Hospital

UH CLEVELAND MEDICAL CENTER

Cleveland, OH · CCN 360137 · Rates published

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You selected 93306 (CPT)

HC TTE W/DOPPLER COMPLETE - TTE COMPLETE

This hospital’s price: $1,291 across 44 payers · range $452-$2,192

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/7901/341567805-1043397292_university-hospitals-health-system_standardcharges.csv · observed 2025-05-16

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.

14,445 distinct procedures filed

44 distinct payers

2,093,880 rate rows

2025-05-16 last MRF observed · ⚠ 17 mo old

Data quality

2,092,187 of 2,093,880 rate rows are consumer-grade (99.9%)

1,693 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
placeholder amount (≤ $0.02) — excluded from medians	493
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	448
per-diem day rate — not a per-procedure price	289
percent-of-charges filed in the dollar field — excluded from medians	251
exceeds 10× this hospital's gross charge — excluded from medians	203
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	6
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	3

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old.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/7901/341567805-1043397292_university-hospitals-health-system_standardcharges.csv
Found on page	https://search.hospitalpriceindex.com/hpi2/machineReadable/ClevelandMedicalCenter/7901
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-09-21
Content fingerprint	71f2639f3e9b99d6… · 4,871,389,959 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	2	$3,178,721.63	$4,565,185.31	$4,508,825.00	nat. median $3,669,056 1.2× median
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	15	$3,710,000.00	$3,895,500.00	$3,710,000.00	nat. median $3,710,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	15	$3,685,266.67	$3,869,530.00	$3,685,266.67	nat. median $3,703,693 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	15	$3,322,473.30	$3,488,596.96	$3,322,473.30	nat. median $3,324,572 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	15	$3,286,000.00	$3,450,300.00	$3,286,000.00	nat. median $3,286,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	15	$2,948,213.33	$3,095,624.00	$2,948,213.33	nat. median $2,994,107 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	18	$2,423,131.23	$4,361,636.22	$2,423,131.23	nat. median $2,466,282 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	18	$2,332,000.00	$4,197,600.00	$2,332,000.00	nat. median $2,401,960 1.0× median
C9399 HCPCS	Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp	44	$2,178.45	$3,069,000.00	$1,705,000.00	nat. median $2,001 outlier · 852.1×
Q2055 HCPCS	Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension	44	$527,622.46	$4,943,841.06	$1,655,586.61	nat. median $622,245 outlier · 2.7×
Q2054 HCPCS	Lisocabtagene Maraleucel(cd8) 1.5x To 70x 10exp6 Cell/ml IV Susp(1of2)	44	$516,442.29	$4,833,305.90	$1,378,761.86	nat. median $640,950 outlier · 2.2×
Q2053 HCPCS	Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension	44	$489,399.16	$4,584,288.00	$1,340,789.62	nat. median $591,650 outlier · 2.3×
Q2041 HCPCS	Axicabtagene Ciloleucel Intravenous Suspension	44	$502,840.73	$4,584,288.00	$1,340,789.62	nat. median $608,101 outlier · 2.2×
Q2042 HCPCS	Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension	44	$541,707.90	$4,599,652.50	$1,253,419.88	nat. median $738,272 1.7× median
Q2057 HCPCS	Afamitresgene Autoleucel	18	$770,620.00	$1,387,116.00	$770,620.00	nat. median $809,217 1.0× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	18	$553,169.30	$4,564,763.28	$553,169.30	nat. median $646,415 0.9× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	21	$353,545.50	$830,737.56	$532,127.61	nat. median $359,358 1.5× median
J2326 HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	44	$1,248.60	$617,972.97	$448,030.41	nat. median $2,487 outlier · 180.1×
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	21	$264,696.72	$620,491.31	$397,454.71	nat. median $249,124 1.6× median
5884 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	$390,088.51	$397,663.05	$393,875.78	nat. median $247,214 1.6× median
5833 APR_DRG	Neonate With Ecmo	7	$377,389.28	$384,717.23	$381,053.25	nat. median $244,017 1.6× median
5834 APR_DRG	Neonate With Ecmo	7	$377,389.28	$384,717.23	$381,053.25	nat. median $307,273 1.2× median
5832 APR_DRG	Neonate With Ecmo	7	$359,027.67	$365,999.08	$362,513.37	nat. median $159,249 outlier · 2.3×
5831 APR_DRG	Neonate With Ecmo	7	$359,027.67	$365,999.08	$362,513.37	nat. median $146,591 outlier · 2.5×
1614 APR_DRG	Implantable Heart Assist Systems	7	$357,640.97	$364,585.45	$361,113.21	nat. median $202,993 1.8× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	21	$223,314.01	$522,565.84	$334,728.71	nat. median $198,433 1.7× median
24 APR_DRG	Heart And/or Lung Transplant	7	$314,673.76	$320,783.93	$317,728.84	nat. median $241,915 1.3× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	21	$201,985.45	$472,095.28	$302,399.88	nat. median $190,557 1.6× median
1611 APR_DRG	Implantable Heart Assist Systems	7	$277,037.33	$282,416.69	$279,727.01	nat. median $76,852 outlier · 3.6×
1612 APR_DRG	Implantable Heart Assist Systems	7	$277,037.33	$282,416.69	$279,727.01	nat. median $84,808 outlier · 3.3×
1613 APR_DRG	Implantable Heart Assist Systems	7	$277,037.33	$282,416.69	$279,727.01	nat. median $120,517 outlier · 2.3×
C9301 HCPCS	Apc	18	$278,250.00	$500,850.00	$278,250.00	nat. median $459,112 0.6× median
74 APR_DRG	Allogeneic Bone Marrow Transplant	7	$269,147.10	$274,373.25	$271,760.17	nat. median $170,172 1.6× median
8413 APR_DRG	Extensive Third Degree Burns With Skin Graft	7	$250,607.03	$255,473.19	$253,040.11	nat. median $61,012 outlier · 4.1×
8411 APR_DRG	Extensive Third Degree Burns With Skin Graft	7	$250,607.03	$255,473.19	$253,040.11	nat. median $31,407 outlier · 8.1×
8412 APR_DRG	Extensive Third Degree Burns With Skin Graft	7	$250,607.03	$255,473.19	$253,040.11	nat. median $32,555 outlier · 7.8×
8414 APR_DRG	Extensive Third Degree Burns With Skin Graft	7	$250,607.03	$255,473.19	$253,040.11	nat. median $156,153 1.6× median
6094 APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	7	$250,588.44	$255,454.24	$253,021.34	nat. median $165,000 1.5× median
6304 APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	7	$243,226.65	$247,949.50	$245,588.08	nat. median $154,011 1.6× median
6314 APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	7	$214,820.70	$218,991.98	$216,906.34	nat. median $133,164 1.6× median
A9543 HCPCS	Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous	44	$56,824.55	$667,861.12	$200,929.76	nat. median $63,643 outlier · 3.2×
5883 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	$197,599.52	$201,436.40	$199,517.96	nat. median $175,429 1.1× median
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And…	21	$134,015.59	$311,255.64	$199,374.30	nat. median $126,722 1.6× median
5882 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	$188,011.05	$191,661.75	$189,836.40	nat. median $145,061 1.3× median
5881 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	$188,011.05	$191,661.75	$189,836.40	nat. median $120,505 1.6× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	21	$124,444.19	$288,606.45	$184,866.40	nat. median $110,192 1.7× median
7 MS_DRG	Lung Transplant	21	$124,136.98	$287,879.53	$184,400.77	nat. median $117,894 1.6× median
5934 APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	7	$182,238.46	$185,777.07	$184,007.76	nat. median $151,838 1.2× median
5914 APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	$169,259.03	$172,545.62	$170,902.33	nat. median $162,514 1.1× median
J9226 HCPCS	Histrelin 50 Mg (65 Mcg/day) Implant Kit	44	$45,212.04	$454,674.59	$163,070.90	nat. median $55,159 outlier · 3.0×

Other procedures at this hospital

Browse this hospital's 14,445 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

S3399	HCPCS	Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit	3	2	—	—	$3,178,721.63	$4,565,185.31	$4,508,825.00	2025-05-16
J1414	HCPCS	Inj, Beqvez, Per Tx Dose	15	15	—	—	$3,710,000.00	$3,895,500.00	$3,710,000.00	2025-05-16
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	15	15	—	—	$3,685,266.67	$3,869,530.00	$3,685,266.67	2025-05-16
J1413	HCPCS	Inj Delandistrogene Mox Rokl	15	15	—	—	$3,322,473.30	$3,488,596.96	$3,322,473.30	2025-05-16
J3394	HCPCS	Inj, Lovotibeglogene Autotem	15	15	—	—	$3,286,000.00	$3,450,300.00	$3,286,000.00	2025-05-16
J3393	HCPCS	Inj, Betibeglogene Autotemce	15	15	—	—	$2,948,213.33	$3,095,624.00	$2,948,213.33	2025-05-16
J3399	HCPCS	Inj Onase Abepar-xioi Treat	18	18	—	—	$2,423,131.23	$4,361,636.22	$2,423,131.23	2025-05-16
J3392	HCPCS	Inj, Exagamglogene Autotem	18	18	—	—	$2,332,000.00	$4,197,600.00	$2,332,000.00	2025-05-16
C9399	HCPCS	Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp	216	44	$3,080,000.00	$2,310,000.00 25% off	$2,178.45	$3,069,000.00	$1,705,000.00	2025-05-16
Q2055	HCPCS	Idecabtagene Vicleucel 300 X 10exp6 To 460 X 10exp6 Cell IV Suspension	143	44	$2,566,800.95	$1,925,100.72 25% off	$527,622.46	$4,943,841.06	$1,655,586.61	2025-05-16
Q2054	HCPCS	Lisocabtagene Maraleucel(cd8) 1.5x To 70x 10exp6 Cell/ml IV Susp(1of2)	102	44	$2,113,045.00	$1,584,783.75 25% off	$516,442.29	$4,833,305.90	$1,378,761.86	2025-05-16
Q2041	HCPCS	Axicabtagene Ciloleucel Intravenous Suspension	102	44	$2,054,850.00	$1,541,137.50 25% off	$502,840.73	$4,584,288.00	$1,340,789.62	2025-05-16
Q2053	HCPCS	Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension	102	44	$2,054,850.00	$1,541,137.50 25% off	$489,399.16	$4,584,288.00	$1,340,789.62	2025-05-16
Q2042	HCPCS	Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension	142	44	$1,920,950.00	$1,440,712.50 25% off	$541,707.90	$4,599,652.50	$1,253,419.88	2025-05-16
Q2057	HCPCS	Afamitresgene Autoleucel	18	18	—	—	$770,620.00	$1,387,116.00	$770,620.00	2025-05-16
Q2056	HCPCS	Ciltacabtagene Car-pos T	19	18	—	—	$553,169.30	$4,564,763.28	$553,169.30	2025-05-16
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	33	21	—	—	$353,545.50	$830,737.56	$532,127.61	2025-05-16
J2326	HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	102	44	$686,636.63	$514,977.48 25% off	$1,248.60	$617,972.97	$448,030.41	2025-05-16
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	33	21	—	—	$264,696.72	$620,491.31	$397,454.71	2025-05-16
5884	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	7	—	—	$390,088.51	$397,663.05	$393,875.78	2025-05-16
5834	APR_DRG	Neonate With Ecmo	7	7	—	—	$377,389.28	$384,717.23	$381,053.25	2025-05-16
5833	APR_DRG	Neonate With Ecmo	7	7	—	—	$377,389.28	$384,717.23	$381,053.25	2025-05-16
5831	APR_DRG	Neonate With Ecmo	7	7	—	—	$359,027.67	$365,999.08	$362,513.37	2025-05-16
5832	APR_DRG	Neonate With Ecmo	7	7	—	—	$359,027.67	$365,999.08	$362,513.37	2025-05-16
1614	APR_DRG	Implantable Heart Assist Systems	7	7	—	—	$357,640.97	$364,585.45	$361,113.21	2025-05-16
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	33	21	—	—	$223,314.01	$522,565.84	$334,728.71	2025-05-16
24	APR_DRG	Heart And/or Lung Transplant	7	7	—	—	$314,673.76	$320,783.93	$317,728.84	2025-05-16
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	33	21	—	—	$201,985.45	$472,095.28	$302,399.88	2025-05-16
1611	APR_DRG	Implantable Heart Assist Systems	7	7	—	—	$277,037.33	$282,416.69	$279,727.01	2025-05-16
1612	APR_DRG	Implantable Heart Assist Systems	7	7	—	—	$277,037.33	$282,416.69	$279,727.01	2025-05-16
1613	APR_DRG	Implantable Heart Assist Systems	7	7	—	—	$277,037.33	$282,416.69	$279,727.01	2025-05-16
C9301	HCPCS	Apc	18	18	—	—	$278,250.00	$500,850.00	$278,250.00	2025-05-16
74	APR_DRG	Allogeneic Bone Marrow Transplant	7	7	—	—	$269,147.10	$274,373.25	$271,760.17	2025-05-16
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft	7	7	—	—	$250,607.03	$255,473.19	$253,040.11	2025-05-16
8412	APR_DRG	Extensive Third Degree Burns With Skin Graft	7	7	—	—	$250,607.03	$255,473.19	$253,040.11	2025-05-16
8413	APR_DRG	Extensive Third Degree Burns With Skin Graft	7	7	—	—	$250,607.03	$255,473.19	$253,040.11	2025-05-16
8411	APR_DRG	Extensive Third Degree Burns With Skin Graft	7	7	—	—	$250,607.03	$255,473.19	$253,040.11	2025-05-16
6094	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	7	7	—	—	$250,588.44	$255,454.24	$253,021.34	2025-05-16
6304	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	7	7	—	—	$243,226.65	$247,949.50	$245,588.08	2025-05-16
6314	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	7	7	—	—	$214,820.70	$218,991.98	$216,906.34	2025-05-16
A9543	HCPCS	Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous	100	44	$307,938.32	$230,953.74 25% off	$56,824.55	$667,861.12	$200,929.76	2025-05-16
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	7	—	—	$197,599.52	$201,436.40	$199,517.96	2025-05-16
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	33	21	—	—	$134,015.59	$311,255.64	$199,374.30	2025-05-16
5881	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	7	—	—	$188,011.05	$191,661.75	$189,836.40	2025-05-16
5882	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	7	7	—	—	$188,011.05	$191,661.75	$189,836.40	2025-05-16
14	MS_DRG	Allogeneic Bone Marrow Transplant	33	21	—	—	$124,444.19	$288,606.45	$184,866.40	2025-05-16
7	MS_DRG	Lung Transplant	33	21	—	—	$124,136.98	$287,879.53	$184,400.77	2025-05-16
5934	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	7	7	—	—	$182,238.46	$185,777.07	$184,007.76	2025-05-16
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	7	—	—	$169,259.03	$172,545.62	$170,902.33	2025-05-16
J9226	HCPCS	Histrelin 50 Mg (65 Mcg/day) Implant Kit	102	44	$249,917.09	$187,437.82 25% off	$45,212.04	$454,674.59	$163,070.90	2025-05-16
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	7	7	—	—	$155,785.52	$158,810.48	$157,298.00	2025-05-16
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	33	21	—	—	$105,062.14	$242,741.95	$155,487.97	2025-05-16
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	33	21	—	—	$103,891.09	$239,970.83	$153,712.93	2025-05-16
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	33	21	—	—	$101,615.05	$234,584.98	$150,263.03	2025-05-16
215	MS_DRG	Other Heart Assist System Implant	33	21	—	—	$101,106.78	$233,382.25	$149,492.63	2025-05-16
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	33	21	—	—	$99,995.31	$230,752.11	$147,807.89	2025-05-16
J1823	HCPCS	Inebilizumab-cdon 10 Mg/ml Intravenous Solution	102	44	$224,883.36	$168,662.52 25% off	$484.40	$202,395.02	$146,736.39	2025-05-16
J0223	HCPCS	Givosiran 189 Mg/ml Subcutaneous Solution	102	44	$222,207.83	$166,655.88 25% off	$116.47	$199,987.05	$144,990.61	2025-05-16
23	APR_DRG	Heart And/or Lung Transplant	7	7	—	—	$140,093.48	$142,813.74	$141,453.61	2025-05-16
22	APR_DRG	Heart And/or Lung Transplant	7	7	—	—	$140,093.48	$142,813.74	$141,453.61	2025-05-16
21	APR_DRG	Heart And/or Lung Transplant	7	7	—	—	$140,093.48	$142,813.74	$141,453.61	2025-05-16
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	7	7	—	—	$139,869.67	$142,585.59	$141,227.63	2025-05-16
J9347	HCPCS	Tremelimumab-actl 20 Mg/ml Intravenous Solution	102	44	$215,735.77	$161,801.83 25% off	$138.24	$194,162.19	$140,767.59	2025-05-16
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	33	21	—	—	$92,321.96	$212,594.43	$136,177.02	2025-05-16
73	APR_DRG	Allogeneic Bone Marrow Transplant	7	7	—	—	$131,922.55	$134,484.16	$133,203.36	2025-05-16
C9293	HCPCS	Glucarpidase 1,000 Unit/1 Ml IV Injection - Reconstituted 1000 Unit/ml	84	44	$202,725.27	$152,043.96 25% off	$57,168.53	$182,452.74	$132,278.23	2025-05-16
850	MS_DRG	Acute Leukemia With Other Procedures	33	21	—	—	$88,233.50	$202,919.73	$129,979.91	2025-05-16
44	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	7	7	—	—	$127,121.01	$129,589.38	$128,355.20	2025-05-16
6024	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	7	7	—	—	$125,079.41	$127,508.14	$126,293.77	2025-05-16
6074	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	7	7	—	—	$123,714.64	$126,116.87	$124,915.75	2025-05-16
0812	RC	Hc Cadaver Donor - Pancreas	304	44	$203,840.00	$152,880.00 25% off	$46,338.24	$242,424.00	$123,588.40	2025-05-16
8504	APR_DRG	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	7	7	—	—	$119,828.60	$122,155.37	$120,991.99	2025-05-16
231	MS_DRG	Coronary Bypass With Ptca With Mcc	33	21	—	—	$81,363.53	$186,663.07	$119,566.73	2025-05-16
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	33	21	—	—	$81,319.79	$186,559.54	$119,500.41	2025-05-16
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	33	21	—	—	$80,122.66	$183,726.74	$117,685.87	2025-05-16
3034	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	7	7	—	—	$116,228.26	$118,485.12	$117,356.69	2025-05-16
8514	APR_DRG	Gender Related Procedures	7	7	—	—	$116,000.27	$118,252.70	$117,126.48	2025-05-16
5933	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	7	7	—	—	$114,442.82	$116,665.01	$115,553.91	2025-05-16
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	33	21	—	—	$77,520.83	$177,569.91	$113,742.12	2025-05-16
14	APR_DRG	Liver Transplant And/or Intestinal Transplant	7	7	—	—	$111,705.66	$113,874.71	$112,790.18	2025-05-16
10	MS_DRG	Pancreas Transplant	33	21	—	—	$76,700.72	$175,629.24	$112,499.03	2025-05-16
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	33	21	—	—	$76,275.29	$174,622.56	$111,854.20	2025-05-16
J9269	HCPCS	Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution	102	44	$171,000.60	$128,250.45 25% off	$338.53	$153,900.54	$111,577.89	2025-05-16
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	33	21	—	—	$75,242.94	$172,179.66	$110,289.40	2025-05-16
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	33	21	—	—	$74,508.48	$170,441.65	$109,176.13	2025-05-16
6303	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	7	7	—	—	$108,050.78	$110,148.85	$109,099.82	2025-05-16
0811	RC	Hc Live Donor - Kidney	128	44	$164,320.00	$123,240.00 25% off	$46,338.24	$183,456.00	$107,218.80	2025-05-16
84	APR_DRG	Autologous Bone Marrow Transplant	7	7	—	—	$106,085.53	$108,145.44	$107,115.49	2025-05-16
Q4244	HCPCS	Drugs	1	1	—	—	$106,917.30	$106,917.30	$106,917.30	2025-05-16
72	APR_DRG	Allogeneic Bone Marrow Transplant	7	7	—	—	$105,825.09	$107,879.95	$106,852.52	2025-05-16
71	APR_DRG	Allogeneic Bone Marrow Transplant	7	7	—	—	$105,825.09	$107,879.95	$106,852.52	2025-05-16
J1305	HCPCS	Evinacumab-dgnb 150 Mg/ml Intravenous Solution	143	44	$200,850.00	$150,637.50 25% off	$186.31	$180,765.00	$106,450.50	2025-05-16
6334	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Anomaly	7	7	—	—	$105,377.06	$107,423.22	$106,400.14	2025-05-16
8424	APR_DRG	Burns With Skin Graft Except Extensive Third Degree Burns	7	7	—	—	$105,278.58	$107,322.82	$106,300.70	2025-05-16
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	33	21	—	—	$71,964.34	$164,421.40	$105,319.86	2025-05-16
6093	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	7	7	—	—	$102,498.81	$104,489.08	$103,493.95	2025-05-16
6023	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	7	7	—	—	$101,332.76	$103,300.39	$102,316.57	2025-05-16
J7330	HCPCS	Implant, Maci Final, Product Assembled, Single	124	44	$156,756.00	$117,567.00 25% off	$44,205.19	$687,533.04	$102,283.29	2025-05-16
J0202	HCPCS	Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution	102	44	$156,047.54	$117,035.66 25% off	$2,441.49	$140,442.79	$101,821.02	2025-05-16
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	33	21	—	—	$68,599.16	$156,458.28	$100,219.10	2025-05-16
Q0480	HCPCS	Driver Pneumatic Vad, Rep	18	18	—	—	$99,999.95	$179,999.91	$99,999.95	2025-05-16
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	33	21	—	—	$68,266.84	$155,671.88	$99,715.37	2025-05-16
6092	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	7	7	—	—	$97,550.96	$99,445.15	$98,498.06	2025-05-16
6091	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	7	7	—	—	$97,550.96	$99,445.15	$98,498.06	2025-05-16
6114	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	7	7	—	—	$97,221.69	$99,109.49	$98,165.59	2025-05-16
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	33	21	—	—	$67,238.21	$153,237.78	$98,156.22	2025-05-16
1834	APR_DRG	Percutaneous Structural Cardiac Procedures	7	7	—	—	$96,776.18	$98,655.33	$97,715.76	2025-05-16
43	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	7	7	—	—	$96,591.49	$98,467.06	$97,529.28	2025-05-16
8634	APR_DRG	Neonatal Aftercare	7	7	—	—	$96,452.25	$98,325.11	$97,388.68	2025-05-16
1784	APR_DRG	External Heart Assist Systems	7	7	—	—	$96,420.44	$98,292.68	$97,356.56	2025-05-16
6904	APR_DRG	Acute Leukemia	7	7	—	—	$96,047.72	$97,912.72	$96,980.22	2025-05-16
A9606	HCPCS	Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln	100	44	$148,062.50	$111,046.88 25% off	$169.06	$133,256.25	$96,610.78	2025-05-16
6214	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	7	7	—	—	$95,485.33	$97,339.41	$96,412.37	2025-05-16
955	MS_DRG	Craniotomy For Multiple Significant Trauma	33	21	—	—	$66,044.82	$150,413.79	$96,347.31	2025-05-16
5913	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	7	—	—	$94,251.12	$96,081.24	$95,166.18	2025-05-16
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	33	21	—	—	$64,894.23	$147,691.13	$94,603.32	2025-05-16
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	33	21	—	—	$64,654.06	$147,122.81	$94,239.28	2025-05-16
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	33	21	—	—	$64,548.88	$146,873.89	$94,079.84	2025-05-16
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	18	18	—	—	$93,216.70	$167,790.06	$93,216.70	2025-05-16
6124	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	7	7	—	—	$90,954.20	$92,720.30	$91,837.25	2025-05-16
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	33	21	—	—	$62,683.37	$142,459.48	$91,252.19	2025-05-16
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	33	21	—	—	$62,596.80	$142,254.62	$91,120.97	2025-05-16
54	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	7	7	—	—	$90,066.40	$91,815.27	$90,940.83	2025-05-16
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	33	21	—	—	$61,353.11	$139,311.68	$89,235.87	2025-05-16
3033	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	7	7	—	—	$87,451.06	$89,149.14	$88,300.10	2025-05-16
6073	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	7	7	—	—	$87,265.09	$88,959.56	$88,112.33	2025-05-16
J9216	HCPCS	Interferon Gamma 1-b Inj	1	1	—	—	$87,934.68	$87,934.68	$87,934.68	2025-05-16
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	33	21	—	—	$60,143.89	$136,450.24	$87,402.98	2025-05-16
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	33	21	—	—	$60,069.42	$136,274.02	$87,290.10	2025-05-16
03060	EAPG	Ventricular Assist Device Procedures	7	7	—	—	$86,251.01	$87,925.78	$87,088.39	2025-05-16
J9359	HCPCS	Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution	102	44	$133,461.89	$100,096.42 25% off	$212.00	$120,115.70	$87,083.88	2025-05-16
Q2043	HCPCS	Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension	102	44	$133,364.40	$100,023.30 25% off	$37,608.76	$544,951.93	$87,020.27	2025-05-16
5894	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	7	7	—	—	$86,084.43	$87,755.98	$86,920.20	2025-05-16
5893	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	7	7	—	—	$86,084.43	$87,755.98	$86,920.20	2025-05-16
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	33	21	—	—	$59,806.91	$135,652.83	$86,892.20	2025-05-16
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	33	21	—	—	$59,606.76	$135,179.23	$86,588.84	2025-05-16
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	32	20	—	—	$57,820.42	$130,952.05	$86,443.34	2025-05-16
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	33	21	—	—	$59,346.14	$134,562.44	$86,193.76	2025-05-16
38230	CPT	Hc Bone Marrow Harvest Transplantation Allogeneic	102	44	$131,958.00	$98,968.50 25% off	$1,519.68	$118,762.20	$86,102.60	2025-05-16
J1747	HCPCS	Spesolimab-sbzo 60 Mg/ml Intravenous Solution	102	44	$131,667.49	$98,750.62 25% off	$61.43	$118,500.74	$85,913.04	2025-05-16
28	MS_DRG	Spinal Procedures With Mcc	33	21	—	—	$59,074.32	$133,919.23	$85,781.75	2025-05-16
J2507	HCPCS	Pegloticase 8 Mg/ml Intravenous Solution	102	44	$131,153.51	$98,365.14 25% off	$3,565.32	$118,038.16	$85,577.66	2025-05-16
6814	APR_DRG	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	7	7	—	—	$84,691.16	$86,335.65	$85,513.41	2025-05-16
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	33	21	—	—	$58,668.45	$132,958.81	$85,166.55	2025-05-16
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	33	21	—	—	$58,668.45	$132,958.81	$85,166.55	2025-05-16
6954	APR_DRG	Chemotherapy For Acute Leukemia	7	7	—	—	$84,215.09	$85,850.33	$85,032.71	2025-05-16
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	33	21	—	—	$58,248.59	$131,965.34	$84,530.19	2025-05-16
1634	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	7	7	—	—	$83,533.95	$85,155.97	$84,344.96	2025-05-16
J9118	HCPCS	Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution	81	44	$128,920.57	$96,690.43 25% off	$655.92	$116,028.51	$84,120.67	2025-05-16
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	33	21	—	—	$57,862.29	$131,051.18	$83,944.62	2025-05-16
1624	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	7	7	—	—	$82,604.02	$84,207.98	$83,406.00	2025-05-16
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	33	21	—	—	$57,256.28	$129,617.16	$83,026.06	2025-05-16
6313	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	7	7	—	—	$82,212.32	$83,808.68	$83,010.50	2025-05-16
5892	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	7	7	—	—	$81,937.54	$83,528.56	$82,733.05	2025-05-16
5891	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	7	7	—	—	$81,937.54	$83,528.56	$82,733.05	2025-05-16
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	33	21	—	—	$56,680.05	$128,253.62	$82,152.65	2025-05-16
224	APR_DRG	Ventricular Shunt Procedures	7	7	—	—	$80,363.26	$81,923.71	$81,143.48	2025-05-16
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	33	21	—	—	$55,908.36	$126,427.50	$80,982.93	2025-05-16
83	APR_DRG	Autologous Bone Marrow Transplant	7	7	—	—	$79,959.53	$81,512.14	$80,735.83	2025-05-16
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	33	21	—	—	$55,589.07	$125,671.94	$80,498.96	2025-05-16
112	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	7	7	—	—	$79,211.19	$80,749.27	$79,980.23	2025-05-16
111	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	7	7	—	—	$79,211.19	$80,749.27	$79,980.23	2025-05-16
114	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	7	7	—	—	$79,211.19	$80,749.27	$79,980.23	2025-05-16
113	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	7	7	—	—	$79,211.19	$80,749.27	$79,980.23	2025-05-16
653	MS_DRG	Major Bladder Procedures With Mcc	33	21	—	—	$54,374.26	$122,797.29	$78,657.61	2025-05-16
7924	APR_DRG	Extensive O.r. Procedures For Other Complications Of Treatment	7	7	—	—	$77,816.20	$79,327.20	$78,571.70	2025-05-16
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	33	21	—	—	$53,933.95	$121,755.36	$77,990.20	2025-05-16
834	MS_DRG	Acute Leukemia With Mcc	33	21	—	—	$53,933.95	$121,755.36	$77,990.20	2025-05-16
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	33	21	—	—	$53,717.98	$121,244.31	$77,662.85	2025-05-16
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	33	21	—	—	$53,405.18	$120,504.17	$77,188.76	2025-05-16
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	33	21	—	—	$53,131.50	$119,856.55	$76,773.92	2025-05-16
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	33	21	—	—	$53,016.09	$119,583.40	$76,598.96	2025-05-16
9504	APR_DRG	Extensive O.r. Procedure Unrelated To Principal Diagnosis	7	7	—	—	$75,652.96	$77,121.95	$76,387.46	2025-05-16
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	33	21	—	—	$52,758.23	$118,973.23	$76,208.11	2025-05-16
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	33	21	—	—	$52,710.75	$118,860.89	$76,136.15	2025-05-16
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	33	21	—	—	$52,705.16	$118,847.67	$76,127.68	2025-05-16
J9348	HCPCS	Naxitamab-gqgk 4 Mg/ml Intravenous Solution	102	44	$116,612.85	$87,459.64 25% off	$641.83	$104,951.57	$76,089.88	2025-05-16
J9229	HCPCS	Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln	102	44	$116,476.42	$87,357.32 25% off	$2,658.13	$104,828.78	$76,000.87	2025-05-16
6022	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	7	7	—	—	$74,435.51	$75,880.86	$75,158.19	2025-05-16
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	33	21	—	—	$52,006.06	$117,193.37	$75,068.02	2025-05-16
J9266	HCPCS	Pegaspargase 750 Unit/ml Injection Solution	102	44	$114,548.67	$85,911.51 25% off	$27,070.53	$262,970.89	$74,743.01	2025-05-16
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	33	21	—	—	$51,787.30	$116,675.71	$74,736.44	2025-05-16
6034	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	7	7	—	—	$73,264.68	$74,687.30	$73,975.99	2025-05-16
6033	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	7	7	—	—	$73,264.68	$74,687.30	$73,975.99	2025-05-16
8633	APR_DRG	Neonatal Aftercare	7	7	—	—	$73,139.42	$74,559.61	$73,849.52	2025-05-16
5932	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	7	7	—	—	$72,804.30	$74,217.98	$73,511.14	2025-05-16
5931	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	7	7	—	—	$72,804.30	$74,217.98	$73,511.14	2025-05-16
J9274	HCPCS	Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution	102	44	$112,071.97	$84,053.98 25% off	$214.76	$100,864.77	$73,126.96	2025-05-16
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	33	21	—	—	$50,422.62	$113,446.40	$72,667.91	2025-05-16
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	33	21	—	—	$50,263.45	$113,069.72	$72,426.63	2025-05-16
914	APR_DRG	Other Major Head And Neck Procedures	7	7	—	—	$71,509.21	$72,897.74	$72,203.48	2025-05-16
5911	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	7	—	—	$71,375.14	$72,761.06	$72,068.10	2025-05-16
5912	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	7	7	—	—	$71,375.14	$72,761.06	$72,068.10	2025-05-16
6302	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	7	7	—	—	$71,178.94	$72,561.06	$71,870.00	2025-05-16
6301	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	7	7	—	—	$71,178.94	$72,561.06	$71,870.00	2025-05-16
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	33	21	—	—	$49,760.76	$111,880.21	$71,664.69	2025-05-16
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	33	21	—	—	$49,368.85	$110,952.83	$71,070.66	2025-05-16
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	33	21	—	—	$49,092.37	$110,298.60	$70,651.59	2025-05-16
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	33	21	—	—	$49,056.06	$110,212.69	$70,596.56	2025-05-16
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	33	21	—	—	$49,037.46	$110,168.64	$70,568.34	2025-05-16
2004	APR_DRG	Cardiac Structural And Valvular Disorders	7	7	—	—	$69,791.90	$71,147.09	$70,469.50	2025-05-16
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	33	21	—	—	$48,869.89	$109,772.13	$70,314.36	2025-05-16
3044	APR_DRG	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	7	7	—	—	$69,305.21	$70,650.94	$69,978.07	2025-05-16
9104	APR_DRG	Craniotomy For Multiple Significant Trauma	7	7	—	—	$68,887.88	$70,225.51	$69,556.70	2025-05-16
1833	APR_DRG	Percutaneous Structural Cardiac Procedures	7	7	—	—	$68,389.13	$69,717.07	$69,053.10	2025-05-16
245	MS_DRG	Aicd Generator Procedures	33	21	—	—	$47,971.59	$107,646.43	$68,952.75	2025-05-16
J7311	HCPCS	Fluocinolone 0.59 Mg Intravitreal Implant	102	44	$105,240.36	$78,930.27 25% off	$340.04	$94,716.32	$68,669.34	2025-05-16
J9600	HCPCS	Porfimer 2.5 Mg/ml IV Syringe	102	44	$105,199.05	$78,899.29 25% off	$24,228.42	$232,847.23	$68,642.38	2025-05-16
0815	RC	Hc Cord Blood Procurement	84	44	$104,963.00	$78,722.25 25% off	$29,599.57	$94,466.70	$68,488.36	2025-05-16
6	MS_DRG	Liver Transplant Without Mcc	33	21	—	—	$47,621.57	$106,818.18	$68,422.21	2025-05-16
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	18	18	—	—	$67,452.66	$121,414.79	$67,452.66	2025-05-16
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	33	21	—	—	$46,935.51	$105,194.71	$67,382.31	2025-05-16
1794	APR_DRG	Defibrillator Implants	7	7	—	—	$66,567.37	$67,859.94	$67,213.65	2025-05-16
799	MS_DRG	Splenic Procedures With Mcc	33	21	—	—	$46,742.80	$104,738.73	$67,090.23	2025-05-16
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	33	21	—	—	$46,734.47	$104,718.91	$67,077.53	2025-05-16
1674	APR_DRG	Other Cardiothoracic And Thoracic Vascular Procedures	7	7	—	—	$66,137.98	$67,422.21	$66,780.10	2025-05-16
214	APR_DRG	Open Craniotomy Except Trauma	7	7	—	—	$66,020.85	$67,302.81	$66,661.83	2025-05-16
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	33	21	—	—	$46,276.44	$103,635.13	$66,383.32	2025-05-16
1204	APR_DRG	Major Respiratory And Chest Procedures	7	7	—	—	$65,652.96	$66,927.78	$66,290.37	2025-05-16
53	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	7	7	—	—	$65,487.13	$66,758.73	$66,122.93	2025-05-16
6604	APR_DRG	Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…	7	7	—	—	$65,464.97	$66,736.13	$66,100.55	2025-05-16
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	33	21	—	—	$46,041.84	$103,080.03	$66,027.75	2025-05-16
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	33	21	—	—	$45,784.94	$102,472.05	$65,638.31	2025-05-16
1603	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	7	7	—	—	$64,515.31	$65,768.03	$65,141.67	2025-05-16
163	MS_DRG	Major Chest Procedures With Mcc	33	21	—	—	$45,387.43	$101,531.46	$65,035.81	2025-05-16
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	33	21	—	—	$45,369.74	$101,489.60	$65,009.00	2025-05-16
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	33	21	—	—	$45,232.91	$101,165.79	$64,801.59	2025-05-16
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	33	21	—	—	$45,226.39	$101,150.37	$64,791.71	2025-05-16
J2350	HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	102	44	$98,446.22	$73,834.67 25% off	$57.81	$88,601.60	$64,236.16	2025-05-16
3124	APR_DRG	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	7	7	—	—	$63,270.07	$64,498.61	$63,884.34	2025-05-16
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	33	21	—	—	$44,478.90	$99,381.52	$63,658.68	2025-05-16
L8688	HCPCS	Generator, M1000-d, Sentiva Duo	82	44	$102,755.64	$77,066.73 25% off	$28,977.09	$92,480.08	$63,364.26	2025-05-16
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	33	21	—	—	$44,228.48	$98,788.97	$63,279.12	2025-05-16
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	33	21	—	—	$44,113.04	$98,515.82	$63,104.15	2025-05-16
901	MS_DRG	Wound Debridements For Injuries With Mcc	33	21	—	—	$43,723.93	$97,595.05	$62,514.36	2025-05-16
6083	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	7	7	—	—	$61,820.80	$63,021.20	$62,421.00	2025-05-16
6084	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	7	7	—	—	$61,820.80	$63,021.20	$62,421.00	2025-05-16
6344	APR_DRG	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	7	7	—	—	$61,640.16	$62,837.06	$62,238.61	2025-05-16
2204	APR_DRG	Major Stomach, Esophageal And Duodenal Procedures	7	7	—	—	$61,635.39	$62,832.19	$62,233.79	2025-05-16
1832	APR_DRG	Percutaneous Structural Cardiac Procedures	7	7	—	—	$61,518.55	$62,713.09	$62,115.82	2025-05-16
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	33	21	—	—	$43,372.99	$96,764.60	$61,982.41	2025-05-16
6072	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	7	7	—	—	$61,314.21	$62,504.78	$61,909.49	2025-05-16
6903	APR_DRG	Acute Leukemia	7	7	—	—	$61,260.38	$62,449.91	$61,855.14	2025-05-16
J0638	HCPCS	Canakinumab (pf) 150 Mg/ml Subcutaneous Solution	102	44	$94,723.08	$71,042.31 25% off	$136.56	$85,250.77	$61,806.81	2025-05-16
6224	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	7	7	—	—	$60,922.36	$62,105.32	$61,513.84	2025-05-16
3032	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	7	7	—	—	$60,524.26	$61,699.49	$61,111.88	2025-05-16
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	33	21	—	—	$42,759.53	$95,312.95	$61,052.56	2025-05-16
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	33	21	—	—	$42,676.67	$95,116.90	$60,926.98	2025-05-16
1623	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	7	7	—	—	$60,181.43	$61,350.00	$60,765.71	2025-05-16
1654	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis	7	7	—	—	$60,077.91	$61,244.47	$60,661.19	2025-05-16
793	MS_DRG	Full Term Neonate With Major Problems	32	20	—	—	$41,303.60	$91,867.77	$60,643.25	2025-05-16
1831	APR_DRG	Percutaneous Structural Cardiac Procedures	7	7	—	—	$59,820.26	$60,981.82	$60,401.04	2025-05-16
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	33	21	—	—	$42,189.82	$93,964.84	$60,189.03	2025-05-16
9114	APR_DRG	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	7	7	—	—	$59,345.53	$60,497.87	$59,921.70	2025-05-16
140	MS_DRG	Major Head And Neck Procedures With Mcc	33	21	—	—	$41,850.05	$93,160.82	$59,674.01	2025-05-16
264	APR_DRG	Other Nervous System And Related Procedures	7	7	—	—	$58,948.70	$60,093.34	$59,521.02	2025-05-16
31	MS_DRG	Ventricular Shunt Procedures With Mcc	33	21	—	—	$41,490.72	$92,310.54	$59,129.37	2025-05-16
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	33	21	—	—	$41,481.43	$92,288.51	$59,115.26	2025-05-16
791	MS_DRG	Prematurity With Major Problems	32	20	—	—	$40,274.07	$89,431.48	$59,035.01	2025-05-16
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	33	21	—	—	$41,212.38	$91,651.90	$58,707.48	2025-05-16
92	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	7	7	—	—	$58,005.64	$59,131.97	$58,568.81	2025-05-16
93	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	7	7	—	—	$58,005.64	$59,131.97	$58,568.81	2025-05-16
91	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	7	7	—	—	$58,005.64	$59,131.97	$58,568.81	2025-05-16
234	APR_DRG	Spinal Procedures	7	7	—	—	$57,760.84	$58,882.41	$58,321.63	2025-05-16
1304	APR_DRG	Respiratory System Diagnosis With Ventilator Support > 96 Hours	7	7	—	—	$57,715.15	$58,835.84	$58,275.50	2025-05-16
1783	APR_DRG	External Heart Assist Systems	7	7	—	—	$57,645.30	$58,764.63	$58,204.96	2025-05-16
1782	APR_DRG	External Heart Assist Systems	7	7	—	—	$57,645.30	$58,764.63	$58,204.96	2025-05-16
1781	APR_DRG	External Heart Assist Systems	7	7	—	—	$57,645.30	$58,764.63	$58,204.96	2025-05-16
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	33	21	—	—	$40,760.00	$90,581.34	$58,021.73	2025-05-16
A9604	HCPCS	Samarium Sm 153 Lexidronam 5,550 Mbq/3 Ml Intravenous Solution	100	44	$88,888.25	$66,666.19 25% off	$4,314.91	$176,050.47	$57,999.58	2025-05-16
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	33	21	—	—	$40,738.58	$90,530.67	$57,989.28	2025-05-16
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	33	21	—	—	$40,681.79	$90,396.30	$57,903.21	2025-05-16
6123	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	7	7	—	—	$57,073.20	$58,181.41	$57,627.30	2025-05-16
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	33	21	—	—	$40,493.75	$89,951.34	$57,618.19	2025-05-16
6804	APR_DRG	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	7	7	—	—	$56,885.26	$57,989.83	$57,437.55	2025-05-16
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	33	21	—	—	$40,343.88	$89,596.69	$57,391.01	2025-05-16
460	MS_DRG	DRG 460	2	1	—	—	$54,349.00	$60,388.00	$57,368.50	2025-05-16
2304	APR_DRG	Major Small Bowel Procedures	7	7	—	—	$56,027.68	$57,115.60	$56,571.64	2025-05-16
204	APR_DRG	Open Craniotomy For Trauma	7	7	—	—	$55,875.84	$56,960.81	$56,418.33	2025-05-16
8423	APR_DRG	Burns With Skin Graft Except Extensive Third Degree Burns	7	7	—	—	$55,845.11	$56,929.48	$56,387.29	2025-05-16
J9309	HCPCS	Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution	102	44	$86,294.33	$64,720.75 25% off	$132.73	$77,664.90	$56,307.05	2025-05-16
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	33	21	—	—	$39,564.71	$87,752.94	$56,210.01	2025-05-16
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	33	21	—	—	$39,538.66	$87,691.27	$56,170.50	2025-05-16
894	APR_DRG	Major Cranial Or Facial Bone Procedures	7	7	—	—	$55,489.91	$56,567.39	$56,028.65	2025-05-16
1664	APR_DRG	Coronary Bypass Without Ami Or Complex Principal Diagnosis	7	7	—	—	$55,452.02	$56,528.76	$55,990.39	2025-05-16
2604	APR_DRG	Major Pancreas, Liver And Shunt Procedures	7	7	—	—	$55,238.49	$56,311.08	$55,774.78	2025-05-16
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	33	21	—	—	$39,210.98	$86,915.88	$55,673.83	2025-05-16
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	33	21	—	—	$39,135.58	$86,737.45	$55,559.54	2025-05-16
304	APR_DRG	Percutaneous Intracranial And Extracranial Vascular Procedures	7	7	—	—	$54,746.67	$55,809.72	$55,278.19	2025-05-16
274	APR_DRG	Other Open Craniotomy	7	7	—	—	$54,686.84	$55,748.72	$55,217.78	2025-05-16
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	33	21	—	—	$38,899.13	$86,177.94	$55,201.14	2025-05-16
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	33	21	—	—	$38,881.45	$86,136.09	$55,174.33	2025-05-16
1694	APR_DRG	Major Abdominal Vascular Procedures	7	7	—	—	$54,596.41	$55,656.53	$55,126.47	2025-05-16
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	33	21	—	—	$38,680.37	$85,660.28	$54,869.56	2025-05-16
J3241	HCPCS	Teprotumumab-trbw 500 Mg Intravenous Solution	102	44	$83,988.16	$62,991.12 25% off	$352.56	$75,589.34	$54,802.27	2025-05-16
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	33	21	—	—	$38,459.75	$85,138.22	$54,535.15	2025-05-16
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	33	21	—	—	$38,423.46	$85,052.31	$54,480.12	2025-05-16
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	33	21	—	—	$38,322.90	$84,814.41	$54,327.73	2025-05-16
9124	APR_DRG	Musculoskeletal And Other Procedures For Multiple Significant Trauma	7	7	—	—	$53,645.16	$54,686.81	$54,165.99	2025-05-16
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	33	21	—	—	$38,063.18	$84,199.83	$53,934.06	2025-05-16

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