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

HOLY ROSARY HOSPITAL

Miles City, MT · CCN 271347 · Rates published

21,760 distinct procedures filed
13 distinct payers
848,855 rate rows
2026-05-09 last MRF observed
Data quality

845,245 of 848,855 rate rows are consumer-grade (99.6%)

3,610 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
placeholder amount (≤ $0.02) — excluded from medians 1,802
per-diem day rate — not a per-procedure price 1,546
template filing: same amount across many unrelated codes — excluded 260
percent-of-charges filed in the dollar field — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://intermountainhealthcare.org/sc10media/files/intermountain-health/locations/hospital-prices/810231792_holy-rosary-healthcare_standardcharges.ashx
Found on page https://intermountainhealthcare.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 8ab8df6416b14643… · 5,566,774 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J1411
OTHER 		Inj Hemgenix Per Tx Dose 2 $3,605,000.00 $3,605,000.00 $3,605,000.00 nat. median
$3,685,267
1.0× median
J1413
OTHER 		Inj Delandistrogene Mox Rokl 2 $3,296,000.00 $3,296,000.00 $3,296,000.00 nat. median
$3,327,860
1.0× median
J3394
OTHER 		Inj Lovotibeglogene Autotem 2 $3,193,000.00 $3,193,000.00 $3,193,000.00 nat. median
$3,286,000
1.0× median
J3393
OTHER 		Inj Betibeglogene Autotemce 2 $2,884,000.00 $2,884,000.00 $2,884,000.00 nat. median
$2,968,000
1.0× median
J3399
OTHER 		Inj Onase Abepar-xioi Treat 2 $2,391,705.69 $2,391,705.69 $2,391,705.69 nat. median
$2,472,216
1.0× median
Q2057
OTHER 		Afamitresgene Autoleucel 2 $770,620.00 $770,620.00 $770,620.00 nat. median
$770,620
1.0× median
Q2042
OTHER 		Tisagenlecleucel Car-pos T 5 $529,192.86 $1,308,631.40 $591,726.20 nat. median
$591,726
1.0× median
Q2056
OTHER 		Ciltacabtagene Car-pos T 5 $527,123.43 $1,269,217.50 $565,868.95 nat. median
$583,076
1.0× median
Q2054
OTHER 		Lisocabtagene Mara Car Pos T 5 $516,726.08 $1,240,975.53 $562,538.19 nat. median
$562,538
1.0× median
Q2055
OTHER 		Idecabtagene Vicleucel Car 5 $526,587.59 $1,258,636.33 $557,317.93 nat. median
$558,082
1.0× median
Q2041
OTHER 		Axicabtagene Ciloleucel Car+ 5 $489,455.96 $1,222,842.28 $533,230.17 nat. median
$533,230
1.0× median
Q2053
OTHER 		Brexucabtagene Car Pos T 5 $460,530.40 $1,123,600.00 $489,304.61 nat. median
$489,720
1.0× median
143901
OTHER 		Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 13 $153,719.19 $326,720.11 $297,413.21 nat. median
$255,642
1.2× median
J3402
OTHER 		Inj. Remestemcel-l-rknd/ Td 2 $205,640.00 $205,640.00 $205,640.00 nat. median
$205,640
1.0× median
210658
OTHER 		Inebilizumab-cdon 10 Mg/ml Intravenous Solution 13 $102,783.49 $218,459.60 $198,863.70 nat. median
$198,864
1.0× median
216356
OTHER 		Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln 13 $98,492.59 $209,339.57 $190,561.74 nat. median
$121,941
1.6× median
218328
OTHER 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 13 $95,507.66 $202,995.30 $184,786.56 nat. median
$80,296
outlier · 2.3×
192637
OTHER 		Flutemetamol F-18 5 Mci (185 Mbq) Intravenous Solution 13 $57,125.38 $364,248.78 $146,396.20 nat. median
$117,976
1.2× median
2782649771
OTHER 		Hc Valve Implant Lvl 71 13 $75,068.60 $159,553.41 $145,241.41 nat. median
$113,676
1.3× median
2722109771
OTHER 		Hc Percutaneous Ventricular Assist Device Lvl 71 13 $75,068.60 $159,553.41 $145,241.41 nat. median
$113,676
1.3× median
2721649601
OTHER 		Hc Kit Pump Device Cardiac Ventricular Smartassist 5.5 S2 13 $72,054.40 $153,146.93 $139,409.60 nat. median
$109,112
1.3× median
2782649770
OTHER 		Hc Valve Implant Lvl 70 13 $71,493.89 $151,955.60 $138,325.14 nat. median
$108,263
1.3× median
278TRIG470
OTHER 		Hc Ntap Triclip G4 Vlv Rpr Systm 13 $71,493.89 $151,955.60 $138,325.14 nat. median
$108,263
1.3× median
2721649701
OTHER 		Hc Pump Blood Vad With Valves 13 $71,474.68 $151,914.78 $138,287.98 nat. median
$108,234
1.3× median
183256
OTHER 		Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln 13 $65,100.34 $138,366.53 $125,955.01 nat. median
$80,599
1.6× median
275C188267
OTHER 		Hc Icd Biv/crt-d Lvl 67 13 $61,759.05 $131,264.83 $119,490.33 nat. median
$93,521
1.3× median
2782649766
OTHER 		Hc Valve Implant Lvl 66 13 $58,818.13 $125,014.10 $113,800.30 nat. median
$89,068
1.3× median
278C188966
OTHER 		Hc Implantable-insertable Device Noc Lvl 66 13 $58,818.13 $125,014.10 $113,800.30 nat. median
$89,068
1.3× median
278C182366
OTHER 		Hc Neurostim Generator/lead Lvl 66 13 $58,818.13 $125,014.10 $113,800.30 nat. median
$89,068
1.3× median
2782649765
OTHER 		Hc Valve Implant Lvl 65 13 $56,017.26 $119,061.03 $108,381.22 nat. median
$84,827
1.3× median
168829
OTHER 		Pegloticase 8 Mg/ml Intravenous Solution 13 $53,501.53 $113,714.02 $103,513.84 nat. median
$91,022
1.1× median
2782669764
OTHER 		Hc Vascular Stent Graft Implant Lvl 64 13 $53,349.74 $113,391.40 $103,220.15 nat. median
$80,787
1.3× median
2782649764
OTHER 		Hc Valve Implant Lvl 64 13 $53,349.74 $113,391.40 $103,220.15 nat. median
$80,787
1.3× median
278C188963
OTHER 		Hc Implantable-insertable Device Noc Lvl 63 13 $50,809.25 $107,991.76 $98,304.86 nat. median
$76,940
1.3× median
2782649763
OTHER 		Hc Valve Implant Lvl 63 13 $50,809.25 $107,991.76 $98,304.86 nat. median
$76,940
1.3× median
199175
OTHER 		Ocrelizumab 30 Mg/ml Intravenous Solution 13 $48,585.11 $103,264.48 $94,001.62 nat. median
$45,427
outlier · 2.1×
278C188962
OTHER 		Hc Implantable-insertable Device Noc Lvl 62 13 $48,389.75 $102,849.25 $93,623.64 nat. median
$73,276
1.3× median
278C187462
OTHER 		Hc Stent Coated/covered Implant Lvl 62 13 $48,389.75 $102,849.25 $93,623.64 nat. median
$73,276
1.3× median
2782669762
OTHER 		Hc Vascular Stent Graft Implant Lvl 62 13 $48,389.75 $102,849.25 $93,623.64 nat. median
$73,276
1.3× median
2782649761
OTHER 		Hc Valve Implant Lvl 61 13 $46,085.47 $97,951.66 $89,165.36 nat. median
$69,787
1.3× median
278C182361
OTHER 		Hc Neurostim Generator/lead Lvl 61 13 $46,085.47 $97,951.66 $89,165.36 nat. median
$69,787
1.3× median
2722109761
OTHER 		Hc Percutaneous Ventricular Assist Device Lvl 61 13 $46,085.47 $97,951.66 $89,165.36 nat. median
$69,787
1.3× median
Q0480
OTHER 		Driver Pneumatic Vad Rep 7 $80,781.07 $195,999.86 $86,797.56 nat. median
$109,316
0.8× median
2721649501
OTHER 		Hc Set Pump Impella Cp W/smart Assist 13 $44,215.20 $93,976.52 $85,546.80 nat. median
$66,955
1.3× median
2722109760
OTHER 		Hc Percutaneous Ventricular Assist Device Lvl 60 13 $43,890.90 $93,287.25 $84,919.35 nat. median
$66,464
1.3× median
K1007
OTHER 		Bil Hkaf Pc S/d Micro Sensor 2 $81,928.74 $81,928.74 $81,928.74 nat. median
$96,013
0.9× median
275C172159
OTHER 		Hc Icd Dual Chamber Lvl 59 13 $41,800.84 $88,844.97 $80,875.55 nat. median
$63,299
1.3× median
272C176959
OTHER 		Hc Guidewire Lvl 59 13 $41,800.84 $88,844.97 $80,875.55 nat. median
$63,299
1.3× median
275C188259
OTHER 		Hc Icd Biv/crt-d Lvl 59 13 $41,800.84 $88,844.97 $80,875.55 nat. median
$63,299
1.3× median
2722109759
OTHER 		Hc Percutaneous Ventricular Assist Device Lvl 59 13 $41,800.84 $88,844.97 $80,875.55 nat. median
$63,299
1.3× median

Other procedures at this hospital

Browse this hospital's 21,760 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
             
84160 OTHER Leuprolide Acetate 11.25 Mg (3 Month) Intramuscular Syringe Kit 63 13 $25,585.00 — $5.05 $25,014.45 $21,747.25 2026-05-09
99357 OTHER Natalizumab 300 Mg/15 Ml Intravenous Solution 54 13 $45,574.33 — $140.48 $44,558.02 $39,649.67 2026-05-09
37226 OTHER Fem/popl Revasc W/stent 43 9 — — $1,220.13 $26,128.77 $20,710.73 2026-05-09
37225 OTHER Fem/popl Revas W/ather 43 9 — — $1,409.13 $29,421.89 $22,201.10 2026-05-09
37229 OTHER Tib/per Revasc W/ather 43 9 — — $1,633.53 $29,534.66 $22,471.34 2026-05-09
37230 OTHER Tib/per Revasc W/stent 43 9 — — $1,635.14 $26,564.24 $22,614.51 2026-05-09
37227 OTHER Fem/popl Revasc Stnt & Ather 43 9 — — $1,688.22 $37,828.94 $28,447.29 2026-05-09
37231 OTHER Tib/per Revasc Stent & Ather 43 9 — — $1,727.64 $36,773.72 $29,507.36 2026-05-09
270Q047741 OTHER Hc Kit Lvad Heartmate 3 Modular Cable Replacement 37 13 $19,031.75 — $8,754.60 $18,607.34 $16,938.26 2026-05-09
209469 OTHER Amivantamab-vmjw 50 Mg/ml Intravenous Solution 37 13 $19,464.22 — $8,953.54 $19,030.17 $17,323.16 2026-05-09
220061 OTHER Pegfilgrastim-cbqv 6 Mg/0.6 Ml Subcutaneous Auto-injector 37 13 $19,639.20 — $9,034.03 $19,201.25 $17,478.89 2026-05-09
205522 OTHER Pegfilgrastim-cbqv 6 Mg/0.6 Ml Subcutaneous Syringe 37 13 $19,639.20 — $9,034.03 $19,201.25 $17,478.89 2026-05-09
135553 OTHER Indium 111-pentetreotide 3 Mci/ml-10 Mcg Intravenous Kit 37 13 $19,649.28 — $9,038.67 $19,211.10 $17,487.86 2026-05-09
7612699001 OTHER Hc Drainage Pelvic/hip Area Deep 37 13 $19,709.71 — $9,066.47 $19,270.18 $17,541.64 2026-05-09
101345 OTHER Darbepoetin Alfa 500 Mcg/ml In Polysorbate Injection Syringe 37 13 $19,802.79 — $9,109.28 $19,361.19 $17,624.48 2026-05-09
218501 OTHER Pegfilgrastim-fpgk 6 Mg/0.6 Ml Subcutaneous Syringe 37 13 $20,228.38 — $9,305.05 $19,777.29 $18,003.26 2026-05-09
190763 OTHER Octreotide,microspheres ER 20 Mg Intramuscular Susp, Extended Release 74 13 $22,015.33 — $9,388.17 $23,094.85 $18,836.82 2026-05-09
181807 OTHER Ado-trastuzumab Emtansine 100 Mg Intravenous Solution 37 13 $20,414.94 — $9,390.87 $19,959.69 $18,169.30 2026-05-09
7612434102 OTHER Hc Rpr Tdn/musc Upr A/e Each Unilat 37 13 $20,448.99 — $9,406.54 $19,992.98 $18,199.60 2026-05-09
214709 OTHER Nivolumab 120 Mg/12 Ml Intravenous Solution 37 13 $20,784.38 — $9,560.81 $20,320.89 $18,498.10 2026-05-09
7613721801 OTHER Hc Ante Carotid Stent Place Open/perc Inc Pta 37 13 $20,889.07 — $9,608.97 $20,423.24 $18,591.27 2026-05-09
270Q048101 OTHER Hc Controller Heartmate 3 Lvad 37 13 $21,146.40 — $9,727.34 $20,674.84 $18,820.30 2026-05-09
270Q050852 OTHER Hc Charger Battery Heartware 37 13 $21,716.00 — $9,989.36 $21,231.73 $19,327.24 2026-05-09
270Q048141 OTHER Hc Kit Controller Heartware 37 13 $22,784.00 — $10,480.64 $22,275.92 $20,277.76 2026-05-09
278C181741 OTHER Hc Implant-septal Defect Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
275C189640 OTHER Hc Lead Icd Subcutan Non Sng/dual Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
278C181742 OTHER Hc Septal Defect Implant Lvl 42 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
278C187642 OTHER Hc Stent Non Coated/non Covered Implant Lvl 42 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C188941 OTHER Hc Implantable-insertable Device Noc Non Implant Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C961042 OTHER Hc Cath Coronary Drug-delivery Tpt Lvl 42 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C961041 OTHER Hc Cath Coronary Drug-delivery Tpt Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
278C181740 OTHER Hc Implant-septal Defect Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C175740 OTHER Hc Catheter Thromb/embolectomy Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C175741 OTHER Hc Catheter Thromb/embolectomy Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
278C176440 OTHER Hc Loop Recorder Implant Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C173240 OTHER Hc Catheter Ep Diag/abl/3d/map Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
275C177741 OTHER Hc Lead Icd Single Coil Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
2782669740 OTHER Hc Vascular Stent Graft Implant Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C961040 OTHER Hc Cath Coronary Drug-delivery Tpt Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
275C189540 OTHER Hc Lead Icd Dual Coil Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
2782669741 OTHER Hc Vascular Stent Graft Implant Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C188942 OTHER Hc Implantable-insertable Device Noc Non Implant Lvl 42 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
275C262140 OTHER Hc Pacemaker Biv Crt-p Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
2721809740 OTHER Hc Device Delivery System Supply Non Implant Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C262341 OTHER Hc Catheter Blln Pta Drug Coated Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
278C187442 OTHER Hc Stent Coated/covered Implant Lvl 42 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
275C262142 OTHER Hc Pacemaker Biv Crt-p Lvl 42 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
278C187441 OTHER Hc Stent Coated/covered Implant Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
275C262141 OTHER Hc Pacemaker Biv Crt-p Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C188640 OTHER Hc Catheter Extravasc Tissue Ablat Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
278C188941 OTHER Hc Implantable-insertable Device Noc Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
2721929740 OTHER Hc Embolization Thrombectomy Non Implant Supply Lvl 40 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
272C175742 OTHER Hc Catheter Thromb/embolectomy Lvl 42 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
2781909742 OTHER Hc Embolization Device Implant Lvl 42 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
275C172241 OTHER Hc Icd Single Chamber Lvl 41 37 13 $23,615.00 — $10,862.90 $23,088.39 $21,017.35 2026-05-09
209758 OTHER Piflufolastat F 18 37 Mbq/ml To 2,960 Mbq/ml (1-80 Mci/ml) IV Solution 37 13 $24,244.35 — $11,152.40 $23,703.70 $21,577.47 2026-05-09
87356 OTHER Digoxin Immune Fab 40 Mg Intravenous Solution 37 13 $24,474.62 — $11,258.33 $23,928.84 $21,782.41 2026-05-09
3100211U01 OTHER Hc Onc Pan-tumor Dna&rna Next-generation Sequencing 37 13 $25,365.00 — $11,667.90 $24,799.36 $22,574.85 2026-05-09
J1412 OTHER Inj Roctavian Ml 2x10^13vc G 14 2 — — $11,667.97 $30,019.53 $20,843.75 2026-05-09
215768 OTHER Kit For Preparation Of Ga-68-gozetotide 25 Mcg Intravenous Solution 37 13 $25,585.00 — $11,769.10 $25,014.45 $22,770.65 2026-05-09
201478 OTHER Copanlisib 60 Mg Intravenous Solution 37 13 $25,585.00 — $11,769.10 $25,014.45 $22,770.65 2026-05-09
201303 OTHER Fluciclovine F18 10 Mci (370 Mbq) Intravenous Solution 37 13 $25,585.00 — $11,769.10 $25,014.45 $22,770.65 2026-05-09
86035 OTHER Alteplase 50 Mg Intravenous Solution 37 13 $25,609.17 — $11,780.22 $25,038.09 $22,792.16 2026-05-09
218728 OTHER Piflufolastat F 18 296 Mbq To 370 Mbq (8 Mci To 10 Mci) IV Syringe 37 13 $26,039.09 — $11,977.98 $25,458.42 $23,174.79 2026-05-09
275C172243 OTHER Hc Icd Single Chamber Lvl 43 37 13 $26,061.10 — $11,988.11 $25,479.94 $23,194.38 2026-05-09
278C181743 OTHER Hc Septal Defect Implant Lvl 43 37 13 $26,061.10 — $11,988.11 $25,479.94 $23,194.38 2026-05-09
278C187643 OTHER Hc Stent Non Coated/non Covered Implant Lvl 43 37 13 $26,061.10 — $11,988.11 $25,479.94 $23,194.38 2026-05-09
2782669743 OTHER Hc Vascular Stent Graft Implant Lvl 43 37 13 $26,061.10 — $11,988.11 $25,479.94 $23,194.38 2026-05-09
2781909743 OTHER Hc Embolization Device Implant Lvl 43 37 13 $26,061.10 — $11,988.11 $25,479.94 $23,194.38 2026-05-09
2782019743 OTHER Hc General Supply Implant Lvl 43 37 13 $26,061.10 — $11,988.11 $25,479.94 $23,194.38 2026-05-09
278C187443 OTHER Hc Stent Coated/covered Implant Lvl 43 37 13 $26,061.10 — $11,988.11 $25,479.94 $23,194.38 2026-05-09
272C175743 OTHER Hc Catheter Thromb/embolectomy Lvl 43 37 13 $26,061.10 — $11,988.11 $25,479.94 $23,194.38 2026-05-09
275C262143 OTHER Hc Pacemaker Biv Crt-p Lvl 43 37 13 $26,061.10 — $11,988.11 $25,479.94 $23,194.38 2026-05-09
7613723701 OTHER Hc Stent Place Artery Stenosis Inc Pta Each Addl 37 13 $27,718.73 — $12,750.62 $27,100.60 $24,669.67 2026-05-09
7613723901 OTHER Hc Stent Placemt Ea Add Vein Inc Pta 37 13 $27,718.73 — $12,750.62 $27,100.60 $24,669.67 2026-05-09
140709 OTHER Certolizumab Pegol 400 Mg/2 Ml (200 Mg/ml X2) Subcutaneous Syringe Kit 74 13 $28,221.33 — $12,981.81 $27,592.00 $25,116.97 2026-05-09
89337 OTHER Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 37 13 $28,224.00 — $12,983.04 $27,594.60 $25,119.36 2026-05-09
275C172144 OTHER Hc Icd Dual Chamber Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
2781909744 OTHER Hc Embolization Device Implant Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
278C181744 OTHER Hc Implant-septal Defect Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
272C198244 OTHER Hc Cath Pressure Valve Occlu Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
2782669744 OTHER Hc Vascular Stent Graft Implant Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
275C172244 OTHER Hc Icd Single Chamber Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
278C188944 OTHER Hc Implantable Insertable Device Noc Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
278C187644 OTHER Hc Stent Non Coated/non Covered Implant Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
2722039744 OTHER Hc Gi Supply Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
272C175744 OTHER Hc Catheter Thromb/embolectomy Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
278C187444 OTHER Hc Stent Coated/covered Implant Lvl 44 37 13 $28,667.25 — $13,186.94 $28,027.97 $25,513.85 2026-05-09
187013 OTHER Siltuximab 400 Mg Intravenous Solution 37 13 $29,013.52 — $13,346.22 $28,366.52 $25,822.03 2026-05-09
220521 OTHER Tenecteplase 50 Mg Kit For Ischemic Stroke (uw) 37 13 $29,253.52 — $13,456.62 $28,601.17 $26,035.63 2026-05-09
7614738301 OTHER Hc Liver Ablation Cryo 1 Or More Sites 37 13 $29,453.91 — $13,548.80 $28,797.09 $26,213.98 2026-05-09
7613299401 OTHER Hc Lung Ablation Cryo Unilateral Inc Image Guide 37 13 $29,453.91 — $13,548.80 $28,797.09 $26,213.98 2026-05-09
189875 OTHER Pembrolizumab 25 Mg/ml Intravenous Solution 37 13 $29,586.91 — $13,609.98 $28,927.12 $26,332.35 2026-05-09
181808 OTHER Ado-trastuzumab Emtansine 160 Mg Intravenous Solution 37 13 $30,027.52 — $13,812.66 $29,357.91 $26,724.49 2026-05-09
270Q050843 OTHER Hc Power Unit Mobile Heartmate Ii 37 13 $30,758.40 — $14,148.86 $30,072.49 $27,374.98 2026-05-09
270Q407901 OTHER Hc Power Unit Mobile Heartmate Ii Replacement 37 13 $30,758.40 — $14,148.86 $30,072.49 $27,374.98 2026-05-09
275C178645 OTHER Hc Pacemaker Single Chamber Lvl 45 37 13 $31,534.00 — $14,505.64 $30,830.79 $28,065.26 2026-05-09
272C173345 OTHER Hc Catheter Ep Diag/abl Non-3d/map/cool-tip Lvl 45 37 13 $31,534.00 — $14,505.64 $30,830.79 $28,065.26 2026-05-09
275C172145 OTHER Hc Icd Dual Chamber Lvl 45 37 13 $31,534.00 — $14,505.64 $30,830.79 $28,065.26 2026-05-09
278C187445 OTHER Hc Stent Coated/covered Implant Lvl 45 37 13 $31,534.00 — $14,505.64 $30,830.79 $28,065.26 2026-05-09
278C181745 OTHER Hc Implant-septal Defect Lvl 45 37 13 $31,534.00 — $14,505.64 $30,830.79 $28,065.26 2026-05-09
2782019745 OTHER Hc General Supply Implant Lvl 45 37 13 $31,534.00 — $14,505.64 $30,830.79 $28,065.26 2026-05-09
275C172245 OTHER Hc Icd Single Chamber Lvl 45 37 13 $31,534.00 — $14,505.64 $30,830.79 $28,065.26 2026-05-09
278C188945 OTHER Hc Implantable-insertable Device Noc Lvl 45 37 13 $31,534.00 — $14,505.64 $30,830.79 $28,065.26 2026-05-09
272C175745 OTHER Hc Catheter Thromb/embolectomy Lvl 45 37 13 $31,534.00 — $14,505.64 $30,830.79 $28,065.26 2026-05-09
215478 OTHER Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution 37 13 $33,044.25 — $15,200.36 $32,307.36 $29,409.38 2026-05-09
3337737201 OTHER Hc Linear Aclrtr Tx 1 Session 37 13 $33,803.76 — $15,549.73 $33,049.94 $30,085.35 2026-05-09
L6975 OTHER Interscap-thor Myoelectronic 23 7 — — $15,948.16 $43,360.26 $17,852.60 2026-05-09
278C182346 OTHER Hc Neurostim Generator/lead Lvl 46 37 13 $34,687.45 — $15,956.23 $33,913.92 $30,871.83 2026-05-09
275C172146 OTHER Hc Icd Dual Chamber Lvl 46 37 13 $34,687.45 — $15,956.23 $33,913.92 $30,871.83 2026-05-09
272C175746 OTHER Hc Catheter Thromb/embolectomy Lvl 46 37 13 $34,687.45 — $15,956.23 $33,913.92 $30,871.83 2026-05-09
278C187446 OTHER Hc Stent Coated/covered Implant Lvl 46 37 13 $34,687.45 — $15,956.23 $33,913.92 $30,871.83 2026-05-09
278C181746 OTHER Hc Septal Defect Implant Lvl 46 37 13 $34,687.45 — $15,956.23 $33,913.92 $30,871.83 2026-05-09
275C188246 OTHER Hc Icd Biv/crt-d Lvl 46 37 13 $34,687.45 — $15,956.23 $33,913.92 $30,871.83 2026-05-09
275C172246 OTHER Hc Icd Single Chamber Lvl 46 37 13 $34,687.45 — $15,956.23 $33,913.92 $30,871.83 2026-05-09
2782669746 OTHER Hc Vascular Stent Graft Implant Lvl 46 37 13 $34,687.45 — $15,956.23 $33,913.92 $30,871.83 2026-05-09
275C178646 OTHER Hc Pacemaker Single Chamber Lvl 46 37 13 $34,687.45 — $15,956.23 $33,913.92 $30,871.83 2026-05-09
102238 OTHER Eculizumab 300 Mg/30 Ml Intravenous Solution 37 13 $34,920.00 — $16,063.20 $34,141.28 $31,078.80 2026-05-09
200639 OTHER Rituximab 1,400 Mg/11.7 Ml (120 Mg/ml)-hyaluronidase Subcutaneous Soln 37 13 $35,105.80 — $16,148.67 $34,322.94 $31,244.16 2026-05-09
134981 OTHER Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe 74 13 $36,604.82 — $16,227.51 $37,086.57 $32,455.01 2026-05-09
218573 OTHER Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution 37 13 $35,407.60 — $16,287.50 $34,618.01 $31,512.76 2026-05-09
2721649201 OTHER Hc Pump Centrifugal Pedimag Blood 37 13 $35,600.00 — $16,376.00 $34,806.12 $31,684.00 2026-05-09
7612434103 OTHER Hc Rpr Tdn/musc Upr A/e Each Bilat 37 13 $35,785.74 — $16,461.44 $34,987.72 $31,849.31 2026-05-09
L5858 OTHER Stance Phase Only 23 7 — — $16,665.36 $43,415.31 $17,875.27 2026-05-09
178159 OTHER Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 37 13 $36,407.79 — $16,747.58 $35,595.90 $32,402.93 2026-05-09
Q0483 OTHER Monitor Elec Vad Rep 23 7 — — $16,816.87 $43,886.77 $18,069.37 2026-05-09
137212 OTHER Panitumumab 400 Mg/20 Ml (20 Mg/ml) Intravenous Solution 37 13 $36,840.32 — $16,946.55 $36,018.78 $32,787.88 2026-05-09
L8614 OTHER Cochlear Device 21 6 — — $17,344.28 $21,424.55 $18,363.90 2026-05-09
210663 OTHER Lurbinectedin 4 Mg Intravenous Solution 37 13 $37,773.12 — $17,375.64 $36,930.78 $33,618.08 2026-05-09
275C188247 OTHER Hc Icd Biv/crt-d Lvl 47 37 13 $38,156.25 — $17,551.88 $37,305.37 $33,959.06 2026-05-09
275C172247 OTHER Hc Icd Single Chamber Lvl 47 37 13 $38,156.25 — $17,551.88 $37,305.37 $33,959.06 2026-05-09
272C173347 OTHER Hc Catheter Ep Diag/abl Non-3d/map/cool-tip Lvl 47 37 13 $38,156.25 — $17,551.88 $37,305.37 $33,959.06 2026-05-09
272C175747 OTHER Hc Catheter Thromb/embolectomy Lvl 47 37 13 $38,156.25 — $17,551.88 $37,305.37 $33,959.06 2026-05-09
272A464947 OTHER Hc Surgical Supply Non Implant Lvl 47 37 13 $38,156.25 — $17,551.88 $37,305.37 $33,959.06 2026-05-09
278C181747 OTHER Hc Septal Defect Implant Lvl 47 37 13 $38,156.25 — $17,551.88 $37,305.37 $33,959.06 2026-05-09
278C187447 OTHER Hc Stent Coated/covered Implant Lvl 47 37 13 $38,156.25 — $17,551.88 $37,305.37 $33,959.06 2026-05-09
275C178647 OTHER Hc Pacemaker Single Chamber Lvl 47 37 13 $38,156.25 — $17,551.88 $37,305.37 $33,959.06 2026-05-09
2782669747 OTHER Hc Vascular Stent Graft Implant Lvl 47 37 13 $38,156.25 — $17,551.88 $37,305.37 $33,959.06 2026-05-09
2781949747 OTHER Hc Endoprosthesis Implant Lvl 47 37 13 $38,156.25 — $17,551.88 $37,305.37 $33,959.06 2026-05-09
203091 OTHER Tenecteplase 50 Mg Intravenous Solution 37 13 $39,030.32 — $17,953.95 $38,159.94 $34,736.98 2026-05-09
7613723601 OTHER Hc Stent Placemt Artery W Pta Init Unilateral 37 13 $40,286.44 — $18,531.76 $39,388.05 $35,854.93 2026-05-09
7613723801 OTHER Hc Stent Placemt Vein Inc Pta 1st Vein Unilateral 37 13 $40,286.44 — $18,531.76 $39,388.05 $35,854.93 2026-05-09
206181 OTHER Caplacizumab-yhdp 11 Mg Injection Kit 37 13 $40,321.19 — $18,547.75 $39,422.03 $35,885.86 2026-05-09
202322 OTHER Nivolumab 240 Mg/24 Ml Intravenous Solution 37 13 $41,568.76 — $19,121.63 $40,641.78 $36,996.20 2026-05-09
275C178648 OTHER Hc Pacemaker Single Chamber Lvl 48 37 13 $41,971.90 — $19,307.07 $41,035.93 $37,354.99 2026-05-09
275C188248 OTHER Hc Icd Biv/crt-d Lvl 48 37 13 $41,971.90 — $19,307.07 $41,035.93 $37,354.99 2026-05-09
275C172248 OTHER Hc Icd Single Chamber Lvl 48 37 13 $41,971.90 — $19,307.07 $41,035.93 $37,354.99 2026-05-09
2782669748 OTHER Hc Vascular Stent Graft Implant Lvl 48 37 13 $41,971.90 — $19,307.07 $41,035.93 $37,354.99 2026-05-09
275C172148 OTHER Hc Icd Dual Chamber Lvl 48 37 13 $41,971.90 — $19,307.07 $41,035.93 $37,354.99 2026-05-09
272C175748 OTHER Hc Catheter Thromb/embolectomy Lvl 48 37 13 $41,971.90 — $19,307.07 $41,035.93 $37,354.99 2026-05-09
278C187448 OTHER Hc Stent Coated/covered Implant Lvl 48 37 13 $41,971.90 — $19,307.07 $41,035.93 $37,354.99 2026-05-09
206261 OTHER Atezolizumab 840 Mg/14 Ml (60 Mg/ml) Intravenous Solution 37 13 $42,043.56 — $19,340.04 $41,105.99 $37,418.77 2026-05-09
187069 OTHER Vedolizumab 300 Mg Intravenous Solution 37 13 $44,029.02 — $20,253.35 $43,047.17 $39,185.83 2026-05-09
2721649301 OTHER Hc Pump Blood Centrimag 37 13 $44,856.00 — $20,633.76 $43,855.71 $39,921.84 2026-05-09
272C175749 OTHER Hc Catheter Thromb/embolectomy Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
275C262149 OTHER Hc Pacemaker Biv Crt-p Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
275C188249 OTHER Hc Icd Biv/crt-d Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
2782669749 OTHER Hc Vascular Stent Graft Implant Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
275C178649 OTHER Hc Pacemaker Single Chamber Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
278C187649 OTHER Hc Stent Non Coated/non Covered Implant Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
275C172149 OTHER Hc Icd Dual Chamber Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
2721489749 OTHER Hc Cardiovascular Non Implant Supply Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
2781909749 OTHER Hc Embolization Device Implant Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
275C172249 OTHER Hc Icd Single Chamber Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
278C188949 OTHER Hc Implantable-insertable Device Noc Lvl 49 37 13 $46,169.15 — $21,237.81 $45,139.58 $41,090.54 2026-05-09
222673 OTHER Toripalimab-tpzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution 37 13 $46,410.53 — $21,348.84 $45,375.58 $41,305.37 2026-05-09
185261 OTHER Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution 37 13 $46,560.00 — $21,417.60 $45,521.71 $41,438.40 2026-05-09
L6880 OTHER Elec Hand Ind Art Digits 23 7 — — $21,429.76 $55,924.93 $23,025.82 2026-05-09
L5856 OTHER Elec Knee-shin Swing/stance 23 7 — — $21,557.21 $56,038.61 $23,072.63 2026-05-09
201091 OTHER Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution 37 13 $47,040.00 — $21,638.40 $45,991.01 $41,865.60 2026-05-09
170071 OTHER Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 37 13 $47,386.50 — $21,797.79 $46,329.78 $42,173.98 2026-05-09
172923 OTHER Brentuximab Vedotin 50 Mg Intravenous Solution 37 13 $48,397.40 — $22,262.80 $47,318.14 $43,073.69 2026-05-09
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 16 4 — — $23,097.89 $26,331.36 $23,097.89 2026-05-09
272C175750 OTHER Hc Catheter Thromb/embolectomy Lvl 50 37 13 $50,786.10 — $23,361.61 $49,653.57 $45,199.63 2026-05-09
275C188250 OTHER Hc Icd Biv/crt-d Lvl 50 37 13 $50,786.10 — $23,361.61 $49,653.57 $45,199.63 2026-05-09
275C172150 OTHER Hc Icd Dual Chamber Lvl 50 37 13 $50,786.10 — $23,361.61 $49,653.57 $45,199.63 2026-05-09
2721489750 OTHER Hc Cardiovascular Non Implant Supply Lvl 50 37 13 $50,786.10 — $23,361.61 $49,653.57 $45,199.63 2026-05-09
272C188750 OTHER Hc Catheter Guiding Lvl 50 37 13 $50,786.10 — $23,361.61 $49,653.57 $45,199.63 2026-05-09
278C187650 OTHER Hc Stent Non Coated/non Covered Implant Lvl 50 37 13 $50,786.10 — $23,361.61 $49,653.57 $45,199.63 2026-05-09
2782669750 OTHER Hc Vascular Stent Graft Implant Lvl 50 37 13 $50,786.10 — $23,361.61 $49,653.57 $45,199.63 2026-05-09
278C188950 OTHER Hc Implantable-insertable Device Noc Lvl 50 37 13 $50,786.10 — $23,361.61 $49,653.57 $45,199.63 2026-05-09
2781909750 OTHER Hc Embolization Device Implant Lvl 50 37 13 $50,786.10 — $23,361.61 $49,653.57 $45,199.63 2026-05-09
86371 OTHER Alteplase 100 Mg Intravenous Solution 37 13 $51,218.33 — $23,560.43 $50,076.16 $45,584.31 2026-05-09
2721649401 OTHER Hc Oxygenator Perfusion Set Cardiohelp Hls Adv 7 37 13 $53,289.65 — $24,513.24 $52,101.29 $47,427.79 2026-05-09
210135 OTHER Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 37 13 $53,500.78 — $24,610.36 $52,307.71 $47,615.69 2026-05-09
217022 OTHER Risankizumab-rzaa 60 Mg/ml Intravenous Solution 37 13 $54,404.05 — $25,025.86 $53,190.84 $48,419.60 2026-05-09
275C172151 OTHER Hc Icd Dual Chamber Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
275C172251 OTHER Hc Icd Single Chamber Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
272C188951 OTHER Hc Implantable-insertable Device Noc Non Implant Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
275C188251 OTHER Hc Icd Biv/crt-d Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
278C187451 OTHER Hc Stent Coated/covered Implant Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
2781909751 OTHER Hc Embolization Device Implant Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
278C187651 OTHER Hc Stent Non Coated/non Covered Implant Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
2782669751 OTHER Hc Vascular Stent Graft Implant Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
2782649751 OTHER Hc Valve Implant Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
2781949751 OTHER Hc Endoprosthesis Implant Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
278C188951 OTHER Hc Implantable-insertable Device Noc Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
275C262151 OTHER Hc Pacemaker Biv Crt-p Lvl 51 37 13 $55,864.75 — $25,697.78 $54,618.97 $49,719.63 2026-05-09
J9266 OTHER Pegaspargase Injection 31 8 — — $26,442.79 $67,537.15 $28,424.06 2026-05-09
196494 OTHER Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution 37 13 $60,062.22 — $27,628.62 $58,722.83 $53,455.38 2026-05-09
213879 OTHER Dostarlimab-gxly 50 Mg/ml Intravenous Solution 37 13 $60,351.85 — $27,761.85 $59,006.00 $53,713.15 2026-05-09
275C188252 OTHER Hc Icd Biv/crt-d Lvl 52 37 13 $61,451.25 — $28,267.58 $60,080.89 $54,691.61 2026-05-09
278C188952 OTHER Hc Implantable-insertable Device Noc Lvl 52 37 13 $61,451.25 — $28,267.58 $60,080.89 $54,691.61 2026-05-09
278C182052 OTHER Hc Generator Neuro Rechg Battery System Implant Lvl 52 37 13 $61,451.25 — $28,267.58 $60,080.89 $54,691.61 2026-05-09
2782649752 OTHER Hc Valve Implant Lvl 52 37 13 $61,451.25 — $28,267.58 $60,080.89 $54,691.61 2026-05-09
278C187452 OTHER Hc Stent Coated/covered Implant Lvl 52 37 13 $61,451.25 — $28,267.58 $60,080.89 $54,691.61 2026-05-09
2782679752 OTHER Hc Left Atrial Appendage Implant Lvl 52 37 13 $61,451.25 — $28,267.58 $60,080.89 $54,691.61 2026-05-09
2782019752 OTHER Hc General Supply Implant Lvl 52 37 13 $61,451.25 — $28,267.58 $60,080.89 $54,691.61 2026-05-09
275C172252 OTHER Hc Icd Single Chamber Lvl 52 37 13 $61,451.25 — $28,267.58 $60,080.89 $54,691.61 2026-05-09
2781909752 OTHER Hc Embolization Device Implant Lvl 52 37 13 $61,451.25 — $28,267.58 $60,080.89 $54,691.61 2026-05-09
L8701 OTHER Ewh S/d Uprt Micro Sensor 9 3 — — $30,132.81 $65,622.56 $30,132.81 2026-05-09
144240 OTHER Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 37 13 $67,543.47 — $31,070.00 $66,037.25 $60,113.69 2026-05-09
2782019753 OTHER Hc General Supply Implant Lvl 53 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
275C172153 OTHER Hc Icd Dual Chamber Lvl 53 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
278C187453 OTHER Hc Stent Coated/covered Implant Lvl 53 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
278C171701 OTHER Hc Brachytherapy Source Hdr Ir192 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
2721489753 OTHER Hc Cardiovascular Non Implant Supply Lvl 53 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
278C261601 OTHER Hc Brachytx Non-str Yttrium-90 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
275C188253 OTHER Hc Icd Biv/crt-d Lvl 53 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
278C188953 OTHER Hc Implantable-insertable Device Noc Lvl 53 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
278C182053 OTHER Hc Generator Neuro Rechg Battery System Implant Lvl 53 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
2782669753 OTHER Hc Vascular Stent Graft Implant Lvl 53 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
2781909753 OTHER Hc Embolization Device Implant Lvl 53 37 13 $67,596.45 — $31,094.37 $66,089.05 $60,160.84 2026-05-09
L7180 OTHER Electronic Elbow Sequential 23 7 — — $32,601.09 $82,025.06 $33,771.95 2026-05-09
275C188254 OTHER Hc Icd Biv/crt-d Lvl 54 37 13 $71,199.95 — $32,751.98 $69,612.19 $63,367.96 2026-05-09
2782669754 OTHER Hc Vascular Stent Graft Implant Lvl 54 37 13 $71,199.95 — $32,751.98 $69,612.19 $63,367.96 2026-05-09
L2006 OTHER Kaf Sng/dbl Swg/stn Mcpr Cus 9 3 — — $33,123.69 $75,571.76 $33,123.69 2026-05-09
275C188255 OTHER Hc Icd Biv/crt-d Lvl 55 37 13 $74,760.00 — $34,389.60 $73,092.85 $66,536.40 2026-05-09
2782649755 OTHER Hc Valve Implant Lvl 55 37 13 $74,760.00 — $34,389.60 $73,092.85 $66,536.40 2026-05-09
2782669755 OTHER Hc Vascular Stent Graft Implant Lvl 55 37 13 $74,760.00 — $34,389.60 $73,092.85 $66,536.40 2026-05-09
L7181 OTHER Electronic Elbo Simultaneous 23 7 — — $35,929.06 $93,599.80 $38,537.58 2026-05-09
275C188256 OTHER Hc Icd Biv/crt-d Lvl 56 37 13 $78,498.05 — $36,109.10 $76,747.54 $69,863.26 2026-05-09
278C182656 OTHER Hc Gen Neuro Rchg W Bat & Lds & Cmpnts Implant Lvl 56 37 13 $78,498.05 — $36,109.10 $76,747.54 $69,863.26 2026-05-09
2721489756 OTHER Hc Cardiovascular Non Implant Supply Lvl 56 37 13 $78,498.05 — $36,109.10 $76,747.54 $69,863.26 2026-05-09
275C172256 OTHER Hc Icd Single Chamber Lvl 56 37 13 $78,498.05 — $36,109.10 $76,747.54 $69,863.26 2026-05-09
2722109757 OTHER Hc Percutaneous Ventricular Assist Device Lvl 57 37 13 $82,422.95 — $37,914.56 $80,584.92 $73,356.43 2026-05-09
2722109758 OTHER Hc Percutaneous Ventricular Assist Device Lvl 58 37 13 $86,544.15 — $39,810.31 $84,614.22 $77,024.29 2026-05-09
2782649758 OTHER Hc Valve Implant Lvl 58 37 13 $86,544.15 — $39,810.31 $84,614.22 $77,024.29 2026-05-09
278C262459 OTHER Hc Wireless Pressure Sensor Lvl 59 37 13 $90,871.40 — $41,800.84 $88,844.97 $80,875.55 2026-05-09
275C172159 OTHER Hc Icd Dual Chamber Lvl 59 37 13 $90,871.40 — $41,800.84 $88,844.97 $80,875.55 2026-05-09
278LIMFW59 OTHER Hc Ntap Limflow System 37 13 $90,871.40 — $41,800.84 $88,844.97 $80,875.55 2026-05-09
275C188259 OTHER Hc Icd Biv/crt-d Lvl 59 37 13 $90,871.40 — $41,800.84 $88,844.97 $80,875.55 2026-05-09
2782649759 OTHER Hc Valve Implant Lvl 59 37 13 $90,871.40 — $41,800.84 $88,844.97 $80,875.55 2026-05-09
278C188959 OTHER Hc Implantable-insertable Device Noc Lvl 59 37 13 $90,871.40 — $41,800.84 $88,844.97 $80,875.55 2026-05-09
278C182359 OTHER Hc Neurostim Generator/lead Lvl 59 37 13 $90,871.40 — $41,800.84 $88,844.97 $80,875.55 2026-05-09
2722109759 OTHER Hc Percutaneous Ventricular Assist Device Lvl 59 37 13 $90,871.40 — $41,800.84 $88,844.97 $80,875.55 2026-05-09
272C176959 OTHER Hc Guidewire Lvl 59 37 13 $90,871.40 — $41,800.84 $88,844.97 $80,875.55 2026-05-09
2722109760 OTHER Hc Percutaneous Ventricular Assist Device Lvl 60 37 13 $95,415.00 — $43,890.90 $93,287.25 $84,919.35 2026-05-09
2721649501 OTHER Hc Set Pump Impella Cp W/smart Assist 37 13 $96,120.00 — $44,215.20 $93,976.52 $85,546.80 2026-05-09
J9226 OTHER Supprelin La Implant 31 8 — — $45,020.65 $110,395.63 $52,493.17 2026-05-09
278C182361 OTHER Hc Neurostim Generator/lead Lvl 61 37 13 $100,185.80 — $46,085.47 $97,951.66 $89,165.36 2026-05-09
2782649761 OTHER Hc Valve Implant Lvl 61 37 13 $100,185.80 — $46,085.47 $97,951.66 $89,165.36 2026-05-09
2722109761 OTHER Hc Percutaneous Ventricular Assist Device Lvl 61 37 13 $100,185.80 — $46,085.47 $97,951.66 $89,165.36 2026-05-09
2782669762 OTHER Hc Vascular Stent Graft Implant Lvl 62 37 13 $105,195.10 — $48,389.75 $102,849.25 $93,623.64 2026-05-09
278C188962 OTHER Hc Implantable-insertable Device Noc Lvl 62 37 13 $105,195.10 — $48,389.75 $102,849.25 $93,623.64 2026-05-09
278C187462 OTHER Hc Stent Coated/covered Implant Lvl 62 37 13 $105,195.10 — $48,389.75 $102,849.25 $93,623.64 2026-05-09
199175 OTHER Ocrelizumab 30 Mg/ml Intravenous Solution 37 13 $105,619.80 — $48,585.11 $103,264.48 $94,001.62 2026-05-09
2782649763 OTHER Hc Valve Implant Lvl 63 37 13 $110,454.90 — $50,809.25 $107,991.76 $98,304.86 2026-05-09
278C188963 OTHER Hc Implantable-insertable Device Noc Lvl 63 37 13 $110,454.90 — $50,809.25 $107,991.76 $98,304.86 2026-05-09
2782669764 OTHER Hc Vascular Stent Graft Implant Lvl 64 37 13 $115,977.70 — $53,349.74 $113,391.40 $103,220.15 2026-05-09
2782649764 OTHER Hc Valve Implant Lvl 64 37 13 $115,977.70 — $53,349.74 $113,391.40 $103,220.15 2026-05-09
168829 OTHER Pegloticase 8 Mg/ml Intravenous Solution 37 13 $116,307.68 — $53,501.53 $113,714.02 $103,513.84 2026-05-09
Q2043 OTHER Sipuleucel-t Auto Cd54+ 31 8 — — $55,015.23 $138,781.95 $60,404.69 2026-05-09
2782649765 OTHER Hc Valve Implant Lvl 65 37 13 $121,776.65 — $56,017.26 $119,061.03 $108,381.22 2026-05-09
192637 OTHER Flutemetamol F-18 5 Mci (185 Mbq) Intravenous Solution 74 13 $248,371.20 — $57,125.38 $364,248.78 $146,396.20 2026-05-09
J7330 OTHER Cultured Chondrocytes Implnt 7 2 — — $57,856.13 $57,856.13 $57,856.13 2026-05-09
2782649766 OTHER Hc Valve Implant Lvl 66 37 13 $127,865.50 — $58,818.13 $125,014.10 $113,800.30 2026-05-09
278C182366 OTHER Hc Neurostim Generator/lead Lvl 66 37 13 $127,865.50 — $58,818.13 $125,014.10 $113,800.30 2026-05-09
278C188966 OTHER Hc Implantable-insertable Device Noc Lvl 66 37 13 $127,865.50 — $58,818.13 $125,014.10 $113,800.30 2026-05-09
L8702 OTHER Ewhf S/d Uprt Micro Sensor 9 3 — — $59,284.57 $129,108.61 $59,284.57 2026-05-09
275C188267 OTHER Hc Icd Biv/crt-d Lvl 67 37 13 $134,258.80 — $61,759.05 $131,264.83 $119,490.33 2026-05-09
J9029 OTHER Instill Adstiladrin Tx Dose 17 5 — — $63,342.28 $158,748.33 $63,354.77 2026-05-09
90288 OTHER Botulism Ig IV 7 2 — — $64,749.00 $64,749.00 $64,749.00 2026-05-09
183256 OTHER Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln 37 13 $141,522.48 — $65,100.34 $138,366.53 $125,955.01 2026-05-09
A9543 OTHER Y90 Ibritumomab Rx 28 6 — — $70,418.21 $163,691.45 $73,978.98 2026-05-09
2721649701 OTHER Hc Pump Blood Vad With Valves 37 13 $155,379.75 — $71,474.68 $151,914.78 $138,287.98 2026-05-09
278TRIG470 OTHER Hc Ntap Triclip G4 Vlv Rpr Systm 37 13 $155,421.50 — $71,493.89 $151,955.60 $138,325.14 2026-05-09
2782649770 OTHER Hc Valve Implant Lvl 70 37 13 $155,421.50 — $71,493.89 $151,955.60 $138,325.14 2026-05-09
2721649601 OTHER Hc Kit Pump Device Cardiac Ventricular Smartassist 5.5 S2 37 13 $156,640.00 — $72,054.40 $153,146.93 $139,409.60 2026-05-09
2722109771 OTHER Hc Percutaneous Ventricular Assist Device Lvl 71 37 13 $163,192.60 — $75,068.60 $159,553.41 $145,241.41 2026-05-09
2782649771 OTHER Hc Valve Implant Lvl 71 37 13 $163,192.60 — $75,068.60 $159,553.41 $145,241.41 2026-05-09
Q0480 OTHER Driver Pneumatic Vad Rep 23 7 — — $80,781.07 $195,999.86 $86,797.56 2026-05-09
K1007 OTHER Bil Hkaf Pc S/d Micro Sensor 7 2 — — $81,928.74 $81,928.74 $81,928.74 2026-05-09
218328 OTHER Tremelimumab-actl 20 Mg/ml Intravenous Solution 37 13 $207,625.35 — $95,507.66 $202,995.30 $184,786.56 2026-05-09
216356 OTHER Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln 37 13 $214,114.32 — $98,492.59 $209,339.57 $190,561.74 2026-05-09
210658 OTHER Inebilizumab-cdon 10 Mg/ml Intravenous Solution 37 13 $223,442.36 — $102,783.49 $218,459.60 $198,863.70 2026-05-09
143901 OTHER Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 37 13 $334,172.15 — $153,719.19 $326,720.11 $297,413.21 2026-05-09
J3402 OTHER Inj. Remestemcel-l-rknd/ Td 7 2 — — $205,640.00 $205,640.00 $205,640.00 2026-05-09
Q2053 OTHER Brexucabtagene Car Pos T 17 5 — — $460,530.40 $1,123,600.00 $489,304.61 2026-05-09
Q2041 OTHER Axicabtagene Ciloleucel Car+ 17 5 — — $489,455.96 $1,222,842.28 $533,230.17 2026-05-09
Q2054 OTHER Lisocabtagene Mara Car Pos T 17 5 — — $516,726.08 $1,240,975.53 $562,538.19 2026-05-09
Q2055 OTHER Idecabtagene Vicleucel Car 17 5 — — $526,587.59 $1,258,636.33 $557,317.93 2026-05-09
Q2056 OTHER Ciltacabtagene Car-pos T 17 5 — — $527,123.43 $1,269,217.50 $565,868.95 2026-05-09
Q2042 OTHER Tisagenlecleucel Car-pos T 17 5 — — $529,192.86 $1,308,631.40 $591,726.20 2026-05-09
Q2057 OTHER Afamitresgene Autoleucel 7 2 — — $770,620.00 $770,620.00 $770,620.00 2026-05-09
J3399 OTHER Inj Onase Abepar-xioi Treat 7 2 — — $2,391,705.69 $2,391,705.69 $2,391,705.69 2026-05-09
J3393 OTHER Inj Betibeglogene Autotemce 7 2 — — $2,884,000.00 $2,884,000.00 $2,884,000.00 2026-05-09
J3394 OTHER Inj Lovotibeglogene Autotem 7 2 — — $3,193,000.00 $3,193,000.00 $3,193,000.00 2026-05-09
J1413 OTHER Inj Delandistrogene Mox Rokl 7 2 — — $3,296,000.00 $3,296,000.00 $3,296,000.00 2026-05-09
J1411 OTHER Inj Hemgenix Per Tx Dose 7 2 — — $3,605,000.00 $3,605,000.00 $3,605,000.00 2026-05-09
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