Price Transparencybeta Hospital negotiated rates

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

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Hospital

LAKE HEALTH

Concord, OH · CCN 360098 · Rates published

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You selected 27447 (CPT)

TOTAL KNEE ARTHROPLASTY

This hospital’s price: $11,928 across 16 payers · range $4,776-$36,074

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/11435/341425870-1972689172_university-hospitals-health-system_standardcharges.csv · observed 2025-05-17

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

14,275 distinct procedures filed
37 distinct payers
1,405,332 rate rows
2025-05-17 last MRF observed · ⚠ 15 mo old
Data quality

1,402,885 of 1,405,332 rate rows are consumer-grade (99.8%)

2,447 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1,702
placeholder amount (≤ $0.02) — excluded from medians 306
per-diem day rate — not a per-procedure price 200
exceeds 10× this hospital's gross charge — excluded from medians 98
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 84
percent-of-charges filed in the dollar field — excluded from medians 57

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 15 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11435/341425870-1972689172_university-hospitals-health-system_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/LakeWestMedicalCenter/11435
Discovered viaDiscovered by HANK
Last fetch success · 2026-08-03
Content fingerprint ddff1495f1c28221… · 4,025,917,395 bytes · first seen 2026-05-08

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
S3399
HCPCS 		Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 1 $4,508,825.00 $4,508,825.00 $4,508,825.00 nat. median
$3,669,056
1.2× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 14 $3,710,000.00 $4,081,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 14 $3,685,266.67 $4,053,793.33 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 14 $3,322,473.30 $3,654,720.62 $3,322,473.30 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 14 $3,286,000.00 $3,614,600.00 $3,286,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 14 $2,948,213.33 $3,243,034.67 $2,948,213.33 nat. median
$2,997,086
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 15 $2,423,131.23 $4,361,636.22 $2,423,131.23 nat. median
$2,460,273
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 15 $2,332,000.00 $4,197,600.00 $2,332,000.00 nat. median
$2,405,851
1.0× median
C9399
HCPCS 		Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 37 $3,090.00 $3,069,000.00 $1,568,600.00 nat. median
$1,984
outlier · 790.4×
Q2055
HCPCS 		Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension 37 $290,192.35 $2,310,120.86 $1,469,089.00 nat. median
$610,161
outlier · 2.4×
Q2054
HCPCS 		Lisocabtagene Maraleucel(cd8) 1.5x To 70x 10exp6 Cell/ml IV Susp(1of2) 37 $284,043.26 $1,901,740.50 $1,436,870.60 nat. median
$624,417
outlier · 2.3×
Q2053
HCPCS 		Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension 37 $269,169.54 $1,849,365.00 $1,397,298.00 nat. median
$577,541
outlier · 2.4×
Q2041
HCPCS 		Axicabtagene Ciloleucel Intravenous Suspension 37 $276,562.40 $1,849,365.00 $1,397,298.00 nat. median
$588,565
outlier · 2.4×
Q2042
HCPCS 		Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension 37 $318,324.12 $2,201,625.00 $1,306,246.00 nat. median
$691,418
1.9× median
Q2057
HCPCS 		Afamitresgene Autoleucel 15 $770,620.00 $1,387,116.00 $770,620.00 nat. median
$809,151
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 15 $553,169.30 $995,704.74 $553,169.30 nat. median
$631,793
0.9× median
J2326
HCPCS 		Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 37 $686.73 $617,972.97 $466,912.91 nat. median
$2,353
outlier · 198.4×
C9301
HCPCS 		Apc 15 $278,250.00 $500,850.00 $278,250.00 nat. median
$459,112
0.6× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 17 $245,675.06 $490,266.40 $257,958.81 nat. median
$370,165
0.7× median
A9543
HCPCS 		Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous 37 $31,253.50 $277,144.49 $209,398.06 nat. median
$63,643
outlier · 3.3×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $189,634.95 $199,116.70 $197,220.35 nat. median
$254,667
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 17 $183,617.81 $366,187.90 $192,798.70 nat. median
$261,939
0.7× median
5834
APR_DRG 		Neonate With Ecmo 5 $183,517.20 $192,693.06 $190,857.89 nat. median
$311,018
0.6× median
5833
APR_DRG 		Neonate With Ecmo 5 $183,517.20 $192,693.06 $190,857.89 nat. median
$250,089
0.8× median
5831
APR_DRG 		Neonate With Ecmo 5 $174,671.65 $183,405.23 $181,658.52 nat. median
$154,685
1.2× median
5832
APR_DRG 		Neonate With Ecmo 5 $174,671.65 $183,405.23 $181,658.52 nat. median
$169,230
1.1× median
1614
APR_DRG 		Implantable Heart Assist Systems 5 $174,003.62 $182,703.80 $180,963.76 nat. median
$209,486
0.9× median
J9226
HCPCS 		Histrelin 50 Mg (65 Mcg/day) Implant Kit 37 $24,866.62 $224,925.38 $169,943.62 nat. median
$55,200
outlier · 3.1×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 17 $154,713.67 $308,396.40 $162,449.35 nat. median
$205,166
0.8× median
24
APR_DRG 		Heart And/or Lung Transplant 5 $153,304.54 $160,969.77 $159,436.72 nat. median
$243,231
0.7× median
J1823
HCPCS 		Inebilizumab-cdon 10 Mg/ml Intravenous Solution 37 $266.42 $202,395.02 $152,920.68 nat. median
$818
outlier · 187.0×
J0223
HCPCS 		Givosiran 189 Mg/ml Subcutaneous Solution 37 $64.06 $199,987.05 $151,101.33 nat. median
$152
outlier · 991.8×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 17 $139,816.54 $278,610.80 $146,807.37 nat. median
$199,832
0.7× median
J9347
HCPCS 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 37 $76.03 $194,162.19 $146,700.32 nat. median
$974
outlier · 150.5×
1613
APR_DRG 		Implantable Heart Assist Systems 5 $135,173.52 $141,932.20 $140,580.46 nat. median
$127,938
1.1× median
1611
APR_DRG 		Implantable Heart Assist Systems 5 $135,173.52 $141,932.20 $140,580.46 nat. median
$82,164
1.7× median
1612
APR_DRG 		Implantable Heart Assist Systems 5 $135,173.52 $141,932.20 $140,580.46 nat. median
$93,192
1.5× median
C9293
HCPCS 		Glucarpidase 1,000 Unit Intravenous Solution 37 $81,090.11 $182,452.74 $137,853.18 nat. median
$24,377
outlier · 5.7×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 5 $131,372.46 $137,941.08 $136,627.36 nat. median
$175,480
0.8× median
8413
APR_DRG 		Extensive Third Degree Burns With Skin Graft 5 $122,440.95 $128,563.00 $127,338.59 nat. median
$64,013
2.0× median
8412
APR_DRG 		Extensive Third Degree Burns With Skin Graft 5 $122,440.95 $128,563.00 $127,338.59 nat. median
$33,878
outlier · 3.8×
8411
APR_DRG 		Extensive Third Degree Burns With Skin Graft 5 $122,440.95 $128,563.00 $127,338.59 nat. median
$31,876
outlier · 4.0×
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 5 $122,440.95 $128,563.00 $127,338.59 nat. median
$165,646
0.8× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 $122,431.99 $128,553.59 $127,329.27 nat. median
$168,174
0.8× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 $118,885.51 $124,829.79 $123,640.93 nat. median
$160,171
0.8× median
J9269
HCPCS 		Tagraxofusp-erzs 1000 Mcg/ml Ns IV - Reconstituted 100 Mcg/ml 37 $186.19 $153,900.54 $116,280.41 nat. median
$498
outlier · 233.6×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 $105,201.20 $110,461.26 $109,409.25 nat. median
$147,677
0.7× median
J7330
HCPCS 		Implant, Maci Final, Product Assembled, Single 37 $62,702.40 $282,160.80 $106,594.08 nat. median
$75,807
1.4× median
J0202
HCPCS 		Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 37 $1,342.82 $140,442.79 $106,112.33 nat. median
$3,876
outlier · 27.4×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $96,905.03 $101,750.28 $100,781.23 nat. median
$180,995
0.6× median

Other procedures at this hospital

Browse this hospital's 14,275 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
S3399 HCPCS Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 1 1 — — $4,508,825.00 $4,508,825.00 $4,508,825.00 2025-05-17
J1414 HCPCS Inj, Beqvez, Per Tx Dose 19 14 — — $3,710,000.00 $4,081,000.00 $3,710,000.00 2025-05-17
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 19 14 — — $3,685,266.67 $4,053,793.33 $3,685,266.67 2025-05-17
J1413 HCPCS Inj Delandistrogene Mox Rokl 19 14 — — $3,322,473.30 $3,654,720.62 $3,322,473.30 2025-05-17
J3394 HCPCS Inj, Lovotibeglogene Autotem 19 14 — — $3,286,000.00 $3,614,600.00 $3,286,000.00 2025-05-17
J3393 HCPCS Inj, Betibeglogene Autotemce 19 14 — — $2,948,213.33 $3,243,034.67 $2,948,213.33 2025-05-17
J3399 HCPCS Inj Onase Abepar-xioi Treat 20 15 — — $2,423,131.23 $4,361,636.22 $2,423,131.23 2025-05-17
J3392 HCPCS Inj, Exagamglogene Autotem 20 15 — — $2,332,000.00 $4,197,600.00 $2,332,000.00 2025-05-17
C9399 HCPCS Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 143 37 $3,080,000.00 $2,310,000.00 25% off $3,090.00 $3,069,000.00 $1,568,600.00 2025-05-17
Q2055 HCPCS Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension 99 37 $2,160,425.00 $1,620,318.75 25% off $290,192.35 $2,310,120.86 $1,469,089.00 2025-05-17
Q2054 HCPCS Lisocabtagene Maraleucel(cd8) 1.5x To 70x 10exp6 Cell/ml IV Susp(1of2) 75 37 $2,113,045.00 $1,584,783.75 25% off $284,043.26 $1,901,740.50 $1,436,870.60 2025-05-17
Q2041 HCPCS Axicabtagene Ciloleucel Intravenous Suspension 75 37 $2,054,850.00 $1,541,137.50 25% off $276,562.40 $1,849,365.00 $1,397,298.00 2025-05-17
Q2053 HCPCS Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension 75 37 $2,054,850.00 $1,541,137.50 25% off $269,169.54 $1,849,365.00 $1,397,298.00 2025-05-17
Q2042 HCPCS Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension 99 37 $1,920,950.00 $1,440,712.50 25% off $318,324.12 $2,201,625.00 $1,306,246.00 2025-05-17
Q2057 HCPCS Afamitresgene Autoleucel 20 15 — — $770,620.00 $1,387,116.00 $770,620.00 2025-05-17
Q2056 HCPCS Ciltacabtagene Car-pos T 20 15 — — $553,169.30 $995,704.74 $553,169.30 2025-05-17
J2326 HCPCS Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 73 37 $686,636.63 $514,977.48 25% off $686.73 $617,972.97 $466,912.91 2025-05-17
C9301 HCPCS Apc 20 15 — — $278,250.00 $500,850.00 $278,250.00 2025-05-17
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 17 — — $245,675.06 $490,266.40 $257,958.81 2025-05-17
A9543 HCPCS Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous 75 37 $307,938.32 $230,953.74 25% off $31,253.50 $277,144.49 $209,398.06 2025-05-17
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $189,634.95 $199,116.70 $197,220.35 2025-05-17
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 24 17 — — $183,617.81 $366,187.90 $192,798.70 2025-05-17
5834 APR_DRG Neonate With Ecmo 5 5 — — $183,517.20 $192,693.06 $190,857.89 2025-05-17
5833 APR_DRG Neonate With Ecmo 5 5 — — $183,517.20 $192,693.06 $190,857.89 2025-05-17
5832 APR_DRG Neonate With Ecmo 5 5 — — $174,671.65 $183,405.23 $181,658.52 2025-05-17
5831 APR_DRG Neonate With Ecmo 5 5 — — $174,671.65 $183,405.23 $181,658.52 2025-05-17
1614 APR_DRG Implantable Heart Assist Systems 5 5 — — $174,003.62 $182,703.80 $180,963.76 2025-05-17
J9226 HCPCS Histrelin 50 Mg (65 Mcg/day) Implant Kit 75 37 $249,917.09 $187,437.82 25% off $24,866.62 $224,925.38 $169,943.62 2025-05-17
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 24 17 — — $154,713.67 $308,396.40 $162,449.35 2025-05-17
24 APR_DRG Heart And/or Lung Transplant 5 5 — — $153,304.54 $160,969.77 $159,436.72 2025-05-17
J1823 HCPCS Inebilizumab-cdon 10 Mg/ml Intravenous Solution 73 37 $224,883.36 $168,662.52 25% off $266.42 $202,395.02 $152,920.68 2025-05-17
J0223 HCPCS Givosiran 189 Mg/ml Subcutaneous Solution 73 37 $222,207.83 $166,655.88 25% off $64.06 $199,987.05 $151,101.33 2025-05-17
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 24 17 — — $139,816.54 $278,610.80 $146,807.37 2025-05-17
J9347 HCPCS Tremelimumab-actl 20 Mg/ml Intravenous Solution 73 37 $215,735.77 $161,801.83 25% off $76.03 $194,162.19 $146,700.32 2025-05-17
1613 APR_DRG Implantable Heart Assist Systems 5 5 — — $135,173.52 $141,932.20 $140,580.46 2025-05-17
1611 APR_DRG Implantable Heart Assist Systems 5 5 — — $135,173.52 $141,932.20 $140,580.46 2025-05-17
1612 APR_DRG Implantable Heart Assist Systems 5 5 — — $135,173.52 $141,932.20 $140,580.46 2025-05-17
C9293 HCPCS Glucarpidase 1,000 Unit Intravenous Solution 59 37 $202,725.27 $152,043.96 25% off $81,090.11 $182,452.74 $137,853.18 2025-05-17
74 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $131,372.46 $137,941.08 $136,627.36 2025-05-17
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $122,440.95 $128,563.00 $127,338.59 2025-05-17
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $122,440.95 $128,563.00 $127,338.59 2025-05-17
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $122,440.95 $128,563.00 $127,338.59 2025-05-17
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 5 5 — — $122,440.95 $128,563.00 $127,338.59 2025-05-17
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $122,431.99 $128,553.59 $127,329.27 2025-05-17
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $118,885.51 $124,829.79 $123,640.93 2025-05-17
J9269 HCPCS Tagraxofusp-erzs 1000 Mcg/ml Ns IV - Reconstituted 100 Mcg/ml 73 37 $171,000.60 $128,250.45 25% off $186.19 $153,900.54 $116,280.41 2025-05-17
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $105,201.20 $110,461.26 $109,409.25 2025-05-17
J7330 HCPCS Implant, Maci Final, Product Assembled, Single 87 37 $156,756.00 $117,567.00 25% off $62,702.40 $282,160.80 $106,594.08 2025-05-17
J0202 HCPCS Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 73 37 $156,047.54 $117,035.66 25% off $1,342.82 $140,442.79 $106,112.33 2025-05-17
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $96,905.03 $101,750.28 $100,781.23 2025-05-17
A9606 HCPCS Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln 73 37 $148,062.50 $111,046.88 25% off $92.98 $133,256.25 $100,682.50 2025-05-17
Q0480 HCPCS Driver Pneumatic Vad, Rep 20 15 — — $99,999.95 $179,999.91 $99,999.95 2025-05-17
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 24 17 — — $92,342.36 $183,690.00 $96,959.48 2025-05-17
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $92,285.87 $96,900.16 $95,977.30 2025-05-17
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $92,285.87 $96,900.16 $95,977.30 2025-05-17
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 20 15 — — $93,216.70 $167,790.06 $93,216.70 2025-05-17
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $89,504.98 $93,980.23 $93,085.18 2025-05-17
J1305 HCPCS Evinacumab-dgnb 150 Mg/ml Intravenous Solution 97 37 $200,850.00 $150,637.50 25% off $102.47 $180,765.00 $92,391.00 2025-05-17
J9359 HCPCS Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution 73 37 $133,461.89 $100,096.42 25% off $116.60 $120,115.70 $90,754.09 2025-05-17
Q2043 HCPCS Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 75 37 $133,364.40 $100,023.30 25% off $31,359.41 $120,027.96 $90,687.79 2025-05-17
14 MS_DRG Allogeneic Bone Marrow Transplant 24 17 — — $85,657.13 $170,323.40 $89,939.99 2025-05-17
7 MS_DRG Lung Transplant 24 17 — — $85,442.56 $169,894.40 $89,714.69 2025-05-17
J1747 HCPCS Spesolimab-sbzo 60 Mg/ml Intravenous Solution 73 37 $131,667.49 $98,750.62 25% off $33.79 $118,500.74 $89,533.90 2025-05-17
J2507 HCPCS Pegloticase 8 Mg/ml Intravenous Solution 73 37 $131,153.51 $98,365.14 25% off $1,960.92 $118,038.16 $89,184.38 2025-05-17
J9118 HCPCS Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 59 37 $128,920.57 $96,690.43 25% off $51,568.23 $116,028.51 $87,665.99 2025-05-17
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $83,252.25 $87,414.86 $86,582.34 2025-05-17
J9228 HCPCS Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 97 37 $177,906.55 $133,429.92 25% off $99.12 $160,115.90 $81,837.01 2025-05-17
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $76,761.50 $80,599.58 $79,831.96 2025-05-17
J9348 HCPCS Naxitamab-gqgk 4 Mg/ml Intravenous Solution 73 37 $116,612.85 $87,459.64 25% off $353.01 $104,951.57 $79,296.74 2025-05-17
J9229 HCPCS Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln 73 37 $116,476.42 $87,357.32 25% off $1,461.97 $104,828.78 $79,203.96 2025-05-17
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 75 37 $114,548.67 $85,911.51 25% off $14,888.79 $103,093.80 $77,893.10 2025-05-17
J9274 HCPCS Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution 73 37 $112,071.97 $84,053.98 25% off $118.12 $100,864.77 $76,208.94 2025-05-17
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 24 17 — — $72,119.55 $143,256.10 $75,725.53 2025-05-17
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 24 17 — — $71,301.62 $141,620.70 $74,866.70 2025-05-17
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 24 17 — — $69,711.90 $138,442.20 $73,197.50 2025-05-17
215 MS_DRG Other Heart Assist System Implant 24 17 — — $69,356.90 $137,732.40 $72,824.75 2025-05-17
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 17 — — $68,580.57 $136,180.20 $72,009.60 2025-05-17
22 APR_DRG Heart And/or Lung Transplant 5 5 — — $69,202.00 $72,662.10 $71,970.08 2025-05-17
23 APR_DRG Heart And/or Lung Transplant 5 5 — — $69,202.00 $72,662.10 $71,970.08 2025-05-17
21 APR_DRG Heart And/or Lung Transplant 5 5 — — $69,202.00 $72,662.10 $71,970.08 2025-05-17
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $69,094.18 $72,548.89 $71,857.95 2025-05-17
J7311 HCPCS Fluocinolone 0.59 Mg Intravitreal Implant 73 37 $105,240.36 $78,930.27 25% off $187.02 $94,716.32 $71,563.45 2025-05-17
J9600 HCPCS Porfimer 75 Mg Intravenous Solution 75 37 $105,199.05 $78,899.29 25% off $13,325.63 $94,679.15 $71,535.35 2025-05-17
73 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $65,265.73 $68,529.02 $67,876.36 2025-05-17
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 20 15 — — $67,452.66 $121,414.79 $67,452.66 2025-05-17
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 73 37 $98,446.22 $73,834.67 25% off $31.79 $88,601.60 $66,943.43 2025-05-17
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 17 — — $63,221.08 $125,464.30 $66,382.13 2025-05-17
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $62,952.63 $66,100.26 $65,470.74 2025-05-17
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $61,969.10 $65,067.56 $64,447.86 2025-05-17
J0638 HCPCS Canakinumab (pf) 150 Mg/ml Subcutaneous Solution 73 37 $94,723.08 $71,042.31 25% off $75.11 $85,250.77 $64,411.69 2025-05-17
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $61,311.63 $64,377.21 $63,764.10 2025-05-17
850 MS_DRG Acute Leukemia With Other Procedures 24 17 — — $60,365.43 $119,754.70 $63,383.70 2025-05-17
L8688 HCPCS Generator, M1000-d, Sentiva Duo 60 37 $102,755.64 $77,066.73 25% off $34,217.63 $92,480.08 $63,348.86 2025-05-17
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 5 5 — — $59,439.57 $62,411.55 $61,817.15 2025-05-17
A9604 HCPCS Samarium Sm 153 Lexidronam 5,550 Mbq/3 Ml Intravenous Solution 73 37 $88,888.25 $66,666.19 25% off $2,373.20 $79,999.43 $60,444.01 2025-05-17
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $57,705.13 $60,590.39 $60,013.34 2025-05-17
8514 APR_DRG Gender Related Procedures 5 5 — — $57,595.30 $60,475.07 $59,899.11 2025-05-17
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $56,845.01 $59,687.26 $59,118.81 2025-05-17
J9309 HCPCS Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution 73 37 $86,294.33 $64,720.75 25% off $73.00 $77,664.90 $58,680.14 2025-05-17
231 MS_DRG Coronary Bypass With Ptca With Mcc 24 17 — — $55,567.05 $110,160.70 $58,345.40 2025-05-17
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 17 — — $55,536.49 $110,099.60 $58,313.31 2025-05-17
14 APR_DRG Liver Transplant And/or Intestinal Transplant 5 5 — — $55,526.41 $58,302.73 $57,747.47 2025-05-17
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 24 17 — — $54,700.34 $108,427.80 $57,435.36 2025-05-17
J3241 HCPCS Teprotumumab-trbw 500 Mg Intravenous Solution 73 37 $83,988.16 $62,991.12 25% off $193.91 $75,589.34 $57,111.94 2025-05-17
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $53,765.71 $56,454.00 $55,916.34 2025-05-17
J2502 HCPCS Pasireotide Pamoate 20 Mg IM Suspension 73 37 $82,121.85 $61,591.39 25% off $289.82 $73,909.67 $55,842.86 2025-05-17
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 24 17 — — $52,883.08 $104,794.30 $55,527.23 2025-05-17
84 APR_DRG Autologous Bone Marrow Transplant 5 5 — — $52,818.96 $55,459.91 $54,931.72 2025-05-17
10 MS_DRG Pancreas Transplant 24 17 — — $52,310.26 $103,649.00 $54,925.77 2025-05-17
38240 CPT Transplt Allo Hct/donor 23 16 — — $3,679.00 $165,815.28 $54,827.31 2025-05-17
72 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $52,693.50 $55,328.18 $54,801.24 2025-05-17
71 APR_DRG Allogeneic Bone Marrow Transplant 5 5 — — $52,693.50 $55,328.18 $54,801.24 2025-05-17
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 24 17 — — $52,013.12 $103,054.90 $54,613.78 2025-05-17
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 5 5 — — $52,477.67 $55,101.55 $54,576.78 2025-05-17
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 5 5 — — $52,430.22 $55,051.73 $54,527.43 2025-05-17
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 24 17 — — $51,292.05 $101,613.20 $53,856.65 2025-05-17
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 17 — — $50,779.06 $100,587.50 $53,318.01 2025-05-17
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $51,091.09 $53,645.64 $53,134.73 2025-05-17
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $50,529.36 $53,055.83 $52,550.53 2025-05-17
J9029 HCPCS Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension 75 37 $77,250.00 $57,937.50 25% off $30,900.00 $113,824.09 $52,530.00 2025-05-17
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 73 37 $75,752.49 $56,814.37 25% off $106.74 $68,177.24 $51,511.69 2025-05-17
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 24 17 — — $49,002.09 $97,034.60 $51,452.19 2025-05-17
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $48,707.51 $51,142.89 $50,655.81 2025-05-17
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $48,707.51 $51,142.89 $50,655.81 2025-05-17
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 5 5 — — $48,548.89 $50,976.33 $50,490.85 2025-05-17
1834 APR_DRG Percutaneous Structural Cardiac Procedures 5 5 — — $48,334.27 $50,750.98 $50,267.64 2025-05-17
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $48,245.30 $50,657.57 $50,175.11 2025-05-17
8634 APR_DRG Neonatal Aftercare 5 5 — — $48,178.21 $50,587.12 $50,105.34 2025-05-17
1784 APR_DRG External Heart Assist Systems 5 5 — — $48,162.89 $50,571.03 $50,089.41 2025-05-17
6904 APR_DRG Acute Leukemia 5 5 — — $47,983.33 $50,382.50 $49,902.66 2025-05-17
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 5 5 — — $47,712.40 $50,098.02 $49,620.90 2025-05-17
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $47,117.84 $49,473.73 $49,002.55 2025-05-17
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 17 — — $46,651.66 $92,335.10 $48,984.24 2025-05-17
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 24 17 — — $46,419.54 $91,871.00 $48,740.52 2025-05-17
L7181 HCPCS Electronic Elbo Simultaneous 20 15 — — $48,370.76 $87,067.37 $48,370.76 2025-05-17
J1628 HCPCS Guselkumab 100 Mg/ml Subcutaneous Syringe 73 37 $70,893.10 $53,169.83 25% off $38.73 $63,803.79 $48,207.31 2025-05-17
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 24 17 — — $45,701.09 $90,434.50 $47,986.14 2025-05-17
33276 CPT Hc Insertion Phrenic Nerve Stimulator System 75 37 $70,201.00 $52,650.75 25% off $22,944.49 $75,091.07 $47,736.68 2025-05-17
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $45,529.57 $47,806.05 $47,350.75 2025-05-17
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 73 37 $69,344.76 $52,008.57 25% off $121.94 $62,410.28 $47,154.43 2025-05-17
955 MS_DRG Craniotomy For Multiple Significant Trauma 24 17 — — $44,867.54 $88,767.90 $47,110.92 2025-05-17
L7180 HCPCS Electronic Elbow Sequential 20 15 — — $46,980.38 $84,564.68 $46,980.38 2025-05-17
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $45,101.89 $47,356.98 $46,905.97 2025-05-17
J3357 HCPCS Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe 121 37 $68,405.39 $51,304.05 25% off $83.81 $123,129.76 $46,515.67 2025-05-17
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 24 17 — — $44,063.92 $87,161.10 $46,267.12 2025-05-17
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 24 17 — — $43,896.17 $86,825.70 $46,090.98 2025-05-17
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 24 17 — — $43,822.70 $86,678.80 $46,013.84 2025-05-17
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $43,841.97 $46,034.07 $45,595.65 2025-05-17
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $43,752.38 $45,940.00 $45,502.48 2025-05-17
A9572 HCPCS Indium 111-pentetreotide 3 Mci/ml-10 Mcg Intravenous Kit 73 37 $66,218.70 $49,664.03 25% off $1,053.04 $59,596.83 $45,028.71 2025-05-17
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $43,183.61 $45,342.79 $44,910.95 2025-05-17
5894 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $43,183.61 $45,342.79 $44,910.95 2025-05-17
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 24 17 — — $42,519.72 $84,073.60 $44,645.71 2025-05-17
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 17 — — $42,459.26 $83,952.70 $44,582.22 2025-05-17
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 5 5 — — $42,512.41 $44,638.03 $44,212.91 2025-05-17
J3245 HCPCS Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 73 37 $64,818.73 $48,614.05 25% off $72.30 $58,336.86 $44,076.74 2025-05-17
6954 APR_DRG Chemotherapy For Acute Leukemia 5 5 — — $42,283.07 $44,397.22 $43,974.39 2025-05-17
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 24 17 — — $41,590.58 $82,215.90 $43,670.11 2025-05-17
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 5 — — $41,954.93 $44,052.68 $43,633.13 2025-05-17
03060 EAPG Ventricular Assist Device Procedures 5 5 — — $41,301.43 $43,366.50 $43,366.50 2025-05-17
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $41,506.95 $43,582.30 $43,167.23 2025-05-17
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $41,318.25 $43,384.16 $42,970.98 2025-05-17
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $41,185.88 $43,245.17 $42,833.32 2025-05-17
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 5 5 — — $41,185.88 $43,245.17 $42,833.32 2025-05-17
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 24 17 — — $40,746.00 $80,527.20 $42,783.30 2025-05-17
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 24 17 — — $40,693.98 $80,423.20 $42,728.68 2025-05-17
C1824 HCPCS Generator, Pulse, Optimizer Smart Ipg 60 37 $69,000.00 $51,750.00 25% off $22,977.00 $62,100.00 $42,538.50 2025-05-17
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 24 17 — — $40,510.64 $80,056.60 $42,536.17 2025-05-17
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 24 17 — — $40,370.83 $79,777.10 $42,389.37 2025-05-17
232 MS_DRG Coronary Bypass With Ptca Without Mcc 24 17 — — $40,188.78 $79,413.10 $42,198.22 2025-05-17
224 APR_DRG Ventricular Shunt Procedures 5 5 — — $40,427.48 $42,448.85 $42,044.58 2025-05-17
28 MS_DRG Spinal Procedures With Mcc 24 17 — — $39,998.94 $79,033.50 $41,998.89 2025-05-17
83 APR_DRG Autologous Bone Marrow Transplant 5 5 — — $40,232.99 $42,244.64 $41,842.31 2025-05-17
0266T CPT Apc 20 15 — — $41,717.26 $75,091.07 $41,717.26 2025-05-17
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 24 17 — — $39,715.45 $78,466.70 $41,701.22 2025-05-17
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 24 17 — — $39,715.45 $78,466.70 $41,701.22 2025-05-17
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $39,872.48 $41,866.10 $41,467.38 2025-05-17
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $39,872.48 $41,866.10 $41,467.38 2025-05-17
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $39,872.48 $41,866.10 $41,467.38 2025-05-17
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 — — $39,872.48 $41,866.10 $41,467.38 2025-05-17
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 24 17 — — $39,422.20 $77,880.40 $41,393.31 2025-05-17
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 17 — — $39,152.39 $77,340.90 $41,110.01 2025-05-17
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 24 17 — — $39,123.13 $77,282.40 $41,079.29 2025-05-17
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 5 5 — — $39,200.46 $41,160.48 $40,768.48 2025-05-17
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 24 17 — — $38,729.11 $76,494.60 $40,665.57 2025-05-17
J9316 HCPCS Pertuzumab 1,200 Mg-trastuzumab 600 Mg-hyaluron-zzxf/15 Ml Subcut Soln 97 37 $70,291.17 $52,718.38 25% off $34.65 $63,262.05 $40,298.68 2025-05-17
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 24 17 — — $38,326.65 $75,689.90 $40,242.98 2025-05-17
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 5 5 — — $38,158.34 $40,066.26 $39,684.67 2025-05-17
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 17 — — $37,787.64 $74,612.20 $39,677.02 2025-05-17
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 24 17 — — $37,564.63 $74,166.30 $39,442.86 2025-05-17
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $37,571.84 $39,450.43 $39,074.71 2025-05-17
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 20 15 — — $38,762.63 $69,772.73 $38,762.63 2025-05-17
J9321 HCPCS Epcoritamab-bysp 48 Mg/0.8 Ml Subcutaneous Solution 97 37 $84,223.03 $63,167.28 25% off $30.17 $75,800.73 $38,742.59 2025-05-17
33902 CPT Hc Perq P-art Revsc St 1st Abnor Connj Unilateral 76 37 $56,767.00 $42,575.25 25% off $5,094.00 $51,090.30 $38,601.56 2025-05-17
653 MS_DRG Major Bladder Procedures With Mcc 24 17 — — $36,716.13 $72,469.80 $38,551.94 2025-05-17
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 5 — — $37,007.80 $38,858.19 $38,488.11 2025-05-17
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 5 — — $37,007.80 $38,858.19 $38,488.11 2025-05-17
8633 APR_DRG Neonatal Aftercare 5 5 — — $36,947.46 $38,794.83 $38,425.36 2025-05-17
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $36,786.02 $38,625.32 $38,257.46 2025-05-17
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $36,786.02 $38,625.32 $38,257.46 2025-05-17
834 MS_DRG Acute Leukemia With Mcc 24 17 — — $36,408.60 $71,854.90 $38,229.03 2025-05-17
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 24 17 — — $36,408.60 $71,854.90 $38,229.03 2025-05-17
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 17 — — $36,257.75 $71,553.30 $38,070.64 2025-05-17
J9042 HCPCS Brentuximab Vedotin 50 Mg/10 Ml IV Injection - Reconstituted 5 Mg/ml 73 37 $55,748.34 $41,811.26 25% off $136.91 $50,173.51 $37,908.88 2025-05-17
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 24 17 — — $36,039.28 $71,116.50 $37,841.24 2025-05-17
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 24 17 — — $35,848.12 $70,734.30 $37,640.53 2025-05-17
914 APR_DRG Other Major Head And Neck Procedures 5 5 — — $36,162.12 $37,970.23 $37,608.60 2025-05-17
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 24 17 — — $35,767.51 $70,573.10 $37,555.89 2025-05-17
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $36,097.53 $37,902.41 $37,541.43 2025-05-17
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $36,097.53 $37,902.41 $37,541.43 2025-05-17
6301 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $36,003.02 $37,803.17 $37,443.14 2025-05-17
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 5 — — $36,003.02 $37,803.17 $37,443.14 2025-05-17
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 24 17 — — $35,587.40 $70,213.00 $37,366.77 2025-05-17
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 24 17 — — $35,554.25 $70,146.70 $37,331.96 2025-05-17
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 24 17 — — $35,550.34 $70,138.90 $37,327.86 2025-05-17
J1323 HCPCS Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution 145 37 $67,211.21 $50,408.41 25% off $100.64 $72,588.11 $37,100.59 2025-05-17
J2329 HCPCS Ublituximab-xiiy 25 Mg/ml Intravenous Solution 73 37 $54,394.88 $40,796.16 25% off $37.76 $48,955.39 $36,988.51 2025-05-17
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 24 17 — — $35,062.06 $69,162.60 $36,815.16 2025-05-17
J0222 HCPCS Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution 73 37 $54,127.53 $40,595.65 25% off $54.47 $48,714.78 $36,806.72 2025-05-17
2004 APR_DRG Cardiac Structural And Valvular Disorders 5 5 — — $35,334.82 $37,101.56 $36,748.21 2025-05-17
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 17 — — $34,909.26 $68,857.10 $36,654.72 2025-05-17
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 5 5 — — $35,100.36 $36,855.38 $36,504.37 2025-05-17
J9999 HCPCS Dinutuximab 3.5 Mg/ml Intravenous Solution 59 37 $53,505.93 $40,129.45 25% off $21,402.37 $48,155.34 $36,384.04 2025-05-17
9104 APR_DRG Craniotomy For Multiple Significant Trauma 5 5 — — $34,899.32 $36,644.29 $36,295.29 2025-05-17
J9119 HCPCS Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 73 37 $53,157.57 $39,868.18 25% off $15.91 $47,841.81 $36,147.14 2025-05-17
C2624 HCPCS Delivery System, Cardiomems Pa Sensor, Includes Cm2000, Cm1000 91 37 $58,500.00 $43,875.00 25% off $19,480.50 $64,125.00 $36,065.25 2025-05-17
1833 APR_DRG Percutaneous Structural Cardiac Procedures 5 5 — — $34,659.04 $36,391.99 $36,045.40 2025-05-17
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 24 17 — — $33,956.07 $66,951.30 $35,653.87 2025-05-17
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 24 17 — — $33,844.89 $66,729.00 $35,537.13 2025-05-17
J1640 HCPCS Hemin 350 Mg Intravenous Powder For Solution 73 37 $51,934.30 $38,950.73 25% off $18.19 $46,740.87 $35,315.32 2025-05-17
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 24 17 — — $33,595.22 $66,229.80 $35,274.98 2025-05-17
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 24 17 — — $33,493.80 $66,027.00 $35,168.49 2025-05-17
1794 APR_DRG Defibrillator Implants 5 5 — — $33,781.43 $35,470.50 $35,132.69 2025-05-17
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 5 5 — — $33,574.58 $35,253.31 $34,917.56 2025-05-17
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 24 17 — — $33,220.06 $65,479.70 $34,881.06 2025-05-17
214 APR_DRG Open Craniotomy Except Trauma 5 5 — — $33,518.15 $35,194.06 $34,858.88 2025-05-17
J9153 HCPCS Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution 73 37 $51,168.11 $38,376.09 25% off $136.96 $46,051.30 $34,794.32 2025-05-17
J9203 HCPCS Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln 73 37 $51,075.18 $38,306.39 25% off $128.22 $45,967.66 $34,731.12 2025-05-17
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 24 17 — — $33,026.96 $65,093.60 $34,678.31 2025-05-17
1204 APR_DRG Major Respiratory And Chest Procedures 5 5 — — $33,340.92 $35,007.97 $34,674.56 2025-05-17
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 24 17 — — $33,001.61 $65,042.90 $34,651.69 2025-05-17
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 24 17 — — $32,988.60 $65,016.90 $34,638.03 2025-05-17
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $33,261.04 $34,924.09 $34,591.48 2025-05-17
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 5 5 — — $33,250.36 $34,912.88 $34,580.37 2025-05-17
228 MS_DRG Other Cardiothoracic Procedures With Mcc 24 17 — — $32,871.55 $64,782.90 $34,515.13 2025-05-17
L8701 HCPCS Ewh S/d Uprt Micro Sensor 20 15 — — $34,284.44 $61,711.99 $34,284.44 2025-05-17
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $32,792.87 $34,432.51 $34,104.58 2025-05-17
J2427 HCPCS Paliperidone Palmitate (3 Month) 819 Mg/2.63 Ml Intramuscular Syringe 73 37 $49,881.54 $37,411.16 25% off $6.97 $44,893.39 $33,919.45 2025-05-17
245 MS_DRG Aicd Generator Procedures 24 17 — — $32,244.13 $63,528.40 $33,856.34 2025-05-17
471 MS_DRG Cervical Spinal Fusion With Mcc 24 17 — — $32,052.32 $63,144.90 $33,654.94 2025-05-17
6 MS_DRG Liver Transplant Without Mcc 24 17 — — $31,999.66 $63,039.60 $33,599.64 2025-05-17
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 5 5 — — $32,192.98 $33,802.63 $33,480.70 2025-05-17
0571T CPT Hc Insj/rplcmt Icds W/substernal Electrode 77 37 $48,900.00 $36,675.00 25% off $7,667.00 $89,889.93 $33,252.00 2025-05-17
J9037 HCPCS Belantamab Mafodotin-blmf 100 Mg Intravenous Solution 59 37 $48,825.25 $36,618.94 25% off $19,530.10 $43,942.73 $33,201.18 2025-05-17
J7314 HCPCS Fluocinolone 0.18 Mg Intravitreal Implant 73 37 $48,734.16 $36,550.62 25% off $288.51 $43,860.74 $33,139.22 2025-05-17
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 24 17 — — $31,520.48 $62,081.50 $33,096.50 2025-05-17
799 MS_DRG Splenic Procedures With Mcc 24 17 — — $31,385.88 $61,812.40 $32,955.17 2025-05-17
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 24 17 — — $31,380.04 $61,800.70 $32,949.04 2025-05-17
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 5 — — $31,494.81 $33,069.55 $32,754.60 2025-05-17
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 5 5 — — $31,494.81 $33,069.55 $32,754.60 2025-05-17
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 5 5 — — $31,407.79 $32,978.18 $32,664.10 2025-05-17
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 5 5 — — $31,405.49 $32,975.76 $32,661.71 2025-05-17
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 24 17 — — $31,060.14 $61,161.10 $32,613.15 2025-05-17
1832 APR_DRG Percutaneous Structural Cardiac Procedures 5 5 — — $31,349.21 $32,916.67 $32,603.18 2025-05-17
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $31,250.77 $32,813.31 $32,500.80 2025-05-17
6903 APR_DRG Acute Leukemia 5 5 — — $31,224.84 $32,786.08 $32,473.83 2025-05-17
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 24 17 — — $30,896.29 $60,833.50 $32,441.10 2025-05-17
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 5 5 — — $31,061.99 $32,615.09 $32,304.47 2025-05-17
J9022 HCPCS Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution 97 37 $54,479.59 $40,859.70 25% off $49.17 $49,031.63 $32,262.88 2025-05-17
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 24 17 — — $30,716.84 $60,474.70 $32,252.68 2025-05-17
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $30,870.22 $32,413.73 $32,105.03 2025-05-17
J9307 HCPCS Pralatrexate 40 Mg/2 Ml (20 Mg/ml) Intravenous Solution 97 37 $65,058.36 $48,793.77 25% off $205.57 $58,552.52 $32,011.91 2025-05-17
163 MS_DRG Major Chest Procedures With Mcc 24 17 — — $30,439.20 $59,919.60 $31,961.16 2025-05-17
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 24 17 — — $30,426.85 $59,894.90 $31,948.19 2025-05-17
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $30,705.06 $32,240.31 $31,933.26 2025-05-17
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 5 5 — — $30,655.19 $32,187.95 $31,881.40 2025-05-17
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 17 — — $30,331.27 $59,703.80 $31,847.83 2025-05-17
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 24 17 — — $30,326.73 $59,694.70 $31,843.07 2025-05-17
93654 CPT Hc Ep Ephys Eval W/ablation Ventricular Tachycardia 77 37 $46,795.00 $35,096.25 25% off $7,667.00 $68,780.35 $31,820.60 2025-05-17
1831 APR_DRG Percutaneous Structural Cardiac Procedures 5 5 — — $30,531.07 $32,057.62 $31,752.31 2025-05-17
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 5 5 — — $30,302.37 $31,817.49 $31,514.46 2025-05-17
63685 CPT Hc Insj/rplcmt Spinal Npg/rcvr Pocket Crtj&connj 74 37 $46,154.00 $34,615.50 25% off $1,857.44 $85,437.73 $31,384.72 2025-05-17
33287 CPT Hc Rmvl&rplcmt Phrenic Nrv Stimulator Pls Generator 76 37 $46,154.00 $34,615.50 25% off $18,461.60 $85,437.73 $31,384.72 2025-05-17
264 APR_DRG Other Nervous System And Related Procedures 5 5 — — $30,111.21 $31,616.77 $31,315.66 2025-05-17
J9144 HCPCS Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 73 37 $46,047.73 $34,535.80 25% off $29.15 $41,442.96 $31,312.46 2025-05-17
J1632 HCPCS Brexanolone 5 Mg/ml Intravenous Solution 59 37 $46,041.00 $34,530.75 25% off $18,416.40 $41,436.90 $31,307.88 2025-05-17
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 24 17 — — $29,804.62 $58,650.80 $31,294.85 2025-05-17
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 24 17 — — $29,629.71 $58,301.10 $31,111.20 2025-05-17
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 24 17 — — $29,549.10 $58,139.90 $31,026.56 2025-05-17
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $29,656.90 $31,139.75 $30,843.18 2025-05-17
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $29,656.90 $31,139.75 $30,843.18 2025-05-17
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 5 5 — — $29,656.90 $31,139.75 $30,843.18 2025-05-17
901 MS_DRG Wound Debridements For Injuries With Mcc 24 17 — — $29,277.31 $57,596.50 $30,741.18 2025-05-17
234 APR_DRG Spinal Procedures 5 5 — — $29,538.97 $31,015.92 $30,720.53 2025-05-17
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 5 5 — — $29,516.95 $30,992.80 $30,697.63 2025-05-17
C9606 HCPCS Hc Perc Drug Elute Cor Revasc W/ami Single 59 37 $45,139.00 $33,854.25 25% off $14,352.00 $40,625.10 $30,694.52 2025-05-17
1783 APR_DRG External Heart Assist Systems 5 5 — — $29,483.30 $30,957.47 $30,662.63 2025-05-17
1782 APR_DRG External Heart Assist Systems 5 5 — — $29,483.30 $30,957.47 $30,662.63 2025-05-17
1781 APR_DRG External Heart Assist Systems 5 5 — — $29,483.30 $30,957.47 $30,662.63 2025-05-17
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 24 17 — — $29,032.20 $57,106.40 $30,483.81 2025-05-17
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