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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

WESTERLY HOSPITAL

Westerly, RI · CCN 410013 · Rates published

21,111 distinct procedures filed
20 distinct payers
540,199 rate rows
2026-01-01 last MRF observed
Data quality

458,750 of 540,199 rate rows are consumer-grade (84.9%)

81,449 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
placeholder amount (≤ $0.02) — excluded from medians 80,016
template filing: same amount across many unrelated codes — excluded 1,433
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.westerlyhospital.org/-/media/Files/YNHHS/sc/46-0543230-Westerly_Hospital_Standard_Charges-1.ashx
Found on page https://www.westerlyhospital.org/patients-visitors/billing-insurance/Pricing
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint bfce6a7deae6c45b… · 92,222,146 bytes · first seen 2026-05-09

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
73554-1111-1
CDM 		Lovotibeglogene Autotemcel 1.7 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 12 $1,392,052.00 $4,352,514.47 $2,777,576.95 nat. median
$2,614,157
1.1× median
51167-290-09
CDM 		Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 16 $987,907.87 $4,840,000.00 $2,568,983.25 nat. median
$4,394,564
0.6× median
51167-290-01
CDM 		Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 16 $987,907.87 $4,840,000.00 $2,568,983.25 nat. median
$4,394,564
0.6× median
73554-3111-1
CDM 		Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 12 $1,257,337.29 $3,931,303.39 $2,508,779.18 nat. median
$2,380,000
1.1× median
60923-514-23
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-537-46
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-534-43
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-521-30
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-536-45
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-518-27
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-559-68
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-512-21
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-526-35
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-503-12
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-510-19
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-540-49
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-509-18
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-519-28
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-561-70
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-502-11
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-532-41
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-524-33
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-520-29
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.36 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-515-24
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-504-13
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-516-25
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-517-26
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-535-44
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-527-36
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-529-38
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-538-47
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-539-48
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-544-53
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-530-39
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-545-54
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-505-14
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-525-34
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-528-37
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-546-55
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-522-31
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-523-32
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-531-40
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-507-16
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-506-15
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-511-20
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-541-50
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-513-22
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-501-10
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-533-42
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median
60923-508-17
CDM 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $431,087.07 $3,586,052.35 $1,300,135.02 nat. median
$1,917,628
0.7× median

Other procedures at this hospital

Browse this hospital's 21,111 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
0003-2328-22 CDM Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 20 20 $174,062.40 $62,662.46 64% off $15,632.51 $130,041.02 $47,146.79 2026-01-01
0003-7125-11 CDM Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 20 20 $73,189.20 $26,348.11 64% off $6,573.11 $54,679.23 $19,824.14 2026-01-01
0006-5087-01 CDM Sotatercept-csrk 45 Mg Subcutaneous 1 Syringe Kit 20 20 $140,000.00 $50,400.00 64% off $12,573.37 $104,593.19 $37,920.60 2026-01-01
0006-5088-01 CDM Sotatercept-csrk 60 Mg Subcutaneous 1 Syringe Kit 20 20 $140,000.00 $50,400.00 64% off $12,573.37 $104,593.19 $37,920.60 2026-01-01
0006-5090-01 CDM Sotatercept-csrk 45 Mg Subcutaneous 1 Syringe Kit 20 20 $70,000.00 $25,200.00 64% off $6,286.69 $52,296.60 $18,960.31 2026-01-01
0006-5091-01 CDM Sotatercept-csrk 60 Mg Subcutaneous 1 Syringe Kit 20 20 $70,000.00 $25,200.00 64% off $6,286.69 $52,296.60 $18,960.31 2026-01-01
0006-5331-01 CDM Belzutifan 40 Mg Tablet 20 20 $106,443.00 $38,319.48 64% off $9,559.63 $79,522.95 $28,831.31 2026-01-01
0008-0100-01 CDM Inotuzumab Ozogamicin 0.9 Mg IV Soln 20 20 $111,434.55 $40,116.44 64% off $10,007.92 $83,252.11 $30,183.33 2026-01-01
0074-1050-01 CDM Risankizumab-rzaa 150 Mg/ml Subcutaneous Syringe 20 20 $108,000.35 $38,880.13 64% off $9,699.49 $80,686.44 $29,253.14 2026-01-01
0074-1069-01 CDM Risankizumab-rzaa 360 Mg/2.4 Ml (150 Mg/ml) Subcut Wearable Injector 20 20 $101,881.66 $36,677.40 64% off $9,149.97 $76,115.20 $27,595.81 2026-01-01
0074-1070-01 CDM Risankizumab-rzaa 360 Mg/2.4 Ml (150 Mg/ml) Subcut Wearable Injector 20 20 $101,881.66 $36,677.40 64% off $9,149.97 $76,115.20 $27,595.81 2026-01-01
0074-2100-01 CDM Risankizumab-rzaa 150 Mg/ml Subcutaneous Pen Injector 20 20 $101,881.65 $36,677.39 64% off $9,149.97 $76,115.19 $27,595.81 2026-01-01
0078-0734-61 CDM Canakinumab (pf) 150 Mg/ml Subcutaneous Solution 20 20 $96,004.05 $34,561.46 64% off $8,622.11 $71,724.07 $26,003.79 2026-01-01
0078-0846-19 CDM Tisagenlecleucel (kymriah) Infusion- B All 20 20 $2,719,137.50 $978,889.50 64% off $244,205.21 $2,031,451.96 $736,509.55 2026-01-01
0078-0958-19 CDM Tisagenlecleucel (kymriah) Infusion - Fl And Lbcl 20 20 $2,719,137.50 $978,889.50 64% off $244,205.21 $2,031,451.96 $736,509.55 2026-01-01
0169-7208-01 CDM Coagulation Factor Viia Recomb 8 Mg (8,000 Mcg) Intravenous Solution 20 20 $85,926.15 $30,933.41 64% off $7,717.01 $64,194.93 $23,274.08 2026-01-01
0187-0010-50 CDM Sodium Benzoate 10 %-sodium Phenylacetate 10 % Intravenous Solution 20 20 $228,303.50 $82,189.26 64% off $20,503.89 $170,564.23 $61,838.62 2026-01-01
0310-4535-30 CDM Tremelimumab-actl 20 Mg/ml Intravenous Solution 20 20 $198,900.00 $71,604.00 64% off $17,863.17 $148,597.04 $53,874.35 2026-01-01
0597-0035-10 CDM Spesolimab-sbzo 60 Mg/ml Intravenous Solution 20 20 $130,389.15 $46,940.09 64% off $11,710.22 $97,412.98 $35,317.40 2026-01-01
0823T CPT Hc Tcat Ins 1chmbr Ldls Pm Ra 19 19 $77,996.56 $28,078.76 64% off $9,251.60 $66,297.08 $21,335.68 2026-01-01
0825T CPT Hc Tcat Rmv&rpl1chmb Ldls Pm Ra 19 19 $77,996.56 $28,078.76 64% off $9,251.60 $66,297.08 $21,335.68 2026-01-01
157 MS_DRG Dental And Oral Diseases With Mcc 20 20 $893,008.00 $321,482.88 64% off $151,877.42 $579,879.94 $321,482.88 2026-01-01
163 MS_DRG Major Chest Procedures With Mcc 20 20 $64,043.98 $23,055.83 64% off $10,892.21 $41,587.33 $23,055.83 2026-01-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 20 20 $90,277.15 $32,499.77 64% off $15,353.79 $58,621.99 $32,499.77 2026-01-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 20 20 $63,206.91 $22,754.49 64% off $10,749.85 $41,043.78 $22,754.49 2026-01-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 20 20 $53,344.37 $19,203.97 64% off $9,072.49 $34,639.48 $19,203.97 2026-01-01
180 MS_DRG Respiratory Neoplasms With Mcc 20 20 $62,206.44 $22,394.32 64% off $10,579.70 $40,394.12 $22,394.32 2026-01-01
196 MS_DRG Interstitial Lung Disease With Mcc 20 20 $71,494.48 $25,738.01 64% off $12,159.35 $46,425.36 $25,738.01 2026-01-01
199 MS_DRG Pneumothorax With Mcc 20 20 $61,595.03 $22,174.21 64% off $10,475.71 $39,997.09 $22,174.21 2026-01-01
205 MS_DRG Other Respiratory System Diagnoses With Mcc 20 20 $73,465.99 $26,447.76 64% off $12,494.65 $47,705.57 $26,447.76 2026-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support Greater Than 96 Hours 20 20 $119,131.33 $42,887.28 64% off $20,261.14 $77,358.62 $42,887.28 2026-01-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support Less Than =96 Hours 20 20 $147,092.13 $52,953.17 64% off $25,016.54 $95,515.13 $52,953.17 2026-01-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 20 20 $86,993.12 $31,317.52 64% off $14,795.27 $56,489.49 $31,317.52 2026-01-01
24338-150-01 CDM Triptorelin Pamoate (pediatric) 22.5 Mg IM Suspension 20 20 $101,004.35 $36,361.57 64% off $9,071.18 $75,459.77 $27,358.19 2026-01-01
24338-150-20 CDM Triptorelin Pamoate (pediatric) 22.5 Mg IM Suspension 20 20 $101,004.35 $36,361.57 64% off $9,071.18 $75,459.77 $27,358.19 2026-01-01
25682-028-01 CDM Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 20 20 $117,406.63 $42,266.39 64% off $10,544.27 $87,713.82 $31,800.93 2026-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 20 20 $68,095.74 $24,514.47 64% off $11,581.31 $44,218.37 $24,514.47 2026-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 20 20 $91,993.08 $33,117.51 64% off $15,645.63 $59,736.24 $33,117.51 2026-01-01
286 MS_DRG Circulatory Disorders Except Ami With Cardiac Catheterization With Mcc 20 20 $135,159.27 $48,657.34 64% off $22,987.07 $87,766.46 $48,657.34 2026-01-01
30237-8900-6 CDM Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 20 20 $354,080.00 $127,468.80 64% off $31,799.86 $264,531.13 $95,906.62 2026-01-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 20 20 $58,893.91 $21,201.81 64% off $10,016.32 $38,243.10 $21,201.81 2026-01-01
326 MS_DRG Stomach Esophageal And Duodenal Procedures With Mcc 20 20 $123,677.36 $44,523.85 64% off $21,034.30 $80,310.62 $44,523.85 2026-01-01
327 MS_DRG Stomach Esophageal And Duodenal Procedures With Cc 20 20 $56,864.15 $20,471.09 64% off $9,671.11 $36,925.07 $20,471.09 2026-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 20 20 $119,109.90 $42,879.56 64% off $20,257.49 $77,344.70 $42,879.56 2026-01-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 20 20 $79,676.75 $28,683.63 64% off $13,550.94 $51,738.56 $28,683.63 2026-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 20 20 $92,171.72 $33,181.82 64% off $15,676.01 $59,852.24 $33,181.82 2026-01-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 20 20 $71,231.26 $25,643.26 64% off $12,114.58 $46,254.44 $25,643.26 2026-01-01
33902 CPT Hc Perq P-art Revsc 1 Abnor Uni 19 19 $70,885.78 $25,518.88 64% off $8,408.15 $60,252.91 $19,390.55 2026-01-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 20 20 $63,174.61 $22,742.86 64% off $10,744.36 $41,022.80 $22,742.86 2026-01-01
345 MS_DRG Minor Small And Large Bowel Procedures With Cc 20 20 $66,315.23 $23,873.48 64% off $11,278.50 $43,062.18 $23,873.48 2026-01-01
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc-mcc 20 20 $56,915.29 $20,489.50 64% off $9,679.81 $36,958.27 $20,489.50 2026-01-01
347 MS_DRG Anal And Stomal Procedures With Mcc 20 20 $64,054.44 $23,059.60 64% off $10,893.99 $41,594.12 $23,059.60 2026-01-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 20 20 $57,282.36 $20,621.65 64% off $9,742.24 $37,196.63 $20,621.65 2026-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 20 20 $68,433.96 $24,636.23 64% off $11,638.84 $44,437.99 $24,636.23 2026-01-01
358 MS_DRG Other Digestive System O.r. Procedures Without Cc-mcc 20 20 $66,360.93 $23,889.93 64% off $11,286.27 $43,091.86 $23,889.93 2026-01-01
36836 CPT Hc Prq Av Fstl Crtj Uxtr 1 Acs 20 20 $70,885.78 $25,518.88 64% off $6,366.24 $52,958.36 $19,200.22 2026-01-01
36837 CPT Hc Prq Av Fstl Crt Uxtr Sep Acs 20 20 $70,885.78 $25,518.88 64% off $6,366.24 $52,958.36 $19,200.22 2026-01-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 20 20 $65,906.77 $23,726.44 64% off $11,209.03 $42,796.95 $23,726.44 2026-01-01
374 MS_DRG Digestive Malignancy With Mcc 20 20 $70,424.55 $25,352.84 64% off $11,977.38 $45,730.59 $25,352.84 2026-01-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 20 20 $55,687.20 $20,047.39 64% off $9,470.94 $36,160.80 $20,047.39 2026-01-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 20 20 $90,776.94 $32,679.70 64% off $15,438.80 $58,946.53 $32,679.70 2026-01-01
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 20 20 $63,856.85 $22,988.47 64% off $10,860.39 $41,465.82 $22,988.47 2026-01-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 20 20 $72,863.13 $26,230.73 64% off $12,392.12 $47,314.10 $26,230.73 2026-01-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 20 20 $54,197.38 $19,511.06 64% off $9,217.56 $35,193.38 $19,511.06 2026-01-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 20 $81,292.68 $29,265.36 64% off $13,825.77 $52,787.87 $29,265.36 2026-01-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 20 $75,607.80 $27,218.81 64% off $12,858.92 $49,096.36 $27,218.81 2026-01-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 20 20 $64,364.14 $23,171.09 64% off $10,946.67 $41,795.23 $23,171.09 2026-01-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 20 20 $53,329.80 $19,198.73 64% off $9,070.01 $34,630.01 $19,198.73 2026-01-01
441 MS_DRG Disorders Of Liver Except Malignancy Cirrhosis Or Alcoholic Hepatitis With Mcc 20 20 $97,608.76 $35,139.15 64% off $16,600.71 $63,382.82 $35,139.15 2026-01-01
444 MS_DRG Disorders Of The Biliary Tract With Mcc 20 20 $65,099.26 $23,435.73 64% off $11,071.69 $42,272.58 $23,435.73 2026-01-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 20 20 $89,542.84 $32,235.42 64% off $15,228.91 $58,145.16 $32,235.42 2026-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 20 $89,824.59 $32,336.85 64% off $15,276.82 $58,328.12 $32,336.85 2026-01-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 20 $87,254.25 $31,411.53 64% off $14,839.68 $56,659.05 $31,411.53 2026-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 20 20 $95,937.01 $34,537.32 64% off $16,316.39 $62,297.26 $34,537.32 2026-01-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 20 20 $155,389.85 $55,940.35 64% off $26,427.77 $100,903.30 $55,940.35 2026-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 20 20 $133,716.28 $48,137.86 64% off $22,741.66 $86,829.44 $48,137.86 2026-01-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 20 20 $114,015.84 $41,045.70 64% off $19,391.13 $74,036.85 $41,045.70 2026-01-01
47783-101-01 CDM Ecallantide 10 Mg/ml (1 Ml) Subcutaneous Solution 20 20 $81,235.65 $29,244.83 64% off $7,295.76 $60,690.69 $22,003.60 2026-01-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 20 20 $56,941.08 $20,498.79 64% off $9,684.20 $36,975.02 $20,498.79 2026-01-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 20 20 $73,829.37 $26,578.57 64% off $12,556.45 $47,941.53 $26,578.57 2026-01-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 20 20 $59,405.55 $21,386.00 64% off $10,103.34 $38,575.34 $21,386.00 2026-01-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 20 20 $66,624.50 $23,984.82 64% off $11,331.09 $43,263.01 $23,984.82 2026-01-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip Foot And Femur With Cc 20 20 $55,770.28 $20,077.30 64% off $9,485.07 $36,214.76 $20,077.30 2026-01-01
501 MS_DRG Soft Tissue Procedures With Cc 20 20 $97,331.70 $35,039.41 64% off $16,553.59 $63,202.91 $35,039.41 2026-01-01
50242-105-01 CDM Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution 20 20 $89,217.30 $32,118.23 64% off $8,012.59 $66,653.73 $24,165.53 2026-01-01
50242-142-01 CDM Mosunetuzumab-axgb 1 Mg/ml Intravenous Solution 20 20 $90,654.75 $32,635.71 64% off $8,141.69 $67,727.64 $24,554.88 2026-01-01
50242-150-01 CDM Ocrelizumab 30 Mg/ml Intravenous Solution 20 20 $97,339.75 $35,042.31 64% off $8,742.06 $72,721.97 $26,365.58 2026-01-01
50242-554-01 CDM Ocrelizumab 920 Mg-hyaluronidase-ocsq 23,000 Unit/23 Ml Subcut Soln 20 20 $197,144.96 $70,972.19 64% off $17,705.55 $147,285.86 $53,398.97 2026-01-01
50242-923-01 CDM Emicizumab-kxwh 150 Mg/ml Subcutaneous Solution 20 20 $73,865.05 $26,591.42 64% off $6,633.81 $55,184.15 $20,007.19 2026-01-01
504 MS_DRG Foot Procedures With Cc 20 20 $62,412.25 $22,468.41 64% off $10,614.70 $40,527.75 $22,468.41 2026-01-01
50419-208-01 CDM Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln 20 20 $90,256.68 $32,492.40 64% off $8,105.93 $67,430.25 $24,447.06 2026-01-01
50633-210-11 CDM Glucarpidase 1,000 Unit Intravenous Solution 20 20 $205,870.00 $74,113.20 64% off $18,489.14 $153,804.29 $55,762.25 2026-01-01
51167-290-01 CDM Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 16 16 — $3,960,000.00 $987,907.87 $4,840,000.00 $2,568,983.25 2026-01-01
51167-290-09 CDM Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 16 16 — $3,960,000.00 $987,907.87 $4,840,000.00 $2,568,983.25 2026-01-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 20 20 $99,045.22 $35,656.28 64% off $16,845.02 $64,315.59 $35,656.28 2026-01-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 20 20 $58,084.85 $20,910.54 64% off $9,878.72 $37,717.73 $20,910.54 2026-01-01
540 MS_DRG Osteomyelitis With Cc 20 20 $56,445.79 $20,320.48 64% off $9,599.96 $36,653.40 $20,320.48 2026-01-01
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 20 20 $91,190.50 $32,828.58 64% off $15,509.13 $59,215.08 $32,828.58 2026-01-01
55513-069-01 CDM Tarlatamab-dlle 10 Mg Intravenous Solution 20 20 $75,000.00 $27,000.00 64% off $6,735.74 $56,032.07 $20,314.61 2026-01-01
55513-077-01 CDM Tarlatamab-dlle 10 Mg Intravenous Solution 20 20 $75,000.00 $27,000.00 64% off $6,735.74 $56,032.07 $20,314.61 2026-01-01
55566-1050-0 CDM Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension 20 20 $76,125.00 $27,405.00 64% off $6,836.77 $56,872.55 $20,619.33 2026-01-01
55566-1050-1 CDM Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension 20 20 $76,125.00 $27,405.00 64% off $6,836.77 $56,872.55 $20,619.33 2026-01-01
559 MS_DRG Aftercare Musculoskeletal System And Connective Tissue With Mcc 20 20 $77,876.04 $28,035.37 64% off $13,244.69 $50,569.26 $28,035.37 2026-01-01
562 MS_DRG Fracture Sprain Strain And Dislocation Except Femur Hip Pelvis And Thigh With Mc… 20 20 $72,626.13 $26,145.41 64% off $12,351.81 $47,160.20 $26,145.41 2026-01-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 20 20 $91,385.97 $32,898.95 64% off $15,542.38 $59,342.01 $32,898.95 2026-01-01
570 MS_DRG Skin Debridement With Mcc 20 20 $87,239.82 $31,406.34 64% off $14,837.22 $56,649.68 $31,406.34 2026-01-01
57894-061-03 CDM Ustekinumab 90 Mg/ml Subcutaneous Syringe 20 20 $134,968.20 $48,588.55 64% off $12,121.47 $100,833.96 $36,557.68 2026-01-01
57894-111-01 CDM Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension 20 20 $2,610,277.50 $939,699.90 64% off $234,428.52 $1,950,123.28 $707,023.58 2026-01-01
57894-111-02 CDM Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension 20 20 $2,610,277.50 $939,699.90 64% off $234,428.52 $1,950,123.28 $707,023.58 2026-01-01
57894-651-11 CDM Guselkumab 200 Mg/2 Ml Subcutaneous Syringe 20 20 $70,283.05 $25,301.90 64% off $6,312.11 $52,508.06 $19,036.97 2026-01-01
57894-651-22 CDM Guselkumab 200 Mg/2 Ml Subcutaneous Syringe 20 20 $70,283.05 $25,301.90 64% off $6,312.11 $52,508.06 $19,036.97 2026-01-01
579 MS_DRG Other Skin Subcutaneous Tissue And Breast Procedures With Mcc 20 20 $63,789.30 $22,964.15 64% off $10,848.90 $41,421.95 $22,964.15 2026-01-01
58468-0200-1 CDM Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 20 20 $147,248.70 $53,009.53 64% off $13,224.38 $110,008.66 $39,884.00 2026-01-01
59572-515-01 CDM Idecabtagene Vicleucel (abecma) Infusion - Mm 20 20 $2,641,562.15 $950,962.37 64% off $237,238.19 $1,973,495.87 $715,497.39 2026-01-01
59572-515-02 CDM Idecabtagene Vicleucel (abecma) Infusion - Mm 20 20 $2,641,562.15 $950,962.37 64% off $237,238.19 $1,973,495.87 $715,497.39 2026-01-01
59572-515-03 CDM Idecabtagene Vicleucel (abecma) Infusion - Mm 20 20 $2,641,562.15 $950,962.37 64% off $237,238.19 $1,973,495.87 $715,497.39 2026-01-01
597 MS_DRG Malignant Breast Disorders With Mcc 20 20 $61,983.72 $22,314.14 64% off $10,541.82 $40,249.49 $22,314.14 2026-01-01
602 MS_DRG Cellulitis With Mcc 20 20 $62,100.29 $22,356.11 64% off $10,561.64 $40,325.19 $22,356.11 2026-01-01
604 MS_DRG Trauma To The Skin Subcutaneous Tissue And Breast With Mcc 20 20 $57,594.99 $20,734.20 64% off $9,795.41 $37,399.64 $20,734.20 2026-01-01
60923-501-10 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-502-11 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-503-12 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-504-13 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-505-14 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-506-15 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-507-16 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-508-17 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-509-18 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-510-19 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-511-20 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-512-21 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-513-22 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-514-23 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-515-24 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-516-25 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-517-26 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-518-27 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-519-28 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-520-29 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-521-30 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-522-31 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-523-32 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-524-33 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-525-34 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-526-35 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-527-36 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-528-37 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-529-38 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-530-39 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-531-40 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-532-41 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-533-42 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-534-43 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-535-44 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-536-45 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-537-46 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-538-47 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-539-48 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-540-49 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-541-50 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-542-51 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-543-52 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-544-53 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-545-54 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-546-55 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-547-56 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-548-57 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-549-58 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-550-59 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-551-60 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-552-61 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-553-62 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-554-63 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-555-64 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-556-65 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-557-66 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-558-67 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-559-68 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
60923-560-69 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $431,087.07 $3,586,052.35 $1,300,135.02 2026-01-01
60923-561-70 CDM Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $431,087.07 $3,586,052.36 $1,300,135.02 2026-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine Nutritional And Metabolic Disorders With … 20 20 $76,520.25 $27,547.29 64% off $13,014.10 $49,688.87 $27,547.29 2026-01-01
617 MS_DRG Amputation Of Lower Limb For Endocrine Nutritional And Metabolic Disorders With … 20 20 $58,011.59 $20,884.17 64% off $9,866.26 $37,670.16 $20,884.17 2026-01-01
61755-010-01 CDM Evinacumab-dgnb 150 Mg/ml Intravenous Solution 20 20 $219,348.50 $78,965.46 64% off $19,699.65 $163,874.00 $59,413.06 2026-01-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine Nutritional And Metabolic Disord… 20 20 $75,578.54 $27,208.27 64% off $12,853.94 $49,077.36 $27,208.27 2026-01-01
62935-153-50 CDM Leuprolide 45 Mg (pediatric 6 Month) Subcutaneous Syringe 20 20 $119,098.95 $42,875.62 64% off $10,696.25 $88,978.14 $32,259.32 2026-01-01
62935-154-50 CDM Leuprolide 45 Mg (pediatric 6 Month) Subcutaneous Syringe 20 20 $119,098.95 $42,875.62 64% off $10,696.25 $88,978.14 $32,259.32 2026-01-01
62935-163-60 CDM Leuprolide 45 Mg (pediatric 6 Month) Subcutaneous Syringe 20 20 $129,047.80 $46,457.21 64% off $11,589.76 $96,410.87 $34,954.07 2026-01-01
63004-8710-1 CDM Corticotropin 80 Unit/ml Injection Gel 20 20 $219,920.00 $79,171.20 64% off $19,750.97 $164,300.97 $59,567.85 2026-01-01
637 MS_DRG Diabetes With Mcc 20 20 $56,851.29 $20,466.46 64% off $9,668.93 $36,916.72 $20,466.46 2026-01-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 20 20 $54,636.04 $19,668.97 64% off $9,292.17 $35,478.23 $19,668.97 2026-01-01
642 MS_DRG Inborn And Other Disorders Of Metabolism 20 20 $123,671.69 $44,521.81 64% off $21,033.34 $80,306.93 $44,521.81 2026-01-01
64406-058-01 CDM Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 20 20 $355,094.63 $127,834.07 64% off $31,890.98 $265,289.15 $96,181.45 2026-01-01
653 MS_DRG Major Bladder Procedures With Mcc 20 20 $206,305.53 $74,269.99 64% off $35,087.20 $133,965.70 $74,269.99 2026-01-01
654 MS_DRG Major Bladder Procedures With Cc 20 20 $74,831.89 $26,939.48 64% off $12,726.96 $48,592.52 $26,939.48 2026-01-01
662 MS_DRG Minor Bladder Procedures With Mcc 20 20 $61,843.37 $22,263.61 64% off $10,517.95 $40,158.35 $22,263.61 2026-01-01
66302-014-01 CDM Dinutuximab 3.5 Mg/ml Intravenous Solution 20 20 $86,657.30 $31,196.63 64% off $7,782.68 $64,741.17 $23,472.12 2026-01-01
66302-110-01 CDM Treprostinil Sodium 10 Mg/ml Injection Solution 20 20 $79,583.00 $28,649.88 64% off $7,147.33 $59,456.00 $21,555.97 2026-01-01
66658-505-01 CDM Emapalumab-lzsg 5 Mg/ml Intravenous Solution 20 20 $83,369.95 $30,013.18 64% off $7,487.44 $62,285.21 $22,581.71 2026-01-01
669 MS_DRG Transurethral Procedures With Cc 20 20 $76,631.92 $27,587.49 64% off $13,033.10 $49,761.38 $27,587.49 2026-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 20 20 $111,438.07 $40,117.71 64% off $18,952.72 $72,362.96 $40,117.71 2026-01-01
67979-002-01 CDM Histrelin 50 Mg (65 Mcg/day) Implant Kit 20 20 $243,836.85 $87,781.27 64% off $21,898.94 $182,169.11 $66,046.01 2026-01-01
69488-003-01 CDM Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution 20 20 $137,000.00 $49,320.00 64% off $12,303.94 $102,351.91 $37,108.02 2026-01-01
69488-003-70 CDM Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution 20 20 $137,000.00 $49,320.00 64% off $12,303.94 $102,351.91 $37,108.02 2026-01-01
69488-010-61 CDM Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln 20 20 $130,050.00 $46,818.00 64% off $11,679.77 $97,159.61 $35,225.54 2026-01-01
69866-1030-5 CDM Autol Chondrocyte-collag,porc 500,000 Cell/cm2 (3 X 5 Cm)implant Sheet 20 20 $260,000.00 $93,600.00 64% off $23,350.55 $194,244.50 $70,423.98 2026-01-01
707 MS_DRG Major Male Pelvic Procedures With Cc-mcc 20 20 $53,848.08 $19,385.31 64% off $9,158.16 $34,966.56 $19,385.31 2026-01-01
71104-983-01 CDM Antihemophil Rfviii Fc-vwf-xten,bdd-ehtl 3,000 (+/-) Unit IV Solution 20 20 $77,100.00 $27,756.00 64% off $6,924.34 $57,600.97 $20,883.42 2026-01-01
71104-984-01 CDM Antihemophil Rfviii Fc-vwf-xten,bdd-ehtl 4,000 (+/-) Unit IV Solution 20 20 $102,800.00 $37,008.00 64% off $9,232.45 $76,801.29 $27,844.56 2026-01-01
71104-990-08 CDM Antihemophil Rfviii Fc-vwf-xten,bdd-ehtl 3,000 (+/-) Unit IV Solution 20 20 $77,100.00 $27,756.00 64% off $6,924.34 $57,600.97 $20,883.42 2026-01-01
71104-991-08 CDM Antihemophil Rfviii Fc-vwf-xten,bdd-ehtl 4,000 (+/-) Unit IV Solution 20 20 $102,800.00 $37,008.00 64% off $9,232.45 $76,801.29 $27,844.56 2026-01-01
71287-119-01 CDM Axicabtagene Ciloleucel (yescarta) Infusion - Fl And Lbcl 20 20 $2,120,000.00 $763,200.00 64% off $190,396.79 $1,583,839.79 $574,226.30 2026-01-01
71287-119-02 CDM Axicabtagene Ciloleucel (yescarta) Infusion - Fl And Lbcl 20 20 $2,120,000.00 $763,200.00 64% off $190,396.79 $1,583,839.79 $574,226.30 2026-01-01
71287-219-01 CDM Brexucabtagene Autoleucel (tecartus) Infusion - Mcl 20 20 $2,310,000.00 $831,600.00 64% off $207,460.65 $1,725,787.69 $625,689.97 2026-01-01
71287-219-02 CDM Brexucabtagene Autoleucel (tecartus) Infusion - Mcl 20 20 $2,120,000.00 $763,200.00 64% off $190,396.79 $1,583,839.79 $574,226.30 2026-01-01
71287-220-01 CDM Brexucabtagene Autoleucel (tecartus) Infusion - B-all 20 20 $2,310,000.00 $831,600.00 64% off $207,460.65 $1,725,787.69 $625,689.97 2026-01-01
71287-220-02 CDM Brexucabtagene Autoleucel (tecartus) Infusion - B-all 20 20 $2,120,000.00 $763,200.00 64% off $190,396.79 $1,583,839.79 $574,226.30 2026-01-01
71336-1001-1 CDM Givosiran 189 Mg/ml Subcutaneous Solution 20 20 $213,080.00 $76,708.80 64% off $19,136.67 $159,190.84 $57,715.16 2026-01-01
71336-1003-1 CDM Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 20 20 $298,377.50 $107,415.90 64% off $26,797.23 $222,916.11 $80,818.96 2026-01-01
717 MS_DRG Other Male Reproductive System O.r. Procedures Except Malignancy With Cc-mcc 20 20 $54,833.88 $19,740.20 64% off $9,325.82 $35,606.70 $19,740.20 2026-01-01
71879-001-01 CDM Dexamethasone (pf) 9 % Intraocular Suspension 20 20 $235,025.00 $84,609.00 64% off $21,107.55 $175,585.82 $63,659.21 2026-01-01
71894-120-02 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-121-03 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-122-03 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-123-03 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-124-04 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-125-04 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-126-04 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-127-05 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-128-05 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-129-05 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-130-06 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-131-06 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-132-06 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-133-07 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-134-07 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-135-07 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-136-08 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-137-08 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-138-08 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-139-09 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-140-09 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
71894-141-09 CDM Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $312,813.53 $2,602,178.95 $943,428.49 2026-01-01
72187-0401-1 CDM Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 20 20 $160,745.95 $57,868.54 64% off $14,436.56 $120,092.37 $43,539.89 2026-01-01
72493-101-40 CDM Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit 20 20 $113,300.00 $40,788.00 64% off $10,175.45 $84,645.78 $30,688.60 2026-01-01
72493-103-03 CDM Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit 20 20 $116,135.00 $41,808.60 64% off $10,430.06 $86,763.79 $31,456.50 2026-01-01
72694-515-01 CDM Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 20 20 $128,920.50 $46,411.38 64% off $11,578.33 $96,315.76 $34,919.60 2026-01-01
72694-954-01 CDM Pegaspargase 750 Unit/ml Injection Solution 20 20 $127,691.25 $45,968.85 64% off $11,467.93 $95,397.40 $34,586.64 2026-01-01
72893-005-01 CDM Pralatrexate 40 Mg/2 Ml (20 Mg/ml) Intravenous Solution 20 20 $70,337.15 $25,321.37 64% off $6,316.97 $52,548.48 $19,051.62 2026-01-01
72893-007-04 CDM Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous 20 20 $114,000.01 $41,040.00 64% off $10,238.32 $85,168.75 $30,878.21 2026-01-01
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 20 20 $72,294.18 $26,025.91 64% off $12,295.36 $46,944.65 $26,025.91 2026-01-01
73153-901-08 CDM Lisocabtagene Maraleucel (breyanzi) Cd8 Injection - Lbcl 20 20 $2,656,752.00 $956,430.72 64% off $238,602.38 $1,984,844.11 $719,611.73 2026-01-01
73372-0116-1 CDM Afamelanotide 16 Mg Subcutaneous Implant 20 20 $216,855.00 $78,067.80 64% off $19,475.71 $162,011.12 $58,737.66 2026-01-01
73554-1111-1 CDM Lovotibeglogene Autotemcel 1.7 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 12 12 — — $1,392,052.00 $4,352,514.47 $2,777,576.95 2026-01-01
73554-3111-1 CDM Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 12 12 — — $1,257,337.29 $3,931,303.39 $2,508,779.18 2026-01-01
73650-316-01 CDM Teplizumab-mzwv 1 Mg/ml Intravenous Solution 20 20 $72,054.80 $25,939.73 64% off $6,471.23 $53,831.73 $19,516.86 2026-01-01
73650-316-10 CDM Teplizumab-mzwv 1 Mg/ml Intravenous Solution 20 20 $72,054.80 $25,939.73 64% off $6,471.23 $53,831.73 $19,516.86 2026-01-01
73650-316-14 CDM Teplizumab-mzwv 1 Mg/ml Intravenous Solution 20 20 $72,054.80 $25,939.73 64% off $6,471.23 $53,831.73 $19,516.86 2026-01-01
73776-001-11 CDM Lifileucel 7.5 X 10exp9 To 72 X 10exp9 Cell Intravenous Suspension 20 20 $2,810,000.00 $1,011,600.00 64% off $252,365.56 $2,099,334.81 $761,120.71 2026-01-01
75987-080-10 CDM Pegloticase 8 Mg/ml Intravenous Solution 20 20 $139,802.80 $50,329.01 64% off $12,555.66 $104,445.87 $37,867.19 2026-01-01
75987-130-15 CDM Teprotumumab-trbw 500 Mg Intravenous Solution 20 20 $80,886.15 $29,119.01 64% off $7,264.37 $60,429.58 $21,908.94 2026-01-01
75987-150-01 CDM Inebilizumab-cdon 10 Mg/ml Intravenous Solution 20 20 $228,492.15 $82,257.17 64% off $20,520.84 $170,705.17 $61,889.72 2026-01-01
76128-155-75 CDM Porfimer 75 Mg Intravenous Solution 20 20 $116,615.00 $41,981.40 64% off $10,473.17 $87,122.39 $31,586.50 2026-01-01
79952-110-01 CDM Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution 20 20 $135,116.30 $48,641.87 64% off $12,134.77 $100,944.61 $36,597.80 2026-01-01
80446-401-01 CDM Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution 20 20 $100,033.75 $36,012.15 64% off $8,984.01 $74,734.64 $27,095.29 2026-01-01
810 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 20 20 $67,281.84 $24,221.46 64% off $11,442.89 $43,689.85 $24,221.46 2026-01-01
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 20 20 $52,987.88 $19,075.64 64% off $9,011.86 $34,407.99 $19,075.64 2026-01-01
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 20 20 $70,754.98 $25,471.79 64% off $12,033.58 $45,945.16 $25,471.79 2026-01-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 20 20 $73,727.71 $26,541.98 64% off $12,539.17 $47,875.52 $26,541.98 2026-01-01
82705-010-01 CDM Epcoritamab-bysp 48 Mg/0.8 Ml Subcutaneous Solution 20 20 $78,211.80 $28,156.25 64% off $7,024.19 $58,431.59 $21,184.57 2026-01-01
83047-410-04 CDM Obecabtagene Autoleucel (aucatzyl) - B-all Infusion (drops Charge) 20 20 $2,625,000.00 $945,000.00 64% off $235,750.74 $1,961,122.38 $711,011.34 2026-01-01
834 MS_DRG Acute Leukemia With Mcc 20 20 $75,386.80 $27,139.25 64% off $12,821.33 $48,952.86 $27,139.25 2026-01-01
835 MS_DRG Acute Leukemia With Cc 20 20 $97,247.82 $35,009.22 64% off $16,539.32 $63,148.44 $35,009.22 2026-01-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 20 20 $78,597.93 $28,295.26 64% off $13,367.46 $51,038.02 $28,295.26 2026-01-01
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 20 20 $63,565.43 $22,883.55 64% off $10,810.83 $41,276.58 $22,883.55 2026-01-01
842 MS_DRG Lymphoma And Non-acute Leukemia Without Cc-mcc 20 20 $55,463.46 $19,966.85 64% off $9,432.89 $36,015.52 $19,966.85 2026-01-01
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 20 20 $88,227.06 $31,761.74 64% off $15,005.13 $57,290.75 $31,761.74 2026-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 20 20 $102,868.97 $37,032.83 64% off $17,495.34 $66,798.56 $37,032.83 2026-01-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 20 20 $73,467.66 $26,448.36 64% off $12,494.94 $47,706.66 $26,448.36 2026-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 20 20 $74,673.66 $26,882.52 64% off $12,700.05 $48,489.77 $26,882.52 2026-01-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 20 20 $57,377.94 $20,656.06 64% off $9,758.50 $37,258.70 $20,656.06 2026-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv Greater Than 96 Hours 20 20 $187,545.89 $67,516.52 64% off $31,896.68 $121,784.01 $67,516.52 2026-01-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv Greater Than 96 Hours With Mcc 20 20 $56,839.85 $20,462.35 64% off $9,666.98 $36,909.29 $20,462.35 2026-01-01
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 20 20 $65,739.65 $23,666.28 64% off $11,180.60 $42,688.43 $23,666.28 2026-01-01
881 MS_DRG Depressive Neuroses 20 20 $54,103.98 $19,477.43 64% off $9,201.68 $35,132.73 $19,477.43 2026-01-01
882 MS_DRG Neuroses Except Depressive 20 20 $98,345.64 $35,404.43 64% off $16,726.03 $63,861.31 $35,404.43 2026-01-01
883 MS_DRG Disorders Of Personality And Impulse Control 20 20 $82,152.41 $29,574.87 64% off $13,971.99 $53,346.15 $29,574.87 2026-01-01
884 MS_DRG Organic Disturbances And Intellectual Disability 20 20 $62,808.67 $22,611.12 64% off $10,682.12 $40,785.17 $22,611.12 2026-01-01
885 MS_DRG Psychoses 20 20 $79,725.35 $28,701.12 64% off $13,559.21 $51,770.12 $28,701.12 2026-01-01
896 MS_DRG Alcohol Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 20 20 $55,963.80 $20,146.97 64% off $9,517.99 $36,340.42 $20,146.97 2026-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 20 20 $70,193.57 $25,269.69 64% off $11,938.10 $45,580.60 $25,269.69 2026-01-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 20 20 $55,252.62 $19,890.94 64% off $9,397.03 $35,878.61 $19,890.94 2026-01-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 20 20 $171,754.14 $61,831.49 64% off $29,210.91 $111,529.55 $61,831.49 2026-01-01
956 MS_DRG Limb Reattachment Hip And Femur Procedures For Multiple Significant Trauma 20 20 $62,198.43 $22,391.43 64% off $10,578.33 $40,388.91 $22,391.43 2026-01-01
974 MS_DRG HIV With Major Related Condition With Mcc 20 20 $78,054.17 $28,099.50 64% off $13,274.98 $50,684.93 $28,099.50 2026-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 20 20 $96,247.79 $34,649.20 64% off $16,369.24 $62,499.06 $34,649.20 2026-01-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 20 20 $61,821.65 $22,255.79 64% off $10,514.25 $40,144.25 $22,255.79 2026-01-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 20 20 $71,873.42 $25,874.43 64% off $12,223.80 $46,671.43 $25,874.43 2026-01-01
988 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 20 20 $65,578.52 $23,608.27 64% off $11,153.20 $42,583.79 $23,608.27 2026-01-01
99999-081-14 CDM Teplizumab-mzwv 100 Mcg/ml Intravenous Solution 20 20 $72,055.00 $25,939.80 64% off $6,471.25 $53,831.88 $19,516.92 2026-01-01
99999-2227-29 CDM Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous 20 20 $114,000.00 $41,040.00 64% off $10,238.32 $85,168.74 $30,878.21 2026-01-01
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