Hospital

MCLEOD MEDICAL CENTER - DILLON

Dillon, SC · CCN 420005 · Rates published

10,741 distinct procedures filed

16 distinct payers

218,220 rate rows

2026-05-24 last MRF observed

Data quality

216,354 of 218,220 rate rows are consumer-grade (99.1%)

1,866 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
template filing: same amount across many unrelated codes — excluded	1,436
placeholder amount (≤ $0.02) — excluded from medians	116
percent-of-charges filed in the dollar field — excluded from medians	110
per-diem day rate — not a per-procedure price	100
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	72
exceeds 10× this hospital's gross charge — excluded from medians	32

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

Source MRF file	https://www.mcleodhealth.org/wp-content/uploads/price-transparency/51-0473471_mcleod-health-dillon_standardcharges.csv
Found on page	https://www.mcleodhealth.org/about-us/price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	5102a53ab0fd2030… · 184,362,425 bytes · first seen 2026-05-05

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
9138 OTHER	Inj, Hemgenix, Per Tx Dose	10	$3,685,266.67	$3,943,235.33	$3,832,677.33	nat. median $3,746,358 1.0× median
9141 OTHER	Inj Onase Abepar-xioi Treat	11	$2,455,110.61	$4,787,465.68	$2,614,692.79	nat. median $2,588,981 1.0× median
2067 OTHER	Afamitresgene Autoleucel	11	$701,541.62	$1,368,006.17	$747,141.83	nat. median $786,032 1.0× median
583-4 OTHER	Neonate With Ecmo	5	$633,496.02	$665,170.82	$652,500.90	nat. median $309,400 outlier · 2.1×
9194 OTHER	Tisagenlecleucel Car-pos T	11	$591,726.20	$1,153,866.09	$630,188.40	nat. median $566,531 1.1× median
9498 OTHER	Ciltacabtagene Car-pos T	11	$565,868.95	$1,103,444.44	$602,650.43	nat. median $587,650 1.0× median
9413 OTHER	Lisocabtagene Car Pos T	11	$562,538.19	$1,096,949.46	$599,103.17	nat. median $562,201 1.1× median
9422 OTHER	Idecabtagene Vicleucel Car	11	$557,317.93	$1,086,769.97	$593,543.60	nat. median $558,082 1.1× median
9035 OTHER	Axicabtagene Ciloleucel Car+	11	$533,230.17	$1,039,798.83	$567,890.13	nat. median $532,192 1.1× median
9391 OTHER	Brexucabtagene Car Pos T	11	$489,304.61	$954,143.99	$521,109.41	nat. median $489,450 1.1× median
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	13	$315,482.64	$1,228,982.49	$454,770.81	nat. median $386,529 1.2× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$400,393.23	$420,412.89	$412,405.03	nat. median $267,493 1.5× median
583-3 OTHER	Neonate With Ecmo	5	$382,488.54	$401,612.96	$393,963.19	nat. median $259,487 1.5× median
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$358,782.05	$376,721.15	$369,545.51	nat. median $105,647 outlier · 3.5×
002-4 OTHER	Heart And/or Lung Transplant	5	$325,827.21	$342,118.57	$335,602.03	nat. median $216,800 1.5× median
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	14	$277,115.46	$797,560.19	$296,513.54	nat. median $239,422 1.2× median
633 OTHER	Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar…	1	$295,570.85	$295,570.85	$295,570.85	nat. median $4,769 outlier · 62.0×
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	5	$281,558.42	$295,636.34	$290,005.17	nat. median $169,856 1.7× median
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$280,029.19	$294,030.65	$288,430.07	nat. median $171,094 1.7× median
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$275,494.81	$289,269.55	$283,759.65	nat. median $156,696 1.8× median
161-4 OTHER	Implantable Heart Assist Systems	5	$270,918.71	$284,464.65	$279,046.27	nat. median $202,242 1.4× median
612 OTHER	Neonate, Birth Weight <750 Grams, Discharged Alive	1	$270,849.83	$270,849.83	$270,849.83	nat. median $2,164 outlier · 125.1×
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	5	$260,733.14	$273,769.79	$268,555.13	nat. median $150,954 1.8× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$259,188.85	$272,148.29	$266,964.51	nat. median $165,000 1.6× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$249,971.78	$262,470.37	$257,470.94	nat. median $153,523 1.7× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	$243,181.78	$255,340.87	$250,477.24	nat. median $151,250 1.7× median
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	5	$240,308.69	$252,324.13	$247,517.95	nat. median $203,379 1.2× median
583-2 OTHER	Neonate With Ecmo	5	$240,020.22	$252,021.24	$247,220.83	nat. median $191,347 1.3× median
011-2 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	$236,635.07	$248,466.83	$243,734.12	nat. median $52,878 outlier · 4.6×
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	5	$231,770.51	$243,359.04	$238,723.63	nat. median $151,691 1.6× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	14	$209,886.24	$604,069.19	$224,578.28	nat. median $181,005 1.2× median
161-3 OTHER	Implantable Heart Assist Systems	5	$218,001.68	$228,901.76	$224,541.73	nat. median $152,491 1.5× median
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	5	$212,654.02	$223,286.72	$219,033.64	nat. median $86,371 outlier · 2.5×
589-2 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	5	$212,654.02	$223,286.72	$219,033.64	nat. median $49,980 outlier · 4.4×
589-3 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	5	$212,654.02	$223,286.72	$219,033.64	nat. median $87,000 outlier · 2.5×
591-3 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$209,325.63	$219,791.92	$215,605.40	nat. median $99,157 outlier · 2.2×
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	14	$1.61	$607,635.23	$215,347.78	nat. median $146,562 1.5× median
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	5	$204,198.09	$214,408.00	$210,324.03	nat. median $210,669 1.0× median
583-1 OTHER	Neonate With Ecmo	5	$202,517.10	$212,642.96	$208,592.61	nat. median $171,226 1.2× median
007-4 OTHER	Allogeneic Bone Marrow Transplant	5	$200,716.78	$210,752.62	$206,738.29	nat. median $172,311 1.2× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	$199,186.40	$209,145.72	$205,161.99	nat. median $110,000 1.9× median
631 OTHER	Neonate, Birth Weight 750-999 Grams, Discharged Alive	1	$196,395.81	$196,395.81	$196,395.81	nat. median $5,302 outlier · 37.0×
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	5	$184,728.26	$193,964.67	$190,270.10	nat. median $124,561 1.5× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	5	$177,617.35	$186,498.22	$182,945.87	nat. median $125,000 1.5× median
002-3 OTHER	Heart And/or Lung Transplant	5	$176,195.87	$185,005.66	$181,481.74	nat. median $133,471 1.4× median
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	$173,724.78	$182,411.01	$178,936.52	nat. median $112,711 1.6× median
591-2 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	$169,970.06	$178,468.56	$175,069.16	nat. median $80,000 outlier · 2.2×
636 OTHER	Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, With Mu…	1	$173,672.49	$173,672.49	$173,672.49	nat. median $53 outlier · 3306.8×
588-1 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	5	$166,259.37	$174,572.34	$171,247.15	nat. median $75,325 outlier · 2.3×
278L869901 OTHER	Impl Uro Impl Crtdg Urolift 2	4	$136,563.05	$199,592.15	$165,976.63	nat. median $163,876 1.0× median

Other procedures at this hospital

Browse this hospital's 10,741 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

1643	OTHER	Y90 Ibritumomab, Rx	26	11	—	—	$56,824.55	$110,807.87	$60,518.14	2026-05-24
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	40	14	—	—	$50,726.64	$162,207.77	$60,304.92	2026-05-24
022-4	OTHER	Ventricular Shunt Procedures	10	5	—	—	$47,950.52	$50,348.05	$49,389.04	2026-05-24
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	10	5	—	—	$51,354.21	$53,921.92	$52,894.84	2026-05-24
512-4	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	10	5	—	—	$51,102.81	$53,657.95	$52,635.90	2026-05-24
278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	38	13	—	—	$28,343.79	$158,414.05	$58,894.50	2026-05-24
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	5	—	—	$141,690.95	$148,775.50	$145,941.68	2026-05-24
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	5	—	—	$99,963.92	$104,962.12	$102,962.84	2026-05-24
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	10	5	—	—	$66,941.89	$70,288.99	$68,950.15	2026-05-24
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	5	—	—	$199,186.40	$209,145.72	$205,161.99	2026-05-24
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	5	—	—	$132,037.13	$138,638.99	$135,998.25	2026-05-24
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	5	—	—	$82,341.90	$86,459.00	$84,812.16	2026-05-24
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	10	5	—	—	$58,338.84	$61,255.78	$60,089.00	2026-05-24
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	38	14	—	—	$136,970.12	$394,210.84	$146,558.03	2026-05-24
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	40	14	—	—	$53,933.09	$155,223.69	$57,708.40	2026-05-24
9194	OTHER	Tisagenlecleucel Car-pos T	26	11	—	—	$591,726.20	$1,153,866.09	$630,188.40	2026-05-24
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	40	14	—	—	$41,968.93	$141,941.40	$52,770.37	2026-05-24
28	OTHER	Spinal Procedures With Mcc	40	14	—	—	$38,611.06	$170,996.22	$63,572.25	2026-05-24
023-4	OTHER	Spinal Procedures	10	5	—	—	$64,161.48	$67,369.56	$66,086.33	2026-05-24
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	40	14	—	—	$61,607.12	$239,160.76	$88,914.17	2026-05-24
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	40	14	—	—	$55,148.49	$169,709.83	$63,094.00	2026-05-24
321-4	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	10	5	—	—	$53,678.17	$56,362.08	$55,288.52	2026-05-24
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	40	14	—	—	$59,371.44	$186,452.84	$69,318.65	2026-05-24
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	10	5	—	—	$54,837.83	$57,579.73	$56,482.97	2026-05-24
312-4	OTHER	Skin Graft For Musculoskeletal And Connective Tissue Diagnoses	10	5	—	—	$58,238.05	$61,149.95	$59,985.19	2026-05-24
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	40	14	—	—	$48,465.71	$139,488.15	$51,858.31	2026-05-24
9273	OTHER	Sipuleucel-t Auto Cd54+	26	11	—	—	$55,272.32	$107,781.03	$58,865.03	2026-05-24
450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	38	13	—	—	$52,701.96	$151,680.42	$56,391.10	2026-05-24
300-4	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	10	5	—	—	$67,857.11	$71,249.97	$69,892.83	2026-05-24
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	38	14	—	—	$70,550.78	$203,050.72	$75,489.33	2026-05-24
8	OTHER	Simultaneous Pancreas And Kidney Transplant	38	14	—	—	$52,457.68	$159,506.92	$59,300.80	2026-05-24
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	66	14	—	—	$82.08	$196,709.83	$69,372.82	2026-05-24
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	40	14	—	—	$40,958.79	$148,145.68	$55,076.97	2026-05-24
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	40	14	—	—	$58,410.81	$183,131.56	$68,083.87	2026-05-24
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	10	5	—	—	$64,217.09	$67,427.95	$66,143.60	2026-05-24
130-3	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	10	5	—	—	$48,023.51	$50,424.68	$49,464.21	2026-05-24
485-4	OTHER	Prostatectomy Procedures	10	5	—	—	$55,553.79	$58,331.48	$57,220.40	2026-05-24
403-4	OTHER	Procedures For Obesity	10	5	—	—	$48,825.19	$51,266.45	$50,289.95	2026-05-24
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	10	5	—	—	$63,174.44	$66,333.16	$65,069.67	2026-05-24
711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	10	5	—	—	$47,789.49	$50,178.96	$49,223.17	2026-05-24
170-4	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	10	5	—	—	$48,859.95	$51,302.95	$50,325.75	2026-05-24
183-4	OTHER	Percutaneous Structural Cardiac Procedures	10	5	—	—	$78,725.05	$82,661.30	$81,086.80	2026-05-24
183-3	OTHER	Percutaneous Structural Cardiac Procedures	10	5	—	—	$55,470.38	$58,243.90	$57,134.49	2026-05-24
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	10	5	—	—	$50,189.91	$52,699.41	$51,695.61	2026-05-24
175-4	OTHER	Percutaneous Cardiac Intervention Without Ami	10	5	—	—	$48,301.55	$50,716.63	$49,750.60	2026-05-24
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	40	14	—	—	$41,696.20	$155,690.43	$57,881.93	2026-05-24
006-4	OTHER	Pancreas Transplant	10	5	—	—	$124,572.88	$130,801.53	$128,310.07	2026-05-24
006-3	OTHER	Pancreas Transplant	10	5	—	—	$106,020.59	$111,321.61	$109,201.20	2026-05-24
006-2	OTHER	Pancreas Transplant	10	5	—	—	$89,652.07	$94,134.67	$92,341.63	2026-05-24
10	OTHER	Pancreas Transplant	38	14	—	—	$70,957.20	$204,220.42	$75,924.20	2026-05-24
006-1	OTHER	Pancreas Transplant	10	5	—	—	$72,345.16	$75,962.42	$74,515.52	2026-05-24
121-4	OTHER	Other Respiratory And Chest Procedures	10	5	—	—	$50,956.84	$53,504.68	$52,485.55	2026-05-24
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	10	5	—	—	$51,605.61	$54,185.89	$53,153.77	2026-05-24
405-4	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	10	5	—	—	$49,204.02	$51,664.23	$50,680.15	2026-05-24
029-4	OTHER	Other Percutaneous Intracranial Procedures	10	5	—	—	$47,986.44	$50,385.76	$49,426.03	2026-05-24
027-4	OTHER	Other Open Craniotomy	10	5	—	—	$52,239.31	$54,851.27	$53,806.49	2026-05-24
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	40	14	—	—	$57,928.76	$216,862.35	$80,624.16	2026-05-24
091-4	OTHER	Other Major Head And Neck Procedures	10	5	—	—	$72,130.84	$75,737.38	$74,294.76	2026-05-24
270	OTHER	Other Major Cardiovascular Procedures With Mcc	40	14	—	—	$3,171.99	$150,163.50	$55,827.15	2026-05-24
264-4	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	10	5	—	—	$48,134.72	$50,541.46	$49,578.77	2026-05-24
215	OTHER	Other Heart Assist System Implant	40	14	—	—	$92,124.92	$327,714.25	$105,352.41	2026-05-24
520-4	OTHER	Other GYN Procedures For Malignancy	10	5	—	—	$57,574.22	$60,452.93	$59,301.45	2026-05-24
228	OTHER	Other Cardiothoracic Procedures With Mcc	40	14	—	—	$48,922.56	$184,041.63	$52,347.14	2026-05-24
167-4	OTHER	Other Cardiothoracic And Thoracic Circulatory Procedures	10	5	—	—	$72,376.44	$75,995.26	$74,547.73	2026-05-24
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	10	5	—	—	$57,381.91	$60,251.01	$59,103.37	2026-05-24
020-4	OTHER	Open Craniotomy For Trauma	10	5	—	—	$58,919.25	$61,865.21	$60,686.82	2026-05-24
021-4	OTHER	Open Craniotomy Except Trauma	10	5	—	—	$66,498.19	$69,823.10	$68,493.13	2026-05-24
1907	OTHER	New Technology - Level 52 ($145,001-$160,000)	28	12	—	—	$133,288.33	$270,719.19	$146,118.95	2026-05-24
1908	OTHER	New Technology - Level 52 ($145,001-$160,000)	28	12	—	—	$133,288.33	$270,719.19	$146,118.95	2026-05-24
1906	OTHER	New Technology - Level 51 ($130,001-$145,000)	28	12	—	—	$120,178.05	$244,091.16	$131,746.64	2026-05-24
1905	OTHER	New Technology - Level 51 ($130,001-$145,000)	28	12	—	—	$120,178.05	$244,091.16	$131,746.64	2026-05-24
1903	OTHER	New Technology - Level 50 ($115,001-$130,000)	28	12	—	—	$107,067.76	$217,463.13	$117,374.33	2026-05-24
1904	OTHER	New Technology - Level 50 ($115,001-$130,000)	28	12	—	—	$107,067.76	$217,463.13	$117,374.33	2026-05-24
1901	OTHER	New Technology - Level 49 ($100,001-$115,000)	28	12	—	—	$93,957.48	$190,835.10	$103,002.02	2026-05-24
1902	OTHER	New Technology - Level 49 ($100,001-$115,000)	28	12	—	—	$93,957.48	$190,835.10	$103,002.02	2026-05-24
1599	OTHER	New Technology - Level 48 ($90,001-$100,000)	28	12	—	—	$83,032.24	$168,645.08	$91,025.10	2026-05-24
1585	OTHER	New Technology - Level 48 ($90,001-$100,000)	28	12	—	—	$83,032.24	$168,645.08	$91,025.10	2026-05-24
1598	OTHER	New Technology - Level 47 ($80,001-$90,000)	28	12	—	—	$74,292.05	$150,893.06	$81,443.56	2026-05-24
1584	OTHER	New Technology - Level 47 ($80,001-$90,000)	28	12	—	—	$74,292.05	$150,893.06	$81,443.56	2026-05-24
1597	OTHER	New Technology - Level 46 ($70,001-$80,000)	28	12	—	—	$65,551.86	$133,141.04	$71,862.02	2026-05-24
1583	OTHER	New Technology - Level 46 ($70,001-$80,000)	28	12	—	—	$65,551.86	$133,141.04	$71,862.02	2026-05-24
1596	OTHER	New Technology - Level 45 ($60,001-$70,000)	28	12	—	—	$56,811.67	$115,389.02	$62,280.49	2026-05-24
1582	OTHER	New Technology - Level 45 ($60,001-$70,000)	28	12	—	—	$56,811.67	$115,389.02	$62,280.49	2026-05-24
1581	OTHER	New Technology - Level 44 ($50,001-$60,000)	28	12	—	—	$48,071.48	$97,637.00	$52,698.94	2026-05-24
1595	OTHER	New Technology - Level 44 ($50,001-$60,000)	28	12	—	—	$48,071.48	$97,637.00	$52,698.94	2026-05-24
681	OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	2	1	—	—	$118,292.96	$118,292.96	$118,292.96	2026-05-24
612	OTHER	Neonate, Birth Weight <750 Grams, Discharged Alive	2	1	—	—	$270,849.83	$270,849.83	$270,849.83	2026-05-24
631	OTHER	Neonate, Birth Weight 750-999 Grams, Discharged Alive	2	1	—	—	$196,395.81	$196,395.81	$196,395.81	2026-05-24
632	OTHER	Neonate, Birth Weight 750-999 Grams, Died	2	1	—	—	$96,386.95	$96,386.95	$96,386.95	2026-05-24
647	OTHER	Neonate, Birth Weight 1500-1999 Grams, Without Significant O.r. Procedures, With…	2	1	—	—	$59,087.42	$59,087.42	$59,087.42	2026-05-24
646	OTHER	Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, Without…	2	1	—	—	$55,019.07	$55,019.07	$55,019.07	2026-05-24
636	OTHER	Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, With Mu…	2	1	—	—	$173,672.49	$173,672.49	$173,672.49	2026-05-24
634	OTHER	Neonate, Birth Weight 1000-1499 Grams, Without Significant O.r. Procedures, Disc…	2	1	—	—	$105,942.01	$105,942.01	$105,942.01	2026-05-24
633	OTHER	Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar…	2	1	—	—	$295,570.85	$295,570.85	$295,570.85	2026-05-24
635	OTHER	Neonate, Birth Weight 1000-1499 Grams, Died	2	1	—	—	$58,964.08	$58,964.08	$58,964.08	2026-05-24
583-4	OTHER	Neonate With Ecmo	10	5	—	—	$633,496.02	$665,170.82	$652,500.90	2026-05-24
583-3	OTHER	Neonate With Ecmo	10	5	—	—	$382,488.54	$401,612.96	$393,963.19	2026-05-24
583-2	OTHER	Neonate With Ecmo	10	5	—	—	$240,020.22	$252,021.24	$247,220.83	2026-05-24
583-1	OTHER	Neonate With Ecmo	10	5	—	—	$202,517.10	$212,642.96	$208,592.61	2026-05-24
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	5	—	—	$240,308.69	$252,324.13	$247,517.95	2026-05-24
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	10	5	—	—	$66,458.80	$69,781.74	$68,452.56	2026-05-24
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	5	—	—	$204,198.09	$214,408.00	$210,324.03	2026-05-24
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	10	5	—	—	$110,900.21	$116,445.22	$114,227.21	2026-05-24
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	10	5	—	—	$79,926.42	$83,922.74	$82,324.21	2026-05-24
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	5	—	—	$212,654.02	$223,286.72	$219,033.64	2026-05-24
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	5	—	—	$212,654.02	$223,286.72	$219,033.64	2026-05-24
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	10	5	—	—	$212,654.02	$223,286.72	$219,033.64	2026-05-24
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	5	—	—	$400,393.23	$420,412.89	$412,405.03	2026-05-24
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	5	—	—	$259,188.85	$272,148.29	$266,964.51	2026-05-24
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	5	—	—	$249,971.78	$262,470.37	$257,470.94	2026-05-24
588-1	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	10	5	—	—	$166,259.37	$174,572.34	$171,247.15	2026-05-24
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	5	—	—	$243,181.78	$255,340.87	$250,477.24	2026-05-24
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	5	—	—	$173,724.78	$182,411.01	$178,936.52	2026-05-24
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	5	—	—	$135,073.57	$141,827.25	$139,125.78	2026-05-24
593-1	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	10	5	—	—	$66,959.27	$70,307.24	$68,968.05	2026-05-24
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	5	—	—	$275,494.81	$289,269.55	$283,759.65	2026-05-24
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	5	—	—	$209,325.63	$219,791.92	$215,605.40	2026-05-24
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	10	5	—	—	$169,970.06	$178,468.56	$175,069.16	2026-05-24
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	10	5	—	—	$47,685.22	$50,069.49	$49,115.78	2026-05-24
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	10	5	—	—	$76,280.60	$80,094.63	$78,569.02	2026-05-24
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	5	—	—	$281,558.42	$295,636.34	$290,005.17	2026-05-24
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	5	—	—	$86,463.86	$90,787.06	$89,057.78	2026-05-24
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	10	5	—	—	$55,366.11	$58,134.42	$57,027.10	2026-05-24
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	10	5	—	—	$81,647.96	$85,730.35	$84,097.40	2026-05-24
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	10	5	—	—	$56,494.50	$59,319.22	$58,189.33	2026-05-24
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	10	5	—	—	$53,827.62	$56,519.00	$55,442.45	2026-05-24
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	10	5	—	—	$111,413.43	$116,984.10	$114,755.83	2026-05-24
611-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	10	5	—	—	$48,433.62	$50,855.30	$49,886.63	2026-05-24
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	10	5	—	—	$71,110.20	$74,665.71	$73,243.50	2026-05-24
613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	10	5	—	—	$52,437.41	$55,059.28	$54,010.53	2026-05-24
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	5	—	—	$132,210.91	$138,821.45	$136,177.23	2026-05-24
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	5	—	—	$92,848.38	$97,490.80	$95,633.83	2026-05-24
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	10	5	—	—	$63,241.63	$66,403.71	$65,138.88	2026-05-24
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	10	5	—	—	$64,743.05	$67,980.20	$66,685.34	2026-05-24
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	10	5	—	—	$64,743.05	$67,980.20	$66,685.34	2026-05-24
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	5	—	—	$177,617.35	$186,498.22	$182,945.87	2026-05-24
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	5	—	—	$123,810.59	$130,001.12	$127,524.91	2026-05-24
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	5	—	—	$90,511.68	$95,037.26	$93,227.03	2026-05-24
602-1	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	10	5	—	—	$53,074.59	$55,728.32	$54,666.83	2026-05-24
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	10	5	—	—	$128,463.14	$134,886.30	$132,317.04	2026-05-24
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	10	5	—	—	$52,576.43	$55,205.25	$54,153.73	2026-05-24
863-4	OTHER	Neonatal Aftercare	10	5	—	—	$106,298.63	$111,613.56	$109,487.59	2026-05-24
863-3	OTHER	Neonatal Aftercare	10	5	—	—	$49,207.50	$51,667.87	$50,683.72	2026-05-24
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	10	5	—	—	$69,977.18	$73,476.04	$72,076.49	2026-05-24
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	38	13	—	—	$66,071.27	$190,158.34	$70,696.26	2026-05-24
426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	38	13	—	—	$17,637.89	$313,663.35	$116,612.43	2026-05-24
365	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	2	1	—	—	$83,969.12	$83,969.12	$83,969.12	2026-05-24
427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	38	13	—	—	$13,222.12	$205,441.36	$76,378.11	2026-05-24
366	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	2	1	—	—	$63,907.07	$63,907.07	$63,907.07	2026-05-24
428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	38	13	—	—	$10,046.66	$160,002.12	$59,484.91	2026-05-24
367	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	2	1	—	—	$48,970.41	$48,970.41	$48,970.41	2026-05-24
299-4	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	10	5	—	—	$89,741.27	$94,228.34	$92,433.51	2026-05-24
299-3	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	10	5	—	—	$70,357.17	$73,875.03	$72,467.88	2026-05-24
299-2	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	10	5	—	—	$52,713.14	$55,348.79	$54,294.53	2026-05-24
740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	10	5	—	—	$60,996.45	$64,046.27	$62,826.34	2026-05-24
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	10	5	—	—	$61,148.21	$64,205.62	$62,982.66	2026-05-24
230-4	OTHER	Major Small Bowel Procedures	10	5	—	—	$52,298.39	$54,913.31	$53,867.34	2026-05-24
120-4	OTHER	Major Respiratory And Chest Procedures	10	5	—	—	$60,270.06	$63,283.57	$62,078.17	2026-05-24
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	10	5	—	—	$62,907.98	$66,053.38	$64,795.22	2026-05-24
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	10	5	—	—	$70,987.39	$74,536.76	$73,117.02	2026-05-24
089-4	OTHER	Major Cranial Or Facial Bone Procedures	10	5	—	—	$61,401.92	$64,472.02	$63,243.98	2026-05-24
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	5	—	—	$143,235.24	$150,397.00	$147,532.30	2026-05-24
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	5	—	—	$62,957.80	$66,105.69	$64,846.53	2026-05-24
160-2	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	10	5	—	—	$49,149.57	$51,607.05	$50,624.06	2026-05-24
653	OTHER	Major Bladder Procedures With Mcc	40	14	—	—	$31,730.31	$147,889.54	$54,981.75	2026-05-24
441-4	OTHER	Major Bladder Procedures	10	5	—	—	$58,210.24	$61,120.75	$59,956.55	2026-05-24
261-4	OTHER	Major Biliary Tract Procedures	10	5	—	—	$55,722.93	$58,509.08	$57,394.62	2026-05-24
169-4	OTHER	Major Abdominal Vascular Procedures	10	5	—	—	$66,579.28	$69,908.25	$68,576.66	2026-05-24
824	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Cc	66	14	—	—	$22,403.48	$4,547,400.00	$64,478.98	2026-05-24
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	66	14	—	—	$21.70	$166,912.21	$57,994.31	2026-05-24
7	OTHER	Lung Transplant	38	14	—	—	$103,153.05	$368,562.69	$137,022.67	2026-05-24
181-4	OTHER	Lower Extremity Vascular Procedures	10	5	—	—	$52,194.13	$54,803.83	$53,759.95	2026-05-24
6	OTHER	Liver Transplant Without Mcc	38	14	—	—	$45,853.16	$198,136.93	$49,062.88	2026-05-24
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	38	14	—	—	$101,955.79	$293,436.83	$109,092.70	2026-05-24
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	10	5	—	—	$184,728.26	$193,964.67	$190,270.10	2026-05-24
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	10	5	—	—	$102,015.63	$107,116.41	$105,076.10	2026-05-24
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	10	5	—	—	$82,311.78	$86,427.37	$84,781.13	2026-05-24
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	10	5	—	—	$67,635.84	$71,017.63	$69,664.91	2026-05-24
9413	OTHER	Lisocabtagene Car Pos T	26	11	—	—	$562,538.19	$1,096,949.46	$599,103.17	2026-05-24
5244	OTHER	Level 4 Blood Product Exchange And Related Services	28	12	—	—	$51,691.52	$104,989.58	$56,667.45	2026-05-24
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	38	14	—	—	$22,983.02	$133,801.84	$49,744.28	2026-05-24
440-4	OTHER	Kidney Transplant	10	5	—	—	$103,008.47	$108,158.90	$106,098.73	2026-05-24
440-3	OTHER	Kidney Transplant	10	5	—	—	$68,570.75	$71,999.29	$70,627.88	2026-05-24
440-2	OTHER	Kidney Transplant	10	5	—	—	$59,186.86	$62,146.21	$60,962.47	2026-05-24
440-1	OTHER	Kidney Transplant	10	5	—	—	$54,073.22	$56,776.88	$55,695.42	2026-05-24
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	40	14	—	—	$77,810.94	$223,946.05	$83,257.71	2026-05-24
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	40	14	—	—	$47,288.87	$183,006.74	$56,012.31	2026-05-24
9138	OTHER	Inj, Hemgenix, Per Tx Dose	22	10	—	—	$3,685,266.67	$3,943,235.33	$3,832,677.33	2026-05-24
9141	OTHER	Inj Onase Abepar-xioi Treat	26	11	—	—	$2,455,110.61	$4,787,465.68	$2,614,692.79	2026-05-24
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	66	14	—	—	$29.96	$140,552.56	$49,568.08	2026-05-24
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	10	5	—	—	$49,432.25	$51,903.86	$50,915.22	2026-05-24
161-4	OTHER	Implantable Heart Assist Systems	10	5	—	—	$270,918.71	$284,464.65	$279,046.27	2026-05-24
161-3	OTHER	Implantable Heart Assist Systems	10	5	—	—	$218,001.68	$228,901.76	$224,541.73	2026-05-24
161-1	OTHER	Implantable Heart Assist Systems	10	5	—	—	$147,342.14	$154,709.25	$151,762.41	2026-05-24
161-2	OTHER	Implantable Heart Assist Systems	10	5	—	—	$147,342.14	$154,709.25	$151,762.41	2026-05-24
278L869901	OTHER	Impl Uro Impl Crtdg Urolift 2	8	4	$210,097.00	$149,168.87 29% off	$136,563.05	$199,592.15	$165,976.63	2026-05-24
9422	OTHER	Idecabtagene Vicleucel Car	26	11	—	—	$557,317.93	$1,086,769.97	$593,543.60	2026-05-24
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	40	14	—	—	$60,530.72	$174,212.20	$64,767.87	2026-05-24
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	38	14	—	—	$106,241.66	$444,362.24	$119,898.80	2026-05-24
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	38	14	—	—	$277,115.46	$797,560.19	$296,513.54	2026-05-24
002-4	OTHER	Heart And/or Lung Transplant	10	5	—	—	$325,827.21	$342,118.57	$335,602.03	2026-05-24
002-3	OTHER	Heart And/or Lung Transplant	10	5	—	—	$176,195.87	$185,005.66	$181,481.74	2026-05-24
002-2	OTHER	Heart And/or Lung Transplant	10	5	—	—	$135,999.22	$142,799.18	$140,079.20	2026-05-24
002-1	OTHER	Heart And/or Lung Transplant	10	5	—	—	$104,252.71	$109,465.34	$107,380.29	2026-05-24
4813326301	OTHER	Hc Ep Rmvl Impltbl Dfb Plse Gen W/rplcmt Plse Gen 2 Ld	10	4	$130,434.00	$92,608.14 29% off	$4,758.96	$139,520.41	$62,720.82	2026-05-24
4813327001	OTHER	Hc Ep Ins/rplcmnt Perm Subq Impltbl Dfb W/subq Eltrd	8	3	$51,118.00	$36,293.78 29% off	$15,900.00	$139,520.41	$50,746.81	2026-05-24
428-4	OTHER	Genetic Disorders	10	5	—	—	$48,834.46	$51,276.18	$50,299.50	2026-05-24
851-4	OTHER	Gender Related Procedures	10	5	—	—	$93,241.12	$97,903.17	$96,038.35	2026-05-24
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	64	14	—	—	$1.70	$204,135.04	$71,459.49	2026-05-24
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	10	5	—	—	$52,487.23	$55,111.59	$54,061.84	2026-05-24
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	62	14	—	—	$0.12	$169,152.01	$52,942.23	2026-05-24
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	5	—	—	$260,733.14	$273,769.79	$268,555.13	2026-05-24
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	5	—	—	$147,502.02	$154,877.12	$151,927.08	2026-05-24
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	5	—	—	$80,942.43	$84,989.55	$83,370.70	2026-05-24
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	10	5	—	—	$65,489.13	$68,763.59	$67,453.80	2026-05-24
178-4	OTHER	External Heart Assist Devices	10	5	—	—	$88,718.31	$93,154.23	$91,379.86	2026-05-24
178-3	OTHER	External Heart Assist Devices	10	5	—	—	$71,942.00	$75,539.10	$74,100.26	2026-05-24
178-2	OTHER	External Heart Assist Devices	10	5	—	—	$57,994.76	$60,894.50	$59,734.60	2026-05-24
178-1	OTHER	External Heart Assist Devices	10	5	—	—	$53,208.98	$55,869.42	$54,805.25	2026-05-24
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	10	5	—	—	$231,770.51	$243,359.04	$238,723.63	2026-05-24
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	10	5	—	—	$70,087.24	$73,591.60	$72,189.85	2026-05-24
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	40	14	—	—	$45,720.85	$133,528.63	$49,015.55	2026-05-24
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	10	5	—	—	$51,905.66	$54,500.94	$53,462.83	2026-05-24
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	10	5	—	—	$59,938.73	$62,935.67	$61,736.89	2026-05-24
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	64	14	—	—	$1.61	$607,635.23	$215,347.78	2026-05-24
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	10	5	—	—	$73,299.77	$76,964.76	$75,498.76	2026-05-24
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	40	14	—	—	$3,515.07	$207,014.07	$50,372.78	2026-05-24
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	40	14	—	—	$36,483.96	$254,053.91	$64,842.99	2026-05-24
213	OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	38	13	—	—	$16,020.63	$162,418.37	$60,383.21	2026-05-24
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	38	14	—	—	$209,886.24	$604,069.19	$224,578.28	2026-05-24
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	5	—	—	$99,190.04	$104,149.54	$102,165.74	2026-05-24
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	5	—	—	$66,218.99	$69,529.94	$68,205.56	2026-05-24
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	10	5	—	—	$49,494.81	$51,969.55	$50,979.65	2026-05-24
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	10	5	—	—	$72,908.20	$76,553.60	$75,095.44	2026-05-24
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	10	5	—	—	$52,078.28	$54,682.19	$53,640.62	2026-05-24
179-4	OTHER	Defibrillator Implants	10	5	—	—	$73,667.02	$77,350.37	$75,877.03	2026-05-24
179-3	OTHER	Defibrillator Implants	10	5	—	—	$54,383.70	$57,102.89	$56,015.21	2026-05-24
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	40	14	—	—	$54,975.64	$163,084.34	$60,630.80	2026-05-24
910-4	OTHER	Craniotomy For Multiple Significant Trauma	10	5	—	—	$76,340.85	$80,157.89	$78,631.07	2026-05-24
955	OTHER	Craniotomy For Multiple Significant Trauma	40	14	—	—	$66,560.75	$191,567.11	$71,220.00	2026-05-24
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	40	14	—	—	$52,525.43	$167,020.36	$62,094.12	2026-05-24
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	10	5	—	—	$73,738.84	$77,425.79	$75,951.01	2026-05-24
166-3	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	10	5	—	—	$53,531.04	$56,207.59	$55,136.97	2026-05-24
232	OTHER	Coronary Bypass With Ptca Without Mcc	40	14	—	—	$58,894.60	$172,541.60	$64,146.78	2026-05-24
231	OTHER	Coronary Bypass With Ptca With Mcc	40	14	—	—	$51,456.23	$239,914.95	$89,194.56	2026-05-24
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	40	14	—	—	$54,018.13	$155,468.44	$57,799.40	2026-05-24
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	40	14	—	—	$68,160.42	$217,582.39	$80,891.86	2026-05-24
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	5	—	—	$85,276.39	$89,540.21	$87,834.69	2026-05-24
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	5	—	—	$62,868.59	$66,012.02	$64,754.65	2026-05-24
165-2	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	10	5	—	—	$51,662.37	$54,245.49	$53,212.24	2026-05-24
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	38	13	—	—	$62,160.39	$190,297.79	$70,748.10	2026-05-24
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	38	13	—	—	$105,028.28	$309,476.89	$115,056.00	2026-05-24
209	OTHER	Complex Aortic Arch Procedures	38	13	—	—	$4,620.75	$322,133.05	$119,761.26	2026-05-24
430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	38	13	—	—	$49,135.43	$177,299.81	$61,020.17	2026-05-24
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	38	13	—	—	$80,412.36	$256,413.22	$95,328.22	2026-05-24
9498	OTHER	Ciltacabtagene Car-pos T	26	11	—	—	$565,868.95	$1,103,444.44	$602,650.43	2026-05-24
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	32	13	—	—	$315,482.64	$1,228,982.49	$454,770.81	2026-05-24
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	5	—	—	$358,782.05	$376,721.15	$369,545.51	2026-05-24
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	5	—	—	$280,029.19	$294,030.65	$288,430.07	2026-05-24
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	5	—	—	$236,635.07	$248,466.83	$243,734.12	2026-05-24
011-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	5	—	—	$99,967.40	$104,965.77	$102,966.42	2026-05-24
695-4	OTHER	Chemotherapy For Acute Leukemia	10	5	—	—	$52,277.54	$54,891.42	$53,845.86	2026-05-24
471	OTHER	Cervical Spinal Fusion With Mcc	40	14	—	—	$38,261.90	$137,424.80	$51,091.21	2026-05-24
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	5	—	—	$95,117.89	$99,873.79	$97,971.43	2026-05-24
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	5	—	—	$65,019.93	$68,270.93	$66,970.53	2026-05-24
163-2	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	10	5	—	—	$49,418.35	$51,889.27	$50,900.90	2026-05-24
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	5	—	—	$108,198.57	$113,608.50	$111,444.53	2026-05-24
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	5	—	—	$77,499.35	$81,374.32	$79,824.33	2026-05-24
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	5	—	—	$59,310.82	$62,276.36	$61,090.15	2026-05-24
162-1	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	10	5	—	—	$50,961.48	$53,509.55	$52,490.32	2026-05-24
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	40	14	—	—	$66,070.66	$218,524.42	$81,242.08	2026-05-24
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	40	14	—	—	$45,525.69	$156,402.62	$56,424.96	2026-05-24
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	40	14	—	—	$37,898.84	$143,444.09	$53,329.03	2026-05-24
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	40	14	—	—	$96,737.61	$278,418.49	$103,509.24	2026-05-24
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	40	14	—	—	$45,617.76	$207,014.07	$69,571.53	2026-05-24
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	40	14	—	—	$57,357.24	$187,304.68	$69,571.53	2026-05-24
277	OTHER	Cardiac Defibrillator Implant Without Mcc	38	13	—	—	$45,670.22	$147,585.55	$48,867.14	2026-05-24
276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	38	13	—	—	$32,723.08	$170,947.84	$63,554.26	2026-05-24
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	38	13	—	—	$56,560.77	$208,663.34	$75,444.89	2026-05-24
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	10	5	—	—	$123,943.82	$130,141.01	$127,662.13	2026-05-24
9391	OTHER	Brexucabtagene Car Pos T	26	11	—	—	$489,304.61	$954,143.99	$521,109.41	2026-05-24
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	40	14	—	—	$54,614.41	$157,184.58	$58,437.41	2026-05-24
886	OTHER	Behavioral And Developmental Disorders	58	13	—	—	$10,663.34	$400,998.00	$56,118.19	2026-05-24
9035	OTHER	Axicabtagene Ciloleucel Car+	26	11	—	—	$533,230.17	$1,039,798.83	$567,890.13	2026-05-24
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	38	14	—	—	$53,717.52	$177,056.79	$57,477.74	2026-05-24
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	38	14	—	—	$43,627.01	$177,056.79	$62,740.60	2026-05-24
008-4	OTHER	Autologous Bone Marrow Transplant	10	5	—	—	$87,216.89	$91,577.73	$89,833.40	2026-05-24
008-3	OTHER	Autologous Bone Marrow Transplant	10	5	—	—	$57,206.98	$60,067.33	$58,923.19	2026-05-24
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	40	14	—	—	$13,105.74	$195,745.03	$72,773.26	2026-05-24
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	40	14	—	—	$34,372.48	$140,071.58	$51,953.55	2026-05-24
007-4	OTHER	Allogeneic Bone Marrow Transplant	10	5	—	—	$200,716.78	$210,752.62	$206,738.29	2026-05-24
14	OTHER	Allogeneic Bone Marrow Transplant	38	14	—	—	$102,015.24	$342,029.43	$127,158.25	2026-05-24
007-3	OTHER	Allogeneic Bone Marrow Transplant	10	5	—	—	$119,587.84	$125,567.23	$123,175.47	2026-05-24
007-2	OTHER	Allogeneic Bone Marrow Transplant	10	5	—	—	$89,009.10	$93,459.55	$91,679.37	2026-05-24
007-1	OTHER	Allogeneic Bone Marrow Transplant	10	5	—	—	$74,091.03	$77,795.58	$76,313.76	2026-05-24
2067	OTHER	Afamitresgene Autoleucel	26	11	—	—	$701,541.62	$1,368,006.17	$747,141.83	2026-05-24
401-4	OTHER	Adrenal Procedures	10	5	—	—	$60,675.54	$63,709.32	$62,495.81	2026-05-24
850	OTHER	Acute Leukemia With Other Procedures	38	13	—	—	$83,311.62	$246,449.37	$91,195.75	2026-05-24
834	OTHER	Acute Leukemia With Mcc	66	14	—	—	$19.47	$156,242.55	$55,644.27	2026-05-24
690-4	OTHER	Acute Leukemia	10	5	—	—	$60,385.91	$63,405.21	$62,197.49	2026-05-24

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