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

GREATER BALTIMORE MEDICAL CENTER

Baltimore, MD · CCN 210044 · Rates published

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You selected 59610 (CPT)

This facility hasn’t published a payer-negotiated rate for this exact code. See its full rate list below.

10,801 distinct procedures filed
37 distinct payers
67,426 rate rows
2026-07-01 last MRF observed
Data quality

17,813 of 67,426 rate rows are consumer-grade (26.4%)

49,613 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
professional (physician) fee — not the facility price 49,413
placeholder amount (≤ $0.02) — excluded from medians 189
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 7
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.gbmc.org/sites/default/files/documents/52-6049658_gbmc_standardcharges.csv
Found on page https://www.gbmc.org/billing-estimates/billing-and-financial-support/hospital-and-physician-charges
Discovered viaDiscovered by HANK
Last fetch success · 2026-09-21
Content fingerprint 5ffee710472ba0f0… · 21,814,630 bytes · first seen 2026-09-21

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
0310-4535-30
NDC 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 1 $78,000.00 $78,000.00 $78,000.00 nat. median
$78,000
1.0× median
0003-2328-22
NDC 		Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 1 $63,061.44 $63,061.44 $63,061.44 nat. median
$63,061
1.0× median
0006-5083-01
NDC 		Pembrolizumab 790 Mg-berahyaluronid-pmph 9,600 Unit/4.8 Ml Subcut Soln 1 $47,623.68 $47,623.68 $47,623.68 nat. median
$47,624
1.0× median
50881-006-03
NDC 		Retifanlimab-dlwr 500 Mg/20 Ml Intravenous Solution 1 $35,865.26 $35,865.26 $35,865.26 nat. median
$35,865
1.0× median
57894-061-03
NDC 		Ustekinumab 90 Mg/ml Subcutaneous Syringe 1 $35,497.34 $35,497.34 $35,497.34 nat. median
$35,497
1.0× median
57894-522-01
NDC 		Amivantamab 3,520 Mg-hyaluronidase-lpuj 44,000 Unit/22 Ml Subcut Soln 1 $33,172.00 $33,172.00 $33,172.00 nat. median
$33,172
1.0× median
50242-105-01
NDC 		Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution 1 $31,200.00 $31,200.00 $31,200.00 nat. median
$31,200
1.0× median
25682-028-01
NDC 		Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 1 $29,477.21 $29,477.21 $29,477.21 nat. median
$29,477
1.0× median
55513-077-01
NDC 		Tarlatamab-dlle 10 Mg/4.2 Ml Reconstituted IV Soln 1 $29,100.00 $29,100.00 $29,100.00 nat. median
$29,100
1.0× median
55513-069-01
NDC 		Tarlatamab-dlle 10 Mg Intravenous Solution 1 $29,100.00 $29,100.00 $29,100.00 nat. median
$29,100
1.0× median
0074-1055-01
NDC 		Telisotuzumab Vedotin-tllv 100 Mg/5 Ml Reconstituted IV Soln 1 $27,960.00 $27,960.00 $27,960.00 nat. median
$27,960
1.0× median
0003-7125-11
NDC 		Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 1 $26,977.72 $26,977.72 $26,977.72 nat. median
$26,978
1.0× median
50242-245-01
NDC 		Pertuzumab 1,200 Mg-trastuzumab 600 Mg-hyaluron-zzxf/15 Ml Subcut Soln 1 $25,413.99 $25,413.99 $25,413.99 nat. median
$25,414
1.0× median
0006-3083-01
NDC 		Pembrolizumab 395 Mg-berahyaluronid-pmph 4,800 Unit/2.4 Ml Subcut Soln 1 $23,811.84 $23,811.84 $23,811.84 nat. median
$23,812
1.0× median
A9604
HCPCS 		Hc Samarium Sm 153 Lexidronam 1 $23,465.38 $23,465.38 $23,465.38 nat. median
$11,059
outlier · 2.1×
57894-515-01
NDC 		Amivantamab 2,400 Mg-hyaluronidase-lpuj 30,000 Unit/15 Ml Subcut Soln 1 $22,617.28 $22,617.28 $22,617.28 nat. median
$22,617
1.0× median
50242-150-01
NDC 		Ocrelizumab 30 Mg/ml Intravenous Solution 1 $22,341.13 $22,341.13 $22,341.13 nat. median
$22,341
1.0× median
0173-0898-03
NDC 		Dostarlimab-gxly 50 Mg/ml Intravenous Solution 1 $22,219.00 $22,219.00 $22,219.00 nat. median
$22,219
1.0× median
0024-5824-11
NDC 		Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 1 $22,099.34 $22,099.34 $22,099.34 nat. median
$22,099
1.0× median
57894-514-01
NDC 		Amivantamab 2,240 Mg-hyaluronidase-lpuj 28,000 Unit/14 Ml Subcut Soln 1 $21,109.46 $21,109.46 $21,109.46 nat. median
$21,109
1.0× median
9999-9904-53
NDC 		Pembrolizumab 200 Mg Ivpb In Ns (batched) 1 $20,693.66 $20,693.66 $20,693.66 nat. median
$20,694
1.0× median
C2616
HCPCS 		Hc Yttrium- 90 Microspheres 1 $20,625.00 $20,625.00 $20,625.00 nat. median
$22,121
0.9× median
50242-917-01
NDC 		Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution 1 $19,697.28 $19,697.28 $19,697.28 nat. median
$19,697
1.0× median
51144-050-01
NDC 		Brentuximab Vedotin 50 Mg Intravenous Solution 1 $19,400.00 $19,400.00 $19,400.00 nat. median
$19,400
1.0× median
57894-450-01
NDC 		Teclistamab-cqyv 90 Mg/ml Subcutaneous Solution 1 $18,925.52 $18,925.52 $18,925.52 nat. median
$18,926
1.0× median
61755-008-01
NDC 		Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 1 $18,842.46 $18,842.46 $18,842.46 nat. median
$18,842
1.0× median
89342055
LOCAL 		Hc Skin Tissue, Cost $14501-15000 1 $18,704.52 $18,704.52 $18,704.52 nat. median
$18,705
1.0× median
89342054
LOCAL 		Hc Skin Tissue, Cost $14001-14500 1 $18,081.68 $18,081.68 $18,081.68 nat. median
$18,082
1.0× median
57894-060-03
NDC 		Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe 1 $17,748.68 $17,748.68 $17,748.68 nat. median
$17,749
1.0× median
89342053
LOCAL 		Hc Skin Tissue, Cost $13501-14000 1 $17,458.85 $17,458.85 $17,458.85 nat. median
$17,459
1.0× median
55513-954-21
NDC 		Panitumumab 100 Mg/5 Ml (20 Mg/ml) Intravenous Solution 1 $16,953.50 $16,953.50 $16,953.50 nat. median
$16,954
1.0× median
50242-260-01
NDC 		Pertuzumab 600 Mg-trastuzumab 600 Mg-hyaluronid-zzxf/10 Ml Subcut Soln 1 $16,942.00 $16,942.00 $16,942.00 nat. median
$16,942
1.0× median
9999-9903-83
NDC 		Pertuzumab 600 Mg-trastuzumab 600 Mg-hyaluronid-zzxf 20,000 Unit/10 Ml Syringe (… 1 $16,942.00 $16,942.00 $16,942.00 nat. median
$16,942
1.0× median
89342052
LOCAL 		Hc Skin Tissue, Cost $13001-13500 1 $16,816.55 $16,816.55 $16,816.55 nat. median
$16,817
1.0× median
57894-060-02
NDC 		Ustekinumab 45 Mg/0.5 Ml Subcutaneous Solution 1 $16,203.92 $16,203.92 $16,203.92 nat. median
$16,204
1.0× median
89342051
LOCAL 		Hc Skin Tissue, Cost $12501-13000 1 $16,193.72 $16,193.72 $16,193.72 nat. median
$16,194
1.0× median
0003-6120-01
NDC 		Nivolumab 600 Mg-hyaluronidase-nvhy 10,000 Unit/5 Ml Subcut Solution 1 $15,977.70 $15,977.70 $15,977.70 nat. median
$15,978
1.0× median
9999-9903-77
NDC 		Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Syringe (batched) 1 $15,795.72 $15,795.72 $15,795.72 nat. median
$15,796
1.0× median
57894-503-01
NDC 		Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 1 $15,795.72 $15,795.72 $15,795.72 nat. median
$15,796
1.0× median
0003-2327-11
NDC 		Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 1 $15,765.40 $15,765.40 $15,765.40 nat. median
$15,765
1.0× median
89342050
LOCAL 		Hc Skin Tissue, Cost $12001-12500 1 $15,570.88 $15,570.88 $15,570.88 nat. median
$15,571
1.0× median
57894-510-01
NDC 		Amivantamab 1,600 Mg-hyaluronidase-lpuj 20,000 Unit/10 Ml Subcut Soln 1 $15,078.18 $15,078.18 $15,078.18 nat. median
$15,078
1.0× median
57894-650-01
NDC 		Guselkumab 200 Mg/20 Ml (10 Mg/ml) Intravenous Solution 1 $15,072.95 $15,072.95 $15,072.95 nat. median
$15,073
1.0× median
89342049
LOCAL 		Hc Skin Tissue, Cost $11501-12000 1 $14,928.59 $14,928.59 $14,928.59 nat. median
$14,929
1.0× median
55292-702-55
NDC 		Hemin 350 Mg/50 Ml Reconstituted IV Soln 1 $14,332.13 $14,332.13 $14,332.13 nat. median
$14,332
1.0× median
89342048
LOCAL 		Hc Skin Tissue, Cost $11001-11500 1 $14,305.75 $14,305.75 $14,305.75 nat. median
$14,306
1.0× median
68727-712-01
NDC 		Lurbinectedin 4 Mg Intravenous Solution 1 $14,070.00 $14,070.00 $14,070.00 nat. median
$14,070
1.0× median
55513-956-01
NDC 		Panitumumab 400 Mg/20 Ml (20 Mg/ml) Intravenous Solution 1 $14,057.00 $14,057.00 $14,057.00 nat. median
$14,057
1.0× median
0003-3734-13
NDC 		Nivolumab 240 Mg/24 Ml Intravenous Solution 1 $13,829.86 $13,829.86 $13,829.86 nat. median
$13,830
1.0× median
50242-918-01
NDC 		Atezolizumab 840 Mg/14 Ml (60 Mg/ml) Intravenous Solution 1 $13,788.10 $13,788.10 $13,788.10 nat. median
$13,788
1.0× median

Other procedures at this hospital

Browse this hospital's 10,801 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
             
0310-4535-30 NDC Tremelimumab-actl 20 Mg/ml Intravenous Solution 1 1 $78,000.00 $76,440.00 $78,000.00 $78,000.00 $78,000.00 2026-07-01
0003-2328-22 NDC Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 1 1 $63,061.44 $61,800.21 $63,061.44 $63,061.44 $63,061.44 2026-07-01
0006-5083-01 NDC Pembrolizumab 790 Mg-berahyaluronid-pmph 9,600 Unit/4.8 Ml Subcut Soln 1 1 $47,623.68 $46,671.21 $47,623.68 $47,623.68 $47,623.68 2026-07-01
50881-006-03 NDC Retifanlimab-dlwr 500 Mg/20 Ml Intravenous Solution 1 1 $35,865.26 $35,147.95 $35,865.26 $35,865.26 $35,865.26 2026-07-01
57894-061-03 NDC Ustekinumab 90 Mg/ml Subcutaneous Syringe 1 1 $35,497.34 $34,787.39 $35,497.34 $35,497.34 $35,497.34 2026-07-01
57894-522-01 NDC Amivantamab 3,520 Mg-hyaluronidase-lpuj 44,000 Unit/22 Ml Subcut Soln 1 1 $33,172.00 $32,508.56 $33,172.00 $33,172.00 $33,172.00 2026-07-01
50242-105-01 NDC Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution 1 1 $31,200.00 $30,576.00 $31,200.00 $31,200.00 $31,200.00 2026-07-01
25682-028-01 NDC Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 1 1 $29,477.21 $28,887.66 $29,477.21 $29,477.21 $29,477.21 2026-07-01
55513-077-01 NDC Tarlatamab-dlle 10 Mg/4.2 Ml Reconstituted IV Soln 1 1 $29,100.00 $28,518.00 $29,100.00 $29,100.00 $29,100.00 2026-07-01
55513-069-01 NDC Tarlatamab-dlle 10 Mg Intravenous Solution 1 1 $29,100.00 $28,518.00 $29,100.00 $29,100.00 $29,100.00 2026-07-01
0074-1055-01 NDC Telisotuzumab Vedotin-tllv 100 Mg/5 Ml Reconstituted IV Soln 1 1 $27,960.00 $27,400.80 $27,960.00 $27,960.00 $27,960.00 2026-07-01
0003-7125-11 NDC Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 1 1 $26,977.72 $26,438.17 $26,977.72 $26,977.72 $26,977.72 2026-07-01
50242-245-01 NDC Pertuzumab 1,200 Mg-trastuzumab 600 Mg-hyaluron-zzxf/15 Ml Subcut Soln 1 1 $25,413.99 $24,905.71 $25,413.99 $25,413.99 $25,413.99 2026-07-01
0006-3083-01 NDC Pembrolizumab 395 Mg-berahyaluronid-pmph 4,800 Unit/2.4 Ml Subcut Soln 1 1 $23,811.84 $23,335.60 $23,811.84 $23,811.84 $23,811.84 2026-07-01
A9604 HCPCS Hc Samarium Sm 153 Lexidronam 1 1 $23,465.38 $22,996.07 $23,465.38 $23,465.38 $23,465.38 2026-07-01
57894-515-01 NDC Amivantamab 2,400 Mg-hyaluronidase-lpuj 30,000 Unit/15 Ml Subcut Soln 1 1 $22,617.28 $22,164.93 $22,617.28 $22,617.28 $22,617.28 2026-07-01
50242-150-01 NDC Ocrelizumab 30 Mg/ml Intravenous Solution 1 1 $22,341.13 $21,894.31 $22,341.13 $22,341.13 $22,341.13 2026-07-01
0173-0898-03 NDC Dostarlimab-gxly 50 Mg/ml Intravenous Solution 1 1 $22,219.00 $21,774.62 $22,219.00 $22,219.00 $22,219.00 2026-07-01
0024-5824-11 NDC Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 1 1 $22,099.34 $21,657.36 $22,099.34 $22,099.34 $22,099.34 2026-07-01
57894-514-01 NDC Amivantamab 2,240 Mg-hyaluronidase-lpuj 28,000 Unit/14 Ml Subcut Soln 1 1 $21,109.46 $20,687.27 $21,109.46 $21,109.46 $21,109.46 2026-07-01
9999-9904-53 NDC Pembrolizumab 200 Mg Ivpb In Ns (batched) 1 1 $20,693.66 $20,279.79 $20,693.66 $20,693.66 $20,693.66 2026-07-01
C2616 HCPCS Hc Yttrium- 90 Microspheres 1 1 $20,625.00 $20,212.50 $20,625.00 $20,625.00 $20,625.00 2026-07-01
50242-917-01 NDC Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution 1 1 $19,697.28 $19,303.33 $19,697.28 $19,697.28 $19,697.28 2026-07-01
51144-050-01 NDC Brentuximab Vedotin 50 Mg Intravenous Solution 1 1 $19,400.00 $19,012.00 $19,400.00 $19,400.00 $19,400.00 2026-07-01
57894-450-01 NDC Teclistamab-cqyv 90 Mg/ml Subcutaneous Solution 1 1 $18,925.52 $18,547.01 $18,925.52 $18,925.52 $18,925.52 2026-07-01
61755-008-01 NDC Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 1 1 $18,842.46 $18,465.61 $18,842.46 $18,842.46 $18,842.46 2026-07-01
89342055 LOCAL Hc Skin Tissue, Cost $14501-15000 1 1 $18,704.52 $18,330.43 $18,704.52 $18,704.52 $18,704.52 2026-07-01
89342054 LOCAL Hc Skin Tissue, Cost $14001-14500 1 1 $18,081.68 $17,720.05 $18,081.68 $18,081.68 $18,081.68 2026-07-01
57894-060-03 NDC Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe 1 1 $17,748.68 $17,393.71 $17,748.68 $17,748.68 $17,748.68 2026-07-01
89342053 LOCAL Hc Skin Tissue, Cost $13501-14000 1 1 $17,458.85 $17,109.67 $17,458.85 $17,458.85 $17,458.85 2026-07-01
55513-954-21 NDC Panitumumab 100 Mg/5 Ml (20 Mg/ml) Intravenous Solution 1 1 $16,953.50 $16,614.43 $16,953.50 $16,953.50 $16,953.50 2026-07-01
50242-260-01 NDC Pertuzumab 600 Mg-trastuzumab 600 Mg-hyaluronid-zzxf/10 Ml Subcut Soln 1 1 $16,942.00 $16,603.16 $16,942.00 $16,942.00 $16,942.00 2026-07-01
9999-9903-83 NDC Pertuzumab 600 Mg-trastuzumab 600 Mg-hyaluronid-zzxf 20,000 Unit/10 Ml Syringe (… 1 1 $16,942.00 $16,603.16 $16,942.00 $16,942.00 $16,942.00 2026-07-01
89342052 LOCAL Hc Skin Tissue, Cost $13001-13500 1 1 $16,816.55 $16,480.22 $16,816.55 $16,816.55 $16,816.55 2026-07-01
57894-060-02 NDC Ustekinumab 45 Mg/0.5 Ml Subcutaneous Solution 1 1 $16,203.92 $15,879.84 $16,203.92 $16,203.92 $16,203.92 2026-07-01
89342051 LOCAL Hc Skin Tissue, Cost $12501-13000 1 1 $16,193.72 $15,869.85 $16,193.72 $16,193.72 $16,193.72 2026-07-01
0003-6120-01 NDC Nivolumab 600 Mg-hyaluronidase-nvhy 10,000 Unit/5 Ml Subcut Solution 1 1 $15,977.70 $15,658.15 $15,977.70 $15,977.70 $15,977.70 2026-07-01
57894-503-01 NDC Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 1 1 $15,795.72 $15,479.81 $15,795.72 $15,795.72 $15,795.72 2026-07-01
9999-9903-77 NDC Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Syringe (batched) 1 1 $15,795.72 $15,479.81 $15,795.72 $15,795.72 $15,795.72 2026-07-01
0003-2327-11 NDC Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 1 1 $15,765.40 $15,450.09 $15,765.40 $15,765.40 $15,765.40 2026-07-01
89342050 LOCAL Hc Skin Tissue, Cost $12001-12500 1 1 $15,570.88 $15,259.46 $15,570.88 $15,570.88 $15,570.88 2026-07-01
57894-510-01 NDC Amivantamab 1,600 Mg-hyaluronidase-lpuj 20,000 Unit/10 Ml Subcut Soln 1 1 $15,078.18 $14,776.62 $15,078.18 $15,078.18 $15,078.18 2026-07-01
57894-650-01 NDC Guselkumab 200 Mg/20 Ml (10 Mg/ml) Intravenous Solution 1 1 $15,072.95 $14,771.49 $15,072.95 $15,072.95 $15,072.95 2026-07-01
89342049 LOCAL Hc Skin Tissue, Cost $11501-12000 1 1 $14,928.59 $14,630.02 $14,928.59 $14,928.59 $14,928.59 2026-07-01
55292-702-55 NDC Hemin 350 Mg/50 Ml Reconstituted IV Soln 1 1 $14,332.13 $14,045.49 $14,332.13 $14,332.13 $14,332.13 2026-07-01
89342048 LOCAL Hc Skin Tissue, Cost $11001-11500 1 1 $14,305.75 $14,019.64 $14,305.75 $14,305.75 $14,305.75 2026-07-01
68727-712-01 NDC Lurbinectedin 4 Mg Intravenous Solution 1 1 $14,070.00 $13,788.60 $14,070.00 $14,070.00 $14,070.00 2026-07-01
55513-956-01 NDC Panitumumab 400 Mg/20 Ml (20 Mg/ml) Intravenous Solution 1 1 $14,057.00 $13,775.86 $14,057.00 $14,057.00 $14,057.00 2026-07-01
0003-3734-13 NDC Nivolumab 240 Mg/24 Ml Intravenous Solution 1 1 $13,829.86 $13,553.26 $13,829.86 $13,829.86 $13,829.86 2026-07-01
50242-918-01 NDC Atezolizumab 840 Mg/14 Ml (60 Mg/ml) Intravenous Solution 1 1 $13,788.10 $13,512.33 $13,788.10 $13,788.10 $13,788.10 2026-07-01
89342047 LOCAL Hc Skin Tissue, Cost $10501-11000 1 1 $13,682.91 $13,409.25 $13,682.91 $13,682.91 $13,682.91 2026-07-01
55513-956-21 NDC Panitumumab 400 Mg/20 Ml (20 Mg/ml) Intravenous Solution 1 1 $13,562.80 $13,291.54 $13,562.80 $13,562.80 $13,562.80 2026-07-01
73536-500-01 NDC Ropeginterferon Alfa-2b-njft 500 Mcg/ml Subcutaneous Syringe 1 1 $13,556.72 $13,285.59 $13,556.72 $13,556.72 $13,556.72 2026-07-01
59572-775-01 NDC Luspatercept-aamt 75 Mg Subcutaneous Solution 1 1 $13,551.58 $13,280.55 $13,551.58 $13,551.58 $13,551.58 2026-07-01
0169-7205-01 NDC Coagulation Factor Viia Recomb 5 Mg (5,000 Mcg) Intravenous Solution 1 1 $13,348.10 $13,081.14 $13,348.10 $13,348.10 $13,348.10 2026-07-01
82959-111-01 NDC Imetelstat 188 Mg/6 Ml Reconstituted IV Soln 1 1 $13,228.09 $12,963.53 $13,228.09 $13,228.09 $13,228.09 2026-07-01
27000543 LOCAL Hc Defib Quadripolar 1 1 $13,161.81 $12,898.57 $13,161.81 $13,161.81 $13,161.81 2026-07-01
27000551 LOCAL Hc Defib Lead Quattro Secure 1 1 $13,161.81 $12,898.57 $13,161.81 $13,161.81 $13,161.81 2026-07-01
89342046 LOCAL Hc Skin Tissue, Cost $10001-10500 1 1 $13,040.61 $12,779.80 $13,040.61 $13,040.61 $13,040.61 2026-07-01
0074-5015-01 NDC Risankizumab-rzaa 60 Mg/ml Intravenous Solution 1 1 $12,946.47 $12,687.54 $12,946.47 $12,946.47 $12,946.47 2026-07-01
48818-001-01 NDC Pralatrexate 20 Mg/ml (1 Ml) Intravenous Solution 1 1 $12,482.74 $12,233.09 $12,482.74 $12,482.74 $12,482.74 2026-07-01
72903-853-01 NDC Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution 1 1 $12,440.00 $12,191.20 $12,440.00 $12,440.00 $12,440.00 2026-07-01
89342045 LOCAL Hc Skin Tissue, Cost $9501-$10000 1 1 $12,417.77 $12,169.41 $12,417.77 $12,417.77 $12,417.77 2026-07-01
51144-003-01 NDC Tisotumab Vedotin-tftv 40 Mg Intravenous Solution 1 1 $12,228.00 $11,983.44 $12,228.00 $12,228.00 $12,228.00 2026-07-01
15054-1120-4 NDC Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe 1 1 $12,003.63 $11,763.55 $12,003.63 $12,003.63 $12,003.63 2026-07-01
50242-109-01 NDC Rituximab 1,600 Mg/13.4 Ml (120 Mg/ml)-hyaluronidase Subcutaneous Soln 1 1 $11,997.29 $11,757.34 $11,997.29 $11,997.29 $11,997.29 2026-07-01
89342044 LOCAL Hc Skin Tissue, Cost $9001-$9500 1 1 $11,794.94 $11,559.04 $11,794.94 $11,794.94 $11,794.94 2026-07-01
27000569 LOCAL Hc Pacemaker Riata Model 7071/65 1 1 $11,641.79 $11,408.95 $11,641.79 $11,641.79 $11,641.79 2026-07-01
27000629 LOCAL Hc Pacemaker Adapt Dr Addrs1 1 1 $11,568.56 $11,337.19 $11,568.56 $11,568.56 $11,568.56 2026-07-01
50242-145-01 NDC Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 1 1 $11,558.01 $11,326.85 $11,558.01 $11,558.01 $11,558.01 2026-07-01
27000575 LOCAL Hc Pacemaker Accent Rf Dr Pm 2210 1 1 $11,531.95 $11,301.31 $11,531.95 $11,531.95 $11,531.95 2026-07-01
27000574 LOCAL Hc Lead Lv 7120q/65cm Durata 1 1 $11,408.94 $11,180.76 $11,408.94 $11,408.94 $11,408.94 2026-07-01
89342043 LOCAL Hc Skin Tissue, Cost $8501-$9000 1 1 $11,152.64 $10,929.59 $11,152.64 $11,152.64 $11,152.64 2026-07-01
64406-008-01 NDC Natalizumab 300 Mg/15 Ml Intravenous Solution 1 1 $11,146.50 $10,923.57 $11,146.50 $11,146.50 $11,146.50 2026-07-01
50242-087-01 NDC Ado-trastuzumab Emtansine 160 Mg Intravenous Solution 1 1 $11,023.30 $10,802.83 $11,023.30 $11,023.30 $11,023.30 2026-07-01
0078-0690-61 NDC Ofatumumab 1,000 Mg/50 Ml Intravenous Solution 1 1 $10,892.30 $10,674.45 $10,892.30 $10,892.30 $10,892.30 2026-07-01
27000567 LOCAL Hc Lead Durata Icd 1 1 $10,865.67 $10,648.36 $10,865.67 $10,865.67 $10,865.67 2026-07-01
27000565 LOCAL Hc Pacemaker Zephyr 5620 1 1 $10,763.16 $10,547.90 $10,763.16 $10,763.16 $10,763.16 2026-07-01
9999-9903-05 NDC Alteplase 100 Mg Ivpb (from Vial) 1 1 $10,716.14 $10,501.82 $10,716.14 $10,716.14 $10,716.14 2026-07-01
27000572 LOCAL Hc Pacemaker Altrua 60 Dddr 1 1 $10,605.75 $10,393.64 $10,605.75 $10,605.75 $10,605.75 2026-07-01
89342042 LOCAL Hc Skin Tissue, Cost $8001-$8500 1 1 $10,529.81 $10,319.21 $10,529.81 $10,529.81 $10,529.81 2026-07-01
50242-108-01 NDC Rituximab 1,400 Mg/11.7 Ml (120 Mg/ml)-hyaluronidase Subcutaneous Soln 1 1 $10,497.47 $10,287.52 $10,497.47 $10,497.47 $10,497.47 2026-07-01
27000568 LOCAL Hc Recorder Loop Dm2100 1 1 $10,455.65 $10,246.54 $10,455.65 $10,455.65 $10,455.65 2026-07-01
72039028 LOCAL Hc C-sect Emergent With Major Surgery 1 1 $10,404.99 $10,196.89 $10,404.99 $10,404.99 $10,404.99 2026-07-01
27000571 LOCAL Hc Lead Commercial 1156/75 1 1 $10,332.64 $10,125.99 $10,332.64 $10,332.64 $10,332.64 2026-07-01
0006-3026-02 NDC Pembrolizumab 25 Mg/ml Intravenous Solution 1 1 $10,268.72 $10,063.35 $10,268.72 $10,268.72 $10,268.72 2026-07-01
0006-3026-01 NDC Pembrolizumab 25 Mg/ml Intravenous Solution 1 1 $10,268.72 $10,063.35 $10,268.72 $10,268.72 $10,268.72 2026-07-01
0006-3026-04 NDC Pembrolizumab 25 Mg/ml Intravenous Solution 1 1 $10,268.72 $10,063.35 $10,268.72 $10,268.72 $10,268.72 2026-07-01
50242-009-01 NDC Tenecteplase 25 Mg Intravenous Solution 1 1 $10,103.46 $9,901.39 $10,103.46 $10,103.46 $10,103.46 2026-07-01
50242-037-06 NDC Tenecteplase 50 Mg Intravenous Solution 1 1 $10,103.46 $9,901.39 $10,103.46 $10,103.46 $10,103.46 2026-07-01
50242-120-47 NDC Tenecteplase 50 Mg Intravenous Solution 1 1 $10,103.46 $9,901.39 $10,103.46 $10,103.46 $10,103.46 2026-07-01
59627-333-04 NDC Interferon Beta-1a 30 Mcg/0.5 Ml Intramuscular Pen Kit 1 1 $10,070.29 $9,868.89 $10,070.29 $10,070.29 $10,070.29 2026-07-01
50242-078-55 NDC Ranibizumab 10 Mg/0.1 Ml Intravitreal Implant Soln,initial Fill Needle 1 1 $10,042.77 $9,841.92 $10,042.77 $10,042.77 $10,042.77 2026-07-01
89342041 LOCAL Hc Skin Tissue, Cost $7501-$8000 1 1 $9,906.97 $9,708.83 $9,906.97 $9,906.97 $9,906.97 2026-07-01
9999-9903-84 NDC Vedolizumab 300 Mg/250 Ml Viaflex Ivpb (batched) 1 1 $9,682.80 $9,489.15 $9,682.80 $9,682.80 $9,682.80 2026-07-01
64764-300-20 NDC Vedolizumab 300 Mg Intravenous Solution 1 1 $9,682.78 $9,489.12 $9,682.78 $9,682.78 $9,682.78 2026-07-01
0469-4425-30 NDC Zolbetuximab-clzb 300 Mg/15 Ml Reconstituted IV Soln 1 1 $9,408.00 $9,219.84 $9,408.00 $9,408.00 $9,408.00 2026-07-01
50242-053-06 NDC Rituximab 10 Mg/ml Concentrate,intravenous 1 1 $9,395.20 $9,207.30 $9,395.20 $9,395.20 $9,395.20 2026-07-01
89342040 LOCAL Hc Skin Tissue, Cost $7001-$7500 1 1 $9,284.14 $9,098.46 $9,284.14 $9,284.14 $9,284.14 2026-07-01
0173-0821-01 NDC Ofatumumab 1,000 Mg/50 Ml Intravenous Solution 1 1 $9,002.20 $8,822.16 $9,002.20 $9,002.20 $9,002.20 2026-07-01
50242-070-01 NDC Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution 1 1 $8,941.48 $8,762.65 $8,941.48 $8,941.48 $8,941.48 2026-07-01
89342039 LOCAL Hc Skin Tissue, Cost $6501-$7000 1 1 $8,641.84 $8,469.00 $8,641.84 $8,641.84 $8,641.84 2026-07-01
25682-001-01 NDC Eculizumab 300 Mg/30 Ml Intravenous Solution 1 1 $8,311.46 $8,145.23 $8,311.46 $8,311.46 $8,311.46 2026-07-01
0002-7678-01 NDC Ramucirumab 10 Mg/ml Intravenous Solution 1 1 $8,223.40 $8,058.93 $8,223.40 $8,223.40 $8,223.40 2026-07-01
25682-025-01 NDC Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 1 1 $8,039.24 $7,878.46 $8,039.24 $8,039.24 $8,039.24 2026-07-01
89342038 LOCAL Hc Skin Tissue, Cost $6001-$6500 1 1 $8,019.01 $7,858.63 $8,019.01 $8,019.01 $8,019.01 2026-07-01
0003-3120-01 NDC Nivolumab 300 Mg-hyaluronidase-nvhy 5,000 Unit/2.5 Ml Subcut Solution 1 1 $7,988.85 $7,829.07 $7,988.85 $7,988.85 $7,988.85 2026-07-01
0078-0825-81 NDC Octreotide,microspheres ER 30 Mg Intramuscular Susp, Extended Release 1 1 $7,978.34 $7,818.78 $7,978.34 $7,978.34 $7,978.34 2026-07-01
50242-077-01 NDC Trastuzumab 600 Mg-hyaluronidase-oysk 10,000 Unit/5 Ml Subcut Solution 1 1 $7,823.54 $7,667.07 $7,823.54 $7,823.54 $7,823.54 2026-07-01
0211U CPT Caris Mi Cancer Seek 1 1 $7,692.59 $7,538.74 $7,692.59 $7,692.59 $7,692.59 2026-07-01
0310-4611-50 NDC Durvalumab 50 Mg/ml Intravenous Solution 1 1 $7,645.96 $7,493.04 $7,645.96 $7,645.96 $7,645.96 2026-07-01
73475-3041-5 NDC Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution 1 1 $7,637.38 $7,484.63 $7,637.38 $7,637.38 $7,637.38 2026-07-01
0002-7623-01 NDC Pemetrexed Disodium 500 Mg Intravenous Powder For Solution 1 1 $7,509.46 $7,359.27 $7,509.46 $7,509.46 $7,509.46 2026-07-01
27000333 LOCAL Hc Cuff Lg Adult 2 Tube W Bulb 1 1 $7,472.71 $7,323.26 $7,472.71 $7,472.71 $7,472.71 2026-07-01
52648 CPT Hc Tu Contact Laser Vap Prostate 1 1 $7,403.38 $7,255.31 $7,403.38 $7,403.38 $7,403.38 2026-07-01
53852 CPT Hc Tuna 1 1 $7,403.38 $7,255.31 $7,403.38 $7,403.38 $7,403.38 2026-07-01
89342037 LOCAL Hc Skin Tissue, Cost $5501-$6000 1 1 $7,396.17 $7,248.25 $7,396.17 $7,396.17 $7,396.17 2026-07-01
55513-132-01 NDC Trastuzumab-anns 420 Mg Intravenous Solution 1 1 $7,166.22 $7,022.90 $7,166.22 $7,166.22 $7,166.22 2026-07-01
13533-800-40 NDC Gamunex-c 1 Gm/10 Ml Ij Soln - Pediatric (wrapped) 1 1 $7,056.56 $6,915.42 $7,056.56 $7,056.56 $7,056.56 2026-07-01
13533-800-41 NDC Gamunex-c 1 Gm/10 Ml Ij Soln - Pediatric (wrapped) 1 1 $7,056.56 $6,915.42 $7,056.56 $7,056.56 $7,056.56 2026-07-01
0480-9262-08 NDC Octreotide,microspheres ER 30 Mg Intramuscular Susp, Extended Release 1 1 $6,962.92 $6,823.66 $6,962.92 $6,962.92 $6,962.92 2026-07-01
0003-3756-14 NDC Nivolumab 120 Mg/12 Ml Intravenous Solution 1 1 $6,914.95 $6,776.65 $6,914.95 $6,914.95 $6,914.95 2026-07-01
50242-088-01 NDC Ado-trastuzumab Emtansine 100 Mg Intravenous Solution 1 1 $6,889.56 $6,751.77 $6,889.56 $6,889.56 $6,889.56 2026-07-01
27000555 LOCAL Hc Stent Carotid Tapered 7.0-10.0 1 1 $6,874.91 $6,737.41 $6,874.91 $6,874.91 $6,874.91 2026-07-01
72579-121-01 NDC Tislelizumab-jsgr 10 Mg/ml Intravenous Solution 1 1 $6,857.96 $6,720.80 $6,857.96 $6,857.96 $6,857.96 2026-07-01
67457-762-30 NDC Octreotide,microspheres ER 30 Mg Intramuscular Susp, Extended Release 1 1 $6,845.13 $6,708.23 $6,845.13 $6,845.13 $6,845.13 2026-07-01
76075-101-21 NDC Carfilzomib 60 Mg Intravenous Solution 1 1 $6,828.52 $6,691.95 $6,828.52 $6,828.52 $6,828.52 2026-07-01
89342036 LOCAL Hc Skin Tissue, Cost $5001-$5500 1 1 $6,753.87 $6,618.79 $6,753.87 $6,753.87 $6,753.87 2026-07-01
50242-103-01 NDC Polatuzumab Vedotin-piiq 30 Mg Intravenous Solution 1 1 $6,685.72 $6,552.01 $6,685.72 $6,685.72 $6,685.72 2026-07-01
59856 CPT Induced Abort 1/> Vag Supp Dlvr Fetus D&c &/Evac 1 1 $6,652.37 $6,519.32 $6,652.37 $6,652.37 $6,652.37 2026-07-01
72039019 LOCAL Hc C-sect Emergent With Minor Surgery 1 1 $6,652.37 $6,519.32 $6,652.37 $6,652.37 $6,652.37 2026-07-01
78459 CPT Hc PET Scan Myocardial Perfus 1 1 $6,581.65 $6,450.02 $6,581.65 $6,581.65 $6,581.65 2026-07-01
70504-3000-2 NDC Rho(d) Immune Globulin-maltose 15,000 Unit (3,000 Mcg)/13 Ml Inj. Soln 1 1 $6,500.42 $6,370.41 $6,500.42 $6,500.42 $6,500.42 2026-07-01
70504-3000-1 NDC Rho(d) Immune Globulin-maltose 15,000 Unit (3,000 Mcg)/13 Ml Inj. Soln 1 1 $6,500.42 $6,370.41 $6,500.42 $6,500.42 $6,500.42 2026-07-01
0310-4505-25 NDC Tremelimumab-actl 20 Mg/ml Intravenous Solution 1 1 $6,500.00 $6,370.00 $6,500.00 $6,500.00 $6,500.00 2026-07-01
72039020 LOCAL Hc Hysterectomy Unschd Emerg A 1 1 $6,481.80 $6,352.16 $6,481.80 $6,481.80 $6,481.80 2026-07-01
72039038 LOCAL Evacuation Of Hematoma - Major 1 1 $6,481.80 $6,352.16 $6,481.80 $6,481.80 $6,481.80 2026-07-01
61795 CPT Hc Stereotactic Volumetric Proc 1 1 $6,474.06 $6,344.58 $6,474.06 $6,474.06 $6,474.06 2026-07-01
50242-061-01 NDC Bevacizumab 25 Mg/ml Intravenous Solution 1 1 $6,375.52 $6,248.01 $6,375.52 $6,375.52 $6,375.52 2026-07-01
99999-849-03 NDC Bevacizumab Intravitreal Syringe 1.25 Mg/0.05 Ml 1 1 $6,375.52 $6,248.01 $6,375.52 $6,375.52 $6,375.52 2026-07-01
72039018 LOCAL Hc C-sect Emergent 1 1 $6,311.22 $6,185.00 $6,311.22 $6,311.22 $6,311.22 2026-07-01
57894-501-01 NDC Amivantamab-vmjw 50 Mg/ml Intravenous Solution 1 1 $6,295.39 $6,169.49 $6,295.39 $6,295.39 $6,295.39 2026-07-01
27000498 LOCAL Hc Cuff Omni Sm Adult 1 1 $6,187.43 $6,063.68 $6,187.43 $6,187.43 $6,187.43 2026-07-01
27000511 LOCAL Hc Cuff Omni Kuff Adult Hp 1 1 $6,187.43 $6,063.68 $6,187.43 $6,187.43 $6,187.43 2026-07-01
27000518 LOCAL Hc Cuff Bp Lg Adult 1 1 $6,187.43 $6,063.68 $6,187.43 $6,187.43 $6,187.43 2026-07-01
89342035 LOCAL Hc Skin Tissue, Cost $4501-$5000 1 1 $6,131.03 $6,008.41 $6,131.03 $6,131.03 $6,131.03 2026-07-01
65597-801-01 NDC Datopotamab Deruxtecan-dlnk 100 Mg/5 Mg Reconstituted IV Soln 1 1 $6,078.59 $5,957.02 $6,078.59 $6,078.59 $6,078.59 2026-07-01
59676-960-02 NDC Doxorubicin, Pegylated Liposomal 2 Mg/ml Intravenous Suspension 1 1 $6,057.45 $5,936.30 $6,057.45 $6,057.45 $6,057.45 2026-07-01
0015-1911-13 NDC Ixabepilone 45 Mg Intravenous Solution 1 1 $6,005.60 $5,885.49 $6,005.60 $6,005.60 $6,005.60 2026-07-01
63459-104-50 NDC Rituximab-abbs 10 Mg/ml Intravenous Solution 1 1 $5,905.30 $5,787.19 $5,905.30 $5,905.30 $5,905.30 2026-07-01
0310-1730-30 NDC Benralizumab 30 Mg/ml Subcutaneous Syringe 1 1 $5,877.56 $5,760.01 $5,877.56 $5,877.56 $5,877.56 2026-07-01
50633-120-11 NDC Digoxin Immune Fab 40 Mg Intravenous Solution 1 1 $5,798.89 $5,682.91 $5,798.89 $5,798.89 $5,798.89 2026-07-01
0003-3774-12 NDC Nivolumab 100 Mg/10 Ml Intravenous Solution 1 1 $5,762.44 $5,647.19 $5,762.44 $5,762.44 $5,762.44 2026-07-01
55513-190-01 NDC Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 1 1 $5,643.98 $5,531.10 $5,643.98 $5,643.98 $5,643.98 2026-07-01
55513-192-01 NDC Pegfilgrastim 6 Mg/0.6 Ml (deliverable) Wearable Subcutaneous Injector 1 1 $5,643.98 $5,531.10 $5,643.98 $5,643.98 $5,643.98 2026-07-01
59821 CPT Surg Rx Missed Abortn,2nd Tri 2 1 $5,628.93 $5,516.35 $5,117.21 $6,140.65 $5,628.93 2026-07-01
0074-1044-01 NDC Telisotuzumab Vedotin-tllv 20 Mg/1 Ml Reconstituted IV Soln 1 1 $5,592.00 $5,480.16 $5,592.00 $5,592.00 $5,592.00 2026-07-01
71225-120-01 NDC Bendamustine 25 Mg/ml Intravenous Solution (equivalent To Vivimusta) 1 1 $5,565.36 $5,454.05 $5,565.36 $5,565.36 $5,565.36 2026-07-01
24338-270-01 NDC Bendamustine 25 Mg/ml Intravenous Solution (equivalent To Vivimusta) 1 1 $5,565.34 $5,454.04 $5,565.34 $5,565.34 $5,565.34 2026-07-01
89342034 LOCAL Hc Skin Tissue, Cost $4001-$4500 1 1 $5,508.20 $5,398.04 $5,508.20 $5,508.20 $5,508.20 2026-07-01
69945-050-40 NDC Indium In-111 Pentetreotide 1 1 $5,500.00 $5,390.00 $5,500.00 $5,500.00 $5,500.00 2026-07-01
55513-222-01 NDC Romiplostim 500 Mcg Subcutaneous Solution 1 1 $5,489.07 $5,379.29 $5,489.07 $5,489.07 $5,489.07 2026-07-01
76075-101-01 NDC Carfilzomib 60 Mg Intravenous Solution 1 1 $5,462.02 $5,352.78 $5,462.02 $5,462.02 $5,462.02 2026-07-01
72039014 LOCAL Hc Vaginal Birth After Prev Csect 1 1 $5,458.35 $5,349.18 $5,458.35 $5,458.35 $5,458.35 2026-07-01
72039013 LOCAL Hc Vaginal Birth W/Epi W/Forceps 1 1 $5,458.35 $5,349.18 $5,458.35 $5,458.35 $5,458.35 2026-07-01
63323-926-88 NDC Romidepsin 10 Mg/2 Ml Intravenous Powder For Solution 1 1 $5,455.18 $5,346.08 $5,455.18 $5,455.18 $5,455.18 2026-07-01
27021838 LOCAL Cath Balloon 8mm X 40mm 80cm # 43606 1 1 $5,421.60 $5,313.17 $5,421.60 $5,421.60 $5,421.60 2026-07-01
27021836 LOCAL Cath Balloon 8mm X 40mm 80cm # 43604 1 1 $5,421.60 $5,313.17 $5,421.60 $5,421.60 $5,421.60 2026-07-01
27021839 LOCAL Cath Balloon 8mm X 40mm 80cm # 43607 1 1 $5,421.60 $5,313.17 $5,421.60 $5,421.60 $5,421.60 2026-07-01
27021837 LOCAL Cath Balloon 8mm X 40mm 80cm #43605 1 1 $5,421.60 $5,313.17 $5,421.60 $5,421.60 $5,421.60 2026-07-01
55292-811-55 NDC Dactinomycin 0.5 Mg Intravenous Solution 1 1 $5,417.08 $5,308.74 $5,417.08 $5,417.08 $5,417.08 2026-07-01
0003-4522-11 NDC Elotuzumab 400 Mg Intravenous Solution 1 1 $5,415.08 $5,306.78 $5,415.08 $5,415.08 $5,415.08 2026-07-01
27033521 LOCAL Hc Syringe Bd Insul 1 Ml Luer Look 1 1 $5,380.84 $5,273.22 $5,380.84 $5,380.84 $5,380.84 2026-07-01
50242-044-13 NDC Alteplase 25 Mg IV Syringe (over 8 Hours) 1 1 $5,358.03 $5,250.87 $5,358.03 $5,358.03 $5,358.03 2026-07-01
50242-044-06 NDC Alteplase 25 Mg IV Syringe (over 8 Hours) 1 1 $5,358.03 $5,250.87 $5,358.03 $5,358.03 $5,358.03 2026-07-01
0078-0818-81 NDC Octreotide,microspheres ER 20 Mg Intramuscular Susp, Extended Release 1 1 $5,328.06 $5,221.49 $5,328.06 $5,328.06 $5,328.06 2026-07-01
44206-439-40 NDC Immune Glob,gamm(igg) 10 %-pro-iga 0 To 50 Mcg/ml Intravenous Solution 1 1 $5,290.53 $5,184.72 $5,290.53 $5,290.53 $5,290.53 2026-07-01
44206-439-93 NDC Immune Glob,gamm(igg) 10 %-pro-iga 0 To 50 Mcg/ml Intravenous Solution 1 1 $5,290.53 $5,184.72 $5,290.53 $5,290.53 $5,290.53 2026-07-01
72039029 LOCAL Hc C-sect Nonemergent With Major Surgery 1 1 $5,287.78 $5,182.02 $5,287.78 $5,287.78 $5,287.78 2026-07-01
15054-0043-1 NDC Irinotecan Liposomal 4.3 Mg/ml Intravenous 1 1 $5,166.00 $5,062.68 $5,166.00 $5,166.00 $5,166.00 2026-07-01
72039012 LOCAL Hc Vaginal Birth W/Epidural 1 1 $5,117.21 $5,014.87 $5,117.21 $5,117.21 $5,117.21 2026-07-01
72039022 LOCAL Hc Fetal Demise 3rd Trimester 1 1 $5,117.21 $5,014.87 $5,117.21 $5,117.21 $5,117.21 2026-07-01
59841 CPT Induced Abortion Dilation & Evacuation 1 1 $5,117.21 $5,014.87 $5,117.21 $5,117.21 $5,117.21 2026-07-01
55513-207-01 NDC Bevacizumab-awwb 25 Mg/ml Intravenous Solution 1 1 $4,927.04 $4,828.50 $4,927.04 $4,927.04 $4,927.04 2026-07-01
55513-326-01 NDC Rituximab-arrx 10 Mg/ml Intravenous Solution 1 1 $4,867.10 $4,769.76 $4,867.10 $4,867.10 $4,867.10 2026-07-01
89342032 LOCAL Hc Skin Tissue, Cost $3501-$3750 1 1 $4,865.90 $4,768.58 $4,865.90 $4,865.90 $4,865.90 2026-07-01
65597-406-01 NDC Fam-trastuzumab Deruxtecan-nxki 100 Mg Intravenous Solution 1 1 $4,849.00 $4,752.02 $4,849.00 $4,849.00 $4,849.00 2026-07-01
89342033 LOCAL Hc Skin Tissue, Cost $3751-$4000 1 1 $4,768.58 $4,673.21 $4,768.58 $4,768.58 $4,768.58 2026-07-01
89142033 LOCAL Hc Bone Tissue, Cost $3751-4000 1 1 $4,768.58 $4,673.21 $4,768.58 $4,768.58 $4,768.58 2026-07-01
89242012 LOCAL Hc Organ Tissue, Cost $3751-4000 1 1 $4,768.58 $4,673.21 $4,768.58 $4,768.58 $4,768.58 2026-07-01
67457-847-44 NDC Trastuzumab-dkst 420 Mg Intravenous Solution 1 1 $4,685.10 $4,591.40 $4,685.10 $4,685.10 $4,685.10 2026-07-01
68700 CPT Hc Plastic Rep Or Canaliculi 1 1 $4,684.77 $4,591.07 $4,684.77 $4,684.77 $4,684.77 2026-07-01
0480-9259-08 NDC Octreotide,microspheres ER 20 Mg Intramuscular Susp, Extended Release 1 1 $4,649.93 $4,556.93 $4,649.93 $4,649.93 $4,649.93 2026-07-01
57894-502-20 NDC Daratumumab 20 Mg/ml Intravenous Solution 1 1 $4,635.52 $4,542.81 $4,635.52 $4,635.52 $4,635.52 2026-07-01
67457-759-20 NDC Octreotide,microspheres ER 20 Mg Intramuscular Susp, Extended Release 1 1 $4,563.42 $4,472.16 $4,563.42 $4,563.42 $4,563.42 2026-07-01
89242011 LOCAL Hc Organ Tissue, Cost $3501-3750 1 1 $4,535.02 $4,444.32 $4,535.02 $4,535.02 $4,535.02 2026-07-01
89142032 LOCAL Hc Bone Tissue, Cost $3501-3750 1 1 $4,535.02 $4,444.32 $4,535.02 $4,535.02 $4,535.02 2026-07-01
51715 CPT Endoscopic Injection/Implant 1 1 $4,528.61 $4,438.04 $4,528.61 $4,528.61 $4,528.61 2026-07-01
78816 CPT Hc Pet/CT Tumor Imag Full Body 1 1 $4,524.89 $4,434.39 $4,524.89 $4,524.89 $4,524.89 2026-07-01
59572-711-01 NDC Luspatercept-aamt 25 Mg Subcutaneous Solution 1 1 $4,517.20 $4,426.86 $4,517.20 $4,517.20 $4,517.20 2026-07-01
0069-0306-01 NDC Trastuzumab-qyyp 420 Mg/20 Ml Reconstituted IV Soln 1 1 $4,475.02 $4,385.52 $4,475.02 $4,475.02 $4,475.02 2026-07-01
0069-0305-01 NDC Trastuzumab-qyyp 420 Mg/20 Ml Reconstituted IV Soln 1 1 $4,475.02 $4,385.52 $4,475.02 $4,475.02 $4,475.02 2026-07-01
72039011 LOCAL Hc Vaginal Birth W/Vacuum Forcep 1 1 $4,434.91 $4,346.21 $4,434.91 $4,434.91 $4,434.91 2026-07-01
74527-022-02 NDC Margetuximab-cmkb 25 Mg/ml Intravenous Solution 1 1 $4,406.40 $4,318.27 $4,406.40 $4,406.40 $4,406.40 2026-07-01
74527-022-01 NDC Margetuximab-cmkb 25 Mg/ml Intravenous Solution 1 1 $4,406.40 $4,318.27 $4,406.40 $4,406.40 $4,406.40 2026-07-01
55135-132-01 NDC Sacituzumab Govitecan-hziy 180 Mg Intravenous Solution 1 1 $4,376.90 $4,289.36 $4,376.90 $4,376.90 $4,376.90 2026-07-01
89242010 LOCAL Hc Organ Tissue, Cost $3251-3500 1 1 $4,301.46 $4,215.43 $4,301.46 $4,301.46 $4,301.46 2026-07-01
89142031 LOCAL Hc Bone Tissue, Cost $3251-3500 1 1 $4,301.46 $4,215.43 $4,301.46 $4,301.46 $4,301.46 2026-07-01
81459 CPT Neo Pantracer Tissue 1 1 $4,299.48 $4,213.49 $4,299.48 $4,299.48 $4,299.48 2026-07-01
77301 CPT Hc Imrt Planning 1 1 $4,252.67 $4,167.62 $4,252.67 $4,252.67 $4,252.67 2026-07-01
89342031 LOCAL Hc Skin Tissue, Cost $3251-$3500 1 1 $4,243.06 $4,158.20 $4,243.06 $4,243.06 $4,243.06 2026-07-01
67105 CPT Hc Argon Retino Pexy (Ret Det) 1 1 $4,216.29 $4,131.96 $4,216.29 $4,216.29 $4,216.29 2026-07-01
55513-730-01 NDC Denosumab 120 Mg/1.7 Ml (70 Mg/ml) Subcutaneous Solution 1 1 $4,200.29 $4,116.28 $4,200.29 $4,200.29 $4,200.29 2026-07-01
78492 CPT Hc PET Scan Myocardial R/s Mult 1 1 $4,113.53 $4,031.26 $4,113.53 $4,113.53 $4,113.53 2026-07-01
27035616 LOCAL Hc Provox Activale 1 1 $4,100.40 $4,018.39 $4,100.40 $4,100.40 $4,100.40 2026-07-01
72039010 LOCAL Hc Vaginal Birth (No Anes Unco 1 1 $4,093.77 $4,011.89 $4,093.77 $4,093.77 $4,093.77 2026-07-01
78206-148-01 NDC Trastuzumab-dttb 420 Mg/20 Ml Reconstituted IV Soln 1 1 $4,068.56 $3,987.19 $4,068.56 $4,068.56 $4,068.56 2026-07-01
89142030 LOCAL Hc Bone Tissue, Cost $3001-3250 1 1 $4,067.89 $3,986.53 $4,067.89 $4,067.89 $4,067.89 2026-07-01
89242009 LOCAL Hc Organ Tissue, Cost $3001-3250 1 1 $4,067.89 $3,986.53 $4,067.89 $4,067.89 $4,067.89 2026-07-01
89342030 LOCAL Hc Skin Tissue, Cost $3001-$3250 1 1 $4,067.89 $3,986.53 $4,067.89 $4,067.89 $4,067.89 2026-07-01
0078-0811-81 NDC Octreotide,microspheres ER 10 Mg Intramuscular Susp, Extended Release 1 1 $4,066.68 $3,985.35 $4,066.68 $4,066.68 $4,066.68 2026-07-01
0003-2291-11 NDC Elotuzumab 300 Mg Intravenous Solution 1 1 $4,061.34 $3,980.11 $4,061.34 $4,061.34 $4,061.34 2026-07-01
63459-348-04 NDC Bendamustine 25 Mg/ml Intravenous Solution (equivalent To Bendeka) 1 1 $4,043.44 $3,962.57 $4,043.44 $4,043.44 $4,043.44 2026-07-01
0078-1000-60 NDC Inclisiran 284 Mg/1.5 Ml Subcutaneous Syringe 1 1 $4,035.00 $3,954.30 $4,035.00 $4,035.00 $4,035.00 2026-07-01
27000871 LOCAL Hc Provox Activalve 1 1 $4,004.64 $3,924.55 $4,004.64 $4,004.64 $4,004.64 2026-07-01
0173-0881-01 NDC Mepolizumab 100 Mg/ml Reconstituted Subcut Soln 1 1 $3,994.95 $3,915.05 $3,994.95 $3,994.95 $3,994.95 2026-07-01
27021823 LOCAL Ankle Restraints 2 1 $3,988.55 $3,908.78 $32.62 $7,944.48 $3,988.55 2026-07-01
78815 CPT Hc PET Scan Tumor Img Metabol 1 1 $3,976.42 $3,896.89 $3,976.42 $3,976.42 $3,976.42 2026-07-01
0069-0342-01 NDC Bevacizumab-bvzr 25 Mg/ml Intravenous Solution 1 1 $3,955.55 $3,876.44 $3,955.55 $3,955.55 $3,955.55 2026-07-01
68152-108-09 NDC Belinostat 500 Mg Intravenous Solution 1 1 $3,942.84 $3,863.98 $3,942.84 $3,942.84 $3,942.84 2026-07-01
70720-951-30 NDC Goserelin 10.8 Mg Subcutaneous Implant 1 1 $3,881.91 $3,804.27 $3,881.91 $3,881.91 $3,881.91 2026-07-01
60574-4113-1 NDC Palivizumab 100 Mg/ml Intramuscular Solution 1 1 $3,859.75 $3,782.56 $3,859.75 $3,859.75 $3,859.75 2026-07-01
66658-231-01 NDC Palivizumab 100 Mg/ml Intramuscular Solution 1 1 $3,859.75 $3,782.56 $3,859.75 $3,859.75 $3,859.75 2026-07-01
89142029 LOCAL Hc Bone Tissue, Cost $2901-3000 1 1 $3,853.79 $3,776.71 $3,853.79 $3,853.79 $3,853.79 2026-07-01
89242008 LOCAL Hc Organ Tissue, Cost $2901-3000 1 1 $3,834.33 $3,757.64 $3,834.33 $3,834.33 $3,834.33 2026-07-01
89342029 LOCAL Hc Skin Tissue, Cost $2901-$3000 1 1 $3,834.33 $3,757.64 $3,834.33 $3,834.33 $3,834.33 2026-07-01
70114-120-01 NDC Pegfilgrastim-cbqv 6 Mg/0.6 Ml Subcutaneous Auto-injector 1 1 $3,796.56 $3,720.63 $3,796.56 $3,796.56 $3,796.56 2026-07-01
70114-101-01 NDC Pegfilgrastim-cbqv 6 Mg/0.6 Ml Subcutaneous Syringe 1 1 $3,796.56 $3,720.63 $3,796.56 $3,796.56 $3,796.56 2026-07-01
77373 CPT Hc Stereotactic Body Rt W/Igrt 1 1 $3,772.37 $3,696.92 $3,772.37 $3,772.37 $3,772.37 2026-07-01
72606-038-01 NDC Denosumab-bmwo 120 Mg/1.7 Ml (70 Mg/ml) Subcutaneous Solution 1 1 $3,764.38 $3,689.10 $3,764.38 $3,764.38 $3,764.38 2026-07-01
11900 CPT Injection Into Skin Lesions, Up To 7 1 1 $3,747.81 $3,672.85 $3,747.81 $3,747.81 $3,747.81 2026-07-01
57894-449-01 NDC Teclistamab-cqyv 10 Mg/ml Subcutaneous Solution 1 1 $3,710.88 $3,636.66 $3,710.88 $3,710.88 $3,710.88 2026-07-01
89142028 LOCAL Hc Bone Tissue, Cost $2801-2900 1 1 $3,698.08 $3,624.12 $3,698.08 $3,698.08 $3,698.08 2026-07-01
89242007 LOCAL Hc Organ Tissue, Cost $2801-2900 1 1 $3,698.08 $3,624.12 $3,698.08 $3,698.08 $3,698.08 2026-07-01
89342028 LOCAL Hc Skin Tissue, Cost $2801-$2900 1 1 $3,698.08 $3,624.12 $3,698.08 $3,698.08 $3,698.08 2026-07-01
12302000 LOCAL Hc Pediatrics 1 1 $3,680.09 $3,606.49 $3,680.09 $3,680.09 $3,680.09 2026-07-01
12302002 LOCAL Peds Room & Board - NICU 1 1 $3,680.09 $3,606.49 $3,680.09 $3,680.09 $3,680.09 2026-07-01
61314-228-94 NDC Denosumab-bbdz 120 Mg/1.7 Ml (70 Mg/ml) Subcutaneous Solution 1 1 $3,665.51 $3,592.20 $3,665.51 $3,665.51 $3,665.51 2026-07-01
89242006 LOCAL Hc Organ Tissue, Cost $2701-2800 1 1 $3,571.57 $3,500.14 $3,571.57 $3,571.57 $3,571.57 2026-07-01
89142027 LOCAL Hc Bone Tissue, Cost $2701-2800 1 1 $3,571.57 $3,500.14 $3,571.57 $3,571.57 $3,571.57 2026-07-01
89342027 LOCAL Hc Skin Tissue, Cost $2701-$2800 1 1 $3,571.57 $3,500.14 $3,571.57 $3,571.57 $3,571.57 2026-07-01
50590 CPT Hc Lithotripsy (Eswl) 1 1 $3,562.92 $3,491.66 $3,562.92 $3,562.92 $3,562.92 2026-07-01
13533-800-24 NDC Gamunex-c 1 Gm/10 Ml Ij Soln - Pediatric (wrapped) 1 1 $3,528.28 $3,457.71 $3,528.28 $3,528.28 $3,528.28 2026-07-01
13533-800-25 NDC Gamunex-c 1 Gm/10 Ml Ij Soln - Pediatric (wrapped) 1 1 $3,528.28 $3,457.71 $3,528.28 $3,528.28 $3,528.28 2026-07-01
55513-954-01 NDC Panitumumab 100 Mg/5 Ml (20 Mg/ml) Intravenous Solution 1 1 $3,514.26 $3,443.97 $3,514.26 $3,514.26 $3,514.26 2026-07-01
81455 CPT Hc Targeted Genomic Seq Analys >50 Genes 3 1 $3,486.07 $3,416.35 $2,788.85 $4,415.68 $3,486.07 2026-07-01
81162 CPT Hc Brca 1/2 Mutation & Del/Dup Analysis 1 1 $3,486.07 $3,416.35 $3,486.07 $3,486.07 $3,486.07 2026-07-01
67457-756-10 NDC Octreotide,microspheres ER 10 Mg Intramuscular Susp, Extended Release 1 1 $3,483.09 $3,413.42 $3,483.09 $3,483.09 $3,483.09 2026-07-01
44087-3535-1 NDC Avelumab 20 Mg/ml Intravenous Solution 1 1 $3,456.24 $3,387.12 $3,456.24 $3,456.24 $3,456.24 2026-07-01
89342026 LOCAL Hc Skin Tissue, Cost $2601-$2700 1 1 $3,445.06 $3,376.16 $3,445.06 $3,445.06 $3,445.06 2026-07-01
89142026 LOCAL Hc Bone Tissue, Cost $2601-2700 1 1 $3,445.06 $3,376.16 $3,445.06 $3,445.06 $3,445.06 2026-07-01
89242005 LOCAL Hc Organ Tissue, Cost $2601-2700 1 1 $3,445.06 $3,376.16 $3,445.06 $3,445.06 $3,445.06 2026-07-01
76075-102-21 NDC Carfilzomib 30 Mg Intravenous Solution 1 1 $3,414.26 $3,345.97 $3,414.26 $3,414.26 $3,414.26 2026-07-01
72039017 LOCAL Hc C-section Nonemergent W / Minor Surgery 1 1 $3,411.47 $3,343.24 $3,411.47 $3,411.47 $3,411.47 2026-07-01
58925 CPT Hc Ovarian Cysectomy 1 1 $3,411.47 $3,343.24 $3,411.47 $3,411.47 $3,411.47 2026-07-01
0008-1179-01 NDC Temsirolimus 30 Mg/3 Ml (10 Mg/ml) (first Dilution) Intravenous Soln 1 1 $3,341.70 $3,274.87 $3,341.70 $3,341.70 $3,341.70 2026-07-01
89342025 LOCAL Hc Skin Tissue, Cost $2501-$2600 1 1 $3,308.81 $3,242.63 $3,308.81 $3,308.81 $3,308.81 2026-07-01
89242004 LOCAL Hc Organ Tissue, Cost $2501-2600 1 1 $3,308.81 $3,242.63 $3,308.81 $3,308.81 $3,308.81 2026-07-01
89142025 LOCAL Hc Bone Tissue, Cost $2501-2600 1 1 $3,308.81 $3,242.63 $3,308.81 $3,308.81 $3,308.81 2026-07-01
82959-112-01 NDC Imetelstat 47 Mg/1.5 Ml Reconstituted IV Soln 1 1 $3,307.02 $3,240.88 $3,307.02 $3,307.02 $3,307.02 2026-07-01
78814 CPT Hc Pet/CT Brain Amyloid 1 1 $3,290.83 $3,225.01 $3,290.83 $3,290.83 $3,290.83 2026-07-01
78608 CPT Hc PET Scan Brain Metabolic 1 1 $3,290.83 $3,225.01 $3,290.83 $3,290.83 $3,290.83 2026-07-01
78609 CPT Hc PET Scan Brain Perfusion 1 1 $3,290.83 $3,225.01 $3,290.83 $3,290.83 $3,290.83 2026-07-01
52204 CPT Hc Cystoscopy W/Biopsy 1 1 $3,279.34 $3,213.75 $3,279.34 $3,279.34 $3,279.34 2026-07-01
59514 CPT Cesarean Delivery Only 1 1 $3,240.90 $3,176.08 $3,240.90 $3,240.90 $3,240.90 2026-07-01
59100 CPT Hc Hysterotomy - Scheduled 1 1 $3,240.90 $3,176.08 $3,240.90 $3,240.90 $3,240.90 2026-07-01
50242-137-01 NDC Tocilizumab 400 Mg/20 Ml (20 Mg/ml) Intravenous Solution 1 1 $3,233.97 $3,169.29 $3,233.97 $3,233.97 $3,233.97 2026-07-01
63020-049-01 NDC Bortezomib 3.5 Mg/1.4 Ml Reconstituted Subcut Soln 1 1 $3,206.00 $3,141.88 $3,206.00 $3,206.00 $3,206.00 2026-07-01
0480-3290-01 NDC Paclitaxel Protein-bound 100 Mg/20 Ml Reconstituted IV Susp 1 1 $3,200.00 $3,136.00 $3,200.00 $3,200.00 $3,200.00 2026-07-01
89342024 LOCAL Hc Skin Tissue, Cost $2401-$2500 1 1 $3,182.30 $3,118.65 $3,182.30 $3,182.30 $3,182.30 2026-07-01
89142024 LOCAL Hc Bone Tissue, Cost $2401-2500 1 1 $3,182.30 $3,118.65 $3,182.30 $3,182.30 $3,182.30 2026-07-01
89242003 LOCAL Hc Organ Tissue, Cost $2401-2500 1 1 $3,182.30 $3,118.65 $3,182.30 $3,182.30 $3,182.30 2026-07-01
20006000 LOCAL Hc Intensive Care 1 1 $3,167.81 $3,104.45 $3,167.81 $3,167.81 $3,167.81 2026-07-01
20606000 LOCAL Hc Intermediate Care 1 1 $3,167.81 $3,104.45 $3,167.81 $3,167.81 $3,167.81 2026-07-01
20106000 LOCAL Hc Intensive Care Unit 59 1 1 $3,167.81 $3,104.45 $3,167.81 $3,167.81 $3,167.81 2026-07-01
0469-3425-10 NDC Zolbetuximab-clzb 100 Mg/5 Ml Reconstituted IV Soln 1 1 $3,136.00 $3,073.28 $3,136.00 $3,136.00 $3,136.00 2026-07-01
42299 CPT Hc Palate/Uvula Augmentation/Inj 1 1 $3,123.18 $3,060.72 $3,123.18 $3,123.18 $3,123.18 2026-07-01
50242-132-01 NDC Trastuzumab 150 Mg Intravenous Solution 1 1 $3,116.84 $3,054.50 $3,116.84 $3,116.84 $3,116.84 2026-07-01
50242-132-10 NDC Trastuzumab 150 Mg Intravenous Solution 1 1 $3,116.84 $3,054.50 $3,116.84 $3,116.84 $3,116.84 2026-07-01
66733-958-23 NDC Cetuximab 200 Mg/100 Ml Intravenous Solution 1 1 $3,107.40 $3,045.25 $3,107.40 $3,107.40 $3,107.40 2026-07-01
72039016 LOCAL Hc C-section Nonemergent 1 1 $3,070.32 $3,008.91 $3,070.32 $3,070.32 $3,070.32 2026-07-01
67228 CPT Hc Argon Retino Vasc 1 1 $3,060.71 $2,999.50 $3,060.71 $3,060.71 $3,060.71 2026-07-01
89142023 LOCAL Hc Bone Tissue, Cost $2301-2400 1 1 $3,055.79 $2,994.67 $3,055.79 $3,055.79 $3,055.79 2026-07-01
89242002 LOCAL Hc Organ Tissue, Cost $2301-2400 1 1 $3,055.79 $2,994.67 $3,055.79 $3,055.79 $3,055.79 2026-07-01
89342023 LOCAL Hc Skin Tissue, Cost $2301-$2400 1 1 $3,055.79 $2,994.67 $3,055.79 $3,055.79 $3,055.79 2026-07-01
76125-150-10 NDC Rabies Immune Globulin (pf) 150 Unit/ml Intramuscular Solution 1 1 $3,012.83 $2,952.58 $3,012.83 $3,012.83 $3,012.83 2026-07-01
76125-150-11 NDC Rabies Immune Globulin (pf) 150 Unit/ml Intramuscular Solution 1 1 $3,012.83 $2,952.58 $3,012.83 $3,012.83 $3,012.83 2026-07-01
13533-318-50 NDC Rabies Immune Globulin (pf) 300 Unit/ml Intramuscular Solution 1 1 $3,003.49 $2,943.42 $3,003.49 $3,003.49 $3,003.49 2026-07-01
17156-021-01 NDC Indium In-111 Labeled Autologous Wbcs 1 1 $2,976.25 $2,916.73 $2,976.25 $2,976.25 $2,976.25 2026-07-01
77372 CPT Hc Cranial Srs 1 Session 1 1 $2,971.87 $2,912.43 $2,971.87 $2,971.87 $2,971.87 2026-07-01
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