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 →

Export CSV
Hospital

NORTHPORT VA MEDICAL CENTER

Northport, NY · CCN 33019F · Rates published

20,662 distinct procedures filed
17 distinct payers
396,456 rate rows
2026-03-26 last MRF observed
Data quality

312,900 of 396,456 rate rows are consumer-grade (78.9%)

83,556 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 79,707
per-diem day rate — not a per-procedure price 3,168
percent-of-charges filed in the dollar field — excluded from medians 481
exceeds 10× this hospital's gross charge — excluded from medians 147
placeholder amount (≤ $0.02) — excluded from medians 53
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://dch.pt.panaceainc.com/MRFDownload/dch/rmc
Found on page https://www.dchsystem.com/patient-visitor/understanding-the-cost-of-your-care/chargemaster/list-of-charges/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 0d6b0b9e91a4f7c6… · 280,265,183 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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 7 $4,505,000.00 $4,595,100.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 7 $3,685,266.66 $3,758,971.99 $3,685,266.66 nat. median
$3,710,000
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 7 $3,335,820.00 $3,402,536.40 $3,335,820.00 nat. median
$3,335,820
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $3,327,859.72 $3,394,416.91 $3,327,859.72 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $3,252,508.07 $3,317,558.23 $3,252,508.07 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 7 $3,180,000.00 $3,243,600.00 $3,180,000.00 nat. median
$3,180,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 8 $2,939,968.88 $4,997,947.10 $2,939,968.88 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 8 $2,588,981.22 $4,401,268.07 $2,588,981.22 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 8 $2,332,000.00 $3,964,400.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 8 $770,620.00 $1,310,054.00 $770,620.00 nat. median
$824,563
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 8 $587,649.57 $999,004.27 $587,649.57 nat. median
$675,122
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 8 $566,531.30 $963,103.21 $566,531.30 nat. median
$754,974
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 8 $562,201.24 $955,742.11 $562,201.24 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 8 $558,081.72 $948,738.92 $558,081.72 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 8 $532,192.24 $904,726.81 $532,192.24 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 8 $489,450.20 $832,065.34 $489,450.20 nat. median
$620,080
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 $3,500.00 $563,437.00 $331,433.53 nat. median
$370,174
0.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 8 $278,250.00 $473,025.00 $278,250.00 nat. median
$324,450
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 8 $265,000.00 $450,500.00 $265,000.00 nat. median
$265,000
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 10 $3,500.00 $367,638.35 $216,257.85 nat. median
$265,286
0.8× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 8 $201,669.02 $342,837.33 $201,669.02 nat. median
$209,753
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $3,500.00 $281,441.92 $165,554.07 nat. median
$206,368
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 $3,500.00 $279,823.50 $164,602.06 nat. median
$202,986
0.8× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 $3,500.00 $184,580.42 $108,576.72 nat. median
$133,176
0.8× median
25682002801
NDC 		Ravulizumab-cwvz 1100 Mg/11 Ml Via 10 $33,531.34 $197,243.17 $103,552.66 nat. median
$133
outlier · 778.6×
7
MS_DRG 		Lung Transplant 10 $3,500.00 $172,940.15 $101,729.50 nat. median
$122,708
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 10 $3,500.00 $160,898.18 $94,645.99 nat. median
$117,303
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 10 $3,500.00 $152,036.22 $89,433.07 nat. median
$108,660
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 8 $87,547.61 $151,868.31 $89,334.30 nat. median
$98,017
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $82,659.00 $148,024.39 $87,073.17 nat. median
$98,905
0.9× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 10 $3,500.00 $146,124.38 $85,955.52 nat. median
$102,358
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 10 $3,500.00 $138,844.68 $81,673.34 nat. median
$100,136
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 10 $3,500.00 $134,278.73 $78,987.49 nat. median
$99,019
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $3,500.00 $132,028.70 $77,663.94 nat. median
$93,672
0.8× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 $67,572.00 $122,041.73 $71,789.25 nat. median
$82,712
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 8 $64,946.25 $117,519.67 $69,129.22 nat. median
$83,442
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 10 $3,500.00 $114,554.08 $67,384.75 nat. median
$79,312
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 $3,500.00 $114,211.78 $67,183.40 nat. median
$81,118
0.8× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 8 $64,274.79 $109,267.14 $64,274.79 nat. median
$69,774
0.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 10 $3,500.00 $107,306.67 $63,121.57 nat. median
$77,576
0.8× median
38240
HCPCS 		Transplt Allo Hct/donor 8 $62,717.34 $106,619.48 $62,717.34 nat. median
$15,912
outlier · 3.9×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 $3,500.00 $104,846.09 $61,674.17 nat. median
$74,915
0.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 10 $3,500.00 $104,418.56 $61,422.68 nat. median
$73,807
0.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 10 $3,500.00 $104,091.78 $61,230.46 nat. median
$72,138
0.8× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $54,139.50 $98,908.41 $58,181.42 nat. median
$68,090
0.9× median
10
MS_DRG 		Pancreas Transplant 10 $3,500.00 $98,354.30 $57,855.47 nat. median
$68,882
0.8× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 10 $3,500.00 $98,315.56 $57,832.68 nat. median
$64,027
0.9× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 10 $3,500.00 $97,823.44 $57,543.20 nat. median
$71,240
0.8× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 10 $3,500.00 $97,769.19 $57,511.29 nat. median
$68,887
0.8× median
310453530
NDC 		Tremelimumab-actl 300 Mg/15 Ml Vial 10 $18,564.00 $109,200.00 $57,330.00 nat. median
$119,134
outlier · 0.5×

Other procedures at this hospital

Browse this hospital's 20,662 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
             
001006010-53086 CDM Kit Impella Cp9 W/smart Assist 13 10 $56,000.00 $28,000.00 50% off $9,520.00 $56,000.00 $30,800.00 2026-03-26
001008312-51771 CDM Impella Rp Flex Kit Sma Assist 13 10 $56,000.00 $28,000.00 50% off $9,520.00 $56,000.00 $30,800.00 2026-03-26
0408T HCPCS Insj/rplc Cardiac Modulj Sys 8 8 — — $31,297.16 $53,205.17 $31,297.16 2026-03-26
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 8 8 — — $22,178.59 $37,703.60 $22,178.59 2026-03-26
0515T HCPCS Insj Wcs Lv Compl Sys 8 8 — — $22,178.59 $37,703.60 $22,178.59 2026-03-26
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 18 14 $64,000.00 $32,000.00 50% off $4,552.00 $64,000.00 $31,961.55 2026-03-26
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 8 8 — — $43,917.79 $74,660.24 $43,917.79 2026-03-26
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 8 8 — — $30,767.54 $52,304.82 $30,767.54 2026-03-26
0870T HCPCS Imp Subq Prtl Ascts Pmp Sys 8 8 — — $34,158.39 $58,069.26 $34,158.39 2026-03-26
0871T HCPCS Rplcmt Subq Prtl Ascites Pmp 8 8 — — $26,838.84 $45,626.02 $26,838.84 2026-03-26
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 8 8 — — $30,767.54 $52,304.82 $30,767.54 2026-03-26
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 8 8 — — $30,767.54 $52,304.82 $30,767.54 2026-03-26
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 8 8 — — $31,297.16 $53,205.17 $31,297.16 2026-03-26
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 8 8 — — $27,054.75 $45,993.07 $27,054.75 2026-03-26
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 8 8 — — $27,054.75 $45,993.07 $27,054.75 2026-03-26
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 13 10 — — $3,500.00 $367,638.35 $216,257.85 2026-03-26
10 MS_DRG Pancreas Transplant 13 10 — — $3,500.00 $98,354.30 $57,855.47 2026-03-26
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 13 10 — — $3,500.00 $76,117.40 $44,774.94 2026-03-26
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 13 10 — — $3,500.00 $60,125.58 $35,367.99 2026-03-26
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 13 10 — — $3,500.00 $42,892.50 $25,230.88 2026-03-26
14 MS_DRG Allogeneic Bone Marrow Transplant 13 10 — — $3,500.00 $160,898.18 $94,645.99 2026-03-26
140 MS_DRG Major Head And Neck Procedures With Mcc 13 10 — — $3,500.00 $60,762.37 $35,742.57 2026-03-26
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 13 10 — — $3,500.00 $54,062.62 $31,801.54 2026-03-26
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 13 10 — — $3,500.00 $82,260.45 $48,388.50 2026-03-26
163 MS_DRG Major Chest Procedures With Mcc 13 10 — — $3,500.00 $63,558.77 $37,387.51 2026-03-26
164 MS_DRG Major Chest Procedures With Cc 13 10 — — $3,500.00 $38,271.01 $22,512.36 2026-03-26
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 13 10 — — $3,500.00 $53,947.66 $31,733.92 2026-03-26
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 13 10 — — $3,500.00 $75,835.83 $44,609.31 2026-03-26
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 13 10 — — $3,500.00 $44,114.39 $25,949.64 2026-03-26
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 10 — — $3,500.00 $563,437.00 $331,433.53 2026-03-26
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 13 10 — — $3,500.00 $97,823.44 $57,543.20 2026-03-26
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 10 — — $3,500.00 $152,036.22 $89,433.07 2026-03-26
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 10 — — $3,500.00 $107,306.67 $63,121.57 2026-03-26
20696 HCPCS App Mltpln Uni Xtrnl Fix 1st 9 9 — — $440.80 $45,993.07 $27,054.75 2026-03-26
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 13 10 — — $3,500.00 $88,783.23 $52,225.43 2026-03-26
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 13 10 — — $3,500.00 $41,173.32 $24,219.60 2026-03-26
209 MS_DRG Complex Aortic Arch Procedures 8 8 — — $87,547.61 $151,868.31 $89,334.30 2026-03-26
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 13 10 — — $3,500.00 $74,046.90 $43,557.00 2026-03-26
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 13 10 — — $3,500.00 $146,124.38 $85,955.52 2026-03-26
21243 HCPCS Reconstruction Of Jaw Joint 9 9 — — $618.24 $45,993.07 $27,054.75 2026-03-26
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 8 8 — — $45,761.78 $79,382.67 $46,695.69 2026-03-26
215 MS_DRG Other Heart Assist System Implant 13 10 — — $3,500.00 $134,278.73 $78,987.49 2026-03-26
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 10 — — $3,500.00 $132,028.70 $77,663.94 2026-03-26
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 10 — — $3,500.00 $90,599.29 $53,293.70 2026-03-26
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 10 — — $3,500.00 $90,599.29 $53,293.70 2026-03-26
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 10 — — $3,500.00 $104,846.09 $61,674.17 2026-03-26
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 13 10 — — $3,500.00 $46,710.59 $27,476.82 2026-03-26
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 10 — — $3,500.00 $74,550.64 $43,853.32 2026-03-26
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 10 — — $3,500.00 $70,771.29 $41,630.17 2026-03-26
22558 HCPCS Arthrd Ant Ntrbd Min Dsc Lum 8 8 — — $27,054.75 $45,993.07 $27,054.75 2026-03-26
22630 HCPCS Arthrd Pst Tq 1ntrspc Lum 8 8 — — $27,054.75 $45,993.07 $27,054.75 2026-03-26
22633 HCPCS Arthrd Cmbn 1ntrspc Lumbar 8 8 — — $27,054.75 $45,993.07 $27,054.75 2026-03-26
228 MS_DRG Other Cardiothoracic Procedures With Mcc 13 10 — — $3,500.00 $69,572.65 $40,925.09 2026-03-26
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 13 10 — — $3,500.00 $46,350.23 $27,264.84 2026-03-26
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 10 — — $3,500.00 $79,684.92 $46,873.48 2026-03-26
231 MS_DRG Coronary Bypass With Ptca With Mcc 13 10 — — $3,500.00 $114,554.08 $67,384.75 2026-03-26
232 MS_DRG Coronary Bypass With Ptca Without Mcc 13 10 — — $3,500.00 $83,977.04 $49,398.26 2026-03-26
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 13 10 — — $3,500.00 $104,418.56 $61,422.68 2026-03-26
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 13 10 — — $3,500.00 $76,228.48 $44,840.28 2026-03-26
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 13 10 — — $3,500.00 $81,471.26 $47,924.27 2026-03-26
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 13 10 — — $3,500.00 $59,774.26 $35,161.33 2026-03-26
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 13 10 — — $3,500.00 $69,240.69 $40,729.82 2026-03-26
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 10 — — $3,500.00 $56,197.70 $33,057.47 2026-03-26
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 13 10 — — $3,500.00 $42,488.22 $24,993.07 2026-03-26
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 13 10 — — $3,500.00 $46,909.51 $27,593.83 2026-03-26
245 MS_DRG Aicd Generator Procedures 13 10 — — $3,500.00 $64,599.83 $37,999.90 2026-03-26
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 13 10 — — $3,500.00 $64,397.04 $37,880.61 2026-03-26
252 MS_DRG Other Vascular Procedures With Mcc 13 10 — — $3,500.00 $50,726.30 $29,839.00 2026-03-26
253 MS_DRG Other Vascular Procedures With Cc 13 10 — — $3,500.00 $39,195.83 $23,056.37 2026-03-26
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 13 10 — — $3,500.00 $40,510.71 $23,829.83 2026-03-26
25682000101 NDC Eculizumab 300 Mg/30 Ml Vial 13 10 $54,793.20 $27,396.60 50% off $9,314.84 $54,793.20 $28,766.43 2026-03-26
25682002801 NDC Ravulizumab-cwvz 1100 Mg/11 Ml Via 13 10 $197,243.17 $98,621.59 50% off $33,531.34 $197,243.17 $103,552.66 2026-03-26
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 13 10 — — $3,500.00 $46,254.64 $27,208.61 2026-03-26
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 13 10 — — $3,500.00 $45,829.69 $26,958.64 2026-03-26
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 13 10 — — $3,500.00 $47,684.49 $28,049.70 2026-03-26
263 MS_DRG Vein Ligation And Stripping 13 10 — — $3,500.00 $45,160.62 $26,565.07 2026-03-26
264 MS_DRG Other Circulatory System O.r. Procedures 13 10 — — $3,500.00 $48,818.56 $28,716.80 2026-03-26
265 MS_DRG Aicd Lead Procedures 13 10 — — $3,500.00 $52,404.15 $30,825.97 2026-03-26
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 13 10 — — $3,500.00 $84,826.94 $49,898.20 2026-03-26
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 13 10 — — $3,500.00 $67,162.44 $39,507.32 2026-03-26
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 13 10 — — $3,500.00 $94,507.79 $55,592.82 2026-03-26
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 13 10 — — $3,500.00 $60,218.59 $35,422.70 2026-03-26
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 13 10 — — $3,500.00 $38,256.80 $22,504.00 2026-03-26
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 13 10 — — $3,500.00 $73,820.87 $43,424.04 2026-03-26
271 MS_DRG Other Major Cardiovascular Procedures With Cc 13 10 — — $3,500.00 $51,604.62 $30,355.66 2026-03-26
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 13 10 — — $3,500.00 $38,645.59 $22,732.70 2026-03-26
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 13 10 — — $3,500.00 $58,956.65 $34,680.38 2026-03-26
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 13 10 — — $3,500.00 $48,186.94 $28,345.26 2026-03-26
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 13 10 — — $3,500.00 $97,769.19 $57,511.29 2026-03-26
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 13 10 — — $3,500.00 $83,253.73 $48,972.78 2026-03-26
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 13 10 — — $3,500.00 $65,324.44 $38,426.14 2026-03-26
27702 HCPCS Reconstruct Ankle Joint 8 8 — — $27,054.75 $45,993.07 $27,054.75 2026-03-26
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 13 10 — — $3,500.00 $77,565.32 $45,626.66 2026-03-26
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 13 10 — — $3,500.00 $52,251.74 $30,736.32 2026-03-26
28 MS_DRG Spinal Procedures With Mcc 13 10 — — $3,500.00 $83,275.67 $48,985.69 2026-03-26
288 MS_DRG Acute And Subacute Endocarditis With Mcc 13 10 — — $3,500.00 $40,624.37 $23,896.69 2026-03-26
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 13 10 — — $3,500.00 $49,735.63 $29,256.25 2026-03-26
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 13 10 — — $3,500.00 $279,823.50 $164,602.06 2026-03-26
31 MS_DRG Ventricular Shunt Procedures With Mcc 13 10 — — $3,500.00 $63,541.97 $37,377.63 2026-03-26
310453530 NDC Tremelimumab-actl 300 Mg/15 Ml Vial 13 10 $109,200.00 $54,600.00 50% off $18,564.00 $109,200.00 $57,330.00 2026-03-26
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 10 8 — — $50,148.75 $92,035.59 $54,138.58 2026-03-26
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 13 10 — — $3,500.00 $63,314.65 $37,243.91 2026-03-26
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 13 10 — — $3,500.00 $40,812.95 $24,007.62 2026-03-26
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 13 10 — — $3,500.00 $61,564.48 $36,214.40 2026-03-26
3232711 NDC Ipilimumab 50 Mg/10 Ml Vial 13 10 $46,845.06 $23,422.53 50% off $7,963.66 $46,845.06 $24,593.66 2026-03-26
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 13 10 — — $3,500.00 $46,369.61 $27,276.24 2026-03-26
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 13 10 — — $3,500.00 $47,136.84 $27,727.55 2026-03-26
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 13 10 — — $3,500.00 $70,089.30 $41,229.00 2026-03-26
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 13 10 — — $3,500.00 $65,040.28 $38,258.99 2026-03-26
332 MS_DRG Rectal Resection With Mcc 13 10 — — $3,500.00 $52,436.45 $30,844.97 2026-03-26
33231 HCPCS 33231 Ins Pulse Gen W/mult Lds 19 15 $49,984.75 $24,992.38 50% off $383.49 $53,205.17 $31,297.16 2026-03-26
33249 HCPCS 33249 Icd Lead/gen Sng/dual 19 15 $40,751.00 $20,375.50 50% off $383.49 $53,205.17 $31,297.16 2026-03-26
33264 HCPCS 33264 Remrep Cvd Gen Mult Led 19 15 $50,720.50 $25,360.25 50% off $618.24 $53,205.17 $31,297.16 2026-03-26
33270 HCPCS Ins/rep Subq Defibrillator 19 15 $59,237.75 $29,618.88 50% off $383.49 $59,237.75 $31,297.16 2026-03-26
33276 HCPCS Insj Phrnc Nrv Stim Sys 9 9 — — $542.16 $74,660.24 $43,917.79 2026-03-26
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 9 9 — — $383.49 $52,304.82 $30,767.54 2026-03-26
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 8 8 — — $28,599.55 $48,619.24 $28,599.55 2026-03-26
335 MS_DRG Peritoneal Adhesiolysis With Mcc 13 10 — — $3,500.00 $51,793.20 $30,466.59 2026-03-26
34 MS_DRG Carotid Artery Stent Procedures With Mcc 13 10 — — $3,500.00 $55,665.55 $32,744.44 2026-03-26
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 13 10 — — $3,500.00 $39,030.49 $22,959.11 2026-03-26
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 13 10 — — $3,500.00 $37,856.40 $22,268.47 2026-03-26
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 13 10 — — $3,500.00 $43,153.41 $25,384.36 2026-03-26
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 13 10 — — $3,500.00 $62,409.21 $36,711.30 2026-03-26
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 8 8 — — $28,872.16 $50,084.36 $29,461.39 2026-03-26
3621528-46188 CDM Pump Set Impella Rp 004334 13 10 $50,000.00 $25,000.00 50% off $8,500.00 $50,000.00 $27,500.00 2026-03-26
37 MS_DRG Extracranial Procedures With Mcc 13 10 — — $3,500.00 $48,192.11 $28,348.30 2026-03-26
3747053-40104 CDM Pump Set Impella Cp 00480003 13 10 $50,000.00 $25,000.00 50% off $8,500.00 $50,000.00 $27,500.00 2026-03-26
38240 HCPCS Transplt Allo Hct/donor 8 8 — — $62,717.34 $106,619.48 $62,717.34 2026-03-26
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 13 10 — — $3,500.00 $184,580.42 $108,576.72 2026-03-26
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 13 10 — — $3,500.00 $55,542.84 $32,672.26 2026-03-26
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 10 8 — — $30,153.75 $57,600.42 $33,882.60 2026-03-26
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 13 10 — — $3,500.00 $76,329.24 $44,899.55 2026-03-26
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 13 10 — — $3,500.00 $43,130.16 $25,370.68 2026-03-26
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 13 10 — — $3,500.00 $51,724.74 $30,426.32 2026-03-26
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 13 10 — — $3,500.00 $48,336.76 $28,433.39 2026-03-26
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 13 10 — — $3,500.00 $51,686.00 $30,403.53 2026-03-26
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 13 10 — — $3,500.00 $49,677.50 $29,222.06 2026-03-26
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 13 10 — — $3,500.00 $59,311.84 $34,889.32 2026-03-26
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 8 — — $82,659.00 $148,024.39 $87,073.17 2026-03-26
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 8 — — $54,139.50 $98,908.41 $58,181.42 2026-03-26
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 8 — — $42,165.00 $78,286.07 $46,050.63 2026-03-26
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 10 8 — — $67,572.00 $122,041.73 $71,789.25 2026-03-26
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 10 8 — — $43,253.25 $80,160.24 $47,153.08 2026-03-26
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 10 8 — — $50,112.00 $91,972.30 $54,101.35 2026-03-26
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 10 8 — — $31,806.00 $60,445.91 $35,556.42 2026-03-26
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 10 8 — — $39,972.00 $74,509.30 $43,829.00 2026-03-26
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 10 8 — — $24,228.00 $47,395.17 $27,879.51 2026-03-26
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 10 — — $3,500.00 $114,211.78 $67,183.40 2026-03-26
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 10 — — $3,500.00 $82,691.86 $48,642.27 2026-03-26
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 10 — — $3,500.00 $59,565.01 $35,038.24 2026-03-26
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 13 10 — — $3,500.00 $77,007.35 $45,298.44 2026-03-26
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 13 10 — — $3,500.00 $40,027.64 $23,545.67 2026-03-26
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 13 10 — — $3,500.00 $79,287.08 $46,639.46 2026-03-26
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 13 10 — — $3,500.00 $45,900.73 $27,000.43 2026-03-26
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 13 10 — — $3,500.00 $72,905.10 $42,885.35 2026-03-26
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 13 10 — — $3,500.00 $51,221.00 $30,130.00 2026-03-26
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 13 10 — — $3,500.00 $41,164.29 $24,214.29 2026-03-26
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 13 10 — — $3,500.00 $44,848.04 $26,381.20 2026-03-26
471 MS_DRG Cervical Spinal Fusion With Mcc 13 10 — — $3,500.00 $68,039.47 $40,023.22 2026-03-26
472 MS_DRG Cervical Spinal Fusion With Cc 13 10 — — $3,500.00 $43,723.03 $25,719.43 2026-03-26
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 13 10 — — $3,500.00 $61,118.86 $35,952.27 2026-03-26
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 13 10 — — $3,500.00 $50,291.03 $29,582.96 2026-03-26
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 13 10 — — $3,500.00 $43,286.45 $25,462.62 2026-03-26
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 13 10 — — $3,500.00 $41,472.98 $24,395.87 2026-03-26
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 13 10 — — $3,500.00 $47,352.55 $27,854.44 2026-03-26
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 13 10 — — $3,500.00 $53,093.89 $31,231.70 2026-03-26
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 13 10 — — $3,500.00 $38,427.29 $22,604.29 2026-03-26
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 13 10 — — $3,500.00 $52,501.03 $30,882.96 2026-03-26
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 13 10 — — $3,500.00 $44,636.22 $26,256.60 2026-03-26
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 13 10 — — $3,500.00 $138,844.68 $81,673.34 2026-03-26
500 MS_DRG Soft Tissue Procedures With Mcc 13 10 — — $3,500.00 $46,547.85 $27,381.09 2026-03-26
50242010501 NDC Polatuzumab Vedotin-piiq 140 Mg Via 13 10 $44,990.40 $22,495.20 50% off $7,648.37 $44,990.40 $23,619.96 2026-03-26
503 MS_DRG Foot Procedures With Mcc 13 10 — — $3,500.00 $41,720.98 $24,541.75 2026-03-26
50633012011 NDC Digoxin Immune Fab 40 Mg Vial 13 10 $53,064.00 $26,532.00 50% off $9,020.88 $53,064.00 $27,858.60 2026-03-26
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 13 10 — — $3,500.00 $44,684.01 $26,284.71 2026-03-26
51144005001 NDC Brentuximab 50 Mg Vial 13 10 $63,291.20 $31,645.60 50% off $10,759.50 $63,291.20 $33,227.88 2026-03-26
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 13 10 — — $3,500.00 $46,833.30 $27,549.00 2026-03-26
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 13 10 — — $3,500.00 $53,942.50 $31,730.88 2026-03-26
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 13 10 — — $3,500.00 $42,742.68 $25,142.75 2026-03-26
545 MS_DRG Connective Tissue Disorders With Mcc 13 10 — — $3,500.00 $37,724.65 $22,190.97 2026-03-26
570 MS_DRG Skin Debridement With Mcc 13 10 — — $3,500.00 $43,658.45 $25,681.44 2026-03-26
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 13 10 — — $3,500.00 $90,290.59 $53,112.11 2026-03-26
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 13 10 — — $3,500.00 $50,508.02 $29,710.60 2026-03-26
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 13 10 — — $3,500.00 $68,975.92 $40,574.07 2026-03-26
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 13 10 — — $3,500.00 $39,907.52 $23,475.01 2026-03-26
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 13 10 — — $3,500.00 $47,499.79 $27,941.05 2026-03-26
6 MS_DRG Liver Transplant Without Mcc 13 10 — — $3,500.00 $65,563.39 $38,566.70 2026-03-26
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 13 10 — — $3,500.00 $41,281.83 $24,283.43 2026-03-26
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 13 10 — — $3,500.00 $50,714.69 $29,832.17 2026-03-26
61885 HCPCS Insrt/redo Neurostim 1 Array 9 9 — — $383.49 $52,304.82 $30,767.54 2026-03-26
61886 HCPCS Implant Neurostim Arrays 9 9 — — $383.49 $52,304.82 $30,767.54 2026-03-26
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 9 9 — — $382.95 $52,304.82 $30,767.54 2026-03-26
619 MS_DRG O.r. Procedures For Obesity With Mcc 13 10 — — $3,500.00 $42,964.83 $25,273.43 2026-03-26
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 13 10 — — $3,500.00 $51,642.09 $30,377.70 2026-03-26
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 13 10 — — $3,500.00 $44,678.84 $26,281.67 2026-03-26
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 13 10 — — $3,500.00 $53,806.87 $31,651.10 2026-03-26
6302602 NDC Pembrolizumab 100 Mg/4 Ml Vial 13 10 $61,023.87 $30,511.94 50% off $10,374.06 $61,023.87 $32,037.53 2026-03-26
63685 HCPCS Ins/rplc Spi Npg/rcvr Pocket 9 9 — — $383.49 $52,304.82 $30,767.54 2026-03-26
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 9 9 — — $286.51 $74,660.24 $43,917.79 2026-03-26
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 9 9 — — $286.51 $52,304.82 $30,767.54 2026-03-26
64654 HCPCS 1st Opn Implt Bat Modulj Sys 8 8 — — $43,917.79 $74,660.24 $43,917.79 2026-03-26
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 8 8 — — $30,767.54 $52,304.82 $30,767.54 2026-03-26
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 13 10 — — $3,500.00 $66,395.22 $39,056.01 2026-03-26
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 13 10 — — $3,500.00 $53,535.64 $31,491.55 2026-03-26
652 MS_DRG Kidney Transplant 12 10 — — $3,500.00 $47,383.54 $27,872.67 2026-03-26
653 MS_DRG Major Bladder Procedures With Mcc 13 10 — — $3,500.00 $72,788.83 $42,816.96 2026-03-26
654 MS_DRG Major Bladder Procedures With Cc 13 10 — — $3,500.00 $41,826.90 $24,604.06 2026-03-26
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 13 10 — — $3,500.00 $46,793.27 $27,525.45 2026-03-26
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 13 10 — — $3,500.00 $38,489.29 $22,640.76 2026-03-26
6600000006-35386 CDM Or Level 6 13 10 $61,798.00 $30,899.00 50% off $2,250.00 $61,798.00 $33,988.90 2026-03-26
6603618844-35364 CDM 33263 Remrep Cvd Gen Dual Led 13 10 $50,720.50 $25,360.25 50% off $2,250.00 $50,720.50 $27,896.28 2026-03-26
662 MS_DRG Minor Bladder Procedures With Mcc 13 10 — — $3,500.00 $45,213.57 $26,596.22 2026-03-26
665 MS_DRG Prostatectomy With Mcc 13 10 — — $3,500.00 $45,984.69 $27,049.82 2026-03-26
668 MS_DRG Transurethral Procedures With Mcc 13 10 — — $3,500.00 $43,385.90 $25,521.12 2026-03-26
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 13 10 — — $3,500.00 $59,939.59 $35,258.58 2026-03-26
68727071201 NDC Lurbinectedin 4 Mg Vial 13 10 $43,848.00 $21,924.00 50% off $7,454.16 $43,848.00 $23,020.20 2026-03-26
69930 HCPCS Implant Cochlear Device 9 9 — — $32,875.79 $55,888.84 $32,875.79 2026-03-26
7 MS_DRG Lung Transplant 13 10 — — $3,500.00 $172,940.15 $101,729.50 2026-03-26
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 13 10 — — $3,500.00 $51,839.70 $30,493.94 2026-03-26
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 13 10 — — $3,500.00 $51,946.92 $30,557.01 2026-03-26
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 13 10 — — $3,500.00 $38,834.17 $22,843.63 2026-03-26
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 13 10 — — $3,500.00 $82,438.70 $48,493.35 2026-03-26
791 MS_DRG Prematurity With Major Problems 13 10 — — $3,500.00 $58,097.70 $34,175.12 2026-03-26
793 MS_DRG Full Term Neonate With Major Problems 13 10 — — $3,500.00 $59,526.27 $35,015.45 2026-03-26
799 MS_DRG Splenic Procedures With Mcc 13 10 — — $3,500.00 $64,167.13 $37,745.37 2026-03-26
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 13 10 — — $3,500.00 $78,061.31 $45,918.42 2026-03-26
800 MS_DRG Splenic Procedures With Cc 13 10 — — $3,500.00 $41,957.36 $24,680.80 2026-03-26
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 13 10 — — $3,500.00 $57,130.27 $33,606.04 2026-03-26
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 13 10 — — $3,500.00 $81,422.18 $47,895.40 2026-03-26
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 13 10 — — $3,500.00 $64,889.15 $38,170.09 2026-03-26
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 13 10 — — $3,500.00 $66,090.39 $38,876.70 2026-03-26
82705001001 NDC Epcoritamab-bysp 48 Mg/0.8 Ml Vial 13 10 $42,631.57 $21,315.79 50% off $7,247.37 $42,631.57 $22,381.57 2026-03-26
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 13 10 — — $3,500.00 $46,485.85 $27,344.62 2026-03-26
834 MS_DRG Acute Leukemia With Mcc 13 10 — — $3,500.00 $76,579.82 $45,046.95 2026-03-26
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 13 10 — — $3,500.00 $67,724.31 $39,837.83 2026-03-26
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 13 10 — — $3,500.00 $47,453.29 $27,913.70 2026-03-26
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 13 10 — — $3,500.00 $39,155.78 $23,032.81 2026-03-26
849 MS_DRG Radiotherapy 13 10 — — $3,500.00 $40,667.01 $23,921.77 2026-03-26
850 MS_DRG Acute Leukemia With Other Procedures 10 8 — — $64,946.25 $117,519.67 $69,129.22 2026-03-26
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 13 10 — — $3,500.00 $69,458.99 $40,858.23 2026-03-26
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 13 10 — — $3,500.00 $64,422.88 $37,895.81 2026-03-26
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 13 10 — — $3,500.00 $94,945.66 $55,850.39 2026-03-26
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 15 11 — — $940.63 $55,590.63 $32,700.37 2026-03-26
901 MS_DRG Wound Debridements For Injuries With Mcc 13 10 — — $3,500.00 $59,875.00 $35,220.59 2026-03-26
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 13 10 — — $3,500.00 $53,113.27 $31,243.10 2026-03-26
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 13 10 — — $3,500.00 $55,259.96 $32,505.86 2026-03-26
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 10 — — $3,500.00 $281,441.92 $165,554.07 2026-03-26
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 13 10 — — $3,500.00 $98,315.56 $57,832.68 2026-03-26
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 13 10 — — $3,500.00 $47,271.17 $27,806.57 2026-03-26
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 13 10 — — $3,500.00 $55,969.08 $32,922.99 2026-03-26
93653 HCPCS Ep Ablate Supravent Arrhyt 19 15 $30,870.00 $15,435.00 50% off $732.22 $44,304.54 $26,061.49 2026-03-26
93654 HCPCS Ep Ablate Ventric Tachy 19 15 $30,870.00 $15,435.00 50% off $977.18 $44,304.54 $26,061.49 2026-03-26
93656 HCPCS Cmp Eval Abl Afib Pulmvein Iso 19 15 $28,314.75 $14,157.38 50% off $977.57 $44,304.54 $26,061.49 2026-03-26
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 13 10 — — $3,500.00 $52,537.19 $30,904.23 2026-03-26
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 13 10 — — $3,500.00 $51,128.01 $30,075.30 2026-03-26
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 13 10 — — $3,500.00 $38,983.99 $22,931.76 2026-03-26
955 MS_DRG Craniotomy For Multiple Significant Trauma 13 10 — — $3,500.00 $92,611.67 $54,477.45 2026-03-26
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 13 10 — — $3,500.00 $54,274.46 $31,926.15 2026-03-26
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 13 10 — — $3,500.00 $104,091.78 $61,230.46 2026-03-26
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 13 10 — — $3,500.00 $60,098.47 $35,352.04 2026-03-26
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 13 10 — — $3,500.00 $43,697.19 $25,704.23 2026-03-26
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 13 10 — — $3,500.00 $38,983.99 $22,931.76 2026-03-26
963 MS_DRG Other Multiple Significant Trauma With Mcc 13 10 — — $3,500.00 $40,980.88 $24,106.40 2026-03-26
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 13 10 — — $3,500.00 $84,735.23 $49,844.25 2026-03-26
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 13 10 — — $3,500.00 $52,321.48 $30,777.34 2026-03-26
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 13 10 — — $3,500.00 $39,735.73 $23,373.96 2026-03-26
974 MS_DRG HIV With Major Related Condition With Mcc 13 10 — — $3,500.00 $42,946.74 $25,262.79 2026-03-26
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 13 10 — — $3,500.00 $66,271.22 $38,983.07 2026-03-26
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 13 10 — — $3,500.00 $49,952.61 $29,383.89 2026-03-26
A9543 HCPCS Y90 Ibritumomab, Rx 8 8 — — $56,824.54 $96,601.72 $56,824.54 2026-03-26
C1604 HCPCS System Detour Endologix 13 10 $50,000.00 $25,000.00 50% off $8,500.00 $50,000.00 $27,500.00 2026-03-26
C1825 HCPCS System Ipg Barostim 26 10 $70,000.00 $35,000.00 50% off $10,710.00 $70,000.00 $37,800.00 2026-03-26
C9760 HCPCS Non-blind Interatrial Shunt 8 8 — — $26,838.84 $45,626.02 $26,838.84 2026-03-26
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 7 — — $3,685,266.66 $3,758,971.99 $3,685,266.66 2026-03-26
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 7 — — $3,327,859.72 $3,394,416.91 $3,327,859.72 2026-03-26
J3387 HCPCS Inj Elivaldogene Autotemecel 7 7 — — $3,180,000.00 $3,243,600.00 $3,180,000.00 2026-03-26
J3389 HCPCS Topi Adm Prad Zami Per Treat 7 7 — — $3,335,820.00 $3,402,536.40 $3,335,820.00 2026-03-26
J3391 HCPCS Inj, Atidarsagene Autotemcel 7 7 — — $4,505,000.00 $4,595,100.00 $4,505,000.00 2026-03-26
J3392 HCPCS Inj, Exagamglogene Autotem 8 8 — — $2,332,000.00 $3,964,400.00 $2,332,000.00 2026-03-26
J3393 HCPCS Inj, Betibeglogene Autotemce 8 8 — — $2,939,968.88 $4,997,947.10 $2,939,968.88 2026-03-26
J3394 HCPCS Inj, Lovotibeglogene Autotem 7 7 — — $3,252,508.07 $3,317,558.23 $3,252,508.07 2026-03-26
J3399 HCPCS Inj Onase Abepar-xioi Treat 8 8 — — $2,588,981.22 $4,401,268.07 $2,588,981.22 2026-03-26
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 8 8 — — $201,669.02 $342,837.33 $201,669.02 2026-03-26
J3403 HCPCS Revakinagene, Per Implant 8 8 — — $265,000.00 $450,500.00 $265,000.00 2026-03-26
J9029 HCPCS Instill Adstiladrin, Tx Dose 8 8 — — $64,274.79 $109,267.14 $64,274.79 2026-03-26
J9226 HCPCS Supprelin La Implant 8 8 — — $43,185.33 $73,415.06 $43,185.33 2026-03-26
J9229 HCPCS Inotuzumab Ozogam 0.9mg (0.1) 18 14 $66,964.66 $33,482.33 50% off $2,816.76 $66,964.66 $30,134.10 2026-03-26
J9266 HCPCS Pegaspargase Injection 8 8 — — $28,424.05 $48,320.89 $28,424.05 2026-03-26
J9359 HCPCS Loncastuximab Tesiri-lpyl 10mg 18 14 $81,283.36 $40,641.68 50% off $221.22 $81,283.36 $36,577.51 2026-03-26
J9600 HCPCS Porfimer Sodium Injection 8 8 — — $24,228.42 $41,188.31 $24,228.42 2026-03-26
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 8 — — $532,192.24 $904,726.81 $532,192.24 2026-03-26
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 8 — — $566,531.30 $963,103.21 $566,531.30 2026-03-26
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 8 — — $54,404.10 $92,486.97 $54,404.10 2026-03-26
Q2053 HCPCS Brexucabtagene Car Pos T 8 8 — — $489,450.20 $832,065.34 $489,450.20 2026-03-26
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 8 — — $562,201.24 $955,742.11 $562,201.24 2026-03-26
Q2055 HCPCS Idecabtagene Vicleucel Car 8 8 — — $558,081.72 $948,738.92 $558,081.72 2026-03-26
Q2056 HCPCS Ciltacabtagene Car-pos T 8 8 — — $587,649.57 $999,004.27 $587,649.57 2026-03-26
Q2057 HCPCS Afamitresgene Autoleucel 8 8 — — $770,620.00 $1,310,054.00 $770,620.00 2026-03-26
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 8 8 — — $278,250.00 $473,025.00 $278,250.00 2026-03-26
Q4130 HCPCS Tissue Strattice 10x16 68 14 $42,560.00 $21,280.00 50% off $124.08 $266,000.00 $34,048.00 2026-03-26
See an error in this hospital's data? Submit a correction