Hospital

FAIRVIEW HOSPITAL

Cleveland, OH · CCN 360077 · Rates published

32,496 distinct procedures filed

44 distinct payers

1,362,971 rate rows

2026-06-15 last MRF observed

Data quality

1,076,337 of 1,362,971 rate rows are consumer-grade (79.0%)

286,634 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	264,427
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	11,509
placeholder amount (≤ $0.02) — excluded from medians	9,162
exceeds 10× this hospital's gross charge — excluded from medians	711
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	403
per-diem day rate — not a per-procedure price	334
percent-of-charges filed in the dollar field — excluded from medians	82
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	6

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

Source MRF file	https://clevelandclinic.pt.panaceainc.com/MRFDownload/clevelandclinic/fairview
Found on page	https://my.clevelandclinic.org/patients/billing-finance/comprehensive-hospital-charges
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-08-14
Content fingerprint	ef41439ffa497886… · 18,134,459 bytes · first seen 2026-07-17

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
J3391 HCPCS	Inj, Atidarsagene Autotemcel	19	$9,152.59	$4,955,500.00	$4,505,000.00	nat. median $4,505,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	22	$14,814.63	$4,053,793.33	$3,672,900.00	nat. median $3,710,000 1.0× median
J3389 HCPCS	Topi Adm Prad Zami Per Treat	19	$9,152.59	$3,669,402.00	$3,335,820.00	nat. median $3,335,820 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	22	$14,814.63	$3,660,645.69	$3,326,657.24	nat. median $3,324,572 1.0× median
J3394 HCPCS	Lyfgenia 1.7 X To 20 X 10exp6 Cell/ml Intravenous Suspension	25	$2.17	$4,761,600.00	$3,252,508.07	nat. median $3,286,000 1.0× median
J3387 HCPCS	Inj Elivaldogene Autotemecel	19	$9,152.59	$3,498,000.00	$3,180,000.00	nat. median $3,180,000 1.0× median
J3393 HCPCS	Zynteglo 2 X 10exp6 To 20 X 10exp6 Cell/ml Intravenous Suspension	26	$2.17	$4,850,496.00	$2,968,000.00	nat. median $2,997,086 1.0× median
J3399 HCPCS	Zolgensma 2 X 10exp13 Vg/ml Intravenous Suspension Kit	33	$2.17	$4,972,500.00	$2,588,981.22	nat. median $2,460,273 1.1× median
J3392 HCPCS	Casgevy 4x10exp6 To 13x10exp6 Cell/ml Intravenous Suspension	27	$2.17	$4,403,520.00	$2,332,000.00	nat. median $2,405,851 1.0× median
Q2057 HCPCS	Tecelra 2.68x 10exp9 To 10x 10exp9 Cell Intravenous Suspension	43	$9,152.59	$3,489,600.00	$1,583,914.90	nat. median $809,151 2.0× median
Q205700 OTHER	Afamitresgene Autoleucel	1	$1,371,703.60	$1,371,703.60	$1,371,703.60	nat. median $1,371,704 1.0× median
C9301 HCPCS	Aucatzyl Intravenous Suspension	37	$9,152.59	$2,520,000.00	$1,312,920.00	nat. median $459,112 outlier · 2.9×
Q2042 HCPCS	Kymriah 0.2 X 10exp6 To 2.5 X 10exp8 Cell Intravenous Suspension	44	$2.17	$2,905,939.24	$1,255,564.30	nat. median $691,418 1.8× median
Q205600 OTHER	Ciltacabtagene Car-pos T	1	$1,046,016.23	$1,046,016.23	$1,046,016.23	nat. median $1,046,016 1.0× median
Q204200 OTHER	Tisagenlecleucel Car-pos T	1	$1,008,425.71	$1,008,425.71	$1,008,425.71	nat. median $1,008,426 1.0× median
Q205400 OTHER	Lisocabtagene Mara Car Pos T	1	$1,000,718.21	$1,000,718.21	$1,000,718.21	nat. median $1,000,718 1.0× median
Q205500 OTHER	Idecabtagene Vicleucel Car	1	$993,385.48	$993,385.48	$993,385.48	nat. median $993,385 1.0× median
Q2056 HCPCS	Carvykti 0.5x 10exp6 To 1x 10exp8 Cell Intravenous Suspension	44	$9,152.59	$2,665,490.12	$991,429.05	nat. median $631,793 1.6× median
Q2054 HCPCS	Breyanzi 1.5x To 70x10exp6 Cell/ml Intravenous Suspension	44	$2.17	$2,678,006.00	$954,575.24	nat. median $624,417 1.5× median
Q204100 OTHER	Axicabtagene Ciloleucel Car+	1	$947,302.19	$947,302.19	$947,302.19	nat. median $947,302 1.0× median
Q205300 OTHER	Brexucabtagene Car Pos T	1	$871,221.36	$871,221.36	$871,221.36	nat. median $871,221 1.0× median
Q2041 HCPCS	Yescarta Intravenous Suspension	44	$2.17	$2,417,184.00	$861,605.24	nat. median $588,565 1.5× median
Q2053 HCPCS	Tecartus 2x10exp6 To 2x10exp8 Cell Intravenous Suspension	44	$2.17	$2,217,600.00	$790,463.52	nat. median $577,541 1.4× median
005-P OTHER	Liver/Intestinal - Pediatric	1	$696,055.00	$696,055.00	$696,055.00	nat. median $696,055 1.0× median
005-A OTHER	Liver/Intestinal - Adult	1	$603,170.00	$603,170.00	$603,170.00	nat. median $603,170 1.0× median
005-I OTHER	Intestinal - Adult	2	$563,700.00	$563,700.00	$563,700.00	nat. median $563,700 1.0× median
006-LA OTHER	Liver (Live Donor) - Adult	3	$374,196.00	$561,500.00	$561,500.00	nat. median $561,500 1.0× median
005-LA OTHER	Liver (Live Donor) - Adult	2	$561,500.00	$561,500.00	$561,500.00	nat. median $561,500 1.0× median
Q205800 OTHER	Obecbtge Autol Up To 400 Mil	1	$560,700.00	$560,700.00	$560,700.00	nat. median $560,700 1.0× median
005-LP OTHER	Liver (Live Donor) - Pediatric	2	$560,500.00	$560,500.00	$560,500.00	nat. median $560,500 1.0× median
006-LP OTHER	Liver (Live Donor) - Pediatric	2	$560,500.00	$560,500.00	$560,500.00	nat. median $560,500 1.0× median
014-UP OTHER	Allogeneic Unrelated Bmt - Pediatric	1	$540,638.00	$540,638.00	$540,638.00	nat. median $540,638 1.0× median
001-P OTHER	Heart - Pediatric	1	$535,426.00	$535,426.00	$535,426.00	nat. median $338,586 1.6× median
005-DA OTHER	Liver (Deceased Donor) - Adult	2	$486,600.00	$486,600.00	$486,600.00	nat. median $486,600 1.0× median
006-DA OTHER	Liver (Deceased Donor) - Adult	3	$358,735.00	$486,600.00	$486,600.00	nat. median $486,600 1.0× median
014-U OTHER	Allogeneic Unrelated Bmt ? Adult & Pediatric	2	$481,200.00	$481,200.00	$481,200.00	nat. median $288,536 1.7× median
006-DP OTHER	Liver (Deceased Donor) -pediatric	2	$471,700.00	$471,700.00	$471,700.00	nat. median $471,700 1.0× median
005-DP OTHER	Liver (Deceased Donor) -pediatric	2	$471,700.00	$471,700.00	$471,700.00	nat. median $471,700 1.0× median
J340300 OTHER	Revakinagene, Per Implant	1	$471,700.00	$471,700.00	$471,700.00	nat. median $471,700 1.0× median
006-P OTHER	Liver (Live & Deceased Donor) - Pediatric	1	$449,447.00	$449,447.00	$449,447.00	nat. median $449,447 1.0× median
002-P OTHER	Heart - Pediatric	3	$444,900.00	$535,426.00	$444,900.00	nat. median $357,576 1.2× median
003-P OTHER	Heart - Pediatric	2	$444,900.00	$444,900.00	$444,900.00	nat. median $444,900 1.0× median
014-RP OTHER	Allogeneic Related Bmt - Pediatric	1	$440,327.00	$440,327.00	$440,327.00	nat. median $440,327 1.0× median
007-D OTHER	Lung (Double) - Adult	3	$433,900.00	$479,141.00	$433,900.00	nat. median $433,900 1.0× median
014-UA OTHER	Allogeneic Unrelated Bmt - Adult	1	$430,092.00	$430,092.00	$430,092.00	nat. median $430,092 1.0× median
007-S OTHER	Lung (Single) - Adult	3	$428,300.00	$451,839.00	$428,300.00	nat. median $428,300 1.0× median
014-R OTHER	Allogeneic Related Bmt ? Adult & Pediatric	2	$428,000.00	$428,000.00	$428,000.00	nat. median $403,789 1.1× median
J3402 HCPCS	Ryoncil 6.68 X 10exp6 Cell/ml Intravenous Suspension	43	$2.17	$931,200.00	$391,104.00	nat. median $209,736 1.9× median
014-RA OTHER	Allogeneic Related Bmt - Adult	1	$366,514.00	$366,514.00	$366,514.00	nat. median $366,514 1.0× median
001-A OTHER	Heart - Adult	4	$36,400.00	$446,380.00	$361,500.00	nat. median $333,282 1.1× median

Other procedures at this hospital

Browse this hospital's 32,496 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J3391	HCPCS	Inj, Atidarsagene Autotemcel	20	19	—	—	$9,152.59	$4,955,500.00	$4,505,000.00	2026-06-15
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	28	22	—	—	$14,814.63	$4,053,793.33	$3,672,900.00	2026-06-15
J3389	HCPCS	Topi Adm Prad Zami Per Treat	20	19	—	—	$9,152.59	$3,669,402.00	$3,335,820.00	2026-06-15
J1413	HCPCS	Inj Delandistrogene Mox Rokl	28	22	—	—	$14,814.63	$3,660,645.69	$3,326,657.24	2026-06-15
J3394	HCPCS	Lyfgenia 1.7 X To 20 X 10exp6 Cell/ml Intravenous Suspension	32	25	—	—	$2.17	$4,761,600.00	$3,252,508.07	2026-06-15
J3387	HCPCS	Inj Elivaldogene Autotemecel	20	19	—	—	$9,152.59	$3,498,000.00	$3,180,000.00	2026-06-15
J3393	HCPCS	Zynteglo 2 X 10exp6 To 20 X 10exp6 Cell/ml Intravenous Suspension	36	26	—	—	$2.17	$4,850,496.00	$2,968,000.00	2026-06-15
J3399	HCPCS	Zolgensma 2 X 10exp13 Vg/ml Intravenous Suspension Kit	56	33	—	$4,972,500.00	$2.17	$4,972,500.00	$2,588,981.22	2026-06-15
J3392	HCPCS	Casgevy 4x10exp6 To 13x10exp6 Cell/ml Intravenous Suspension	38	27	—	—	$2.17	$4,403,520.00	$2,332,000.00	2026-06-15
Q2057	HCPCS	Tecelra 2.68x 10exp9 To 10x 10exp9 Cell Intravenous Suspension	64	43	$3,489,600.00	$2,268,240.00 35% off	$9,152.59	$3,489,600.00	$1,583,914.90	2026-06-15
Q205700	OTHER	Afamitresgene Autoleucel	1	1	—	—	$1,371,703.60	$1,371,703.60	$1,371,703.60	2026-06-15
C9301	HCPCS	Aucatzyl Intravenous Suspension	53	37	$2,520,000.00	$1,638,000.00 35% off	$9,152.59	$2,520,000.00	$1,312,920.00	2026-06-15
Q2042	HCPCS	Kymriah 0.2 X 10exp6 To 2.5 X 10exp8 Cell Intravenous Suspension	108	44	$2,905,939.24	$1,888,860.51 35% off	$2.17	$2,905,939.24	$1,255,564.30	2026-06-15
Q205600	OTHER	Ciltacabtagene Car-pos T	1	1	—	—	$1,046,016.23	$1,046,016.23	$1,046,016.23	2026-06-15
Q204200	OTHER	Tisagenlecleucel Car-pos T	1	1	—	—	$1,008,425.71	$1,008,425.71	$1,008,425.71	2026-06-15
Q205400	OTHER	Lisocabtagene Mara Car Pos T	1	1	—	—	$1,000,718.21	$1,000,718.21	$1,000,718.21	2026-06-15
Q205500	OTHER	Idecabtagene Vicleucel Car	1	1	—	—	$993,385.48	$993,385.48	$993,385.48	2026-06-15
Q2056	HCPCS	Carvykti 0.5x 10exp6 To 1x 10exp8 Cell Intravenous Suspension	72	44	$2,665,490.12	$1,732,568.58 35% off	$9,152.59	$2,665,490.12	$991,429.05	2026-06-15
Q2054	HCPCS	Breyanzi 1.5x To 70x10exp6 Cell/ml Intravenous Suspension	72	44	$2,678,006.00	$1,740,703.90 35% off	$2.17	$2,678,006.00	$954,575.24	2026-06-15
Q204100	OTHER	Axicabtagene Ciloleucel Car+	1	1	—	—	$947,302.19	$947,302.19	$947,302.19	2026-06-15
Q205300	OTHER	Brexucabtagene Car Pos T	1	1	—	—	$871,221.36	$871,221.36	$871,221.36	2026-06-15
Q2041	HCPCS	Yescarta Intravenous Suspension	72	44	$2,417,184.00	$1,571,169.60 35% off	$2.17	$2,417,184.00	$861,605.24	2026-06-15
Q2053	HCPCS	Tecartus 2x10exp6 To 2x10exp8 Cell Intravenous Suspension	72	44	$2,217,600.00	$1,441,440.00 35% off	$2.17	$2,217,600.00	$790,463.52	2026-06-15
005-P	OTHER	Liver/Intestinal - Pediatric	1	1	—	—	$696,055.00	$696,055.00	$696,055.00	2026-06-15
005-A	OTHER	Liver/Intestinal - Adult	1	1	—	—	$603,170.00	$603,170.00	$603,170.00	2026-06-15
005-I	OTHER	Intestinal - Adult	2	2	—	—	$563,700.00	$563,700.00	$563,700.00	2026-06-15
006-LA	OTHER	Liver (Live Donor) - Adult	3	3	—	—	$374,196.00	$561,500.00	$561,500.00	2026-06-15
005-LA	OTHER	Liver (Live Donor) - Adult	2	2	—	—	$561,500.00	$561,500.00	$561,500.00	2026-06-15
Q205800	OTHER	Obecbtge Autol Up To 400 Mil	1	1	—	—	$560,700.00	$560,700.00	$560,700.00	2026-06-15
006-LP	OTHER	Liver (Live Donor) - Pediatric	2	2	—	—	$560,500.00	$560,500.00	$560,500.00	2026-06-15
005-LP	OTHER	Liver (Live Donor) - Pediatric	2	2	—	—	$560,500.00	$560,500.00	$560,500.00	2026-06-15
014-UP	OTHER	Allogeneic Unrelated Bmt - Pediatric	1	1	—	—	$540,638.00	$540,638.00	$540,638.00	2026-06-15
001-P	OTHER	Heart - Pediatric	1	1	—	—	$535,426.00	$535,426.00	$535,426.00	2026-06-15
006-DA	OTHER	Liver (Deceased Donor) - Adult	3	3	—	—	$358,735.00	$486,600.00	$486,600.00	2026-06-15
005-DA	OTHER	Liver (Deceased Donor) - Adult	2	2	—	—	$486,600.00	$486,600.00	$486,600.00	2026-06-15
014-U	OTHER	Allogeneic Unrelated Bmt ? Adult & Pediatric	2	2	—	—	$481,200.00	$481,200.00	$481,200.00	2026-06-15
006-DP	OTHER	Liver (Deceased Donor) -pediatric	2	2	—	—	$471,700.00	$471,700.00	$471,700.00	2026-06-15
005-DP	OTHER	Liver (Deceased Donor) -pediatric	2	2	—	—	$471,700.00	$471,700.00	$471,700.00	2026-06-15
J340300	OTHER	Revakinagene, Per Implant	1	1	—	—	$471,700.00	$471,700.00	$471,700.00	2026-06-15
006-P	OTHER	Liver (Live & Deceased Donor) - Pediatric	1	1	—	—	$449,447.00	$449,447.00	$449,447.00	2026-06-15
003-P	OTHER	Heart - Pediatric	2	2	—	—	$444,900.00	$444,900.00	$444,900.00	2026-06-15
002-P	OTHER	Heart - Pediatric	3	3	—	—	$444,900.00	$535,426.00	$444,900.00	2026-06-15
014-RP	OTHER	Allogeneic Related Bmt - Pediatric	1	1	—	—	$440,327.00	$440,327.00	$440,327.00	2026-06-15
007-D	OTHER	Lung (Double) - Adult	3	3	—	—	$433,900.00	$479,141.00	$433,900.00	2026-06-15
014-UA	OTHER	Allogeneic Unrelated Bmt - Adult	1	1	—	—	$430,092.00	$430,092.00	$430,092.00	2026-06-15
007-S	OTHER	Lung (Single) - Adult	3	3	—	—	$428,300.00	$451,839.00	$428,300.00	2026-06-15
014-R	OTHER	Allogeneic Related Bmt ? Adult & Pediatric	2	2	—	—	$428,000.00	$428,000.00	$428,000.00	2026-06-15
J3402	HCPCS	Ryoncil 6.68 X 10exp6 Cell/ml Intravenous Suspension	65	43	$931,200.00	$605,280.00 35% off	$2.17	$931,200.00	$391,104.00	2026-06-15
014-RA	OTHER	Allogeneic Related Bmt - Adult	1	1	—	—	$366,514.00	$366,514.00	$366,514.00	2026-06-15
002-A	OTHER	Heart - Adult	3	3	—	—	$361,500.00	$446,380.00	$361,500.00	2026-06-15
001-A	OTHER	Heart - Adult	4	4	—	—	$36,400.00	$446,380.00	$361,500.00	2026-06-15
J340200	OTHER	Inj. Remestemcel-l-rknd/ Td	1	1	—	—	$358,970.86	$358,970.86	$358,970.86	2026-06-15
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	28	18	—	—	$273,587.23	$720,202.74	$332,135.10	2026-06-15
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	23	20	—	—	$9,152.59	$802,584.30	$278,250.00	2026-06-15
J0225	HCPCS	Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe	74	44	$859,327.20	$558,562.68 35% off	$2.17	$859,327.20	$274,984.70	2026-06-15
J3403	HCPCS	Revakinagene, Per Implant	23	20	—	—	$9,152.59	$764,366.00	$265,000.00	2026-06-15
017-P	OTHER	Autologous Bmt - Pediatric	1	1	—	—	$247,521.00	$247,521.00	$247,521.00	2026-06-15
016-P	OTHER	Autologous Bmt - Pediatric	1	1	—	—	$247,521.00	$247,521.00	$247,521.00	2026-06-15
5884	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	9	9	—	—	$211,451.76	$225,822.27	$219,663.48	2026-06-15
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	28	18	—	—	$204,464.23	$467,382.60	$215,756.63	2026-06-15
5834	APR_DRG	Neonate With Ecmo	9	9	—	—	$204,548.30	$218,449.64	$212,491.92	2026-06-15
5833	APR_DRG	Neonate With Ecmo	9	9	—	—	$204,548.30	$218,449.64	$212,491.92	2026-06-15
016-A	OTHER	Autologous Bmt - Adult	1	1	—	—	$205,695.00	$205,695.00	$205,695.00	2026-06-15
017-A	OTHER	Autologous Bmt - Adult	1	1	—	—	$205,695.00	$205,695.00	$205,695.00	2026-06-15
5831	APR_DRG	Neonate With Ecmo	9	9	—	—	$194,567.34	$207,790.36	$202,123.35	2026-06-15
5832	APR_DRG	Neonate With Ecmo	9	9	—	—	$194,567.34	$207,790.36	$202,123.35	2026-06-15
652-C	OTHER	Kidney Transplant - Cadaveric	1	1	—	—	$185,100.00	$185,100.00	$185,100.00	2026-06-15
651-C	OTHER	Kidney Transplant With Hemodialysis Without Mcc - Cadaveric	1	1	—	—	$185,100.00	$185,100.00	$185,100.00	2026-06-15
650-C	OTHER	Kidney Transplant With Hemodialysis With Mcc - Cadaveric	1	1	—	—	$185,100.00	$185,100.00	$185,100.00	2026-06-15
1614	APR_DRG	Implantable Heart Assist Systems	9	9	—	—	$172,141.08	$183,839.99	$178,826.17	2026-06-15
652-P	OTHER	Kidney (Deceased & Live Donor) - Pediatric	1	1	—	—	$175,870.00	$175,870.00	$175,870.00	2026-06-15
651-P	OTHER	Kidney (Deceased & Live Donor) - Pediatric	1	1	—	—	$175,870.00	$175,870.00	$175,870.00	2026-06-15
650-P	OTHER	Kidney (Deceased & Live Donor) - Pediatric	1	1	—	—	$175,870.00	$175,870.00	$175,870.00	2026-06-15
651-D	OTHER	Kidney (Deceased) - Adult & Pediatric	2	2	—	—	$175,300.00	$175,300.00	$175,300.00	2026-06-15
652-D	OTHER	Kidney (Deceased) - Adult & Pediatric	2	2	—	—	$175,300.00	$175,300.00	$175,300.00	2026-06-15
650-D	OTHER	Kidney (Deceased) - Adult & Pediatric	2	2	—	—	$175,300.00	$175,300.00	$175,300.00	2026-06-15
650-LD	OTHER	Kidney Transplant With Hemodialysis With Mcc - Live Donor	1	1	—	—	$170,100.00	$170,100.00	$170,100.00	2026-06-15
651-LD	OTHER	Kidney Transplant With Hemodialysis Without Mcc - Live Donor	1	1	—	—	$170,100.00	$170,100.00	$170,100.00	2026-06-15
652-LD	OTHER	Kidney Transplant - Live Donor	1	1	—	—	$170,100.00	$170,100.00	$170,100.00	2026-06-15
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	28	18	—	—	$162,091.98	$356,083.64	$166,954.74	2026-06-15
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	29	19	—	—	$10,732.00	$401,113.00	$161,144.23	2026-06-15
651-L	OTHER	Kidney ( Live Donor) - Adult & Pediatric	2	2	—	—	$161,100.00	$161,100.00	$161,100.00	2026-06-15
650-L	OTHER	Kidney ( Live Donor) - Adult & Pediatric	2	2	—	—	$161,100.00	$161,100.00	$161,100.00	2026-06-15
652-L	OTHER	Kidney (Live Donor) - Adult & Pediatric	2	2	—	—	$161,100.00	$161,100.00	$161,100.00	2026-06-15
652-A	OTHER	Kidney (Deceased & Live Donor) - Adult	1	1	—	—	$158,573.00	$158,573.00	$158,573.00	2026-06-15
650-A	OTHER	Kidney (Deceased & Live Donor) - Adult	1	1	—	—	$158,573.00	$158,573.00	$158,573.00	2026-06-15
651-A	OTHER	Kidney (Deceased & Live Donor) - Adult	1	1	—	—	$158,573.00	$158,573.00	$158,573.00	2026-06-15
24	APR_DRG	Heart And/or Lung Transplant	9	9	—	—	$151,395.83	$161,684.86	$157,275.28	2026-06-15
J733000	OTHER	Cultured Chondrocytes Implnt	1	1	—	—	$149,032.28	$149,032.28	$149,032.28	2026-06-15
A954300	OTHER	Y90 Ibritumomab, Rx	1	1	—	—	$144,835.13	$144,835.13	$144,835.13	2026-06-15
6094	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	9	9	—	—	$135,620.30	$144,837.21	$140,887.10	2026-06-15
1612	APR_DRG	Implantable Heart Assist Systems	9	9	—	—	$133,224.64	$142,278.74	$138,398.41	2026-06-15
1613	APR_DRG	Implantable Heart Assist Systems	9	9	—	—	$133,224.64	$142,278.74	$138,398.41	2026-06-15
1611	APR_DRG	Implantable Heart Assist Systems	9	9	—	—	$133,224.64	$142,278.74	$138,398.41	2026-06-15
6304	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	9	9	—	—	$131,618.48	$140,563.42	$136,729.88	2026-06-15
74	APR_DRG	Allogeneic Bone Marrow Transplant	9	9	—	—	$129,415.07	$138,210.27	$134,440.90	2026-06-15
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft	9	9	—	—	$120,464.05	$128,650.93	$125,142.27	2026-06-15
8412	APR_DRG	Extensive Third Degree Burns With Skin Graft	9	9	—	—	$120,464.05	$128,650.93	$125,142.27	2026-06-15
8411	APR_DRG	Extensive Third Degree Burns With Skin Graft	9	9	—	—	$120,464.05	$128,650.93	$125,142.27	2026-06-15
8413	APR_DRG	Extensive Third Degree Burns With Skin Graft	9	9	—	—	$120,464.05	$128,650.93	$125,142.27	2026-06-15
6314	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	9	9	—	—	$116,177.19	$124,072.73	$120,688.93	2026-06-15
J902900	OTHER	Instill Adstiladrin, Tx Dose	1	1	—	—	$114,409.13	$114,409.13	$114,409.13	2026-06-15
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	9	9	—	—	$106,815.53	$114,074.84	$110,963.71	2026-06-15
5881	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	9	9	—	—	$101,603.33	$108,508.41	$105,549.09	2026-06-15
5882	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	9	9	—	—	$101,603.33	$108,508.41	$105,549.09	2026-06-15
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	29	19	—	—	$10,732.00	$213,976.43	$105,370.43	2026-06-15
9028800	OTHER	Botulism Ig IV	1	1	—	—	$104,850.90	$104,850.90	$104,850.90	2026-06-15
J9028	HCPCS	Anktiva 400 Mcg/0.4 Ml Intravesical Solution	73	43	$322,200.00	$209,430.00 35% off	$2.17	$322,200.00	$103,104.00	2026-06-15
5934	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	9	9	—	—	$98,465.34	$105,157.16	$102,289.24	2026-06-15
7	MS_DRG	Lung Transplant	29	19	—	—	$26,000.00	$215,983.44	$98,553.95	2026-06-15
A9699	HCPCS	Radiopharm Rx Agent Noc	1	1	—	—	$97,225.26	$97,225.26	$97,225.26	2026-06-15
Q204300	OTHER	Sipuleucel-t Auto Cd54+	1	1	—	—	$96,839.32	$96,839.32	$96,839.32	2026-06-15
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	9	9	—	—	$91,409.63	$97,621.93	$94,959.51	2026-06-15
14	MS_DRG	Allogeneic Bone Marrow Transplant	30	20	—	—	$12,900.00	$254,000.00	$94,247.31	2026-06-15
J2779	HCPCS	Susvimo 10 Mg/0.1 Ml Intravitreal Solution	74	44	$288,000.00	$187,200.00 35% off	$2.17	$288,000.00	$92,160.00	2026-06-15
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	28	18	—	—	$80,270.97	$188,991.76	$87,607.42	2026-06-15
209	MS_DRG	Complex Aortic Arch Procedures	21	17	—	—	$86,214.40	$200,761.56	$86,214.40	2026-06-15
64654	HCPCS	Initial Open Implantation Bat Modulation System	62	43	$180,002.00	$117,001.30 35% off	$964.31	$180,002.00	$84,240.93	2026-06-15
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	28	18	—	—	$17,737.00	$136,387.35	$83,963.42	2026-06-15
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	28	18	—	—	$12,225.00	$181,358.24	$82,850.79	2026-06-15
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	29	19	—	—	$27,200.00	$171,958.52	$78,587.84	2026-06-15
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	2	1	—	—	$72,104.19	$84,832.51	$78,468.35	2026-06-15
215	MS_DRG	Other Heart Assist System Implant	28	18	—	—	$75,914.05	$166,062.85	$77,692.61	2026-06-15
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	9	9	—	—	$74,683.11	$79,758.66	$77,583.42	2026-06-15
J922600	OTHER	Supprelin La Implant	1	1	—	—	$76,869.91	$76,869.91	$76,869.91	2026-06-15
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	29	19	—	—	$12,225.00	$283,600.00	$74,596.43	2026-06-15
C9293	HCPCS	Voraxaze 1000 Unit Intravenous Solution	66	43	$155,638.80	$101,165.22 35% off	$448.69	$155,638.80	$72,838.96	2026-06-15
27879075_IP	CDM	Tavr Device Kit	1	1	$105,000.00	$68,250.00 35% off	$70,245.00	$70,245.00	$70,245.00	2026-06-15
6024	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	9	9	—	—	$67,394.13	$71,974.31	$70,011.37	2026-06-15
21	APR_DRG	Heart And/or Lung Transplant	9	9	—	—	$67,106.52	$71,667.16	$69,712.60	2026-06-15
22	APR_DRG	Heart And/or Lung Transplant	9	9	—	—	$67,106.52	$71,667.16	$69,712.60	2026-06-15
23	APR_DRG	Heart And/or Lung Transplant	9	9	—	—	$67,106.52	$71,667.16	$69,712.60	2026-06-15
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	9	9	—	—	$66,998.86	$71,552.18	$69,600.76	2026-06-15
6074	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	9	9	—	—	$66,651.79	$71,181.53	$69,240.21	2026-06-15
001-C	OTHER	Deep Brain Stimulation Bilateral	1	1	—	—	$69,100.00	$69,100.00	$69,100.00	2026-06-15
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	28	18	—	—	$17,737.00	$111,493.80	$68,748.12	2026-06-15
J9226	HCPCS	Supprelin La 50 Mg (65 Mcg/day) Implant Kit	74	44	$180,653.82	$117,424.98 35% off	$2.17	$180,653.82	$67,194.18	2026-06-15
27879075_OP	CDM	Tavr Device Kit	1	1	$105,000.00	$68,250.00 35% off	$66,675.00	$66,675.00	$66,675.00	2026-06-15
850	MS_DRG	Acute Leukemia With Other Procedures	28	18	—	—	$48,143.00	$144,423.14	$66,100.04	2026-06-15
73	APR_DRG	Allogeneic Bone Marrow Transplant	9	9	—	—	$63,161.61	$67,454.15	$65,614.49	2026-06-15
27882225_IP	CDM	Sapien 3 Transcatheter Heart Valve	1	1	$97,500.00	$63,375.00 35% off	$65,227.50	$65,227.50	$65,227.50	2026-06-15
J9274	HCPCS	Kimmtrak 100 Mcg/0.5 Ml Intravenous Solution	74	44	$201,504.00	$130,977.60 35% off	$2.17	$201,504.00	$64,481.28	2026-06-15
231	MS_DRG	Coronary Bypass With Ptca With Mcc	28	18	—	—	$17,737.00	$104,320.01	$64,363.40	2026-06-15
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	29	19	—	—	$12,225.00	$212,600.00	$64,162.96	2026-06-15
5933	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	9	9	—	—	$61,611.84	$65,799.05	$64,004.53	2026-06-15
A9543	HCPCS	Zevalin (y-90) 3.2 Mg/2 Ml Intravenous Kit	74	44	$148,248.86	$96,361.76 35% off	$14,774.74	$163,904.70	$63,991.79	2026-06-15
44	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	9	9	—	—	$60,843.37	$64,978.35	$63,206.22	2026-06-15
27882225_OP	CDM	Sapien 3 Transcatheter Heart Valve	1	1	$97,500.00	$63,375.00 35% off	$61,912.50	$61,912.50	$61,912.50	2026-06-15
0452T	OTHER	Insj/rplcmt Dev Vasc Seal	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
0453T	OTHER	Insj/rplcmt Mech-elec Ntrfce	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
0454T	OTHER	Insj/rplcmt Subq Electrode	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
33991	HCPCS	Insj Perq Vad L Hrt Artl&ven	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
33983	HCPCS	Replace Vad Intra W/bp	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
33981	HCPCS	Replace Vad Pump Ext	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
0459T	OTHER	Relocaj Rplcmt Aortic Ventr	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
33982	HCPCS	Replace Vad Intra Without Bp	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
33975	HCPCS	Implant Ventricular Device	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
33976	HCPCS	Implant Ventricular Device	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
33979	HCPCS	Insert Intracorporeal Device	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
0451T	OTHER	Insj/rplcmt Aortic Ventr Sys	9	9	—	—	$55,880.23	$64,703.42	$61,762.35	2026-06-15
27879075	CDM	Tavr Device Kit	43	30	$105,000.00	$68,250.00 35% off	$16,317.00	$105,000.00	$60,511.50	2026-06-15
6303	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	9	9	—	—	$58,137.04	$62,088.10	$60,394.79	2026-06-15
27881015_IP	CDM	Mitraclip System	1	1	$90,000.00	$58,500.00 35% off	$60,210.00	$60,210.00	$60,210.00	2026-06-15
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	29	19	—	—	$12,225.00	$289,300.00	$60,119.36	2026-06-15
8504	APR_DRG	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	9	9	—	—	$57,322.43	$61,218.12	$59,548.54	2026-06-15
38240	HCPCS	Trnsplj Allogeneic Hematopoietic Cells Per Donor	70	44	$131,220.00	$85,293.00 35% off	$364.10	$172,636.49	$59,509.30	2026-06-15
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	28	18	—	—	$54,521.39	$127,084.69	$59,110.28	2026-06-15
6334	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Anomaly	9	9	—	—	$56,683.65	$60,535.94	$58,884.96	2026-06-15
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	29	19	—	—	$12,225.00	$193,600.00	$58,678.46	2026-06-15
233	MS_DRG	Coronary Bypass With Cardiac Catheterization With Mcc	29	19	—	—	$22,852.00	$217,200.00	$58,428.10	2026-06-15
J9248	HCPCS	Hepzato (62 Mm Catheter) 50 Mg Intra-arterial Solution	74	44	$181,536.00	$117,998.40 35% off	$2.17	$181,536.00	$58,091.52	2026-06-15
3034	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	9	9	—	—	$55,584.52	$59,362.11	$57,743.14	2026-06-15
8514	APR_DRG	Gender Related Procedures	9	9	—	—	$55,474.30	$59,244.39	$57,628.64	2026-06-15
10	MS_DRG	Pancreas Transplant	33	22	—	—	$10,700.00	$240,800.00	$57,620.75	2026-06-15
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	31	20	—	—	$54,566.03	$292,000.00	$57,294.33	2026-06-15
6093	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	9	9	—	—	$55,119.53	$58,865.52	$57,260.10	2026-06-15
27881015_OP	CDM	Mitraclip System	1	1	$90,000.00	$58,500.00 35% off	$57,150.00	$57,150.00	$57,150.00	2026-06-15
6023	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	9	9	—	—	$54,484.86	$58,187.71	$56,600.77	2026-06-15
27882225	CDM	Sapien 3 Transcatheter Heart Valve	43	30	$97,500.00	$63,375.00 35% off	$15,151.50	$97,500.00	$56,189.25	2026-06-15
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	28	18	—	—	$48,834.11	$119,626.29	$55,677.02	2026-06-15
14	APR_DRG	Liver Transplant And/or Intestinal Transplant	9	9	—	—	$53,400.59	$57,029.75	$55,474.40	2026-06-15
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	29	19	—	—	$17,737.00	$269,394.00	$55,201.39	2026-06-15
37289	HCPCS	Revsc Evasc Tpvt Athrc Uni Sf Les Ea Addl Vsl	52	37	$107,690.00	$69,998.50 35% off	$382.05	$107,690.00	$54,975.74	2026-06-15
37285	HCPCS	Revsc Evasc Tpvt St Plmt Uni Sf Les Ea Addl Vsl	52	37	$107,690.00	$69,998.50 35% off	$270.05	$107,690.00	$54,975.74	2026-06-15
37291	HCPCS	Revsc Evasc Tpvt Athrc Uni Cplx Les Ea Addl Vsl	52	37	$107,690.00	$69,998.50 35% off	$522.15	$107,690.00	$54,975.74	2026-06-15
37278	HCPCS	Revsc Evsc Fpvt St Athrc Uni Cplx Les Ea Add Vsl	52	37	$107,690.00	$69,998.50 35% off	$480.27	$107,690.00	$54,975.74	2026-06-15
37276	HCPCS	Revsc Evasc Fpvt St Athrc Uni Sf Les Ea Addl Vsl	52	37	$107,690.00	$69,998.50 35% off	$340.87	$107,690.00	$54,975.74	2026-06-15
37272	HCPCS	Revsc Evasc Fpvt Athrc Uni Sf Les Ea Addl Vsl	52	37	$107,690.00	$69,998.50 35% off	$321.54	$107,690.00	$54,975.74	2026-06-15
37274	HCPCS	Revsc Evasc Fpvt Athrc Uni Cplx Les Ea Addl Vsl	52	37	$107,690.00	$69,998.50 35% off	$442.64	$107,690.00	$54,975.74	2026-06-15
37287	HCPCS	Revsc Evasc Tpvt St Plmt Uni Cplx Les Ea Add Vsl	52	37	$107,690.00	$69,998.50 35% off	$405.26	$107,690.00	$54,975.74	2026-06-15
37293	HCPCS	Revsc Evasc Tpvt St Athrc Uni Sf Les Ea Addl Vsl	52	37	$107,690.00	$69,998.50 35% off	$530.63	$107,690.00	$54,975.74	2026-06-15
37295	HCPCS	Revsc Evsc Tpvt St Athrc Uni Cplx Les Ea Add Vsl	52	37	$107,690.00	$69,998.50 35% off	$667.53	$107,690.00	$54,975.74	2026-06-15
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	28	18	—	—	$12,225.00	$88,238.70	$54,534.26	2026-06-15
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	29	19	—	—	$50,844.54	$194,500.00	$54,467.24	2026-06-15
6092	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	9	9	—	—	$52,429.62	$55,992.79	$54,465.72	2026-06-15
6091	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	9	9	—	—	$52,429.62	$55,992.79	$54,465.72	2026-06-15
6114	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	9	9	—	—	$52,250.69	$55,801.71	$54,279.85	2026-06-15
J2777	HCPCS	Vabysmo 6 Mg/0.05 Ml Intravitreal Solution	74	44	$168,976.08	$109,834.45 35% off	$2.17	$168,976.08	$54,072.35	2026-06-15
6214	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	9	9	—	—	$51,306.89	$54,793.76	$53,299.39	2026-06-15
27880805	CDM	Pascal Precision Ace Implant System	45	31	$91,800.00	$59,670.00 35% off	$14,265.72	$91,800.00	$52,904.34	2026-06-15
27882245	CDM	Pascal Precision Transcatheter Valve System	45	31	$91,800.00	$59,670.00 35% off	$14,265.72	$91,800.00	$52,904.34	2026-06-15
84	APR_DRG	Autologous Bone Marrow Transplant	9	9	—	—	$50,687.60	$54,132.39	$52,656.05	2026-06-15
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	28	18	—	—	$12,225.00	$150,790.00	$52,624.41	2026-06-15
5913	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	9	9	—	—	$50,635.82	$54,077.09	$52,602.26	2026-06-15
72	APR_DRG	Allogeneic Bone Marrow Transplant	9	9	—	—	$50,561.48	$53,997.70	$52,525.04	2026-06-15
71	APR_DRG	Allogeneic Bone Marrow Transplant	9	9	—	—	$50,561.48	$53,997.70	$52,525.04	2026-06-15
J3357	HCPCS	Stelara 45 Mg/0.5 Ml Subcutaneous Solution	109	39	$104,945.34	$68,214.47 35% off	$2.17	$104,945.34	$52,472.63	2026-06-15
955	MS_DRG	Craniotomy For Multiple Significant Trauma	28	18	—	—	$49,916.09	$112,261.29	$52,286.76	2026-06-15
8424	APR_DRG	Burns With Skin Graft Except Extensive Third Degree Burns	9	9	—	—	$50,297.98	$53,716.29	$52,251.30	2026-06-15
92930	HCPCS	Perq Tcat Plmt Ntrac St 2+les 2+st 2+c Segments	62	43	$129,228.00	$83,998.20 35% off	$950.74	$129,228.00	$52,100.26	2026-06-15
27881015	CDM	Mitraclip System	43	30	$90,000.00	$58,500.00 35% off	$13,986.00	$90,000.00	$51,867.00	2026-06-15
J9269	HCPCS	Elzonris 1000 Mcg/ml Intravenous Solution	74	44	$162,031.92	$105,320.75 35% off	$2.17	$162,031.92	$51,850.21	2026-06-15
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	28	18	—	—	$17,737.00	$111,517.45	$51,176.70	2026-06-15
J9029	HCPCS	Adstiladrin 3x10exp11 Vp/ml Intravesical Suspension	74	44	$73,080.00	$47,502.00 35% off	$2.17	$185,394.20	$51,156.00	2026-06-15
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	28	18	—	—	$13,243.00	$75,876.25	$51,139.64	2026-06-15
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	28	18	—	—	$45,063.10	$109,264.25	$50,907.16	2026-06-15
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	29	19	—	—	$47,300.94	$148,400.00	$50,750.30	2026-06-15
6124	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	9	9	—	—	$48,843.56	$52,163.02	$50,740.40	2026-06-15
J926600	OTHER	Pegaspargase Injection	1	1	—	—	$50,594.83	$50,594.83	$50,594.83	2026-06-15
J0223	HCPCS	Givlaari 189 Mg/ml Subcutaneous Solution	74	44	$158,018.40	$102,711.96 35% off	$2.17	$158,018.40	$50,565.89	2026-06-15
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	29	19	—	—	$12,225.00	$223,200.00	$50,335.61	2026-06-15
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	28	18	—	—	$12,225.00	$81,369.34	$50,335.61	2026-06-15
J960000	OTHER	Porfimer Sodium Injection	1	1	—	—	$49,817.93	$49,817.93	$49,817.93	2026-06-15
37286	HCPCS	Revsc Evasc Tpvt St Plmt Uni Cplx Les 1st Vsl	62	43	$107,690.00	$69,998.50 35% off	$1,092.74	$107,690.00	$49,242.53	2026-06-15
37288	HCPCS	Revsc Evasc Tpvt Athrc Uni Sf Les 1st Vsl	62	43	$107,690.00	$69,998.50 35% off	$1,085.34	$107,690.00	$49,242.53	2026-06-15
37290	HCPCS	Revsc Evasc Tpvt Athrc Uni Cplx Les 1st Vsl	62	43	$107,690.00	$69,998.50 35% off	$1,365.59	$107,690.00	$49,242.53	2026-06-15
37277	HCPCS	Revsc Evasc Fpvt St Athrc Uni Cplx Les 1st Vsl	62	43	$107,690.00	$69,998.50 35% off	$1,206.38	$107,690.00	$49,242.53	2026-06-15
37275	HCPCS	Revsc Evasc Fpvt St Athrc Uni Sf Les 1st Vsl	62	43	$107,690.00	$69,998.50 35% off	$886.54	$107,690.00	$49,242.53	2026-06-15
37273	HCPCS	Revsc Evasc Fpvt Athrc Uni Cplx Les 1st Vsl	62	43	$107,690.00	$69,998.50 35% off	$1,020.35	$107,690.00	$49,242.53	2026-06-15
37294	HCPCS	Revsc Evasc Tpvt St Athrc Uni Cplx Les 1st Vsl	62	43	$107,690.00	$69,998.50 35% off	$1,452.08	$107,690.00	$49,242.53	2026-06-15
37284	HCPCS	Revsc Evasc Tpvt St Plmt Uni Sf Les 1st Vsl	62	43	$107,690.00	$69,998.50 35% off	$813.97	$107,690.00	$49,242.53	2026-06-15
37292	HCPCS	Revsc Evasc Tpvt St Athrc Uni Sf Les 1st Vsl	62	43	$107,690.00	$69,998.50 35% off	$1,211.17	$107,690.00	$49,242.53	2026-06-15
37271	HCPCS	Revsc Evasc Fpvt Athrc Uni Sf Les 1st Vsl	62	43	$107,690.00	$69,998.50 35% off	$728.49	$107,690.00	$49,242.53	2026-06-15
6073	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	9	9	—	—	$46,838.04	$50,021.21	$48,657.00	2026-06-15
J0179	HCPCS	Beovu 6 Mg/0.05 Ml Intravitreal Syringe	74	44	$150,004.08	$97,502.65 35% off	$2.17	$150,004.08	$48,001.31	2026-06-15
5894	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	9	9	—	—	$46,196.19	$49,335.74	$47,990.22	2026-06-15
5893	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	9	9	—	—	$46,196.19	$49,335.74	$47,990.22	2026-06-15
1834	APR_DRG	Percutaneous Structural Cardiac Procedures	9	9	—	—	$46,192.61	$49,331.91	$47,986.49	2026-06-15
43	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	9	9	—	—	$46,103.40	$49,236.64	$47,893.82	2026-06-15
8634	APR_DRG	Neonatal Aftercare	9	9	—	—	$46,036.24	$49,164.92	$47,824.06	2026-06-15
1784	APR_DRG	External Heart Assist Devices	9	9	—	—	$46,020.86	$49,148.50	$47,808.08	2026-06-15
6904	APR_DRG	Acute Leukemia	9	9	—	—	$45,840.92	$48,956.33	$47,621.15	2026-06-15
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	28	18	—	—	$46,266.03	$102,091.04	$47,605.18	2026-06-15
J2778	HCPCS	Darvocet-n 50 50 Mg-325 Mg Tab	114	44	$140,400.00	$91,260.00 35% off	$2.17	$140,400.00	$47,251.62	2026-06-15
266	MS_DRG	Endovascular Cardiac Valve Replacement W Mcc	30	20	—	—	$12,225.00	$173,600.00	$46,955.36	2026-06-15
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	30	20	—	—	$44,177.39	$240,500.00	$46,816.00	2026-06-15
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	28	18	—	—	$17,737.00	$75,024.68	$46,457.66	2026-06-15
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	29	19	—	—	$42,630.46	$207,900.00	$46,310.39	2026-06-15
28	MS_DRG	Spinal Procedures With Mcc	29	19	—	—	$12,225.00	$108,100.00	$46,046.95	2026-06-15
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	28	18	—	—	$12,492.00	$74,331.68	$46,034.09	2026-06-15
6313	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	9	9	—	—	$44,091.22	$47,087.71	$45,803.50	2026-06-15
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	29	19	—	—	$12,492.00	$158,200.00	$45,705.06	2026-06-15
5891	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	9	9	—	—	$43,942.54	$46,928.93	$45,649.05	2026-06-15
5892	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	9	9	—	—	$43,942.54	$46,928.93	$45,649.05	2026-06-15
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	23	18	—	—	$43,517.62	$99,125.69	$45,556.81	2026-06-15
001-B	OTHER	Deep Brain Stimulation Unilateral	1	1	—	—	$45,300.00	$45,300.00	$45,300.00	2026-06-15
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	2	1	—	—	$41,435.71	$48,750.22	$45,092.96	2026-06-15
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	29	19	—	—	$22,852.00	$168,400.00	$44,990.29	2026-06-15
J0177	HCPCS	Eylea Hd 8 Mg/0.07 Ml Intravitreal Solution For Injection	74	44	$140,454.00	$91,295.10 35% off	$2.17	$140,454.00	$44,945.28	2026-06-15
J0178	HCPCS	Eylea 2 Mg/0.05 Ml Intravitreal Syringe	74	44	$139,847.76	$90,901.04 35% off	$2.17	$139,847.76	$44,751.28	2026-06-15
54	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	9	9	—	—	$42,953.11	$45,872.26	$44,621.19	2026-06-15
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	30	19	—	—	$38,820.00	$188,200.00	$44,366.92	2026-06-15
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	33	22	—	—	$26,000.00	$308,400.00	$44,283.25	2026-06-15
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	29	19	—	—	$17,737.00	$228,300.00	$44,222.56	2026-06-15
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	29	19	—	—	$12,225.00	$139,200.00	$43,944.22	2026-06-15
471A	OTHER	Bilateral Total Hip Replacement Proc. Of Lower Extremitv	1	1	—	—	$43,800.00	$43,800.00	$43,800.00	2026-06-15
213	MS_DRG	Endovascular Abdominal Aorta With Iliac Branch Procedures	21	17	—	—	$43,767.22	$101,223.29	$43,767.22	2026-06-15
834	MS_DRG	Acute Leukemia Without Major O.r. Procedures With Mcc	29	19	—	—	$40,494.01	$152,300.00	$43,389.66	2026-06-15
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	30	20	—	—	$41,690.21	$240,500.00	$43,357.82	2026-06-15
3033	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	9	9	—	—	$41,690.43	$44,523.77	$43,309.48	2026-06-15
J1930	HCPCS	Somatuline Depot 60 Mg/0.2 Ml Subcutaneous Syringe	154	44	$101,184.00	$65,769.60 35% off	$2.17	$113,976.00	$43,305.44	2026-06-15
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	29	19	—	—	$39,779.93	$128,400.00	$43,238.52	2026-06-15
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	29	19	—	—	$17,737.00	$203,786.00	$43,125.06	2026-06-15
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	28	18	—	—	$12,225.00	$68,881.73	$42,703.00	2026-06-15
11	MS_DRG	Tracheostomy For Face,mouth & Neck Diagnoses W Mcc	28	18	—	—	$39,542.39	$90,963.48	$42,482.93	2026-06-15
461	MS_DRG	Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc	29	19	—	—	$12,225.00	$116,800.00	$42,376.24	2026-06-15
6814	APR_DRG	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	9	9	—	—	$40,358.04	$43,100.82	$41,925.34	2026-06-15
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Without Mcc	29	19	—	—	$22,852.00	$158,100.00	$41,920.15	2026-06-15
6954	APR_DRG	Chemotherapy For Acute Leukemia	9	9	—	—	$40,127.85	$42,854.99	$41,686.22	2026-06-15
33276	HCPCS	Insj Phrnc Nrv Stim Sys	31	22	—	—	$15,711.47	$120,196.88	$41,671.36	2026-06-15
J9600	HCPCS	Photofrin 75 Mg Intravenous Solution	74	44	$111,950.40	$72,767.76 35% off	$2.17	$111,950.40	$41,639.95	2026-06-15
3004	APR_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	9	9	—	—	$39,975.08	$42,691.84	$41,527.51	2026-06-15
6022	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	9	9	—	—	$39,863.83	$42,573.03	$41,411.94	2026-06-15
1634	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	9	9	—	—	$39,799.24	$42,504.04	$41,344.84	2026-06-15
653	MS_DRG	Major Bladder Procedures With Mcc	29	19	—	—	$39,905.91	$144,700.00	$41,103.09	2026-06-15
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	29	19	—	—	$12,225.00	$146,600.00	$40,937.61	2026-06-15
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	28	18	—	—	$13,243.00	$45,004.75	$40,913.41	2026-06-15
1624	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	9	9	—	—	$39,350.15	$42,024.43	$40,878.31	2026-06-15
6034	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	9	9	—	—	$39,227.62	$41,893.58	$40,751.02	2026-06-15
6033	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	9	9	—	—	$39,227.62	$41,893.58	$40,751.02	2026-06-15
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	29	19	—	—	$12,225.00	$160,500.00	$40,642.63	2026-06-15
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	28	18	—	—	$12,225.00	$113,821.00	$40,510.26	2026-06-15
5931	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	9	9	—	—	$38,977.45	$41,626.40	$40,491.13	2026-06-15
5932	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	9	9	—	—	$38,977.45	$41,626.40	$40,491.13	2026-06-15
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	29	19	—	—	$12,225.00	$120,500.00	$39,973.99	2026-06-15
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	2	1	—	—	$36,648.70	$43,118.17	$39,883.43	2026-06-15
224	APR_DRG	Ventricular Shunt Procedures	9	9	—	—	$38,268.43	$40,869.20	$39,754.59	2026-06-15
5912	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	9	9	—	—	$38,200.25	$40,796.38	$39,683.75	2026-06-15
5911	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	9	9	—	—	$38,200.25	$40,796.38	$39,683.75	2026-06-15
6301	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	9	9	—	—	$38,093.62	$40,682.51	$39,572.99	2026-06-15

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