Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

CAPE FEAR VALLEY HOKE HOSPITAL

Raeford, NC · CCN 340188 · Rates published

17,439 distinct procedures filed
22 distinct payers
755,367 rate rows
2026-08-01 last MRF observed
Data quality

420,776 of 755,367 rate rows are consumer-grade (55.7%)

334,591 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 318,687
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 12,372
placeholder amount (≤ $0.02) — excluded from medians 2,618
exceeds 10× this hospital's gross charge — excluded from medians 394
percent-of-charges filed in the dollar field — excluded from medians 389
per-diem day rate — not a per-procedure price 125
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 4
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apim.services.craneware.com/api-pricing-transparency/api/public/ce5859a3e1522778c0b0cafe4913c4b9/charges/mrf
Found on page https://www.capefearvalley.com/price-transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-18
Content fingerprint 9b065b207e3ad823… · 140,433,896 bytes · first seen 2026-05-17

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
59572050200
NDC 		Pomalyst 10 $295,879.52 $505,460.85 $369,849.40 nat. median
$710
outlier · 521.0×
59572050400
NDC 		Pomalyst 10 $295,879.52 $505,460.85 $369,849.40 nat. median
$710
outlier · 521.0×
59572050100
NDC 		Pomalyst 10 $295,879.52 $505,460.85 $369,849.40 nat. median
$710
outlier · 521.0×
59572050300
NDC 		Pomalyst 10 $295,879.52 $505,460.85 $369,849.40 nat. median
$751
outlier · 492.6×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 22 $128,788.97 $811,590.43 $324,636.17 nat. median
$370,165
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 22 $96,465.55 $530,487.05 $212,194.82 nat. median
$261,939
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 22 $81,410.40 $424,012.50 $170,217.27 nat. median
$205,166
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 22 $73,651.02 $404,413.45 $161,765.38 nat. median
$199,832
0.8× median
60505267708
NDC 		ARIPiprazole 10 $98,094.59 $167,578.25 $122,618.23 nat. median
$76,372
1.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 22 $48,923.40 $267,675.28 $109,211.51 nat. median
$132,706
0.8× median
7
MS_DRG 		Lung Transplant 22 $45,329.54 $250,963.60 $102,393.15 nat. median
$122,690
0.8× median
66215060214
NDC 		Uptravi 10 $77,364.42 $132,164.21 $96,705.52 nat. median
$45,137
outlier · 2.1×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 22 $45,441.30 $236,673.42 $96,562.76 nat. median
$114,305
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 13 $88,284.50 $220,711.25 $90,050.19 nat. median
$96,134
0.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 22 $38,390.05 $220,952.35 $88,380.94 nat. median
$108,240
0.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 22 $37,964.02 $212,464.85 $86,685.66 nat. median
$100,978
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 $1,279.00 $215,192.67 $86,077.07 nat. median
$96,835
0.9× median
50419048858
NDC 		Nexavar 10 $66,139.20 $112,987.80 $82,674.00 nat. median
$1,041
outlier · 79.4×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 22 $37,136.00 $202,013.58 $82,421.54 nat. median
$99,646
0.8× median
59572041028
NDC 		Revlimid 10 $64,714.12 $110,553.29 $80,892.65 nat. median
$4,279
outlier · 18.9×
00187552675
NDC 		Targretin 10 $64,483.91 $110,160.01 $80,604.88 nat. median
$50,205
1.6× median
215
MS_DRG 		Other Heart Assist System Implant 22 $36,951.09 $195,458.35 $79,747.01 nat. median
$98,002
0.8× median
59572050421
NDC 		Pomalyst 10 $62,141.80 $106,158.91 $77,677.25 nat. median
$41,078
1.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 $33,755.16 $192,228.02 $77,355.56 nat. median
$92,900
0.8× median
00069814020
NDC 		Xalkori 10 $61,628.86 $105,282.64 $77,036.08 nat. median
$1,128
outlier · 68.3×
00069814120
NDC 		Xalkori 10 $61,628.86 $105,282.64 $77,036.08 nat. median
$1,268
outlier · 60.7×
00069098038
NDC 		Sutent 10 $58,275.72 $99,554.36 $72,844.65 nat. median
$881
outlier · 82.7×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 21 $1,279.00 $177,889.95 $71,155.98 nat. median
$81,124
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 21 $1,279.00 $171,397.80 $69,930.30 nat. median
$81,364
0.9× median
00069013501
NDC 		Bosulif 10 $55,726.10 $95,198.75 $69,657.62 nat. median
$43,386
1.6× median
00069013601
NDC 		Bosulif 10 $55,725.97 $95,198.53 $69,657.46 nat. median
$1,463
outlier · 47.6×
00078068715
NDC 		Promacta 10 $55,075.77 $94,087.77 $68,844.71 nat. median
$1,836
outlier · 37.5×
00069014501
NDC 		Inlyta 10 $54,860.89 $93,720.69 $68,576.11 nat. median
$387
outlier · 177.0×
00069015111
NDC 		Inlyta 10 $54,860.89 $93,720.69 $68,576.11 nat. median
$1,162
outlier · 59.0×
24979071544
NDC 		SORAfenib Tosylate 10 $54,654.83 $93,368.66 $68,318.53 nat. median
$42,552
1.6× median
13668068212
NDC 		SORAfenib Tosylate 10 $54,654.83 $93,368.66 $68,318.53 nat. median
$42,552
1.6× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 22 $29,768.44 $167,140.15 $68,193.18 nat. median
$79,040
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 $29,752.52 $166,648.72 $67,992.68 nat. median
$80,459
0.8× median
00003052411
NDC 		Sprycel 10 $52,490.38 $89,671.06 $65,612.97 nat. median
$1,145
outlier · 57.3×
00003052811
NDC 		Sprycel 10 $52,490.38 $89,671.06 $65,612.97 nat. median
$1,145
outlier · 57.3×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 22 $28,370.45 $156,735.20 $63,947.96 nat. median
$77,385
0.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 $27,274.55 $153,202.65 $62,504.17 nat. median
$74,472
0.8× median
60505363006
NDC 		Dasatinib 10 $49,866.36 $85,188.37 $62,332.96 nat. median
$38,824
1.6× median
60505362906
NDC 		Dasatinib 10 $49,866.36 $85,188.37 $62,332.96 nat. median
$638
outlier · 97.7×
66993023460
NDC 		Dasatinib 10 $49,866.36 $85,188.37 $62,332.96 nat. median
$38,824
1.6× median
66993023560
NDC 		Dasatinib 10 $49,866.36 $85,188.37 $62,332.96 nat. median
$658
outlier · 94.8×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 22 $27,541.75 $152,588.83 $62,256.24 nat. median
$73,475
0.8× median
00078056651
NDC 		Afinitor 10 $49,607.42 $84,746.02 $62,009.28 nat. median
$55,912
1.1× median
00078056751
NDC 		Afinitor 10 $49,607.42 $84,746.02 $62,009.28 nat. median
$1,867
outlier · 33.2×
00078062051
NDC 		Afinitor 10 $49,607.42 $84,746.02 $62,009.28 nat. median
$55,912
1.1× median

Other procedures at this hospital

Browse this hospital's 17,439 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
00003052411 NDC Sprycel 11 10 $109,354.95 $65,612.97 40% off $52,490.38 $89,671.06 $65,612.97 2026-08-01
00003052711 NDC Sprycel 11 10 $54,686.97 $32,812.18 40% off $26,249.75 $44,843.32 $32,812.18 2026-08-01
00003052811 NDC Sprycel 11 10 $109,354.95 $65,612.97 40% off $52,490.38 $89,671.06 $65,612.97 2026-08-01
00003085222 NDC Sprycel 11 10 $98,548.88 $59,129.33 40% off $47,303.46 $80,810.08 $59,129.33 2026-08-01
00003085522 NDC Sprycel 11 10 $98,548.88 $59,129.33 40% off $47,303.46 $80,810.08 $59,129.33 2026-08-01
00003085722 NDC Sprycel 11 10 $98,548.88 $59,129.33 40% off $47,303.46 $80,810.08 $59,129.33 2026-08-01
00006056840 NDC Zolinza 11 10 $81,070.56 $48,642.34 40% off $38,913.87 $66,477.86 $48,642.34 2026-08-01
00054048113 NDC Everolimus 11 10 $80,594.15 $48,356.49 40% off $38,685.19 $66,087.20 $48,356.49 2026-08-01
00054048213 NDC Everolimus 11 10 $80,594.15 $48,356.49 40% off $38,685.19 $66,087.20 $48,356.49 2026-08-01
00054049713 NDC Everolimus 11 10 $80,594.15 $48,356.49 40% off $38,685.19 $66,087.20 $48,356.49 2026-08-01
00054049714 NDC Everolimus 11 10 $80,594.21 $48,356.53 40% off $38,685.22 $66,087.25 $48,356.53 2026-08-01
00069013501 NDC Bosulif 11 10 $116,096.04 $69,657.62 40% off $55,726.10 $95,198.75 $69,657.62 2026-08-01
00069013601 NDC Bosulif 11 10 $116,095.77 $69,657.46 40% off $55,725.97 $95,198.53 $69,657.46 2026-08-01
00069014501 NDC Inlyta 11 10 $114,293.52 $68,576.11 40% off $54,860.89 $93,720.69 $68,576.11 2026-08-01
00069015111 NDC Inlyta 11 10 $114,293.52 $68,576.11 40% off $54,860.89 $93,720.69 $68,576.11 2026-08-01
00069077038 NDC Sutent 11 10 $69,748.13 $41,848.88 40% off $33,479.10 $57,193.47 $41,848.88 2026-08-01
00069098038 NDC Sutent 11 10 $121,407.75 $72,844.65 40% off $58,275.72 $99,554.36 $72,844.65 2026-08-01
00069814020 NDC Xalkori 11 10 $128,393.46 $77,036.08 40% off $61,628.86 $105,282.64 $77,036.08 2026-08-01
00069814120 NDC Xalkori 11 10 $128,393.46 $77,036.08 40% off $61,628.86 $105,282.64 $77,036.08 2026-08-01
00074057622 NDC Venclexta 11 10 $84,369.96 $50,621.98 40% off $40,497.58 $69,183.37 $50,621.98 2026-08-01
00078056651 NDC Afinitor 11 10 $103,348.80 $62,009.28 40% off $49,607.42 $84,746.02 $62,009.28 2026-08-01
00078056751 NDC Afinitor 11 10 $103,348.80 $62,009.28 40% off $49,607.42 $84,746.02 $62,009.28 2026-08-01
00078059451 NDC Afinitor 11 10 $98,806.38 $59,283.83 40% off $47,427.06 $81,021.23 $59,283.83 2026-08-01
00078060715 NDC Gilenya 11 10 $63,112.05 $37,867.23 40% off $30,293.78 $51,751.88 $37,867.23 2026-08-01
00078062051 NDC Afinitor 11 10 $103,348.80 $62,009.28 40% off $49,607.42 $84,746.02 $62,009.28 2026-08-01
00078062651 NDC Afinitor Disperz 11 10 $98,313.72 $58,988.23 40% off $47,190.59 $80,617.25 $58,988.23 2026-08-01
00078062751 NDC Afinitor Disperz 11 10 $99,298.41 $59,579.05 40% off $47,663.24 $81,424.70 $59,579.05 2026-08-01
00078062851 NDC Afinitor Disperz 11 10 $103,348.80 $62,009.28 40% off $49,607.42 $84,746.02 $62,009.28 2026-08-01
00078068166 NDC Tafinlar 11 10 $84,975.30 $50,985.18 40% off $40,788.14 $69,679.75 $50,985.18 2026-08-01
00078068615 NDC Promacta 11 10 $76,500.27 $45,900.16 40% off $36,720.13 $62,730.22 $45,900.16 2026-08-01
00078068715 NDC Promacta 11 10 $114,741.18 $68,844.71 40% off $55,075.77 $94,087.77 $68,844.71 2026-08-01
00078111215 NDC Mekinist 11 10 $92,257.88 $55,354.73 40% off $44,283.78 $75,651.46 $55,354.73 2026-08-01
00093763056 NDC Imatinib Mesylate 11 10 $49,213.80 $29,528.28 40% off $23,622.62 $40,355.32 $29,528.28 2026-08-01
00093776624 NDC Everolimus 11 10 $77,051.97 $46,231.18 40% off $36,984.95 $63,182.62 $46,231.18 2026-08-01
00187355510 NDC Ancobon 11 10 $80,313.57 $48,188.14 40% off $38,550.51 $65,857.13 $48,188.14 2026-08-01
00187552675 NDC Targretin 11 10 $134,341.47 $80,604.88 40% off $64,483.91 $110,160.01 $80,604.88 2026-08-01
00310135030 NDC Tagrisso 11 10 $95,224.91 $57,134.95 40% off $45,707.96 $78,084.43 $57,134.95 2026-08-01
00378309785 NDC Everolimus 11 10 $76,268.51 $45,761.11 40% off $36,608.88 $62,540.18 $45,761.11 2026-08-01
00378427193 NDC Ambrisentan 11 10 $47,147.63 $28,288.58 40% off $22,630.86 $38,661.06 $28,288.58 2026-08-01
00378668028 NDC SUNItinib Malate 11 10 $95,663.31 $57,397.99 40% off $45,918.39 $78,443.91 $57,397.99 2026-08-01
00378692078 NDC Abiraterone Acetate 11 10 $52,509.96 $31,505.98 40% off $25,204.78 $43,058.17 $31,505.98 2026-08-01
00469012599 NDC Xtandi 11 10 $80,510.04 $48,306.02 40% off $38,644.82 $66,018.23 $48,306.02 2026-08-01
00480418489 NDC PAZOPanib Hydrochloride 11 10 $86,601.24 $51,960.74 40% off $41,568.60 $71,013.02 $51,960.74 2026-08-01
00597013730 NDC Gilotrif 11 10 $63,694.17 $38,216.50 40% off $30,573.20 $52,229.22 $38,216.50 2026-08-01
00597013830 NDC Gilotrif 11 10 $63,694.17 $38,216.50 40% off $30,573.20 $52,229.22 $38,216.50 2026-08-01
00597014130 NDC Gilotrif 11 10 $63,694.17 $38,216.50 40% off $30,573.20 $52,229.22 $38,216.50 2026-08-01
00597014360 NDC Ofev 11 10 $70,199.82 $42,119.89 40% off $33,695.91 $57,563.85 $42,119.89 2026-08-01
00597014560 NDC Ofev 11 10 $70,199.82 $42,119.89 40% off $33,695.91 $57,563.85 $42,119.89 2026-08-01
00832607950 NDC Olanzapine 11 10 $59,490.72 $35,694.43 40% off $28,555.55 $48,782.39 $35,694.43 2026-08-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 45 22 — — $96,465.55 $530,487.05 $212,194.82 2026-08-01
10 MS_DRG Pancreas Transplant 44 22 — — $28,072.09 $146,208.80 $59,653.19 2026-08-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 44 22 — — $19,344.48 $111,957.52 $44,783.01 2026-08-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 44 22 — — $14,968.32 $88,998.52 $35,599.41 2026-08-01
13668068212 NDC SORAfenib Tosylate 11 10 $113,864.22 $68,318.53 40% off $54,654.83 $93,368.66 $68,318.53 2026-08-01
14 MS_DRG Allogeneic Bone Marrow Transplant 44 22 — — $45,441.30 $236,673.42 $96,562.76 2026-08-01
140 MS_DRG Major Head And Neck Procedures With Mcc 44 22 — — $15,393.33 $89,912.70 $35,965.08 2026-08-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 44 22 — — $12,252.93 $80,294.02 $32,117.61 2026-08-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 44 22 — — $21,511.91 $120,776.98 $49,277.01 2026-08-01
163 MS_DRG Major Chest Procedures With Mcc 44 22 — — $16,680.24 $93,927.42 $38,225.55 2026-08-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 44 22 — — $14,110.14 $80,129.00 $32,335.74 2026-08-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 44 22 — — $21,511.91 $112,041.20 $45,712.81 2026-08-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 44 22 — — $128,788.97 $811,590.43 $324,636.17 2026-08-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 44 22 — — $27,917.32 $145,402.72 $59,324.31 2026-08-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 45 22 — — $38,390.05 $220,952.35 $88,380.94 2026-08-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 44 22 — — $28,370.45 $156,735.20 $63,947.96 2026-08-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 44 22 — — $22,972.55 $130,141.55 $52,645.42 2026-08-01
209 MS_DRG Complex Aortic Arch Procedures 13 13 — — $88,284.50 $220,711.25 $90,050.19 2026-07-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 44 22 — — $19,789.48 $108,984.98 $44,465.87 2026-08-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 44 22 — — $37,964.02 $212,464.85 $86,685.66 2026-08-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 13 13 — — $46,658.16 $116,645.40 $47,591.32 2026-07-15
215 MS_DRG Other Heart Assist System Implant 44 22 — — $36,951.09 $195,458.35 $79,747.01 2026-08-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 22 — — $33,755.16 $192,228.02 $77,355.56 2026-08-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 22 — — $22,941.05 $132,748.83 $53,099.53 2026-08-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 22 — — $21,218.63 $132,748.83 $53,099.53 2026-08-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 44 22 — — $27,274.55 $153,202.65 $62,504.17 2026-08-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 44 22 — — $13,026.77 $69,738.90 $28,453.47 2026-08-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 44 22 — — $19,008.52 $109,708.20 $43,883.28 2026-08-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 44 22 — — $16,624.02 $104,282.30 $41,712.92 2026-08-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 44 22 — — $17,947.17 $102,561.45 $41,128.92 2026-08-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 44 22 — — $11,590.52 $69,221.55 $27,688.62 2026-08-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 44 22 — — $20,391.62 $117,079.38 $46,831.75 2026-08-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 44 22 — — $29,768.44 $167,140.15 $68,193.18 2026-08-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 44 22 — — $21,758.45 $123,241.45 $49,863.11 2026-08-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 44 22 — — $27,541.75 $152,588.83 $62,256.24 2026-08-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 44 22 — — $19,088.11 $112,117.05 $44,846.82 2026-08-01
23472 CPT Prosthetic Repair Of Shoulder Joint; Total Shoulder 58 22 $4,675.50 $2,805.30 40% off $5,132.57 $43,428.12 $30,399.69 2026-07-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 44 22 — — $20,998.16 $119,643.92 $48,120.78 2026-08-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 44 22 — — $14,996.76 $88,494.10 $35,397.64 2026-08-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 44 22 — — $18,128.69 $102,084.85 $41,544.91 2026-08-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 44 22 — — $13,945.56 $83,359.35 $33,343.74 2026-08-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 44 22 — — $12,558.07 $70,024.48 $28,569.99 2026-08-01
245 MS_DRG Aicd Generator Procedures 44 22 — — $17,620.36 $95,422.02 $38,932.19 2026-08-01
24979071544 NDC SORAfenib Tosylate 11 10 $113,864.22 $68,318.53 40% off $54,654.83 $93,368.66 $68,318.53 2026-08-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 44 22 — — $16,216.61 $95,130.92 $38,052.37 2026-08-01
252 MS_DRG Other Vascular Procedures With Mcc 44 22 — — $12,688.11 $75,504.18 $30,201.67 2026-08-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 44 22 — — $10,571.82 $69,084.35 $27,633.74 2026-08-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 44 22 — — $12,606.16 $71,137.10 $28,889.11 2026-08-01
264 MS_DRG Other Circulatory System O.r. Procedures 44 22 — — $12,907.22 $72,765.25 $29,579.04 2026-08-01
265 MS_DRG Aicd Lead Procedures 44 22 — — $13,151.40 $77,913.02 $31,165.21 2026-08-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 44 22 — — $21,359.17 $124,461.65 $49,784.66 2026-08-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 44 22 — — $17,003.66 $99,101.15 $39,640.46 2026-08-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 44 22 — — $23,651.23 $138,360.20 $55,344.08 2026-08-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 44 22 — — $15,161.35 $89,132.00 $35,652.80 2026-08-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 44 22 — — $18,454.14 $108,660.48 $43,464.19 2026-08-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 44 22 — — $12,735.52 $76,765.15 $30,706.06 2026-08-01
27241024190 NDC metFORMIN HCl 11 10 $48,709.04 $29,225.42 40% off $23,380.34 $39,941.41 $29,225.42 2026-08-01
273 MS_DRG Percutaneous Intracardiac Procedures With Comorbity 44 22 — — $14,313.35 $87,320.30 $34,928.12 2026-08-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 44 22 — — $11,640.30 $71,858.48 $28,743.39 2026-08-01
27487 CPT Revision Of Thigh And Lower Leg Bone Components Of Total Knee Joint Prosthesis 58 22 $13,550.50 $8,130.30 40% off $7,162.69 $43,428.12 $30,399.69 2026-07-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 44 22 — — $25,003.83 $143,042.50 $57,300.45 2026-08-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 44 22 — — $22,048.68 $122,202.98 $49,858.81 2026-08-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 44 22 — — $16,824.84 $96,462.38 $38,584.95 2026-08-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 44 22 — — $18,014.90 $114,036.32 $45,614.53 2026-08-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 44 22 — — $11,922.74 $77,694.20 $31,077.68 2026-08-01
28 MS_DRG Spinal Procedures With Mcc 44 22 — — $21,659.56 $122,234.50 $49,636.50 2026-08-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 44 22 — — $12,438.52 $74,081.88 $29,632.75 2026-08-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 44 22 — — $73,651.02 $404,413.45 $161,765.38 2026-08-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 44 22 — — $15,262.61 $93,903.32 $37,561.33 2026-08-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 43 21 — — $1,279.00 $134,810.92 $53,924.37 2026-08-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 44 22 — — $15,947.38 $93,576.95 $37,430.78 2026-08-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 44 22 — — $15,495.60 $91,064.28 $36,425.71 2026-08-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 44 22 — — $11,891.25 $69,249.38 $27,699.75 2026-08-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 44 22 — — $10,763.51 $70,350.85 $28,140.34 2026-08-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 44 22 — — $18,271.27 $103,303.18 $41,871.67 2026-08-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 44 22 — — $16,621.65 $96,054.40 $38,421.76 2026-08-01
332 MS_DRG Rectal Resection With Mcc 44 22 — — $12,817.82 $77,959.40 $31,183.76 2026-08-01
33230 CPT Insrt Pulse Gen W/dual Leads 51 22 $54,162.00 $32,497.20 40% off $21,374.16 $55,093.38 $31,413.96 2026-08-01
33231 CPT Insrt Pulse Gen W/mult Leads 51 22 $76,140.00 $45,684.00 40% off $30,530.32 $77,744.63 $44,161.20 2026-08-01
33240 CPT Insrt Pulse Gen W/singl Lead 51 22 $54,164.00 $32,498.40 40% off $21,374.16 $55,093.38 $31,415.12 2026-08-01
33249 CPT Insj/rplcmt Defib W/lead(s) 51 22 $57,800.00 $34,680.00 40% off $27,744.00 $77,744.62 $34,207.64 2026-08-01
33262 CPT Rmvl& Replc Pulse Gen 1 Lead 51 22 $63,903.00 $38,341.80 40% off $21,374.16 $55,093.37 $37,063.74 2026-08-01
33263 CPT Rmvl & Rplcmt Dfb Gen 2 Lead 51 22 $62,018.00 $37,210.80 40% off $21,374.16 $55,093.37 $35,970.44 2026-08-01
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 51 22 $62,625.00 $37,575.00 40% off $30,060.00 $77,744.62 $36,322.50 2026-08-01
33270 CPT Ins/rep Subq Defibrillator 51 22 $76,329.00 $45,797.40 40% off $30,530.32 $77,744.62 $44,270.82 2026-08-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 44 22 — — $13,341.72 $77,035.92 $30,814.37 2026-08-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 44 22 — — $14,240.20 $82,595.32 $33,038.13 2026-08-01
35573047302 NDC Phenoxybenzamine HCl 11 10 $58,268.97 $34,961.38 40% off $27,969.11 $47,780.56 $34,961.38 2026-08-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 44 22 — — $15,516.94 $92,277.05 $36,910.82 2026-08-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 13 13 — — $29,833.02 $74,582.55 $30,429.68 2026-07-15
37 MS_DRG Extracranial Procedures With Mcc 44 22 — — $12,317.28 $71,865.90 $28,746.36 2026-08-01
37271 CPT Revsc Evsc Fpvt Athrc Sf 1st 28 22 $46,822.00 $28,093.20 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
37273 CPT Revsc Evsc Fpvt Athrc Cplx 1 28 22 $46,822.00 $28,093.20 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
37275 CPT Rvsc Evsc Fpvt St Athrc Sf 1 28 22 $46,822.00 $28,093.20 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
37277 CPT Rvsc Evsc Fpvt St Athr Cpx 1 28 22 $46,822.00 $28,093.20 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
37284 CPT Revsc Evasc Tpvt St Sf 1st 28 22 $45,628.00 $27,376.80 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
37286 CPT Revsc Evasc Tpvt St Cplx 1st 28 22 $45,628.00 $27,376.80 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
37288 CPT Revsc Evsc Tpvt Athrc Sf 1st 28 22 $46,822.00 $28,093.20 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
37290 CPT Revsc Evsc Tpvt Athrc Cplx 1 28 22 $46,822.00 $28,093.20 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
37292 CPT Rvsc Evsc Tpvt St Athrc Sf 1 28 22 $45,628.00 $27,376.80 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
37294 CPT Rvsc Evsc Tpvt St Athr Cpx 1 28 22 $45,628.00 $27,376.80 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
38779177907 NDC Syrup 11 10 $51,318.72 $30,791.23 40% off $24,632.99 $42,081.35 $30,791.23 2026-08-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 44 22 — — $48,923.40 $267,675.28 $109,211.51 2026-08-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 44 22 — — $13,845.31 $82,419.15 $32,967.66 2026-08-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 43 21 — — $1,279.00 $85,373.20 $34,149.28 2026-08-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 44 22 — — $19,455.56 $112,261.68 $44,904.67 2026-08-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 44 22 — — $12,928.22 $76,937.60 $30,775.04 2026-08-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 44 22 — — $10,337.81 $72,073.60 $28,829.44 2026-08-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 44 22 — — $12,936.69 $76,882.00 $30,752.80 2026-08-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 44 22 — — $13,023.72 $73,998.45 $29,846.04 2026-08-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 44 22 — — $14,845.38 $87,830.23 $35,132.09 2026-08-01
42494034001 NDC Flucytosine 11 10 $71,480.97 $42,888.58 40% off $34,310.87 $58,614.40 $42,888.58 2026-08-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 43 21 — — $1,279.00 $215,192.67 $86,077.07 2026-08-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 43 21 — — $1,279.00 $144,678.08 $57,871.23 2026-08-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 43 21 — — $1,279.00 $115,071.05 $46,028.42 2026-08-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 43 21 — — $1,279.00 $177,889.95 $71,155.98 2026-08-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 43 21 — — $1,279.00 $117,761.75 $47,104.70 2026-08-01
43598046860 NDC Abiraterone Acetate 11 10 $55,869.03 $33,521.42 40% off $26,817.13 $45,812.60 $33,521.42 2026-08-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 43 21 — — $1,279.00 $134,720.05 $53,888.02 2026-08-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 43 21 — — $1,279.00 $89,458.40 $35,783.36 2026-08-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 43 21 — — $1,279.00 $109,648.85 $43,859.54 2026-08-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 43 21 — — $1,279.00 $70,721.75 $28,288.70 2026-08-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 44 22 — — $29,752.52 $166,648.72 $67,992.68 2026-08-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 44 22 — — $20,507.78 $121,396.35 $48,558.54 2026-08-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 44 22 — — $15,694.07 $88,193.70 $35,965.57 2026-08-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 44 22 — — $21,853.28 $113,819.15 $46,438.21 2026-08-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 44 22 — — $19,361.75 $116,508.20 $46,603.28 2026-08-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 44 22 — — $11,056.44 $68,576.23 $27,430.49 2026-08-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 44 22 — — $18,324.10 $107,345.70 $42,938.28 2026-08-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 44 22 — — $12,670.50 $76,214.42 $30,485.77 2026-08-01
471 MS_DRG Cervical Spinal Fusion With Mcc 44 22 — — $17,520.46 $100,360.25 $40,151.04 2026-08-01
47335047583 NDC Imatinib Mesylate 11 10 $53,297.69 $31,978.61 40% off $25,582.89 $43,704.11 $31,978.61 2026-08-01
47335090618 NDC QUEtiapine Fumarate 11 10 $74,439.72 $44,663.83 40% off $35,731.07 $61,040.57 $44,663.83 2026-08-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 44 22 — — $16,258.61 $90,424.50 $36,893.20 2026-08-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 44 22 — — $12,717.24 $74,879.25 $29,951.70 2026-08-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 44 22 — — $11,973.20 $70,660.55 $28,264.22 2026-08-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 44 22 — — $13,097.21 $78,903.25 $31,561.30 2026-08-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 44 22 — — $12,993.59 $78,052.10 $31,220.84 2026-08-01
49884012591 NDC Everolimus 11 10 $76,349.02 $45,809.41 40% off $36,647.53 $62,606.20 $45,809.41 2026-08-01
49884012891 NDC Everolimus 11 10 $76,349.02 $45,809.41 40% off $36,647.53 $62,606.20 $45,809.41 2026-08-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 44 22 — — $37,136.00 $202,013.58 $82,421.54 2026-08-01
500 MS_DRG Soft Tissue Procedures With Mcc 44 22 — — $11,801.84 $69,505.27 $27,802.11 2026-08-01
50242014001 NDC Erivedge 11 10 $74,374.35 $44,624.61 40% off $35,699.69 $60,986.97 $44,624.61 2026-08-01
50419048858 NDC Nexavar 11 10 $137,790.00 $82,674.00 40% off $66,139.20 $112,987.80 $82,674.00 2026-08-01
50881000560 NDC Jakafi 11 10 $95,058.72 $57,035.23 40% off $45,628.19 $77,948.15 $57,035.23 2026-08-01
50881001060 NDC Jakafi 11 10 $95,058.72 $57,035.23 40% off $45,628.19 $77,948.15 $57,035.23 2026-08-01
50881001560 NDC Jakafi 11 10 $95,058.72 $57,035.23 40% off $45,628.19 $77,948.15 $57,035.23 2026-08-01
50881002060 NDC Jakafi 11 10 $95,058.72 $57,035.23 40% off $45,628.19 $77,948.15 $57,035.23 2026-08-01
50881002560 NDC Jakafi 11 10 $95,058.72 $57,035.23 40% off $45,628.19 $77,948.15 $57,035.23 2026-08-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 44 22 — — $11,543.44 $69,915.08 $27,966.03 2026-08-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 44 22 — — $13,208.29 $80,121.60 $32,048.64 2026-08-01
51991082128 NDC Everolimus 11 10 $72,965.16 $43,779.10 40% off $35,023.28 $59,831.43 $43,779.10 2026-08-01
51991082228 NDC Everolimus 11 10 $76,319.41 $45,791.65 40% off $36,633.32 $62,581.92 $45,791.65 2026-08-01
51991082428 NDC Everolimus 11 10 $76,319.41 $45,791.65 40% off $36,633.32 $62,581.92 $45,791.65 2026-08-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 44 22 — — $21,926.09 $132,305.67 $52,922.27 2026-08-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 44 22 — — $12,804.95 $75,190.80 $30,076.32 2026-08-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 44 22 — — $19,342.44 $101,704.65 $41,495.50 2026-08-01
57894015012 NDC Zytiga 11 10 $64,649.16 $38,789.50 40% off $31,031.60 $53,012.31 $38,789.50 2026-08-01
57894019506 NDC Zytiga 11 10 $64,649.43 $38,789.66 40% off $31,031.73 $53,012.53 $38,789.66 2026-08-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 44 22 — — $12,109.01 $70,871.95 $28,348.78 2026-08-01
57962014009 NDC Imbruvica 11 10 $97,985.79 $58,791.47 40% off $47,033.18 $80,348.35 $58,791.47 2026-08-01
57962028028 NDC Imbruvica 11 10 $91,454.53 $54,872.72 40% off $43,898.17 $74,992.71 $54,872.72 2026-08-01
57962042028 NDC Imbruvica 11 10 $91,454.53 $54,872.72 40% off $43,898.17 $74,992.71 $54,872.72 2026-08-01
59572041028 NDC Revlimid 11 10 $134,821.08 $80,892.65 40% off $64,714.12 $110,553.29 $80,892.65 2026-08-01
59572050100 NDC Pomalyst 11 10 $616,415.67 $369,849.40 40% off $295,879.52 $505,460.85 $369,849.40 2026-08-01
59572050200 NDC Pomalyst 11 10 $616,415.67 $369,849.40 40% off $295,879.52 $505,460.85 $369,849.40 2026-08-01
59572050300 NDC Pomalyst 11 10 $616,415.67 $369,849.40 40% off $295,879.52 $505,460.85 $369,849.40 2026-08-01
59572050400 NDC Pomalyst 11 10 $616,415.67 $369,849.40 40% off $295,879.52 $505,460.85 $369,849.40 2026-08-01
59572050421 NDC Pomalyst 11 10 $129,462.08 $77,677.25 40% off $62,141.80 $106,158.91 $77,677.25 2026-08-01
59651024130 NDC Imatinib Mesylate 11 10 $49,213.80 $29,528.28 40% off $23,622.62 $40,355.32 $29,528.28 2026-08-01
59651033201 NDC Flucytosine 11 10 $71,480.97 $42,888.58 40% off $34,310.87 $58,614.40 $42,888.58 2026-08-01
6 MS_DRG Liver Transplant Without Mcc 44 22 — — $17,493.02 $96,805.40 $39,496.60 2026-08-01
60219175406 NDC Abiraterone Acetate 11 10 $55,869.03 $33,521.42 40% off $26,817.13 $45,812.60 $33,521.42 2026-08-01
60505267708 NDC ARIPiprazole 11 10 $204,363.72 $122,618.23 40% off $98,094.59 $167,578.25 $122,618.23 2026-08-01
60505290103 NDC Imatinib Mesylate 11 10 $49,213.26 $29,527.96 40% off $23,622.36 $40,354.87 $29,527.96 2026-08-01
60505362806 NDC Dasatinib 11 10 $51,953.49 $31,172.09 40% off $24,937.68 $42,601.86 $31,172.09 2026-08-01
60505362906 NDC Dasatinib 11 10 $103,888.26 $62,332.96 40% off $49,866.36 $85,188.37 $62,332.96 2026-08-01
60505363006 NDC Dasatinib 11 10 $103,888.26 $62,332.96 40% off $49,866.36 $85,188.37 $62,332.96 2026-08-01
60505363103 NDC Dasatinib 11 10 $93,622.46 $56,173.48 40% off $44,938.78 $76,770.42 $56,173.48 2026-08-01
60505381703 NDC Dasatinib 11 10 $93,622.46 $56,173.48 40% off $44,938.78 $76,770.42 $56,173.48 2026-08-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 44 22 — — $14,159.93 $75,487.48 $30,798.89 2026-08-01
61958170101 NDC Zydelig 11 10 $78,982.11 $47,389.27 40% off $37,911.41 $64,765.33 $47,389.27 2026-08-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 44 22 — — $13,743.37 $76,818.98 $31,342.14 2026-08-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 44 22 — — $14,433.23 $79,926.88 $32,610.16 2026-08-01
64980044903 NDC Fingolimod 11 10 $49,990.59 $29,994.35 40% off $23,995.48 $40,992.28 $29,994.35 2026-08-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 44 22 — — $16,673.80 $97,999.68 $39,199.87 2026-08-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 44 22 — — $12,830.69 $79,537.42 $31,814.97 2026-08-01
65162063711 NDC Pantoprazole Sodium 11 10 $48,573.72 $29,144.23 40% off $23,315.39 $39,830.45 $29,144.23 2026-08-01
652 MS_DRG Kidney Transplant 44 22 — — $11,472.32 $70,705.05 $28,282.02 2026-08-01
653 MS_DRG Major Bladder Procedures With Mcc 44 22 — — $19,949.66 $107,178.82 $43,728.96 2026-08-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 44 22 — — $12,104.27 $69,857.60 $27,943.04 2026-08-01
66215060214 NDC Uptravi 11 10 $161,175.87 $96,705.52 40% off $77,364.42 $132,164.21 $96,705.52 2026-08-01
665 MS_DRG Prostatectomy With Mcc 44 22 — — $12,698.95 $68,696.77 $28,028.28 2026-08-01
66993023360 NDC Dasatinib 11 10 $51,953.49 $31,172.09 40% off $24,937.68 $42,601.86 $31,172.09 2026-08-01
66993023460 NDC Dasatinib 11 10 $103,888.26 $62,332.96 40% off $49,866.36 $85,188.37 $62,332.96 2026-08-01
66993023560 NDC Dasatinib 11 10 $103,888.26 $62,332.96 40% off $49,866.36 $85,188.37 $62,332.96 2026-08-01
66993023630 NDC Dasatinib 11 10 $93,622.46 $56,173.48 40% off $44,938.78 $76,770.42 $56,173.48 2026-08-01
66993023730 NDC Dasatinib 11 10 $93,622.46 $56,173.48 40% off $44,938.78 $76,770.42 $56,173.48 2026-08-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 44 22 — — $15,259.22 $88,731.48 $35,492.59 2026-08-01
67877024610 NDC QUEtiapine Fumarate 11 10 $58,271.22 $34,962.73 40% off $27,970.19 $47,782.40 $34,962.73 2026-08-01
67877024810 NDC QUEtiapine Fumarate 11 10 $88,866.72 $53,320.03 40% off $42,656.03 $72,870.71 $53,320.03 2026-08-01
68462013508 NDC Abiraterone Acetate 11 10 $52,439.22 $31,463.53 40% off $25,170.83 $43,000.16 $31,463.53 2026-08-01
69238175406 NDC Abiraterone Acetate 11 10 $55,869.03 $33,521.42 40% off $26,817.13 $45,812.60 $33,521.42 2026-08-01
7 MS_DRG Lung Transplant 44 22 — — $45,329.54 $250,963.60 $102,393.15 2026-08-01
70377001311 NDC Everolimus 11 10 $76,352.18 $45,811.31 40% off $36,649.05 $62,608.79 $45,811.31 2026-08-01
70377001322 NDC Everolimus 11 10 $76,352.17 $45,811.30 40% off $36,649.04 $62,608.78 $45,811.30 2026-08-01
70710174503 NDC Dasatinib 11 10 $93,622.46 $56,173.48 40% off $44,938.78 $76,770.42 $56,173.48 2026-08-01
71921017820 NDC Abiraterone Acetate 11 10 $49,636.62 $29,781.97 40% off $23,825.58 $40,702.03 $29,781.97 2026-08-01
72205003092 NDC Abiraterone Acetate 11 10 $52,439.22 $31,463.53 40% off $25,170.83 $43,000.16 $31,463.53 2026-08-01
72606056601 NDC Abiraterone Acetate 11 10 $51,914.88 $31,148.93 40% off $24,919.14 $42,570.20 $31,148.93 2026-08-01
73556016801 NDC Tavneos 11 10 $89,386.83 $53,632.10 40% off $42,905.68 $73,297.20 $53,632.10 2026-08-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 44 22 — — $14,405.80 $77,102.68 $31,457.89 2026-08-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 44 22 — — $14,552.44 $77,256.55 $31,520.67 2026-08-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 44 22 — — $21,203.39 $121,032.88 $48,591.09 2026-08-01
791 MS_DRG Prematurity With Major Problems 44 22 — — $14,819.98 $86,087.12 $34,434.85 2026-08-01
793 MS_DRG Full Term Neonate With Major Problems 44 22 — — $15,194.53 $88,138.05 $35,255.22 2026-08-01
799 MS_DRG Splenic Procedures With Mcc 44 22 — — $17,173.33 $94,800.85 $38,678.75 2026-08-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 44 22 — — $19,497.56 $114,748.38 $45,899.35 2026-08-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 44 22 — — $13,211.00 $84,698.22 $33,879.29 2026-08-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 44 22 — — $20,788.53 $119,573.50 $47,829.40 2026-08-01
82293000210 NDC Abiraterone Acetate 11 10 $55,869.03 $33,521.42 40% off $26,817.13 $45,812.60 $33,521.42 2026-08-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 44 22 — — $16,918.32 $95,837.45 $38,771.15 2026-08-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 44 22 — — $17,243.43 $97,562.02 $39,516.20 2026-08-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 44 22 — — $11,514.32 $69,416.25 $27,766.50 2026-08-01
834 MS_DRG Acute Leukemia With Mcc 44 22 — — $19,789.48 $112,621.45 $45,350.89 2026-08-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 44 22 — — $18,028.11 $99,907.80 $40,762.38 2026-08-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 44 22 — — $11,870.59 $70,805.18 $28,322.07 2026-08-01
850 MS_DRG Acute Leukemia With Other Procedures 43 21 — — $1,279.00 $171,397.80 $69,930.30 2026-08-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 44 22 — — $18,008.13 $102,398.25 $41,268.62 2026-08-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Proc With Comorbity 44 22 — — $16,349.71 $95,168.00 $38,067.20 2026-08-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 44 22 — — $24,629.61 $138,988.80 $56,442.86 2026-08-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 36 20 — — $14,378.71 $82,487.77 $32,951.20 2026-08-01
901 MS_DRG Wound Debridements For Injuries With Mcc 44 22 — — $16,075.06 $88,638.75 $36,164.61 2026-08-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 44 22 — — $14,146.72 $78,931.05 $32,203.87 2026-08-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 44 22 — — $14,561.91 $82,013.05 $33,371.05 2026-08-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 44 22 — — $81,410.40 $424,012.50 $170,217.27 2026-08-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 44 22 — — $23,689.49 $143,826.92 $57,530.77 2026-08-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 44 22 — — $11,841.47 $70,543.70 $28,217.48 2026-08-01
92930 CPT Prq Tcat Plmt Ntrac St 2+les 28 22 $54,836.00 $32,901.60 40% off $18,161.68 $45,404.20 $31,782.94 2026-07-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 44 22 — — $15,724.20 $83,031.08 $33,876.68 2026-08-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 44 22 — — $11,819.79 $78,104.00 $31,241.60 2026-08-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 44 22 — — $13,427.41 $76,080.90 $30,771.15 2026-08-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 44 22 — — $24,195.45 $135,637.98 $55,340.29 2026-08-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 44 22 — — $14,015.65 $80,598.20 $32,239.28 2026-08-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 44 22 — — $26,348.99 $152,119.67 $60,847.87 2026-08-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 44 22 — — $14,988.97 $88,959.55 $35,583.82 2026-08-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 44 22 — — $22,488.60 $124,329.98 $50,726.63 2026-08-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 44 22 — — $13,210.32 $77,794.32 $31,117.73 2026-08-01
981 MS_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis With Comorbity 45 22 — — $17,170.28 $97,821.63 $39,348.56 2026-08-01
987 MS_DRG Non-extensive O.r. Proc Unrelated To Principal Diagnosis With Comorbity 44 22 — — $12,932.96 $74,393.42 $29,757.37 2026-08-01
J9600 HCPCS Photofrin 53 22 $104,972.22 $62,983.33 40% off $24,228.42 $86,077.22 $42,399.74 2026-08-01
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