Hospital

LONG ISLAND COMMUNITY HOSPITAL

Patchogue, NY · CCN 330141 · Rates published

8,705 distinct procedures filed

28 distinct payers

348,809 rate rows

2026-05-06 last MRF observed

Data quality

280,208 of 348,809 rate rows are consumer-grade (80.3%)

68,601 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
placeholder amount (≤ $0.02) — excluded from medians	44,743
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	22,233
template filing: same amount across many unrelated codes — excluded	1,135
per-diem day rate — not a per-procedure price	464
percent-of-charges filed in the dollar field — excluded from medians	26

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

Source MRF file	https://app.vestacare.com/download/csv/11-1704595_longislandcommunityhospital_standardcharges.csv
Found on page	https://licommunityhospital.org/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	5ac3dea710d96627… · 381,329,181 bytes · first seen 2026-05-06

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
222 OTHER	Cardiovascular Diagnosis With Major Complications	4	$694,096.20	$694,096.20	$694,096.20	nat. median $4,745 outlier · 146.3×
224 OTHER	Cardiovascular Diagnosis With Complications	4	$530,701.92	$530,701.92	$530,701.92	nat. median $16,458 outlier · 32.2×
Q2041 OTHER	Axicabtagene Ciloleucel Intravenous Suspension	22	$244,727.98	$1,101,275.91	$489,455.96	nat. median $533,230 0.9× median
Q2053 OTHER	Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension	22	$230,265.20	$506,583.44	$460,530.40	nat. median $489,720 0.9× median
226 OTHER	Cardiovascular Diagnosis Without Complications	4	$371,640.15	$371,640.15	$371,640.15	nat. median $1,982 outlier · 187.6×
227 OTHER	Other Circulatory System Diagnosis With Complications	4	$345,437.19	$345,437.19	$345,437.19	nat. median $2,024 outlier · 170.7×
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	27	$171,350.43	$1,588,614.47	$342,700.86	nat. median $424,868 0.8× median
APR612 OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	9	$287,594.30	$287,594.30	$287,594.30	nat. median $287,594 1.0× median
APR405 OTHER	Other Procedures For Endocrine, Nutritional & Metabolic Disorders	9	$286,883.30	$286,883.30	$286,883.30	nat. median $286,883 1.0× median
APR169 OTHER	Major Abdominal Vascular Procedures	9	$283,107.80	$283,107.80	$283,107.80	nat. median $283,108 1.0× median
APR130 OTHER	Respiratory System Diagnosis W Ventilator Support 96+ Hours	9	$275,529.80	$275,529.80	$275,529.80	nat. median $275,530 1.0× median
APR176 OTHER	Cardiac Pacemaker & Defibrillator Device Replacement	9	$270,513.65	$270,513.65	$270,513.65	nat. median $270,514 1.0× median
APR304 OTHER	Dorsal & Lumbar Fusion Proc Except For Curvature Of Back	9	$269,953.85	$269,953.85	$269,953.85	nat. median $269,954 1.0× median
APR690 OTHER	Acute Leukemia	9	$268,161.05	$268,161.05	$268,161.05	nat. median $268,161 1.0× median
APR911 OTHER	Extensive Abdominal/thoracic Procedures For Mult Significant Trauma	9	$266,525.30	$266,525.30	$266,525.30	nat. median $266,525 1.0× median
APR680 OTHER	Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	9	$266,373.65	$266,373.65	$266,373.65	nat. median $266,374 1.0× median
APR815 OTHER	Other Injury, Poisoning & Toxic Effect Diagnoses	9	$265,998.80	$265,998.80	$265,998.80	nat. median $265,999 1.0× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	25	$126,084.32	$971,420.00	$252,168.64	nat. median $263,894 1.0× median
APR912 OTHER	Musculoskeletal & Other Procedures For Multiple Significant Trauma	9	$249,632.30	$249,632.30	$249,632.30	nat. median $249,632 1.0× median
APR181 OTHER	Lower Extremity Arterial Procedures #	9	$242,083.10	$242,083.10	$242,083.10	nat. median $242,083 1.0× median
APR020 OTHER	Craniotomy For Trauma	9	$237,031.85	$237,031.85	$237,031.85	nat. median $237,032 1.0× median
APR950 OTHER	Extensive Procedure Unrelated To Principal Diagnosis	9	$233,533.55	$233,533.55	$233,533.55	nat. median $233,534 1.0× median
APR167 OTHER	Other Cardiothoracic & Thoracic Vascular Procedures	9	$227,443.70	$227,443.70	$227,443.70	nat. median $227,444 1.0× median
APR024 OTHER	Extracranial Vascular Procedures	9	$221,266.55	$221,266.55	$221,266.55	nat. median $221,267 1.0× median
APR021 OTHER	Craniotomy Except For Trauma	9	$221,221.55	$221,221.55	$221,221.55	nat. median $221,222 1.0× median
APR710 OTHER	Infectious & Parasitic Diseases Including HIV W O.r. Procedure	9	$217,441.10	$217,441.10	$217,441.10	nat. median $217,441 1.0× median
APR163 OTHER	Cardiac Valve Procedures Without Ami Or Complex Pdx	9	$215,424.65	$215,424.65	$215,424.65	nat. median $215,425 1.0× median
APR182 OTHER	Other Peripheral Vascular Procedures #	9	$213,907.70	$213,907.70	$213,907.70	nat. median $213,908 1.0× median
APR165 OTHER	Coronary Bypass W Ami Or Complex Pdx	9	$208,368.65	$208,368.65	$208,368.65	nat. median $208,369 1.0× median
246 OTHER	Non-surgical Treatment Of Respiratory System With Major Complications	4	$202,671.63	$202,671.63	$202,671.63	nat. median $2,106 outlier · 96.3×
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	27	$99,241.29	$1,030,416.34	$198,482.59	nat. median $218,232 0.9× median
APR691 OTHER	Lymphoma, Myeloma & Non-acute Leukemia	9	$189,648.65	$189,648.65	$189,648.65	nat. median $189,649 1.0× median
APR622 OTHER	Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond	9	$182,371.70	$182,371.70	$182,371.70	nat. median $182,372 1.0× median
APR260 OTHER	Major Pancreas, Liver & Shunt Procedures	9	$180,090.20	$180,090.20	$180,090.20	nat. median $180,090 1.0× median
APR166 OTHER	Coronary Bypass Without Ami Or Complex Pdx	9	$179,225.30	$179,225.30	$179,225.30	nat. median $179,225 1.0× median
APR089 OTHER	Major Cranial/facial Bone Procedures	9	$177,744.80	$177,744.80	$177,744.80	nat. median $177,745 1.0× median
APR621 OTHER	Neonate Bwt 2000-2499g W Major Anomaly	9	$175,494.35	$175,494.35	$175,494.35	nat. median $175,494 1.0× median
APR695 OTHER	Chemotherapy For Acute Leukemia #	9	$171,365.60	$171,365.60	$171,365.60	nat. median $171,366 1.0× median
APR951 OTHER	Moderately Extensive Procedure Unrelated To Principal Diagnosis	9	$164,540.90	$164,540.90	$164,540.90	nat. median $164,541 1.0× median
APR092 OTHER	Facial Bone Procedures Except Major Cranial/facial Bone Procedures	9	$162,906.05	$162,906.05	$162,906.05	nat. median $162,906 1.0× median
APR791 OTHER	O.r. Procedure For Other Complications Of Treatment	9	$156,979.55	$156,979.55	$156,979.55	nat. median $156,980 1.0× median
APR175 OTHER	Percutaneous Coronary Intervention Without Ami	9	$156,652.85	$156,652.85	$156,652.85	nat. median $156,653 1.0× median
APR220 OTHER	Major Stomach, Esophageal & Duodenal Procedures	9	$155,750.60	$155,750.60	$155,750.60	nat. median $155,751 1.0× median
APR023 OTHER	Spinal Procedures	9	$154,953.20	$154,953.20	$154,953.20	nat. median $154,953 1.0× median
APR049 OTHER	Bacterial & Tuberculous Infections Of Nervous System	9	$154,058.15	$154,058.15	$154,058.15	nat. median $154,058 1.0× median
APR264 OTHER	Other Hepatobiliary, Pancreas & Abdominal Procedures	9	$153,412.85	$153,412.85	$153,412.85	nat. median $153,413 1.0× median
APR261 OTHER	Major Biliary Tract Procedures	9	$153,009.65	$153,009.65	$153,009.65	nat. median $153,010 1.0× median
APR441 OTHER	Major Bladder Procedures	9	$152,423.30	$152,423.30	$152,423.30	nat. median $152,423 1.0× median
APR177 OTHER	Cardiac Pacemaker & Defibrillator Revision Except Device Replacement	9	$150,677.30	$150,677.30	$150,677.30	nat. median $150,677 1.0× median
APR711 OTHER	Post-op, Post-trauma, Other Device Infections W O.r. Procedure	9	$147,145.25	$147,145.25	$147,145.25	nat. median $147,145 1.0× median

Other procedures at this hospital

Browse this hospital's 8,705 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

001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	36	25	—	—	$126,084.32	$971,420.00	$252,168.64	2026-05-06
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	36	25	—	—	$57,077.90	$380,028.00	$114,155.81	2026-05-06
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	39	27	—	—	$99,241.29	$1,030,416.34	$198,482.59	2026-05-06
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	39	27	—	—	$68,486.76	$642,786.93	$136,973.52	2026-05-06
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	36	25	—	—	$48,278.89	$367,258.00	$96,557.77	2026-05-06
007	OTHER	Lung Transplant	36	25	—	—	$57,181.50	$450,694.00	$114,363.00	2026-05-06
014	OTHER	Allogeneic Bone Marrow Transplant	39	27	—	—	$53,439.56	$451,832.00	$106,879.12	2026-05-06
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	39	27	—	—	$28,893.26	$208,156.00	$57,786.52	2026-05-06
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	39	27	—	—	$28,893.26	$76,208.00	$57,786.52	2026-05-06
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	39	27	—	—	$171,350.43	$1,588,614.47	$342,700.86	2026-05-06
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	39	27	—	—	$39,463.61	$331,578.21	$78,927.21	2026-05-06
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	39	27	—	—	$28,727.88	$190,616.00	$57,455.76	2026-05-06
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	39	27	—	—	$26,532.42	$261,271.11	$53,064.85	2026-05-06
028	OTHER	Spinal Procedures With Mcc	39	27	—	—	$28,192.26	$223,661.58	$56,384.51	2026-05-06
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	39	27	—	—	$32,289.12	$256,994.46	$64,578.23	2026-05-06
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	39	27	—	—	$50,233.25	$375,690.00	$100,466.49	2026-05-06
215	OTHER	Other Heart Assist System Implant	36	25	—	—	$47,650.82	$365,375.00	$95,301.63	2026-05-06
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	39	27	—	—	$45,283.94	$332,830.00	$90,567.88	2026-05-06
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	39	27	—	—	$29,768.01	$254,808.26	$59,536.01	2026-05-06
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	39	27	—	—	$26,662.03	$205,169.00	$53,324.06	2026-05-06
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	39	27	—	—	$36,020.37	$266,838.00	$72,040.74	2026-05-06
222	OTHER	Cardiovascular Diagnosis With Major Complications	6	4	—	—	$694,096.20	$694,096.20	$694,096.20	2026-05-06
224	OTHER	Cardiovascular Diagnosis With Complications	6	4	—	—	$530,701.92	$530,701.92	$530,701.92	2026-05-06
226	OTHER	Cardiovascular Diagnosis Without Complications	6	4	—	—	$371,640.15	$371,640.15	$371,640.15	2026-05-06
227	OTHER	Other Circulatory System Diagnosis With Complications	6	4	—	—	$345,437.19	$345,437.19	$345,437.19	2026-05-06
231	OTHER	Coronary Bypass With Ptca With Mcc	39	27	—	—	$37,897.14	$292,233.00	$75,794.29	2026-05-06
232	OTHER	Coronary Bypass With Ptca Without Mcc	39	27	—	—	$27,832.23	$218,075.71	$55,664.46	2026-05-06
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	39	27	—	—	$36,431.03	$269,559.00	$72,862.06	2026-05-06
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	39	27	—	—	$27,516.33	$202,924.00	$55,032.67	2026-05-06
246	OTHER	Non-surgical Treatment Of Respiratory System With Major Complications	6	4	—	—	$202,671.63	$202,671.63	$202,671.63	2026-05-06
247	OTHER	Non-surgical Treatment Of Respiratory System With Complications	6	4	—	—	$113,364.09	$113,364.09	$113,364.09	2026-05-06
248	OTHER	Non-surgical Treatment Of Respiratory System Without Complications	6	4	—	—	$81,361.35	$81,361.35	$81,361.35	2026-05-06
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	39	27	—	—	$29,214.26	$229,067.23	$58,428.53	2026-05-06
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	36	25	—	—	$32,041.51	$229,941.00	$64,083.02	2026-05-06
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	39	27	—	—	$32,882.81	$343,364.16	$65,765.61	2026-05-06
276	OTHER	Cardiac Defibrillator Implant With Mcc	39	27	—	—	$29,047.49	$303,185.24	$58,094.98	2026-05-06
338	OTHER	Major Respiratory Infections And Inflammations With Mcc	6	4	—	—	$107,701.02	$107,701.02	$107,701.02	2026-05-06
339	OTHER	Major Respiratory Infections And Inflammations With Cc	6	4	—	—	$100,779.84	$100,779.84	$100,779.84	2026-05-06
340	OTHER	Major Respiratory Infections And Inflammations Without Cc/mcc	6	4	—	—	$75,299.49	$75,299.49	$75,299.49	2026-05-06
341	OTHER	Other Respiratory System Diagnosis With Mcc	6	4	—	—	$88,902.45	$88,902.45	$88,902.45	2026-05-06
342	OTHER	Other Respiratory System Diagnosis With Cc	6	4	—	—	$70,138.53	$70,138.53	$70,138.53	2026-05-06
343	OTHER	Other Respiratory System Diagnosis Without Cc/mcc	6	4	—	—	$67,461.03	$67,461.03	$67,461.03	2026-05-06
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	33	25	—	—	$41,363.61	$239,116.02	$82,727.22	2026-05-06
454	OTHER	Combined Anterior And Posterior Spinal Fusion With Cc	33	25	—	—	$28,611.28	$165,042.24	$57,222.56	2026-05-06
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	36	25	—	—	$39,356.76	$292,071.00	$78,713.52	2026-05-06
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	36	25	—	—	$28,420.81	$197,931.00	$56,841.63	2026-05-06
459	OTHER	Spinal Fusion Except Cervical With Mcc	36	27	—	—	$31,008.35	$265,950.78	$62,016.70	2026-05-06
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	39	27	—	—	$31,873.34	$211,632.00	$63,746.68	2026-05-06
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	39	27	—	—	$26,508.73	$216,327.21	$53,017.46	2026-05-06
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	36	25	—	—	$29,084.19	$212,373.00	$58,168.38	2026-05-06
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	39	27	—	—	$26,598.85	$186,064.00	$53,197.71	2026-05-06
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	26	25	—	—	$24,041.00	$138,218.30	$56,142.95	2026-05-06
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	36	25	—	—	$28,287.96	$200,789.00	$56,575.91	2026-05-06
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	39	27	—	—	$32,553.44	$297,927.67	$65,106.88	2026-05-06
955	OTHER	Craniotomy For Multiple Significant Trauma	35	25	—	—	$28,490.03	$255,180.00	$56,980.06	2026-05-06
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	38	27	—	—	$33,796.57	$257,412.00	$67,593.15	2026-05-06
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	38	27	—	—	$32,124.66	$286,206.78	$64,249.32	2026-05-06
A9543	OTHER	Hc Y90 Ibritumomab, Rx	24	22	$563,122.20	$73,205.89 87% off	$300.00	$72,024.24	$65,476.58	2026-05-06
APR020	OTHER	Craniotomy For Trauma	9	9	—	—	$237,031.85	$237,031.85	$237,031.85	2026-05-06
APR021	OTHER	Craniotomy Except For Trauma	9	9	—	—	$221,221.55	$221,221.55	$221,221.55	2026-05-06
APR022	OTHER	Ventricular Shunt Procedures	9	9	—	—	$128,644.85	$128,644.85	$128,644.85	2026-05-06
APR023	OTHER	Spinal Procedures	9	9	—	—	$154,953.20	$154,953.20	$154,953.20	2026-05-06
APR024	OTHER	Extracranial Vascular Procedures	9	9	—	—	$221,266.55	$221,266.55	$221,266.55	2026-05-06
APR026	OTHER	Other Nervous System & Related Procedures	9	9	—	—	$143,161.85	$143,161.85	$143,161.85	2026-05-06
APR040	OTHER	Spinal Disorders & Injuries	9	9	—	—	$106,148.45	$106,148.45	$106,148.45	2026-05-06
APR041	OTHER	Nervous System Malignancy	9	9	—	—	$134,230.25	$134,230.25	$134,230.25	2026-05-06
APR042	OTHER	Degenerative Nervous System Disorders Exc Mult Sclerosis	9	9	—	—	$122,250.35	$122,250.35	$122,250.35	2026-05-06
APR043	OTHER	Multiple Sclerosis & Other Demyelinating Diseases	9	9	—	—	$94,584.35	$94,584.35	$94,584.35	2026-05-06
APR044	OTHER	Intracranial Hemorrhage	9	9	—	—	$124,852.70	$124,852.70	$124,852.70	2026-05-06
APR045	OTHER	Cva & Precerebral Occlusion W Infarct	9	9	—	—	$93,612.80	$93,612.80	$93,612.80	2026-05-06
APR048	OTHER	Peripheral, Cranial & Autonomic Nerve Disorders	9	9	—	—	$66,319.85	$66,319.85	$66,319.85	2026-05-06
APR049	OTHER	Bacterial & Tuberculous Infections Of Nervous System	9	9	—	—	$154,058.15	$154,058.15	$154,058.15	2026-05-06
APR050	OTHER	Non-bacterial Infections Of Nervous System Exc Viral Meningitis	9	9	—	—	$118,332.65	$118,332.65	$118,332.65	2026-05-06
APR051	OTHER	Viral Meningitis	9	9	—	—	$71,366.60	$71,366.60	$71,366.60	2026-05-06
APR052	OTHER	Nontraumatic Stupor & Coma	9	9	—	—	$76,664.45	$76,664.45	$76,664.45	2026-05-06
APR053	OTHER	Seizure	9	9	—	—	$59,807.00	$59,807.00	$59,807.00	2026-05-06
APR054	OTHER	Migraine & Other Headaches	9	9	—	—	$60,613.85	$60,613.85	$60,613.85	2026-05-06
APR055	OTHER	Head Trauma W Coma >1 Hr Or Hemorrhage	9	9	—	—	$74,337.50	$74,337.50	$74,337.50	2026-05-06
APR057	OTHER	Concussion, Closed Skull Fx Nos,uncomplicated Intracranial Injury, Coma < 1 Hr O…	9	9	—	—	$55,707.05	$55,707.05	$55,707.05	2026-05-06
APR058	OTHER	Other Disorders Of Nervous System	9	9	—	—	$93,013.40	$93,013.40	$93,013.40	2026-05-06
APR070	OTHER	Orbital Procedures	9	9	—	—	$99,065.00	$99,065.00	$99,065.00	2026-05-06
APR073	OTHER	Eye Procedures Except Orbit	9	9	—	—	$103,751.30	$103,751.30	$103,751.30	2026-05-06
APR082	OTHER	Eye Disorders Except Major Infections	9	9	—	—	$63,782.30	$63,782.30	$63,782.30	2026-05-06
APR089	OTHER	Major Cranial/facial Bone Procedures	9	9	—	—	$177,744.80	$177,744.80	$177,744.80	2026-05-06
APR090	OTHER	Major Larynx & Trachea Procedures	9	9	—	—	$139,851.20	$139,851.20	$139,851.20	2026-05-06
APR091	OTHER	Other Major Head & Neck Procedures	9	9	—	—	$113,134.70	$113,134.70	$113,134.70	2026-05-06
APR092	OTHER	Facial Bone Procedures Except Major Cranial/facial Bone Procedures	9	9	—	—	$162,906.05	$162,906.05	$162,906.05	2026-05-06
APR093	OTHER	Sinus & Mastoid Procedures	9	9	—	—	$99,942.05	$99,942.05	$99,942.05	2026-05-06
APR095	OTHER	Cleft Lip & Palate Repair	9	9	—	—	$72,632.45	$72,632.45	$72,632.45	2026-05-06
APR097	OTHER	Tonsil & Adenoid Procedures	9	9	—	—	$73,689.05	$73,689.05	$73,689.05	2026-05-06
APR098	OTHER	Other Ear, Nose, Mouth & Throat Procedures	9	9	—	—	$60,496.85	$60,496.85	$60,496.85	2026-05-06
APR110	OTHER	Ear, Nose, Mouth, Throat, Cranial/facial Malignancies	9	9	—	—	$74,458.55	$74,458.55	$74,458.55	2026-05-06
APR120	OTHER	Major Respiratory & Chest Procedures	9	9	—	—	$141,519.80	$141,519.80	$141,519.80	2026-05-06
APR121	OTHER	Other Respiratory & Chest Procedures	9	9	—	—	$126,878.15	$126,878.15	$126,878.15	2026-05-06
APR130	OTHER	Respiratory System Diagnosis W Ventilator Support 96+ Hours	9	9	—	—	$275,529.80	$275,529.80	$275,529.80	2026-05-06
APR132	OTHER	Bpd & Oth Chronic Respiratory Diseases Arising In Perinatal Period	9	9	—	—	$59,216.15	$59,216.15	$59,216.15	2026-05-06
APR133	OTHER	Respiratory Failure	9	9	—	—	$59,177.90	$59,177.90	$59,177.90	2026-05-06
APR134	OTHER	Pulmonary Embolism	9	9	—	—	$69,024.80	$69,024.80	$69,024.80	2026-05-06
APR135	OTHER	Major Chest & Respiratory Trauma	9	9	—	—	$58,683.80	$58,683.80	$58,683.80	2026-05-06
APR136	OTHER	Respiratory Malignancy	9	9	—	—	$89,180.30	$89,180.30	$89,180.30	2026-05-06
APR137	OTHER	Major Respiratory Infections & Inflammations	9	9	—	—	$68,127.50	$68,127.50	$68,127.50	2026-05-06
APR140	OTHER	Chronic Obstructive Pulmonary Disease	9	9	—	—	$54,508.70	$54,508.70	$54,508.70	2026-05-06
APR142	OTHER	Interstitial & Alveolar Lung Diseases	9	9	—	—	$81,862.85	$81,862.85	$81,862.85	2026-05-06
APR143	OTHER	Other Respiratory Diagnoses Except Signs, Symptoms & Minor Diagnoses	9	9	—	—	$66,012.50	$66,012.50	$66,012.50	2026-05-06
APR163	OTHER	Cardiac Valve Procedures Without Ami Or Complex Pdx	9	9	—	—	$215,424.65	$215,424.65	$215,424.65	2026-05-06
APR165	OTHER	Coronary Bypass W Ami Or Complex Pdx	9	9	—	—	$208,368.65	$208,368.65	$208,368.65	2026-05-06
APR166	OTHER	Coronary Bypass Without Ami Or Complex Pdx	9	9	—	—	$179,225.30	$179,225.30	$179,225.30	2026-05-06
APR167	OTHER	Other Cardiothoracic & Thoracic Vascular Procedures	9	9	—	—	$227,443.70	$227,443.70	$227,443.70	2026-05-06
APR169	OTHER	Major Abdominal Vascular Procedures	9	9	—	—	$283,107.80	$283,107.80	$283,107.80	2026-05-06
APR171	OTHER	Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock	9	9	—	—	$126,092.90	$126,092.90	$126,092.90	2026-05-06
APR174	OTHER	Percutaneous Coronary Intervention W Ami	9	9	—	—	$112,771.55	$112,771.55	$112,771.55	2026-05-06
APR175	OTHER	Percutaneous Coronary Intervention Without Ami	9	9	—	—	$156,652.85	$156,652.85	$156,652.85	2026-05-06
APR176	OTHER	Cardiac Pacemaker & Defibrillator Device Replacement	9	9	—	—	$270,513.65	$270,513.65	$270,513.65	2026-05-06
APR177	OTHER	Cardiac Pacemaker & Defibrillator Revision Except Device Replacement	9	9	—	—	$150,677.30	$150,677.30	$150,677.30	2026-05-06
APR180	OTHER	Other Circulatory System Procedures	9	9	—	—	$128,121.50	$128,121.50	$128,121.50	2026-05-06
APR181	OTHER	Lower Extremity Arterial Procedures #	9	9	—	—	$242,083.10	$242,083.10	$242,083.10	2026-05-06
APR182	OTHER	Other Peripheral Vascular Procedures #	9	9	—	—	$213,907.70	$213,907.70	$213,907.70	2026-05-06
APR190	OTHER	Acute Myocardial Infarction	9	9	—	—	$60,484.25	$60,484.25	$60,484.25	2026-05-06
APR191	OTHER	Cardiac Catheterization For Coronary Artery Disease	9	9	—	—	$56,383.85	$56,383.85	$56,383.85	2026-05-06
APR192	OTHER	Cardiac Catheterization For Other Non-coronary Conditions	9	9	—	—	$102,480.05	$102,480.05	$102,480.05	2026-05-06
APR193	OTHER	Acute & Subacute Endocarditis	9	9	—	—	$102,348.65	$102,348.65	$102,348.65	2026-05-06
APR194	OTHER	Heart Failure	9	9	—	—	$74,968.40	$74,968.40	$74,968.40	2026-05-06
APR196	OTHER	Cardiac Arrest And Shock	9	9	—	—	$82,684.55	$82,684.55	$82,684.55	2026-05-06
APR197	OTHER	Peripheral & Other Vascular Disorders	9	9	—	—	$67,233.35	$67,233.35	$67,233.35	2026-05-06
APR199	OTHER	Hypertension	9	9	—	—	$58,650.05	$58,650.05	$58,650.05	2026-05-06
APR200	OTHER	Cardiac Structural & Valvular Disorders	9	9	—	—	$57,446.75	$57,446.75	$57,446.75	2026-05-06
APR204	OTHER	Syncope & Collapse	9	9	—	—	$58,148.75	$58,148.75	$58,148.75	2026-05-06
APR205	OTHER	Cardiomyopathy	9	9	—	—	$73,487.00	$73,487.00	$73,487.00	2026-05-06
APR206	OTHER	Malfunction,reaction,complication Of Cardiac/vasc Device Or Procedure	9	9	—	—	$119,265.50	$119,265.50	$119,265.50	2026-05-06
APR207	OTHER	Other Circulatory System Diagnoses	9	9	—	—	$63,417.80	$63,417.80	$63,417.80	2026-05-06
APR220	OTHER	Major Stomach, Esophageal & Duodenal Procedures	9	9	—	—	$155,750.60	$155,750.60	$155,750.60	2026-05-06
APR221	OTHER	Major Small & Large Bowel Procedures	9	9	—	—	$140,103.65	$140,103.65	$140,103.65	2026-05-06
APR222	OTHER	Other Stomach, Esophageal & Duodenal Procedures	9	9	—	—	$99,306.65	$99,306.65	$99,306.65	2026-05-06
APR223	OTHER	Other Small & Large Bowel Procedures	9	9	—	—	$90,159.50	$90,159.50	$90,159.50	2026-05-06
APR224	OTHER	Peritoneal Adhesiolysis	9	9	—	—	$81,292.70	$81,292.70	$81,292.70	2026-05-06
APR225	OTHER	Appendectomy	9	9	—	—	$63,965.45	$63,965.45	$63,965.45	2026-05-06
APR226	OTHER	Anal Procedures	9	9	—	—	$69,699.35	$69,699.35	$69,699.35	2026-05-06
APR227	OTHER	Hernia Procedures Except Inguinal, Femoral & Umbilical	9	9	—	—	$81,165.35	$81,165.35	$81,165.35	2026-05-06
APR228	OTHER	Inguinal, Femoral & Umbilical Hernia Procedures	9	9	—	—	$63,959.60	$63,959.60	$63,959.60	2026-05-06
APR229	OTHER	Other Digestive System & Abdominal Procedures	9	9	—	—	$106,598.90	$106,598.90	$106,598.90	2026-05-06
APR240	OTHER	Digestive Malignancy	9	9	—	—	$79,331.60	$79,331.60	$79,331.60	2026-05-06
APR241	OTHER	Peptic Ulcer & Gastritis	9	9	—	—	$58,677.05	$58,677.05	$58,677.05	2026-05-06
APR242	OTHER	Major Esophageal Disorders	9	9	—	—	$65,334.35	$65,334.35	$65,334.35	2026-05-06
APR243	OTHER	Other Esophageal Disorders	9	9	—	—	$67,953.35	$67,953.35	$67,953.35	2026-05-06
APR245	OTHER	Inflammatory Bowel Disease	9	9	—	—	$57,505.70	$57,505.70	$57,505.70	2026-05-06
APR246	OTHER	Gastrointestinal Vascular Insufficiency	9	9	—	—	$90,602.30	$90,602.30	$90,602.30	2026-05-06
APR252	OTHER	Malfunction, Reaction & Complication Of Gi Device Or Procedure	9	9	—	—	$70,381.55	$70,381.55	$70,381.55	2026-05-06
APR253	OTHER	Other & Unspecified Gastrointestinal Hemorrhage	9	9	—	—	$71,667.20	$71,667.20	$71,667.20	2026-05-06
APR254	OTHER	Other Digestive System Diagnoses	9	9	—	—	$55,670.60	$55,670.60	$55,670.60	2026-05-06
APR260	OTHER	Major Pancreas, Liver & Shunt Procedures	9	9	—	—	$180,090.20	$180,090.20	$180,090.20	2026-05-06
APR261	OTHER	Major Biliary Tract Procedures	9	9	—	—	$153,009.65	$153,009.65	$153,009.65	2026-05-06
APR262	OTHER	Cholecystectomy Except Laparoscopic	9	9	—	—	$114,714.20	$114,714.20	$114,714.20	2026-05-06
APR263	OTHER	Laparoscopic Cholecystectomy	9	9	—	—	$73,481.15	$73,481.15	$73,481.15	2026-05-06
APR264	OTHER	Other Hepatobiliary, Pancreas & Abdominal Procedures	9	9	—	—	$153,412.85	$153,412.85	$153,412.85	2026-05-06
APR279	OTHER	Hepatic Coma & Other Major Acute Liver Disorders	9	9	—	—	$98,611.85	$98,611.85	$98,611.85	2026-05-06
APR280	OTHER	Alcoholic Liver Disease	9	9	—	—	$92,907.65	$92,907.65	$92,907.65	2026-05-06
APR281	OTHER	Malignancy Of Hepatobiliary System & Pancreas	9	9	—	—	$81,260.75	$81,260.75	$81,260.75	2026-05-06
APR282	OTHER	Disorders Of Pancreas Except Malignancy	9	9	—	—	$56,681.75	$56,681.75	$56,681.75	2026-05-06
APR283	OTHER	Other Disorders Of The Liver	9	9	—	—	$70,402.25	$70,402.25	$70,402.25	2026-05-06
APR284	OTHER	Disorders Of Gallbladder & Biliary Tract	9	9	—	—	$61,215.95	$61,215.95	$61,215.95	2026-05-06
APR301	OTHER	Hip Joint Replacement	9	9	—	—	$131,135.15	$131,135.15	$131,135.15	2026-05-06
APR302	OTHER	Knee Joint Replacement	9	9	—	—	$125,270.30	$125,270.30	$125,270.30	2026-05-06
APR304	OTHER	Dorsal & Lumbar Fusion Proc Except For Curvature Of Back	9	9	—	—	$269,953.85	$269,953.85	$269,953.85	2026-05-06
APR305	OTHER	Amputation Of Lower Limb Except Toes	9	9	—	—	$145,100.45	$145,100.45	$145,100.45	2026-05-06
APR308	OTHER	Hip And Femur Fracture Repair	9	9	—	—	$114,306.50	$114,306.50	$114,306.50	2026-05-06
APR309	OTHER	Other Significant Hip And Femur Surgery	9	9	—	—	$122,547.35	$122,547.35	$122,547.35	2026-05-06
APR310	OTHER	Intervertebral Disc Excision & Decompression	9	9	—	—	$92,258.75	$92,258.75	$92,258.75	2026-05-06
APR312	OTHER	Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses	9	9	—	—	$138,524.60	$138,524.60	$138,524.60	2026-05-06
APR313	OTHER	Knee & Lower Leg Procedures Except Foot	9	9	—	—	$120,182.60	$120,182.60	$120,182.60	2026-05-06
APR314	OTHER	Foot & Toe Procedures	9	9	—	—	$118,784.90	$118,784.90	$118,784.90	2026-05-06
APR315	OTHER	Shoulder, Upper Arm & Forearm Procedures Except Joint Replacement	9	9	—	—	$90,722.00	$90,722.00	$90,722.00	2026-05-06
APR316	OTHER	Hand & Wrist Procedures	9	9	—	—	$66,719.90	$66,719.90	$66,719.90	2026-05-06
APR317	OTHER	Tendon, Muscle & Other Soft Tissue Procedures	9	9	—	—	$102,247.85	$102,247.85	$102,247.85	2026-05-06
APR320	OTHER	Other Musculoskeletal System & Connective Tissue Procedures	9	9	—	—	$87,180.05	$87,180.05	$87,180.05	2026-05-06
APR321	OTHER	Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp	9	9	—	—	$125,445.80	$125,445.80	$125,445.80	2026-05-06
APR322	OTHER	Shoulder & Elbow Joint Replacement #	9	9	—	—	$139,476.35	$139,476.35	$139,476.35	2026-05-06
APR340	OTHER	Fracture Of Femur	9	9	—	—	$68,986.55	$68,986.55	$68,986.55	2026-05-06
APR341	OTHER	Fracture Of Pelvis Or Dislocation Of Hip	9	9	—	—	$73,601.30	$73,601.30	$73,601.30	2026-05-06
APR342	OTHER	Fractures & Dislocations Except Femur, Pelvis & Back	9	9	—	—	$64,311.50	$64,311.50	$64,311.50	2026-05-06
APR343	OTHER	Musculoskeletal Malignancy & Pathol Fracture D/t Muscskel Malig	9	9	—	—	$117,340.85	$117,340.85	$117,340.85	2026-05-06
APR344	OTHER	Osteomyelitis, Septic Arthritis & Other Musculoskeletal Infections	9	9	—	—	$86,933.90	$86,933.90	$86,933.90	2026-05-06
APR346	OTHER	Connective Tissue Disorders	9	9	—	—	$86,508.65	$86,508.65	$86,508.65	2026-05-06
APR347	OTHER	Other Back & Neck Disorders, Fractures & Injuries	9	9	—	—	$60,425.30	$60,425.30	$60,425.30	2026-05-06
APR349	OTHER	Malfunction, Reaction, Complic Of Orthopedic Device Or Procedure	9	9	—	—	$68,340.80	$68,340.80	$68,340.80	2026-05-06
APR351	OTHER	Other Musculoskeletal System & Connective Tissue Diagnoses	9	9	—	—	$74,842.85	$74,842.85	$74,842.85	2026-05-06
APR361	OTHER	Skin Graft For Skin & Subcutaneous Tissue Diagnoses	9	9	—	—	$83,694.80	$83,694.80	$83,694.80	2026-05-06
APR362	OTHER	Mastectomy Procedures	9	9	—	—	$90,541.55	$90,541.55	$90,541.55	2026-05-06
APR363	OTHER	Breast Procedures Except Mastectomy	9	9	—	—	$90,633.35	$90,633.35	$90,633.35	2026-05-06
APR364	OTHER	Other Skin, Subcutaneous Tissue & Related Procedures	9	9	—	—	$70,067.45	$70,067.45	$70,067.45	2026-05-06
APR380	OTHER	Skin Ulcers	9	9	—	—	$59,185.10	$59,185.10	$59,185.10	2026-05-06
APR381	OTHER	Major Skin Disorders	9	9	—	—	$73,149.50	$73,149.50	$73,149.50	2026-05-06
APR382	OTHER	Malignant Breast Disorders	9	9	—	—	$69,651.65	$69,651.65	$69,651.65	2026-05-06
APR384	OTHER	Contusion, Open Wound & Other Trauma To Skin & Subcutaneous Tissue	9	9	—	—	$53,797.70	$53,797.70	$53,797.70	2026-05-06
APR401	OTHER	Pituitary & Adrenal Procedures	9	9	—	—	$120,387.80	$120,387.80	$120,387.80	2026-05-06
APR403	OTHER	Procedures For Obesity	9	9	—	—	$97,375.25	$97,375.25	$97,375.25	2026-05-06
APR404	OTHER	Thyroid, Parathyroid & Thyroglossal Procedures	9	9	—	—	$76,504.70	$76,504.70	$76,504.70	2026-05-06
APR405	OTHER	Other Procedures For Endocrine, Nutritional & Metabolic Disorders	9	9	—	—	$286,883.30	$286,883.30	$286,883.30	2026-05-06
APR420	OTHER	Diabetes	9	9	—	—	$54,456.50	$54,456.50	$54,456.50	2026-05-06
APR421	OTHER	Malnutrition, Failure To Thrive & Other Nutritional Disorders	9	9	—	—	$109,147.25	$109,147.25	$109,147.25	2026-05-06
APR423	OTHER	Inborn Errors Of Metabolism	9	9	—	—	$71,664.95	$71,664.95	$71,664.95	2026-05-06
APR424	OTHER	Other Endocrine Disorders	9	9	—	—	$63,276.50	$63,276.50	$63,276.50	2026-05-06
APR425	OTHER	Electrolyte Disorders Except Hypovolemia Related	9	9	—	—	$53,572.70	$53,572.70	$53,572.70	2026-05-06
APR441	OTHER	Major Bladder Procedures	9	9	—	—	$152,423.30	$152,423.30	$152,423.30	2026-05-06
APR442	OTHER	Kidney & Urinary Tract Procedures For Malignancy	9	9	—	—	$97,614.20	$97,614.20	$97,614.20	2026-05-06
APR443	OTHER	Kidney & Urinary Tract Procedures For Nonmalignancy	9	9	—	—	$105,181.85	$105,181.85	$105,181.85	2026-05-06
APR444	OTHER	Renal Dialysis Access Device Procedure Only	9	9	—	—	$110,346.50	$110,346.50	$110,346.50	2026-05-06
APR445	OTHER	Other Bladder Procedures	9	9	—	—	$102,309.50	$102,309.50	$102,309.50	2026-05-06
APR446	OTHER	Urethral & Transurethral Procedures	9	9	—	—	$64,771.40	$64,771.40	$64,771.40	2026-05-06
APR447	OTHER	Other Kidney, Urinary Tract & Related Procedures	9	9	—	—	$136,833.05	$136,833.05	$136,833.05	2026-05-06
APR460	OTHER	Renal Failure	9	9	—	—	$68,562.65	$68,562.65	$68,562.65	2026-05-06
APR461	OTHER	Kidney & Urinary Tract Malignancy	9	9	—	—	$140,841.65	$140,841.65	$140,841.65	2026-05-06
APR462	OTHER	Nephritis & Nephrosis	9	9	—	—	$72,966.35	$72,966.35	$72,966.35	2026-05-06
APR463	OTHER	Kidney & Urinary Tract Infections	9	9	—	—	$58,844.45	$58,844.45	$58,844.45	2026-05-06
APR466	OTHER	Malfunction, Reaction, Complic Of Genitourinary Device Or Proc	9	9	—	—	$88,276.70	$88,276.70	$88,276.70	2026-05-06
APR468	OTHER	Other Kidney & Urinary Tract Diagnoses, Signs & Symptoms	9	9	—	—	$65,894.60	$65,894.60	$65,894.60	2026-05-06
APR469	OTHER	Acute Kidney Injury #	9	9	—	—	$69,500.90	$69,500.90	$69,500.90	2026-05-06
APR470	OTHER	Chronic Kidney Disease #	9	9	—	—	$64,478.00	$64,478.00	$64,478.00	2026-05-06
APR480	OTHER	Major Male Pelvic Procedures	9	9	—	—	$90,287.75	$90,287.75	$90,287.75	2026-05-06
APR481	OTHER	Penis Procedures	9	9	—	—	$65,420.75	$65,420.75	$65,420.75	2026-05-06
APR482	OTHER	Transurethral Prostatectomy	9	9	—	—	$71,310.35	$71,310.35	$71,310.35	2026-05-06
APR484	OTHER	Other Male Reproductive System & Related Procedures	9	9	—	—	$117,990.65	$117,990.65	$117,990.65	2026-05-06
APR500	OTHER	Malignancy, Male Reproductive System	9	9	—	—	$55,744.85	$55,744.85	$55,744.85	2026-05-06
APR510	OTHER	Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs	9	9	—	—	$106,436.00	$106,436.00	$106,436.00	2026-05-06
APR511	OTHER	Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy	9	9	—	—	$119,409.95	$119,409.95	$119,409.95	2026-05-06
APR512	OTHER	Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig	9	9	—	—	$121,818.35	$121,818.35	$121,818.35	2026-05-06
APR513	OTHER	Uterine & Adnexa Procedures For Non-malignancy Except Leiomyoma	9	9	—	—	$74,607.95	$74,607.95	$74,607.95	2026-05-06
APR514	OTHER	Female Reproductive System Reconstructive Procedures	9	9	—	—	$73,032.95	$73,032.95	$73,032.95	2026-05-06
APR517	OTHER	Dilation & Curettage For Non-obstetric Diagnoses	9	9	—	—	$127,887.95	$127,887.95	$127,887.95	2026-05-06
APR518	OTHER	Other Female Reproductive System & Related Procedures	9	9	—	—	$77,851.55	$77,851.55	$77,851.55	2026-05-06
APR519	OTHER	Uterine & Adnexa Procedures For Leiomyoma	9	9	—	—	$77,046.95	$77,046.95	$77,046.95	2026-05-06
APR530	OTHER	Female Reproductive System Malignancy	9	9	—	—	$62,218.55	$62,218.55	$62,218.55	2026-05-06
APR531	OTHER	Female Reproductive System Infections	9	9	—	—	$53,273.90	$53,273.90	$53,273.90	2026-05-06
APR544	OTHER	D&c, Aspiration Curettage Or Hysterotomy For Obstetric Diagnoses	9	9	—	—	$85,930.40	$85,930.40	$85,930.40	2026-05-06
APR545	OTHER	Ectopic Pregnancy Procedure	9	9	—	—	$62,945.30	$62,945.30	$62,945.30	2026-05-06
APR581	OTHER	Neonate, Transferred < 5 Days Old, Born Here	9	9	—	—	$56,697.95	$56,697.95	$56,697.95	2026-05-06
APR608	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	9	9	—	—	$145,692.20	$145,692.20	$145,692.20	2026-05-06
APR612	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	9	9	—	—	$287,594.30	$287,594.30	$287,594.30	2026-05-06
APR614	OTHER	Neonate Bwt 1500-1999g W Or Without Other Significant Condition	9	9	—	—	$136,223.30	$136,223.30	$136,223.30	2026-05-06
APR621	OTHER	Neonate Bwt 2000-2499g W Major Anomaly	9	9	—	—	$175,494.35	$175,494.35	$175,494.35	2026-05-06
APR622	OTHER	Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond	9	9	—	—	$182,371.70	$182,371.70	$182,371.70	2026-05-06
APR623	OTHER	Neonate Bwt 2000-2499g W Congenital/perinatal Infection	9	9	—	—	$54,942.50	$54,942.50	$54,942.50	2026-05-06
APR625	OTHER	Neonate Bwt 2000-2499g W Other Significant Condition	9	9	—	—	$84,648.35	$84,648.35	$84,648.35	2026-05-06
APR633	OTHER	Neonate Birthwt >2499g W Major Anomaly	9	9	—	—	$91,726.85	$91,726.85	$91,726.85	2026-05-06
APR634	OTHER	Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond	9	9	—	—	$93,553.85	$93,553.85	$93,553.85	2026-05-06
APR636	OTHER	Neonate Birthwt >2499g W Congenital/perinatal Infection	9	9	—	—	$95,473.10	$95,473.10	$95,473.10	2026-05-06
APR650	OTHER	Splenectomy	9	9	—	—	$80,560.55	$80,560.55	$80,560.55	2026-05-06
APR651	OTHER	Other Procedures Of Blood & Blood-forming Organs	9	9	—	—	$88,784.75	$88,784.75	$88,784.75	2026-05-06
APR660	OTHER	Major Hematologic/immunologic Diag Exc Sickle Cell Crisis & Coagul	9	9	—	—	$116,397.20	$116,397.20	$116,397.20	2026-05-06
APR661	OTHER	Coagulation & Platelet Disorders	9	9	—	—	$79,255.55	$79,255.55	$79,255.55	2026-05-06
APR662	OTHER	Sickle Cell Anemia Crisis	9	9	—	—	$63,335.45	$63,335.45	$63,335.45	2026-05-06
APR680	OTHER	Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	9	9	—	—	$266,373.65	$266,373.65	$266,373.65	2026-05-06
APR690	OTHER	Acute Leukemia	9	9	—	—	$268,161.05	$268,161.05	$268,161.05	2026-05-06
APR691	OTHER	Lymphoma, Myeloma & Non-acute Leukemia	9	9	—	—	$189,648.65	$189,648.65	$189,648.65	2026-05-06
APR692	OTHER	Radiotherapy	9	9	—	—	$118,664.30	$118,664.30	$118,664.30	2026-05-06
APR694	OTHER	Lymphatic & Other Malignancies & Neoplasms Of Uncertain Behavior	9	9	—	—	$96,616.10	$96,616.10	$96,616.10	2026-05-06
APR695	OTHER	Chemotherapy For Acute Leukemia #	9	9	—	—	$171,365.60	$171,365.60	$171,365.60	2026-05-06
APR696	OTHER	Other Chemotherapy #	9	9	—	—	$99,367.85	$99,367.85	$99,367.85	2026-05-06
APR710	OTHER	Infectious & Parasitic Diseases Including HIV W O.r. Procedure	9	9	—	—	$217,441.10	$217,441.10	$217,441.10	2026-05-06
APR711	OTHER	Post-op, Post-trauma, Other Device Infections W O.r. Procedure	9	9	—	—	$147,145.25	$147,145.25	$147,145.25	2026-05-06
APR720	OTHER	Septicemia & Disseminated Infections	9	9	—	—	$81,462.35	$81,462.35	$81,462.35	2026-05-06
APR721	OTHER	Post-operative, Post-traumatic, Other Device Infections	9	9	—	—	$79,278.05	$79,278.05	$79,278.05	2026-05-06
APR724	OTHER	Other Infectious & Parasitic Diseases	9	9	—	—	$87,442.40	$87,442.40	$87,442.40	2026-05-06
APR740	OTHER	Mental Illness Diagnosis W O.r. Procedure	9	9	—	—	$106,121.90	$106,121.90	$106,121.90	2026-05-06
APR750	OTHER	Schizophrenia	9	9	—	—	$114,272.30	$114,272.30	$114,272.30	2026-05-06
APR751	OTHER	Major Depressive Disorders & Other/unspecified Psychoses	9	9	—	—	$78,824.45	$78,824.45	$78,824.45	2026-05-06
APR752	OTHER	Disorders Of Personality & Impulse Control	9	9	—	—	$66,580.40	$66,580.40	$66,580.40	2026-05-06
APR753	OTHER	Bipolar Disorders	9	9	—	—	$78,678.65	$78,678.65	$78,678.65	2026-05-06
APR754	OTHER	Depression Except Major Depressive Disorder	9	9	—	—	$73,977.95	$73,977.95	$73,977.95	2026-05-06
APR755	OTHER	Adjustment Disorders & Neuroses Except Depressive Diagnoses	9	9	—	—	$58,754.45	$58,754.45	$58,754.45	2026-05-06
APR756	OTHER	Acute Anxiety & Delirium States	9	9	—	—	$52,925.15	$52,925.15	$52,925.15	2026-05-06
APR757	OTHER	Organic Mental Health Disturbances	9	9	—	—	$81,601.40	$81,601.40	$81,601.40	2026-05-06
APR758	OTHER	Behavioral Disorders	9	9	—	—	$57,880.10	$57,880.10	$57,880.10	2026-05-06
APR759	OTHER	Eating Disorders	9	9	—	—	$129,700.55	$129,700.55	$129,700.55	2026-05-06
APR760	OTHER	Other Mental Health Disorders	9	9	—	—	$70,687.55	$70,687.55	$70,687.55	2026-05-06
APR772	OTHER	Alcohol & Drug Dependence W Rehab Or Rehab/detox Therapy	9	9	—	—	$87,166.55	$87,166.55	$87,166.55	2026-05-06
APR773	OTHER	Opioid Abuse & Dependence	9	9	—	—	$64,295.30	$64,295.30	$64,295.30	2026-05-06
APR774	OTHER	Cocaine Abuse & Dependence	9	9	—	—	$57,758.60	$57,758.60	$57,758.60	2026-05-06
APR775	OTHER	Alcohol Abuse & Dependence	9	9	—	—	$55,426.25	$55,426.25	$55,426.25	2026-05-06
APR791	OTHER	O.r. Procedure For Other Complications Of Treatment	9	9	—	—	$156,979.55	$156,979.55	$156,979.55	2026-05-06
APR812	OTHER	Poisoning Of Medicinal Agents	9	9	—	—	$62,875.10	$62,875.10	$62,875.10	2026-05-06
APR813	OTHER	Other Complications Of Treatment	9	9	—	—	$58,397.60	$58,397.60	$58,397.60	2026-05-06
APR815	OTHER	Other Injury, Poisoning & Toxic Effect Diagnoses	9	9	—	—	$265,998.80	$265,998.80	$265,998.80	2026-05-06
APR850	OTHER	Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service	9	9	—	—	$130,804.40	$130,804.40	$130,804.40	2026-05-06
APR860	OTHER	Rehabilitation	9	9	—	—	$100,954.55	$100,954.55	$100,954.55	2026-05-06
APR861	OTHER	Signs, Symptoms & Other Factors Influencing Health Status	9	9	—	—	$60,544.10	$60,544.10	$60,544.10	2026-05-06
APR862	OTHER	Other Aftercare & Convalescence	9	9	—	—	$83,358.20	$83,358.20	$83,358.20	2026-05-06
APR890	OTHER	HIV W Multiple Major HIV Related Conditions	9	9	—	—	$129,936.35	$129,936.35	$129,936.35	2026-05-06
APR892	OTHER	HIV W Major HIV Related Condition	9	9	—	—	$71,887.70	$71,887.70	$71,887.70	2026-05-06
APR893	OTHER	HIV W Multiple Significant HIV Related Conditions	9	9	—	—	$75,410.75	$75,410.75	$75,410.75	2026-05-06
APR911	OTHER	Extensive Abdominal/thoracic Procedures For Mult Significant Trauma	9	9	—	—	$266,525.30	$266,525.30	$266,525.30	2026-05-06
APR912	OTHER	Musculoskeletal & Other Procedures For Multiple Significant Trauma	9	9	—	—	$249,632.30	$249,632.30	$249,632.30	2026-05-06
APR930	OTHER	Multiple Significant Trauma Without O.r. Procedure	9	9	—	—	$81,460.55	$81,460.55	$81,460.55	2026-05-06
APR950	OTHER	Extensive Procedure Unrelated To Principal Diagnosis	9	9	—	—	$233,533.55	$233,533.55	$233,533.55	2026-05-06
APR951	OTHER	Moderately Extensive Procedure Unrelated To Principal Diagnosis	9	9	—	—	$164,540.90	$164,540.90	$164,540.90	2026-05-06
APR952	OTHER	Nonextensive Procedure Unrelated To Principal Diagnosis	9	9	—	—	$111,369.35	$111,369.35	$111,369.35	2026-05-06
J9029	OTHER	Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension	29	25	$488,220.00	$63,468.60 87% off	$31,677.38	$233,552.00	$63,354.77	2026-05-06
Q2041	OTHER	Axicabtagene Ciloleucel Intravenous Suspension	24	22	$3,550,576.00	$461,574.88 87% off	$244,727.98	$1,101,275.91	$489,455.96	2026-05-06
Q2043	OTHER	Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension	29	25	$253,242.35	$32,921.51 87% off	$27,507.62	$127,712.87	$55,015.23	2026-05-06
Q2053	OTHER	Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension	23	22	$3,550,576.00	$461,574.88 87% off	$230,265.20	$506,583.44	$460,530.40	2026-05-06
S2055	OTHER	Harvest Donor Multiviseral Organs	6	4	—	—	$126,105.95	$126,105.95	$126,105.95	2026-05-06

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