|
S3399
|
HCPCS
|
Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit
|
4
|
1
|
—
|
—
|
$3,392,890.81
|
$4,734,266.25
|
$4,091,758.69
|
2025-05-17
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
15
|
15
|
—
|
—
|
$3,710,000.00
|
$3,895,500.00
|
$3,710,000.00
|
2025-05-17
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
15
|
15
|
—
|
—
|
$3,685,266.67
|
$3,869,530.00
|
$3,685,266.67
|
2025-05-17
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
15
|
15
|
—
|
—
|
$3,322,473.30
|
$3,488,596.96
|
$3,322,473.30
|
2025-05-17
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
15
|
15
|
—
|
—
|
$3,286,000.00
|
$3,450,300.00
|
$3,286,000.00
|
2025-05-17
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
15
|
15
|
—
|
—
|
$2,948,213.33
|
$3,095,624.00
|
$2,948,213.33
|
2025-05-17
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
18
|
18
|
—
|
—
|
$2,423,131.23
|
$4,361,636.22
|
$2,423,131.23
|
2025-05-17
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
18
|
18
|
—
|
—
|
$2,332,000.00
|
$4,197,600.00
|
$2,332,000.00
|
2025-05-17
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension
|
124
|
41
|
$2,566,800.95
|
$1,925,100.72
25% off
|
$527,622.46
|
$2,310,120.86
|
$1,590,359.06
|
2025-05-17
|
|
C9399
|
HCPCS
|
Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp
|
176
|
41
|
$3,080,000.00
|
$2,310,000.00
25% off
|
$2,325.23
|
$3,069,000.00
|
$1,550,395.00
|
2025-05-17
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel(cd8) 1.5x To 70x 10exp6 Cell/ml IV Susp(1of2)
|
89
|
41
|
$2,113,045.00
|
$1,584,783.75
25% off
|
$516,442.29
|
$1,901,740.50
|
$1,436,870.60
|
2025-05-17
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Intravenous Suspension
|
89
|
41
|
$2,054,850.00
|
$1,541,137.50
25% off
|
$502,840.73
|
$1,849,365.00
|
$1,397,298.00
|
2025-05-17
|
|
Q2053
|
HCPCS
|
Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension
|
89
|
41
|
$2,054,850.00
|
$1,541,137.50
25% off
|
$489,399.16
|
$1,849,365.00
|
$1,397,298.00
|
2025-05-17
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension
|
124
|
41
|
$1,920,950.00
|
$1,440,712.50
25% off
|
$578,205.95
|
$2,201,625.00
|
$1,306,246.00
|
2025-05-17
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
18
|
18
|
—
|
—
|
$770,620.00
|
$1,387,116.00
|
$770,620.00
|
2025-05-17
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
18
|
18
|
—
|
—
|
$553,169.30
|
$995,704.74
|
$553,169.30
|
2025-05-17
|
|
J2326
|
HCPCS
|
Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution
|
88
|
41
|
$686,636.63
|
$514,977.48
25% off
|
$1,248.60
|
$617,972.97
|
$466,912.91
|
2025-05-17
|
|
C9301
|
HCPCS
|
Apc
|
18
|
18
|
—
|
—
|
$278,250.00
|
$500,850.00
|
$278,250.00
|
2025-05-17
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
29
|
20
|
—
|
—
|
$260,488.43
|
$569,048.44
|
$273,512.85
|
2025-05-17
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$218,886.09
|
$225,323.92
|
$223,177.98
|
2025-05-17
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
7
|
7
|
—
|
—
|
$211,768.01
|
$217,996.49
|
$215,920.33
|
2025-05-17
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
7
|
7
|
—
|
—
|
$211,768.01
|
$217,996.49
|
$215,920.33
|
2025-05-17
|
|
A9543
|
HCPCS
|
Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous
|
89
|
41
|
$307,938.32
|
$230,953.74
25% off
|
$56,824.55
|
$277,144.49
|
$209,398.06
|
2025-05-17
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
7
|
7
|
—
|
—
|
$201,476.10
|
$207,401.87
|
$205,426.61
|
2025-05-17
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
7
|
7
|
—
|
—
|
$201,476.10
|
$207,401.87
|
$205,426.61
|
2025-05-17
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
7
|
7
|
—
|
—
|
$200,698.84
|
$206,601.75
|
$204,634.11
|
2025-05-17
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
29
|
20
|
—
|
—
|
$194,636.30
|
$425,031.48
|
$204,368.12
|
2025-05-17
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
7
|
7
|
—
|
—
|
$176,615.18
|
$181,809.75
|
$180,078.23
|
2025-05-17
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
29
|
20
|
—
|
—
|
$163,964.65
|
$357,953.33
|
$172,162.88
|
2025-05-17
|
|
J9226
|
HCPCS
|
Histrelin 50 Mg (65 Mcg/day) Implant Kit
|
89
|
41
|
$249,917.09
|
$187,437.82
25% off
|
$45,212.04
|
$224,925.38
|
$169,943.62
|
2025-05-17
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
7
|
7
|
—
|
—
|
$155,519.50
|
$160,093.61
|
$158,568.90
|
2025-05-17
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
7
|
7
|
—
|
—
|
$155,519.50
|
$160,093.61
|
$158,568.90
|
2025-05-17
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
7
|
7
|
—
|
—
|
$155,519.50
|
$160,093.61
|
$158,568.90
|
2025-05-17
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
29
|
20
|
—
|
—
|
$148,156.54
|
$323,381.41
|
$155,564.37
|
2025-05-17
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$151,096.92
|
$155,540.95
|
$154,059.61
|
2025-05-17
|
|
J1823
|
HCPCS
|
Inebilizumab-cdon 10 Mg/ml Intravenous Solution
|
88
|
41
|
$224,883.36
|
$168,662.52
25% off
|
$484.40
|
$202,395.02
|
$152,920.68
|
2025-05-17
|
|
J0223
|
HCPCS
|
Givosiran 189 Mg/ml Subcutaneous Solution
|
88
|
41
|
$222,207.83
|
$166,655.88
25% off
|
$116.47
|
$199,987.05
|
$151,101.33
|
2025-05-17
|
|
C9150
|
HCPCS
|
Lab/Radiology
|
1
|
1
|
—
|
—
|
$149,760.00
|
$149,760.00
|
$149,760.00
|
2025-05-17
|
|
J9347
|
HCPCS
|
Tremelimumab-actl 20 Mg/ml Intravenous Solution
|
88
|
41
|
$215,735.77
|
$161,801.83
25% off
|
$138.24
|
$194,162.19
|
$146,700.32
|
2025-05-17
|
|
90288
|
CPT
|
Botulism Ig IV
|
1
|
1
|
—
|
—
|
$146,115.00
|
$146,115.00
|
$146,115.00
|
2025-05-17
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
7
|
7
|
—
|
—
|
$140,704.99
|
$144,843.37
|
$143,463.91
|
2025-05-17
|
|
8412
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
7
|
7
|
—
|
—
|
$140,704.99
|
$144,843.37
|
$143,463.91
|
2025-05-17
|
|
8411
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
7
|
7
|
—
|
—
|
$140,704.99
|
$144,843.37
|
$143,463.91
|
2025-05-17
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
7
|
7
|
—
|
—
|
$140,704.99
|
$144,843.37
|
$143,463.91
|
2025-05-17
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$140,694.57
|
$144,832.64
|
$143,453.28
|
2025-05-17
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
7
|
7
|
—
|
—
|
$136,568.19
|
$140,584.90
|
$139,246.00
|
2025-05-17
|
|
C9293
|
HCPCS
|
Glucarpidase 1,000 Unit/1 Ml IV Injection - Reconstituted 1000 Unit/ml
|
71
|
41
|
$202,725.27
|
$152,043.96
25% off
|
$61,020.31
|
$182,452.74
|
$137,853.18
|
2025-05-17
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
7
|
7
|
—
|
—
|
$120,646.30
|
$124,194.72
|
$123,011.92
|
2025-05-17
|
|
J9269
|
HCPCS
|
Tagraxofusp-erzs 1000 Mcg/ml Ns IV - Reconstituted 100 Mcg/ml
|
88
|
41
|
$171,000.60
|
$128,250.45
25% off
|
$338.53
|
$153,900.54
|
$116,280.41
|
2025-05-17
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$110,993.62
|
$114,258.13
|
$113,169.96
|
2025-05-17
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$105,619.16
|
$108,725.61
|
$107,690.13
|
2025-05-17
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$105,619.16
|
$108,725.61
|
$107,690.13
|
2025-05-17
|
|
J7330
|
HCPCS
|
Implant, Maci Final, Product Assembled, Single
|
105
|
41
|
$156,756.00
|
$117,567.00
25% off
|
$47,183.56
|
$282,160.80
|
$106,594.08
|
2025-05-17
|
|
J0202
|
HCPCS
|
Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution
|
88
|
41
|
$156,047.54
|
$117,035.66
25% off
|
$2,441.49
|
$140,442.79
|
$106,112.33
|
2025-05-17
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$102,383.55
|
$105,394.83
|
$104,391.07
|
2025-05-17
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
29
|
20
|
—
|
—
|
$97,779.25
|
$213,207.57
|
$102,668.21
|
2025-05-17
|
|
A9606
|
HCPCS
|
Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln
|
88
|
41
|
$148,062.50
|
$111,046.88
25% off
|
$169.06
|
$133,256.25
|
$100,682.50
|
2025-05-17
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
18
|
18
|
—
|
—
|
$99,999.95
|
$179,999.91
|
$99,999.95
|
2025-05-17
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$95,108.42
|
$97,905.73
|
$96,973.29
|
2025-05-17
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
29
|
20
|
—
|
—
|
$90,685.22
|
$197,693.06
|
$95,219.48
|
2025-05-17
|
|
7
|
MS_DRG
|
Lung Transplant
|
29
|
20
|
—
|
—
|
$90,457.51
|
$197,195.12
|
$94,980.39
|
2025-05-17
|
|
J1305
|
HCPCS
|
Evinacumab-dgnb 150 Mg/ml Intravenous Solution
|
122
|
41
|
$200,850.00
|
$150,637.50
25% off
|
$186.31
|
$180,765.00
|
$94,399.50
|
2025-05-17
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
18
|
18
|
—
|
—
|
$93,216.70
|
$167,790.06
|
$93,216.70
|
2025-05-17
|
|
J9359
|
HCPCS
|
Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution
|
88
|
41
|
$133,461.89
|
$100,096.42
25% off
|
$212.00
|
$120,115.70
|
$90,754.09
|
2025-05-17
|
|
Q2043
|
HCPCS
|
Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension
|
89
|
41
|
$133,364.40
|
$100,023.30
25% off
|
$40,142.68
|
$120,027.96
|
$90,687.79
|
2025-05-17
|
|
J1747
|
HCPCS
|
Spesolimab-sbzo 60 Mg/ml Intravenous Solution
|
88
|
41
|
$131,667.49
|
$98,750.62
25% off
|
$61.43
|
$118,500.74
|
$89,533.90
|
2025-05-17
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
7
|
7
|
—
|
—
|
$87,556.35
|
$90,131.54
|
$89,273.14
|
2025-05-17
|
|
J2507
|
HCPCS
|
Pegloticase 8 Mg/ml Intravenous Solution
|
88
|
41
|
$131,153.51
|
$98,365.14
25% off
|
$3,565.32
|
$118,038.16
|
$89,184.38
|
2025-05-17
|
|
J9118
|
HCPCS
|
Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution
|
68
|
39
|
$128,920.57
|
$96,690.43
25% off
|
$218.64
|
$116,028.51
|
$87,665.99
|
2025-05-17
|
|
J9228
|
HCPCS
|
Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution
|
122
|
41
|
$177,906.55
|
$133,429.92
25% off
|
$180.22
|
$160,115.90
|
$83,616.07
|
2025-05-17
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
7
|
7
|
—
|
—
|
$78,760.77
|
$81,077.26
|
$80,305.10
|
2025-05-17
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
7
|
7
|
—
|
—
|
$78,760.77
|
$81,077.26
|
$80,305.10
|
2025-05-17
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
7
|
7
|
—
|
—
|
$78,760.77
|
$81,077.26
|
$80,305.10
|
2025-05-17
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
7
|
—
|
—
|
$78,635.33
|
$80,948.13
|
$80,177.20
|
2025-05-17
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
29
|
20
|
—
|
—
|
$76,319.79
|
$166,276.25
|
$80,135.78
|
2025-05-17
|
|
J9348
|
HCPCS
|
Naxitamab-gqgk 4 Mg/ml Intravenous Solution
|
88
|
41
|
$116,612.85
|
$87,459.64
25% off
|
$641.83
|
$104,951.57
|
$79,296.74
|
2025-05-17
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
29
|
20
|
—
|
—
|
$75,451.85
|
$164,378.06
|
$79,224.44
|
2025-05-17
|
|
J9229
|
HCPCS
|
Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln
|
88
|
41
|
$116,476.42
|
$87,357.32
25% off
|
$2,658.13
|
$104,828.78
|
$79,203.96
|
2025-05-17
|
|
J9266
|
HCPCS
|
Pegaspargase 750 Unit/ml Injection Solution
|
89
|
41
|
$114,548.67
|
$85,911.51
25% off
|
$27,070.53
|
$103,093.80
|
$77,893.10
|
2025-05-17
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
29
|
20
|
—
|
—
|
$73,764.91
|
$160,688.80
|
$77,453.16
|
2025-05-17
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
29
|
20
|
—
|
—
|
$73,388.20
|
$159,864.94
|
$77,057.61
|
2025-05-17
|
|
J9274
|
HCPCS
|
Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution
|
88
|
41
|
$112,071.97
|
$84,053.98
25% off
|
$214.76
|
$100,864.77
|
$76,208.94
|
2025-05-17
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
29
|
20
|
—
|
—
|
$72,564.40
|
$158,063.31
|
$76,192.62
|
2025-05-17
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$74,180.87
|
$76,362.66
|
$75,635.39
|
2025-05-17
|
|
03060
|
EAPG
|
Ventricular Assist Device Procedures
|
7
|
7
|
—
|
—
|
$72,757.48
|
$74,897.40
|
$74,184.09
|
2025-05-17
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
7
|
7
|
—
|
—
|
$71,489.55
|
$73,592.18
|
$72,891.30
|
2025-05-17
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$70,345.20
|
$72,414.17
|
$71,724.52
|
2025-05-17
|
|
J7311
|
HCPCS
|
Fluocinolone 0.59 Mg Intravitreal Implant
|
88
|
41
|
$105,240.36
|
$78,930.27
25% off
|
$340.04
|
$94,716.32
|
$71,563.45
|
2025-05-17
|
|
J9600
|
HCPCS
|
Porfimer 2.5 Mg/ml IV Syringe
|
89
|
41
|
$105,199.05
|
$78,899.29
25% off
|
$24,228.42
|
$94,679.15
|
$71,535.35
|
2025-05-17
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$69,580.23
|
$71,626.71
|
$70,944.55
|
2025-05-17
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
29
|
20
|
—
|
—
|
$66,877.16
|
$145,625.45
|
$70,221.02
|
2025-05-17
|
|
8504
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
7
|
7
|
—
|
—
|
$67,402.05
|
$69,384.46
|
$68,723.66
|
2025-05-17
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
18
|
18
|
—
|
—
|
$67,452.66
|
$121,414.79
|
$67,452.66
|
2025-05-17
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
29
|
20
|
—
|
—
|
$63,846.89
|
$138,998.36
|
$67,039.23
|
2025-05-17
|
|
J2350
|
HCPCS
|
Ocrelizumab 30 Mg/ml Intravenous Solution
|
88
|
41
|
$98,446.22
|
$73,834.67
25% off
|
$57.81
|
$88,601.60
|
$66,943.43
|
2025-05-17
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
7
|
7
|
—
|
—
|
$65,384.02
|
$67,307.08
|
$66,666.06
|
2025-05-17
|
|
8514
|
APR_DRG
|
Gender Related Procedures
|
7
|
7
|
—
|
—
|
$65,256.22
|
$67,175.52
|
$66,535.76
|
2025-05-17
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$64,383.26
|
$66,276.88
|
$65,645.67
|
2025-05-17
|
|
J0638
|
HCPCS
|
Canakinumab (pf) 150 Mg/ml Subcutaneous Solution
|
88
|
41
|
$94,723.08
|
$71,042.31
25% off
|
$136.56
|
$85,250.77
|
$64,411.69
|
2025-05-17
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
7
|
7
|
—
|
—
|
$62,849.04
|
$64,697.55
|
$64,081.38
|
2025-05-17
|
|
L8688
|
HCPCS
|
Generator, M1000-d, Sentiva Duo
|
69
|
41
|
$102,755.64
|
$77,066.73
25% off
|
$30,929.45
|
$92,480.08
|
$63,364.26
|
2025-05-17
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
7
|
7
|
—
|
—
|
$60,800.45
|
$62,588.69
|
$61,992.61
|
2025-05-17
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
29
|
20
|
—
|
—
|
$58,755.08
|
$127,862.68
|
$61,692.83
|
2025-05-17
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
29
|
20
|
—
|
—
|
$58,722.64
|
$127,791.76
|
$61,658.77
|
2025-05-17
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$59,698.90
|
$61,454.75
|
$60,869.46
|
2025-05-17
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
29
|
20
|
—
|
—
|
$57,835.37
|
$125,851.31
|
$60,727.14
|
2025-05-17
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$59,552.91
|
$61,304.47
|
$60,720.62
|
2025-05-17
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$59,552.91
|
$61,304.47
|
$60,720.62
|
2025-05-17
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
7
|
7
|
—
|
—
|
$59,301.79
|
$61,045.96
|
$60,464.57
|
2025-05-17
|
|
A9604
|
HCPCS
|
Samarium Sm 153 Lexidronam 5,550 Mbq/3 Ml Intravenous Solution
|
89
|
41
|
$88,888.25
|
$66,666.19
25% off
|
$4,314.91
|
$79,999.43
|
$60,444.01
|
2025-05-17
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
7
|
7
|
—
|
—
|
$59,246.59
|
$60,989.13
|
$60,408.29
|
2025-05-17
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$57,688.50
|
$59,385.22
|
$58,819.64
|
2025-05-17
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
29
|
20
|
—
|
—
|
$55,906.98
|
$121,633.94
|
$58,702.33
|
2025-05-17
|
|
J9309
|
HCPCS
|
Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution
|
88
|
41
|
$86,294.33
|
$64,720.75
25% off
|
$132.73
|
$77,664.90
|
$58,680.14
|
2025-05-17
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$57,034.91
|
$58,712.41
|
$58,153.24
|
2025-05-17
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
29
|
20
|
—
|
—
|
$55,299.14
|
$120,304.60
|
$58,064.10
|
2025-05-17
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
29
|
20
|
—
|
—
|
$54,983.83
|
$119,615.03
|
$57,733.02
|
2025-05-17
|
|
J3241
|
HCPCS
|
Teprotumumab-trbw 500 Mg Intravenous Solution
|
88
|
41
|
$83,988.16
|
$62,991.12
25% off
|
$352.56
|
$75,589.34
|
$57,111.94
|
2025-05-17
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
29
|
20
|
—
|
—
|
$54,218.67
|
$117,941.66
|
$56,929.60
|
2025-05-17
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
29
|
20
|
—
|
—
|
$53,674.31
|
$116,751.14
|
$56,358.03
|
2025-05-17
|
|
6091
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$54,915.16
|
$56,530.31
|
$55,991.93
|
2025-05-17
|
|
6092
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$54,915.16
|
$56,530.31
|
$55,991.93
|
2025-05-17
|
|
J2502
|
HCPCS
|
Pasireotide Pamoate 40 Mg IM Suspension
|
88
|
41
|
$82,121.85
|
$61,591.39
25% off
|
$526.94
|
$73,909.67
|
$55,842.86
|
2025-05-17
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
7
|
7
|
—
|
—
|
$54,730.60
|
$56,340.32
|
$55,803.75
|
2025-05-17
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
7
|
7
|
—
|
—
|
$54,480.89
|
$56,083.27
|
$55,549.15
|
2025-05-17
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
7
|
7
|
—
|
—
|
$54,377.37
|
$55,976.71
|
$55,443.60
|
2025-05-17
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
7
|
7
|
—
|
—
|
$54,299.32
|
$55,896.36
|
$55,364.02
|
2025-05-17
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
7
|
7
|
—
|
—
|
$54,281.49
|
$55,878.01
|
$55,345.84
|
2025-05-17
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
7
|
7
|
—
|
—
|
$54,072.57
|
$55,662.94
|
$55,132.81
|
2025-05-17
|
|
38240
|
CPT
|
Transplt Allo Hct/donor
|
22
|
18
|
—
|
—
|
$2,801.74
|
$98,689.15
|
$54,827.31
|
2025-05-17
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
7
|
7
|
—
|
—
|
$53,757.35
|
$55,338.44
|
$54,811.41
|
2025-05-17
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
29
|
20
|
—
|
—
|
$51,788.66
|
$112,627.31
|
$54,378.09
|
2025-05-17
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$53,065.56
|
$54,626.31
|
$54,106.06
|
2025-05-17
|
|
J9029
|
HCPCS
|
Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension
|
89
|
41
|
$77,250.00
|
$57,937.50
25% off
|
$23,252.25
|
$172,800.00
|
$52,530.00
|
2025-05-17
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$51,217.60
|
$52,724.00
|
$52,221.86
|
2025-05-17
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
29
|
20
|
—
|
—
|
$49,294.50
|
$107,172.64
|
$51,759.23
|
2025-05-17
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
7
|
7
|
—
|
—
|
$50,719.98
|
$52,211.74
|
$51,714.49
|
2025-05-17
|
|
J9298
|
HCPCS
|
Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution
|
88
|
41
|
$75,752.49
|
$56,814.37
25% off
|
$194.08
|
$68,177.24
|
$51,511.69
|
2025-05-17
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
29
|
20
|
—
|
—
|
$49,048.18
|
$125,519.92
|
$51,500.59
|
2025-05-17
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
29
|
20
|
—
|
—
|
$48,285.79
|
$104,966.63
|
$50,700.08
|
2025-05-17
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
7
|
7
|
—
|
—
|
$49,254.04
|
$50,702.68
|
$50,219.80
|
2025-05-17
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$49,149.80
|
$50,595.38
|
$50,113.52
|
2025-05-17
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
29
|
20
|
—
|
—
|
$47,401.29
|
$103,032.22
|
$49,771.35
|
2025-05-17
|
|
5894
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
7
|
7
|
—
|
—
|
$48,488.04
|
$49,914.15
|
$49,438.78
|
2025-05-17
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
7
|
7
|
—
|
—
|
$48,488.04
|
$49,914.15
|
$49,438.78
|
2025-05-17
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
29
|
20
|
—
|
—
|
$46,548.51
|
$101,167.22
|
$48,875.94
|
2025-05-17
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
29
|
20
|
—
|
—
|
$46,370.50
|
$100,777.92
|
$48,689.03
|
2025-05-17
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
7
|
7
|
—
|
—
|
$47,707.08
|
$49,110.23
|
$48,642.52
|
2025-05-17
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
29
|
20
|
—
|
—
|
$46,292.53
|
$100,607.42
|
$48,607.16
|
2025-05-17
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
18
|
18
|
—
|
—
|
$48,370.76
|
$87,067.37
|
$48,370.76
|
2025-05-17
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
7
|
7
|
—
|
—
|
$47,440.24
|
$48,835.54
|
$48,370.44
|
2025-05-17
|
|
J1628
|
HCPCS
|
Guselkumab 100 Mg/ml Subcutaneous Syringe
|
88
|
41
|
$70,893.10
|
$53,169.83
25% off
|
$70.43
|
$63,803.79
|
$48,207.31
|
2025-05-17
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
7
|
7
|
—
|
—
|
$47,058.45
|
$48,442.53
|
$47,981.17
|
2025-05-17
|
|
33276
|
CPT
|
Hc Insertion Phrenic Nerve Stimulator System
|
89
|
41
|
$70,201.00
|
$52,650.75
25% off
|
$21,130.50
|
$75,091.07
|
$47,736.68
|
2025-05-17
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
7
|
7
|
—
|
—
|
$46,537.21
|
$47,905.96
|
$47,449.71
|
2025-05-17
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
7
|
7
|
—
|
—
|
$46,317.67
|
$47,679.95
|
$47,225.86
|
2025-05-17
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
29
|
20
|
—
|
—
|
$44,909.89
|
$97,583.58
|
$47,155.38
|
2025-05-17
|
|
J9043
|
HCPCS
|
Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution
|
88
|
41
|
$69,344.76
|
$52,008.57
25% off
|
$221.71
|
$62,410.28
|
$47,154.43
|
2025-05-17
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
29
|
20
|
—
|
—
|
$44,845.72
|
$97,443.25
|
$47,088.01
|
2025-05-17
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
7
|
7
|
—
|
—
|
$46,163.65
|
$47,521.40
|
$47,068.82
|
2025-05-17
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
7
|
7
|
—
|
—
|
$46,163.65
|
$47,521.40
|
$47,068.82
|
2025-05-17
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
18
|
18
|
—
|
—
|
$46,980.38
|
$84,564.68
|
$46,980.38
|
2025-05-17
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
7
|
7
|
—
|
—
|
$45,281.24
|
$46,613.04
|
$46,169.10
|
2025-05-17
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
29
|
20
|
—
|
—
|
$43,923.93
|
$95,427.36
|
$46,120.13
|
2025-05-17
|
|
83
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$45,054.94
|
$46,380.09
|
$45,938.37
|
2025-05-17
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
7
|
—
|
—
|
$44,635.50
|
$45,948.30
|
$45,510.70
|
2025-05-17
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
7
|
—
|
—
|
$44,635.50
|
$45,948.30
|
$45,510.70
|
2025-05-17
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
7
|
—
|
—
|
$44,635.50
|
$45,948.30
|
$45,510.70
|
2025-05-17
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
7
|
—
|
—
|
$44,635.50
|
$45,948.30
|
$45,510.70
|
2025-05-17
|
|
J9350
|
HCPCS
|
Mosunetuzumab-axgb 1 Mg/ml Intravenous Solution
|
123
|
41
|
$98,373.24
|
$73,779.93
25% off
|
$640.96
|
$88,535.92
|
$45,251.69
|
2025-05-17
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
29
|
20
|
—
|
—
|
$43,027.70
|
$93,467.30
|
$45,179.09
|
2025-05-17
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
29
|
20
|
—
|
—
|
$42,972.50
|
$93,346.59
|
$45,121.13
|
2025-05-17
|
|
A9572
|
HCPCS
|
Indium 111-pentetreotide 3 Mci/ml-10 Mcg Intravenous Kit
|
88
|
41
|
$66,218.70
|
$49,664.03
25% off
|
$1,914.61
|
$59,596.83
|
$45,028.71
|
2025-05-17
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
29
|
20
|
—
|
—
|
$42,777.94
|
$92,921.08
|
$44,916.84
|
2025-05-17
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
29
|
20
|
—
|
—
|
$42,629.59
|
$92,596.67
|
$44,761.07
|
2025-05-17
|
|
7924
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
7
|
7
|
—
|
—
|
$43,853.58
|
$45,143.40
|
$44,713.46
|
2025-05-17
|
|
J3357
|
HCPCS
|
Ustekinumab 45 Mg/0.5 Ml Subcutaneous Solution
|
156
|
41
|
$65,655.09
|
$49,241.32
25% off
|
$152.39
|
$123,129.76
|
$44,645.46
|
2025-05-17
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
29
|
20
|
—
|
—
|
$42,436.40
|
$92,174.17
|
$44,558.22
|
2025-05-17
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
29
|
20
|
—
|
—
|
$42,234.96
|
$91,733.58
|
$44,346.71
|
2025-05-17
|
|
J3245
|
HCPCS
|
Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe
|
88
|
41
|
$64,818.73
|
$48,614.05
25% off
|
$131.46
|
$58,336.86
|
$44,076.74
|
2025-05-17
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
29
|
20
|
—
|
—
|
$41,934.14
|
$91,075.70
|
$44,030.85
|
2025-05-17
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
29
|
20
|
—
|
—
|
$41,934.14
|
$91,075.70
|
$44,030.85
|
2025-05-17
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
29
|
20
|
—
|
—
|
$41,622.95
|
$90,395.18
|
$43,704.10
|
2025-05-17
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
7
|
7
|
—
|
—
|
$42,641.06
|
$43,895.21
|
$43,477.16
|
2025-05-17
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
29
|
20
|
—
|
—
|
$41,336.64
|
$89,768.99
|
$43,403.47
|
2025-05-17
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
29
|
20
|
—
|
—
|
$41,305.59
|
$89,701.09
|
$43,370.87
|
2025-05-17
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
29
|
20
|
—
|
—
|
$40,887.48
|
$88,786.69
|
$42,931.85
|
2025-05-17
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$41,958.67
|
$43,192.75
|
$42,781.39
|
2025-05-17
|
|
C2624
|
HCPCS
|
Delivery Sys, Cordella And Pulm Artery Sensor (ide G1900020)
|
108
|
41
|
$71,250.00
|
$53,437.50
25% off
|
$17,608.50
|
$64,125.00
|
$42,630.66
|
2025-05-17
|
|
C1824
|
HCPCS
|
Generator, Pulse, Optimizer Smart Ipg
|
69
|
41
|
$69,000.00
|
$51,750.00
25% off
|
$20,769.00
|
$62,100.00
|
$42,548.85
|
2025-05-17
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
29
|
20
|
—
|
—
|
$40,460.40
|
$87,852.68
|
$42,483.42
|
2025-05-17
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
7
|
7
|
—
|
—
|
$41,302.40
|
$42,517.18
|
$42,112.25
|
2025-05-17
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
7
|
7
|
—
|
—
|
$41,302.40
|
$42,517.18
|
$42,112.25
|
2025-05-17
|
|
8633
|
APR_DRG
|
Neonatal Aftercare
|
7
|
7
|
—
|
—
|
$41,232.19
|
$42,444.91
|
$42,040.67
|
2025-05-17
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
29
|
20
|
—
|
—
|
$39,888.44
|
$86,601.81
|
$41,882.86
|
2025-05-17
|
|
5931
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$41,044.35
|
$42,251.54
|
$41,849.14
|
2025-05-17
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$41,044.35
|
$42,251.54
|
$41,849.14
|
2025-05-17
|
|
0266T
|
CPT
|
Apc
|
20
|
18
|
—
|
—
|
$3,342.35
|
$75,091.07
|
$41,717.26
|
2025-05-17
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
29
|
20
|
—
|
—
|
$39,651.77
|
$86,084.25
|
$41,634.36
|
2025-05-17
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
7
|
7
|
—
|
—
|
$40,318.44
|
$41,504.27
|
$41,109.00
|
2025-05-17
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$40,243.28
|
$41,426.91
|
$41,032.37
|
2025-05-17
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$40,243.28
|
$41,426.91
|
$41,032.37
|
2025-05-17
|
|
6301
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
7
|
7
|
—
|
—
|
$40,133.32
|
$41,313.71
|
$40,920.25
|
2025-05-17
|
|
6302
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
7
|
7
|
—
|
—
|
$40,133.32
|
$41,313.71
|
$40,920.25
|
2025-05-17
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
29
|
20
|
—
|
—
|
$38,751.41
|
$84,115.14
|
$40,688.98
|
2025-05-17
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
29
|
20
|
—
|
—
|
$38,425.06
|
$83,401.43
|
$40,346.31
|
2025-05-17
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
29
|
20
|
—
|
—
|
$38,425.06
|
$83,401.43
|
$40,346.31
|
2025-05-17
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
29
|
20
|
—
|
—
|
$38,265.00
|
$83,051.36
|
$40,178.25
|
2025-05-17
|
|
2004
|
APR_DRG
|
Cardiac Structural And Valvular Disorders
|
7
|
7
|
—
|
—
|
$39,355.86
|
$40,513.39
|
$40,127.55
|
2025-05-17
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
29
|
20
|
—
|
—
|
$38,033.17
|
$82,544.37
|
$39,934.83
|
2025-05-17
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
7
|
7
|
—
|
—
|
$39,083.06
|
$40,232.57
|
$39,849.40
|
2025-05-17
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
29
|
20
|
—
|
—
|
$37,830.31
|
$82,100.76
|
$39,721.83
|
2025-05-17
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
29
|
20
|
—
|
—
|
$37,744.78
|
$81,913.65
|
$39,632.02
|
2025-05-17
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
7
|
7
|
—
|
—
|
$38,849.15
|
$39,991.77
|
$39,610.90
|
2025-05-17
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
29
|
20
|
—
|
—
|
$37,553.65
|
$81,495.69
|
$39,431.33
|
2025-05-17
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
29
|
20
|
—
|
—
|
$37,518.46
|
$81,418.74
|
$39,394.38
|
2025-05-17
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
29
|
20
|
—
|
—
|
$37,514.32
|
$81,409.68
|
$39,390.04
|
2025-05-17
|
|
1833
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
7
|
7
|
—
|
—
|
$38,569.59
|
$39,703.99
|
$39,325.85
|
2025-05-17
|
|
33367
|
CPT
|
Hc Cath Replace Aortic Valve W/byp Prq Art/venous Apprch
|
72
|
41
|
$57,653.00
|
$43,239.75
25% off
|
$2,071.52
|
$51,887.70
|
$39,204.04
|
2025-05-17
|
|
33364
|
CPT
|
Hc Cath Replace Aortic Valve Open Iliac Artery Approach
|
72
|
41
|
$57,653.00
|
$43,239.75
25% off
|
$2,071.52
|
$51,887.70
|
$39,204.04
|
2025-05-17
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
29
|
20
|
—
|
—
|
$36,996.18
|
$80,276.50
|
$38,845.99
|
2025-05-17
|
|
J9316
|
HCPCS
|
Pertuzumab 1,200 Mg-trastuzumab 600 Mg-hyaluron-zzxf/15 Ml Subcut Soln
|
122
|
41
|
$70,291.17
|
$52,718.38
25% off
|
$62.99
|
$63,262.05
|
$38,776.53
|
2025-05-17
|
|
L2006
|
HCPCS
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
19
|
18
|
—
|
—
|
$38,762.63
|
$69,772.73
|
$38,762.63
|
2025-05-17
|
|
J9321
|
HCPCS
|
Epcoritamab-bysp 48 Mg/0.8 Ml Subcutaneous Solution
|
122
|
41
|
$84,223.03
|
$63,167.28
25% off
|
$54.86
|
$75,800.73
|
$38,742.59
|
2025-05-17
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
29
|
20
|
—
|
—
|
$36,834.04
|
$79,921.91
|
$38,675.74
|
2025-05-17
|
|
33902
|
CPT
|
Hc Perq P-art Revsc St 1st Abnor Connj Unilateral
|
90
|
41
|
$56,767.00
|
$42,575.25
25% off
|
$2,227.38
|
$51,090.30
|
$38,601.56
|
2025-05-17
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
7
|
7
|
—
|
—
|
$37,548.47
|
$38,652.84
|
$38,284.72
|
2025-05-17
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
7
|
7
|
—
|
—
|
$37,307.80
|
$38,405.08
|
$38,039.32
|
2025-05-17
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
7
|
7
|
—
|
—
|
$37,242.14
|
$38,337.50
|
$37,972.38
|
2025-05-17
|
|
J9042
|
HCPCS
|
Brentuximab Vedotin 50 Mg/10 Ml IV Injection - Reconstituted 5 Mg/ml
|
88
|
41
|
$55,748.34
|
$41,811.26
25% off
|
$248.93
|
$50,173.51
|
$37,908.88
|
2025-05-17
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
7
|
7
|
—
|
—
|
$37,035.93
|
$38,125.23
|
$37,762.13
|
2025-05-17
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
7
|
7
|
—
|
—
|
$36,942.99
|
$38,029.55
|
$37,667.36
|
2025-05-17
|
|
6604
|
APR_DRG
|
Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…
|
7
|
7
|
—
|
—
|
$36,930.57
|
$38,016.76
|
$37,654.70
|
2025-05-17
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
29
|
20
|
—
|
—
|
$35,822.57
|
$77,709.86
|
$37,613.70
|
2025-05-17
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
29
|
20
|
—
|
—
|
$35,704.59
|
$77,451.84
|
$37,489.82
|
2025-05-17
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
29
|
20
|
—
|
—
|
$35,439.64
|
$76,872.42
|
$37,211.62
|
2025-05-17
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
7
|
7
|
—
|
—
|
$36,398.26
|
$37,468.80
|
$37,111.95
|
2025-05-17
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
29
|
20
|
—
|
—
|
$35,332.01
|
$76,637.03
|
$37,098.61
|
2025-05-17
|
|
J2329
|
HCPCS
|
Ublituximab-xiiy 25 Mg/ml Intravenous Solution
|
88
|
41
|
$54,394.88
|
$40,796.16
25% off
|
$68.66
|
$48,955.39
|
$36,988.51
|
2025-05-17
|
|
J0222
|
HCPCS
|
Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution
|
88
|
41
|
$54,127.53
|
$40,595.65
25% off
|
$99.04
|
$48,714.78
|
$36,806.72
|
2025-05-17
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
29
|
20
|
—
|
—
|
$35,041.55
|
$76,001.78
|
$36,793.63
|
2025-05-17
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
29
|
20
|
—
|
—
|
$34,836.63
|
$75,553.64
|
$36,578.46
|
2025-05-17
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
29
|
20
|
—
|
—
|
$34,809.72
|
$75,494.79
|
$36,550.21
|
2025-05-17
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
29
|
20
|
—
|
—
|
$34,795.93
|
$75,464.62
|
$36,535.73
|
2025-05-17
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
29
|
20
|
—
|
—
|
$34,671.73
|
$75,193.01
|
$36,405.32
|
2025-05-17
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
7
|
7
|
—
|
—
|
$35,700.30
|
$36,750.30
|
$36,400.30
|
2025-05-17
|
|
J9999
|
HCPCS
|
Dinutuximab 3.5 Mg/ml Intravenous Solution
|
71
|
41
|
$53,505.93
|
$40,129.45
25% off
|
$16,105.28
|
$48,155.34
|
$36,384.04
|
2025-05-17
|
|
J9119
|
HCPCS
|
Cemiplimab-rwlc 50 Mg/ml Intravenous Solution
|
88
|
41
|
$53,157.57
|
$39,868.18
25% off
|
$28.92
|
$47,841.81
|
$36,147.14
|
2025-05-17
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
29
|
20
|
—
|
—
|
$34,005.94
|
$73,736.93
|
$35,706.24
|
2025-05-17
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
7
|
7
|
—
|
—
|
$34,887.96
|
$35,914.07
|
$35,572.04
|
2025-05-17
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
7
|
7
|
—
|
—
|
$34,887.96
|
$35,914.07
|
$35,572.04
|
2025-05-17
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
29
|
20
|
—
|
—
|
$33,802.40
|
$73,291.80
|
$35,492.52
|
2025-05-17
|
|
6344
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
7
|
7
|
—
|
—
|
$34,786.71
|
$35,809.85
|
$35,468.80
|
2025-05-17
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
7
|
7
|
—
|
—
|
$34,784.03
|
$35,807.09
|
$35,466.07
|
2025-05-17
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
29
|
20
|
—
|
—
|
$33,746.53
|
$73,169.58
|
$35,433.86
|
2025-05-17
|
|
1832
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
7
|
7
|
—
|
—
|
$34,718.55
|
$35,739.68
|
$35,399.30
|
2025-05-17
|
|
0408T
|
CPT
|
Hc Insj/rplc Car Modulj Sys Pls Gen Transvns Eltrd
|
90
|
41
|
$52,041.00
|
$39,030.75
25% off
|
$1,232.00
|
$53,500.26
|
$35,387.88
|
2025-05-17
|
|
J1640
|
HCPCS
|
Hemin Intravenous Solution 350 Mg/50 Ml - Reconstituted 7 Mg/ml
|
88
|
41
|
$51,934.30
|
$38,950.73
25% off
|
$33.07
|
$46,740.87
|
$35,315.32
|
2025-05-17
|
|
6072
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$34,604.01
|
$35,621.78
|
$35,282.52
|
2025-05-17
|
|
6903
|
APR_DRG
|
Acute Leukemia
|
7
|
7
|
—
|
—
|
$34,573.85
|
$35,590.73
|
$35,251.77
|
2025-05-17
|
|
6224
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$34,384.37
|
$35,395.68
|
$35,058.58
|
2025-05-17
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
29
|
20
|
—
|
—
|
$33,238.03
|
$72,057.52
|
$34,899.93
|
2025-05-17
|
|
3032
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
7
|
7
|
—
|
—
|
$34,161.24
|
$35,165.98
|
$34,831.07
|
2025-05-17
|
|
J9153
|
HCPCS
|
Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution
|
88
|
41
|
$51,168.11
|
$38,376.09
25% off
|
$249.02
|
$46,051.30
|
$34,794.32
|
2025-05-17
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
29
|
20
|
—
|
—
|
$33,095.20
|
$71,745.18
|
$34,749.96
|
2025-05-17
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
29
|
20
|
—
|
—
|
$33,089.00
|
$71,731.60
|
$34,743.45
|
2025-05-17
|
|
J9203
|
HCPCS
|
Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln
|
88
|
41
|
$51,075.18
|
$38,306.39
25% off
|
$233.12
|
$45,967.66
|
$34,731.12
|
2025-05-17
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
7
|
7
|
—
|
—
|
$33,969.07
|
$34,968.16
|
$34,635.13
|
2025-05-17
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
7
|
7
|
—
|
—
|
$33,911.05
|
$34,908.44
|
$34,575.98
|
2025-05-17
|
|
1831
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
7
|
7
|
—
|
—
|
$33,766.63
|
$34,759.77
|
$34,428.72
|
2025-05-17
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
29
|
20
|
—
|
—
|
$32,749.54
|
$70,989.22
|
$34,387.02
|
2025-05-17
|
|
L8701
|
HCPCS
|
Ewh S/d Uprt Micro Sensor
|
18
|
18
|
—
|
—
|
$34,284.44
|
$61,711.99
|
$34,284.44
|
2025-05-17
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
29
|
20
|
—
|
—
|
$32,575.66
|
$70,608.98
|
$34,204.44
|
2025-05-17
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
7
|
7
|
—
|
—
|
$33,500.54
|
$34,485.85
|
$34,157.42
|
2025-05-17
|
|
0915T
|
CPT
|
Hc Insj Perm Ccm-d Sys Pg&dual Transvns Eltrds/lds
|
88
|
41
|
$50,016.00
|
$37,512.00
25% off
|
$1,232.00
|
$53,500.26
|
$34,010.88
|
2025-05-17
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
29
|
20
|
—
|
—
|
$32,385.25
|
$92,078.91
|
$34,004.51
|
2025-05-17
|
|
264
|
APR_DRG
|
Other Nervous System And Related Procedures
|
7
|
7
|
—
|
—
|
$33,278.12
|
$34,256.89
|
$33,930.63
|
2025-05-17
|
|
J2427
|
HCPCS
|
Paliperidone Palmitate (3 Month) 819 Mg/2.63 Ml Intramuscular Syringe
|
88
|
41
|
$49,881.54
|
$37,411.16
25% off
|
$12.67
|
$44,893.39
|
$33,919.45
|
2025-05-17
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
29
|
20
|
—
|
—
|
$32,090.63
|
$69,548.22
|
$33,695.16
|
2025-05-17
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
29
|
20
|
—
|
—
|
$32,077.53
|
$69,519.55
|
$33,681.41
|
2025-05-17
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
29
|
20
|
—
|
—
|
$31,976.10
|
$69,297.74
|
$33,574.91
|
2025-05-17
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
29
|
20
|
—
|
—
|
$31,971.28
|
$69,287.18
|
$33,569.84
|
2025-05-17
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
7
|
—
|
—
|
$32,749.53
|
$33,712.75
|
$33,391.68
|
2025-05-17
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
7
|
—
|
—
|
$32,749.53
|
$33,712.75
|
$33,391.68
|
2025-05-17
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
7
|
—
|
—
|
$32,749.53
|
$33,712.75
|
$33,391.68
|
2025-05-17
|
|
0571T
|
CPT
|
Hc Insj/rplcmt Icds W/substernal Electrode
|
90
|
41
|
$48,900.00
|
$36,675.00
25% off
|
$1,232.00
|
$61,770.60
|
$33,252.00
|
2025-05-17
|
|
234
|
APR_DRG
|
Spinal Procedures
|
7
|
7
|
—
|
—
|
$32,612.31
|
$33,571.49
|
$33,251.76
|
2025-05-17
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
7
|
7
|
—
|
—
|
$32,586.69
|
$33,545.13
|
$33,225.65
|
2025-05-17
|
|
J9037
|
HCPCS
|
Belantamab Mafodotin-blmf 100 Mg Intravenous Solution
|
68
|
39
|
$48,825.25
|
$36,618.94
25% off
|
$127.11
|
$43,942.73
|
$33,201.18
|
2025-05-17
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
7
|
7
|
—
|
—
|
$32,547.55
|
$33,504.83
|
$33,185.73
|
2025-05-17
|
|
1782
|
APR_DRG
|
External Heart Assist Systems
|
7
|
7
|
—
|
—
|
$32,547.55
|
$33,504.83
|
$33,185.73
|
2025-05-17
|
|
1781
|
APR_DRG
|
External Heart Assist Systems
|
7
|
7
|
—
|
—
|
$32,547.55
|
$33,504.83
|
$33,185.73
|
2025-05-17
|
|
J7314
|
HCPCS
|
Fluocinolone 0.18 Mg Intravitreal Implant
|
88
|
41
|
$48,734.16
|
$36,550.62
25% off
|
$524.57
|
$43,860.74
|
$33,139.22
|
2025-05-17
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
29
|
20
|
—
|
—
|
$31,417.25
|
$68,075.53
|
$32,988.11
|
2025-05-17
|
|
6123
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$32,226.87
|
$33,174.72
|
$32,858.77
|
2025-05-17
|
|
474
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
29
|
20
|
—
|
—
|
$31,231.66
|
$67,669.64
|
$32,793.24
|
2025-05-17
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
7
|
7
|
—
|
—
|
$32,121.53
|
$33,066.29
|
$32,751.37
|
2025-05-17
|
|
25
|
MS_DRG
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
29
|
20
|
—
|
—
|
$31,146.09
|
$71,373.85
|
$32,703.39
|
2025-05-17
|
|
901
|
MS_DRG
|
Wound Debridements For Injuries With Mcc
|
29
|
20
|
—
|
—
|
$30,857.68
|
$66,851.81
|
$32,400.56
|
2025-05-17
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
7
|
7
|
—
|
—
|
$31,640.85
|
$32,571.46
|
$32,261.26
|
2025-05-17
|