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

ALLEGHANY MEMORIAL HOSPITAL

Sparta, NC · CCN 341320 · Rates published

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You selected 93306 (CPT)

HC ECHOCARDIOGRAM/DOPPLER/COMPLETE

This hospital’s price: $808 across 10 payers · range $213-$1,738

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/13448/560525657_alleghany-county-memorial-hospital,-inc_standardcharges.csv · observed 2025-08-12

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.

14,774 distinct procedures filed
10 distinct payers
416,073 rate rows
2025-08-12 last MRF observed · ⚠ 14 mo old
Data quality

413,797 of 416,073 rate rows are consumer-grade (99.5%)

2,276 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
per-diem day rate — not a per-procedure price 1,998
percent-of-charges filed in the dollar field — excluded from medians 199
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 43
placeholder amount (≤ $0.02) — excluded from medians 25
exceeds 10× this hospital's gross charge — excluded from medians 11

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/13448/560525657_alleghany-county-memorial-hospital,-inc_standardcharges.csv
Found on page https://alleghanyhealth.org/pricing-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-22
Content fingerprint d74cab302a66a8af… · 759,979,154 bytes · first seen 2026-05-05

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
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $486,184.24 $486,184.24 $486,184.24 nat. median
$249,036
2.0× median
J9118
HCPCS 		Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 10 $82.51 $351,279.14 $328,369.63 nat. median
$200
outlier · 1643.1×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $307,262.58 $307,262.58 $307,262.58 nat. median
$359,454
0.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 5 $266,195.95 $266,195.95 $266,195.95 nat. median
$110,307
outlier · 2.4×
J3316
HCPCS 		Triptorelin Pamoate (pediatric) 22.5 Mg IM Suspension 10 $3,416.05 $283,245.05 $264,772.54 nat. median
$4,430
outlier · 59.8×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 $244,455.06 $244,455.06 $244,455.06 nat. median
$190,559
1.3× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 4 $235,087.48 $235,087.48 $235,087.48 nat. median
$95,038
outlier · 2.5×
J0638
HCPCS 		Canakinumab (pf) 150 Mg/ml Subcutaneous Solution 10 $128.01 $244,641.06 $228,686.21 nat. median
$253
outlier · 904.8×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 $217,733.99 $217,733.99 $217,733.99 nat. median
$126,695
1.7× median
7
MS_DRG 		Lung Transplant 4 $193,796.08 $193,796.08 $193,796.08 nat. median
$117,974
1.6× median
J9043
HCPCS 		Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 10 $277.38 $182,397.54 $170,502.05 nat. median
$735
outlier · 232.1×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 $167,787.88 $167,787.88 $167,787.88 nat. median
$104,013
1.6× median
J1628
HCPCS 		Guselkumab 100 Mg/ml Subcutaneous Auto-injector 10 $143.16 $174,938.32 $163,529.30 nat. median
$228
outlier · 716.4×
J1304
HCPCS 		Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution 10 $159.38 $173,015.34 $161,731.73 nat. median
$193
outlier · 836.0×
652
MS_DRG 		Kidney Transplant 5 $148,386.13 $148,386.13 $148,386.13 nat. median
$29,925
outlier · 5.0×
J9042
HCPCS 		Brentuximab Vedotin 50 Mg Intravenous Solution 10 $237.27 $154,975.38 $144,868.29 nat. median
$951
outlier · 152.3×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 5 $138,857.68 $138,857.68 $138,857.68 nat. median
$198,418
0.7× median
J9272
HCPCS 		Dostarlimab-gxly 50 Mg/ml Intravenous Solution 10 $245.72 $142,688.41 $133,382.64 nat. median
$786
outlier · 169.7×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $128,054.45 $128,054.45 $128,054.45 nat. median
$90,551
1.4× median
J1440
HCPCS 		Fecal Microbiota, Live-jslm 150 Ml Rectal Suspension Enema 10 $66.79 $131,945.94 $123,340.77 nat. median
$106
outlier · 1159.4×
850
MS_DRG 		Acute Leukemia With Other Procedures 5 $122,807.63 $122,807.63 $122,807.63 nat. median
$78,268
1.6× median
J9119
HCPCS 		Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 10 $29.14 $128,320.59 $119,951.86 nat. median
$91
outlier · 1317.5×
J9144
HCPCS 		Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 10 $51.56 $127,258.95 $118,959.46 nat. median
$211
outlier · 562.6×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 5 $111,191.26 $111,191.26 $111,191.26 nat. median
$78,049
1.4× median
10
MS_DRG 		Pancreas Transplant 4 $106,292.62 $106,292.62 $106,292.62 nat. median
$64,933
1.6× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 5 $105,681.11 $105,681.11 $105,681.11 nat. median
$66,715
1.6× median
J9228
HCPCS 		Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 10 $177.59 $112,766.19 $105,411.88 nat. median
$9,003
outlier · 11.7×
834
MS_DRG 		Acute Leukemia With Mcc 5 $103,781.59 $103,781.59 $103,781.59 nat. median
$50,371
outlier · 2.1×
8
MS_DRG 		Simultaneous Pancreas And Kidney Transplant 4 $103,431.22 $103,431.22 $103,431.22 nat. median
$50,831
outlier · 2.0×
J9380
HCPCS 		Teclistamab-cqyv 90 Mg/ml Subcutaneous Solution 10 $32.50 $109,208.65 $102,086.34 nat. median
$1,881
outlier · 54.3×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $101,960.30 $101,960.30 $101,960.30 nat. median
$97,323
1.0× median
J7313
HCPCS 		Fluocinolone 0.19 Mg Intravitreal Implant 10 $534.00 $106,462.40 $99,519.20 nat. median
$612
outlier · 162.7×
C9047
HCPCS 		Caplacizumab-yhdp 11 Mg Injection Kit 10 $38,323.98 $103,700.19 $96,937.13 nat. median
$3,316
outlier · 29.2×
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 5 $94,360.02 $94,360.02 $94,360.02 nat. median
$50,870
1.9× median
J3101
HCPCS 		Tenecteplase 50 Mg Intravenous Solution 10 $173.27 $99,647.50 $93,148.75 nat. median
$3,820
outlier · 24.4×
J9289
HCPCS 		Nivolumab 600 Mg-hyaluronidase-nvhy 10,000 Unit/5 Ml Subcut Solution 10 $36,558.04 $98,921.76 $92,470.34 nat. median
$2,776
outlier · 33.3×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 $89,212.37 $89,212.37 $89,212.37 nat. median
$74,370
1.2× median
J8565
HCPCS 		Gefitinib 250 Mg Tablet 10 $159.84 $95,407.86 $89,185.61 nat. median
$261
outlier · 342.2×
215
MS_DRG 		Other Heart Assist System Implant 5 $88,745.21 $88,745.21 $88,745.21 nat. median
$93,901
0.9× median
6
MS_DRG 		Liver Transplant Without Mcc 4 $88,604.17 $88,604.17 $88,604.17 nat. median
$44,153
outlier · 2.0×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 5 $88,034.54 $88,034.54 $88,034.54 nat. median
$61,728
1.4× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $87,454.99 $87,454.99 $87,454.99 nat. median
$93,276
0.9× median
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 5 $86,723.39 $86,723.39 $86,723.39 nat. median
$47,429
1.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 5 $85,481.65 $85,481.65 $85,481.65 nat. median
$77,028
1.1× median
S2054
HCPCS 		Transplantation Of Multivisc 1 $85,323.96 $85,323.96 $85,323.96 nat. median
$3,261
outlier · 26.2×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 5 $84,122.02 $84,122.02 $84,122.02 nat. median
$66,649
1.3× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 $83,966.66 $83,966.66 $83,966.66 nat. median
$77,632
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 5 $83,718.75 $83,718.75 $83,718.75 nat. median
$67,976
1.2× median
J9307
HCPCS 		Pralatrexate 20 Mg/ml (1 Ml) Intravenous Solution 10 $401.23 $177,512.30 $82,523.92 nat. median
$897
outlier · 92.0×
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 5 $82,473.71 $82,473.71 $82,473.71 nat. median
$57,556
1.4× median

Other procedures at this hospital

Browse this hospital's 14,774 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 4 4 — — $486,184.24 $486,184.24 $486,184.24 2025-08-12
J9118 HCPCS Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 26 10 $381,825.15 $190,912.58 50% off $82.51 $351,279.14 $328,369.63 2025-08-12
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $307,262.58 $307,262.58 $307,262.58 2025-08-12
14 MS_DRG Allogeneic Bone Marrow Transplant 5 5 — — $266,195.95 $266,195.95 $266,195.95 2025-08-12
J3316 HCPCS Triptorelin Pamoate (pediatric) 22.5 Mg IM Suspension 26 10 $307,875.05 $153,937.53 50% off $3,416.05 $283,245.05 $264,772.54 2025-08-12
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 4 — — $244,455.06 $244,455.06 $244,455.06 2025-08-12
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 4 4 — — $235,087.48 $235,087.48 $235,087.48 2025-08-12
J0638 HCPCS Canakinumab (pf) 150 Mg/ml Subcutaneous Solution 26 10 $265,914.20 $132,957.10 50% off $128.01 $244,641.06 $228,686.21 2025-08-12
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 4 — — $217,733.99 $217,733.99 $217,733.99 2025-08-12
7 MS_DRG Lung Transplant 4 4 — — $193,796.08 $193,796.08 $193,796.08 2025-08-12
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 26 10 $198,258.20 $99,129.10 50% off $277.38 $182,397.54 $170,502.05 2025-08-12
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 4 — — $167,787.88 $167,787.88 $167,787.88 2025-08-12
J1628 HCPCS Guselkumab 100 Mg/ml Subcutaneous Auto-injector 26 10 $190,150.35 $95,075.18 50% off $143.16 $174,938.32 $163,529.30 2025-08-12
J1304 HCPCS Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution 26 10 $188,060.15 $94,030.08 50% off $159.38 $173,015.34 $161,731.73 2025-08-12
652 MS_DRG Kidney Transplant 5 5 — — $148,386.13 $148,386.13 $148,386.13 2025-08-12
J9042 HCPCS Brentuximab Vedotin 50 Mg Intravenous Solution 26 10 $168,451.50 $84,225.75 50% off $237.27 $154,975.38 $144,868.29 2025-08-12
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 5 5 — — $138,857.68 $138,857.68 $138,857.68 2025-08-12
J9272 HCPCS Dostarlimab-gxly 50 Mg/ml Intravenous Solution 26 10 $155,096.10 $77,548.05 50% off $245.72 $142,688.41 $133,382.64 2025-08-12
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 5 — — $128,054.45 $128,054.45 $128,054.45 2025-08-12
J1440 HCPCS Fecal Microbiota, Live-jslm 150 Ml Rectal Suspension Enema 26 10 $143,419.50 $71,709.75 50% off $66.79 $131,945.94 $123,340.77 2025-08-12
850 MS_DRG Acute Leukemia With Other Procedures 5 5 — — $122,807.63 $122,807.63 $122,807.63 2025-08-12
J9119 HCPCS Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 26 10 $139,478.90 $69,739.45 50% off $29.14 $128,320.59 $119,951.86 2025-08-12
J9144 HCPCS Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 26 10 $138,324.95 $69,162.48 50% off $51.56 $127,258.95 $118,959.46 2025-08-12
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 5 5 — — $111,191.26 $111,191.26 $111,191.26 2025-08-12
10 MS_DRG Pancreas Transplant 4 4 — — $106,292.62 $106,292.62 $106,292.62 2025-08-12
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 5 5 — — $105,681.11 $105,681.11 $105,681.11 2025-08-12
J9228 HCPCS Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 26 10 $122,571.95 $61,285.98 50% off $177.59 $112,766.19 $105,411.88 2025-08-12
834 MS_DRG Acute Leukemia With Mcc 5 5 — — $103,781.59 $103,781.59 $103,781.59 2025-08-12
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 4 4 — — $103,431.22 $103,431.22 $103,431.22 2025-08-12
J9380 HCPCS Teclistamab-cqyv 90 Mg/ml Subcutaneous Solution 26 10 $118,705.05 $59,352.53 50% off $32.50 $109,208.65 $102,086.34 2025-08-12
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 5 5 — — $101,960.30 $101,960.30 $101,960.30 2025-08-12
J7313 HCPCS Fluocinolone 0.19 Mg Intravitreal Implant 26 10 $115,720.00 $57,860.00 50% off $534.00 $106,462.40 $99,519.20 2025-08-12
C9047 HCPCS Caplacizumab-yhdp 11 Mg Injection Kit 26 10 $112,717.60 $56,358.80 50% off $38,323.98 $103,700.19 $96,937.13 2025-08-12
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 5 5 — — $94,360.02 $94,360.02 $94,360.02 2025-08-12
J3101 HCPCS Tenecteplase 50 Mg Intravenous Solution 26 10 $108,312.50 $54,156.25 50% off $173.27 $99,647.50 $93,148.75 2025-08-12
J9289 HCPCS Nivolumab 600 Mg-hyaluronidase-nvhy 10,000 Unit/5 Ml Subcut Solution 26 10 $107,523.65 $53,761.83 50% off $36,558.04 $98,921.76 $92,470.34 2025-08-12
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 5 — — $89,212.37 $89,212.37 $89,212.37 2025-08-12
J8565 HCPCS Gefitinib 250 Mg Tablet 26 10 $103,704.20 $51,852.10 50% off $159.84 $95,407.86 $89,185.61 2025-08-12
215 MS_DRG Other Heart Assist System Implant 5 5 — — $88,745.21 $88,745.21 $88,745.21 2025-08-12
6 MS_DRG Liver Transplant Without Mcc 4 4 — — $88,604.17 $88,604.17 $88,604.17 2025-08-12
955 MS_DRG Craniotomy For Multiple Significant Trauma 5 5 — — $88,034.54 $88,034.54 $88,034.54 2025-08-12
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 5 — — $87,454.99 $87,454.99 $87,454.99 2025-08-12
228 MS_DRG Other Cardiothoracic Procedures With Mcc 5 5 — — $86,723.39 $86,723.39 $86,723.39 2025-08-12
231 MS_DRG Coronary Bypass With Ptca With Mcc 5 5 — — $85,481.65 $85,481.65 $85,481.65 2025-08-12
S2054 HCPCS Transplantation Of Multivisc 3 1 — — $85,323.96 $85,323.96 $85,323.96 2025-08-12
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 5 5 — — $84,122.02 $84,122.02 $84,122.02 2025-08-12
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 5 — — $83,966.66 $83,966.66 $83,966.66 2025-08-12
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 5 5 — — $83,718.75 $83,718.75 $83,718.75 2025-08-12
J9307 HCPCS Pralatrexate 20 Mg/ml (1 Ml) Intravenous Solution 39 10 $96,474.10 $48,237.05 50% off $401.23 $177,512.30 $82,523.92 2025-08-12
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 5 5 — — $82,473.71 $82,473.71 $82,473.71 2025-08-12
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 5 5 — — $81,817.03 $81,817.03 $81,817.03 2025-08-12
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 5 5 — — $81,542.68 $81,542.68 $81,542.68 2025-08-12
J9303 HCPCS Panitumumab 400 Mg/20 Ml (20 Mg/ml) Intravenous Solution 26 10 $94,587.95 $47,293.98 50% off $155.52 $87,020.91 $81,345.64 2025-08-12
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 5 5 — — $81,133.91 $81,133.91 $81,133.91 2025-08-12
J0139 HCPCS Adalimumab 80 Mg/0.8 Ml Subcutaneous Pen Kit 54 10 $180,736.25 $90,368.13 50% off $30,725.09 $249,416.37 $79,523.76 2025-08-12
S2053 HCPCS Transplantation Of Small Int 3 1 — — $78,771.20 $78,771.20 $78,771.20 2025-08-12
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 5 5 — — $78,380.49 $78,380.49 $78,380.49 2025-08-12
37 MS_DRG Extracranial Procedures With Mcc 5 5 — — $77,384.45 $77,384.45 $77,384.45 2025-08-12
J0775 HCPCS Collagenase Clostridium Histolyticum 0.9 Mg Solution For Injection 26 10 $89,961.95 $44,980.98 50% off $70.92 $82,764.99 $77,367.28 2025-08-12
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 5 — — $76,683.70 $76,683.70 $76,683.70 2025-08-12
J7189 HCPCS Coagulation Factor Viia Recomb 2 Mg (2,000 Mcg) Intravenous Solution 48 10 $94,327.40 $47,163.70 50% off $2.31 $206,870.56 $76,452.16 2025-08-12
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 5 5 — — $75,446.37 $75,446.37 $75,446.37 2025-08-12
Q0480 HCPCS Driver Pneumatic Vad, Rep 3 1 — — $74,999.94 $76,182.94 $74,999.94 2025-08-12
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 5 5 — — $73,528.12 $73,528.12 $73,528.12 2025-08-12
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 5 5 — — $72,493.52 $72,493.52 $72,493.52 2025-08-12
J0717 HCPCS Certolizumab Pegol 400 Mg/2 Ml (200 Mg/ml X2) Subcutaneous Syringe Kit 48 10 $78,892.55 $39,446.28 50% off $4.88 $214,477.35 $72,036.79 2025-08-12
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 5 5 — — $71,927.19 $71,927.19 $71,927.19 2025-08-12
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 5 5 — — $70,807.76 $70,807.76 $70,807.76 2025-08-12
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 5 — — $69,065.80 $69,065.80 $69,065.80 2025-08-12
J1930 HCPCS Lanreotide 60 Mg/0.2 Ml Subcutaneous Syringe 26 10 $80,057.20 $40,028.60 50% off $50.71 $73,652.62 $68,849.19 2025-08-12
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 5 5 — — $68,658.13 $68,658.13 $68,658.13 2025-08-12
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 5 — — $68,206.38 $68,206.38 $68,206.38 2025-08-12
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 5 5 — — $68,111.63 $68,111.63 $68,111.63 2025-08-12
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 5 5 — — $67,389.94 $67,389.94 $67,389.94 2025-08-12
J9029 HCPCS Instill Adstiladrin, Tx Dose 3 1 — — $67,100.04 $72,000.00 $67,100.04 2025-08-12
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 5 5 — — $66,495.27 $66,495.27 $66,495.27 2025-08-12
J9015 HCPCS Aldesleukin 22 Million Unit Intravenous Solution 26 10 $76,651.90 $38,325.95 50% off $2,230.10 $70,519.75 $65,920.64 2025-08-12
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 5 5 — — $65,059.62 $65,059.62 $65,059.62 2025-08-12
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 5 5 — — $64,536.26 $64,536.26 $64,536.26 2025-08-12
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 5 5 — — $64,147.32 $64,147.32 $64,147.32 2025-08-12
J7330 HCPCS Cultured Chondrocytes Implnt 3 1 — — $64,034.94 $67,405.20 $64,034.94 2025-08-12
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 5 — — $63,690.07 $63,690.07 $63,690.07 2025-08-12
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 5 — — $63,690.07 $63,690.07 $63,690.07 2025-08-12
J9153 HCPCS Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution 37 10 $148,672.30 $74,336.15 50% off $245.99 $136,778.52 $63,587.14 2025-08-12
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 5 5 — — $63,471.91 $63,471.91 $63,471.91 2025-08-12
J9022 HCPCS Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution 37 10 $147,961.45 $73,980.73 50% off $88.68 $136,124.53 $63,283.11 2025-08-12
J9039 HCPCS Blinatumomab 35 Mcg Intravenous Solution 26 10 $73,064.20 $36,532.10 50% off $153.59 $67,219.06 $62,835.21 2025-08-12
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 5 5 — — $62,522.15 $62,522.15 $62,522.15 2025-08-12
J9021 HCPCS Asparaginase Erwinia Chrysanthemi-rywn 10 Mg/0.5 Ml IM Solution 26 10 $72,259.25 $36,129.63 50% off $54.10 $66,478.51 $62,142.96 2025-08-12
J0391 HCPCS Artesunate 110 Mg Intravenous Solution 37 10 $70,727.30 $35,363.65 50% off $51.61 $130,138.19 $60,500.11 2025-08-12
J0491 HCPCS Anifrolumab-fnia 300 Mg/2 Ml (150 Mg/ml) Intravenous Solution 26 10 $70,141.60 $35,070.80 50% off $18.11 $64,530.27 $60,321.77 2025-08-12
232 MS_DRG Coronary Bypass With Ptca Without Mcc 5 5 — — $60,311.92 $60,311.92 $60,311.92 2025-08-12
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 5 5 — — $59,795.17 $59,795.17 $59,795.17 2025-08-12
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 5 5 — — $58,658.11 $58,658.11 $58,658.11 2025-08-12
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 3 1 — — $58,592.45 $77,820.00 $58,592.45 2025-08-12
J0517 HCPCS Benralizumab 30 Mg/ml Subcutaneous Syringe 26 10 $68,046.55 $34,023.28 50% off $174.60 $62,602.83 $58,520.03 2025-08-12
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 5 5 — — $57,685.21 $57,685.21 $57,685.21 2025-08-12
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 5 5 — — $57,357.97 $57,357.97 $57,357.97 2025-08-12
J9057 HCPCS Copanlisib 60 Mg Intravenous Solution 26 10 $66,402.25 $33,201.13 50% off $90.36 $61,090.07 $57,105.93 2025-08-12
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 5 5 — — $56,986.66 $56,986.66 $56,986.66 2025-08-12
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 5 5 — — $56,247.35 $56,247.35 $56,247.35 2025-08-12
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 5 5 — — $56,031.39 $56,031.39 $56,031.39 2025-08-12
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 4 4 — — $55,491.51 $55,491.51 $55,491.51 2025-08-12
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 5 5 — — $54,908.65 $54,908.65 $54,908.65 2025-08-12
90288 CPT Botulism Ig IV 3 1 — — $54,435.00 $57,300.00 $54,435.00 2025-08-12
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 5 5 — — $54,429.36 $54,429.36 $54,429.36 2025-08-12
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 5 5 — — $54,019.49 $54,019.49 $54,019.49 2025-08-12
J1162 HCPCS Digoxin Immune Fab 40 Mg Intravenous Solution 26 10 $62,437.30 $31,218.65 50% off $5,452.62 $57,442.32 $53,696.08 2025-08-12
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 5 — — $53,669.12 $53,669.12 $53,669.12 2025-08-12
J7504 HCPCS Lymphocyte,anti-thymo Immune Globulin 50 Mg/ml Intravenous Solution 26 10 $62,065.20 $31,032.60 50% off $3,819.41 $57,099.98 $53,376.07 2025-08-12
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 5 — — $52,446.11 $52,446.11 $52,446.11 2025-08-12
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 5 5 — — $52,229.05 $52,229.05 $52,229.05 2025-08-12
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 26 10 $60,505.30 $30,252.65 50% off $115.96 $55,664.88 $52,034.56 2025-08-12
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 5 5 — — $51,595.51 $51,595.51 $51,595.51 2025-08-12
264 MS_DRG Other Circulatory System O.r. Procedures 5 5 — — $51,494.15 $51,494.15 $51,494.15 2025-08-12
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 5 5 — — $51,466.60 $51,466.60 $51,466.60 2025-08-12
J0480 HCPCS Basiliximab 20 Mg Intravenous Solution 26 10 $59,515.50 $29,757.75 50% off $4,740.98 $54,754.26 $51,183.33 2025-08-12
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 5 5 — — $50,972.99 $50,972.99 $50,972.99 2025-08-12
163 MS_DRG Major Chest Procedures With Mcc 5 5 — — $50,878.23 $50,878.23 $50,878.23 2025-08-12
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 5 5 — — $50,095.95 $50,095.95 $50,095.95 2025-08-12
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 5 5 — — $50,081.63 $50,081.63 $50,081.63 2025-08-12
949 MS_DRG Aftercare With Cc/mcc 5 5 — — $49,593.52 $49,593.52 $49,593.52 2025-08-12
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 5 5 — — $49,547.25 $49,547.25 $49,547.25 2025-08-12
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 5 5 — — $49,216.71 $49,216.71 $49,216.71 2025-08-12
28 MS_DRG Spinal Procedures With Mcc 5 5 — — $48,912.61 $48,912.61 $48,912.61 2025-08-12
44135 CPT Intestine Transplnt Cadaver 3 1 — — $48,762.00 $48,762.00 $48,762.00 2025-08-12
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 5 — — $48,653.68 $48,653.68 $48,653.68 2025-08-12
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 5 5 — — $48,087.35 $48,087.35 $48,087.35 2025-08-12
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 5 5 — — $47,907.76 $47,907.76 $47,907.76 2025-08-12
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 5 5 — — $47,790.97 $47,790.97 $47,790.97 2025-08-12
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 5 5 — — $47,608.07 $47,608.07 $47,608.07 2025-08-12
J9226 HCPCS Supprelin La Implant 3 1 — — $47,522.64 $58,520.84 $47,522.64 2025-08-12
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 5 — — $47,364.57 $47,364.57 $47,364.57 2025-08-12
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 5 5 — — $47,316.09 $47,316.09 $47,316.09 2025-08-12
J0565 HCPCS Bezlotoxumab 25 Mg/ml Intravenous Solution 26 10 $54,758.00 $27,379.00 50% off $43.32 $50,377.36 $47,091.88 2025-08-12
332 MS_DRG Rectal Resection With Mcc 5 5 — — $46,242.92 $46,242.92 $46,242.92 2025-08-12
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 5 5 — — $46,150.37 $46,150.37 $46,150.37 2025-08-12
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 5 5 — — $46,071.04 $46,071.04 $46,071.04 2025-08-12
252 MS_DRG Other Vascular Procedures With Mcc 5 5 — — $45,979.59 $45,979.59 $45,979.59 2025-08-12
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 5 5 — — $45,965.27 $45,965.27 $45,965.27 2025-08-12
665 MS_DRG Prostatectomy With Mcc 5 5 — — $45,774.65 $45,774.65 $45,774.65 2025-08-12
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 5 5 — — $45,631.42 $45,631.42 $45,631.42 2025-08-12
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 5 5 — — $45,631.42 $45,631.42 $45,631.42 2025-08-12
974 MS_DRG HIV With Major Related Condition With Mcc 5 5 — — $45,278.84 $45,278.84 $45,278.84 2025-08-12
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 5 5 — — $45,130.10 $45,130.10 $45,130.10 2025-08-12
J3110 HCPCS Teriparatide 20 Mcg/dose (560 Mcg/2.24 Ml) Subcutaneous Pen Injector 26 10 $52,266.85 $26,133.43 50% off $57.38 $48,085.50 $44,949.49 2025-08-12
J0180 HCPCS Agalsidase Beta 35 Mg Intravenous Solution 37 10 $102,931.25 $51,465.63 50% off $218.28 $94,696.75 $44,023.70 2025-08-12
E0194 HCPCS Air Fluidized Bed 3 1 — — $27,218.00 $43,671.15 $43,671.15 2025-08-12
245 MS_DRG Aicd Generator Procedures 5 5 — — $43,586.46 $43,586.46 $43,586.46 2025-08-12
Q5120 HCPCS Pegfilgrastim-bmez 6 Mg/0.6 Ml Subcutaneous Syringe 26 10 $50,072.05 $25,036.03 50% off $26.41 $46,066.29 $43,061.96 2025-08-12
J9061 HCPCS Amivantamab-vmjw 50 Mg/ml Intravenous Solution 26 10 $50,057.85 $25,028.93 50% off $21.11 $46,053.22 $43,049.75 2025-08-12
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 5 5 — — $42,925.38 $42,925.38 $42,925.38 2025-08-12
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 5 5 — — $42,753.49 $42,753.49 $42,753.49 2025-08-12
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 5 5 — — $42,433.97 $42,433.97 $42,433.97 2025-08-12
271 MS_DRG Other Major Cardiovascular Procedures With Cc 5 5 — — $41,993.25 $41,993.25 $41,993.25 2025-08-12
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 5 5 — — $41,770.68 $41,770.68 $41,770.68 2025-08-12
J9072 HCPCS Cyclophosphamide 500 Mg/ml Intravenous Solution 26 10 $48,326.25 $24,163.13 50% off $3.77 $44,460.15 $41,560.57 2025-08-12
J2427 HCPCS Paliperidone Palmitate (3 Month) 273 Mg/0.88 Ml Intramuscular Syringe 81 10 $91,321.90 $45,660.95 50% off $12.88 $252,042.51 $41,300.96 2025-08-12
J0597 HCPCS C1 Esterase Inhibitor 500 Unit (10 Ml) Intravenous Solution 26 10 $48,024.10 $24,012.05 50% off $66.25 $44,182.17 $41,300.72 2025-08-12
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 5 5 — — $41,087.56 $41,087.56 $41,087.56 2025-08-12
653 MS_DRG Major Bladder Procedures With Mcc 5 5 — — $40,895.84 $40,895.84 $40,895.84 2025-08-12
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 5 5 — — $40,838.55 $40,838.55 $40,838.55 2025-08-12
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 5 5 — — $40,555.39 $40,555.39 $40,555.39 2025-08-12
56 MS_DRG Degenerative Nervous System Disorders With Mcc 5 5 — — $40,535.55 $40,535.55 $40,535.55 2025-08-12
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 5 5 — — $40,286.54 $40,286.54 $40,286.54 2025-08-12
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 5 5 — — $40,019.91 $40,019.91 $40,019.91 2025-08-12
471 MS_DRG Cervical Spinal Fusion With Mcc 5 5 — — $39,949.39 $39,949.39 $39,949.39 2025-08-12
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 5 5 — — $39,773.10 $39,773.10 $39,773.10 2025-08-12
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 5 5 — — $39,650.80 $39,650.80 $39,650.80 2025-08-12
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 5 5 — — $39,424.93 $39,424.93 $39,424.93 2025-08-12
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 5 5 — — $39,089.98 $39,089.98 $39,089.98 2025-08-12
J1306 HCPCS Inclisiran 284 Mg/1.5 Ml Subcutaneous Syringe 26 10 $45,364.10 $22,682.05 50% off $12.80 $41,734.97 $39,013.12 2025-08-12
799 MS_DRG Splenic Procedures With Mcc 5 5 — — $39,002.94 $39,002.94 $39,002.94 2025-08-12
34 MS_DRG Carotid Artery Stent Procedures With Mcc 5 5 — — $38,976.49 $38,976.49 $38,976.49 2025-08-12
J9056 HCPCS Bendamustine 25 Mg/ml Intravenous Solution 26 10 $45,202.10 $22,601.05 50% off $35.35 $41,585.93 $38,873.80 2025-08-12
140 MS_DRG Major Head And Neck Procedures With Mcc 5 5 — — $38,849.79 $38,849.79 $38,849.79 2025-08-12
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 5 5 — — $38,746.22 $38,746.22 $38,746.22 2025-08-12
J8510 HCPCS Busulfan 2 Mg Tablet 26 10 $45,033.85 $22,516.93 50% off $156.60 $41,431.14 $38,729.11 2025-08-12
K0606 HCPCS Aed Garment W Elec Analysis 3 1 — — $34,023.00 $38,655.68 $38,655.68 2025-08-12
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 5 5 — — $38,528.06 $38,528.06 $38,528.06 2025-08-12
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 5 5 — — $38,427.79 $38,427.79 $38,427.79 2025-08-12
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 5 5 — — $38,248.20 $38,248.20 $38,248.20 2025-08-12
J2353 HCPCS Octreotide,microspheres ER 10 Mg Intramuscular Susp, Extended Release 48 10 $45,535.05 $22,767.53 50% off $216.52 $82,187.42 $38,208.22 2025-08-12
J0741 HCPCS Cabotegravir ER 600 Mg/3 Ml-rilpivirine ER 900 Mg/3ml IM Suspension,er 37 10 $89,278.75 $44,639.38 50% off $23.90 $82,136.45 $38,184.52 2025-08-12
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 5 5 — — $37,896.72 $37,896.72 $37,896.72 2025-08-12
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 5 5 — — $37,089.09 $37,089.09 $37,089.09 2025-08-12
901 MS_DRG Wound Debridements For Injuries With Mcc 5 5 — — $36,913.91 $36,913.91 $36,913.91 2025-08-12
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 5 5 — — $36,797.12 $36,797.12 $36,797.12 2025-08-12
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 5 5 — — $36,760.76 $36,760.76 $36,760.76 2025-08-12
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml Subcutaneous Syringe 26 10 $42,510.40 $21,255.20 50% off $143.16 $39,109.57 $36,558.95 2025-08-12
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 5 5 — — $36,468.78 $36,468.78 $36,468.78 2025-08-12
J9354 HCPCS Ado-trastuzumab Emtansine 100 Mg Intravenous Solution 37 10 $52,463.65 $26,231.83 50% off $40.61 $77,226.41 $35,901.89 2025-08-12
263 MS_DRG Vein Ligation And Stripping 5 5 — — $35,755.91 $35,755.91 $35,755.91 2025-08-12
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 5 5 — — $35,745.99 $35,745.99 $35,745.99 2025-08-12
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 5 5 — — $35,711.83 $35,711.83 $35,711.83 2025-08-12
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 5 5 — — $35,694.20 $35,694.20 $35,694.20 2025-08-12
L7181 HCPCS Electronic Elbo Simultaneous 3 1 — — $33,892.38 $35,619.72 $35,619.72 2025-08-12
849 MS_DRG Radiotherapy 5 5 — — $35,609.37 $35,609.37 $35,609.37 2025-08-12
J9266 HCPCS Pegaspargase Injection 3 1 — — $30,645.89 $35,510.31 $35,510.31 2025-08-12
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 5 5 — — $35,439.69 $35,439.69 $35,439.69 2025-08-12
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 5 5 — — $35,430.87 $35,430.87 $35,430.87 2025-08-12
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 5 5 — — $35,373.58 $35,373.58 $35,373.58 2025-08-12
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 5 5 — — $35,314.08 $35,314.08 $35,314.08 2025-08-12
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 5 5 — — $35,309.67 $35,309.67 $35,309.67 2025-08-12
835 MS_DRG Acute Leukemia With Cc 5 5 — — $35,232.55 $35,232.55 $35,232.55 2025-08-12
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 5 5 — — $35,135.59 $35,135.59 $35,135.59 2025-08-12
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 5 5 — — $34,919.63 $34,919.63 $34,919.63 2025-08-12
J2182 HCPCS Mepolizumab 100 Mg Subcutaneous Solution 26 10 $40,177.75 $20,088.88 50% off $32.20 $36,963.53 $34,552.86 2025-08-12
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 5 5 — — $34,161.59 $34,161.59 $34,161.59 2025-08-12
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 5 5 — — $34,102.09 $34,102.09 $34,102.09 2025-08-12
265 MS_DRG Aicd Lead Procedures 5 5 — — $34,067.93 $34,067.93 $34,067.93 2025-08-12
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 5 5 — — $33,823.33 $33,823.33 $33,823.33 2025-08-12
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 5 5 — — $33,339.64 $33,339.64 $33,339.64 2025-08-12
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 5 5 — — $33,069.70 $33,069.70 $33,069.70 2025-08-12
472 MS_DRG Cervical Spinal Fusion With Cc 5 5 — — $32,500.06 $32,500.06 $32,500.06 2025-08-12
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 5 5 — — $32,476.92 $32,476.92 $32,476.92 2025-08-12
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 5 5 — — $32,388.78 $32,388.78 $32,388.78 2025-08-12
A9543 HCPCS Y90 Ibritumomab, Rx 3 1 — — $32,332.94 $68,198.81 $32,332.94 2025-08-12
545 MS_DRG Connective Tissue Disorders With Mcc 5 5 — — $32,000.94 $32,000.94 $32,000.94 2025-08-12
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 5 5 — — $31,976.70 $31,976.70 $31,976.70 2025-08-12
35 MS_DRG Carotid Artery Stent Procedures With Cc 5 5 — — $31,520.55 $31,520.55 $31,520.55 2025-08-12
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 5 5 — — $31,491.90 $31,491.90 $31,491.90 2025-08-12
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 5 5 — — $31,433.51 $31,433.51 $31,433.51 2025-08-12
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 5 5 — — $31,419.19 $31,419.19 $31,419.19 2025-08-12
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 5 5 — — $31,227.47 $31,227.47 $31,227.47 2025-08-12
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 5 5 — — $31,195.52 $31,195.52 $31,195.52 2025-08-12
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 5 5 — — $31,117.29 $31,117.29 $31,117.29 2025-08-12
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 5 5 — — $30,858.36 $30,858.36 $30,858.36 2025-08-12
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 5 5 — — $30,524.52 $30,524.52 $30,524.52 2025-08-12
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 5 5 — — $30,492.56 $30,492.56 $30,492.56 2025-08-12
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 5 5 — — $30,450.70 $30,450.70 $30,450.70 2025-08-12
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 5 5 — — $30,359.25 $30,359.25 $30,359.25 2025-08-12
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 5 5 — — $30,333.90 $30,333.90 $30,333.90 2025-08-12
J0177 HCPCS Aflibercept 8 Mg/0.07 Ml Intravitreal Solution For Injection 26 10 $35,209.15 $17,604.58 50% off $361.09 $32,392.42 $30,279.87 2025-08-12
253 MS_DRG Other Vascular Procedures With Cc 5 5 — — $30,230.33 $30,230.33 $30,230.33 2025-08-12
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 5 5 — — $30,192.87 $30,192.87 $30,192.87 2025-08-12
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 5 5 — — $30,092.61 $30,092.61 $30,092.61 2025-08-12
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 5 5 — — $30,006.67 $30,006.67 $30,006.67 2025-08-12
709 MS_DRG Penis Procedures With Cc/mcc 5 5 — — $29,958.19 $29,958.19 $29,958.19 2025-08-12
314 MS_DRG Other Circulatory System Diagnoses With Mcc 5 5 — — $29,435.93 $29,435.93 $29,435.93 2025-08-12
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 5 5 — — $29,405.08 $29,405.08 $29,405.08 2025-08-12
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 5 5 — — $29,368.72 $29,368.72 $29,368.72 2025-08-12
791 MS_DRG Prematurity With Major Problems 5 5 — — $29,293.80 $29,293.80 $29,293.80 2025-08-12
31 MS_DRG Ventricular Shunt Procedures With Mcc 5 5 — — $29,188.02 $29,188.02 $29,188.02 2025-08-12
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 5 5 — — $29,012.83 $29,012.83 $29,012.83 2025-08-12
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 5 5 — — $28,953.34 $28,953.34 $28,953.34 2025-08-12
L7180 HCPCS Electronic Elbow Sequential 3 1 — — $23,500.00 $28,717.11 $28,717.11 2025-08-12
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 5 5 — — $28,543.46 $28,543.46 $28,543.46 2025-08-12
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 5 5 — — $28,449.81 $28,449.81 $28,449.81 2025-08-12
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 5 5 — — $28,417.86 $28,417.86 $28,417.86 2025-08-12
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 5 5 — — $28,375.99 $28,375.99 $28,375.99 2025-08-12
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 3 1 — — $28,276.11 $36,746.08 $28,276.11 2025-08-12
J7169 HCPCS Factor Xa,inactivated-zhzo (recombinant) 200 Mg Intravenous Solution 26 10 $32,875.00 $16,437.50 50% off $142.50 $30,245.00 $28,272.50 2025-08-12
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 5 5 — — $28,135.79 $28,135.79 $28,135.79 2025-08-12
570 MS_DRG Skin Debridement With Mcc 5 5 — — $28,055.36 $28,055.36 $28,055.36 2025-08-12
J9032 HCPCS Belinostat 500 Mg Intravenous Solution 26 10 $32,617.70 $16,308.85 50% off $51.60 $30,008.28 $28,051.22 2025-08-12
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 5 5 — — $27,992.56 $27,992.56 $27,992.56 2025-08-12
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 5 5 — — $27,958.40 $27,958.40 $27,958.40 2025-08-12
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 5 5 — — $27,958.40 $27,958.40 $27,958.40 2025-08-12
335 MS_DRG Peritoneal Adhesiolysis With Mcc 5 5 — — $27,858.14 $27,858.14 $27,858.14 2025-08-12
582 MS_DRG Mastectomy For Malignancy With Cc/mcc 5 5 — — $27,750.16 $27,750.16 $27,750.16 2025-08-12
583 MS_DRG Mastectomy For Malignancy Without Cc/mcc 5 5 — — $27,750.16 $27,750.16 $27,750.16 2025-08-12
J0791 HCPCS Crizanlizumab-tmca 10 Mg/ml Intravenous Solution 26 10 $32,256.20 $16,128.10 50% off $134.56 $29,675.70 $27,740.33 2025-08-12
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 5 5 — — $27,636.68 $27,636.68 $27,636.68 2025-08-12
500 MS_DRG Soft Tissue Procedures With Mcc 5 5 — — $27,585.99 $27,585.99 $27,585.99 2025-08-12
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 5 5 — — $27,181.63 $27,181.63 $27,181.63 2025-08-12
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 5 5 — — $27,087.97 $27,087.97 $27,087.97 2025-08-12
J9176 HCPCS Elotuzumab 300 Mg Intravenous Solution 26 10 $31,421.15 $15,710.58 50% off $7.82 $28,907.46 $27,022.19 2025-08-12
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 5 5 — — $26,954.66 $26,954.66 $26,954.66 2025-08-12
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 5 5 — — $26,824.64 $26,824.64 $26,824.64 2025-08-12
374 MS_DRG Digestive Malignancy With Mcc 5 5 — — $26,809.22 $26,809.22 $26,809.22 2025-08-12
J3315 HCPCS Triptorelin Pamoate 11.25 Mg IM Suspension 37 10 $31,329.65 $15,664.83 50% off $487.44 $57,646.51 $26,799.36 2025-08-12
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 5 5 — — $26,775.06 $26,775.06 $26,775.06 2025-08-12
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 5 5 — — $26,725.48 $26,725.48 $26,725.48 2025-08-12
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 5 5 — — $26,681.41 $26,681.41 $26,681.41 2025-08-12
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 5 5 — — $26,650.56 $26,650.56 $26,650.56 2025-08-12
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 5 5 — — $26,618.60 $26,618.60 $26,618.60 2025-08-12
575 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis Without Cc/mcc 5 5 — — $26,618.60 $26,618.60 $26,618.60 2025-08-12
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 5 5 — — $26,586.65 $26,586.65 $26,586.65 2025-08-12
91 MS_DRG Other Disorders Of Nervous System With Mcc 5 5 — — $26,512.83 $26,512.83 $26,512.83 2025-08-12
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 5 5 — — $26,478.67 $26,478.67 $26,478.67 2025-08-12
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 5 5 — — $26,365.19 $26,365.19 $26,365.19 2025-08-12
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 5 5 — — $26,365.19 $26,365.19 $26,365.19 2025-08-12
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 5 5 — — $26,316.71 $26,316.71 $26,316.71 2025-08-12
164 MS_DRG Major Chest Procedures With Cc 5 5 — — $26,242.89 $26,242.89 $26,242.89 2025-08-12
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 5 5 — — $26,117.28 $26,117.28 $26,117.28 2025-08-12
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/mcc 5 5 — — $26,117.28 $26,117.28 $26,117.28 2025-08-12
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 5 5 — — $25,938.79 $25,938.79 $25,938.79 2025-08-12
J2777 HCPCS Faricimab-svoa 6 Mg/0.05 Ml Intravitreal Syringe 26 10 $30,108.90 $15,054.45 50% off $37.44 $27,700.19 $25,893.66 2025-08-12
J0609 HCPCS Ferric Citrate 210 Mg Iron Tablet 26 10 $30,075.20 $15,037.60 50% off $10,225.57 $27,669.18 $25,864.67 2025-08-12
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 5 5 — — $25,847.34 $25,847.34 $25,847.34 2025-08-12
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 5 5 — — $25,812.08 $25,812.08 $25,812.08 2025-08-12
330 MS_DRG Major Small And Large Bowel Procedures With Cc 5 5 — — $25,792.25 $25,792.25 $25,792.25 2025-08-12
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 5 5 — — $25,715.12 $25,715.12 $25,715.12 2025-08-12
70 MS_DRG Nonspecific Cerebrovascular Disorders With Mcc 5 5 — — $25,613.75 $25,613.75 $25,613.75 2025-08-12
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 5 5 — — $25,588.41 $25,588.41 $25,588.41 2025-08-12
113 MS_DRG Orbital Procedures With Cc/mcc 5 5 — — $25,493.66 $25,493.66 $25,493.66 2025-08-12
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 5 5 — — $25,412.12 $25,412.12 $25,412.12 2025-08-12
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 5 5 — — $25,323.98 $25,323.98 $25,323.98 2025-08-12
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 5 5 — — $25,250.16 $25,250.16 $25,250.16 2025-08-12
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