Hospital

Davie Medical Center

Bermuda Run, NC · CCN 340187 · Rates published

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You selected 29916 (CPT)

HIP ARTHRO W/LABRAL REPAIR

This hospital’s price: $6,915 across 11 payers · range $6,915-$10,385

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/12945/560552787-1144211301_north-carolina-baptist-hospital_standardcharges.csv · observed 2025-10-21

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.

42,663 distinct procedures filed

60 distinct payers

3,577,917 rate rows

2026-08-01 last MRF observed

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

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/12945/560552787-1144211301_north-carolina-baptist-hospital_standardcharges.csv
Found on page	https://www.wakehealth.edu/cms-hpt.txt
Discovered via	Discovered by HANK (automated)
Last fetch	success · 2026-10-31
Content fingerprint	3855cd511a58e5b6… · 4,783,788,371 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	10	$4,377,500.00	$4,421,275.00	$4,377,500.00	nat. median $4,505,000 1.0× median
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	11	$3,710,000.00	$4,266,500.00	$3,710,000.00	nat. median $3,710,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	11	$3,685,266.67	$4,238,056.67	$3,685,266.67	nat. median $3,705,478 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	11	$3,324,571.90	$3,823,257.69	$3,324,571.90	nat. median $3,324,572 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	11	$3,261,355.00	$3,750,558.25	$3,261,355.00	nat. median $3,286,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	11	$2,950,686.67	$3,393,289.67	$2,950,686.67	nat. median $2,994,107 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	11	$2,452,115.60	$4,482,792.78	$2,452,115.60	nat. median $2,467,989 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	11	$2,332,000.00	$4,314,200.00	$2,332,000.00	nat. median $2,401,965 1.0× median
Q2055 HCPCS	Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension	38	$541,260.45	$2,691,403.20	$1,635,775.06	nat. median $623,527 outlier · 2.6×
Q2054 HCPCS	Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp	38	$541,635.66	$2,632,375.80	$1,587,005.73	nat. median $640,950 outlier · 2.5×
Q2041 HCPCS	Axicabtagene Ciloleucel Intravenous Suspension	38	$533,076.48	$2,494,800.00	$1,516,284.00	nat. median $608,239 outlier · 2.5×
Q2053 HCPCS	Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension	38	$489,720.00	$2,289,600.00	$1,391,568.00	nat. median $592,235 outlier · 2.3×
Q2056 HCPCS	Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension	38	$553,378.83	$2,819,111.18	$1,133,906.85	nat. median $646,415 1.8× median
Q2042 HCPCS	Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension	38	$542,853.09	$3,142,235.34	$1,122,410.16	nat. median $739,658 1.5× median
Q2057 HCPCS	Afamitresgene Autoleucel	11	$770,620.00	$1,425,647.00	$770,620.00	nat. median $813,967 0.9× median
J2326 HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	38	$1,246.94	$806,742.27	$503,765.73	nat. median $2,492 outlier · 202.2×
J0225 HCPCS	Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe	38	$4,983.86	$698,203.35	$435,989.21	nat. median $8,223 outlier · 53.0×
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	20	$344,219.65	$608,910.87	$372,797.63	nat. median $359,244 1.0× median
J9029 HCPCS	Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension	38	$63,431.05	$1,296,000.00	$333,576.00	nat. median $68,400 outlier · 4.9×
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	23	$85,135.00	$454,805.37	$275,683.15	nat. median $248,541 1.1× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	11	$270,375.00	$310,931.25	$270,375.00	nat. median $319,951 0.8× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	20	$218,882.02	$382,658.25	$232,175.04	nat. median $198,115 1.2× median
A9513 HCPCS	Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution	38	$312.69	$364,286.88	$224,441.20	nat. median $479 outlier · 468.3×
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	20	$198,354.96	$345,700.28	$209,751.07	nat. median $190,359 1.1× median
J9226 HCPCS	Histrelin 50 Mg (65 Mcg/day) Implant Kit	38	$45,560.39	$285,289.16	$178,147.23	nat. median $55,159 outlier · 3.2×
270961 CDM	Microscope Surg Pwr Crd	38	$53,329.02	$242,404.65	$156,889.67	nat. median $2,546 outlier · 61.6×
J1305 HCPCS	Evinacumab-dgnb 150 Mg/ml Intravenous Solution	38	$189.75	$246,789.54	$152,049.78	nat. median $301 outlier · 504.5×
J0223 HCPCS	Givosiran 189 Mg/ml Subcutaneous Solution	38	$117.19	$242,066.25	$147,122.49	nat. median $153 outlier · 964.3×
J7330 HCPCS	Cultured Chondrocytes Implnt	1	$146,124.84	$146,124.84	$146,124.84	nat. median $75,037 1.9× median
C9293 HCPCS	Glucarpidase 1,000 Unit Intravenous Solution	38	$47,027.26	$225,130.50	$140,581.49	nat. median $30,130 outlier · 4.7×
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And…	20	$132,939.29	$227,922.55	$138,290.31	nat. median $126,461 1.1× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	23	$96,232.00	$238,473.00	$132,129.10	nat. median $110,084 1.2× median
7 MS_DRG	Lung Transplant	20	$123,431.90	$211,008.84	$129,187.38	nat. median $117,977 1.1× median
77371 CPT	Hc Radiation Delivery Stereotactic Cranial Cobalt	38	$7,400.02	$189,350.10	$122,551.60	nat. median $9,444 outlier · 13.0×
15 MS_DRG	Bone Marrow Transplant	1	$114,135.00	$114,135.00	$114,135.00	nat. median $2,024 outlier · 56.4×
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	23	$85,135.00	$284,750.00	$109,470.91	nat. median $103,938 1.1× median
Q0480 HCPCS	Driver Pneumatic Vad, Rep	11	$109,316.30	$125,713.75	$109,316.30	nat. median $111,503 1.0× median
J9269 HCPCS	Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution	38	$348.62	$173,650.64	$108,435.18	nat. median $512 outlier · 211.6×
212 MS_DRG	Concomitant Aortic And Mitral Valve Procedures	20	$103,946.79	$175,892.91	$107,688.11	nat. median $97,137 1.1× median
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	20	$101,756.28	$171,945.21	$105,271.18	nat. median $94,943 1.1× median
215 MS_DRG	Other Heart Assist System Implant	20	$101,267.13	$171,063.64	$104,731.45	nat. median $93,787 1.1× median
426 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	20	$100,197.42	$169,135.81	$103,551.17	nat. median $93,226 1.1× median
212807 CDM	Module Genexpert Xiv Dsktp Config Anlyz	38	$33,303.20	$151,378.20	$97,975.34	nat. median $97,975 1.0× median
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	20	$92,812.44	$155,826.66	$95,402.82	nat. median $90,512 1.1× median
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	11	$93,216.70	$107,199.21	$93,216.70	nat. median $96,983 1.0× median
850 MS_DRG	Acute Leukemia With Other Procedures	20	$88,877.62	$148,735.34	$91,061.24	nat. median $78,164 1.2× median
J2507 HCPCS	Pegloticase 8 Mg/ml Intravenous Solution	38	$3,638.86	$145,380.74	$90,782.20	nat. median $9,222 outlier · 9.8×
212428 CDM	Vision 1321 Cart & Utensil W/d 460-480v, 60hz, 2 Resevoir,vented	38	$30,412.13	$138,236.98	$89,470.04	nat. median $89,470 1.0× median
J9348 HCPCS	Naxitamab-gqgk 4 Mg/ml Intravenous Solution	38	$685.91	$142,532.33	$89,003.52	nat. median $833 outlier · 106.9×
J9359 HCPCS	Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution	38	$216.74	$142,065.09	$88,711.76	nat. median $737 outlier · 120.4×

Other procedures at this hospital

Browse this hospital's 42,663 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	10	10	—	—	$4,377,500.00	$4,421,275.00	$4,377,500.00	2025-10-21
J1414	HCPCS	Inj, Beqvez, Per Tx Dose	11	11	—	—	$3,710,000.00	$4,266,500.00	$3,710,000.00	2025-10-21
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	11	11	—	—	$3,685,266.67	$4,238,056.67	$3,685,266.67	2025-10-21
J1413	HCPCS	Inj Delandistrogene Mox Rokl	11	11	—	—	$3,324,571.90	$3,823,257.69	$3,324,571.90	2025-10-21
J3394	HCPCS	Inj, Lovotibeglogene Autotem	11	11	—	—	$3,261,355.00	$3,750,558.25	$3,261,355.00	2025-10-21
J3393	HCPCS	Inj, Betibeglogene Autotemce	11	11	—	—	$2,950,686.67	$3,393,289.67	$2,950,686.67	2025-10-21
J3399	HCPCS	Inj Onase Abepar-xioi Treat	13	11	—	—	$2,452,115.60	$4,482,792.78	$2,452,115.60	2025-10-21
J3392	HCPCS	Inj, Exagamglogene Autotem	13	11	—	—	$2,332,000.00	$4,314,200.00	$2,332,000.00	2025-10-21
Q2055	HCPCS	Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension	97	38	$2,990,448.00	$1,495,224.00 50% off	$541,260.45	$2,691,403.20	$1,635,775.06	2025-10-21
Q2054	HCPCS	Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp	97	38	$2,924,862.00	$1,462,431.00 50% off	$541,635.66	$2,632,375.80	$1,587,005.73	2025-10-21
Q2041	HCPCS	Axicabtagene Ciloleucel Intravenous Suspension	97	38	$2,772,000.00	$1,386,000.00 50% off	$533,076.48	$2,494,800.00	$1,516,284.00	2025-10-21
Q2053	HCPCS	Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension	97	38	$2,544,000.00	$1,272,000.00 50% off	$489,720.00	$2,289,600.00	$1,391,568.00	2025-10-21
Q2056	HCPCS	Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension	136	38	$3,132,345.75	$1,566,172.88 50% off	$553,378.83	$2,819,111.18	$1,133,906.85	2025-10-21
Q2042	HCPCS	Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension	140	38	$2,741,682.25	$1,370,841.13 50% off	$542,853.09	$3,142,235.34	$1,122,410.16	2025-10-21
Q2057	HCPCS	Afamitresgene Autoleucel	13	11	—	—	$770,620.00	$1,425,647.00	$770,620.00	2025-10-21
J2326	HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	95	38	$896,380.30	$448,190.15 50% off	$1,246.94	$806,742.27	$503,765.73	2025-10-21
J0225	HCPCS	Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe	95	38	$775,781.50	$387,890.75 50% off	$4,983.86	$698,203.35	$435,989.21	2025-10-21
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	30	20	—	—	$344,219.65	$608,910.87	$372,797.63	2025-10-21
J9029	HCPCS	Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension	134	38	$1,440,000.00	$720,000.00 50% off	$63,431.05	$1,296,000.00	$333,576.00	2025-10-21
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	36	23	—	—	$85,135.00	$454,805.37	$275,683.15	2025-10-21
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	11	11	—	—	$270,375.00	$310,931.25	$270,375.00	2025-10-21
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	26	20	—	—	$218,882.02	$382,658.25	$232,175.04	2025-10-21
A9513	HCPCS	Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution	96	38	$404,763.20	$202,381.60 50% off	$312.69	$364,286.88	$224,441.20	2025-10-21
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	26	20	—	—	$198,354.96	$345,700.28	$209,751.07	2025-10-21
J9226	HCPCS	Histrelin 50 Mg (65 Mcg/day) Implant Kit	97	38	$316,987.95	$158,493.98 50% off	$45,560.39	$285,289.16	$178,147.23	2025-10-21
270961	CDM	Microscope Surg Pwr Crd	86	38	$269,338.50	$134,669.25 50% off	$53,329.02	$242,404.65	$156,889.67	2025-10-21
J1305	HCPCS	Evinacumab-dgnb 150 Mg/ml Intravenous Solution	94	38	$274,210.60	$137,105.30 50% off	$189.75	$246,789.54	$152,049.78	2025-10-21
J0223	HCPCS	Givosiran 189 Mg/ml Subcutaneous Solution	95	38	$268,962.50	$134,481.25 50% off	$117.19	$242,066.25	$147,122.49	2025-10-21
J7330	HCPCS	Cultured Chondrocytes Implnt	2	1	—	—	$146,124.84	$146,124.84	$146,124.84	2025-10-21
C9293	HCPCS	Glucarpidase 1,000 Unit Intravenous Solution	86	38	$250,145.00	$125,072.50 50% off	$47,027.26	$225,130.50	$140,581.49	2025-10-21
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	26	20	—	—	$132,939.29	$227,922.55	$138,290.31	2025-10-21
14	MS_DRG	Allogeneic Bone Marrow Transplant	42	23	—	—	$96,232.00	$238,473.00	$132,129.10	2025-10-21
7	MS_DRG	Lung Transplant	30	20	—	—	$123,431.90	$211,008.84	$129,187.38	2025-10-21
77371	CPT	Hc Radiation Delivery Stereotactic Cranial Cobalt	99	38	$210,389.00	$105,194.50 50% off	$7,400.02	$189,350.10	$122,551.60	2025-10-21
15	MS_DRG	Bone Marrow Transplant	1	1	—	—	$114,135.00	$114,135.00	$114,135.00	2025-10-21
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	36	23	—	—	$85,135.00	$284,750.00	$109,470.91	2025-10-21
Q0480	HCPCS	Driver Pneumatic Vad, Rep	11	11	—	—	$109,316.30	$125,713.75	$109,316.30	2025-10-21
J9269	HCPCS	Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution	95	38	$192,945.15	$96,472.58 50% off	$348.62	$173,650.64	$108,435.18	2025-10-21
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	30	20	—	—	$103,946.79	$175,892.91	$107,688.11	2025-10-21
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	30	20	—	—	$101,756.28	$171,945.21	$105,271.18	2025-10-21
215	MS_DRG	Other Heart Assist System Implant	30	20	—	—	$101,267.13	$171,063.64	$104,731.45	2025-10-21
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	30	20	—	—	$100,197.42	$169,135.81	$103,551.17	2025-10-21
212807	CDM	Module Genexpert Xiv Dsktp Config Anlyz	86	38	$168,198.00	$84,099.00 50% off	$33,303.20	$151,378.20	$97,975.34	2025-10-21
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	30	20	—	—	$92,812.44	$155,826.66	$95,402.82	2025-10-21
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	11	11	—	—	$93,216.70	$107,199.21	$93,216.70	2025-10-21
850	MS_DRG	Acute Leukemia With Other Procedures	30	20	—	—	$88,877.62	$148,735.34	$91,061.24	2025-10-21
J2507	HCPCS	Pegloticase 8 Mg/ml Intravenous Solution	95	38	$161,534.15	$80,767.08 50% off	$3,638.86	$145,380.74	$90,782.20	2025-10-21
212428	CDM	Vision 1321 Cart & Utensil W/d 460-480v, 60hz, 2 Resevoir,vented	86	38	$153,596.64	$76,798.32 50% off	$30,412.13	$138,236.98	$89,470.04	2025-10-21
J9348	HCPCS	Naxitamab-gqgk 4 Mg/ml Intravenous Solution	95	38	$158,369.25	$79,184.63 50% off	$685.91	$142,532.33	$89,003.52	2025-10-21
J9359	HCPCS	Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution	95	38	$157,850.10	$78,925.05 50% off	$216.74	$142,065.09	$88,711.76	2025-10-21
J7311	HCPCS	Fluocinolone 0.59 Mg Intravitreal Implant	95	38	$156,956.25	$78,478.13 50% off	$339.76	$141,260.63	$88,209.41	2025-10-21
J9118	HCPCS	Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution	85	38	$150,248.75	$75,124.38 50% off	$141.58	$135,223.88	$84,439.80	2025-10-21
231	MS_DRG	Coronary Bypass With Ptca With Mcc	30	20	—	—	$82,265.81	$136,819.59	$83,765.99	2025-10-21
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	30	20	—	—	$82,223.71	$160,669.19	$83,719.52	2025-10-21
A9699	HCPCS	Radiopharm Rx Agent Noc	2	1	—	—	$83,658.94	$83,658.94	$83,658.94	2025-10-21
J9600	HCPCS	Porfimer 75 Mg Intravenous Solution	94	37	$149,388.50	$74,694.25 50% off	$5,816.72	$134,449.65	$82,835.92	2025-10-21
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	30	20	—	—	$81,071.55	$134,667.33	$82,448.29	2025-10-21
10	MS_DRG	Pancreas Transplant	37	23	—	—	$77,778.22	$138,362.00	$80,168.52	2025-10-21
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	30	20	—	—	$78,567.48	$130,154.52	$79,685.38	2025-10-21
206331	CDM	Agreement Equipment Service Techcare Basic 3 Year Warranty	86	38	$135,556.20	$67,778.10 50% off	$26,840.13	$122,000.58	$78,961.49	2025-10-21
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	30	20	—	—	$77,368.77	$127,994.19	$78,362.75	2025-10-21
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	30	20	—	—	$76,375.21	$126,203.59	$77,266.49	2025-10-21
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	30	20	—	—	$75,668.33	$124,929.68	$76,486.54	2025-10-21
J9229	HCPCS	Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln	95	38	$133,462.95	$66,731.48 50% off	$2,698.05	$120,116.66	$75,006.18	2025-10-21
J9281	HCPCS	Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit	95	38	$132,710.00	$66,355.00 50% off	$317.42	$119,439.00	$74,583.02	2025-10-21
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	28	20	—	—	$73,052.13	$120,516.97	$73,787.20	2025-10-21
61799	CPT	Srs Cran Les Complex Addl	2	1	—	—	$70,225.00	$74,136.00	$72,180.50	2025-10-21
61800	CPT	Apply Srs Headframe Add-on	2	1	—	—	$70,225.00	$74,136.00	$72,180.50	2025-10-21
61796	CPT	Srs Cranial Lesion Simple	2	1	—	—	$70,225.00	$74,136.00	$72,180.50	2025-10-21
61797	CPT	Srs Cran Les Simple Addl	2	1	—	—	$70,225.00	$74,136.00	$72,180.50	2025-10-21
61798	CPT	Srs Cranial Lesion Complex	2	1	—	—	$70,225.00	$74,136.00	$72,180.50	2025-10-21
63620	CPT	Srs Spinal Lesion	2	1	—	—	$70,225.00	$74,136.00	$72,180.50	2025-10-21
63621	CPT	Srs Spinal Lesion Addl	2	1	—	—	$70,225.00	$74,136.00	$72,180.50	2025-10-21
J2350	HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	95	38	$128,168.50	$64,084.25 50% off	$59.70	$115,351.65	$72,030.70	2025-10-21
J3316	HCPCS	Triptorelin Pamoate (pediatric) 22.5 Mg IM Suspension	94	38	$129,094.95	$64,547.48 50% off	$3,772.85	$116,185.46	$71,583.15	2025-10-21
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	30	20	—	—	$69,514.12	$114,680.19	$70,447.26	2025-10-21
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	30	20	—	—	$69,164.73	$114,103.78	$70,109.29	2025-10-21
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	30	20	—	—	$68,083.27	$112,319.65	$69,063.17	2025-10-21
J9274	HCPCS	Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution	95	38	$121,610.00	$60,805.00 50% off	$217.09	$109,449.00	$68,344.82	2025-10-21
955	MS_DRG	Craniotomy For Multiple Significant Trauma	28	20	—	—	$66,828.57	$110,249.73	$67,522.73	2025-10-21
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	11	11	—	—	$67,452.66	$77,570.56	$67,452.66	2025-10-21
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	30	20	—	—	$65,618.90	$108,254.09	$66,673.34	2025-10-21
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	30	20	—	—	$65,255.80	$107,655.07	$66,321.96	2025-10-21
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	24	20	—	—	$65,366.39	$107,733.33	$66,184.23	2025-10-21
J0638	HCPCS	Canakinumab (pf) 150 Mg/ml Subcutaneous Solution	94	38	$118,141.90	$59,070.95 50% off	$141.00	$106,327.71	$65,509.68	2025-10-21
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	30	20	—	—	$63,294.49	$104,419.41	$64,423.99	2025-10-21
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	30	20	—	—	$63,203.47	$104,269.25	$64,335.92	2025-10-21
0811	RC	Hc Kidney Acquistion Live Donor	86	38	$109,153.00	$54,576.50 50% off	$21,612.29	$98,237.70	$63,581.62	2025-10-21
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	26	20	—	—	$61,895.92	$102,013.49	$63,007.36	2025-10-21
J9266	HCPCS	Pegaspargase 750 Unit/ml Injection Solution	97	38	$111,658.30	$55,829.15 50% off	$20,991.76	$113,193.66	$62,751.96	2025-10-21
61645	CPT	Hc Perq Art Trluml M-thrombec &/nfs Intracranial	86	38	$106,500.00	$53,250.00 50% off	$4,086.00	$95,850.00	$62,036.25	2025-10-21
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	30	20	—	—	$60,624.59	$100,014.78	$61,843.57	2025-10-21
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	30	20	—	—	$60,546.30	$99,885.61	$61,771.89	2025-10-21
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	30	20	—	—	$60,270.30	$99,430.30	$61,519.25	2025-10-21
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	30	20	—	—	$60,059.88	$99,083.16	$61,326.61	2025-10-21
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	30	20	—	—	$59,785.85	$98,631.07	$61,075.77	2025-10-21
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	41	23	—	—	$36,000.00	$178,500.00	$61,027.78	2025-10-21
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	41	23	—	—	$36,000.00	$178,500.00	$61,027.78	2025-10-21
28	MS_DRG	Spinal Procedures With Mcc	30	20	—	—	$59,500.07	$115,334.19	$60,814.18	2025-10-21
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	30	20	—	—	$58,631.96	$96,727.46	$60,019.49	2025-10-21
J3241	HCPCS	Teprotumumab-trbw 500 Mg Intravenous Solution	96	38	$106,508.00	$53,254.00 50% off	$359.09	$95,857.20	$59,857.50	2025-10-21
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	30	20	—	—	$58,225.80	$96,057.40	$59,647.69	2025-10-21
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	26	20	—	—	$58,181.76	$95,892.00	$59,607.38	2025-10-21
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	30	20	—	—	$57,588.67	$95,006.29	$59,064.46	2025-10-21
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	30	20	—	—	$56,982.85	$94,006.86	$58,509.91	2025-10-21
0636	RC	Vincristine Sulfate Liposomal 5 Mg/31 Ml(0.16 Mg/ml)(final Conc)iv Kit	86	38	$103,230.15	$51,615.08 50% off	$19,407.27	$92,907.14	$58,015.35	2025-10-21
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	30	20	—	—	$56,171.51	$108,882.16	$57,767.17	2025-10-21
J9334	HCPCS	Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln	95	38	$102,524.50	$51,262.25 50% off	$33.74	$92,272.05	$57,618.77	2025-10-21
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	30	20	—	—	$55,835.81	$92,114.54	$57,459.89	2025-10-21
A9543	HCPCS	Y90 Ibritumomab, Rx	13	11	—	—	$56,824.55	$105,125.42	$56,824.55	2025-10-21
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	17	11	—	—	$55,945.97	$232,222.18	$56,505.43	2025-10-21
653	MS_DRG	Major Bladder Procedures With Mcc	30	20	—	—	$54,558.61	$90,007.49	$56,290.71	2025-10-21
834	MS_DRG	Acute Leukemia With Mcc	30	20	—	—	$54,095.69	$89,243.79	$55,866.95	2025-10-21
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	30	20	—	—	$54,095.69	$89,243.79	$55,866.95	2025-10-21
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	30	20	—	—	$53,868.63	$88,869.20	$55,659.12	2025-10-21
819	OTHER	Hc Heart Transplant	16	16	$156,253.00	$78,127.00 50% off	$29,938.00	$140,628.00	$55,548.00	2026-08-01
J0202	HCPCS	Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution	95	38	$98,689.90	$49,344.95 50% off	$2,440.70	$88,820.91	$55,463.72	2025-10-21
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	30	20	—	—	$53,539.78	$88,326.69	$55,358.07	2025-10-21
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	37	23	—	—	$53,252.05	$180,697.00	$55,094.69	2025-10-21
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	30	20	—	—	$53,130.69	$87,651.79	$54,983.58	2025-10-21
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	30	20	—	—	$52,859.59	$87,204.55	$54,735.42	2025-10-21
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	26	20	—	—	$52,809.67	$87,038.03	$54,689.72	2025-10-21
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	30	20	—	—	$52,803.80	$87,112.51	$54,684.37	2025-10-21
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	30	20	—	—	$52,068.80	$85,899.95	$54,011.52	2025-10-21
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	30	20	—	—	$51,838.80	$85,520.52	$53,800.99	2025-10-21
J9347	HCPCS	Tremelimumab-actl 20 Mg/ml Intravenous Solution	134	38	$234,050.00	$117,025.00 50% off	$141.17	$210,645.00	$53,761.29	2025-10-21
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	30	20	—	—	$50,404.03	$83,153.51	$52,487.60	2025-10-21
235464	CDM	Set Console Elcsurg Acessa Provu Capital	86	38	$90,000.00	$45,000.00 50% off	$17,820.00	$81,000.00	$52,425.00	2025-10-21
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	30	20	—	—	$50,236.67	$82,877.42	$52,334.39	2025-10-21
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	30	20	—	—	$49,860.85	$82,257.41	$51,990.37	2025-10-21
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	30	20	—	—	$49,708.17	$82,005.53	$51,850.60	2025-10-21
J1304	HCPCS	Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution	96	38	$92,957.50	$46,478.75 50% off	$155.34	$83,661.75	$51,544.93	2025-10-21
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	30	20	—	—	$49,296.14	$81,325.79	$51,473.41	2025-10-21
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	30	20	—	—	$49,005.47	$80,846.25	$51,207.33	2025-10-21
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	30	20	—	—	$48,967.30	$80,783.28	$51,172.39	2025-10-21
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	30	20	—	—	$48,947.72	$80,750.99	$51,154.48	2025-10-21
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	30	20	—	—	$48,771.56	$80,460.36	$50,993.20	2025-10-21
J9210	HCPCS	Emapalumab-lzsg 5 Mg/ml Intravenous Solution	134	38	$219,530.65	$109,765.33 50% off	$381.64	$197,577.59	$50,854.27	2025-10-21
243061	CDM	Unit Hrt/lng Cardiohelp-i 70107278	86	38	$86,741.24	$43,370.62 50% off	$17,174.77	$78,067.12	$50,526.78	2025-10-21
245	MS_DRG	Aicd Generator Procedures	30	20	—	—	$47,827.11	$78,902.27	$50,128.67	2025-10-21
471	MS_DRG	Cervical Spinal Fusion With Mcc	30	20	—	—	$47,538.40	$92,147.84	$49,864.36	2025-10-21
6	MS_DRG	Liver Transplant Without Mcc	30	20	—	—	$47,459.12	$78,295.18	$49,791.80	2025-10-21
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	30	20	—	—	$46,737.82	$77,105.22	$49,131.53	2025-10-21
J9298	HCPCS	Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution	95	38	$87,244.90	$43,622.45 50% off	$197.65	$78,520.41	$49,031.64	2025-10-21
799	MS_DRG	Splenic Procedures With Mcc	30	20	—	—	$46,535.23	$76,771.00	$48,946.08	2025-10-21
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	30	20	—	—	$46,526.42	$76,756.47	$48,937.99	2025-10-21
L7181	HCPCS	Electronic Elbo Simultaneous	11	11	—	—	$48,632.79	$55,927.71	$48,632.79	2025-10-21
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	30	20	—	—	$46,044.90	$75,962.09	$48,497.20	2025-10-21
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	30	20	—	—	$45,798.27	$75,555.21	$48,271.44	2025-10-21
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	40	22	—	—	$45,091.65	$140,091.00	$48,100.86	2025-10-21
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	30	20	—	—	$45,528.15	$75,109.58	$48,024.18	2025-10-21
163	MS_DRG	Major Chest Procedures With Mcc	30	20	—	—	$45,110.24	$74,420.14	$47,641.61	2025-10-21
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	30	20	—	—	$44,947.78	$74,152.12	$47,492.90	2025-10-21
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	30	20	—	—	$44,940.93	$74,140.82	$47,486.63	2025-10-21
0812	RC	Hc Cadaver Donor - Kidney	172	38	$109,153.00	$54,576.50 50% off	$15,444.40	$146,703.60	$47,434.17	2025-10-21
J9043	HCPCS	Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution	95	38	$83,264.90	$41,632.45 50% off	$227.10	$74,938.41	$46,794.88	2025-10-21
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	30	20	—	—	$44,155.03	$72,844.29	$46,767.22	2025-10-21
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	30	20	—	—	$43,891.76	$72,409.97	$46,526.22	2025-10-21
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	30	20	—	—	$43,770.40	$72,209.76	$46,415.11	2025-10-21
901	MS_DRG	Wound Debridements For Injuries With Mcc	30	20	—	—	$43,361.30	$71,534.85	$46,040.63	2025-10-21
J3245	HCPCS	Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe	95	38	$81,810.05	$40,905.03 50% off	$126.24	$73,629.05	$45,977.25	2025-10-21
A9517	HCPCS	Sodium Iodide-131 (i-131) 500 Mci/0.5 Ml Oral Kit (therapeutic)	95	38	$81,656.25	$40,828.13 50% off	$23.13	$73,490.63	$45,890.82	2025-10-21
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	30	20	—	—	$42,992.33	$70,926.15	$45,702.85	2025-10-21
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	28	20	—	—	$42,347.37	$69,862.13	$45,112.47	2025-10-21
212217	CDM	Amsco 7053hp, 200-208v, 3 Ph, 60 Hz, Steam Heated	86	38	$77,388.00	$38,694.00 50% off	$15,322.82	$69,649.20	$45,078.51	2025-10-21
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	30	20	—	—	$42,260.27	$81,916.78	$45,032.74	2025-10-21
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	30	20	—	—	$41,748.41	$68,873.99	$44,564.18	2025-10-21
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	30	20	—	—	$41,686.75	$68,772.27	$44,507.73	2025-10-21
140	MS_DRG	Major Head And Neck Procedures With Mcc	30	20	—	—	$41,391.18	$68,284.66	$44,237.15	2025-10-21
31	MS_DRG	Ventricular Shunt Procedures With Mcc	30	20	—	—	$41,013.40	$67,661.43	$43,891.36	2025-10-21
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	30	20	—	—	$41,003.62	$67,645.28	$43,882.40	2025-10-21
793	MS_DRG	Full Term Neonate With Major Problems	26	20	—	—	$40,816.68	$67,271.83	$43,711.27	2025-10-21
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	30	20	—	—	$40,720.77	$67,178.66	$43,623.46	2025-10-21
0266T	CPT	Apc	13	11	—	—	$17,264.00	$50,095.59	$43,561.38	2025-10-21
33276	CPT	Insj Phrnc Nrv Stim Sys	13	11	—	—	$38,760.00	$50,095.59	$43,561.38	2025-10-21
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	30	20	—	—	$40,245.12	$66,393.97	$43,188.06	2025-10-21
77301	CPT	Hc Imrt Planning	96	37	$74,119.00	$37,059.50 50% off	$1,324.50	$66,707.10	$43,174.32	2025-10-21
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	28	20	—	—	$40,222.61	$66,356.83	$43,167.45	2025-10-21
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	26	20	—	—	$40,162.91	$66,194.32	$43,112.81	2025-10-21
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	30	20	—	—	$39,965.21	$65,932.19	$42,931.84	2025-10-21
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	30	20	—	—	$39,807.64	$65,672.24	$42,787.59	2025-10-21
791	MS_DRG	Prematurity With Major Problems	26	20	—	—	$39,734.24	$65,487.81	$42,720.40	2025-10-21
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	30	20	—	—	$38,988.47	$64,320.82	$42,037.71	2025-10-21
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	30	20	—	—	$38,961.07	$64,275.61	$42,012.63	2025-10-21
61650	CPT	Hc Evasc Intracranial Prolng Admn Rx Agent Art 1st	86	38	$71,706.00	$35,853.00 50% off	$4,086.00	$64,535.40	$41,768.75	2025-10-21
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	30	20	—	—	$38,616.57	$63,707.27	$41,697.25	2025-10-21
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	30	20	—	—	$38,537.29	$63,576.49	$41,624.71	2025-10-21
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	31	20	—	—	$38,459.00	$63,447.32	$41,553.04	2025-10-21
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	30	20	—	—	$38,288.70	$63,166.38	$41,397.13	2025-10-21
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	30	20	—	—	$38,270.11	$63,135.70	$41,380.11	2025-10-21
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	30	20	—	—	$38,058.71	$62,786.95	$41,186.61	2025-10-21
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	30	20	—	—	$37,826.76	$62,404.29	$40,974.26	2025-10-21
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	30	20	—	—	$37,788.59	$62,341.32	$40,939.33	2025-10-21
J3357	HCPCS	Ustekinumab 45 Mg/0.5 Ml Subcutaneous Solution	173	38	$90,489.30	$45,244.65 50% off	$157.68	$157,994.24	$40,867.84	2025-10-21
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	30	20	—	—	$37,682.89	$62,166.94	$40,842.55	2025-10-21
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	28	20	—	—	$37,409.83	$72,514.75	$40,592.61	2025-10-21
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	30	20	—	—	$37,207.24	$61,382.25	$40,407.15	2025-10-21
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	30	20	—	—	$36,917.54	$60,904.33	$40,141.98	2025-10-21
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	30	20	—	—	$36,622.95	$60,418.33	$39,872.30	2025-10-21
212564	CDM	Histocore Spectra Cv	86	38	$68,000.00	$34,000.00 50% off	$13,464.00	$61,200.00	$39,610.00	2025-10-21
L7180	HCPCS	Electronic Elbow Sequential	11	11	—	—	$39,208.42	$45,089.68	$39,208.42	2025-10-21
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	30	20	—	—	$35,709.83	$58,911.91	$39,036.43	2025-10-21
J2327	HCPCS	Risankizumab-rzaa 150 Mg/ml Subcutaneous Pen Injector	143	38	$132,514.50	$66,257.25 50% off	$14.84	$119,263.05	$38,826.75	2025-10-21
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	30	20	—	—	$35,462.22	$58,503.42	$38,809.76	2025-10-21
0100T	CPT	Prosth Retina Receive&gen	2	1	—	—	$38,760.00	$38,760.00	$38,760.00	2025-10-21
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	11	11	—	—	$38,606.32	$44,397.27	$38,606.32	2025-10-21
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	30	20	—	—	$35,084.44	$57,880.18	$38,463.94	2025-10-21
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	30	20	—	—	$35,082.48	$57,876.95	$38,462.15	2025-10-21
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	30	20	—	—	$35,076.61	$57,867.26	$38,456.75	2025-10-21
265	MS_DRG	Aicd Lead Procedures	30	20	—	—	$34,912.19	$57,596.01	$38,306.24	2025-10-21
J2329	HCPCS	Ublituximab-xiiy 25 Mg/ml Intravenous Solution	95	38	$68,096.30	$34,048.15 50% off	$71.90	$61,286.67	$38,270.12	2025-10-21
J9272	HCPCS	Dostarlimab-gxly 50 Mg/ml Intravenous Solution	95	38	$68,068.35	$34,034.18 50% off	$243.82	$61,261.52	$38,254.42	2025-10-21
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	30	20	—	—	$34,755.59	$57,337.68	$38,162.90	2025-10-21
J9042	HCPCS	Brentuximab Vedotin 50 Mg Intravenous Solution	95	38	$67,862.00	$33,931.00 50% off	$258.52	$61,075.80	$38,138.44	2025-10-21
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	30	20	—	—	$34,552.02	$57,001.84	$37,976.56	2025-10-21
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	30	20	—	—	$34,543.22	$56,987.31	$37,968.49	2025-10-21
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	30	20	—	—	$34,456.11	$66,789.30	$37,888.75	2025-10-21
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	30	20	—	—	$34,291.69	$56,572.35	$37,738.25	2025-10-21
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	30	20	—	—	$34,280.92	$56,554.59	$37,728.40	2025-10-21
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	30	20	—	—	$34,267.22	$56,531.99	$37,715.86	2025-10-21
264	MS_DRG	Other Circulatory System O.r. Procedures	30	20	—	—	$34,206.54	$56,431.88	$37,660.30	2025-10-21
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	40	22	—	—	$33,985.36	$140,091.00	$37,645.12	2025-10-21
J1640	HCPCS	Hemin 350 Mg Intravenous Powder For Solution	94	38	$67,711.85	$33,855.93 50% off	$34.17	$60,940.67	$37,546.22	2025-10-21
332	MS_DRG	Rectal Resection With Mcc	30	20	—	—	$33,948.17	$56,005.63	$37,423.80	2025-10-21
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	30	20	—	—	$33,910.98	$55,944.28	$37,389.74	2025-10-21
J2840	HCPCS	Sebelipase Alfa 2 Mg/ml Intravenous Solution	95	38	$66,390.00	$33,195.00 50% off	$539.69	$59,751.00	$37,311.18	2025-10-21
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	30	20	—	—	$33,710.34	$55,613.28	$37,206.08	2025-10-21
811	OTHER	Living Donor Kidney	16	16	$104,632.00	$52,316.00 50% off	$20,047.00	$94,169.00	$37,197.00	2026-08-01
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	30	20	—	—	$33,657.49	$55,526.09	$37,157.69	2025-10-21
665	MS_DRG	Prostatectomy With Mcc	30	20	—	—	$33,604.64	$55,438.91	$37,109.32	2025-10-21
252	MS_DRG	Other Vascular Procedures With Mcc	30	20	—	—	$33,573.32	$55,387.24	$37,080.64	2025-10-21
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	30	20	—	—	$33,522.43	$55,303.28	$37,034.06	2025-10-21
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	30	20	—	—	$33,336.48	$54,996.51	$36,863.83	2025-10-21
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	30	20	—	—	$33,197.50	$54,767.23	$36,736.62	2025-10-21
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	30	20	—	—	$32,852.02	$63,679.96	$36,420.38	2025-10-21
37	MS_DRG	Extracranial Procedures With Mcc	30	20	—	—	$32,501.65	$53,619.25	$36,099.63	2025-10-21
143	MS_DRG	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	30	20	—	—	$32,315.70	$53,312.48	$35,929.40	2025-10-21
469	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	30	20	—	—	$31,990.77	$52,776.43	$35,631.97	2025-10-21
579	MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	30	20	—	—	$31,899.75	$52,626.27	$35,548.64	2025-10-21
656	MS_DRG	Kidney And Ureter Procedures For Neoplasm With Mcc	30	20	—	—	$31,886.05	$52,603.67	$35,536.10	2025-10-21
J0222	HCPCS	Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution	94	38	$63,627.50	$31,813.75 50% off	$99.82	$57,264.75	$35,281.45	2025-10-21
205182	CDM	Cable Monitor Hybrid Cardiosave Latex-free Dehp-free	86	38	$60,562.13	$30,281.07 50% off	$11,991.30	$54,505.92	$35,277.44	2025-10-21
485	MS_DRG	Knee Procedures With Principal Diagnosis Of Infection With Mcc	30	20	—	—	$31,507.29	$51,978.82	$35,189.39	2025-10-21
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	30	20	—	—	$31,361.46	$51,738.24	$35,055.90	2025-10-21
324	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	30	20	—	—	$31,270.44	$51,588.08	$34,972.58	2025-10-21
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	30	20	—	—	$31,210.74	$51,489.59	$34,917.92	2025-10-21
929	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	24	20	—	—	$31,126.57	$51,301.12	$34,840.88	2025-10-21
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	30	20	—	—	$31,063.94	$51,247.40	$34,783.55	2025-10-21
J9119	HCPCS	Cemiplimab-rwlc 50 Mg/ml Intravenous Solution	93	38	$61,836.95	$30,918.48 50% off	$28.70	$55,653.26	$34,752.37	2025-10-21
500	MS_DRG	Soft Tissue Procedures With Mcc	30	20	—	—	$31,012.07	$51,161.83	$34,736.07	2025-10-21
22556	CPT	Arthrd Ant Ntrbd Min Dsc Thc	2	1	—	—	$33,732.00	$35,613.00	$34,672.50	2025-10-21
22558	CPT	Arthrd Ant Ntrbd Min Dsc Lum	2	1	—	—	$33,732.00	$35,613.00	$34,672.50	2025-10-21
274	MS_DRG	Percutaneous And Other Intracardiac Procedures Without Mcc	30	20	—	—	$30,545.23	$50,391.67	$34,308.71	2025-10-21
662	MS_DRG	Minor Bladder Procedures With Mcc	30	20	—	—	$30,531.53	$50,369.06	$34,296.17	2025-10-21
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	11	11	—	—	$34,284.44	$39,427.11	$34,284.44	2025-10-21
652	MS_DRG	Kidney Transplant	41	23	—	—	$30,059.79	$140,091.00	$34,202.97	2025-10-21
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	30	20	—	—	$30,401.36	$50,154.32	$34,177.01	2025-10-21
212144	CDM	Histocore Spectra St	86	38	$58,499.10	$29,249.55 50% off	$11,582.82	$52,649.19	$34,075.72	2025-10-21
515	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	30	20	—	—	$30,265.32	$49,929.89	$34,052.47	2025-10-21
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	30	20	—	—	$30,202.68	$49,826.56	$33,995.12	2025-10-21
829	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	30	20	—	—	$30,181.15	$49,791.03	$33,975.43	2025-10-21
0620T	CPT	Evasc Ven Artlz Tibl/prnl Vn	13	11	—	—	$10,829.00	$38,963.36	$33,881.18	2025-10-21
173	MS_DRG	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	30	20	—	—	$30,032.39	$49,545.62	$33,839.27	2025-10-21
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	30	20	—	—	$29,934.52	$49,384.16	$33,749.67	2025-10-21
570	MS_DRG	Skin Debridement With Mcc	30	20	—	—	$29,460.83	$48,602.69	$33,316.03	2025-10-21
974	MS_DRG	HIV With Major Related Condition With Mcc	30	20	—	—	$29,225.94	$48,215.19	$33,101.02	2025-10-21
J9203	HCPCS	Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln	95	38	$58,551.90	$29,275.95 50% off	$236.62	$52,696.71	$32,906.17	2025-10-21
J7314	HCPCS	Fluocinolone 0.18 Mg Intravitreal Implant	95	38	$58,474.00	$29,237.00 50% off	$532.58	$52,626.60	$32,862.39	2025-10-21
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	30	20	—	—	$28,857.95	$47,608.10	$32,764.16	2025-10-21
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	30	20	—	—	$28,783.57	$47,485.39	$32,696.09	2025-10-21
208085	CDM	Bronchoscope Flexible 6.3mm Dia 89cml 2.2mm Channel Ultrasound-video	86	38	$56,080.92	$28,040.46 50% off	$11,104.02	$50,472.83	$32,667.13	2025-10-21
353	MS_DRG	Hernia Procedures Except Inguinal And Femoral With Mcc	30	20	—	—	$28,705.27	$47,356.22	$32,624.40	2025-10-21
J7313	HCPCS	Fluocinolone 0.19 Mg Intravitreal Implant	95	38	$57,875.00	$28,937.50 50% off	$497.80	$52,087.50	$32,525.75	2025-10-21
668	MS_DRG	Transurethral Procedures With Mcc	30	20	—	—	$28,541.83	$47,086.58	$32,474.79	2025-10-21
521	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	30	20	—	—	$28,526.17	$47,060.75	$32,460.45	2025-10-21
800	MS_DRG	Splenic Procedures With Cc	30	20	—	—	$28,517.36	$47,046.21	$32,452.38	2025-10-21
240	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	30	20	—	—	$28,501.70	$47,020.38	$32,438.05	2025-10-21
472	MS_DRG	Cervical Spinal Fusion With Cc	30	20	—	—	$28,354.90	$54,962.78	$32,303.66	2025-10-21
253394	CDM	Defib Extrn Lifenet 5 Yr Subscription	86	38	$55,125.00	$27,562.50 50% off	$10,914.75	$49,612.50	$32,110.31	2025-10-21
625	MS_DRG	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	30	20	—	—	$28,060.31	$46,292.20	$32,033.99	2025-10-21
462	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	30	20	—	—	$28,028.01	$46,238.91	$32,004.43	2025-10-21
325	MS_DRG	Coronary Intravascular Lithotripsy Without Intraluminal Device	30	20	—	—	$28,011.37	$46,211.47	$31,989.21	2025-10-21
510	MS_DRG	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	30	20	—	—	$27,972.22	$46,146.88	$31,953.35	2025-10-21
321	MS_DRG	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	30	20	—	—	$27,861.63	$45,964.43	$31,852.13	2025-10-21
J9144	HCPCS	Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln	97	38	$57,917.60	$28,958.80 50% off	$54.67	$52,125.84	$31,680.93	2025-10-21
654	MS_DRG	Major Bladder Procedures With Cc	30	20	—	—	$27,619.89	$45,565.63	$31,630.85	2025-10-21
406	MS_DRG	Pancreas, Liver And Shunt Procedures With Cc	30	20	—	—	$27,485.81	$45,344.43	$31,508.11	2025-10-21
258	MS_DRG	Cardiac Pacemaker Device Replacement With Mcc	30	20	—	—	$27,457.43	$45,297.60	$31,482.13	2025-10-21
J3380	HCPCS	Vedolizumab 300 Mg Intravenous Solution	98	38	$56,357.80	$28,178.90 50% off	$22.06	$50,722.02	$31,250.40	2025-10-21
33264	CPT	Hc Remove/replace Icd Biv	97	38	$53,574.00	$26,787.00 50% off	$9,021.86	$54,514.00	$31,206.85	2025-10-21
33270	CPT	Hc Insert/replace Subq Defibrillator	97	38	$53,574.00	$26,787.00 50% off	$9,021.86	$54,514.00	$31,206.85	2025-10-21
33249	CPT	Hc Implant Aicd Dual Chamber W Lea	100	38	$53,574.00	$26,787.00 50% off	$9,021.86	$54,514.00	$31,206.85	2025-10-21
0915T	CPT	Insj Perm Ccm-d Sys Pg&eltrd	11	11	—	—	$31,036.25	$35,691.69	$31,036.25	2025-10-21
0408T	CPT	Insj/rplc Cardiac Modulj Sys	13	11	—	—	$31,036.25	$38,760.00	$31,036.25	2025-10-21
33231	CPT	Insrt Pulse Gen W/mult Leads	13	11	—	—	$31,036.25	$54,514.00	$31,036.25	2025-10-21
411	MS_DRG	Cholecystectomy With C.d.e. With Mcc	30	20	—	—	$26,781.15	$44,181.91	$30,863.06	2025-10-21
288	MS_DRG	Acute And Subacute Endocarditis With Mcc	30	20	—	—	$26,733.19	$44,102.80	$30,819.14	2025-10-21
69930	CPT	Implant Cochlear Device	13	11	—	—	$30,790.61	$49,444.00	$30,790.61	2025-10-21
619	MS_DRG	O.r. Procedures For Obesity With Mcc	30	20	—	—	$26,684.26	$44,022.07	$30,774.35	2025-10-21
963	MS_DRG	Other Multiple Significant Trauma With Mcc	28	20	—	—	$26,588.34	$43,863.84	$30,686.55	2025-10-21

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