Hospital

FAIRVIEW HOSPITAL

Great Barrington, MA · CCN 221302 · Rates published

7,069 distinct procedures filed

29 distinct payers

525,722 rate rows

2026-05-09 last MRF observed

Data quality

509,786 of 525,722 rate rows are consumer-grade (97.0%)

15,936 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	11,061
placeholder amount (≤ $0.02) — excluded from medians	1,973
template filing: same amount across many unrelated codes — excluded	1,210
exceeds 10× this hospital's gross charge — excluded from medians	895
per-diem day rate — not a per-procedure price	797

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

Source MRF file	https://bhs-publicdownload.s3.us-east-1.amazonaws.com/Public/042133860_Fairview-Hospital_StandardCharges.csv
Found on page	https://www.berkshirehealthsystems.org/patient-journey/billing-and-finances/
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-08-05
Content fingerprint	988276103c4823ce… · 73,045,350 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
681 OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	1	$1,548,662.86	$1,548,662.86	$1,548,662.86	nat. median $1
002-4 OTHER	Heart And/or Lung Transplant	8	$220,000.00	$862,873.84	$673,157.46	nat. median $178,618 outlier · 3.8×
633 OTHER	Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar…	1	$657,409.26	$657,409.26	$657,409.26	nat. median $6,203 outlier · 106.0×
583-4 OTHER	Neonate With Ecmo	8	$221,000.00	$1,140,085.75	$645,786.83	nat. median $265,200 outlier · 2.4×
636 OTHER	Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, With Mu…	1	$603,686.99	$603,686.99	$603,686.99	nat. median $83 outlier · 7239.8×
634 OTHER	Neonate, Birth Weight 1000-1499 Grams, Without Significant O.r. Procedures, Disc…	1	$545,869.47	$545,869.47	$545,869.47	nat. median $187 outlier · 2926.0×
583-3 OTHER	Neonate With Ecmo	8	$221,000.00	$902,969.61	$527,119.66	nat. median $243,684 outlier · 2.2×
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	$221,000.00	$935,179.96	$518,765.65	nat. median $240,448 outlier · 2.2×
161-4 OTHER	Implantable Heart Assist Systems	8	$378,107.24	$894,142.70	$458,644.10	nat. median $162,664 outlier · 2.8×
613 OTHER	Neonate, Birth Weight <750 Grams, Died	1	$431,029.59	$431,029.59	$431,029.59	nat. median $40,673 outlier · 10.6×
583-2 OTHER	Neonate With Ecmo	8	$219,000.00	$665,853.49	$390,105.83	nat. median $180,907 outlier · 2.2×
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	$165,000.00	$585,216.17	$358,424.90	nat. median $168,174 outlier · 2.1×
161-3 OTHER	Implantable Heart Assist Systems	8	$153,530.20	$685,006.00	$351,367.01	nat. median $123,032 outlier · 2.9×
007-4 OTHER	Allogeneic Bone Marrow Transplant	6	$200,000.00	$565,687.06	$350,482.56	nat. median $133,615 outlier · 2.6×
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	$132,000.00	$602,478.03	$334,208.72	nat. median $151,800 outlier · 2.2×
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	8	$130,000.00	$589,942.81	$327,255.35	nat. median $133,956 outlier · 2.4×
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	8	$215,493.03	$678,788.35	$325,610.28	nat. median $195,063 1.7× median
583-1 OTHER	Neonate With Ecmo	8	$219,000.00	$575,417.03	$312,478.64	nat. median $161,998 1.9× median
632 OTHER	Neonate, Birth Weight 750-999 Grams, Died	1	$310,651.34	$310,651.34	$310,651.34	nat. median $4,380 outlier · 70.9×
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	8	$120,000.00	$551,603.20	$305,960.81	nat. median $120,000 outlier · 2.5×
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	8	$190,000.00	$630,553.52	$304,721.55	nat. median $113,251 outlier · 2.7×
002-3 OTHER	Heart And/or Lung Transplant	8	$140,000.00	$533,588.15	$304,404.44	nat. median $125,034 outlier · 2.4×
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	$110,000.00	$560,314.82	$297,935.10	nat. median $100,636 outlier · 3.0×
603-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	8	$80,000.00	$490,268.27	$292,786.01	nat. median $96,000 outlier · 3.0×
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	8	$201,314.73	$420,304.81	$283,906.15	nat. median $76,237 outlier · 3.7×
161-2 OTHER	Implantable Heart Assist Systems	8	$96,762.39	$550,000.75	$282,117.96	nat. median $98,784 outlier · 2.9×
006-4 OTHER	Pancreas Transplant	8	$85,000.00	$487,128.70	$279,324.71	nat. median $85,000 outlier · 3.3×
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	8	$120,000.00	$588,974.43	$277,416.11	nat. median $134,440 outlier · 2.1×
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	$139,000.00	$548,563.55	$275,042.38	nat. median $98,526 outlier · 2.8×
161-1 OTHER	Implantable Heart Assist Systems	8	$72,192.37	$522,497.83	$268,011.82	nat. median $93,844 outlier · 2.9×
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	$50,021.00	$588,217.40	$259,948.87	nat. median $67,330 outlier · 3.9×
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	8	$204,352.48	$561,832.73	$245,986.57	nat. median $191,184 1.3× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	$121,000.00	$609,913.85	$244,227.12	nat. median $131,648 1.9× median
360 OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	1	$236,885.23	$236,885.23	$236,885.23	nat. median $3,274 outlier · 72.4×
J022500000 OTHER	Vutrisiran 25mg/0.5ml Syringe	29	$4,929.41	$345,211.79	$227,748.93	nat. median $227,749 1.0× median
008-4 OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	6	$120,000.00	$286,157.95	$224,890.97	nat. median $64,857 outlier · 3.5×
002-2 OTHER	Heart And/or Lung Transplant	8	$138,000.00	$395,981.33	$216,593.24	nat. median $94,014 outlier · 2.3×
588-1 OTHER	Female Reproductive System Reconstructive Procedures	8	$50,000.00	$388,322.62	$215,412.90	nat. median $102,622 outlier · 2.1×
607-4 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	8	$100,000.00	$335,799.23	$212,983.08	nat. median $98,925 outlier · 2.2×
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	8	$100,000.00	$437,187.67	$203,656.11	nat. median $109,000 1.9× median
004-3 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	8	$91,000.00	$383,438.43	$198,167.78	nat. median $69,525 outlier · 2.9×
608 OTHER	Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period	1	$197,741.62	$197,741.62	$197,741.62	nat. median $10,556 outlier · 18.7×
609-3 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	8	$126,498.40	$291,557.08	$192,851.44	nat. median $79,677 outlier · 2.4×
635 OTHER	Neonate, Birth Weight 1000-1499 Grams, Died	1	$192,469.53	$192,469.53	$192,469.53	nat. median $242 outlier · 795.7×
005-4 OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	8	$88,000.00	$369,258.50	$192,259.67	nat. median $74,505 outlier · 2.6×
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	8	$99,000.00	$392,215.38	$190,243.38	nat. median $104,317 1.8× median
006-3 OTHER	Pancreas Transplant	8	$85,000.00	$342,524.13	$185,804.80	nat. median $76,342 outlier · 2.4×
002-1 OTHER	Heart And/or Lung Transplant	8	$50,000.00	$339,461.42	$185,679.37	nat. median $50,000 outlier · 3.7×
001-3 OTHER	Liver Transplant And/or Intestinal Transplant	8	$92,000.00	$318,898.60	$184,737.03	nat. median $73,704 outlier · 2.5×
163-4 OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	8	$108,619.85	$303,435.17	$182,352.10	nat. median $54,499 outlier · 3.3×

Other procedures at this hospital

Browse this hospital's 7,069 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

681	OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	1	1	—	—	$1,548,662.86	$1,548,662.86	$1,548,662.86	2026-05-09
002-4	OTHER	Heart And/or Lung Transplant	13	8	—	—	$220,000.00	$862,873.84	$673,157.46	2026-05-09
633	OTHER	Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar…	1	1	—	—	$657,409.26	$657,409.26	$657,409.26	2026-05-09
583-4	OTHER	Neonate With Ecmo	13	8	—	—	$221,000.00	$1,140,085.75	$645,786.83	2026-05-09
636	OTHER	Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, With Mu…	1	1	—	—	$603,686.99	$603,686.99	$603,686.99	2026-05-09
634	OTHER	Neonate, Birth Weight 1000-1499 Grams, Without Significant O.r. Procedures, Disc…	1	1	—	—	$545,869.47	$545,869.47	$545,869.47	2026-05-09
583-3	OTHER	Neonate With Ecmo	13	8	—	—	$221,000.00	$902,969.61	$527,119.66	2026-05-09
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	13	8	—	—	$221,000.00	$935,179.96	$518,765.65	2026-05-09
161-4	OTHER	Implantable Heart Assist Systems	13	8	—	—	$378,107.24	$894,142.70	$458,644.10	2026-05-09
613	OTHER	Neonate, Birth Weight <750 Grams, Died	1	1	—	—	$431,029.59	$431,029.59	$431,029.59	2026-05-09
583-2	OTHER	Neonate With Ecmo	13	8	—	—	$219,000.00	$665,853.49	$390,105.83	2026-05-09
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	13	8	—	—	$165,000.00	$585,216.17	$358,424.90	2026-05-09
161-3	OTHER	Implantable Heart Assist Systems	13	8	—	—	$153,530.20	$685,006.00	$351,367.01	2026-05-09
007-4	OTHER	Allogeneic Bone Marrow Transplant	10	6	—	—	$200,000.00	$565,687.06	$350,482.56	2026-05-09
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	13	8	—	—	$132,000.00	$602,478.03	$334,208.72	2026-05-09
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	13	8	—	—	$130,000.00	$589,942.81	$327,255.35	2026-05-09
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	13	8	—	—	$215,493.03	$678,788.35	$325,610.28	2026-05-09
583-1	OTHER	Neonate With Ecmo	13	8	—	—	$219,000.00	$575,417.03	$312,478.64	2026-05-09
632	OTHER	Neonate, Birth Weight 750-999 Grams, Died	1	1	—	—	$310,651.34	$310,651.34	$310,651.34	2026-05-09
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	13	8	—	—	$120,000.00	$551,603.20	$305,960.81	2026-05-09
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	13	8	—	—	$190,000.00	$630,553.52	$304,721.55	2026-05-09
002-3	OTHER	Heart And/or Lung Transplant	13	8	—	—	$140,000.00	$533,588.15	$304,404.44	2026-05-09
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	13	8	—	—	$110,000.00	$560,314.82	$297,935.10	2026-05-09
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	13	8	—	—	$80,000.00	$490,268.27	$292,786.01	2026-05-09
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	13	8	—	—	$201,314.73	$420,304.81	$283,906.15	2026-05-09
161-2	OTHER	Implantable Heart Assist Systems	13	8	—	—	$96,762.39	$550,000.75	$282,117.96	2026-05-09
006-4	OTHER	Pancreas Transplant	13	8	—	—	$85,000.00	$487,128.70	$279,324.71	2026-05-09
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	13	8	—	—	$120,000.00	$588,974.43	$277,416.11	2026-05-09
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	6	—	—	$139,000.00	$548,563.55	$275,042.38	2026-05-09
161-1	OTHER	Implantable Heart Assist Systems	13	8	—	—	$72,192.37	$522,497.83	$268,011.82	2026-05-09
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	6	—	—	$50,021.00	$588,217.40	$259,948.87	2026-05-09
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	13	8	—	—	$204,352.48	$561,832.73	$245,986.57	2026-05-09
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	13	8	—	—	$121,000.00	$609,913.85	$244,227.12	2026-05-09
360	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	1	1	—	—	$236,885.23	$236,885.23	$236,885.23	2026-05-09
J022500000	OTHER	Vutrisiran 25mg/0.5ml Syringe	90	29	$363,380.83	$345,211.79	$4,929.41	$345,211.79	$227,748.93	2026-05-09
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	6	—	—	$120,000.00	$286,157.95	$224,890.97	2026-05-09
002-2	OTHER	Heart And/or Lung Transplant	13	8	—	—	$138,000.00	$395,981.33	$216,593.24	2026-05-09
588-1	OTHER	Female Reproductive System Reconstructive Procedures	13	8	—	—	$50,000.00	$388,322.62	$215,412.90	2026-05-09
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	13	8	—	—	$100,000.00	$335,799.23	$212,983.08	2026-05-09
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	13	8	—	—	$100,000.00	$437,187.67	$203,656.11	2026-05-09
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	13	8	—	—	$91,000.00	$383,438.43	$198,167.78	2026-05-09
608	OTHER	Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period	1	1	—	—	$197,741.62	$197,741.62	$197,741.62	2026-05-09
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	13	8	—	—	$126,498.40	$291,557.08	$192,851.44	2026-05-09
635	OTHER	Neonate, Birth Weight 1000-1499 Grams, Died	1	1	—	—	$192,469.53	$192,469.53	$192,469.53	2026-05-09
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	13	8	—	—	$88,000.00	$369,258.50	$192,259.67	2026-05-09
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	13	8	—	—	$99,000.00	$392,215.38	$190,243.38	2026-05-09
006-3	OTHER	Pancreas Transplant	13	8	—	—	$85,000.00	$342,524.13	$185,804.80	2026-05-09
002-1	OTHER	Heart And/or Lung Transplant	13	8	—	—	$50,000.00	$339,461.42	$185,679.37	2026-05-09
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	13	8	—	—	$92,000.00	$318,898.60	$184,737.03	2026-05-09
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	13	8	—	—	$108,619.85	$303,435.17	$182,352.10	2026-05-09
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	13	8	—	—	$120,000.00	$340,910.16	$178,978.02	2026-05-09
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	6	—	—	$171,094.02	$289,535.77	$177,480.43	2026-05-09
007-3	OTHER	Allogeneic Bone Marrow Transplant	10	6	—	—	$132,000.00	$333,374.43	$176,937.81	2026-05-09
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	13	8	—	—	$91,000.00	$345,048.86	$175,066.26	2026-05-09
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	13	8	—	—	$92,000.00	$344,733.74	$168,501.79	2026-05-09
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	13	8	—	—	$120,000.00	$318,664.19	$166,612.22	2026-05-09
318	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	1	1	—	—	$163,385.96	$163,385.96	$163,385.96	2026-05-09
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	13	8	—	—	$111,711.67	$283,115.08	$163,372.76	2026-05-09
178-4	OTHER	External Heart Assist Systems	10	6	—	—	$136,018.43	$301,410.02	$162,871.10	2026-05-09
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	13	8	—	—	$95,000.00	$327,975.30	$162,074.26	2026-05-09
007-2	OTHER	Allogeneic Bone Marrow Transplant	10	6	—	—	$120,000.00	$260,768.56	$160,144.56	2026-05-09
006-2	OTHER	Pancreas Transplant	13	8	—	—	$85,000.00	$297,344.33	$159,777.92	2026-05-09
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	13	8	—	—	$116,714.95	$258,124.72	$157,818.27	2026-05-09
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	13	8	—	—	$129,467.08	$272,942.55	$157,151.01	2026-05-09
440-4	OTHER	Kidney Transplant	13	8	—	—	$90,000.00	$324,094.07	$156,858.72	2026-05-09
910-4	OTHER	Craniotomy For Multiple Significant Trauma	13	8	—	—	$117,104.11	$247,099.72	$155,849.65	2026-05-09
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	13	8	—	—	$87,000.00	$267,274.42	$155,394.27	2026-05-09
863-4	OTHER	Neonatal Aftercare	13	8	—	—	$152,102.00	$250,170.13	$154,368.31	2026-05-09
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	13	8	—	—	$70,000.00	$263,616.08	$149,445.96	2026-05-09
007-1	OTHER	Allogeneic Bone Marrow Transplant	10	6	—	—	$141,963.84	$232,193.51	$148,481.90	2026-05-09
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	13	8	—	—	$79,000.00	$310,867.15	$147,254.07	2026-05-09
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	13	8	—	—	$93,000.00	$255,181.13	$147,180.48	2026-05-09
091-4	OTHER	Other Major Head And Neck Procedures	13	8	—	—	$112,209.13	$231,209.75	$146,589.99	2026-05-09
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	6	—	—	$131,186.13	$252,829.34	$145,507.11	2026-05-09
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	13	8	—	—	$81,365.99	$226,813.59	$144,980.55	2026-05-09
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	13	8	—	—	$80,000.00	$263,043.51	$144,359.58	2026-05-09
362	OTHER	Cardiac Defibrillator Implant Without Mcc	1	1	—	—	$142,841.40	$142,841.40	$142,841.40	2026-05-09
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	13	8	—	—	$87,277.31	$233,446.25	$142,729.78	2026-05-09
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	13	8	—	—	$117,646.57	$575,098.73	$141,957.09	2026-05-09
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	13	8	—	—	$62,000.00	$239,410.29	$140,218.75	2026-05-09
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	13	8	—	—	$80,000.00	$238,580.24	$139,659.14	2026-05-09
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	13	8	—	—	$67,140.38	$206,934.78	$138,153.97	2026-05-09
020-4	OTHER	Open Craniotomy For Trauma	13	8	—	—	$81,694.04	$267,190.09	$136,430.89	2026-05-09
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	13	8	—	—	$80,468.67	$250,127.85	$135,961.08	2026-05-09
023-4	OTHER	Spinal Procedures	13	8	—	—	$71,664.39	$271,764.41	$135,429.88	2026-05-09
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	13	8	—	—	$50,000.00	$237,304.43	$134,419.99	2026-05-09
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	13	8	—	—	$96,000.00	$244,548.11	$133,705.87	2026-05-09
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	13	8	—	—	$88,407.80	$215,692.52	$132,944.79	2026-05-09
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	13	8	—	—	$85,936.17	$277,484.74	$131,760.42	2026-05-09
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	13	8	—	—	$77,000.00	$271,916.53	$131,051.05	2026-05-09
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	13	8	—	—	$33,354.00	$257,379.92	$130,409.42	2026-05-09
022-4	OTHER	Ventricular Shunt Procedures	13	8	—	—	$85,170.72	$181,332.80	$130,243.76	2026-05-09
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	6	—	—	$50,000.00	$153,366.15	$129,756.54	2026-05-09
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	13	8	—	—	$70,000.00	$212,614.44	$129,506.45	2026-05-09
647	OTHER	Neonate, Birth Weight 1500-1999 Grams, Without Significant O.r. Procedures, With…	1	1	—	—	$128,000.24	$128,000.24	$128,000.24	2026-05-09
006-1	OTHER	Pancreas Transplant	13	8	—	—	$50,000.00	$233,726.78	$127,844.52	2026-05-09
179-4	OTHER	Defibrillator Implants	10	6	—	—	$113,421.59	$245,566.45	$126,960.51	2026-05-09
690-4	OTHER	Acute Leukemia	13	8	—	—	$115,000.00	$199,606.56	$126,755.85	2026-05-09
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	13	8	—	—	$111,380.14	$232,427.91	$125,981.01	2026-05-09
321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	13	8	—	—	$58,357.48	$186,853.68	$124,688.77	2026-05-09
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	13	8	—	—	$93,026.23	$301,967.31	$124,548.78	2026-05-09
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	13	8	—	—	$90,000.00	$200,194.51	$123,846.82	2026-05-09
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	13	8	—	—	$110,000.00	$356,588.78	$123,750.01	2026-05-09
440-3	OTHER	Kidney Transplant	13	8	—	—	$110,244.15	$221,155.97	$122,877.21	2026-05-09
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	13	8	—	—	$106,025.66	$181,956.58	$122,447.78	2026-05-09
740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	13	8	—	—	$76,853.02	$212,929.55	$120,630.65	2026-05-09
178-3	OTHER	External Heart Assist Systems	10	6	—	—	$100,626.04	$222,982.32	$120,491.58	2026-05-09
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	13	8	—	—	$84,664.17	$222,075.41	$120,359.52	2026-05-09
317	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	1	1	—	—	$119,341.71	$119,341.71	$119,341.71	2026-05-09
021-4	OTHER	Open Craniotomy Except Trauma	13	8	—	—	$100,791.68	$218,470.86	$118,567.76	2026-05-09
120-4	OTHER	Major Respiratory And Chest Procedures	13	8	—	—	$99,162.68	$200,624.90	$115,987.06	2026-05-09
183-4	OTHER	Percutaneous Structural Cardiac Procedures	10	6	—	—	$114,442.73	$257,206.29	$115,000.00	2026-05-09
213	OTHER	Splenic Procedures Age 0-17	1	1	—	—	$113,461.55	$113,461.55	$113,461.55	2026-05-09
510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	13	8	—	—	$107,521.16	$185,403.57	$113,356.32	2026-05-09
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	6	—	—	$110,168.05	$231,805.00	$113,088.59	2026-05-09
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	13	8	—	—	$89,000.00	$196,835.90	$113,022.79	2026-05-09
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	13	8	—	—	$70,000.00	$202,488.66	$112,763.88	2026-05-09
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	13	8	—	—	$4,296.30	$192,393.63	$112,681.87	2026-05-09
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	13	8	—	—	$80,000.00	$222,643.82	$112,259.11	2026-05-09
403-4	OTHER	Procedures For Obesity	13	8	—	—	$67,682.77	$148,836.94	$112,190.41	2026-05-09
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	13	8	—	—	$89,000.00	$244,017.80	$112,110.04	2026-05-09
440-2	OTHER	Kidney Transplant	13	8	—	—	$89,511.91	$219,207.30	$111,549.78	2026-05-09
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	13	8	—	—	$93,530.66	$182,909.60	$110,764.91	2026-05-09
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	13	8	—	—	$90,592.45	$180,496.32	$110,356.02	2026-05-09
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	13	8	—	—	$88,554.13	$208,529.54	$110,000.00	2026-05-09
711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	13	8	—	—	$77,989.00	$167,594.55	$108,151.12	2026-05-09
162	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Age 0-17	1	1	—	—	$108,023.98	$108,023.98	$108,023.98	2026-05-09
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	6	—	—	$59,643.74	$184,404.44	$108,002.34	2026-05-09
440-1	OTHER	Kidney Transplant	13	8	—	—	$79,753.56	$163,603.36	$107,806.15	2026-05-09
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	13	8	—	—	$60,000.00	$199,037.83	$107,687.15	2026-05-09
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	13	8	—	—	$96,414.12	$187,540.17	$107,462.38	2026-05-09
401-4	OTHER	Adrenal Procedures	13	8	—	—	$95,875.76	$181,645.31	$107,305.55	2026-05-09
441-4	OTHER	Major Bladder Procedures	13	8	—	—	$92,000.00	$218,432.44	$107,040.96	2026-05-09
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	13	8	—	—	$76,542.31	$215,757.85	$105,638.45	2026-05-09
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	13	8	—	—	$70,000.00	$176,038.67	$105,513.50	2026-05-09
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	13	8	—	—	$88,958.78	$203,099.66	$104,940.54	2026-05-09
027-4	OTHER	Other Open Craniotomy	10	6	—	—	$88,345.08	$208,918.03	$104,808.51	2026-05-09
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	13	8	—	—	$70,715.62	$200,683.15	$103,794.35	2026-05-09
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	13	8	—	—	$73,764.90	$196,619.54	$103,728.04	2026-05-09
024-4	OTHER	Open Extracranial Vascular Procedures	13	8	—	—	$61,771.45	$146,087.89	$103,463.12	2026-05-09
630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	13	8	—	—	$56,407.60	$208,087.62	$103,358.18	2026-05-09
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	13	8	—	—	$65,939.61	$202,004.47	$103,181.01	2026-05-09
261-4	OTHER	Major Biliary Tract Procedures	13	8	—	—	$73,269.27	$189,588.38	$102,338.06	2026-05-09
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	13	8	—	—	$91,315.22	$233,409.29	$102,330.13	2026-05-09
222-4	OTHER	Other Stomach, Esophageal And Duodenal Procedures	13	8	—	—	$75,779.49	$238,350.92	$101,052.58	2026-05-09
169-4	OTHER	Major Abdominal Vascular Procedures	13	8	—	—	$88,470.51	$234,111.06	$100,991.26	2026-05-09
121-4	OTHER	Other Respiratory And Chest Procedures	13	8	—	—	$66,028.06	$164,037.60	$100,293.11	2026-05-09
480-4	OTHER	Major Male Pelvic Procedures	13	8	—	—	$79,447.54	$406,155.20	$100,260.44	2026-05-09
650-4	OTHER	Splenectomy	13	8	—	—	$72,039.08	$218,974.69	$100,149.79	2026-05-09
089-4	OTHER	Major Cranial Or Facial Bone Procedures	13	8	—	—	$96,004.40	$205,536.00	$100,000.00	2026-05-09
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	10	6	—	—	$89,398.38	$182,021.91	$99,966.21	2026-05-09
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	13	8	—	—	$96,091.24	$261,663.94	$99,934.89	2026-05-09
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	13	8	—	—	$67,288.79	$218,840.00	$99,524.64	2026-05-09
183-3	OTHER	Percutaneous Structural Cardiac Procedures	10	6	—	—	$84,726.89	$205,038.88	$99,291.20	2026-05-09
181-4	OTHER	Lower Extremity Arterial Procedures	10	6	—	—	$74,890.22	$193,565.68	$98,116.25	2026-05-09
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	13	8	—	—	$78,067.80	$244,233.00	$98,000.00	2026-05-09
648	OTHER	Neonate, Birth Weight 1500-1999 Grams, Without Significant O.r. Procedures, With…	1	1	—	—	$97,753.80	$97,753.80	$97,753.80	2026-05-09
178-2	OTHER	External Heart Assist Systems	10	6	—	—	$93,751.47	$207,749.45	$97,750.76	2026-05-09
695-4	OTHER	Chemotherapy For Acute Leukemia	10	6	—	—	$85,000.00	$187,859.12	$97,388.96	2026-05-09
264-4	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	13	8	—	—	$79,619.60	$168,403.03	$97,000.00	2026-05-09
005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	13	8	—	—	$63,000.00	$165,282.67	$96,803.62	2026-05-09
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	13	8	—	—	$86,000.00	$261,233.54	$96,355.93	2026-05-09
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	13	8	—	—	$59,761.34	$204,940.37	$96,016.85	2026-05-09
404-4	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures	13	8	—	—	$80,000.00	$178,505.74	$95,459.26	2026-05-09
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	13	8	—	—	$83,686.46	$190,391.53	$95,000.00	2026-05-09
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	13	8	—	—	$60,685.99	$193,565.68	$94,964.59	2026-05-09
611-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	13	8	—	—	$203.40	$166,208.78	$93,896.20	2026-05-09
008-2	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	6	—	—	$92,175.59	$150,760.73	$93,668.98	2026-05-09
026-4	OTHER	Other Nervous System And Related Procedures	13	8	—	—	$68,179.38	$167,957.26	$93,104.76	2026-05-09
232-4	OTHER	Gastric Fundoplication	10	6	—	—	$89,239.18	$249,234.15	$92,983.21	2026-05-09
423-4	OTHER	Inborn Errors Of Metabolism	13	8	—	—	$22,756.85	$98,739.40	$92,930.46	2026-05-09
229-4	OTHER	Other Digestive System And Abdominal Procedures	13	8	—	—	$66,412.39	$151,932.78	$92,892.18	2026-05-09
178-1	OTHER	External Heart Assist Systems	10	6	—	—	$83,618.92	$185,295.97	$92,481.83	2026-05-09
951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	13	8	—	—	$68,380.69	$218,744.75	$92,481.02	2026-05-09
176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	13	8	—	—	$74,435.81	$190,157.11	$92,300.98	2026-05-09
405-4	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	13	8	—	—	$84,279.84	$166,577.70	$92,000.00	2026-05-09
J182300000	OTHER	Inebilizumab-cdon 100mg/10ml	90	29	$142,335.40	$135,218.63	$487.62	$142,335.40	$90,738.82	2026-05-09
305-4	OTHER	Amputation Of Lower Limb Except Toes	13	8	—	—	$62,848.86	$147,732.60	$90,324.18	2026-05-09
179-3	OTHER	Defibrillator Implants	10	6	—	—	$82,171.64	$179,055.27	$90,229.25	2026-05-09
303-1	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	13	8	—	—	$60,070.09	$156,140.65	$90,156.13	2026-05-09
910-3	OTHER	Craniotomy For Multiple Significant Trauma	13	8	—	—	$69,774.89	$147,233.04	$90,018.75	2026-05-09
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	13	8	—	—	$73,000.00	$158,012.09	$89,455.56	2026-05-09
483-4	OTHER	Penis, Testes And Scrotal Procedures	13	8	—	—	$76,957.87	$125,870.91	$89,201.70	2026-05-09
442-4	OTHER	Kidney And Urinary Tract Procedures For Malignancy	13	8	—	—	$57,305.79	$154,042.48	$89,000.00	2026-05-09
614-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	13	8	—	—	$67,000.00	$147,594.26	$88,734.24	2026-05-09
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	13	8	—	—	$81,339.54	$153,363.00	$88,663.08	2026-05-09
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	6	—	—	$50,000.00	$151,337.15	$88,636.15	2026-05-09
362-4	OTHER	Mastectomy Procedures	13	8	—	—	$82,053.15	$144,562.29	$88,385.84	2026-05-09
227-4	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical	13	8	—	—	$58,946.03	$283,657.54	$87,434.30	2026-05-09
750-4	OTHER	Schizophrenia	13	8	—	—	$20,715.42	$91,000.00	$87,344.85	2026-05-09
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	10	6	—	—	$67,528.39	$296,867.26	$87,224.33	2026-05-09
514-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	13	8	—	—	$50,000.00	$142,667.80	$86,901.79	2026-05-09
224-4	OTHER	Peritoneal Adhesiolysis	13	8	—	—	$51,585.82	$141,883.86	$86,748.24	2026-05-09
443-4	OTHER	Kidney And Urinary Tract Procedures For Non-malignancy	13	8	—	—	$49,339.33	$189,223.55	$86,659.18	2026-05-09
512-4	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	13	8	—	—	$81,000.00	$148,620.29	$86,502.22	2026-05-09
029-4	OTHER	Other Percutaneous Intracranial Procedures	10	6	—	—	$78,538.97	$156,121.43	$85,840.26	2026-05-09
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	13	8	—	—	$70,000.00	$171,611.76	$85,715.86	2026-05-09
315-4	OTHER	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	13	8	—	—	$53,758.35	$140,027.79	$85,613.43	2026-05-09
180-4	OTHER	Other Circulatory System Procedures	13	8	—	—	$63,586.98	$166,111.45	$85,167.03	2026-05-09
073-4	OTHER	Orbit And Eye Procedures	13	8	—	—	$69,543.33	$130,024.98	$85,039.05	2026-05-09
175-4	OTHER	Percutaneous Cardiac Intervention Without Ami	13	8	—	—	$66,380.22	$154,445.98	$84,803.47	2026-05-09
613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	13	8	—	—	$62,000.00	$156,117.60	$84,755.83	2026-05-09
021-3	OTHER	Open Craniotomy Except Trauma	13	8	—	—	$52,878.73	$140,027.79	$84,049.95	2026-05-09
396	OTHER	Major Head And Neck Procedures With Mcc	1	1	—	—	$83,882.70	$83,882.70	$83,882.70	2026-05-09
174-4	OTHER	Percutaneous Cardiac Intervention With Ami	13	8	—	—	$43,373.32	$139,774.17	$83,791.16	2026-05-09
320-4	OTHER	Other Musculoskeletal System And Connective Tissue Procedures	13	8	—	—	$52,032.87	$136,688.40	$83,571.72	2026-05-09
183-2	OTHER	Percutaneous Structural Cardiac Procedures	10	6	—	—	$68,678.18	$155,172.26	$83,149.06	2026-05-09
170-4	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	13	8	—	—	$77,979.35	$165,079.00	$83,000.00	2026-05-09
162-1	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	13	8	—	—	$52,322.33	$165,182.76	$82,974.85	2026-05-09
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	13	8	—	—	$71,704.11	$138,486.83	$82,849.54	2026-05-09
310-4	OTHER	Vertebral And Intervertebral Spinal Procedures Including Disc Procedures	13	8	—	—	$63,683.46	$135,235.82	$82,683.61	2026-05-09
518-4	OTHER	Other Female Reproductive System And Related Procedures	13	8	—	—	$69,712.18	$182,724.73	$81,808.41	2026-05-09
930-4	OTHER	Multiple Significant Trauma Without O.r. Procedure	13	8	—	—	$40,245.60	$104,846.95	$81,794.70	2026-05-09
182-4	OTHER	Other Peripheral Vascular And Related Procedures	10	6	—	—	$70,339.33	$164,452.63	$81,576.46	2026-05-09
309-4	OTHER	Other Significant Hip And Femur Surgery	13	8	—	—	$73,568.37	$154,884.05	$81,539.58	2026-05-09
230-4	OTHER	Major Small Bowel Procedures	10	6	—	—	$75,959.56	$185,472.74	$81,034.72	2026-05-09
402	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures Age >17 Without Cc/mcc	1	1	—	—	$80,976.20	$80,976.20	$80,976.20	2026-05-09
171-4	OTHER	Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock	13	8	—	—	$51,259.38	$131,831.10	$80,601.95	2026-05-09
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	13	8	—	—	$67,903.88	$172,065.88	$80,416.06	2026-05-09
842-3	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	13	8	—	—	$55,459.70	$153,572.17	$80,348.20	2026-05-09
363-4	OTHER	Breast Procedures Except Mastectomy	13	8	—	—	$61,308.32	$116,828.80	$80,320.35	2026-05-09
023-3	OTHER	Spinal Procedures	13	8	—	—	$53,470.50	$198,667.82	$80,310.89	2026-05-09
484-4	OTHER	Other Male Reproductive System And Related Procedures	13	8	—	—	$76,144.70	$139,904.82	$80,250.62	2026-05-09
183-1	OTHER	Percutaneous Structural Cardiac Procedures	10	6	—	—	$65,375.17	$164,484.05	$80,109.90	2026-05-09
691	OTHER	Kidney Transplant With Hemodialysis With Mcc	1	1	—	—	$79,643.71	$79,643.71	$79,643.71	2026-05-09
177-4	OTHER	Cardiac Pacemaker And Defibrillator Revision Except Device Replacement	13	8	—	—	$37,944.42	$119,780.08	$79,354.07	2026-05-09
444-4	OTHER	Renal Dialysis Access Device Procedures	13	8	—	—	$63,173.70	$166,220.30	$79,312.07	2026-05-09
049-4	OTHER	Bacterial And Tuberculous Infections Of Nervous System	13	8	—	—	$64,566.30	$129,202.62	$78,994.89	2026-05-09
J235100000	OTHER	Ocrelizumab Hyal-ocsq 920mg Vl	90	29	$125,688.58	$119,404.15	$46.30	$119,404.15	$78,775.32	2026-05-09
325-4	OTHER	Non-elective Or Complex Knee Joint Replacement	10	6	—	—	$62,112.36	$167,296.30	$78,298.43	2026-05-09
097-4	OTHER	Tonsil And Adenoid Procedures	13	8	—	—	$58,598.69	$205,743.72	$78,053.32	2026-05-09
166-3	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	13	8	—	—	$48,966.25	$170,385.91	$77,780.12	2026-05-09
231-4	OTHER	Major Large Bowel Procedures	10	6	—	—	$52,606.96	$163,192.19	$77,243.73	2026-05-09
519-4	OTHER	Uterine And Adnexa Procedures For Leiomyoma	13	8	—	—	$69,170.62	$133,767.87	$77,097.00	2026-05-09
609-1	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	13	8	—	—	$55,130.20	$131,562.10	$77,053.10	2026-05-09
163-2	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	13	8	—	—	$47,945.11	$159,868.16	$76,933.36	2026-05-09
165-2	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	13	8	—	—	$58,708.04	$170,451.24	$76,324.45	2026-05-09
J934700000	OTHER	Tremelimumab-actl 300mg/15ml	91	29	$123,538.09	$117,361.19	$140.73	$117,361.19	$76,099.46	2026-05-09
690-3	OTHER	Acute Leukemia	13	8	—	—	$68,100.21	$114,642.25	$75,903.93	2026-05-09
317-4	OTHER	Tendon, Muscle And Other Soft Tissue Procedures	13	8	—	—	$70,553.45	$129,633.01	$75,713.37	2026-05-09
130-3	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	13	8	—	—	$65,535.98	$199,201.20	$75,656.56	2026-05-09
179-2	OTHER	Defibrillator Implants	10	6	—	—	$59,651.99	$189,447.18	$75,617.24	2026-05-09
104	OTHER	Craniotomy, Ventricular Shunt And Endovascular Intracranial Procedures Age 0-17	1	1	—	—	$75,527.80	$75,527.80	$75,527.80	2026-05-09
312-3	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	13	8	—	—	$49,332.89	$115,989.56	$75,208.99	2026-05-09
793-4	OTHER	Moderately Extensive O.r. Procedures For Other Complications Of Treatment	10	6	—	—	$60,324.16	$234,649.59	$75,183.22	2026-05-09
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	13	8	—	—	$72,087.32	$202,281.15	$75,000.00	2026-05-09
020-3	OTHER	Open Craniotomy For Trauma	13	8	—	—	$47,084.79	$128,925.94	$74,488.22	2026-05-09
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	13	8	—	—	$64,481.07	$176,834.13	$73,770.46	2026-05-09
091-3	OTHER	Other Major Head And Neck Procedures	13	8	—	—	$65,993.52	$147,575.05	$73,555.84	2026-05-09
098-4	OTHER	Other Ear, Nose, Mouth And Throat Procedures	13	8	—	—	$65,174.16	$152,827.30	$73,384.58	2026-05-09
692-4	OTHER	Radiotherapy	13	8	—	—	$61,982.11	$128,856.45	$73,302.76	2026-05-09
621-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	13	8	—	—	$275.45	$117,512.82	$72,999.11	2026-05-09
160-2	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	13	8	—	—	$62,078.59	$187,029.49	$72,632.96	2026-05-09
167-3	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	13	8	—	—	$66,391.05	$170,001.63	$72,423.74	2026-05-09
548-4	OTHER	Postpartum And Post Abortion Diagnosis With O.r. Procedure	10	6	—	—	$61,277.76	$131,977.12	$72,210.05	2026-05-09
445-4	OTHER	Other Bladder Procedures	13	8	—	—	$59,048.63	$119,776.23	$71,929.73	2026-05-09
106	OTHER	Concussion Age 0-17	1	1	—	—	$71,820.09	$71,820.09	$71,820.09	2026-05-09
677	OTHER	Neonate, Birth Weight 2000-2499 Grams, Without Significant O.r. Procedures, With…	1	1	—	—	$71,384.63	$71,384.63	$71,384.63	2026-05-09
890-4	OTHER	HIV With Multiple Major HIV Related Conditions	13	8	—	—	$41,459.70	$144,516.07	$71,374.62	2026-05-09
322-4	OTHER	Shoulder And Elbow Joint Replacement	10	6	—	—	$60,566.99	$155,478.02	$71,280.10	2026-05-09
316-4	OTHER	Hand And Wrist Procedures	13	8	—	—	$56,685.07	$134,777.10	$70,729.35	2026-05-09
169-3	OTHER	Major Abdominal Vascular Procedures	13	8	—	—	$52,602.13	$143,905.18	$70,678.75	2026-05-09
308-4	OTHER	Hip And Femur Fracture Repair	13	8	—	—	$38,385.04	$119,534.13	$70,621.27	2026-05-09
447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	13	8	—	—	$55,464.88	$161,316.90	$70,572.38	2026-05-09
346-4	OTHER	Connective Tissue Disorders	13	8	—	—	$40,346.90	$148,951.95	$69,725.46	2026-05-09
740-3	OTHER	Mental Illness Diagnosis With O.r. Procedure	13	8	—	—	$27,048.10	$89,156.81	$69,554.28	2026-05-09
163-1	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	13	8	—	—	$47,298.66	$144,473.91	$68,928.15	2026-05-09
636-4	OTHER	Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection	13	8	—	—	$57,000.00	$115,449.24	$68,923.38	2026-05-09
680-3	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	13	8	—	—	$50,238.25	$127,650.13	$68,020.50	2026-05-09
364-4	OTHER	Other Skin, Subcutaneous Tissue And Related Procedures	13	8	—	—	$39,888.60	$111,114.56	$67,935.80	2026-05-09
381-4	OTHER	Major Skin Disorders	13	8	—	—	$55,490.49	$90,759.25	$67,707.55	2026-05-09
910-2	OTHER	Craniotomy For Multiple Significant Trauma	13	8	—	—	$60,291.48	$138,287.69	$67,200.38	2026-05-09
513-4	OTHER	Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma	13	8	—	—	$63,398.83	$111,733.26	$67,173.72	2026-05-09
321-3	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	13	8	—	—	$39,332.20	$109,831.07	$67,151.06	2026-05-09
008-1	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	10	6	—	—	$62,527.24	$118,729.02	$67,146.98	2026-05-09
260-3	OTHER	Major Pancreas, Liver And Shunt Procedures	13	8	—	—	$43,519.66	$114,242.60	$67,034.83	2026-05-09
898	OTHER	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Age >21 Without…	1	1	—	—	$67,004.46	$67,004.46	$67,004.46	2026-05-09
603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	13	8	—	—	$64,109.60	$117,712.65	$67,000.00	2026-05-09
179-1	OTHER	Defibrillator Implants	10	6	—	—	$52,881.94	$139,392.97	$66,852.73	2026-05-09
661-4	OTHER	Coagulation And Platelet Disorders	13	8	—	—	$52,353.91	$89,202.69	$66,802.20	2026-05-09
323-4	OTHER	Non-elective Or Complex Hip Joint Replacement	10	6	—	—	$51,201.49	$259,029.14	$66,736.61	2026-05-09
313-4	OTHER	Knee And Lower Leg Procedures Except Foot	13	8	—	—	$55,213.46	$147,102.38	$66,568.63	2026-05-09
952-4	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	13	8	—	—	$58,540.13	$130,048.04	$66,414.76	2026-05-09
030-3	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	10	6	—	—	$50,899.16	$129,110.40	$65,936.82	2026-05-09
165-1	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	13	8	—	—	$57,776.95	$202,551.25	$65,929.29	2026-05-09
623-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	13	8	—	—	$53,295.37	$119,584.09	$65,359.09	2026-05-09
314-4	OTHER	Foot And Toe Procedures	13	8	—	—	$40,195.74	$106,795.26	$65,294.95	2026-05-09
304-2	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	13	8	—	—	$48,953.39	$125,367.50	$65,229.05	2026-05-09
050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	13	8	—	—	$60,958.21	$136,630.75	$65,098.58	2026-05-09
105	OTHER	Traumatic Stupor And Coma <1 Hour Age 0-17	1	1	—	—	$65,015.87	$65,015.87	$65,015.87	2026-05-09
612-2	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	13	8	—	—	$58,312.83	$132,895.55	$64,995.00	2026-05-09
027-3	OTHER	Other Open Craniotomy	10	6	—	—	$55,700.92	$116,794.22	$64,668.65	2026-05-09
022-3	OTHER	Ventricular Shunt Procedures	13	8	—	—	$38,124.53	$83,697.40	$64,490.82	2026-05-09
055-4	OTHER	Head Trauma With Coma > 1 Hour Or Hemorrhage	13	8	—	—	$40,322.79	$253,368.28	$64,433.14	2026-05-09
043-4	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	13	8	—	—	$61,740.89	$114,953.52	$64,387.97	2026-05-09
220-3	OTHER	Major Stomach, Esophageal And Duodenal Procedures	13	8	—	—	$50,725.50	$115,860.42	$64,200.02	2026-05-09
631	OTHER	Neonate, Birth Weight 750-999 Grams, Discharged Alive	1	1	—	—	$64,158.99	$64,158.99	$64,158.99	2026-05-09
401-3	OTHER	Adrenal Procedures	13	8	—	—	$54,723.20	$190,301.29	$63,122.61	2026-05-09
089-3	OTHER	Major Cranial Or Facial Bone Procedures	13	8	—	—	$58,857.59	$142,740.81	$62,741.68	2026-05-09
794-4	OTHER	Non-extensive O.r. Procedures For Other Complications Of Treatment	10	6	—	—	$57,519.66	$106,872.11	$62,581.19	2026-05-09

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