|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
15
|
15
|
—
|
—
|
$3,710,000.00
|
$3,895,500.00
|
$3,710,000.00
|
2025-05-18
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
15
|
15
|
—
|
—
|
$3,685,266.67
|
$3,869,530.00
|
$3,685,266.67
|
2025-05-18
|
|
S3399
|
HCPCS
|
Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit
|
2
|
1
|
—
|
—
|
$2,705,295.00
|
$4,531,369.13
|
$3,618,332.06
|
2025-05-18
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
15
|
15
|
—
|
—
|
$3,322,473.30
|
$3,488,596.96
|
$3,322,473.30
|
2025-05-18
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
15
|
15
|
—
|
—
|
$3,286,000.00
|
$3,450,300.00
|
$3,286,000.00
|
2025-05-18
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
15
|
15
|
—
|
—
|
$2,948,213.33
|
$3,095,624.00
|
$2,948,213.33
|
2025-05-18
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
18
|
18
|
—
|
—
|
$2,423,131.23
|
$4,361,636.22
|
$2,423,131.23
|
2025-05-18
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
18
|
18
|
—
|
—
|
$2,332,000.00
|
$4,197,600.00
|
$2,332,000.00
|
2025-05-18
|
|
C9399
|
HCPCS
|
Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp
|
184
|
41
|
$3,080,000.00
|
$2,310,000.00
25% off
|
$1,854.00
|
$3,069,000.00
|
$1,602,700.00
|
2025-05-18
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension
|
128
|
41
|
$2,446,250.00
|
$1,834,687.50
25% off
|
$461,028.00
|
$2,201,625.00
|
$1,516,932.50
|
2025-05-18
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension
|
128
|
41
|
$2,160,425.00
|
$1,620,318.75
25% off
|
$518,502.00
|
$2,310,120.86
|
$1,406,436.68
|
2025-05-18
|
|
Q2054
|
HCPCS
|
Lisocabtagene Maraleucel(cd8) 1.5x To 70x 10exp6 Cell/ml IV Susp(1of2)
|
91
|
41
|
$2,113,045.00
|
$1,584,783.75
25% off
|
$507,130.80
|
$1,901,740.50
|
$1,375,592.29
|
2025-05-18
|
|
Q2053
|
HCPCS
|
Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension
|
91
|
41
|
$2,054,850.00
|
$1,541,137.50
25% off
|
$489,399.16
|
$1,849,365.00
|
$1,337,707.35
|
2025-05-18
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Intravenous Suspension
|
91
|
41
|
$2,054,850.00
|
$1,541,137.50
25% off
|
$493,164.00
|
$1,849,365.00
|
$1,337,707.35
|
2025-05-18
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
18
|
18
|
—
|
—
|
$770,620.00
|
$1,387,116.00
|
$770,620.00
|
2025-05-18
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
18
|
18
|
—
|
—
|
$553,169.30
|
$995,704.74
|
$553,169.30
|
2025-05-18
|
|
J2326
|
HCPCS
|
Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution
|
88
|
40
|
$686,636.63
|
$514,977.48
25% off
|
$1,248.60
|
$617,972.97
|
$447,000.45
|
2025-05-18
|
|
C9301
|
HCPCS
|
Apc
|
18
|
18
|
—
|
—
|
$278,250.00
|
$500,850.00
|
$278,250.00
|
2025-05-18
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
29
|
20
|
—
|
—
|
$245,675.06
|
$627,654.13
|
$257,958.81
|
2025-05-18
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$218,383.73
|
$222,624.19
|
$220,503.96
|
2025-05-18
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
7
|
7
|
—
|
—
|
$211,268.27
|
$215,370.57
|
$213,319.42
|
2025-05-18
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
7
|
7
|
—
|
—
|
$211,268.27
|
$215,370.57
|
$213,319.42
|
2025-05-18
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
7
|
7
|
—
|
—
|
$200,980.15
|
$204,882.68
|
$202,931.41
|
2025-05-18
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
7
|
7
|
—
|
—
|
$200,980.15
|
$204,882.68
|
$202,931.41
|
2025-05-18
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
7
|
7
|
—
|
—
|
$200,203.18
|
$204,090.62
|
$202,146.90
|
2025-05-18
|
|
A9543
|
HCPCS
|
Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous
|
88
|
40
|
$307,938.32
|
$230,953.74
25% off
|
$1,883.00
|
$277,144.49
|
$200,467.85
|
2025-05-18
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
29
|
20
|
—
|
—
|
$183,617.81
|
$468,805.02
|
$192,798.70
|
2025-05-18
|
|
24
|
APR_DRG
|
Heart And/or Lung Transplant
|
7
|
7
|
—
|
—
|
$176,128.40
|
$179,548.37
|
$177,838.39
|
2025-05-18
|
|
J7330
|
HCPCS
|
Implant, Maci Final, Product Assembled, Double
|
108
|
41
|
$313,512.00
|
$235,134.00
25% off
|
$37,621.44
|
$282,160.80
|
$173,999.16
|
2025-05-18
|
|
J9226
|
HCPCS
|
Histrelin 50 Mg (65 Mcg/day) Implant Kit
|
91
|
41
|
$249,917.09
|
$187,437.82
25% off
|
$45,212.04
|
$224,925.38
|
$162,696.02
|
2025-05-18
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
29
|
20
|
—
|
—
|
$154,713.67
|
$394,818.56
|
$162,449.35
|
2025-05-18
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
7
|
7
|
—
|
—
|
$155,040.49
|
$158,050.99
|
$156,545.74
|
2025-05-18
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
7
|
7
|
—
|
—
|
$155,040.49
|
$158,050.99
|
$156,545.74
|
2025-05-18
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
7
|
7
|
—
|
—
|
$155,040.49
|
$158,050.99
|
$156,545.74
|
2025-05-18
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$150,619.55
|
$153,544.20
|
$152,081.87
|
2025-05-18
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…
|
29
|
20
|
—
|
—
|
$139,816.54
|
$356,686.12
|
$146,807.37
|
2025-05-18
|
|
J1823
|
HCPCS
|
Inebilizumab-cdon 10 Mg/ml Intravenous Solution
|
88
|
40
|
$224,883.36
|
$168,662.52
25% off
|
$484.40
|
$202,395.02
|
$146,399.07
|
2025-05-18
|
|
J0223
|
HCPCS
|
Givosiran 189 Mg/ml Subcutaneous Solution
|
88
|
40
|
$222,207.83
|
$166,655.88
25% off
|
$116.47
|
$199,987.05
|
$144,657.30
|
2025-05-18
|
|
C9150
|
HCPCS
|
Lab/Radiology
|
2
|
1
|
—
|
—
|
$134,784.00
|
$149,760.00
|
$142,272.00
|
2025-05-18
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
7
|
7
|
—
|
—
|
$140,231.44
|
$142,954.38
|
$141,592.91
|
2025-05-18
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
7
|
7
|
—
|
—
|
$140,231.44
|
$142,954.38
|
$141,592.91
|
2025-05-18
|
|
8412
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
7
|
7
|
—
|
—
|
$140,231.44
|
$142,954.38
|
$141,592.91
|
2025-05-18
|
|
8411
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
7
|
7
|
—
|
—
|
$140,231.44
|
$142,954.38
|
$141,592.91
|
2025-05-18
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$140,221.03
|
$142,943.77
|
$141,582.40
|
2025-05-18
|
|
J9347
|
HCPCS
|
Tremelimumab-actl 20 Mg/ml Intravenous Solution
|
88
|
40
|
$215,735.77
|
$161,801.83
25% off
|
$138.24
|
$194,162.19
|
$140,443.98
|
2025-05-18
|
|
90288
|
CPT
|
Botulism Ig IV
|
2
|
1
|
—
|
—
|
$131,503.50
|
$146,115.00
|
$138,809.25
|
2025-05-18
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
7
|
7
|
—
|
—
|
$136,096.18
|
$138,738.82
|
$137,417.50
|
2025-05-18
|
|
C9293
|
HCPCS
|
Glucarpidase 1,000 Unit Intravenous Solution
|
73
|
41
|
$202,725.27
|
$152,043.96
25% off
|
$48,654.06
|
$182,452.74
|
$131,974.15
|
2025-05-18
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
7
|
7
|
—
|
—
|
$120,180.16
|
$122,513.76
|
$121,346.96
|
2025-05-18
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$110,531.02
|
$112,677.25
|
$111,604.14
|
2025-05-18
|
|
J9269
|
HCPCS
|
Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution
|
88
|
40
|
$171,000.60
|
$128,250.45
25% off
|
$338.53
|
$153,900.54
|
$111,321.39
|
2025-05-18
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$105,158.55
|
$107,200.46
|
$106,179.51
|
2025-05-18
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$105,158.55
|
$107,200.46
|
$106,179.51
|
2025-05-18
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$101,924.13
|
$103,903.24
|
$102,913.69
|
2025-05-18
|
|
J0202
|
HCPCS
|
Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution
|
88
|
40
|
$156,047.54
|
$117,035.66
25% off
|
$2,441.49
|
$140,442.79
|
$101,586.95
|
2025-05-18
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
18
|
18
|
—
|
—
|
$99,999.95
|
$179,999.91
|
$99,999.95
|
2025-05-18
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …
|
29
|
20
|
—
|
—
|
$92,342.36
|
$235,165.59
|
$96,959.48
|
2025-05-18
|
|
A9606
|
HCPCS
|
Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln
|
88
|
40
|
$148,062.50
|
$111,046.88
25% off
|
$169.06
|
$133,256.25
|
$96,388.69
|
2025-05-18
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$94,651.69
|
$96,489.58
|
$95,570.63
|
2025-05-18
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
18
|
18
|
—
|
—
|
$93,216.70
|
$167,790.06
|
$93,216.70
|
2025-05-18
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
29
|
20
|
—
|
—
|
$85,657.13
|
$218,053.26
|
$89,939.99
|
2025-05-18
|
|
7
|
MS_DRG
|
Lung Transplant
|
29
|
20
|
—
|
—
|
$85,442.56
|
$217,504.04
|
$89,714.69
|
2025-05-18
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
7
|
7
|
—
|
—
|
$87,102.40
|
$88,793.71
|
$87,948.06
|
2025-05-18
|
|
J9359
|
HCPCS
|
Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution
|
88
|
40
|
$133,461.89
|
$100,096.42
25% off
|
$212.00
|
$120,115.70
|
$86,883.69
|
2025-05-18
|
|
Q2043
|
HCPCS
|
Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension
|
91
|
41
|
$133,364.40
|
$100,023.30
25% off
|
$32,007.46
|
$120,027.96
|
$86,820.23
|
2025-05-18
|
|
J1747
|
HCPCS
|
Spesolimab-sbzo 60 Mg/ml Intravenous Solution
|
88
|
40
|
$131,667.49
|
$98,750.62
25% off
|
$61.43
|
$118,500.74
|
$85,715.54
|
2025-05-18
|
|
J2507
|
HCPCS
|
Pegloticase 8 Mg/ml Intravenous Solution
|
88
|
40
|
$131,153.51
|
$98,365.14
25% off
|
$3,565.32
|
$118,038.16
|
$85,380.93
|
2025-05-18
|
|
J9118
|
HCPCS
|
Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution
|
62
|
36
|
$128,920.57
|
$96,690.43
25% off
|
$196.78
|
$116,028.51
|
$83,927.29
|
2025-05-18
|
|
23
|
APR_DRG
|
Heart And/or Lung Transplant
|
7
|
7
|
—
|
—
|
$78,310.07
|
$79,830.65
|
$79,070.36
|
2025-05-18
|
|
21
|
APR_DRG
|
Heart And/or Lung Transplant
|
7
|
7
|
—
|
—
|
$78,310.07
|
$79,830.65
|
$79,070.36
|
2025-05-18
|
|
22
|
APR_DRG
|
Heart And/or Lung Transplant
|
7
|
7
|
—
|
—
|
$78,310.07
|
$79,830.65
|
$79,070.36
|
2025-05-18
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
7
|
—
|
—
|
$78,184.66
|
$79,702.81
|
$78,943.74
|
2025-05-18
|
|
J9348
|
HCPCS
|
Naxitamab-gqgk 4 Mg/ml Intravenous Solution
|
88
|
40
|
$116,612.85
|
$87,459.64
25% off
|
$641.83
|
$104,951.57
|
$75,914.97
|
2025-05-18
|
|
03060
|
EAPG
|
Ventricular Assist Device Procedures
|
7
|
7
|
—
|
—
|
$75,149.77
|
$76,608.99
|
$75,879.38
|
2025-05-18
|
|
J9229
|
HCPCS
|
Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln
|
88
|
40
|
$116,476.42
|
$87,357.32
25% off
|
$2,658.13
|
$104,828.78
|
$75,826.15
|
2025-05-18
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
29
|
20
|
—
|
—
|
$72,119.55
|
$183,400.87
|
$75,725.53
|
2025-05-18
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
29
|
20
|
—
|
—
|
$71,301.62
|
$181,307.18
|
$74,866.70
|
2025-05-18
|
|
J9266
|
HCPCS
|
Pegaspargase 750 Unit/ml Injection Solution
|
91
|
41
|
$114,548.67
|
$85,911.51
25% off
|
$27,070.53
|
$103,093.80
|
$74,571.18
|
2025-05-18
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$73,731.85
|
$75,163.54
|
$74,447.69
|
2025-05-18
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
29
|
20
|
—
|
—
|
$69,711.90
|
$177,237.96
|
$73,197.50
|
2025-05-18
|
|
J9274
|
HCPCS
|
Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution
|
88
|
40
|
$112,071.97
|
$84,053.98
25% off
|
$214.76
|
$100,864.77
|
$72,958.85
|
2025-05-18
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
29
|
20
|
—
|
—
|
$69,356.90
|
$176,329.26
|
$72,824.75
|
2025-05-18
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
29
|
20
|
—
|
—
|
$68,580.57
|
$174,342.08
|
$72,009.60
|
2025-05-18
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
7
|
7
|
—
|
—
|
$71,041.51
|
$72,420.96
|
$71,731.23
|
2025-05-18
|
|
6024
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$69,897.59
|
$71,254.83
|
$70,576.21
|
2025-05-18
|
|
6074
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$69,132.90
|
$70,475.29
|
$69,804.09
|
2025-05-18
|
|
J7311
|
HCPCS
|
Fluocinolone 0.59 Mg Intravitreal Implant
|
88
|
40
|
$105,240.36
|
$78,930.27
25% off
|
$340.04
|
$94,716.32
|
$68,511.47
|
2025-05-18
|
|
J9600
|
HCPCS
|
Porfimer 75 Mg Intravenous Solution
|
91
|
41
|
$105,199.05
|
$78,899.29
25% off
|
$24,228.42
|
$94,679.15
|
$68,484.59
|
2025-05-18
|
|
8504
|
APR_DRG
|
Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…
|
7
|
7
|
—
|
—
|
$66,955.53
|
$68,255.64
|
$67,605.58
|
2025-05-18
|
|
L8702
|
HCPCS
|
Ewhf S/d Uprt Micro Sensor
|
18
|
18
|
—
|
—
|
$67,452.66
|
$121,414.79
|
$67,452.66
|
2025-05-18
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
29
|
20
|
—
|
—
|
$63,221.08
|
$160,623.26
|
$66,382.13
|
2025-05-18
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
7
|
7
|
—
|
—
|
$64,938.23
|
$66,199.17
|
$65,568.70
|
2025-05-18
|
|
8514
|
APR_DRG
|
Gender Related Procedures
|
7
|
7
|
—
|
—
|
$64,810.49
|
$66,068.95
|
$65,439.72
|
2025-05-18
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$63,937.85
|
$65,179.36
|
$64,558.60
|
2025-05-18
|
|
J2350
|
HCPCS
|
Ocrelizumab 30 Mg/ml Intravenous Solution
|
88
|
40
|
$98,446.22
|
$73,834.67
25% off
|
$57.81
|
$88,601.60
|
$64,088.49
|
2025-05-18
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
29
|
20
|
—
|
—
|
$60,365.43
|
$153,313.65
|
$63,383.70
|
2025-05-18
|
|
L8688
|
HCPCS
|
Generator, M1000-d, Sentiva Duo
|
70
|
41
|
$102,755.64
|
$77,066.73
25% off
|
$24,661.35
|
$92,480.08
|
$63,364.26
|
2025-05-18
|
|
14
|
APR_DRG
|
Liver Transplant And/or Intestinal Transplant
|
7
|
7
|
—
|
—
|
$62,404.20
|
$63,615.93
|
$63,010.06
|
2025-05-18
|
|
J1303
|
HCPCS
|
Ravulizumab-cwvz 100 Mg/ml Intravenous Solution
|
123
|
40
|
$129,891.37
|
$97,418.53
25% off
|
$220.32
|
$116,902.23
|
$62,347.86
|
2025-05-18
|
|
J0638
|
HCPCS
|
Canakinumab (pf) 150 Mg/ml Subcutaneous Solution
|
88
|
40
|
$94,723.08
|
$71,042.31
25% off
|
$136.56
|
$85,250.77
|
$61,664.72
|
2025-05-18
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
7
|
7
|
—
|
—
|
$60,356.35
|
$61,528.32
|
$60,942.34
|
2025-05-18
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$59,255.21
|
$60,405.80
|
$59,830.50
|
2025-05-18
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$59,109.28
|
$60,257.03
|
$59,683.16
|
2025-05-18
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$59,109.28
|
$60,257.03
|
$59,683.16
|
2025-05-18
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
7
|
7
|
—
|
—
|
$58,858.25
|
$60,001.13
|
$59,429.69
|
2025-05-18
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
7
|
7
|
—
|
—
|
$58,803.07
|
$59,944.88
|
$59,373.97
|
2025-05-18
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
29
|
20
|
—
|
—
|
$55,567.05
|
$141,031.12
|
$58,345.40
|
2025-05-18
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
29
|
20
|
—
|
—
|
$55,536.49
|
$140,952.90
|
$58,313.31
|
2025-05-18
|
|
A9604
|
HCPCS
|
Samarium Sm 153 Lexidronam 5,550 Mbq/3 Ml Intravenous Solution
|
88
|
40
|
$88,888.25
|
$66,666.19
25% off
|
$1,883.00
|
$79,999.43
|
$57,866.25
|
2025-05-18
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$57,245.56
|
$58,357.12
|
$57,801.34
|
2025-05-18
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
29
|
20
|
—
|
—
|
$54,700.34
|
$138,812.61
|
$57,435.36
|
2025-05-18
|
|
6023
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$56,592.21
|
$57,691.08
|
$57,141.65
|
2025-05-18
|
|
J3357
|
HCPCS
|
Ustekinumab 90 Mg/ml Subcutaneous Syringe
|
158
|
40
|
$68,405.39
|
$51,304.05
25% off
|
$152.39
|
$123,129.76
|
$56,619.93
|
2025-05-18
|
|
J9309
|
HCPCS
|
Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution
|
88
|
40
|
$86,294.33
|
$64,720.75
25% off
|
$132.73
|
$77,664.90
|
$56,177.61
|
2025-05-18
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
29
|
20
|
—
|
—
|
$52,883.08
|
$134,160.89
|
$55,527.23
|
2025-05-18
|
|
6091
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$54,473.24
|
$55,530.97
|
$55,002.11
|
2025-05-18
|
|
6092
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
7
|
7
|
—
|
—
|
$54,473.24
|
$55,530.97
|
$55,002.11
|
2025-05-18
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
29
|
20
|
—
|
—
|
$52,310.26
|
$132,694.64
|
$54,925.77
|
2025-05-18
|
|
38240
|
CPT
|
Transplt Allo Hct/donor
|
23
|
18
|
—
|
—
|
$2,673.40
|
$98,689.15
|
$54,827.31
|
2025-05-18
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
7
|
7
|
—
|
—
|
$54,288.75
|
$55,342.90
|
$54,815.82
|
2025-05-18
|
|
J3241
|
HCPCS
|
Teprotumumab-trbw 500 Mg Intravenous Solution
|
88
|
40
|
$83,988.16
|
$62,991.12
25% off
|
$352.56
|
$75,589.34
|
$54,676.29
|
2025-05-18
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
29
|
20
|
—
|
—
|
$52,013.12
|
$131,934.05
|
$54,613.78
|
2025-05-18
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
7
|
7
|
—
|
—
|
$54,039.13
|
$55,088.43
|
$54,563.78
|
2025-05-18
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
7
|
7
|
—
|
—
|
$53,935.65
|
$54,982.95
|
$54,459.30
|
2025-05-18
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
7
|
7
|
—
|
—
|
$53,857.63
|
$54,903.41
|
$54,380.52
|
2025-05-18
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
7
|
7
|
—
|
—
|
$53,839.81
|
$54,885.24
|
$54,362.53
|
2025-05-18
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
7
|
7
|
—
|
—
|
$53,630.96
|
$54,672.33
|
$54,151.65
|
2025-05-18
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
29
|
20
|
—
|
—
|
$51,292.05
|
$130,088.35
|
$53,856.65
|
2025-05-18
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
7
|
7
|
—
|
—
|
$53,315.85
|
$54,351.11
|
$53,833.48
|
2025-05-18
|
|
J2502
|
HCPCS
|
Pasireotide Pamoate 40 Mg IM Suspension
|
88
|
40
|
$82,121.85
|
$61,591.39
25% off
|
$526.94
|
$73,909.67
|
$53,461.32
|
2025-05-18
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
29
|
20
|
—
|
—
|
$50,779.06
|
$128,775.21
|
$53,318.01
|
2025-05-18
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$52,624.32
|
$53,646.15
|
$53,135.23
|
2025-05-18
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
29
|
20
|
—
|
—
|
$49,002.09
|
$124,226.68
|
$51,452.19
|
2025-05-18
|
|
6124
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$50,777.03
|
$51,762.99
|
$51,270.01
|
2025-05-18
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
7
|
7
|
—
|
—
|
$50,279.60
|
$51,255.91
|
$50,767.76
|
2025-05-18
|
|
J9029
|
HCPCS
|
Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension
|
91
|
41
|
$77,250.00
|
$57,937.50
25% off
|
$18,540.00
|
$172,800.00
|
$50,289.75
|
2025-05-18
|
|
J9298
|
HCPCS
|
Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution
|
88
|
40
|
$75,752.49
|
$56,814.37
25% off
|
$194.08
|
$68,177.24
|
$49,314.87
|
2025-05-18
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
7
|
7
|
—
|
—
|
$48,814.20
|
$49,762.05
|
$49,288.13
|
2025-05-18
|
|
6073
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$48,710.01
|
$49,655.83
|
$49,182.92
|
2025-05-18
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
29
|
20
|
—
|
—
|
$46,651.66
|
$118,210.24
|
$48,984.24
|
2025-05-18
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
29
|
20
|
—
|
—
|
$46,419.54
|
$125,519.92
|
$48,740.52
|
2025-05-18
|
|
5893
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
7
|
7
|
—
|
—
|
$48,048.48
|
$48,981.46
|
$48,514.97
|
2025-05-18
|
|
5894
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
7
|
7
|
—
|
—
|
$48,048.48
|
$48,981.46
|
$48,514.97
|
2025-05-18
|
|
L7181
|
HCPCS
|
Electronic Elbo Simultaneous
|
18
|
18
|
—
|
—
|
$48,370.76
|
$87,067.37
|
$48,370.76
|
2025-05-18
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
29
|
20
|
—
|
—
|
$45,701.09
|
$115,777.03
|
$47,986.14
|
2025-05-18
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
7
|
7
|
—
|
—
|
$47,267.82
|
$48,185.64
|
$47,726.73
|
2025-05-18
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
7
|
7
|
—
|
—
|
$47,001.07
|
$47,913.72
|
$47,457.39
|
2025-05-18
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
29
|
20
|
—
|
—
|
$44,867.54
|
$113,643.40
|
$47,110.92
|
2025-05-18
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
7
|
7
|
—
|
—
|
$46,619.43
|
$47,524.66
|
$47,072.04
|
2025-05-18
|
|
L7180
|
HCPCS
|
Electronic Elbow Sequential
|
18
|
18
|
—
|
—
|
$46,980.38
|
$84,564.68
|
$46,980.38
|
2025-05-18
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
7
|
7
|
—
|
—
|
$46,098.38
|
$46,993.50
|
$46,545.94
|
2025-05-18
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
7
|
7
|
—
|
—
|
$45,878.91
|
$46,769.76
|
$46,324.34
|
2025-05-18
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
29
|
20
|
—
|
—
|
$44,063.92
|
$111,586.32
|
$46,267.12
|
2025-05-18
|
|
5892
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
7
|
7
|
—
|
—
|
$45,724.95
|
$46,612.82
|
$46,168.89
|
2025-05-18
|
|
5891
|
APR_DRG
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
7
|
7
|
—
|
—
|
$45,724.95
|
$46,612.82
|
$46,168.89
|
2025-05-18
|
|
J1628
|
HCPCS
|
Guselkumab 100 Mg/ml Subcutaneous Syringe
|
88
|
40
|
$70,893.10
|
$53,169.83
25% off
|
$70.43
|
$63,803.79
|
$46,151.41
|
2025-05-18
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
29
|
20
|
—
|
—
|
$43,896.17
|
$111,156.93
|
$46,090.98
|
2025-05-18
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
29
|
20
|
—
|
—
|
$43,822.70
|
$110,968.87
|
$46,013.84
|
2025-05-18
|
|
33276
|
CPT
|
Hc Insertion Phrenic Nerve Stimulator System
|
91
|
41
|
$70,201.00
|
$52,650.75
25% off
|
$12,673.10
|
$75,091.07
|
$45,700.85
|
2025-05-18
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
7
|
7
|
—
|
—
|
$44,842.87
|
$45,713.61
|
$45,278.24
|
2025-05-18
|
|
J9043
|
HCPCS
|
Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution
|
88
|
40
|
$69,344.76
|
$52,008.57
25% off
|
$221.71
|
$62,410.28
|
$45,143.43
|
2025-05-18
|
|
83
|
APR_DRG
|
Autologous Bone Marrow Transplant
|
7
|
7
|
—
|
—
|
$44,616.65
|
$45,483.00
|
$45,049.83
|
2025-05-18
|
|
J9350
|
HCPCS
|
Mosunetuzumab-axgb 1 Mg/ml Intravenous Solution
|
126
|
41
|
$98,373.24
|
$73,779.93
25% off
|
$640.96
|
$88,535.92
|
$44,661.45
|
2025-05-18
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
29
|
20
|
—
|
—
|
$42,519.72
|
$107,633.61
|
$44,645.71
|
2025-05-18
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
7
|
—
|
—
|
$44,197.36
|
$45,055.56
|
$44,626.46
|
2025-05-18
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
7
|
—
|
—
|
$44,197.36
|
$45,055.56
|
$44,626.46
|
2025-05-18
|
|
111
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
7
|
—
|
—
|
$44,197.36
|
$45,055.56
|
$44,626.46
|
2025-05-18
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
7
|
7
|
—
|
—
|
$44,197.36
|
$45,055.56
|
$44,626.46
|
2025-05-18
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
29
|
20
|
—
|
—
|
$42,459.26
|
$107,478.83
|
$44,582.22
|
2025-05-18
|
|
7924
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
7
|
7
|
—
|
—
|
$43,415.74
|
$44,258.76
|
$43,837.25
|
2025-05-18
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
29
|
20
|
—
|
—
|
$41,590.58
|
$105,255.32
|
$43,670.11
|
2025-05-18
|
|
C2624
|
HCPCS
|
Delivery Sys, Cordella And Pulm Artery Sensor (ide G1900020)
|
109
|
41
|
$71,250.00
|
$53,437.50
25% off
|
$14,040.00
|
$64,125.00
|
$43,533.75
|
2025-05-18
|
|
A9572
|
HCPCS
|
Indium 111-pentetreotide 3 Mci/ml-10 Mcg Intravenous Kit
|
88
|
40
|
$66,218.70
|
$49,664.03
25% off
|
$1,883.00
|
$59,596.83
|
$43,108.38
|
2025-05-18
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
29
|
20
|
—
|
—
|
$40,746.00
|
$103,093.40
|
$42,783.30
|
2025-05-18
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
29
|
20
|
—
|
—
|
$40,693.98
|
$102,960.26
|
$42,728.68
|
2025-05-18
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
7
|
7
|
—
|
—
|
$42,203.66
|
$43,023.15
|
$42,613.41
|
2025-05-18
|
|
C1824
|
HCPCS
|
Generator, Pulse, Optimizer Smart Ipg
|
70
|
41
|
$69,000.00
|
$51,750.00
25% off
|
$16,560.00
|
$62,100.00
|
$42,548.85
|
2025-05-18
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
29
|
20
|
—
|
—
|
$40,510.64
|
$102,490.92
|
$42,536.17
|
2025-05-18
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
29
|
20
|
—
|
—
|
$40,370.83
|
$102,133.10
|
$42,389.37
|
2025-05-18
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
29
|
20
|
—
|
—
|
$40,188.78
|
$101,667.09
|
$42,198.22
|
2025-05-18
|
|
J3245
|
HCPCS
|
Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe
|
88
|
40
|
$64,818.73
|
$48,614.05
25% off
|
$131.46
|
$58,336.86
|
$42,197.00
|
2025-05-18
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
29
|
20
|
—
|
—
|
$39,998.94
|
$101,181.12
|
$41,998.89
|
2025-05-18
|
|
6022
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$41,521.52
|
$42,327.77
|
$41,924.65
|
2025-05-18
|
|
0266T
|
CPT
|
Apc
|
20
|
18
|
—
|
—
|
$4,337.33
|
$75,091.07
|
$41,717.26
|
2025-05-18
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
29
|
20
|
—
|
—
|
$39,715.45
|
$100,455.48
|
$41,701.22
|
2025-05-18
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
29
|
20
|
—
|
—
|
$39,715.45
|
$100,455.48
|
$41,701.22
|
2025-05-18
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
29
|
20
|
—
|
—
|
$39,422.20
|
$99,704.88
|
$41,393.31
|
2025-05-18
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
7
|
7
|
—
|
—
|
$40,865.50
|
$41,659.00
|
$41,262.25
|
2025-05-18
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
7
|
7
|
—
|
—
|
$40,865.50
|
$41,659.00
|
$41,262.25
|
2025-05-18
|
|
8633
|
APR_DRG
|
Neonatal Aftercare
|
7
|
7
|
—
|
—
|
$40,795.31
|
$41,587.46
|
$41,191.38
|
2025-05-18
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
29
|
20
|
—
|
—
|
$39,152.39
|
$99,014.20
|
$41,110.01
|
2025-05-18
|
|
5931
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$40,607.54
|
$41,396.04
|
$41,001.79
|
2025-05-18
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$40,607.54
|
$41,396.04
|
$41,001.79
|
2025-05-18
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
29
|
20
|
—
|
—
|
$38,729.11
|
$97,930.74
|
$40,665.57
|
2025-05-18
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
25
|
20
|
—
|
—
|
$39,123.13
|
$79,481.98
|
$40,296.82
|
2025-05-18
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
7
|
7
|
—
|
—
|
$39,881.90
|
$40,656.30
|
$40,269.10
|
2025-05-18
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
29
|
20
|
—
|
—
|
$38,326.65
|
$96,900.54
|
$40,242.98
|
2025-05-18
|
|
5911
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$39,806.77
|
$40,579.72
|
$40,193.24
|
2025-05-18
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
7
|
7
|
—
|
—
|
$39,806.77
|
$40,579.72
|
$40,193.24
|
2025-05-18
|
|
6302
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
7
|
7
|
—
|
—
|
$39,696.85
|
$40,467.66
|
$40,082.26
|
2025-05-18
|
|
6301
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
7
|
7
|
—
|
—
|
$39,696.85
|
$40,467.66
|
$40,082.26
|
2025-05-18
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
29
|
20
|
—
|
—
|
$37,787.64
|
$95,520.83
|
$39,677.02
|
2025-05-18
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
29
|
20
|
—
|
—
|
$37,564.63
|
$94,949.98
|
$39,442.86
|
2025-05-18
|
|
2004
|
APR_DRG
|
Cardiac Structural And Valvular Disorders
|
7
|
7
|
—
|
—
|
$38,919.68
|
$39,675.41
|
$39,297.54
|
2025-05-18
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
7
|
7
|
—
|
—
|
$38,646.98
|
$39,397.41
|
$39,022.19
|
2025-05-18
|
|
J9316
|
HCPCS
|
Pertuzumab 1,200 Mg-trastuzumab 600 Mg-hyaluron-zzxf/15 Ml Subcut Soln
|
123
|
40
|
$70,291.17
|
$52,718.38
25% off
|
$62.99
|
$63,262.05
|
$38,892.91
|
2025-05-18
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
7
|
7
|
—
|
—
|
$38,413.15
|
$39,159.04
|
$38,786.09
|
2025-05-18
|
|
L2006
|
HCPCS
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
20
|
18
|
—
|
—
|
$38,762.63
|
$69,772.73
|
$38,762.63
|
2025-05-18
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
29
|
20
|
—
|
—
|
$36,716.13
|
$92,778.07
|
$38,551.94
|
2025-05-18
|
|
1833
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
7
|
7
|
—
|
—
|
$38,133.69
|
$38,874.15
|
$38,503.92
|
2025-05-18
|
|
834
|
MS_DRG
|
Acute Leukemia With Mcc
|
29
|
20
|
—
|
—
|
$36,408.60
|
$91,990.85
|
$38,229.03
|
2025-05-18
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
29
|
20
|
—
|
—
|
$36,408.60
|
$91,990.85
|
$38,229.03
|
2025-05-18
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
29
|
20
|
—
|
—
|
$36,257.75
|
$91,604.74
|
$38,070.64
|
2025-05-18
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
29
|
20
|
—
|
—
|
$36,039.28
|
$91,045.53
|
$37,841.24
|
2025-05-18
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
29
|
20
|
—
|
—
|
$35,848.12
|
$90,556.23
|
$37,640.53
|
2025-05-18
|
|
J1305
|
HCPCS
|
Evinacumab-dgnb 150 Mg/ml Intravenous Solution
|
123
|
40
|
$57,744.38
|
$43,308.29
25% off
|
$186.31
|
$180,765.00
|
$37,591.59
|
2025-05-18
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
29
|
20
|
—
|
—
|
$35,767.51
|
$90,349.85
|
$37,555.89
|
2025-05-18
|
|
33364
|
CPT
|
Hc Cath Replace Aortic Valve Open Iliac Artery Approach
|
74
|
41
|
$57,653.00
|
$43,239.75
25% off
|
$2,898.70
|
$51,887.70
|
$37,532.11
|
2025-05-18
|
|
33367
|
CPT
|
Hc Cath Replace Aortic Valve W/byp Prq Art/venous Apprch
|
74
|
41
|
$57,653.00
|
$43,239.75
25% off
|
$2,898.70
|
$51,887.70
|
$37,532.11
|
2025-05-18
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
7
|
7
|
—
|
—
|
$37,112.96
|
$37,833.60
|
$37,473.28
|
2025-05-18
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
29
|
20
|
—
|
—
|
$35,587.40
|
$89,888.84
|
$37,366.77
|
2025-05-18
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
29
|
20
|
—
|
—
|
$35,554.25
|
$89,803.96
|
$37,331.96
|
2025-05-18
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
29
|
20
|
—
|
—
|
$35,550.34
|
$89,793.98
|
$37,327.86
|
2025-05-18
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
7
|
7
|
—
|
—
|
$36,872.36
|
$37,588.33
|
$37,230.35
|
2025-05-18
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
7
|
7
|
—
|
—
|
$36,806.73
|
$37,521.42
|
$37,164.08
|
2025-05-18
|
|
J1323
|
HCPCS
|
Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution
|
199
|
40
|
$67,211.21
|
$50,408.41
25% off
|
$182.98
|
$72,588.11
|
$37,100.59
|
2025-05-18
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
7
|
7
|
—
|
—
|
$36,600.61
|
$37,311.30
|
$36,955.95
|
2025-05-18
|
|
33902
|
CPT
|
Hc Perq P-art Revsc St 1st Abnor Connj Unilateral
|
91
|
40
|
$56,767.00
|
$42,575.25
25% off
|
$2,004.64
|
$51,090.30
|
$36,955.32
|
2025-05-18
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
7
|
7
|
—
|
—
|
$36,507.69
|
$37,216.58
|
$36,862.13
|
2025-05-18
|
|
6604
|
APR_DRG
|
Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…
|
7
|
7
|
—
|
—
|
$36,495.27
|
$37,203.92
|
$36,849.59
|
2025-05-18
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
29
|
20
|
—
|
—
|
$35,062.06
|
$88,544.09
|
$36,815.16
|
2025-05-18
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
29
|
20
|
—
|
—
|
$34,909.26
|
$88,152.98
|
$36,654.72
|
2025-05-18
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
7
|
7
|
—
|
—
|
$35,963.17
|
$36,661.49
|
$36,312.33
|
2025-05-18
|
|
J9042
|
HCPCS
|
Brentuximab Vedotin 50 Mg Intravenous Solution
|
88
|
40
|
$55,748.34
|
$41,811.26
25% off
|
$248.93
|
$50,173.51
|
$36,292.17
|
2025-05-18
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
29
|
20
|
—
|
—
|
$33,956.07
|
$85,713.11
|
$35,653.87
|
2025-05-18
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
7
|
7
|
—
|
—
|
$35,265.46
|
$35,950.23
|
$35,607.84
|
2025-05-18
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
29
|
20
|
—
|
—
|
$33,844.89
|
$85,428.52
|
$35,537.13
|
2025-05-18
|
|
J2329
|
HCPCS
|
Ublituximab-xiiy 25 Mg/ml Intravenous Solution
|
88
|
40
|
$54,394.88
|
$40,796.16
25% off
|
$68.66
|
$48,955.39
|
$35,411.07
|
2025-05-18
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
29
|
20
|
—
|
—
|
$33,595.22
|
$84,789.43
|
$35,274.98
|
2025-05-18
|
|
J0222
|
HCPCS
|
Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution
|
88
|
40
|
$54,127.53
|
$40,595.65
25% off
|
$99.04
|
$48,714.78
|
$35,237.03
|
2025-05-18
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
29
|
20
|
—
|
—
|
$33,493.80
|
$84,529.80
|
$35,168.49
|
2025-05-18
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
29
|
20
|
—
|
—
|
$33,220.06
|
$83,829.13
|
$34,881.06
|
2025-05-18
|
|
J9999
|
HCPCS
|
Dinutuximab 3.5 Mg/ml Intravenous Solution
|
73
|
41
|
$53,505.93
|
$40,129.45
25% off
|
$12,841.42
|
$48,155.34
|
$34,832.36
|
2025-05-18
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
7
|
7
|
—
|
—
|
$34,453.42
|
$35,122.42
|
$34,787.92
|
2025-05-18
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
7
|
7
|
—
|
—
|
$34,453.42
|
$35,122.42
|
$34,787.92
|
2025-05-18
|
|
6344
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
7
|
7
|
—
|
—
|
$34,352.22
|
$35,019.25
|
$34,685.74
|
2025-05-18
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
7
|
7
|
—
|
—
|
$34,349.53
|
$35,016.51
|
$34,683.02
|
2025-05-18
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
29
|
20
|
—
|
—
|
$33,026.96
|
$83,334.83
|
$34,678.31
|
2025-05-18
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
29
|
20
|
—
|
—
|
$33,001.61
|
$83,269.92
|
$34,651.69
|
2025-05-18
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
29
|
20
|
—
|
—
|
$32,988.60
|
$83,236.64
|
$34,638.03
|
2025-05-18
|
|
1832
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
7
|
7
|
—
|
—
|
$34,284.08
|
$34,949.79
|
$34,616.93
|
2025-05-18
|
|
J9119
|
HCPCS
|
Cemiplimab-rwlc 50 Mg/ml Intravenous Solution
|
88
|
40
|
$53,157.57
|
$39,868.18
25% off
|
$28.92
|
$47,841.81
|
$34,605.57
|
2025-05-18
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
29
|
20
|
—
|
—
|
$32,871.55
|
$82,937.06
|
$34,515.13
|
2025-05-18
|
|
6072
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$34,169.58
|
$34,833.07
|
$34,501.32
|
2025-05-18
|
|
6903
|
APR_DRG
|
Acute Leukemia
|
7
|
7
|
—
|
—
|
$34,139.42
|
$34,802.32
|
$34,470.87
|
2025-05-18
|
|
L8701
|
HCPCS
|
Ewh S/d Uprt Micro Sensor
|
18
|
18
|
—
|
—
|
$34,284.44
|
$61,711.99
|
$34,284.44
|
2025-05-18
|
|
6224
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$33,950.03
|
$34,609.25
|
$34,279.64
|
2025-05-18
|
|
3032
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
7
|
7
|
—
|
—
|
$33,726.97
|
$34,381.86
|
$34,054.42
|
2025-05-18
|
|
0408T
|
CPT
|
Hc Insj/rplc Car Modulj Sys Pls Gen Transvns Eltrd
|
94
|
41
|
$52,041.00
|
$39,030.75
25% off
|
$4,337.33
|
$53,500.26
|
$33,878.69
|
2025-05-18
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
7
|
7
|
—
|
—
|
$33,534.87
|
$34,186.04
|
$33,860.46
|
2025-05-18
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
29
|
20
|
—
|
—
|
$32,244.13
|
$81,331.01
|
$33,856.34
|
2025-05-18
|
|
J1640
|
HCPCS
|
Hemin 350 Mg Intravenous Powder For Solution
|
88
|
40
|
$51,934.30
|
$38,950.73
25% off
|
$33.07
|
$46,740.87
|
$33,809.23
|
2025-05-18
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
7
|
7
|
—
|
—
|
$33,476.87
|
$34,126.91
|
$33,801.89
|
2025-05-18
|
|
1831
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
7
|
7
|
—
|
—
|
$33,332.51
|
$33,979.74
|
$33,656.13
|
2025-05-18
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
29
|
20
|
—
|
—
|
$32,052.32
|
$80,840.04
|
$33,654.94
|
2025-05-18
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
29
|
20
|
—
|
—
|
$31,999.66
|
$80,705.24
|
$33,599.64
|
2025-05-18
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
7
|
7
|
—
|
—
|
$33,066.51
|
$33,708.58
|
$33,387.55
|
2025-05-18
|
|
J9153
|
HCPCS
|
Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution
|
88
|
40
|
$51,168.11
|
$38,376.09
25% off
|
$249.02
|
$46,051.30
|
$33,310.44
|
2025-05-18
|
|
J9203
|
HCPCS
|
Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln
|
88
|
40
|
$51,075.18
|
$38,306.39
25% off
|
$233.12
|
$45,967.66
|
$33,249.94
|
2025-05-18
|
|
264
|
APR_DRG
|
Other Nervous System And Related Procedures
|
7
|
7
|
—
|
—
|
$32,844.18
|
$33,481.93
|
$33,163.05
|
2025-05-18
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
29
|
20
|
—
|
—
|
$31,520.48
|
$79,478.65
|
$33,096.50
|
2025-05-18
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
29
|
20
|
—
|
—
|
$31,385.88
|
$79,134.14
|
$32,955.17
|
2025-05-18
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
29
|
20
|
—
|
—
|
$31,380.04
|
$79,119.16
|
$32,949.04
|
2025-05-18
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
7
|
—
|
—
|
$32,315.78
|
$32,943.27
|
$32,629.52
|
2025-05-18
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
7
|
—
|
—
|
$32,315.78
|
$32,943.27
|
$32,629.52
|
2025-05-18
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (ecmo)
|
7
|
7
|
—
|
—
|
$32,315.78
|
$32,943.27
|
$32,629.52
|
2025-05-18
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
29
|
20
|
—
|
—
|
$31,060.14
|
$78,300.32
|
$32,613.15
|
2025-05-18
|
|
0915T
|
CPT
|
Hc Insj Perm Ccm-d Sys Pg&dual Transvns Eltrds/lds
|
91
|
41
|
$50,016.00
|
$37,512.00
25% off
|
$12,003.84
|
$53,500.26
|
$32,560.42
|
2025-05-18
|
|
234
|
APR_DRG
|
Spinal Procedures
|
7
|
7
|
—
|
—
|
$32,178.61
|
$32,803.44
|
$32,491.02
|
2025-05-18
|
|
J2427
|
HCPCS
|
Paliperidone Palmitate (3 Month) 819 Mg/2.63 Ml Intramuscular Syringe
|
88
|
40
|
$49,881.54
|
$37,411.16
25% off
|
$12.67
|
$44,893.39
|
$32,472.88
|
2025-05-18
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
7
|
7
|
—
|
—
|
$32,153.01
|
$32,777.34
|
$32,465.17
|
2025-05-18
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
29
|
20
|
—
|
—
|
$30,896.29
|
$77,880.92
|
$32,441.10
|
2025-05-18
|
|
1781
|
APR_DRG
|
External Heart Assist Systems
|
7
|
7
|
—
|
—
|
$32,113.87
|
$32,737.44
|
$32,425.65
|
2025-05-18
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
7
|
7
|
—
|
—
|
$32,113.87
|
$32,737.44
|
$32,425.65
|
2025-05-18
|
|
1782
|
APR_DRG
|
External Heart Assist Systems
|
7
|
7
|
—
|
—
|
$32,113.87
|
$32,737.44
|
$32,425.65
|
2025-05-18
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
29
|
20
|
—
|
—
|
$30,716.84
|
$92,078.91
|
$32,252.68
|
2025-05-18
|
|
6123
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
7
|
7
|
—
|
—
|
$31,793.32
|
$32,410.67
|
$32,101.99
|
2025-05-18
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
7
|
7
|
—
|
—
|
$31,688.01
|
$32,303.31
|
$31,995.66
|
2025-05-18
|
|
163
|
MS_DRG
|
Major Chest Procedures With Mcc
|
29
|
20
|
—
|
—
|
$30,439.20
|
$76,710.92
|
$31,961.16
|
2025-05-18
|
|
650
|
MS_DRG
|
Kidney Transplant With Hemodialysis With Mcc
|
29
|
20
|
—
|
—
|
$30,426.85
|
$76,679.29
|
$31,948.19
|
2025-05-18
|
|
221
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
29
|
20
|
—
|
—
|
$30,331.27
|
$76,434.64
|
$31,847.83
|
2025-05-18
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
29
|
20
|
—
|
—
|
$30,326.73
|
$76,422.99
|
$31,843.07
|
2025-05-18
|
|
0571T
|
CPT
|
Hc Insj/rplcmt Icds W/substernal Electrode
|
91
|
40
|
$48,900.00
|
$36,675.00
25% off
|
$1,519.51
|
$53,500.26
|
$31,833.90
|
2025-05-18
|
|
J9037
|
HCPCS
|
Belantamab Mafodotin-blmf 100 Mg Intravenous Solution
|
62
|
36
|
$48,825.25
|
$36,618.94
25% off
|
$114.40
|
$43,942.73
|
$31,785.24
|
2025-05-18
|
|
J7314
|
HCPCS
|
Fluocinolone 0.18 Mg Intravitreal Implant
|
88
|
40
|
$48,734.16
|
$36,550.62
25% off
|
$524.57
|
$43,860.74
|
$31,725.94
|
2025-05-18
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
7
|
7
|
—
|
—
|
$31,207.51
|
$31,813.48
|
$31,510.49
|
2025-05-18
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
7
|
7
|
—
|
—
|
$31,122.43
|
$31,726.75
|
$31,424.59
|
2025-05-18
|
|
8423
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
7
|
7
|
—
|
—
|
$31,105.21
|
$31,709.19
|
$31,407.20
|
2025-05-18
|
|
856
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
29
|
20
|
—
|
—
|
$29,804.62
|
$75,086.56
|
$31,294.85
|
2025-05-18
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
7
|
7
|
—
|
—
|
$30,906.19
|
$31,506.31
|
$31,206.25
|
2025-05-18
|