Hospital

CLARION HOSPITAL

Clarion, PA · CCN 390093 · Rates published

29,704 distinct procedures filed

24 distinct payers

994,024 rate rows

2026-05-23 last MRF observed

Data quality

979,524 of 994,024 rate rows are consumer-grade (98.5%)

14,500 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	9,914
template filing: same amount across many unrelated codes — excluded	2,872
percent-of-charges filed in the dollar field — excluded from medians	828
placeholder amount (≤ $0.02) — excluded from medians	554
per-diem day rate — not a per-procedure price	332

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.independence.health/documents/content/251010039_Butler-Clarion_standardcharges.csv
Found on page	https://www.independence.health/patients-visitors/financial-services/price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	b05181087874eec2… · 61,945,456 bytes · first seen 2026-05-08

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
J3391 OTHER	Inj- Atidarsagene Autotemcel	16	$4,459,950.00	$4,955,500.00	$4,505,000.00	nat. median $4,505,000 1.0× median
J1411 OTHER	Inj- Hemgenix- Per Tx Dose	17	$3,648,414.00	$4,090,646.00	$3,740,545.67	nat. median $3,685,267 1.0× median
J1413 OTHER	Inj Delandistrogene Mox Rokl	17	$3,283,297.96	$3,681,273.47	$3,366,209.53	nat. median $3,327,860 1.0× median
J3394 OTHER	Inj- Lovotibeglogene Autotem	17	$3,215,961.26	$3,605,774.75	$3,297,172.41	nat. median $3,286,000 1.0× median
J3393 OTHER	Inj- Betibeglogene Autotemce	17	$2,916,282.60	$4,886,982.66	$3,034,112.20	nat. median $2,968,000 1.0× median
J3399 OTHER	Inj Onase Abepar-xioi Treat	17	$2,430,559.50	$4,073,028.50	$2,528,763.93	nat. median $2,472,216 1.0× median
J3392 OTHER	Inj- Exagamglogene Autotem	17	$2,308,680.00	$3,868,788.00	$2,401,960.00	nat. median $2,332,000 1.0× median
Q2057 OTHER	Afamitresgene Autoleucel	18	$762,913.80	$2,076,574.30	$824,563.40	nat. median $770,620 1.1× median
C9301 OTHER	Obecabtagene Car Pos T	1	$639,975.00	$639,975.00	$639,975.00	nat. median $56,282 outlier · 11.4×
Q2042 OTHER	Tisagenlecleucel Car-pos T	21	$523,452.56	$1,594,512.75	$627,229.77	nat. median $591,726 1.1× median
Q2056 OTHER	Ciltacabtagene Car-pos T	21	$507,687.00	$1,524,835.72	$599,821.09	nat. median $583,076 1.0× median
Q2054 OTHER	Lisocabtagene Mara Car Pos T	21	$496,390.21	$1,515,860.40	$596,290.48	nat. median $562,538 1.1× median
Q2055 OTHER	Idecabtagene Vicleucel Car	21	$503,454.53	$1,501,793.48	$590,757.01	nat. median $558,082 1.1× median
Q2041 OTHER	Axicabtagene Ciloleucel Car+	21	$489,136.91	$1,436,884.67	$565,223.98	nat. median $533,230 1.1× median
Q2053 OTHER	Brexucabtagene Car Pos T	21	$449,440.00	$1,318,519.33	$518,662.89	nat. median $489,720 1.1× median
5834 OTHER	Neonate W Ecmo	5	$348,720.78	$450,093.22	$391,385.19	nat. median $372,748 1.1× median
MS-018 OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	20	$227,305.89	$690,924.80	$305,304.15	nat. median $309,559 1.0× median
MS-633 OTHER	Neonate- Birth Weight 1000-1499 Grams- With Significant O.r. Procedures- Dischar…	2	$298,916.71	$298,916.71	$298,916.71	nat. median $297,836 1.0× median
Q2058 OTHER	Obecbtge Autol Up To 400 Mil	19	$275,467.50	$714,357.00	$294,945.00	nat. median $281,111 1.0× median
5833 OTHER	Neonate W Ecmo	5	$240,611.28	$295,366.01	$291,584.76	nat. median $252,069 1.2× median
MS-612 OTHER	Neonate- Birth Weight <750 Grams- Discharged Alive	2	$273,915.85	$273,915.85	$273,915.85	nat. median $272,926 1.0× median
J3403 OTHER	Revakinagene- Per Implant	19	$254,925.00	$680,340.00	$272,950.00	nat. median $265,000 1.0× median
5884 OTHER	Neonate Bwt <1500g W Major Procedure	5	$255,334.24	$293,634.55	$270,117.48	nat. median $243,175 1.1× median
0024 OTHER	N/a	5	$226,121.83	$260,040.25	$255,582.38	nat. median $235,636 1.1× median
E0766 OTHER	Elec Stim Cancer Treatment	2	$225,164.05	$225,164.05	$225,164.05	nat. median $16,410 outlier · 13.7×
J3402 OTHER	Inj. Remestemcel-l-rknd/ Td	19	$203,583.60	$554,134.00	$217,978.40	nat. median $205,640 1.1× median
1614 OTHER	N/a	5	$180,393.07	$222,853.51	$214,637.93	nat. median $194,298 1.1× median
8414 OTHER	N/a	5	$160,463.90	$211,261.93	$200,103.58	nat. median $161,322 1.2× median
MS-631 OTHER	Neonate- Birth Weight 750-999 Grams- Discharged Alive	2	$198,619.01	$198,619.01	$198,619.01	nat. median $197,901 1.0× median
MS-001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	20	$179,274.59	$472,942.90	$198,130.11	nat. median $224,278 0.9× median
5832 OTHER	Neonate W Ecmo	5	$184,745.38	$223,883.52	$191,669.93	nat. median $152,272 1.3× median
5883 OTHER	Neonate Bwt <1500g W Major Procedure	5	$166,062.47	$190,971.95	$182,253.78	nat. median $163,694 1.1× median
6304 OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	5	$157,255.13	$214,196.05	$182,117.43	nat. median $164,743 1.1× median
5914 OTHER	Neonate Birthwt 500-749g Without Major Procedure	5	$162,204.55	$186,535.34	$179,775.78	nat. median $149,152 1.2× median
MS-636 OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- With Mu…	2	$175,638.46	$175,638.46	$175,638.46	nat. median $183,596 1.0× median
0074 OTHER	N/a	5	$142,323.32	$177,059.70	$173,565.86	nat. median $147,645 1.2× median
480 OTHER	Liver Transplant And/or Intestinal Transplant	1	$168,924.19	$168,924.19	$168,924.19	nat. median $2,811 outlier · 60.1×
6094 OTHER	Neonate Bwt 1500-2499g W Major Procedure	5	$157,892.52	$193,065.84	$167,883.24	nat. median $170,784 1.0× median
6314 OTHER	Neonate Birthwt >2499g W Other Major Procedure	5	$157,927.60	$189,542.69	$164,819.64	nat. median $163,675 1.0× median
0094 OTHER	N/a	5	$153,193.15	$176,843.29	$160,801.69	nat. median $165,362 1.0× median
114 OTHER	Upper Limb & Toe Amputation For Circ System Disorders	3	$15,457.00	$241,893.83	$154,257.95	nat. median $10,012 outlier · 15.4×
5934 OTHER	Neonate Birthwt 750-999g Without Major Procedure	5	$149,181.16	$172,965.64	$153,236.57	nat. median $129,842 1.2× median
0014 OTHER	N/a	5	$134,554.07	$157,462.70	$153,058.19	nat. median $147,828 1.0× median
5831 OTHER	Neonate W Ecmo	5	$141,507.09	$165,831.71	$151,442.01	nat. median $139,037 1.1× median
MS-927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	20	$137,226.27	$439,946.88	$150,981.61	nat. median $175,322 0.9× median
MS-003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	20	$136,399.47	$419,782.65	$150,063.03	nat. median $169,886 0.9× median
K1007 OTHER	Bil Hkaf Pc S/d Micro Sensor	1	$145,724.16	$145,724.16	$145,724.16	nat. median $96,013 1.5× median
5882 OTHER	Neonate Bwt <1500g W Major Procedure	5	$138,102.87	$167,573.83	$145,716.29	nat. median $119,369 1.2× median
1613 OTHER	N/a	5	$131,120.01	$150,788.10	$143,310.40	nat. median $79 outlier · 1820.5×
0044 OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure	5	$135,905.78	$156,383.87	$141,461.60	nat. median $138,863 1.0× median

Other procedures at this hospital

Browse this hospital's 29,704 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

154	OTHER	Stomach, Esophageal & Duodenal Procedures Age >17 W Cc	2	1	—	—	$39,647.94	$39,647.94	$39,647.94	2026-05-23
1214	OTHER	Other Respiratory & Chest Procedures	12	6	—	—	$62.28	$44,300.76	$39,752.44	2026-05-23
6344	OTHER	Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond	10	5	—	—	$34,433.01	$40,256.54	$39,757.84	2026-05-23
107	OTHER	Coronary Bypass W Cardiac Cath	2	1	—	—	$39,862.72	$39,862.72	$39,862.72	2026-05-23
7114	OTHER	Post-op, Post-trauma, Other Device Infections W O.r. Procedure	10	5	—	—	$34,744.57	$43,499.96	$39,956.28	2026-05-23
L2006	OTHER	Kaf Sng/dbl Swg/stn Mcpr Cus	52	20	—	—	$36,436.06	$88,896.29	$40,097.90	2026-05-23
MS-463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	54	20	—	—	$34,374.17	$194,309.87	$40,295.70	2026-05-23
MS-023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	54	20	—	—	$36,309.59	$130,150.95	$40,513.45	2026-05-23
1673	OTHER	Other Cardiothoracic & Thoracic Vascular Procedures	10	5	—	—	$34,025.58	$42,775.42	$40,518.26	2026-05-23
MS-430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	52	20	—	—	$34,816.50	$92,273.60	$40,773.63	2026-05-23
6092	OTHER	Neonate Bwt 1500-2499g W Major Procedure	10	5	—	—	$34,584.34	$47,373.84	$40,806.72	2026-05-23
C1816	OTHER	Receiver/transmitter- Neuro	2	1	—	—	$40,847.61	$40,847.61	$40,847.61	2026-05-23
5114	OTHER	Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy	10	5	—	—	$37,070.69	$44,359.03	$40,853.38	2026-05-23
MS-361	OTHER	Cardiac Defibrillator Implant With Mcc	4	2	—	—	$40,888.38	$40,888.38	$40,888.38	2026-05-23
4284	OTHER	N/a	2	1	—	—	$40,987.50	$40,987.50	$40,987.50	2026-05-23
204	OTHER	Disorders Of Pancreas Except Malignancy	6	3	—	—	$11,777.19	$45,389.80	$41,108.02	2026-05-23
1793	OTHER	N/a	10	5	—	—	$36,139.42	$41,560.36	$41,135.52	2026-05-23
6133	OTHER	Neonate Birthwt 1500-1999g W Congenital/perinatal Infection	10	5	—	—	$38,684.66	$48,646.81	$41,155.14	2026-05-23
1622	OTHER	N/a	10	5	—	—	$36,676.27	$42,177.73	$41,302.71	2026-05-23
1833	OTHER	Percutaneous Structural Cardiac Procedures	10	5	—	—	$35,960.01	$41,766.77	$41,354.04	2026-05-23
4402	OTHER	N/a	10	5	—	—	$38,208.07	$43,939.31	$41,411.68	2026-05-23
MS-820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	54	20	—	—	$37,055.50	$196,142.98	$41,464.37	2026-05-23
MS-235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	54	20	—	—	$37,449.46	$146,648.96	$41,491.24	2026-05-23
1824	OTHER	Other Peripheral Vascular Procedures	10	5	—	—	$30,961.97	$42,347.83	$41,517.67	2026-05-23
7104	OTHER	N/a	10	5	—	—	$36,144.90	$43,478.87	$41,566.66	2026-05-23
488	OTHER	HIV W Extensive O.r. Procedure	2	1	—	—	$41,588.35	$41,588.35	$41,588.35	2026-05-23
MS-648	OTHER	Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…	4	2	—	—	$41,655.22	$41,655.22	$41,655.22	2026-05-23
MS-276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	52	20	—	—	$33,093.51	$113,652.94	$41,791.29	2026-05-23
MS-790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome- Neonate	54	20	—	—	$6,451.81	$328,127.05	$41,829.78	2026-05-23
191	OTHER	Pancreas, Liver & Shunt Procedures W Cc	2	1	—	—	$41,883.91	$41,883.91	$41,883.91	2026-05-23
MS-016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	54	20	—	—	$35,221.73	$295,131.03	$41,923.22	2026-05-23
4014	OTHER	N/a	10	5	—	—	$36,493.44	$56,338.06	$41,967.48	2026-05-23
6224	OTHER	Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond	10	5	—	—	$36,533.16	$47,760.24	$42,013.15	2026-05-23
3043	OTHER	N/a	10	5	—	—	$36,006.58	$42,585.53	$42,112.37	2026-05-23
MS-457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	54	20	—	—	$36,527.89	$95,409.60	$42,159.36	2026-05-23
MS-028	OTHER	Spinal Procedures With Mcc	54	20	—	—	$38,617.20	$174,145.64	$42,285.84	2026-05-23
4054	OTHER	Other Procedures For Endocrine, Nutritional & Metabolic Disorders	10	5	—	—	$34,870.57	$43,619.72	$42,567.53	2026-05-23
MS-232	OTHER	Coronary Bypass With Ptca Without Mcc	54	20	—	—	$38,878.27	$137,483.40	$42,862.83	2026-05-23
234	OTHER	Other Musculoskelet Sys & Conn Tiss O.r. Proc Without Cc	6	3	—	—	$10,081.85	$46,514.86	$42,904.13	2026-05-23
0304	OTHER	Percutaneous Intra & Extracranial Vascular Procedures	10	5	—	—	$35,894.28	$44,999.65	$42,964.42	2026-05-23
6123	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	10	5	—	—	$38,090.29	$43,803.86	$43,062.68	2026-05-23
MS-266	OTHER	Endovascular Cardiac Valve Replacement W Mcc	54	20	—	—	$36,896.95	$98,054.40	$43,131.09	2026-05-23
MS-969	OTHER	HIV With Extensive O.r. Procedures With Mcc	54	20	—	—	$39,343.49	$214,474.10	$43,277.84	2026-05-23
16508566	OTHER	Injection Ocrelizumab 1mg	28	10	$86,743.27	$48,576.23 44% off	$29,492.71	$77,201.51	$43,371.64	2026-05-23
1764	OTHER	N/a	10	5	—	—	$34,535.72	$47,704.21	$43,389.60	2026-05-23
0274	OTHER	Other Open Craniotomy	16	6	—	—	$39.80	$54,613.48	$43,546.10	2026-05-23
7404	OTHER	N/a	10	5	—	—	$39,612.51	$61,234.53	$43,573.78	2026-05-23
3032	OTHER	N/a	10	5	—	—	$34,956.84	$44,655.12	$43,628.44	2026-05-23
0091	OTHER	N/a	10	5	—	—	$37,839.67	$47,427.32	$43,680.65	2026-05-23
3214	OTHER	N/a	10	5	—	—	$36,793.36	$44,229.88	$43,820.26	2026-05-23
0924	OTHER	N/a	10	5	—	—	$39,162.62	$50,239.86	$44,216.59	2026-05-23
2304	OTHER	N/a	10	5	—	—	$35,265.67	$45,159.33	$44,220.43	2026-05-23
5104	OTHER	Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs	10	5	—	—	$40,482.15	$46,554.50	$44,240.48	2026-05-23
4044	OTHER	Thyroid, Parathyroid & Thyroglossal Procedures	10	5	—	—	$34,453.55	$47,459.70	$44,265.32	2026-05-23
0264	OTHER	Other Nervous System & Related Procedures	10	5	—	—	$33,373.00	$44,894.19	$44,318.08	2026-05-23
L7180	OTHER	Electronic Elbow Sequential	52	20	—	—	$16,020.34	$98,481.94	$44,421.64	2026-05-23
6113	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	10	5	—	—	$38,532.65	$49,288.60	$44,533.81	2026-05-23
8412	OTHER	N/a	10	5	—	—	$34,193.34	$45,871.76	$44,717.42	2026-05-23
8411	OTHER	N/a	10	5	—	—	$34,193.34	$45,871.76	$44,717.42	2026-05-23
16508973	OTHER	Pegaspargase 3750 Iu Inj`	28	10	$89,498.68	$50,119.26 44% off	$30,429.55	$79,653.83	$44,749.34	2026-05-23
0083	OTHER	N/a	10	5	—	—	$38,936.65	$52,036.35	$44,777.18	2026-05-23
7584	OTHER	N/a	10	5	—	—	$24,532.79	$45,745.35	$44,785.84	2026-05-23
MS-459	OTHER	Spinal Fusion Except Cervical With Mcc	8	4	—	—	$44,802.50	$73,570.22	$45,013.88	2026-05-23
6234	OTHER	Neonate Bwt 2000-2499g W Congenital/perinatal Infection	10	5	—	—	$39,872.72	$47,316.77	$45,081.65	2026-05-23
0224	OTHER	Ventricular Shunt Procedures	10	5	—	—	$36,769.40	$51,805.86	$45,149.65	2026-05-23
1653	OTHER	N/a	10	5	—	—	$40,183.60	$46,211.16	$45,280.19	2026-05-23
1000044	OTHER	Mesh 11	8	3	$64,750.00	$36,260.00 44% off	$25,900.00	$48,562.50	$45,325.00	2026-05-23
27800046	OTHER	Mesh, 40x30cm TransorbTSB40x30	8	3	$64,750.00	$36,260.00 44% off	$25,900.00	$48,562.50	$45,325.00	2026-05-23
MS-207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	54	20	—	—	$41,159.91	$229,139.00	$45,493.59	2026-05-23
3004	OTHER	N/a	2	1	—	—	$45,519.91	$45,519.91	$45,519.91	2026-05-23
1633	OTHER	N/a	10	5	—	—	$41,029.95	$47,184.47	$45,586.96	2026-05-23
1782	OTHER	N/a	10	5	—	—	$38,044.41	$50,171.35	$45,839.98	2026-05-23
1304	OTHER	Respiratory System Diagnosis W Ventilator Support 96+ Hours	10	5	—	—	$40,948.47	$47,090.77	$45,952.69	2026-05-23
MS-691	OTHER	Urinary Stones W Esw Lithotripsy W Cc/mcc	4	2	—	—	$46,157.86	$46,157.86	$46,157.86	2026-05-23
6514	OTHER	Other Procedures Of Blood & Blood-forming Organs	10	5	—	—	$36,281.16	$64,825.49	$46,161.55	2026-05-23
MS-217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	54	20	—	—	$41,100.72	$105,204.80	$46,276.33	2026-05-23
MS-573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	54	20	—	—	$39,193.31	$219,973.44	$46,318.66	2026-05-23
0266T	OTHER	Implt/rpl Crtd Sns Dev Total	46	18	—	—	$42,858.47	$103,037.65	$46,321.78	2026-05-23
33276	OTHER	Insj Phrnc Nrv Stim Sys	46	18	—	—	$42,858.47	$103,037.65	$46,321.78	2026-05-23
1814	OTHER	N/a	10	5	—	—	$35,787.46	$48,472.05	$46,389.13	2026-05-23
MS-218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	54	20	—	—	$37,863.78	$105,204.80	$46,487.64	2026-05-23
0052	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	10	5	—	—	$40,456.13	$53,081.84	$46,524.57	2026-05-23
7924	OTHER	N/a	10	5	—	—	$40,559.53	$47,728.61	$46,643.48	2026-05-23
2993	OTHER	N/a	2	1	—	—	$46,657.97	$46,657.97	$46,657.97	2026-05-23
486	OTHER	Other O.r. Procedures For Multiple Significant Trauma	2	1	—	—	$46,783.60	$46,783.60	$46,783.60	2026-05-23
0092	OTHER	N/a	10	5	—	—	$39,830.26	$59,650.55	$46,996.13	2026-05-23
0061	OTHER	Pancreas Transplant	10	5	—	—	$40,559.53	$48,187.71	$47,011.81	2026-05-23
214	OTHER	No Longer Valid	6	3	—	—	$18,992.71	$50,663.80	$47,054.45	2026-05-23
MS-447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	52	20	—	—	$42,671.46	$142,982.74	$47,239.18	2026-05-23
MS-317	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	52	20	—	—	$39,372.78	$106,984.00	$47,273.83	2026-05-23
2614	OTHER	N/a	10	5	—	—	$40,822.47	$48,059.36	$47,348.43	2026-05-23
MS-955	OTHER	Craniotomy For Multiple Significant Trauma	54	20	—	—	$43,262.86	$159,480.74	$47,589.15	2026-05-23
J9226	OTHER	Supprelin La Implant	58	21	—	—	$44,158.25	$121,316.25	$47,721.89	2026-05-23
MS-268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	54	20	—	—	$13,254.09	$111,819.83	$48,406.00	2026-05-23
0894	OTHER	N/a	10	5	—	—	$41,083.37	$50,392.04	$48,512.94	2026-05-23
1204	OTHER	N/a	10	5	—	—	$42,326.20	$55,893.12	$48,602.68	2026-05-23
MS-870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	54	20	—	—	$44,274.01	$232,805.22	$48,866.71	2026-05-23
4403	OTHER	N/a	10	5	—	—	$43,712.83	$50,269.79	$48,897.17	2026-05-23
1783	OTHER	N/a	10	5	—	—	$45,383.64	$52,191.22	$49,318.14	2026-05-23
K0606	OTHER	Aed Garment W Elec Analysis	10	5	—	—	$49,319.85	$49,319.85	$49,319.85	2026-05-23
MS-928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	54	20	—	—	$27,393.38	$227,305.89	$49,328.25	2026-05-23
6083	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	10	5	—	—	$42,771.29	$50,241.39	$49,520.11	2026-05-23
MS-427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	52	20	—	—	$13,371.80	$115,497.60	$49,643.91	2026-05-23
1603	OTHER	N/a	10	5	—	—	$45,791.07	$52,659.76	$49,701.78	2026-05-23
L7181	OTHER	Electronic Elbo Simultaneous	54	20	—	—	$33,754.11	$148,491.09	$50,043.95	2026-05-23
6072	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	10	5	—	—	$43,761.45	$50,983.33	$50,325.70	2026-05-23
MS-275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	52	20	—	—	$44,977.28	$152,148.30	$50,412.22	2026-05-23
MS-019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	54	20	—	—	$45,856.28	$185,144.31	$50,452.58	2026-05-23
MS-010	OTHER	Pancreas Transplant	54	20	—	—	$39,552.12	$127,568.00	$50,732.49	2026-05-23
0011	OTHER	N/a	10	5	—	—	$44,740.65	$58,171.43	$51,451.78	2026-05-23
9504	OTHER	N/a	10	5	—	—	$44,801.60	$52,153.85	$51,521.87	2026-05-23
6302	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	10	5	—	—	$39,505.00	$58,529.57	$51,607.30	2026-05-23
2204	OTHER	N/a	10	5	—	—	$41,690.75	$53,640.16	$51,849.13	2026-05-23
MS-227	OTHER	Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc	4	2	—	—	$47,505.13	$56,947.40	$52,226.26	2026-05-23
0234	OTHER	Spinal Procedures	10	5	—	—	$42,904.13	$53,492.12	$52,389.51	2026-05-23
C1882	OTHER	Aicd- Other Than Sing/dual	6	3	—	—	$32,248.84	$70,387.55	$53,042.78	2026-05-23
7594	OTHER	N/a	10	5	—	—	$25,889.29	$57,500.34	$53,096.34	2026-05-23
2324	OTHER	N/a	10	5	—	—	$29,652.03	$54,242.58	$53,160.53	2026-05-23
1694	OTHER	N/a	10	5	—	—	$43,484.81	$54,911.44	$53,289.74	2026-05-23
106	OTHER	Coronary Bypass W Ptca	2	1	—	—	$53,363.94	$53,363.94	$53,363.94	2026-05-23
0914	OTHER	Other Major Head & Neck Procedures	10	5	—	—	$47,856.30	$59,230.42	$53,480.72	2026-05-23
MS-454	OTHER	Combined Anterior/posterior Spinal Fusion W Cc	8	4	—	—	$42,456.84	$66,573.21	$53,596.11	2026-05-23
0041	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure	10	5	—	—	$41,434.65	$61,813.31	$53,698.44	2026-05-23
MS-957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	54	20	—	—	$47,505.22	$185,144.31	$53,873.00	2026-05-23
6954	OTHER	N/a	10	5	—	—	$41,554.48	$58,996.22	$53,975.62	2026-05-23
MS-233	OTHER	Coronary Bypass With Cardiac Catheterization With Mcc	54	20	—	—	$49,138.07	$201,642.32	$54,051.87	2026-05-23
1623	OTHER	N/a	10	5	—	—	$49,308.67	$56,705.00	$54,120.38	2026-05-23
105	OTHER	Cardiac Valve & Oth Major Cardiothoracic Proc Without Card Cath	2	1	—	—	$54,257.04	$54,257.04	$54,257.04	2026-05-23
MS-219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	54	20	—	—	$49,244.62	$150,315.18	$54,285.89	2026-05-23
6313	OTHER	Neonate Birthwt >2499g W Other Major Procedure	10	5	—	—	$49,491.50	$56,915.25	$54,618.22	2026-05-23
9124	OTHER	N/a	10	5	—	—	$45,955.41	$57,279.60	$54,819.01	2026-05-23
6144	OTHER	Neonate Bwt 1500-1999g W Or Without Other Significant Condition	10	5	—	—	$47,766.59	$57,404.27	$55,189.95	2026-05-23
2604	OTHER	N/a	10	5	—	—	$43,903.20	$58,123.22	$55,444.26	2026-05-23
MS-020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	54	20	—	—	$50,575.21	$161,313.86	$55,632.74	2026-05-23
1794	OTHER	N/a	10	5	—	—	$48,137.05	$57,423.17	$55,634.05	2026-05-23
MS-646	OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- Without…	4	2	—	—	$55,641.89	$55,641.89	$55,641.89	2026-05-23
6254	OTHER	Neonate Bwt 2000-2499g W Other Significant Condition	10	5	—	—	$48,834.82	$72,442.94	$56,160.07	2026-05-23
MS-225	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…	4	2	—	—	$51,890.40	$61,380.08	$56,635.24	2026-05-23
1664	OTHER	N/a	10	5	—	—	$48,773.19	$60,469.11	$56,726.75	2026-05-23
0071	OTHER	N/a	10	5	—	—	$56,269.91	$65,922.35	$57,073.97	2026-05-23
108	OTHER	Other Cardiothoracic Procedures	2	1	—	—	$57,400.81	$57,400.81	$57,400.81	2026-05-23
0012	OTHER	N/a	10	5	—	—	$51,456.06	$59,174.51	$57,642.57	2026-05-23
6334	OTHER	Neonate Birthwt >2499g W Major Anomaly	10	5	—	—	$56,767.04	$66,855.50	$58,276.25	2026-05-23
3614	OTHER	Skin Graft For Skin & Subcutaneous Tissue Diagnoses	10	5	—	—	$41,037.49	$59,408.39	$58,499.42	2026-05-23
Q2043	OTHER	Sipuleucel-t Auto Cd54+	60	21	—	—	$53,062.44	$148,941.23	$58,588.66	2026-05-23
9114	OTHER	N/a	10	5	—	—	$49,425.76	$63,536.71	$58,620.92	2026-05-23
MS-231	OTHER	Coronary Bypass With Ptca With Mcc	54	20	—	—	$52,038.71	$190,643.65	$59,328.83	2026-05-23
MS-456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	54	20	—	—	$53,901.46	$172,312.53	$59,412.38	2026-05-23
27800201	OTHER	Valve, 26mm Reslilia Tavr	8	3	$85,000.00	$47,600.00 44% off	$34,000.00	$63,750.00	$59,500.00	2026-05-23
27800157	OTHER	Tavr, Resilia 29mm	8	3	$85,000.00	$47,600.00 44% off	$34,000.00	$63,750.00	$59,500.00	2026-05-23
MS-635	OTHER	Neonate- Birth Weight 1000-1499 Grams- Died	4	2	—	—	$59,631.56	$59,631.56	$59,631.56	2026-05-23
2994	OTHER	N/a	2	1	—	—	$59,668.36	$59,668.36	$59,668.36	2026-05-23
MS-647	OTHER	Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…	4	2	—	—	$59,756.29	$59,756.29	$59,756.29	2026-05-23
6214	OTHER	Neonate Bwt 2000-2499g W Major Anomaly	10	5	—	—	$55,816.60	$67,535.09	$59,990.69	2026-05-23
38240	OTHER	Transplt Allo Hct/donor	56	21	—	—	$124.39	$133,705.84	$60,025.39	2026-05-23
0042	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure	10	5	—	—	$52,618.78	$70,990.70	$60,511.63	2026-05-23
A9543	OTHER	Y90 Ibritumomab- Rx	52	20	—	—	$56,256.30	$184,526.46	$60,518.14	2026-05-23
8504	OTHER	Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service	10	5	—	—	$47,120.87	$69,669.13	$60,581.82	2026-05-23
1834	OTHER	Percutaneous Structural Cardiac Procedures	10	5	—	—	$52,117.54	$61,748.75	$60,722.15	2026-05-23
6904	OTHER	N/a	10	5	—	—	$45,149.45	$64,129.50	$60,908.52	2026-05-23
6814	OTHER	Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	10	5	—	—	$53,465.83	$61,496.20	$60,937.11	2026-05-23
16509457	OTHER	Loncastuximab Tesirine 0.075mg	28	10	$122,172.16	$68,416.41 44% off	$41,538.53	$108,733.22	$61,086.08	2026-05-23
MS-850	OTHER	Acute Leukemia With Other Procedures	52	20	—	—	$55,657.29	$280,466.14	$61,223.02	2026-05-23
9104	OTHER	N/a	10	5	—	—	$51,964.15	$62,506.30	$61,272.24	2026-05-23
3124	OTHER	Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses	10	5	—	—	$42,178.29	$62,995.89	$61,315.64	2026-05-23
6084	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	10	5	—	—	$49,549.02	$79,617.48	$62,191.31	2026-05-23
3044	OTHER	N/a	10	5	—	—	$48,843.03	$65,473.49	$62,344.79	2026-05-23
6073	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	10	5	—	—	$59,252.71	$68,140.65	$62,776.20	2026-05-23
E0194	OTHER	Air Fluidized Bed	10	5	—	—	$63,002.69	$63,002.69	$63,002.69	2026-05-23
5911	OTHER	Neonate Birthwt 500-749g Without Major Procedure	10	5	—	—	$23,309.13	$68,979.57	$63,112.65	2026-05-23
6124	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	10	5	—	—	$56,916.32	$70,311.71	$63,330.77	2026-05-23
3033	OTHER	N/a	10	5	—	—	$48,063.78	$65,818.25	$63,637.89	2026-05-23
MS-429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	52	20	—	—	$53,082.99	$175,978.75	$63,698.24	2026-05-23
27800055	OTHER	Optimizer Pulse Generator	8	3	$91,000.00	$50,960.00 44% off	$36,400.00	$68,250.00	$63,700.00	2026-05-23
MS-223	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…	4	2	—	—	$63,355.50	$65,290.47	$64,322.99	2026-05-23
0062	OTHER	Pancreas Transplant	10	5	—	—	$56,028.87	$68,605.97	$64,433.24	2026-05-23
1654	OTHER	N/a	10	5	—	—	$54,709.35	$69,050.97	$65,251.22	2026-05-23
MS-226	OTHER	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	4	2	—	—	$58,951.03	$71,729.19	$65,340.11	2026-05-23
0053	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	10	5	—	—	$61,270.69	$70,461.33	$65,855.16	2026-05-23
J9029	OTHER	Instill Adstiladrin- Tx Dose	56	21	—	—	$62,708.86	$170,687.17	$67,142.82	2026-05-23
6804	OTHER	N/a	10	5	—	—	$58,676.14	$69,078.25	$67,477.60	2026-05-23
8413	OTHER	N/a	10	5	—	—	$52,184.65	$69,444.32	$67,608.32	2026-05-23
6022	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	10	5	—	—	$62,349.86	$72,859.18	$68,842.82	2026-05-23
MS-216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	54	20	—	—	$61,423.55	$194,309.87	$69,164.79	2026-05-23
0072	OTHER	N/a	10	5	—	—	$60,340.79	$74,350.88	$69,391.94	2026-05-23
MS-215	OTHER	Other Heart Assist System Implant	54	20	—	—	$62,231.25	$169,516.80	$70,396.39	2026-05-23
1784	OTHER	N/a	10	5	—	—	$57,907.85	$71,043.43	$70,397.54	2026-05-23
8634	OTHER	Neonatal Aftercare	10	5	—	—	$68,294.97	$81,981.24	$70,666.24	2026-05-23
6033	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	10	5	—	—	$46,544.99	$71,441.89	$70,668.44	2026-05-23
0013	OTHER	N/a	10	5	—	—	$64,053.54	$73,661.61	$70,920.76	2026-05-23
104	OTHER	Cardiac Valve & Oth Major Cardiothoracic Proc W Card Cath	2	1	—	—	$71,164.54	$71,164.54	$71,164.54	2026-05-23
L8702	OTHER	Ewhf S/d Uprt Micro Sensor	50	20	—	—	$66,778.13	$158,513.75	$71,499.82	2026-05-23
6093	OTHER	Neonate Bwt 1500-2499g W Major Procedure	10	5	—	—	$62,538.17	$76,637.69	$72,086.67	2026-05-23
1634	OTHER	N/a	10	5	—	—	$60,896.81	$73,938.01	$72,344.11	2026-05-23
MS-005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	54	20	—	—	$66,268.78	$256,635.68	$72,895.65	2026-05-23
1674	OTHER	Other Cardiothoracic & Thoracic Vascular Procedures	10	5	—	—	$53,604.83	$74,440.42	$73,414.43	2026-05-23
0063	OTHER	Pancreas Transplant	10	5	—	—	$67,733.42	$80,471.66	$74,393.69	2026-05-23
MS-426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	52	20	—	—	$17,837.55	$176,339.20	$75,086.86	2026-05-23
MS-224	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…	4	2	—	—	$69,594.32	$82,153.69	$75,874.01	2026-05-23
6134	OTHER	Neonate Birthwt 1500-1999g W Congenital/perinatal Infection	10	5	—	—	$69,698.68	$80,153.52	$75,878.99	2026-05-23
0093	OTHER	N/a	10	5	—	—	$66,020.85	$118,849.85	$75,924.02	2026-05-23
MS-212	OTHER	Testes Procedures Age 0-17	52	20	—	—	$69,333.24	$229,139.00	$76,880.33	2026-05-23
112	OTHER	No Longer Valid	6	3	—	—	$19,675.62	$143,114.21	$77,245.38	2026-05-23
4404	OTHER	N/a	10	5	—	—	$68,144.96	$82,949.83	$77,347.88	2026-05-23
MS-209	OTHER	Kidney And Urinary Tract Signs And Symptoms Age 0-17	44	17	—	—	$4,673.06	$181,100.80	$77,841.89	2026-05-23
16508876	OTHER	Ipilimumab 1mg Inj	28	10	$159,363.12	$89,243.34 44% off	$54,183.46	$141,833.18	$79,681.56	2026-05-23
6114	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	10	5	—	—	$69,373.42	$82,882.75	$79,779.47	2026-05-23
MS-002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	54	20	—	—	$70,133.88	$181,308.80	$80,116.29	2026-05-23
MS-222	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…	4	2	—	—	$77,853.04	$86,872.63	$82,362.83	2026-05-23
8514	OTHER	N/a	6	3	—	—	$74,096.87	$85,211.45	$82,897.37	2026-05-23
1624	OTHER	N/a	10	5	—	—	$69,593.22	$88,762.16	$84,004.14	2026-05-23
A9699	OTHER	Radiopharm Rx Agent Noc	2	1	—	—	$84,843.15	$84,843.15	$84,843.15	2026-05-23
6023	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	10	5	—	—	$78,029.43	$91,108.03	$84,855.02	2026-05-23
MS-014	OTHER	Allogeneic Bone Marrow Transplant	54	20	—	—	$77,242.76	$471,109.78	$84,967.04	2026-05-23
6303	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	10	5	—	—	$84,422.11	$102,279.10	$86,682.70	2026-05-23
0084	OTHER	N/a	10	5	—	—	$63,300.99	$99,484.75	$87,758.13	2026-05-23
3034	OTHER	N/a	10	5	—	—	$69,257.01	$93,383.82	$88,195.84	2026-05-23
0021	OTHER	N/a	10	5	—	—	$84,974.92	$97,721.21	$88,616.05	2026-05-23
0073	OTHER	N/a	10	5	—	—	$75,247.95	$90,519.40	$89,516.19	2026-05-23
113	OTHER	Amputation For Circ System Disorders Except Upper Limb & Toe	6	3	—	—	$26,820.46	$180,020.56	$89,963.37	2026-05-23
MS-007	OTHER	Lung Transplant	54	20	—	—	$83,175.19	$361,123.06	$91,558.44	2026-05-23
6074	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	10	5	—	—	$85,594.63	$98,433.88	$92,052.41	2026-05-23
5932	OTHER	Neonate Birthwt 750-999g Without Major Procedure	10	5	—	—	$85,435.76	$98,251.18	$92,755.50	2026-05-23
0054	OTHER	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	10	5	—	—	$88,700.00	$102,005.06	$93,657.74	2026-05-23
5912	OTHER	Neonate Birthwt 500-749g Without Major Procedure	10	5	—	—	$91,297.28	$109,759.70	$95,671.89	2026-05-23
0043	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure	10	5	—	—	$85,272.10	$98,062.98	$96,583.71	2026-05-23
MS-632	OTHER	Neonate- Birth Weight 750-999 Grams- Died	4	2	—	—	$97,478.05	$97,478.05	$97,478.05	2026-05-23
8424	OTHER	N/a	10	5	—	—	$89,836.69	$108,194.58	$97,684.63	2026-05-23
MS-453	OTHER	Combined Anterior/posterior Spinal Fusion W Mcc	8	4	—	—	$65,720.86	$100,388.09	$97,908.47	2026-05-23
MS-004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	54	20	—	—	$89,027.24	$410,617.09	$97,929.96	2026-05-23
1611	OTHER	N/a	10	5	—	—	$99,726.74	$115,322.77	$100,641.72	2026-05-23
5933	OTHER	Neonate Birthwt 750-999g Without Major Procedure	10	5	—	—	$102,993.67	$119,958.61	$104,311.77	2026-05-23
5893	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	10	5	—	—	$94,738.87	$120,615.84	$104,403.37	2026-05-23
1612	OTHER	N/a	10	5	—	—	$103,933.79	$121,040.59	$105,252.63	2026-05-23
0022	OTHER	N/a	10	5	—	—	$92,399.74	$109,679.01	$106,259.76	2026-05-23
MS-634	OTHER	Neonate- Birth Weight 1000-1499 Grams- Without Significant O.r. Procedures- Disc…	4	2	—	—	$107,141.27	$107,141.27	$107,141.27	2026-05-23
J7330	OTHER	Cultured Chondrocytes Implnt	10	5	—	—	$29,124.96	$189,873.82	$109,499.39	2026-05-23
5892	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	10	5	—	—	$96,801.36	$120,615.84	$109,663.95	2026-05-23
1604	OTHER	N/a	10	5	—	—	$103,555.12	$130,020.12	$110,989.64	2026-05-23
Q0480	OTHER	Driver Pneumatic Vad- Rep	54	20	—	—	$75,872.06	$333,776.36	$112,488.19	2026-05-23
0064	OTHER	Pancreas Transplant	10	5	—	—	$87,890.62	$117,834.26	$113,274.55	2026-05-23
5891	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	10	5	—	—	$99,743.76	$120,615.84	$113,686.21	2026-05-23
6024	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	10	5	—	—	$111,687.29	$128,440.46	$118,050.49	2026-05-23
495	OTHER	Lung Transplant	2	1	—	—	$119,142.54	$119,142.54	$119,142.54	2026-05-23
MS-681	OTHER	Neonate- Birth Weight >2499 Grams- With Significant O.r. Procedures- With Multip…	4	2	—	—	$119,632.04	$119,632.04	$119,632.04	2026-05-23
6034	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	10	5	—	—	$82,198.23	$159,988.12	$120,222.77	2026-05-23
5913	OTHER	Neonate Birthwt 500-749g Without Major Procedure	10	5	—	—	$114,888.80	$138,453.94	$120,394.66	2026-05-23
103	OTHER	Heart Transplant Or Implant Of Heart Assist System	2	1	—	—	$125,704.52	$125,704.52	$125,704.52	2026-05-23
0023	OTHER	N/a	10	5	—	—	$126,966.27	$146,011.30	$129,185.49	2026-05-23
5881	OTHER	Neonate Bwt <1500g W Major Procedure	10	5	—	—	$124,900.36	$143,635.50	$138,102.87	2026-05-23
0044	OTHER	Tracheostomy W Mv 96+ Hours W Extensive Procedure	10	5	—	—	$135,905.78	$156,383.87	$141,461.60	2026-05-23
1613	OTHER	N/a	10	5	—	—	$131,120.01	$150,788.10	$143,310.40	2026-05-23
5882	OTHER	Neonate Bwt <1500g W Major Procedure	10	5	—	—	$138,102.87	$167,573.83	$145,716.29	2026-05-23
K1007	OTHER	Bil Hkaf Pc S/d Micro Sensor	2	1	—	—	$145,724.16	$145,724.16	$145,724.16	2026-05-23
MS-003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	54	20	—	—	$136,399.47	$419,782.65	$150,063.03	2026-05-23
MS-927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	54	20	—	—	$137,226.27	$439,946.88	$150,981.61	2026-05-23
5831	OTHER	Neonate W Ecmo	10	5	—	—	$141,507.09	$165,831.71	$151,442.01	2026-05-23
0014	OTHER	N/a	10	5	—	—	$134,554.07	$157,462.70	$153,058.19	2026-05-23
5934	OTHER	Neonate Birthwt 750-999g Without Major Procedure	10	5	—	—	$149,181.16	$172,965.64	$153,236.57	2026-05-23
114	OTHER	Upper Limb & Toe Amputation For Circ System Disorders	6	3	—	—	$15,457.00	$241,893.83	$154,257.95	2026-05-23
0094	OTHER	N/a	10	5	—	—	$153,193.15	$176,843.29	$160,801.69	2026-05-23
6314	OTHER	Neonate Birthwt >2499g W Other Major Procedure	10	5	—	—	$157,927.60	$189,542.69	$164,819.64	2026-05-23
6094	OTHER	Neonate Bwt 1500-2499g W Major Procedure	10	5	—	—	$157,892.52	$193,065.84	$167,883.24	2026-05-23
480	OTHER	Liver Transplant And/or Intestinal Transplant	2	1	—	—	$168,924.19	$168,924.19	$168,924.19	2026-05-23
0074	OTHER	N/a	10	5	—	—	$142,323.32	$177,059.70	$173,565.86	2026-05-23
MS-636	OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- With Mu…	4	2	—	—	$175,638.46	$175,638.46	$175,638.46	2026-05-23
5914	OTHER	Neonate Birthwt 500-749g Without Major Procedure	10	5	—	—	$162,204.55	$186,535.34	$179,775.78	2026-05-23
6304	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	10	5	—	—	$157,255.13	$214,196.05	$182,117.43	2026-05-23
5883	OTHER	Neonate Bwt <1500g W Major Procedure	10	5	—	—	$166,062.47	$190,971.95	$182,253.78	2026-05-23
5832	OTHER	Neonate W Ecmo	10	5	—	—	$184,745.38	$223,883.52	$191,669.93	2026-05-23
MS-001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	54	20	—	—	$179,274.59	$472,942.90	$198,130.11	2026-05-23
MS-631	OTHER	Neonate- Birth Weight 750-999 Grams- Discharged Alive	4	2	—	—	$198,619.01	$198,619.01	$198,619.01	2026-05-23
8414	OTHER	N/a	10	5	—	—	$160,463.90	$211,261.93	$200,103.58	2026-05-23
1614	OTHER	N/a	10	5	—	—	$180,393.07	$222,853.51	$214,637.93	2026-05-23
J3402	OTHER	Inj. Remestemcel-l-rknd/ Td	48	19	—	—	$203,583.60	$554,134.00	$217,978.40	2026-05-23
E0766	OTHER	Elec Stim Cancer Treatment	4	2	—	—	$225,164.05	$225,164.05	$225,164.05	2026-05-23
0024	OTHER	N/a	10	5	—	—	$226,121.83	$260,040.25	$255,582.38	2026-05-23
5884	OTHER	Neonate Bwt <1500g W Major Procedure	10	5	—	—	$255,334.24	$293,634.55	$270,117.48	2026-05-23
J3403	OTHER	Revakinagene- Per Implant	48	19	—	—	$254,925.00	$680,340.00	$272,950.00	2026-05-23
MS-612	OTHER	Neonate- Birth Weight <750 Grams- Discharged Alive	4	2	—	—	$273,915.85	$273,915.85	$273,915.85	2026-05-23
5833	OTHER	Neonate W Ecmo	10	5	—	—	$240,611.28	$295,366.01	$291,584.76	2026-05-23
Q2058	OTHER	Obecbtge Autol Up To 400 Mil	48	19	—	—	$275,467.50	$714,357.00	$294,945.00	2026-05-23
MS-633	OTHER	Neonate- Birth Weight 1000-1499 Grams- With Significant O.r. Procedures- Dischar…	4	2	—	—	$298,916.71	$298,916.71	$298,916.71	2026-05-23
MS-018	OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	54	20	—	—	$227,305.89	$690,924.80	$305,304.15	2026-05-23
5834	OTHER	Neonate W Ecmo	10	5	—	—	$348,720.78	$450,093.22	$391,385.19	2026-05-23
Q2053	OTHER	Brexucabtagene Car Pos T	54	21	—	—	$449,440.00	$1,318,519.33	$518,662.89	2026-05-23
Q2041	OTHER	Axicabtagene Ciloleucel Car+	54	21	—	—	$489,136.91	$1,436,884.67	$565,223.98	2026-05-23
Q2055	OTHER	Idecabtagene Vicleucel Car	54	21	—	—	$503,454.53	$1,501,793.48	$590,757.01	2026-05-23
Q2054	OTHER	Lisocabtagene Mara Car Pos T	54	21	—	—	$496,390.21	$1,515,860.40	$596,290.48	2026-05-23
Q2056	OTHER	Ciltacabtagene Car-pos T	54	21	—	—	$507,687.00	$1,524,835.72	$599,821.09	2026-05-23
Q2042	OTHER	Tisagenlecleucel Car-pos T	54	21	—	—	$523,452.56	$1,594,512.75	$627,229.77	2026-05-23
C9301	OTHER	Obecabtagene Car Pos T	2	1	—	—	$639,975.00	$639,975.00	$639,975.00	2026-05-23
Q2057	OTHER	Afamitresgene Autoleucel	46	18	—	—	$762,913.80	$2,076,574.30	$824,563.40	2026-05-23
J3392	OTHER	Inj- Exagamglogene Autotem	38	17	—	—	$2,308,680.00	$3,868,788.00	$2,401,960.00	2026-05-23
J3399	OTHER	Inj Onase Abepar-xioi Treat	38	17	—	—	$2,430,559.50	$4,073,028.50	$2,528,763.93	2026-05-23
J3393	OTHER	Inj- Betibeglogene Autotemce	38	17	—	—	$2,916,282.60	$4,886,982.66	$3,034,112.20	2026-05-23
J3394	OTHER	Inj- Lovotibeglogene Autotem	36	17	—	—	$3,215,961.26	$3,605,774.75	$3,297,172.41	2026-05-23
J1413	OTHER	Inj Delandistrogene Mox Rokl	36	17	—	—	$3,283,297.96	$3,681,273.47	$3,366,209.53	2026-05-23
J1411	OTHER	Inj- Hemgenix- Per Tx Dose	36	17	—	—	$3,648,414.00	$4,090,646.00	$3,740,545.67	2026-05-23
J3391	OTHER	Inj- Atidarsagene Autotemcel	34	16	—	—	$4,459,950.00	$4,955,500.00	$4,505,000.00	2026-05-23

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