Hospital

TRINITY HEALTH ANN ARBOR HOSPITAL

Ann Arbor, MI · CCN 230156 · Rates published

23,333 distinct procedures filed

129 distinct payers

5,512,727 rate rows

2025-01-01 last MRF observed · ⚠ 21 mo old

Data quality

4,982,023 of 5,512,727 rate rows are consumer-grade (90.4%)

530,704 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	475,956
template filing: same amount across many unrelated codes — excluded	40,816
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	7,349
percent-of-charges filed in the dollar field — excluded from medians	3,639
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	1,924
placeholder amount (≤ $0.02) — excluded from medians	955
per-diem day rate — not a per-procedure price	36
exceeds 10× this hospital's gross charge — excluded from medians	29

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 21 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/stjosephmercy-annarbor
Found on page	https://www.trinityhealthmichigan.org/tools-and-resources/billing-and-insurance/our-prices
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-15
Content fingerprint	b05ab7c1a9290e68… · 187,259,741 bytes · first seen 2026-05-08

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
'583-4 OTHER	Neonate With Ecmo	5	$339,942.66	$353,540.37	$339,942.66	—
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	15	$296,010.99	$689,621.66	$296,010.99	nat. median $168,055 1.8× median
'588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$221,954.82	$230,833.01	$221,954.82	—
'583-3 OTHER	Neonate With Ecmo	5	$220,189.50	$228,997.08	$220,189.50	—
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	15	$217,785.60	$507,231.59	$217,785.60	nat. median $186,516 1.2× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	15	$211,845.70	$493,382.15	$211,845.70	nat. median $131,925 1.6× median
'161-4 OTHER	Implantable Heart Assist Systems	5	$182,608.38	$189,912.72	$182,608.38	—
'631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	5	$180,813.99	$188,046.55	$180,813.99	—
A9596 HCPCS	Gallium Ga-68 Gozetotide Diagnostic 1 Millicurie	122	$1,017.21	$221,400.00	$179,580.00	nat. median $1,026 outlier · 175.0×
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	15	$171,397.55	$399,073.38	$171,397.55	nat. median $145,435 1.2× median
'011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$168,948.47	$175,706.41	$168,948.47	—
'630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	5	$166,100.94	$172,744.98	$166,100.94	—
'841-4 OTHER	Extensive Third Degree Burns With Skin Graft	5	$158,667.81	$165,014.52	$158,667.81	—
'609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	5	$146,034.99	$151,876.39	$146,034.99	—
'588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$143,178.98	$148,906.14	$143,178.98	—
'007-4 OTHER	Allogeneic Bone Marrow Transplant	5	$138,565.52	$144,108.14	$138,565.52	—
'593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	$130,096.20	$135,300.05	$130,096.20	—
'591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$128,819.60	$133,972.38	$128,819.60	—
'588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$123,245.66	$128,175.49	$123,245.66	—
'583-2 OTHER	Neonate With Ecmo	5	$122,076.85	$126,959.92	$122,076.85	—
'603-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	5	$118,600.10	$123,344.10	$118,600.10	—
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	15	$118,249.95	$275,154.60	$118,249.95	nat. median $97,418 1.2× median
J1747 HCPCS	Injection Spesolimab-sbzo 1 Mg	122	$61.42	$140,820.28	$114,220.90	nat. median $76 outlier · 1511.1×
'009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	5	$109,710.50	$114,098.92	$109,710.50	—
'004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	$108,911.10	$113,267.54	$108,911.10	—
'588-1 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$105,637.84	$109,863.35	$105,637.84	—
'842-4 OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	5	$102,055.71	$106,137.94	$102,055.71	—
'160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	5	$100,998.94	$105,038.90	$100,998.94	—
7 MS_DRG	Lung Transplant	14	$98,713.07	$229,602.48	$99,848.27	nat. median $70,649 1.4× median
'591-3 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$99,042.25	$103,003.94	$99,042.25	—
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	15	$98,534.05	$229,185.06	$98,534.05	nat. median $65,418 1.5× median
'011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$98,531.12	$102,472.36	$98,531.12	—
'161-3 OTHER	Implantable Heart Assist Systems	5	$94,938.70	$98,736.25	$94,938.70	—
14 MS_DRG	Allogeneic Bone Marrow Transplant	14	$92,246.54	$214,525.13	$93,307.38	nat. median $72,715 1.3× median
'161-2 OTHER	Implantable Heart Assist Systems	5	$91,136.14	$94,781.59	$91,136.14	—
'593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	$89,629.41	$93,214.59	$89,629.41	—
'583-1 OTHER	Neonate With Ecmo	5	$88,734.93	$92,284.33	$88,734.93	—
'589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	5	$86,775.82	$90,246.85	$86,775.82	—
212 MS_DRG	Concomitant Aortic And Mitral Valve?procedures	15	$86,705.63	$201,605.96	$86,705.63	nat. median $74,509 1.2× median
'589-2 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	5	$85,379.91	$88,795.11	$85,379.91	—
'011-2 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$84,602.32	$87,986.41	$84,602.32	—
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	14	$83,328.26	$193,731.30	$84,286.54	nat. median $69,922 1.2× median
'589-3 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	5	$83,560.69	$86,903.12	$83,560.69	—
215 MS_DRG	Other Heart Assist System Implant	15	$82,242.88	$191,200.63	$82,242.88	nat. median $73,023 1.1× median
'630-3 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	5	$79,620.05	$82,804.85	$79,620.05	—
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	15	$78,152.62	$181,663.81	$78,152.62	nat. median $69,822 1.1× median
'161-1 OTHER	Implantable Heart Assist Systems	5	$75,533.46	$78,554.80	$75,533.46	—
'591-2 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$74,680.78	$77,668.01	$74,680.78	—
A9542 HCPCS	Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries	111	$4,336.55	$88,020.00	$71,394.00	nat. median $3,055 outlier · 23.4×
453 MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	15	$71,377.82	$165,867.69	$71,377.82	nat. median $2,106 outlier · 33.9×

Other procedures at this hospital

Browse this hospital's 23,333 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

'583-4	OTHER	Neonate With Ecmo	5	5	—	—	$339,942.66	$353,540.37	$339,942.66	2025-01-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	19	15	—	—	$296,010.99	$689,621.66	$296,010.99	2025-01-01
'588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	5	—	—	$221,954.82	$230,833.01	$221,954.82	2025-01-01
'583-3	OTHER	Neonate With Ecmo	5	5	—	—	$220,189.50	$228,997.08	$220,189.50	2025-01-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	19	15	—	—	$217,785.60	$507,231.59	$217,785.60	2025-01-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	19	15	—	—	$211,845.70	$493,382.15	$211,845.70	2025-01-01
'161-4	OTHER	Implantable Heart Assist Systems	5	5	—	—	$182,608.38	$189,912.72	$182,608.38	2025-01-01
'631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	5	5	—	—	$180,813.99	$188,046.55	$180,813.99	2025-01-01
A9596	HCPCS	Gallium Ga-68 Gozetotide Diagnostic 1 Millicurie	136	122	$246,000.00	$159,900.00 35% off	$1,017.21	$221,400.00	$179,580.00	2025-01-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	19	15	—	—	$171,397.55	$399,073.38	$171,397.55	2025-01-01
'011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	5	—	—	$168,948.47	$175,706.41	$168,948.47	2025-01-01
'630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	5	5	—	—	$166,100.94	$172,744.98	$166,100.94	2025-01-01
'841-4	OTHER	Extensive Third Degree Burns With Skin Graft	5	5	—	—	$158,667.81	$165,014.52	$158,667.81	2025-01-01
'609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	5	5	—	—	$146,034.99	$151,876.39	$146,034.99	2025-01-01
'588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	5	—	—	$143,178.98	$148,906.14	$143,178.98	2025-01-01
'007-4	OTHER	Allogeneic Bone Marrow Transplant	5	5	—	—	$138,565.52	$144,108.14	$138,565.52	2025-01-01
'593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	5	—	—	$130,096.20	$135,300.05	$130,096.20	2025-01-01
'591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	5	—	—	$128,819.60	$133,972.38	$128,819.60	2025-01-01
'588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	5	—	—	$123,245.66	$128,175.49	$123,245.66	2025-01-01
'583-2	OTHER	Neonate With Ecmo	5	5	—	—	$122,076.85	$126,959.92	$122,076.85	2025-01-01
'603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	5	5	—	—	$118,600.10	$123,344.10	$118,600.10	2025-01-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	19	15	—	—	$118,249.95	$275,154.60	$118,249.95	2025-01-01
J1747	HCPCS	Injection Spesolimab-sbzo 1 Mg	136	122	$156,466.98	$101,703.54 35% off	$61.42	$140,820.28	$114,220.90	2025-01-01
'009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	5	5	—	—	$109,710.50	$114,098.92	$109,710.50	2025-01-01
'004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	5	—	—	$108,911.10	$113,267.54	$108,911.10	2025-01-01
'588-1	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	5	—	—	$105,637.84	$109,863.35	$105,637.84	2025-01-01
'842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	5	5	—	—	$102,055.71	$106,137.94	$102,055.71	2025-01-01
'160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	5	5	—	—	$100,998.94	$105,038.90	$100,998.94	2025-01-01
7	MS_DRG	Lung Transplant	18	14	—	—	$98,713.07	$229,602.48	$99,848.27	2025-01-01
'591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	5	—	—	$99,042.25	$103,003.94	$99,042.25	2025-01-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	19	15	—	—	$98,534.05	$229,185.06	$98,534.05	2025-01-01
'011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	5	—	—	$98,531.12	$102,472.36	$98,531.12	2025-01-01
'161-3	OTHER	Implantable Heart Assist Systems	5	5	—	—	$94,938.70	$98,736.25	$94,938.70	2025-01-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	18	14	—	—	$92,246.54	$214,525.13	$93,307.38	2025-01-01
'161-2	OTHER	Implantable Heart Assist Systems	5	5	—	—	$91,136.14	$94,781.59	$91,136.14	2025-01-01
'593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	5	—	—	$89,629.41	$93,214.59	$89,629.41	2025-01-01
'583-1	OTHER	Neonate With Ecmo	5	5	—	—	$88,734.93	$92,284.33	$88,734.93	2025-01-01
'589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	5	5	—	—	$86,775.82	$90,246.85	$86,775.82	2025-01-01
212	MS_DRG	Concomitant Aortic And Mitral Valve?procedures	19	15	—	—	$86,705.63	$201,605.96	$86,705.63	2025-01-01
'589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	5	5	—	—	$85,379.91	$88,795.11	$85,379.91	2025-01-01
'011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	5	—	—	$84,602.32	$87,986.41	$84,602.32	2025-01-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	18	14	—	—	$83,328.26	$193,731.30	$84,286.54	2025-01-01
'589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	5	5	—	—	$83,560.69	$86,903.12	$83,560.69	2025-01-01
215	MS_DRG	Other Heart Assist System Implant	19	15	—	—	$82,242.88	$191,200.63	$82,242.88	2025-01-01
'630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	5	5	—	—	$79,620.05	$82,804.85	$79,620.05	2025-01-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	19	15	—	—	$78,152.62	$181,663.81	$78,152.62	2025-01-01
'161-1	OTHER	Implantable Heart Assist Systems	5	5	—	—	$75,533.46	$78,554.80	$75,533.46	2025-01-01
'591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	5	—	—	$74,680.78	$77,668.01	$74,680.78	2025-01-01
A9542	HCPCS	Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries	121	111	$97,800.00	$63,570.00 35% off	$4,336.55	$88,020.00	$71,394.00	2025-01-01
453	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	19	15	—	—	$71,377.82	$165,867.69	$71,377.82	2025-01-01
'303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	5	5	—	—	$70,601.45	$73,425.51	$70,601.45	2025-01-01
'008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	5	5	—	—	$70,331.36	$73,144.61	$70,331.36	2025-01-01
A9604	HCPCS	Samarium Sm-153 Lexidronam Therapeutic Per 150 Millicuries	136	122	$95,760.00	$62,244.00 35% off	$17,259.85	$86,184.00	$69,904.80	2025-01-01
27800000002-2814	CDM	Valve Sapien 3 Ultra Thv 26mm W/command System	121	111	$94,575.00	$61,473.75 35% off	$23,643.75	$85,117.50	$69,039.75	2025-01-01
27800000002-2112	CDM	Valve Sapien 3 Thv 26mm W/command System	121	111	$94,575.00	$61,473.75 35% off	$23,643.75	$85,117.50	$69,039.75	2025-01-01
27800000002-2116	CDM	Valve Sapien 3 Thv 29mm W/command System	121	111	$94,575.00	$61,473.75 35% off	$23,643.75	$85,117.50	$69,039.75	2025-01-01
27800000002-2106	CDM	Valve Sapien 3 Thv 23mm W/command System	121	111	$94,575.00	$61,473.75 35% off	$23,643.75	$85,117.50	$69,039.75	2025-01-01
27800000002-2117	CDM	Valve Sapien Transcath 23mm Ascendra + Sys	121	111	$94,575.00	$61,473.75 35% off	$23,643.75	$85,117.50	$69,039.75	2025-01-01
27800000002-2107	CDM	Valve Sapien 3 Thv 23mm W/command System	121	111	$94,575.00	$61,473.75 35% off	$23,643.75	$85,117.50	$69,039.75	2025-01-01
27800000002-2811	CDM	Valve Sapien 3 Ultra Thv 23mm W/command System	121	111	$94,575.00	$61,473.75 35% off	$23,643.75	$85,117.50	$69,039.75	2025-01-01
27800000002-2808	CDM	Valve Sapien 3 Ultra Thv 20mm W/command System	121	111	$94,575.00	$61,473.75 35% off	$23,643.75	$85,117.50	$69,039.75	2025-01-01
27800000002-2111	CDM	Valve Sapien 3 Thv 26mm W/command System	121	111	$94,575.00	$61,473.75 35% off	$23,643.75	$85,117.50	$69,039.75	2025-01-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	19	15	—	—	$68,094.37	$158,212.02	$68,094.37	2025-01-01
'007-3	OTHER	Allogeneic Bone Marrow Transplant	5	5	—	—	$68,059.14	$70,781.51	$68,059.14	2025-01-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	19	15	—	—	$67,909.73	$157,781.51	$67,909.73	2025-01-01
'004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	5	—	—	$67,422.66	$70,119.57	$67,422.66	2025-01-01
27800000002-100	CDM	Device Impella 5.5 Smartassist	121	111	$90,000.00	$58,500.00 35% off	$22,500.00	$81,000.00	$65,700.00	2025-01-01
'850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	5	5	—	—	$65,688.22	$68,315.75	$65,688.22	2025-01-01
'005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	5	5	—	—	$65,678.53	$68,305.67	$65,678.53	2025-01-01
'851-4	OTHER	Gender Related Procedures	5	5	—	—	$65,531.37	$68,152.62	$65,531.37	2025-01-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	19	15	—	—	$65,387.34	$151,900.31	$65,387.34	2025-01-01
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	19	15	—	—	$64,410.34	$149,622.33	$64,410.34	2025-01-01
27800000002-2443	CDM	Valve Aortic Evolut Tm Pro 26mm	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-1489	CDM	Kit Mitraclip 2 Mbr0102	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-1495	CDM	Kit Mitraclp 2 Sgc0301 Cds0501	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2445	CDM	Valve Aortic Evolut Tm Pro 29mm	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-3060	CDM	Kit Mitraclip 2 Mbr0202	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2449	CDM	Valve Aortic Evolut Tm Pro 34mm	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2450	CDM	Valve Aortic Evolut Tm Pro 34mm	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-1487	CDM	Kit Mitraclip 1 Mbr0301	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2448	CDM	Valve Aortic Evolut Tm Pro 34mm	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2009	CDM	Valve Aort 26mm Pro Perc	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2447	CDM	Valve Aortic Evolut Tm Pro 29mm	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-1493	CDM	Kit Mitraclp 1 Sgc0301 Cds0501	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-1490	CDM	Kit Mitraclip 2 Mbr0302	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2824	CDM	Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-1485	CDM	Kit Mitraclip 1 Mbr0201	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2010	CDM	Valve Aort 26mm Pro Perc	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2021	CDM	Valve Aort 34mm Evolutr	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2978	CDM	Kit Mitraclip G4 Delivery Sys Ntw	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2022	CDM	Valve Aort 34mm Evolutr	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2446	CDM	Valve Aortic Evolut Tm Pro 29mm	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-1496	CDM	Kit Mitraclp 3 Sgc0301 Cds0501	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-1483	CDM	Kit Mitraclip 1 Mbr0101	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2444	CDM	Valve Aortic Evolut Tm Pro 26mm	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
27800000002-2952	CDM	Kit Mitraclip 1 Mbr0303	121	111	$87,300.00	$56,745.00 35% off	$21,825.00	$78,570.00	$63,729.00	2025-01-01
J9298	HCPCS	Opdualag Per 1 Each	136	122	$87,194.88	$56,676.67 35% off	$190.50	$78,475.39	$63,652.26	2025-01-01
27200000002-22961	CDM	Handpiece Electr Ster Disp Electrosurgical	121	111	$86,692.50	$56,350.13 35% off	$21,673.13	$78,023.25	$63,285.53	2025-01-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	19	15	—	—	$62,853.71	$145,992.91	$62,853.71	2025-01-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	19	15	—	—	$62,144.04	$144,338.24	$62,144.04	2025-01-01
A9606	HCPCS	Radium Ra-223 Dichloride Therapeutic Per Microcurie	136	122	$85,076.88	$55,299.97 35% off	$165.18	$76,569.19	$62,106.12	2025-01-01
'602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	5	5	—	—	$61,949.25	$64,427.22	$61,949.25	2025-01-01
'007-1	OTHER	Allogeneic Bone Marrow Transplant	5	5	—	—	$61,656.74	$64,123.01	$61,656.74	2025-01-01
'613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	5	5	—	—	$60,475.22	$62,894.23	$60,475.22	2025-01-01
'162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	5	5	—	—	$60,154.85	$62,561.04	$60,154.85	2025-01-01
'593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	5	—	—	$58,771.06	$61,121.90	$58,771.06	2025-01-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	19	15	—	—	$58,301.05	$135,377.94	$58,301.05	2025-01-01
J9359	HCPCS	Loncastuximab-lpyl 0.1 Mg	136	122	$78,900.03	$51,285.02 35% off	$206.41	$71,010.03	$57,597.02	2025-01-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	19	15	—	—	$56,721.95	$131,696.10	$56,721.95	2025-01-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	19	15	—	—	$56,152.76	$130,369.00	$56,152.76	2025-01-01
'005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	5	5	—	—	$56,091.88	$58,335.56	$56,091.88	2025-01-01
'167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	5	5	—	—	$56,037.38	$58,278.88	$56,037.38	2025-01-01
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	19	15	—	—	$55,789.90	$129,522.94	$55,789.90	2025-01-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	19	15	—	—	$55,695.97	$129,303.94	$55,695.97	2025-01-01
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	19	15	—	—	$55,411.78	$128,641.33	$55,411.78	2025-01-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	19	15	—	—	$55,268.08	$128,306.27	$55,268.08	2025-01-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	19	15	—	—	$54,977.47	$127,628.68	$54,977.47	2025-01-01
'163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	5	5	—	—	$54,630.57	$56,815.79	$54,630.57	2025-01-01
'007-2	OTHER	Allogeneic Bone Marrow Transplant	5	5	—	—	$54,576.07	$56,759.11	$54,576.07	2025-01-01
'863-4	OTHER	Neonatal Aftercare	5	5	—	—	$54,566.98	$56,749.66	$54,566.98	2025-01-01
'609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	5	5	—	—	$53,768.20	$55,918.93	$53,768.20	2025-01-01
459	MS_DRG	Spinal Fusion Except Cervical With Mcc	19	15	—	—	$53,482.66	$124,143.39	$53,482.66	2025-01-01
27800000002-248	CDM	Impella Rp With Smart Assist	121	111	$72,750.00	$47,287.50 35% off	$18,187.50	$65,475.00	$53,107.50	2025-01-01
27800000002-1642	CDM	Set Pump Impella Cp	121	111	$72,750.00	$47,287.50 35% off	$18,187.50	$65,475.00	$53,107.50	2025-01-01
27800000002-1646	CDM	Set Pump Impella Rp	121	111	$72,750.00	$47,287.50 35% off	$18,187.50	$65,475.00	$53,107.50	2025-01-01
'603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	5	5	—	—	$52,989.39	$55,108.97	$52,989.39	2025-01-01
'612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	5	5	—	—	$52,589.09	$54,692.65	$52,589.09	2025-01-01
'160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	5	5	—	—	$52,565.47	$54,668.09	$52,565.47	2025-01-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	19	15	—	—	$51,339.19	$119,145.69	$51,339.19	2025-01-01
'009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	5	5	—	—	$50,612.41	$52,636.91	$50,612.41	2025-01-01
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	18	14	—	—	$49,827.52	$115,621.09	$50,400.54	2025-01-01
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	18	14	—	—	$49,827.52	$115,621.09	$50,400.54	2025-01-01
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	19	15	—	—	$50,382.25	$116,914.50	$50,382.25	2025-01-01
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	19	15	—	—	$50,157.47	$116,390.40	$50,157.47	2025-01-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc	19	15	—	—	$50,094.05	$116,242.52	$50,094.05	2025-01-01
'680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	5	5	—	—	$50,019.53	$52,020.31	$50,019.53	2025-01-01
27800000002-274	CDM	Valve Sapien Thv Edwards Resilia 23mm	121	111	$68,000.00	$44,200.00 35% off	$17,000.00	$61,200.00	$49,640.00	2025-01-01
27800000002-276	CDM	Valve Sapien Thv Edwards Resilia 29mm	121	111	$68,000.00	$44,200.00 35% off	$17,000.00	$61,200.00	$49,640.00	2025-01-01
27800000002-278	CDM	Valve Sapien Thv Edwards Resilia 26mm	121	111	$68,000.00	$44,200.00 35% off	$17,000.00	$61,200.00	$49,640.00	2025-01-01
27800000002-280	CDM	Valve Sapien Thv Edwards Resilia 20mm	121	111	$68,000.00	$44,200.00 35% off	$17,000.00	$61,200.00	$49,640.00	2025-01-01
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	19	15	—	—	$49,541.72	$114,954.73	$49,541.72	2025-01-01
'176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	5	5	—	—	$49,492.05	$51,471.73	$49,492.05	2025-01-01
454	MS_DRG	Combined Anterior/posterior Spinal Fusion W Cc	19	15	—	—	$49,340.22	$114,484.90	$49,340.22	2025-01-01
955	MS_DRG	Craniotomy For Multiple Significant Trauma	19	15	—	—	$49,130.69	$113,996.36	$49,130.69	2025-01-01
'841-3	OTHER	Extensive Third Degree Burns With Skin Graft	5	5	—	—	$49,062.68	$51,025.19	$49,062.68	2025-01-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	19	15	—	—	$49,011.08	$113,717.47	$49,011.08	2025-01-01
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	19	15	—	—	$48,781.48	$113,182.13	$48,781.48	2025-01-01
J9229	HCPCS	Inj Inotuzumab Oxogam Per 0.1 Mg	136	122	$66,706.47	$43,359.21 35% off	$2,618.85	$60,035.82	$48,695.72	2025-01-01
28	MS_DRG	Spinal Procedures With Mcc	19	15	—	—	$48,616.10	$112,796.54	$48,616.10	2025-01-01
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	18	15	—	—	$48,407.37	$112,309.87	$48,407.37	2025-01-01
'303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	5	5	—	—	$48,062.23	$49,984.72	$48,062.23	2025-01-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	19	15	—	—	$47,993.93	$111,345.89	$47,993.93	2025-01-01
27800000002-2813	CDM	Valve Sapien 3 Ultra Thv 26mm W/command System	121	111	$65,000.00	$42,250.00 35% off	$16,250.00	$58,500.00	$47,450.00	2025-01-01
27800000002-2115	CDM	Valve Sapien 3 Thv 29mm W/command System	121	111	$65,000.00	$42,250.00 35% off	$16,250.00	$58,500.00	$47,450.00	2025-01-01
27800000002-2110	CDM	Valve Sapien 3 Thv 26mm W/command System	121	111	$65,000.00	$42,250.00 35% off	$16,250.00	$58,500.00	$47,450.00	2025-01-01
27800000002-2810	CDM	Valve Sapien 3 Ultra Thv 23mm W/command System	121	111	$65,000.00	$42,250.00 35% off	$16,250.00	$58,500.00	$47,450.00	2025-01-01
27800000002-2103	CDM	Valve Sapien 3 Thv 20mm W/command System	121	111	$65,000.00	$42,250.00 35% off	$16,250.00	$58,500.00	$47,450.00	2025-01-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	19	15	—	—	$47,448.03	$110,073.07	$47,448.03	2025-01-01
J2507	HCPCS	Pegloticase Per 1 Mg	136	122	$64,638.66	$42,015.13 35% off	$3,447.06	$58,174.79	$47,186.22	2025-01-01
'690-4	OTHER	Acute Leukemia	5	5	—	—	$46,645.73	$48,511.56	$46,645.73	2025-01-01
'631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	5	5	—	—	$46,559.13	$48,421.50	$46,559.13	2025-01-01
'020-4	OTHER	Open Craniotomy For Trauma	5	5	—	—	$46,108.57	$47,952.91	$46,108.57	2025-01-01
'607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	5	5	—	—	$46,032.87	$47,874.18	$46,032.87	2025-01-01
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	19	15	—	—	$45,971.68	$106,630.83	$45,971.68	2025-01-01
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	19	15	—	—	$45,862.50	$106,376.27	$45,862.50	2025-01-01
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	19	15	—	—	$45,747.70	$106,108.60	$45,747.70	2025-01-01
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	19	15	—	—	$45,706.76	$106,013.14	$45,706.76	2025-01-01
7772694881	NDC	Nitroprusside 25 Mcg/ml Solution 1000 Ml Bag	121	111	$62,500.00	$40,625.00 35% off	$15,625.00	$56,250.00	$45,625.00	2025-01-01
834	MS_DRG	Acute Leukemia Without Major O.r. Procedures With Mcc	19	15	—	—	$45,187.35	$104,802.08	$45,187.35	2025-01-01
'312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	5	5	—	—	$44,468.00	$46,246.72	$44,468.00	2025-01-01
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	19	15	—	—	$44,434.33	$103,046.33	$44,434.33	2025-01-01
'630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	5	5	—	—	$44,131.28	$45,896.53	$44,131.28	2025-01-01
'361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	5	5	—	—	$44,094.95	$45,858.75	$44,094.95	2025-01-01
'091-3	OTHER	Other Major Head And Neck Procedures	5	5	—	—	$44,092.52	$45,856.22	$44,092.52	2025-01-01
27800000002-2008	CDM	Valve Aort 26mm Pro Perc	121	111	$60,000.00	$39,000.00 35% off	$15,000.00	$54,000.00	$43,800.00	2025-01-01
27800000002-2005	CDM	Valve Aort 26mm Evolutr	121	111	$60,000.00	$39,000.00 35% off	$15,000.00	$54,000.00	$43,800.00	2025-01-01
27800000002-246	CDM	Valve Aortic 23mm Evolut Fx	121	111	$60,000.00	$39,000.00 35% off	$15,000.00	$54,000.00	$43,800.00	2025-01-01
27800000002-1999	CDM	Valve Aort 23mm Pro Perc	121	111	$60,000.00	$39,000.00 35% off	$15,000.00	$54,000.00	$43,800.00	2025-01-01
27800000002-242	CDM	Valve Aortic 26mm Evolut Fx	121	111	$60,000.00	$39,000.00 35% off	$15,000.00	$54,000.00	$43,800.00	2025-01-01
27800000002-244	CDM	Valve Aortic 34mm Evolut Fx	121	111	$60,000.00	$39,000.00 35% off	$15,000.00	$54,000.00	$43,800.00	2025-01-01
27800000002-2020	CDM	Valve Aort 34mm Evolutr	121	111	$60,000.00	$39,000.00 35% off	$15,000.00	$54,000.00	$43,800.00	2025-01-01
27800000002-243	CDM	Valve Aortic 29mm Evolut Fx	121	111	$60,000.00	$39,000.00 35% off	$15,000.00	$54,000.00	$43,800.00	2025-01-01
27800000002-2014	CDM	Valve Aort 29mm Evolutr	121	111	$60,000.00	$39,000.00 35% off	$15,000.00	$54,000.00	$43,800.00	2025-01-01
27800000002-2017	CDM	Valve Aort 29mm Pro Perc	121	111	$60,000.00	$39,000.00 35% off	$15,000.00	$54,000.00	$43,800.00	2025-01-01
653	MS_DRG	Major Bladder Procedures With Mcc	19	15	—	—	$43,698.96	$101,331.76	$43,698.96	2025-01-01
'602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	5	5	—	—	$43,668.00	$45,414.72	$43,668.00	2025-01-01
'091-4	OTHER	Other Major Head And Neck Procedures	5	5	—	—	$43,639.54	$45,385.12	$43,639.54	2025-01-01
'178-4	OTHER	External Heart Assist Systems	5	5	—	—	$43,387.00	$45,122.48	$43,387.00	2025-01-01
J2350	HCPCS	Injection Ocrelizumab 1 Mg	136	122	$59,143.14	$38,443.04 35% off	$60.25	$53,228.83	$43,174.49	2025-01-01
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	18	14	—	—	$42,479.52	$98,488.50	$42,968.04	2025-01-01
'740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	5	5	—	—	$42,556.72	$44,258.99	$42,556.72	2025-01-01
'911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	5	5	—	—	$42,421.67	$44,118.54	$42,421.67	2025-01-01
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	19	15	—	—	$42,342.24	$98,168.42	$42,342.24	2025-01-01
'625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	5	5	—	—	$41,989.88	$43,669.48	$41,989.88	2025-01-01
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	19	15	—	—	$41,967.33	$97,294.29	$41,967.33	2025-01-01
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	19	15	—	—	$41,876.61	$97,082.78	$41,876.61	2025-01-01
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	19	15	—	—	$41,633.37	$96,515.62	$41,633.37	2025-01-01
'591-1	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	5	—	—	$41,550.82	$43,212.85	$41,550.82	2025-01-01
'004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	5	—	—	$41,458.77	$43,117.12	$41,458.77	2025-01-01
'759-4	OTHER	Eating Disorders	5	5	—	—	$41,375.80	$43,030.83	$41,375.80	2025-01-01
'166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	5	5	—	—	$41,169.90	$42,816.70	$41,169.90	2025-01-01
'162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	5	5	—	—	$41,068.76	$42,711.51	$41,068.76	2025-01-01
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	19	15	—	—	$41,012.80	$95,068.72	$41,012.80	2025-01-01
'165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	5	5	—	—	$40,926.45	$42,563.51	$40,926.45	2025-01-01
'681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	5	5	—	—	$40,912.52	$42,549.02	$40,912.52	2025-01-01
27200000002-21713	CDM	Connect Perf Y 1/2x3/8x3/8in Unequal	121	111	$56,000.00	$36,400.00 35% off	$14,000.00	$50,400.00	$40,880.00	2025-01-01
27200000002-22959	CDM	Handpiece Electr Ster Disp Electrosurgical	121	111	$56,000.00	$36,400.00 35% off	$14,000.00	$50,400.00	$40,880.00	2025-01-01
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	19	15	—	—	$40,835.39	$94,655.05	$40,835.39	2025-01-01
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	19	15	—	—	$40,689.28	$94,314.39	$40,689.28	2025-01-01
'232-4	OTHER	Gastric Fundoplication	5	5	—	—	$40,555.82	$42,178.05	$40,555.82	2025-01-01
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	19	15	—	—	$40,372.97	$93,576.90	$40,372.97	2025-01-01
'695-4	OTHER	Chemotherapy For Acute Leukemia	5	5	—	—	$40,356.58	$41,970.84	$40,356.58	2025-01-01
'092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	5	5	—	—	$40,222.74	$41,831.65	$40,222.74	2025-01-01
A9543	HCPCS	Yttrium Y-90 Ibritumomab Tiuxetan Therapeutic Per Treatment Dose Up To 40 Millic…	136	122	$55,035.00	$35,772.75 35% off	$13,758.75	$114,584.02	$40,175.55	2025-01-01
799	MS_DRG	Splenic Procedures With Mcc	19	15	—	—	$40,014.12	$92,740.20	$40,014.12	2025-01-01
471	MS_DRG	Cervical Spinal Fusion With Mcc	19	15	—	—	$39,728.33	$92,073.84	$39,728.33	2025-01-01
J9350	HCPCS	Injection Mosunetzumab-axgb 1 Mg	136	122	$54,267.30	$35,273.75 35% off	$637.19	$48,840.57	$39,615.13	2025-01-01
6	MS_DRG	Liver Transplant Without Mcc	18	14	—	—	$39,069.23	$90,537.09	$39,518.53	2025-01-01
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	19	15	—	—	$39,416.84	$91,347.58	$39,416.84	2025-01-01
10	MS_DRG	Pancreas Transplant	18	14	—	—	$38,882.18	$90,100.96	$39,329.32	2025-01-01
'304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	5	5	—	—	$38,955.83	$40,514.06	$38,955.83	2025-01-01
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	19	15	—	—	$38,827.59	$89,973.68	$38,827.59	2025-01-01
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	19	15	—	—	$38,631.71	$89,516.96	$38,631.71	2025-01-01
'011-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	5	—	—	$38,578.54	$40,121.68	$38,578.54	2025-01-01
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	19	15	—	—	$38,424.59	$90,669.99	$38,424.59	2025-01-01
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	19	15	—	—	$38,294.53	$88,730.81	$38,294.53	2025-01-01
163	MS_DRG	Major Chest Procedures With Mcc	19	15	—	—	$38,079.38	$88,229.16	$38,079.38	2025-01-01
'050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	5	5	—	—	$37,925.09	$39,442.09	$37,925.09	2025-01-01
C2616	HCPCS	Brachytherapy Source Non-stranded Yttrium-90 Per Source	136	122	$51,900.00	$33,735.00 35% off	$12,975.00	$46,710.00	$37,887.00	2025-01-01
'183-4	OTHER	Percutaneous Structural Cardiac Procedures	5	5	—	—	$37,811.24	$39,323.69	$37,811.24	2025-01-01
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	19	15	—	—	$37,557.56	$87,012.49	$37,557.56	2025-01-01
'441-4	OTHER	Major Bladder Procedures	5	5	—	—	$37,527.82	$39,028.93	$37,527.82	2025-01-01
'169-4	OTHER	Major Abdominal Vascular Procedures	5	5	—	—	$37,295.88	$38,787.72	$37,295.88	2025-01-01
'120-4	OTHER	Major Respiratory And Chest Procedures	5	5	—	—	$37,248.03	$38,737.95	$37,248.03	2025-01-01
455	MS_DRG	Combined Anterior/posterior Spinal Fusion Without Cc/mcc	19	15	—	—	$37,212.36	$86,207.62	$37,212.36	2025-01-01
'004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	5	—	—	$37,047.58	$38,529.48	$37,047.58	2025-01-01
'912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	5	5	—	—	$36,893.15	$38,368.88	$36,893.15	2025-01-01
'009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	5	5	—	—	$36,696.94	$38,164.82	$36,696.94	2025-01-01
27800000002-208	CDM	Plug Cardiac Amulet Amplatzer 20mm	121	111	$50,238.24	$32,654.86 35% off	$12,559.56	$45,214.42	$36,673.92	2025-01-01
27800000002-102	CDM	Plug Cardiac Amulet Amplatzer 22mm	121	111	$50,238.24	$32,654.86 35% off	$12,559.56	$45,214.42	$36,673.92	2025-01-01
27800000002-105	CDM	Plug Cardiac Amulet Amplatzer 16mm	121	111	$50,238.24	$32,654.86 35% off	$12,559.56	$45,214.42	$36,673.92	2025-01-01
27800000002-104	CDM	Plug Cardiac Amulet Amplatzer 18mm	121	111	$50,238.24	$32,654.86 35% off	$12,559.56	$45,214.42	$36,673.92	2025-01-01
245	MS_DRG	Aicd Generator Procedures	19	15	—	—	$36,616.69	$84,818.75	$36,616.69	2025-01-01
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	19	15	—	—	$36,613.47	$84,811.26	$36,613.47	2025-01-01
27800000002-1647	CDM	Set Pump Impella Rp	121	111	$50,000.00	$32,500.00 35% off	$12,500.00	$45,000.00	$36,500.00	2025-01-01
27800000002-1643	CDM	Set Pump Impella Cp	121	111	$50,000.00	$32,500.00 35% off	$12,500.00	$45,000.00	$36,500.00	2025-01-01
27800000002-249	CDM	Impella Rp With Smart Assist	121	111	$50,000.00	$32,500.00 35% off	$12,500.00	$45,000.00	$36,500.00	2025-01-01
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	19	15	—	—	$36,499.48	$84,545.46	$36,499.48	2025-01-01
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	19	15	—	—	$36,379.86	$84,266.56	$36,379.86	2025-01-01
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	19	15	—	—	$36,344.54	$84,184.21	$36,344.54	2025-01-01
27800000002-19	CDM	Device Clsur Watchman Flx Laa 20mm	121	111	$49,470.00	$32,155.50 35% off	$12,367.50	$44,523.00	$36,113.10	2025-01-01
'651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	5	5	—	—	$36,090.13	$37,533.74	$36,090.13	2025-01-01
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	19	15	—	—	$36,046.70	$83,489.77	$36,046.70	2025-01-01
'008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	5	5	—	—	$35,884.83	$37,320.22	$35,884.83	2025-01-01
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	19	15	—	—	$35,789.80	$82,890.79	$35,789.80	2025-01-01
'510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	5	5	—	—	$35,724.95	$37,153.95	$35,724.95	2025-01-01
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	19	15	—	—	$35,690.26	$82,658.69	$35,690.26	2025-01-01
'310-4	OTHER	Intervertebral Disc Excision And Decompression	5	5	—	—	$35,519.65	$36,940.44	$35,519.65	2025-01-01
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	19	15	—	—	$35,471.90	$86,621.29	$35,471.90	2025-01-01
'514-4	OTHER	Female Reproductive System Reconstructive Procedures	5	5	—	—	$35,347.66	$36,761.57	$35,347.66	2025-01-01
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	19	15	—	—	$35,255.94	$81,646.04	$35,255.94	2025-01-01
'179-4	OTHER	Defibrillator Implants	5	5	—	—	$35,161.74	$36,568.21	$35,161.74	2025-01-01
'602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	5	5	—	—	$35,012.76	$36,413.27	$35,012.76	2025-01-01
901	MS_DRG	Wound Debridements For Injuries With Mcc	19	15	—	—	$34,982.19	$81,007.76	$34,982.19	2025-01-01
'611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	5	5	—	—	$34,941.30	$36,338.95	$34,941.30	2025-01-01
'792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	5	5	—	—	$34,874.69	$36,269.68	$34,874.69	2025-01-01
'021-4	OTHER	Open Craniotomy Except Trauma	5	5	—	—	$34,802.02	$36,194.10	$34,802.02	2025-01-01
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	19	15	—	—	$34,781.49	$80,539.81	$34,781.49	2025-01-01
'160-2	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	5	5	—	—	$34,767.50	$36,158.20	$34,767.50	2025-01-01
'089-4	OTHER	Major Cranial Or Facial Bone Procedures	5	5	—	—	$34,740.24	$36,129.85	$34,740.24	2025-01-01
'181-4	OTHER	Lower Extremity Arterial Procedures	5	5	—	—	$34,684.53	$36,071.91	$34,684.53	2025-01-01
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	19	15	—	—	$34,588.02	$80,088.71	$34,588.02	2025-01-01
'261-4	OTHER	Major Biliary Tract Procedures	5	5	—	—	$34,425.33	$35,802.34	$34,425.33	2025-01-01
'841-1	OTHER	Extensive Third Degree Burns With Skin Graft	5	5	—	—	$34,422.30	$35,799.19	$34,422.30	2025-01-01
'841-2	OTHER	Extensive Third Degree Burns With Skin Graft	5	5	—	—	$34,419.88	$35,796.68	$34,419.88	2025-01-01
J9266	HCPCS	Pegaspargase Per 1 Vial	136	122	$46,818.87	$30,432.27 35% off	$11,704.72	$47,276.01	$34,177.78	2025-01-01
'009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	5	5	—	—	$34,065.00	$35,427.60	$34,065.00	2025-01-01
793	MS_DRG	Full Term Neonate With Major Problems	18	15	—	—	$34,030.87	$78,789.68	$34,030.87	2025-01-01
'623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	5	5	—	—	$34,012.31	$35,372.80	$34,012.31	2025-01-01
'170-4	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	5	5	—	—	$33,936.61	$35,294.07	$33,936.61	2025-01-01
'950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	5	5	—	—	$33,800.35	$35,152.36	$33,800.35	2025-01-01
33270	HCPCS	Hc Insertion/replacement Permanent Subcutaneous Implantable Defi	136	122	$46,274.00	$30,078.10 35% off	$1,276.63	$54,855.47	$33,780.02	2025-01-01
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	19	15	—	—	$33,623.86	$77,840.67	$33,623.86	2025-01-01
'220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	5	5	—	—	$33,599.29	$34,943.26	$33,599.29	2025-01-01
'162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	5	5	—	—	$33,561.14	$34,903.59	$33,561.14	2025-01-01
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	19	15	—	—	$33,474.54	$77,492.52	$33,474.54	2025-01-01
'027-4	OTHER	Other Open Craniotomy	5	5	—	—	$33,441.84	$34,779.51	$33,441.84	2025-01-01
27800000002-309	CDM	Coil Web Sgl Layer 6x2mm	121	111	$45,600.43	$29,640.28 35% off	$11,400.11	$41,040.39	$33,288.31	2025-01-01
31	MS_DRG	Ventricular Shunt Procedures With Mcc	19	15	—	—	$33,286.68	$77,054.52	$33,286.68	2025-01-01
'613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	5	5	—	—	$33,277.72	$34,608.83	$33,277.72	2025-01-01
791	MS_DRG	Prematurity With Major Problems	18	15	—	—	$33,134.95	$76,700.75	$33,134.95	2025-01-01
'165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	5	5	—	—	$33,088.17	$34,411.70	$33,088.17	2025-01-01
'230-4	OTHER	Major Small Bowel Procedures	5	5	—	—	$33,063.34	$34,385.87	$33,063.34	2025-01-01
'612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	5	5	—	—	$32,957.96	$34,276.28	$32,957.96	2025-01-01
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	19	15	—	—	$32,814.64	$75,953.90	$32,814.64	2025-01-01
'163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	5	5	—	—	$32,764.17	$34,074.74	$32,764.17	2025-01-01
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	19	15	—	—	$32,710.27	$75,710.57	$32,710.27	2025-01-01
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	19	15	—	—	$32,681.37	$75,643.18	$32,681.37	2025-01-01
A9504	HCPCS	Technetium Tc-99m Apcitide Diagnostic Per Study Dose Up To 20 Millicuries	121	111	$44,600.00	$28,990.00 35% off	$782.88	$40,140.00	$32,558.00	2025-01-01
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	19	15	—	—	$32,467.03	$75,143.41	$32,467.03	2025-01-01

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