Hospital

SUNRISE HOSPITAL AND MEDICAL CENTER

Las Vegas, NV · CCN 290003 · Rates published

Your selected procedure

You selected 93306 (CPT)

ECHO2D COMP W CF DOP

This hospital’s price: $1,782 across 15 payers · range $155-$6,184

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1762537_SUNRISE-HOSPITAL-AND-MEDICAL-CENTER_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-03-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

41,625 distinct procedures filed

36 distinct payers

1,288,649 rate rows

2026-07-31 last MRF observed

Data quality

746,751 of 1,288,649 rate rows are consumer-grade (57.9%)

541,898 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
professional (physician) fee — not the facility price	495,816
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	24,799
per-diem day rate — not a per-procedure price	11,355
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	7,010
placeholder amount (≤ $0.02) — excluded from medians	2,032
template filing: same amount across many unrelated codes — excluded	567
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	171
exceeds 10× this hospital's gross charge — excluded from medians	102
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	46

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

Source MRF file	https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1762537_SUNRISE-HOSPITAL-AND-MEDICAL-CENTER_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page	https://www.sunrisehealthinfo.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-11
Content fingerprint	1a73c09e44c5da68… · 814,459,846 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
845 OTHER	Inj, Atidarsagene Autotem	12	$6,236.64	$4,955,500.00	$4,505,000.00	nat. median $17,146 outlier · 262.7×
00845 OTHER	Inj, Atidarsagene Autotem	1	$4,505,000.00	$4,505,000.00	$4,505,000.00	nat. median $4,414,900 1.0× median
9138 OTHER	Inj, Hemgenix, Per Tx Dos	12	$552,790.05	$4,422,320.40	$3,685,267.00	nat. median $3,758,972 1.0× median
09138 OTHER	Inj, Hemgenix, Per Tx Dos	1	$3,685,267.00	$3,685,267.00	$3,685,267.00	nat. median $3,574,709 1.0× median
J1414 HCPCS	Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose	1	$3,500,490.28	$3,500,490.28	$3,500,490.28	nat. median $3,710,000 0.9× median
00908 OTHER	Topi Adm Prad Zami Per Tr	1	$3,335,820.00	$3,335,820.00	$3,335,820.00	nat. median $14,694 outlier · 227.0×
908 OTHER	Topi Adm Prad Zami Per Tr	16	$0.64	$4,002,984.00	$3,335,820.00	nat. median $30,329 outlier · 110.0×
00714 OTHER	Inj Delandistrogene Mox R	1	$3,327,860.00	$3,327,860.00	$3,327,860.00	nat. median $3,228,024 1.0× median
714 OTHER	Inj Delandistrogene Mox R	13	$7,335.12	$3,993,432.00	$3,327,860.00	nat. median $3,325,455 1.0× median
00748 OTHER	Inj, Lovotibeglogene Auto	1	$3,252,508.00	$3,252,508.00	$3,252,508.00	nat. median $3,187,420 1.0× median
748 OTHER	Inj, Lovotibeglogene Auto	13	$13,962.33	$3,903,009.60	$3,252,508.00	nat. median $3,252,508 1.0× median
J1411 HCPCS	Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose	3	$2,968,000.00	$3,444,000.00	$3,206,000.00	nat. median $3,703,693 0.9× median
C9172 HCPCS	Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose	2	$2,884,000.00	$3,500,490.28	$3,192,245.14	nat. median $3,605,000 0.9× median
906 OTHER	Inj Elivaldogene Autoteme	16	$0.64	$3,816,000.00	$3,180,000.00	nat. median $24,952 outlier · 127.4×
00906 OTHER	Inj Elivaldogene Autoteme	1	$3,180,000.00	$3,180,000.00	$3,180,000.00	nat. median $3,084,600 1.0× median
746 OTHER	Inj, Betibeglogene Autote	13	$12,915.31	$3,527,962.80	$2,939,969.00	nat. median $2,939,969 1.0× median
00746 OTHER	Inj, Betibeglogene Autote	1	$2,939,969.00	$2,939,969.00	$2,939,969.00	nat. median $2,878,960 1.0× median
J1413 HCPCS	Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose	2	$2,636,800.00	$3,200,490.28	$2,918,645.14	nat. median $3,324,572 0.9× median
J3394 HCPCS	Injection, Lovotibeglogene Autotemcel, Per Treatment	2	$2,628,800.00	$3,100,490.28	$2,864,645.14	nat. median $3,286,000 0.9× median
9141 OTHER	Inj Onase Abepar-xioi Tre	12	$388,347.15	$3,106,777.20	$2,588,981.00	nat. median $2,588,981 1.0× median
09141 OTHER	Inj Onase Abepar-xioi Tre	1	$2,588,981.00	$2,588,981.00	$2,588,981.00	nat. median $2,511,312 1.0× median
J3393 HCPCS	Injection, Betibeglogene Autotemcel, Per Treatment	2	$2,374,400.00	$2,800,490.28	$2,587,445.14	nat. median $2,994,107 0.9× median
00824 OTHER	Inj, Exagamglogene Autote	1	$2,332,000.00	$2,332,000.00	$2,332,000.00	nat. median $2,285,360 1.0× median
824 OTHER	Inj, Exagamglogene Autote	13	$15,123.50	$2,798,400.00	$2,332,000.00	nat. median $2,262,040 1.0× median
J3392 HCPCS	Injection, Exagamglogene Autotemcel, Per Treatment	1	$2,200,490.28	$2,200,490.28	$2,200,490.28	nat. median $2,401,960 0.9× median
J3399 HCPCS	Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge…	3	$1,842,227.74	$2,322,534.64	$2,082,381.19	nat. median $2,466,282 0.8× median
Q2057 HCPCS	Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…	4	$732,102.01	$1,656,833.00	$1,656,833.00	nat. median $809,217 outlier · 2.0×
2067 OTHER	Afamitresgene Autoleucel	12	$115,593.00	$924,744.00	$770,620.00	nat. median $789,886 1.0× median
415455 CDM	Kit Hrt Implant Lvas	10	$243,777.39	$1,166,399.00	$717,335.39	nat. median $717,335 1.0× median
Q2058 HCPCS	Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,…	2	$598,237.50	$598,237.50	$598,237.50	nat. median $319,951 1.9× median
9498 OTHER	Ciltacabtagene Car-pos T	12	$88,147.44	$705,179.52	$587,649.60	nat. median $587,650 1.0× median
09498 OTHER	Ciltacabtagene Car-pos T	1	$587,649.60	$587,649.60	$587,649.60	nat. median $570,020 1.0× median
09194 OTHER	Tisagenlecleucel Car-pos	1	$566,531.30	$566,531.30	$566,531.30	nat. median $549,535 1.0× median
9194 OTHER	Tisagenlecleucel Car-pos	12	$84,979.70	$679,837.56	$566,531.30	nat. median $577,003 1.0× median
09413 OTHER	Lisocabtagene Car Pos T	1	$562,201.20	$562,201.20	$562,201.20	nat. median $545,335 1.0× median
9413 OTHER	Lisocabtagene Car Pos T	12	$84,330.18	$674,641.44	$562,201.20	nat. median $562,201 1.0× median
09422 OTHER	Idecabtagene Vicleucel Ca	1	$558,081.80	$558,081.80	$558,081.80	nat. median $541,339 1.0× median
9422 OTHER	Idecabtagene Vicleucel Ca	12	$83,712.27	$669,698.16	$558,081.80	nat. median $562,826 1.0× median
Q2056 HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	8	$405,756.74	$1,263,446.58	$553,169.00	nat. median $646,415 0.9× median
Q2042 HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	8	$408,858.00	$1,218,042.30	$538,217.75	nat. median $738,272 0.7× median
09035 OTHER	Axicabtagene Ciloleucel C	1	$532,192.20	$532,192.20	$532,192.20	nat. median $516,226 1.0× median
9035 OTHER	Axicabtagene Ciloleucel C	12	$79,828.83	$638,630.64	$532,192.20	nat. median $533,230 1.0× median
Q2055 HCPCS	Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…	7	$387,752.24	$1,199,875.72	$530,190.66	nat. median $622,245 0.9× median
Q2054 HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	8	$379,082.81	$1,208,732.67	$516,726.08	nat. median $640,950 0.8× median
Q2041 HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	8	$359,552.00	$1,144,213.32	$502,841.00	nat. median $608,101 0.8× median
8414 APR_DRG	Extensive Third Degree Burns With Skin Graft	1	$501,787.64	$501,787.64	$501,787.64	nat. median $156,153 outlier · 3.2×
9391 OTHER	Brexucabtagene Car Pos T	12	$73,417.53	$587,340.24	$489,450.20	nat. median $492,768 1.0× median
09391 OTHER	Brexucabtagene Car Pos T	1	$489,450.20	$489,450.20	$489,450.20	nat. median $474,767 1.0× median
Q2053 HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	8	$359,552.00	$1,052,317.93	$464,990.71	nat. median $591,650 0.8× median
J3402 HCPCS	Injection, Remestemcel-l-rknd, Per Therapeutic Dose	4	$191,598.58	$433,588.39	$433,588.39	nat. median $209,753 outlier · 2.1×

Other procedures at this hospital

Browse this hospital's 41,625 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

00845	OTHER	Inj, Atidarsagene Autotem	1	1	—	—	$4,505,000.00	$4,505,000.00	$4,505,000.00	2026-03-01
845	OTHER	Inj, Atidarsagene Autotem	13	12	$14,513.83	—	$6,236.64	$4,955,500.00	$4,505,000.00	2026-07-31
09138	OTHER	Inj, Hemgenix, Per Tx Dos	1	1	—	—	$3,685,267.00	$3,685,267.00	$3,685,267.00	2026-03-01
9138	OTHER	Inj, Hemgenix, Per Tx Dos	13	12	—	—	$552,790.05	$4,422,320.40	$3,685,267.00	2026-03-01
J1414	HCPCS	Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose	1	1	—	—	$3,500,490.28	$3,500,490.28	$3,500,490.28	2026-03-01
908	OTHER	Topi Adm Prad Zami Per Tr	17	16	$32,590.51	—	$0.64	$4,002,984.00	$3,335,820.00	2026-07-31
00908	OTHER	Topi Adm Prad Zami Per Tr	1	1	—	—	$3,335,820.00	$3,335,820.00	$3,335,820.00	2026-03-01
714	OTHER	Inj Delandistrogene Mox R	14	13	$16,196.11	—	$7,335.12	$3,993,432.00	$3,327,860.00	2026-07-31
00714	OTHER	Inj Delandistrogene Mox R	1	1	—	—	$3,327,860.00	$3,327,860.00	$3,327,860.00	2026-03-01
748	OTHER	Inj, Lovotibeglogene Auto	14	13	$23,047.63	—	$13,962.33	$3,903,009.60	$3,252,508.00	2026-07-31
00748	OTHER	Inj, Lovotibeglogene Auto	1	1	—	—	$3,252,508.00	$3,252,508.00	$3,252,508.00	2026-03-01
J1411	HCPCS	Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose	4	3	—	—	$2,968,000.00	$3,444,000.00	$3,206,000.00	2026-07-31
C9172	HCPCS	Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose	2	2	—	—	$2,884,000.00	$3,500,490.28	$3,192,245.14	2026-03-01
906	OTHER	Inj Elivaldogene Autoteme	17	16	$28,579.61	—	$0.64	$3,816,000.00	$3,180,000.00	2026-07-31
00906	OTHER	Inj Elivaldogene Autoteme	1	1	—	—	$3,180,000.00	$3,180,000.00	$3,180,000.00	2026-03-01
746	OTHER	Inj, Betibeglogene Autote	14	13	$25,229.97	—	$12,915.31	$3,527,962.80	$2,939,969.00	2026-07-31
00746	OTHER	Inj, Betibeglogene Autote	1	1	—	—	$2,939,969.00	$2,939,969.00	$2,939,969.00	2026-03-01
J1413	HCPCS	Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose	2	2	—	—	$2,636,800.00	$3,200,490.28	$2,918,645.14	2026-03-01
J3394	HCPCS	Injection, Lovotibeglogene Autotemcel, Per Treatment	2	2	—	—	$2,628,800.00	$3,100,490.28	$2,864,645.14	2026-03-01
9141	OTHER	Inj Onase Abepar-xioi Tre	13	12	—	—	$388,347.15	$3,106,777.20	$2,588,981.00	2026-03-01
09141	OTHER	Inj Onase Abepar-xioi Tre	1	1	—	—	$2,588,981.00	$2,588,981.00	$2,588,981.00	2026-03-01
J3393	HCPCS	Injection, Betibeglogene Autotemcel, Per Treatment	2	2	—	—	$2,374,400.00	$2,800,490.28	$2,587,445.14	2026-03-01
824	OTHER	Inj, Exagamglogene Autote	14	13	$36,080.46	—	$15,123.50	$2,798,400.00	$2,332,000.00	2026-07-31
00824	OTHER	Inj, Exagamglogene Autote	1	1	—	—	$2,332,000.00	$2,332,000.00	$2,332,000.00	2026-03-01
J3392	HCPCS	Injection, Exagamglogene Autotemcel, Per Treatment	1	1	—	—	$2,200,490.28	$2,200,490.28	$2,200,490.28	2026-03-01
J3399	HCPCS	Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge…	4	3	—	—	$1,842,227.74	$2,322,534.64	$2,082,381.19	2026-07-31
Q2057	HCPCS	Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure…	5	4	—	—	$732,102.01	$1,656,833.00	$1,656,833.00	2026-03-01
2067	OTHER	Afamitresgene Autoleucel	13	12	—	—	$115,593.00	$924,744.00	$770,620.00	2026-03-01
415455	CDM	Kit Hrt Implant Lvas	12	10	$1,166,399.00	$1,166,399.00	$243,777.39	$1,166,399.00	$717,335.39	2026-03-01
Q2058	HCPCS	Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, …	3	2	—	—	$598,237.50	$598,237.50	$598,237.50	2026-03-01
09498	OTHER	Ciltacabtagene Car-pos T	1	1	—	—	$587,649.60	$587,649.60	$587,649.60	2026-03-01
9498	OTHER	Ciltacabtagene Car-pos T	13	12	$574,740.00	—	$88,147.44	$705,179.52	$587,649.60	2026-07-31
9194	OTHER	Tisagenlecleucel Car-pos	13	12	$544,627.92	—	$84,979.70	$679,837.56	$566,531.30	2026-07-31
09194	OTHER	Tisagenlecleucel Car-pos	1	1	—	—	$566,531.30	$566,531.30	$566,531.30	2026-03-01
09413	OTHER	Lisocabtagene Car Pos T	1	1	—	—	$562,201.20	$562,201.20	$562,201.20	2026-03-01
9413	OTHER	Lisocabtagene Car Pos T	13	12	$521,901.60	—	$84,330.18	$674,641.44	$562,201.20	2026-07-31
09422	OTHER	Idecabtagene Vicleucel Ca	1	1	—	—	$558,081.80	$558,081.80	$558,081.80	2026-03-01
9422	OTHER	Idecabtagene Vicleucel Ca	13	12	$533,604.00	—	$83,712.27	$669,698.16	$558,081.80	2026-07-31
Q2056	HCPCS	Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige…	11	8	$1,059,735.00	—	$405,756.74	$1,263,446.58	$553,169.00	2026-07-31
Q2042	HCPCS	Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka…	11	8	$1,007,149.23	—	$408,858.00	$1,218,042.30	$538,217.75	2026-07-31
9035	OTHER	Axicabtagene Ciloleucel C	13	12	$507,461.72	—	$79,828.83	$638,630.64	$532,192.20	2026-07-31
09035	OTHER	Axicabtagene Ciloleucel C	1	1	—	—	$532,192.20	$532,192.20	$532,192.20	2026-03-01
Q2055	HCPCS	Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (…	9	7	$956,040.50	—	$387,752.24	$1,199,875.72	$530,190.66	2026-07-31
Q2054	HCPCS	Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi…	11	8	$935,073.70	—	$379,082.81	$1,208,732.67	$516,726.08	2026-07-31
Q2041	HCPCS	Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via…	11	8	$965,878.60	—	$359,552.00	$1,144,213.32	$502,841.00	2026-07-31
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft	1	1	—	—	$501,787.64	$501,787.64	$501,787.64	2026-03-01
09391	OTHER	Brexucabtagene Car Pos T	1	1	—	—	$489,450.20	$489,450.20	$489,450.20	2026-03-01
9391	OTHER	Brexucabtagene Car Pos T	13	12	$507,528.00	—	$73,417.53	$587,340.24	$489,450.20	2026-07-31
Q2053	HCPCS	Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V…	11	8	$964,817.66	—	$359,552.00	$1,052,317.93	$464,990.71	2026-07-31
J3402	HCPCS	Injection, Remestemcel-l-rknd, Per Therapeutic Dose	5	4	—	—	$191,598.58	$433,588.39	$433,588.39	2026-03-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	19	12	—	—	$361,046.42	$830,102.96	$379,657.06	2026-03-01
831	OTHER	Obecbtge Autol Up To 400	14	13	$19,727.85	—	$4,270.57	$333,900.00	$278,250.00	2026-07-31
00831	OTHER	Obecbtge Autol Up To 400	1	1	—	—	$278,250.00	$278,250.00	$278,250.00	2026-03-01
897	OTHER	Revakinagene, Per Implant	13	12	$14,600.40	—	$39,750.00	$318,000.00	$265,000.00	2026-07-31
00897	OTHER	Revakinagene, Per Implant	1	1	—	—	$265,000.00	$265,000.00	$265,000.00	2026-03-01
C1827	HCPCS	Generator Pulse Implnt	12	10	$424,122.00	$424,122.00	$88,641.50	$424,122.00	$260,835.03	2026-03-01
J3403	HCPCS	Revakinagene Taroretcel-lwey, Per Implant	2	2	—	—	$251,763.01	$265,013.70	$258,388.36	2026-03-01
018	OTHER	$1,418.00	1	1	$541,434.98	—	$251,802.30	$251,802.30	$251,802.30	2026-07-31
8424	APR_DRG	Burns With Skin Graft Except Extensive Third Degree Burns	1	1	—	—	$249,535.74	$249,535.74	$249,535.74	2026-03-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	22	15	—	—	$221,393.00	$538,703.43	$242,044.70	2026-03-01
5834	APR_DRG	Neonate With Ecmo	1	1	—	—	$227,217.11	$227,217.11	$227,217.11	2026-03-01
001	OTHER	$1,418.00	1	1	$422,031.84	—	$221,338.20	$221,338.20	$221,338.20	2026-07-31
00886	OTHER	Inj. Remestemcel-l-rknd/	1	1	—	—	$201,669.00	$201,669.00	$201,669.00	2026-03-01
886	OTHER	Inj. Remestemcel-l-rknd/	14	13	$22,268.44	—	$9,344.73	$242,002.80	$201,669.00	2026-07-31
8413	APR_DRG	Extensive Third Degree Burns With Skin Graft	1	1	—	—	$199,330.81	$199,330.81	$199,330.81	2026-03-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	23	15	—	—	$138,108.00	$490,660.00	$187,338.20	2026-03-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	16	12	—	—	$177,166.52	$345,498.86	$184,740.90	2026-03-01
5833	APR_DRG	Neonate With Ecmo	1	1	—	—	$182,534.43	$182,534.43	$182,534.43	2026-03-01
5884	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	1	1	—	—	$179,983.28	$179,983.28	$179,983.28	2026-03-01
01907	OTHER	New Technology - Level 52	1	1	—	—	$168,540.50	$168,540.50	$168,540.50	2026-03-01
01908	OTHER	New Technology - Level 52	1	1	—	—	$168,540.50	$168,540.50	$168,540.50	2026-03-01
1908	OTHER	New Technology - Level 52	13	12	$198,218.93	—	$24,474.04	$195,792.36	$163,160.30	2026-07-31
1907	OTHER	New Technology - Level 52	13	12	$198,218.93	—	$24,474.04	$195,792.36	$163,160.30	2026-07-31
24	APR_DRG	Heart And/or Lung Transplant	1	1	—	—	$162,058.85	$162,058.85	$162,058.85	2026-03-01
003	OTHER	$1,418.00	1	1	$404,952.00	—	$156,003.70	$156,003.70	$156,003.70	2026-07-31
01905	OTHER	New Technology - Level 51	1	1	—	—	$151,962.80	$151,962.80	$151,962.80	2026-03-01
01906	OTHER	New Technology - Level 51	1	1	—	—	$151,962.80	$151,962.80	$151,962.80	2026-03-01
435041	CDM	Kit Lo Prfl Comp Shth 7f	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
C2624	HCPCS	System Mntr 2x15mm 4.5cm	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
421214	CDM	Kit Cath Rt Heart	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
576313	CDM	Set Vntrc Asst 2.5in	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
435578	CDM	Cath Vasc Assist Strl	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
920215	CDM	Kit Cath Rt Heart	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
418418	CDM	Pump Heart 21fr 85mm	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
439901	CDM	System Hrt Vlv Transcath	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
589717	CDM	Set Pump Asst 2.5in	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
418417	CDM	Kit Bld Pump Cann 29fr	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
589716	CDM	Set Vntrc 17.4x13.8in	22	16	$325,404.00	$325,404.00	$44,254.94	$325,404.00	$149,685.84	2026-03-01
437377	CDM	Valve Tavr 34mm	12	10	$242,000.00	$242,000.00	$50,578.00	$242,000.00	$148,830.00	2026-03-01
437378	CDM	Valve Tavr 29mm	12	10	$242,000.00	$242,000.00	$50,578.00	$242,000.00	$148,830.00	2026-03-01
409703	CDM	Genrator Imp Pulse 7	12	10	$242,000.00	$242,000.00	$50,578.00	$242,000.00	$148,830.00	2026-03-01
437039	CDM	Valve Tavr 26mm	12	10	$242,000.00	$242,000.00	$50,578.00	$242,000.00	$148,830.00	2026-03-01
C2616	HCPCS	Brachytx Ns Yttrium 90	103	9	$244,409.00	$244,409.00	$12,613.29	$221,924.00	$148,524.00	2026-07-31
1905	OTHER	New Technology - Level 51	13	12	$178,722.05	—	$22,066.77	$176,534.16	$147,111.80	2026-07-31
1906	OTHER	New Technology - Level 51	13	12	$178,722.05	—	$22,066.77	$176,534.16	$147,111.80	2026-07-31
410975	CDM	Stent Eprsth 40x40x20cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
578830	CDM	Valve Pulm 18mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
597719	CDM	Valve Tavr 26mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
593876	CDM	Valve Tavr 29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
594399	CDM	Valve Tavr 26mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
589828	CDM	Kit Aor Vlv 20fr 29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
419449	CDM	Valve Plm Trnscth 22mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410345	CDM	Occluder Cardiac Lt 18mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
413134	CDM	Valve Tavr 20mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
409893	CDM	Transcth Aortic Vlv 29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
409892	CDM	Transcth Aortic Vlv 27mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
437463	CDM	Stent Vasc 250mm 12mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
437689	CDM	Stnt Thorac 28x28mm 10cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
917536	CDM	Valve Tavr Sz 23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
417395	CDM	Valve Heart Trnscth 26mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410352	CDM	Occluder Cardiac Lt 34mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
583135	CDM	Valve Aor Tavr 23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410559	CDM	Stent Graft 10cm 21x21mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
416252	CDM	Valve Aor With Intro 25mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
590894	CDM	Valve Xt Sapien 26mm Ta	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
574447	CDM	Valve Aor 21mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
412374	CDM	Stent Eprsth 37x37x20cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
417394	CDM	Valve Heart Trnscth 23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
573152	CDM	Valve Aor Cndt 24mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
423155	CDM	Device Clsr 40mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
438779	CDM	Stent Vasc 600mm 40mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
587800	CDM	Valve Aor Tavr 23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
574759	CDM	Graft Art St Tis 6-32mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
419450	CDM	Valve Plm Trnscth 25mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
593933	CDM	Kit Aor Vlv 14fr 20mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
587801	CDM	Valve Aor Tavr 26mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410348	CDM	Occluder Cardiac Lt 25mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
416251	CDM	Valve Aor With Intro 23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
416371	CDM	Valve Aor Tavr 23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410209	CDM	Occluder Cardiac Lt 16mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
417746	CDM	Valve Aor Tavr 34mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
417744	CDM	Valve Aor Tavr 26mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
596320	CDM	Valve Tavr 34mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
481027	CDM	Valve Aor 25mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
438780	CDM	Stent Vasc Vo3	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
423154	CDM	Device Clsr 35mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
590895	CDM	Valve Xt Sapien 23mm Ta	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
409889	CDM	Transcth Aortic Vlv 23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
593480	CDM	Valve Tavr 23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410563	CDM	Stent 20fr 31x31mm 10cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
411366	CDM	Stent Eprsth 37x37x15cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
598198	CDM	Valve Pulm 24mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
417745	CDM	Valve Aor Tavr 29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
408706	CDM	Graft Evas 45x45mm 10cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
482967	CDM	Valve Tavr 29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
416373	CDM	Valve Aor Tavr 27mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
437462	CDM	Stent Vasc 600mm 50mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
598197	CDM	Valve Pulm 23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
423152	CDM	Device Clsr 27mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
416372	CDM	Valve Aor Tavr 25mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
418381	CDM	Stent Eprsth 34x34x20cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
593387	CDM	Kit Aor Vlv 14fr 29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
589825	CDM	Valve 29mm Ascendra Aor	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
593753	CDM	Valve 23mm Thv	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
589826	CDM	Valve Novaflx+ Trnfml 23	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
409890	CDM	Transcth Aortic Vlv 25mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410350	CDM	Occluder Cardiac Lt 31mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
407908	CDM	Valve Tavr 23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410347	CDM	Occluder Cardiac Lt 22mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
919971	CDM	Stnt Thorac 26x26mm 10cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
918199	CDM	Stent Graft 15cn 28x28mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
481469	CDM	Stent Thor 31x26mm 10cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
583134	CDM	Valve Aor Tavr 26mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
439727	CDM	Graft Evas 40x40x10cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
409871	CDM	Stent Eprsth 40x40x15cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410522	CDM	Stent Thor 20f 26x21x10	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
420974	CDM	Tavr Heart Valve 29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410349	CDM	Occluder Cardiac Lt 28mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
485896	CDM	Implant Generator Pulse	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
434124	CDM	System Trcsd 1clip 1cath	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
437762	CDM	Stent Vasc 250mm 16mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
917538	CDM	Valve Tavr Size 34mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
916616	CDM	Valve Tavr Sz 29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
407910	CDM	Valve Tavr 29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
589707	CDM	Valve Aor 26x20-23mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
407909	CDM	Valve Tavr 26mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
485167	CDM	Stent Eprsth 12x37mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
416253	CDM	Valve Aor With Intro 27mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
417393	CDM	Valve Heart Trnscth 20mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
589710	CDM	Valve Aor 23x18-20mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
437690	CDM	Graft Evas 34x34x10cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410562	CDM	Stent Eprsth 31x31x20cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
429795	CDM	Stent Eprsth 37x37x10cm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
410346	CDM	Occluder Cardiac Lt 20mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
917537	CDM	Valve Tavr Sz 26mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
439902	CDM	Valve Pulm 16mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
593386	CDM	Valve 26mm Thv	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
597871	CDM	Valve Tavr 29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
589706	CDM	Valve Aor 29x23-26mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
591646	CDM	Valve Aor 31x26-29mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
920463	CDM	Stent Graft 20cm 45x45mm	12	10	$233,280.00	$233,280.00	$48,755.52	$233,280.00	$143,467.20	2026-03-01
J7330	HCPCS	Autologous Cultured Chondrocytes, Implant	7	5	$134,810.16	—	$59,694.36	$180,011.44	$143,236.05	2026-07-31
1614	APR_DRG	Implantable Heart Assist Systems	1	1	—	—	$142,833.96	$142,833.96	$142,833.96	2026-03-01
C1822	HCPCS	Pulse Gen Imp	24	10	$228,033.00	$228,033.00	$46,562.27	$233,280.00	$140,161.59	2026-03-01
584033	CDM	Valve Aor Cndt 18mm	12	10	$227,160.00	$227,160.00	$47,476.44	$227,160.00	$139,703.40	2026-03-01
573151	CDM	Valve Aor Cndt 23mm	12	10	$227,160.00	$227,160.00	$47,476.44	$227,160.00	$139,703.40	2026-03-01
418382	CDM	Stent Graft 15cm 31x31mm	12	10	$222,192.00	$222,192.00	$46,438.13	$222,192.00	$136,648.08	2026-03-01
485245	CDM	Stent Graft 15cm 40x34mm	12	10	$222,192.00	$222,192.00	$46,438.13	$222,192.00	$136,648.08	2026-03-01
418550	CDM	Stent 34mmx34mmx15cm	12	10	$222,192.00	$222,192.00	$46,438.13	$222,192.00	$136,648.08	2026-03-01
01904	OTHER	New Technology - Level 50	1	1	—	—	$135,385.10	$135,385.10	$135,385.10	2026-03-01
01903	OTHER	New Technology - Level 50	1	1	—	—	$135,385.10	$135,385.10	$135,385.10	2026-03-01
419840	CDM	Valve Aortic 27mm	12	10	$217,378.00	$217,378.00	$45,432.00	$217,378.00	$133,687.47	2026-03-01
419776	CDM	Valve Aortic 23mm	12	10	$217,378.00	$217,378.00	$45,432.00	$217,378.00	$133,687.47	2026-03-01
419839	CDM	Valve Aortic 25mm	12	10	$217,378.00	$217,378.00	$45,432.00	$217,378.00	$133,687.47	2026-03-01
419838	CDM	Valve Aortic 21mm	12	10	$217,378.00	$217,378.00	$45,432.00	$217,378.00	$133,687.47	2026-03-01
419512	CDM	Implant Cust Cranial Lge	12	10	$217,229.00	$217,229.00	$45,400.86	$217,229.00	$133,595.83	2026-03-01
C9150	HCPCS	Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose	1	1	—	—	$132,600.00	$132,600.00	$132,600.00	2026-03-01
1903	OTHER	New Technology - Level 50	13	12	$159,225.17	—	$19,659.49	$157,275.96	$131,063.30	2026-07-31
1904	OTHER	New Technology - Level 50	13	12	$159,225.17	—	$19,659.49	$157,275.96	$131,063.30	2026-07-31
581498	CDM	Valve Pulmonary >23mm	12	10	$211,478.00	$211,478.00	$44,198.90	$211,478.00	$130,058.97	2026-03-01
8412	APR_DRG	Extensive Third Degree Burns With Skin Graft	1	1	—	—	$129,533.11	$129,533.11	$129,533.11	2026-03-01
8411	APR_DRG	Extensive Third Degree Burns With Skin Graft	1	1	—	—	$129,533.11	$129,533.11	$129,533.11	2026-03-01
417834	CDM	Device Clsr 20mm	12	10	$210,409.00	$210,409.00	$43,975.48	$210,409.00	$129,401.54	2026-03-01
417836	CDM	Device Clsr 27mm	12	10	$210,409.00	$210,409.00	$43,975.48	$210,409.00	$129,401.54	2026-03-01
417838	CDM	Device Clsr 35mm	12	10	$210,409.00	$210,409.00	$43,975.48	$210,409.00	$129,401.54	2026-03-01
417835	CDM	Device Clsr 24mm	12	10	$210,409.00	$210,409.00	$43,975.48	$210,409.00	$129,401.54	2026-03-01
417837	CDM	Device Clsr 31mm	12	10	$210,409.00	$210,409.00	$43,975.48	$210,409.00	$129,401.54	2026-03-01
417735	CDM	Kit Impl Crnl Cstm Lg	12	10	$206,601.00	$206,601.00	$43,179.61	$206,601.00	$127,059.62	2026-03-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	23	15	—	—	$115,412.58	$311,100.00	$126,364.14	2026-03-01
594551	CDM	Valve Aor Cndt 9mm	12	10	$204,569.00	$204,569.00	$42,754.92	$204,569.00	$125,809.93	2026-03-01
597392	CDM	Valve Aor Cndt 10mm	12	10	$204,569.00	$204,569.00	$42,754.92	$204,569.00	$125,809.93	2026-03-01
586606	CDM	Valve Aor Cndt 14mm	12	10	$204,569.00	$204,569.00	$42,754.92	$204,569.00	$125,809.93	2026-03-01
586171	CDM	Valve Aor Cndt 11mm	12	10	$204,569.00	$204,569.00	$42,754.92	$204,569.00	$125,809.93	2026-03-01
594740	CDM	Valve Aor 12mm Av0012	12	10	$204,569.00	$204,569.00	$42,754.92	$204,569.00	$125,809.93	2026-03-01
593591	CDM	Valve Aor Cndt 17mm	12	10	$204,569.00	$204,569.00	$42,754.92	$204,569.00	$125,809.93	2026-03-01
8434	APR_DRG	Extensive Third Degree Burns Without Skin Graft	1	1	—	—	$124,196.61	$124,196.61	$124,196.61	2026-03-01
598338	CDM	Valve Aor Crvlv 9-17mm	12	10	$201,774.00	$201,774.00	$42,170.77	$201,774.00	$124,091.01	2026-03-01
5832	APR_DRG	Neonate With Ecmo	1	1	—	—	$123,852.29	$123,852.29	$123,852.29	2026-03-01
74	APR_DRG	Allogeneic Bone Marrow Transplant	1	1	—	—	$122,909.77	$122,909.77	$122,909.77	2026-03-01
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	1	1	—	—	$122,883.00	$122,883.00	$122,883.00	2026-03-01
A9543	HCPCS	Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil…	6	4	$141,717.88	—	$52,381.27	$157,514.42	$122,172.78	2026-07-31
004	OTHER	$1,418.00	1	1	$233,631.00	—	$121,826.50	$121,826.50	$121,826.50	2026-07-31
913728	CDM	Valve Mitral Size 33	12	10	$197,909.00	$197,909.00	$41,362.98	$197,909.00	$121,714.04	2026-03-01
598339	CDM	Valve Aortic 6-30mm	12	10	$196,029.00	$196,029.00	$40,970.06	$196,029.00	$120,557.83	2026-03-01
586414	CDM	Valve Aor Crvlv 26mm	12	10	$196,029.00	$196,029.00	$40,970.06	$196,029.00	$120,557.83	2026-03-01
595303	CDM	Valve Aortic 20mm	12	10	$196,029.00	$196,029.00	$40,970.06	$196,029.00	$120,557.83	2026-03-01
415919	CDM	Valve Aor Crvlvcndt 16mm	12	10	$196,029.00	$196,029.00	$40,970.06	$196,029.00	$120,557.83	2026-03-01
6094	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	1	1	—	—	$120,376.27	$120,376.27	$120,376.27	2026-03-01
J9999	HCPCS	Carmustine Wafers 8/box	11	9	$190,939.00	$190,939.00	$28,640.85	$190,939.00	$120,291.57	2026-03-01
423409	CDM	Bundle Surg Gd Mdl Cstm	22	16	$261,002.00	$261,002.00	$35,496.27	$261,002.00	$120,060.92	2026-03-01
913241	CDM	Coil Embol Neuro 4x2mm	12	10	$193,951.00	$193,951.00	$40,535.76	$193,951.00	$119,279.87	2026-03-01
01901	OTHER	New Technology - Level 49	1	1	—	—	$118,807.40	$118,807.40	$118,807.40	2026-03-01
01902	OTHER	New Technology - Level 49	1	1	—	—	$118,807.40	$118,807.40	$118,807.40	2026-03-01
C1882	HCPCS	Crt-d Crd 5.37x8.08x0.99	216	10	$220,338.00	$220,338.00	$33,015.31	$242,000.00	$118,483.50	2026-03-01
419694	CDM	Device Embl 10mm 2.5mm	12	10	$191,844.00	$191,844.00	$40,095.40	$191,844.00	$117,984.06	2026-03-01
411781	CDM	Graft Endo Aaa 28.5x12mm	12	10	$188,421.00	$188,421.00	$39,379.99	$188,421.00	$115,878.92	2026-03-01
918878	CDM	Graft Endo Aaa 26x12mm	12	10	$188,421.00	$188,421.00	$39,379.99	$188,421.00	$115,878.92	2026-03-01
411669	CDM	Graft Endo Aaa 36x14mm	12	10	$188,421.00	$188,421.00	$39,379.99	$188,421.00	$115,878.92	2026-03-01
913391	CDM	Graft Endo Aaa 23x12mm	12	10	$188,421.00	$188,421.00	$39,379.99	$188,421.00	$115,878.92	2026-03-01
914107	CDM	Graft Endo Aaa 32x14mm	12	10	$188,421.00	$188,421.00	$39,379.99	$188,421.00	$115,878.92	2026-03-01
1902	OTHER	New Technology - Level 49	13	12	$139,728.29	—	$17,252.22	$138,017.76	$115,014.80	2026-07-31
1901	OTHER	New Technology - Level 49	13	12	$139,728.29	—	$17,252.22	$138,017.76	$115,014.80	2026-07-31
7	MS_DRG	Lung Transplant	19	12	—	—	$109,230.05	$248,941.69	$114,860.47	2026-03-01
585062	CDM	Valve Aortic 13mm Cryo	12	10	$186,014.00	$186,014.00	$38,876.93	$186,014.00	$114,398.61	2026-03-01
303496	CDM	Valve Aortic =16mm	12	10	$182,197.00	$182,197.00	$38,079.17	$182,197.00	$112,051.15	2026-03-01
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	1	1	—	—	$111,058.85	$111,058.85	$111,058.85	2026-03-01
591903	CDM	Coil Embl 30x4mm	12	10	$180,507.00	$180,507.00	$37,725.96	$180,507.00	$111,011.80	2026-03-01
587841	CDM	Coil Embl 5x25mm	12	10	$180,507.00	$180,507.00	$37,725.96	$180,507.00	$111,011.80	2026-03-01
301096	CDM	Valve Pulmonary Sm	12	10	$180,401.00	$180,401.00	$37,703.81	$180,401.00	$110,946.62	2026-03-01
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	1	1	—	—	$109,710.92	$109,710.92	$109,710.92	2026-03-01
419710	CDM	Device Embl 3.75x16mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
420249	CDM	Device Embl 4.75mm 20mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419736	CDM	Device Embl 5mm 35mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
420247	CDM	Device Embl 3.25mm 14mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419732	CDM	Device Embl 5mm 18mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419719	CDM	Device Emb 4.25mm 16mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419705	CDM	Device Embl 3.5mm 16mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419700	CDM	Device Embl 3mm 14mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419731	CDM	Device Embl 5.0x16mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419697	CDM	Device Embl 2.5mm 20mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419702	CDM	Device Embl 3mm 18mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419709	CDM	Device Embl 3.75mm 14mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419720	CDM	Device Embl 4.25mm 18mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419707	CDM	Device Embl 3.5mm 20mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419727	CDM	Device Embl 4.75mm 16mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419734	CDM	Device Embl 5mm 25mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419728	CDM	Device Embl 4.75mm 18mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419699	CDM	Device Embl 3mm 10mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419712	CDM	Device Embl 4mm 12mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
421593	CDM	Device Embl 4mm 10mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
420246	CDM	Device Embl 3mm 12mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419703	CDM	Device Embl 3.25x12mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
420950	CDM	Device Embl 4.75mm 25mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419729	CDM	Device Embl 5mm 12mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419725	CDM	Device Embl 4.5mm 20mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419733	CDM	Device Embl 5.0x20mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419724	CDM	Device Embl 4.5mm 18mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419814	CDM	Device Embl 2.75mm 12mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419735	CDM	Device Embl 5.0x.0mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419714	CDM	Device Embl 4mm 16mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
420399	CDM	Device Embl 4.50x25mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419726	CDM	Device Embl 4.5mm 30mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419717	CDM	Device Embl 4mm 30mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419721	CDM	Device Embl 4.25mm 20mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419722	CDM	Device Embl 4.5mm 12mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419698	CDM	Device Embl 2.75mm 14mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419706	CDM	Device Embl 3.5mm 18mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419695	CDM	Device Embl 2.5mm 12mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
419715	CDM	Device Embl 4mm 18mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01
409561	CDM	Device Embl 3mm 30mm	12	10	$178,044.00	$178,044.00	$37,211.20	$178,044.00	$109,497.06	2026-03-01

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