Hospital

KALKASKA MEMORIAL HEALTH CENTER

Kalkaska, MI · CCN 231301 · Rates published

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You selected 59400 (CPT)

OBSTETRICAL CARE

This hospital’s price: $1,555 across 6 payers

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/8136/386032904_kalkaska-memorial-health-center_standardcharges.csv · observed 2026-04-17

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

15,165 distinct procedures filed

31 distinct payers

992,302 rate rows

2026-04-17 last MRF observed

Data quality

673,458 of 992,302 rate rows are consumer-grade (67.9%)

318,844 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
professional (physician) fee — not the facility price	299,996
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	14,685
per-diem day rate — not a per-procedure price	1,931
placeholder amount (≤ $0.02) — excluded from medians	808
exceeds 10× this hospital's gross charge — excluded from medians	734
percent-of-charges filed in the dollar field — excluded from medians	684
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	6

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

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/8136/386032904_kalkaska-memorial-health-center_standardcharges.csv
Found on page	https://www.munsonhealthcare.org/patients-visitors/munson-healthcare-chargemaster-information
Discovered via	Discovered by HANK
Last fetch	success · 2026-08-11
Content fingerprint	be293938a2989ad8… · 1,360,241,528 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code	Description	Payers	Min $	Max $	Avg median	vs national
J3391 HCPCS	Inj, Atidarsagene Autotemcel	6	$3,176,025.00	$3,176,025.00	$3,176,025.00	nat. median $4,505,000 0.7× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	6	$2,598,113.00	$2,598,113.00	$2,598,113.00	nat. median $3,710,000 0.7× median
J3389 HCPCS	Topi Adm Prad Zami Per Treat	6	$2,351,753.10	$2,351,753.10	$2,351,753.10	nat. median $3,335,820 0.7× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	6	$2,346,141.11	$2,346,141.11	$2,346,141.11	nat. median $3,324,572 0.7× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	6	$2,293,018.19	$2,293,018.19	$2,293,018.19	nat. median $3,286,000 0.7× median
J3387 HCPCS	Inj Elivaldogene Autotemecel	6	$2,241,900.00	$2,241,900.00	$2,241,900.00	nat. median $3,180,000 0.7× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	6	$2,072,678.07	$2,072,678.07	$2,072,678.07	nat. median $2,997,086 0.7× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	6	$1,825,231.76	$1,825,231.76	$1,825,231.76	nat. median $2,460,273 0.7× median
J3392 HCPCS	Inj, Exagamglogene Autotem	6	$1,644,060.00	$1,644,060.00	$1,644,060.00	nat. median $2,405,851 0.7× median
Q2057 HCPCS	Afamitresgene Autoleucel	6	$543,287.10	$543,287.10	$543,287.10	nat. median $809,151 0.7× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	6	$414,292.95	$414,292.95	$414,292.95	nat. median $631,793 0.7× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	6	$399,404.57	$399,404.57	$399,404.57	nat. median $691,418 0.6× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	6	$396,351.88	$396,351.88	$396,351.88	nat. median $624,417 0.6× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	6	$393,447.62	$393,447.62	$393,447.62	nat. median $610,161 0.6× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	6	$375,195.53	$375,195.53	$375,195.53	nat. median $588,565 0.6× median
Q2053 HCPCS	Brexucabtagene Car Pos T	6	$345,062.39	$345,062.39	$345,062.39	nat. median $577,541 0.6× median
5834 APR_DRG	Inpatient Apr-DRG	6	$278,136.62	$278,136.62	$278,136.62	nat. median $311,018 0.9× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	6	$196,166.25	$196,166.25	$196,166.25	nat. median $302,242 0.6× median
J3403 HCPCS	Revakinagene, Per Implant	6	$186,825.00	$186,825.00	$186,825.00	nat. median $265,000 0.7× median
5884 APR_DRG	Inpatient Apr-DRG	6	$186,266.36	$186,266.36	$186,266.36	nat. median $254,667 0.7× median
114 APR_DRG	Inpatient Apr-DRG	6	$171,409.63	$171,409.63	$171,409.63	nat. median $119,243 1.4× median
5833 APR_DRG	Inpatient Apr-DRG	6	$168,322.70	$168,322.70	$168,322.70	nat. median $250,089 0.7× median
6314 APR_DRG	Inpatient Apr-DRG	6	$161,670.57	$161,670.57	$161,670.57	nat. median $147,677 1.1× median
1614 APR_DRG	Inpatient Apr-DRG	6	$152,200.44	$152,200.44	$152,200.44	nat. median $209,486 0.7× median
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	6	$142,176.66	$142,176.66	$142,176.66	nat. median $209,736 0.7× median
6094 APR_DRG	Inpatient Apr-DRG	6	$137,286.12	$137,286.12	$137,286.12	nat. median $168,174 0.8× median
113 APR_DRG	Inpatient Apr-DRG	6	$132,169.95	$132,169.95	$132,169.95	nat. median $67,603 2.0× median
8414 APR_DRG	Inpatient Apr-DRG	6	$129,024.42	$129,024.42	$129,024.42	nat. median $165,646 0.8× median
74 APR_DRG	Inpatient Apr-DRG	6	$118,526.15	$118,526.15	$118,526.15	nat. median $175,480 0.7× median
6304 APR_DRG	Inpatient Apr-DRG	6	$118,203.64	$118,203.64	$118,203.64	nat. median $160,171 0.7× median
112 APR_DRG	Inpatient Apr-DRG	6	$112,214.57	$112,214.57	$112,214.57	nat. median $63,564 1.8× median
5934 APR_DRG	Inpatient Apr-DRG	6	$111,817.44	$111,817.44	$111,817.44	nat. median $156,285 0.7× median
94 APR_DRG	Inpatient Apr-DRG	6	$111,458.36	$111,458.36	$111,458.36	nat. median $165,599 0.7× median
5914 APR_DRG	Inpatient Apr-DRG	6	$110,432.22	$110,432.22	$110,432.22	nat. median $168,361 0.7× median
5883 APR_DRG	Inpatient Apr-DRG	6	$102,870.14	$102,870.14	$102,870.14	nat. median $180,995 0.6× median
5882 APR_DRG	Inpatient Apr-DRG	6	$94,899.91	$94,899.91	$94,899.91	nat. median $147,847 0.6× median
44 APR_DRG	Inpatient Apr-DRG	6	$93,586.31	$93,586.31	$93,586.31	nat. median $127,600 0.7× median
5832 APR_DRG	Inpatient Apr-DRG	6	$93,512.19	$93,512.19	$93,512.19	nat. median $169,230 0.6× median
5881 APR_DRG	Inpatient Apr-DRG	6	$88,877.29	$88,877.29	$88,877.29	nat. median $120,928 0.7× median
5892 APR_DRG	Inpatient Apr-DRG	6	$87,244.18	$87,244.18	$87,244.18	nat. median $89,188 1.0× median
5893 APR_DRG	Inpatient Apr-DRG	6	$87,181.58	$87,181.58	$87,181.58	nat. median $71,350 1.2× median
5891 APR_DRG	Inpatient Apr-DRG	6	$86,123.89	$86,123.89	$86,123.89	nat. median $96,420 0.9× median
1604 APR_DRG	Inpatient Apr-DRG	6	$84,654.54	$84,654.54	$84,654.54	nat. median $101,315 0.8× median
5913 APR_DRG	Inpatient Apr-DRG	6	$83,318.91	$83,318.91	$83,318.91	nat. median $108,751 0.8× median
8424 APR_DRG	Inpatient Apr-DRG	6	$83,220.75	$83,220.75	$83,220.75	nat. median $83,517 1.0× median
1613 APR_DRG	Inpatient Apr-DRG	6	$82,616.29	$82,616.29	$82,616.29	nat. median $127,938 0.6× median
5831 APR_DRG	Inpatient Apr-DRG	6	$79,835.85	$79,835.85	$79,835.85	nat. median $154,685 0.5× median
Q0480 HCPCS	Driver Pneumatic Vad, Rep	6	$78,185.74	$78,185.74	$78,185.74	nat. median $111,503 0.7× median
5933 APR_DRG	Inpatient Apr-DRG	6	$75,731.29	$75,731.29	$75,731.29	nat. median $112,711 0.7× median
1612 APR_DRG	Inpatient Apr-DRG	6	$75,073.24	$75,073.24	$75,073.24	nat. median $93,192 0.8× median

Other procedures at this hospital

Browse this hospital's 15,165 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J3391	HCPCS	Inj, Atidarsagene Autotemcel	6	6	—	—	$3,176,025.00	$3,176,025.00	$3,176,025.00	2026-04-17
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	6	6	—	—	$2,598,113.00	$2,598,113.00	$2,598,113.00	2026-04-17
J3389	HCPCS	Topi Adm Prad Zami Per Treat	6	6	—	—	$2,351,753.10	$2,351,753.10	$2,351,753.10	2026-04-17
J1413	HCPCS	Inj Delandistrogene Mox Rokl	6	6	—	—	$2,346,141.11	$2,346,141.11	$2,346,141.11	2026-04-17
J3394	HCPCS	Inj, Lovotibeglogene Autotem	6	6	—	—	$2,293,018.19	$2,293,018.19	$2,293,018.19	2026-04-17
J3387	HCPCS	Inj Elivaldogene Autotemecel	6	6	—	—	$2,241,900.00	$2,241,900.00	$2,241,900.00	2026-04-17
J3393	HCPCS	Inj, Betibeglogene Autotemce	6	6	—	—	$2,072,678.07	$2,072,678.07	$2,072,678.07	2026-04-17
J3399	HCPCS	Inj Onase Abepar-xioi Treat	6	6	—	—	$1,825,231.76	$1,825,231.76	$1,825,231.76	2026-04-17
J3392	HCPCS	Inj, Exagamglogene Autotem	6	6	—	—	$1,644,060.00	$1,644,060.00	$1,644,060.00	2026-04-17
Q2057	HCPCS	Afamitresgene Autoleucel	6	6	—	—	$543,287.10	$543,287.10	$543,287.10	2026-04-17
Q2056	HCPCS	Ciltacabtagene Car-pos T	6	6	—	—	$414,292.95	$414,292.95	$414,292.95	2026-04-17
Q2042	HCPCS	Tisagenlecleucel Car-pos T	6	6	—	—	$399,404.57	$399,404.57	$399,404.57	2026-04-17
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	6	6	—	—	$396,351.88	$396,351.88	$396,351.88	2026-04-17
Q2055	HCPCS	Idecabtagene Vicleucel Car	6	6	—	—	$393,447.62	$393,447.62	$393,447.62	2026-04-17
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	6	6	—	—	$375,195.53	$375,195.53	$375,195.53	2026-04-17
Q2053	HCPCS	Brexucabtagene Car Pos T	6	6	—	—	$345,062.39	$345,062.39	$345,062.39	2026-04-17
5834	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$278,136.62	$278,136.62	$278,136.62	2026-04-17
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	6	6	—	—	$196,166.25	$196,166.25	$196,166.25	2026-04-17
J3403	HCPCS	Revakinagene, Per Implant	6	6	—	—	$186,825.00	$186,825.00	$186,825.00	2026-04-17
5884	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$186,266.36	$186,266.36	$186,266.36	2026-04-17
114	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$171,409.63	$171,409.63	$171,409.63	2026-04-17
5833	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$168,322.70	$168,322.70	$168,322.70	2026-04-17
6314	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$161,670.57	$161,670.57	$161,670.57	2026-04-17
1614	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$152,200.44	$152,200.44	$152,200.44	2026-04-17
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	6	6	—	—	$142,176.66	$142,176.66	$142,176.66	2026-04-17
6094	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$137,286.12	$137,286.12	$137,286.12	2026-04-17
113	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$132,169.95	$132,169.95	$132,169.95	2026-04-17
8414	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$129,024.42	$129,024.42	$129,024.42	2026-04-17
74	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$118,526.15	$118,526.15	$118,526.15	2026-04-17
6304	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$118,203.64	$118,203.64	$118,203.64	2026-04-17
112	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$112,214.57	$112,214.57	$112,214.57	2026-04-17
5934	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$111,817.44	$111,817.44	$111,817.44	2026-04-17
94	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$111,458.36	$111,458.36	$111,458.36	2026-04-17
5914	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$110,432.22	$110,432.22	$110,432.22	2026-04-17
5883	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$102,870.14	$102,870.14	$102,870.14	2026-04-17
5882	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$94,899.91	$94,899.91	$94,899.91	2026-04-17
44	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$93,586.31	$93,586.31	$93,586.31	2026-04-17
5832	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$93,512.19	$93,512.19	$93,512.19	2026-04-17
5881	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$88,877.29	$88,877.29	$88,877.29	2026-04-17
5892	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$87,244.18	$87,244.18	$87,244.18	2026-04-17
5893	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$87,181.58	$87,181.58	$87,181.58	2026-04-17
5891	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$86,123.89	$86,123.89	$86,123.89	2026-04-17
1604	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$84,654.54	$84,654.54	$84,654.54	2026-04-17
5913	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$83,318.91	$83,318.91	$83,318.91	2026-04-17
8424	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$83,220.75	$83,220.75	$83,220.75	2026-04-17
1613	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$82,616.29	$82,616.29	$82,616.29	2026-04-17
5831	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$79,835.85	$79,835.85	$79,835.85	2026-04-17
Q0480	HCPCS	Driver Pneumatic Vad, Rep	6	6	—	—	$78,185.74	$78,185.74	$78,185.74	2026-04-17
5933	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$75,731.29	$75,731.29	$75,731.29	2026-04-17
1612	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$75,073.24	$75,073.24	$75,073.24	2026-04-17
J7330	HCPCS	Cultured Chondrocytes Implnt	2	2	—	—	$71,167.10	$71,167.10	$71,167.10	2026-04-17
93	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$67,205.67	$67,205.67	$67,205.67	2026-04-17
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	6	6	—	—	$67,032.13	$67,032.13	$67,032.13	2026-04-17
6303	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$66,708.88	$66,708.88	$66,708.88	2026-04-17
5912	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$63,994.04	$63,994.04	$63,994.04	2026-04-17
1611	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$63,338.99	$63,338.99	$63,338.99	2026-04-17
54	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$60,219.01	$60,219.01	$60,219.01	2026-04-17
6034	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$60,006.17	$60,006.17	$60,006.17	2026-04-17
90288	CPT	Botulism Ig IV	2	2	—	—	$58,905.00	$58,905.00	$58,905.00	2026-04-17
43	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$58,114.15	$58,114.15	$58,114.15	2026-04-17
73	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$56,734.44	$56,734.44	$56,734.44	2026-04-17
72	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$54,526.92	$54,526.92	$54,526.92	2026-04-17
6134	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$54,138.30	$54,138.30	$54,138.30	2026-04-17
84	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$53,246.37	$53,246.37	$53,246.37	2026-04-17
8504	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$53,112.66	$53,112.66	$53,112.66	2026-04-17
6024	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$52,957.41	$52,957.41	$52,957.41	2026-04-17
3034	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$52,531.73	$52,531.73	$52,531.73	2026-04-17
111	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$52,011.40	$52,011.40	$52,011.40	2026-04-17
8514	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$49,106.26	$49,106.26	$49,106.26	2026-04-17
8513	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$49,106.26	$49,106.26	$49,106.26	2026-04-17
53	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$48,800.77	$48,800.77	$48,800.77	2026-04-17
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	6	6	—	—	$48,505.21	$48,505.21	$48,505.21	2026-04-17
8634	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$48,464.23	$48,464.23	$48,464.23	2026-04-17
6124	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$48,298.47	$48,298.47	$48,298.47	2026-04-17
5932	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$47,070.00	$47,070.00	$47,070.00	2026-04-17
8413	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$47,048.97	$47,048.97	$47,048.97	2026-04-17
C1824	HCPCS	Generator Optimizer Ipg86302	32	27	$65,000.00	$55,250.00	$23,400.00	$61,750.00	$46,800.00	2026-04-17
71	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$46,797.57	$46,797.57	$46,797.57	2026-04-17
1624	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$46,470.55	$46,470.55	$46,470.55	2026-04-17
J9029	HCPCS	Instill Adstiladrin, Tx Dose	6	6	—	—	$45,313.73	$45,313.73	$45,313.73	2026-04-17
1634	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$45,250.10	$45,250.10	$45,250.10	2026-04-17
38240	CPT	Transplt Allo Hct/donor	6	6	—	—	$44,389.70	$44,389.70	$44,389.70	2026-04-17
6093	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$44,254.51	$44,254.51	$44,254.51	2026-04-17
1603	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$43,516.83	$43,516.83	$43,516.83	2026-04-17
1674	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$41,009.32	$41,009.32	$41,009.32	2026-04-17
6023	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$39,673.19	$39,673.19	$39,673.19	2026-04-17
J2507	HCPCS	Krystexxa 8 mg/mL Vial	40	29	$101,171.24	$85,995.56	$2,657.01	$96,112.68	$39,335.38	2026-04-17
A9543	HCPCS	Kit Yttrium 90 Therasphere 3 Gbq36432	71	29	$48,523.00	$41,244.55	$17,365.50	$69,162.84	$38,590.00	2026-04-17
6313	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$38,399.65	$38,399.65	$38,399.65	2026-04-17
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	6	6	—	—	$38,354.90	$38,354.90	$38,354.90	2026-04-17
914	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$37,694.03	$37,694.03	$37,694.03	2026-04-17
6033	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$37,362.00	$37,362.00	$37,362.00	2026-04-17
6804	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$37,353.48	$37,353.48	$37,353.48	2026-04-17
9114	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$36,743.51	$36,743.51	$36,743.51	2026-04-17
42	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$36,620.31	$36,620.31	$36,620.31	2026-04-17
J9359	HCPCS	Zynlonta 10 Mg/2 Ml Vial	39	29	$93,205.29	$79,224.50	$155.96	$88,545.03	$36,350.06	2026-04-17
6074	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$36,294.79	$36,294.79	$36,294.79	2026-04-17
1784	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$36,195.13	$36,195.13	$36,195.13	2026-04-17
6904	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$35,755.43	$35,755.43	$35,755.43	2026-04-17
2994	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$35,745.41	$35,745.41	$35,745.41	2026-04-17
1704	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$35,615.21	$35,615.21	$35,615.21	2026-04-17
1764	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$35,574.64	$35,574.64	$35,574.64	2026-04-17
6254	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$35,411.38	$35,411.38	$35,411.38	2026-04-17
913	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$34,918.09	$34,918.09	$34,918.09	2026-04-17
L7181	HCPCS	Electronic Elbo Simultaneous	6	6	—	—	$34,783.42	$34,783.42	$34,783.42	2026-04-17
1602	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$34,390.75	$34,390.75	$34,390.75	2026-04-17
1623	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$34,223.98	$34,223.98	$34,223.98	2026-04-17
204	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$34,110.30	$34,110.30	$34,110.30	2026-04-17
3124	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$33,959.06	$33,959.06	$33,959.06	2026-04-17
L7180	HCPCS	Electronic Elbow Sequential	6	6	—	—	$33,783.59	$33,783.59	$33,783.59	2026-04-17
92	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$33,647.06	$33,647.06	$33,647.06	2026-04-17
3033	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$33,634.04	$33,634.04	$33,634.04	2026-04-17
6514	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$33,255.44	$33,255.44	$33,255.44	2026-04-17
83	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$32,420.10	$32,420.10	$32,420.10	2026-04-17
C2624	HCPCS	System Delivery Pa Sensor60810	32	27	$45,000.00	$38,250.00	$16,200.00	$42,750.00	$32,400.00	2026-04-17
6114	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$31,921.81	$31,921.81	$31,921.81	2026-04-17
4414	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$31,804.12	$31,804.12	$31,804.12	2026-04-17
1654	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$31,728.50	$31,728.50	$31,728.50	2026-04-17
1664	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$31,618.32	$31,618.32	$31,618.32	2026-04-17
924	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$31,540.20	$31,540.20	$31,540.20	2026-04-17
3614	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$31,497.63	$31,497.63	$31,497.63	2026-04-17
6123	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$31,363.92	$31,363.92	$31,363.92	2026-04-17
91	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$31,264.76	$31,264.76	$31,264.76	2026-04-17
33276	CPT	Insj Phrnc Nrv Stim Sys	6	6	—	—	$31,083.87	$31,083.87	$31,083.87	2026-04-17
64568	CPT	Opn Impltj Crnl Nrv Nea&pg	6	6	—	—	$31,083.87	$31,083.87	$31,083.87	2026-04-17
64654	CPT	1st Opn Implt Bat Modulj Sys	6	6	—	—	$31,083.87	$31,083.87	$31,083.87	2026-04-17
0620T	CPT	Evasc Ven Artlz Tibl/prnl Vn	6	6	—	—	$31,083.87	$31,083.87	$31,083.87	2026-04-17
8412	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$31,072.45	$31,072.45	$31,072.45	2026-04-17
1834	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$30,924.21	$30,924.21	$30,924.21	2026-04-17
6022	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$30,871.63	$30,871.63	$30,871.63	2026-04-17
9124	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$30,741.92	$30,741.92	$30,741.92	2026-04-17
6954	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$30,658.29	$30,658.29	$30,658.29	2026-04-17
J9226	HCPCS	Supprelin La Implant	8	7	—	—	$30,445.66	$44,814.97	$30,445.66	2026-04-17
894	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$30,260.15	$30,260.15	$30,260.15	2026-04-17
9104	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$30,118.93	$30,118.93	$30,118.93	2026-04-17
C1767	HCPCS	Controller Medtronic Dbs79104	576	27	$53,295.00	$45,300.75	$1,021.50	$98,151.63	$29,750.20	2026-04-17
1204	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$29,524.48	$29,524.48	$29,524.48	2026-04-17
7404	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$29,414.30	$29,414.30	$29,414.30	2026-04-17
8411	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$29,151.38	$29,151.38	$29,151.38	2026-04-17
3044	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$29,110.32	$29,110.32	$29,110.32	2026-04-17
6814	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$29,048.22	$29,048.22	$29,048.22	2026-04-17
1694	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$29,034.19	$29,034.19	$29,034.19	2026-04-17
1622	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$28,856.41	$28,856.41	$28,856.41	2026-04-17
504	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$28,412.20	$28,412.20	$28,412.20	2026-04-17
6092	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$28,372.14	$28,372.14	$28,372.14	2026-04-17
1633	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$28,336.58	$28,336.58	$28,336.58	2026-04-17
6073	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$28,196.86	$28,196.86	$28,196.86	2026-04-17
1653	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$28,113.72	$28,113.72	$28,113.72	2026-04-17
1783	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$27,965.49	$27,965.49	$27,965.49	2026-04-17
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	6	6	—	—	$27,874.21	$27,874.21	$27,874.21	2026-04-17
214	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$27,735.62	$27,735.62	$27,735.62	2026-04-17
1794	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$27,659.00	$27,659.00	$27,659.00	2026-04-17
6234	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$27,584.88	$27,584.88	$27,584.88	2026-04-17
2993	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$27,246.84	$27,246.84	$27,246.84	2026-04-17
6224	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$26,733.02	$26,733.02	$26,733.02	2026-04-17
6302	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$26,722.50	$26,722.50	$26,722.50	2026-04-17
5144	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$26,629.35	$26,629.35	$26,629.35	2026-04-17
4844	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$26,574.26	$26,574.26	$26,574.26	2026-04-17
5134	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$26,282.80	$26,282.80	$26,282.80	2026-04-17
234	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$26,153.59	$26,153.59	$26,153.59	2026-04-17
9504	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,977.81	$25,977.81	$25,977.81	2026-04-17
6133	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,962.29	$25,962.29	$25,962.29	2026-04-17
4014	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,948.76	$25,948.76	$25,948.76	2026-04-17
1814	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,864.13	$25,864.13	$25,864.13	2026-04-17
J2350	HCPCS	Ocrevus 300 Mg/10 Ml Inject	102	29	$67,912.06	$57,725.25	$41.82	$64,604.62	$25,806.58	2026-04-17
7924	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,806.04	$25,806.04	$25,806.04	2026-04-17
2614	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,761.97	$25,761.97	$25,761.97	2026-04-17
6032	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,674.83	$25,674.83	$25,674.83	2026-04-17
912	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,661.31	$25,661.31	$25,661.31	2026-04-17
9103	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,628.25	$25,628.25	$25,628.25	2026-04-17
1601	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,625.25	$25,625.25	$25,625.25	2026-04-17
4234	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,402.89	$25,402.89	$25,402.89	2026-04-17
4424	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,314.25	$25,314.25	$25,314.25	2026-04-17
2304	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,207.08	$25,207.08	$25,207.08	2026-04-17
6144	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,194.56	$25,194.56	$25,194.56	2026-04-17
6021	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,058.84	$25,058.84	$25,058.84	2026-04-17
3104	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$25,057.34	$25,057.34	$25,057.34	2026-04-17
2244	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$24,986.73	$24,986.73	$24,986.73	2026-04-17
6903	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$24,889.07	$24,889.07	$24,889.07	2026-04-17
J9229	HCPCS	Besponsa 0.9 Mg/3.6 Ml Inject	39	29	$63,395.49	$53,886.17	$1,985.82	$60,225.72	$24,724.24	2026-04-17
6084	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$24,713.79	$24,713.79	$24,713.79	2026-04-17
41	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$24,692.26	$24,692.26	$24,692.26	2026-04-17
1304	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$24,680.24	$24,680.24	$24,680.24	2026-04-17
2204	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$24,674.23	$24,674.23	$24,674.23	2026-04-17
213	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$24,670.22	$24,670.22	$24,670.22	2026-04-17
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	6	6	—	—	$24,653.94	$24,653.94	$24,653.94	2026-04-17
5931	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$24,546.52	$24,546.52	$24,546.52	2026-04-17
3004	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$24,331.18	$24,331.18	$24,331.18	2026-04-17
1763	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$24,260.07	$24,260.07	$24,260.07	2026-04-17
0870T	CPT	Imp Subq Prtl Ascts Pmp Sys	6	6	—	—	$24,176.42	$24,176.42	$24,176.42	2026-04-17
434	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,984.63	$23,984.63	$23,984.63	2026-04-17
J9309	HCPCS	Polivy 140 Mg/7 Ml Vial	39	29	$61,258.34	$52,069.59	$96.42	$58,195.42	$23,890.75	2026-04-17
8434	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,814.36	$23,814.36	$23,814.36	2026-04-17
6334	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,682.14	$23,682.14	$23,682.14	2026-04-17
1621	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,650.59	$23,650.59	$23,650.59	2026-04-17
6614	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,590.50	$23,590.50	$23,590.50	2026-04-17
5114	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,583.49	$23,583.49	$23,583.49	2026-04-17
3214	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,524.39	$23,524.39	$23,524.39	2026-04-17
1652	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,519.88	$23,519.88	$23,519.88	2026-04-17
8503	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,509.87	$23,509.87	$23,509.87	2026-04-17
6091	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,487.83	$23,487.83	$23,487.83	2026-04-17
3032	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,436.25	$23,436.25	$23,436.25	2026-04-17
4054	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,365.14	$23,365.14	$23,365.14	2026-04-17
C1882	HCPCS	Generator Allure Quadra Mp Pm356260223	502	31	$36,000.00	$30,600.00	$5,040.00	$38,589.00	$23,310.80	2026-04-17
2644	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,292.52	$23,292.52	$23,292.52	2026-04-17
69930	CPT	Implant Cochlear Device	6	6	—	—	$23,268.63	$23,268.63	$23,268.63	2026-04-17
274	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,220.91	$23,220.91	$23,220.91	2026-04-17
1824	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,084.69	$23,084.69	$23,084.69	2026-04-17
4034	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$23,006.06	$23,006.06	$23,006.06	2026-04-17
1782	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,982.53	$22,982.53	$22,982.53	2026-04-17
6083	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,964.00	$22,964.00	$22,964.00	2026-04-17
7114	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,690.06	$22,690.06	$22,690.06	2026-04-17
3043	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,676.04	$22,676.04	$22,676.04	2026-04-17
2314	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,589.40	$22,589.40	$22,589.40	2026-04-17
4044	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,571.37	$22,571.37	$22,571.37	2026-04-17
1754	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,363.54	$22,363.54	$22,363.54	2026-04-17
8423	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,297.93	$22,297.93	$22,297.93	2026-04-17
4284	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,235.33	$22,235.33	$22,235.33	2026-04-17
2224	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,183.25	$22,183.25	$22,183.25	2026-04-17
0915T	CPT	Insj Perm Ccm-d Sys Pg&eltrd	6	6	—	—	$22,151.31	$22,151.31	$22,151.31	2026-04-17
33270	CPT	Ins/rep Subq Defibrillator	6	6	—	—	$22,151.31	$22,151.31	$22,151.31	2026-04-17
33264	CPT	Rmvl & Rplcmt Dfb Gen Mlt Ld	6	6	—	—	$22,151.31	$22,151.31	$22,151.31	2026-04-17
33249	CPT	Insj/rplcmt Defib W/lead(s)	6	6	—	—	$22,151.31	$22,151.31	$22,151.31	2026-04-17
33231	CPT	Insrt Pulse Gen W/mult Leads	6	6	—	—	$22,151.31	$22,151.31	$22,151.31	2026-04-17
0408T	CPT	Insj/rplc Cardiac Modulj Sys	6	6	—	—	$22,151.31	$22,151.31	$22,151.31	2026-04-17
0571T	CPT	Insj/rplcmt Icds Ss Eltrd	6	6	—	—	$22,151.31	$22,151.31	$22,151.31	2026-04-17
1303	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,150.70	$22,150.70	$22,150.70	2026-04-17
1714	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,139.68	$22,139.68	$22,139.68	2026-04-17
203	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,133.17	$22,133.17	$22,133.17	2026-04-17
1833	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,107.63	$22,107.63	$22,107.63	2026-04-17
82	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,042.52	$22,042.52	$22,042.52	2026-04-17
3134	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$22,032.01	$22,032.01	$22,032.01	2026-04-17
1693	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,967.91	$21,967.91	$21,967.91	2026-04-17
C1820	HCPCS	Implant Restore Rechargeable45627	384	27	$42,500.00	$36,125.00	$8,910.00	$53,437.50	$21,870.00	2026-04-17
4834	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,791.12	$21,791.12	$21,791.12	2026-04-17
33287	CPT	Rmv&rplcmt Phrnc Nrv Stim Pg	6	6	—	—	$21,776.47	$21,776.47	$21,776.47	2026-04-17
0674T	CPT	Laps Insj Nw/rpcmt Prm Isdss	6	6	—	—	$21,776.47	$21,776.47	$21,776.47	2026-04-17
0908T	CPT	Opn Imp Int Nstm Sys Vgs Nrv	6	6	—	—	$21,776.47	$21,776.47	$21,776.47	2026-04-17
64582	CPT	Opn Mpltj Hpglsl Nstm Ary Pg	6	6	—	—	$21,776.47	$21,776.47	$21,776.47	2026-04-17
63685	CPT	Ins/rplc Spi Npg/rcvr Pocket	6	6	—	—	$21,776.47	$21,776.47	$21,776.47	2026-04-17
61891	CPT	Rev/rplcmt Sk-mnt Crnl Nstm	6	6	—	—	$21,776.47	$21,776.47	$21,776.47	2026-04-17
61885	CPT	Insrt/redo Neurostim 1 Array	6	6	—	—	$21,776.47	$21,776.47	$21,776.47	2026-04-17
61886	CPT	Implant Neurostim Arrays	6	6	—	—	$21,776.47	$21,776.47	$21,776.47	2026-04-17
64656	CPT	Revj/rplcmt Bat Mod Sys Pg	6	6	—	—	$21,776.47	$21,776.47	$21,776.47	2026-04-17
0909T	CPT	Rplcmt Int Nstim Sys Vgs Nrv	6	6	—	—	$21,776.47	$21,776.47	$21,776.47	2026-04-17
1703	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,756.57	$21,756.57	$21,756.57	2026-04-17
1632	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,738.04	$21,738.04	$21,738.04	2026-04-17
52	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,690.46	$21,690.46	$21,690.46	2026-04-17
3154	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,623.86	$21,623.86	$21,623.86	2026-04-17
224	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,407.51	$21,407.51	$21,407.51	2026-04-17
C1822	HCPCS	Kit Charger Nevro65981	214	31	$46,250.00	$39,312.50	$900.00	$53,437.50	$21,375.00	2026-04-17
893	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,359.93	$21,359.93	$21,359.93	2026-04-17
3254	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,321.87	$21,321.87	$21,321.87	2026-04-17
1793	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,174.64	$21,174.64	$21,174.64	2026-04-17
3224	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,152.60	$21,152.60	$21,152.60	2026-04-17
3031	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,102.52	$21,102.52	$21,102.52	2026-04-17
3084	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,081.99	$21,081.99	$21,081.99	2026-04-17
304	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,058.95	$21,058.95	$21,058.95	2026-04-17
7934	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,042.43	$21,042.43	$21,042.43	2026-04-17
1663	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,032.91	$21,032.91	$21,032.91	2026-04-17
1673	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$21,010.88	$21,010.88	$21,010.88	2026-04-17
1214	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,847.12	$20,847.12	$20,847.12	2026-04-17
L5856	HCPCS	Elec Knee-shin Swing/stance	6	6	—	—	$20,839.64	$20,839.64	$20,839.64	2026-04-17
6504	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,818.57	$20,818.57	$20,818.57	2026-04-17
6072	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,817.57	$20,817.57	$20,817.57	2026-04-17
L6700	HCPCS	Ue Add Ext Power Myoel	6	6	—	—	$20,804.68	$20,804.68	$20,804.68	2026-04-17
1781	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,760.48	$20,760.48	$20,760.48	2026-04-17
L6880	HCPCS	Elec Hand Ind Art Digits	6	6	—	—	$20,741.25	$20,741.25	$20,741.25	2026-04-17
8633	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,718.41	$20,718.41	$20,718.41	2026-04-17
294	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,676.34	$20,676.34	$20,676.34	2026-04-17
2604	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,659.32	$20,659.32	$20,659.32	2026-04-17
3244	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,599.22	$20,599.22	$20,599.22	2026-04-17
233	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,584.20	$20,584.20	$20,584.20	2026-04-17
1651	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,534.12	$20,534.12	$20,534.12	2026-04-17
293	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,379.37	$20,379.37	$20,379.37	2026-04-17
33289	CPT	Tcat Impl Wrls P-art Prs Snr	6	6	—	—	$20,242.02	$20,242.02	$20,242.02	2026-04-17
9514	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,226.12	$20,226.12	$20,226.12	2026-04-17
2004	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,224.62	$20,224.62	$20,224.62	2026-04-17
6223	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,183.05	$20,183.05	$20,183.05	2026-04-17
954	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,149.00	$20,149.00	$20,149.00	2026-04-17
5194	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,115.95	$20,115.95	$20,115.95	2026-04-17
1774	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,092.91	$20,092.91	$20,092.91	2026-04-17
1631	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,075.88	$20,075.88	$20,075.88	2026-04-17
734	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,071.38	$20,071.38	$20,071.38	2026-04-17
923	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,067.37	$20,067.37	$20,067.37	2026-04-17
7594	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,052.35	$20,052.35	$20,052.35	2026-04-17
3234	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$20,019.29	$20,019.29	$20,019.29	2026-04-17
4474	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,975.72	$19,975.72	$19,975.72	2026-04-17
1744	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,972.22	$19,972.22	$19,972.22	2026-04-17
1662	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,966.71	$19,966.71	$19,966.71	2026-04-17
2992	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,859.54	$19,859.54	$19,859.54	2026-04-17
9123	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,859.04	$19,859.04	$19,859.04	2026-04-17
3204	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,688.76	$19,688.76	$19,688.76	2026-04-17
7944	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,607.13	$19,607.13	$19,607.13	2026-04-17
4484	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,597.62	$19,597.62	$19,597.62	2026-04-17
3213	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,553.55	$19,553.55	$19,553.55	2026-04-17
1762	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,500.46	$19,500.46	$19,500.46	2026-04-17
4624	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,404.31	$19,404.31	$19,404.31	2026-04-17
4413	APR_DRG	Inpatient Apr-DRG	6	6	—	—	$19,358.24	$19,358.24	$19,358.24	2026-04-17
J9026	HCPCS	Tarlatamab-dlle 10 Mg Vial	39	29	$49,376.80	$41,970.28	$1,104.44	$46,907.96	$19,256.95	2026-04-17

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