Hospital

ESSENTIA HEALTH ST MARY'S MEDICAL CENTER

Duluth, MN · CCN 240002 · Rates published

19,813 distinct procedures filed

53 distinct payers

1,281,662 rate rows

2026-01-01 last MRF observed

Data quality

1,269,258 of 1,281,662 rate rows are consumer-grade (99.0%)

12,404 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
template filing: same amount across many unrelated codes — excluded	11,152
placeholder amount (≤ $0.02) — excluded from medians	474
percent-of-charges filed in the dollar field — excluded from medians	422
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	212
per-diem day rate — not a per-procedure price	144

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

Source MRF file	https://www.essentiahealth.org/standard-charges/2026/410695604_Essentia-St-Marys-Medical-Center_standardcharges.csv
Found on page	https://www.essentiahealth.org/patients-visitors/billing/price-estimates/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-18
Content fingerprint	ffcd40e9b840693b… · 371,671,226 bytes · first seen 2026-05-13

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 CPT	Inj- Atidarsagene Autotemcel	23	$4,377,500.00	$4,505,000.00	$4,505,000.00	nat. median $4,505,000 1.0× median
J1414 CPT	Inj- Beqvez- Per Tx Dose	2	$3,500,000.00	$3,710,000.00	$3,710,000.00	nat. median $3,710,000 1.0× median
J1411 CPT	Inj- Hemgenix- Per Tx Dose	26	$3,672,900.00	$3,710,000.00	$3,685,266.67	nat. median $3,710,000 1.0× median
C9172 CPT	Inj Beqvez Per Tx Dose	1	$3,605,000.00	$3,605,000.00	$3,605,000.00	nat. median $3,570,000 1.0× median
J1413 CPT	Inj Delandistrogene Mox Rokl	26	$3,316,462.59	$3,392,000.00	$3,316,462.59	nat. median $3,325,455 1.0× median
J3394 CPT	Inj- Lovotibeglogene Autotem	25	$3,193,000.00	$3,286,000.00	$3,248,445.72	nat. median $3,286,000 1.0× median
J3393 CPT	Inj- Betibeglogene Autotemce	25	$2,945,740.00	$2,968,000.00	$2,945,740.00	nat. median $3,006,423 1.0× median
J3399 CPT	Inj Onase Abepar-xioi Treat	26	$2,278,010.83	$2,455,110.61	$2,455,110.61	nat. median $2,469,189 1.0× median
J3392 CPT	Inj- Exagamglogene Autotem	24	$2,332,000.00	$2,332,000.00	$2,332,000.00	nat. median $2,448,600 1.0× median
C9081 CPT	Idecabtagene Car Pos T	1	$1,000,528.86	$1,000,528.86	$1,000,528.86	nat. median $30,475 outlier · 32.8×
C9076 CPT	Lisocabtagene Car Pos T	1	$1,000,528.86	$1,000,528.86	$1,000,528.86	nat. median $30,475 outlier · 32.8×
C9098 CPT	Ciltacabtagene Car Pos T	1	$1,000,528.86	$1,000,528.86	$1,000,528.86	nat. median $57,174 outlier · 17.5×
Q2040 CPT	Tisagenlecleucel Car-pos T	1	$1,000,528.86	$1,000,528.86	$1,000,528.86	nat. median $25,594 outlier · 39.1×
C9073 CPT	Brexucabtagene Autoleucel Ca	1	$1,000,528.86	$1,000,528.86	$1,000,528.86	nat. median $29,278 outlier · 34.2×
Q2057 CPT	Afamitresgene Autoleucel	23	$770,620.00	$770,620.00	$770,620.00	nat. median $824,563 0.9× median
Q2042 CPT	Tisagenlecleucel Car-pos T	28	$529,192.86	$1,387,149.29	$591,726.20	nat. median $754,974 0.8× median
Q2056 CPT	Ciltacabtagene Car-pos T	28	$527,123.43	$1,345,370.55	$565,868.95	nat. median $675,122 0.8× median
Q2054 CPT	Lisocabtagene Mara Car Pos T	28	$516,485.97	$1,315,434.04	$562,538.19	nat. median $674,188 0.8× median
Q2055 CPT	Idecabtagene Vicleucel Car	28	$526,587.59	$1,334,154.49	$557,317.93	nat. median $625,184 0.9× median
Q2041 CPT	Axicabtagene Ciloleucel Car+	28	$489,455.96	$1,296,212.81	$533,230.17	nat. median $634,511 0.8× median
Q2053 CPT	Brexucabtagene Car Pos T	28	$460,530.40	$1,191,016.00	$489,304.61	nat. median $620,080 0.8× median
5834 APR_DRG	Neonate W Ecmo	12	$260,426.64	$1,206,342.90	$390,361.97	nat. median $309,665 1.3× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	31	$5,701.00	$863,148.77	$295,888.32	nat. median $370,174 0.8× median
Q2058 CPT	Obecbtge Autol Up To 400 Mil	23	$270,375.00	$278,250.00	$278,250.00	nat. median $324,450 0.9× median
J3403 CPT	Revakinagene- Per Implant	22	$257,500.00	$257,500.00	$257,500.00	nat. median $265,000 1.0× median
5884 APR_DRG	Neonate Bwt 1500g W Major Procedure	12	$173,711.73	$780,399.02	$254,666.60	nat. median $246,434 1.0× median
5833 APR_DRG	Neonate W Ecmo	12	$156,977.59	$705,221.00	$252,888.58	nat. median $244,017 1.0× median
24 APR_DRG	Heart Or Lung Transplant	12	$197,053.53	$894,317.79	$225,530.55	nat. median $234,738 1.0× median
J3402 CPT	Inj. Remestemcel-l-rknd/ Td	22	$205,640.00	$205,640.00	$205,640.00	nat. median $209,753 1.0× median
114 APR_DRG	Psychiatric	11	$78,957.46	$354,715.97	$198,309.46	nat. median $117,173 1.7× median
5832 APR_DRG	Neonate W Ecmo	12	$101,336.57	$455,253.98	$194,172.15	nat. median $156,126 1.2× median
1614 APR_DRG	Cardiac Defibrillator & Heart Assist Implant	12	$129,038.86	$579,706.40	$193,278.30	nat. median $207,730 0.9× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	31	$5,701.00	$644,700.73	$192,019.62	nat. median $265,286 0.7× median
6304 APR_DRG	Neonate Birthwt 2499g W Major Cardiovascular Procedure	11	$67,924.25	$305,149.32	$185,770.26	nat. median $150,721 1.2× median
8414 APR_DRG	Extensive 3rd Degree Burns W Skin Graft	11	$171,478.23	$770,365.02	$183,225.66	nat. median $160,267 1.1× median
222 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…	3	$124,412.09	$175,251.92	$175,251.92	nat. median $63,570 outlier · 2.8×
6094 APR_DRG	Neonate Bwt 15002499g W Major Procedure	11	$139,538.36	$626,875.33	$167,444.50	nat. median $162,982 1.0× median
5883 APR_DRG	Neonate Bwt 1500g W Major Procedure	12	$119,969.15	$538,960.75	$165,628.52	nat. median $182,736 0.9× median
6314 APR_DRG	Neonate Birthwt 2499g W Other Major Procedure	11	$88,109.72	$395,832.44	$164,388.59	nat. median $122,924 1.3× median
224 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…	3	$115,192.41	$162,264.70	$162,264.70	nat. median $54,196 outlier · 3.0×
5914 APR_DRG	Neonate Birthwt 500749g Wo Major Procedure	12	$134,558.16	$732,840.43	$161,780.72	nat. median $164,279 1.0× median
74 APR_DRG	Allogeneic Bone Marrow Transplant	12	$91,406.46	$410,643.05	$153,561.93	nat. median $187,294 0.8× median
94 APR_DRG	Extracorporeal Membrane Oxygenation Ecmo	12	$85,263.45	$383,045.61	$152,792.37	nat. median $164,834 0.9× median
5934 APR_DRG	Neonate Birthwt 750999g Wo Major Procedure	12	$139,297.97	$721,386.02	$150,011.84	nat. median $151,838 1.0× median
E0766 CPT	Elec Stim Cancer Treatment	1	$149,026.20	$149,026.20	$149,026.20	nat. median $16,785 outlier · 8.9×
226 MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	3	$104,008.22	$146,510.20	$146,510.20	nat. median $49,935 outlier · 2.9×
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	33	$5,701.00	$542,991.17	$146,293.52	nat. median $206,368 0.7× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	33	$5,701.00	$490,515.85	$145,434.96	nat. median $202,986 0.7× median
5882 APR_DRG	Neonate Bwt 1500g W Major Procedure	12	$97,243.09	$436,864.07	$145,335.69	nat. median $145,336 1.0× median
453 MS_DRG	Combined Anterior/posterior Spinal Fusion W Mcc	7	$129,553.67	$202,828.58	$144,626.91	nat. median $87,411 1.7× median

Other procedures at this hospital

Browse this hospital's 19,813 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

J9226	CPT	Supprelin La Implant	112	47	$132,981.50	$87,767.79 34% off	$44,016.88	$117,019.37	$49,243.51	2026-01-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	72	33	—	—	$5,701.00	$542,991.17	$146,293.52	2026-01-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	72	33	—	—	$5,701.00	$490,515.85	$145,434.96	2026-01-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	72	33	—	—	$5,701.00	$323,400.97	$94,909.72	2026-01-01
212	MS_DRG	Testes Procedures Age 0-17	72	33	—	—	$5,701.00	$249,332.17	$74,509.28	2026-01-01
215	MS_DRG	Other Heart Assist System Implant	72	33	—	—	$5,701.00	$242,490.64	$68,225.31	2026-01-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	72	33	—	—	$5,701.00	$220,888.01	$67,031.70	2026-01-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	72	33	—	—	$5,701.00	$193,947.65	$57,761.63	2026-01-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	72	33	—	—	$5,701.00	$193,837.79	$57,580.05	2026-01-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	72	33	—	—	$5,701.00	$184,496.78	$53,916.98	2026-01-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	72	33	—	—	$5,701.00	$177,092.19	$52,611.67	2026-01-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization With Mcc	72	33	—	—	$5,701.00	$178,895.85	$52,384.87	2026-01-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	72	33	—	—	$5,701.00	$170,836.63	$52,211.52	2026-01-01
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	72	33	—	—	$5,701.00	$152,864.19	$49,147.30	2026-01-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	72	33	—	—	$5,701.00	$161,745.12	$48,857.46	2026-01-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	72	33	—	—	$5,701.00	$159,227.33	$47,359.62	2026-01-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	72	33	—	—	$5,701.00	$152,605.54	$47,127.34	2026-01-01
955	MS_DRG	Craniotomy For Multiple Significant Trauma	72	33	—	—	$5,701.00	$156,283.80	$46,121.46	2026-01-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	72	33	—	—	$5,701.00	$147,803.43	$45,053.92	2026-01-01
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	72	33	—	—	$5,701.00	$136,168.95	$45,053.92	2026-01-01
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	72	33	—	—	$5,701.00	$140,945.88	$44,890.16	2026-01-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	72	33	—	—	$5,701.00	$148,039.19	$44,090.53	2026-01-01
266	MS_DRG	Endovascular Cardiac Valve Replacement W Mcc	72	33	—	—	$5,701.00	$137,114.27	$41,991.77	2026-01-01
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	72	33	—	—	$5,701.00	$144,747.75	$41,943.12	2026-01-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	72	33	—	—	$5,701.00	$139,812.88	$41,540.90	2026-01-01
28	MS_DRG	Spinal Procedures With Mcc	72	33	—	—	$5,701.00	$139,144.52	$41,168.84	2026-01-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	72	33	—	—	$5,701.00	$141,774.47	$41,157.19	2026-01-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	72	33	—	—	$5,701.00	$131,359.97	$40,859.13	2026-01-01
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome- Neonate	78	33	—	—	$519.00	$136,075.11	$40,724.83	2026-01-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	72	33	—	—	$5,701.00	$134,674.30	$40,211.62	2026-01-01
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	72	33	—	—	$5,701.00	$133,257.47	$40,185.58	2026-01-01
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	72	33	—	—	$5,701.00	$130,574.88	$39,263.99	2026-01-01
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	72	33	—	—	$5,701.00	$123,616.62	$39,052.94	2026-01-01
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	72	33	—	—	$5,701.00	$114,511.38	$38,139.57	2026-01-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc	72	33	—	—	$5,701.00	$140,462.93	$37,843.57	2026-01-01
834	MS_DRG	Acute Leukemia Without Major O.r. Procedures With Mcc	72	33	—	—	$5,701.00	$126,505.21	$37,616.77	2026-01-01
405	MS_DRG	Pancreas- Liver And Shunt Procedures With Mcc	72	33	—	—	$5,701.00	$124,250.65	$37,483.84	2026-01-01
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Without Mcc	72	33	—	—	$5,701.00	$121,767.19	$37,430.39	2026-01-01
11	MS_DRG	Tracheostomy For Facemouth & Neck Diagnoses W Mcc	72	33	—	—	$5,701.00	$123,499.89	$37,371.47	2026-01-01
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	68	32	—	—	$5,701.00	$239,913.34	$75,517.21	2026-01-01
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	68	32	—	—	$5,701.00	$190,894.26	$61,733.73	2026-01-01
850	MS_DRG	Acute Leukemia With Other Procedures	68	32	—	—	$5,701.00	$210,837.45	$59,334.85	2026-01-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	68	32	—	—	$5,701.00	$162,482.14	$49,461.81	2026-01-01
317	MS_DRG	Endovascular Cardiac Valve Replacement With Mcc	68	32	—	—	$5,701.00	$141,591.35	$45,815.86	2026-01-01
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	68	32	—	—	$5,701.00	$153,452.43	$45,782.29	2026-01-01
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	68	32	—	—	$5,701.00	$125,205.12	$39,516.14	2026-01-01
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	68	32	—	—	$5,701.00	$126,008.52	$38,521.92	2026-01-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	68	31	—	—	$5,701.00	$863,148.77	$295,888.32	2026-01-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	68	31	—	—	$5,701.00	$644,700.73	$192,019.62	2026-01-01
7	MS_DRG	Lung Transplant	68	31	—	—	$5,701.00	$299,111.16	$88,734.70	2026-01-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	68	31	—	—	$5,701.00	$299,866.50	$82,346.59	2026-01-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	68	31	—	—	$5,701.00	$252,229.91	$77,645.44	2026-01-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	68	31	—	—	$5,701.00	$243,735.81	$70,647.49	2026-01-01
10	MS_DRG	Pancreas Transplant	68	31	—	—	$5,701.00	$182,484.84	$49,167.86	2026-01-01
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	68	31	—	—	$5,701.00	$181,434.24	$48,886.24	2026-01-01
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	68	31	—	—	$5,701.00	$138,146.56	$40,630.27	2026-01-01
8	MS_DRG	Simultaneous Pancreas/kidney Transplant	68	31	—	—	$5,701.00	$124,534.47	$38,402.69	2026-01-01
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	68	31	—	—	$5,701.00	$138,146.56	$37,222.09	2026-01-01
Q2042	CPT	Tisagenlecleucel Car-pos T	58	28	—	—	$529,192.86	$1,387,149.29	$591,726.20	2026-01-01
Q2056	CPT	Ciltacabtagene Car-pos T	58	28	—	—	$527,123.43	$1,345,370.55	$565,868.95	2026-01-01
Q2054	CPT	Lisocabtagene Mara Car Pos T	58	28	—	—	$516,485.97	$1,315,434.04	$562,538.19	2026-01-01
Q2055	CPT	Idecabtagene Vicleucel Car	58	28	—	—	$526,587.59	$1,334,154.49	$557,317.93	2026-01-01
Q2041	CPT	Axicabtagene Ciloleucel Car+	58	28	—	—	$489,455.96	$1,296,212.81	$533,230.17	2026-01-01
Q2053	CPT	Brexucabtagene Car Pos T	58	28	—	—	$460,530.40	$1,191,016.00	$489,304.61	2026-01-01
J9029	CPT	Instill Adstiladrin- Tx Dose	58	28	—	—	$61,800.00	$168,273.23	$63,342.28	2026-01-01
Q2043	CPT	Sipuleucel-t Auto Cd54+	58	28	—	—	$53,472.87	$147,108.88	$55,272.32	2026-01-01
J1411	CPT	Inj- Hemgenix- Per Tx Dose	54	26	—	—	$3,672,900.00	$3,710,000.00	$3,685,266.67	2026-01-01
J1413	CPT	Inj Delandistrogene Mox Rokl	54	26	—	—	$3,316,462.59	$3,392,000.00	$3,316,462.59	2026-01-01
J3399	CPT	Inj Onase Abepar-xioi Treat	54	26	—	—	$2,278,010.83	$2,455,110.61	$2,455,110.61	2026-01-01
Q0480	CPT	Driver Pneumatic Vad- Rep	54	26	—	—	$94,999.95	$108,727.22	$108,727.22	2026-01-01
38240	CPT	Transplt Allo Hct/donor	54	26	—	—	$52,684.72	$126,053.09	$59,316.21	2026-01-01
A9543	CPT	Y90 Ibritumomab- Rx	54	26	—	—	$56,824.55	$65,476.58	$56,824.55	2026-01-01
L7181	CPT	Electronic Elbo Simultaneous	54	26	—	—	$44,875.22	$48,370.76	$48,370.76	2026-01-01
L7180	CPT	Electronic Elbow Sequential	54	26	—	—	$43,585.32	$46,980.38	$46,980.38	2026-01-01
0266T	CPT	Implt/rpl Crtd Sns Dev Total	54	26	—	—	$45,000.50	$108,833.71	$45,132.80	2026-01-01
33276	CPT	Insj Phrnc Nrv Stim Sys	54	26	—	—	$45,000.50	$108,833.71	$45,132.80	2026-01-01
L2006	CPT	Kaf Sng/dbl Swg/stn Mcpr Cus	54	26	—	—	$35,961.43	$38,762.63	$38,762.63	2026-01-01
J3394	CPT	Inj- Lovotibeglogene Autotem	52	25	—	—	$3,193,000.00	$3,286,000.00	$3,248,445.72	2026-01-01
J3393	CPT	Inj- Betibeglogene Autotemce	52	25	—	—	$2,945,740.00	$2,968,000.00	$2,945,740.00	2026-01-01
L8702	CPT	Ewhf S/d Uprt Micro Sensor	52	25	—	—	$65,871.74	$67,452.66	$67,452.66	2026-01-01
J3392	CPT	Inj- Exagamglogene Autotem	50	24	—	—	$2,332,000.00	$2,332,000.00	$2,332,000.00	2026-01-01
J3391	CPT	Inj- Atidarsagene Autotemcel	48	23	—	—	$4,377,500.00	$4,505,000.00	$4,505,000.00	2026-01-01
Q2057	CPT	Afamitresgene Autoleucel	48	23	—	—	$770,620.00	$770,620.00	$770,620.00	2026-01-01
Q2058	CPT	Obecbtge Autol Up To 400 Mil	48	23	—	—	$270,375.00	$278,250.00	$278,250.00	2026-01-01
J7330	CPT	Autologous Cultured Chondrocytes Sheet	54	23	$197,466.00	$130,327.56 34% off	$65,361.25	$169,820.76	$141,188.19	2026-01-01
C1822	CPT	Kit Stimulator Senza Ii Ipg Nipg2500	54	23	$61,100.00	$40,326.00 34% off	$20,224.10	$52,546.00	$43,686.50	2026-01-01
C2624	CPT	System Cardiac Sensor And Delivery Cardiomems Cm2000	54	23	$53,815.00	$35,517.90 34% off	$17,812.76	$46,280.90	$38,477.72	2026-01-01
J3403	CPT	Revakinagene- Per Implant	44	22	—	—	$257,500.00	$257,500.00	$257,500.00	2026-01-01
J3402	CPT	Inj. Remestemcel-l-rknd/ Td	44	22	—	—	$205,640.00	$205,640.00	$205,640.00	2026-01-01
209	MS_DRG	Kidney And Urinary Tract Signs And Symptoms Age 0-17	44	22	—	—	$77,556.36	$77,556.36	$77,556.36	2026-01-01
213	MS_DRG	Splenic Procedures Age 0-17	44	22	—	—	$39,103.65	$39,103.65	$39,103.65	2026-01-01
5834	APR_DRG	Neonate W Ecmo	24	12	—	—	$260,426.64	$1,206,342.90	$390,361.97	2026-01-01
5884	APR_DRG	Neonate Bwt 1500g W Major Procedure	24	12	—	—	$173,711.73	$780,399.02	$254,666.60	2026-01-01
5833	APR_DRG	Neonate W Ecmo	24	12	—	—	$156,977.59	$705,221.00	$252,888.58	2026-01-01
24	APR_DRG	Heart Or Lung Transplant	24	12	—	—	$197,053.53	$894,317.79	$225,530.55	2026-01-01
5832	APR_DRG	Neonate W Ecmo	24	12	—	—	$101,336.57	$455,253.98	$194,172.15	2026-01-01
1614	APR_DRG	Cardiac Defibrillator & Heart Assist Implant	24	12	—	—	$129,038.86	$579,706.40	$193,278.30	2026-01-01
5883	APR_DRG	Neonate Bwt 1500g W Major Procedure	24	12	—	—	$119,969.15	$538,960.75	$165,628.52	2026-01-01
5914	APR_DRG	Neonate Birthwt 500749g Wo Major Procedure	24	12	—	—	$134,558.16	$732,840.43	$161,780.72	2026-01-01
74	APR_DRG	Allogeneic Bone Marrow Transplant	24	12	—	—	$91,406.46	$410,643.05	$153,561.93	2026-01-01
94	APR_DRG	Extracorporeal Membrane Oxygenation Ecmo	24	12	—	—	$85,263.45	$383,045.61	$152,792.37	2026-01-01
5934	APR_DRG	Neonate Birthwt 750999g Wo Major Procedure	24	12	—	—	$139,297.97	$721,386.02	$150,011.84	2026-01-01
5882	APR_DRG	Neonate Bwt 1500g W Major Procedure	24	12	—	—	$97,243.09	$436,864.07	$145,335.69	2026-01-01
5831	APR_DRG	Neonate W Ecmo	24	12	—	—	$82,911.74	$372,480.53	$141,137.35	2026-01-01
6034	APR_DRG	Neonate Birthwt 10001249g W Or Wo Other Significant Condition	24	12	—	—	$95,032.67	$426,933.77	$138,755.74	2026-01-01
14	APR_DRG	Liver Transplant Or Intestinal Transplant	24	12	—	—	$88,130.70	$395,926.72	$136,566.14	2026-01-01
44	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	24	12	—	—	$88,856.79	$399,188.63	$135,629.87	2026-01-01
1613	APR_DRG	Cardiac Defibrillator & Heart Assist Implant	24	12	—	—	$100,764.37	$452,683.41	$130,777.34	2026-01-01
23	APR_DRG	Heart Or Lung Transplant	24	12	—	—	$94,960.62	$426,610.09	$126,634.07	2026-01-01
5881	APR_DRG	Neonate Bwt 1500g W Major Procedure	24	12	—	—	$64,009.15	$287,560.75	$124,573.23	2026-01-01
5913	APR_DRG	Neonate Birthwt 500749g Wo Major Procedure	24	12	—	—	$78,821.41	$381,829.46	$120,079.43	2026-01-01
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	24	12	—	—	$59,006.32	$265,085.59	$112,764.90	2026-01-01
6024	APR_DRG	Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom	24	12	—	—	$99,887.27	$546,870.42	$111,395.47	2026-01-01
1612	APR_DRG	Cardiac Defibrillator & Heart Assist Implant	24	12	—	—	$80,904.87	$363,464.69	$104,977.03	2026-01-01
5933	APR_DRG	Neonate Birthwt 750999g Wo Major Procedure	24	12	—	—	$89,617.66	$560,829.41	$104,038.52	2026-01-01
1611	APR_DRG	Cardiac Defibrillator & Heart Assist Implant	24	12	—	—	$76,859.66	$345,291.62	$100,018.06	2026-01-01
5891	APR_DRG	Neonate Bwt 500g Or Ga 24 Weeks	24	12	—	—	$41,692.84	$802,695.06	$99,482.94	2026-01-01
64	APR_DRG	Pancreas Transplant	24	12	—	—	$82,885.85	$372,364.25	$98,241.53	2026-01-01
5892	APR_DRG	Neonate Bwt 500g Or Ga 24 Weeks	24	12	—	—	$34,670.89	$642,157.31	$96,548.35	2026-01-01
5893	APR_DRG	Neonate Bwt 500g Or Ga 24 Weeks	24	12	—	—	$27,561.16	$545,167.19	$94,491.23	2026-01-01
22	APR_DRG	Heart Or Lung Transplant	24	12	—	—	$70,471.13	$316,591.16	$92,158.00	2026-01-01
5912	APR_DRG	Neonate Birthwt 500749g Wo Major Procedure	24	12	—	—	$41,956.16	$293,566.07	$91,058.73	2026-01-01
54	APR_DRG	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	24	12	—	—	$84,351.20	$439,447.20	$88,467.98	2026-01-01
6074	APR_DRG	Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom	24	12	—	—	$76,714.83	$475,249.70	$85,371.14	2026-01-01
5932	APR_DRG	Neonate Birthwt 750999g Wo Major Procedure	24	12	—	—	$71,009.49	$445,424.24	$85,212.62	2026-01-01
43	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	24	12	—	—	$68,609.06	$308,225.83	$85,048.88	2026-01-01
21	APR_DRG	Heart Or Lung Transplant	24	12	—	—	$60,413.02	$271,405.16	$84,752.67	2026-01-01
3034	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	24	12	—	—	$49,909.33	$224,217.38	$80,990.46	2026-01-01
6023	APR_DRG	Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom	24	12	—	—	$78,733.64	$431,223.28	$79,016.70	2026-01-01
1624	APR_DRG	Cardiac Valve Procedures W Cardiac Catheterization	24	12	—	—	$47,093.14	$211,565.67	$76,982.66	2026-01-01
84	APR_DRG	Autologous Bone Marrow Transplant	24	12	—	—	$54,255.32	$243,741.73	$76,111.88	2026-01-01
73	APR_DRG	Allogeneic Bone Marrow Transplant	24	12	—	—	$63,498.51	$285,266.72	$75,051.32	2026-01-01
4404	APR_DRG	Kidney Transplant	24	12	—	—	$55,546.60	$249,542.78	$71,941.82	2026-01-01
63	APR_DRG	Pancreas Transplant	24	12	—	—	$58,560.74	$263,083.82	$69,792.42	2026-01-01
93	APR_DRG	Extracorporeal Membrane Oxygenation Ecmo	24	12	—	—	$44,993.94	$202,135.03	$65,848.62	2026-01-01
1674	APR_DRG	Other Cardiothoracic Procedures	24	12	—	—	$41,870.67	$188,103.77	$64,561.80	2026-01-01
1634	APR_DRG	Cardiac Valve Procedures Wo Cardiac Catheterization	24	12	—	—	$40,870.39	$183,609.99	$64,125.67	2026-01-01
13	APR_DRG	Liver Transplant Or Intestinal Transplant	24	12	—	—	$63,886.02	$329,742.53	$63,886.02	2026-01-01
6022	APR_DRG	Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom	24	12	—	—	$55,346.54	$248,644.03	$63,190.14	2026-01-01
6093	APR_DRG	Neonate Bwt 15002499g W Major Procedure	24	12	—	—	$54,253.92	$243,735.44	$62,520.31	2026-01-01
1784	APR_DRG	External Heart Assist Systems	24	12	—	—	$58,054.30	$260,808.65	$61,452.31	2026-01-01
6033	APR_DRG	Neonate Birthwt 10001249g W Or Wo Other Significant Condition	24	12	—	—	$46,245.34	$207,756.96	$61,290.06	2026-01-01
53	APR_DRG	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	24	12	—	—	$60,434.00	$271,499.43	$61,110.70	2026-01-01
72	APR_DRG	Allogeneic Bone Marrow Transplant	24	12	—	—	$49,669.40	$223,139.50	$60,182.61	2026-01-01
1654	APR_DRG	Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure	24	12	—	—	$39,843.52	$178,996.80	$59,887.14	2026-01-01
6073	APR_DRG	Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom	24	12	—	—	$59,097.49	$332,567.63	$59,097.49	2026-01-01
71	APR_DRG	Allogeneic Bone Marrow Transplant	24	12	—	—	$43,983.86	$197,597.26	$57,173.59	2026-01-01
3044	APR_DRG	Dorsal & Lumbar Fusion Proc Except For Curvature Of Back	24	12	—	—	$31,446.72	$141,274.23	$56,785.09	2026-01-01
62	APR_DRG	Pancreas Transplant	24	12	—	—	$50,836.86	$228,384.33	$55,882.31	2026-01-01
3033	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	24	12	—	—	$28,689.99	$128,889.64	$55,192.39	2026-01-01
5911	APR_DRG	Neonate Birthwt 500749g Wo Major Procedure	24	12	—	—	$1,141.07	$266,879.96	$54,737.65	2026-01-01
6084	APR_DRG	Neonate Bwt 12501499g W Or Wo Other Significant Condition	24	12	—	—	$48,539.24	$218,614.30	$53,938.32	2026-01-01
1834	APR_DRG	Percutaneous Structural Cardiac Procedures	24	12	—	—	$31,305.42	$140,639.45	$53,554.29	2026-01-01
3124	APR_DRG	Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses	24	12	—	—	$37,718.44	$169,449.89	$53,178.44	2026-01-01
42	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	24	12	—	—	$47,461.77	$213,221.77	$52,481.07	2026-01-01
1664	APR_DRG	Coronary Bypass Wo Cardiac Cath Or Percutaneous Cardiac Procedure	24	12	—	—	$32,181.90	$144,577.00	$52,443.86	2026-01-01
3614	APR_DRG	Skin Graft For Skin & Subcutaneous Tissue Diagnoses	24	12	—	—	$34,670.72	$155,758.01	$51,523.96	2026-01-01
914	APR_DRG	Other Major Head & Neck Procedures	24	12	—	—	$39,215.37	$176,174.84	$51,369.90	2026-01-01
12	APR_DRG	Liver Transplant Or Intestinal Transplant	24	12	—	—	$45,743.80	$205,503.79	$51,321.52	2026-01-01
214	APR_DRG	Craniotomy Except For Trauma	24	12	—	—	$37,143.45	$166,866.75	$50,531.13	2026-01-01
1794	APR_DRG	Defibrillator Implants	24	12	—	—	$38,981.04	$175,122.10	$49,802.50	2026-01-01
1623	APR_DRG	Cardiac Valve Procedures W Cardiac Catheterization	24	12	—	—	$28,060.44	$126,061.39	$49,179.56	2026-01-01
1204	APR_DRG	Major Respiratory & Chest Procedures	24	12	—	—	$37,150.45	$166,898.18	$48,475.50	2026-01-01
2604	APR_DRG	Major Pancreas, Liver & Shunt Procedures	24	12	—	—	$33,373.15	$149,928.68	$48,086.25	2026-01-01
274	APR_DRG	Other Open Craniotomy	24	12	—	—	$33,916.66	$152,370.40	$47,365.81	2026-01-01
2324	APR_DRG	Gastric Fundoplication	24	12	—	—	$26,450.89	$118,830.50	$47,044.30	2026-01-01
41	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo	24	12	—	—	$31,693.65	$142,383.53	$46,572.44	2026-01-01
2204	APR_DRG	Major Stomach, Esophageal & Duodenal Procedures	24	12	—	—	$45,202.39	$203,071.49	$46,521.08	2026-01-01
234	APR_DRG	Spinal Procedures	24	12	—	—	$43,663.49	$196,157.99	$46,393.07	2026-01-01
1694	APR_DRG	Major Thoracic Abdominal Vascular Procedures	24	12	—	—	$46,217.43	$220,471.52	$46,217.43	2026-01-01
1603	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	24	12	—	—	$23,878.83	$107,275.52	$45,671.15	2026-01-01
204	APR_DRG	Craniotomy For Trauma	24	12	—	—	$37,001.45	$166,228.82	$45,271.48	2026-01-01
1783	APR_DRG	External Heart Assist Systems	24	12	—	—	$38,155.63	$171,413.95	$45,265.53	2026-01-01
11	APR_DRG	Liver Transplant Or Intestinal Transplant	24	12	—	—	$40,614.37	$182,459.84	$44,623.24	2026-01-01
6072	APR_DRG	Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom	24	12	—	—	$42,991.27	$193,138.05	$43,647.52	2026-01-01
4403	APR_DRG	Kidney Transplant	24	12	—	—	$43,599.14	$202,006.19	$43,599.14	2026-01-01
924	APR_DRG	Facial Bone Procedures Except Major Cranialfacial Bone Procedures	24	12	—	—	$31,543.95	$141,711.04	$43,572.35	2026-01-01
1782	APR_DRG	External Heart Assist Systems	24	12	—	—	$37,489.00	$168,419.15	$43,513.55	2026-01-01
6083	APR_DRG	Neonate Bwt 12501499g W Or Wo Other Significant Condition	24	12	—	—	$42,947.92	$201,314.84	$42,947.92	2026-01-01
4414	APR_DRG	Major Bladder Procedures	24	12	—	—	$35,494.03	$159,456.74	$42,484.25	2026-01-01
894	APR_DRG	Major CranialFacial Bone Procedures	24	12	—	—	$35,156.17	$157,938.91	$42,074.91	2026-01-01
61	APR_DRG	Pancreas Transplant	24	12	—	—	$39,959.64	$179,518.46	$41,792.09	2026-01-01
2614	APR_DRG	Major Biliary Tract Procedures	24	12	—	—	$38,445.22	$172,714.94	$41,681.20	2026-01-01
1764	APR_DRG	Cardiac Pacemaker & Defibrillator Device Replacement	24	12	—	—	$31,634.89	$142,119.56	$41,373.08	2026-01-01
1633	APR_DRG	Cardiac Valve Procedures Wo Cardiac Catheterization	24	12	—	—	$24,295.73	$109,148.45	$40,922.81	2026-01-01
1304	APR_DRG	Respiratory System Diagnosis W Ventilator Support 96+ Hours	24	12	—	—	$40,841.68	$203,178.34	$40,841.68	2026-01-01
5144	APR_DRG	Female Reproductive System Reconstructive Procedures	24	12	—	—	$24,721.73	$111,062.24	$40,537.28	2026-01-01
5104	APR_DRG	Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs	24	12	—	—	$31,603.41	$141,978.15	$40,375.78	2026-01-01
52	APR_DRG	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	24	12	—	—	$40,350.47	$191,412.82	$40,350.47	2026-01-01
1814	APR_DRG	Lower Extremity Arterial Procedures	24	12	—	—	$33,954.43	$152,540.09	$40,232.88	2026-01-01
1653	APR_DRG	Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure	24	12	—	—	$26,762.17	$120,228.91	$40,078.82	2026-01-01
92	APR_DRG	Extracorporeal Membrane Oxygenation Ecmo	24	12	—	—	$32,817.04	$147,430.39	$39,726.05	2026-01-01
224	APR_DRG	Ventricular Shunt Procedures	24	12	—	—	$30,488.41	$136,969.01	$39,157.44	2026-01-01
83	APR_DRG	Autologous Bone Marrow Transplant	24	12	—	—	$30,479.31	$136,928.15	$38,834.43	2026-01-01
3032	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	24	12	—	—	$22,265.78	$100,028.92	$38,728.75	2026-01-01
2644	APR_DRG	Other Hepatobiliary, Pancreas & Abdominal Procedures	24	12	—	—	$28,450.06	$127,811.76	$38,689.30	2026-01-01
3634	APR_DRG	Breast Procedures Except Mastectomy	24	12	—	—	$21,379.52	$96,047.37	$38,544.17	2026-01-01
5114	APR_DRG	Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy	24	12	—	—	$26,285.81	$118,088.87	$38,471.98	2026-01-01
264	APR_DRG	Other Nervous System & Related Procedures	24	12	—	—	$26,719.50	$120,037.22	$38,437.00	2026-01-01
1214	APR_DRG	Other Respiratory & Chest Procedures	24	12	—	—	$31,285.14	$140,548.31	$38,421.37	2026-01-01
4044	APR_DRG	Thyroid, Parathyroid & Thyroglossal Procedures	24	12	—	—	$30,476.52	$136,915.58	$38,390.85	2026-01-01
3214	APR_DRG	Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp	24	12	—	—	$30,352.70	$136,359.36	$38,360.34	2026-01-01
2304	APR_DRG	Major Small Bowel Procedures	24	12	—	—	$26,588.69	$119,449.57	$38,352.15	2026-01-01
4402	APR_DRG	Kidney Transplant	24	12	—	—	$38,108.04	$173,252.31	$38,108.04	2026-01-01
91	APR_DRG	Extracorporeal Membrane Oxygenation Ecmo	24	12	—	—	$26,932.85	$120,995.68	$37,740.38	2026-01-01
5184	APR_DRG	Other Female Reproductive System & Related Procedures	24	12	—	—	$25,732.51	$115,603.15	$37,613.85	2026-01-01
304	APR_DRG	Percutaneous Intracranial And Extracranial Vascular Procedures	24	12	—	—	$26,213.06	$117,762.05	$37,262.57	2026-01-01
1673	APR_DRG	Other Cardiothoracic Procedures	24	12	—	—	$19,796.55	$88,935.89	$37,098.83	2026-01-01
4054	APR_DRG	Other Procedures For Endocrine, Nutritional & Metabolic Disorders	24	12	—	—	$30,191.12	$135,633.44	$36,917.98	2026-01-01
1781	APR_DRG	External Heart Assist Systems	24	12	—	—	$35,986.48	$161,669.06	$36,915.74	2026-01-01
1824	APR_DRG	Other Peripheral Vascular Procedures	24	12	—	—	$33,582.30	$150,868.28	$36,728.19	2026-01-01
1622	APR_DRG	Cardiac Valve Procedures W Cardiac Catheterization	24	12	—	—	$21,350.84	$95,918.53	$36,580.08	2026-01-01
114	APR_DRG	Psychiatric	22	11	—	—	$78,957.46	$354,715.97	$198,309.46	2026-01-01
6304	APR_DRG	Neonate Birthwt 2499g W Major Cardiovascular Procedure	22	11	—	—	$67,924.25	$305,149.32	$185,770.26	2026-01-01
8414	APR_DRG	Extensive 3rd Degree Burns W Skin Graft	22	11	—	—	$171,478.23	$770,365.02	$183,225.66	2026-01-01
6094	APR_DRG	Neonate Bwt 15002499g W Major Procedure	22	11	—	—	$139,538.36	$626,875.33	$167,444.50	2026-01-01
6314	APR_DRG	Neonate Birthwt 2499g W Other Major Procedure	22	11	—	—	$88,109.72	$395,832.44	$164,388.59	2026-01-01
113	APR_DRG	Pediatric	22	11	—	—	$48,995.78	$220,113.27	$115,654.09	2026-01-01
112	APR_DRG	OB	22	11	—	—	$25,952.85	$116,593.04	$99,304.32	2026-01-01
8424	APR_DRG	Full Thickness Burns W Skin Graft	22	11	—	—	$46,679.03	$209,705.31	$93,836.29	2026-01-01
6303	APR_DRG	Neonate Birthwt 2499g W Major Cardiovascular Procedure	22	11	—	—	$50,338.12	$226,143.73	$88,705.40	2026-01-01
8634	APR_DRG	Neonatal Aftercare	22	11	—	—	$45,768.29	$205,613.78	$71,101.56	2026-01-01
6134	APR_DRG	Neonate Birthwt 15001999g W Congenitalperinatal Infection	22	11	—	—	$43,582.35	$195,793.46	$69,517.04	2026-01-01
6114	APR_DRG	Neonate Birthwt 15001999g W Major Anomaly	22	11	—	—	$69,191.81	$432,470.85	$69,191.81	2026-01-01
6124	APR_DRG	Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond	22	11	—	—	$60,388.53	$271,295.17	$60,980.45	2026-01-01
8504	APR_DRG	Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service	22	11	—	—	$38,920.18	$174,848.70	$60,423.01	2026-01-01
8413	APR_DRG	Extensive 3rd Degree Burns W Skin Graft	22	11	—	—	$54,977.90	$246,987.93	$58,636.05	2026-01-01
6214	APR_DRG	Neonate Bwt 20002499g W Major Anomaly	22	11	—	—	$58,289.49	$418,948.67	$58,572.79	2026-01-01
6804	APR_DRG	Major Or Procedures For Lymphatichematopoieticother Neoplasms	22	11	—	—	$35,709.48	$160,424.63	$58,522.92	2026-01-01
6334	APR_DRG	Neonate Birthwt 2499g W Major Anomaly	22	11	—	—	$49,565.87	$222,674.41	$57,982.60	2026-01-01
9104	APR_DRG	Craniotomy For Multiple Significant Trauma	22	11	—	—	$41,720.98	$187,431.27	$54,210.72	2026-01-01
6814	APR_DRG	Other Or Procedures For Lymphatichematopoieticother Neoplasms	22	11	—	—	$37,347.00	$167,781.22	$53,325.80	2026-01-01
7404	APR_DRG	Mental Illness Diagnosis W Or Procedure	22	11	—	—	$37,731.73	$169,509.59	$53,107.73	2026-01-01
6904	APR_DRG	Acute Leukemia	22	11	—	—	$41,443.98	$186,186.84	$52,824.92	2026-01-01
9114	APR_DRG	Extensive AbdominalThoraic Procedures For Mult Si	22	11	—	—	$40,640.95	$182,579.25	$50,840.74	2026-01-01
6302	APR_DRG	Neonate Birthwt 2499g W Major Cardiovascular Procedure	22	11	—	—	$28,246.51	$126,897.29	$50,761.84	2026-01-01
7594	APR_DRG	Eating Disorders	22	11	—	—	$25,523.36	$114,663.54	$49,869.48	2026-01-01
6144	APR_DRG	Neonate Bwt 15001999g W Or Wo Other Significant Condition	22	11	—	—	$37,561.75	$168,745.97	$49,786.13	2026-01-01
6313	APR_DRG	Neonate Birthwt 2499g W Other Major Procedure	22	11	—	—	$25,244.26	$113,409.68	$49,361.90	2026-01-01
6254	APR_DRG	Neonate Bwt 20002499g W Other Significant Condition	22	11	—	—	$25,190.39	$113,167.71	$48,706.96	2026-01-01
9124	APR_DRG	Musculoskeletal & Other Procedures For Multiple Significant Trauma	22	11	—	—	$35,872.46	$161,156.83	$47,544.43	2026-01-01
6954	APR_DRG	Chemotherapy For Acute Leukemia	22	11	—	—	$32,013.32	$143,819.66	$46,812.83	2026-01-01
111	APR_DRG	Medical/Surgical/Gyn	22	11	—	—	$17,634.40	$79,222.43	$45,282.65	2026-01-01
9504	APR_DRG	Extensive Procedure Unrelated To Principal Diagnosis	22	11	—	—	$40,572.40	$182,271.29	$44,684.27	2026-01-01
6113	APR_DRG	Neonate Birthwt 15001999g W Major Anomaly	22	11	—	—	$42,747.72	$319,532.54	$42,747.72	2026-01-01
6133	APR_DRG	Neonate Birthwt 15001999g W Congenitalperinatal Infection	22	11	—	—	$28,419.99	$127,676.63	$42,191.02	2026-01-01
6234	APR_DRG	Neonate Bwt 20002499g W Congenitalperinatal Infection	22	11	—	—	$30,122.57	$135,325.48	$41,037.42	2026-01-01
7924	APR_DRG	Extensive Or Procedures For Other Complications Of Treatment	22	11	—	—	$32,226.66	$144,778.12	$40,453.18	2026-01-01
6514	APR_DRG	Other Procedures Of Blood & Blood-forming Organs	22	11	—	—	$33,546.62	$150,708.02	$40,035.66	2026-01-01
8411	APR_DRG	Extensive 3rd Degree Burns W Skin Graft	22	11	—	—	$15,691.18	$70,492.56	$39,784.10	2026-01-01
8412	APR_DRG	Extensive 3rd Degree Burns W Skin Graft	22	11	—	—	$17,861.03	$80,240.60	$39,784.10	2026-01-01
7584	APR_DRG	Childhood Behavioral Disorders	22	11	—	—	$9,718.85	$43,661.90	$38,842.62	2026-01-01
6123	APR_DRG	Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond	22	11	—	—	$37,990.45	$187,412.42	$37,990.45	2026-01-01
8633	APR_DRG	Neonatal Aftercare	22	11	—	—	$28,995.67	$130,262.91	$36,830.90	2026-01-01
453	MS_DRG	Combined Anterior/posterior Spinal Fusion W Mcc	18	7	—	—	$129,553.67	$202,828.58	$144,626.91	2026-01-01
459	MS_DRG	Spinal Fusion Except Cervical With Mcc	18	7	—	—	$96,964.23	$151,806.71	$108,245.77	2026-01-01
454	MS_DRG	Combined Anterior/posterior Spinal Fusion W Cc	18	7	—	—	$89,420.31	$139,995.99	$99,824.13	2026-01-01
455	MS_DRG	Combined Anterior/posterior Spinal Fusion Without Cc/mcc	18	7	—	—	$67,333.87	$105,417.58	$75,168.00	2026-01-01
460	MS_DRG	Spinal Fusion Except Cervical Without Mcc	18	7	—	—	$53,478.50	$83,725.67	$59,700.59	2026-01-01
222	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…	8	3	—	—	$124,412.09	$175,251.92	$175,251.92	2026-01-01
224	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…	8	3	—	—	$115,192.41	$162,264.70	$162,264.70	2026-01-01
226	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	8	3	—	—	$104,008.22	$146,510.20	$146,510.20	2026-01-01
223	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…	8	3	—	—	$84,798.66	$119,450.82	$119,450.82	2026-01-01
225	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…	8	3	—	—	$82,182.57	$115,765.70	$115,765.70	2026-01-01
227	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc	8	3	—	—	$81,581.35	$114,918.80	$114,918.80	2026-01-01
248	MS_DRG	Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4…	8	3	—	—	$48,906.24	$68,891.31	$68,891.31	2026-01-01
246	MS_DRG	Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar…	8	3	—	—	$48,672.25	$68,561.71	$68,561.71	2026-01-01
338	MS_DRG	Appendectomy With Complicated Principal Diagnosis With Mcc	8	3	—	—	$43,165.47	$60,804.63	$60,804.63	2026-01-01
341	MS_DRG	Appendectomy Without Complicated Principal Diagnosis With Mcc	8	3	—	—	$36,706.49	$51,706.25	$51,706.25	2026-01-01
247	MS_DRG	Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc	8	3	—	—	$31,027.47	$43,706.55	$43,706.55	2026-01-01
249	MS_DRG	Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc	8	3	—	—	$29,519.56	$41,582.45	$41,582.45	2026-01-01
339	MS_DRG	Appendectomy With Complicated Principal Diagnosis With Cc	8	3	—	—	$26,459.87	$37,272.45	$37,272.45	2026-01-01
J1414	CPT	Inj- Beqvez- Per Tx Dose	6	2	—	—	$3,500,000.00	$3,710,000.00	$3,710,000.00	2026-01-01
C9172	CPT	Inj Beqvez Per Tx Dose	2	1	—	—	$3,605,000.00	$3,605,000.00	$3,605,000.00	2026-01-01
C9098	CPT	Ciltacabtagene Car Pos T	2	1	—	—	$1,000,528.86	$1,000,528.86	$1,000,528.86	2026-01-01
C9081	CPT	Idecabtagene Car Pos T	2	1	—	—	$1,000,528.86	$1,000,528.86	$1,000,528.86	2026-01-01
Q2040	CPT	Tisagenlecleucel Car-pos T	2	1	—	—	$1,000,528.86	$1,000,528.86	$1,000,528.86	2026-01-01
C9076	CPT	Lisocabtagene Car Pos T	2	1	—	—	$1,000,528.86	$1,000,528.86	$1,000,528.86	2026-01-01
C9073	CPT	Brexucabtagene Autoleucel Ca	2	1	—	—	$1,000,528.86	$1,000,528.86	$1,000,528.86	2026-01-01
E0766	CPT	Elec Stim Cancer Treatment	2	1	—	—	$149,026.20	$149,026.20	$149,026.20	2026-01-01
0424T	CPT	Insj/rplc Nstim Apnea Compl	2	1	—	—	$126,528.65	$126,528.65	$126,528.65	2026-01-01
0431T	CPT	Rmvl/rplc Nstim Apnea Pls Gn	2	1	—	—	$67,539.18	$67,539.18	$67,539.18	2026-01-01
0427T	CPT	Insj/rplc Nstim Apnea Pls Gn	2	1	—	—	$67,539.18	$67,539.18	$67,539.18	2026-01-01
C9741	CPT	Impl Pressure Sensor W/angio	2	1	—	—	$52,493.55	$52,493.55	$52,493.55	2026-01-01
0294T	CPT	Ins Lt Atrl Mont Pres Lead	2	1	—	—	$52,493.55	$52,493.55	$52,493.55	2026-01-01
3060	EAPG	Ventricular Assist Device Procedures	4	1	—	—	$44,046.93	$57,407.60	$50,727.26	2026-01-01
0163T	CPT	Tot Disc Arthrp Ea Addl Lmbr	2	1	—	—	$50,375.50	$50,375.50	$50,375.50	2026-01-01
63196	CPT	Incise Spine&cord 2 Trx Crvl	2	1	—	—	$50,375.50	$50,375.50	$50,375.50	2026-01-01
63182	CPT	Revise Spinal Cord Ligaments	2	1	—	—	$50,375.50	$50,375.50	$50,375.50	2026-01-01
63180	CPT	Revise Spinal Cord Ligaments	2	1	—	—	$50,375.50	$50,375.50	$50,375.50	2026-01-01
0375T	CPT	Total Disc Arthrp Ant Appr	2	1	—	—	$50,375.50	$50,375.50	$50,375.50	2026-01-01
63198	CPT	Incise Spin&cord 2 Stgs Crvl	2	1	—	—	$50,375.50	$50,375.50	$50,375.50	2026-01-01
63194	CPT	Incise Spine & Cord Cervical	2	1	—	—	$50,375.50	$50,375.50	$50,375.50	2026-01-01
63199	CPT	Incise Spin&cord 2 Stgs Thrc	2	1	—	—	$50,375.50	$50,375.50	$50,375.50	2026-01-01
63195	CPT	Incise Spine & Cord Thoracic	2	1	—	—	$50,375.50	$50,375.50	$50,375.50	2026-01-01
0775T	CPT	Arthrd Si Jt Prq Iartic Impl	2	1	—	—	$50,375.50	$50,375.50	$50,375.50	2026-01-01
90288	CPT	Botulism Ig IV	2	1	—	—	$48,705.00	$48,705.00	$48,705.00	2026-01-01
250	EAPG	Cochlear Device Implantation	4	1	—	—	$38,557.16	$50,252.62	$44,404.89	2026-01-01
97	EAPG	Aicd And Related Cardiac Device Insertion Or Replacement	4	1	—	—	$34,226.79	$44,608.74	$39,417.76	2026-01-01
224	EAPG	Level Ii Neurostimulator And Related Device Implantation	4	1	—	—	$32,095.20	$41,830.57	$36,962.89	2026-01-01

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