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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

CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHAB

Cleveland, OH · CCN 363304 · Rates published

7,434 distinct procedures filed
31 distinct payers
538,194 rate rows
2025-06-28 last MRF observed · ⚠ 17 mo old
Data quality

326,034 of 538,194 rate rows are consumer-grade (60.6%)

212,160 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 161,275
per-diem day rate — not a per-procedure price 34,990
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 10,060
placeholder amount (≤ $0.02) — excluded from medians 5,819
exceeds 10× this hospital's gross charge — excluded from medians 16

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old.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/childrens
Found on page https://my.clevelandclinic.org/patients/billing-finance/comprehensive-hospital-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-11-04
Content fingerprint 4fad2e7f027e2b6b… · 7,201,438 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
J3393
HCPCS 		Zynteglo 2 X 10exp6 To 20 X 10exp6 Cell/ml Intravenous Suspension 3 $500,000.00 $4,569,600.00 $4,049,472.00 nat. median
$2,994,107
1.4× median
J3399
HCPCS 		Zolgensma 2 X 10exp13 Vg/ml Intravenous Suspension Kit 14 $500,000.00 $4,911,300.00 $3,832,650.00 nat. median
$2,467,989
1.6× median
J3392
HCPCS 		Casgevy 4x10exp6 To 13x10exp6 Cell/ml Intravenous Suspension 4 $500,000.00 $4,561,920.00 $3,590,400.00 nat. median
$2,401,965
1.5× median
J3394
HCPCS 		Lyfgenia 1.7 X To 20 X 10exp6 Cell/ml Intravenous Suspension 2 $500,000.00 $4,483,344.00 $2,491,672.00 nat. median
$3,286,000
0.8× median
Q2042
HCPCS 		Kymriah 0.2 X 10exp6 To 2.5 X 10exp8 Cell Intravenous Suspension 26 $500,000.00 $2,848,960.04 $1,709,376.02 nat. median
$739,658
outlier · 2.3×
Q2056
HCPCS 		Carvykti 0.5x 10exp6 To 1x 10exp8 Cell Intravenous Suspension 26 $500,000.00 $2,505,866.40 $1,661,389.42 nat. median
$646,415
outlier · 2.6×
Q2041
HCPCS 		Yescarta Intravenous Suspension 26 $500,000.00 $2,417,184.00 $1,602,592.99 nat. median
$608,239
outlier · 2.6×
Q2054
HCPCS 		Breyanzi 1.5x To 70x10exp6 Cell/ml Intravenous Suspension 26 $500,000.00 $2,339,891.68 $1,551,348.18 nat. median
$640,950
outlier · 2.4×
Q2053
HCPCS 		Tecartus 2x10exp6 To 2x10exp8 Cell Intravenous Suspension 26 $500,000.00 $2,217,600.00 $1,470,268.80 nat. median
$592,235
outlier · 2.5×
J0225
HCPCS 		Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe 26 $8,673.54 $859,327.20 $569,733.93 nat. median
$8,223
outlier · 69.3×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $283,600.00 $283,600.00 $283,600.00 nat. median
$90,512
outlier · 3.1×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $269,394.00 $269,394.00 $269,394.00 nat. median
$63,564
outlier · 4.2×
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 $228,300.00 $228,300.00 $228,300.00 nat. median
$51,152
outlier · 4.5×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $223,200.00 $223,200.00 $223,200.00 nat. median
$61,995
outlier · 3.6×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization With Mcc 1 $217,200.00 $217,200.00 $217,200.00 nat. median
$71,737
outlier · 3.0×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $212,600.00 $212,600.00 $212,600.00 nat. median
$77,487
outlier · 2.7×
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 $207,900.00 $207,900.00 $207,900.00 nat. median
$53,768
outlier · 3.9×
428
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $203,786.00 $203,786.00 $203,786.00 nat. median
$50,496
outlier · 4.0×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $194,500.00 $194,500.00 $194,500.00 nat. median
$62,577
outlier · 3.1×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $193,600.00 $193,600.00 $193,600.00 nat. median
$72,247
outlier · 2.7×
J2779
HCPCS 		Susvimo 10 Mg/0.1 Ml Intravitreal Solution 26 $139.54 $288,000.00 $190,944.00 nat. median
$88
outlier · 2167.6×
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 1 $188,200.00 $188,200.00 $188,200.00 nat. median
$49,873
outlier · 3.8×
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 1 $185,200.00 $185,200.00 $185,200.00 nat. median
$47,347
outlier · 3.9×
650-D
OTHER 		Kidney (Deceased) - Adult & Pediatric 1 $175,300.00 $175,300.00 $175,300.00 nat. median
$175,300
1.0× median
651-D
OTHER 		Kidney (Deceased) - Adult & Pediatric 1 $175,300.00 $175,300.00 $175,300.00 nat. median
$175,300
1.0× median
652-D
OTHER 		Kidney (Deceased) - Adult & Pediatric 1 $175,300.00 $175,300.00 $175,300.00 nat. median
$175,300
1.0× median
402
MS_DRG 		Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 $172,700.00 $172,700.00 $172,700.00 nat. median
$36,864
outlier · 4.7×
837
MS_DRG 		Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 1 $171,600.00 $171,600.00 $171,600.00 nat. median
$45,402
outlier · 3.8×
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 1 $168,400.00 $168,400.00 $168,400.00 nat. median
$55,425
outlier · 3.0×
651-L
OTHER 		Kidney ( Live Donor) - Adult & Pediatric 1 $161,100.00 $161,100.00 $161,100.00 nat. median
$161,100
1.0× median
652-L
OTHER 		Kidney (Live Donor) - Adult & Pediatric 1 $161,100.00 $161,100.00 $161,100.00 nat. median
$161,100
1.0× median
650-L
OTHER 		Kidney ( Live Donor) - Adult & Pediatric 1 $161,100.00 $161,100.00 $161,100.00 nat. median
$161,100
1.0× median
239
MS_DRG 		Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 1 $159,900.00 $159,900.00 $159,900.00 nat. median
$45,172
outlier · 3.5×
267
MS_DRG 		Endovascular Cardiac Valve Replacement Without Mcc 1 $159,600.00 $159,600.00 $159,600.00 nat. median
$45,843
outlier · 3.5×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $158,200.00 $158,200.00 $158,200.00 nat. median
$55,110
outlier · 2.9×
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Without Mcc 1 $158,100.00 $158,100.00 $158,100.00 nat. median
$51,559
outlier · 3.1×
834
MS_DRG 		Acute Leukemia Without Major O.r. Procedures With Mcc 1 $152,300.00 $152,300.00 $152,300.00 nat. median
$50,314
outlier · 3.0×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 1 $148,400.00 $148,400.00 $148,400.00 nat. median
$59,324
outlier · 2.5×
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $146,600.00 $146,600.00 $146,600.00 nat. median
$50,558
outlier · 2.9×
458
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $145,800.00 $145,800.00 $145,800.00 nat. median
$40,320
outlier · 3.6×
653
MS_DRG 		Major Bladder Procedures With Mcc 1 $144,700.00 $144,700.00 $144,700.00 nat. median
$49,995
outlier · 2.9×
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 1 $144,100.00 $144,100.00 $144,100.00 nat. median
$46,201
outlier · 3.1×
229
MS_DRG 		Other Cardiothoracic Procedures Without Mcc 1 $143,800.00 $143,800.00 $143,800.00 nat. median
$30,744
outlier · 4.7×
485
MS_DRG 		Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 $140,400.00 $140,400.00 $140,400.00 nat. median
$30,564
outlier · 4.6×
448
MS_DRG 		Multiple Level Spinal Fusion Except Cervical Without Mcc 1 $132,220.00 $132,220.00 $132,220.00 nat. median
$39,065
outlier · 3.4×
236
MS_DRG 		Coronary Bypass Without Cardiac Catheterization Without Mcc 1 $130,900.00 $130,900.00 $130,900.00 nat. median
$40,285
outlier · 3.2×
J9274
HCPCS 		Kimmtrak 100 Mcg/0.5 Ml Intravenous Solution 26 $375.82 $196,608.00 $130,351.10 nat. median
$418
outlier · 312.0×
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 1 $128,400.00 $128,400.00 $128,400.00 nat. median
$50,728
outlier · 2.5×
221
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $127,500.00 $127,500.00 $127,500.00 nat. median
$46,440
outlier · 2.7×
471
MS_DRG 		Cervical Spinal Fusion With Mcc 1 $125,500.00 $125,500.00 $125,500.00 nat. median
$44,798
outlier · 2.8×

Other procedures at this hospital

Browse this hospital's 7,434 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
             
J3393 HCPCS Zynteglo 2 X 10exp6 To 20 X 10exp6 Cell/ml Intravenous Suspension 3 3 — — $500,000.00 $4,569,600.00 $4,049,472.00 2025-06-28
J3399 HCPCS Zolgensma 2 X 10exp13 Vg/ml Intravenous Suspension Kit 18 14 — $4,972,500.00 $500,000.00 $4,911,300.00 $3,832,650.00 2025-06-28
J3392 HCPCS Casgevy 4x10exp6 To 13x10exp6 Cell/ml Intravenous Suspension 5 4 — — $500,000.00 $4,561,920.00 $3,590,400.00 2025-06-28
J3394 HCPCS Lyfgenia 1.7 X To 20 X 10exp6 Cell/ml Intravenous Suspension 2 2 — — $500,000.00 $4,483,344.00 $2,491,672.00 2025-06-28
Q2042 HCPCS Kymriah 0.2 X 10exp6 To 2.5 X 10exp8 Cell Intravenous Suspension 79 26 $2,848,960.04 $1,851,824.03 35% off $500,000.00 $2,848,960.04 $1,709,376.02 2025-06-28
Q2056 HCPCS Carvykti 0.5x 10exp6 To 1x 10exp8 Cell Intravenous Suspension 41 26 $2,505,866.40 $1,628,813.16 35% off $500,000.00 $2,505,866.40 $1,661,389.42 2025-06-28
Q2041 HCPCS Yescarta Intravenous Suspension 41 26 $2,417,184.00 $1,571,169.60 35% off $500,000.00 $2,417,184.00 $1,602,592.99 2025-06-28
Q2054 HCPCS Breyanzi 1.5x To 70x10exp6 Cell/ml Intravenous Suspension 41 26 $2,339,891.68 $1,520,929.59 35% off $500,000.00 $2,339,891.68 $1,551,348.18 2025-06-28
Q2053 HCPCS Tecartus 2x10exp6 To 2x10exp8 Cell Intravenous Suspension 41 26 $2,217,600.00 $1,441,440.00 35% off $500,000.00 $2,217,600.00 $1,470,268.80 2025-06-28
J0225 HCPCS Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe 41 26 $859,327.20 $558,562.68 35% off $8,673.54 $859,327.20 $569,733.93 2025-06-28
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $283,600.00 $283,600.00 $283,600.00 2025-06-28
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $269,394.00 $269,394.00 $269,394.00 2025-06-28
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 1 — — $228,300.00 $228,300.00 $228,300.00 2025-06-28
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $223,200.00 $223,200.00 $223,200.00 2025-06-28
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 1 1 — — $217,200.00 $217,200.00 $217,200.00 2025-06-28
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $212,600.00 $212,600.00 $212,600.00 2025-06-28
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 1 — — $207,900.00 $207,900.00 $207,900.00 2025-06-28
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $203,786.00 $203,786.00 $203,786.00 2025-06-28
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $194,500.00 $194,500.00 $194,500.00 2025-06-28
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $193,600.00 $193,600.00 $193,600.00 2025-06-28
J2779 HCPCS Susvimo 10 Mg/0.1 Ml Intravitreal Solution 41 26 $288,000.00 $187,200.00 35% off $139.54 $288,000.00 $190,944.00 2025-06-28
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $188,200.00 $188,200.00 $188,200.00 2025-06-28
228 MS_DRG Other Cardiothoracic Procedures With Mcc 1 1 — — $185,200.00 $185,200.00 $185,200.00 2025-06-28
650-D OTHER Kidney (Deceased) - Adult & Pediatric 1 1 — — $175,300.00 $175,300.00 $175,300.00 2025-06-28
651-D OTHER Kidney (Deceased) - Adult & Pediatric 1 1 — — $175,300.00 $175,300.00 $175,300.00 2025-06-28
652-D OTHER Kidney (Deceased) - Adult & Pediatric 1 1 — — $175,300.00 $175,300.00 $175,300.00 2025-06-28
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $172,700.00 $172,700.00 $172,700.00 2025-06-28
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 1 1 — — $171,600.00 $171,600.00 $171,600.00 2025-06-28
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $168,400.00 $168,400.00 $168,400.00 2025-06-28
651-L OTHER Kidney ( Live Donor) - Adult & Pediatric 1 1 — — $161,100.00 $161,100.00 $161,100.00 2025-06-28
652-L OTHER Kidney (Live Donor) - Adult & Pediatric 1 1 — — $161,100.00 $161,100.00 $161,100.00 2025-06-28
650-L OTHER Kidney ( Live Donor) - Adult & Pediatric 1 1 — — $161,100.00 $161,100.00 $161,100.00 2025-06-28
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 1 1 — — $159,900.00 $159,900.00 $159,900.00 2025-06-28
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 1 1 — — $159,600.00 $159,600.00 $159,600.00 2025-06-28
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $158,200.00 $158,200.00 $158,200.00 2025-06-28
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 1 1 — — $158,100.00 $158,100.00 $158,100.00 2025-06-28
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 1 1 — — $152,300.00 $152,300.00 $152,300.00 2025-06-28
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $148,400.00 $148,400.00 $148,400.00 2025-06-28
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $146,600.00 $146,600.00 $146,600.00 2025-06-28
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $145,800.00 $145,800.00 $145,800.00 2025-06-28
653 MS_DRG Major Bladder Procedures With Mcc 1 1 — — $144,700.00 $144,700.00 $144,700.00 2025-06-28
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 1 1 — — $144,100.00 $144,100.00 $144,100.00 2025-06-28
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 1 1 — — $143,800.00 $143,800.00 $143,800.00 2025-06-28
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 1 — — $140,400.00 $140,400.00 $140,400.00 2025-06-28
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 1 1 — — $132,220.00 $132,220.00 $132,220.00 2025-06-28
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 1 1 — — $130,900.00 $130,900.00 $130,900.00 2025-06-28
J9274 HCPCS Kimmtrak 100 Mcg/0.5 Ml Intravenous Solution 41 26 $196,608.00 $127,795.20 35% off $375.82 $196,608.00 $130,351.10 2025-06-28
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $128,400.00 $128,400.00 $128,400.00 2025-06-28
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $127,500.00 $127,500.00 $127,500.00 2025-06-28
471 MS_DRG Cervical Spinal Fusion With Mcc 1 1 — — $125,500.00 $125,500.00 $125,500.00 2025-06-28
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 1 — — $124,000.00 $124,000.00 $124,000.00 2025-06-28
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $120,500.00 $120,500.00 $120,500.00 2025-06-28
163 MS_DRG Major Chest Procedures With Mcc 1 1 — — $119,500.00 $119,500.00 $119,500.00 2025-06-28
J9248 HCPCS Hepzato (62 Mm Catheter) 50 Mg Intra-arterial Solution 41 26 $180,000.00 $117,000.00 35% off $1,354.15 $180,000.00 $119,340.00 2025-06-28
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 1 1 — — $119,200.00 $119,200.00 $119,200.00 2025-06-28
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 1 1 — — $117,800.00 $117,800.00 $117,800.00 2025-06-28
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 1 1 — — $116,800.00 $116,800.00 $116,800.00 2025-06-28
J9226 HCPCS Supprelin La 50 Mg (65 Mcg/day) Implant Kit 41 26 $175,562.52 $114,115.64 35% off $52,896.99 $175,562.52 $116,397.95 2025-06-28
654 MS_DRG Major Bladder Procedures With Cc 1 1 — — $115,500.00 $115,500.00 $115,500.00 2025-06-28
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 1 1 — — $114,400.00 $114,400.00 $114,400.00 2025-06-28
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 1 1 — — $112,000.00 $112,000.00 $112,000.00 2025-06-28
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $111,300.00 $111,300.00 $111,300.00 2025-06-28
J2777 HCPCS Vabysmo 6 Mg/0.05 Ml Intravitreal Solution 41 26 $164,854.80 $107,155.62 35% off $60.76 $164,854.80 $109,298.73 2025-06-28
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 1 1 — — $108,180.00 $108,180.00 $108,180.00 2025-06-28
J9269 HCPCS Elzonris 1000 Mcg/ml Intravenous Solution 41 26 $162,031.92 $105,320.75 35% off $592.43 $162,031.92 $107,427.16 2025-06-28
835 MS_DRG Acute Leukemia Without Major O.r. Procedures With Cc 1 1 — — $106,100.00 $106,100.00 $106,100.00 2025-06-28
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $105,500.00 $105,500.00 $105,500.00 2025-06-28
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 1 1 — — $104,500.00 $104,500.00 $104,500.00 2025-06-28
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 2 2 — — $35,400.00 $173,600.00 $104,500.00 2025-06-28
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 1 1 — — $103,500.00 $103,500.00 $103,500.00 2025-06-28
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 1 1 — — $103,500.00 $103,500.00 $103,500.00 2025-06-28
472 MS_DRG Cervical Spinal Fusion With Cc 1 1 — — $102,300.00 $102,300.00 $102,300.00 2025-06-28
J0223 HCPCS Givlaari 189 Mg/ml Subcutaneous Solution 41 26 $153,417.60 $99,721.44 35% off $203.82 $153,417.60 $101,715.87 2025-06-28
A9543 HCPCS Zevalin (y-90) 3.2 Mg/2 Ml Intravenous Kit 40 26 $148,248.86 $96,361.76 35% off $44,667.38 $148,248.86 $99,586.17 2025-06-28
C9293 HCPCS Voraxaze 1000 Unit Intravenous Solution 40 26 $148,226.40 $96,347.16 35% off $44,660.61 $148,226.40 $99,571.09 2025-06-28
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $98,600.00 $98,600.00 $98,600.00 2025-06-28
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $98,000.00 $98,000.00 $98,000.00 2025-06-28
619 MS_DRG O.r. Procedures For Obesity With Mcc 1 1 — — $97,600.00 $97,600.00 $97,600.00 2025-06-28
J0179 HCPCS Beovu 6 Mg/0.05 Ml Intravitreal Syringe 41 26 $147,062.88 $95,590.87 35% off $594.98 $147,062.88 $97,502.69 2025-06-28
252 MS_DRG Other Vascular Procedures With Mcc 1 1 — — $96,400.00 $96,400.00 $96,400.00 2025-06-28
469 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc 1 1 — — $95,100.00 $95,100.00 $95,100.00 2025-06-28
655 MS_DRG Major Bladder Procedures Without Cc/mcc 1 1 — — $92,000.00 $92,000.00 $92,000.00 2025-06-28
J0177 HCPCS Eylea Hd 8 Mg/0.07 Ml Intravitreal Solution For Injection 41 26 $137,700.00 $89,505.00 35% off $562.06 $137,700.00 $91,295.10 2025-06-28
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 1 1 — — $90,700.00 $90,700.00 $90,700.00 2025-06-28
J0178 HCPCS Eylea 2 Mg/0.05 Ml Intravitreal Syringe 41 26 $136,530.00 $88,744.50 35% off $1,392.76 $136,530.00 $90,519.39 2025-06-28
335 MS_DRG Peritoneal Adhesiolysis With Mcc 1 1 — — $89,400.00 $89,400.00 $89,400.00 2025-06-28
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 1 1 — — $85,900.00 $85,900.00 $85,900.00 2025-06-28
462 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc 1 1 — — $85,200.00 $85,200.00 $85,200.00 2025-06-28
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 1 1 — — $83,000.00 $83,000.00 $83,000.00 2025-06-28
J7352 HCPCS Scenesse 16 Mg Subcutaneous Implant 40 26 $120,982.00 $78,638.30 35% off $36,451.88 $120,982.00 $81,269.66 2025-06-28
514 MS_DRG Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/mcc 1 1 — — $81,100.00 $81,100.00 $81,100.00 2025-06-28
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 2 2 — — $64,500.00 $97,000.00 $80,750.00 2025-06-28
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 1 1 — — $78,400.00 $78,400.00 $78,400.00 2025-06-28
J0202 HCPCS Lemtrada 12 Mg/1.2 Ml Intravenous Solution 41 26 $117,798.96 $76,569.32 35% off $4,272.61 $117,798.96 $78,100.71 2025-06-28
288 MS_DRG Acute And Subacute Endocarditis With Mcc 1 1 — — $78,100.00 $78,100.00 $78,100.00 2025-06-28
164 MS_DRG Major Chest Procedures With Cc 1 1 — — $78,100.00 $78,100.00 $78,100.00 2025-06-28
J9281 HCPCS Jelmyto 40 Mg X 2 Intra-pyelocalyceal Kit 41 26 $117,504.00 $76,377.60 35% off $547.74 $117,504.00 $77,905.15 2025-06-28
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 1 1 — — $77,600.00 $77,600.00 $77,600.00 2025-06-28
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 1 1 — — $77,200.00 $77,200.00 $77,200.00 2025-06-28
J9600 HCPCS Photofrin 75 Mg Intravenous Solution 40 26 $111,950.40 $72,767.76 35% off $33,730.66 $111,950.40 $75,202.68 2025-06-28
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 1 1 — — $75,200.00 $75,200.00 $75,200.00 2025-06-28
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 1 1 — — $74,300.00 $74,300.00 $74,300.00 2025-06-28
245 MS_DRG Aicd Generator Procedures 1 1 — — $74,200.00 $74,200.00 $74,200.00 2025-06-28
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 1 1 — — $73,800.00 $73,800.00 $73,800.00 2025-06-28
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 1 1 — — $73,600.00 $73,600.00 $73,600.00 2025-06-28
J9229 HCPCS Besponsa 0.9 Mg(0.25 Mg/ml Initial Concentration) Intravenous Solution 41 26 $109,958.40 $71,472.96 35% off $4,651.73 $109,958.40 $72,902.42 2025-06-28
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 1 1 — — $72,800.00 $72,800.00 $72,800.00 2025-06-28
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 1 1 — — $72,100.00 $72,100.00 $72,100.00 2025-06-28
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $72,000.00 $72,000.00 $72,000.00 2025-06-28
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 1 1 — — $71,900.00 $71,900.00 $71,900.00 2025-06-28
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 1 1 — — $71,700.00 $71,700.00 $71,700.00 2025-06-28
J2507 HCPCS Krystexxa 8 Mg/ml Intravenous Solution 41 26 $108,080.82 $70,252.53 35% off $6,239.31 $108,080.82 $71,657.58 2025-06-28
J3357 HCPCS Stelara 45 Mg/0.5 Ml Subcutaneous Solution 80 26 $104,945.34 $68,214.47 35% off $31,620.00 $104,945.34 $70,497.00 2025-06-28
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $70,100.00 $70,100.00 $70,100.00 2025-06-28
J2778 HCPCS Darvocet-n 50 50 Mg-325 Mg Tab 80 26 $140,400.00 $91,260.00 35% off $158.22 $140,400.00 $68,936.40 2025-06-28
620 MS_DRG O.r. Procedures For Obesity With Cc 1 1 — — $68,400.00 $68,400.00 $68,400.00 2025-06-28
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 1 1 — — $68,300.00 $68,300.00 $68,300.00 2025-06-28
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 2 2 — — $35,400.00 $100,800.00 $68,100.00 2025-06-28
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $67,300.00 $67,300.00 $67,300.00 2025-06-28
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 1 1 — — $67,000.00 $67,000.00 $67,000.00 2025-06-28
J2326 HCPCS Spinraza (pf) 12 Mg/5 Ml Intrathecal Solution 40 26 $99,288.57 $64,537.57 35% off $29,915.65 $99,288.57 $66,697.10 2025-06-28
J9359 HCPCS Zynlonta 10 Mg Intravenous Solution 41 26 $99,959.04 $64,973.38 35% off $370.99 $99,959.04 $66,272.84 2025-06-28
J1951 HCPCS Fensolvi 45 Mg Subcutaneous Syringe 41 26 $98,795.04 $64,216.78 35% off $234.95 $98,795.04 $65,501.11 2025-06-28
Q5128 HCPCS Cimerli 0.5 Mg/0.05 Ml Intravitreal Solution 41 26 $97,920.00 $63,648.00 35% off $256.83 $97,920.00 $64,920.96 2025-06-28
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $64,200.00 $64,200.00 $64,200.00 2025-06-28
539 MS_DRG Osteomyelitis With Mcc 1 1 — — $63,600.00 $63,600.00 $63,600.00 2025-06-28
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 1 1 — — $62,300.00 $62,300.00 $62,300.00 2025-06-28
483 MS_DRG Major Joint/limb Reattachment Procedure Of Upper Extremities 1 1 — — $62,100.00 $62,100.00 $62,100.00 2025-06-28
253 MS_DRG Other Vascular Procedures With Cc 1 1 — — $61,900.00 $61,900.00 $61,900.00 2025-06-28
333 MS_DRG Rectal Resection With Cc 1 1 — — $61,900.00 $61,900.00 $61,900.00 2025-06-28
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 1 1 — — $61,900.00 $61,900.00 $61,900.00 2025-06-28
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 1 1 — — $60,800.00 $60,800.00 $60,800.00 2025-06-28
500 MS_DRG Soft Tissue Procedures With Mcc 1 1 — — $60,800.00 $60,800.00 $60,800.00 2025-06-28
470 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 1 1 — — $60,600.00 $60,600.00 $60,600.00 2025-06-28
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 1 1 — — $60,200.00 $60,200.00 $60,200.00 2025-06-28
J1930 HCPCS Somatuline Depot 60 Mg/0.2 Ml Subcutaneous Syringe 119 26 $97,296.00 $63,242.40 35% off $69.21 $109,584.00 $59,832.86 2025-06-28
330 MS_DRG Major Small And Large Bowel Procedures With Cc 1 1 — — $59,600.00 $59,600.00 $59,600.00 2025-06-28
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 1 1 — — $59,600.00 $59,600.00 $59,600.00 2025-06-28
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/mcc 1 1 — — $59,500.00 $59,500.00 $59,500.00 2025-06-28
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 1 1 — — $59,200.00 $59,200.00 $59,200.00 2025-06-28
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 1 1 — — $58,200.00 $58,200.00 $58,200.00 2025-06-28
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 1 1 — — $57,400.00 $57,400.00 $57,400.00 2025-06-28
165 MS_DRG Major Chest Procedures Without Cc/mcc 1 1 — — $57,400.00 $57,400.00 $57,400.00 2025-06-28
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 2 2 — — $16,400.00 $97,400.00 $56,900.00 2025-06-28
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 1 1 — — $56,100.00 $56,100.00 $56,100.00 2025-06-28
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 1 1 — — $56,100.00 $56,100.00 $56,100.00 2025-06-28
Q5124 HCPCS Byooviz 0.5 Mg/0.05 Ml Intravitreal Solution 41 26 $83,800.80 $54,470.52 35% off $149.75 $83,800.80 $55,559.93 2025-06-28
264 MS_DRG Other Circulatory System O.r. Procedures 1 1 — — $54,600.00 $54,600.00 $54,600.00 2025-06-28
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 1 1 — — $53,900.00 $53,900.00 $53,900.00 2025-06-28
822 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures Without Cc/mcc 1 1 — — $53,000.00 $53,000.00 $53,000.00 2025-06-28
J2781 HCPCS Syfovre (pf) 15 Mg/0.1 Ml Intravitreal Solution 41 26 $79,628.40 $51,758.46 35% off $251.98 $79,628.40 $52,793.63 2025-06-28
545 MS_DRG Connective Tissue Disorders With Mcc 1 1 — — $52,500.00 $52,500.00 $52,500.00 2025-06-28
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc 1 1 — — $51,200.00 $51,200.00 $51,200.00 2025-06-28
663 MS_DRG Minor Bladder Procedures With Cc 1 1 — — $50,900.00 $50,900.00 $50,900.00 2025-06-28
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 1 1 — — $50,700.00 $50,700.00 $50,700.00 2025-06-28
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 1 1 — — $50,500.00 $50,500.00 $50,500.00 2025-06-28
196 MS_DRG Interstitial Lung Disease With Mcc 1 1 — — $50,400.00 $50,400.00 $50,400.00 2025-06-28
661 MS_DRG Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc 1 1 — — $50,400.00 $50,400.00 $50,400.00 2025-06-28
J9029 HCPCS Adstiladrin 3x10exp11 Vp/ml Intravesical Suspension 41 26 $72,000.00 $46,800.00 35% off $21,693.60 $110,662.31 $50,400.00 2025-06-28
J2782 HCPCS Izervay (pf) 2 Mg/0.1 Ml Intravitreal Solution 41 26 $75,600.00 $49,140.00 35% off $188.03 $75,600.00 $50,122.80 2025-06-28
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 1 1 — — $50,100.00 $50,100.00 $50,100.00 2025-06-28
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 1 1 — — $49,800.00 $49,800.00 $49,800.00 2025-06-28
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 1 1 — — $49,800.00 $49,800.00 $49,800.00 2025-06-28
254 MS_DRG Other Vascular Procedures Without Cc/mcc 1 1 — — $49,600.00 $49,600.00 $49,600.00 2025-06-28
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc… 1 1 — — $49,400.00 $49,400.00 $49,400.00 2025-06-28
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 1 1 — — $48,700.00 $48,700.00 $48,700.00 2025-06-28
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 1 1 — — $48,700.00 $48,700.00 $48,700.00 2025-06-28
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 1 1 — — $48,600.00 $48,600.00 $48,600.00 2025-06-28
J0638 HCPCS Ilaris (pf) 150 Mg/ml Subcutaneous Solution 41 26 $72,797.79 $47,318.56 35% off $238.97 $72,797.79 $48,264.93 2025-06-28
J2502 HCPCS Signifor Lar 60 Mg IM Suspension 41 26 $72,075.84 $46,849.30 35% off $922.15 $72,075.84 $47,786.28 2025-06-28
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 1 1 — — $47,500.00 $47,500.00 $47,500.00 2025-06-28
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/mcc 1 1 — — $47,500.00 $47,500.00 $47,500.00 2025-06-28
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 1 1 — — $47,500.00 $47,500.00 $47,500.00 2025-06-28
177 MS_DRG Respiratory Infections And Inflammations With Mcc 1 1 — — $46,700.00 $46,700.00 $46,700.00 2025-06-28
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 1 1 — — $46,500.00 $46,500.00 $46,500.00 2025-06-28
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 1 1 — — $46,400.00 $46,400.00 $46,400.00 2025-06-28
672 MS_DRG Urethral Procedures Without Cc/mcc 1 1 — — $46,000.00 $46,000.00 $46,000.00 2025-06-28
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 1 1 — — $46,000.00 $46,000.00 $46,000.00 2025-06-28
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 1 1 — — $46,000.00 $46,000.00 $46,000.00 2025-06-28
825 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures Without Cc/mcc 1 1 — — $45,700.00 $45,700.00 $45,700.00 2025-06-28
671 MS_DRG Urethral Procedures With Cc/mcc 1 1 — — $45,200.00 $45,200.00 $45,200.00 2025-06-28
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 1 1 — — $45,100.00 $45,100.00 $45,100.00 2025-06-28
497 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $44,600.00 $44,600.00 $44,600.00 2025-06-28
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 1 1 — — $44,600.00 $44,600.00 $44,600.00 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
314 MS_DRG Other Circulatory System Diagnoses With Mcc 1 1 — — $43,600.00 $43,600.00 $43,600.00 2025-06-28
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $43,500.00 $43,500.00 $43,500.00 2025-06-28
479 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/mcc 1 1 — — $42,700.00 $42,700.00 $42,700.00 2025-06-28
374 MS_DRG Digestive Malignancy With Mcc 1 1 — — $42,100.00 $42,100.00 $42,100.00 2025-06-28
262 MS_DRG Cardiac Pacemaker Revision Except Device Replacement Without Cc/mcc 1 1 — — $41,900.00 $41,900.00 $41,900.00 2025-06-28
J3241 HCPCS Tepezza 500 Mg Intravenous Solution 41 26 $63,040.08 $40,976.05 35% off $616.99 $63,040.08 $41,795.57 2025-06-28
J3245 HCPCS Ilumya 100 Mg/ml Subcutaneous Syringe 41 26 $62,054.88 $40,335.67 35% off $230.06 $62,054.88 $41,142.39 2025-06-28
3 MS_DRG Craniotomy Age 0-17 1 1 — — $41,100.00 $41,100.00 $41,100.00 2025-06-28
189 MS_DRG Pulmonary Edema And Respiratory Failure 1 1 — — $41,000.00 $41,000.00 $41,000.00 2025-06-28
261 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Cc 2 2 — — $35,400.00 $46,400.00 $40,900.00 2025-06-28
489 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc 1 1 — — $40,900.00 $40,900.00 $40,900.00 2025-06-28
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 1 1 — — $40,800.00 $40,800.00 $40,800.00 2025-06-28
501 MS_DRG Soft Tissue Procedures With Cc 2 2 — — $30,000.00 $51,600.00 $40,800.00 2025-06-28
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 1 1 — — $40,800.00 $40,800.00 $40,800.00 2025-06-28
444 MS_DRG Disorders Of The Biliary Tract With Mcc 1 1 — — $40,700.00 $40,700.00 $40,700.00 2025-06-28
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 1 1 — — $40,300.00 $40,300.00 $40,300.00 2025-06-28
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 1 1 — — $40,000.00 $40,000.00 $40,000.00 2025-06-28
686 MS_DRG Kidney And Urinary Tract Neoplasms With Mcc 1 1 — — $39,300.00 $39,300.00 $39,300.00 2025-06-28
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 2 2 — — $35,400.00 $42,800.00 $39,100.00 2025-06-28
291 MS_DRG Heart Failure And Shock With Mcc 1 1 — — $38,900.00 $38,900.00 $38,900.00 2025-06-28
664 MS_DRG Minor Bladder Procedures Without Cc/mcc 1 1 — — $38,900.00 $38,900.00 $38,900.00 2025-06-28
J9042 HCPCS Adcetris 50 Mg Intravenous Solution 41 26 $58,560.00 $38,064.00 35% off $435.63 $58,560.00 $38,825.28 2025-06-28
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 2 2 — — $22,900.00 $54,500.00 $38,700.00 2025-06-28
858 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures Without Cc/mcc 1 1 — — $38,300.00 $38,300.00 $38,300.00 2025-06-28
669 MS_DRG Transurethral Procedures With Cc 1 1 — — $37,800.00 $37,800.00 $37,800.00 2025-06-28
868 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Cc 1 1 — — $37,600.00 $37,600.00 $37,600.00 2025-06-28
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 1 1 — — $37,600.00 $37,600.00 $37,600.00 2025-06-28
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 1 1 — — $37,500.00 $37,500.00 $37,500.00 2025-06-28
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 1 1 — — $37,400.00 $37,400.00 $37,400.00 2025-06-28
358 MS_DRG Other Digestive System O.r. Procedures Without Cc/mcc 1 1 — — $37,100.00 $37,100.00 $37,100.00 2025-06-28
180 MS_DRG Respiratory Neoplasms With Mcc 1 1 — — $37,100.00 $37,100.00 $37,100.00 2025-06-28
334 MS_DRG Rectal Resection Without Cc/mcc 2 2 — — $22,200.00 $51,500.00 $36,850.00 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
186 MS_DRG Pleural Effusion With Mcc 1 1 — — $36,600.00 $36,600.00 $36,600.00 2025-06-28
299 MS_DRG Peripheral Vascular Disorders With Mcc 1 1 — — $36,100.00 $36,100.00 $36,100.00 2025-06-28
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 1 1 — — $36,000.00 $36,000.00 $36,000.00 2025-06-28
357 MS_DRG Other Digestive System O.r. Procedures With Cc 2 2 — — $22,800.00 $48,700.00 $35,750.00 2025-06-28
J7170 HCPCS Hemlibra 30 Mg/ml Subcutaneous Solution 119 26 $65,288.34 $42,437.42 35% off $90.97 $65,288.37 $35,647.43 2025-06-28
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $35,600.00 $35,600.00 $35,600.00 2025-06-28
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 2 2 — — $24,500.00 $46,700.00 $35,600.00 2025-06-28
257 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/mcc 1 1 — — $35,400.00 $35,400.00 $35,400.00 2025-06-28
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 1 1 — — $35,400.00 $35,400.00 $35,400.00 2025-06-28
265 MS_DRG Aicd Lead Procedures 1 1 — — $35,400.00 $35,400.00 $35,400.00 2025-06-28
337 MS_DRG Peritoneal Adhesiolysis Without Cc/mcc 1 1 — — $35,300.00 $35,300.00 $35,300.00 2025-06-28
336 MS_DRG Peritoneal Adhesiolysis With Cc 1 1 — — $35,300.00 $35,300.00 $35,300.00 2025-06-28
148 MS_DRG Ear, Nose, Mouth And Throat Malignancy Without Cc/mcc 1 1 — — $34,800.00 $34,800.00 $34,800.00 2025-06-28
6840311006 NDC Babybig 100 Mg Intravenous Solution 40 26 $51,570.00 $33,520.50 35% off $15,538.04 $51,570.00 $34,642.15 2025-06-28
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc/mcc 1 1 — — $34,500.00 $34,500.00 $34,500.00 2025-06-28
393 MS_DRG Other Digestive System Diagnoses With Mcc 1 1 — — $34,500.00 $34,500.00 $34,500.00 2025-06-28
512 MS_DRG Shoulder,elbow Or Forearm Proc,exc Major Joint Proc Without Cc/mcc 1 1 — — $34,500.00 $34,500.00 $34,500.00 2025-06-28
505 MS_DRG Foot Procedures Without Cc/mcc 1 1 — — $34,400.00 $34,400.00 $34,400.00 2025-06-28
385 MS_DRG Inflammatory Bowel Disease With Mcc 1 1 — — $34,400.00 $34,400.00 $34,400.00 2025-06-28
J9153 HCPCS Vyxeos 44 Mg-100 Mg Intravenous Solution 41 26 $51,684.00 $33,594.60 35% off $435.79 $51,684.00 $34,266.49 2025-06-28
502 MS_DRG Soft Tissue Procedures Without Cc/mcc 2 2 — — $30,000.00 $38,100.00 $34,050.00 2025-06-28
375 MS_DRG Digestive Malignancy With Cc 1 1 — — $33,500.00 $33,500.00 $33,500.00 2025-06-28
682 MS_DRG Renal Failure With Mcc 1 1 — — $33,500.00 $33,500.00 $33,500.00 2025-06-28
J9021 HCPCS Rylaze 10 Mg/0.5 Ml Intramuscular Solution 41 26 $50,240.00 $32,656.00 35% off $95.16 $50,240.00 $33,309.12 2025-06-28
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 1 1 — — $33,300.00 $33,300.00 $33,300.00 2025-06-28
388 MS_DRG Gastrointestinal Obstruction With Mcc 1 1 — — $33,100.00 $33,100.00 $33,100.00 2025-06-28
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 1 1 — — $33,100.00 $33,100.00 $33,100.00 2025-06-28
75 MS_DRG Major Chest Procedures 1 1 — — $32,300.00 $32,300.00 $32,300.00 2025-06-28
J9203 HCPCS Mylotarg 4.5 Mg (1 Mg/ml Initial Concentration) Intravenous Solution 41 26 $48,216.00 $31,340.40 35% off $407.96 $48,216.00 $31,967.21 2025-06-28
546 MS_DRG Connective Tissue Disorders With Cc 1 1 — — $31,800.00 $31,800.00 $31,800.00 2025-06-28
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 1 1 — — $31,800.00 $31,800.00 $31,800.00 2025-06-28
182 MS_DRG Respiratory Neoplasms Without Cc/mcc 1 1 — — $31,800.00 $31,800.00 $31,800.00 2025-06-28
149 MS_DRG Dysequilibrium 1 1 — — $31,200.00 $31,200.00 $31,200.00 2025-06-28
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 1 1 — — $30,500.00 $30,500.00 $30,500.00 2025-06-28
J9043 HCPCS Jevtana 10 Mg/ml (first Dilution) Intravenous Solution 41 26 $45,947.92 $29,866.15 35% off $387.98 $45,947.92 $30,463.47 2025-06-28
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 1 1 — — $30,400.00 $30,400.00 $30,400.00 2025-06-28
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 1 1 — — $30,400.00 $30,400.00 $30,400.00 2025-06-28
J7311 HCPCS Retisert 0.59 Mg Intravitreal Implant 41 26 $45,660.00 $29,679.00 35% off $595.06 $45,660.00 $30,272.58 2025-06-28
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 1 1 — — $30,200.00 $30,200.00 $30,200.00 2025-06-28
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 1 1 — — $30,200.00 $30,200.00 $30,200.00 2025-06-28
503 MS_DRG Foot Procedures With Mcc 1 1 — — $30,000.00 $30,000.00 $30,000.00 2025-06-28
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 1 1 — — $29,900.00 $29,900.00 $29,900.00 2025-06-28
551 MS_DRG Medical Back Problems With Mcc 1 1 — — $29,900.00 $29,900.00 $29,900.00 2025-06-28
849 MS_DRG Radiotherapy 1 1 — — $29,700.00 $29,700.00 $29,700.00 2025-06-28
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 1 1 — — $29,600.00 $29,600.00 $29,600.00 2025-06-28
670 MS_DRG Transurethral Procedures Without Cc/mcc 1 1 — — $29,500.00 $29,500.00 $29,500.00 2025-06-28
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 2 2 — — $17,600.00 $40,400.00 $29,000.00 2025-06-28
178 MS_DRG Respiratory Infections And Inflammations With Cc 1 1 — — $28,900.00 $28,900.00 $28,900.00 2025-06-28
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 1 1 — — $28,900.00 $28,900.00 $28,900.00 2025-06-28
4 MS_DRG Spinal Procedures 1 1 — — $28,700.00 $28,700.00 $28,700.00 2025-06-28
844 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 1 1 — — $28,600.00 $28,600.00 $28,600.00 2025-06-28
520 MS_DRG Back And Neck Procedures Except Spinal Fusion Without Cc/mcc 1 1 — — $28,600.00 $28,600.00 $28,600.00 2025-06-28
256 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 1 1 — — $28,500.00 $28,500.00 $28,500.00 2025-06-28
836 MS_DRG Acute Leukemia Without Major O.r. Procedures Without Cc/mcc 1 1 — — $28,500.00 $28,500.00 $28,500.00 2025-06-28
J9037 HCPCS Blenrep 100 Mg Intravenous Solution 40 26 $42,367.04 $27,538.58 35% off $12,765.19 $42,367.04 $28,460.06 2025-06-28
345 MS_DRG Minor Small And Large Bowel Procedures With Cc 1 1 — — $28,400.00 $28,400.00 $28,400.00 2025-06-28
842 MS_DRG Lymphoma And Non-acute Leukemia Without Cc/mcc 1 1 — — $28,400.00 $28,400.00 $28,400.00 2025-06-28
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 1 — — $28,200.00 $28,200.00 $28,200.00 2025-06-28
303 MS_DRG Atherosclerosis Without Mcc 2 2 — — $16,900.00 $39,400.00 $28,150.00 2025-06-28
205 MS_DRG Other Respiratory System Diagnoses With Mcc 1 1 — — $28,000.00 $28,000.00 $28,000.00 2025-06-28
687 MS_DRG Kidney And Urinary Tract Neoplasms With Cc 1 1 — — $28,000.00 $28,000.00 $28,000.00 2025-06-28
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 1 1 — — $27,600.00 $27,600.00 $27,600.00 2025-06-28
675 MS_DRG Other Kidney And Urinary Tract Procedures Without Cc/mcc 1 1 — — $27,500.00 $27,500.00 $27,500.00 2025-06-28
315 MS_DRG Other Circulatory System Diagnoses With Cc 1 1 — — $27,400.00 $27,400.00 $27,400.00 2025-06-28
J9216 HCPCS Actimmune 100 Mcg (2 Million Unit)/0.5 Ml Subcutaneous Solution 40 26 $40,606.35 $26,394.13 35% off $12,234.69 $40,606.35 $27,277.31 2025-06-28
5 MS_DRG Carotid Endarterectomy 1 1 — — $27,200.00 $27,200.00 $27,200.00 2025-06-28
304 MS_DRG Hypertension With Mcc 1 1 — — $27,100.00 $27,100.00 $27,100.00 2025-06-28
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 1 1 — — $26,900.00 $26,900.00 $26,900.00 2025-06-28
292 MS_DRG Heart Failure And Shock With Cc 1 1 — — $26,700.00 $26,700.00 $26,700.00 2025-06-28
J1640 HCPCS Panhematin 350 Mg Intravenous Solution 41 26 $39,385.77 $25,600.75 35% off $57.88 $39,385.77 $26,112.77 2025-06-28
8 MS_DRG Vagal NeNe Stimulation 1 1 — — $26,000.00 $26,000.00 $26,000.00 2025-06-28
7 MS_DRG Vagal NeNe Stimulation 1 1 — — $26,000.00 $26,000.00 $26,000.00 2025-06-28
J9223 HCPCS Zepzelca 4 Mg Intravenous Solution 41 26 $38,928.00 $25,303.20 35% off $358.81 $38,928.00 $25,809.26 2025-06-28
J2506 HCPCS Neulasta 6 Mg/0.6 Ml Subcutaneous Syringe 41 26 $38,507.94 $25,030.16 35% off $34.97 $38,507.94 $25,530.76 2025-06-28
181 MS_DRG Respiratory Neoplasms With Cc 1 1 — — $25,400.00 $25,400.00 $25,400.00 2025-06-28
348 MS_DRG Anal And Stomal Procedures With Cc 1 1 — — $25,400.00 $25,400.00 $25,400.00 2025-06-28
176 MS_DRG Pulmonary Embolism Without Mcc 1 1 — — $25,000.00 $25,000.00 $25,000.00 2025-06-28
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc/mcc 1 1 — — $24,600.00 $24,600.00 $24,600.00 2025-06-28
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 1 1 — — $24,500.00 $24,500.00 $24,500.00 2025-06-28
544 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $23,800.00 $23,800.00 $23,800.00 2025-06-28
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 1 1 — — $23,400.00 $23,400.00 $23,400.00 2025-06-28
J1323 HCPCS Elrexfio 40 Mg/ml Subcutaneous Solution 41 26 $34,769.92 $22,600.45 35% off $320.22 $34,769.92 $23,052.46 2025-06-28
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