Price Transparencybeta Hospital negotiated rates

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

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Hospital

CHARLEVOIX AREA HOSPITAL

Charlevoix, MI · CCN 231322 · Rates published

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You selected 93306 (CPT)

Echo 2D & M W SPCT & Color (C/G)

This hospital’s price: $1,671 across 27 payers · range $386-$2,089

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/8131/381459366_munson-healthcare-charlevoix-hospital_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.

15,057 distinct procedures filed
27 distinct payers
906,483 rate rows
2026-04-17 last MRF observed
Data quality

615,856 of 906,483 rate rows are consumer-grade (67.9%)

290,627 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
professional (physician) fee — not the facility price 289,032
placeholder amount (≤ $0.02) — excluded from medians 810
percent-of-charges filed in the dollar field — excluded from medians 619
per-diem day rate — not a per-procedure price 75
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 49
exceeds 10× this hospital's gross charge — excluded from medians 34
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 6
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8131/381459366_munson-healthcare-charlevoix-hospital_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/munsonhealthcarecharlevoixhospital/8131
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-22
Content fingerprint 9c2eba8f229bb555… · 1,197,593,691 bytes · first seen 2026-05-04

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 5 $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 5 $2,598,113.00 $2,598,113.00 $2,598,113.00 nat. median
$3,703,693
0.7× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 5 $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 5 $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 5 $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 5 $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 5 $2,072,678.07 $2,072,678.07 $2,072,678.07 nat. median
$2,994,107
0.7× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 5 $1,825,231.76 $1,825,231.76 $1,825,231.76 nat. median
$2,466,282
0.7× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 5 $1,644,060.00 $1,644,060.00 $1,644,060.00 nat. median
$2,401,960
0.7× median
Q2057
HCPCS 		Afamitresgene Autoleucel 5 $543,287.10 $543,287.10 $543,287.10 nat. median
$809,217
0.7× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $414,292.95 $414,292.95 $414,292.95 nat. median
$646,415
0.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $399,404.57 $399,404.57 $399,404.57 nat. median
$738,272
0.5× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 5 $396,351.88 $396,351.88 $396,351.88 nat. median
$640,950
0.6× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 5 $393,447.62 $393,447.62 $393,447.62 nat. median
$622,245
0.6× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 5 $375,195.53 $375,195.53 $375,195.53 nat. median
$608,101
0.6× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 5 $345,062.39 $345,062.39 $345,062.39 nat. median
$591,650
0.6× median
5834
APR_DRG 		Neonate With Ecmo 5 $277,842.62 $277,842.62 $277,842.62 nat. median
$307,273
0.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 5 $196,166.25 $196,166.25 $196,166.25 nat. median
$319,951
0.6× median
J3403
HCPCS 		Revakinagene, Per Implant 5 $186,825.00 $186,825.00 $186,825.00 nat. median
$265,000
0.7× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $185,972.36 $185,972.36 $185,972.36 nat. median
$247,214
0.8× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $171,115.63 $171,115.63 $171,115.63 nat. median
$124,042
1.4× median
5833
APR_DRG 		Neonate With Ecmo 5 $168,028.70 $168,028.70 $168,028.70 nat. median
$244,017
0.7× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 $161,376.57 $161,376.57 $161,376.57 nat. median
$133,164
1.2× median
1614
APR_DRG 		Implantable Heart Assist Systems 5 $151,906.44 $151,906.44 $151,906.44 nat. median
$202,993
0.7× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 5 $142,176.66 $142,176.66 $142,176.66 nat. median
$209,753
0.7× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 $136,992.12 $136,992.12 $136,992.12 nat. median
$165,000
0.8× median
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $131,875.95 $131,875.95 $131,875.95 nat. median
$67,766
1.9× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 5 $128,730.42 $128,730.42 $128,730.42 nat. median
$156,153
0.8× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 5 $118,232.15 $118,232.15 $118,232.15 nat. median
$170,172
0.7× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 $117,909.64 $117,909.64 $117,909.64 nat. median
$154,011
0.8× median
112
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $111,920.57 $111,920.57 $111,920.57 nat. median
$68,020
1.6× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 5 $111,523.44 $111,523.44 $111,523.44 nat. median
$151,838
0.7× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 5 $111,164.36 $111,164.36 $111,164.36 nat. median
$163,587
0.7× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $110,138.22 $110,138.22 $110,138.22 nat. median
$162,514
0.7× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $102,576.14 $102,576.14 $102,576.14 nat. median
$175,429
0.6× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $94,605.91 $94,605.91 $94,605.91 nat. median
$145,061
0.7× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 5 $93,292.31 $93,292.31 $93,292.31 nat. median
$122,016
0.8× median
5832
APR_DRG 		Neonate With Ecmo 5 $93,218.19 $93,218.19 $93,218.19 nat. median
$159,249
0.6× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 5 $93,150.44 $93,150.44 $93,150.44 nat. median
$111,503
0.8× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $88,583.29 $88,583.29 $88,583.29 nat. median
$120,505
0.7× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $86,950.18 $86,950.18 $86,950.18 nat. median
$89,188
1.0× median
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $86,887.58 $86,887.58 $86,887.58 nat. median
$71,350
1.2× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $85,829.89 $85,829.89 $85,829.89 nat. median
$93,998
0.9× median
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 5 $84,360.54 $84,360.54 $84,360.54 nat. median
$98,624
0.9× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $83,024.91 $83,024.91 $83,024.91 nat. median
$101,541
0.8× median
8424
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns 5 $82,926.75 $82,926.75 $82,926.75 nat. median
$82,002
1.0× median
1613
APR_DRG 		Implantable Heart Assist Systems 5 $82,322.29 $82,322.29 $82,322.29 nat. median
$120,517
0.7× median
J1823
HCPCS 		Inebilizumab-cdon 100 Mg/10 Ml Vial 27 $349.36 $93,499.00 $81,250.63 nat. median
$818
outlier · 99.4×
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 5 $80,438.55 $80,438.55 $80,438.55 nat. median
$97,020
0.8× median
5831
APR_DRG 		Neonate With Ecmo 5 $79,541.85 $79,541.85 $79,541.85 nat. median
$146,591
0.5× median

Other procedures at this hospital

Browse this hospital's 15,057 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 5 5 — — $3,176,025.00 $3,176,025.00 $3,176,025.00 2026-04-17
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 5 5 — — $2,598,113.00 $2,598,113.00 $2,598,113.00 2026-04-17
J3389 HCPCS Topi Adm Prad Zami Per Treat 5 5 — — $2,351,753.10 $2,351,753.10 $2,351,753.10 2026-04-17
J1413 HCPCS Inj Delandistrogene Mox Rokl 5 5 — — $2,346,141.11 $2,346,141.11 $2,346,141.11 2026-04-17
J3394 HCPCS Inj, Lovotibeglogene Autotem 5 5 — — $2,293,018.19 $2,293,018.19 $2,293,018.19 2026-04-17
J3387 HCPCS Inj Elivaldogene Autotemecel 5 5 — — $2,241,900.00 $2,241,900.00 $2,241,900.00 2026-04-17
J3393 HCPCS Inj, Betibeglogene Autotemce 5 5 — — $2,072,678.07 $2,072,678.07 $2,072,678.07 2026-04-17
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 5 — — $1,825,231.76 $1,825,231.76 $1,825,231.76 2026-04-17
J3392 HCPCS Inj, Exagamglogene Autotem 5 5 — — $1,644,060.00 $1,644,060.00 $1,644,060.00 2026-04-17
Q2057 HCPCS Afamitresgene Autoleucel 5 5 — — $543,287.10 $543,287.10 $543,287.10 2026-04-17
Q2056 HCPCS Ciltacabtagene Car-pos T 5 5 — — $414,292.95 $414,292.95 $414,292.95 2026-04-17
Q2042 HCPCS Tisagenlecleucel Car-pos T 5 5 — — $399,404.57 $399,404.57 $399,404.57 2026-04-17
Q2054 HCPCS Lisocabtagene Mara Car Pos T 5 5 — — $396,351.88 $396,351.88 $396,351.88 2026-04-17
Q2055 HCPCS Idecabtagene Vicleucel Car 5 5 — — $393,447.62 $393,447.62 $393,447.62 2026-04-17
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 5 5 — — $375,195.53 $375,195.53 $375,195.53 2026-04-17
Q2053 HCPCS Brexucabtagene Car Pos T 5 5 — — $345,062.39 $345,062.39 $345,062.39 2026-04-17
5834 APR_DRG Neonate With Ecmo 5 5 — — $277,842.62 $277,842.62 $277,842.62 2026-04-17
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 5 5 — — $196,166.25 $196,166.25 $196,166.25 2026-04-17
J3403 HCPCS Revakinagene, Per Implant 5 5 — — $186,825.00 $186,825.00 $186,825.00 2026-04-17
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $185,972.36 $185,972.36 $185,972.36 2026-04-17
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $171,115.63 $171,115.63 $171,115.63 2026-04-17
5833 APR_DRG Neonate With Ecmo 5 5 — — $168,028.70 $168,028.70 $168,028.70 2026-04-17
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $161,376.57 $161,376.57 $161,376.57 2026-04-17
1614 APR_DRG Implantable Heart Assist Systems 5 5 — — $151,906.44 $151,906.44 $151,906.44 2026-04-17
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 5 5 — — $142,176.66 $142,176.66 $142,176.66 2026-04-17
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $136,992.12 $136,992.12 $136,992.12 2026-04-17
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $131,875.95 $131,875.95 $131,875.95 2026-04-17
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $128,730.42 $128,730.42 $128,730.42 2026-04-17
74 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $118,232.15 $118,232.15 $118,232.15 2026-04-17
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $117,909.64 $117,909.64 $117,909.64 2026-04-17
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $111,920.57 $111,920.57 $111,920.57 2026-04-17
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $111,523.44 $111,523.44 $111,523.44 2026-04-17
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $111,164.36 $111,164.36 $111,164.36 2026-04-17
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $110,138.22 $110,138.22 $110,138.22 2026-04-17
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $102,576.14 $102,576.14 $102,576.14 2026-04-17
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $94,605.91 $94,605.91 $94,605.91 2026-04-17
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $93,292.31 $93,292.31 $93,292.31 2026-04-17
5832 APR_DRG Neonate With Ecmo 5 5 — — $93,218.19 $93,218.19 $93,218.19 2026-04-17
Q0480 HCPCS Driver Pneumatic Vad, Rep 5 5 — — $93,150.44 $93,150.44 $93,150.44 2026-04-17
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $88,583.29 $88,583.29 $88,583.29 2026-04-17
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $86,950.18 $86,950.18 $86,950.18 2026-04-17
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $86,887.58 $86,887.58 $86,887.58 2026-04-17
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $85,829.89 $85,829.89 $85,829.89 2026-04-17
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $84,360.54 $84,360.54 $84,360.54 2026-04-17
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $83,024.91 $83,024.91 $83,024.91 2026-04-17
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 5 5 — — $82,926.75 $82,926.75 $82,926.75 2026-04-17
1613 APR_DRG Implantable Heart Assist Systems 5 5 — — $82,322.29 $82,322.29 $82,322.29 2026-04-17
J1823 HCPCS Inebilizumab-cdon 100 Mg/10 Ml Vial 55 27 $93,499.00 $79,474.15 $349.36 $93,499.00 $81,250.63 2026-04-17
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 5 5 — — $80,438.55 $80,438.55 $80,438.55 2026-04-17
5831 APR_DRG Neonate With Ecmo 5 5 — — $79,541.85 $79,541.85 $79,541.85 2026-04-17
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $75,437.29 $75,437.29 $75,437.29 2026-04-17
1612 APR_DRG Implantable Heart Assist Systems 5 5 — — $74,779.24 $74,779.24 $74,779.24 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 Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $66,911.67 $66,911.67 $66,911.67 2026-04-17
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $66,414.88 $66,414.88 $66,414.88 2026-04-17
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $63,700.04 $63,700.04 $63,700.04 2026-04-17
1611 APR_DRG Implantable Heart Assist Systems 5 5 — — $63,044.99 $63,044.99 $63,044.99 2026-04-17
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $59,925.01 $59,925.01 $59,925.01 2026-04-17
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 5 — — $59,712.17 $59,712.17 $59,712.17 2026-04-17
90288 CPT Botulism Ig IV 2 2 — — $58,905.00 $58,905.00 $58,905.00 2026-04-17
C1824 HCPCS Generator Optimizer Ipg86302 47 27 $65,000.00 $55,250.00 $30,550.00 $65,000.00 $58,500.00 2026-04-17
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 5 5 — — $58,206.25 $58,206.25 $58,206.25 2026-04-17
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $57,820.15 $57,820.15 $57,820.15 2026-04-17
73 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $56,440.44 $56,440.44 $56,440.44 2026-04-17
72 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $54,232.92 $54,232.92 $54,232.92 2026-04-17
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 5 5 — — $53,844.30 $53,844.30 $53,844.30 2026-04-17
84 APR_DRG Autologous Bone Marrow Transplant 5 5 — — $52,952.37 $52,952.37 $52,952.37 2026-04-17
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 5 5 — — $52,818.66 $52,818.66 $52,818.66 2026-04-17
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $52,663.41 $52,663.41 $52,663.41 2026-04-17
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $52,237.73 $52,237.73 $52,237.73 2026-04-17
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $51,717.40 $51,717.40 $51,717.40 2026-04-17
J3357 HCPCS Stelara 90 mg/mL Syringe 49 27 $56,262.32 $47,822.98 $289.09 $56,262.32 $50,636.09 2026-04-17
J9359 HCPCS Zynlonta 10 Mg/2 Ml Vial 54 27 $56,643.46 $48,146.95 $155.96 $56,643.46 $50,101.14 2026-04-17
8514 APR_DRG Gender Related Procedures 5 5 — — $48,812.26 $48,812.26 $48,812.26 2026-04-17
8513 APR_DRG Gender Related Procedures 5 5 — — $48,812.26 $48,812.26 $48,812.26 2026-04-17
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $48,506.77 $48,506.77 $48,506.77 2026-04-17
8634 APR_DRG Neonatal Aftercare 5 5 — — $48,170.23 $48,170.23 $48,170.23 2026-04-17
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $48,004.47 $48,004.47 $48,004.47 2026-04-17
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $46,776.00 $46,776.00 $46,776.00 2026-04-17
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $46,754.97 $46,754.97 $46,754.97 2026-04-17
71 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $46,503.57 $46,503.57 $46,503.57 2026-04-17
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $46,176.55 $46,176.55 $46,176.55 2026-04-17
J9029 HCPCS Instill Adstiladrin, Tx Dose 5 5 — — $45,313.73 $45,313.73 $45,313.73 2026-04-17
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 5 — — $44,956.10 $44,956.10 $44,956.10 2026-04-17
38240 CPT Transplt Allo Hct/donor 5 5 — — $44,389.70 $44,389.70 $44,389.70 2026-04-17
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $43,960.51 $43,960.51 $43,960.51 2026-04-17
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $43,222.83 $43,222.83 $43,222.83 2026-04-17
L7181 HCPCS Electronic Elbo Simultaneous 5 5 — — $41,430.60 $41,430.60 $41,430.60 2026-04-17
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 5 5 — — $40,715.32 $40,715.32 $40,715.32 2026-04-17
C2624 HCPCS System Delivery Pa Sensor60810 47 27 $45,000.00 $38,250.00 $21,150.00 $45,000.00 $40,500.00 2026-04-17
A9543 HCPCS Kit Yttrium 90 Therasphere 3 Gbq36432 83 27 $45,862.50 $38,983.13 $21,555.38 $69,162.84 $40,061.31 2026-04-17
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $39,379.19 $39,379.19 $39,379.19 2026-04-17
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 5 5 — — $38,354.90 $38,354.90 $38,354.90 2026-04-17
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $38,105.65 $38,105.65 $38,105.65 2026-04-17
L7180 HCPCS Electronic Elbow Sequential 5 5 — — $37,593.04 $37,593.04 $37,593.04 2026-04-17
914 APR_DRG Other Major Head And Neck Procedures 5 5 — — $37,400.03 $37,400.03 $37,400.03 2026-04-17
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 5 — — $37,068.00 $37,068.00 $37,068.00 2026-04-17
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 5 5 — — $37,059.48 $37,059.48 $37,059.48 2026-04-17
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 5 5 — — $36,449.51 $36,449.51 $36,449.51 2026-04-17
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $36,326.31 $36,326.31 $36,326.31 2026-04-17
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $36,000.79 $36,000.79 $36,000.79 2026-04-17
1784 APR_DRG External Heart Assist Devices 5 5 — — $35,901.13 $35,901.13 $35,901.13 2026-04-17
J2350 HCPCS Ocrevus 300 Mg/10 Ml Inject 55 27 $41,281.92 $35,089.64 $41.82 $41,281.92 $35,873.99 2026-04-17
6904 APR_DRG Acute Leukemia 5 5 — — $35,461.43 $35,461.43 $35,461.43 2026-04-17
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 5 5 — — $35,451.41 $35,451.41 $35,451.41 2026-04-17
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 5 5 — — $35,321.21 $35,321.21 $35,321.21 2026-04-17
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 5 5 — — $35,280.64 $35,280.64 $35,280.64 2026-04-17
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 5 5 — — $35,117.38 $35,117.38 $35,117.38 2026-04-17
913 APR_DRG Other Major Head And Neck Procedures 5 5 — — $34,624.09 $34,624.09 $34,624.09 2026-04-17
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $34,096.75 $34,096.75 $34,096.75 2026-04-17
J9228 HCPCS Yervoy 200 Mg/40 Ml Vial 83 27 $72,437.78 $61,572.12 $131.77 $72,437.78 $34,045.76 2026-04-17
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $33,929.98 $33,929.98 $33,929.98 2026-04-17
204 APR_DRG Open Craniotomy For Trauma 5 5 — — $33,816.30 $33,816.30 $33,816.30 2026-04-17
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 5 5 — — $33,665.06 $33,665.06 $33,665.06 2026-04-17
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $33,353.06 $33,353.06 $33,353.06 2026-04-17
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $33,340.04 $33,340.04 $33,340.04 2026-04-17
J9350 HCPCS Lunsumio 30 Mg/30 Ml Vial 54 27 $37,455.32 $31,837.03 $462.04 $37,455.32 $33,129.23 2026-04-17
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 5 5 — — $32,961.44 $32,961.44 $32,961.44 2026-04-17
C1767 HCPCS Controller Medtronic Dbs79104 598 27 $47,400.00 $40,290.00 $1,333.63 $103,317.50 $32,350.00 2026-04-17
83 APR_DRG Autologous Bone Marrow Transplant 5 5 — — $32,126.10 $32,126.10 $32,126.10 2026-04-17
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 5 5 — — $31,627.81 $31,627.81 $31,627.81 2026-04-17
4414 APR_DRG Major Bladder Procedures 5 5 — — $31,510.12 $31,510.12 $31,510.12 2026-04-17
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 5 5 — — $31,434.50 $31,434.50 $31,434.50 2026-04-17
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 5 5 — — $31,324.32 $31,324.32 $31,324.32 2026-04-17
J3241 HCPCS Tepezza 500 Mg/10.5 Ml Vial 55 27 $36,037.90 $30,632.22 $260.36 $36,037.90 $31,316.94 2026-04-17
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 5 5 — — $31,246.20 $31,246.20 $31,246.20 2026-04-17
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 5 5 — — $31,203.63 $31,203.63 $31,203.63 2026-04-17
64568 CPT Opn Impltj Crnl Nrv Nea&pg 5 5 — — $31,083.87 $31,083.87 $31,083.87 2026-04-17
64654 CPT 1st Opn Implt Bat Modulj Sys 5 5 — — $31,083.87 $31,083.87 $31,083.87 2026-04-17
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 5 5 — — $31,083.87 $31,083.87 $31,083.87 2026-04-17
33276 CPT Insj Phrnc Nrv Stim Sys 5 5 — — $31,083.87 $31,083.87 $31,083.87 2026-04-17
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $31,069.92 $31,069.92 $31,069.92 2026-04-17
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $30,970.76 $30,970.76 $30,970.76 2026-04-17
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $30,778.45 $30,778.45 $30,778.45 2026-04-17
1834 APR_DRG Percutaneous Structural Cardiac Procedures 5 5 — — $30,630.21 $30,630.21 $30,630.21 2026-04-17
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $30,577.63 $30,577.63 $30,577.63 2026-04-17
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 5 5 — — $30,447.92 $30,447.92 $30,447.92 2026-04-17
J9226 HCPCS Supprelin La Implant 7 6 — — $30,445.66 $44,814.97 $30,445.66 2026-04-17
6954 APR_DRG Chemotherapy For Acute Leukemia 5 5 — — $30,364.29 $30,364.29 $30,364.29 2026-04-17
894 APR_DRG Major Cranial Or Facial Bone Procedures 5 5 — — $29,966.15 $29,966.15 $29,966.15 2026-04-17
9104 APR_DRG Craniotomy For Multiple Significant Trauma 5 5 — — $29,824.93 $29,824.93 $29,824.93 2026-04-17
L8701 HCPCS Ewh S/d Uprt Micro Sensor 5 5 — — $29,584.73 $29,584.73 $29,584.73 2026-04-17
1204 APR_DRG Major Respiratory And Chest Procedures 5 5 — — $29,230.48 $29,230.48 $29,230.48 2026-04-17
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 5 5 — — $29,120.30 $29,120.30 $29,120.30 2026-04-17
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $28,857.38 $28,857.38 $28,857.38 2026-04-17
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 5 5 — — $28,816.32 $28,816.32 $28,816.32 2026-04-17
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 5 5 — — $28,754.22 $28,754.22 $28,754.22 2026-04-17
1694 APR_DRG Major Abdominal Vascular Procedures 5 5 — — $28,740.19 $28,740.19 $28,740.19 2026-04-17
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $28,562.41 $28,562.41 $28,562.41 2026-04-17
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 5 5 — — $28,118.20 $28,118.20 $28,118.20 2026-04-17
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $28,078.14 $28,078.14 $28,078.14 2026-04-17
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 5 — — $28,042.58 $28,042.58 $28,042.58 2026-04-17
J9334 HCPCS Vyvgart Hytrulo 1008 Mg/5.6 Ml Inj 55 27 $32,176.92 $27,350.39 $24.05 $32,176.92 $27,961.74 2026-04-17
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $27,902.86 $27,902.86 $27,902.86 2026-04-17
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 5 5 — — $27,819.72 $27,819.72 $27,819.72 2026-04-17
C1822 HCPCS Kit Charger Nevro65981 221 27 $42,750.00 $36,337.50 $893.00 $53,200.00 $27,750.00 2026-04-17
1783 APR_DRG External Heart Assist Devices 5 5 — — $27,671.49 $27,671.49 $27,671.49 2026-04-17
C1882 HCPCS Generator Allure Quadra Mp Pm356260223 453 27 $36,000.00 $30,600.00 $6,580.00 $40,620.00 $27,623.51 2026-04-17
214 APR_DRG Open Craniotomy Except Trauma 5 5 — — $27,441.62 $27,441.62 $27,441.62 2026-04-17
1794 APR_DRG Defibrillator Implants 5 5 — — $27,365.00 $27,365.00 $27,365.00 2026-04-17
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 5 5 — — $27,290.88 $27,290.88 $27,290.88 2026-04-17
J9298 HCPCS Opdualag 240 Mg/80 mg/20mL Inject 54 27 $30,843.94 $26,217.35 $142.17 $30,843.94 $27,281.46 2026-04-17
2993 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 5 5 — — $26,952.84 $26,952.84 $26,952.84 2026-04-17
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $26,439.02 $26,439.02 $26,439.02 2026-04-17
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $26,428.50 $26,428.50 $26,428.50 2026-04-17
5144 APR_DRG Female Reproductive System Reconstructive Procedures 5 5 — — $26,335.35 $26,335.35 $26,335.35 2026-04-17
4844 APR_DRG Other Male Reproductive System And Related Procedures 5 5 — — $26,280.26 $26,280.26 $26,280.26 2026-04-17
5134 APR_DRG Gynecologic Procedures Without Malignancy 5 5 — — $25,988.80 $25,988.80 $25,988.80 2026-04-17
234 APR_DRG Spinal Procedures 5 5 — — $25,859.59 $25,859.59 $25,859.59 2026-04-17
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 5 5 — — $25,683.81 $25,683.81 $25,683.81 2026-04-17
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 5 5 — — $25,668.29 $25,668.29 $25,668.29 2026-04-17
4014 APR_DRG Adrenal Procedures 5 5 — — $25,654.76 $25,654.76 $25,654.76 2026-04-17
1814 APR_DRG Lower Vascular Procedures 5 5 — — $25,570.13 $25,570.13 $25,570.13 2026-04-17
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 5 5 — — $25,512.04 $25,512.04 $25,512.04 2026-04-17
C1820 HCPCS Implant Restore Rechargeable45627 395 27 $42,500.00 $36,125.00 $11,632.50 $56,250.00 $25,504.08 2026-04-17
2614 APR_DRG Major Biliary Tract Procedures 5 5 — — $25,467.97 $25,467.97 $25,467.97 2026-04-17
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 5 — — $25,380.83 $25,380.83 $25,380.83 2026-04-17
912 APR_DRG Other Major Head And Neck Procedures 5 5 — — $25,367.31 $25,367.31 $25,367.31 2026-04-17
9103 APR_DRG Craniotomy For Multiple Significant Trauma 5 5 — — $25,334.25 $25,334.25 $25,334.25 2026-04-17
1601 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $25,331.25 $25,331.25 $25,331.25 2026-04-17
J1628 HCPCS Tremfya 200 Mg/20 Ml Inject 55 27 $29,132.88 $24,762.95 $51.42 $29,132.88 $25,316.47 2026-04-17
4234 APR_DRG Inborn Errors Of Metabolism 5 5 — — $25,108.89 $25,108.89 $25,108.89 2026-04-17
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 5 5 — — $25,020.25 $25,020.25 $25,020.25 2026-04-17
L6700 HCPCS Ue Add Ext Power Myoel 5 5 — — $24,965.62 $24,965.62 $24,965.62 2026-04-17
2304 APR_DRG Major Small Bowel Procedures 5 5 — — $24,913.08 $24,913.08 $24,913.08 2026-04-17
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 5 5 — — $24,900.56 $24,900.56 $24,900.56 2026-04-17
L5856 HCPCS Elec Knee-shin Swing/stance 5 5 — — $24,858.10 $24,858.10 $24,858.10 2026-04-17
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $24,764.84 $24,764.84 $24,764.84 2026-04-17
3104 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 5 5 — — $24,763.34 $24,763.34 $24,763.34 2026-04-17
L6880 HCPCS Elec Hand Ind Art Digits 5 5 — — $24,711.13 $24,711.13 $24,711.13 2026-04-17
2244 APR_DRG Peritoneal Adhesiolysis 5 5 — — $24,692.73 $24,692.73 $24,692.73 2026-04-17
6903 APR_DRG Acute Leukemia 5 5 — — $24,595.07 $24,595.07 $24,595.07 2026-04-17
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 5 — — $24,419.79 $24,419.79 $24,419.79 2026-04-17
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $24,398.26 $24,398.26 $24,398.26 2026-04-17
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 5 5 — — $24,386.24 $24,386.24 $24,386.24 2026-04-17
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 5 5 — — $24,380.23 $24,380.23 $24,380.23 2026-04-17
213 APR_DRG Open Craniotomy Except Trauma 5 5 — — $24,376.22 $24,376.22 $24,376.22 2026-04-17
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $24,252.52 $24,252.52 $24,252.52 2026-04-17
0870T CPT Imp Subq Prtl Ascts Pmp Sys 5 5 — — $24,176.42 $24,176.42 $24,176.42 2026-04-17
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 5 5 — — $24,037.18 $24,037.18 $24,037.18 2026-04-17
1763 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 5 5 — — $23,966.07 $23,966.07 $23,966.07 2026-04-17
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 5 5 — — $23,690.63 $23,690.63 $23,690.63 2026-04-17
8434 APR_DRG Extensive Third Degree Burns Without Skin Graft 5 5 — — $23,520.36 $23,520.36 $23,520.36 2026-04-17
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 5 5 — — $23,388.14 $23,388.14 $23,388.14 2026-04-17
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $23,356.59 $23,356.59 $23,356.59 2026-04-17
6614 APR_DRG Coagulation And Platelet Disorders 5 5 — — $23,296.50 $23,296.50 $23,296.50 2026-04-17
5114 APR_DRG Gynecologic Procedures For Malignancy 5 5 — — $23,289.49 $23,289.49 $23,289.49 2026-04-17
69930 CPT Implant Cochlear Device 5 5 — — $23,268.63 $23,268.63 $23,268.63 2026-04-17
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 5 5 — — $23,230.39 $23,230.39 $23,230.39 2026-04-17
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 5 5 — — $23,225.88 $23,225.88 $23,225.88 2026-04-17
8503 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 5 5 — — $23,215.87 $23,215.87 $23,215.87 2026-04-17
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $23,193.83 $23,193.83 $23,193.83 2026-04-17
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $23,142.25 $23,142.25 $23,142.25 2026-04-17
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 5 5 — — $23,071.14 $23,071.14 $23,071.14 2026-04-17
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 5 5 — — $22,998.52 $22,998.52 $22,998.52 2026-04-17
274 APR_DRG Other Open Craniotomy 5 5 — — $22,926.91 $22,926.91 $22,926.91 2026-04-17
1824 APR_DRG Other Upper Vascular Procedures 5 5 — — $22,790.69 $22,790.69 $22,790.69 2026-04-17
4034 APR_DRG Procedures For Obesity 5 5 — — $22,712.06 $22,712.06 $22,712.06 2026-04-17
1782 APR_DRG External Heart Assist Devices 5 5 — — $22,688.53 $22,688.53 $22,688.53 2026-04-17
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 5 — — $22,670.00 $22,670.00 $22,670.00 2026-04-17
C1772 HCPCS Pump Infusion Syncromed Iii With Filter29134 76 27 $28,000.00 $23,800.00 $11,632.50 $28,000.00 $22,585.00 2026-04-17
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 5 5 — — $22,396.06 $22,396.06 $22,396.06 2026-04-17
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 5 5 — — $22,382.04 $22,382.04 $22,382.04 2026-04-17
2314 APR_DRG Major Large Bowel Procedures 5 5 — — $22,295.40 $22,295.40 $22,295.40 2026-04-17
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 5 5 — — $22,277.37 $22,277.37 $22,277.37 2026-04-17
33270 CPT Ins/rep Subq Defibrillator 5 5 — — $22,151.31 $22,151.31 $22,151.31 2026-04-17
33249 CPT Insj/rplcmt Defib W/lead(s) 5 5 — — $22,151.31 $22,151.31 $22,151.31 2026-04-17
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 5 5 — — $22,151.31 $22,151.31 $22,151.31 2026-04-17
33231 CPT Insrt Pulse Gen W/mult Leads 5 5 — — $22,151.31 $22,151.31 $22,151.31 2026-04-17
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 5 5 — — $22,151.31 $22,151.31 $22,151.31 2026-04-17
0408T CPT Insj/rplc Cardiac Modulj Sys 5 5 — — $22,151.31 $22,151.31 $22,151.31 2026-04-17
0571T CPT Insj/rplcmt Icds Ss Eltrd 5 5 — — $22,151.31 $22,151.31 $22,151.31 2026-04-17
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 5 5 — — $22,069.54 $22,069.54 $22,069.54 2026-04-17
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 5 5 — — $22,003.93 $22,003.93 $22,003.93 2026-04-17
C1721 HCPCS Device Evera S Dr Df158104 308 27 $27,497.50 $23,372.88 $10,906.46 $33,950.00 $21,998.00 2026-04-17
4284 APR_DRG Genetic Disorders 5 5 — — $21,941.33 $21,941.33 $21,941.33 2026-04-17
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 5 5 — — $21,889.25 $21,889.25 $21,889.25 2026-04-17
J9043 HCPCS Jevtana 60 Mg/6 Ml Inject 54 27 $24,736.18 $21,025.76 $162.71 $24,736.18 $21,879.15 2026-04-17
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 5 5 — — $21,856.70 $21,856.70 $21,856.70 2026-04-17
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 5 5 — — $21,845.68 $21,845.68 $21,845.68 2026-04-17
203 APR_DRG Open Craniotomy For Trauma 5 5 — — $21,839.17 $21,839.17 $21,839.17 2026-04-17
1833 APR_DRG Percutaneous Structural Cardiac Procedures 5 5 — — $21,813.63 $21,813.63 $21,813.63 2026-04-17
0909T CPT Rplcmt Int Nstim Sys Vgs Nrv 5 5 — — $21,776.47 $21,776.47 $21,776.47 2026-04-17
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 5 5 — — $21,776.47 $21,776.47 $21,776.47 2026-04-17
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 5 5 — — $21,776.47 $21,776.47 $21,776.47 2026-04-17
61886 CPT Implant Neurostim Arrays 5 5 — — $21,776.47 $21,776.47 $21,776.47 2026-04-17
61885 CPT Insrt/redo Neurostim 1 Array 5 5 — — $21,776.47 $21,776.47 $21,776.47 2026-04-17
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 5 5 — — $21,776.47 $21,776.47 $21,776.47 2026-04-17
64656 CPT Revj/rplcmt Bat Mod Sys Pg 5 5 — — $21,776.47 $21,776.47 $21,776.47 2026-04-17
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 5 5 — — $21,776.47 $21,776.47 $21,776.47 2026-04-17
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 5 5 — — $21,776.47 $21,776.47 $21,776.47 2026-04-17
0908T CPT Opn Imp Int Nstm Sys Vgs Nrv 5 5 — — $21,776.47 $21,776.47 $21,776.47 2026-04-17
82 APR_DRG Autologous Bone Marrow Transplant 5 5 — — $21,748.52 $21,748.52 $21,748.52 2026-04-17
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 5 5 — — $21,738.01 $21,738.01 $21,738.01 2026-04-17
1693 APR_DRG Major Abdominal Vascular Procedures 5 5 — — $21,673.91 $21,673.91 $21,673.91 2026-04-17
4834 APR_DRG Penis, Testes And Scrotal Procedures 5 5 — — $21,497.12 $21,497.12 $21,497.12 2026-04-17
1703 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 5 5 — — $21,462.57 $21,462.57 $21,462.57 2026-04-17
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 5 — — $21,444.04 $21,444.04 $21,444.04 2026-04-17
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $21,396.46 $21,396.46 $21,396.46 2026-04-17
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 5 5 — — $21,329.86 $21,329.86 $21,329.86 2026-04-17
224 APR_DRG Ventricular Shunt Procedures 5 5 — — $21,113.51 $21,113.51 $21,113.51 2026-04-17
893 APR_DRG Major Cranial Or Facial Bone Procedures 5 5 — — $21,065.93 $21,065.93 $21,065.93 2026-04-17
C2622 HCPCS Implant Penile Tactra 11mmx16cmx25cm84221 76 27 $23,401.88 $19,891.60 $10,998.88 $25,976.08 $21,061.69 2026-04-17
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 5 5 — — $21,027.87 $21,027.87 $21,027.87 2026-04-17
C1722 HCPCS Device Evera S Vr Df158107 453 27 $25,500.00 $21,675.00 $10,927.50 $46,490.00 $21,027.63 2026-04-17
1793 APR_DRG Defibrillator Implants 5 5 — — $20,880.64 $20,880.64 $20,880.64 2026-04-17
3224 APR_DRG Shoulder And Elbow Joint Replacement 5 5 — — $20,858.60 $20,858.60 $20,858.60 2026-04-17
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $20,808.52 $20,808.52 $20,808.52 2026-04-17
3084 APR_DRG Hip And Femur Fracture Repair 5 5 — — $20,787.99 $20,787.99 $20,787.99 2026-04-17
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 5 5 — — $20,764.95 $20,764.95 $20,764.95 2026-04-17
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 5 5 — — $20,748.43 $20,748.43 $20,748.43 2026-04-17
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 5 5 — — $20,738.91 $20,738.91 $20,738.91 2026-04-17
1673 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 5 5 — — $20,716.88 $20,716.88 $20,716.88 2026-04-17
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 2 2 — — $20,609.51 $20,609.51 $20,609.51 2026-04-17
1214 APR_DRG Other Respiratory And Chest Procedures 5 5 — — $20,553.12 $20,553.12 $20,553.12 2026-04-17
6504 APR_DRG Splenic Procedures 5 5 — — $20,524.57 $20,524.57 $20,524.57 2026-04-17
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $20,523.57 $20,523.57 $20,523.57 2026-04-17
J9024 HCPCS Tecentriq Hybreza 1875 Mg-30,000 Unit/15 Ml Inject 54 27 $23,178.72 $19,701.92 $22.63 $23,178.72 $20,501.58 2026-04-17
1781 APR_DRG External Heart Assist Devices 5 5 — — $20,466.48 $20,466.48 $20,466.48 2026-04-17
8633 APR_DRG Neonatal Aftercare 5 5 — — $20,424.41 $20,424.41 $20,424.41 2026-04-17
294 APR_DRG Other Percutaneous Intracranial Procedures 5 5 — — $20,382.34 $20,382.34 $20,382.34 2026-04-17
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 5 5 — — $20,365.32 $20,365.32 $20,365.32 2026-04-17
3244 APR_DRG Elective Hip Joint Replacement 5 5 — — $20,305.22 $20,305.22 $20,305.22 2026-04-17
233 APR_DRG Spinal Procedures 5 5 — — $20,290.20 $20,290.20 $20,290.20 2026-04-17
33289 CPT Tcat Impl Wrls P-art Prs Snr 5 5 — — $20,242.02 $20,242.02 $20,242.02 2026-04-17
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 5 5 — — $20,240.12 $20,240.12 $20,240.12 2026-04-17
293 APR_DRG Other Percutaneous Intracranial Procedures 5 5 — — $20,085.37 $20,085.37 $20,085.37 2026-04-17
J9266 HCPCS Pegaspargase Injection 7 6 — — $20,038.96 $29,496.67 $20,038.96 2026-04-17
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 5 5 — — $19,932.12 $19,932.12 $19,932.12 2026-04-17
2004 APR_DRG Cardiac Structural And Valvular Disorders 5 5 — — $19,930.62 $19,930.62 $19,930.62 2026-04-17
6223 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $19,889.05 $19,889.05 $19,889.05 2026-04-17
954 APR_DRG Cleft Lip And Palate Repair 5 5 — — $19,855.00 $19,855.00 $19,855.00 2026-04-17
5194 APR_DRG Gynecologic Procedures For Leiomyoma 5 5 — — $19,821.95 $19,821.95 $19,821.95 2026-04-17
1774 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 5 5 — — $19,798.91 $19,798.91 $19,798.91 2026-04-17
1631 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 5 — — $19,781.88 $19,781.88 $19,781.88 2026-04-17
734 APR_DRG Orbit And Eye Procedures 5 5 — — $19,777.38 $19,777.38 $19,777.38 2026-04-17
923 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 5 5 — — $19,773.37 $19,773.37 $19,773.37 2026-04-17
7594 APR_DRG Eating Disorders 5 5 — — $19,758.35 $19,758.35 $19,758.35 2026-04-17
3234 APR_DRG Non-elective Or Complex Hip Joint Replacement 5 5 — — $19,725.29 $19,725.29 $19,725.29 2026-04-17
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 5 5 — — $19,681.72 $19,681.72 $19,681.72 2026-04-17
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