Price Transparency 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

POPLAR BLUFF REGIONAL MEDICAL CENTER

Poplar Bluff, MO · CCN 260119 · Rates published

77,245 distinct procedures filed
57 distinct payers
2,049,102 rate rows
2026-05-08 last MRF observed
Data quality

1,995,894 of 2,049,102 rate rows are consumer-grade (97.4%)

53,208 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
per-diem day rate — not a per-procedure price 29,934
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 10,921
placeholder amount (≤ $0.02) — excluded from medians 9,309
template filing: same amount across many unrelated codes — excluded 1,760
exceeds 10× this hospital's gross charge — excluded from medians 1,284
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.pbrmc.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/431238701_poplar-bluff-regional-medical-center_standardcharges.csv
Found on page https://www.pbrmc.com/pricing-information
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint eb9f28b159459182… · 426,394,471 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
583-4
OTHER 		Neonate With Ecmo 5 $841,479.11 $1,228,559.50 $883,553.06 nat. median
$309,400
outlier · 2.9×
51905029-3127866
OTHER 		30237-8900-06 - Sipuleucel-t - Susp 22 $166,729.19 $750,281.36 $541,869.87 nat. median
$541,870
1.0× median
583-3
OTHER 		Neonate With Ecmo 5 $508,063.44 $741,772.62 $533,466.61 nat. median
$259,487
outlier · 2.1×
609-4
OTHER 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 $373,996.40 $546,034.74 $392,696.22 nat. median
$169,856
outlier · 2.3×
011-3
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $367,241.99 $536,173.31 $385,604.09 nat. median
$171,094
outlier · 2.3×
011-4
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $367,241.99 $536,173.31 $385,604.09 nat. median
$105,647
outlier · 3.6×
591-4
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $358,626.58 $523,594.81 $376,557.91 nat. median
$156,696
outlier · 2.4×
18
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 $3,818.04 $865,850.30 $345,926.22 nat. median
$386,529
0.9× median
583-2
OTHER 		Neonate With Ecmo 5 $318,821.06 $465,478.75 $334,762.12 nat. median
$191,347
1.7× median
631-4
OTHER 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 $298,953.38 $436,471.93 $313,901.05 nat. median
$203,379
1.5× median
011-2
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $287,998.41 $420,477.67 $302,398.33 nat. median
$52,878
outlier · 5.7×
002-4
OTHER 		Heart And/or Lung Transplant 5 $286,260.57 $417,940.43 $300,573.59 nat. median
$216,800
1.4× median
127538326-3127866
OTHER 		00310-4535-30 - Tremelimumab Actl 20 mg/mL Soln 22 $91,693.05 $412,618.72 $298,002.41 nat. median
$298,002
1.0× median
007-4
OTHER 		Allogeneic Bone Marrow Transplant 5 $273,701.01 $399,603.47 $287,386.06 nat. median
$172,311
1.7× median
588-3
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $269,847.40 $393,977.20 $283,339.77 nat. median
$165,000
1.7× median
588-4
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $269,847.40 $393,977.20 $283,339.77 nat. median
$267,493
1.1× median
588-2
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $269,847.40 $393,977.20 $283,339.77 nat. median
$153,523
1.8× median
593-4
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 5 $257,411.96 $375,821.46 $270,282.56 nat. median
$151,250
1.8× median
591-3
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $244,460.51 $356,912.35 $256,683.54 nat. median
$99,157
outlier · 2.6×
103958919-3127864
OTHER 		69866-1030-08 - Autologous Cultured Chondrocytes 1 22 $78,962.69 $355,332.10 $256,628.74 nat. median
$256,629
1.0× median
103958918-3127864
OTHER 		69866-1030-05 - Autologous Cultured Chondrocytes 1 22 $78,962.69 $355,332.10 $256,628.74 nat. median
$256,629
1.0× median
630-4
OTHER 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 $242,001.72 $353,322.52 $254,101.81 nat. median
$210,669
1.2× median
101891901-3127866
OTHER 		72187-0401-01 - Tagraxofusp 1000 mcg/mL Soln 22 $75,692.05 $340,614.23 $245,999.17 nat. median
$245,999
1.0× median
583-1
OTHER 		Neonate With Ecmo 5 $232,890.65 $340,020.35 $244,535.18 nat. median
$171,226
1.4× median
591-2
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $225,773.48 $329,629.27 $237,062.15 nat. median
$80,000
outlier · 3.0×
588-1
OTHER 		Female Reproductive System Reconstructive Procedures 5 $220,844.01 $322,432.25 $231,886.21 nat. median
$75,325
outlier · 3.1×
1
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 22 $3,818.04 $562,602.98 $226,866.61 nat. median
$239,422
0.9× median
161-4
OTHER 		Implantable Heart Assist Systems 5 $211,684.88 $309,059.93 $222,269.13 nat. median
$202,242
1.1× median
102534551-3127868
OTHER 		71336-1001-01 - Givosiran 189 mg/mL Soln 22 $68,234.40 $307,054.80 $221,761.80 nat. median
$221,762
1.0× median
105162272-3211899
OTHER 		Ic-s-per Ins Lh Vad Art [mopb] 23 $297.00 $302,561.41 $214,314.33 nat. median
$214,314
1.0× median
009-4
OTHER 		Extracorporeal Membrane Oxygenation (ecmo) 5 $193,449.58 $282,436.39 $203,122.06 nat. median
$150,954
1.3× median
101883920-3127866
OTHER 		79952-0110-01 - Loncastuximab Tesirine 10 Mg Injec 22 $61,920.74 $278,643.35 $201,242.42 nat. median
$201,242
1.0× median
1279402-3127868
OTHER 		00003-2328-22 - Ipilimumab Soln 22 $61,381.44 $276,216.50 $199,489.69 nat. median
$199,490
1.0× median
001-4
OTHER 		Liver Transplant And/or Intestinal Transplant 4 $189,869.38 $203,160.24 $194,616.11 nat. median
$124,561
1.6× median
161-3
OTHER 		Implantable Heart Assist Systems 5 $184,111.27 $268,802.46 $193,316.84 nat. median
$152,491
1.3× median
602-4
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 $184,025.18 $268,676.76 $193,226.44 nat. median
$125,000
1.5× median
841-4
OTHER 		Extensive Third Degree Burns With Skin Graft 5 $181,096.19 $264,400.43 $190,151.00 nat. median
$151,691
1.3× median
1287035-3127866
OTHER 		76128-0155-75 - Porfimer 75. Mg Rec Injection 22 $57,711.99 $259,703.97 $187,563.98 nat. median
$187,564
1.0× median
607-4
OTHER 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 $176,022.22 $256,992.45 $184,823.33 nat. median
$100,015
1.8× median
603-4
OTHER 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 $170,638.57 $249,132.31 $179,170.50 nat. median
$107,050
1.7× median
589-3
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $169,283.14 $247,153.39 $177,747.30 nat. median
$87,000
outlier · 2.0×
589-2
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $169,283.14 $247,153.39 $177,747.30 nat. median
$49,980
outlier · 3.6×
589-1
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $169,283.14 $247,153.39 $177,747.30 nat. median
$86,371
outlier · 2.1×
602-3
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 $165,599.71 $241,775.58 $173,879.70 nat. median
$99,067
1.8× median
927
OTHER 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 24 $3,818.04 $429,104.47 $171,247.85 nat. median
$146,562
1.2× median
3
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 24 $3,818.04 $426,597.92 $170,245.35 nat. median
$181,005
0.9× median
103469064-3127866
OTHER 		00008-0100-01 - Inotuzumab Ozogamicin 0.9 Mg Powde 22 $52,277.95 $235,250.76 $169,903.32 nat. median
$169,903
1.0× median
593-3
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 5 $161,789.07 $236,212.04 $169,878.52 nat. median
$112,711
1.5× median
593-2
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 5 $160,632.20 $234,523.01 $168,663.81 nat. median
$89,334
1.9× median
1286149-3127868
OTHER 		54396-0801-01 - Pegloticase Soln 22 $50,023.72 $225,106.76 $162,577.10 nat. median
$162,577
1.0× median

Other procedures at this hospital

Browse this hospital's 77,245 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
123904877-3211899 OTHER Stry-stm Prfrm Sz 3 Hum X[mopb] 22 19 $93,817.05 $28,145.12 70% off $9,381.70 $84,435.34 $56,290.23 2026-05-08
123906857-3211899 OTHER Stry-stm Hum Prfrm Sz 1 +[mopb] 22 19 $93,817.05 $28,145.12 70% off $9,381.70 $84,435.34 $56,290.23 2026-05-08
123906938-3211899 OTHER Stry-stm Hum Prfrm Sz 2 +[mopb] 22 19 $93,817.05 $28,145.12 70% off $9,381.70 $84,435.34 $56,290.23 2026-05-08
123906949-3211899 OTHER Stry-stm Shldr Prfrm Sz 3 + Hum[mopb] 22 19 $93,817.05 $28,145.12 70% off $9,381.70 $84,435.34 $56,290.23 2026-05-08
166-4 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 5 5 — — $53,823.96 $78,582.99 $56,515.16 2026-05-08
178-3 OTHER External Heart Assist Systems 5 5 — — $54,313.54 $79,297.77 $57,029.22 2026-05-08
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 24 24 — — $3,818.04 $144,637.43 $57,474.04 2026-05-08
841-3 OTHER Extensive Third Degree Burns With Skin Graft 5 5 — — $54,763.25 $79,954.34 $57,501.41 2026-05-08
98780797-3127866 OTHER 50242-0918-01 - Atezolizumab 840 Mg/14 Ml Soln 25 22 $88,491.30 $26,547.39 70% off $17,698.26 $79,642.17 $57,519.35 2026-05-08
105162236-3211899 OTHER Ic-trluml Perip Athrc Iliac Art [mopb] 26 23 $90,283.56 $23,022.31 74% off $297.00 $81,255.20 $57,555.76 2026-05-08
105162160-3211899 OTHER Ic-atherectomy Iliac Artery Surg [mopb] 26 23 $90,283.56 $23,022.31 74% off $297.00 $81,255.20 $57,555.76 2026-05-08
105162232-3211899 OTHER Ic-fem/popl Revas W/ather [mopb] 26 23 $90,438.51 $23,061.82 75% off $297.00 $81,394.66 $57,654.55 2026-05-08
97083307-3127868 OTHER 55292-0702-55 - Hemin 350 Mg Powder 25 22 $88,701.13 $26,610.34 70% off $17,740.23 $79,831.02 $57,655.73 2026-05-08
928 OTHER Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 24 24 — — $3,818.04 $145,483.62 $57,812.49 2026-05-08
312-4 OTHER Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 5 5 — — $55,108.75 $80,458.78 $57,864.19 2026-05-08
1328480-3349936 OTHER Ir Iliac Revasc W Stent 30 27 $103,422.36 $21,718.70 79% off $856.97 $93,080.12 $57,916.53 2026-05-08
134322695-3127868 OTHER 25682-0007-01 - Sebelipase Alfa 2 mg/mL Soln 25 22 $89,129.52 $26,738.86 70% off $17,825.90 $80,216.57 $57,934.19 2026-05-08
19 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 23 23 — — $3,818.04 $144,721.47 $57,938.51 2026-05-08
006-1 OTHER Pancreas Transplant 4 4 — — $56,527.82 $60,484.77 $57,941.01 2026-05-08
220-4 OTHER Major Stomach, Esophageal And Duodenal Procedures 5 5 — — $55,357.04 $80,821.27 $58,124.89 2026-05-08
2008855-3127866 OTHER 00074-3683-03 - Leuprolide 30 Mg/4 Months Powder 25 22 $89,610.94 $26,883.28 70% off $17,922.19 $80,649.85 $58,247.11 2026-05-08
910-4 OTHER Craniotomy For Multiple Significant Trauma 5 5 — — $55,563.36 $81,122.50 $58,341.52 2026-05-08
10 OTHER Pancreas Transplant 22 22 — — $3,818.04 $145,543.65 $58,393.71 2026-05-08
179-4 OTHER Defibrillator Implants 5 5 — — $55,677.36 $81,288.94 $58,461.23 2026-05-08
40256775-3127868 OTHER 44087-8822-01 - Interferon Beta-1a - Kit 25 22 $90,117.96 $27,035.39 70% off $18,023.59 $81,106.16 $58,576.67 2026-05-08
105162215-3211899 OTHER Ic-perc De Cor Revasc W Ami Sing [mopb] 26 23 $92,173.13 $23,504.15 74% off $18,434.63 $82,955.82 $58,760.37 2026-05-08
091-4 OTHER Other Major Head And Neck Procedures 5 5 — — $56,359.97 $82,285.55 $59,177.96 2026-05-08
134322469-3125869 OTHER 99999-1029-52 - Skin Substitute 50.27 Cm2 Misc 25 22 $91,272.10 $27,381.63 70% off $18,254.42 $82,144.89 $59,326.87 2026-05-08
97301849-3127866 OTHER 00003-3734-13 - Nivolumab 240 Mg / 24 Ml Soln 25 22 $91,290.76 $27,387.23 70% off $18,258.15 $82,161.68 $59,338.99 2026-05-08
105162250-3211899 OTHER Ic-pacer Sing Perm In/repl At Sur [mopb] 26 23 $93,114.13 $23,744.11 74% off $297.00 $83,802.72 $59,360.26 2026-05-08
1288223-3127867 OTHER 00169-7050-01 - Coagulation Factor VIIa Rec Inject 25 22 $91,373.46 $27,412.04 70% off $18,274.69 $82,236.11 $59,392.75 2026-05-08
39888518-3127867 OTHER 00169-7205-01 - Coagulation Factor VIIa 5000 Mcg ( 25 22 $91,373.46 $27,412.04 70% off $18,274.69 $82,236.11 $59,392.75 2026-05-08
99211218-3127868 OTHER 00074-3779-03 - Leuprolide 11.25 Mg/3 Months Kit 25 22 $91,535.75 $27,460.73 70% off $18,307.15 $82,382.18 $59,498.24 2026-05-08
104988123-3211899 OTHER Pmp It Snchr Ii Rsrv 20ml - 8637-20[mopb] 22 19 $99,415.08 $29,824.52 70% off $9,941.51 $89,473.57 $59,649.05 2026-05-08
162-3 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $56,840.45 $82,987.06 $59,682.47 2026-05-08
136950616-3211899 OTHER Fem/pop Atherectomy Complex[mopb] 26 23 $93,643.45 $23,879.08 74% off $297.00 $84,279.10 $59,697.70 2026-05-08
136950635-3211899 OTHER Tib/per Atherectomy Complex[mopb] 26 23 $93,643.45 $23,879.08 74% off $297.00 $84,279.10 $59,697.70 2026-05-08
167-4 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 5 5 — — $56,873.32 $83,035.05 $59,716.99 2026-05-08
008-2 OTHER Autologous Bone Marrow Transplant Or T-cell Immunotherapy 5 5 — — $56,926.64 $83,112.89 $59,772.97 2026-05-08
104059220-3127868 OTHER 00074-5015-01 - Risankizumab Rzaa 60 mg/mL Soln 25 22 $92,779.48 $27,833.84 70% off $18,555.90 $83,501.53 $60,306.66 2026-05-08
625-4 OTHER Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 5 5 — — $57,835.06 $84,439.18 $60,726.81 2026-05-08
260-4 OTHER Major Pancreas, Liver And Shunt Procedures 5 5 — — $57,898.63 $84,532.00 $60,793.56 2026-05-08
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 24 24 — — $3,818.04 $154,429.70 $61,390.50 2026-05-08
105162239-3211899 OTHER Ic-tib/per Revasc W/ather [mopb] 26 23 $96,567.00 $24,624.58 75% off $297.00 $86,910.30 $61,561.46 2026-05-08
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 24 24 — — $3,818.04 $154,935.77 $61,592.92 2026-05-08
99533657-3127866 OTHER 68727-0712-01 - Lurbinectedin 4 Mg Powder 25 22 $95,043.36 $28,513.01 70% off $19,008.67 $85,539.02 $61,778.18 2026-05-08
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 24 — — $3,818.04 $155,597.95 $61,857.75 2026-05-08
608-2 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 5 — — $59,830.15 $87,352.02 $62,821.66 2026-05-08
20 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 24 24 — — $3,818.04 $159,408.81 $63,381.92 2026-05-08
1279159-3123927 OTHER 63004-7731-01 - Corticotropin 400. Soln 40 37 $117,556.22 $24,686.81 79% off $747.48 $105,800.60 $63,480.36 2026-05-08
133781954-3123927 OTHER 63004-8710-01 - Corticotropin 80 units/mL Soln 40 37 $117,556.22 $24,686.81 79% off $747.48 $105,800.60 $63,480.36 2026-05-08
303-3 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $60,496.88 $88,325.45 $63,521.73 2026-05-08
1328429-3349936 OTHER Ir Fem Pop Revasc W Stent 30 27 $113,454.70 $23,825.49 79% off $856.97 $102,109.23 $63,534.63 2026-05-08
440-3 OTHER Kidney Transplant 4 4 — — $62,025.06 $66,366.81 $63,575.68 2026-05-08
39400101-3211899 OTHER Lithotripsy Bilateral Eswl 25 22 $97,812.86 $29,343.86 70% off $19,562.57 $88,031.57 $63,578.36 2026-05-08
612-2 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $60,553.04 $88,407.44 $63,580.70 2026-05-08
695-4 OTHER Chemotherapy For Acute Leukemia 5 5 — — $60,564.72 $88,424.50 $63,592.96 2026-05-08
105162225-3211899 OTHER Ic-insert Pulse Gen Multileads [mopb] 26 23 $99,775.49 $25,442.75 74% off $297.00 $89,797.94 $63,606.88 2026-05-08
105162222-3211899 OTHER Ic-rem/rep Pm Gen Multi Leads [mopb] 26 23 $99,775.49 $25,442.75 74% off $297.00 $89,797.94 $63,606.88 2026-05-08
165-4 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 5 5 — — $60,755.66 $88,703.26 $63,793.44 2026-05-08
623-4 OTHER Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 5 5 — — $60,884.77 $88,891.76 $63,929.00 2026-05-08
690-4 OTHER Acute Leukemia 5 5 — — $61,063.39 $89,152.55 $64,116.56 2026-05-08
105162248-3211899 OTHER Ic-pacer Dual Perm In/repl Surg [mopb] 26 23 $100,582.96 $25,648.65 74% off $297.00 $90,524.66 $64,121.63 2026-05-08
680-4 OTHER Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 5 5 — — $61,203.27 $89,356.77 $64,263.43 2026-05-08
128230441-3127866 OTHER 73536-0500-01 - Ropeginterferon Alfa-2b 500 mcg/mL 25 22 $98,957.90 $29,687.37 70% off $19,791.58 $89,062.11 $64,322.64 2026-05-08
104987088-3211899 OTHER Medtmedt- Pmp Mgmt Sfwr Prgm 40ml Ea1[mopb] 22 19 $107,368.29 $32,210.49 70% off $10,736.83 $96,631.46 $64,420.97 2026-05-08
183-4 OTHER Percutaneous Structural Cardiac Procedures 5 5 — — $62,010.37 $90,535.14 $65,110.89 2026-05-08
105162151-3211899 OTHER Ic-pacer Upgrade Surg [mopb] 26 23 $102,423.40 $26,117.97 75% off $297.00 $92,181.06 $65,294.92 2026-05-08
105117743-3211899 OTHER Edwledwl- Vlv Aor Ins Rsl Bvn Pricrd 21 Ea1/pk5/bx 22 19 $109,452.64 $32,835.79 70% off $10,945.26 $98,507.38 $65,671.58 2026-05-08
104992724-3211899 OTHER Edwledwl- Vlv Aor Ins Rsl Bvn Pricrd 23 Ea1/pk5/bx 22 19 $109,452.64 $32,835.79 70% off $10,945.26 $98,507.38 $65,671.58 2026-05-08
105162234-3211899 OTHER Ic-iliac Revasc W/stent [mopb] 26 23 $103,422.36 $26,372.71 74% off $297.00 $93,080.12 $65,931.75 2026-05-08
009-2 OTHER Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $63,244.80 $92,337.41 $66,407.04 2026-05-08
1328631-3349936 OTHER Ir Tib Per Revasc Stent 30 27 $118,882.80 $24,965.39 79% off $856.97 $106,994.52 $66,574.37 2026-05-08
752-4 OTHER Disorders Of Personality And Impulse Control 5 5 — — $66,947.11 $71,633.41 $66,947.11 2026-05-08
607-1 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $64,250.74 $93,806.08 $67,463.28 2026-05-08
004-2 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $64,338.65 $93,934.43 $67,555.59 2026-05-08
456 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 24 — — $3,818.04 $170,103.28 $67,659.21 2026-05-08
231 OTHER Coronary Bypass With Ptca With Mcc 24 24 — — $3,818.04 $170,633.38 $67,871.24 2026-05-08
005-3 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $64,742.20 $94,523.62 $67,979.31 2026-05-08
614-3 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 5 5 — — $64,993.85 $94,891.01 $68,243.54 2026-05-08
633-3 OTHER Neonate Birth Weight > 2499 Grams With Major Anomaly 5 5 — — $65,155.55 $95,127.10 $68,413.32 2026-05-08
622-3 OTHER Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $65,263.74 $95,285.06 $68,526.93 2026-05-08
622-4 OTHER Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $65,263.74 $95,285.06 $68,526.93 2026-05-08
863-3 OTHER Neonatal Aftercare 5 5 — — $65,362.43 $95,429.14 $68,630.55 2026-05-08
105455094-3127866 OTHER 57894-0450-01 - Teclistamab Cqyv 90 mg/mL Soln 25 22 $106,265.84 $31,879.75 70% off $21,253.17 $95,639.26 $69,072.80 2026-05-08
609-1 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $66,040.14 $96,418.60 $69,342.15 2026-05-08
99090581-3127868 OTHER 59572-0775-01 - Luspatercept 75 Mg Powder 25 22 $106,823.59 $32,047.08 70% off $21,364.72 $96,141.23 $69,435.33 2026-05-08
911-4 OTHER Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 5 5 — — $66,544.54 $97,155.03 $69,871.77 2026-05-08
178-4 OTHER External Heart Assist Systems 5 5 — — $68,497.95 $100,007.01 $71,922.85 2026-05-08
132289860-3127868 OTHER 57894-0650-02 - Guselkumab 200 Mg/20 Ml Soln 25 22 $110,706.46 $33,211.94 70% off $22,141.29 $99,635.81 $71,959.20 2026-05-08
105162287-3211899 OTHER Ic-s-fem Pop Revas Stnt [mopb] 26 23 $113,454.70 $28,930.95 74% off $297.00 $102,109.23 $72,327.38 2026-05-08
105162231-3211899 OTHER Ic-fem/popl Revasc W/stent [mopb] 26 23 $113,454.70 $28,930.95 74% off $297.00 $102,109.23 $72,327.38 2026-05-08
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 16 16 — — $3,818.04 $179,265.36 $72,448.16 2026-05-08
304-4 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 5 5 — — $69,013.40 $100,759.57 $72,464.07 2026-05-08
613-3 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 5 5 — — $69,653.42 $101,693.99 $73,136.09 2026-05-08
128043651-3127868 OTHER 57894-0640-01 - Guselkumab 100 mg/mL Soln 25 22 $112,985.49 $33,895.65 70% off $22,597.10 $101,686.94 $73,440.57 2026-05-08
106693419-3127868 OTHER 57894-0640-11 - Guselkumab 100 mg/mL Soln 25 22 $112,985.49 $33,895.65 70% off $22,597.10 $101,686.94 $73,440.57 2026-05-08
104984089-3211899 OTHER Medtmedt- Nrstm Impl 1.9inx.6in Rstradv 0-4cm 0-10 22 19 $122,657.46 $36,797.24 70% off $12,265.75 $110,391.71 $73,594.48 2026-05-08
105418980-3211899 OTHER Medtneur- Nrstm Instm X Chrg Fr 44x51 Ea1[mopb] 22 19 $122,657.46 $36,797.24 70% off $12,265.75 $110,391.71 $73,594.48 2026-05-08
105168273-3211899 OTHER Medtneur- Stm Neuro Xtrn Mic Rchrg 14x41 Ea1 10 Hl 22 19 $122,657.46 $36,797.24 70% off $12,265.75 $110,391.71 $73,594.48 2026-05-08
104984090-3211899 OTHER Medtmedt- Nrstm Impl 1.9inx.6in Restores Ensor 0-4 22 19 $122,657.46 $36,797.24 70% off $12,265.75 $110,391.71 $73,594.48 2026-05-08
104984088-3211899 OTHER Medt- Nrstm Impl 1.9inx2.6in .6in Rs[mopb] 22 19 $122,657.46 $36,797.24 70% off $12,265.75 $110,391.71 $73,594.48 2026-05-08
104885038-3211899 OTHER Medtneur- Kt Nrstm Intstm Mic 4 Ea1[mopb] 22 19 $122,657.46 $36,797.24 70% off $12,265.75 $110,391.71 $73,594.48 2026-05-08
1287179-3127868 OTHER 57894-0060-03 - Ustekinumab Soln 25 22 $113,381.52 $34,014.46 70% off $22,676.30 $102,043.37 $73,697.99 2026-05-08
99409703-3127866 OTHER 57894-0503-01 - Daratumumab-hyaluronidase 1800 Mg- 25 22 $113,697.04 $34,109.11 70% off $22,739.41 $102,327.34 $73,903.08 2026-05-08
631-3 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $70,924.43 $103,549.66 $74,470.65 2026-05-08
001-2 OTHER Liver Transplant And/or Intestinal Transplant 4 4 — — $73,120.94 $78,239.41 $74,948.96 2026-05-08
614-4 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 5 5 — — $71,499.89 $104,389.84 $75,074.88 2026-05-08
98764318-3127866 OTHER 00008-4510-01 - Gemtuzumab Ozogamicin 4.5 Mg Powde 25 22 $116,339.14 $34,901.74 70% off $23,267.83 $104,705.23 $75,620.44 2026-05-08
130-4 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 5 5 — — $72,164.06 $105,359.53 $75,772.26 2026-05-08
105162137-3211899 OTHER Ic-tib/per Revasc W/stent [mopb] 26 23 $118,882.80 $30,315.11 74% off $297.00 $106,994.52 $75,787.79 2026-05-08
681-4 OTHER Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 5 5 — — $72,867.76 $106,386.93 $76,511.15 2026-05-08
634-4 OTHER Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 5 5 — — $72,995.61 $106,573.59 $76,645.39 2026-05-08
163-4 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 5 — — $73,376.92 $107,130.31 $77,045.77 2026-05-08
123911538-3211899 OTHER Nrstm Nrv Non Rchrg F-15 Axnc - 4101[mopb] 22 19 $128,607.26 $38,582.18 70% off $12,860.73 $115,746.53 $77,164.36 2026-05-08
104984087-3211899 OTHER Medtmedt- Nrstm Impl 49x65mm Prmadv Thk1 5mm Spnl 22 19 $128,607.26 $38,582.18 70% off $12,860.73 $115,746.53 $77,164.36 2026-05-08
104987124-3211899 OTHER Medtneur- Nrstm Nr MRI Prmdv Srscn Ea1[mopb] 22 19 $128,607.26 $38,582.18 70% off $12,860.73 $115,746.53 $77,164.36 2026-05-08
609-2 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $73,543.73 $107,373.84 $77,220.91 2026-05-08
98889636-3127866 OTHER 68727-0745-02 - Cytarabine Liposomal-daunorubicin 25 22 $119,906.30 $35,971.89 70% off $23,981.26 $107,915.67 $77,939.10 2026-05-08
104885045-3211899 OTHER Medtneur- Kit Snm Impl Kit Intstm 2 Ea1[mopb] 22 19 $130,300.88 $39,090.26 70% off $13,030.09 $117,270.79 $78,180.53 2026-05-08
104885046-3211899 OTHER Medtneur- Kit Snm Mic Impl Kit Ea1[mopb] 22 19 $130,300.88 $39,090.26 70% off $13,030.09 $117,270.79 $78,180.53 2026-05-08
104885047-3211899 OTHER Medtneur- Kit Snm Repl Intstm 2 Ea1[mopb] 22 19 $130,300.88 $39,090.26 70% off $13,030.09 $117,270.79 $78,180.53 2026-05-08
008-3 OTHER Autologous Bone Marrow Transplant Or T-cell Immunotherapy 5 5 — — $74,874.20 $109,316.33 $78,617.91 2026-05-08
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 24 — — $3,818.04 $197,697.55 $78,695.67 2026-05-08
607-2 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $75,418.73 $110,111.35 $79,189.67 2026-05-08
621-3 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 5 5 — — $75,632.75 $110,423.81 $79,414.38 2026-05-08
612-3 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $75,946.63 $110,882.09 $79,743.97 2026-05-08
215 OTHER Other Heart Assist System Implant 25 25 — — $3,818.04 $529,450.35 $80,522.86 2026-05-08
303-4 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $77,105.39 $112,573.87 $80,960.66 2026-05-08
124195787-3211899 OTHER Biot-sys Cor Stnt Pk Ppyrs 2.5x20[mopb] 22 19 $135,000.00 $40,500.00 70% off $13,500.00 $121,500.00 $81,000.00 2026-05-08
124274986-3211899 OTHER Biot-sys Cor Stnt Pk Ppyrs 3.5x20[mopb] 22 19 $135,000.00 $40,500.00 70% off $13,500.00 $121,500.00 $81,000.00 2026-05-08
123897041-3211899 OTHER Biot-sys Cor Stnt Pk Ppyrs 4.0x20[mopb] 22 19 $135,000.00 $40,500.00 70% off $13,500.00 $121,500.00 $81,000.00 2026-05-08
123896836-3211899 OTHER Biot-sys Cor Stnt Pk Ppyrs 3.0x20[mopb] 22 19 $135,000.00 $40,500.00 70% off $13,500.00 $121,500.00 $81,000.00 2026-05-08
123897095-3211899 OTHER Biot-sys Stnt Cor Pk Ppyrs 4.0x26[mopb] 22 19 $135,000.00 $40,500.00 70% off $13,500.00 $121,500.00 $81,000.00 2026-05-08
123896808-3211899 OTHER Biot-sys Cor Stnt Pk Ppyrs 3.0x15[mopb] 22 19 $135,000.00 $40,500.00 70% off $13,500.00 $121,500.00 $81,000.00 2026-05-08
96694815-3127868 OTHER 50242-0150-01 - Ocrelizumab 300 Mg/10 Ml Soln 40 37 $151,301.73 $31,773.36 79% off $2,177.93 $136,171.56 $81,702.93 2026-05-08
95181033-3127866 OTHER 50242-0917-01 - Atezolizumab 1200 Mg/20 Ml Soln 25 22 $126,416.09 $37,924.83 70% off $25,283.22 $113,774.48 $82,170.46 2026-05-08
002-1 OTHER Heart And/or Lung Transplant 4 4 — — $81,458.42 $87,160.51 $83,494.88 2026-05-08
5 OTHER Liver Transplant With Mcc Or Intestinal Transplant 22 22 — — $3,818.04 $208,253.96 $83,725.80 2026-05-08
95048080-3127868 OTHER 47783-0101-01 - Ecallantide 10 mg/mL Soln 25 22 $129,187.23 $38,756.17 70% off $25,837.45 $116,268.51 $83,971.70 2026-05-08
006-2 OTHER Pancreas Transplant 4 4 — — $82,472.54 $88,245.62 $84,534.35 2026-05-08
603-3 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 5 — — $82,157.81 $119,950.41 $86,265.70 2026-05-08
603-2 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 5 — — $82,157.81 $119,950.41 $86,265.70 2026-05-08
98425875-3127866 OTHER 61755-0008-01 - Cemiplimab 350 Mg/7 Ml Soln 25 22 $133,244.68 $39,973.40 70% off $26,648.94 $119,920.21 $86,609.04 2026-05-08
021-4 OTHER Open Craniotomy Except Trauma 5 5 — — $82,831.33 $120,933.74 $86,972.90 2026-05-08
53132921-3127866 OTHER 00074-3473-03 - Leuprolide 45 Mg/6 Months Powder 25 22 $134,418.35 $40,325.51 70% off $26,883.67 $120,976.52 $87,371.93 2026-05-08
212 OTHER Hip & Femur Procedures Except Major Joint Age 0-17 24 24 — — $3,818.04 $219,528.60 $87,427.08 2026-05-08
105162276-3211899 OTHER Ic-cc-ins Defib W Elect [mopb] 26 23 $137,725.57 $35,120.02 75% off $297.00 $123,953.01 $87,800.05 2026-05-08
611-3 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 5 5 — — $85,568.97 $124,930.69 $89,847.42 2026-05-08
608-4 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 5 — — $85,999.37 $125,559.09 $90,299.34 2026-05-08
608-3 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 5 — — $85,999.37 $125,559.09 $90,299.34 2026-05-08
2 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 22 22 — — $3,818.04 $228,684.65 $91,978.87 2026-05-08
95380079-3127867 OTHER 00169-7208-01 - Coagulation Factor VIIa 8000 Mcg ( 25 22 $141,626.38 $42,487.91 70% off $28,325.28 $127,463.74 $92,057.15 2026-05-08
99247005-3127868 OTHER 75987-0130-15 - Teprotumumab Trbw 500 Mg Powder 25 22 $143,109.14 $42,932.74 70% off $28,621.83 $128,798.23 $93,020.94 2026-05-08
001-3 OTHER Liver Transplant And/or Intestinal Transplant 4 4 — — $90,762.46 $97,115.83 $93,031.52 2026-05-08
593-1 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $88,942.07 $129,855.43 $93,389.18 2026-05-08
1328634-3349936 OTHER Ir Tib Per Revasc Stent And Atherectomy 30 27 $167,163.78 $35,104.39 79% off $856.97 $150,447.40 $93,611.71 2026-05-08
004-3 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $89,162.94 $130,177.90 $93,621.09 2026-05-08
008-4 OTHER Autologous Bone Marrow Transplant Or T-cell Immunotherapy 5 5 — — $89,273.29 $130,339.01 $93,736.96 2026-05-08
124117041-3211899 OTHER Wl G-gft Evas Gore Ilc Brch 14.5x10[mopb] 22 19 $156,361.75 $46,908.53 70% off $15,636.18 $140,725.58 $93,817.05 2026-05-08
123904318-3211899 OTHER Wl G-eprsth Xcldr Aaa 26x14.5x12 16[mopb] 22 19 $156,361.75 $46,908.53 70% off $15,636.18 $140,725.58 $93,817.05 2026-05-08
123904313-3211899 OTHER Wl G-eprsth Xcldr Aaa 36x14.5x14 18[mopb] 22 19 $156,361.75 $46,908.53 70% off $15,636.18 $140,725.58 $93,817.05 2026-05-08
105168496-3211899 OTHER Medtendo- Gft Stnt Vlnt Navion 37x37x97 Ea1/ca25r 22 19 $156,361.75 $46,908.53 70% off $15,636.18 $140,725.58 $93,817.05 2026-05-08
105168497-3211899 OTHER Medt- Sys Gft Stnt Thor Vlnt Nvn Ea1[mopb] 22 19 $156,361.75 $46,908.53 70% off $15,636.18 $140,725.58 $93,817.05 2026-05-08
123904301-3211899 OTHER Wl G-eprsth Xcldr Aaa 32x14.5x14 18[mopb] 22 19 $156,361.75 $46,908.53 70% off $15,636.18 $140,725.58 $93,817.05 2026-05-08
602-1 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $89,963.40 $131,346.56 $94,461.57 2026-05-08
1278993-3127866 OTHER 51144-0050-01 - Brentuximab Vedotin Rec Injection 25 22 $149,010.56 $44,703.17 70% off $29,802.11 $134,109.50 $96,856.86 2026-05-08
104095815-3211899 OTHER Abotvasc- Defib Crd Qd Asr Mp 40j Ea1x Mtl Stfn Ca 22 19 $161,574.39 $48,472.32 70% off $16,157.44 $145,416.95 $96,944.63 2026-05-08
37656995-3349936 OTHER Ir Fem Pop Revasc W Stent W Atherectomy 30 27 $174,137.55 $36,568.89 79% off $856.97 $156,723.79 $97,517.02 2026-05-08
14 OTHER Allogeneic Bone Marrow Transplant 22 22 — — $3,818.04 $242,409.77 $97,523.20 2026-05-08
162-4 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $93,062.76 $135,871.64 $97,715.90 2026-05-08
100575164-3127868 OTHER 47335-0177-95 - Tildrakizumab 100 mg/mL Soln 25 22 $150,582.30 $45,174.69 70% off $30,116.46 $135,524.07 $97,878.49 2026-05-08
440-4 OTHER Kidney Transplant 4 4 — — $96,726.89 $103,497.77 $99,145.06 2026-05-08
613-4 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 5 5 — — $94,456.52 $137,906.51 $99,179.34 2026-05-08
106849961-3127866 OTHER 50242-0245-01 - Hyaluronidase/pertuzumab/trastuzum 25 22 $153,858.75 $46,157.63 70% off $30,771.75 $138,472.88 $100,008.19 2026-05-08
842-4 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 5 5 — — $96,844.39 $141,392.81 $101,686.61 2026-05-08
1288090-3127866 OTHER 00024-5824-11 - Cabazitaxel Soln 25 22 $157,280.98 $47,184.29 70% off $31,456.20 $141,552.88 $102,232.64 2026-05-08
630-3 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $97,451.53 $142,279.24 $102,324.11 2026-05-08
105646369-3127868 OTHER 00078-0734-61 - Canakinumab 150 mg/mL Soln 25 22 $158,744.62 $47,623.39 70% off $31,748.92 $142,870.16 $103,184.00 2026-05-08
007-2 OTHER Allogeneic Bone Marrow Transplant 5 5 — — $99,043.72 $144,603.83 $103,995.90 2026-05-08
007-1 OTHER Allogeneic Bone Marrow Transplant 5 5 — — $99,043.72 $144,603.83 $103,995.90 2026-05-08
005-4 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $99,218.13 $144,858.47 $104,179.04 2026-05-08
006-3 OTHER Pancreas Transplant 4 4 — — $102,491.29 $109,665.69 $105,053.57 2026-05-08
621-4 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 5 5 — — $101,324.01 $147,933.05 $106,390.21 2026-05-08
105162238-3211899 OTHER Ic-tib/per Revasc Stent & Ather [mopb] 26 23 $167,163.78 $42,626.76 75% off $297.00 $150,447.40 $106,566.91 2026-05-08
011-1 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $102,324.65 $149,393.99 $107,440.88 2026-05-08
1284898-3127866 OTHER 48818-0001-02 - PRALAtrexate Soln 25 22 $167,463.29 $50,238.99 70% off $33,492.66 $150,716.96 $108,851.14 2026-05-08
104095738-3211899 OTHER Abotsjud- Defib Crt-d Qd Asr Mp 76x41x14 Ea1/bx5[m 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104787756-3211899 OTHER Sjudimes- Defib Crd Unfy Qd Qrtt Df4 Is4 Ea11mm Ss 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104788199-3211899 OTHER Sjudimes- Defib Crd Qd Asr Is1 Df1 40 Ea1cs Bn Lcp 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104788531-3211899 OTHER Medtcrdm- Defib Crd Srscn Crtd MRI Df1 Ea1/ca12bx1 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104788200-3211899 OTHER Sjudimes- Defib Crd Qd Asr Is1 Df4 38 Ea1cs Bn Lcp 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104788493-3211899 OTHER Sjudmedi- Defib Crd Unfy Is1 Df4 Rf 36 Ea1 1.5mm S 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104788198-3211899 OTHER Sjudimes- Defib Crd Unfy Asr Is1 Df4 36 Ea1cs Bn L 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104095550-3211899 OTHER Abbo- Defib Card Unify Asr Crt-d 40j[mopb] 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104789291-3211899 OTHER Bostbost- Defib Crd Mmntm Crt-d 72.9g Ea1/bx6 Fllp 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104095867-3211899 OTHER Abotsjud- Defib Crd Gllnt Hf 2ch Crt Ea1strls[mopb 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104789028-3211899 OTHER Medtcrdm- Defib Crd Srscn Crtd Qd Df1 Ea1/pr2/bx24 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104788532-3211899 OTHER Medtcrdm- Defib Card Claria Biphsc 35cc Ea1/ca12bx 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104789297-3211899 OTHER Bostcsrm- Defib Crt-d Mmntm 32cc 72.8gm Ea1/bx10fl 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
104788197-3211899 OTHER Sjudimes- Defib Crd Unfy Asr Is1 Df1 36 Ea1cs Bn L 21 18 $182,421.46 $54,726.44 70% off $36,484.29 $164,179.31 $109,452.88 2026-05-08
105162218-3211899 OTHER Ic-rem/rep Cvd Gen Dual Leads [mopb] 26 23 $171,870.07 $43,826.86 75% off $297.00 $154,683.06 $109,567.17 2026-05-08
105162139-3211899 OTHER Ic-fem/popl Revasc Stnt & Ather [mopb] 26 23 $174,137.55 $44,405.08 74% off $297.00 $156,723.79 $111,012.69 2026-05-08
4 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 24 24 — — $3,818.04 $279,088.17 $111,248.20 2026-05-08
602-2 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $107,484.06 $156,926.73 $112,858.26 2026-05-08
009-3 OTHER Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $110,208.41 $160,904.28 $115,718.83 2026-05-08
103461918-3127866 OTHER 00003-7125-11 - Nivolumab-relatlimab Rmbw 240 Mg-8 25 22 $178,573.82 $53,572.15 70% off $35,714.76 $160,716.44 $116,072.98 2026-05-08
136353214-3127866 OTHER 55566-1050-01 - Nadofaragene Firadenovec Vncg Susp 25 22 $179,228.70 $53,768.61 70% off $35,845.74 $161,305.83 $116,498.66 2026-05-08
160-4 OTHER Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $111,918.43 $163,400.90 $117,514.35 2026-05-08
006-4 OTHER Pancreas Transplant 4 4 — — $116,135.77 $124,265.28 $119,039.17 2026-05-08
161-1 OTHER Implantable Heart Assist Systems 5 5 — — $115,127.25 $168,085.78 $120,883.61 2026-05-08
161-2 OTHER Implantable Heart Assist Systems 5 5 — — $115,127.25 $168,085.78 $120,883.61 2026-05-08
105162221-3211899 OTHER Ic-insert Pulse Gen W Dual Leads [mopb] 26 23 $196,772.06 $50,176.88 75% off $297.00 $177,094.85 $125,442.19 2026-05-08
105162217-3211899 OTHER Ic-rem/rep Cvd Gen Multi Leads [mopb] 26 23 $196,772.06 $50,176.88 75% off $297.00 $177,094.85 $125,442.19 2026-05-08
105162220-3211899 OTHER Ic-insert Pulse Gen W Multi Leads [mopb] 26 23 $196,772.06 $50,176.88 75% off $297.00 $177,094.85 $125,442.19 2026-05-08
105162219-3211899 OTHER Ic-rem/rep Cvd Gen Single Lead [mopb] 26 23 $196,772.06 $50,176.88 75% off $297.00 $177,094.85 $125,442.19 2026-05-08
105162183-3211899 OTHER Ic-insert Single Chamber Icd [mopb] 26 23 $196,784.65 $50,180.09 74% off $297.00 $177,106.18 $125,450.21 2026-05-08
105162257-3211899 OTHER Ic-insert Sing/dual Defib [mopb] 26 23 $196,784.65 $50,180.09 74% off $297.00 $177,106.18 $125,450.21 2026-05-08
105162182-3211899 OTHER Ic-insert Dual Chamber Icd [mopb] 26 23 $196,784.65 $50,180.09 74% off $297.00 $177,106.18 $125,450.21 2026-05-08
104788846-3211899 OTHER Bostcsrm- Defib Crd Tlgn Rf He Dr 2ch Ea1 Ss Lcp B 21 18 $210,313.58 $63,094.07 70% off $42,062.72 $189,282.22 $126,188.15 2026-05-08
104788848-3211899 OTHER Bostcsrm- Dsc- Defib Card Tlgn Rf He Dr No Known P 21 18 $210,313.58 $63,094.07 70% off $42,062.72 $189,282.22 $126,188.15 2026-05-08
104788188-3211899 OTHER Bostcsrm- Dsc- Defib Card Tlgn Rf He Dr No Known P 21 18 $210,313.58 $63,094.07 70% off $42,062.72 $189,282.22 $126,188.15 2026-05-08
105117609-3211899 OTHER Bostcsrm- Dsc- Defib Card Tlgn Rf He Dr No Known P 21 18 $210,313.58 $63,094.07 70% off $42,062.72 $189,282.22 $126,188.15 2026-05-08
105354083-3211899 OTHER Bostcsrm- Dsc- Defib Card Tlgn Rf He Dr No Known P 21 18 $210,313.58 $63,094.07 70% off $42,062.72 $189,282.22 $126,188.15 2026-05-08
104788847-3211899 OTHER Bostcsrm- Dsc- Defib Card Tlgn Rf He Dr No Known P 21 18 $210,313.58 $63,094.07 70% off $42,062.72 $189,282.22 $126,188.15 2026-05-08
104989635-3211899 OTHER Bostcsrm- Dsc- Defib Card Tlgn Rf He Dr No Known P 21 18 $210,313.58 $63,094.07 70% off $42,062.72 $189,282.22 $126,188.15 2026-05-08
102525788-3127868 OTHER 25682-0028-01 - Ravulizumab 100 mg/mL Soln 25 22 $205,414.67 $61,624.40 70% off $41,082.93 $184,873.20 $133,519.54 2026-05-08
98898725-3127866 OTHER 50242-0105-01 - Polatuzumab Vedotin 140 Mg Powder 25 22 $206,227.55 $61,868.27 70% off $41,245.51 $185,604.80 $134,047.91 2026-05-08
002-2 OTHER Heart And/or Lung Transplant 4 4 — — $131,304.93 $140,496.27 $134,587.55 2026-05-08
612-4 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $128,388.53 $187,447.25 $134,807.95 2026-05-08
607-3 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $128,783.26 $188,023.57 $135,222.43 2026-05-08
1282361-3127868 OTHER 57665-0002-02 - Pegaspargase 3750. Soln 25 22 $223,408.52 $67,022.56 70% off $44,681.70 $201,067.67 $145,215.54 2026-05-08
1282362-3127868 OTHER 54482-0301-01 - Pegaspargase 3750. Soln 25 22 $223,408.52 $67,022.56 70% off $44,681.70 $201,067.67 $145,215.54 2026-05-08
99090561-3127868 OTHER 72694-0954-01 - Pegaspargase 3,750 IntlUnit(s) / 5 25 22 $223,408.52 $67,022.56 70% off $44,681.70 $201,067.67 $145,215.54 2026-05-08
94990000-3127868 OTHER 57894-0061-03 - Ustekinumab 90 mg/mL Soln 25 22 $226,762.94 $68,028.88 70% off $45,352.59 $204,086.65 $147,395.91 2026-05-08
102917747-3127866 OTHER 72493-0103-03 - mitoMYcin 40 Mg Kit 40 37 $273,934.44 $57,526.23 79% off $7,964.52 $246,541.00 $147,924.60 2026-05-08
863-4 OTHER Neonatal Aftercare 5 5 — — $141,197.30 $206,148.05 $148,257.16 2026-05-08
7 OTHER Lung Transplant 22 22 — — $3,818.04 $388,151.07 $148,913.03 2026-05-08
004-4 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $145,457.17 $212,367.46 $152,730.02 2026-05-08
611-4 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 5 5 — — $147,991.07 $216,066.96 $155,390.62 2026-05-08
609-3 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $148,338.25 $216,573.85 $155,755.16 2026-05-08
104095673-3211899 OTHER Abmiabmi- Pmp Set Impella Rp US 11f Ea1/bx10 Fib R 22 19 $260,602.92 $78,180.88 70% off $26,060.29 $234,542.63 $156,361.75 2026-05-08
107613797-3211899 OTHER Abmiabmi- Bndl Impl W Impll Pmp C9+ Comp Ea1[mopb] 22 19 $260,602.92 $78,180.88 70% off $26,060.29 $234,542.63 $156,361.75 2026-05-08
104095409-3211899 OTHER Abio- Set Vntrc Impella 2.5 9f[mopb] 22 19 $260,602.92 $78,180.88 70% off $26,060.29 $234,542.63 $156,361.75 2026-05-08
104095411-3211899 OTHER Dev Impella Cp 14frx04.7x75mm - 0048-0003[mopb] 22 19 $260,602.92 $78,180.88 70% off $26,060.29 $234,542.63 $156,361.75 2026-05-08
007-3 OTHER Allogeneic Bone Marrow Transplant 5 5 — — $149,729.16 $218,604.57 $157,215.61 2026-05-08
002-3 OTHER Heart And/or Lung Transplant 4 4 — — $154,680.08 $165,507.68 $158,547.08 2026-05-08
105162140-3211899 OTHER Ic-insert/replce Gen+lds Sgl/dual [mopb] 26 23 $249,295.74 $63,570.42 74% off $297.00 $224,366.17 $158,926.04 2026-05-08
633-4 OTHER Neonate Birth Weight > 2499 Grams With Major Anomaly 5 5 — — $152,528.18 $222,691.14 $160,154.59 2026-05-08
95367892-3127868 OTHER 60809-0801-01 - Pegloticase 8 mg/mL Soln 25 22 $250,118.62 $75,035.59 70% off $50,023.72 $225,106.76 $162,577.10 2026-05-08
1286149-3127868 OTHER 54396-0801-01 - Pegloticase Soln 25 22 $250,118.62 $75,035.59 70% off $50,023.72 $225,106.76 $162,577.10 2026-05-08
593-2 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $160,632.20 $234,523.01 $168,663.81 2026-05-08
593-3 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $161,789.07 $236,212.04 $169,878.52 2026-05-08
103469064-3127866 OTHER 00008-0100-01 - Inotuzumab Ozogamicin 0.9 Mg Powde 25 22 $261,389.73 $78,416.92 70% off $52,277.95 $235,250.76 $169,903.32 2026-05-08
3 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 24 24 — — $3,818.04 $426,597.92 $170,245.35 2026-05-08
927 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 24 24 — — $3,818.04 $429,104.47 $171,247.85 2026-05-08
602-3 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $165,599.71 $241,775.58 $173,879.70 2026-05-08
589-1 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $169,283.14 $247,153.39 $177,747.30 2026-05-08
589-2 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $169,283.14 $247,153.39 $177,747.30 2026-05-08
589-3 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $169,283.14 $247,153.39 $177,747.30 2026-05-08
603-4 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 5 — — $170,638.57 $249,132.31 $179,170.50 2026-05-08
607-4 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $176,022.22 $256,992.45 $184,823.33 2026-05-08
1287035-3127866 OTHER 76128-0155-75 - Porfimer 75. Mg Rec Injection 25 22 $288,559.97 $86,567.99 70% off $57,711.99 $259,703.97 $187,563.98 2026-05-08
841-4 OTHER Extensive Third Degree Burns With Skin Graft 5 5 — — $181,096.19 $264,400.43 $190,151.00 2026-05-08
602-4 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $184,025.18 $268,676.76 $193,226.44 2026-05-08
161-3 OTHER Implantable Heart Assist Systems 5 5 — — $184,111.27 $268,802.46 $193,316.84 2026-05-08
001-4 OTHER Liver Transplant And/or Intestinal Transplant 4 4 — — $189,869.38 $203,160.24 $194,616.11 2026-05-08
1279402-3127868 OTHER 00003-2328-22 - Ipilimumab Soln 25 22 $306,907.22 $92,072.17 70% off $61,381.44 $276,216.50 $199,489.69 2026-05-08
101883920-3127866 OTHER 79952-0110-01 - Loncastuximab Tesirine 10 Mg Injec 25 22 $309,603.72 $92,881.12 70% off $61,920.74 $278,643.35 $201,242.42 2026-05-08
009-4 OTHER Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $193,449.58 $282,436.39 $203,122.06 2026-05-08
105162272-3211899 OTHER Ic-s-per Ins Lh Vad Art [mopb] 26 23 $336,179.34 $85,725.73 75% off $297.00 $302,561.41 $214,314.33 2026-05-08
102534551-3127868 OTHER 71336-1001-01 - Givosiran 189 mg/mL Soln 25 22 $341,172.00 $102,351.60 70% off $68,234.40 $307,054.80 $221,761.80 2026-05-08
161-4 OTHER Implantable Heart Assist Systems 5 5 — — $211,684.88 $309,059.93 $222,269.13 2026-05-08
1 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 22 22 — — $3,818.04 $562,602.98 $226,866.61 2026-05-08
588-1 OTHER Female Reproductive System Reconstructive Procedures 5 5 — — $220,844.01 $322,432.25 $231,886.21 2026-05-08
591-2 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $225,773.48 $329,629.27 $237,062.15 2026-05-08
583-1 OTHER Neonate With Ecmo 5 5 — — $232,890.65 $340,020.35 $244,535.18 2026-05-08
101891901-3127866 OTHER 72187-0401-01 - Tagraxofusp 1000 mcg/mL Soln 25 22 $378,460.26 $113,538.08 70% off $75,692.05 $340,614.23 $245,999.17 2026-05-08
630-4 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $242,001.72 $353,322.52 $254,101.81 2026-05-08
103958918-3127864 OTHER 69866-1030-05 - Autologous Cultured Chondrocytes 1 25 22 $394,813.44 $118,444.03 70% off $78,962.69 $355,332.10 $256,628.74 2026-05-08
103958919-3127864 OTHER 69866-1030-08 - Autologous Cultured Chondrocytes 1 25 22 $394,813.44 $118,444.03 70% off $78,962.69 $355,332.10 $256,628.74 2026-05-08
591-3 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $244,460.51 $356,912.35 $256,683.54 2026-05-08
593-4 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $257,411.96 $375,821.46 $270,282.56 2026-05-08
588-3 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $269,847.40 $393,977.20 $283,339.77 2026-05-08
588-2 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $269,847.40 $393,977.20 $283,339.77 2026-05-08
588-4 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $269,847.40 $393,977.20 $283,339.77 2026-05-08
007-4 OTHER Allogeneic Bone Marrow Transplant 5 5 — — $273,701.01 $399,603.47 $287,386.06 2026-05-08
127538326-3127866 OTHER 00310-4535-30 - Tremelimumab Actl 20 mg/mL Soln 25 22 $458,465.25 $137,539.58 70% off $91,693.05 $412,618.72 $298,002.41 2026-05-08
002-4 OTHER Heart And/or Lung Transplant 5 5 — — $286,260.57 $417,940.43 $300,573.59 2026-05-08
011-2 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $287,998.41 $420,477.67 $302,398.33 2026-05-08
631-4 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $298,953.38 $436,471.93 $313,901.05 2026-05-08
583-2 OTHER Neonate With Ecmo 5 5 — — $318,821.06 $465,478.75 $334,762.12 2026-05-08
18 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 24 — — $3,818.04 $865,850.30 $345,926.22 2026-05-08
591-4 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $358,626.58 $523,594.81 $376,557.91 2026-05-08
011-4 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $367,241.99 $536,173.31 $385,604.09 2026-05-08
011-3 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $367,241.99 $536,173.31 $385,604.09 2026-05-08
609-4 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $373,996.40 $546,034.74 $392,696.22 2026-05-08
583-3 OTHER Neonate With Ecmo 5 5 — — $508,063.44 $741,772.62 $533,466.61 2026-05-08
51905029-3127866 OTHER 30237-8900-06 - Sipuleucel-t - Susp 25 22 $833,645.95 $250,093.79 70% off $166,729.19 $750,281.36 $541,869.87 2026-05-08
583-4 OTHER Neonate With Ecmo 5 5 — — $841,479.11 $1,228,559.50 $883,553.06 2026-05-08
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