Hospital

ATRIUM HEALTH CLEVELAND

Shelby, NC · CCN 340021 · Rates published

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You selected 93306 (CPT)

HC ECHOCARDIOGRAM/DOPPLER/COMPLETE

This hospital’s price: $1,655 across 30 payers · range $498-$3,382

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/11166/334038167-1669348991_atrium-health-hospitals-inc_standardcharges.csv · observed 2025-12-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

13,844 distinct procedures filed

31 distinct payers

1,645,580 rate rows

2025-12-01 last MRF observed

Data quality

1,511,179 of 1,645,580 rate rows are consumer-grade (91.8%)

134,401 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
professional (physician) fee — not the facility price	129,954
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	3,146
percent-of-charges filed in the dollar field — excluded from medians	798
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	319
per-diem day rate — not a per-procedure price	133
exceeds 10× this hospital's gross charge — excluded from medians	34
placeholder amount (≤ $0.02) — excluded from medians	17

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

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/11166/334038167-1669348991_atrium-health-hospitals-inc_standardcharges.csv
Found on page	https://atriumhealth.org/for-patients-visitors/financial-assistance/pricing
Discovered via	Discovered by HANK (automated)
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-29
Content fingerprint	fbc5ac5ef3370f4e… · 2,651,116,051 bytes · first seen 2026-05-14

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	4	$4,595,100.00	$4,744,215.50	$4,696,462.50	nat. median $4,505,000 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	4	$3,313,414.63	$3,420,938.18	$3,386,504.66	nat. median $3,286,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	4	$3,004,654.80	$3,102,158.79	$3,070,933.95	nat. median $2,994,107 1.0× median
J1413 HCPCS	Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp	13	$2,240,000.00	$4,980,800.00	$3,013,600.00	nat. median $3,324,572 0.9× median
J1411 HCPCS	Etranacogene Dezaparvovec-drlb 1x10exp13 Gc/ml Intravenous Suspension	12	$2,450,000.00	$4,637,500.00	$2,597,000.00	nat. median $3,705,478 0.7× median
J3399 HCPCS	Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit	14	$1,625,431.05	$4,755,546.85	$2,559,452.81	nat. median $2,467,386 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	4	$2,378,640.00	$2,455,829.20	$2,431,110.00	nat. median $2,401,965 1.0× median
Q2054 HCPCS	Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp	31	$446,334.34	$3,028,697.28	$1,955,103.80	nat. median $640,950 outlier · 3.1×
Q2055 HCPCS	Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension	31	$443,699.28	$3,010,816.57	$1,943,561.33	nat. median $622,450 outlier · 3.1×
Q2056 HCPCS	Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension	31	$438,526.62	$2,975,716.35	$1,920,903.21	nat. median $646,415 outlier · 3.0×
Q2041 HCPCS	Axicabtagene Ciloleucel Intravenous Suspension	31	$423,007.20	$2,870,406.00	$1,852,922.61	nat. median $608,239 outlier · 3.0×
Q2042 HCPCS	Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension	31	$410,698.61	$3,383,140.05	$1,837,876.28	nat. median $739,258 outlier · 2.5×
Q2053 HCPCS	Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension	31	$356,160.00	$2,416,800.00	$1,560,108.00	nat. median $591,721 outlier · 2.6×
Q2057 HCPCS	Afamitresgene Autoleucel	4	$786,032.40	$811,539.92	$803,371.35	nat. median $813,967 1.0× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	15	$199,549.46	$511,508.16	$423,920.25	nat. median $249,036 1.7× median
J2326 HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	30	$1,305.86	$524,046.84	$345,595.10	nat. median $2,480 outlier · 139.3×
J0225 HCPCS	Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe	30	$5,103.71	$453,533.80	$299,093.60	nat. median $8,223 outlier · 36.4×
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	4	$283,815.00	$293,025.08	$290,075.62	nat. median $319,951 0.9× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	15	$266,632.69	$684,826.74	$287,070.37	nat. median $359,454 0.8× median
J3403 HCPCS	Revakinagene, Per Implant	4	$262,650.00	$271,173.25	$268,443.75	nat. median $265,000 1.0× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	15	$93,655.05	$253,627.25	$232,105.13	nat. median $110,307 outlier · 2.1×
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	15	$152,200.79	$389,176.42	$226,129.07	nat. median $190,559 1.2× median
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	4	$209,752.80	$216,559.48	$214,379.70	nat. median $209,753 1.0× median
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And…	15	$100,881.73	$256,586.67	$199,656.90	nat. median $126,695 1.6× median
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	15	$76,418.45	$223,987.59	$190,605.09	nat. median $95,038 outlier · 2.0×
A9607 HCPCS	Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln	30	$260.96	$277,612.80	$183,078.33	nat. median $432 outlier · 423.4×
7 MS_DRG	Lung Transplant	15	$93,423.12	$237,316.34	$179,267.83	nat. median $117,974 1.5× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	15	$121,074.64	$430,782.33	$170,779.49	nat. median $198,418 0.9× median
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	15	$79,021.08	$200,106.73	$155,209.38	nat. median $104,013 1.5× median
J9029 HCPCS	Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension	31	$33,607.00	$228,047.50	$142,949.77	nat. median $68,423 outlier · 2.1×
77371 CPT	Hc Radiation Delivery Stereotactic Cranial Cobalt	30	$7,322.05	$210,862.95	$139,058.57	nat. median $9,408 outlier · 14.8×
Q0480 HCPCS	Driver Pneumatic Vad, Rep	4	$132,128.29	$136,415.98	$135,042.89	nat. median $111,503 1.2× median
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	15	$69,401.93	$175,254.32	$118,454.62	nat. median $90,551 1.3× median
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	4	$114,097.24	$117,799.81	$116,614.09	nat. median $96,983 1.2× median
J9226 HCPCS	Histrelin 50 Mg (65 Mcg/day) Implant Kit	31	$27,309.73	$185,316.03	$116,163.89	nat. median $55,159 outlier · 2.1×
850 MS_DRG	Acute Leukemia With Other Procedures	15	$66,315.01	$167,278.89	$113,601.15	nat. median $78,268 1.5× median
J0223 HCPCS	Givosiran 189 Mg/ml Subcutaneous Solution	30	$119.71	$161,964.55	$106,811.36	nat. median $153 outlier · 700.1×
J1747 HCPCS	Spesolimab-sbzo 60 Mg/ml Intravenous Solution	30	$67.04	$159,048.72	$104,888.45	nat. median $92 outlier · 1139.7×
429 MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	15	$60,191.11	$151,456.96	$102,855.62	nat. median $78,049 1.3× median
C9293 HCPCS	Glucarpidase 1,000 Unit Intravenous Solution	31	$23,060.94	$156,484.95	$101,015.15	nat. median $30,297 outlier · 3.3×
10 MS_DRG	Pancreas Transplant	15	$57,607.45	$144,781.71	$98,324.21	nat. median $64,933 1.5× median
19 MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	15	$57,286.26	$143,951.84	$97,758.55	nat. median $66,715 1.5× median
J0801 HCPCS	Corticotropin 80 Unit/ml Injection Gel	31	$22,198.96	$150,635.80	$97,239.37	nat. median $5,212 outlier · 18.7×
212 MS_DRG	Concomitant Aortic And Mitral Valve Procedures	15	$78,136.90	$197,822.33	$95,259.83	nat. median $97,323 1.0× median
0795T CPT	Hc Tcat Insert Perm Dual Chamber Leadls Pm Compl Sys	31	$18,266.75	$144,181.83	$93,073.17	nat. median $21,629 outlier · 4.3×
834 MS_DRG	Acute Leukemia With Mcc	15	$40,417.94	$100,370.24	$90,490.63	nat. median $50,371 1.8× median
8 MS_DRG	Simultaneous Pancreas And Kidney Transplant	15	$39,812.07	$98,804.93	$90,185.13	nat. median $50,831 1.8× median
J9269 HCPCS	Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution	30	$364.07	$128,322.77	$84,625.49	nat. median $512 outlier · 165.1×
L8702 HCPCS	Ewhf S/d Uprt Micro Sensor	4	$82,562.05	$85,241.27	$84,383.27	nat. median $70,178 1.2× median
790 MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	15	$43,352.32	$107,951.62	$84,000.02	nat. median $50,870 1.7× median

Other procedures at this hospital

Browse this hospital's 13,844 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

J3391	HCPCS	Inj, Atidarsagene Autotemcel	4	4	—	—	$4,595,100.00	$4,744,215.50	$4,696,462.50	2025-12-01
J3394	HCPCS	Inj, Lovotibeglogene Autotem	4	4	—	—	$3,313,414.63	$3,420,938.18	$3,386,504.66	2025-12-01
J3393	HCPCS	Inj, Betibeglogene Autotemce	4	4	—	—	$3,004,654.80	$3,102,158.79	$3,070,933.95	2025-12-01
J1413	HCPCS	Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp	18	13	—	—	$2,240,000.00	$4,980,800.00	$3,013,600.00	2025-12-01
J1411	HCPCS	Etranacogene Dezaparvovec-drlb 1x10exp13 Gc/ml Intravenous Suspension	15	12	—	—	$2,450,000.00	$4,637,500.00	$2,597,000.00	2025-12-01
J3399	HCPCS	Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit	24	14	—	—	$1,625,431.05	$4,755,546.85	$2,559,452.81	2025-12-01
J3392	HCPCS	Inj, Exagamglogene Autotem	4	4	—	—	$2,378,640.00	$2,455,829.20	$2,431,110.00	2025-12-01
Q2054	HCPCS	Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp	78	31	$3,188,102.40	$1,594,051.20 50% off	$446,334.34	$3,028,697.28	$1,955,103.80	2025-12-01
Q2055	HCPCS	Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension	78	31	$3,169,280.60	$1,584,640.30 50% off	$443,699.28	$3,010,816.57	$1,943,561.33	2025-12-01
Q2056	HCPCS	Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension	78	31	$3,132,333.00	$1,566,166.50 50% off	$438,526.62	$2,975,716.35	$1,920,903.21	2025-12-01
Q2041	HCPCS	Axicabtagene Ciloleucel Intravenous Suspension	78	31	$3,021,480.00	$1,510,740.00 50% off	$423,007.20	$2,870,406.00	$1,852,922.61	2025-12-01
Q2042	HCPCS	Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension	124	31	$2,933,561.50	$1,466,780.75 50% off	$410,698.61	$3,383,140.05	$1,837,876.28	2025-12-01
Q2053	HCPCS	Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension	78	31	$2,544,000.00	$1,272,000.00 50% off	$356,160.00	$2,416,800.00	$1,560,108.00	2025-12-01
Q2057	HCPCS	Afamitresgene Autoleucel	4	4	—	—	$786,032.40	$811,539.92	$803,371.35	2025-12-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	19	15	—	—	$199,549.46	$511,508.16	$423,920.25	2025-12-01
J2326	HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	74	30	$551,628.25	$275,814.13 50% off	$1,305.86	$524,046.84	$345,595.10	2025-12-01
J0225	HCPCS	Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe	74	30	$477,404.00	$238,702.00 50% off	$5,103.71	$453,533.80	$299,093.60	2025-12-01
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	4	4	—	—	$283,815.00	$293,025.08	$290,075.62	2025-12-01
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	19	15	—	—	$266,632.69	$684,826.74	$287,070.37	2025-12-01
J3403	HCPCS	Revakinagene, Per Implant	4	4	—	—	$262,650.00	$271,173.25	$268,443.75	2025-12-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	19	15	—	—	$93,655.05	$253,627.25	$232,105.13	2025-12-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	19	15	—	—	$152,200.79	$389,176.42	$226,129.07	2025-12-01
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	4	4	—	—	$209,752.80	$216,559.48	$214,379.70	2025-12-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	19	15	—	—	$100,881.73	$256,586.67	$199,656.90	2025-12-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	19	15	—	—	$76,418.45	$223,987.59	$190,605.09	2025-12-01
A9607	HCPCS	Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln	74	30	$292,224.00	$146,112.00 50% off	$260.96	$277,612.80	$183,078.33	2025-12-01
7	MS_DRG	Lung Transplant	19	15	—	—	$93,423.12	$237,316.34	$179,267.83	2025-12-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	19	15	—	—	$121,074.64	$430,782.33	$170,779.49	2025-12-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	19	15	—	—	$79,021.08	$200,106.73	$155,209.38	2025-12-01
J9029	HCPCS	Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension	78	31	$240,050.00	$120,025.00 50% off	$33,607.00	$228,047.50	$142,949.77	2025-12-01
77371	CPT	Hc Radiation Delivery Stereotactic Cranial Cobalt	74	30	$221,961.00	$110,980.50 50% off	$7,322.05	$210,862.95	$139,058.57	2025-12-01
Q0480	HCPCS	Driver Pneumatic Vad, Rep	4	4	—	—	$132,128.29	$136,415.98	$135,042.89	2025-12-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	19	15	—	—	$69,401.93	$175,254.32	$118,454.62	2025-12-01
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	4	4	—	—	$114,097.24	$117,799.81	$116,614.09	2025-12-01
J9226	HCPCS	Histrelin 50 Mg (65 Mcg/day) Implant Kit	78	31	$195,069.50	$97,534.75 50% off	$27,309.73	$185,316.03	$116,163.89	2025-12-01
850	MS_DRG	Acute Leukemia With Other Procedures	19	15	—	—	$66,315.01	$167,278.89	$113,601.15	2025-12-01
J0223	HCPCS	Givosiran 189 Mg/ml Subcutaneous Solution	74	30	$170,489.00	$85,244.50 50% off	$119.71	$161,964.55	$106,811.36	2025-12-01
J1747	HCPCS	Spesolimab-sbzo 60 Mg/ml Intravenous Solution	74	30	$167,419.70	$83,709.85 50% off	$67.04	$159,048.72	$104,888.45	2025-12-01
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	19	15	—	—	$60,191.11	$151,456.96	$102,855.62	2025-12-01
C9293	HCPCS	Glucarpidase 1,000 Unit Intravenous Solution	74	31	$164,721.00	$82,360.50 50% off	$23,060.94	$156,484.95	$101,015.15	2025-12-01
10	MS_DRG	Pancreas Transplant	19	15	—	—	$57,607.45	$144,781.71	$98,324.21	2025-12-01
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	19	15	—	—	$57,286.26	$143,951.84	$97,758.55	2025-12-01
J0801	HCPCS	Corticotropin 80 Unit/ml Injection Gel	74	31	$158,564.00	$79,282.00 50% off	$22,198.96	$150,635.80	$97,239.37	2025-12-01
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	19	15	—	—	$78,136.90	$197,822.33	$95,259.83	2025-12-01
0795T	CPT	Hc Tcat Insert Perm Dual Chamber Leadls Pm Compl Sys	78	31	$151,770.35	$75,885.18 50% off	$18,266.75	$144,181.83	$93,073.17	2025-12-01
834	MS_DRG	Acute Leukemia With Mcc	19	15	—	—	$40,417.94	$100,370.24	$90,490.63	2025-12-01
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	19	15	—	—	$39,812.07	$98,804.93	$90,185.13	2025-12-01
J9269	HCPCS	Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution	74	30	$135,076.60	$67,538.30 50% off	$364.07	$128,322.77	$84,625.49	2025-12-01
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	4	4	—	—	$82,562.05	$85,241.27	$84,383.27	2025-12-01
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	19	15	—	—	$43,352.32	$107,951.62	$84,000.02	2025-12-01
215	MS_DRG	Other Heart Assist System Implant	19	15	—	—	$76,034.70	$192,390.97	$82,913.18	2025-12-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	19	15	—	—	$58,226.66	$146,381.51	$82,524.41	2025-12-01
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	19	15	—	—	$75,195.49	$190,222.79	$81,707.75	2025-12-01
955	MS_DRG	Craniotomy For Multiple Significant Trauma	19	15	—	—	$49,561.96	$123,995.10	$81,434.88	2025-12-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	19	15	—	—	$61,128.01	$153,877.55	$79,864.10	2025-12-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	19	15	—	—	$61,094.98	$153,792.20	$78,448.67	2025-12-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	19	15	—	—	$51,239.67	$128,329.65	$77,815.66	2025-12-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	19	15	—	—	$54,031.37	$135,542.41	$77,442.63	2025-12-01
6	MS_DRG	Liver Transplant Without Mcc	19	15	—	—	$35,651.93	$88,056.62	$77,256.93	2025-12-01
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	19	15	—	—	$45,050.38	$112,338.84	$76,290.93	2025-12-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	19	15	—	—	$44,701.07	$111,436.34	$75,683.48	2025-12-01
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	19	15	—	—	$36,594.45	$90,491.74	$75,617.01	2025-12-01
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	19	15	—	—	$41,667.59	$103,598.91	$75,429.69	2025-12-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	19	15	—	—	$50,463.01	$126,323.08	$75,051.57	2025-12-01
93656	CPT	Hc Ep Ephys Evl Trnsptl Tx Atrial Fib Isolat Pulm Vein	78	31	$121,044.20	$60,522.10 50% off	$16,946.19	$114,991.99	$74,230.36	2025-12-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	19	15	—	—	$56,506.80	$141,938.01	$73,229.60	2025-12-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	19	15	—	—	$55,952.24	$140,505.26	$71,644.32	2025-12-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	19	15	—	—	$47,023.98	$117,437.88	$69,790.40	2025-12-01
J9359	HCPCS	Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution	74	30	$111,115.60	$55,557.80 50% off	$221.24	$105,559.82	$69,613.93	2025-12-01
0915T	CPT	Hc Insert Perm Card Contract Mod-defib W/guide; Pulse Generator & Leads	78	31	$110,987.60	$55,493.80 50% off	$15,538.26	$105,438.22	$68,063.14	2025-12-01
0408T	CPT	Hc Insert Or Replace Perm Cardiac Cont Mod Gen+elect	78	31	$110,987.60	$55,493.80 50% off	$15,538.26	$105,438.22	$68,063.14	2025-12-01
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	19	15	—	—	$43,675.61	$108,786.94	$68,015.96	2025-12-01
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	19	15	—	—	$42,491.31	$105,727.15	$67,058.92	2025-12-01
33288	CPT	Hc Rmvl&rplcmt Phrnc Nrv Stim Trnsvns Stim/snsg Ld	78	31	$109,284.20	$54,642.10 50% off	$11,944.32	$103,819.99	$67,018.54	2025-12-01
0414T	CPT	Hc Removal & Replace Permament Ccm Pulse Generator Only	78	31	$109,005.70	$54,502.85 50% off	$15,260.80	$103,555.42	$66,847.75	2025-12-01
0916T	CPT	Hc Insert Perm Card Contract Mod-defib W/guide; Pulse Generator Only	78	31	$109,005.70	$54,502.85 50% off	$15,260.80	$103,555.42	$66,847.75	2025-12-01
0409T	CPT	Hc Insert Or Replace Perm Ccm Pulse Generator Only	78	31	$109,005.70	$54,502.85 50% off	$15,260.80	$103,555.42	$66,847.75	2025-12-01
33287	CPT	Hc Rmvl&rplcmt Phrenic Nrv Stimulator Pls Generator	78	31	$109,005.70	$54,502.85 50% off	$15,260.80	$103,555.42	$66,847.75	2025-12-01
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	19	15	—	—	$39,490.17	$97,973.25	$66,535.05	2025-12-01
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	19	15	—	—	$34,982.10	$86,326.07	$65,499.53	2025-12-01
J9348	HCPCS	Naxitamab-gqgk 4 Mg/ml Intravenous Solution	74	30	$104,288.60	$52,144.30 50% off	$699.72	$99,074.17	$65,336.81	2025-12-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	19	15	—	—	$41,908.66	$104,221.76	$63,888.16	2025-12-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	19	15	—	—	$51,490.58	$128,977.93	$63,724.10	2025-12-01
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	19	15	—	—	$37,766.80	$93,520.67	$63,511.05	2025-12-01
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	19	15	—	—	$36,720.96	$90,818.61	$63,005.52	2025-12-01
J9118	HCPCS	Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution	74	30	$100,182.50	$50,091.25 50% off	$83.72	$95,173.38	$62,764.34	2025-12-01
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	19	15	—	—	$37,646.60	$93,210.15	$62,337.94	2025-12-01
J2507	HCPCS	Pegloticase 8 Mg/ml Intravenous Solution	74	30	$99,415.25	$49,707.63 50% off	$3,734.05	$94,444.49	$62,283.65	2025-12-01
33266	CPT	Hc Maze Procedure Without Cardio By	73	30	$99,183.65	$49,591.83 50% off	$1,700.88	$94,224.47	$62,138.56	2025-12-01
0811	RC	Hc Kidney Acquistion Live Donor	74	31	$98,460.75	$49,230.38 50% off	$13,784.51	$93,537.71	$61,685.66	2025-12-01
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	19	15	—	—	$33,951.73	$83,663.96	$61,510.34	2025-12-01
L7181	HCPCS	Electronic Elbo Simultaneous	4	4	—	—	$58,766.80	$60,673.84	$60,063.13	2025-12-01
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	19	15	—	—	$48,693.25	$121,750.65	$59,931.78	2025-12-01
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	19	15	—	—	$40,417.94	$100,370.24	$59,698.19	2025-12-01
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	19	15	—	—	$43,383.94	$108,033.34	$59,504.58	2025-12-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	19	15	—	—	$46,958.64	$117,269.01	$59,504.58	2025-12-01
37	MS_DRG	Extracranial Procedures With Mcc	19	15	—	—	$24,910.32	$73,730.67	$59,438.13	2025-12-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	19	15	—	—	$45,106.61	$112,484.11	$59,300.76	2025-12-01
A9543	HCPCS	Y90 Ibritumomab, Rx	4	4	—	—	$57,961.04	$59,841.93	$59,239.60	2025-12-01
33277	CPT	Hc Ins Phrenic Nrv Stimulator Transvns Sensing Ld	74	30	$94,209.80	$47,104.90 50% off	$259.77	$89,499.31	$59,022.44	2025-12-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	19	15	—	—	$48,432.49	$121,076.95	$58,413.42	2025-12-01
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	4	4	—	—	$56,377.77	$58,207.28	$57,621.40	2025-12-01
J9229	HCPCS	Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln	74	30	$91,682.00	$45,841.00 50% off	$2,752.01	$87,097.90	$57,438.78	2025-12-01
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	19	15	—	—	$25,975.82	$63,057.13	$56,727.65	2025-12-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	19	15	—	—	$44,504.27	$110,927.88	$56,348.44	2025-12-01
93653	CPT	Hc Ep Ephys Eval W/ablation Supravent Arrhythmia	78	31	$91,417.45	$45,708.73 50% off	$12,798.44	$86,846.58	$56,061.75	2025-12-01
J3316	HCPCS	Triptorelin Pamoate (pediatric) 22.5 Mg IM Suspension	74	30	$89,190.70	$44,595.35 50% off	$3,893.62	$84,731.17	$55,877.97	2025-12-01
J9281	HCPCS	Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit	74	30	$88,490.00	$44,245.00 50% off	$324.90	$84,065.50	$55,438.99	2025-12-01
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	19	15	—	—	$38,962.34	$96,609.51	$55,312.53	2025-12-01
652	MS_DRG	Kidney Transplant	19	15	—	—	$23,156.71	$141,379.93	$54,972.53	2025-12-01
J9600	HCPCS	Porfimer 75 Mg Intravenous Solution	78	31	$91,941.00	$45,970.50 50% off	$12,871.74	$87,343.95	$54,750.86	2025-12-01
L7180	HCPCS	Electronic Elbow Sequential	4	4	—	—	$53,323.46	$55,053.86	$54,499.71	2025-12-01
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	19	15	—	—	$33,843.50	$83,384.31	$54,260.70	2025-12-01
0571T	CPT	Hc Insert/replace Icds W/substernal Electrode	78	31	$87,916.70	$43,958.35 50% off	$12,308.34	$83,520.87	$53,914.92	2025-12-01
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	19	15	—	—	$46,019.63	$114,842.96	$53,588.61	2025-12-01
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	19	15	—	—	$31,980.95	$78,572.18	$53,360.74	2025-12-01
93590	CPT	Hc Cath Perq Transcath Cls Paravalvr Leak 1 Mitral Valve	78	31	$86,855.80	$43,427.90 50% off	$12,159.81	$82,513.01	$53,264.32	2025-12-01
93591	CPT	Hc Cath Perq Transcath Cls Paravalvr Leak 1 Aortic Valve	78	31	$86,855.80	$43,427.90 50% off	$12,159.81	$82,513.01	$53,264.32	2025-12-01
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	19	15	—	—	$28,435.10	$69,410.96	$52,714.56	2025-12-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	19	15	—	—	$42,926.38	$106,851.19	$52,550.97	2025-12-01
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	19	15	—	—	$39,530.24	$98,076.76	$52,349.21	2025-12-01
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	19	15	—	—	$39,494.39	$97,984.15	$51,844.80	2025-12-01
J2350	HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	74	30	$82,588.85	$41,294.43 50% off	$60.60	$78,459.41	$51,741.92	2025-12-01
J9274	HCPCS	Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution	74	30	$81,970.00	$40,985.00 50% off	$221.43	$77,871.50	$51,354.21	2025-12-01
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	19	15	—	—	$31,550.82	$77,460.85	$50,792.33	2025-12-01
J0638	HCPCS	Canakinumab (pf) 150 Mg/ml Subcutaneous Solution	74	30	$80,911.45	$40,455.73 50% off	$144.44	$76,865.88	$50,691.03	2025-12-01
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	19	15	—	—	$47,101.40	$121,282.15	$50,469.52	2025-12-01
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	19	15	—	—	$33,002.89	$81,212.50	$50,348.97	2025-12-01
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	19	15	—	—	$40,254.86	$99,948.95	$50,142.17	2025-12-01
0914T	CPT	Hc Perq Transcath Thera Rx Balloon Angio, Separate Lesion, 1 Artery/branch	74	31	$79,223.25	$39,611.63 50% off	$11,091.26	$75,262.09	$49,633.36	2025-12-01
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	19	15	—	—	$38,797.17	$96,182.78	$48,999.54	2025-12-01
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	19	15	—	—	$34,265.21	$84,473.85	$48,313.61	2025-12-01
0812	RC	Hc Cadaver Donor - Pancreas	212	31	$85,226.70	$42,613.35 50% off	$10,769.81	$109,180.51	$48,194.89	2025-12-01
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	19	15	—	—	$40,018.71	$99,338.81	$48,084.40	2025-12-01
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	19	15	—	—	$28,289.61	$69,035.07	$47,727.57	2025-12-01
J7311	HCPCS	Fluocinolone 0.59 Mg Intravitreal Implant	74	30	$76,100.00	$38,050.00 50% off	$347.12	$72,295.00	$47,676.65	2025-12-01
264	MS_DRG	Other Circulatory System O.r. Procedures	19	15	—	—	$26,134.67	$63,467.52	$47,633.80	2025-12-01
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	19	15	—	—	$37,267.07	$92,229.56	$47,623.22	2025-12-01
163	MS_DRG	Major Chest Procedures With Mcc	19	15	—	—	$33,965.09	$83,698.46	$47,064.06	2025-12-01
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	11	8	—	—	$29,188.54	$71,357.61	$46,915.49	2025-12-01
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	19	15	—	—	$36,971.16	$91,465.07	$46,790.44	2025-12-01
93654	CPT	Hc Ep Ephys Eval W/ablation Ventricular Tachycardia	78	31	$76,123.95	$38,061.98 50% off	$10,657.35	$72,317.75	$46,683.01	2025-12-01
33274	CPT	Hc Tcat Insj/rpl Perm Leadless Pacemaker Rv W/img	78	31	$75,885.15	$37,942.58 50% off	$10,623.92	$72,090.89	$46,536.57	2025-12-01
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	19	15	—	—	$31,015.95	$76,078.95	$46,340.42	2025-12-01
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	19	15	—	—	$34,636.31	$85,432.65	$46,291.18	2025-12-01
28	MS_DRG	Spinal Procedures With Mcc	19	15	—	—	$42,648.53	$110,397.64	$45,736.59	2025-12-01
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	19	15	—	—	$26,188.09	$63,605.53	$45,527.09	2025-12-01
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	19	15	—	—	$32,052.93	$111,826.75	$45,511.78	2025-12-01
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	19	15	—	—	$31,918.40	$78,410.56	$45,006.28	2025-12-01
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	19	15	—	—	$39,724.93	$98,579.76	$44,927.22	2025-12-01
J1305	HCPCS	Evinacumab-dgnb 150 Mg/ml Intravenous Solution	121	30	$168,754.60	$84,377.30 50% off	$197.63	$160,316.87	$44,719.97	2025-12-01
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	19	15	—	—	$39,787.56	$109,605.91	$44,639.55	2025-12-01
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	19	15	—	—	$39,787.56	$109,605.91	$44,639.55	2025-12-01
J9266	HCPCS	Pegaspargase 750 Unit/ml Injection Solution	78	31	$74,455.55	$37,227.78 50% off	$10,423.78	$70,732.77	$44,338.28	2025-12-01
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	19	15	—	—	$30,270.22	$74,152.28	$44,316.27	2025-12-01
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	19	15	—	—	$33,848.41	$83,397.02	$44,251.93	2025-12-01
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	19	15	—	—	$26,765.14	$65,096.38	$44,208.23	2025-12-01
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	19	15	—	—	$33,279.12	$81,926.14	$44,206.64	2025-12-01
0266T	CPT	Apc	4	4	—	—	$43,102.41	$44,501.13	$44,053.20	2025-12-01
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	19	15	—	—	$27,214.25	$66,256.74	$44,039.04	2025-12-01
J3241	HCPCS	Teprotumumab-trbw 500 Mg Intravenous Solution	74	30	$70,069.55	$35,034.78 50% off	$366.38	$66,566.07	$43,898.57	2025-12-01
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	19	15	—	—	$36,762.42	$90,925.74	$43,117.53	2025-12-01
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	19	15	—	—	$36,735.01	$90,854.92	$43,043.42	2025-12-01
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	4	4	—	—	$41,964.16	$43,325.93	$42,889.84	2025-12-01
332	MS_DRG	Rectal Resection With Mcc	19	15	—	—	$25,949.12	$62,988.12	$42,776.24	2025-12-01
252	MS_DRG	Other Vascular Procedures With Mcc	19	15	—	—	$25,679.93	$62,292.63	$42,532.65	2025-12-01
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	19	15	—	—	$29,568.79	$72,340.01	$42,519.40	2025-12-01
665	MS_DRG	Prostatectomy With Mcc	19	15	—	—	$25,702.42	$62,350.74	$42,343.08	2025-12-01
C9607	HCPCS	Hc Perc D-e Cor Revasc Chro Sing Ld	78	31	$68,873.40	$34,436.70 50% off	$9,642.28	$65,429.73	$42,236.61	2025-12-01
C9602	HCPCS	Hc Perc D-e Cor Stent Ather S	78	31	$68,873.40	$34,436.70 50% off	$9,642.28	$65,429.73	$42,236.61	2025-12-01
974	MS_DRG	HIV With Major Related Condition With Mcc	19	15	—	—	$22,557.88	$54,226.41	$41,884.43	2025-12-01
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	19	15	—	—	$30,471.24	$74,671.62	$41,746.84	2025-12-01
653	MS_DRG	Major Bladder Procedures With Mcc	19	15	—	—	$35,658.45	$101,229.16	$41,349.65	2025-12-01
245	MS_DRG	Aicd Generator Procedures	19	15	—	—	$35,916.20	$88,739.40	$40,722.11	2025-12-01
J9334	HCPCS	Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln	74	30	$64,353.85	$32,176.93 50% off	$34.57	$61,136.16	$40,317.69	2025-12-01
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	19	15	—	—	$37,376.72	$92,512.84	$40,104.47	2025-12-01
33745	CPT	Hc Transcatheter Intracardiac Shunt Creation	74	30	$63,758.65	$31,879.33 50% off	$970.73	$60,570.72	$39,944.79	2025-12-01
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	19	15	—	—	$34,459.20	$84,975.04	$39,943.89	2025-12-01
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	19	15	—	—	$31,506.54	$77,346.44	$39,645.36	2025-12-01
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	19	15	—	—	$35,133.92	$86,718.30	$39,025.66	2025-12-01
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	19	15	—	—	$25,778.32	$62,546.86	$38,845.15	2025-12-01
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	19	15	—	—	$30,412.20	$74,519.09	$38,387.43	2025-12-01
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	19	15	—	—	$29,066.24	$71,041.64	$38,154.79	2025-12-01
J0202	HCPCS	Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution	74	30	$60,741.85	$30,370.93 50% off	$2,478.49	$57,704.76	$38,054.77	2025-12-01
J9298	HCPCS	Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution	74	30	$60,528.35	$30,264.18 50% off	$201.79	$57,501.93	$37,921.01	2025-12-01
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	19	15	—	—	$30,455.08	$74,629.86	$37,639.05	2025-12-01
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	19	15	—	—	$23,402.00	$56,407.30	$37,515.08	2025-12-01
471	MS_DRG	Cervical Spinal Fusion With Mcc	19	15	—	—	$34,833.21	$88,203.71	$37,324.06	2025-12-01
33901	CPT	Hc Perq Pulm Art Revasc Init Normal Nat Conn Bil	78	31	$60,757.25	$30,378.63 50% off	$8,506.02	$57,719.39	$37,259.38	2025-12-01
33903	CPT	Hc Perq Pulm Art Revasc Init Abnormal Conn Bil	78	31	$60,757.25	$30,378.63 50% off	$8,506.02	$57,719.39	$37,259.38	2025-12-01
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	19	15	—	—	$28,707.08	$70,113.71	$37,159.35	2025-12-01
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	19	15	—	—	$23,259.32	$56,038.67	$37,019.75	2025-12-01
J1628	HCPCS	Guselkumab 200 Mg/20 Ml (10 Mg/ml) Intravenous Solution	74	30	$58,261.65	$29,130.83 50% off	$77.49	$55,348.57	$36,500.93	2025-12-01
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	19	15	—	—	$26,382.78	$64,108.53	$36,469.37	2025-12-01
799	MS_DRG	Splenic Procedures With Mcc	19	15	—	—	$34,007.96	$86,342.41	$36,439.80	2025-12-01
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	19	15	—	—	$28,901.09	$70,614.90	$36,415.10	2025-12-01
140	MS_DRG	Major Head And Neck Procedures With Mcc	19	15	—	—	$31,294.26	$76,798.04	$36,296.71	2025-12-01
L6700	HCPCS	Ue Add Ext Power Myoel	4	4	—	—	$35,412.23	$36,561.39	$36,193.38	2025-12-01
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	19	15	—	—	$23,877.83	$57,636.67	$36,159.53	2025-12-01
L5856	HCPCS	Elec Knee-shin Swing/stance	4	4	—	—	$35,259.72	$36,403.93	$36,037.50	2025-12-01
J9043	HCPCS	Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution	74	30	$57,484.95	$28,742.48 50% off	$231.82	$54,610.70	$36,014.32	2025-12-01
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	19	15	—	—	$32,444.12	$79,768.86	$35,996.13	2025-12-01
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	19	15	—	—	$29,052.89	$71,007.14	$35,902.45	2025-12-01
324	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	19	15	—	—	$24,026.13	$58,019.82	$35,841.54	2025-12-01
J1304	HCPCS	Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution	74	30	$57,204.60	$28,602.30 50% off	$162.59	$54,344.37	$35,838.68	2025-12-01
L6880	HCPCS	Elec Hand Ind Art Digits	4	4	—	—	$35,051.25	$36,188.70	$35,824.44	2025-12-01
J3357	HCPCS	Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe	168	30	$58,303.00	$29,151.50 50% off	$152.39	$107,452.32	$35,431.02	2025-12-01
56	MS_DRG	Degenerative Nervous System Disorders With Mcc	19	15	—	—	$19,169.45	$45,471.95	$35,382.93	2025-12-01
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	19	15	—	—	$25,643.37	$62,198.21	$35,380.86	2025-12-01
469	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	19	15	—	—	$24,543.44	$59,356.32	$35,055.73	2025-12-01
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	19	15	—	—	$28,631.19	$69,917.60	$34,651.73	2025-12-01
64	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	19	15	—	—	$15,550.50	$37,778.65	$34,572.85	2025-12-01
901	MS_DRG	Wound Debridements For Injuries With Mcc	19	15	—	—	$32,186.47	$80,453.45	$34,488.06	2025-12-01
J1440	HCPCS	Fecal Microbiota, Live-jslm 150 Ml Rectal Suspension Enema	74	30	$54,810.00	$27,405.00 50% off	$65.12	$52,069.50	$34,338.46	2025-12-01
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	19	15	—	—	$29,244.77	$71,502.88	$34,072.18	2025-12-01
462	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	19	15	—	—	$21,697.60	$52,003.74	$34,038.56	2025-12-01
92943	CPT	Hc Cath Prq Trluml Coronry Chronic Occlus Revasc One Vsl	78	31	$55,177.25	$27,588.63 50% off	$7,724.82	$52,418.39	$33,837.45	2025-12-01
92937	CPT	Hc Cath Prq Trluml Coronary Byp Grft Revasc One Vessel	78	31	$55,177.25	$27,588.63 50% off	$7,724.82	$52,418.39	$33,837.45	2025-12-01
92933	CPT	Hc Cath Prq Trluml Coronry Stent/ath/angio One Art/brnch	78	31	$55,177.25	$27,588.63 50% off	$7,724.82	$52,418.39	$33,837.45	2025-12-01
34706	CPT	Hc Evasc Rpr Dplmnt Aorto-bi-iliac Ndgft Rpt	73	30	$53,755.20	$26,877.60 50% off	$2,082.65	$51,067.44	$33,677.64	2025-12-01
34703	CPT	Hc Evasc Rpr Dplmnt Aorto-un-iliac Ndgft	73	30	$53,755.20	$26,877.60 50% off	$1,254.83	$51,067.44	$33,677.64	2025-12-01
34702	CPT	Hc Evasc Rpr Dplmnt Aorto-aortic Ndgft Rpt	73	30	$53,755.20	$26,877.60 50% off	$1,641.11	$51,067.44	$33,677.64	2025-12-01
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	19	15	—	—	$23,502.66	$81,437.67	$33,576.66	2025-12-01
J3245	HCPCS	Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe	74	30	$53,271.20	$26,635.60 50% off	$130.00	$50,607.64	$33,374.40	2025-12-01
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	19	15	—	—	$30,812.82	$75,554.15	$33,364.98	2025-12-01
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	19	15	—	—	$26,759.51	$65,081.86	$33,110.72	2025-12-01
263	MS_DRG	Vein Ligation And Stripping	19	15	—	—	$20,420.51	$48,704.25	$33,075.40	2025-12-01
34701	CPT	Hc Evasc Rpr Dplmnt Aorto-aortic Ndgft	73	30	$52,774.60	$26,387.30 50% off	$1,132.55	$50,135.87	$33,063.29	2025-12-01
468	MS_DRG	Revision Of Hip Or Knee Replacement Without Cc/mcc	19	15	—	—	$20,007.26	$47,636.50	$33,018.33	2025-12-01
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	19	15	—	—	$30,157.08	$73,859.92	$32,989.25	2025-12-01
849	MS_DRG	Radiotherapy	19	15	—	—	$20,343.22	$48,504.50	$32,939.85	2025-12-01
240	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	19	15	—	—	$22,037.77	$52,882.64	$32,774.74	2025-12-01
970	MS_DRG	HIV With Extensive O.r. Procedures Without Mcc	19	15	—	—	$20,218.10	$48,181.27	$32,721.74	2025-12-01
258	MS_DRG	Cardiac Pacemaker Device Replacement With Mcc	19	15	—	—	$21,287.84	$50,945.07	$32,666.70	2025-12-01
411	MS_DRG	Cholecystectomy With C.d.e. With Mcc	19	15	—	—	$20,802.18	$49,690.29	$32,501.59	2025-12-01
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	19	15	—	—	$24,091.49	$58,188.70	$32,301.82	2025-12-01
265	MS_DRG	Aicd Lead Procedures	19	15	—	—	$26,641.43	$64,776.78	$31,829.11	2025-12-01
321	MS_DRG	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	19	15	—	—	$21,578.12	$51,695.04	$31,600.61	2025-12-01
36906	CPT	Hc Perq Thrmbc/nfs Dial Circuit Tcat Plmt IV Stent	78	31	$51,463.50	$25,731.75 50% off	$7,204.89	$48,890.33	$31,559.99	2025-12-01
274	MS_DRG	Percutaneous And Other Intracardiac Procedures Without Mcc	19	15	—	—	$23,505.32	$56,674.24	$31,545.57	2025-12-01
31	MS_DRG	Ventricular Shunt Procedures With Mcc	19	15	—	—	$25,450.01	$76,097.11	$31,479.19	2025-12-01
33231	CPT	Insrt Pulse Gen W/mult Leads	4	4	—	—	$30,709.25	$31,705.79	$31,386.65	2025-12-01
793	MS_DRG	Full Term Neonate With Major Problems	19	15	—	—	$11,456.40	$75,732.11	$31,335.85	2025-12-01
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	19	15	—	—	$23,066.75	$55,541.12	$31,287.71	2025-12-01
249	MS_DRG	Cardiac	1	1	—	—	$31,218.10	$31,218.10	$31,218.10	2025-12-01
247	MS_DRG	Cardiac	1	1	—	—	$31,218.10	$31,218.10	$31,218.10	2025-12-01
52	MS_DRG	Spinal Disorders And Injuries With Cc/mcc	19	15	—	—	$15,714.27	$36,544.99	$31,168.12	2025-12-01
69930	CPT	Implant Cochlear Device	4	4	—	—	$30,466.19	$31,454.85	$31,138.24	2025-12-01
515	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	19	15	—	—	$23,304.31	$56,154.89	$30,936.06	2025-12-01
835	MS_DRG	Acute Leukemia With Cc	19	15	—	—	$16,581.57	$38,785.81	$30,720.43	2025-12-01
34710	CPT	Hc Dlyd Placement Xtn Prosth For Evasc Rpr 1st Vsl	73	30	$48,866.00	$24,433.00 50% off	$729.27	$46,422.70	$30,614.55	2025-12-01
J9042	HCPCS	Brentuximab Vedotin 50 Mg Intravenous Solution	74	30	$48,850.00	$24,425.00 50% off	$263.81	$46,407.50	$30,604.53	2025-12-01
272	MS_DRG	Other Major Cardiovascular Procedures Without Cc/mcc	19	15	—	—	$19,156.11	$45,437.45	$30,590.57	2025-12-01
791	MS_DRG	Prematurity With Major Problems	19	15	—	—	$25,542.24	$73,723.72	$30,547.06	2025-12-01
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	19	15	—	—	$26,763.72	$65,092.75	$30,342.65	2025-12-01
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	19	15	—	—	$26,178.25	$63,580.11	$30,260.30	2025-12-01
472	MS_DRG	Cervical Spinal Fusion With Cc	19	15	—	—	$21,932.35	$52,610.25	$30,063.64	2025-12-01
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	19	15	—	—	$26,238.75	$72,289.16	$29,983.66	2025-12-01
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	19	15	—	—	$27,395.44	$71,649.97	$29,935.70	2025-12-01
64582	CPT	Opn Mpltj Hpglsl Nstm Ary Pg	4	4	—	—	$29,188.24	$30,135.43	$29,832.10	2025-12-01
64568	CPT	Opn Impltj Crnl Nrv Nea&pg	4	4	—	—	$29,188.24	$30,135.43	$29,832.10	2025-12-01
0268T	CPT	Apc	4	4	—	—	$29,188.24	$30,135.43	$29,832.10	2025-12-01
61886	CPT	Implant Neurostim Arrays	4	4	—	—	$29,188.24	$30,135.43	$29,832.10	2025-12-01
0674T	CPT	Laps Insj Nw/rpcmt Prm Isdss	4	4	—	—	$29,188.24	$30,135.43	$29,832.10	2025-12-01
J9382	HCPCS	Zenocutuzumab-zbco 375 Mg/18.75 Ml (20 Mg/ml) Intravenous Solution	121	30	$47,550.00	$23,775.00 50% off	$33.57	$90,297.55	$29,790.08	2025-12-01
34841	CPT	Hc Endovasc Repair Visceral Aorta With 1 Graft	74	31	$47,419.35	$23,709.68 50% off	$6,638.71	$45,048.38	$29,708.22	2025-12-01
34845	CPT	Hc Viscer And Infrarenal Abdom Aorta 1 Prosthesis	74	31	$47,419.35	$23,709.68 50% off	$6,638.71	$45,048.38	$29,708.22	2025-12-01
34846	CPT	Hc Rep Visc Ao Fen+uni/mod 2 Visc	74	31	$47,419.35	$23,709.68 50% off	$6,638.71	$45,048.38	$29,708.22	2025-12-01
34705	CPT	Hc Evasc Rpr Dplmnt Aorto-bi-iliac Ndgft	73	30	$47,419.35	$23,709.68 50% off	$1,395.14	$45,048.38	$29,708.22	2025-12-01
545	MS_DRG	Connective Tissue Disorders With Mcc	19	15	—	—	$19,329.70	$45,885.98	$29,601.94	2025-12-01
J9272	HCPCS	Dostarlimab-gxly 50 Mg/ml Intravenous Solution	74	30	$47,227.55	$23,613.78 50% off	$248.59	$44,866.17	$29,588.06	2025-12-01
325	MS_DRG	Coronary Intravascular Lithotripsy Without Intraluminal Device	19	15	—	—	$21,685.65	$51,972.87	$29,579.51	2025-12-01
34718	CPT	Hc Evasc Rpr Iliac Art N/a A-iliac Art Ndgft Uni	74	30	$46,825.95	$23,412.98 50% off	$1,113.67	$44,484.65	$29,336.46	2025-12-01
34717	CPT	Hc Iliac Branch Endograft Placement With Ao/ Iliac Endograft	73	30	$46,825.95	$23,412.98 50% off	$403.34	$44,484.65	$29,336.46	2025-12-01
34707	CPT	Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft	73	30	$46,825.95	$23,412.98 50% off	$1,064.61	$44,484.65	$29,336.46	2025-12-01
C9606	HCPCS	Hc Perc D-e Cor Revasc W Ami S	74	31	$46,767.55	$23,383.78 50% off	$6,547.46	$44,429.17	$29,299.87	2025-12-01
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	19	15	—	—	$26,528.98	$64,486.24	$29,175.31	2025-12-01
35	MS_DRG	Carotid Artery Stent Procedures With Cc	19	15	—	—	$17,557.84	$41,308.09	$29,157.56	2025-12-01
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	19	15	—	—	$24,888.00	$70,184.54	$29,157.07	2025-12-01
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	19	15	—	—	$22,240.19	$53,405.62	$29,145.46	2025-12-01
406	MS_DRG	Pancreas, Liver And Shunt Procedures With Cc	19	15	—	—	$21,308.22	$50,997.74	$29,131.06	2025-12-01
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	19	15	—	—	$22,293.61	$53,543.63	$29,072.37	2025-12-01
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	19	15	—	—	$26,615.34	$68,497.56	$28,907.50	2025-12-01
36837	CPT	Hc Perq Av Fistula Create Up Ext Separate Access	78	31	$47,026.65	$23,513.33 50% off	$6,583.73	$44,675.32	$28,839.09	2025-12-01
36836	CPT	Hc Perq Av Fistula Create Upper Ext Single Access	78	31	$47,026.65	$23,513.33 50% off	$6,583.73	$44,675.32	$28,839.09	2025-12-01
0238T	CPT	Hc Athrc Trluml Perip Iliac Art	78	31	$46,943.75	$23,471.88 50% off	$6,572.13	$44,596.56	$28,788.25	2025-12-01
33362	CPT	Hc Cath Replace Aortic Valve Openfemoral Artery Approach	73	30	$45,777.15	$22,888.58 50% off	$1,212.11	$43,488.29	$28,679.38	2025-12-01
0913T	CPT	Hc Perq Transcath Thera Rx Balloon Angio, Ivus, Oct, 1 Artery/branch	78	31	$46,753.35	$23,376.68 50% off	$5,461.03	$44,415.68	$28,671.49	2025-12-01
320	MS_DRG	Other Endovascular Cardiac Valve Procedures Without Mcc	19	15	—	—	$17,838.96	$42,034.45	$28,545.01	2025-12-01
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	19	15	—	—	$26,313.90	$63,930.58	$28,449.58	2025-12-01
510	MS_DRG	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	19	15	—	—	$21,657.55	$51,900.24	$28,364.14	2025-12-01
656	MS_DRG	Kidney And Ureter Procedures For Neoplasm With Mcc	19	15	—	—	$24,468.22	$59,162.02	$28,340.47	2025-12-01
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	19	15	—	—	$22,311.39	$67,950.98	$28,279.86	2025-12-01
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	19	15	—	—	$25,410.04	$61,595.33	$28,208.70	2025-12-01
286	MS_DRG	Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc	19	15	—	—	$17,125.58	$40,191.31	$28,206.64	2025-12-01
J9024	HCPCS	Atezolizumab 1,875 Mg-hyaluronidase-tqjs 30,000 Unit/15 Ml Subcut Soln	74	30	$45,007.30	$22,503.65 50% off	$32.22	$42,756.94	$28,197.08	2025-12-01
Q0483	HCPCS	Monitor Elec Vad, Rep	4	4	—	—	$27,506.24	$28,398.84	$28,113.00	2025-12-01
33340	CPT	Hc Perq Clsr Tcat L Atr Apndge W/endocardial Implnt	73	30	$44,758.00	$22,379.00 50% off	$716.24	$42,520.10	$28,040.88	2025-12-01
829	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	19	15	—	—	$23,243.87	$55,998.72	$28,034.73	2025-12-01
253	MS_DRG	Other Vascular Procedures With Cc	19	15	—	—	$19,513.14	$46,359.93	$27,964.06	2025-12-01

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