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

RARITAN BAY MEDICAL CENTER

Perth Amboy, NJ · CCN 310039 · Rates published

52,438 distinct procedures filed
20 distinct payers
2,278,663 rate rows
2025-12-31 last MRF observed
Data quality

1,869,462 of 2,278,663 rate rows are consumer-grade (82.0%)

409,201 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 404,146
exceeds 10× this hospital's gross charge — excluded from medians 2,276
placeholder amount (≤ $0.02) — excluded from medians 1,064
per-diem day rate — not a per-procedure price 924
percent-of-charges filed in the dollar field — excluded from medians 520
template filing: same amount across many unrelated codes — excluded 271
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hackensackmeridianhealth.org/-/media/project/hmh/hmh/public/files/cdm/20260101/221487576-1770569832_hackensack-meridian-health_standardcharges.csv
Found on page https://www.hackensackmeridianhealth.org/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-19
Content fingerprint 532fb19e291c971a… · 2,188,309,931 bytes · first seen 2026-05-15

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 6 $4,377,500.00 $4,771,475.00 $4,377,500.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 7 $3,710,000.00 $4,452,000.00 $3,802,750.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 7 $3,685,266.67 $4,422,320.00 $3,777,398.33 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $3,324,571.90 $3,989,486.28 $3,407,686.20 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $3,261,355.00 $3,913,626.00 $3,342,888.88 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 7 $2,950,686.67 $3,540,824.00 $3,024,453.83 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 7 $2,452,115.60 $2,942,538.72 $2,513,418.49 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $2,332,000.00 $2,798,400.00 $2,390,300.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 8 $655,027.00 $924,744.00 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 10 $491,575.89 $922,082.02 $613,024.06 nat. median
$754,974
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 10 $460,390.31 $933,986.41 $574,133.80 nat. median
$674,188
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $460,071.38 $954,928.83 $573,736.07 nat. median
$625,184
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 9 $470,372.01 $674,570.57 $567,213.30 nat. median
$675,122
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 10 $453,115.01 $884,589.61 $565,061.06 nat. median
$634,511
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 10 $416,262.00 $878,671.10 $519,103.20 nat. median
$620,080
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 $4,529.00 $1,303,203.52 $343,792.20 nat. median
$370,174
0.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $270,375.00 $324,450.00 $277,134.38 nat. median
$324,450
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 16 $5,095.00 $1,064,226.54 $275,777.01 nat. median
$265,286
1.0× median
5834
APR_DRG 		1 $263,700.81 $263,700.81 $263,700.81 nat. median
$309,665
0.9× median
5884
APR_DRG 		1 $252,297.48 $252,297.48 $252,297.48 nat. median
$246,434
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 $5,095.00 $896,271.11 $232,381.29 nat. median
$206,368
1.1× median
0024
APR_DRG 		1 $217,484.20 $217,484.20 $217,484.20 nat. median
$372,987
0.6× median
5914
APR_DRG 		1 $211,881.29 $211,881.29 $211,881.29 nat. median
$164,279
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 16 $5,095.00 $809,707.28 $210,015.23 nat. median
$202,986
1.0× median
1614
APR_DRG 		1 $206,769.43 $206,769.43 $206,769.43 nat. median
$207,730
1.0× median
8414
APR_DRG 		1 $200,628.89 $200,628.89 $200,628.89 nat. median
$160,267
1.3× median
0034
APR_DRG 		1 $193,574.88 $193,574.88 $193,574.88 nat. median
$267,508
0.7× median
5883
APR_DRG 		1 $188,495.69 $188,495.69 $188,495.69 nat. median
$182,736
1.0× median
5833
APR_DRG 		1 $176,349.22 $176,349.22 $176,349.22 nat. median
$244,017
0.7× median
5934
APR_DRG 		1 $174,064.66 $174,064.66 $174,064.66 nat. median
$151,838
1.1× median
0014
APR_DRG 		1 $162,740.13 $162,740.13 $162,740.13 nat. median
$190,591
0.9× median
5913
APR_DRG 		1 $150,089.36 $150,089.36 $150,089.36 nat. median
$102,636
1.5× median
0064
APR_DRG 		1 $149,325.21 $149,325.21 $149,325.21 nat. median
$98,565
1.5× median
0044
APR_DRG 		1 $148,223.13 $148,223.13 $148,223.13 nat. median
$195,681
0.8× median
6094
APR_DRG 		1 $146,310.46 $146,310.46 $146,310.46 nat. median
$162,982
0.9× median
5891
APR_DRG 		1 $145,878.54 $145,878.54 $145,878.54 nat. median
$93,260
1.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 $5,095.00 $533,845.53 $138,739.07 nat. median
$133,176
1.0× median
0023
APR_DRG 		1 $137,941.74 $137,941.74 $137,941.74 nat. median
$167,082
0.8× median
6034
APR_DRG 		1 $137,867.36 $137,867.36 $137,867.36 nat. median
$109,499
1.3× median
6024
APR_DRG 		1 $134,052.13 $134,052.13 $134,052.13 nat. median
$118,620
1.1× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $132,999.99 $132,999.99 $132,999.99 nat. median
$111,989
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 15 $4,529.00 $458,724.00 $128,117.07 nat. median
$117,303
1.1× median
7
MS_DRG 		Lung Transplant 15 $5,095.00 $451,605.45 $127,212.85 nat. median
$122,708
1.0× median
5933
APR_DRG 		1 $121,880.62 $121,880.62 $121,880.62 nat. median
$108,996
1.1× median
5912
APR_DRG 		1 $120,867.52 $120,867.52 $120,867.52 nat. median
$81,294
1.5× median
1604
APR_DRG 		1 $120,599.67 $120,599.67 $120,599.67 nat. median
$97,957
1.2× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 16 $5,095.00 $515,244.00 $118,229.68 nat. median
$108,660
1.1× median
0033
APR_DRG 		1 $117,474.67 $117,474.67 $117,474.67 nat. median
$144,032
0.8× median
0022
APR_DRG 		1 $114,790.35 $114,790.35 $114,790.35 nat. median
$140,623
0.8× median
6304
APR_DRG 		1 $112,312.06 $112,312.06 $112,312.06 nat. median
$150,721
0.7× median

Other procedures at this hospital

Browse this hospital's 52,438 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
             
0011 APR_DRG — 1 1 — — $73,702.97 $73,702.97 $73,702.97 2025-12-31
0012 APR_DRG — 1 1 — — $78,039.67 $78,039.67 $78,039.67 2025-12-31
0013 APR_DRG — 1 1 — — $91,727.50 $91,727.50 $91,727.50 2025-12-31
0014 APR_DRG — 1 1 — — $162,740.13 $162,740.13 $162,740.13 2025-12-31
0021 APR_DRG — 1 1 — — $89,049.08 $89,049.08 $89,049.08 2025-12-31
0022 APR_DRG — 1 1 — — $114,790.35 $114,790.35 $114,790.35 2025-12-31
0023 APR_DRG — 1 1 — — $137,941.74 $137,941.74 $137,941.74 2025-12-31
0024 APR_DRG — 1 1 — — $217,484.20 $217,484.20 $217,484.20 2025-12-31
0031 APR_DRG — 1 1 — — $57,800.22 $57,800.22 $57,800.22 2025-12-31
0032 APR_DRG — 1 1 — — $71,432.12 $71,432.12 $71,432.12 2025-12-31
0033 APR_DRG — 1 1 — — $117,474.67 $117,474.67 $117,474.67 2025-12-31
0034 APR_DRG — 1 1 — — $193,574.88 $193,574.88 $193,574.88 2025-12-31
0041 APR_DRG — 1 1 — — $52,199.42 $52,199.42 $52,199.42 2025-12-31
0042 APR_DRG — 1 1 — — $71,018.46 $71,018.46 $71,018.46 2025-12-31
0043 APR_DRG — 1 1 — — $103,021.79 $103,021.79 $103,021.79 2025-12-31
0044 APR_DRG — 1 1 — — $148,223.13 $148,223.13 $148,223.13 2025-12-31
0051 APR_DRG — 1 1 — — $50,138.76 $50,138.76 $50,138.76 2025-12-31
0052 APR_DRG — 1 1 — — $55,709.77 $55,709.77 $55,709.77 2025-12-31
0053 APR_DRG — 1 1 — — $68,179.05 $68,179.05 $68,179.05 2025-12-31
0054 APR_DRG — 1 1 — — $99,581.27 $99,581.27 $99,581.27 2025-12-31
0061 APR_DRG — 1 1 — — $60,029.49 $60,029.49 $60,029.49 2025-12-31
0062 APR_DRG — 1 1 — — $84,402.89 $84,402.89 $84,402.89 2025-12-31
0063 APR_DRG — 1 1 — — $94,371.46 $94,371.46 $94,371.46 2025-12-31
0064 APR_DRG — 1 1 — — $149,325.21 $149,325.21 $149,325.21 2025-12-31
0187433001 NDC Isoproterenol Hcl 0.2 Mg/ml Ij Soln 27 13 $65,582.32 — $8,722.45 $63,352.52 $51,114.86 2025-12-31
0204 APR_DRG — 1 1 — — $67,081.58 $67,081.58 $67,081.58 2025-12-31
0214 APR_DRG — 1 1 — — $74,949.77 $74,949.77 $74,949.77 2025-12-31
0224 APR_DRG — 1 1 — — $65,639.90 $65,639.90 $65,639.90 2025-12-31
0234 APR_DRG — 1 1 — — $71,718.22 $71,718.22 $71,718.22 2025-12-31
0244 APR_DRG — 1 1 — — $63,665.98 $63,665.98 $63,665.98 2025-12-31
0264 APR_DRG — 1 1 — — $53,013.60 $53,013.60 $53,013.60 2025-12-31
0494 APR_DRG — 1 1 — — $47,080.50 $47,080.50 $47,080.50 2025-12-31
0571T HCPCS Insj/rplcmt Icds W/substernal Electrode 36 18 $66,076.00 $35,518.46 46% off $8,788.11 $64,285.34 $51,321.22 2025-12-31
0704 APR_DRG — 1 1 — — $55,816.05 $55,816.05 $55,816.05 2025-12-31
0795T HCPCS Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys 36 18 $62,030.00 $21,127.41 66% off $8,249.99 $60,348.99 $48,178.70 2025-12-31
0894 APR_DRG — 1 1 — — $65,617.60 $65,617.60 $65,617.60 2025-12-31
0904 APR_DRG — 1 1 — — $75,795.15 $75,795.15 $75,795.15 2025-12-31
0914 APR_DRG — 1 1 — — $58,781.28 $58,781.28 $58,781.28 2025-12-31
0924 APR_DRG — 1 1 — — $51,793.13 $51,793.13 $51,793.13 2025-12-31
0974 APR_DRG — 1 1 — — $48,524.75 $48,524.75 $48,524.75 2025-12-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 31 16 — $243,649.60 $5,095.00 $1,064,226.54 $275,777.01 2025-12-31
10 MS_DRG Pancreas Transplant 28 15 — $68,964.70 $5,095.00 $275,514.99 $78,278.74 2025-12-31
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 31 16 — $46,673.35 $5,095.00 $203,862.50 $53,479.25 2025-12-31
1204 APR_DRG — 1 1 — — $55,710.28 $55,710.28 $55,710.28 2025-12-31
1214 APR_DRG — 1 1 — — $48,251.97 $48,251.97 $48,251.97 2025-12-31
1304 APR_DRG — 1 1 — — $52,723.65 $52,723.65 $52,723.65 2025-12-31
14 MS_DRG Allogeneic Bone Marrow Transplant 28 15 — $113,327.69 $4,529.00 $458,724.00 $128,117.07 2025-12-31
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 28 15 — $52,209.21 $4,529.00 $251,021.00 $59,455.27 2025-12-31
1603 APR_DRG — 1 1 — — $54,152.64 $54,152.64 $54,152.64 2025-12-31
1604 APR_DRG — 1 1 — — $120,599.67 $120,599.67 $120,599.67 2025-12-31
1612 APR_DRG — 1 1 — — $53,580.62 $53,580.62 $53,580.62 2025-12-31
1613 APR_DRG — 1 1 — — $86,171.67 $86,171.67 $86,171.67 2025-12-31
1614 APR_DRG — 1 1 — — $206,769.43 $206,769.43 $206,769.43 2025-12-31
1622 APR_DRG — 1 1 — — $49,353.92 $49,353.92 $49,353.92 2025-12-31
1623 APR_DRG — 1 1 — — $65,316.51 $65,316.51 $65,316.51 2025-12-31
1624 APR_DRG — 1 1 — — $102,733.00 $102,733.00 $102,733.00 2025-12-31
1633 APR_DRG — 1 1 — — $54,066.86 $54,066.86 $54,066.86 2025-12-31
1634 APR_DRG — 1 1 — — $87,115.71 $87,115.71 $87,115.71 2025-12-31
1653 APR_DRG — 1 1 — — $52,532.23 $52,532.23 $52,532.23 2025-12-31
1654 APR_DRG — 1 1 — — $78,201.62 $78,201.62 $78,201.62 2025-12-31
1664 APR_DRG — 1 1 — — $68,426.46 $68,426.46 $68,426.46 2025-12-31
1674 APR_DRG — 1 1 — — $79,431.83 $79,431.83 $79,431.83 2025-12-31
1694 APR_DRG — 1 1 — — $66,523.20 $66,523.20 $66,523.20 2025-12-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 28 15 — $52,209.21 $4,529.00 $208,576.56 $59,455.27 2025-12-31
1704 APR_DRG — 1 1 — — $48,989.46 $48,989.46 $48,989.46 2025-12-31
1754 APR_DRG — 1 1 — — $50,508.59 $50,508.59 $50,508.59 2025-12-31
1764 APR_DRG — 1 1 — — $48,030.24 $48,030.24 $48,030.24 2025-12-31
1774 APR_DRG — 1 1 — — $46,419.18 $46,419.18 $46,419.18 2025-12-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 22 14 — $326,207.42 $4,529.00 $1,303,203.52 $343,792.20 2025-12-31
1814 APR_DRG — 1 1 — — $60,202.85 $60,202.85 $60,202.85 2025-12-31
1824 APR_DRG — 1 1 — — $54,930.37 $54,930.37 $54,930.37 2025-12-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 24 15 — $68,569.40 $5,095.00 $299,501.32 $75,346.79 2025-12-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 31 16 — $95,317.98 $5,095.00 $515,244.00 $118,229.68 2025-12-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 31 16 — $69,726.74 $5,095.00 $400,186.00 $83,129.44 2025-12-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 31 16 — $55,939.86 $4,529.00 $244,337.28 $63,936.98 2025-12-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 31 16 — $47,809.93 $5,095.00 $303,464.00 $59,740.30 2025-12-31
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 22 14 — $94,229.84 $5,095.00 $411,582.44 $105,201.01 2025-12-31
215 MS_DRG Other Heart Assist System Implant 32 16 — $91,642.69 $5,095.00 $494,646.00 $103,755.68 2025-12-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 16 — $83,479.89 $5,095.00 $376,985.00 $94,585.42 2025-12-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 16 — $55,859.41 $5,095.00 $244,242.00 $63,555.99 2025-12-31
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 16 — $51,460.14 $5,095.00 $226,681.00 $58,613.74 2025-12-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 32 16 — $66,927.67 $5,095.00 $295,250.00 $75,990.30 2025-12-31
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 32 16 — $45,815.29 $5,095.00 $200,114.62 $52,988.26 2025-12-31
2204 APR_DRG — 1 1 — — $64,483.36 $64,483.36 $64,483.36 2025-12-31
2214 APR_DRG — 1 1 — — $57,372.14 $57,372.14 $57,372.14 2025-12-31
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $67,832.80 $67,832.80 $67,832.80 2025-12-31
2224 APR_DRG — 1 1 — — $51,822.21 $51,822.21 $51,822.21 2025-12-31
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $50,039.09 $50,039.09 $50,039.09 2025-12-31
2234 APR_DRG — 1 1 — — $50,427.49 $50,427.49 $50,427.49 2025-12-31
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 1 — — $59,303.26 $59,303.26 $59,303.26 2025-12-31
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 1 — — $53,258.71 $53,258.71 $53,258.71 2025-12-31
228 MS_DRG Other Cardiothoracic Procedures With Mcc 32 16 — $43,104.45 $5,095.00 $252,434.00 $50,207.78 2025-12-31
2294 APR_DRG — 1 1 — — $51,611.19 $51,611.19 $51,611.19 2025-12-31
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 31 16 — $49,347.86 $5,095.00 $215,544.38 $56,497.57 2025-12-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 32 16 — $73,297.37 $5,095.00 $322,400.00 $83,146.17 2025-12-31
232 MS_DRG Coronary Bypass With Ptca Without Mcc 32 16 — $52,838.91 $5,095.00 $236,473.00 $60,162.70 2025-12-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 32 16 — $67,610.14 $5,095.00 $295,311.41 $76,757.00 2025-12-31
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 32 16 — $46,018.56 $5,095.00 $201,002.48 $53,219.75 2025-12-31
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 32 16 — $50,897.04 $5,095.00 $223,019.00 $57,981.15 2025-12-31
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 31 16 — $43,568.08 $5,095.00 $190,299.12 $49,974.79 2025-12-31
245 MS_DRG Aicd Generator Procedures 33 17 — $42,269.74 $5,095.00 $192,394.00 $48,068.56 2025-12-31
2604 APR_DRG — 1 1 — — $67,604.46 $67,604.46 $67,604.46 2025-12-31
2614 APR_DRG — 1 1 — — $51,734.64 $51,734.64 $51,734.64 2025-12-31
2624 APR_DRG — 1 1 — — $47,094.60 $47,094.60 $47,094.60 2025-12-31
2644 APR_DRG — 1 1 — — $54,620.31 $54,620.31 $54,620.31 2025-12-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 31 16 — $51,819.10 $5,095.00 $276,053.00 $59,286.50 2025-12-31
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 31 16 — $40,694.62 $5,095.00 $224,485.00 $46,731.95 2025-12-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 32 16 — $57,673.27 $5,095.00 $257,328.00 $65,593.71 2025-12-31
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 32 16 — $44,399.32 $5,095.00 $194,298.00 $50,681.48 2025-12-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 22 14 — $61,128.00 $5,095.00 $266,998.33 $68,523.11 2025-12-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc 22 14 — $53,580.20 $5,095.00 $234,030.63 $60,159.91 2025-12-31
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 22 14 — $43,277.44 $5,095.00 $189,029.68 $48,744.14 2025-12-31
28 MS_DRG Spinal Procedures With Mcc 31 16 — $52,586.34 $5,095.00 $229,689.59 $60,152.37 2025-12-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 31 16 — $185,378.63 $5,095.00 $809,707.28 $210,015.23 2025-12-31
3031 APR_DRG — 1 1 — — $46,424.30 $46,424.30 $46,424.30 2025-12-31
3032 APR_DRG — 1 1 — — $55,863.97 $55,863.97 $55,863.97 2025-12-31
3033 APR_DRG — 1 1 — — $81,846.38 $81,846.38 $81,846.38 2025-12-31
3034 APR_DRG — 1 1 — — $111,181.99 $111,181.99 $111,181.99 2025-12-31
3043 APR_DRG — 1 1 — — $50,900.66 $50,900.66 $50,900.66 2025-12-31
3044 APR_DRG — 1 1 — — $84,775.16 $84,775.16 $84,775.16 2025-12-31
3054 APR_DRG — 1 1 — — $50,143.05 $50,143.05 $50,143.05 2025-12-31
3094 APR_DRG — 1 1 — — $52,525.18 $52,525.18 $52,525.18 2025-12-31
3124 APR_DRG — 1 1 — — $84,333.89 $84,333.89 $84,333.89 2025-12-31
3134 APR_DRG — 1 1 — — $48,279.58 $48,279.58 $48,279.58 2025-12-31
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 22 14 — $53,511.00 $5,095.00 $233,728.38 $60,083.24 2025-12-31
3174 APR_DRG — 1 1 — — $51,007.01 $51,007.01 $51,007.01 2025-12-31
3214 APR_DRG — 1 1 — — $68,449.71 $68,449.71 $68,449.71 2025-12-31
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 31 16 — $43,932.23 $5,095.00 $201,753.00 $50,385.76 2025-12-31
33231 HCPCS Ins Pacng Cvdfb Pls Gen Only W/exist Multi Leads 38 19 $75,878.00 $35,518.46 53% off $422.73 $135,136.00 $53,683.68 2025-12-31
3614 APR_DRG — 1 1 — — $57,798.17 $57,798.17 $57,798.17 2025-12-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 31 16 — $122,221.39 $5,095.00 $533,845.53 $138,739.07 2025-12-31
4014 APR_DRG — 1 1 — — $72,817.49 $72,817.49 $72,817.49 2025-12-31
4034 APR_DRG — 1 1 — — $61,677.07 $61,677.07 $61,677.07 2025-12-31
4044 APR_DRG — 1 1 — — $50,631.08 $50,631.08 $50,631.08 2025-12-31
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 31 16 — $46,957.06 $5,095.00 $206,482.00 $53,799.44 2025-12-31
4054 APR_DRG — 1 1 — — $54,121.00 $54,121.00 $54,121.00 2025-12-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 14 — $90,609.91 $5,095.00 $395,771.09 $101,190.02 2025-12-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 14 — $61,436.79 $5,095.00 $268,347.11 $68,865.27 2025-12-31
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 14 — $47,609.25 $5,095.00 $207,950.40 $53,543.92 2025-12-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 22 14 — $72,144.36 $5,095.00 $315,116.21 $80,729.59 2025-12-31
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 22 14 — $47,318.62 $5,095.00 $206,680.96 $53,221.88 2025-12-31
4401 APR_DRG — 1 1 — — $49,888.27 $49,888.27 $49,888.27 2025-12-31
4402 APR_DRG — 1 1 — — $52,201.02 $52,201.02 $52,201.02 2025-12-31
4403 APR_DRG — 1 1 — — $59,027.41 $59,027.41 $59,027.41 2025-12-31
4404 APR_DRG — 1 1 — — $93,448.69 $93,448.69 $93,448.69 2025-12-31
4414 APR_DRG — 1 1 — — $62,422.19 $62,422.19 $62,422.19 2025-12-31
4424 APR_DRG — 1 1 — — $48,255.42 $48,255.42 $48,255.42 2025-12-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 22 14 — $57,994.18 $5,095.00 $253,310.27 $65,050.75 2025-12-31
4474 APR_DRG — 1 1 — — $50,353.69 $50,353.69 $50,353.69 2025-12-31
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 22 14 — $44,547.23 $5,095.00 $194,575.93 $50,151.10 2025-12-31
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 2 1 — — $74,055.37 $74,055.37 $74,055.37 2025-12-31
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 2 1 — — $49,120.81 $49,120.81 $49,120.81 2025-12-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 34 18 — $73,256.72 $5,095.00 $350,280.00 $83,100.49 2025-12-31
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 34 18 — $49,644.55 $5,095.00 $251,221.00 $57,349.06 2025-12-31
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 1 — — $54,225.32 $54,225.32 $54,225.32 2025-12-31
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 35 18 — $53,081.10 $5,095.00 $231,850.66 $59,054.99 2025-12-31
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 31 16 — $46,717.46 $5,095.00 $204,055.18 $53,529.04 2025-12-31
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 35 18 — $44,067.17 $5,095.00 $196,275.00 $49,159.74 2025-12-31
471 MS_DRG Cervical Spinal Fusion With Mcc 34 18 — $42,014.58 $5,095.00 $192,341.00 $48,659.97 2025-12-31
4804 APR_DRG — 1 1 — — $50,470.03 $50,470.03 $50,470.03 2025-12-31
4834 APR_DRG — 1 1 — — $61,065.84 $61,065.84 $61,065.84 2025-12-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 29 15 — $92,114.97 $5,095.00 $393,629.00 $103,810.05 2025-12-31
5104 APR_DRG — 1 1 — — $65,389.67 $65,389.67 $65,389.67 2025-12-31
5114 APR_DRG — 1 1 — — $51,572.49 $51,572.49 $51,572.49 2025-12-31
5144 APR_DRG — 1 1 — — $50,075.46 $50,075.46 $50,075.46 2025-12-31
5184 APR_DRG — 1 1 — — $47,114.20 $47,114.20 $47,114.20 2025-12-31
5194 APR_DRG — 1 1 — — $49,022.97 $49,022.97 $49,022.97 2025-12-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 31 16 — $53,267.08 $5,095.00 $232,662.95 $60,920.61 2025-12-31
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 31 16 — $46,668.16 $5,095.00 $203,839.83 $53,473.40 2025-12-31
5831 APR_DRG — 1 1 — — $84,656.77 $84,656.77 $84,656.77 2025-12-31
5832 APR_DRG — 1 1 — — $94,063.12 $94,063.12 $94,063.12 2025-12-31
5833 APR_DRG — 1 1 — — $176,349.22 $176,349.22 $176,349.22 2025-12-31
5834 APR_DRG — 1 1 — — $263,700.81 $263,700.81 $263,700.81 2025-12-31
5881 APR_DRG — 1 1 — — $83,082.22 $83,082.22 $83,082.22 2025-12-31
5882 APR_DRG — 1 1 — — $92,313.61 $92,313.61 $92,313.61 2025-12-31
5883 APR_DRG — 1 1 — — $188,495.69 $188,495.69 $188,495.69 2025-12-31
5884 APR_DRG — 1 1 — — $252,297.48 $252,297.48 $252,297.48 2025-12-31
5891 APR_DRG — 1 1 — — $145,878.54 $145,878.54 $145,878.54 2025-12-31
5892 APR_DRG — 1 1 — — $102,326.58 $102,326.58 $102,326.58 2025-12-31
5893 APR_DRG — 1 1 — — $73,197.70 $73,197.70 $73,197.70 2025-12-31
5911 APR_DRG — 1 1 — — $87,118.91 $87,118.91 $87,118.91 2025-12-31
5912 APR_DRG — 1 1 — — $120,867.52 $120,867.52 $120,867.52 2025-12-31
5913 APR_DRG — 1 1 — — $150,089.36 $150,089.36 $150,089.36 2025-12-31
5914 APR_DRG — 1 1 — — $211,881.29 $211,881.29 $211,881.29 2025-12-31
5932 APR_DRG — 1 1 — — $91,513.46 $91,513.46 $91,513.46 2025-12-31
5933 APR_DRG — 1 1 — — $121,880.62 $121,880.62 $121,880.62 2025-12-31
5934 APR_DRG — 1 1 — — $174,064.66 $174,064.66 $174,064.66 2025-12-31
6 MS_DRG Liver Transplant Without Mcc 29 15 — $41,944.51 $5,095.00 $186,767.00 $47,704.86 2025-12-31
6022 APR_DRG — 1 1 — — $72,941.45 $72,941.45 $72,941.45 2025-12-31
6023 APR_DRG — 1 1 — — $96,830.97 $96,830.97 $96,830.97 2025-12-31
6024 APR_DRG — 1 1 — — $134,052.13 $134,052.13 $134,052.13 2025-12-31
6032 APR_DRG — 1 1 — — $53,287.15 $53,287.15 $53,287.15 2025-12-31
6033 APR_DRG — 1 1 — — $79,182.43 $79,182.43 $79,182.43 2025-12-31
6034 APR_DRG — 1 1 — — $137,867.36 $137,867.36 $137,867.36 2025-12-31
6072 APR_DRG — 1 1 — — $56,539.19 $56,539.19 $56,539.19 2025-12-31
6073 APR_DRG — 1 1 — — $76,571.53 $76,571.53 $76,571.53 2025-12-31
6074 APR_DRG — 1 1 — — $107,049.45 $107,049.45 $107,049.45 2025-12-31
6083 APR_DRG — 1 1 — — $68,126.13 $68,126.13 $68,126.13 2025-12-31
6084 APR_DRG — 1 1 — — $99,872.51 $99,872.51 $99,872.51 2025-12-31
6092 APR_DRG — 1 1 — — $49,458.47 $49,458.47 $49,458.47 2025-12-31
6093 APR_DRG — 1 1 — — $78,903.37 $78,903.37 $78,903.37 2025-12-31
6094 APR_DRG — 1 1 — — $146,310.46 $146,310.46 $146,310.46 2025-12-31
6113 APR_DRG — 1 1 — — $54,935.75 $54,935.75 $54,935.75 2025-12-31
6114 APR_DRG — 1 1 — — $86,306.97 $86,306.97 $86,306.97 2025-12-31
6123 APR_DRG — 1 1 — — $54,063.02 $54,063.02 $54,063.02 2025-12-31
6124 APR_DRG — 1 1 — — $82,929.75 $82,929.75 $82,929.75 2025-12-31
6133 APR_DRG — 1 1 — — $55,287.20 $55,287.20 $55,287.20 2025-12-31
6134 APR_DRG — 1 1 — — $73,712.19 $73,712.19 $73,712.19 2025-12-31
6144 APR_DRG — 1 1 — — $49,377.94 $49,377.94 $49,377.94 2025-12-31
6214 APR_DRG — 1 1 — — $71,101.74 $71,101.74 $71,101.74 2025-12-31
6224 APR_DRG — 1 1 — — $55,135.69 $55,135.69 $55,135.69 2025-12-31
6234 APR_DRG — 1 1 — — $54,396.08 $54,396.08 $54,396.08 2025-12-31
6303 APR_DRG — 1 1 — — $48,975.11 $48,975.11 $48,975.11 2025-12-31
6304 APR_DRG — 1 1 — — $112,312.06 $112,312.06 $112,312.06 2025-12-31
6314 APR_DRG — 1 1 — — $99,707.29 $99,707.29 $99,707.29 2025-12-31
6334 APR_DRG — 1 1 — — $50,964.34 $50,964.34 $50,964.34 2025-12-31
6344 APR_DRG — 1 1 — — $53,865.45 $53,865.45 $53,865.45 2025-12-31
6504 APR_DRG — 1 1 — — $50,515.77 $50,515.77 $50,515.77 2025-12-31
6514 APR_DRG — 1 1 — — $54,682.96 $54,682.96 $54,682.96 2025-12-31
653 MS_DRG Major Bladder Procedures With Mcc 31 16 — $48,219.06 $5,095.00 $210,701.00 $55,223.67 2025-12-31
6804 APR_DRG — 1 1 — — $73,073.87 $73,073.87 $73,073.87 2025-12-31
6814 APR_DRG — 1 1 — — $69,072.03 $69,072.03 $69,072.03 2025-12-31
6904 APR_DRG — 1 1 — — $78,823.04 $78,823.04 $78,823.04 2025-12-31
6954 APR_DRG — 1 1 — — $65,438.74 $65,438.74 $65,438.74 2025-12-31
7 MS_DRG Lung Transplant 29 15 — $113,042.24 $5,095.00 $451,605.45 $127,212.85 2025-12-31
7104 APR_DRG — 1 1 — — $54,099.41 $54,099.41 $54,099.41 2025-12-31
7114 APR_DRG — 1 1 — — $54,186.53 $54,186.53 $54,186.53 2025-12-31
7404 APR_DRG — 1 1 — — $54,374.62 $54,374.62 $54,374.62 2025-12-31
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 29 15 — $51,421.21 $4,529.00 $224,600.49 $59,907.23 2025-12-31
7914 APR_DRG — 1 1 — — $50,463.69 $50,463.69 $50,463.69 2025-12-31
799 MS_DRG Splenic Procedures With Mcc 31 16 — $41,127.97 $5,095.00 $180,476.00 $47,221.02 2025-12-31
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 28 15 — $47,064.32 $5,095.00 $201,488.00 $53,675.39 2025-12-31
8010000020-108127 CDM Live Donor Kidney Acquisition 29 13 $88,000.00 — $11,704.00 $85,615.20 $71,658.40 2025-12-31
8010000021-108126 CDM Cadaver Donor Kidney Acquisit 29 13 $93,500.00 — $12,435.50 $90,966.15 $76,137.05 2025-12-31
8010000023-108124 CDM Cadaver Kidney/pancreas Acquis 29 13 $80,453.00 — $10,700.25 $78,272.72 $65,512.88 2025-12-31
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 31 16 — $50,361.61 $5,095.00 $219,972.32 $57,641.65 2025-12-31
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 31 16 — $40,476.65 $5,095.00 $176,796.19 $46,485.96 2025-12-31
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 31 16 — $41,307.02 $5,095.00 $189,930.00 $47,423.08 2025-12-31
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 31 16 — $47,809.93 $4,529.00 $211,422.00 $54,761.94 2025-12-31
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 31 16 — $43,311.18 $4,529.00 $206,290.00 $49,684.88 2025-12-31
8411 APR_DRG — 1 1 — — $49,537.01 $49,537.01 $49,537.01 2025-12-31
8412 APR_DRG — 1 1 — — $50,392.83 $50,392.83 $50,392.83 2025-12-31
8413 APR_DRG — 1 1 — — $77,546.57 $77,546.57 $77,546.57 2025-12-31
8414 APR_DRG — 1 1 — — $200,628.89 $200,628.89 $200,628.89 2025-12-31
8424 APR_DRG — 1 1 — — $105,141.01 $105,141.01 $105,141.01 2025-12-31
8434 APR_DRG — 1 1 — — $51,463.97 $51,463.97 $51,463.97 2025-12-31
850 MS_DRG Acute Leukemia With Other Procedures 22 14 — $79,680.91 $5,095.00 $348,034.79 $89,080.33 2025-12-31
8504 APR_DRG — 1 1 — — $49,263.78 $49,263.78 $49,263.78 2025-12-31
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 31 16 — $43,260.14 $5,095.00 $194,122.00 $49,627.28 2025-12-31
8634 APR_DRG — 1 1 — — $95,498.84 $95,498.84 $95,498.84 2025-12-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 31 16 — $60,172.19 $4,529.00 $262,823.53 $68,713.39 2025-12-31
9103 APR_DRG — 1 1 — — $48,767.48 $48,767.48 $48,767.48 2025-12-31
9104 APR_DRG — 1 1 — — $100,740.12 $100,740.12 $100,740.12 2025-12-31
9114 APR_DRG — 1 1 — — $73,781.77 $73,781.77 $73,781.77 2025-12-31
9124 APR_DRG — 1 1 — — $73,375.09 $73,375.09 $73,375.09 2025-12-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 31 16 — $205,197.00 $5,095.00 $896,271.11 $232,381.29 2025-12-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 31 16 — $57,771.02 $5,095.00 $252,335.52 $66,003.54 2025-12-31
9504 APR_DRG — 1 1 — — $65,683.46 $65,683.46 $65,683.46 2025-12-31
9514 APR_DRG — 1 1 — — $48,095.65 $48,095.65 $48,095.65 2025-12-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 31 16 — $59,063.29 $5,095.00 $257,980.00 $67,461.93 2025-12-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 31 16 — $64,563.69 $5,095.00 $291,676.00 $73,669.42 2025-12-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 31 16 — $54,703.80 $5,095.00 $238,938.38 $62,542.03 2025-12-31
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 31 16 — $41,120.19 $5,095.00 $179,607.10 $47,212.23 2025-12-31
A9543 HCPCS Y-90 Yttrium Ibrit To 40 Mci Tx 66 19 $129,984.00 $56,824.55 56% off $10,098.00 $128,407.29 $56,824.55 2025-12-31
C1605 HCPCS System Leadless Pacemaker Aveir Dr 32 14 $118,965.00 — $18,439.58 $115,741.05 $61,058.79 2025-12-31
C1826 HCPCS Generator Neurostimulator Pain Management Closed Loop Evoke 3042 64 14 $101,640.00 — $15,217.84 $98,885.56 $50,255.52 2025-12-31
C1827 HCPCS Generator Neurostimulator Vagal Nerve Stimulator Permanent Pulse 32 14 $136,290.00 — $21,124.95 $132,596.54 $68,145.00 2025-12-31
E0194NU HCPCS Air Fluidized Bed 1 1 — — $59,056.79 $59,056.79 $59,056.79 2025-12-31
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 8 7 — $3,685,266.67 $3,685,266.67 $4,422,320.00 $3,777,398.33 2025-12-31
J1413 HCPCS Inj Delandistrogene Mox Rokl 8 7 — $3,324,571.90 $3,324,571.90 $3,989,486.28 $3,407,686.20 2025-12-31
J1414 HCPCS Inj, Beqvez, Per Tx Dose 8 7 — $3,710,000.00 $3,710,000.00 $4,452,000.00 $3,802,750.00 2025-12-31
J3391 HCPCS Inj, Atidarsagene Autotemcel 7 6 — $4,377,500.00 $4,377,500.00 $4,771,475.00 $4,377,500.00 2025-12-31
J3392 HCPCS Inj, Exagamglogene Autotem 8 7 — $2,332,000.00 $2,332,000.00 $2,798,400.00 $2,390,300.00 2025-12-31
J3393 HCPCS Inj, Betibeglogene Autotemce 8 7 — $2,950,686.67 $2,950,686.67 $3,540,824.00 $3,024,453.83 2025-12-31
J3394 HCPCS Inj, Lovotibeglogene Autotem 8 7 — $3,261,355.00 $3,261,355.00 $3,913,626.00 $3,342,888.88 2025-12-31
J3399 HCPCS Inj Onase Abepar-xioi Treat 8 7 — $2,452,115.60 $2,452,115.60 $2,942,538.72 $2,513,418.49 2025-12-31
J7330 HCPCS Graft Cartilage Membrane Collagen Maci 3x5cm 81073 60 14 $139,304.08 — $10,156.23 $134,567.74 $55,377.68 2025-12-31
J9029 HCPCS Instill Adstiladrin, Tx Dose 9 8 — $63,431.05 $53,916.39 $76,117.26 $63,431.05 2025-12-31
J9226 HCPCS Supprelin La Implant 12 10 — $45,560.39 $38,726.33 $93,292.40 $48,294.01 2025-12-31
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 1 1 — — $51,723.74 $51,723.74 $51,723.74 2025-12-31
L7181 HCPCS Electronic Elbo Simultaneous 2 2 — — $37,355.19 $74,831.36 $56,093.28 2025-12-31
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $82,339.68 $82,339.68 $82,339.68 2025-12-31
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $132,999.99 $132,999.99 $132,999.99 2025-12-31
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 12 10 — $533,076.48 $453,115.01 $884,589.61 $565,061.06 2025-12-31
Q2042 HCPCS Tisagenlecleucel Car-pos T 12 10 — $578,324.58 $491,575.89 $922,082.02 $613,024.06 2025-12-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 12 10 — $55,945.97 $47,554.07 $112,575.34 $59,302.73 2025-12-31
Q2053 HCPCS Brexucabtagene Car Pos T 12 10 — $489,720.00 $416,262.00 $878,671.10 $519,103.20 2025-12-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 12 10 — $541,635.66 $460,390.31 $933,986.41 $574,133.80 2025-12-31
Q2055 HCPCS Idecabtagene Vicleucel Car 12 10 — $541,260.45 $460,071.38 $954,928.83 $573,736.07 2025-12-31
Q2056 HCPCS Ciltacabtagene Car-pos T 10 9 — $553,378.83 $470,372.01 $674,570.57 $567,213.30 2025-12-31
Q2057 HCPCS Afamitresgene Autoleucel 9 8 — $770,620.00 $655,027.00 $924,744.00 $770,620.00 2025-12-31
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 8 7 — $270,375.00 $270,375.00 $324,450.00 $277,134.38 2025-12-31
Sx00000046460-81225 CDM Kit Starter Stapler Endowrist 45 27 12 $72,354.00 — $9,623.08 $70,393.21 $60,799.07 2025-12-31
Sx00000065138-76470 CDM Carticel Cs1000 32 14 $108,087.82 — $16,753.61 $105,158.64 $54,043.91 2025-12-31
Sx00000069838-74891 CDM Jts Implant Set 32 14 $172,360.00 — $26,715.80 $167,689.04 $86,180.00 2025-12-31
Sx00000075430-72942 CDM Ligasure Kit 27 12 $87,094.62 — $11,583.58 $84,734.36 $73,185.61 2025-12-31
Sx00000076504-72753 CDM Ligasure Kit Lf1744/gen 27 12 $79,401.17 — $10,560.36 $77,249.40 $66,720.80 2025-12-31
Sx00000102245-62927 CDM Custom Pelvis IMPLaNT 32 14 $112,294.40 — $17,405.63 $109,251.22 $56,147.20 2025-12-31
Sx00000201156-24772 CDM Repiphysis Total Femur 32 14 $99,200.00 — $15,376.00 $96,511.68 $49,600.00 2025-12-31
Sx00000295724-6449 CDM Probe Laser Diffusing Tip Neuroblate Nb3 Fullfire 1.6mm Ffd016 27 12 $58,260.16 — $7,748.60 $56,681.31 $48,956.01 2025-12-31
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