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

HILLCREST HOSPITAL

Mayfield Heights, OH · CCN 360230 · Rates published

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You selected 482 (MS_DRG)

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

This hospital’s price: $11,479 across 17 payers · range $11,145-$47,500

Source: https://clevelandclinic.pt.panaceainc.com/MRFDownload/clevelandclinic/hillcrest-mentor · observed 2025-06-28

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.

7,801 distinct procedures filed
39 distinct payers
697,651 rate rows
2025-06-28 last MRF observed · ⚠ 17 mo old
Data quality

365,649 of 697,651 rate rows are consumer-grade (52.4%)

332,002 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 279,966
per-diem day rate — not a per-procedure price 35,137
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 8,429
placeholder amount (≤ $0.02) — excluded from medians 8,306
exceeds 10× this hospital's gross charge — excluded from medians 157
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 7

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old.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://clevelandclinic.pt.panaceainc.com/MRFDownload/clevelandclinic/hillcrest-mentor
Found on page https://my.clevelandclinic.org/patients/billing-finance/comprehensive-hospital-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-11-02
Content fingerprint 14930d49ed27dd82… · 25,299,944 bytes · first seen 2026-05-14

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
J3394
HCPCS 		Lyfgenia 1.7 X To 20 X 10exp6 Cell/ml Intravenous Suspension 16 $500,000.00 $4,925,280.00 $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 16 $500,000.00 $4,999,680.00 $2,968,000.00 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Zolgensma 2 X 10exp13 Vg/ml Intravenous Suspension Kit 24 $500,000.00 $4,905,945.00 $2,579,703.37 nat. median
$2,467,989
1.0× median
J3392
HCPCS 		Casgevy 4x10exp6 To 13x10exp6 Cell/ml Intravenous Suspension 18 $500,000.00 $4,435,200.00 $2,367,860.00 nat. median
$2,401,965
1.0× median
Q2042
HCPCS 		Kymriah 0.2 X 10exp6 To 2.5 X 10exp8 Cell Intravenous Suspension 34 $500,000.00 $2,848,960.04 $1,384,617.79 nat. median
$739,658
1.9× median
Q2056
HCPCS 		Carvykti 0.5x 10exp6 To 1x 10exp8 Cell Intravenous Suspension 34 $500,000.00 $2,505,866.40 $1,185,334.43 nat. median
$646,415
1.8× median
Q2054
HCPCS 		Breyanzi 1.5x To 70x10exp6 Cell/ml Intravenous Suspension 34 $474,060.62 $2,339,891.68 $1,110,444.84 nat. median
$640,950
1.7× median
Q2041
HCPCS 		Yescarta Intravenous Suspension 34 $459,381.45 $2,417,184.00 $1,052,461.87 nat. median
$608,239
1.7× median
Q2053
HCPCS 		Tecartus 2x10exp6 To 2x10exp8 Cell Intravenous Suspension 34 $449,440.00 $2,217,600.00 $1,049,310.75 nat. median
$592,235
1.8× median
005-I
OTHER 		Intestinal - Adult 2 $563,700.00 $563,700.00 $563,700.00 nat. median
$563,700
1.0× median
006-LA
OTHER 		Liver (Live Donor) - Adult 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
005-LP
OTHER 		Liver (Live Donor) - Pediatric 2 $560,500.00 $560,500.00 $560,500.00 nat. median
$560,500
1.0× median
006-LP
OTHER 		Liver (Live Donor) - Pediatric 2 $560,500.00 $560,500.00 $560,500.00 nat. median
$560,500
1.0× median
005-DA
OTHER 		Liver (Deceased Donor) - Adult 2 $486,600.00 $486,600.00 $486,600.00 nat. median
$486,600
1.0× median
006-DA
OTHER 		Liver (Deceased Donor) - Adult 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
006-DP
OTHER 		Liver (Deceased Donor) -pediatric 2 $471,700.00 $471,700.00 $471,700.00 nat. median
$471,700
1.0× median
005-DP
OTHER 		Liver (Deceased Donor) -pediatric 2 $471,700.00 $471,700.00 $471,700.00 nat. median
$471,700
1.0× median
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
J0225
HCPCS 		Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe 34 $4,926.00 $859,327.20 $306,779.81 nat. median
$8,223
outlier · 37.3×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 16 $258,029.62 $584,548.40 $265,770.51 nat. median
$359,244
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 16 $192,803.23 $212,083.55 $192,803.23 nat. median
$248,541
0.8× 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
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
652-C
OTHER 		Kidney Transplant - Cadaveric 1 $185,100.00 $185,100.00 $185,100.00 nat. median
$185,100
1.0× 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
650-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-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
652-LD
OTHER 		Kidney Transplant - 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
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 $162,423.01 $367,703.40 $167,295.70 nat. median
$198,115
0.8× 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
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
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
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 17 $41,100.00 $161,441.64 $146,765.13 nat. median
$190,359
0.8× median
J2779
HCPCS 		Susvimo 10 Mg/0.1 Ml Intravitreal Solution 34 $79.08 $288,000.00 $102,816.00 nat. median
$88
outlier · 1167.2×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 17 $28,700.00 $106,553.19 $96,866.54 nat. median
$126,461
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 18 $12,900.00 $4,334,979.46 $92,535.10 nat. median
$110,084
0.8× median
7
MS_DRG 		Lung Transplant 17 $26,000.00 $4,868,232.55 $92,302.81 nat. median
$117,977
0.8× median
C9293
HCPCS 		Voraxaze 1000 Unit Intravenous Solution 28 $722.95 $148,226.40 $84,489.05 nat. median
$30,130
outlier · 2.8×
J9226
HCPCS 		Supprelin La 50 Mg (65 Mcg/day) Implant Kit 34 $38,799.32 $175,562.52 $81,998.53 nat. median
$55,159
1.5× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 16 $75,610.98 $83,172.08 $75,610.98 nat. median
$103,938
0.7× median
215
MS_DRG 		Other Heart Assist System Implant 16 $72,707.25 $164,219.40 $74,888.47 nat. median
$93,787
0.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 16 $11,938.00 $168,855.45 $74,751.28 nat. median
$97,137
0.8× median
A9543
HCPCS 		Zevalin (y-90) 3.2 Mg/2 Ml Intravenous Kit 34 $14,774.74 $148,248.86 $73,086.69 nat. median
$63,504
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 17 $27,200.00 $165,065.70 $73,080.38 nat. median
$94,943
0.8× median

Other procedures at this hospital

Browse this hospital's 7,801 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
             
J3394 HCPCS Lyfgenia 1.7 X To 20 X 10exp6 Cell/ml Intravenous Suspension 23 16 — — $500,000.00 $4,925,280.00 $3,286,000.00 2025-06-28
J3393 HCPCS Zynteglo 2 X 10exp6 To 20 X 10exp6 Cell/ml Intravenous Suspension 25 16 — — $500,000.00 $4,999,680.00 $2,968,000.00 2025-06-28
J3399 HCPCS Zolgensma 2 X 10exp13 Vg/ml Intravenous Suspension Kit 43 24 — $4,972,500.00 $500,000.00 $4,905,945.00 $2,579,703.37 2025-06-28
J3392 HCPCS Casgevy 4x10exp6 To 13x10exp6 Cell/ml Intravenous Suspension 30 18 — — $500,000.00 $4,435,200.00 $2,367,860.00 2025-06-28
Q2042 HCPCS Kymriah 0.2 X 10exp6 To 2.5 X 10exp8 Cell Intravenous Suspension 92 34 $2,848,960.04 $1,851,824.03 35% off $500,000.00 $2,848,960.04 $1,384,617.79 2025-06-28
Q2056 HCPCS Carvykti 0.5x 10exp6 To 1x 10exp8 Cell Intravenous Suspension 57 34 $2,505,866.40 $1,628,813.16 35% off $500,000.00 $2,505,866.40 $1,185,334.43 2025-06-28
Q2054 HCPCS Breyanzi 1.5x To 70x10exp6 Cell/ml Intravenous Suspension 57 34 $2,339,891.68 $1,520,929.59 35% off $474,060.62 $2,339,891.68 $1,110,444.84 2025-06-28
Q2041 HCPCS Yescarta Intravenous Suspension 57 34 $2,417,184.00 $1,571,169.60 35% off $459,381.45 $2,417,184.00 $1,052,461.87 2025-06-28
Q2053 HCPCS Tecartus 2x10exp6 To 2x10exp8 Cell Intravenous Suspension 57 34 $2,217,600.00 $1,441,440.00 35% off $449,440.00 $2,217,600.00 $1,049,310.75 2025-06-28
005-I OTHER Intestinal - Adult 2 2 — — $563,700.00 $563,700.00 $563,700.00 2025-06-28
006-LA OTHER Liver (Live Donor) - Adult 2 2 — — $561,500.00 $561,500.00 $561,500.00 2025-06-28
005-LA OTHER Liver (Live Donor) - Adult 2 2 — — $561,500.00 $561,500.00 $561,500.00 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-LP OTHER Liver (Live Donor) - Pediatric 2 2 — — $560,500.00 $560,500.00 $560,500.00 2025-06-28
005-DA OTHER Liver (Deceased Donor) - Adult 2 2 — — $486,600.00 $486,600.00 $486,600.00 2025-06-28
006-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
006-DP OTHER Liver (Deceased Donor) -pediatric 2 2 — — $471,700.00 $471,700.00 $471,700.00 2025-06-28
005-DP OTHER Liver (Deceased Donor) -pediatric 2 2 — — $471,700.00 $471,700.00 $471,700.00 2025-06-28
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
J0225 HCPCS Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe 60 34 $859,327.20 $558,562.68 35% off $4,926.00 $859,327.20 $306,779.81 2025-06-28
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 16 — — $258,029.62 $584,548.40 $265,770.51 2025-06-28
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 19 16 — — $192,803.23 $212,083.55 $192,803.23 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
652-C OTHER Kidney Transplant - Cadaveric 1 1 — — $185,100.00 $185,100.00 $185,100.00 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-D OTHER Kidney (Deceased) - Adult & Pediatric 2 2 — — $175,300.00 $175,300.00 $175,300.00 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
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
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 27 16 — — $162,423.01 $367,703.40 $167,295.70 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
650-L OTHER Kidney ( Live Donor) - Adult & Pediatric 2 2 — — $161,100.00 $161,100.00 $161,100.00 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
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 20 17 — — $41,100.00 $161,441.64 $146,765.13 2025-06-28
J2779 HCPCS Susvimo 10 Mg/0.1 Ml Intravitreal Solution 60 34 $288,000.00 $187,200.00 35% off $79.08 $288,000.00 $102,816.00 2025-06-28
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 20 17 — — $28,700.00 $106,553.19 $96,866.54 2025-06-28
14 MS_DRG Allogeneic Bone Marrow Transplant 30 18 — — $12,900.00 $4,334,979.46 $92,535.10 2025-06-28
7 MS_DRG Lung Transplant 29 17 — — $26,000.00 $4,868,232.55 $92,302.81 2025-06-28
C9293 HCPCS Voraxaze 1000 Unit Intravenous Solution 43 28 $148,226.40 $96,347.16 35% off $722.95 $148,226.40 $84,489.05 2025-06-28
J9226 HCPCS Supprelin La 50 Mg (65 Mcg/day) Implant Kit 60 34 $175,562.52 $114,115.64 35% off $38,799.32 $175,562.52 $81,998.53 2025-06-28
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 19 16 — — $75,610.98 $83,172.08 $75,610.98 2025-06-28
215 MS_DRG Other Heart Assist System Implant 27 16 — — $72,707.25 $164,219.40 $74,888.47 2025-06-28
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 27 16 — — $11,938.00 $168,855.45 $74,751.28 2025-06-28
A9543 HCPCS Zevalin (y-90) 3.2 Mg/2 Ml Intravenous Kit 60 34 $148,248.86 $96,361.76 35% off $14,774.74 $148,248.86 $73,086.69 2025-06-28
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 27 17 — — $27,200.00 $165,065.70 $73,080.38 2025-06-28
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 16 — — $16,812.00 $162,368.70 $71,891.28 2025-06-28
J9274 HCPCS Kimmtrak 100 Mcg/0.5 Ml Intravenous Solution 60 34 $196,608.00 $127,795.20 35% off $208.93 $196,608.00 $70,189.06 2025-06-28
J9248 HCPCS Hepzato (62 Mm Catheter) 50 Mg Intra-arterial Solution 60 34 $180,000.00 $117,000.00 35% off $693.50 $180,000.00 $68,085.00 2025-06-28
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 25 17 — — $19,639.00 $283,600.00 $66,258.08 2025-06-28
J9029 HCPCS Adstiladrin 3x10exp11 Vp/ml Intravesical Suspension 60 34 $72,000.00 $46,800.00 35% off $15,912.00 $144,556.65 $63,354.77 2025-06-28
850 MS_DRG Acute Leukemia With Other Procedures 27 16 — — $46,072.00 $142,784.45 $63,256.62 2025-06-28
J2777 HCPCS Vabysmo 6 Mg/0.05 Ml Intravitreal Solution 60 34 $164,854.80 $107,155.62 35% off $34.25 $164,854.80 $58,853.16 2025-06-28
231 MS_DRG Coronary Bypass With Ptca With Mcc 27 16 — — $16,812.00 $131,345.45 $58,213.18 2025-06-28
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 27 17 — — $13,264.00 $212,600.00 $58,181.06 2025-06-28
J9269 HCPCS Elzonris 1000 Mcg/ml Intravenous Solution 60 34 $162,031.92 $105,320.75 35% off $326.65 $162,031.92 $57,845.40 2025-06-28
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 27 16 — — $16,812.00 $129,279.30 $57,302.22 2025-06-28
10 MS_DRG Pancreas Transplant 32 20 — — $10,700.00 $1,615,106.56 $56,981.67 2025-06-28
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 30 18 — — $54,477.76 $1,784,276.68 $56,656.87 2025-06-28
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 28 17 — — $11,938.00 $289,300.00 $55,392.14 2025-06-28
J0223 HCPCS Givlaari 189 Mg/ml Subcutaneous Solution 60 34 $153,417.60 $99,721.44 35% off $112.02 $153,417.60 $54,770.08 2025-06-28
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 28 17 — — $20,885.00 $217,200.00 $54,525.67 2025-06-28
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 27 17 — — $13,264.00 $193,600.00 $53,180.68 2025-06-28
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 27 16 — — $51,312.97 $115,695.10 $52,852.36 2025-06-28
J0179 HCPCS Beovu 6 Mg/0.05 Ml Intravitreal Syringe 60 34 $147,062.88 $95,590.87 35% off $325.68 $147,062.88 $52,501.44 2025-06-28
J0177 HCPCS Eylea Hd 8 Mg/0.07 Ml Intravitreal Solution For Injection 60 34 $137,700.00 $89,505.00 35% off $333.70 $137,700.00 $52,085.03 2025-06-28
J3357 HCPCS Stelara 45 Mg/0.5 Ml Subcutaneous Solution 95 34 $104,945.34 $68,214.47 35% off $152.57 $104,945.34 $51,003.39 2025-06-28
J2778 HCPCS Darvocet-n 50 50 Mg-325 Mg Tab 93 34 $140,400.00 $91,260.00 35% off $137.14 $140,400.00 $50,544.00 2025-06-28
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 28 17 — — $47,843.38 $194,500.00 $49,278.68 2025-06-28
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 17 — — $16,812.00 $269,394.00 $48,842.50 2025-06-28
J0178 HCPCS Eylea 2 Mg/0.05 Ml Intravitreal Syringe 60 34 $136,530.00 $88,744.50 35% off $821.98 $136,530.00 $48,741.21 2025-06-28
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 26 16 — — $13,264.00 $109,538.50 $48,598.53 2025-06-28
955 MS_DRG Craniotomy For Multiple Significant Trauma 27 16 — — $46,967.27 $105,838.65 $48,376.29 2025-06-28
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 27 16 — — $45,946.28 $103,522.95 $47,324.67 2025-06-28
J9600 HCPCS Photofrin 75 Mg Intravenous Solution 60 34 $111,950.40 $72,767.76 35% off $23,170.54 $111,950.40 $47,063.67 2025-06-28
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 27 16 — — $15,763.00 $103,922.85 $46,122.60 2025-06-28
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 26 16 — — $13,264.00 $150,790.00 $45,869.06 2025-06-28
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 28 17 — — $44,499.54 $148,400.00 $45,834.53 2025-06-28
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 27 16 — — $43,522.97 $98,026.65 $44,828.66 2025-06-28
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 28 17 — — $11,938.00 $223,200.00 $44,435.99 2025-06-28
J1930 HCPCS Somatuline Depot 60 Mg/0.2 Ml Subcutaneous Syringe 126 34 $109,584.00 $71,229.60 35% off $48.00 $109,584.00 $44,266.36 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
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 27 16 — — $42,387.86 $95,452.10 $43,659.50 2025-06-28
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 30 18 — — $41,552.07 $1,120,812.31 $43,214.15 2025-06-28
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 30 18 — — $41,552.07 $1,120,812.31 $43,214.15 2025-06-28
J7352 HCPCS Scenesse 16 Mg Subcutaneous Implant 60 34 $120,982.00 $78,638.30 35% off $2,873.33 $120,982.00 $43,190.57 2025-06-28
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 27 16 — — $12,198.00 $96,013.20 $42,635.25 2025-06-28
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 27 16 — — $16,812.00 $95,889.20 $42,580.58 2025-06-28
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 28 17 — — $11,938.00 $116,800.00 $42,240.93 2025-06-28
J0202 HCPCS Lemtrada 12 Mg/1.2 Ml Intravenous Solution 60 34 $117,798.96 $76,569.32 35% off $2,337.69 $117,798.96 $42,054.22 2025-06-28
232 MS_DRG Coronary Bypass With Ptca Without Mcc 27 16 — — $16,812.00 $94,684.85 $42,049.58 2025-06-28
J9281 HCPCS Jelmyto 40 Mg X 2 Intra-pyelocalyceal Kit 60 34 $117,504.00 $76,377.60 35% off $300.59 $117,504.00 $41,948.93 2025-06-28
28 MS_DRG Spinal Procedures With Mcc 28 17 — — $11,938.00 $108,100.00 $41,850.03 2025-06-28
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 28 17 — — $40,092.34 $207,900.00 $41,295.11 2025-06-28
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 29 18 — — $11,938.00 $173,600.00 $41,243.86 2025-06-28
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 28 17 — — $20,885.00 $168,400.00 $41,123.09 2025-06-28
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 16 — — $11,938.00 $92,214.15 $40,960.25 2025-06-28
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 21 16 — — $40,929.50 $92,144.40 $40,929.50 2025-06-28
653 MS_DRG Major Bladder Procedures With Mcc 28 17 — — $38,399.58 $144,700.00 $39,551.57 2025-06-28
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 28 17 — — $12,198.00 $158,200.00 $39,525.81 2025-06-28
Q5128 HCPCS Cimerli 0.5 Mg/0.05 Ml Intravitreal Solution 60 34 $97,920.00 $63,648.00 35% off $201.01 $97,920.00 $39,363.84 2025-06-28
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 28 17 — — $11,938.00 $139,200.00 $39,291.41 2025-06-28
J9229 HCPCS Besponsa 0.9 Mg(0.25 Mg/ml Initial Concentration) Intravenous Solution 60 34 $109,958.40 $71,472.96 35% off $2,580.15 $109,958.40 $39,255.14 2025-06-28
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 28 17 — — $38,076.34 $152,300.00 $39,218.63 2025-06-28
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 32 20 — — $26,000.00 $1,224,682.79 $38,986.74 2025-06-28
J2507 HCPCS Krystexxa 8 Mg/ml Intravenous Solution 60 34 $108,080.82 $70,252.53 35% off $3,391.91 $108,080.82 $38,584.85 2025-06-28
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 28 17 — — $37,402.51 $128,400.00 $38,524.59 2025-06-28
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 28 17 — — $37,213.21 $188,200.00 $38,329.61 2025-06-28
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 27 16 — — $37,178.36 $83,636.45 $38,293.71 2025-06-28
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 27 16 — — $37,174.26 $83,627.15 $38,289.49 2025-06-28
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 28 17 — — $11,938.00 $160,500.00 $38,076.34 2025-06-28
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 17 — — $16,812.00 $203,786.00 $37,917.79 2025-06-28
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 28 17 — — $16,812.00 $228,300.00 $37,688.17 2025-06-28
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 28 17 — — $20,885.00 $158,100.00 $37,210.94 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
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 17 — — $11,938.00 $146,600.00 $36,500.43 2025-06-28
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 28 17 — — $35,012.69 $144,100.00 $36,063.07 2025-06-28
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 28 17 — — $34,724.98 $159,900.00 $35,766.73 2025-06-28
J9359 HCPCS Zynlonta 10 Mg Intravenous Solution 60 34 $99,959.04 $64,973.38 35% off $200.49 $99,959.04 $35,685.38 2025-06-28
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 28 17 — — $34,522.01 $171,600.00 $35,557.67 2025-06-28
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 27 16 — — $15,763.00 $79,826.55 $35,498.58 2025-06-28
J2326 HCPCS Spinraza (pf) 12 Mg/5 Ml Intrathecal Solution 60 34 $99,288.57 $64,537.57 35% off $1,210.10 $99,288.57 $35,446.02 2025-06-28
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 27 16 — — $11,938.00 $113,821.00 $35,381.72 2025-06-28
J1951 HCPCS Fensolvi 45 Mg Subcutaneous Syringe 60 34 $98,795.04 $64,216.78 35% off $131.71 $98,795.04 $35,269.82 2025-06-28
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 28 17 — — $11,938.00 $120,500.00 $35,119.30 2025-06-28
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 27 16 — — $11,938.00 $77,551.15 $34,495.36 2025-06-28
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 28 17 — — $10,479.00 $124,000.00 $34,481.69 2025-06-28
6 MS_DRG Liver Transplant Without Mcc 28 16 — — $33,442.25 $1,609,905.30 $34,445.52 2025-06-28
228 MS_DRG Other Cardiothoracic Procedures With Mcc 28 17 — — $16,812.00 $185,200.00 $34,358.68 2025-06-28
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 27 16 — — $32,938.59 $74,020.25 $33,926.75 2025-06-28
799 MS_DRG Splenic Procedures With Mcc 27 16 — — $32,797.13 $73,699.40 $33,781.04 2025-06-28
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 27 16 — — $32,790.98 $73,685.45 $33,774.71 2025-06-28
245 MS_DRG Aicd Generator Procedures 28 17 — — $11,938.00 $114,194.00 $33,699.21 2025-06-28
Q5124 HCPCS Byooviz 0.5 Mg/0.05 Ml Intravitreal Solution 60 34 $83,800.80 $54,470.52 35% off $149.75 $83,800.80 $33,687.92 2025-06-28
471 MS_DRG Cervical Spinal Fusion With Mcc 28 17 — — $11,938.00 $125,500.00 $33,497.61 2025-06-28
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 28 17 — — $32,282.54 $112,000.00 $33,251.02 2025-06-28
163 MS_DRG Major Chest Procedures With Mcc 28 17 — — $31,802.11 $119,500.00 $32,756.17 2025-06-28
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 28 16 — — $31,789.13 $622,206.65 $32,742.80 2025-06-28
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 28 17 — — $11,938.00 $159,600.00 $32,454.75 2025-06-28
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 27 16 — — $11,938.00 $109,092.00 $32,093.92 2025-06-28
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 28 17 — — $31,135.12 $103,500.00 $32,069.17 2025-06-28
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 27 16 — — $30,951.29 $69,512.85 $31,879.83 2025-06-28
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 17 — — $11,938.00 $127,500.00 $31,688.67 2025-06-28
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 28 17 — — $10,479.00 $117,800.00 $31,683.88 2025-06-28
901 MS_DRG Wound Debridements For Injuries With Mcc 27 16 — — $30,580.89 $68,672.75 $31,498.32 2025-06-28
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 28 17 — — $11,938.00 $135,700.00 $30,866.55 2025-06-28
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 27 16 — — $29,872.89 $67,066.95 $30,769.08 2025-06-28
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 29 18 — — $16,400.00 $97,400.00 $30,338.30 2025-06-28
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 27 16 — — $16,812.00 $68,088.40 $30,323.25 2025-06-28
140 MS_DRG Major Head And Neck Procedures With Mcc 27 16 — — $29,205.22 $65,552.60 $30,081.38 2025-06-28
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 28 17 — — $11,938.00 $145,800.00 $29,812.07 2025-06-28
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 28 17 — — $28,934.60 $64,938.80 $29,802.64 2025-06-28
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 27 16 — — $11,938.00 $66,020.70 $29,411.60 2025-06-28
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 27 16 — — $28,389.25 $63,701.90 $29,240.93 2025-06-28
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 27 16 — — $28,347.56 $63,607.35 $29,197.99 2025-06-28
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 28 17 — — $28,099.49 $111,300.00 $28,942.47 2025-06-28
31 MS_DRG Ventricular Shunt Procedures With Mcc 28 17 — — $11,938.00 $79,700.00 $28,941.43 2025-06-28
793 MS_DRG Full Term Neonate With Major Problems 21 16 — — $28,804.07 $64,642.75 $28,804.07 2025-06-28
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 27 16 — — $11,938.00 $96,323.00 $28,737.10 2025-06-28
J2782 HCPCS Izervay (pf) 2 Mg/0.1 Ml Intravitreal Solution 60 34 $75,600.00 $49,140.00 35% off $109.53 $75,600.00 $28,595.70 2025-06-28
J2781 HCPCS Syfovre (pf) 15 Mg/0.1 Ml Intravitreal Solution 60 34 $79,628.40 $51,758.46 35% off $147.36 $79,628.40 $28,427.33 2025-06-28
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 28 17 — — $11,938.00 $130,900.00 $28,404.97 2025-06-28
6840311006 NDC Babybig 100 Mg Intravenous Solution 43 28 $51,570.00 $33,520.50 35% off $9,576.55 $51,570.00 $28,363.50 2025-06-28
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 27 16 — — $27,527.49 $61,747.35 $28,353.31 2025-06-28
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 27 16 — — $27,508.36 $61,703.95 $28,333.61 2025-06-28
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 28 17 — — $18,934.00 $132,220.00 $28,209.52 2025-06-28
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 27 16 — — $27,267.80 $61,158.35 $28,085.83 2025-06-28
791 MS_DRG Prematurity With Major Problems 21 16 — — $28,048.24 $62,928.45 $28,048.24 2025-06-28
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 27 16 — — $27,212.45 $61,032.80 $28,028.82 2025-06-28
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 27 16 — — $26,716.30 $59,907.50 $27,517.79 2025-06-28
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 27 16 — — $26,689.65 $59,847.05 $27,490.34 2025-06-28
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 27 16 — — $26,425.18 $59,247.20 $27,217.94 2025-06-28
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 21 16 — — $27,157.78 $60,908.80 $27,157.78 2025-06-28
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 28 17 — — $16,812.00 $172,700.00 $27,038.87 2025-06-28
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 27 16 — — $11,938.00 $86,209.00 $27,025.88 2025-06-28
34 MS_DRG Carotid Artery Stent Procedures With Mcc 28 17 — — $11,938.00 $75,400.00 $26,878.27 2025-06-28
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 27 16 — — $25,875.73 $58,001.00 $26,652.00 2025-06-28
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 28 17 — — $10,251.00 $78,400.00 $26,615.85 2025-06-28
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 28 17 — — $11,938.00 $94,700.00 $26,283.72 2025-06-28
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 28 17 — — $11,938.00 $71,900.00 $26,081.43 2025-06-28
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 28 17 — — $25,238.13 $82,500.00 $25,995.27 2025-06-28
J0638 HCPCS Ilaris (pf) 150 Mg/ml Subcutaneous Solution 60 34 $72,797.79 $47,318.56 35% off $124.48 $72,797.79 $25,988.81 2025-06-28
335 MS_DRG Peritoneal Adhesiolysis With Mcc 28 17 — — $25,065.23 $89,400.00 $25,817.19 2025-06-28
J2502 HCPCS Signifor Lar 60 Mg IM Suspension 60 34 $72,075.84 $46,849.30 35% off $463.20 $72,075.84 $25,731.07 2025-06-28
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 27 16 — — $24,801.44 $55,564.40 $25,545.48 2025-06-28
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 27 16 — — $24,800.07 $55,561.30 $25,544.07 2025-06-28
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 28 17 — — $15,600.00 $55,552.00 $25,167.91 2025-06-28
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 27 16 — — $24,423.52 $54,707.25 $25,156.23 2025-06-28
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 28 17 — — $24,362.70 $98,000.00 $25,093.58 2025-06-28
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 27 16 — — $24,247.89 $54,308.90 $24,975.33 2025-06-28
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 27 16 — — $24,240.37 $54,291.85 $24,967.58 2025-06-28
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 27 16 — — $24,230.81 $54,270.15 $24,957.73 2025-06-28
264 MS_DRG Other Circulatory System O.r. Procedures 28 17 — — $24,188.44 $54,600.00 $24,914.09 2025-06-28
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 28 16 — — $24,033.99 $468,954.18 $24,755.01 2025-06-28
332 MS_DRG Rectal Resection With Mcc 27 16 — — $24,008.02 $53,764.85 $24,728.26 2025-06-28
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 27 16 — — $23,982.05 $53,705.95 $24,701.51 2025-06-28
265 MS_DRG Aicd Lead Procedures 28 17 — — $11,938.00 $76,800.00 $24,681.16 2025-06-28
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 27 16 — — $11,938.00 $55,043.60 $24,571.82 2025-06-28
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 27 16 — — $23,805.05 $53,304.50 $24,519.20 2025-06-28
665 MS_DRG Prostatectomy With Mcc 27 16 — — $23,768.15 $53,220.80 $24,481.19 2025-06-28
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 27 16 — — $11,938.00 $54,721.20 $24,429.67 2025-06-28
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 29 18 — — $23,580.90 $100,800.00 $24,288.33 2025-06-28
271 MS_DRG Other Major Cardiovascular Procedures With Cc 27 16 — — $11,938.00 $74,794.00 $23,841.96 2025-06-28
252 MS_DRG Other Vascular Procedures With Mcc 28 17 — — $16,812.00 $96,400.00 $23,746.28 2025-06-28
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 28 17 — — $11,938.00 $90,700.00 $23,710.74 2025-06-28
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 27 16 — — $22,868.12 $51,179.45 $23,554.16 2025-06-28
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 28 17 — — $11,938.00 $119,200.00 $23,483.86 2025-06-28
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 27 16 — — $22,577.68 $50,520.70 $23,255.01 2025-06-28
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 28 17 — — $22,568.11 $103,500.00 $23,245.15 2025-06-28
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 28 17 — — $11,938.00 $70,100.00 $23,242.62 2025-06-28
J9266 HCPCS Oncaspar 750 Unit/ml Injection Solution 60 34 $25,742.56 $16,732.66 35% off $5,689.11 $61,720.81 $23,168.30 2025-06-28
37 MS_DRG Extracranial Procedures With Mcc 29 18 — — $9,800.00 $92,700.00 $22,997.97 2025-06-28
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 28 17 — — $22,096.57 $72,000.00 $22,759.47 2025-06-28
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 27 16 — — $22,037.80 $49,296.20 $22,698.93 2025-06-28
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 27 16 — — $21,994.06 $49,197.00 $22,653.88 2025-06-28
469 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc 28 17 — — $11,938.00 $95,100.00 $22,641.23 2025-06-28
500 MS_DRG Soft Tissue Procedures With Mcc 28 17 — — $21,957.84 $60,800.00 $22,616.58 2025-06-28
J3241 HCPCS Tepezza 500 Mg Intravenous Solution 60 34 $63,040.08 $40,976.05 35% off $333.40 $63,040.08 $22,505.31 2025-06-28
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 28 17 — — $11,938.00 $140,400.00 $22,303.64 2025-06-28
662 MS_DRG Minor Bladder Procedures With Mcc 27 16 — — $21,622.30 $48,353.80 $22,270.97 2025-06-28
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 27 16 — — $11,938.00 $58,263.00 $22,201.81 2025-06-28
J3245 HCPCS Ilumya 100 Mg/ml Subcutaneous Syringe 60 34 $62,054.88 $40,335.67 35% off $135.92 $62,054.88 $22,153.60 2025-06-28
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 27 16 — — $11,938.00 $49,524.05 $22,138.26 2025-06-28
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 29 18 — — $21,436.41 $97,000.00 $22,079.50 2025-06-28
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 28 17 — — $21,377.64 $104,500.00 $22,018.97 2025-06-28
652 MS_DRG Kidney Transplant 28 16 — — $21,292.90 $414,786.43 $21,931.69 2025-06-28
J9216 HCPCS Actimmune 100 Mcg (2 Million Unit)/0.5 Ml Subcutaneous Solution 43 28 $40,606.35 $26,394.13 35% off $8,852.18 $40,606.35 $21,927.43 2025-06-28
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 27 16 — — $21,273.77 $47,563.30 $21,911.98 2025-06-28
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 27 16 — — $11,938.00 $60,519.00 $21,631.86 2025-06-28
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 28 17 — — $16,812.00 $143,800.00 $21,531.41 2025-06-28
570 MS_DRG Skin Debridement With Mcc 27 16 — — $20,874.67 $46,658.10 $21,500.91 2025-06-28
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 28 17 — — $18,934.00 $108,180.00 $21,392.68 2025-06-28
974 MS_DRG HIV With Major Related Condition With Mcc 27 16 — — $20,710.65 $46,286.10 $21,331.97 2025-06-28
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 28 17 — — $11,938.00 $87,500.00 $21,205.43 2025-06-28
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 28 17 — — $20,453.70 $105,500.00 $21,067.31 2025-06-28
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 28 17 — — $20,401.76 $85,900.00 $21,013.81 2025-06-28
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 27 16 — — $20,347.09 $45,461.50 $20,957.50 2025-06-28
J9042 HCPCS Adcetris 50 Mg Intravenous Solution 60 34 $58,560.00 $38,064.00 35% off $230.74 $58,560.00 $20,905.92 2025-06-28
668 MS_DRG Transurethral Procedures With Mcc 27 16 — — $20,232.96 $45,202.65 $20,839.95 2025-06-28
800 MS_DRG Splenic Procedures With Cc 27 16 — — $20,215.87 $45,163.90 $20,822.35 2025-06-28
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 28 17 — — $20,204.94 $77,600.00 $20,811.09 2025-06-28
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 27 16 — — $19,896.73 $44,440.05 $20,493.63 2025-06-28
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 27 16 — — $19,835.23 $44,300.55 $20,430.29 2025-06-28
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 27 16 — — $11,938.00 $45,177.85 $20,222.03 2025-06-28
654 MS_DRG Major Bladder Procedures With Cc 28 17 — — $19,589.20 $115,500.00 $20,176.88 2025-06-28
472 MS_DRG Cervical Spinal Fusion With Cc 28 17 — — $11,938.00 $102,300.00 $20,102.43 2025-06-28
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 28 17 — — $19,495.58 $73,800.00 $20,080.45 2025-06-28
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 28 17 — — $19,475.76 $43,485.25 $20,060.03 2025-06-28
462 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc 28 17 — — $12,931.00 $85,200.00 $19,874.18 2025-06-28
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 27 16 — — $11,938.00 $44,362.55 $19,862.56 2025-06-28
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mmc Or 4+ A… 27 16 — — $11,938.00 $44,125.40 $19,758.00 2025-06-28
J7170 HCPCS Hemlibra 30 Mg/ml Subcutaneous Solution 126 34 $13,057.68 $8,487.49 35% off $50.84 $65,288.37 $19,671.39 2025-06-28
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 27 16 — — $19,003.54 $42,414.20 $19,573.65 2025-06-28
288 MS_DRG Acute And Subacute Endocarditis With Mcc 28 17 — — $18,970.05 $78,100.00 $19,539.15 2025-06-28
619 MS_DRG O.r. Procedures For Obesity With Mcc 28 17 — — $18,935.88 $97,600.00 $19,503.96 2025-06-28
963 MS_DRG Other Multiple Significant Trauma With Mcc 27 16 — — $18,868.91 $42,108.85 $19,434.98 2025-06-28
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 27 16 — — $18,778.02 $41,902.70 $19,341.36 2025-06-28
124-B OTHER Circulatory Disorders W/Cath And Complex Dx 1 1 — — $19,300.00 $19,300.00 $19,300.00 2025-06-28
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 28 17 — — $18,717.20 $48,600.00 $19,278.72 2025-06-28
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 28 17 — — $18,644.07 $59,600.00 $19,203.39 2025-06-28
263 MS_DRG Vein Ligation And Stripping 27 16 — — $18,632.45 $41,572.55 $19,191.42 2025-06-28
849 MS_DRG Radiotherapy 28 17 — — $18,557.28 $41,402.05 $19,114.00 2025-06-28
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 27 16 — — $18,500.56 $41,273.40 $19,055.58 2025-06-28
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 27 16 — — $18,435.64 $41,126.15 $18,988.71 2025-06-28
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 27 16 — — $18,413.09 $41,075.00 $18,965.48 2025-06-28
503 MS_DRG Foot Procedures With Mcc 28 17 — — $18,389.85 $41,022.30 $18,941.55 2025-06-28
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 27 16 — — $18,371.40 $40,980.45 $18,922.54 2025-06-28
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 27 16 — — $18,184.15 $40,555.75 $18,729.67 2025-06-28
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 27 16 — — $17,993.48 $40,123.30 $18,533.28 2025-06-28
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 28 17 — — $17,964.10 $72,100.00 $18,503.02 2025-06-28
J9153 HCPCS Vyxeos 44 Mg-100 Mg Intravenous Solution 60 34 $51,684.00 $33,594.60 35% off $232.80 $51,684.00 $18,451.19 2025-06-28
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 28 17 — — $17,755.66 $39,583.90 $18,288.33 2025-06-28
483 MS_DRG Major Joint/limb Reattachment Procedure Of Upper Extremities 28 17 — — $17,717.39 $62,100.00 $18,248.91 2025-06-28
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 28 17 — — $11,938.00 $75,200.00 $18,230.62 2025-06-28
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 27 16 — — $17,627.87 $39,294.05 $18,156.71 2025-06-28
545 MS_DRG Connective Tissue Disorders With Mcc 28 17 — — $17,571.83 $52,500.00 $18,098.98 2025-06-28
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 27 16 — — $17,558.16 $39,135.95 $18,084.90 2025-06-28
164 MS_DRG Major Chest Procedures With Cc 28 17 — — $17,504.17 $78,100.00 $18,029.30 2025-06-28
253 MS_DRG Other Vascular Procedures With Cc 28 17 — — $16,812.00 $63,240.00 $18,016.44 2025-06-28
56 MS_DRG Degenerative Nervous System Disorders With Mcc 28 17 — — $17,416.02 $41,200.00 $17,938.50 2025-06-28
J9021 HCPCS Rylaze 10 Mg/0.5 Ml Intramuscular Solution 60 34 $50,240.00 $32,656.00 35% off $51.20 $50,240.00 $17,935.68 2025-06-28
397 MS_DRG Appendix Procedures With Mcc 27 16 — — $17,236.28 $38,405.90 $17,753.37 2025-06-28
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 27 16 — — $17,034.68 $37,948.65 $17,545.72 2025-06-28
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 28 17 — — $16,896.64 $74,300.00 $17,403.54 2025-06-28
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 27 16 — — $11,938.00 $55,296.00 $17,403.03 2025-06-28
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 27 16 — — $16,832.40 $37,489.85 $17,337.37 2025-06-28
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 27 16 — — $16,780.46 $37,372.05 $17,283.87 2025-06-28
J9203 HCPCS Mylotarg 4.5 Mg (1 Mg/ml Initial Concentration) Intravenous Solution 60 34 $48,216.00 $31,340.40 35% off $226.28 $48,216.00 $17,213.11 2025-06-28
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 28 17 — — $16,685.47 $57,400.00 $17,186.03 2025-06-28
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 28 17 — — $16,685.47 $63,500.00 $17,186.03 2025-06-28
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 28 17 — — $12,198.00 $77,400.00 $17,167.94 2025-06-28
792 MS_DRG Prematurity Without Major Problems 21 16 — — $17,044.25 $37,970.35 $17,044.25 2025-06-28
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 28 17 — — $16,544.01 $61,900.00 $17,040.33 2025-06-28
347 MS_DRG Anal And Stomal Procedures With Mcc 27 16 — — $16,477.72 $36,685.40 $16,972.05 2025-06-28
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 28 17 — — $16,430.56 $98,600.00 $16,923.48 2025-06-28
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 28 17 — — $16,285.00 $60,800.00 $16,773.55 2025-06-28
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