Hospital

THE NEBRASKA METHODIST HOSPITAL

Omaha, NE · CCN 280040 · Rates published

69,678 distinct procedures filed

15 distinct payers

710,192 rate rows

2026-05-22 last MRF observed

Data quality

703,260 of 710,192 rate rows are consumer-grade (99.0%)

6,932 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
per-diem day rate — not a per-procedure price	5,435
exceeds 10× this hospital's gross charge — excluded from medians	740
template filing: same amount across many unrelated codes — excluded	666
placeholder amount (≤ $0.02) — excluded from medians	67
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	24

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

Source MRF file	https://bestcare.org/sites/default/files/2026-02/470376604-1427147883_Nebraska-Methodist-Hospital_standardcharges.zip
Found on page	https://bestcare.org/patient-resources/billing-and-insurance/patient-estimates-and-pricing
Discovered via	CMS hospital list
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-05-19
Content fingerprint	9dd14d739afe5a6b… · 10,507,384 bytes · first seen 2026-05-18

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
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	$50,021.00	$1,285,028.84	$1,285,028.84	nat. median $105,647 outlier · 12.2×
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	$50,721.96	$1,184,770.53	$1,184,770.53	nat. median $171,094 outlier · 6.9×
011-2 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	$36,235.57	$846,282.71	$846,282.71	nat. median $52,878 outlier · 16.0×
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	12	$473,343.94	$1,731,359.68	$819,709.38	nat. median $424,868 1.9× median
002-4 OTHER	Heart And/or Lung Transplant	2	$220,000.00	$809,943.59	$662,457.69	nat. median $216,800 outlier · 3.1×
583-4 OTHER	Neonate With Ecmo	2	$221,000.00	$733,977.10	$605,732.82	nat. median $309,400 2.0× median
583-3 OTHER	Neonate With Ecmo	2	$221,000.00	$727,070.45	$600,552.84	nat. median $259,487 outlier · 2.3×
358654 OTHER	Axicabtagene Ciloleucel Susp	12	$495,761.13	$1,386,000.00	$583,775.71	nat. median $623,700 0.9× median
007 OTHER	Lung Transplant	11	$141,952.32	$1,230,334.65	$582,509.12	nat. median $141,082 outlier · 4.1×
358652 OTHER	Brexucabtagene Autoleucel Susp	12	$455,439.60	$1,386,000.00	$559,948.28	nat. median $623,700 0.9× median
161-4 OTHER	Implantable Heart Assist Systems	2	$454,651.66	$580,200.59	$548,813.35	nat. median $202,242 outlier · 2.7×
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	$221,000.00	$652,464.47	$544,598.35	nat. median $267,493 outlier · 2.0×
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	2	$120,000.00	$553,976.59	$445,482.44	nat. median $124,561 outlier · 3.6×
583-2 OTHER	Neonate With Ecmo	2	$219,000.00	$456,253.16	$396,939.87	nat. median $191,347 outlier · 2.1×
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	$165,000.00	$470,214.92	$393,911.19	nat. median $169,856 outlier · 2.3×
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	2	$190,000.00	$412,515.49	$356,886.62	nat. median $151,691 outlier · 2.4×
161-3 OTHER	Implantable Heart Assist Systems	2	$200,000.00	$395,070.49	$346,302.87	nat. median $152,491 outlier · 2.3×
002-3 OTHER	Heart And/or Lung Transplant	2	$140,000.00	$407,833.50	$340,875.12	nat. median $133,471 outlier · 2.6×
007-4 OTHER	Allogeneic Bone Marrow Transplant	2	$200,000.00	$379,229.74	$334,422.30	nat. median $172,311 1.9× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	$132,000.00	$399,389.09	$332,541.82	nat. median $165,000 outlier · 2.0×
001-3 OTHER	Liver Transplant And/or Intestinal Transplant	2	$92,000.00	$408,347.57	$329,260.68	nat. median $81,541 outlier · 4.0×
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	$130,000.00	$388,766.54	$324,074.90	nat. median $153,523 outlier · 2.1×
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	$120,000.00	$391,283.69	$323,462.77	nat. median $156,696 outlier · 2.1×
583-1 OTHER	Neonate With Ecmo	2	$219,000.00	$342,527.23	$311,645.42	nat. median $171,226 1.8× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	11	$246,180.17	$519,925.53	$307,181.17	nat. median $263,894 1.2× median
161-2 OTHER	Implantable Heart Assist Systems	2	$176,854.75	$349,030.60	$305,986.64	nat. median $109,992 outlier · 2.8×
440-4 OTHER	Kidney Transplant	2	$90,000.00	$372,015.09	$301,511.32	nat. median $87,123 outlier · 3.5×
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	$121,000.00	$408,068.38	$297,668.28	nat. median $151,250 2.0× median
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	2	$207,541.00	$307,397.93	$282,433.70	nat. median $86,371 outlier · 3.3×
161-1 OTHER	Implantable Heart Assist Systems	2	$117,988.01	$331,980.02	$278,482.02	nat. median $101,352 outlier · 2.7×
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	2	$126,772.99	$322,822.12	$273,809.84	nat. median $203,379 1.3× median
007-3 OTHER	Allogeneic Bone Marrow Transplant	2	$132,000.00	$317,043.31	$270,782.48	nat. median $104,111 outlier · 2.6×
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	$99,000.00	$316,041.77	$261,781.33	nat. median $112,711 outlier · 2.3×
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	$139,000.00	$301,705.54	$261,029.15	nat. median $150,954 1.7× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	2	$110,000.00	$303,433.87	$255,075.40	nat. median $110,000 outlier · 2.3×
004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	14	$151,830.74	$528,860.02	$250,410.02	nat. median $150,232 1.7× median
603-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	2	$80,000.00	$307,081.07	$250,310.80	nat. median $107,050 outlier · 2.3×
607-4 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	2	$100,000.00	$294,169.61	$245,627.21	nat. median $100,015 outlier · 2.5×
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	2	$121,997.26	$276,148.51	$237,610.70	nat. median $210,669 1.1× median
005-4 OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	2	$88,000.00	$286,533.96	$236,900.47	nat. median $88,000 outlier · 2.7×
007-2 OTHER	Allogeneic Bone Marrow Transplant	2	$110,744.75	$275,751.88	$234,500.10	nat. median $74,284 outlier · 3.2×
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	14	$158,938.88	$409,758.80	$234,031.37	nat. median $146,562 1.6× median
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	14	$180,222.40	$407,354.04	$232,657.90	nat. median $218,232 1.1× median
006-4 OTHER	Pancreas Transplant	2	$85,000.00	$278,257.95	$229,943.46	nat. median $92,449 outlier · 2.5×
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	2	$100,000.00	$270,535.89	$227,901.92	nat. median $125,000 1.8× median
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	2	$175,359.69	$229,326.44	$215,834.75	nat. median $106,926 outlier · 2.0×
002-2 OTHER	Heart And/or Lung Transplant	2	$101,036.65	$253,465.36	$215,358.18	nat. median $106,681 outlier · 2.0×
178-4 OTHER	External Heart Assist Systems	2	$141,926.97	$237,263.43	$213,429.32	nat. median $67,533 outlier · 3.2×
588-1 OTHER	Female Reproductive System Reconstructive Procedures	2	$50,000.00	$258,572.78	$206,429.59	nat. median $75,325 outlier · 2.7×
008-4 OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	2	$119,052.22	$234,682.03	$205,774.58	nat. median $81,385 outlier · 2.5×

Other procedures at this hospital

Browse this hospital's 69,678 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	4	2	—	—	$56,940.69	$70,207.62	$66,890.89	2026-05-22
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	17	14	—	—	$45,911.93	$117,616.25	$67,175.85	2026-05-22
167-3	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	4	2	—	—	$47,761.52	$74,220.44	$67,605.71	2026-05-22
180-4	OTHER	Other Circulatory System Procedures	4	2	—	—	$41,007.45	$77,437.78	$68,330.20	2026-05-22
483-4	OTHER	Penis, Testes And Scrotal Procedures	4	2	—	—	$50,601.29	$74,306.85	$68,380.46	2026-05-22
177-4	OTHER	Cardiac Pacemaker And Defibrillator Revision Except Device Replacement	4	2	—	—	$51,565.42	$74,541.73	$68,797.65	2026-05-22
364-4	OTHER	Other Skin, Subcutaneous Tissue And Related Procedures	4	2	—	—	$49,768.10	$75,337.20	$68,944.93	2026-05-22
303-1	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	4	2	—	—	$65,037.62	$70,431.42	$69,082.96	2026-05-22
049-4	OTHER	Bacterial And Tuberculous Infections Of Nervous System	4	2	—	—	$68,474.86	$70,917.42	$69,085.51	2026-05-22
681-3	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	4	2	—	—	$35,874.82	$80,429.11	$69,290.53	2026-05-22
445-4	OTHER	Other Bladder Procedures	4	2	—	—	$51,384.41	$75,456.85	$69,438.74	2026-05-22
623-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	4	2	—	—	$51,630.90	$75,820.24	$69,772.90	2026-05-22
165-2	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	4	2	—	—	$51,711.77	$76,148.18	$70,039.08	2026-05-22
384-4	OTHER	Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue	4	2	—	—	$27,219.44	$84,414.09	$70,115.43	2026-05-22
073-4	OTHER	Orbit And Eye Procedures	4	2	—	—	$51,904.34	$76,221.30	$70,142.06	2026-05-22
421-4	OTHER	Malnutrition, Failure To Thrive And Other Nutritional Disorders	4	2	—	—	$29,251.69	$83,817.07	$70,175.73	2026-05-22
220-3	OTHER	Major Stomach, Esophageal And Duodenal Procedures	4	2	—	—	$37,547.61	$81,189.13	$70,278.75	2026-05-22
042-4	OTHER	Degenerative Nervous System Disorders Except Multiple Sclerosis	4	2	—	—	$39,138.24	$81,229.01	$70,706.32	2026-05-22
660-4	OTHER	Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…	4	2	—	—	$37,868.05	$81,689.90	$70,734.44	2026-05-22
020-3	OTHER	Open Craniotomy For Trauma	4	2	—	—	$42,287.40	$80,537.68	$70,975.11	2026-05-22
540-4	OTHER	Cesarean Section Without Sterilization	4	2	—	—	$32,931.07	$83,772.16	$71,061.89	2026-05-22
759-4	OTHER	Eating Disorders	4	2	—	—	$30,803.55	$84,612.54	$71,160.29	2026-05-22
163-2	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	4	2	—	—	$51,532.04	$72,075.54	$71,304.95	2026-05-22
022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	17	14	—	—	$34,828.76	$151,482.24	$71,748.08	2026-05-22
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	17	14	—	—	$49,052.78	$125,734.47	$71,812.52	2026-05-22
284-4	OTHER	Disorders Of Gallbladder And Biliary Tract	4	2	—	—	$19,238.05	$89,582.58	$71,996.45	2026-05-22
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	17	14	—	—	$49,230.24	$126,193.16	$72,074.49	2026-05-22
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	17	14	—	—	$49,230.24	$126,193.16	$72,074.49	2026-05-22
310-4	OTHER	Vertebral And Intervertebral Spinal Procedures Including Disc Procedures	4	2	—	—	$67,408.80	$73,799.44	$72,201.77	2026-05-22
608-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	4	2	—	—	$61,000.00	$77,196.26	$73,147.20	2026-05-22
955	OTHER	Craniotomy For Multiple Significant Trauma	17	14	—	—	$50,387.10	$129,183.27	$73,782.28	2026-05-22
021-3	OTHER	Open Craniotomy Except Trauma	4	2	—	—	$59,720.12	$79,161.67	$74,301.28	2026-05-22
166-3	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	4	2	—	—	$53,388.42	$81,311.00	$74,330.36	2026-05-22
911-3	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	4	2	—	—	$48,716.67	$82,963.98	$74,402.15	2026-05-22
043-4	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	4	2	—	—	$61,413.45	$79,190.48	$74,746.22	2026-05-22
316-4	OTHER	Hand And Wrist Procedures	4	2	—	—	$47,105.50	$84,526.30	$75,171.10	2026-05-22
098-4	OTHER	Other Ear, Nose, Mouth And Throat Procedures	4	2	—	—	$60,826.75	$80,393.66	$75,501.93	2026-05-22
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	17	14	—	—	$51,728.81	$132,651.27	$75,763.00	2026-05-22
443-4	OTHER	Kidney And Urinary Tract Procedures For Non-malignancy	4	2	—	—	$51,534.61	$83,867.91	$75,784.58	2026-05-22
183-2	OTHER	Percutaneous Structural Cardiac Procedures	4	2	—	—	$60,794.66	$80,781.42	$75,784.73	2026-05-22
344-4	OTHER	Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections	4	2	—	—	$32,326.39	$90,741.44	$76,137.68	2026-05-22
752-4	OTHER	Disorders Of Personality And Impulse Control	4	2	—	—	$50,000.00	$85,091.15	$76,318.36	2026-05-22
055-4	OTHER	Head Trauma With Coma > 1 Hour Or Hemorrhage	4	2	—	—	$47,393.07	$86,379.85	$76,633.15	2026-05-22
793-4	OTHER	Moderately Extensive O.r. Procedures For Other Complications Of Treatment	4	2	—	—	$64,219.83	$81,019.30	$76,819.43	2026-05-22
231-4	OTHER	Major Large Bowel Procedures	4	2	—	—	$58,910.04	$82,819.96	$76,842.48	2026-05-22
362-4	OTHER	Mastectomy Procedures	4	2	—	—	$56,894.48	$83,553.39	$76,888.66	2026-05-22
130-3	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	4	2	—	—	$74,097.40	$77,856.56	$76,916.77	2026-05-22
315-4	OTHER	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	4	2	—	—	$62,344.21	$81,831.71	$76,959.84	2026-05-22
363-4	OTHER	Breast Procedures Except Mastectomy	4	2	—	—	$56,967.65	$83,657.53	$76,985.06	2026-05-22
952-4	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	4	2	—	—	$58,540.13	$83,205.51	$77,039.16	2026-05-22
910-3	OTHER	Craniotomy For Multiple Significant Trauma	4	2	—	—	$75,844.62	$80,687.14	$77,055.25	2026-05-22
050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	4	2	—	—	$60,958.21	$82,760.13	$77,309.65	2026-05-22
484-4	OTHER	Other Male Reproductive System And Related Procedures	4	2	—	—	$60,133.50	$83,675.26	$77,789.82	2026-05-22
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	4	2	—	—	$50,000.00	$87,145.20	$77,858.90	2026-05-22
030-3	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	4	2	—	—	$57,248.80	$84,794.23	$77,907.87	2026-05-22
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	17	14	—	—	$53,351.97	$136,846.64	$78,159.17	2026-05-22
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	17	14	—	—	$53,666.05	$137,658.46	$78,622.83	2026-05-22
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	17	14	—	—	$58,027.46	$165,102.06	$78,978.07	2026-05-22
863-3	OTHER	Neonatal Aftercare	4	2	—	—	$6,728.90	$103,548.77	$79,343.80	2026-05-22
322-4	OTHER	Shoulder And Elbow Joint Replacement	4	2	—	—	$58,844.57	$86,418.42	$79,524.95	2026-05-22
029-4	OTHER	Other Percutaneous Intracranial Procedures	4	2	—	—	$79,589.32	$80,687.14	$79,863.77	2026-05-22
622-2	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$14,813.15	$101,691.93	$79,972.23	2026-05-22
320-4	OTHER	Other Musculoskeletal System And Connective Tissue Procedures	4	2	—	—	$56,483.66	$88,007.15	$80,126.27	2026-05-22
609-1	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	4	2	—	—	$55,130.20	$88,483.54	$80,145.20	2026-05-22
010	OTHER	Pancreas Transplant	13	11	—	—	$78,655.71	$167,888.85	$80,310.61	2026-05-22
179-3	OTHER	Defibrillator Implants	4	2	—	—	$66,417.70	$85,100.01	$80,429.43	2026-05-22
751-3	OTHER	Major Depressive Disorders And Other Or Unspecified Psychoses	4	2	—	—	$22,909.72	$100,082.01	$80,788.94	2026-05-22
230-4	OTHER	Major Small Bowel Procedures	4	2	—	—	$48,612.10	$94,732.10	$80,843.21	2026-05-22
312-3	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	4	2	—	—	$52,583.47	$90,338.17	$80,899.49	2026-05-22
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	17	14	—	—	$54,668.89	$170,879.16	$80,931.16	2026-05-22
171-4	OTHER	Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock	4	2	—	—	$77,880.75	$82,095.39	$81,041.73	2026-05-22
519-4	OTHER	Uterine And Adnexa Procedures For Leiomyoma	4	2	—	—	$58,859.97	$88,787.11	$81,305.32	2026-05-22
518-4	OTHER	Other Female Reproductive System And Related Procedures	4	2	—	—	$70,072.69	$85,886.62	$81,933.14	2026-05-22
625-2	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	3	2	—	—	$1,861.30	$82,511.96	$82,511.96	2026-05-22
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	4	2	—	—	$61,096.35	$89,724.39	$82,567.38	2026-05-22
471	OTHER	Cervical Spinal Fusion With Mcc	17	14	—	—	$49,713.30	$175,163.81	$82,959.64	2026-05-22
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	4	2	—	—	$81,050.46	$83,828.15	$83,133.73	2026-05-22
625-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	4	2	—	—	$52,141.85	$93,852.42	$83,424.78	2026-05-22
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	17	14	—	—	$56,986.61	$146,241.12	$83,524.77	2026-05-22
890-4	OTHER	HIV With Multiple Major HIV Related Conditions	4	2	—	—	$47,934.83	$95,399.06	$83,533.00	2026-05-22
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	4	2	—	—	$59,643.74	$91,731.90	$83,709.86	2026-05-22
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	17	14	—	—	$57,174.47	$146,726.68	$83,802.09	2026-05-22
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	4	2	—	—	$73,770.46	$87,364.56	$83,966.04	2026-05-22
842-3	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	4	2	—	—	$70,066.26	$88,665.24	$84,015.49	2026-05-22
224-4	OTHER	Peritoneal Adhesiolysis	4	2	—	—	$80,582.00	$94,362.73	$84,027.18	2026-05-22
630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	4	2	—	—	$70,516.88	$88,538.94	$84,033.42	2026-05-22
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	17	14	—	—	$64,244.81	$147,361.93	$84,164.92	2026-05-22
690-3	OTHER	Acute Leukemia	4	2	—	—	$60,849.86	$91,997.80	$84,210.82	2026-05-22
650-4	OTHER	Splenectomy	4	2	—	—	$61,902.58	$91,842.69	$84,357.66	2026-05-22
317-4	OTHER	Tendon, Muscle And Other Soft Tissue Procedures	4	2	—	—	$47,476.52	$96,726.32	$84,413.87	2026-05-22
514-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	4	2	—	—	$50,000.00	$96,431.62	$84,823.71	2026-05-22
162-1	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	4	2	—	—	$55,396.28	$95,204.06	$85,252.11	2026-05-22
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	4	2	—	—	$66,298.31	$91,574.59	$85,255.51	2026-05-22
324-4	OTHER	Elective Hip Joint Replacement	4	2	—	—	$58,609.64	$94,294.72	$85,373.45	2026-05-22
403-4	OTHER	Procedures For Obesity	4	2	—	—	$76,277.29	$89,283.45	$86,031.91	2026-05-22
447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	4	2	—	—	$55,464.88	$96,482.58	$86,228.15	2026-05-22
512-4	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	4	2	—	—	$67,820.90	$92,921.79	$86,646.57	2026-05-22
183-3	OTHER	Percutaneous Structural Cardiac Procedures	4	2	—	—	$73,871.45	$91,940.19	$87,423.00	2026-05-22
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	17	14	—	—	$86,253.06	$183,606.79	$87,826.37	2026-05-22
026-4	OTHER	Other Nervous System And Related Procedures	4	2	—	—	$66,381.76	$95,662.73	$88,342.49	2026-05-22
711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	4	2	—	—	$81,972.22	$90,912.06	$88,677.10	2026-05-22
446-4	OTHER	Urethral And Transurethral Procedures	4	2	—	—	$44,155.33	$104,208.86	$89,195.48	2026-05-22
603-1	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	4	2	—	—	$38,202.44	$106,283.06	$89,262.90	2026-05-22
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	4	2	—	—	$65,200.66	$120,590.15	$89,312.25	2026-05-22
622-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$16,275.80	$114,020.64	$89,584.43	2026-05-22
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	4	2	—	—	$66,945.35	$97,543.95	$89,894.29	2026-05-22
005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	4	2	—	—	$63,000.00	$99,057.34	$90,043.01	2026-05-22
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	4	2	—	—	$79,271.11	$94,038.55	$90,346.69	2026-05-22
325-4	OTHER	Non-elective Or Complex Knee Joint Replacement	4	2	—	—	$85,161.18	$92,276.99	$90,498.04	2026-05-22
613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	4	2	—	—	$62,000.00	$101,800.50	$91,850.38	2026-05-22
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	17	14	—	—	$71,689.55	$161,278.05	$92,113.02	2026-05-22
024-4	OTHER	Open Extracranial Vascular Procedures	4	2	—	—	$59,786.88	$103,113.75	$92,282.03	2026-05-22
022-4	OTHER	Ventricular Shunt Procedures	4	2	—	—	$59,854.92	$103,147.71	$92,324.51	2026-05-22
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	4	2	—	—	$68,354.96	$100,386.82	$92,378.86	2026-05-22
231	OTHER	Coronary Bypass With Ptca With Mcc	17	14	—	—	$68,355.79	$161,786.64	$92,403.50	2026-05-22
175-4	OTHER	Percutaneous Cardiac Intervention Without Ami	4	2	—	—	$61,733.12	$102,764.37	$92,506.56	2026-05-22
404-4	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures	4	2	—	—	$68,672.06	$100,852.14	$92,807.12	2026-05-22
309-4	OTHER	Other Significant Hip And Femur Surgery	4	2	—	—	$81,539.58	$96,861.48	$93,031.01	2026-05-22
082-4	OTHER	Eye Infections And Other Eye Disorders	4	2	—	—	$28,495.53	$114,554.64	$93,039.86	2026-05-22
323-4	OTHER	Non-elective Or Complex Hip Joint Replacement	4	2	—	—	$77,751.09	$98,481.98	$93,299.25	2026-05-22
283-4	OTHER	Other Disorders Of The Liver	4	2	—	—	$20,741.38	$117,488.36	$93,301.61	2026-05-22
264-4	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	4	2	—	—	$42,869.60	$115,888.56	$93,761.82	2026-05-22
170-4	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	4	2	—	—	$70,565.66	$103,269.57	$95,093.59	2026-05-22
653	OTHER	Major Bladder Procedures With Mcc	17	14	—	—	$56,940.80	$201,460.49	$95,409.28	2026-05-22
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$70,908.44	$104,388.55	$96,018.52	2026-05-22
229-4	OTHER	Other Digestive System And Abdominal Procedures	4	2	—	—	$52,663.07	$110,796.65	$96,263.26	2026-05-22
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	4	2	—	—	$69,308.82	$105,868.71	$96,728.74	2026-05-22
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	4	2	—	—	$75,845.93	$104,700.98	$97,487.22	2026-05-22
232-4	OTHER	Gastric Fundoplication	4	2	—	—	$72,187.10	$106,017.17	$97,559.65	2026-05-22
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	4	2	—	—	$59,098.76	$110,384.51	$97,563.07	2026-05-22
695-4	OTHER	Chemotherapy For Acute Leukemia	4	2	—	—	$52,886.45	$112,493.95	$97,592.07	2026-05-22
169-4	OTHER	Major Abdominal Vascular Procedures	4	2	—	—	$93,376.22	$231,531.45	$97,743.37	2026-05-22
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	4	2	—	—	$63,791.05	$111,942.22	$99,904.43	2026-05-22
442-4	OTHER	Kidney And Urinary Tract Procedures For Malignancy	4	2	—	—	$61,467.37	$112,819.67	$99,981.60	2026-05-22
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	4	2	—	—	$74,052.46	$108,755.90	$100,080.04	2026-05-22
603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	4	2	—	—	$50,642.37	$116,912.26	$100,344.79	2026-05-22
440-1	OTHER	Kidney Transplant	4	2	—	—	$71,368.04	$110,029.98	$100,364.49	2026-05-22
027-4	OTHER	Other Open Craniotomy	4	2	—	—	$80,417.54	$107,271.31	$100,557.87	2026-05-22
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	4	2	—	—	$74,004.96	$109,420.00	$100,566.24	2026-05-22
321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	4	2	—	—	$68,163.67	$111,413.63	$100,601.14	2026-05-22
008-2	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	4	2	—	—	$58,189.83	$114,758.50	$100,616.33	2026-05-22
181-4	OTHER	Lower Extremity Arterial Procedures	4	2	—	—	$83,978.80	$106,498.00	$100,868.20	2026-05-22
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	4	2	—	—	$70,155.55	$117,962.54	$101,596.52	2026-05-22
621-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	3	2	—	—	$275.45	$101,740.67	$101,740.67	2026-05-22
163	OTHER	Major Chest Procedures With Mcc	17	14	—	—	$49,126.81	$215,070.45	$101,852.64	2026-05-22
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	4	2	—	—	$85,239.50	$107,993.66	$102,305.12	2026-05-22
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	4	2	—	—	$70,000.00	$113,333.74	$102,500.30	2026-05-22
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	4	2	—	—	$60,000.00	$117,362.06	$103,021.54	2026-05-22
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	4	2	—	—	$90,889.50	$107,091.83	$103,041.25	2026-05-22
510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	4	2	—	—	$77,235.00	$113,431.23	$104,382.17	2026-05-22
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	17	14	—	—	$16,550.75	$220,920.38	$104,622.17	2026-05-22
178-1	OTHER	External Heart Assist Systems	4	2	—	—	$79,337.87	$113,203.01	$104,736.73	2026-05-22
176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	4	2	—	—	$74,435.81	$115,638.17	$105,337.58	2026-05-22
401-4	OTHER	Adrenal Procedures	4	2	—	—	$78,475.15	$115,252.62	$106,058.25	2026-05-22
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	17	14	—	—	$73,046.55	$187,751.50	$107,233.19	2026-05-22
740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	4	2	—	—	$79,405.91	$116,621.99	$107,317.97	2026-05-22
120-4	OTHER	Major Respiratory And Chest Procedures	4	2	—	—	$79,019.48	$116,788.17	$107,346.00	2026-05-22
612-2	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$57,491.44	$130,805.32	$107,965.27	2026-05-22
222-4	OTHER	Other Stomach, Esophageal And Duodenal Procedures	4	2	—	—	$62,638.20	$124,047.78	$108,695.38	2026-05-22
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	4	2	—	—	$85,636.19	$116,653.01	$108,898.80	2026-05-22
215	OTHER	Other Heart Assist System Implant	17	14	—	—	$77,228.97	$191,094.74	$109,142.66	2026-05-22
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	4	2	—	—	$79,322.46	$121,199.83	$110,730.49	2026-05-22
261-4	OTHER	Major Biliary Tract Procedures	4	2	—	—	$80,651.19	$121,908.88	$111,594.46	2026-05-22
441-4	OTHER	Major Bladder Procedures	4	2	—	—	$92,000.00	$118,578.54	$111,933.90	2026-05-22
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	4	2	—	—	$104,916.30	$115,520.74	$112,869.62	2026-05-22
910-4	OTHER	Craniotomy For Multiple Significant Trauma	4	2	—	—	$111,503.48	$117,832.61	$113,085.77	2026-05-22
178-2	OTHER	External Heart Assist Systems	4	2	—	—	$84,311.31	$123,827.77	$113,948.65	2026-05-22
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	4	2	—	—	$84,175.23	$124,002.82	$114,045.92	2026-05-22
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	4	2	—	—	$85,235.64	$124,426.03	$114,628.43	2026-05-22
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	4	2	—	—	$103,812.23	$118,611.77	$114,911.89	2026-05-22
227-4	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical	4	2	—	—	$58,717.47	$134,384.91	$115,468.05	2026-05-22
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	13	11	—	—	$113,017.51	$241,522.40	$115,519.55	2026-05-22
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	4	2	—	—	$80,019.56	$127,884.90	$115,918.57	2026-05-22
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	4	2	—	—	$97,000.00	$122,817.36	$116,363.02	2026-05-22
121-4	OTHER	Other Respiratory And Chest Procedures	4	2	—	—	$79,629.29	$129,092.51	$116,726.70	2026-05-22
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	4	2	—	—	$86,776.20	$127,446.17	$117,278.68	2026-05-22
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	4	2	—	—	$61,364.67	$135,988.08	$117,332.23	2026-05-22
089-4	OTHER	Major Cranial Or Facial Bone Procedures	4	2	—	—	$87,130.53	$127,840.58	$117,663.07	2026-05-22
007-1	OTHER	Allogeneic Bone Marrow Transplant	4	2	—	—	$87,344.93	$128,283.74	$118,049.04	2026-05-22
405-4	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	4	2	—	—	$68,639.96	$134,884.61	$118,323.45	2026-05-22
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	17	14	—	—	$81,149.64	$208,695.73	$119,195.36	2026-05-22
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	4	2	—	—	$67,140.38	$138,303.59	$120,512.79	2026-05-22
178-3	OTHER	External Heart Assist Systems	4	2	—	—	$96,737.21	$129,823.72	$121,552.09	2026-05-22
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	4	2	—	—	$62,000.00	$141,886.54	$121,914.90	2026-05-22
020-4	OTHER	Open Craniotomy For Trauma	4	2	—	—	$118,136.87	$123,588.46	$122,225.56	2026-05-22
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	4	2	—	—	$84,342.12	$135,409.75	$122,642.84	2026-05-22
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	4	2	—	—	$87,935.48	$134,374.98	$122,765.11	2026-05-22
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	4	2	—	—	$50,000.00	$147,767.27	$123,325.45	2026-05-22
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	4	2	—	—	$70,000.00	$142,074.88	$124,056.16	2026-05-22
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	4	2	—	—	$90,519.76	$135,602.53	$124,331.84	2026-05-22
182-4	OTHER	Other Peripheral Vascular And Related Procedures	4	2	—	—	$90,000.00	$136,178.64	$124,633.98	2026-05-22
179-4	OTHER	Defibrillator Implants	4	2	—	—	$88,714.74	$137,319.77	$125,168.51	2026-05-22
006-1	OTHER	Pancreas Transplant	4	2	—	—	$50,000.00	$150,319.87	$125,239.90	2026-05-22
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	4	2	—	—	$70,000.00	$145,316.60	$126,487.45	2026-05-22
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	4	2	—	—	$70,000.00	$145,513.80	$126,635.35	2026-05-22
570	OTHER	Skin Debridement With Mcc	17	14	—	—	$32,238.57	$269,218.61	$127,488.00	2026-05-22
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	17	14	—	—	$75,391.42	$269,573.96	$127,656.23	2026-05-22
614-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	4	2	—	—	$64,666.60	$151,791.16	$130,010.02	2026-05-22
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$70,000.00	$150,113.80	$130,085.35	2026-05-22
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	17	14	—	—	$70,533.32	$278,158.28	$131,720.31	2026-05-22
014	OTHER	Allogeneic Bone Marrow Transplant	13	11	—	—	$89,656.00	$213,786.42	$131,733.01	2026-05-22
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	4	2	—	—	$95,712.74	$149,207.54	$135,833.84	2026-05-22
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	4	2	—	—	$80,000.00	$154,527.68	$135,895.76	2026-05-22
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	4	2	—	—	$94,617.65	$149,801.38	$136,005.44	2026-05-22
611-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	3	2	—	—	$203.40	$136,072.28	$136,072.28	2026-05-22
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$89,000.00	$154,113.32	$137,834.99	2026-05-22
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	4	2	—	—	$114,121.14	$145,985.77	$138,019.61	2026-05-22
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	4	2	—	—	$110,174.74	$147,751.76	$138,357.51	2026-05-22
008	OTHER	Simultaneous Pancreas And Kidney Transplant	13	11	—	—	$61,434.26	$295,220.90	$139,798.26	2026-05-22
480-4	OTHER	Major Male Pelvic Procedures	4	2	—	—	$61,930.82	$166,957.03	$140,700.47	2026-05-22
091-4	OTHER	Other Major Head And Neck Procedures	4	2	—	—	$102,593.90	$156,987.22	$143,388.89	2026-05-22
690-4	OTHER	Acute Leukemia	4	2	—	—	$115,000.00	$152,943.38	$143,457.54	2026-05-22
006	OTHER	Liver Transplant Without Mcc	13	11	—	—	$50,828.01	$304,361.87	$144,125.87	2026-05-22
021-4	OTHER	Open Craniotomy Except Trauma	4	2	—	—	$103,908.51	$158,250.22	$144,664.79	2026-05-22
863-4	OTHER	Neonatal Aftercare	4	2	—	—	$124,496.82	$151,875.37	$145,030.73	2026-05-22
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$80,000.00	$167,108.99	$145,331.74	2026-05-22
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	4	2	—	—	$87,000.00	$165,790.59	$146,092.94	2026-05-22
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	4	2	—	—	$80,000.00	$170,508.03	$147,881.02	2026-05-22
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	4	2	—	—	$95,000.00	$166,747.81	$148,810.86	2026-05-22
023-4	OTHER	Spinal Procedures	4	2	—	—	$112,443.22	$163,596.91	$150,808.48	2026-05-22
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	4	2	—	—	$93,000.00	$170,359.57	$151,019.68	2026-05-22
183-4	OTHER	Percutaneous Structural Cardiac Procedures	4	2	—	—	$115,000.00	$164,625.08	$152,218.81	2026-05-22
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	4	2	—	—	$66,193.04	$185,380.48	$155,583.61	2026-05-22
006-2	OTHER	Pancreas Transplant	4	2	—	—	$85,000.00	$180,955.52	$156,966.64	2026-05-22
754-4	OTHER	Depression Except Major Depressive Disorder	4	2	—	—	$25,906.11	$205,372.42	$160,505.84	2026-05-22
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	4	2	—	—	$120,000.00	$175,943.38	$161,957.54	2026-05-22
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$92,000.00	$228,435.69	$165,832.08	2026-05-22
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	4	2	—	—	$132,497.46	$177,521.04	$166,265.14	2026-05-22
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	4	2	—	—	$117,063.61	$182,785.77	$166,355.23	2026-05-22
002-1	OTHER	Heart And/or Lung Transplant	4	2	—	—	$50,000.00	$208,373.83	$168,780.37	2026-05-22
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	4	2	—	—	$110,000.00	$191,205.81	$170,904.36	2026-05-22
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	4	2	—	—	$77,000.00	$202,900.81	$171,425.61	2026-05-22
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	4	2	—	—	$91,000.00	$201,037.32	$173,527.99	2026-05-22
951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	4	2	—	—	$86,228.02	$203,208.80	$173,963.60	2026-05-22
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	4	2	—	—	$33,354.00	$223,873.35	$176,243.51	2026-05-22
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	4	2	—	—	$87,000.00	$206,680.96	$176,760.72	2026-05-22
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$73,000.00	$213,443.58	$178,332.68	2026-05-22
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	4	2	—	—	$120,000.00	$199,065.26	$179,298.95	2026-05-22
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	4	2	—	—	$79,000.00	$214,347.63	$180,510.72	2026-05-22
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	17	14	—	—	$67,098.02	$383,310.36	$181,502.45	2026-05-22
440-2	OTHER	Kidney Transplant	4	2	—	—	$110,950.16	$206,293.20	$182,457.44	2026-05-22
006-3	OTHER	Pancreas Transplant	4	2	—	—	$85,000.00	$220,292.62	$186,469.46	2026-05-22
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$86,000.00	$221,367.28	$187,525.46	2026-05-22
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	4	2	—	—	$114,307.29	$215,280.48	$190,037.18	2026-05-22
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	13	11	—	—	$124,212.39	$406,887.76	$192,664.70	2026-05-22
593-1	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	2	—	—	$1,908.00	$194,861.88	$194,861.88	2026-05-22
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	3	2	—	—	$4,296.30	$195,745.99	$195,745.99	2026-05-22
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	4	2	—	—	$91,000.00	$232,488.38	$197,116.29	2026-05-22
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	4	2	—	—	$110,010.42	$228,167.57	$198,628.28	2026-05-22
440-3	OTHER	Kidney Transplant	4	2	—	—	$125,330.00	$232,464.01	$205,680.51	2026-05-22
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	4	2	—	—	$119,052.22	$234,682.03	$205,774.58	2026-05-22
588-1	OTHER	Female Reproductive System Reconstructive Procedures	4	2	—	—	$50,000.00	$258,572.78	$206,429.59	2026-05-22
178-4	OTHER	External Heart Assist Systems	4	2	—	—	$141,926.97	$237,263.43	$213,429.32	2026-05-22
002-2	OTHER	Heart And/or Lung Transplant	4	2	—	—	$101,036.65	$253,465.36	$215,358.18	2026-05-22
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	4	2	—	—	$175,359.69	$229,326.44	$215,834.75	2026-05-22
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$100,000.00	$270,535.89	$227,901.92	2026-05-22
006-4	OTHER	Pancreas Transplant	4	2	—	—	$85,000.00	$278,257.95	$229,943.46	2026-05-22
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	17	14	—	—	$180,222.40	$407,354.04	$232,657.90	2026-05-22
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	17	14	—	—	$158,938.88	$409,758.80	$234,031.37	2026-05-22
007-2	OTHER	Allogeneic Bone Marrow Transplant	4	2	—	—	$110,744.75	$275,751.88	$234,500.10	2026-05-22
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	4	2	—	—	$88,000.00	$286,533.96	$236,900.47	2026-05-22
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	4	2	—	—	$121,997.26	$276,148.51	$237,610.70	2026-05-22
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	4	2	—	—	$100,000.00	$294,169.61	$245,627.21	2026-05-22
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	4	2	—	—	$80,000.00	$307,081.07	$250,310.80	2026-05-22
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	17	14	—	—	$151,830.74	$528,860.02	$250,410.02	2026-05-22
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	4	2	—	—	$110,000.00	$303,433.87	$255,075.40	2026-05-22
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	4	2	—	—	$139,000.00	$301,705.54	$261,029.15	2026-05-22
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	4	2	—	—	$99,000.00	$316,041.77	$261,781.33	2026-05-22
007-3	OTHER	Allogeneic Bone Marrow Transplant	4	2	—	—	$132,000.00	$317,043.31	$270,782.48	2026-05-22
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	4	2	—	—	$126,772.99	$322,822.12	$273,809.84	2026-05-22
161-1	OTHER	Implantable Heart Assist Systems	4	2	—	—	$117,988.01	$331,980.02	$278,482.02	2026-05-22
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	4	2	—	—	$207,541.00	$307,397.93	$282,433.70	2026-05-22
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	4	2	—	—	$121,000.00	$408,068.38	$297,668.28	2026-05-22
440-4	OTHER	Kidney Transplant	4	2	—	—	$90,000.00	$372,015.09	$301,511.32	2026-05-22
161-2	OTHER	Implantable Heart Assist Systems	4	2	—	—	$176,854.75	$349,030.60	$305,986.64	2026-05-22
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	13	11	—	—	$246,180.17	$519,925.53	$307,181.17	2026-05-22
583-1	OTHER	Neonate With Ecmo	4	2	—	—	$219,000.00	$342,527.23	$311,645.42	2026-05-22
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	4	2	—	—	$120,000.00	$391,283.69	$323,462.77	2026-05-22
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	4	2	—	—	$130,000.00	$388,766.54	$324,074.90	2026-05-22
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	4	2	—	—	$92,000.00	$408,347.57	$329,260.68	2026-05-22
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	4	2	—	—	$132,000.00	$399,389.09	$332,541.82	2026-05-22
007-4	OTHER	Allogeneic Bone Marrow Transplant	4	2	—	—	$200,000.00	$379,229.74	$334,422.30	2026-05-22
002-3	OTHER	Heart And/or Lung Transplant	4	2	—	—	$140,000.00	$407,833.50	$340,875.12	2026-05-22
161-3	OTHER	Implantable Heart Assist Systems	4	2	—	—	$200,000.00	$395,070.49	$346,302.87	2026-05-22
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	4	2	—	—	$190,000.00	$412,515.49	$356,886.62	2026-05-22
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	4	2	—	—	$165,000.00	$470,214.92	$393,911.19	2026-05-22
583-2	OTHER	Neonate With Ecmo	4	2	—	—	$219,000.00	$456,253.16	$396,939.87	2026-05-22
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	4	2	—	—	$120,000.00	$553,976.59	$445,482.44	2026-05-22
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	4	2	—	—	$221,000.00	$652,464.47	$544,598.35	2026-05-22
161-4	OTHER	Implantable Heart Assist Systems	4	2	—	—	$454,651.66	$580,200.59	$548,813.35	2026-05-22
358652	OTHER	Brexucabtagene Autoleucel Susp	20	12	$1,386,000.00	$498,960.00 64% off	$455,439.60	$1,386,000.00	$559,948.28	2026-05-22
007	OTHER	Lung Transplant	13	11	—	—	$141,952.32	$1,230,334.65	$582,509.12	2026-05-22
358654	OTHER	Axicabtagene Ciloleucel Susp	20	12	$1,386,000.00	$498,960.00 64% off	$495,761.13	$1,386,000.00	$583,775.71	2026-05-22
583-3	OTHER	Neonate With Ecmo	4	2	—	—	$221,000.00	$727,070.45	$600,552.84	2026-05-22
583-4	OTHER	Neonate With Ecmo	4	2	—	—	$221,000.00	$733,977.10	$605,732.82	2026-05-22
002-4	OTHER	Heart And/or Lung Transplant	4	2	—	—	$220,000.00	$809,943.59	$662,457.69	2026-05-22
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	12	—	—	$473,343.94	$1,731,359.68	$819,709.38	2026-05-22
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	2	—	—	$36,235.57	$846,282.71	$846,282.71	2026-05-22
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	2	—	—	$50,721.96	$1,184,770.53	$1,184,770.53	2026-05-22
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	2	—	—	$50,021.00	$1,285,028.84	$1,285,028.84	2026-05-22

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