Hospital

SOUTH POINTE HOSPITAL

Warrensville Heights, OH · CCN 360144 · Rates published

20,220 distinct procedures filed

39 distinct payers

1,025,481 rate rows

2025-06-28 last MRF observed · ⚠ 14 mo old

Data quality

660,147 of 1,025,481 rate rows are consumer-grade (64.4%)

365,334 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	310,628
per-diem day rate — not a per-procedure price	35,399
placeholder amount (≤ $0.02) — excluded from medians	8,133
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	7,702
template filing: same amount across many unrelated codes — excluded	2,853
exceeds 10× this hospital's gross charge — excluded from medians	253
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	251
percent-of-charges filed in the dollar field — excluded from medians	111
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	4

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old.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://clevelandclinic.pt.panaceainc.com/MRFDownload/clevelandclinic/southpointe
Found on page	https://my.clevelandclinic.org/patients/billing-finance/comprehensive-hospital-charges
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-08-17
Content fingerprint	a4940b8bcfaff17c… · 24,019,049 bytes · first seen 2026-05-06

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
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	14	$3,654,350.00	$4,040,190.00	$3,672,900.00	nat. median $3,710,000 1.0× median
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	13	$3,605,000.00	$3,965,500.00	$3,605,000.00	nat. median $3,710,000 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	14	$3,325,454.76	$3,658,000.24	$3,325,454.76	nat. median $3,324,572 1.0× median
J3394 HCPCS	Lyfgenia 1.7 X To 20 X 10exp6 Cell/ml Intravenous Suspension	14	$3,286,000.00	$4,483,344.00	$3,286,000.00	nat. median $3,286,000 1.0× median
J3393 HCPCS	Zynteglo 2 X 10exp6 To 20 X 10exp6 Cell/ml Intravenous Suspension	14	$2,968,000.00	$4,596,480.00	$2,968,000.00	nat. median $2,997,086 1.0× median
J3399 HCPCS	Zolgensma 2 X 10exp13 Vg/ml Intravenous Suspension Kit	23	$1,698,300.00	$4,948,785.00	$2,740,462.83	nat. median $2,460,273 1.1× median
J3392 HCPCS	Casgevy 4x10exp6 To 13x10exp6 Cell/ml Intravenous Suspension	17	$2,332,000.00	$4,540,800.00	$2,425,280.00	nat. median $2,405,851 1.0× median
Q2042 HCPCS	Kymriah 0.2 X 10exp6 To 2.5 X 10exp8 Cell Intravenous Suspension	34	$518,240.68	$2,848,960.04	$1,469,677.33	nat. median $691,418 outlier · 2.1×
Q2056 HCPCS	Carvykti 0.5x 10exp6 To 1x 10exp8 Cell Intravenous Suspension	34	$507,495.55	$2,505,866.40	$1,314,326.92	nat. median $631,793 outlier · 2.1×
Q2041 HCPCS	Yescarta Intravenous Suspension	34	$459,381.45	$2,417,184.00	$1,267,813.00	nat. median $588,565 outlier · 2.2×
Q2054 HCPCS	Breyanzi 1.5x To 70x10exp6 Cell/ml Intravenous Suspension	34	$474,060.62	$2,339,891.68	$1,227,273.19	nat. median $624,417 2.0× median
Q2053 HCPCS	Tecartus 2x10exp6 To 2x10exp8 Cell Intravenous Suspension	34	$449,440.00	$2,217,600.00	$1,163,131.20	nat. median $577,541 outlier · 2.0×
005-I OTHER	Intestinal - Adult	2	$563,700.00	$563,700.00	$563,700.00	nat. median $563,700 1.0× median
006-LA OTHER	Liver (Live Donor) - Adult	2	$561,500.00	$561,500.00	$561,500.00	nat. median $561,500 1.0× median
005-LA OTHER	Liver (Live Donor) - Adult	2	$561,500.00	$561,500.00	$561,500.00	nat. median $561,500 1.0× median
006-LP OTHER	Liver (Live Donor) - Pediatric	2	$560,500.00	$560,500.00	$560,500.00	nat. median $560,500 1.0× median
005-LP OTHER	Liver (Live Donor) - Pediatric	2	$560,500.00	$560,500.00	$560,500.00	nat. median $560,500 1.0× median
006-DA OTHER	Liver (Deceased Donor) - Adult	2	$486,600.00	$486,600.00	$486,600.00	nat. median $486,600 1.0× median
005-DA OTHER	Liver (Deceased Donor) - Adult	2	$486,600.00	$486,600.00	$486,600.00	nat. median $486,600 1.0× median
014-U OTHER	Allogeneic Unrelated Bmt ? Adult & Pediatric	2	$481,200.00	$481,200.00	$481,200.00	nat. median $288,536 1.7× median
005-DP OTHER	Liver (Deceased Donor) -pediatric	2	$471,700.00	$471,700.00	$471,700.00	nat. median $471,700 1.0× median
006-DP OTHER	Liver (Deceased Donor) -pediatric	2	$471,700.00	$471,700.00	$471,700.00	nat. median $471,700 1.0× median
003-P OTHER	Heart - Pediatric	2	$444,900.00	$444,900.00	$444,900.00	nat. median $444,900 1.0× median
002-P OTHER	Heart - Pediatric	2	$444,900.00	$444,900.00	$444,900.00	nat. median $357,576 1.2× median
007-D OTHER	Lung (Double) - Adult	2	$433,900.00	$433,900.00	$433,900.00	nat. median $433,900 1.0× median
007-S OTHER	Lung (Single) - Adult	2	$428,300.00	$428,300.00	$428,300.00	nat. median $428,300 1.0× median
014-R OTHER	Allogeneic Related Bmt ? Adult & Pediatric	2	$428,000.00	$428,000.00	$428,000.00	nat. median $403,789 1.1× median
001-A OTHER	Heart - Adult	3	$36,400.00	$361,500.00	$361,500.00	nat. median $333,282 1.1× median
002-A OTHER	Heart - Adult	2	$361,500.00	$361,500.00	$361,500.00	nat. median $333,282 1.1× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	16	$282,151.60	$584,548.40	$290,616.15	nat. median $370,165 0.8× median
J0225 HCPCS	Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe	39	$4,926.00	$859,327.20	$258,915.29	nat. median $8,133 outlier · 31.8×
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	16	$210,875.89	$436,608.65	$217,202.17	nat. median $261,939 0.8× median
650-C OTHER	Kidney Transplant With Hemodialysis With Mcc - Cadaveric	1	$185,100.00	$185,100.00	$185,100.00	nat. median $185,100 1.0× median
651-C OTHER	Kidney Transplant With Hemodialysis Without Mcc - Cadaveric	1	$185,100.00	$185,100.00	$185,100.00	nat. median $185,100 1.0× median
652-C OTHER	Kidney Transplant - Cadaveric	1	$185,100.00	$185,100.00	$185,100.00	nat. median $185,100 1.0× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	16	$177,678.12	$367,703.40	$183,008.46	nat. median $205,166 0.9× median
652-D OTHER	Kidney (Deceased) - Adult & Pediatric	2	$175,300.00	$175,300.00	$175,300.00	nat. median $175,300 1.0× median
651-D OTHER	Kidney (Deceased) - Adult & Pediatric	2	$175,300.00	$175,300.00	$175,300.00	nat. median $175,300 1.0× median
650-D OTHER	Kidney (Deceased) - Adult & Pediatric	2	$175,300.00	$175,300.00	$175,300.00	nat. median $175,300 1.0× median
650-LD OTHER	Kidney Transplant With Hemodialysis With Mcc - Live Donor	1	$170,100.00	$170,100.00	$170,100.00	nat. median $170,100 1.0× median
651-LD OTHER	Kidney Transplant With Hemodialysis Without Mcc - Live Donor	1	$170,100.00	$170,100.00	$170,100.00	nat. median $170,100 1.0× median
652-LD OTHER	Kidney Transplant - Live Donor	1	$170,100.00	$170,100.00	$170,100.00	nat. median $170,100 1.0× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	17	$41,100.00	$332,189.80	$162,976.59	nat. median $199,832 0.8× median
651-L OTHER	Kidney ( Live Donor) - Adult & Pediatric	2	$161,100.00	$161,100.00	$161,100.00	nat. median $161,100 1.0× median
650-L OTHER	Kidney ( Live Donor) - Adult & Pediatric	2	$161,100.00	$161,100.00	$161,100.00	nat. median $161,100 1.0× median
652-L OTHER	Kidney (Live Donor) - Adult & Pediatric	2	$161,100.00	$161,100.00	$161,100.00	nat. median $161,100 1.0× median
J2779 HCPCS	Susvimo 10 Mg/0.1 Ml Intravitreal Solution	34	$79.08	$288,000.00	$114,912.00	nat. median $88 outlier · 1308.2×
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	17	$28,700.00	$219,015.00	$107,632.35	nat. median $132,706 0.8× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	18	$12,900.00	$4,334,979.46	$102,297.95	nat. median $114,305 0.9× median
7 MS_DRG	Lung Transplant	17	$26,000.00	$4,868,232.55	$101,060.48	nat. median $122,690 0.8× median

Other procedures at this hospital

Browse this hospital's 20,220 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

J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	16	14	—	—	$3,654,350.00	$4,040,190.00	$3,672,900.00	2025-06-28
J1414	HCPCS	Inj, Beqvez, Per Tx Dose	15	13	—	—	$3,605,000.00	$3,965,500.00	$3,605,000.00	2025-06-28
J1413	HCPCS	Inj Delandistrogene Mox Rokl	16	14	—	—	$3,325,454.76	$3,658,000.24	$3,325,454.76	2025-06-28
J3394	HCPCS	Lyfgenia 1.7 X To 20 X 10exp6 Cell/ml Intravenous Suspension	16	14	—	—	$3,286,000.00	$4,483,344.00	$3,286,000.00	2025-06-28
J3393	HCPCS	Zynteglo 2 X 10exp6 To 20 X 10exp6 Cell/ml Intravenous Suspension	17	14	—	—	$2,968,000.00	$4,596,480.00	$2,968,000.00	2025-06-28
J3399	HCPCS	Zolgensma 2 X 10exp13 Vg/ml Intravenous Suspension Kit	38	23	—	$4,972,500.00	$1,698,300.00	$4,948,785.00	$2,740,462.83	2025-06-28
J3392	HCPCS	Casgevy 4x10exp6 To 13x10exp6 Cell/ml Intravenous Suspension	24	17	—	—	$2,332,000.00	$4,540,800.00	$2,425,280.00	2025-06-28
Q2042	HCPCS	Kymriah 0.2 X 10exp6 To 2.5 X 10exp8 Cell Intravenous Suspension	94	34	$2,848,960.04	$1,851,824.03 35% off	$518,240.68	$2,848,960.04	$1,469,677.33	2025-06-28
Q2056	HCPCS	Carvykti 0.5x 10exp6 To 1x 10exp8 Cell Intravenous Suspension	56	34	$2,505,866.40	$1,628,813.16 35% off	$507,495.55	$2,505,866.40	$1,314,326.92	2025-06-28
Q2041	HCPCS	Yescarta Intravenous Suspension	56	34	$2,417,184.00	$1,571,169.60 35% off	$459,381.45	$2,417,184.00	$1,267,813.00	2025-06-28
Q2054	HCPCS	Breyanzi 1.5x To 70x10exp6 Cell/ml Intravenous Suspension	56	34	$2,339,891.68	$1,520,929.59 35% off	$474,060.62	$2,339,891.68	$1,227,273.19	2025-06-28
Q2053	HCPCS	Tecartus 2x10exp6 To 2x10exp8 Cell Intravenous Suspension	56	34	$2,217,600.00	$1,441,440.00 35% off	$449,440.00	$2,217,600.00	$1,163,131.20	2025-06-28
005-I	OTHER	Intestinal - Adult	2	2	—	—	$563,700.00	$563,700.00	$563,700.00	2025-06-28
005-LA	OTHER	Liver (Live Donor) - Adult	2	2	—	—	$561,500.00	$561,500.00	$561,500.00	2025-06-28
006-LA	OTHER	Liver (Live Donor) - Adult	2	2	—	—	$561,500.00	$561,500.00	$561,500.00	2025-06-28
006-LP	OTHER	Liver (Live Donor) - Pediatric	2	2	—	—	$560,500.00	$560,500.00	$560,500.00	2025-06-28
005-LP	OTHER	Liver (Live Donor) - Pediatric	2	2	—	—	$560,500.00	$560,500.00	$560,500.00	2025-06-28
006-DA	OTHER	Liver (Deceased Donor) - Adult	2	2	—	—	$486,600.00	$486,600.00	$486,600.00	2025-06-28
005-DA	OTHER	Liver (Deceased Donor) - Adult	2	2	—	—	$486,600.00	$486,600.00	$486,600.00	2025-06-28
014-U	OTHER	Allogeneic Unrelated Bmt ? Adult & Pediatric	2	2	—	—	$481,200.00	$481,200.00	$481,200.00	2025-06-28
005-DP	OTHER	Liver (Deceased Donor) -pediatric	2	2	—	—	$471,700.00	$471,700.00	$471,700.00	2025-06-28
006-DP	OTHER	Liver (Deceased Donor) -pediatric	2	2	—	—	$471,700.00	$471,700.00	$471,700.00	2025-06-28
002-P	OTHER	Heart - Pediatric	2	2	—	—	$444,900.00	$444,900.00	$444,900.00	2025-06-28
003-P	OTHER	Heart - Pediatric	2	2	—	—	$444,900.00	$444,900.00	$444,900.00	2025-06-28
007-D	OTHER	Lung (Double) - Adult	2	2	—	—	$433,900.00	$433,900.00	$433,900.00	2025-06-28
007-S	OTHER	Lung (Single) - Adult	2	2	—	—	$428,300.00	$428,300.00	$428,300.00	2025-06-28
014-R	OTHER	Allogeneic Related Bmt ? Adult & Pediatric	2	2	—	—	$428,000.00	$428,000.00	$428,000.00	2025-06-28
002-A	OTHER	Heart - Adult	2	2	—	—	$361,500.00	$361,500.00	$361,500.00	2025-06-28
001-A	OTHER	Heart - Adult	3	3	—	—	$36,400.00	$361,500.00	$361,500.00	2025-06-28
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	25	16	—	—	$282,151.60	$584,548.40	$290,616.15	2025-06-28
J0225	HCPCS	Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe	65	39	$859,327.20	$558,562.68 35% off	$4,926.00	$859,327.20	$258,915.29	2025-06-28
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	25	16	—	—	$210,875.89	$436,608.65	$217,202.17	2025-06-28
652-C	OTHER	Kidney Transplant - Cadaveric	1	1	—	—	$185,100.00	$185,100.00	$185,100.00	2025-06-28
651-C	OTHER	Kidney Transplant With Hemodialysis Without Mcc - Cadaveric	1	1	—	—	$185,100.00	$185,100.00	$185,100.00	2025-06-28
650-C	OTHER	Kidney Transplant With Hemodialysis With Mcc - Cadaveric	1	1	—	—	$185,100.00	$185,100.00	$185,100.00	2025-06-28
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	25	16	—	—	$177,678.12	$367,703.40	$183,008.46	2025-06-28
651-D	OTHER	Kidney (Deceased) - Adult & Pediatric	2	2	—	—	$175,300.00	$175,300.00	$175,300.00	2025-06-28
652-D	OTHER	Kidney (Deceased) - Adult & Pediatric	2	2	—	—	$175,300.00	$175,300.00	$175,300.00	2025-06-28
650-D	OTHER	Kidney (Deceased) - Adult & Pediatric	2	2	—	—	$175,300.00	$175,300.00	$175,300.00	2025-06-28
651-LD	OTHER	Kidney Transplant With Hemodialysis Without Mcc - Live Donor	1	1	—	—	$170,100.00	$170,100.00	$170,100.00	2025-06-28
650-LD	OTHER	Kidney Transplant With Hemodialysis With Mcc - Live Donor	1	1	—	—	$170,100.00	$170,100.00	$170,100.00	2025-06-28
652-LD	OTHER	Kidney Transplant - Live Donor	1	1	—	—	$170,100.00	$170,100.00	$170,100.00	2025-06-28
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	26	17	—	—	$41,100.00	$332,189.80	$162,976.59	2025-06-28
651-L	OTHER	Kidney ( Live Donor) - Adult & Pediatric	2	2	—	—	$161,100.00	$161,100.00	$161,100.00	2025-06-28
650-L	OTHER	Kidney ( Live Donor) - Adult & Pediatric	2	2	—	—	$161,100.00	$161,100.00	$161,100.00	2025-06-28
652-L	OTHER	Kidney (Live Donor) - Adult & Pediatric	2	2	—	—	$161,100.00	$161,100.00	$161,100.00	2025-06-28
J2779	HCPCS	Susvimo 10 Mg/0.1 Ml Intravitreal Solution	57	34	$288,000.00	$187,200.00 35% off	$79.08	$288,000.00	$114,912.00	2025-06-28
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	26	17	—	—	$28,700.00	$219,015.00	$107,632.35	2025-06-28
14	MS_DRG	Allogeneic Bone Marrow Transplant	28	18	—	—	$12,900.00	$4,334,979.46	$102,297.95	2025-06-28
7	MS_DRG	Lung Transplant	27	17	—	—	$26,000.00	$4,868,232.55	$101,060.48	2025-06-28
A9699	HCPCS	Radiopharm Rx Agent Noc	1	1	—	—	$97,225.26	$97,225.26	$97,225.26	2025-06-28
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	26	16	—	—	$82,814.86	$4,055,315.72	$86,127.46	2025-06-28
C9293	HCPCS	Voraxaze 1000 Unit Intravenous Solution	48	33	$148,226.40	$96,347.16 35% off	$902.96	$148,226.40	$83,006.79	2025-06-28
215	MS_DRG	Other Heart Assist System Implant	25	16	—	—	$79,641.82	$164,219.40	$82,031.07	2025-06-28
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	25	16	—	—	$13,964.00	$168,855.45	$81,875.42	2025-06-28
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	26	17	—	—	$27,200.00	$165,065.70	$81,250.30	2025-06-28
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	25	16	—	—	$17,771.00	$162,368.70	$78,750.18	2025-06-28
J9226	HCPCS	Supprelin La 50 Mg (65 Mcg/day) Implant Kit	65	39	$175,562.52	$114,115.64 35% off	$16,296.34	$175,562.52	$78,453.65	2025-06-28
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	26	17	—	—	$13,964.00	$283,600.00	$72,594.53	2025-06-28
850	MS_DRG	Acute Leukemia With Other Procedures	25	16	—	—	$46,072.00	$142,784.45	$69,314.70	2025-06-28
001-C	OTHER	Deep Brain Stimulation Bilateral	1	1	—	—	$69,100.00	$69,100.00	$69,100.00	2025-06-28
0454T	OTHER	Insj/rplcmt Subq Electrode	8	8	—	—	$61,469.13	$71,174.79	$67,939.57	2025-06-28
0453T	OTHER	Insj/rplcmt Mech-elec Ntrfce	8	8	—	—	$61,469.13	$71,174.79	$67,939.57	2025-06-28
J2777	HCPCS	Vabysmo 6 Mg/0.05 Ml Intravitreal Solution	57	34	$164,854.80	$107,155.62 35% off	$34.25	$164,854.80	$65,777.07	2025-06-28
A9543	HCPCS	Zevalin (y-90) 3.2 Mg/2 Ml Intravenous Kit	64	39	$148,248.86	$96,361.76 35% off	$14,774.74	$148,248.86	$64,611.79	2025-06-28
10	MS_DRG	Pancreas Transplant	30	20	—	—	$10,700.00	$1,615,106.56	$63,967.04	2025-06-28
231	MS_DRG	Coronary Bypass With Ptca With Mcc	25	16	—	—	$13,964.00	$131,345.45	$63,803.52	2025-06-28
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	26	17	—	—	$13,964.00	$212,600.00	$63,768.42	2025-06-28
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	28	18	—	—	$59,721.66	$1,784,276.68	$63,603.57	2025-06-28
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	25	16	—	—	$17,771.00	$129,279.30	$62,808.08	2025-06-28
J9248	HCPCS	Hepzato (62 Mm Catheter) 50 Mg Intra-arterial Solution	65	39	$180,000.00	$117,000.00 35% off	$693.50	$180,000.00	$61,560.00	2025-06-28
J0223	HCPCS	Givlaari 189 Mg/ml Subcutaneous Solution	57	34	$153,417.60	$99,721.44 35% off	$112.02	$153,417.60	$61,213.62	2025-06-28
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	26	17	—	—	$13,964.00	$289,300.00	$60,720.85	2025-06-28
J9274	HCPCS	Kimmtrak 100 Mcg/0.5 Ml Intravenous Solution	65	39	$196,608.00	$127,795.20 35% off	$208.93	$196,608.00	$59,237.99	2025-06-28
233	MS_DRG	Coronary Bypass With Cardiac Catheterization With Mcc	26	17	—	—	$13,964.00	$217,200.00	$58,893.49	2025-06-28
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	26	17	—	—	$13,964.00	$193,600.00	$58,304.29	2025-06-28
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	25	16	—	—	$56,263.36	$115,695.10	$57,951.26	2025-06-28
38240	HCPCS	Trnsplj Allogeneic Hematopoietic Cells Per Donor	64	39	$131,220.00	$85,293.00 35% off	$1,558.77	$131,220.00	$56,448.36	2025-06-28
J0177	HCPCS	Eylea Hd 8 Mg/0.07 Ml Intravitreal Solution For Injection	57	34	$137,700.00	$89,505.00 35% off	$333.70	$137,700.00	$55,768.50	2025-06-28
J0178	HCPCS	Eylea 2 Mg/0.05 Ml Intravitreal Syringe	57	34	$136,530.00	$88,744.50 35% off	$821.98	$136,530.00	$54,475.47	2025-06-28
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	26	17	—	—	$17,771.00	$269,394.00	$54,367.24	2025-06-28
J9029	HCPCS	Adstiladrin 3x10exp11 Vp/ml Intravesical Suspension	65	39	$72,000.00	$46,800.00 35% off	$15,984.00	$144,556.65	$54,000.00	2025-06-28
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	25	16	—	—	$13,964.00	$109,538.50	$53,297.18	2025-06-28
955	MS_DRG	Craniotomy For Multiple Significant Trauma	25	16	—	—	$51,514.63	$105,838.65	$53,060.07	2025-06-28
J3357	HCPCS	Stelara 45 Mg/0.5 Ml Subcutaneous Solution	99	39	$104,945.34	$68,214.47 35% off	$152.57	$104,945.34	$52,472.63	2025-06-28
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	26	17	—	—	$11,984.00	$194,500.00	$52,472.00	2025-06-28
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	25	16	—	—	$50,398.96	$103,522.95	$51,910.93	2025-06-28
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	26	17	—	—	$48,818.04	$148,400.00	$50,770.76	2025-06-28
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	25	16	—	—	$15,763.00	$103,922.85	$50,591.62	2025-06-28
J2778	HCPCS	Darvocet-n 50 50 Mg-325 Mg Tab	99	39	$140,400.00	$91,260.00 35% off	$137.14	$140,400.00	$50,544.00	2025-06-28
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	25	16	—	—	$13,964.00	$159,178.00	$50,314.57	2025-06-28
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	25	16	—	—	$47,750.90	$98,026.65	$49,183.43	2025-06-28
J9269	HCPCS	Elzonris 1000 Mcg/ml Intravenous Solution	65	39	$162,031.92	$105,320.75 35% off	$326.65	$162,031.92	$48,820.22	2025-06-28
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	26	17	—	—	$13,964.00	$223,200.00	$48,748.59	2025-06-28
J1930	HCPCS	Somatuline Depot 60 Mg/0.2 Ml Subcutaneous Syringe	125	34	$109,584.00	$71,229.60 35% off	$48.00	$109,584.00	$48,648.00	2025-06-28
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	28	18	—	—	$45,597.21	$1,120,812.31	$48,561.03	2025-06-28
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	28	18	—	—	$45,597.21	$1,120,812.31	$48,561.03	2025-06-28
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	25	16	—	—	$46,510.51	$95,452.10	$47,905.83	2025-06-28
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	25	16	—	—	$13,964.00	$96,013.20	$46,780.84	2025-06-28
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	25	16	—	—	$17,771.00	$95,889.20	$46,721.10	2025-06-28
461	MS_DRG	Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc	26	17	—	—	$13,964.00	$116,800.00	$46,349.96	2025-06-28
J9600	HCPCS	Photofrin 75 Mg Intravenous Solution	64	39	$111,950.40	$72,767.76 35% off	$16,296.34	$111,950.40	$46,224.04	2025-06-28
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	25	16	—	—	$13,964.00	$94,684.85	$46,140.86	2025-06-28
28	MS_DRG	Spinal Procedures With Mcc	26	17	—	—	$13,964.00	$108,100.00	$45,922.80	2025-06-28
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	26	17	—	—	$44,002.10	$207,900.00	$45,762.18	2025-06-28
001-B	OTHER	Deep Brain Stimulation Unilateral	1	1	—	—	$45,300.00	$45,300.00	$45,300.00	2025-06-28
266	MS_DRG	Endovascular Cardiac Valve Replacement W Mcc	27	18	—	—	$13,964.00	$173,600.00	$45,260.41	2025-06-28
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	25	16	—	—	$13,964.00	$92,214.15	$44,950.50	2025-06-28
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	20	15	—	—	$5,351.00	$92,144.40	$44,916.90	2025-06-28
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	26	17	—	—	$13,964.00	$168,400.00	$44,464.35	2025-06-28
J0179	HCPCS	Beovu 6 Mg/0.05 Ml Intravitreal Syringe	65	39	$147,062.88	$95,590.87 35% off	$325.68	$147,062.88	$44,310.05	2025-06-28
653	MS_DRG	Major Bladder Procedures With Mcc	26	17	—	—	$42,152.35	$144,700.00	$43,838.44	2025-06-28
8	MS_DRG	Simultaneous Pancreas/kidney Transplant	30	20	—	—	$26,000.00	$1,224,682.79	$43,830.51	2025-06-28
471A	OTHER	Bilateral Total Hip Replacement Proc. Of Lower Extremitv	1	1	—	—	$43,800.00	$43,800.00	$43,800.00	2025-06-28
834	MS_DRG	Acute Leukemia Without Major O.r. Procedures With Mcc	26	17	—	—	$41,799.12	$152,300.00	$43,471.08	2025-06-28
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	26	17	—	—	$13,964.00	$158,200.00	$43,383.03	2025-06-28
J7352	HCPCS	Scenesse 16 Mg Subcutaneous Implant	64	39	$120,982.00	$78,638.30 35% off	$2,873.33	$120,982.00	$43,251.07	2025-06-28
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	26	17	—	—	$13,964.00	$139,200.00	$43,126.88	2025-06-28
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	26	17	—	—	$41,062.81	$128,400.00	$42,705.32	2025-06-28
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	26	17	—	—	$40,855.95	$188,200.00	$42,490.19	2025-06-28
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	26	17	—	—	$17,771.00	$203,786.00	$42,250.26	2025-06-28
11	MS_DRG	Tracheostomy For Face,mouth & Neck Diagnoses W Mcc	25	16	—	—	$40,817.86	$83,636.45	$42,042.40	2025-06-28
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	25	16	—	—	$40,813.38	$83,627.15	$42,037.78	2025-06-28
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	26	17	—	—	$17,771.00	$228,300.00	$41,995.58	2025-06-28
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	26	17	—	—	$13,964.00	$160,500.00	$41,799.12	2025-06-28
33276	HCPCS	Insj Phrnc Nrv Stim Sys	24	19	—	—	$17,282.87	$45,888.99	$41,717.26	2025-06-28
0266T	OTHER	Implt/rpl Crtd Sns Dev Total	24	19	—	—	$17,282.87	$45,888.99	$41,717.26	2025-06-28
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Without Mcc	26	17	—	—	$13,964.00	$158,100.00	$40,252.56	2025-06-28
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	26	17	—	—	$13,964.00	$146,600.00	$40,077.07	2025-06-28
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	26	17	—	—	$38,451.34	$144,100.00	$39,989.40	2025-06-28
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	26	17	—	—	$38,136.95	$159,900.00	$39,662.43	2025-06-28
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	26	17	—	—	$37,915.16	$171,600.00	$39,431.76	2025-06-28
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	25	16	—	—	$15,763.00	$95,704.00	$38,982.30	2025-06-28
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	25	16	—	—	$14,362.00	$120,149.00	$38,854.60	2025-06-28
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	26	17	—	—	$13,964.00	$120,500.00	$38,567.84	2025-06-28
6	MS_DRG	Liver Transplant Without Mcc	26	16	—	—	$36,735.26	$1,609,905.30	$38,204.67	2025-06-28
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	25	16	—	—	$13,964.00	$77,551.15	$37,886.04	2025-06-28
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	26	17	—	—	$11,984.00	$124,000.00	$37,871.10	2025-06-28
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	26	17	—	—	$13,964.00	$185,200.00	$37,736.68	2025-06-28
C9766	HCPCS	Revasc Endov W/ivl W/atherectomy Incl Angioplasty	56	34	$90,220.00	$58,643.00 35% off	$5,688.00	$90,220.00	$37,666.85	2025-06-28
Q5128	HCPCS	Cimerli 0.5 Mg/0.05 Ml Intravitreal Solution	65	39	$97,920.00	$63,648.00 35% off	$201.01	$97,920.00	$37,650.24	2025-06-28
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	25	16	—	—	$36,184.89	$74,020.25	$37,270.44	2025-06-28
799	MS_DRG	Splenic Procedures With Mcc	25	16	—	—	$36,030.31	$73,699.40	$37,111.22	2025-06-28
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	25	16	—	—	$36,023.58	$73,685.45	$37,104.29	2025-06-28
245	MS_DRG	Aicd Generator Procedures	26	17	—	—	$13,964.00	$120,547.00	$37,016.05	2025-06-28
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	26	17	—	—	$35,467.99	$112,000.00	$36,886.71	2025-06-28
471	MS_DRG	Cervical Spinal Fusion With Mcc	26	17	—	—	$13,964.00	$125,500.00	$36,795.75	2025-06-28
471B	OTHER	Bilateral Total Knee Replacement Proc. Of Low Extr	1	1	—	—	$36,700.00	$36,700.00	$36,700.00	2025-06-28
163	MS_DRG	Major Chest Procedures With Mcc	26	17	—	—	$34,943.00	$119,500.00	$36,340.72	2025-06-28
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	26	16	—	—	$34,928.82	$622,206.65	$36,325.97	2025-06-28
267	MS_DRG	Endovascular Cardiac Valve Replacement Without Mcc	26	17	—	—	$13,964.00	$159,600.00	$35,656.17	2025-06-28
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	26	17	—	—	$34,214.15	$103,500.00	$35,582.71	2025-06-28
J2326	HCPCS	Spinraza (pf) 12 Mg/5 Ml Intrathecal Solution	64	39	$99,288.57	$64,537.57 35% off	$1,210.10	$99,288.57	$35,495.67	2025-06-28
J0202	HCPCS	Lemtrada 12 Mg/1.2 Ml Intravenous Solution	65	39	$117,798.96	$76,569.32 35% off	$2,337.69	$117,798.96	$35,492.83	2025-06-28
J9281	HCPCS	Jelmyto 40 Mg X 2 Intra-pyelocalyceal Kit	65	39	$117,504.00	$76,377.60 35% off	$300.59	$117,504.00	$35,403.96	2025-06-28
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	25	16	—	—	$13,964.00	$117,356.00	$35,261.88	2025-06-28
0620T	OTHER	Endovascular Venous Arterialization Tibl/prnl Vn	67	39	$82,502.00	$53,626.30 35% off	$5,834.00	$82,502.00	$35,042.61	2025-06-28
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	25	16	—	—	$34,013.27	$69,512.85	$35,033.67	2025-06-28
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	26	17	—	—	$13,964.00	$127,500.00	$34,819.04	2025-06-28
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	26	17	—	—	$11,984.00	$117,800.00	$34,813.81	2025-06-28
33902	HCPCS	Perq P-art Revsc St 1st Abnor Connj Unilateral	67	39	$90,220.00	$58,643.00 35% off	$5,291.34	$90,220.00	$34,689.59	2025-06-28
901	MS_DRG	Wound Debridements For Injuries With Mcc	25	16	—	—	$33,608.52	$68,672.75	$34,616.78	2025-06-28
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	26	17	—	—	$13,964.00	$135,700.00	$33,920.67	2025-06-28
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	25	16	—	—	$32,834.87	$67,066.95	$33,819.92	2025-06-28
36836	HCPCS	Perq Av Fistula Creation Uxtr Single Access	64	39	$90,220.00	$58,643.00 35% off	$2,842.25	$90,220.00	$33,697.17	2025-06-28
36837	HCPCS	Perq Av Fistula Creation Uxtr Sep Access Sites	64	39	$90,220.00	$58,643.00 35% off	$2,842.25	$90,220.00	$33,697.17	2025-06-28
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	27	18	—	—	$16,400.00	$97,400.00	$33,349.18	2025-06-28
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	25	16	—	—	$17,771.00	$68,088.40	$33,326.99	2025-06-28
J9229	HCPCS	Besponsa 0.9 Mg(0.25 Mg/ml Initial Concentration) Intravenous Solution	65	39	$109,958.40	$71,472.96 35% off	$2,580.15	$109,958.40	$33,130.47	2025-06-28
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	26	17	—	—	$31,809.55	$64,938.80	$33,081.93	2025-06-28
140	MS_DRG	Major Head And Neck Procedures With Mcc	25	16	—	—	$32,105.27	$65,552.60	$33,068.43	2025-06-28
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	26	17	—	—	$13,964.00	$145,800.00	$32,768.40	2025-06-28
J2507	HCPCS	Krystexxa 8 Mg/ml Intravenous Solution	65	39	$108,080.82	$70,252.53 35% off	$3,391.91	$108,080.82	$32,564.75	2025-06-28
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	25	16	—	—	$13,964.00	$66,020.70	$32,330.79	2025-06-28
Q5124	HCPCS	Byooviz 0.5 Mg/0.05 Ml Intravitreal Solution	65	39	$83,800.80	$54,470.52 35% off	$149.75	$83,800.80	$32,221.41	2025-06-28
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	25	16	—	—	$31,213.62	$63,701.90	$32,150.03	2025-06-28
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	26	17	—	—	$30,896.99	$111,300.00	$32,132.87	2025-06-28
12	MS_DRG	Tracheostomy For Face,mouth & Neck Diagnoses W Cc	25	16	—	—	$31,168.07	$63,607.35	$32,103.11	2025-06-28
31	MS_DRG	Ventricular Shunt Procedures With Mcc	26	17	—	—	$13,964.00	$79,700.00	$31,817.01	2025-06-28
J2781	HCPCS	Syfovre (pf) 15 Mg/0.1 Ml Intravitreal Solution	57	34	$79,628.40	$51,758.46 35% off	$147.36	$79,628.40	$31,771.73	2025-06-28
793	MS_DRG	Full Term Neonate With Major Problems	20	15	—	—	$5,351.00	$64,642.75	$31,666.91	2025-06-28
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	25	16	—	—	$13,964.00	$101,681.00	$31,593.73	2025-06-28
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	26	17	—	—	$17,771.00	$132,220.00	$31,482.48	2025-06-28
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	26	17	—	—	$13,964.00	$130,900.00	$31,230.80	2025-06-28
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	25	16	—	—	$30,271.94	$61,747.35	$31,180.10	2025-06-28
739	MS_DRG	Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc	25	16	—	—	$30,251.03	$61,703.95	$31,158.56	2025-06-28
61715	HCPCS	Mrgfus Stereotactic Ablation Target Intracranial	63	39	$80,808.00	$52,525.20 35% off	$3,809.11	$80,808.00	$31,070.68	2025-06-28
6840311006	NDC	Babybig 100 Mg Intravenous Solution	41	28	$51,570.00	$33,520.50 35% off	$11,242.26	$51,570.00	$30,942.00	2025-06-28
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	25	16	—	—	$29,988.17	$61,158.35	$30,887.82	2025-06-28
791	MS_DRG	Prematurity With Major Problems	20	15	—	—	$5,351.00	$62,928.45	$30,840.98	2025-06-28
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	25	16	—	—	$29,927.68	$61,032.80	$30,825.51	2025-06-28
0746T	OTHER	Car Fcl Abltj Radj Arrhyt Conv Loclzj & Mapg	41	28	$51,097.00	$33,213.05 35% off	$11,139.15	$51,097.00	$30,658.20	2025-06-28
0745T	OTHER	Car Fcl Abltj Radj Arrhyt N-invas Loclzj & Mapg	41	28	$51,097.00	$33,213.05 35% off	$11,139.15	$51,097.00	$30,658.20	2025-06-28
0747T	OTHER	Car Fcl Abltj Radj Arrhyt Dlvr Radj Ther	41	28	$51,097.00	$33,213.05 35% off	$11,139.15	$51,097.00	$30,658.20	2025-06-28
J2782	HCPCS	Izervay (pf) 2 Mg/0.1 Ml Intravitreal Solution	57	34	$75,600.00	$49,140.00 35% off	$109.53	$75,600.00	$30,618.00	2025-06-28
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	26	17	—	—	$29,275.75	$78,400.00	$30,446.78	2025-06-28
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	25	16	—	—	$29,385.52	$59,907.50	$30,267.09	2025-06-28
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	25	16	—	—	$29,356.40	$59,847.05	$30,237.09	2025-06-28
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	26	17	—	—	$17,771.00	$172,700.00	$30,184.07	2025-06-28
J9359	HCPCS	Zynlonta 10 Mg Intravenous Solution	65	39	$99,959.04	$64,973.38 35% off	$200.49	$99,959.04	$30,117.66	2025-06-28
93585	HCPCS	Venography Chd Azygos/hemiazygos Venous System	48	33	$55,131.00	$35,835.15 35% off	$70.73	$55,131.00	$30,046.40	2025-06-28
93586	HCPCS	Venography Chd Coronary Sinus	48	33	$55,131.00	$35,835.15 35% off	$89.71	$55,131.00	$30,046.40	2025-06-28
93588	HCPCS	Venography Chd Venovenous Collateral Below Heart	48	33	$55,131.00	$35,835.15 35% off	$133.37	$55,131.00	$30,046.40	2025-06-28
93587	HCPCS	Venography Chd Venovenous Coltrl At/above Hrt	48	33	$55,131.00	$35,835.15 35% off	$131.86	$55,131.00	$30,046.40	2025-06-28
93584	HCPCS	Venography Chd Anomalous/persistent Svc Nt DRG	48	33	$55,131.00	$35,835.15 35% off	$75.17	$55,131.00	$30,046.40	2025-06-28
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	25	16	—	—	$29,067.40	$59,247.20	$29,939.42	2025-06-28
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	19	15	—	—	$29,867.94	$60,908.80	$29,867.94	2025-06-28
J1951	HCPCS	Fensolvi 45 Mg Subcutaneous Syringe	65	39	$98,795.04	$64,216.78 35% off	$131.71	$98,795.04	$29,766.95	2025-06-28
273	MS_DRG	Percutaneous Intracardiac Procedures W Mcc	25	16	—	—	$13,964.00	$91,005.00	$29,723.81	2025-06-28
33231	HCPCS	Insrt Pulse Gen W/mult Leads	24	19	—	—	$19,678.43	$32,694.60	$29,722.37	2025-06-28
0571T	OTHER	Insj/rplcmt Icds Ss Eltrd	24	19	—	—	$19,678.43	$32,694.60	$29,722.37	2025-06-28
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	26	17	—	—	$13,964.00	$75,400.00	$29,562.51	2025-06-28
69930	HCPCS	Implant Cochlear Device	24	19	—	—	$8,817.19	$32,435.83	$29,487.12	2025-06-28
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	25	16	—	—	$28,466.99	$58,001.00	$29,321.00	2025-06-28
33270	HCPCS	Ins/rplcmnt Perm Subq Impltbl Dfb W/subq Eltrd	64	39	$48,692.00	$31,649.80 35% off	$5,124.00	$48,692.00	$29,215.20	2025-06-28
33264	HCPCS	Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld	66	39	$48,692.00	$31,649.80 35% off	$480.63	$48,692.00	$29,215.20	2025-06-28
33249	HCPCS	Insj/rplcmt Perm Dfb W/trnsvns Lds 1/dual Chmbr	66	39	$48,692.00	$31,649.80 35% off	$1,090.37	$48,692.00	$29,215.20	2025-06-28
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	26	17	—	—	$13,964.00	$94,700.00	$28,912.82	2025-06-28
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	26	17	—	—	$27,770.25	$82,500.00	$28,881.06	2025-06-28
J2502	HCPCS	Signifor Lar 60 Mg IM Suspension	57	34	$72,075.84	$46,849.30 35% off	$463.20	$72,075.84	$28,758.26	2025-06-28
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	26	17	—	—	$13,964.00	$71,900.00	$28,691.77	2025-06-28
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	26	17	—	—	$27,581.32	$89,400.00	$28,684.57	2025-06-28
64568	HCPCS	Opn Impltj Crnl Nrv Nea&pg	24	19	—	—	$17,282.87	$31,075.26	$28,250.24	2025-06-28
63685	HCPCS	Ins/rplc Spi Npg/rcvr Pocket	24	19	—	—	$17,282.87	$31,075.26	$28,250.24	2025-06-28
64582	HCPCS	Opn Mpltj Hpglsl Nstm Ary Pg	24	19	—	—	$17,282.87	$31,075.26	$28,250.24	2025-06-28
33287	HCPCS	Rmv&rplcmt Phrnc Nrv Stim Pg	24	19	—	—	$17,282.87	$31,075.26	$28,250.24	2025-06-28
0268T	OTHER	Implt/rpl Crtd Sns Dev Gen	24	19	—	—	$17,282.87	$31,075.26	$28,250.24	2025-06-28
0674T	OTHER	Laps Insj Nw/rpcmt Prm Isdss	15	13	—	—	$28,250.24	$31,075.26	$28,250.24	2025-06-28
61886	HCPCS	Implant Neurostim Arrays	24	19	—	—	$17,282.87	$31,075.26	$28,250.24	2025-06-28
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	25	16	—	—	$27,293.07	$55,564.40	$28,111.86	2025-06-28
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	25	16	—	—	$27,291.57	$55,561.30	$28,110.32	2025-06-28
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	26	17	—	—	$26,813.64	$98,000.00	$27,886.18	2025-06-28
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	26	17	—	—	$15,600.00	$55,552.00	$27,696.40	2025-06-28
264	MS_DRG	Other Circulatory System O.r. Procedures	26	17	—	—	$26,623.21	$54,600.00	$27,688.14	2025-06-28
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	25	16	—	—	$26,880.10	$54,707.25	$27,686.50	2025-06-28
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	26	16	—	—	$26,454.44	$468,954.18	$27,512.61	2025-06-28
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	25	16	—	—	$26,688.18	$54,308.90	$27,488.83	2025-06-28
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	25	16	—	—	$26,679.97	$54,291.85	$27,480.37	2025-06-28
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	25	16	—	—	$26,669.51	$54,270.15	$27,469.60	2025-06-28
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	27	18	—	—	$25,959.33	$100,800.00	$27,257.30	2025-06-28
332	MS_DRG	Rectal Resection With Mcc	25	16	—	—	$26,426.06	$53,764.85	$27,218.84	2025-06-28
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	25	16	—	—	$26,397.69	$53,705.95	$27,189.62	2025-06-28
265	MS_DRG	Aicd Lead Procedures	26	17	—	—	$13,964.00	$81,071.00	$27,161.63	2025-06-28
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	25	16	—	—	$13,964.00	$55,043.60	$27,042.15	2025-06-28
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	25	16	—	—	$26,204.27	$53,304.50	$26,990.40	2025-06-28
665	MS_DRG	Prostatectomy With Mcc	25	16	—	—	$26,163.95	$53,220.80	$26,948.87	2025-06-28
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	25	16	—	—	$13,964.00	$54,721.20	$26,886.82	2025-06-28
CorniaIP	OTHER	Cornea (Inpatient )	2	2	—	—	$26,700.00	$26,700.00	$26,700.00	2025-06-28
MULVISC	OTHER	Multivisceral - Adult & Pediatric	2	2	—	—	$26,700.00	$26,700.00	$26,700.00	2025-06-28
37233	HCPCS	Revsc Opn/prq Tib/pero W/athrc/angiop Uni Ea Vsl	49	33	$49,247.00	$32,010.55 35% off	$2,345.00	$49,247.00	$26,445.64	2025-06-28
33289	HCPCS	Tcat Impl Wrls P-art Prs Snr	24	19	—	—	$19,678.43	$28,989.62	$26,354.20	2025-06-28
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	25	16	—	—	$13,964.00	$78,953.00	$26,244.60	2025-06-28
252	MS_DRG	Other Vascular Procedures With Mcc	26	17	—	—	$13,964.00	$96,400.00	$26,140.05	2025-06-28
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	26	17	—	—	$13,964.00	$90,700.00	$26,101.22	2025-06-28
143	MS_DRG	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	25	16	—	—	$25,180.45	$51,179.45	$25,935.86	2025-06-28
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	26	17	—	—	$13,964.00	$119,200.00	$25,853.29	2025-06-28
656	MS_DRG	Kidney And Ureter Procedures For Neoplasm With Mcc	26	17	—	—	$24,852.61	$103,500.00	$25,846.72	2025-06-28
579	MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	25	16	—	—	$24,863.07	$50,520.70	$25,608.96	2025-06-28
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	26	17	—	—	$13,964.00	$70,100.00	$25,589.68	2025-06-28
C9760	HCPCS	Non-blind Interatrial Shunt	16	14	—	—	$25,040.31	$28,043.47	$25,494.06	2025-06-28
37	MS_DRG	Extracranial Procedures With Mcc	27	18	—	—	$9,800.00	$92,700.00	$25,322.33	2025-06-28
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	26	17	—	—	$24,337.34	$72,000.00	$25,310.83	2025-06-28
500	MS_DRG	Soft Tissue Procedures With Mcc	26	17	—	—	$24,185.75	$60,800.00	$25,153.18	2025-06-28
929	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	25	16	—	—	$24,273.12	$49,296.20	$25,001.31	2025-06-28
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	25	16	—	—	$24,225.33	$49,197.00	$24,952.09	2025-06-28
469	MS_DRG	Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc	26	17	—	—	$13,964.00	$95,100.00	$24,932.52	2025-06-28
515	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	27	18	—	—	$23,615.96	$97,000.00	$24,796.76	2025-06-28
485	MS_DRG	Knee Procedures With Principal Diagnosis Of Infection With Mcc	26	17	—	—	$13,964.00	$140,400.00	$24,563.61	2025-06-28
93653	HCPCS	Compre Ep Eval Abltj 3d Mapg Tx Svt	64	39	$63,556.00	$41,311.40 35% off	$5,834.00	$63,556.00	$24,561.82	2025-06-28
93656	HCPCS	Compre Ep Eval Abltj Atr Fib Pulm Vein Isolation	64	39	$63,556.00	$41,311.40 35% off	$5,834.00	$63,556.00	$24,561.82	2025-06-28
93654	HCPCS	Compre Ep Eval Abltj 3d Mapg Tx Vt	64	39	$63,556.00	$41,311.40 35% off	$5,834.00	$63,556.00	$24,561.82	2025-06-28
662	MS_DRG	Minor Bladder Procedures With Mcc	25	16	—	—	$23,819.08	$48,353.80	$24,533.65	2025-06-28
829	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	26	17	—	—	$23,551.74	$104,500.00	$24,493.81	2025-06-28
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	25	16	—	—	$13,964.00	$61,501.00	$24,452.34	2025-06-28
652	MS_DRG	Kidney Transplant	26	16	—	—	$23,459.14	$414,786.43	$24,397.50	2025-06-28
324	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	25	16	—	—	$13,964.00	$51,216.00	$24,382.89	2025-06-28
36016145	CDM	Sel Cca H/n Bilat W/wo Arch	40	27	$40,534.00	$26,347.10 35% off	$8,836.41	$40,534.00	$24,320.40	2025-06-28
173	MS_DRG	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	25	16	—	—	$23,438.23	$47,563.30	$24,141.38	2025-06-28
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	26	17	—	—	$17,771.00	$108,180.00	$23,921.69	2025-06-28
274	MS_DRG	Percutaneous Intracardiac Procedures Without Mcc	25	16	—	—	$13,964.00	$63,885.00	$23,829.54	2025-06-28
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	26	17	—	—	$13,964.00	$143,800.00	$23,719.76	2025-06-28
570	MS_DRG	Skin Debridement With Mcc	25	16	—	—	$23,002.11	$46,658.10	$23,692.17	2025-06-28
C9764	HCPCS	Revasc Endov W/ivl Incl Angioplasty	56	34	$56,602.00	$36,791.30 35% off	$4,290.00	$56,602.00	$23,631.33	2025-06-28
974	MS_DRG	HIV With Major Related Condition With Mcc	25	16	—	—	$22,822.89	$46,286.10	$23,507.58	2025-06-28
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	26	17	—	—	$22,542.10	$105,500.00	$23,443.78	2025-06-28
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	26	17	—	—	$22,485.35	$85,900.00	$23,384.76	2025-06-28
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	26	17	—	—	$13,964.00	$87,500.00	$23,363.55	2025-06-28
240	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	26	17	—	—	$22,270.27	$77,600.00	$23,161.08	2025-06-28
353	MS_DRG	Hernia Procedures Except Inguinal And Femoral With Mcc	25	16	—	—	$22,425.60	$45,461.50	$23,098.37	2025-06-28
668	MS_DRG	Transurethral Procedures With Mcc	25	16	—	—	$22,300.89	$45,202.65	$22,969.92	2025-06-28
800	MS_DRG	Splenic Procedures With Cc	25	16	—	—	$22,282.22	$45,163.90	$22,950.69	2025-06-28
36016155	CDM	Ica H/n Bilat W/wo Arch	40	27	$38,074.00	$24,748.10 35% off	$8,300.13	$38,074.00	$22,844.40	2025-06-28
0786T	OTHER	Insj/rplcmt Perq Eltrd Ra Sac W/integrated Nstim	42	28	$38,937.00	$25,309.05 35% off	$5,124.00	$38,937.00	$22,778.15	2025-06-28
625	MS_DRG	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	25	16	—	—	$21,933.48	$44,440.05	$22,591.48	2025-06-28
510	MS_DRG	Shoulder,elbow Or Forearm Proc,exc Major Joint Proc W Mcc	25	16	—	—	$21,866.27	$44,300.55	$22,522.26	2025-06-28
654	MS_DRG	Major Bladder Procedures With Cc	26	17	—	—	$21,597.43	$115,500.00	$22,461.32	2025-06-28
406	MS_DRG	Pancreas, Liver And Shunt Procedures With Cc	26	17	—	—	$21,495.12	$73,800.00	$22,354.93	2025-06-28
258	MS_DRG	Cardiac Pacemaker Device Replacement With Mcc	26	17	—	—	$21,473.47	$43,485.25	$22,332.40	2025-06-28
521	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	25	16	—	—	$17,771.00	$45,177.85	$22,288.94	2025-06-28
33901	HCPCS	Perq P-art Revsc St 1st Nml Native Connj Bi	68	39	$56,602.00	$36,791.30 35% off	$5,291.34	$56,602.00	$22,173.83	2025-06-28

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