Hospital

GLENS FALLS HOSPITAL

Glens Falls, NY · CCN 330191 · Rates published

86,500 distinct procedures filed

30 distinct payers

2,354,933 rate rows

2026-05-08 last MRF observed

Data quality

1,695,405 of 2,354,933 rate rows are consumer-grade (72.0%)

659,528 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	370,785
professional (physician) fee — not the facility price	267,508
template filing: same amount across many unrelated codes — excluded	8,425
placeholder amount (≤ $0.02) — excluded from medians	7,561
exceeds 10× this hospital's gross charge — excluded from medians	3,240
per-diem day rate — not a per-procedure price	1,496
percent-of-charges filed in the dollar field — excluded from medians	513

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

Source MRF file	https://albany.pt.panaceainc.com/MRFDownload/albany/albanygfh
Found on page	https://www.albanymed.org/patients-visitors/billing-insurance/hospital-pricing-transparency/
Discovered via	CMS hospital list
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-05-21
Content fingerprint	a0778367553bc1cb… · 15,757,441 bytes · first seen 2026-05-13

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	3	$3,020,475.00	$4,421,275.00	$4,377,500.00	nat. median $4,505,000 1.0× median
C9172 HCPCS	Inj, Beqvez, Per Tx Dose	1	$4,200,000.00	$4,200,000.00	$4,200,000.00	nat. median $3,570,000 1.2× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	6	$2,293,954.61	$4,887,120.69	$3,840,000.00	nat. median $3,325,455 1.2× median
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	5	$2,559,900.00	$4,200,000.00	$3,747,100.00	nat. median $3,710,000 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	6	$2,250,334.95	$4,794,191.85	$3,720,000.00	nat. median $3,286,000 1.1× median
J1411 OTHER	Inj- Hemgenix- Per Tx Dose	8	$3,672,900.00	$3,856,545.00	$3,691,264.50	nat. median $3,685,267 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	4	$2,542,834.00	$3,722,119.34	$3,679,083.33	nat. median $3,710,000 1.0× median
C9172 OTHER	Inj- Beqvez- Per Tx Dose	8	$3,605,000.00	$3,785,250.00	$3,623,025.00	nat. median $3,675,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	6	$2,035,973.80	$4,337,509.40	$3,360,000.00	nat. median $3,006,423 1.1× median
J1413 OTHER	Inj Delandistrogene Mox Rokl	8	$3,325,454.76	$3,491,727.50	$3,342,082.04	nat. median $3,327,860 1.0× median
J3394 OTHER	Inj- Lovotibeglogene Autotem	8	$3,286,000.00	$3,450,300.00	$3,302,430.00	nat. median $3,286,000 1.0× median
J3393 OTHER	Inj- Betibeglogene Autotemce	8	$2,968,000.00	$3,116,400.00	$2,982,840.00	nat. median $2,968,000 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	6	$1,691,959.76	$3,604,609.93	$2,786,453.23	nat. median $2,469,189 1.1× median
J3392 HCPCS	Inj, Exagamglogene Autotem	6	$1,609,080.00	$3,428,040.00	$2,640,000.00	nat. median $2,448,600 1.1× median
J3399 OTHER	Inj Onase Abepar-xioi Treat	8	$2,388,614.23	$2,550,000.00	$2,436,386.52	nat. median $2,472,216 1.0× median
Q2057 HCPCS	Afamitresgene Autoleucel	6	$531,727.80	$1,960,629.90	$1,132,811.40	nat. median $824,563 1.4× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	7	$399,043.96	$1,471,387.28	$850,137.13	nat. median $754,974 1.1× median
0024 APR_DRG		8	$204,348.46	$1,218,721.78	$659,485.26	nat. median $372,987 1.8× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	8	$373,728.61	$1,378,042.45	$637,620.48	nat. median $674,188 0.9× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	8	$373,469.71	$1,377,087.83	$633,974.92	nat. median $625,184 1.0× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	8	$381,831.39	$1,407,919.70	$626,466.60	nat. median $675,122 0.9× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	8	$367,822.77	$1,356,265.97	$604,296.00	nat. median $634,511 1.0× median
C9098 HCPCS	Ciltacabtagene Car Pos T	1	$558,000.00	$558,000.00	$558,000.00	nat. median $57,174 outlier · 9.8×
Q2053 HCPCS	Brexucabtagene Car Pos T	8	$337,906.80	$1,245,957.38	$554,400.00	nat. median $620,080 0.9× median
Q2042 OTHER	Tisagenlecleucel Car-pos T	8	$529,192.86	$843,269.62	$545,068.65	nat. median $591,726 0.9× median
Q2056 OTHER	Ciltacabtagene Car-pos T	8	$527,123.43	$836,873.27	$542,937.13	nat. median $583,076 0.9× median
Q2055 OTHER	Idecabtagene Vicleucel Car	8	$526,587.59	$799,739.00	$542,385.22	nat. median $558,082 1.0× median
Q2054 OTHER	Lisocabtagene Mara Car Pos T	8	$516,726.08	$781,858.30	$532,227.86	nat. median $562,538 0.9× median
Q2041 OTHER	Axicabtagene Ciloleucel Car+	8	$489,455.96	$741,576.00	$504,139.64	nat. median $533,230 0.9× median
5834 APR_DRG		8	$150,509.29	$897,124.44	$485,459.73	nat. median $309,665 1.6× median
5883 APR_DRG		8	$147,869.29	$881,354.90	$476,926.38	nat. median $182,736 outlier · 2.6×
5884 APR_DRG		8	$147,869.29	$881,354.90	$476,926.38	nat. median $246,434 1.9× median
Q2053 OTHER	Brexucabtagene Car Pos T	8	$460,530.40	$741,576.00	$474,346.31	nat. median $489,720 1.0× median
1614 APR_DRG		8	$135,277.95	$806,143.10	$436,227.12	nat. median $207,730 outlier · 2.1×
0034 APR_DRG		8	$131,357.41	$782,724.55	$423,554.67	nat. median $267,508 1.6× median
5914 APR_DRG		8	$113,606.51	$676,693.16	$366,178.05	nat. median $164,279 outlier · 2.2×
5881 APR_DRG		8	$113,197.20	$674,248.27	$364,855.05	nat. median $124,573 outlier · 2.9×
5882 APR_DRG		8	$113,197.20	$674,248.27	$364,855.05	nat. median $145,336 outlier · 2.5×
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	1	$361,288.92	$361,288.92	$361,288.92	nat. median $209,753 1.7× median
8414 APR_DRG		8	$109,887.11	$654,476.10	$354,155.76	nat. median $160,267 outlier · 2.2×
0044 APR_DRG		8	$105,991.13	$631,204.24	$341,562.69	nat. median $195,681 1.7× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	9	$304,757.14	$693,915.52	$335,629.58	nat. median $370,174 0.9× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	5	$186,558.75	$687,894.56	$335,265.00	nat. median $324,450 1.0× median
0014 APR_DRG		8	$102,677.52	$611,411.11	$330,852.06	nat. median $190,591 1.7× median
5934 APR_DRG		8	$102,271.15	$608,983.68	$329,538.51	nat. median $151,838 outlier · 2.2×
MS-018 OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	9	$301,434.42	$622,902.32	$304,448.77	nat. median $309,559 1.0× median
6094 APR_DRG		8	$93,665.84	$557,581.61	$301,723.38	nat. median $162,982 1.9× median
6024 APR_DRG		8	$88,738.99	$528,152.12	$285,798.24	nat. median $118,620 outlier · 2.4×
0023 APR_DRG		8	$88,430.26	$526,307.98	$284,800.32	nat. median $167,082 1.7× median
8413 APR_DRG		8	$85,939.94	$511,432.57	$276,750.81	nat. median $66,693 outlier · 4.1×

Other procedures at this hospital

Browse this hospital's 86,500 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

Q2043	HCPCS	Sipuleucel-t 50000000 Cells IV Susp	50	13	$187,808.70	$93,904.35 50% off	$55,945.97	$187,808.70	$122,075.66	2025-12-31
A9513	HCPCS	Lutetium Lu 177 Dotatate 370 Mbq/ml IV Soln	38	12	$183,026.68	$91,513.34 50% off	$312.69	$155,572.68	$118,967.34	2025-12-31
C9293	HCPCS	Glucarpidase 1000 Units/ml Intrathecal Syringe	42	11	$129,700.20	$64,850.10 50% off	$494.09	$110,245.17	$81,711.13	2025-12-31
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	20	9	—	—	$304,757.14	$693,915.52	$335,629.58	2025-12-31
MS-018	OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	11	9	—	—	$301,434.42	$622,902.32	$304,448.77	2026-05-08
MS-001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	10	9	—	—	$225,146.24	$465,255.81	$226,271.97	2026-05-08
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	20	9	—	—	$191,703.95	$436,499.52	$211,247.31	2025-12-31
MS-927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	11	9	—	—	$189,613.83	$391,829.49	$191,509.97	2026-05-08
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	20	9	—	—	$173,188.76	$394,341.44	$190,876.71	2025-12-31
MS-003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	11	9	—	—	$171,300.51	$353,985.74	$173,013.52	2026-05-08
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	20	9	—	—	$114,184.53	$259,992.00	$125,959.65	2025-12-31
MS-004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	11	9	—	—	$112,939.60	$233,385.21	$114,068.99	2026-05-08
MS-014	OTHER	Allogeneic Bone Marrow Transplant	11	9	—	—	$104,721.30	$216,402.43	$105,768.52	2026-05-08
MS-007	OTHER	Lung Transplant	10	9	—	—	$104,457.54	$215,857.37	$104,979.82	2026-05-08
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	20	9	—	—	$88,033.61	$200,447.76	$97,188.14	2025-12-31
215	MS_DRG	Other Heart Assist System Implant	20	9	—	—	$85,616.58	$194,944.32	$94,528.90	2025-12-31
MS-002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	10	9	—	—	$88,079.30	$182,012.38	$88,519.70	2026-05-08
MS-212	OTHER	Testes Procedures Age 0-17	11	9	—	—	$87,073.79	$179,934.55	$87,944.53	2026-05-08
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	20	9	—	—	$77,990.54	$177,580.24	$86,138.66	2025-12-31
MS-005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	10	9	—	—	$85,119.53	$175,896.14	$85,545.12	2026-05-08
MS-215	OTHER	Other Heart Assist System Implant	11	9	—	—	$84,683.12	$174,994.31	$85,529.95	2026-05-08
MS-426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	11	9	—	—	$83,728.76	$173,022.18	$84,566.05	2026-05-08
J1411	OTHER	Inj- Hemgenix- Per Tx Dose	8	8	—	—	$3,672,900.00	$3,856,545.00	$3,691,264.50	2026-05-08
C9172	OTHER	Inj- Beqvez- Per Tx Dose	8	8	—	—	$3,605,000.00	$3,785,250.00	$3,623,025.00	2026-05-08
J1413	OTHER	Inj Delandistrogene Mox Rokl	8	8	—	—	$3,325,454.76	$3,491,727.50	$3,342,082.04	2026-05-08
J3394	OTHER	Inj- Lovotibeglogene Autotem	8	8	—	—	$3,286,000.00	$3,450,300.00	$3,302,430.00	2026-05-08
J3393	OTHER	Inj- Betibeglogene Autotemce	8	8	—	—	$2,968,000.00	$3,116,400.00	$2,982,840.00	2026-05-08
J3399	OTHER	Inj Onase Abepar-xioi Treat	10	8	—	—	$2,388,614.23	$2,550,000.00	$2,436,386.52	2026-05-08
0024	APR_DRG	—	46	8	—	—	$204,348.46	$1,218,721.78	$659,485.26	2025-12-31
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	24	8	—	—	$373,728.61	$1,378,042.45	$637,620.48	2025-12-31
Q2055	HCPCS	Idecabtagene Vicleucel Car	24	8	—	—	$373,469.71	$1,377,087.83	$633,974.92	2025-12-31
Q2056	HCPCS	Ciltacabtagene Car-pos T	24	8	—	—	$381,831.39	$1,407,919.70	$626,466.60	2025-12-31
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	24	8	—	—	$367,822.77	$1,356,265.97	$604,296.00	2025-12-31
Q2053	HCPCS	Brexucabtagene Car Pos T	24	8	—	—	$337,906.80	$1,245,957.38	$554,400.00	2025-12-31
Q2042	OTHER	Tisagenlecleucel Car-pos T	11	8	—	—	$529,192.86	$843,269.62	$545,068.65	2026-05-08
Q2056	OTHER	Ciltacabtagene Car-pos T	11	8	—	—	$527,123.43	$836,873.27	$542,937.13	2026-05-08
Q2055	OTHER	Idecabtagene Vicleucel Car	11	8	—	—	$526,587.59	$799,739.00	$542,385.22	2026-05-08
Q2054	OTHER	Lisocabtagene Mara Car Pos T	11	8	—	—	$516,726.08	$781,858.30	$532,227.86	2026-05-08
Q2041	OTHER	Axicabtagene Ciloleucel Car+	11	8	—	—	$489,455.96	$741,576.00	$504,139.64	2026-05-08
5834	APR_DRG	—	46	8	—	—	$150,509.29	$897,124.44	$485,459.73	2025-12-31
5883	APR_DRG	—	46	8	—	—	$147,869.29	$881,354.90	$476,926.38	2025-12-31
5884	APR_DRG	—	46	8	—	—	$147,869.29	$881,354.90	$476,926.38	2025-12-31
Q2053	OTHER	Brexucabtagene Car Pos T	11	8	—	—	$460,530.40	$741,576.00	$474,346.31	2026-05-08
1614	APR_DRG	—	46	8	—	—	$135,277.95	$806,143.10	$436,227.12	2025-12-31
0034	APR_DRG	—	46	8	—	—	$131,357.41	$782,724.55	$423,554.67	2025-12-31
5914	APR_DRG	—	46	8	—	—	$113,606.51	$676,693.16	$366,178.05	2025-12-31
5881	APR_DRG	—	46	8	—	—	$113,197.20	$674,248.27	$364,855.05	2025-12-31
5882	APR_DRG	—	46	8	—	—	$113,197.20	$674,248.27	$364,855.05	2025-12-31
8414	APR_DRG	—	46	8	—	—	$109,887.11	$654,476.10	$354,155.76	2025-12-31
0044	APR_DRG	—	46	8	—	—	$105,991.13	$631,204.24	$341,562.69	2025-12-31
0014	APR_DRG	—	46	8	—	—	$102,677.52	$611,411.11	$330,852.06	2025-12-31
5934	APR_DRG	—	46	8	—	—	$102,271.15	$608,983.68	$329,538.51	2025-12-31
6094	APR_DRG	—	46	8	—	—	$93,665.84	$557,581.61	$301,723.38	2025-12-31
6024	APR_DRG	—	46	8	—	—	$88,738.99	$528,152.12	$285,798.24	2025-12-31
0023	APR_DRG	—	46	8	—	—	$88,430.26	$526,307.98	$284,800.32	2025-12-31
8413	APR_DRG	—	46	8	—	—	$85,939.94	$511,432.57	$276,750.81	2025-12-31
5833	APR_DRG	—	46	8	—	—	$85,644.66	$509,668.75	$275,796.36	2025-12-31
5832	APR_DRG	—	46	8	—	—	$84,048.96	$500,137.18	$270,638.55	2025-12-31
5831	APR_DRG	—	46	8	—	—	$84,048.96	$500,137.18	$270,638.55	2025-12-31
6034	APR_DRG	—	46	8	—	—	$81,770.31	$486,526.12	$263,273.22	2025-12-31
0054	APR_DRG	—	46	8	—	—	$80,949.95	$481,625.87	$260,621.55	2025-12-31
5933	APR_DRG	—	46	8	—	—	$79,947.16	$475,635.89	$257,380.20	2025-12-31
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	18	8	—	—	$227,628.03	$518,296.72	$249,523.74	2025-12-31
0022	APR_DRG	—	46	8	—	—	$75,431.96	$448,665.26	$242,785.62	2025-12-31
6074	APR_DRG	—	46	8	—	—	$72,507.19	$431,194.77	$233,331.84	2025-12-31
6304	APR_DRG	—	46	8	—	—	$71,828.34	$427,139.75	$231,137.55	2025-12-31
5892	APR_DRG	—	46	8	—	—	$71,298.58	$423,975.36	$229,425.21	2025-12-31
5891	APR_DRG	—	46	8	—	—	$71,298.58	$423,975.36	$229,425.21	2025-12-31
0021	APR_DRG	—	46	8	—	—	$71,071.71	$422,620.19	$228,691.89	2025-12-31
0033	APR_DRG	—	46	8	—	—	$69,452.04	$412,945.41	$223,456.59	2025-12-31
5913	APR_DRG	—	46	8	—	—	$69,403.51	$412,655.52	$223,299.72	2025-12-31
0904	APR_DRG	—	46	8	—	—	$65,986.41	$392,244.18	$212,254.56	2025-12-31
6023	APR_DRG	—	46	8	—	—	$65,587.04	$389,858.67	$210,963.69	2025-12-31
5932	APR_DRG	—	46	8	—	—	$65,470.10	$389,160.13	$210,585.69	2025-12-31
5912	APR_DRG	—	46	8	—	—	$64,767.27	$384,961.90	$208,313.91	2025-12-31
3034	APR_DRG	—	46	8	—	—	$64,022.34	$380,512.20	$205,906.05	2025-12-31
5931	APR_DRG	—	46	8	—	—	$63,486.15	$377,309.40	$204,172.92	2025-12-31
6314	APR_DRG	—	46	8	—	—	$61,793.97	$367,201.52	$198,703.26	2025-12-31
4404	APR_DRG	—	46	8	—	—	$61,037.93	$362,685.46	$196,259.49	2025-12-31
0043	APR_DRG	—	46	8	—	—	$59,204.84	$351,735.85	$190,334.34	2025-12-31
1604	APR_DRG	—	46	8	—	—	$58,464.00	$347,310.60	$187,939.71	2025-12-31
8504	APR_DRG	—	34	8	—	—	$44,914.89	$266,377.75	$187,014.31	2025-12-31
1613	APR_DRG	—	46	8	—	—	$57,854.14	$343,667.71	$185,968.44	2025-12-31
3614	APR_DRG	—	46	8	—	—	$56,456.07	$335,316.66	$181,449.45	2025-12-31
6022	APR_DRG	—	46	8	—	—	$55,774.87	$331,247.67	$179,247.60	2025-12-31
1624	APR_DRG	—	46	8	—	—	$55,194.25	$327,779.42	$177,370.83	2025-12-31
0053	APR_DRG	—	46	8	—	—	$54,305.48	$322,470.51	$174,498.03	2025-12-31
3044	APR_DRG	—	46	8	—	—	$54,010.19	$320,706.70	$173,543.58	2025-12-31
6073	APR_DRG	—	46	8	—	—	$53,816.65	$319,550.62	$172,917.99	2025-12-31
3124	APR_DRG	—	46	8	—	—	$52,958.28	$314,423.33	$170,143.47	2025-12-31
6033	APR_DRG	—	46	8	—	—	$52,819.12	$313,592.07	$169,693.65	2025-12-31
6814	APR_DRG	—	46	8	—	—	$52,776.44	$313,337.10	$169,555.68	2025-12-31
6804	APR_DRG	—	46	8	—	—	$52,630.84	$312,467.42	$169,085.07	2025-12-31
5911	APR_DRG	—	46	8	—	—	$52,298.14	$310,480.07	$168,009.66	2025-12-31
6904	APR_DRG	—	46	8	—	—	$51,501.16	$305,719.52	$165,433.59	2025-12-31
8424	APR_DRG	—	46	8	—	—	$50,826.40	$301,688.95	$163,252.53	2025-12-31
6124	APR_DRG	—	46	8	—	—	$49,866.87	$295,957.43	$160,151.04	2025-12-31
4054	APR_DRG	—	46	8	—	—	$49,366.94	$292,971.17	$158,535.09	2025-12-31
0013	APR_DRG	—	46	8	—	—	$49,240.64	$292,216.75	$158,126.85	2025-12-31
6114	APR_DRG	—	46	8	—	—	$48,347.19	$286,879.90	$155,238.93	2025-12-31
9504	APR_DRG	—	46	8	—	—	$47,765.98	$283,408.16	$153,360.27	2025-12-31
0234	APR_DRG	—	46	8	—	—	$47,577.70	$282,283.51	$152,751.69	2025-12-31
0032	APR_DRG	—	46	8	—	—	$45,697.83	$271,054.48	$146,675.34	2025-12-31
0064	APR_DRG	—	46	8	—	—	$44,986.22	$266,803.86	$144,375.21	2025-12-31
4474	APR_DRG	—	46	8	—	—	$44,937.69	$266,513.97	$144,218.34	2025-12-31
9124	APR_DRG	—	46	8	—	—	$44,621.94	$264,627.91	$143,197.74	2025-12-31
5124	APR_DRG	—	46	8	—	—	$44,193.93	$262,071.25	$141,814.26	2025-12-31
6072	APR_DRG	—	46	8	—	—	$44,047.75	$261,198.08	$141,341.76	2025-12-31
2604	APR_DRG	—	46	8	—	—	$43,744.28	$259,385.37	$140,360.85	2025-12-31
6954	APR_DRG	—	46	8	—	—	$43,512.15	$257,998.76	$139,610.52	2025-12-31
0924	APR_DRG	—	46	8	—	—	$43,316.85	$256,832.20	$138,979.26	2025-12-31
0063	APR_DRG	—	46	8	—	—	$43,087.64	$255,463.06	$138,238.38	2025-12-31
6093	APR_DRG	—	46	8	—	—	$42,905.79	$254,376.83	$137,650.59	2025-12-31
0214	APR_DRG	—	46	8	—	—	$42,661.97	$252,920.38	$136,862.46	2025-12-31
0041	APR_DRG	—	46	8	—	—	$42,353.24	$251,076.23	$135,864.54	2025-12-31
0042	APR_DRG	—	46	8	—	—	$42,353.24	$251,076.23	$135,864.54	2025-12-31
1694	APR_DRG	—	46	8	—	—	$42,319.91	$250,877.15	$135,756.81	2025-12-31
9104	APR_DRG	—	46	8	—	—	$42,317.57	$250,863.18	$135,749.25	2025-12-31
6084	APR_DRG	—	46	8	—	—	$42,316.98	$250,859.68	$135,747.36	2025-12-31
2204	APR_DRG	—	46	8	—	—	$41,763.25	$247,552.10	$133,957.53	2025-12-31
8412	APR_DRG	—	46	8	—	—	$41,729.34	$247,349.52	$133,847.91	2025-12-31
1654	APR_DRG	—	46	8	—	—	$41,698.35	$247,164.41	$133,747.74	2025-12-31
3214	APR_DRG	—	46	8	—	—	$41,625.84	$246,731.31	$133,513.38	2025-12-31
1634	APR_DRG	—	46	8	—	—	$41,525.27	$246,130.57	$133,188.30	2025-12-31
3033	APR_DRG	—	46	8	—	—	$41,180.29	$244,069.88	$132,073.20	2025-12-31
4014	APR_DRG	—	46	8	—	—	$41,178.53	$244,059.40	$132,067.53	2025-12-31
6032	APR_DRG	—	46	8	—	—	$40,656.97	$240,943.91	$130,381.65	2025-12-31
3104	APR_DRG	—	46	8	—	—	$40,327.77	$238,977.52	$129,317.58	2025-12-31
6083	APR_DRG	—	46	8	—	—	$40,219.01	$238,327.88	$128,966.04	2025-12-31
0894	APR_DRG	—	46	8	—	—	$40,189.77	$238,153.24	$128,871.54	2025-12-31
0244	APR_DRG	—	46	8	—	—	$40,043.59	$237,280.07	$128,399.04	2025-12-31
6214	APR_DRG	—	46	8	—	—	$40,034.82	$237,227.68	$128,370.69	2025-12-31
4414	APR_DRG	—	46	8	—	—	$39,866.43	$236,221.78	$127,826.37	2025-12-31
0204	APR_DRG	—	46	8	—	—	$39,437.83	$233,661.63	$126,441.00	2025-12-31
1674	APR_DRG	—	46	8	—	—	$39,094.01	$231,607.92	$125,329.68	2025-12-31
0031	APR_DRG	—	46	8	—	—	$39,061.27	$231,412.33	$125,223.84	2025-12-31
1814	APR_DRG	—	46	8	—	—	$39,008.06	$231,094.50	$125,051.85	2025-12-31
7914	APR_DRG	—	46	8	—	—	$38,974.14	$230,891.92	$124,942.23	2025-12-31
2214	APR_DRG	—	46	8	—	—	$38,960.11	$230,808.09	$124,896.87	2025-12-31
4034	APR_DRG	—	46	8	—	—	$38,775.34	$229,704.40	$124,299.63	2025-12-31
6021	APR_DRG	—	46	8	—	—	$38,284.18	$226,770.53	$122,712.03	2025-12-31
9114	APR_DRG	—	46	8	—	—	$38,270.14	$226,686.71	$122,666.67	2025-12-31
3134	APR_DRG	—	46	8	—	—	$38,159.05	$226,023.10	$122,307.57	2025-12-31
5104	APR_DRG	—	46	8	—	—	$37,796.52	$223,857.62	$121,135.77	2025-12-31
4424	APR_DRG	—	46	8	—	—	$37,601.22	$222,691.06	$120,504.51	2025-12-31
6123	APR_DRG	—	46	8	—	—	$37,408.85	$221,541.96	$119,882.70	2025-12-31
1774	APR_DRG	—	46	8	—	—	$37,359.73	$221,248.57	$119,723.94	2025-12-31
6914	APR_DRG	—	46	8	—	—	$37,349.21	$221,185.71	$119,689.92	2025-12-31
7104	APR_DRG	—	46	8	—	—	$37,276.70	$220,752.61	$119,455.56	2025-12-31
3174	APR_DRG	—	46	8	—	—	$37,262.67	$220,668.79	$119,410.20	2025-12-31
3054	APR_DRG	—	46	8	—	—	$37,167.95	$220,102.97	$119,104.02	2025-12-31
0264	APR_DRG	—	46	8	—	—	$37,016.50	$219,198.36	$118,614.51	2025-12-31
9514	APR_DRG	—	46	8	—	—	$37,011.83	$219,170.42	$118,599.39	2025-12-31
1824	APR_DRG	—	46	8	—	—	$36,993.70	$219,062.14	$118,540.80	2025-12-31
6113	APR_DRG	—	46	8	—	—	$36,957.45	$218,845.60	$118,423.62	2025-12-31
1664	APR_DRG	—	46	8	—	—	$36,755.14	$217,637.12	$117,769.68	2025-12-31
5114	APR_DRG	—	46	8	—	—	$36,727.07	$217,469.47	$117,678.96	2025-12-31
4444	APR_DRG	—	46	8	—	—	$36,490.26	$216,054.93	$116,913.51	2025-12-31
0012	APR_DRG	—	46	8	—	—	$36,358.11	$215,265.58	$116,486.37	2025-12-31
0011	APR_DRG	—	46	8	—	—	$36,358.11	$215,265.58	$116,486.37	2025-12-31
2644	APR_DRG	—	46	8	—	—	$36,307.24	$214,961.71	$116,321.94	2025-12-31
14	MS_DRG	Allogeneic Bone Marrow Transplant	18	8	—	—	$105,875.65	$241,073.12	$116,236.95	2025-12-31
2614	APR_DRG	—	46	8	—	—	$36,225.38	$214,472.74	$116,057.34	2025-12-31
7	MS_DRG	Lung Transplant	18	8	—	—	$105,608.97	$240,465.92	$115,945.02	2025-12-31
1612	APR_DRG	—	46	8	—	—	$36,149.37	$214,018.69	$115,811.64	2025-12-31
1204	APR_DRG	—	46	8	—	—	$35,934.19	$212,733.37	$115,116.12	2025-12-31
1304	APR_DRG	—	46	8	—	—	$35,828.94	$212,104.69	$114,775.92	2025-12-31
6903	APR_DRG	—	46	8	—	—	$35,771.05	$211,758.91	$114,588.81	2025-12-31
1214	APR_DRG	—	46	8	—	—	$35,737.14	$211,556.33	$114,479.19	2025-12-31
3014	APR_DRG	—	46	8	—	—	$35,717.26	$211,437.58	$114,414.93	2025-12-31
2624	APR_DRG	—	46	8	—	—	$35,716.67	$211,434.09	$114,413.04	2025-12-31
5194	APR_DRG	—	46	8	—	—	$35,688.61	$211,266.44	$114,322.32	2025-12-31
6071	APR_DRG	—	46	8	—	—	$35,644.17	$211,000.99	$114,178.68	2025-12-31
7114	APR_DRG	—	46	8	—	—	$35,613.18	$210,815.88	$114,078.51	2025-12-31
5184	APR_DRG	—	46	8	—	—	$35,274.04	$208,790.11	$112,982.31	2025-12-31
0494	APR_DRG	—	46	8	—	—	$35,213.23	$208,426.87	$112,785.75	2025-12-31
1714	APR_DRG	—	46	8	—	—	$35,191.60	$208,297.64	$112,715.82	2025-12-31
9524	APR_DRG	—	46	8	—	—	$35,003.32	$207,172.99	$112,107.24	2025-12-31
6303	APR_DRG	—	46	8	—	—	$34,967.65	$206,959.94	$111,991.95	2025-12-31
0434	APR_DRG	—	46	8	—	—	$34,922.04	$206,687.51	$111,844.53	2025-12-31
3814	APR_DRG	—	46	8	—	—	$34,834.92	$206,167.10	$111,562.92	2025-12-31
0052	APR_DRG	—	46	8	—	—	$34,488.76	$204,099.42	$110,444.04	2025-12-31
2294	APR_DRG	—	46	8	—	—	$34,156.64	$202,115.56	$109,370.52	2025-12-31
3084	APR_DRG	—	46	8	—	—	$34,051.39	$201,486.88	$109,030.32	2025-12-31
3094	APR_DRG	—	46	8	—	—	$33,912.82	$200,659.11	$108,582.39	2025-12-31
1623	APR_DRG	—	46	8	—	—	$33,863.70	$200,365.72	$108,423.63	2025-12-31
6504	APR_DRG	—	46	8	—	—	$33,666.65	$199,188.68	$107,786.70	2025-12-31
0051	APR_DRG	—	46	8	—	—	$33,626.30	$198,947.68	$107,656.29	2025-12-31
6082	APR_DRG	—	46	8	—	—	$33,567.25	$198,594.92	$107,465.40	2025-12-31
4403	APR_DRG	—	46	8	—	—	$33,487.73	$198,119.91	$107,208.36	2025-12-31
2234	APR_DRG	—	46	8	—	—	$32,938.67	$194,840.27	$105,433.65	2025-12-31
2244	APR_DRG	—	46	8	—	—	$32,880.79	$194,494.49	$105,246.54	2025-12-31
2224	APR_DRG	—	46	8	—	—	$32,678.47	$193,286.02	$104,592.60	2025-12-31
3024	APR_DRG	—	46	8	—	—	$32,145.21	$190,100.68	$102,868.92	2025-12-31
4234	APR_DRG	—	46	8	—	—	$32,118.90	$189,943.50	$102,783.87	2025-12-31
0224	APR_DRG	—	46	8	—	—	$31,821.86	$188,169.21	$101,823.75	2025-12-31
8411	APR_DRG	—	46	8	—	—	$31,700.82	$187,446.22	$101,432.52	2025-12-31
6334	APR_DRG	—	46	8	—	—	$31,625.40	$186,995.67	$101,188.71	2025-12-31
0504	APR_DRG	—	46	8	—	—	$31,582.13	$186,737.21	$101,048.85	2025-12-31
3043	APR_DRG	—	46	8	—	—	$31,471.61	$186,077.09	$100,691.64	2025-12-31
Q0480	OTHER	Driver Pneumatic Vad- Rep	8	8	—	—	$99,999.91	$104,999.91	$100,499.91	2026-05-08
3644	APR_DRG	—	46	8	—	—	$31,364.61	$185,437.92	$100,345.77	2025-12-31
8634	APR_DRG	—	46	8	—	—	$31,304.38	$185,078.17	$100,151.10	2025-12-31
3032	APR_DRG	—	46	8	—	—	$31,242.40	$184,707.95	$99,950.76	2025-12-31
2274	APR_DRG	—	46	8	—	—	$31,156.45	$184,194.52	$99,672.93	2025-12-31
6134	APR_DRG	—	46	8	—	—	$30,597.46	$180,855.50	$97,866.09	2025-12-31
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	18	8	—	—	$89,050.20	$202,762.48	$97,817.52	2025-12-31
6031	APR_DRG	—	46	8	—	—	$30,574.66	$180,719.28	$97,792.38	2025-12-31
6224	APR_DRG	—	46	8	—	—	$30,544.25	$180,537.66	$97,694.10	2025-12-31
3154	APR_DRG	—	46	8	—	—	$30,336.09	$179,294.26	$97,021.26	2025-12-31
8444	APR_DRG	—	46	8	—	—	$30,022.10	$177,418.68	$96,006.33	2025-12-31
4434	APR_DRG	—	46	8	—	—	$29,952.51	$177,003.05	$95,781.42	2025-12-31
0062	APR_DRG	—	46	8	—	—	$29,880.01	$176,569.96	$95,547.06	2025-12-31
0061	APR_DRG	—	46	8	—	—	$29,880.01	$176,569.96	$95,547.06	2025-12-31
6133	APR_DRG	—	46	8	—	—	$29,834.99	$176,301.02	$95,401.53	2025-12-31
6144	APR_DRG	—	46	8	—	—	$29,767.16	$175,895.86	$95,182.29	2025-12-31
6143	APR_DRG	—	46	8	—	—	$29,767.16	$175,895.86	$95,182.29	2025-12-31
3204	APR_DRG	—	46	8	—	—	$29,577.12	$174,760.74	$94,568.04	2025-12-31
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	18	8	—	—	$86,057.80	$195,948.96	$94,541.64	2025-12-31
6604	APR_DRG	—	46	8	—	—	$29,427.44	$173,866.61	$94,084.20	2025-12-31
1754	APR_DRG	—	46	8	—	—	$29,033.92	$171,516.02	$92,812.23	2025-12-31
6313	APR_DRG	—	46	8	—	—	$28,831.02	$170,304.05	$92,156.40	2025-12-31
3464	APR_DRG	—	46	8	—	—	$28,822.25	$170,251.66	$92,128.05	2025-12-31
1653	APR_DRG	—	46	8	—	—	$28,745.65	$169,794.12	$91,880.46	2025-12-31
1804	APR_DRG	—	46	8	—	—	$28,498.32	$168,316.71	$91,080.99	2025-12-31
1704	APR_DRG	—	46	8	—	—	$28,459.73	$168,086.19	$90,956.25	2025-12-31
5134	APR_DRG	—	46	8	—	—	$28,395.99	$167,705.48	$90,750.24	2025-12-31
1603	APR_DRG	—	46	8	—	—	$28,270.28	$166,954.55	$90,343.89	2025-12-31
4402	APR_DRG	—	46	8	—	—	$27,482.66	$162,249.89	$87,798.06	2025-12-31
6614	APR_DRG	—	46	8	—	—	$27,018.98	$159,480.17	$86,299.29	2025-12-31
6122	APR_DRG	—	46	8	—	—	$26,925.42	$158,921.34	$85,996.89	2025-12-31
1633	APR_DRG	—	46	8	—	—	$26,899.11	$158,764.17	$85,911.84	2025-12-31
3123	APR_DRG	—	46	8	—	—	$26,794.45	$158,138.98	$85,573.53	2025-12-31
1622	APR_DRG	—	46	8	—	—	$26,527.82	$156,546.31	$84,711.69	2025-12-31
1934	APR_DRG	—	46	8	—	—	$26,423.15	$155,921.11	$84,373.38	2025-12-31
2284	APR_DRG	—	46	8	—	—	$26,374.03	$155,627.73	$84,214.62	2025-12-31
3031	APR_DRG	—	46	8	—	—	$26,163.54	$154,370.35	$83,534.22	2025-12-31
5893	APR_DRG	—	46	8	—	—	$26,047.18	$153,675.31	$83,158.11	2025-12-31
6964	APR_DRG	—	46	8	—	—	$26,015.02	$153,483.21	$83,054.16	2025-12-31
8423	APR_DRG	—	46	8	—	—	$25,834.34	$152,403.96	$82,470.15	2025-12-31
0213	APR_DRG	—	46	8	—	—	$25,649.57	$151,300.27	$81,872.91	2025-12-31
5464	APR_DRG	—	46	8	—	—	$25,508.07	$150,455.04	$81,415.53	2025-12-31
0233	APR_DRG	—	46	8	—	—	$25,441.99	$150,060.36	$81,201.96	2025-12-31
1303	APR_DRG	—	46	8	—	—	$25,342.59	$149,466.60	$80,880.66	2025-12-31
4834	APR_DRG	—	46	8	—	—	$25,334.40	$149,417.71	$80,854.20	2025-12-31
6081	APR_DRG	—	46	8	—	—	$25,137.94	$148,244.16	$80,219.16	2025-12-31
8503	APR_DRG	—	34	8	—	—	$19,249.23	$113,069.18	$79,381.83	2025-12-31
0984	APR_DRG	—	46	8	—	—	$24,653.21	$145,348.71	$78,652.35	2025-12-31
8633	APR_DRG	—	46	8	—	—	$24,594.73	$144,999.44	$78,463.35	2025-12-31
Q2042	HCPCS	Tisagenlecleucel Car-pos T	18	7	—	—	$399,043.96	$1,471,387.28	$850,137.13	2025-12-31
5834	OTHER	Neonate W Ecmo	18	7	$87.00	$43.50 50% off	$73.95	$838,817.90	$151,478.30	2026-05-08
5884	OTHER	Poisoning Of Medicinal Agents	18	7	$1,410.00	$705.00 50% off	$1,198.50	$824,073.27	$148,826.10	2026-05-08
1614	OTHER	Disorders Of Gallbladder & Biliary Tract	18	7	$556.88	$278.44 50% off	$473.35	$753,749.69	$136,176.60	2026-05-08
5914	OTHER	Other Injury Poisoning & Toxic Effect Diagnoses	18	7	$750.00	$375.00 50% off	$637.50	$632,713.05	$114,405.05	2026-05-08
5882	OTHER	Neonate Bwt <1500g W Major Procedure	18	7	$358.50	$179.25 50% off	$304.72	$630,427.06	$113,993.85	2026-05-08
5934	OTHER	Toxic Effects Of Non-medicinal Substances	18	7	$187.00	$93.50 50% off	$158.95	$569,404.19	$103,017.32	2026-05-08
8413	OTHER	Extensive 3rd Degree Burns W Skin Graft	18	7	$1,140.00	$570.00 50% off	$969.00	$478,193.19	$86,610.68	2026-05-08
5832	OTHER	O.r. Procedure For Other Complications Of Treatment	18	7	$104.40	$52.20 50% off	$88.74	$467,631.91	$84,710.97	2026-05-08
6034	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	18	7	$1,350.00	$675.00 50% off	$1,147.50	$454,905.48	$82,421.79	2026-05-08
J1413	HCPCS	Inj Delandistrogene Mox Rokl	18	6	—	—	$2,293,954.61	$4,887,120.69	$3,840,000.00	2025-12-31
J3394	HCPCS	Inj, Lovotibeglogene Autotem	18	6	—	—	$2,250,334.95	$4,794,191.85	$3,720,000.00	2025-12-31
J3393	HCPCS	Inj, Betibeglogene Autotemce	18	6	—	—	$2,035,973.80	$4,337,509.40	$3,360,000.00	2025-12-31
J3399	HCPCS	Inj Onase Abepar-xioi Treat	18	6	—	—	$1,691,959.76	$3,604,609.93	$2,786,453.23	2025-12-31
J3392	HCPCS	Inj, Exagamglogene Autotem	18	6	—	—	$1,609,080.00	$3,428,040.00	$2,640,000.00	2025-12-31
Q2057	HCPCS	Afamitresgene Autoleucel	16	6	—	—	$531,727.80	$1,960,629.90	$1,132,811.40	2025-12-31
0024	OTHER	Heart &/or Lung Transplant	17	6	—	—	$205,566.17	$1,139,513.76	$205,566.17	2026-05-08
5883	OTHER	Neonate Bwt <1500g W Major Procedure	17	6	—	—	$148,826.10	$824,073.27	$148,826.10	2026-05-08
0034	OTHER	Cardiac Valve Procedures Without Ami Or Complex Pdx	17	6	—	—	$132,237.94	$731,853.17	$132,237.94	2026-05-08
5881	OTHER	Neonate Bwt <1500g W Major Procedure	17	6	—	—	$113,993.85	$630,427.06	$113,993.85	2026-05-08
8414	OTHER	Extensive 3rd Degree Burns W Skin Graft	17	6	—	—	$110,668.47	$611,939.93	$110,668.47	2026-05-08
0044	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure	17	6	—	—	$106,754.49	$590,180.57	$106,754.49	2026-05-08
0014	OTHER	Liver Transplant &/or Intestinal Transplant	17	6	—	—	$103,425.58	$571,673.85	$103,425.58	2026-05-08
6094	OTHER	Procedure W Diag Of Rehab Aftercare Or Oth Contact W Health Service	17	6	—	—	$94,372.26	$521,342.88	$94,372.26	2026-05-08
6024	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	17	6	—	—	$89,422.66	$493,826.09	$89,422.66	2026-05-08
0023	OTHER	Heart &/or Lung Transplant	17	6	—	—	$89,112.50	$492,101.80	$89,112.50	2026-05-08
5833	OTHER	O.r. Procedure For Other Complications Of Treatment	17	6	—	—	$86,314.04	$476,544.01	$86,314.04	2026-05-08
5831	OTHER	O.r. Procedure For Other Complications Of Treatment	17	6	—	—	$84,710.97	$467,631.91	$84,710.97	2026-05-08
0054	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	17	6	—	—	$81,597.64	$450,323.70	$81,597.64	2026-05-08
5933	OTHER	Other Injury Poisoning & Toxic Effect Diagnoses	17	6	—	—	$80,590.22	$444,723.03	$80,590.22	2026-05-08
J1414	HCPCS	Inj, Beqvez, Per Tx Dose	14	5	—	—	$2,559,900.00	$4,200,000.00	$3,747,100.00	2025-12-31
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	12	5	—	—	$186,558.75	$687,894.56	$335,265.00	2025-12-31
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	8	4	—	—	$2,542,834.00	$3,722,119.34	$3,679,083.33	2025-12-31
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	10	4	—	—	$84,651.71	$192,747.36	$84,651.71	2025-12-31
J3391	HCPCS	Inj, Atidarsagene Autotemcel	6	3	—	—	$3,020,475.00	$4,421,275.00	$4,377,500.00	2025-12-31
Q0480	HCPCS	Driver Pneumatic Vad, Rep	4	2	—	—	$106,120.93	$110,365.77	$108,243.35	2025-12-31
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	4	2	—	—	$93,216.70	$96,945.37	$95,081.04	2025-12-31
C9172	HCPCS	Inj, Beqvez, Per Tx Dose	6	1	—	—	$4,200,000.00	$4,200,000.00	$4,200,000.00	2025-12-31
C9098	HCPCS	Ciltacabtagene Car Pos T	6	1	—	—	$558,000.00	$558,000.00	$558,000.00	2025-12-31
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	4	1	—	—	$361,288.92	$361,288.92	$361,288.92	2025-12-31
116024	OTHER	Glucarpidase 1000 Units IV Solr	1	1	$247,046.40	$123,523.20 50% off	$209,989.44	$209,989.44	$209,989.44	2026-05-08
40811602401	OTHER	Glucarpidase 1000 Units/ml Intrathecal Syringe	1	1	$247,046.40	$123,523.20 50% off	$209,989.44	$209,989.44	$209,989.44	2026-05-08
180670	OTHER	Sipuleucel-t 50000000 Cells IV Susp	1	1	$187,808.70	$93,904.35 50% off	$159,637.40	$159,637.40	$159,637.40	2026-05-08
MS-453	OTHER	Combined Anterior/posterior Spinal Fusion W Mcc	1	1	—	—	$121,859.54	$121,859.54	$121,859.54	2026-05-08
MS-222	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…	1	1	—	—	$101,917.00	$101,917.00	$101,917.00	2026-05-08
52946	OTHER	Unit Pressure Monitor Irraflow	1	1	$112,500.00	$56,250.00 50% off	$95,625.00	$95,625.00	$95,625.00	2026-05-08
MS-224	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…	1	1	—	—	$94,364.34	$94,364.34	$94,364.34	2026-05-08
108956	OTHER	Ipilimumab 200 Mg/40ml IV Soln	1	1	$104,438.60	$52,219.30 50% off	$88,772.81	$88,772.81	$88,772.81	2026-05-08
MS-459	OTHER	Spinal Fusion Except Cervical With Mcc	1	1	—	—	$88,291.86	$88,291.86	$88,291.86	2026-05-08
MS-226	OTHER	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	1	1	—	—	$85,202.38	$85,202.38	$85,202.38	2026-05-08
MS-454	OTHER	Combined Anterior/posterior Spinal Fusion W Cc	1	1	—	—	$81,075.97	$81,075.97	$81,075.97	2026-05-08

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