22
441059301 OTHER Generator Sentiva Implt 1000 60 16 $216,664.00 $51,999.36 76% off $36,399.55 $216,664.00 $108,332.00 2026-05-22
492043314 OTHER Defib/emblem MRI A219 60 16 $213,840.00 $51,321.60 76% off $35,925.12 $213,840.00 $106,920.00 2026-05-22
440019165 OTHER Barostim Neo Sys 100062-202 60 16 $210,000.00 $50,400.00 76% off $35,280.00 $210,000.00 $105,000.00 2026-05-22
492019165 OTHER Barostim Neo Sys 100062-202 60 16 $210,000.00 $50,400.00 76% off $35,280.00 $210,000.00 $105,000.00 2026-05-22
441019165 OTHER Barostim Neo Sys 100062-202 60 16 $210,000.00 $50,400.00 76% off $35,280.00 $210,000.00 $105,000.00 2026-05-22
84 APR_DRG Autologous Bone Marrow Transplant 1 1 — — $102,981.64 $102,981.64 $102,981.64 2026-07-17
681 MS_DRG Neonate- Birth Weight >2499 Grams- With Significant O.r. Procedures- With Multip… 3 1 — — $102,819.68 $102,819.68 $102,819.68 2026-07-17
0113 RC Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $102,798.61 $102,798.61 $102,798.61 2026-05-22
104 APR_DRG Head Trauma With Deep Coma 1 1 — — $102,780.61 $102,780.61 $102,780.61 2026-07-17
5912 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 1 1 — — $101,865.49 $101,865.49 $101,865.49 2026-07-17
5911 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 1 1 — — $101,865.49 $101,865.49 $101,865.49 2026-07-17
5913 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 1 1 — — $101,865.49 $101,865.49 $101,865.49 2026-07-17
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 1 1 — — $101,057.67 $101,057.67 $101,057.67 2026-07-17
6073 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 1 1 — — $100,390.44 $100,390.44 $100,390.44 2026-07-17
5932 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 1 1 — — $99,497.53 $99,497.53 $99,497.53 2026-07-17
5931 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 1 1 — — $99,497.53 $99,497.53 $99,497.53 2026-07-17
1634 APR_DRG Cardiac Valve Procedures Wo Ami Or Complex Pdx 1 1 — — $98,790.84 $98,790.84 $98,790.84 2026-07-17
3033 APR_DRG Dorsal And Lumbar Fusion Proc For Curvature Of Back 1 1 — — $98,520.74 $98,520.74 $98,520.74 2026-07-17
3032 APR_DRG Dorsal And Lumbar Fusion Proc For Curvature Of Back 1 1 — — $98,520.74 $98,520.74 $98,520.74 2026-07-17
3031 APR_DRG Dorsal And Lumbar Fusion Proc For Curvature Of Back 1 1 — — $98,520.74 $98,520.74 $98,520.74 2026-07-17
L8614 HCPCS Elctrd Profle Nucmof P783831 26 9 $120,300.00 $28,872.00 76% off $27,095.22 $142,500.00 $98,100.00 2026-07-17
440082654 OTHER Gen Asp 7mm Sgl 103 60 16 $195,360.00 $46,886.40 76% off $32,820.48 $195,360.00 $97,680.00 2026-05-22
441082654 OTHER Gen Asp 7mm Sgl 103 60 16 $195,360.00 $46,886.40 76% off $32,820.48 $195,360.00 $97,680.00 2026-05-22
510420195 OTHER Tebentafusp-tebn 100 Mcg/0.5 Ml Inj 60 16 $193,897.27 $46,535.34 76% off $32,574.74 $193,897.27 $96,948.64 2026-05-22
855220195 OTHER Tebentafusp-tebn 100 Mcg/0.5 Ml Inj 60 16 $193,897.27 $46,535.34 76% off $32,574.74 $193,897.27 $96,948.64 2026-05-22
510520195 OTHER Tebentafusp-tebn 100 Mcg/0.5 Ml Inj 60 16 $193,897.27 $46,535.34 76% off $32,574.74 $193,897.27 $96,948.64 2026-05-22
510020195 OTHER Tebentafusp-tebn 100 Mcg/0.5 Ml Inj 60 16 $193,897.27 $46,535.34 76% off $32,574.74 $193,897.27 $96,948.64 2026-05-22
510320195 OTHER Tebentafusp-tebn 100 Mcg/0.5 Ml Inj 60 16 $193,897.27 $46,535.34 76% off $32,574.74 $193,897.27 $96,948.64 2026-05-22
835220195 OTHER Tebentafusp-tebn 100 Mcg/0.5 Ml Inj 60 16 $193,897.27 $46,535.34 76% off $32,574.74 $193,897.27 $96,948.64 2026-05-22
440088880 OTHER Generator Vagus Aspire Sr 106 60 16 $192,580.00 $46,219.20 76% off $32,353.44 $192,580.00 $96,290.00 2026-05-22
441088880 OTHER Generator Vagus Aspire Sr 106 60 16 $192,580.00 $46,219.20 76% off $32,353.44 $192,580.00 $96,290.00 2026-05-22
C1822 HCPCS Senza Hfx Iq Hfx-d 19 11 $128,250.00 $30,780.00 76% off $41.40 $128,250.00 $96,187.50 2026-07-17
440015761 OTHER Gammatile 6/brchy Ther Gt-06 60 16 $192,000.00 $46,080.00 76% off $32,256.00 $192,000.00 $96,000.00 2026-05-22
440060102 OTHER Kt Neurostimulator Rns-320-k 60 16 $191,700.00 $46,008.00 76% off $32,205.60 $191,700.00 $95,850.00 2026-05-22
441060102 OTHER Kt Neurostimulator Rns-320-k 60 16 $191,700.00 $46,008.00 76% off $32,205.60 $191,700.00 $95,850.00 2026-05-22
103 APR_DRG Head Trauma With Deep Coma 1 1 — — $95,397.99 $95,397.99 $95,397.99 2026-07-17
101 APR_DRG Head Trauma With Deep Coma 1 1 — — $95,397.99 $95,397.99 $95,397.99 2026-07-17
102 APR_DRG Head Trauma With Deep Coma 1 1 — — $95,397.99 $95,397.99 $95,397.99 2026-07-17
441065476 OTHER Ipg Neo2 100065-202 60 16 $189,000.00 $45,360.00 76% off $31,752.00 $189,000.00 $94,500.00 2026-05-22
440013797 OTHER Pulse Generator 100054-202 60 16 $189,000.00 $45,360.00 76% off $31,752.00 $189,000.00 $94,500.00 2026-05-22
441013797 OTHER Pulse Generator 100054-202 60 16 $189,000.00 $45,360.00 76% off $31,752.00 $189,000.00 $94,500.00 2026-05-22
440065476 OTHER Ipg Neo2 100065-202 60 16 $189,000.00 $45,360.00 76% off $31,752.00 $189,000.00 $94,500.00 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
6022 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 1 1 — — $93,303.83 $93,303.83 $93,303.83 2026-07-17
6021 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 1 1 — — $93,303.83 $93,303.83 $93,303.83 2026-07-17
6072 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 1 1 — — $92,588.51 $92,588.51 $92,588.51 2026-07-17
0074 OTHER Allogeneic Bone Marrow Transplant 2 1 — — $92,412.49 $92,412.49 $92,412.49 2026-05-22
53 APR_DRG Tracheostomy W Mv 96 Hours Wo Extensive Procedure 1 1 — — $92,372.68 $92,372.68 $92,372.68 2026-07-17
6334 APR_DRG Neonate Birthwt 2499g W Major Anomaly 1 1 — — $90,997.53 $90,997.53 $90,997.53 2026-07-17
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
492078839 OTHER Bndl Triclip 5g Sys Tcg50100 60 16 $180,000.00 $43,200.00 76% off $30,240.00 $180,000.00 $90,000.00 2026-05-22
440078839 OTHER Bndl Triclip 5g Sys Tcg50100 60 16 $180,000.00 $43,200.00 76% off $30,240.00 $180,000.00 $90,000.00 2026-05-22
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec… 77 17 — — $83,140.63 $158,990.76 $89,865.39 2026-07-17
8633 APR_DRG Neonatal Aftercare 1 1 — — $89,404.09 $89,404.09 $89,404.09 2026-07-17
6124 APR_DRG Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond 1 1 — — $87,808.19 $87,808.19 $87,808.19 2026-07-17
492078833 OTHER Syst Bndl Mitraclip G5 Mcg50100 60 16 $174,000.00 $41,760.00 76% off $29,232.00 $174,000.00 $87,000.00 2026-05-22
440015760 OTHER Gammatile 5/brchy Ther Gt-05 60 16 $174,000.00 $41,760.00 76% off $29,232.00 $174,000.00 $87,000.00 2026-05-22
440078833 OTHER Syst Bndl Mitraclip G5 Mcg50100 60 16 $174,000.00 $41,760.00 76% off $29,232.00 $174,000.00 $87,000.00 2026-05-22
3124 APR_DRG Skin Graft Except Hand For Musculoskeletal And Connective Tissue Diagnoses 1 1 — — $86,462.64 $86,462.64 $86,462.64 2026-07-17
6083 APR_DRG Neonate Bwt 12501499g W Or Wo Other Significant Condition 1 1 — — $85,250.29 $85,250.29 $85,250.29 2026-07-17
6084 APR_DRG Neonate Bwt 12501499g W Or Wo Other Significant Condition 1 1 — — $85,250.29 $85,250.29 $85,250.29 2026-07-17
635 MS_DRG Neonate- Birth Weight 1000-1499 Grams- Died 3 1 — — $84,974.31 $84,974.31 $84,974.31 2026-07-17
C1882 HCPCS Defib Inogen X4 Crt-d G148 104 9 $114,003.40 $27,360.82 76% off $15,449.52 $128,124.78 $84,640.00 2026-07-17
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
1204 APR_DRG Major Respiratory And Chest Procedures 1 1 — — $83,294.26 $83,294.26 $83,294.26 2026-07-17
6033 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 1 1 — — $83,071.03 $83,071.03 $83,071.03 2026-07-17
6034 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 1 1 — — $83,071.03 $83,071.03 $83,071.03 2026-07-17
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 1 1 — — $83,006.90 $83,006.90 $83,006.90 2026-07-17
7 MS_DRG Lung Transplant 74 17 — — $69,376.61 $147,050.14 $82,476.28 2026-07-17
1611 OTHER Implantable Heart Assist Systems 2 1 — — $82,318.94 $82,318.94 $82,318.94 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
5881 OTHER Neonate Bwt 1500g W Major Procedure 2 1 — — $82,259.54 $82,259.54 $82,259.54 2026-05-22
6113 APR_DRG Neonate Birthwt 15001999g W Major Anomaly 1 1 — — $82,173.18 $82,173.18 $82,173.18 2026-07-17
6032 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 1 1 — — $81,894.45 $81,894.45 $81,894.45 2026-07-17
3044 APR_DRG Dorsal And Lumbar Fusion Proc Except For Curvature Of Back 1 1 — — $81,557.76 $81,557.76 $81,557.76 2026-07-17
0023 RC Heart andOR Lung Transplant 2 1 — — $81,282.42 $81,282.42 $81,282.42 2026-05-22
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 1 1 — — $81,106.36 $81,106.36 $81,106.36 2026-07-17
14 MS_DRG Allogeneic Bone Marrow Transplant 74 17 — — $64,820.84 $147,421.45 $80,899.17 2026-07-17
12 APR_DRG Liver Transplant andOR Intestinal Transplant 1 1 — — $80,860.93 $80,860.93 $80,860.93 2026-07-17
13 APR_DRG Liver Transplant andOR Intestinal Transplant 1 1 — — $80,860.93 $80,860.93 $80,860.93 2026-07-17
11 APR_DRG Liver Transplant andOR Intestinal Transplant 1 1 — — $80,860.93 $80,860.93 $80,860.93 2026-07-17
634 MS_DRG Neonate- Birth Weight 1000-1499 Grams- Without Significant O.r. Procedures- Disc… 3 1 — — $80,655.19 $80,655.19 $80,655.19 2026-07-17
2604 APR_DRG Major Pancreas Liver And Shunt Procedures 1 1 — — $80,593.30 $80,593.30 $80,593.30 2026-07-17
9104 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $80,534.11 $80,534.11 $80,534.11 2026-07-17
510018653 OTHER Tagraxofusp-erzs (Elzonris) 1000 Mcg Inj 60 16 $160,681.65 $38,563.60 76% off $26,994.52 $160,681.65 $80,340.82 2026-05-22
510518653 OTHER Tagraxofusp-erzs (Elzonris) 1000 Mcg Inj 60 16 $160,681.65 $38,563.60 76% off $26,994.52 $160,681.65 $80,340.82 2026-05-22
510418653 OTHER Tagraxofusp-erzs (Elzonris) 1000 Mcg Inj 60 16 $160,681.65 $38,563.60 76% off $26,994.52 $160,681.65 $80,340.82 2026-05-22
835218653 OTHER Tagraxofusp-erzs (Elzonris) 1000 Mcg Inj 60 16 $160,681.65 $38,563.60 76% off $26,994.52 $160,681.65 $80,340.82 2026-05-22
855218653 OTHER Tagraxofusp-erzs (Elzonris) 1000 Mcg Inj 60 16 $160,681.65 $38,563.60 76% off $26,994.52 $160,681.65 $80,340.82 2026-05-22
510318653 OTHER Tagraxofusp-erzs (Elzonris) 1000 Mcg Inj 60 16 $160,681.65 $38,563.60 76% off $26,994.52 $160,681.65 $80,340.82 2026-05-22
1664 APR_DRG Coronary Bypass Wo Ami Or Complex Pdx 1 1 — — $80,082.71 $80,082.71 $80,082.71 2026-07-17
1613 APR_DRG Cardiac Defibrillator And Heart Assist Implant 1 1 — — $79,064.00 $79,064.00 $79,064.00 2026-07-17
1694 APR_DRG Major Abdominal Vascular Procedures 1 1 — — $78,956.70 $78,956.70 $78,956.70 2026-07-17
894 APR_DRG Major Cranialfacial Bone Procedures 1 1 — — $78,290.71 $78,290.71 $78,290.71 2026-07-17
6123 APR_DRG Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond 1 1 — — $78,229.04 $78,229.04 $78,229.04 2026-07-17
440015758 OTHER Gammatile 4/brchy Ther Gt-04 60 16 $156,000.00 $37,440.00 76% off $26,208.00 $156,000.00 $78,000.00 2026-05-22
6954 APR_DRG Chemotherapy For Acute Leukemia 1 1 — — $77,931.82 $77,931.82 $77,931.82 2026-07-17
4414 APR_DRG Major Bladder Procedures 1 1 — — $77,734.49 $77,734.49 $77,734.49 2026-07-17
440012380 OTHER Nail Fem Retro 14x460 2339-1446s 60 16 $155,313.00 $37,275.12 76% off $26,092.58 $155,313.00 $77,656.50 2026-05-22
441069295 OTHER Kt Imp Generator Pulse 60 16 $155,263.00 $37,263.12 76% off $26,084.18 $155,263.00 $77,631.50 2026-05-22
613 MS_DRG Neonate- Birth Weight <750 Grams- Died 3 1 — — $77,067.16 $77,067.16 $77,067.16 2026-07-17
440086195 OTHER Genrtr Nrstm 16chnl222etctrsy33 60 16 $151,518.00 $36,364.32 76% off $25,455.02 $151,518.00 $75,759.00 2026-05-22
441086195 OTHER Genrtr Nrstm 16chnl222etctrsy33 60 16 $151,518.00 $36,364.32 76% off $25,455.02 $151,518.00 $75,759.00 2026-05-22
6904 APR_DRG Acute Leukemia 1 1 — — $75,731.58 $75,731.58 $75,731.58 2026-07-17
4403 APR_DRG Kidney Transplant 1 1 — — $75,265.39 $75,265.39 $75,265.39 2026-07-17
492089214 OTHER Pump Set Cp Impella 0048-0003 60 16 $150,000.00 $36,000.00 76% off $25,200.00 $150,000.00 $75,000.00 2026-05-22
1814 APR_DRG Lower Extremity Arterial Procedures 1 1 — — $74,867.03 $74,867.03 $74,867.03 2026-07-17
440083698 OTHER Fortiva 35x35cm Pd3535 60 16 $148,639.00 $35,673.36 76% off $24,971.35 $148,639.00 $74,319.50 2026-05-22
441083698 OTHER Fortiva 35x35cm Pd3535 60 16 $148,639.00 $35,673.36 76% off $24,971.35 $148,639.00 $74,319.50 2026-05-22
2304 APR_DRG Major Small Bowel Procedures 1 1 — — $74,314.51 $74,314.51 $74,314.51 2026-07-17
214 APR_DRG Craniotomy Except For Trauma 1 1 — — $74,122.11 $74,122.11 $74,122.11 2026-07-17
441082281 OTHER Custm Kit Acet Pv-acrkt-04k 60 16 $147,840.00 $35,481.60 76% off $24,837.12 $147,840.00 $73,920.00 2026-05-22
440082281 OTHER Custm Kit Acet Pv-acrkt-04k 60 16 $147,840.00 $35,481.60 76% off $24,837.12 $147,840.00 $73,920.00 2026-05-22
441084021 OTHER Imp Fix 19.5x80mm Opra 1807 60 16 $147,600.00 $35,424.00 76% off $24,796.80 $147,600.00 $73,800.00 2026-05-22
441073891 OTHER Fixture Imp 16mm 80mm 1800 60 16 $147,600.00 $35,424.00 76% off $24,796.80 $147,600.00 $73,800.00 2026-05-22
440084021 OTHER Imp Fix 19.5x80mm Opra 1807 60 16 $147,600.00 $35,424.00 76% off $24,796.80 $147,600.00 $73,800.00 2026-05-22
440073891 OTHER Fixture Imp 16mm 80mm 1800 60 16 $147,600.00 $35,424.00 76% off $24,796.80 $147,600.00 $73,800.00 2026-05-22
440087539 OTHER Fixture Imp 17.5mm 80mm 1803 60 16 $147,600.00 $35,424.00 76% off $24,796.80 $147,600.00 $73,800.00 2026-05-22
441087539 OTHER Fixture Imp 17.5mm 80mm 1803 60 16 $147,600.00 $35,424.00 76% off $24,796.80 $147,600.00 $73,800.00 2026-05-22
1324 APR_DRG Bpd And Oth Chronic Respiratory Diseases Arising In Perinatal Period 1 1 — — $73,412.96 $73,412.96 $73,412.96 2026-07-17
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 1 1 — — $73,269.89 $73,269.89 $73,269.89 2026-07-17
6903 APR_DRG Acute Leukemia 1 1 — — $73,161.36 $73,161.36 $73,161.36 2026-07-17
6031 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 1 1 — — $72,539.77 $72,539.77 $72,539.77 2026-07-17
9114 APR_DRG Extensive Abdominalthoracic Procedures For Mult Significant Trauma 1 1 — — $72,184.58 $72,184.58 $72,184.58 2026-07-17
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 15 6 — — $50,118.53 $87,340.74 $71,748.67 2026-07-17
3043 APR_DRG Dorsal And Lumbar Fusion Proc Except For Curvature Of Back 1 1 — — $71,609.85 $71,609.85 $71,609.85 2026-07-17
441016822 OTHER Synchron 2 Flex28 39573 60 16 $142,500.00 $34,200.00 76% off $23,940.00 $142,500.00 $71,250.00 2026-05-22
440016822 OTHER Synchron 2 Flex28 39573 60 16 $142,500.00 $34,200.00 76% off $23,940.00 $142,500.00 $71,250.00 2026-05-22
6224 APR_DRG Neonate Bwt 20002499g W Resp Dist Syndoth Maj Resp Cond 1 1 — — $71,049.93 $71,049.93 $71,049.93 2026-07-17
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 74 17 — — $68,042.90 $123,993.66 $71,046.31 2026-07-17
C1767 HCPCS Battery Activa Mdin 37601 234 9 $95,563.55 $22,935.25 76% off $4,374.46 $206,226.00 $71,011.58 2026-07-17
6094 OTHER Neonate Bwt 15002499g W Major Procedure 2 1 — — $70,877.49 $70,877.49 $70,877.49 2026-05-22
6112 APR_DRG Neonate Birthwt 15001999g W Major Anomaly 1 1 — — $70,258.14 $70,258.14 $70,258.14 2026-07-17
1214 APR_DRG Other Respiratory And Chest Procedures 1 1 — — $70,144.68 $70,144.68 $70,144.68 2026-07-17
209 MS_DRG Kidney And Urinary Tract Signs And Symptoms Age 0-17 37 13 — — $3,693.82 $128,966.41 $69,986.74 2026-07-17
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
441059427 OTHER Kt Neuro Prc 10 Neurokit-400-t10 60 16 $139,625.00 $33,510.00 76% off $23,457.00 $139,625.00 $69,812.50 2026-05-22
440059427 OTHER Kt Neuro Prc 10 Neurokit-400-t10 60 16 $139,625.00 $33,510.00 76% off $23,457.00 $139,625.00 $69,812.50 2026-05-22
441022564 OTHER Rod 10.7x335mm 10deg P10.7-80c335 60 16 $138,984.00 $33,356.16 76% off $23,349.31 $138,984.00 $69,492.00 2026-05-22
440022564 OTHER Rod 10.7x335mm 10deg P10.7-80c335 60 16 $138,984.00 $33,356.16 76% off $23,349.31 $138,984.00 $69,492.00 2026-05-22
2204 APR_DRG Major Stomach Esophageal And Duodenal Procedures 1 1 — — $69,292.46 $69,292.46 $69,292.46 2026-07-17
212 MS_DRG Testes Procedures Age 0-17 86 17 — — $7,190.96 $123,899.50 $69,284.12 2026-07-17
440020993 OTHER Generator Ipg 10-b411-3xx 60 16 $138,000.00 $33,120.00 76% off $23,184.00 $138,000.00 $69,000.00 2026-05-22
440015757 OTHER Gammatile 3/brchy Ther Gt-03 60 16 $138,000.00 $33,120.00 76% off $23,184.00 $138,000.00 $69,000.00 2026-05-22
492020993 OTHER Generator Ipg 10-b411-3xx 60 16 $138,000.00 $33,120.00 76% off $23,184.00 $138,000.00 $69,000.00 2026-05-22
441027438 OTHER Hfx Iq Ipg Kt 1090-a 60 16 $137,970.00 $33,112.80 76% off $23,178.96 $137,970.00 $68,985.00 2026-05-22
440027438 OTHER Hfx Iq Ipg Kt 1090-a 60 16 $137,970.00 $33,112.80 76% off $23,178.96 $137,970.00 $68,985.00 2026-05-22
6814 APR_DRG Other Or Procedures For Lymphatichematopoieticother Neoplasms 1 1 — — $68,717.73 $68,717.73 $68,717.73 2026-07-17
82 APR_DRG Autologous Bone Marrow Transplant 1 1 — — $68,706.63 $68,706.63 $68,706.63 2026-07-17
83 APR_DRG Autologous Bone Marrow Transplant 1 1 — — $68,706.63 $68,706.63 $68,706.63 2026-07-17
81 APR_DRG Autologous Bone Marrow Transplant 1 1 — — $68,706.63 $68,706.63 $68,706.63 2026-07-17
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 74 17 — — $11,906.58 $125,575.55 $68,284.83 2026-07-17
7104 APR_DRG Infectious And Parasitic Diseases Including HIV W Or Procedure 1 1 — — $68,180.01 $68,180.01 $68,180.01 2026-07-17
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 70 17 — — $62,578.15 $120,740.26 $67,847.89 2026-07-17
510313649 OTHER Ustekinumab 45 Mg/0.5 Ml Inj 60 16 $135,292.05 $32,470.09 76% off $22,729.06 $135,292.05 $67,646.02 2026-05-22
510013649 OTHER Ustekinumab 45 Mg/0.5 Ml Inj 60 16 $135,292.05 $32,470.09 76% off $22,729.06 $135,292.05 $67,646.02 2026-05-22
855213649 OTHER Ustekinumab 45 Mg/0.5 Ml Inj 60 16 $135,292.05 $32,470.09 76% off $22,729.06 $135,292.05 $67,646.02 2026-05-22
855213713 OTHER Ustekinumab 90 Mg/1 Ml Inj 60 16 $135,291.91 $32,470.06 76% off $22,729.04 $135,291.91 $67,645.96 2026-05-22
510013713 OTHER Ustekinumab 90 Mg/1 Ml Inj 60 16 $135,291.91 $32,470.06 76% off $22,729.04 $135,291.91 $67,645.96 2026-05-22
510313713 OTHER Ustekinumab 90 Mg/1 Ml Inj 60 16 $135,291.91 $32,470.06 76% off $22,729.04 $135,291.91 $67,645.96 2026-05-22
1612 APR_DRG Cardiac Defibrillator And Heart Assist Implant 1 1 — — $67,327.79 $67,327.79 $67,327.79 2026-07-17
1604 OTHER Major Cardiothoracic Repair Of Heart Anomaly 2 1 — — $66,951.91 $66,951.91 $66,951.91 2026-05-22
0022 RC Health Insurance - Prospective Payment System (hipps) - Skilled Nursing Facility… 2 1 — — $66,841.49 $66,841.49 $66,841.49 2026-05-22
6344 APR_DRG Neonate Birthwt 2499g W Resp Dist Syndoth Maj Resp Cond 1 1 — — $66,538.47 $66,538.47 $66,538.47 2026-07-17
1764 APR_DRG Cardiac Pacemaker And Defibrillator Device Replacement 1 1 — — $66,368.27 $66,368.27 $66,368.27 2026-07-17
1763 APR_DRG Cardiac Pacemaker And Defibrillator Device Replacement 1 1 — — $66,368.27 $66,368.27 $66,368.27 2026-07-17
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96 Hours 1 1 — — $66,348.54 $66,348.54 $66,348.54 2026-07-17
215 MS_DRG Other Heart Assist System Implant 86 17 — — $57,773.12 $119,212.69 $66,299.26 2026-07-17
510020157 OTHER Loncastuximab Tesirine-lpyl 10 Mg Inj 60 16 $132,168.06 $31,720.34 76% off $22,204.23 $132,168.06 $66,084.03 2026-05-22
510520157 OTHER Loncastuximab Tesirine-lpyl 10 Mg Inj 60 16 $132,168.06 $31,720.34 76% off $22,204.23 $132,168.06 $66,084.03 2026-05-22
855220157 OTHER Loncastuximab Tesirine-lpyl 10 Mg Inj 60 16 $132,168.06 $31,720.34 76% off $22,204.23 $132,168.06 $66,084.03 2026-05-22
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