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

HIGHLAND HOSPITAL

Rochester, NY · CCN 330164 · Rates published

22,406 distinct procedures filed
59 distinct payers
834,716 rate rows
2026-04-01 last MRF observed
Data quality

741,762 of 834,716 rate rows are consumer-grade (88.9%)

92,954 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 92,520
placeholder amount (≤ $0.02) — excluded from medians 434
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.urmc.rochester.edu/getmedia/5479e418-958b-4a8a-b3ab-610f5962d661/160743037-HIGHLAND-HOSPITAL-OF-ROCHESTER-standardcharges.csv
Found on page https://www.urmc.rochester.edu/pay-a-bill/cost-estimates-pricing
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 020592dabe89a1a7… · 445,250,856 bytes · first seen 2026-05-08

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
0845
OTHER 		Inj, Atidarsagene Autotemcel 13 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$1,043
outlier · 4319.3×
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 13 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dose 13 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,746,358
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 13 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
0908
OTHER 		Topi Adm Prad Zami Per Treat 13 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 13 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
0714
OTHER 		Inj Delandistrogene Mox Rokl 13 $3,316,462.59 $3,316,462.59 $3,316,462.59 nat. median
$3,316,463
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 13 $3,316,462.59 $3,316,462.59 $3,316,462.59 nat. median
$3,325,455
1.0× median
0748
OTHER 		Inj, Lovotibeglogene Autotem 13 $3,248,445.72 $3,248,445.72 $3,248,445.72 nat. median
$3,248,446
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 13 $3,248,445.72 $3,248,445.72 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 13 $3,090,000.00 $3,090,000.00 $3,090,000.00 nat. median
$3,180,000
1.0× median
0906
OTHER 		Inj Elivaldogene Autotemecel 13 $3,090,000.00 $3,090,000.00 $3,090,000.00 nat. median
$289
outlier · 10692.0×
J3393
HCPCS 		Inj, Betibeglogene Autotemce 13 $2,945,740.00 $2,945,740.00 $2,945,740.00 nat. median
$3,004,655
1.0× median
0746
OTHER 		Inj, Betibeglogene Autotemce 13 $2,945,740.00 $2,945,740.00 $2,945,740.00 nat. median
$2,945,740
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Treat 13 $2,455,110.61 $2,455,110.61 $2,455,110.61 nat. median
$2,588,981
0.9× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 13 $2,455,110.60 $2,455,110.60 $2,455,110.60 nat. median
$2,468,984
1.0× median
0824
OTHER 		Inj, Exagamglogene Autotem 13 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$17,829
outlier · 130.8×
J3392
HCPCS 		Inj, Exagamglogene Autotem 13 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
2067
OTHER 		Afamitresgene Autoleucel 13 $770,620.00 $770,620.00 $770,620.00 nat. median
$786,032
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 13 $770,620.00 $770,620.00 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 13 $591,726.20 $591,726.20 $591,726.20 nat. median
$753,246
0.8× median
9194
OTHER 		Tisagenlecleucel Car-pos T 13 $591,726.20 $591,726.20 $591,726.20 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 13 $565,868.95 $565,868.95 $565,868.95 nat. median
$587,650
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 13 $565,868.94 $565,868.94 $565,868.94 nat. median
$674,867
0.8× median
9413
OTHER 		Lisocabtagene Car Pos T 13 $562,538.19 $562,538.19 $562,538.19 nat. median
$562,201
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 13 $562,538.18 $562,538.18 $562,538.18 nat. median
$673,137
0.8× median
9422
OTHER 		Idecabtagene Vicleucel Car 13 $557,317.93 $557,317.93 $557,317.93 nat. median
$558,082
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 13 $557,317.93 $557,317.93 $557,317.93 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 13 $533,230.17 $533,230.17 $533,230.17 nat. median
$634,303
0.8× median
9035
OTHER 		Axicabtagene Ciloleucel Car+ 13 $533,230.17 $533,230.17 $533,230.17 nat. median
$532,192
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 13 $489,304.61 $489,304.61 $489,304.61 nat. median
$489,450
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 13 $489,304.61 $489,304.61 $489,304.61 nat. median
$619,808
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 $328,919.71 $463,263.34 $389,715.52 nat. median
$370,174
1.1× median
SUP-284765
CDM 		Console Ultrasonic Aspirator W/accessory Nexus 11 $353,528.55 $353,528.55 $353,528.55 nat. median
$353,529
1.0× median
24
APR_DRG 		16 $247,055.49 $679,158.53 $345,877.68 nat. median
$234,729
1.5× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 13 $242,044.14 $339,545.46 $286,782.32 nat. median
$265,286
1.1× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 $229,158.76 $330,274.51 $278,966.28 nat. median
$206,474
1.4× median
0831
OTHER 		Obecbtge Autol Up To 400 Mil 13 $278,250.00 $278,250.00 $278,250.00 nat. median
$1,043
outlier · 266.8×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 13 $278,250.00 $278,250.00 $278,250.00 nat. median
$324,450
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 13 $257,500.00 $257,500.00 $257,500.00 nat. median
$265,000
1.0× median
0897
OTHER 		Revakinagene, Per Implant 13 $257,500.00 $257,500.00 $257,500.00 nat. median
$257,500
1.0× median
5834
APR_DRG 		16 $182,050.96 $500,492.32 $254,871.35 nat. median
$309,665
0.8× median
5884
APR_DRG 		16 $178,863.47 $491,731.42 $250,408.85 nat. median
$246,434
1.0× median
5883
APR_DRG 		16 $178,863.47 $491,731.42 $250,408.85 nat. median
$182,665
1.4× median
1907
OTHER 		New Technology - Level 52 ($145,001-$160,000) 13 $162,105.50 $583,766.13 $245,953.17 nat. median
$153,199
1.6× median
1908
OTHER 		New Technology - Level 52 ($145,001-$160,000) 13 $162,105.50 $583,766.13 $245,953.17 nat. median
$152,962
1.6× median
1614
APR_DRG 		16 $163,660.89 $449,946.84 $229,125.24 nat. median
$207,730
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 13 $190,526.49 $267,143.36 $225,742.42 nat. median
$202,976
1.1× median
34
APR_DRG 		16 $158,927.30 $436,936.46 $222,498.21 nat. median
$209,067
1.1× median
1906
OTHER 		New Technology - Level 51 ($130,001-$145,000) 13 $146,160.75 $526,346.70 $221,761.14 nat. median
$138,020
1.6× median

Other procedures at this hospital

Browse this hospital's 22,406 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
             
0620T CPT Endovascular Venous Arterialization Tibl/Prnl Vn 29 14 — — $34,956.95 $129,266.18 $57,364.19 2026-04-01
0714 OTHER Inj Delandistrogene Mox Rokl 16 13 — — $3,316,462.59 $3,316,462.59 $3,316,462.59 2026-04-01
0717 OTHER Instill Adstiladrin, Tx Dose 16 13 — — $63,342.28 $63,342.28 $63,342.28 2026-04-01
0746 OTHER Inj, Betibeglogene Autotemce 16 13 — — $2,945,740.00 $2,945,740.00 $2,945,740.00 2026-04-01
0748 OTHER Inj, Lovotibeglogene Autotem 16 13 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 2026-04-01
0824 OTHER Inj, Exagamglogene Autotem 16 13 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-04-01
0831 OTHER Obecbtge Autol Up To 400 Mil 16 13 — — $278,250.00 $278,250.00 $278,250.00 2026-04-01
0845 OTHER Inj, Atidarsagene Autotemcel 16 13 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-04-01
0886 OTHER Inj. Remestemcel-l-rknd/ Td 16 13 — — $205,640.00 $205,640.00 $205,640.00 2026-04-01
0897 OTHER Revakinagene, Per Implant 16 13 — — $257,500.00 $257,500.00 $257,500.00 2026-04-01
0906 OTHER Inj Elivaldogene Autotemecel 16 13 — — $3,090,000.00 $3,090,000.00 $3,090,000.00 2026-04-01
0908 OTHER Topi Adm Prad Zami Per Treat 16 13 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 13 13 — — $242,044.14 $339,545.46 $286,782.32 2026-04-01
11 APR_DRG — 21 16 — — $44,226.73 $121,679.67 $61,917.41 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 13 13 — — $46,412.96 $64,608.44 $54,991.69 2026-04-01
12 APR_DRG — 21 16 — — $44,226.73 $121,679.67 $61,917.41 2026-04-01
1204 APR_DRG — 21 16 — — $43,714.89 $120,272.88 $61,200.84 2026-04-01
1214 APR_DRG — 21 16 — — $43,476.97 $119,618.97 $60,867.76 2026-04-01
13 APR_DRG — 21 16 — — $59,780.88 $164,430.57 $83,693.22 2026-04-01
1304 APR_DRG — 21 16 — — $43,587.81 $119,923.61 $61,022.93 2026-04-01
14 APR_DRG — 21 16 — — $124,299.68 $341,761.78 $174,019.55 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 13 13 — — $102,622.94 $143,605.08 $121,591.23 2026-04-01
1579 OTHER New Technology - Level 42 ($30,001-$40,000) 16 13 — — $37,204.95 $133,980.59 $56,448.89 2026-04-01
1580 OTHER New Technology - Level 43 ($40,001-$50,000) 16 13 — — $47,834.78 $172,260.21 $72,576.91 2026-04-01
1581 OTHER New Technology - Level 44 ($50,001-$60,000) 16 13 — — $58,464.62 $210,539.83 $88,704.93 2026-04-01
1582 OTHER New Technology - Level 45 ($60,001-$70,000) 16 13 — — $69,094.45 $248,819.45 $104,832.96 2026-04-01
1583 OTHER New Technology - Level 46 ($70,001-$80,000) 16 13 — — $79,724.29 $287,099.07 $120,960.99 2026-04-01
1584 OTHER New Technology - Level 47 ($80,001-$90,000) 16 13 — — $90,354.12 $325,378.69 $137,089.01 2026-04-01
1585 OTHER New Technology - Level 48 ($90,001-$100,000) 16 13 — — $100,983.95 $363,658.31 $153,217.03 2026-04-01
1593 OTHER New Technology - Level 42 ($30,001-$40,000) 16 13 — — $37,204.95 $133,980.59 $56,448.89 2026-04-01
1594 OTHER New Technology - Level 43 ($40,001-$50,000) 16 13 — — $47,834.78 $172,260.21 $72,576.91 2026-04-01
1595 OTHER New Technology - Level 44 ($50,001-$60,000) 16 13 — — $58,464.62 $210,539.83 $88,704.93 2026-04-01
1596 OTHER New Technology - Level 45 ($60,001-$70,000) 16 13 — — $69,094.45 $248,819.45 $104,832.96 2026-04-01
1597 OTHER New Technology - Level 46 ($70,001-$80,000) 16 13 — — $79,724.29 $287,099.07 $120,960.99 2026-04-01
1598 OTHER New Technology - Level 47 ($80,001-$90,000) 16 13 — — $90,354.12 $325,378.69 $137,089.01 2026-04-01
1599 OTHER New Technology - Level 48 ($90,001-$100,000) 16 13 — — $100,983.95 $363,658.31 $153,217.03 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 13 13 — — $55,513.22 $77,397.81 $65,774.00 2026-04-01
1604 APR_DRG — 21 16 — — $70,917.01 $195,038.44 $99,283.80 2026-04-01
1612 APR_DRG — 21 16 — — $43,974.69 $120,986.95 $61,564.56 2026-04-01
1613 APR_DRG — 21 16 — — $70,180.67 $193,014.60 $98,252.93 2026-04-01
1614 APR_DRG — 21 16 — — $163,660.89 $449,946.84 $229,125.24 2026-04-01
1623 APR_DRG — 21 16 — — $41,215.01 $113,401.93 $57,701.02 2026-04-01
1624 APR_DRG — 21 16 — — $66,969.17 $184,187.72 $93,756.83 2026-04-01
1634 APR_DRG — 21 16 — — $50,465.47 $138,826.99 $70,651.65 2026-04-01
1643 OTHER Y90 Ibritumomab, Rx 16 13 — — $56,824.55 $56,824.55 $56,824.55 2026-04-01
1654 APR_DRG — 21 16 — — $50,674.44 $139,401.35 $70,944.21 2026-04-01
1664 APR_DRG — 21 16 — — $44,706.09 $122,997.20 $62,588.52 2026-04-01
1674 APR_DRG — 21 16 — — $47,530.01 $130,758.80 $66,542.00 2026-04-01
1694 APR_DRG — 21 16 — — $51,424.90 $141,463.99 $71,994.85 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 13 13 — — $55,513.22 $77,397.81 $65,774.00 2026-04-01
1714 APR_DRG — 21 16 — — $42,818.30 $117,808.58 $59,945.61 2026-04-01
1774 APR_DRG — 21 16 — — $45,436.07 $125,003.58 $63,610.49 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 13 — — $328,919.71 $463,263.34 $389,715.52 2026-04-01
1814 APR_DRG — 21 16 — — $47,426.23 $130,473.57 $66,396.71 2026-04-01
1824 APR_DRG — 21 16 — — $44,994.13 $123,788.89 $62,991.77 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 13 13 — — $71,708.61 $100,158.56 $84,962.86 2026-04-01
1901 OTHER New Technology - Level 49 ($100,001-$115,000) 16 13 — — $114,271.25 $411,507.84 $173,377.07 2026-04-01
1902 OTHER New Technology - Level 49 ($100,001-$115,000) 16 13 — — $114,271.25 $411,507.84 $173,377.07 2026-04-01
1903 OTHER New Technology - Level 50 ($115,001-$130,000) 16 13 — — $130,216.00 $468,927.27 $197,569.10 2026-04-01
1904 OTHER New Technology - Level 50 ($115,001-$130,000) 16 13 — — $130,216.00 $468,927.27 $197,569.10 2026-04-01
1905 OTHER New Technology - Level 51 ($130,001-$145,000) 16 13 — — $146,160.75 $526,346.70 $221,761.14 2026-04-01
1906 OTHER New Technology - Level 51 ($130,001-$145,000) 16 13 — — $146,160.75 $526,346.70 $221,761.14 2026-04-01
1907 OTHER New Technology - Level 52 ($145,001-$160,000) 16 13 — — $162,105.50 $583,766.13 $245,953.17 2026-04-01
1908 OTHER New Technology - Level 52 ($145,001-$160,000) 16 13 — — $162,105.50 $583,766.13 $245,953.17 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 13 — — $109,605.72 $153,418.57 $129,864.68 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 13 — — $75,800.03 $105,908.57 $89,810.51 2026-04-01
204 APR_DRG — 21 16 — — $47,945.12 $131,899.76 $67,123.17 2026-04-01
2067 OTHER Afamitresgene Autoleucel 16 13 — — $770,620.00 $770,620.00 $770,620.00 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 13 13 — — $62,030.60 $86,557.24 $73,496.02 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 1 1 — — $121,590.29 $121,590.29 $121,590.29 2026-04-01
21 APR_DRG — 21 16 — — $86,139.35 $236,877.34 $120,595.08 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 13 13 — — $55,195.82 $76,951.74 $65,397.93 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 13 13 — — $96,469.32 $134,956.87 $114,300.21 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 1 1 — — $61,414.71 $61,414.71 $61,414.71 2026-04-01
214 APR_DRG — 21 16 — — $51,837.90 $142,599.13 $72,573.05 2026-04-01
215 MS_DRG Other Heart Assist System Implant 13 13 — — $91,513.07 $127,991.44 $108,427.88 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 13 — — $86,970.52 $121,607.41 $103,045.70 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 13 — — $57,192.05 $79,757.21 $67,763.13 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 13 — — $51,231.01 $71,379.65 $60,700.28 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 13 — — $69,191.70 $96,621.34 $81,980.74 2026-04-01
22 APR_DRG — 21 16 — — $91,403.84 $251,346.90 $127,965.37 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 13 — — $47,200.21 $65,714.84 $55,924.46 2026-04-01
2204 APR_DRG — 21 16 — — $50,752.80 $139,616.73 $71,053.92 2026-04-01
2214 APR_DRG — 21 16 — — $47,368.34 $130,314.45 $66,315.67 2026-04-01
2224 APR_DRG — 21 16 — — $39,783.99 $109,468.74 $55,697.59 2026-04-01
2234 APR_DRG — 21 16 — — $40,098.15 $110,332.21 $56,137.41 2026-04-01
2244 APR_DRG — 21 16 — — $40,028.26 $110,140.11 $56,039.56 2026-04-01
2294 APR_DRG — 21 16 — — $41,568.71 $114,374.07 $58,196.19 2026-04-01
23 APR_DRG — 21 16 — — $107,097.77 $294,482.00 $149,936.88 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 13 — — $50,982.26 $71,030.06 $60,405.55 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 13 13 — — $72,793.65 $101,683.46 $86,248.45 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 13 13 — — $53,476.87 $74,535.96 $63,361.26 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 13 13 — — $69,979.85 $97,728.99 $82,914.56 2026-04-01
234 APR_DRG — 21 16 — — $57,773.07 $158,912.07 $80,882.29 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 13 13 — — $46,783.85 $65,129.69 $55,431.13 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 13 13 — — $52,870.60 $73,683.92 $62,642.93 2026-04-01
24 APR_DRG — 21 16 — — $247,055.49 $679,158.53 $345,877.68 2026-04-01
244 APR_DRG — 21 16 — — $48,676.52 $133,910.01 $68,147.12 2026-04-01
2604 APR_DRG — 21 16 — — $53,144.66 $146,190.81 $74,402.53 2026-04-01
2614 APR_DRG — 21 16 — — $44,066.47 $121,239.20 $61,693.05 2026-04-01
2624 APR_DRG — 21 16 — — $43,452.27 $119,551.05 $60,833.17 2026-04-01
264 APR_DRG — 21 16 — — $45,021.66 $123,864.56 $63,030.32 2026-04-01
2644 APR_DRG — 21 16 — — $44,165.31 $121,510.86 $61,831.42 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 13 13 — — $56,129.30 $78,263.63 $66,503.94 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 13 13 — — $61,555.40 $85,889.39 $72,932.98 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 13 13 — — $63,170.03 $88,158.57 $74,846.05 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc 13 13 — — $55,809.22 $77,813.81 $66,124.71 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 13 13 — — $54,167.84 $75,507.03 $64,179.94 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 13 13 — — $190,526.49 $267,143.36 $225,742.42 2026-04-01
3014 APR_DRG — 21 16 — — $43,452.97 $119,552.99 $60,834.16 2026-04-01
3024 APR_DRG — 21 16 — — $39,140.14 $107,699.09 $54,796.19 2026-04-01
3033 APR_DRG — 21 16 — — $50,048.94 $137,682.15 $70,068.52 2026-04-01
3034 APR_DRG — 21 16 — — $77,628.05 $213,483.88 $108,679.27 2026-04-01
3044 APR_DRG — 21 16 — — $65,539.56 $180,258.41 $91,755.37 2026-04-01
3054 APR_DRG — 21 16 — — $45,204.51 $124,367.13 $63,286.31 2026-04-01
3084 APR_DRG — 21 16 — — $41,441.63 $114,024.80 $58,018.28 2026-04-01
3094 APR_DRG — 21 16 — — $41,274.32 $113,564.92 $57,784.04 2026-04-01
31 APR_DRG — 21 16 — — $47,490.47 $130,650.14 $66,486.66 2026-04-01
3104 APR_DRG — 21 16 — — $49,019.62 $134,853.05 $68,627.47 2026-04-01
3124 APR_DRG — 21 16 — — $64,269.50 $176,767.63 $89,977.29 2026-04-01
3134 APR_DRG — 21 16 — — $46,401.14 $127,656.11 $64,961.60 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 1 — — $71,918.80 $71,918.80 $71,918.80 2026-04-01
3174 APR_DRG — 21 16 — — $45,318.88 $124,681.47 $63,446.42 2026-04-01
32 APR_DRG — 21 16 — — $55,503.34 $152,673.68 $77,704.68 2026-04-01
3214 APR_DRG — 21 16 — — $50,586.90 $139,160.74 $70,821.65 2026-04-01
33 APR_DRG — 21 16 — — $84,183.78 $231,502.43 $117,857.29 2026-04-01
33276 CPT Insj Phrnc Nrv Stim Sys 16 13 — — $52,642.48 $93,376.94 $60,742.57 2026-04-01
34 APR_DRG — 21 16 — — $158,927.30 $436,936.46 $222,498.21 2026-04-01
3614 APR_DRG — 21 16 — — $68,492.67 $188,375.10 $95,889.73 2026-04-01
3814 APR_DRG — 21 16 — — $42,387.65 $116,624.93 $59,342.70 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 13 13 — — $131,501.82 $184,191.00 $155,807.93 2026-04-01
4014 APR_DRG — 21 16 — — $50,046.82 $137,676.33 $70,065.55 2026-04-01
4034 APR_DRG — 21 16 — — $47,145.25 $129,701.29 $66,003.34 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 13 13 — — $49,523.65 $68,980.16 $58,677.34 2026-04-01
4054 APR_DRG — 21 16 — — $59,933.37 $164,849.69 $83,906.71 2026-04-01
41 APR_DRG — 21 16 — — $51,465.14 $141,574.59 $72,051.19 2026-04-01
42 APR_DRG — 21 16 — — $51,465.14 $141,574.59 $72,051.19 2026-04-01
4234 APR_DRG — 21 16 — — $39,108.37 $107,611.77 $54,751.71 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $118,399.17 $118,399.17 $118,399.17 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $77,624.44 $77,624.44 $77,624.44 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $60,504.33 $60,504.33 $60,504.33 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $96,829.07 $96,829.07 $96,829.07 2026-04-01
43 APR_DRG — 21 16 — — $71,811.48 $197,496.92 $100,536.07 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 1 — — $62,060.21 $62,060.21 $62,060.21 2026-04-01
434 APR_DRG — 21 16 — — $42,492.84 $116,914.05 $59,489.97 2026-04-01
44 APR_DRG — 21 16 — — $128,300.47 $352,758.03 $179,620.66 2026-04-01
4403 APR_DRG — 21 16 — — $40,761.07 $112,154.25 $57,065.49 2026-04-01
4404 APR_DRG — 21 16 — — $74,024.73 $203,580.08 $103,634.62 2026-04-01
4414 APR_DRG — 21 16 — — $48,462.61 $133,322.07 $67,847.64 2026-04-01
4424 APR_DRG — 21 16 — — $45,727.64 $125,804.96 $64,018.69 2026-04-01
4444 APR_DRG — 21 16 — — $44,386.28 $122,118.20 $62,140.78 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $71,866.27 $71,866.27 $71,866.27 2026-04-01
4474 APR_DRG — 21 16 — — $54,585.57 $150,151.16 $76,419.79 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 1 1 — — $57,368.97 $57,368.97 $57,368.97 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 12 12 — — $79,446.55 $111,033.34 $94,131.04 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 12 12 — — $54,972.04 $76,637.24 $65,132.78 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 13 — — $75,594.97 $105,620.38 $89,567.55 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 13 — — $54,606.49 $76,123.51 $64,699.67 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 12 12 — — $59,572.54 $83,102.72 $70,583.62 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 13 13 — — $59,442.77 $85,435.80 $72,550.57 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 13 13 — — $50,936.79 $70,966.16 $60,351.68 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 13 13 — — $46,683.10 $64,988.10 $55,311.76 2026-04-01
494 APR_DRG — 21 16 — — $42,844.42 $117,880.37 $59,982.18 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 13 13 — — $92,718.48 $129,685.50 $109,856.08 2026-04-01
51 APR_DRG — 21 16 — — $40,928.39 $112,614.12 $57,299.74 2026-04-01
5104 APR_DRG — 21 16 — — $45,963.44 $126,453.06 $64,348.81 2026-04-01
5114 APR_DRG — 21 16 — — $44,672.20 $122,904.07 $62,541.07 2026-04-01
5124 APR_DRG — 21 16 — — $53,687.56 $147,682.97 $75,162.58 2026-04-01
5166 OTHER Cochlear Implant Procedure 16 13 — — $35,807.96 $128,949.80 $54,329.31 2026-04-01
5184 APR_DRG — 21 16 — — $42,917.84 $118,082.17 $60,084.97 2026-04-01
5194 APR_DRG — 21 16 — — $43,418.38 $119,457.92 $60,785.73 2026-04-01
52 APR_DRG — 21 16 — — $41,969.71 $115,476.21 $58,757.59 2026-04-01
5244 OTHER Level 4 Blood Product Exchange And Related Services 16 13 — — $68,311.05 $245,998.32 $103,644.36 2026-04-01
53 APR_DRG — 21 16 — — $65,896.08 $181,238.31 $92,254.50 2026-04-01
54 APR_DRG — 21 16 — — $98,066.17 $269,658.46 $137,292.64 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 13 13 — — $55,879.66 $77,912.79 $66,208.16 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 13 13 — — $51,109.75 $71,209.24 $60,556.61 2026-04-01
5831 APR_DRG — 21 16 — — $101,807.87 $279,942.58 $142,531.01 2026-04-01
5832 APR_DRG — 21 16 — — $101,807.87 $279,942.58 $142,531.01 2026-04-01
5833 APR_DRG — 21 16 — — $103,734.49 $285,237.93 $145,228.28 2026-04-01
5834 APR_DRG — 21 16 — — $182,050.96 $500,492.32 $254,871.35 2026-04-01
5881 APR_DRG — 21 16 — — $137,000.97 $376,671.52 $191,801.35 2026-04-01
5882 APR_DRG — 21 16 — — $137,000.97 $376,671.52 $191,801.35 2026-04-01
5883 APR_DRG — 21 16 — — $178,863.47 $491,731.42 $250,408.85 2026-04-01
5884 APR_DRG — 21 16 — — $178,863.47 $491,731.42 $250,408.85 2026-04-01
5891 APR_DRG — 21 16 — — $86,413.27 $237,630.22 $120,978.57 2026-04-01
5892 APR_DRG — 21 16 — — $86,413.27 $237,630.22 $120,978.57 2026-04-01
5911 APR_DRG — 21 16 — — $63,472.45 $174,576.92 $88,861.42 2026-04-01
5912 APR_DRG — 21 16 — — $78,527.47 $215,955.95 $109,938.45 2026-04-01
5913 APR_DRG — 21 16 — — $84,125.18 $231,341.38 $117,775.26 2026-04-01
5914 APR_DRG — 21 16 — — $137,495.16 $378,029.80 $192,493.21 2026-04-01
5931 APR_DRG — 21 16 — — $76,980.67 $211,704.53 $107,772.93 2026-04-01
5932 APR_DRG — 21 16 — — $79,376.06 $218,288.31 $111,126.48 2026-04-01
5933 APR_DRG — 21 16 — — $96,855.42 $266,330.67 $135,597.58 2026-04-01
5934 APR_DRG — 21 16 — — $123,809.03 $340,413.20 $173,332.63 2026-04-01
6021 APR_DRG — 21 16 — — $46,552.22 $128,071.35 $65,173.11 2026-04-01
6022 APR_DRG — 21 16 — — $67,670.20 $186,114.54 $94,738.28 2026-04-01
6023 APR_DRG — 21 16 — — $79,517.25 $218,676.39 $111,324.15 2026-04-01
6024 APR_DRG — 21 16 — — $107,470.53 $295,506.53 $150,458.74 2026-04-01
6032 APR_DRG — 21 16 — — $49,417.09 $135,945.49 $69,183.92 2026-04-01
6033 APR_DRG — 21 16 — — $64,101.47 $176,305.81 $89,742.06 2026-04-01
6034 APR_DRG — 21 16 — — $99,056.66 $272,380.84 $138,679.32 2026-04-01
6071 APR_DRG — 21 16 — — $43,364.72 $119,310.44 $60,710.61 2026-04-01
6072 APR_DRG — 21 16 — — $53,511.07 $147,197.87 $74,915.49 2026-04-01
6073 APR_DRG — 21 16 — — $65,305.88 $179,616.14 $91,428.22 2026-04-01
6074 APR_DRG — 21 16 — — $87,872.53 $241,641.02 $123,021.53 2026-04-01
6082 APR_DRG — 21 16 — — $40,857.08 $112,418.14 $57,199.91 2026-04-01
6083 APR_DRG — 21 16 — — $48,888.31 $134,492.13 $68,443.63 2026-04-01
6084 APR_DRG — 21 16 — — $51,421.37 $141,454.29 $71,989.91 2026-04-01
6093 APR_DRG — 21 16 — — $52,132.29 $143,408.27 $72,985.20 2026-04-01
6094 APR_DRG — 21 16 — — $113,419.12 $311,856.34 $158,786.76 2026-04-01
6113 APR_DRG — 21 16 — — $44,950.35 $123,668.58 $62,930.49 2026-04-01
6114 APR_DRG — 21 16 — — $58,702.14 $161,465.63 $82,182.99 2026-04-01
6123 APR_DRG — 21 16 — — $45,495.37 $125,166.57 $63,693.52 2026-04-01
6124 APR_DRG — 21 16 — — $60,536.98 $166,508.73 $84,751.77 2026-04-01
6214 APR_DRG — 21 16 — — $48,665.93 $133,880.91 $68,132.29 2026-04-01
63 APR_DRG — 21 16 — — $52,351.85 $144,011.74 $73,292.58 2026-04-01
6303 APR_DRG — 21 16 — — $42,547.90 $117,065.40 $59,567.06 2026-04-01
6304 APR_DRG — 21 16 — — $87,052.88 $239,388.22 $121,874.03 2026-04-01
6314 APR_DRG — 21 16 — — $74,937.56 $206,089.01 $104,912.58 2026-04-01
64 APR_DRG — 21 16 — — $54,644.17 $150,312.22 $76,501.83 2026-04-01
64568 CPT Opn Impltj Crnl Nrv Nea&pg 16 13 — — $52,642.48 $93,376.94 $60,742.57 2026-04-01
64654 CPT 1st Opn Implt Bat Modulj Sys 16 13 — — $52,642.48 $93,376.94 $60,742.57 2026-04-01
6504 APR_DRG — 21 16 — — $40,977.10 $112,748.01 $57,367.94 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 13 13 — — $48,706.97 $67,832.41 $57,709.71 2026-04-01
6804 APR_DRG — 21 16 — — $63,874.15 $175,681.01 $89,423.80 2026-04-01
6814 APR_DRG — 21 16 — — $64,049.94 $176,164.16 $89,669.91 2026-04-01
6903 APR_DRG — 21 16 — — $43,517.92 $119,731.51 $60,925.09 2026-04-01
6904 APR_DRG — 21 16 — — $62,510.20 $171,932.15 $87,514.27 2026-04-01
6914 APR_DRG — 21 16 — — $45,423.36 $124,968.65 $63,592.70 2026-04-01
6954 APR_DRG — 21 16 — — $52,864.39 $145,420.47 $74,010.14 2026-04-01
7 MS_DRG Lung Transplant 13 13 — — $109,804.55 $153,697.99 $130,100.25 2026-04-01
7104 APR_DRG — 21 16 — — $45,335.82 $124,728.04 $63,470.14 2026-04-01
7114 APR_DRG — 21 16 — — $43,327.31 $119,207.60 $60,658.23 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 13 13 — — $53,936.03 $75,181.25 $63,905.29 2026-04-01
7914 APR_DRG — 21 16 — — $47,385.28 $130,361.02 $66,339.39 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 13 13 — — $47,352.67 $65,929.10 $56,105.09 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 13 13 — — $54,351.50 $75,765.15 $64,397.55 2026-04-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 13 13 — — $50,359.94 $70,155.47 $59,668.21 2026-04-01
8412 APR_DRG — 21 16 — — $50,711.86 $139,504.19 $70,996.60 2026-04-01
8413 APR_DRG — 21 16 — — $104,091.01 $286,217.83 $145,727.40 2026-04-01
8414 APR_DRG — 21 16 — — $133,004.42 $365,686.91 $186,206.18 2026-04-01
8424 APR_DRG — 21 16 — — $61,695.49 $169,692.93 $86,373.69 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 1 1 — — $93,075.01 $93,075.01 $93,075.01 2026-04-01
8504 APR_DRG — 21 16 — — $54,558.04 $150,075.49 $76,381.25 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 13 13 — — $62,537.91 $87,270.20 $74,097.09 2026-04-01
894 APR_DRG — 21 16 — — $48,853.01 $134,395.11 $68,394.21 2026-04-01
9035 OTHER Axicabtagene Ciloleucel Car+ 16 13 — — $533,230.17 $533,230.17 $533,230.17 2026-04-01
904 APR_DRG — 21 16 — — $79,999.44 $220,001.68 $111,999.21 2026-04-01
9104 APR_DRG — 21 16 — — $51,422.07 $141,456.23 $71,990.90 2026-04-01
9114 APR_DRG — 21 16 — — $46,535.28 $128,024.78 $65,149.39 2026-04-01
9124 APR_DRG — 21 16 — — $54,204.34 $149,103.35 $75,886.07 2026-04-01
9138 OTHER Inj, Hemgenix, Per Tx Dose 16 13 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2026-04-01
9141 OTHER Inj Onase Abepar-xioi Treat 16 13 — — $2,455,110.61 $2,455,110.61 $2,455,110.61 2026-04-01
9194 OTHER Tisagenlecleucel Car-pos T 16 13 — — $591,726.20 $591,726.20 $591,726.20 2026-04-01
924 APR_DRG — 21 16 — — $52,628.59 $144,772.37 $73,680.03 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 13 — — $229,158.76 $330,274.51 $278,966.28 2026-04-01
9273 OTHER Sipuleucel-t Auto Cd54+ 16 13 — — $55,272.32 $55,272.32 $55,272.32 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 13 13 — — $62,134.92 $86,703.84 $73,619.61 2026-04-01
9391 OTHER Brexucabtagene Car Pos T 16 13 — — $489,304.61 $489,304.61 $489,304.61 2026-04-01
9413 OTHER Lisocabtagene Car Pos T 16 13 — — $562,538.19 $562,538.19 $562,538.19 2026-04-01
9422 OTHER Idecabtagene Vicleucel Car 16 13 — — $557,317.93 $557,317.93 $557,317.93 2026-04-01
9498 OTHER Ciltacabtagene Car-pos T 16 13 — — $565,868.95 $565,868.95 $565,868.95 2026-04-01
9504 APR_DRG — 21 16 — — $58,000.40 $159,536.88 $81,200.55 2026-04-01
9514 APR_DRG — 21 16 — — $45,016.01 $123,849.04 $63,022.41 2026-04-01
9524 APR_DRG — 21 16 — — $42,590.97 $117,183.77 $59,627.35 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 13 13 — — $54,739.34 $76,310.21 $64,857.07 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 13 13 — — $64,923.75 $90,623.22 $76,923.92 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 13 13 — — $61,714.99 $86,113.68 $73,122.07 2026-04-01
A9543 CPT Hb Y90 Ibritumomab, Rx 29 21 — — $56,824.55 $107,313.08 $73,468.00 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 16 13 — — $56,824.55 $56,824.55 $56,824.55 2026-04-01
A9545 CPT Hb I131 Tositumomab, Rx 18 13 — — $11,347.48 $68,322.00 $68,322.00 2026-04-01
C1813 HCPCS Hb Pump Aic Impella 5.0 18 11 — — $8,773.98 $73,688.00 $56,264.37 2026-04-01
C1825 HCPCS Generator Pulse Legacy Implantable 7 5 — — $58,500.00 $58,500.00 $58,500.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 16 13 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 16 13 — — $3,316,462.59 $3,316,462.59 $3,316,462.59 2026-04-01
J3387 HCPCS Inj Elivaldogene Autotemecel 16 13 — — $3,090,000.00 $3,090,000.00 $3,090,000.00 2026-04-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 16 13 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 16 13 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 16 13 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 16 13 — — $2,945,740.00 $2,945,740.00 $2,945,740.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 16 13 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 16 13 — — $2,455,110.60 $2,455,110.60 $2,455,110.60 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 16 13 — — $205,640.00 $205,640.00 $205,640.00 2026-04-01
J3403 HCPCS Revakinagene, Per Implant 16 13 — — $257,500.00 $257,500.00 $257,500.00 2026-04-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 16 13 — — $63,342.28 $63,342.28 $63,342.28 2026-04-01
L6880 CPT Hb Electric Hand Ind Art Digits 24 19 — — $22,521.57 $82,069.00 $57,379.28 2026-04-01
L7181 CPT Hb Electronic Elbo Simultaneous 24 19 — — $37,769.02 $137,632.00 $131,078.00 2026-04-01
PX-81200005 CDM Hb Heart, Incoming 18 13 — — $13,239.13 $82,900.00 $82,900.00 2026-04-01
PX-81200007 CDM Hb Liver, Incoming 18 13 — — $12,025.41 $75,300.00 $75,300.00 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 16 13 — — $533,230.17 $533,230.17 $533,230.17 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 16 13 — — $591,726.20 $591,726.20 $591,726.20 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 16 13 — — $55,272.32 $55,272.32 $55,272.32 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 16 13 — — $489,304.61 $489,304.61 $489,304.61 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 16 13 — — $562,538.18 $562,538.18 $562,538.18 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 16 13 — — $557,317.93 $557,317.93 $557,317.93 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 16 13 — — $565,868.94 $565,868.94 $565,868.94 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 16 13 — — $770,620.00 $770,620.00 $770,620.00 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 16 13 — — $278,250.00 $278,250.00 $278,250.00 2026-04-01
SUP-284765 CDM Console Ultrasonic Aspirator W/accessory Nexus 16 11 — — $353,528.55 $353,528.55 $353,528.55 2026-04-01
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