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

MERRICK MEDICAL CENTER

Central City, NE · CCN 281328 · Rates published

57,599 distinct procedures filed
11 distinct payers
264,540 rate rows
2026-05-06 last MRF observed
Data quality

264,009 of 264,540 rate rows are consumer-grade (99.8%)

531 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
exceeds 10× this hospital's gross charge — excluded from medians 473
placeholder amount (≤ $0.02) — excluded from medians 54
per-diem day rate — not a per-procedure price 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.bryanhealth.com/app/files/public/0c8f55af-3354-471c-9d96-e1d3c2e2a445/470376552_bryan-medical-center_standardcharges.csv
Found on page https://www.bryanhealth.com/patients-visitors/pricing-insurance-financial-assistance-billing/price-estimates/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 0417c71779047805… · 23,324,872 bytes · first seen 2026-05-05

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
0773
OTHER 		Inj, Beqvez, Per Tx Dose 2 $3,615,617.60 $3,615,617.60 $3,615,617.60 nat. median
$3,635,800
1.0× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dose 2 $3,615,617.60 $3,615,617.60 $3,615,617.60 nat. median
$3,746,358
1.0× median
0714
OTHER 		Inj Delandistrogene Mox Rokl 2 $3,237,275.39 $3,237,275.39 $3,237,275.39 nat. median
$3,316,463
1.0× median
0748
OTHER 		Inj, Lovotibeglogene Autotem 2 $3,111,770.08 $3,111,770.08 $3,111,770.08 nat. median
$3,248,446
1.0× median
0746
OTHER 		Inj, Betibeglogene Autotemce 2 $2,892,494.08 $2,892,494.08 $2,892,494.08 nat. median
$2,945,740
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Treat 2 $2,342,314.76 $2,342,314.76 $2,342,314.76 nat. median
$2,588,981
0.9× median
0824
OTHER 		Inj, Exagamglogene Autotem 2 $2,272,673.92 $2,272,673.92 $2,272,673.92 nat. median
$17,829
outlier · 127.5×
9194
OTHER 		Tisagenlecleucel Car-pos T 2 $551,234.37 $551,234.37 $551,234.37 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 2 $537,292.80 $537,292.80 $537,292.80 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Car 2 $514,872.16 $514,872.16 $514,872.16 nat. median
$558,082
0.9× median
9413
OTHER 		Lisocabtagene Mara Car Pos T 2 $503,346.57 $503,346.57 $503,346.57 nat. median
$562,201
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel Car+ 2 $477,063.83 $477,063.83 $477,063.83 nat. median
$532,192
0.9× median
9391
OTHER 		Brexucabtagene Car Pos T 2 $475,635.48 $475,635.48 $475,635.48 nat. median
$489,450
1.0× median
583 - 4
OTHER 		Neonate With Ecmo 4 $472,816.54 $774,455.49 $472,816.54 nat. median
$472,817
1.0× median
588 - 4
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $289,591.51 $688,447.48 $289,591.51 nat. median
$289,592
1.0× median
11 - 4
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $270,719.54 $1,355,897.38 $270,719.54 nat. median
$270,720
1.0× median
2 - 4
OTHER 		Heart And/or Lung Transplant 4 $270,540.72 $854,611.48 $270,540.72 nat. median
$270,541
1.0× median
583 - 3
OTHER 		Neonate With Ecmo 4 $269,284.70 $767,167.94 $269,284.70 nat. median
$269,285
1.0× median
583 - 2
OTHER 		Neonate With Ecmo 4 $206,760.87 $481,415.24 $206,760.87 nat. median
$206,761
1.0× median
161 - 4
OTHER 		Implantable Heart Assist Systems 4 $201,889.94 $612,198.29 $201,889.94 nat. median
$201,890
1.0× median
609 - 4
OTHER 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 $201,765.88 $496,146.98 $201,765.88 nat. median
$201,766
1.0× median
11 - 3
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $201,473.27 $1,250,109.90 $201,473.27 nat. median
$201,473
1.0× median
9 - 4
OTHER 		Extracorporeal Membrane Oxygenation (ecmo) 4 $197,917.39 $318,344.42 $197,917.39 nat. median
$197,917
1.0× median
631 - 4
OTHER 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 $194,062.06 $340,625.56 $194,062.06 nat. median
$194,062
1.0× median
588 - 3
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $192,867.64 $421,415.15 $192,867.64 nat. median
$192,868
1.0× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $192,644.09 $192,644.09 $192,644.09 nat. median
$263,894
0.7× median
591 - 4
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 4 $189,899.56 $412,862.74 $189,899.56 nat. median
$189,900
1.0× median
583 - 1
OTHER 		Neonate With Ecmo 4 $185,593.33 $361,417.39 $185,593.33 nat. median
$185,593
1.0× median
841 - 4
OTHER 		Extensive Third Degree Burns With Skin Graft 4 $179,586.16 $435,265.46 $179,586.16 nat. median
$179,586
1.0× median
630 - 4
OTHER 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 $175,994.35 $291,377.93 $175,994.35 nat. median
$175,994
1.0× median
593 - 4
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 4 $166,958.36 $430,573.09 $166,958.36 nat. median
$166,958
1.0× median
588 - 2
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $165,266.84 $410,206.78 $165,266.84 nat. median
$165,267
1.0× median
11 - 2
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $160,168.32 $892,954.68 $160,168.32 nat. median
$160,168
1.0× median
7 - 4
OTHER 		Allogeneic Bone Marrow Transplant 4 $159,283.63 $400,144.02 $159,283.63 nat. median
$159,284
1.0× median
161 - 3
OTHER 		Implantable Heart Assist Systems 4 $158,084.08 $416,858.39 $158,084.08 nat. median
$158,084
1.0× median
RX-180700
OTHER 		Inebilizumab-cdon 10 Mg/ml IV Soln 7 $99,109.00 $471,303.98 $157,101.33 nat. median
$157,101
1.0× median
4 - 4
OTHER 		Tracheostomy With Mv >96 Hours With Extensive Procedure 4 $152,101.72 $320,168.06 $152,101.72 nat. median
$152,102
1.0× median
1 - 4
OTHER 		Liver Transplant And/or Intestinal Transplant 4 $150,589.02 $584,528.06 $150,589.02 nat. median
$150,589
1.0× median
2 - 3
OTHER 		Heart And/or Lung Transplant 4 $147,367.69 $430,325.27 $147,367.69 nat. median
$147,368
1.0× median
003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 $145,907.94 $145,907.94 $145,907.94 nat. median
$218,232
0.7× median
591 - 3
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 4 $143,217.17 $245,309.97 $143,217.17 nat. median
$143,217
1.0× median
588 - 1
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $141,657.41 $272,832.91 $141,657.41 nat. median
$141,657
1.0× median
RX-195281
OTHER 		Ocrelizumab-hyaluronidase-ocsq 920 Mg-23,000 Unit/23 Ml Subq Soln 6 $86,908.72 $416,190.80 $138,730.27 nat. median
$138,730
1.0× median
RX-171544
OTHER 		Triptorelin Pamoate(pediatric) 22.5 Mg IM Susr 7 $91,614.64 $408,687.54 $136,229.19 nat. median
$136,229
1.0× median
589 - 1
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 4 $134,989.72 $324,350.74 $134,989.72 nat. median
$134,990
1.0× median
589 - 3
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 4 $134,989.72 $218,079.29 $134,989.72 nat. median
$134,990
1.0× median
589 - 2
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 4 $134,989.72 $236,219.83 $134,989.72 nat. median
$134,990
1.0× median
9 - 3
OTHER 		Extracorporeal Membrane Oxygenation (ecmo) 4 $133,013.29 $227,153.07 $133,013.29 nat. median
$133,013
1.0× median
RX-176607
OTHER 		Tagraxofusp-erzs 1000 Mcg/ml IV Soln 6 $71,386.00 $340,547.89 $126,469.87 nat. median
$126,470
1.0× median
602 - 4
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 $125,775.77 $285,455.77 $125,775.77 nat. median
$125,776
1.0× median

Other procedures at this hospital

Browse this hospital's 57,599 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
             
SUP-421192 OTHER Heartmate 3 Lvas Implant Kit 6 6 $179,865.00 $107,919.00 40% off $34,174.35 $269,797.50 $80,939.25 2026-05-06
RX-180700 OTHER Inebilizumab-cdon 10 Mg/ml IV Soln 14 7 $157,101.33 $94,260.79 40% off $99,109.00 $471,303.98 $157,101.33 2026-05-06
RX-195281 OTHER Ocrelizumab-hyaluronidase-ocsq 920 Mg-23,000 Unit/23 Ml Subq Soln 12 6 $138,730.27 $83,238.16 40% off $86,908.72 $416,190.80 $138,730.27 2026-05-06
RX-116024 OTHER Glucarpidase 1000 Units IV Solr 5 5 $117,179.45 $70,307.67 40% off $22,264.10 $175,769.17 $58,589.73 2026-05-06
RX-176607 OTHER Tagraxofusp-erzs 1000 Mcg/ml IV Soln 12 6 $113,515.96 $68,109.58 40% off $71,386.00 $340,547.89 $126,469.87 2026-05-06
RX-127653 OTHER Alemtuzumab 12 Mg/1.2 Ml IV Soln 14 7 $93,329.92 $55,997.96 40% off $58,317.38 $279,989.78 $93,329.93 2026-05-06
SUP-477331 OTHER Kit Implants Aprevo 5-level 6 6 $90,000.00 $54,000.00 40% off $17,100.00 $135,000.00 $40,500.00 2026-05-06
PX-48100147 OTHER Insj Phrnc Nrv Stim Sys 9 9 $89,960.00 $53,976.00 40% off $4,100.00 $134,940.00 $43,855.69 2026-05-06
RX-188655 OTHER Spesolimab-sbzo 60 Mg/ml IV Soln 8 8 $85,948.33 $51,569.00 40% off $16,330.18 $128,922.49 $36,275.88 2026-05-06
RX-117842 OTHER Pegaspargase 750 Units/ml Inj Soln 14 7 $85,902.11 $51,541.27 40% off $56,848.12 $257,706.36 $85,902.12 2026-05-06
SUP-431937 OTHER Cath Impella 5.5 S2 W Smart Assist 6 6 $79,200.00 $47,520.00 40% off $15,048.00 $118,800.00 $35,640.00 2026-05-06
SUP-477330 OTHER Kit Implants Aprevo 4-level 6 6 $79,200.00 $47,520.00 40% off $15,048.00 $118,800.00 $35,640.00 2026-05-06
RX-171544 OTHER Triptorelin Pamoate(pediatric) 22.5 Mg IM Susr 14 7 $75,014.08 $45,008.45 40% off $91,614.64 $408,687.54 $136,229.19 2026-05-06
SUP-408769 OTHER Kit Symmetry Includes 3 Items 8103 Gen,304-20 Lead,402 Tunlr 4 4 $71,199.00 $42,719.40 40% off $28,479.60 $106,798.50 $40,903.82 2026-05-06
PX-48100113 OTHER Hc Stent Ather Two Vessels T2 With IV Litho 7 7 $70,928.00 $42,556.80 40% off $4,100.00 $106,392.00 $42,556.80 2026-05-06
PX-32900364 OTHER Stent Athr Two Vessels T2 6 6 $70,928.00 $42,556.80 40% off $17,499.90 $106,392.00 $39,010.40 2026-05-06
RX-169080 OTHER Ocrelizumab 30 Mg/ml IV Soln 14 7 $69,376.35 $41,625.80 40% off $35,648.40 $157,164.74 $69,376.35 2026-05-06
SUP-477329 OTHER Kit Implants Aprevo 3-level 4 4 $68,400.00 $41,040.00 40% off $27,360.00 $102,600.00 $39,295.80 2026-05-06
RX-168999 OTHER Canakinumab (pf) 150 Mg/ml Subq Soln 14 7 $67,967.33 $40,780.40 40% off $42,481.20 $203,902.01 $67,967.34 2026-05-06
SUP-485668 OTHER Sentiva Generator Vns 1000 4 4 $66,443.69 $39,866.21 40% off $26,577.48 $99,665.53 $38,171.90 2026-05-06
PX-48100026 OTHER Insrt Repl Icd Subq Electrode 7 7 $62,664.00 $37,598.40 40% off $4,100.00 $93,996.00 $37,598.40 2026-05-06
PX-48100154 OTHER Insj/Rplc Cardiac Modulj Sys 7 7 $62,664.00 $37,598.40 40% off $4,100.00 $93,996.00 $37,598.40 2026-05-06
RX-177364 OTHER Polatuzumab Vedotin-piiq 140 Mg IV Solr 16 8 $62,628.21 $37,576.92 40% off $23,798.72 $187,884.62 $46,416.44 2026-05-06
PX-48100116 OTHER Hc Pta Stent Two Or More Vessels T2 With IV Litho 7 7 $60,401.00 $36,240.60 40% off $4,100.00 $90,601.50 $36,240.60 2026-05-06
PX-48100022 OTHER Insrt Repl Icd Single Dual Chamber 7 7 $57,608.00 $34,564.80 40% off $4,100.00 $86,412.00 $34,564.80 2026-05-06
PX-62400003 OTHER Fdaide G170258 5 5 $56,243.00 $33,745.80 40% off $28,121.50 $84,364.50 $36,501.71 2026-05-06
RX-191286 OTHER Efgartigimod-hyaluronidas-qvfc 1,008 Mg-11,200 Unit/5.6 Ml Subq Soln 14 7 $55,161.03 $33,096.62 40% off $34,159.10 $165,483.07 $55,161.03 2026-05-06
RX-179408 OTHER Teprotumumab-trbw 500 Mg IV Solr 14 7 $55,066.25 $33,039.74 40% off $35,919.20 $165,198.73 $55,066.25 2026-05-06
RX-194235 OTHER Tarlatamab-dlle 10 Mg IV Solr 12 6 $50,493.62 $30,296.17 40% off $31,292.72 $151,480.84 $58,017.17 2026-05-06
RX-169458 OTHER Guselkumab 100 Mg/ml Subq Syrg 16 8 $48,965.89 $29,379.53 40% off $15,194.40 $146,897.65 $41,222.00 2026-05-06
RX-108073 OTHER Pralatrexate 40 Mg/2 Ml (20 Mg/ml) IV Soln 14 7 $47,958.69 $28,775.22 40% off $31,410.32 $143,876.09 $47,958.70 2026-05-06
RX-174798 OTHER Tildrakizumab-asmn 100 Mg/ml Subq Syr 16 8 $46,776.85 $28,066.10 40% off $34,709.00 $217,623.48 $70,842.60 2026-05-06
RX-178839 OTHER Luspatercept-aamt 75 Mg Subq Solr 16 8 $40,669.93 $24,401.96 40% off $25,189.20 $122,009.81 $39,378.97 2026-05-06
RX-189658 OTHER Ublituximab-xiiy 25 Mg/ml IV Soln 14 7 $37,352.04 $22,411.22 40% off $21,225.90 $112,056.14 $37,352.05 2026-05-06
RX-187695 OTHER Risankizumab-rzaa 60 Mg/ml IV Soln 14 7 $35,746.03 $21,447.62 40% off $17,929.20 $107,238.07 $35,746.03 2026-05-06
RX-4084600041 OTHER Alteplase 50 & 100 Mg IV Solr Repackaging Only 14 7 $29,592.12 $17,755.28 40% off $37,778.80 $116,103.02 $57,630.43 2026-05-06
RX-173341 OTHER Tenecteplase 50 Mg IV Solr 16 8 $27,901.35 $16,740.81 40% off $21,204.98 $167,407.75 $40,924.10 2026-05-06
0773 OTHER Inj, Beqvez, Per Tx Dose 2 2 — — $3,615,617.60 $3,615,617.60 $3,615,617.60 2026-05-06
9138 OTHER Inj, Hemgenix, Per Tx Dose 2 2 — — $3,615,617.60 $3,615,617.60 $3,615,617.60 2026-05-06
0714 OTHER Inj Delandistrogene Mox Rokl 2 2 — — $3,237,275.39 $3,237,275.39 $3,237,275.39 2026-05-06
0748 OTHER Inj, Lovotibeglogene Autotem 2 2 — — $3,111,770.08 $3,111,770.08 $3,111,770.08 2026-05-06
0746 OTHER Inj, Betibeglogene Autotemce 2 2 — — $2,892,494.08 $2,892,494.08 $2,892,494.08 2026-05-06
9141 OTHER Inj Onase Abepar-xioi Treat 2 2 — — $2,342,314.76 $2,342,314.76 $2,342,314.76 2026-05-06
0824 OTHER Inj, Exagamglogene Autotem 2 2 — — $2,272,673.92 $2,272,673.92 $2,272,673.92 2026-05-06
9194 OTHER Tisagenlecleucel Car-pos T 2 2 — — $551,234.37 $551,234.37 $551,234.37 2026-05-06
9498 OTHER Ciltacabtagene Car-pos T 2 2 — — $537,292.80 $537,292.80 $537,292.80 2026-05-06
9422 OTHER Idecabtagene Vicleucel Car 2 2 — — $514,872.16 $514,872.16 $514,872.16 2026-05-06
9413 OTHER Lisocabtagene Mara Car Pos T 2 2 — — $503,346.57 $503,346.57 $503,346.57 2026-05-06
9035 OTHER Axicabtagene Ciloleucel Car+ 2 2 — — $477,063.83 $477,063.83 $477,063.83 2026-05-06
9391 OTHER Brexucabtagene Car Pos T 2 2 — — $475,635.48 $475,635.48 $475,635.48 2026-05-06
583 - 4 OTHER Neonate With Ecmo 4 4 — — $472,816.54 $774,455.49 $472,816.54 2026-05-06
588 - 4 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $289,591.51 $688,447.48 $289,591.51 2026-05-06
11 - 4 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $270,719.54 $1,355,897.38 $270,719.54 2026-05-06
2 - 4 OTHER Heart And/or Lung Transplant 4 4 — — $270,540.72 $854,611.48 $270,540.72 2026-05-06
583 - 3 OTHER Neonate With Ecmo 4 4 — — $269,284.70 $767,167.94 $269,284.70 2026-05-06
583 - 2 OTHER Neonate With Ecmo 4 4 — — $206,760.87 $481,415.24 $206,760.87 2026-05-06
161 - 4 OTHER Implantable Heart Assist Systems 4 4 — — $201,889.94 $612,198.29 $201,889.94 2026-05-06
609 - 4 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 4 — — $201,765.88 $496,146.98 $201,765.88 2026-05-06
11 - 3 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $201,473.27 $1,250,109.90 $201,473.27 2026-05-06
9 - 4 OTHER Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $197,917.39 $318,344.42 $197,917.39 2026-05-06
631 - 4 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 4 — — $194,062.06 $340,625.56 $194,062.06 2026-05-06
588 - 3 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $192,867.64 $421,415.15 $192,867.64 2026-05-06
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 $759,540.13 — $192,644.09 $192,644.09 $192,644.09 2026-05-06
591 - 4 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 4 4 — — $189,899.56 $412,862.74 $189,899.56 2026-05-06
583 - 1 OTHER Neonate With Ecmo 4 4 — — $185,593.33 $361,417.39 $185,593.33 2026-05-06
841 - 4 OTHER Extensive Third Degree Burns With Skin Graft 4 4 — — $179,586.16 $435,265.46 $179,586.16 2026-05-06
630 - 4 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 4 — — $175,994.35 $291,377.93 $175,994.35 2026-05-06
593 - 4 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 4 4 — — $166,958.36 $430,573.09 $166,958.36 2026-05-06
588 - 2 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $165,266.84 $410,206.78 $165,266.84 2026-05-06
11 - 2 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $160,168.32 $892,954.68 $160,168.32 2026-05-06
7 - 4 OTHER Allogeneic Bone Marrow Transplant 4 4 — — $159,283.63 $400,144.02 $159,283.63 2026-05-06
161 - 3 OTHER Implantable Heart Assist Systems 4 4 — — $158,084.08 $416,858.39 $158,084.08 2026-05-06
4 - 4 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $152,101.72 $320,168.06 $152,101.72 2026-05-06
1 - 4 OTHER Liver Transplant And/or Intestinal Transplant 4 4 — — $150,589.02 $584,528.06 $150,589.02 2026-05-06
2 - 3 OTHER Heart And/or Lung Transplant 4 4 — — $147,367.69 $430,325.27 $147,367.69 2026-05-06
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 $504,792.82 — $145,907.94 $145,907.94 $145,907.94 2026-05-06
591 - 3 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 4 4 — — $143,217.17 $245,309.97 $143,217.17 2026-05-06
588 - 1 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $141,657.41 $272,832.91 $141,657.41 2026-05-06
589 - 1 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 4 — — $134,989.72 $324,350.74 $134,989.72 2026-05-06
589 - 2 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 4 — — $134,989.72 $236,219.83 $134,989.72 2026-05-06
589 - 3 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 4 — — $134,989.72 $218,079.29 $134,989.72 2026-05-06
9 - 3 OTHER Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $133,013.29 $227,153.07 $133,013.29 2026-05-06
602 - 4 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $125,775.77 $285,455.77 $125,775.77 2026-05-06
591 - 2 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 4 4 — — $122,839.35 $179,911.44 $122,839.35 2026-05-06
593 - 3 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 4 4 — — $122,135.19 $333,471.28 $122,135.19 2026-05-06
510 - 4 OTHER Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 1 1 — — $119,686.90 $119,686.90 $119,686.90 2026-05-06
161 - 1 OTHER Implantable Heart Assist Systems 4 4 — — $116,318.82 $350,288.51 $116,318.82 2026-05-06
161 - 2 OTHER Implantable Heart Assist Systems 4 4 — — $116,318.82 $368,279.42 $116,318.82 2026-05-06
160 - 4 OTHER Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $115,895.30 $241,973.65 $115,895.30 2026-05-06
2 - 2 OTHER Heart And/or Lung Transplant 4 4 — — $111,592.49 $267,443.82 $111,592.49 2026-05-06
5 - 4 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 4 — — $105,960.07 $302,336.13 $105,960.07 2026-05-06
4 - 3 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $104,885.44 $212,124.40 $104,885.44 2026-05-06
7 - 3 OTHER Allogeneic Bone Marrow Transplant 4 4 — — $101,306.46 $334,528.05 $101,306.46 2026-05-06
842 - 4 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 4 4 — — $100,542.41 $210,043.58 $100,542.41 2026-05-06
2 - 1 OTHER Heart And/or Lung Transplant 4 4 — — $98,630.15 $219,865.52 $98,630.15 2026-05-06
6 - 4 OTHER Pancreas Transplant 4 4 — — $98,364.05 $293,603.70 $98,364.05 2026-05-06
593 - 2 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 4 4 — — $98,236.57 $226,168.77 $98,236.57 2026-05-06
607 - 4 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $97,225.25 $310,392.88 $97,225.25 2026-05-06
630 - 3 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 4 — — $97,012.21 $175,943.85 $97,012.21 2026-05-06
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 $320,417.42 — $95,218.38 $95,218.38 $95,218.38 2026-05-06
480 - 4 OTHER Major Male Pelvic Procedures 1 1 — — $94,158.27 $94,158.27 $94,158.27 2026-05-06
851 - 3 OTHER Gender Related Procedures 4 4 — — $67,937.60 $92,776.13 $92,776.13 2026-05-06
851 - 4 OTHER Gender Related Procedures 4 4 — — $92,776.13 $209,159.82 $92,776.13 2026-05-06
603 - 4 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 4 — — $91,993.26 $324,016.41 $91,993.26 2026-05-06
602 - 3 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $87,327.67 $241,033.77 $87,327.67 2026-05-06
611 - 4 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 4 4 — — $80,862.76 $179,754.79 $80,862.76 2026-05-06
613 - 4 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 4 4 — — $80,120.10 $149,711.49 $80,120.10 2026-05-06
863 - 4 OTHER Neonatal Aftercare 4 4 — — $79,087.39 $160,251.20 $79,087.39 2026-05-06
11 - 1 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $78,883.75 $83,216.43 $78,883.75 2026-05-06
1 - 3 OTHER Liver Transplant And/or Intestinal Transplant 4 4 — — $78,182.16 $430,867.68 $78,182.16 2026-05-06
162 - 4 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 4 — — $77,886.12 $201,750.70 $77,886.12 2026-05-06
303 - 4 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 4 — — $77,509.66 $185,646.55 $77,509.66 2026-05-06
5 - 3 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 4 — — $76,897.91 $214,090.66 $76,897.91 2026-05-06
440 - 4 OTHER Kidney Transplant 4 4 — — $76,265.62 $392,531.50 $76,265.62 2026-05-06
6 - 3 OTHER Pancreas Transplant 4 4 — — $75,805.30 $232,441.62 $75,805.30 2026-05-06
426 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 $238,294.98 — $75,762.80 $75,762.80 $75,762.80 2026-05-06
593 - 1 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 4 4 — — $74,761.47 $205,608.40 $74,761.47 2026-05-06
510 - 3 OTHER Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 1 1 — — $72,821.69 $72,821.69 $72,821.69 2026-05-06
7 - 2 OTHER Allogeneic Bone Marrow Transplant 4 4 — — $71,340.78 $290,959.42 $71,340.78 2026-05-06
8 - 4 OTHER Autologous Bone Marrow Transplant 4 4 — — $70,844.54 $247,624.59 $70,844.54 2026-05-06
609 - 3 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 4 — — $69,990.65 $154,036.79 $69,990.65 2026-05-06
602 - 2 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $69,780.17 $176,324.95 $69,780.17 2026-05-06
215 OTHER Other Heart Assist System Implant 2 2 $265,522.50 — $68,447.19 $68,447.19 $68,447.19 2026-05-06
163 - 4 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 4 — — $68,153.67 $125,153.14 $68,153.67 2026-05-06
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 $255,115.35 — $67,249.69 $67,249.69 $67,249.69 2026-05-06
4 - 2 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $67,025.99 $153,538.80 $67,025.99 2026-05-06
299 - 4 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $66,778.72 $66,778.72 $66,778.72 2026-05-06
9 - 2 OTHER Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $66,759.05 $96,790.86 $66,759.05 2026-05-06
607 - 3 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $66,658.94 $233,575.55 $66,658.94 2026-05-06
6 - 2 OTHER Pancreas Transplant 4 4 — — $65,352.44 $190,935.11 $65,352.44 2026-05-06
120 OTHER Car T-cell Immunotherapy 4 4 — — $65,239.56 $68,759.98 $65,239.56 2026-05-06
178 - 4 OTHER External Heart Assist Systems 4 4 — — $64,808.28 $250,348.36 $64,808.28 2026-05-06
612 - 4 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $63,698.56 $162,612.58 $63,698.56 2026-05-06
633 - 4 OTHER Neonate Birth Weight > 2499 Grams With Major Anomaly 4 4 — — $63,531.72 $158,062.83 $63,531.72 2026-05-06
7 - 1 OTHER Allogeneic Bone Marrow Transplant 4 4 — — $62,975.58 $135,358.51 $62,975.58 2026-05-06
621 - 4 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 4 4 — — $62,468.21 $142,877.52 $62,468.21 2026-05-06
0717 OTHER Instill Adstiladrin, Tx Dose 2 2 — — $61,789.09 $61,789.09 $61,789.09 2026-05-06
165 - 4 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 4 4 — — $61,229.30 $127,883.92 $61,229.30 2026-05-06
1 - 2 OTHER Liver Transplant And/or Intestinal Transplant 4 4 — — $60,419.91 $174,933.84 $60,419.91 2026-05-06
167 - 4 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 4 4 — — $59,992.96 $192,866.30 $59,992.96 2026-05-06
841 - 3 OTHER Extensive Third Degree Burns With Skin Graft 4 4 — — $58,404.11 $143,080.92 $58,404.11 2026-05-06
183 - 4 OTHER Percutaneous Structural Cardiac Procedures 4 4 — — $58,328.82 $173,704.05 $58,328.82 2026-05-06
910 - 4 OTHER Craniotomy For Multiple Significant Trauma 4 4 — — $58,156.84 $117,652.84 $58,156.84 2026-05-06
456 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 2 $171,384.22 — $57,767.31 $57,767.31 $57,767.31 2026-05-06
5244 OTHER Transplt Allo Hct/donor 2 2 — — $57,637.75 $57,637.75 $57,637.75 2026-05-06
631 - 3 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 4 — — $57,037.72 $111,707.30 $57,037.72 2026-05-06
162 - 3 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 4 — — $56,973.55 $134,937.67 $56,973.55 2026-05-06
680 - 4 OTHER Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 4 — — $56,528.64 $141,785.67 $56,528.64 2026-05-06
608 - 4 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 4 — — $55,454.00 $153,330.72 $55,454.00 2026-05-06
1643 OTHER Y90 Ibritumomab, Rx 2 2 — — $55,378.93 $55,378.93 $55,378.93 2026-05-06
625 - 4 OTHER Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 4 4 — — $55,372.72 $143,487.74 $55,372.72 2026-05-06
911 - 4 OTHER Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 4 4 — — $55,315.40 $187,311.21 $55,315.40 2026-05-06
304 - 4 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 4 4 — — $54,663.43 $129,590.66 $54,663.43 2026-05-06
166 - 4 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 4 — — $54,585.57 $124,468.11 $54,585.57 2026-05-06
9273 OTHER Sipuleucel-t Auto Cd54+ 2 2 — — $54,123.65 $54,123.65 $54,123.65 2026-05-06
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 $101,942.37 — $54,092.32 $54,092.32 $54,092.32 2026-05-06
179 - 4 OTHER Defibrillator Implants 4 4 — — $53,873.71 $144,892.87 $53,873.71 2026-05-06
303 - 3 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 4 — — $53,791.57 $121,891.63 $53,791.57 2026-05-06
160 - 3 OTHER Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $53,717.13 $74,079.53 $53,717.13 2026-05-06
91 - 4 OTHER Other Major Head And Neck Procedures 4 4 — — $53,559.70 $165,644.96 $53,559.70 2026-05-06
614 - 4 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 4 4 — — $53,458.74 $206,541.26 $53,458.74 2026-05-06
1 - 1 OTHER Liver Transplant And/or Intestinal Transplant 4 4 — — $53,080.57 $155,916.54 $53,080.57 2026-05-06
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 2 $202,026.13 — $52,782.77 $52,782.77 $52,782.77 2026-05-06
850 - 4 OTHER Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 4 4 — — $52,736.62 $155,900.18 $52,736.62 2026-05-06
21 - 4 OTHER Open Craniotomy Except Trauma 4 4 — — $52,662.18 $166,977.62 $52,662.18 2026-05-06
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 2 $180,594.70 — $52,381.31 $52,381.31 $52,381.31 2026-05-06
246 OTHER Class IV Therapeutic Radiopharmaceuticals 4 4 — — $52,343.27 $58,451.73 $52,343.27 2026-05-06
178 - 3 OTHER External Heart Assist Systems 4 4 — — $52,293.42 $136,983.42 $52,293.42 2026-05-06
299 - 3 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $52,218.12 $52,218.12 $52,218.12 2026-05-06
603 - 3 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 4 — — $52,092.35 $163,049.78 $52,092.35 2026-05-06
602 - 1 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $29,047.31 $51,981.12 $51,981.12 2026-05-06
440 - 3 OTHER Kidney Transplant 4 4 — — $51,851.93 $245,284.26 $51,851.93 2026-05-06
912 - 4 OTHER Musculoskeletal And Other Procedures For Multiple Significant Trauma 4 4 — — $51,431.83 $130,841.49 $51,431.83 2026-05-06
5 - 2 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 4 — — $51,274.40 $123,834.51 $51,274.40 2026-05-06
300 - 4 OTHER Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $50,944.99 $50,944.99 $50,944.99 2026-05-06
690 - 4 OTHER Acute Leukemia 4 4 — — $50,529.17 $161,378.11 $50,529.17 2026-05-06
8 - 3 OTHER Autologous Bone Marrow Transplant 4 4 — — $49,863.51 $195,604.09 $49,863.51 2026-05-06
607 - 2 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $49,787.36 $110,145.52 $49,787.36 2026-05-06
480 - 3 OTHER Major Male Pelvic Procedures 1 1 — — $49,376.22 $49,376.22 $49,376.22 2026-05-06
928 OTHER Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 2 $47,617.35 — $49,307.14 $49,307.14 $49,307.14 2026-05-06
260 - 4 OTHER Major Pancreas, Liver And Shunt Procedures 4 4 — — $49,135.40 $157,436.24 $49,135.40 2026-05-06
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 2 $167,556.14 — $49,016.36 $49,016.36 $49,016.36 2026-05-06
163 - 3 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 4 — — $48,995.93 $94,237.77 $48,995.93 2026-05-06
9 - 1 OTHER Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $48,886.42 $91,951.20 $48,886.42 2026-05-06
169 - 4 OTHER Major Abdominal Vascular Procedures 4 4 — — $48,666.53 $103,133.86 $48,666.53 2026-05-06
23 - 4 OTHER Spinal Procedures 4 4 — — $48,016.27 $149,444.96 $48,016.27 2026-05-06
740 - 4 OTHER Mental Illness Diagnosis With O.r. Procedure 4 4 — — $47,886.22 $123,053.62 $47,886.22 2026-05-06
608 - 3 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 4 — — $47,868.25 $149,910.22 $47,868.25 2026-05-06
120 - 4 OTHER Major Respiratory And Chest Procedures 4 4 — — $47,370.29 $123,228.97 $47,370.29 2026-05-06
681 - 4 OTHER Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 4 — — $47,293.29 $131,288.05 $47,293.29 2026-05-06
312 - 4 OTHER Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 4 4 — — $47,204.31 $134,474.75 $47,204.31 2026-05-06
130 - 4 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 4 — — $46,813.30 $112,997.88 $46,813.30 2026-05-06
220 - 4 OTHER Major Stomach, Esophageal And Duodenal Procedures 4 4 — — $46,658.43 $145,930.95 $46,658.43 2026-05-06
695 - 4 OTHER Chemotherapy For Acute Leukemia 4 4 — — $46,506.14 $118,697.92 $46,506.14 2026-05-06
4 - 1 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $46,371.81 $119,584.02 $46,371.81 2026-05-06
20 - 4 OTHER Open Craniotomy For Trauma 4 4 — — $46,006.47 $130,404.29 $46,006.47 2026-05-06
89 - 4 OTHER Major Cranial Or Facial Bone Procedures 4 4 — — $45,979.09 $134,890.91 $45,979.09 2026-05-06
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 2 $188,896.37 — $45,931.18 $45,931.18 $45,931.18 2026-05-06
361 - 4 OTHER Skin Graft For Skin And Subcutaneous Tissue Diagnoses 4 4 — — $45,927.75 $123,086.35 $45,927.75 2026-05-06
428 - 4 OTHER Genetic Disorders 3 3 — — $45,872.14 $45,872.14 $45,872.14 2026-05-06
261 - 4 OTHER Major Biliary Tract Procedures 4 4 — — $45,687.33 $128,632.08 $45,687.33 2026-05-06
950 - 4 OTHER Extensive O.r. Procedure Unrelated To Principal Diagnosis 4 4 — — $45,680.48 $240,750.87 $45,680.48 2026-05-06
609 - 2 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 4 — — $45,669.36 $102,923.44 $45,669.36 2026-05-06
165 - 3 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 4 4 — — $45,500.81 $96,624.86 $45,500.81 2026-05-06
6 - 1 OTHER Pancreas Transplant 4 4 — — $45,393.00 $158,609.92 $45,393.00 2026-05-06
955 OTHER Craniotomy For Multiple Significant Trauma 2 2 $138,908.06 — $43,922.77 $46,271.46 $45,097.11 2026-05-06
623 - 4 OTHER Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 4 4 — — $44,623.82 $94,672.63 $44,623.82 2026-05-06
27 - 4 OTHER Other Open Craniotomy 4 4 — — $44,321.79 $113,187.26 $44,321.79 2026-05-06
630 - 2 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 4 — — $44,213.13 $93,421.80 $44,213.13 2026-05-06
440 - 2 OTHER Kidney Transplant 4 4 — — $44,188.32 $217,670.14 $44,188.32 2026-05-06
612 - 3 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $44,111.31 $158,392.49 $44,111.31 2026-05-06
1142 OTHER Supprelin La Implant 2 2 — — $44,110.34 $44,110.34 $44,110.34 2026-05-06
1580 OTHER Implt/rpl Crtd Sns Dev Total 2 2 — — $43,855.69 $43,855.69 $43,855.69 2026-05-06
92 - 4 OTHER Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 4 4 — — $43,829.82 $99,224.72 $43,829.82 2026-05-06
401 - 4 OTHER Adrenal Procedures 4 4 — — $43,471.32 $121,608.73 $43,471.32 2026-05-06
520 - 4 OTHER Other GYN Procedures For Malignancy 3 3 — — $43,311.33 $43,311.33 $43,311.33 2026-05-06
613 - 3 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 4 4 — — $43,295.07 $107,414.73 $43,295.07 2026-05-06
611 - 3 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 4 4 — — $43,124.81 $143,576.58 $43,124.81 2026-05-06
162 - 2 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 4 — — $43,072.62 $118,115.76 $43,072.62 2026-05-06
3060 OTHER Ventricular Assist Device Procedures 4 4 — — $42,925.84 $52,563.06 $42,925.84 2026-05-06
441 - 4 OTHER Major Bladder Procedures 4 4 — — $42,874.12 $125,118.07 $42,874.12 2026-05-06
178 - 2 OTHER External Heart Assist Systems 4 4 — — $42,578.08 $130,656.79 $42,578.08 2026-05-06
603 - 2 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 4 — — $42,503.64 $123,359.89 $42,503.64 2026-05-06
183 - 3 OTHER Percutaneous Structural Cardiac Procedures 4 4 — — $42,384.71 $97,010.63 $42,384.71 2026-05-06
511 - 4 OTHER Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 4 4 — — $41,488.04 $114,753.72 $41,488.04 2026-05-06
440 - 1 OTHER Kidney Transplant 4 4 — — $41,352.86 $116,098.07 $41,352.86 2026-05-06
622 - 4 OTHER Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $41,307.51 $225,214.86 $41,307.51 2026-05-06
028 OTHER Spinal Procedures With Mcc 2 2 $64,982.52 — $41,302.73 $41,302.73 $41,302.73 2026-05-06
321 - 4 OTHER Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 4 4 — — $41,178.32 $112,696.28 $41,178.32 2026-05-06
22 - 4 OTHER Ventricular Shunt Procedures 4 4 — — $41,151.79 $108,836.24 $41,151.79 2026-05-06
792 - 4 OTHER Extensive O.r. Procedures For Other Complications Of Treatment 4 4 — — $41,028.59 $116,472.15 $41,028.59 2026-05-06
179 - 3 OTHER Defibrillator Implants 4 4 — — $41,026.88 $89,793.23 $41,026.88 2026-05-06
457 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 2 $153,331.71 — $40,992.01 $40,992.01 $40,992.01 2026-05-06
790 OTHER Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 2 $156,775.09 — $40,857.27 $40,857.27 $40,857.27 2026-05-06
842 - 3 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 4 4 — — $40,611.91 $93,555.07 $40,611.91 2026-05-06
651 - 4 OTHER Other Procedures Of Blood And Blood-forming Organs 4 4 — — $40,605.06 $105,923.09 $40,605.06 2026-05-06
098 OTHER Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 2 2 $74,883.95 — $40,558.54 $40,558.54 $40,558.54 2026-05-06
863 - 3 OTHER Neonatal Aftercare 4 4 — — $40,457.90 $109,259.42 $40,457.90 2026-05-06
304 - 3 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 4 4 — — $40,297.90 $92,182.66 $40,297.90 2026-05-06
160 - 2 OTHER Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $40,244.86 $48,095.00 $40,244.86 2026-05-06
30 - 4 OTHER Percutaneous Intracranial And Extracranial Vascular Procedures 4 4 — — $40,172.13 $113,949.44 $40,172.13 2026-05-06
170 - 4 OTHER Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 4 4 — — $40,141.33 $108,964.83 $40,141.33 2026-05-06
181 - 4 OTHER Lower Extremity Arterial Procedures 4 4 — — $40,052.35 $112,371.29 $40,052.35 2026-05-06
166 - 3 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 4 — — $40,046.36 $85,795.25 $40,046.36 2026-05-06
121 - 4 OTHER Other Respiratory And Chest Procedures 4 4 — — $39,706.68 $136,211.88 $39,706.68 2026-05-06
512 - 4 OTHER Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 4 4 — — $39,690.43 $98,046.37 $39,690.43 2026-05-06
430 OTHER Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 2 2 $236,352.91 — $39,644.65 $39,644.65 $39,644.65 2026-05-06
230 - 4 OTHER Major Small Bowel Procedures 4 4 — — $39,468.83 $99,956.51 $39,468.83 2026-05-06
023 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 2 $153,889.09 — $39,391.68 $39,391.68 $39,391.68 2026-05-06
8 - 2 OTHER Autologous Bone Marrow Transplant 4 4 — — $39,137.71 $121,087.36 $39,137.71 2026-05-06
303 - 2 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 4 — — $39,122.31 $88,451.22 $39,122.31 2026-05-06
405 - 4 OTHER Other Procedures For Endocrine, Nutritional And Metabolic Disorders 4 4 — — $39,025.63 $142,323.41 $39,025.63 2026-05-06
264 - 4 OTHER Other Hepatobiliary, Pancreas And Abdominal Procedures 4 4 — — $38,949.48 $122,279.74 $38,949.48 2026-05-06
710 - 4 OTHER Infectious And Parasitic Diseases Including HIV With O.r. Procedure 4 4 — — $38,809.16 $110,475.18 $38,809.16 2026-05-06
176 - 4 OTHER Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 4 4 — — $38,650.87 $122,015.54 $38,650.87 2026-05-06
404 - 4 OTHER Thyroid, Parathyroid And Thyroglossal Procedures 4 4 — — $38,559.33 $106,414.07 $38,559.33 2026-05-06
634 - 4 OTHER Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 4 4 — — $38,536.22 $85,776.54 $38,536.22 2026-05-06
403 - 4 OTHER Procedures For Obesity 4 4 — — $38,451.52 $94,207.37 $38,451.52 2026-05-06
299 - 2 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $38,405.32 $38,405.32 $38,405.32 2026-05-06
178 - 1 OTHER External Heart Assist Systems 4 4 — — $38,319.76 $119,446.08 $38,319.76 2026-05-06
841 - 1 OTHER Extensive Third Degree Burns With Skin Graft 4 4 — — $38,267.57 $41,081.00 $38,267.57 2026-05-06
841 - 2 OTHER Extensive Third Degree Burns With Skin Graft 4 4 — — $38,267.57 $46,764.68 $38,267.57 2026-05-06
167 - 3 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 4 4 — — $38,080.19 $78,313.65 $38,080.19 2026-05-06
711 - 4 OTHER Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 4 4 — — $37,837.20 $95,925.80 $37,837.20 2026-05-06
834 OTHER Acute Leukemia With Mcc 2 2 $56,122.36 — $37,739.10 $37,739.10 $37,739.10 2026-05-06
29 - 4 OTHER Other Percutaneous Intracranial Procedures 4 4 — — $37,583.09 $83,978.62 $37,583.09 2026-05-06
484 - 4 OTHER Other Male Reproductive System And Related Procedures 4 4 — — $37,579.66 $88,289.89 $37,579.66 2026-05-06
910 - 3 OTHER Craniotomy For Multiple Significant Trauma 4 4 — — $37,541.16 $80,027.40 $37,541.16 2026-05-06
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 2 $114,382.10 — $37,493.00 $37,493.00 $37,493.00 2026-05-06
485 - 4 OTHER Prostatectomy Procedures 3 3 — — $37,492.39 $37,492.39 $37,492.39 2026-05-06
26 - 4 OTHER Other Nervous System And Related Procedures 4 4 — — $37,349.51 $100,938.47 $37,349.51 2026-05-06
21 - 3 OTHER Open Craniotomy Except Trauma 4 4 — — $37,060.31 $83,527.39 $37,060.31 2026-05-06
175 - 4 OTHER Percutaneous Cardiac Intervention Without Ami 4 4 — — $36,947.37 $108,431.76 $36,947.37 2026-05-06
754 - 4 OTHER Depression Except Major Depressive Disorder 1 1 — — $36,818.82 $36,818.82 $36,818.82 2026-05-06
165 - 2 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 4 4 — — $36,687.27 $80,347.71 $36,687.27 2026-05-06
609 - 1 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 4 — — $36,684.71 $93,363.35 $36,684.71 2026-05-06
447 - 4 OTHER Other Kidney, Urinary Tract And Related Procedures 4 4 — — $36,595.72 $101,803.53 $36,595.72 2026-05-06
442 - 4 OTHER Kidney And Urinary Tract Procedures For Malignancy 4 4 — — $36,481.07 $119,041.61 $36,481.07 2026-05-06
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 2 $151,769.82 — $36,391.06 $36,391.06 $36,391.06 2026-05-06
448 - 4 OTHER Other Kidney, Urinary Tract And Related Percutaneous Procedures 3 3 — — $36,288.56 $36,288.56 $36,288.56 2026-05-06
163 - 2 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 4 — — $36,161.08 $76,050.46 $36,161.08 2026-05-06
650 - 4 OTHER Splenic Procedures 4 4 — — $36,143.97 $96,907.76 $36,143.97 2026-05-06
614 - 3 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 4 4 — — $36,105.46 $160,162.35 $36,105.46 2026-05-06
162 - 1 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 4 — — $35,890.71 $100,454.51 $35,890.71 2026-05-06
951 - 4 OTHER Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 4 4 — — $35,817.98 $214,415.64 $35,817.98 2026-05-06
91 - 3 OTHER Other Major Head And Neck Procedures 4 4 — — $35,787.18 $72,248.88 $35,787.18 2026-05-06
300 - 3 OTHER Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $35,620.34 $35,620.34 $35,620.34 2026-05-06
607 - 1 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $35,591.25 $51,742.28 $35,591.25 2026-05-06
130 - 3 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 4 — — $35,315.75 $82,150.31 $35,315.75 2026-05-06
43 - 4 OTHER Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 4 4 — — $35,267.83 $83,557.78 $35,267.83 2026-05-06
514 - 4 OTHER Female Reproductive System Reconstructive Procedures 4 4 — — $35,089.01 $101,749.76 $35,089.01 2026-05-06
466 OTHER Class Xiv Combined Chemotherapy And Pharmacotherapy 6 6 $185,389.90 — $34,364.93 $41,185.84 $35,074.15 2026-05-06
231 - 4 OTHER Major Large Bowel Procedures 4 4 — — $34,840.89 $87,387.43 $34,840.89 2026-05-06
182 - 4 OTHER Other Peripheral Vascular And Related Procedures 4 4 — — $34,651.80 $143,688.80 $34,651.80 2026-05-06
250 OTHER Cochlear Device Implantation 6 6 $78,118.54 — $15,003.11 $41,197.91 $34,610.01 2026-05-06
222 - 4 OTHER Other Stomach, Esophageal And Duodenal Procedures 4 4 — — $34,605.60 $113,465.48 $34,605.60 2026-05-06
229 - 4 OTHER Other Digestive System And Abdominal Procedures 4 4 — — $34,356.62 $116,907.01 $34,356.62 2026-05-06
518 - 4 OTHER Other Female Reproductive System And Related Procedures 4 4 — — $34,301.00 $90,623.22 $34,301.00 2026-05-06
89 - 3 OTHER Major Cranial Or Facial Bone Procedures 4 4 — — $34,285.60 $69,078.55 $34,285.60 2026-05-06
326 OTHER Stomach, Esophageal And Duodenal Procedures With Mcc 2 2 $72,800.25 — $34,284.78 $34,284.78 $34,284.78 2026-05-06
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