Hospital

AVERA SACRED HEART HOSPITAL

Yankton, SD · CCN 430012 · Rates published

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You selected 481 (MS_DRG)

MS-DRG 481

This hospital’s price: $18,024 across 2 payers · range $18,024-$18,389

Source: https://www.avera.org/app/files/public/14ca39ed-760e-484f-8e7e-19bb3f14df01/460225483_avera-sacred-heart-hospital_standardcharges.csv · observed 2026-07-15

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

1,229 distinct procedures filed

6 distinct payers

15,924 rate rows

2026-07-15 last MRF observed

Data quality

15,615 of 15,924 rate rows are consumer-grade (98.1%)

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

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	287
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	8
exceeds 10× this hospital's gross charge — excluded from medians	8
placeholder amount (≤ $0.02) — excluded from medians	6

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

Source MRF file	https://www.avera.org/app/files/public/14ca39ed-760e-484f-8e7e-19bb3f14df01/460225483_avera-sacred-heart-hospital_standardcharges.csv
Discovered via	Discovered by HANK (automated)
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint	fca3cabb29dc525f… · 3,881,703 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
428 MS_DRG	Ms-DRG 428	1	$153,749.51	$153,749.51	$153,749.51	nat. median $50,496 outlier · 3.0×
1824 APR_DRG	Apr-DRG 1824	1	$138,508.41	$138,508.41	$138,508.41	nat. median $43,299 outlier · 3.2×
4693 APR_DRG	Apr-DRG 4693	1	$114,628.37	$114,628.37	$114,628.37	nat. median $9,282 outlier · 12.3×
3082 APR_DRG	Apr-DRG 3082	1	$109,204.13	$109,204.13	$109,204.13	nat. median $14,026 outlier · 7.8×
2201 APR_DRG	Apr-DRG 2201	1	$88,291.73	$88,291.73	$88,291.73	nat. median $12,006 outlier · 7.4×
3031 APR_DRG	Apr-DRG 3031	1	$87,820.09	$87,820.09	$87,820.09	nat. median $34,001 outlier · 2.6×
2234 APR_DRG	Apr-DRG 2234	1	$86,465.03	$86,465.03	$86,465.03	nat. median $34,193 outlier · 2.5×
7113 APR_DRG	Apr-DRG 7113	1	$81,006.83	$81,006.83	$81,006.83	nat. median $20,824 outlier · 3.9×
7114 APR_DRG	Apr-DRG 7114	1	$81,006.83	$81,006.83	$81,006.83	nat. median $38,355 outlier · 2.1×
3042 APR_DRG	Apr-DRG 3042	1	$77,826.10	$77,826.10	$77,826.10	nat. median $27,976 outlier · 2.8×
3054 APR_DRG	Apr-DRG 3054	1	$75,230.28	$75,230.28	$75,230.28	nat. median $33,556 outlier · 2.2×
J2350 HCPCS	Ocrelizumab 300 Mg/10 Ml	5	$6.09	$86,126.02	$72,141.64	nat. median $518 outlier · 139.3×
867 MS_DRG	Ms-DRG 867	1	$70,595.63	$70,595.63	$70,595.63	nat. median $20,236 outlier · 3.5×
38 MS_DRG	Ms-DRG 38	1	$68,085.87	$68,085.87	$68,085.87	nat. median $16,177 outlier · 4.2×
3122 APR_DRG	Apr-DRG 3122	1	$67,667.53	$67,667.53	$67,667.53	nat. median $16,559 outlier · 4.1×
3253 APR_DRG	Apr-DRG 3253	2	$24,776.91	$65,602.33	$65,602.33	nat. median $22,233 outlier · 3.0×
3041 APR_DRG	Apr-DRG 3041	1	$64,958.98	$64,958.98	$64,958.98	nat. median $22,805 outlier · 2.8×
486 MS_DRG	Ms-DRG 486	1	$64,930.09	$64,930.09	$64,930.09	nat. median $20,195 outlier · 3.2×
573 MS_DRG	Ms-DRG 573	1	$62,736.70	$62,736.70	$62,736.70	nat. median $58,052 1.1× median
464 MS_DRG	Ms-DRG 464	1	$61,599.19	$61,599.19	$61,599.19	nat. median $28,649 outlier · 2.2×
9123 APR_DRG	Apr-DRG 9123	1	$57,797.15	$57,797.15	$57,797.15	nat. median $29,349 2.0× median
3133 APR_DRG	Apr-DRG 3133	1	$57,528.41	$57,528.41	$57,528.41	nat. median $21,495 outlier · 2.7×
3053 APR_DRG	Apr-DRG 3053	1	$56,283.37	$56,283.37	$56,283.37	nat. median $19,021 outlier · 3.0×
6333 APR_DRG	Apr-DRG 6333	1	$56,028.24	$56,028.24	$56,028.24	nat. median $20,566 outlier · 2.7×
602 MS_DRG	Ms-DRG 602	1	$55,861.56	$55,861.56	$55,861.56	nat. median $14,007 outlier · 4.0×
551 MS_DRG	Ms-DRG 551	1	$51,765.09	$51,765.09	$51,765.09	nat. median $16,085 outlier · 3.2×
7214 APR_DRG	Apr-DRG 7214	1	$51,296.28	$51,296.28	$51,296.28	nat. median $20,625 outlier · 2.5×
896 MS_DRG	Ms-DRG 896	1	$51,253.74	$51,253.74	$51,253.74	nat. median $15,465 outlier · 3.3×
708 MS_DRG	Ms-DRG 708	1	$50,674.11	$50,674.11	$50,674.11	nat. median $15,257 outlier · 3.3×
820 MS_DRG	Ms-DRG 820	1	$50,516.54	$50,516.54	$50,516.54	nat. median $53,768 0.9× median
69 MS_DRG	Ms-DRG 69	1	$47,319.27	$47,319.27	$47,319.27	nat. median $8,413 outlier · 5.6×
354 MS_DRG	Ms-DRG 354	1	$45,694.52	$45,694.52	$45,694.52	nat. median $16,463 outlier · 2.8×
239 MS_DRG	Ms-DRG 239	1	$43,706.61	$43,706.61	$43,706.61	nat. median $45,172 1.0× median
8174 APR_DRG	Apr-DRG 8174	1	$43,704.25	$43,704.25	$43,704.25	nat. median $12,122 outlier · 3.6×
2484 APR_DRG	Apr-DRG 2484	1	$43,404.77	$43,404.77	$43,404.77	nat. median $19,277 outlier · 2.3×
1344 APR_DRG	Apr-DRG 1344	1	$43,036.92	$43,036.92	$43,036.92	nat. median $15,873 outlier · 2.7×
3132 APR_DRG	Apr-DRG 3132	1	$43,018.94	$43,018.94	$43,018.94	nat. median $14,268 outlier · 3.0×
743 MS_DRG	Ms-DRG 743	1	$42,105.79	$42,105.79	$42,105.79	nat. median $12,360 outlier · 3.4×
853 MS_DRG	Ms-DRG 853	2	$41,172.24	$65,658.51	$41,172.24	nat. median $45,362 0.9× median
7204 APR_DRG	Apr-DRG 7204	2	$41,100.60	$77,998.10	$41,100.60	nat. median $20,530 outlier · 2.0×
2314 APR_DRG	Apr-DRG 2314	1	$41,033.49	$41,033.49	$41,033.49	nat. median $31,563 1.3× median
2302 APR_DRG	Apr-DRG 2302	1	$38,239.72	$38,239.72	$38,239.72	nat. median $12,895 outlier · 3.0×
914 MS_DRG	Ms-DRG 914	1	$37,615.05	$37,615.05	$37,615.05	nat. median $9,243 outlier · 4.1×
7922 APR_DRG	Apr-DRG 7922	1	$36,395.57	$36,395.57	$36,395.57	nat. median $12,904 outlier · 2.8×
742 MS_DRG	Ms-DRG 742	1	$36,215.67	$36,215.67	$36,215.67	nat. median $17,778 outlier · 2.0×
2312 APR_DRG	Apr-DRG 2312	1	$35,519.04	$35,519.04	$35,519.04	nat. median $12,631 outlier · 2.8×
448 MS_DRG	Ms-DRG 448	2	$35,440.04	$122,988.25	$35,440.04	nat. median $39,065 0.9× median
7102 APR_DRG	Apr-DRG 7102	1	$34,565.36	$34,565.36	$34,565.36	nat. median $12,695 outlier · 2.7×
6633 APR_DRG	Apr-DRG 6633	1	$34,500.39	$34,500.39	$34,500.39	nat. median $8,538 outlier · 4.0×
6914 APR_DRG	Apr-DRG 6914	1	$34,039.34	$34,039.34	$34,039.34	nat. median $33,182 1.0× median

Other procedures at this hospital

Browse this hospital's 1,229 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

428	MS_DRG	Ms-DRG 428	1	1	—	—	$153,749.51	$153,749.51	$153,749.51	2026-07-15
1824	APR_DRG	Apr-DRG 1824	2	1	—	—	$138,508.41	$138,508.41	$138,508.41	2026-07-15
4693	APR_DRG	Apr-DRG 4693	2	1	—	—	$114,628.37	$114,628.37	$114,628.37	2026-07-15
3082	APR_DRG	Apr-DRG 3082	2	1	—	—	$109,204.13	$109,204.13	$109,204.13	2026-07-15
2201	APR_DRG	Apr-DRG 2201	2	1	—	—	$88,291.73	$88,291.73	$88,291.73	2026-07-15
3031	APR_DRG	Apr-DRG 3031	2	1	—	—	$87,820.09	$87,820.09	$87,820.09	2026-07-15
2234	APR_DRG	Apr-DRG 2234	2	1	—	—	$86,465.03	$86,465.03	$86,465.03	2026-07-15
7113	APR_DRG	Apr-DRG 7113	2	1	—	—	$81,006.83	$81,006.83	$81,006.83	2026-07-15
7114	APR_DRG	Apr-DRG 7114	2	1	—	—	$81,006.83	$81,006.83	$81,006.83	2026-07-15
3042	APR_DRG	Apr-DRG 3042	2	1	—	—	$77,826.10	$77,826.10	$77,826.10	2026-07-15
3054	APR_DRG	Apr-DRG 3054	2	1	—	—	$75,230.28	$75,230.28	$75,230.28	2026-07-15
J2350	HCPCS	Ocrelizumab 300 Mg/10 Ml	10	5	$88,789.00	$86,126.02	$6.09	$86,126.02	$72,141.64	2026-07-15
867	MS_DRG	Ms-DRG 867	1	1	—	—	$70,595.63	$70,595.63	$70,595.63	2026-07-15
38	MS_DRG	Ms-DRG 38	1	1	—	—	$68,085.87	$68,085.87	$68,085.87	2026-07-15
3122	APR_DRG	Apr-DRG 3122	2	1	—	—	$67,667.53	$67,667.53	$67,667.53	2026-07-15
3253	APR_DRG	Apr-DRG 3253	3	2	—	—	$24,776.91	$65,602.33	$65,602.33	2026-07-15
3041	APR_DRG	Apr-DRG 3041	2	1	—	—	$64,958.98	$64,958.98	$64,958.98	2026-07-15
486	MS_DRG	Ms-DRG 486	1	1	—	—	$64,930.09	$64,930.09	$64,930.09	2026-07-15
573	MS_DRG	Ms-DRG 573	1	1	—	—	$62,736.70	$62,736.70	$62,736.70	2026-07-15
464	MS_DRG	Ms-DRG 464	1	1	—	—	$61,599.19	$61,599.19	$61,599.19	2026-07-15
9123	APR_DRG	Apr-DRG 9123	2	1	—	—	$57,797.15	$57,797.15	$57,797.15	2026-07-15
3133	APR_DRG	Apr-DRG 3133	2	1	—	—	$57,528.41	$57,528.41	$57,528.41	2026-07-15
3053	APR_DRG	Apr-DRG 3053	2	1	—	—	$56,283.37	$56,283.37	$56,283.37	2026-07-15
6333	APR_DRG	Apr-DRG 6333	2	1	—	—	$56,028.24	$56,028.24	$56,028.24	2026-07-15
602	MS_DRG	Ms-DRG 602	1	1	—	—	$55,861.56	$55,861.56	$55,861.56	2026-07-15
551	MS_DRG	Ms-DRG 551	1	1	—	—	$51,765.09	$51,765.09	$51,765.09	2026-07-15
7214	APR_DRG	Apr-DRG 7214	2	1	—	—	$51,296.28	$51,296.28	$51,296.28	2026-07-15
896	MS_DRG	Ms-DRG 896	1	1	—	—	$51,253.74	$51,253.74	$51,253.74	2026-07-15
708	MS_DRG	Ms-DRG 708	1	1	—	—	$50,674.11	$50,674.11	$50,674.11	2026-07-15
820	MS_DRG	Ms-DRG 820	2	1	—	—	$50,516.54	$50,516.54	$50,516.54	2026-07-15
69	MS_DRG	Ms-DRG 69	1	1	—	—	$47,319.27	$47,319.27	$47,319.27	2026-07-15
354	MS_DRG	Ms-DRG 354	1	1	—	—	$45,694.52	$45,694.52	$45,694.52	2026-07-15
239	MS_DRG	Ms-DRG 239	2	1	—	—	$43,706.61	$43,706.61	$43,706.61	2026-07-15
8174	APR_DRG	Apr-DRG 8174	2	1	—	—	$43,704.25	$43,704.25	$43,704.25	2026-07-15
2484	APR_DRG	Apr-DRG 2484	2	1	—	—	$43,404.77	$43,404.77	$43,404.77	2026-07-15
1344	APR_DRG	Apr-DRG 1344	2	1	—	—	$43,036.92	$43,036.92	$43,036.92	2026-07-15
3132	APR_DRG	Apr-DRG 3132	2	1	—	—	$43,018.94	$43,018.94	$43,018.94	2026-07-15
743	MS_DRG	Ms-DRG 743	1	1	—	—	$42,105.79	$42,105.79	$42,105.79	2026-07-15
853	MS_DRG	Ms-DRG 853	3	2	—	—	$41,172.24	$65,658.51	$41,172.24	2026-07-15
7204	APR_DRG	Apr-DRG 7204	3	2	—	—	$41,100.60	$77,998.10	$41,100.60	2026-07-15
2314	APR_DRG	Apr-DRG 2314	2	1	—	—	$41,033.49	$41,033.49	$41,033.49	2026-07-15
2302	APR_DRG	Apr-DRG 2302	2	1	—	—	$38,239.72	$38,239.72	$38,239.72	2026-07-15
914	MS_DRG	Ms-DRG 914	1	1	—	—	$37,615.05	$37,615.05	$37,615.05	2026-07-15
7922	APR_DRG	Apr-DRG 7922	2	1	—	—	$36,395.57	$36,395.57	$36,395.57	2026-07-15
742	MS_DRG	Ms-DRG 742	1	1	—	—	$36,215.67	$36,215.67	$36,215.67	2026-07-15
2312	APR_DRG	Apr-DRG 2312	2	1	—	—	$35,519.04	$35,519.04	$35,519.04	2026-07-15
448	MS_DRG	Ms-DRG 448	3	2	—	—	$35,440.04	$122,988.25	$35,440.04	2026-07-15
7102	APR_DRG	Apr-DRG 7102	2	1	—	—	$34,565.36	$34,565.36	$34,565.36	2026-07-15
6633	APR_DRG	Apr-DRG 6633	2	1	—	—	$34,500.39	$34,500.39	$34,500.39	2026-07-15
6914	APR_DRG	Apr-DRG 6914	2	1	—	—	$34,039.34	$34,039.34	$34,039.34	2026-07-15
543	MS_DRG	Ms-DRG 543	1	1	—	—	$33,656.72	$33,656.72	$33,656.72	2026-07-15
402	MS_DRG	Ms-DRG 402	3	2	—	—	$33,552.92	$144,985.91	$33,552.92	2026-07-15
J3380	HCPCS	Vedolizumab 300 Mg Vial	12	5	$39,149.00	$37,975.12	$72.63	$37,975.12	$33,394.62	2026-07-15
178	MS_DRG	Ms-DRG 178	1	1	—	—	$32,734.81	$32,734.81	$32,734.81	2026-07-15
384	MS_DRG	Ms-DRG 384	1	1	—	—	$31,177.76	$31,177.76	$31,177.76	2026-07-15
3172	APR_DRG	Apr-DRG 3172	2	1	—	—	$30,657.50	$30,657.50	$30,657.50	2026-07-15
7593	APR_DRG	Apr-DRG 7593	2	1	—	—	$30,443.44	$30,443.44	$30,443.44	2026-07-15
433	MS_DRG	Ms-DRG 433	1	1	—	—	$30,240.94	$30,240.94	$30,240.94	2026-07-15
574	MS_DRG	Ms-DRG 574	2	1	—	—	$30,042.88	$30,042.88	$30,042.88	2026-07-15
441	MS_DRG	Ms-DRG 441	1	1	—	—	$29,963.11	$29,963.11	$29,963.11	2026-07-15
467	MS_DRG	Ms-DRG 467	2	1	—	—	$29,732.16	$29,732.16	$29,732.16	2026-07-15
523	APR_DRG	Apr-DRG 523	2	1	—	—	$29,588.38	$29,588.38	$29,588.38	2026-07-15
6612	APR_DRG	Apr-DRG 6612	2	1	—	—	$29,216.75	$29,216.75	$29,216.75	2026-07-15
4253	APR_DRG	Apr-DRG 4253	2	1	—	—	$29,132.82	$29,132.82	$29,132.82	2026-07-15
1414	APR_DRG	Apr-DRG 1414	2	1	—	—	$27,848.12	$27,848.12	$27,848.12	2026-07-15
100	MS_DRG	Ms-DRG 100	1	1	—	—	$27,789.82	$27,789.82	$27,789.82	2026-07-15
7112	APR_DRG	Apr-DRG 7112	2	1	—	—	$27,655.37	$27,655.37	$27,655.37	2026-07-15
7203	APR_DRG	Apr-DRG 7203	2	1	—	—	$27,632.34	$27,632.34	$27,632.34	2026-07-15
897	MS_DRG	Ms-DRG 897	1	1	—	—	$27,545.03	$27,545.03	$27,545.03	2026-07-15
193	MS_DRG	Ms-DRG 193	4	3	—	—	$11,458.81	$60,773.58	$27,048.37	2026-07-15
2301	APR_DRG	Apr-DRG 2301	2	1	—	—	$26,919.72	$26,919.72	$26,919.72	2026-07-15
2332	APR_DRG	Apr-DRG 2332	2	1	—	—	$26,823.15	$26,823.15	$26,823.15	2026-07-15
451	MS_DRG	Ms-DRG 451	3	2	—	—	$26,791.09	$103,011.75	$26,791.09	2026-07-15
788	MS_DRG	Ms-DRG 788	1	1	—	—	$26,655.25	$26,655.25	$26,655.25	2026-07-15
5013	APR_DRG	Apr-DRG 5013	2	1	—	—	$26,441.53	$26,441.53	$26,441.53	2026-07-15
3081	APR_DRG	Apr-DRG 3081	2	1	—	—	$26,364.92	$26,364.92	$26,364.92	2026-07-15
6511	APR_DRG	Apr-DRG 6511	2	1	—	—	$26,160.42	$26,160.42	$26,160.42	2026-07-15
J3101	HCPCS	Tenecteplase 50 Mg/10 Ml Syrng	10	5	$31,584.00	$30,637.29	$0.41	$30,637.29	$25,662.68	2026-07-15
2072	APR_DRG	Apr-DRG 2072	2	1	—	—	$25,562.37	$25,562.37	$25,562.37	2026-07-15
7921	APR_DRG	Apr-DRG 7921	2	1	—	—	$25,450.52	$25,450.52	$25,450.52	2026-07-15
2803	APR_DRG	Apr-DRG 2803	2	1	—	—	$25,220.75	$25,220.75	$25,220.75	2026-07-15
190	MS_DRG	Ms-DRG 190	1	1	—	—	$25,114.05	$25,114.05	$25,114.05	2026-07-15
2453	APR_DRG	Apr-DRG 2453	2	1	—	—	$24,927.31	$24,927.31	$24,927.31	2026-07-15
5403	APR_DRG	Apr-DRG 5403	2	1	—	—	$24,815.16	$24,815.16	$24,815.16	2026-07-15
2413	APR_DRG	Apr-DRG 2413	2	1	—	—	$24,222.68	$24,222.68	$24,222.68	2026-07-15
480	MS_DRG	Ms-DRG 480	3	2	—	—	$24,180.10	$58,385.89	$24,180.10	2026-07-15
J9306	HCPCS	Pertuzumab 420 Mg/14 Ml Vial	8	5	$29,670.00	$28,780.39	$508.34	$28,780.39	$24,107.29	2026-07-15
1943	APR_DRG	Apr-DRG 1943	2	1	—	—	$23,960.02	$23,960.02	$23,960.02	2026-07-15
4263	APR_DRG	Apr-DRG 4263	2	1	—	—	$23,610.37	$23,610.37	$23,610.37	2026-07-15
1973	APR_DRG	Apr-DRG 1973	2	1	—	—	$23,288.24	$23,288.24	$23,288.24	2026-07-15
200	MS_DRG	Ms-DRG 200	1	1	—	—	$23,286.49	$23,286.49	$23,286.49	2026-07-15
2473	APR_DRG	Apr-DRG 2473	2	1	—	—	$22,919.06	$22,919.06	$22,919.06	2026-07-15
468	MS_DRG	Ms-DRG 468	3	2	—	—	$22,779.18	$50,984.00	$22,779.18	2026-07-15
760	MS_DRG	Ms-DRG 760	1	1	—	—	$22,757.63	$22,757.63	$22,757.63	2026-07-15
J2353	HCPCS	Octreotide (Depot) 30 Mg Syr	8	5	$27,842.00	$27,006.83	$17.33	$27,006.83	$22,621.69	2026-07-15
641	MS_DRG	Ms-DRG 641	2	2	—	—	$17,255.74	$27,822.77	$22,539.26	2026-07-15
846	MS_DRG	Ms-DRG 846	2	1	—	—	$22,176.58	$22,176.58	$22,176.58	2026-07-15
483	MS_DRG	Ms-DRG 483	2	1	—	—	$22,128.03	$22,128.03	$22,128.03	2026-07-15
857	MS_DRG	Ms-DRG 857	2	1	—	—	$22,068.37	$22,068.37	$22,068.37	2026-07-15
8134	APR_DRG	Apr-DRG 8134	2	1	—	—	$21,996.49	$21,996.49	$21,996.49	2026-07-15
291	MS_DRG	Ms-DRG 291	4	3	—	—	$10,736.33	$59,904.35	$21,948.53	2026-07-15
2231	APR_DRG	Apr-DRG 2231	2	1	—	—	$21,718.26	$21,718.26	$21,718.26	2026-07-15
4633	APR_DRG	Apr-DRG 4633	2	1	—	—	$21,707.88	$21,707.88	$21,707.88	2026-07-15
4203	APR_DRG	Apr-DRG 4203	2	1	—	—	$21,684.29	$21,684.29	$21,684.29	2026-07-15
439	MS_DRG	Ms-DRG 439	2	1	—	—	$21,433.29	$21,433.29	$21,433.29	2026-07-15
J9271	HCPCS	Pembrolizumab 100 Mg/4 Ml Vial	8	5	$26,038.00	$25,257.65	$13.37	$25,257.65	$21,156.53	2026-07-15
6602	APR_DRG	Apr-DRG 6602	2	1	—	—	$21,114.61	$21,114.61	$21,114.61	2026-07-15
3853	APR_DRG	Apr-DRG 3853	2	1	—	—	$21,044.93	$21,044.93	$21,044.93	2026-07-15
J0717	HCPCS	Certolizumab Pegol 400 Mg Kit	8	5	$25,886.00	$25,109.77	$3.42	$25,109.77	$21,032.67	2026-07-15
2331	APR_DRG	Apr-DRG 2331	2	1	—	—	$20,941.04	$20,941.04	$20,941.04	2026-07-15
327	MS_DRG	Ms-DRG 327	2	1	—	—	$20,410.39	$20,410.39	$20,410.39	2026-07-15
806	MS_DRG	Ms-DRG 806	1	1	—	—	$20,325.27	$20,325.27	$20,325.27	2026-07-15
5421	APR_DRG	Apr-DRG 5421	2	1	—	—	$20,302.06	$20,302.06	$20,302.06	2026-07-15
5192	APR_DRG	Apr-DRG 5192	2	1	—	—	$20,269.71	$20,269.71	$20,269.71	2026-07-15
330	MS_DRG	Ms-DRG 330	3	2	—	—	$20,018.56	$63,080.93	$20,018.56	2026-07-15
6341	APR_DRG	Apr-DRG 6341	2	1	—	—	$20,010.95	$20,010.95	$20,010.95	2026-07-15
3852	APR_DRG	Apr-DRG 3852	2	1	—	—	$19,908.07	$19,908.07	$19,908.07	2026-07-15
1373	APR_DRG	Apr-DRG 1373	2	1	—	—	$19,737.75	$19,737.75	$19,737.75	2026-07-15
5402	APR_DRG	Apr-DRG 5402	3	2	—	—	$6,283.65	$19,664.86	$19,664.86	2026-07-15
2014	APR_DRG	Apr-DRG 2014	2	1	—	—	$19,645.67	$19,645.67	$19,645.67	2026-07-15
2833	APR_DRG	Apr-DRG 2833	2	1	—	—	$19,395.49	$19,395.49	$19,395.49	2026-07-15
2493	APR_DRG	Apr-DRG 2493	2	1	—	—	$19,047.29	$19,047.29	$19,047.29	2026-07-15
5392	APR_DRG	Apr-DRG 5392	2	1	—	—	$18,929.87	$18,929.87	$18,929.87	2026-07-15
299	MS_DRG	Ms-DRG 299	1	1	—	—	$18,917.50	$18,917.50	$18,917.50	2026-07-15
2013	APR_DRG	Apr-DRG 2013	2	1	—	—	$18,842.79	$18,842.79	$18,842.79	2026-07-15
3162	APR_DRG	Apr-DRG 3162	2	1	—	—	$18,439.54	$18,439.54	$18,439.54	2026-07-15
522	MS_DRG	Ms-DRG 522	3	2	—	—	$18,312.09	$64,129.42	$18,312.09	2026-07-15
1394	APR_DRG	Apr-DRG 1394	2	1	—	—	$18,180.09	$18,180.09	$18,180.09	2026-07-15
7202	APR_DRG	Apr-DRG 7202	3	2	—	—	$7,839.43	$18,171.81	$18,171.81	2026-07-15
502	APR_DRG	Apr-DRG 502	2	1	—	—	$18,082.60	$18,082.60	$18,082.60	2026-07-15
481	MS_DRG	Ms-DRG 481	3	2	—	—	$18,024.20	$18,388.90	$18,024.20	2026-07-15
7233	APR_DRG	Apr-DRG 7233	2	1	—	—	$17,972.01	$17,972.01	$17,972.01	2026-07-15
452	APR_DRG	Apr-DRG 452	2	1	—	—	$17,950.03	$17,950.03	$17,950.03	2026-07-15
592	MS_DRG	Ms-DRG 592	2	1	—	—	$17,553.16	$17,553.16	$17,553.16	2026-07-15
5131	APR_DRG	Apr-DRG 5131	2	1	—	—	$17,482.50	$17,482.50	$17,482.50	2026-07-15
2402	APR_DRG	Apr-DRG 2402	2	1	—	—	$17,166.82	$17,166.82	$17,166.82	2026-07-15
786	MS_DRG	Ms-DRG 786	1	1	—	—	$17,133.34	$17,133.34	$17,133.34	2026-07-15
2532	APR_DRG	Apr-DRG 2532	2	1	—	—	$17,098.88	$17,098.88	$17,098.88	2026-07-15
8123	APR_DRG	Apr-DRG 8123	2	1	—	—	$17,048.93	$17,048.93	$17,048.93	2026-07-15
871	MS_DRG	Ms-DRG 871	4	3	—	—	$17,045.29	$29,632.70	$17,045.73	2026-07-15
241	APR_DRG	Apr-DRG 241	2	1	—	—	$17,010.97	$17,010.97	$17,010.97	2026-07-15
64	MS_DRG	Ms-DRG 64	3	2	—	—	$16,959.94	$37,563.14	$16,959.94	2026-07-15
617	MS_DRG	Ms-DRG 617	3	2	—	—	$16,781.70	$47,064.29	$16,781.70	2026-07-15
202	MS_DRG	Ms-DRG 202	1	1	—	—	$16,663.19	$16,663.19	$16,663.19	2026-07-15
1942	APR_DRG	Apr-DRG 1942	2	1	—	—	$16,427.20	$16,427.20	$16,427.20	2026-07-15
470	MS_DRG	Ms-DRG 470	2	1	—	—	$16,382.01	$16,382.01	$16,382.01	2026-07-15
4252	APR_DRG	Apr-DRG 4252	2	1	—	—	$15,982.00	$15,982.00	$15,982.00	2026-07-15
3641	APR_DRG	Apr-DRG 3641	2	1	—	—	$15,925.05	$15,925.05	$15,925.05	2026-07-15
5191	APR_DRG	Apr-DRG 5191	2	1	—	—	$15,800.18	$15,800.18	$15,800.18	2026-07-15
2522	APR_DRG	Apr-DRG 2522	2	1	—	—	$15,776.54	$15,776.54	$15,776.54	2026-07-15
377	MS_DRG	Ms-DRG 377	3	2	—	—	$15,764.95	$24,546.41	$15,764.95	2026-07-15
3832	APR_DRG	Apr-DRG 3832	2	1	—	—	$15,764.22	$15,764.22	$15,764.22	2026-07-15
1332	APR_DRG	Apr-DRG 1332	2	1	—	—	$15,621.33	$15,621.33	$15,621.33	2026-07-15
3263	APR_DRG	Apr-DRG 3263	1	1	—	—	$15,503.84	$15,503.84	$15,503.84	2026-07-15
5391	APR_DRG	Apr-DRG 5391	2	1	—	—	$15,376.33	$15,376.33	$15,376.33	2026-07-15
205	MS_DRG	Ms-DRG 205	2	1	—	—	$15,298.24	$15,298.24	$15,298.24	2026-07-15
2442	APR_DRG	Apr-DRG 2442	2	1	—	—	$15,080.90	$15,080.90	$15,080.90	2026-07-15
4692	APR_DRG	Apr-DRG 4692	2	1	—	—	$15,066.01	$15,066.01	$15,066.01	2026-07-15
8612	APR_DRG	Apr-DRG 8612	2	1	—	—	$15,011.87	$15,011.87	$15,011.87	2026-07-15
5401	APR_DRG	Apr-DRG 5401	3	2	—	—	$4,912.30	$14,955.03	$14,955.03	2026-07-15
6343	APR_DRG	Apr-DRG 6343	2	1	—	—	$14,932.41	$14,932.41	$14,932.41	2026-07-15
2482	APR_DRG	Apr-DRG 2482	2	1	—	—	$14,891.09	$14,891.09	$14,891.09	2026-07-15
J9173	HCPCS	Durvalumab 500 Mg/10 Ml Vial	8	5	$18,222.00	$17,675.82	$16.91	$17,675.82	$14,805.77	2026-07-15
421	APR_DRG	Apr-DRG 421	2	1	—	—	$14,765.22	$14,765.22	$14,765.22	2026-07-15
1133	APR_DRG	Apr-DRG 1133	2	1	—	—	$14,765.22	$14,765.22	$14,765.22	2026-07-15
5603	APR_DRG	Apr-DRG 5603	3	2	—	—	$4,254.40	$14,679.06	$14,679.06	2026-07-15
91	MS_DRG	Ms-DRG 91	2	1	—	—	$14,674.64	$14,674.64	$14,674.64	2026-07-15
698	MS_DRG	Ms-DRG 698	3	2	—	—	$14,607.99	$61,228.50	$14,607.99	2026-07-15
7201	APR_DRG	Apr-DRG 7201	2	1	—	—	$14,501.62	$14,501.62	$14,501.62	2026-07-15
640	MS_DRG	Ms-DRG 640	1	1	—	—	$14,501.30	$14,501.30	$14,501.30	2026-07-15
1392	APR_DRG	Apr-DRG 1392	2	1	—	—	$14,473.27	$14,473.27	$14,473.27	2026-07-15
8102	APR_DRG	Apr-DRG 8102	2	1	—	—	$14,463.15	$14,463.15	$14,463.15	2026-07-15
789	MS_DRG	Ms-DRG 789	1	1	—	—	$14,424.06	$14,424.06	$14,424.06	2026-07-15
418	MS_DRG	Ms-DRG 418	2	1	—	—	$14,412.89	$14,412.89	$14,412.89	2026-07-15
5011	APR_DRG	Apr-DRG 5011	2	1	—	—	$14,266.74	$14,266.74	$14,266.74	2026-07-15
1352	APR_DRG	Apr-DRG 1352	2	1	—	—	$14,155.83	$14,155.83	$14,155.83	2026-07-15
2063	APR_DRG	Apr-DRG 2063	2	1	—	—	$14,135.92	$14,135.92	$14,135.92	2026-07-15
4262	APR_DRG	Apr-DRG 4262	2	1	—	—	$14,077.91	$14,077.91	$14,077.91	2026-07-15
683	MS_DRG	Ms-DRG 683	1	1	—	—	$14,053.90	$14,053.90	$14,053.90	2026-07-15
177	MS_DRG	Ms-DRG 177	3	2	—	—	$14,048.73	$17,876.99	$14,048.73	2026-07-15
371	MS_DRG	Ms-DRG 371	3	2	—	—	$14,002.30	$19,753.68	$14,002.30	2026-07-15
1413	APR_DRG	Apr-DRG 1413	2	1	—	—	$13,988.00	$13,988.00	$13,988.00	2026-07-15
183	MS_DRG	Ms-DRG 183	2	1	—	—	$13,762.88	$13,762.88	$13,762.88	2026-07-15
6263	APR_DRG	Apr-DRG 6263	2	1	—	—	$13,597.08	$13,597.08	$13,597.08	2026-07-15
1451	APR_DRG	Apr-DRG 1451	2	1	—	—	$13,563.83	$13,563.83	$13,563.83	2026-07-15
451	APR_DRG	Apr-DRG 451	2	1	—	—	$13,518.47	$13,518.47	$13,518.47	2026-07-15
7752	APR_DRG	Apr-DRG 7752	3	2	—	—	$1,988.60	$13,480.51	$13,480.51	2026-07-15
1353	APR_DRG	Apr-DRG 1353	2	1	—	—	$13,450.29	$13,450.29	$13,450.29	2026-07-15
813	MS_DRG	Ms-DRG 813	3	2	—	—	$13,422.13	$13,455.65	$13,422.13	2026-07-15
1383	APR_DRG	Apr-DRG 1383	2	1	—	—	$13,296.18	$13,296.18	$13,296.18	2026-07-15
807	MS_DRG	Ms-DRG 807	6	5	—	—	$12,417.73	$15,865.68	$13,164.43	2026-07-15
1992	APR_DRG	Apr-DRG 1992	2	1	—	—	$13,066.92	$13,066.92	$13,066.92	2026-07-15
1393	APR_DRG	Apr-DRG 1393	3	2	—	—	$6,845.25	$13,063.21	$13,063.21	2026-07-15
682	MS_DRG	Ms-DRG 682	3	2	—	—	$13,055.95	$45,783.53	$13,055.95	2026-07-15
5422	APR_DRG	Apr-DRG 5422	2	1	—	—	$13,016.97	$13,016.97	$13,016.97	2026-07-15
36482	CPT	Endoven Ther Chem Adhes 1St	8	5	$15,754.00	$15,281.38	$10,240.10	$15,281.38	$12,941.91	2026-07-15
865	MS_DRG	Ms-DRG 865	2	1	—	—	$12,830.52	$12,830.52	$12,830.52	2026-07-15
2511	APR_DRG	Apr-DRG 2511	2	1	—	—	$12,827.11	$12,827.11	$12,827.11	2026-07-15
4632	APR_DRG	Apr-DRG 4632	2	1	—	—	$12,805.18	$12,805.18	$12,805.18	2026-07-15
4202	APR_DRG	Apr-DRG 4202	2	1	—	—	$12,757.23	$12,757.23	$12,757.23	2026-07-15
1381	APR_DRG	Apr-DRG 1381	2	1	—	—	$12,722.64	$12,722.64	$12,722.64	2026-07-15
7241	APR_DRG	Apr-DRG 7241	2	1	—	—	$12,689.30	$12,689.30	$12,689.30	2026-07-15
7222	APR_DRG	Apr-DRG 7222	2	1	—	—	$12,689.30	$12,689.30	$12,689.30	2026-07-15
637	MS_DRG	Ms-DRG 637	1	1	—	—	$12,627.04	$12,627.04	$12,627.04	2026-07-15
553	APR_DRG	Apr-DRG 553	2	1	—	—	$12,500.00	$12,500.00	$12,500.00	2026-07-15
6403	APR_DRG	Apr-DRG 6403	2	1	—	—	$12,401.90	$12,401.90	$12,401.90	2026-07-15
2012	APR_DRG	Apr-DRG 2012	2	1	—	—	$12,387.73	$12,387.73	$12,387.73	2026-07-15
2492	APR_DRG	Apr-DRG 2492	2	1	—	—	$12,264.21	$12,264.21	$12,264.21	2026-07-15
1351	APR_DRG	Apr-DRG 1351	2	1	—	—	$12,257.73	$12,257.73	$12,257.73	2026-07-15
2481	APR_DRG	Apr-DRG 2481	2	1	—	—	$12,112.35	$12,112.35	$12,112.35	2026-07-15
2441	APR_DRG	Apr-DRG 2441	2	1	—	—	$11,936.20	$11,936.20	$11,936.20	2026-07-15
918	MS_DRG	Ms-DRG 918	1	1	—	—	$11,591.93	$11,591.93	$11,591.93	2026-07-15
8111	APR_DRG	Apr-DRG 8111	2	1	—	—	$11,550.44	$11,550.44	$11,550.44	2026-07-15
J1569	HCPCS	Immune Glob Gamagar 30gr/300ml	8	5	$14,132.00	$13,708.84	$21.77	$13,708.84	$11,482.92	2026-07-15
5602	APR_DRG	Apr-DRG 5602	2	1	—	—	$11,361.15	$11,361.15	$11,361.15	2026-07-15
7753	APR_DRG	Apr-DRG 7753	2	1	—	—	$11,184.14	$11,184.14	$11,184.14	2026-07-15
1441	APR_DRG	Apr-DRG 1441	2	1	—	—	$11,144.84	$11,144.84	$11,144.84	2026-07-15
4213	APR_DRG	Apr-DRG 4213	2	1	—	—	$10,910.48	$10,910.48	$10,910.48	2026-07-15
4631	APR_DRG	Apr-DRG 4631	2	1	—	—	$10,887.10	$10,887.10	$10,887.10	2026-07-15
1412	APR_DRG	Apr-DRG 1412	2	1	—	—	$10,885.16	$10,885.16	$10,885.16	2026-07-15
189	MS_DRG	Ms-DRG 189	3	2	—	—	$10,762.55	$51,134.69	$10,762.55	2026-07-15
308	MS_DRG	Ms-DRG 308	3	2	—	—	$10,643.02	$35,342.91	$10,643.02	2026-07-15
1391	APR_DRG	Apr-DRG 1391	2	1	—	—	$10,535.03	$10,535.03	$10,535.03	2026-07-15
4261	APR_DRG	Apr-DRG 4261	2	1	—	—	$10,394.01	$10,394.01	$10,394.01	2026-07-15
4222	APR_DRG	Apr-DRG 4222	2	1	—	—	$10,223.22	$10,223.22	$10,223.22	2026-07-15
2491	APR_DRG	Apr-DRG 2491	2	1	—	—	$10,211.07	$10,211.07	$10,211.07	2026-07-15
1132	APR_DRG	Apr-DRG 1132	3	2	—	—	$4,146.27	$10,159.83	$10,159.83	2026-07-15
2471	APR_DRG	Apr-DRG 2471	2	1	—	—	$10,140.20	$10,140.20	$10,140.20	2026-07-15
5601	APR_DRG	Apr-DRG 5601	3	2	—	—	$2,943.61	$9,926.06	$9,926.06	2026-07-15
39	MS_DRG	Ms-DRG 39	3	2	—	—	$9,833.45	$30,311.22	$9,833.45	2026-07-15
2071	APR_DRG	Apr-DRG 2071	2	1	—	—	$9,724.27	$9,724.27	$9,724.27	2026-07-15
689	MS_DRG	Ms-DRG 689	3	2	—	—	$9,706.73	$141,331.70	$9,706.73	2026-07-15
3811	APR_DRG	Apr-DRG 3811	2	1	—	—	$9,664.37	$9,664.37	$9,664.37	2026-07-15
2011	APR_DRG	Apr-DRG 2011	2	1	—	—	$9,492.50	$9,492.50	$9,492.50	2026-07-15
481	APR_DRG	Apr-DRG 481	2	1	—	—	$9,404.59	$9,404.59	$9,404.59	2026-07-15
1981	APR_DRG	Apr-DRG 1981	2	1	—	—	$9,260.73	$9,260.73	$9,260.73	2026-07-15
445	MS_DRG	Ms-DRG 445	2	1	—	—	$9,228.44	$9,228.44	$9,228.44	2026-07-15
872	MS_DRG	Ms-DRG 872	3	2	—	—	$8,972.94	$30,444.34	$8,972.94	2026-07-15
1382	APR_DRG	Apr-DRG 1382	2	1	—	—	$8,941.53	$8,941.53	$8,941.53	2026-07-15
J9317	HCPCS	Sacituzumab Gov-hziy 180Mg	8	5	$10,917.00	$10,589.85	$4,156.37	$10,589.85	$8,870.36	2026-07-15
65	MS_DRG	Ms-DRG 65	3	2	—	—	$8,850.69	$34,010.14	$8,850.69	2026-07-15
6393	APR_DRG	Apr-DRG 6393	2	1	—	—	$8,847.28	$8,847.28	$8,847.28	2026-07-15
5612	APR_DRG	Apr-DRG 5612	3	2	—	—	$3,332.74	$8,795.73	$8,795.73	2026-07-15
372	MS_DRG	Ms-DRG 372	3	2	—	—	$8,695.79	$25,711.71	$8,695.79	2026-07-15
378	MS_DRG	Ms-DRG 378	3	2	—	—	$8,581.90	$51,544.64	$8,581.90	2026-07-15
Q5119	HCPCS	Rituximab-pvvr 500Mg/50Ml Vial	10	5	$10,504.00	$10,189.19	$1,112.40	$10,189.19	$8,534.76	2026-07-15
1131	APR_DRG	Apr-DRG 1131	2	1	—	—	$8,489.99	$8,489.99	$8,489.99	2026-07-15
2543	APR_DRG	Apr-DRG 2543	1	1	—	—	$8,449.64	$8,449.64	$8,449.64	2026-07-15
4221	APR_DRG	Apr-DRG 4221	2	1	—	—	$8,437.34	$8,437.34	$8,437.34	2026-07-15
442	MS_DRG	Ms-DRG 442	2	1	—	—	$8,411.09	$8,411.09	$8,411.09	2026-07-15
552	MS_DRG	Ms-DRG 552	2	1	—	—	$8,390.28	$8,390.28	$8,390.28	2026-07-15
1411	APR_DRG	Apr-DRG 1411	2	1	—	—	$8,186.27	$8,186.27	$8,186.27	2026-07-15
638	MS_DRG	Ms-DRG 638	1	1	—	—	$8,148.35	$8,148.35	$8,148.35	2026-07-15
812	MS_DRG	Ms-DRG 812	2	1	—	—	$8,035.63	$8,035.63	$8,035.63	2026-07-15
281	MS_DRG	Ms-DRG 281	2	1	—	—	$8,026.11	$8,026.11	$8,026.11	2026-07-15
2843	APR_DRG	Apr-DRG 2843	2	1	—	—	$8,001.00	$8,001.00	$8,001.00	2026-07-15
6391	APR_DRG	Apr-DRG 6391	2	1	—	—	$7,798.33	$7,798.33	$7,798.33	2026-07-15
563	MS_DRG	Ms-DRG 563	2	1	—	—	$7,783.33	$7,783.33	$7,783.33	2026-07-15
866	MS_DRG	Ms-DRG 866	2	1	—	—	$7,671.78	$7,671.78	$7,671.78	2026-07-15
603	MS_DRG	Ms-DRG 603	2	1	—	—	$7,670.61	$7,670.61	$7,670.61	2026-07-15
6262	APR_DRG	Apr-DRG 6262	2	1	—	—	$7,638.35	$7,638.35	$7,638.35	2026-07-15
3851	APR_DRG	Apr-DRG 3851	2	1	—	—	$7,626.72	$7,626.72	$7,626.72	2026-07-15
74174	CPT	CTA Abd&Pelv Wwo Dye	8	5	$8,770.00	$8,506.90	$613.90	$8,506.90	$7,599.20	2026-07-15
312	MS_DRG	Ms-DRG 312	2	1	—	—	$7,588.24	$7,588.24	$7,588.24	2026-07-15
793	MS_DRG	Ms-DRG 793	1	1	—	—	$7,554.05	$7,554.05	$7,554.05	2026-07-15
8613	APR_DRG	Apr-DRG 8613	1	1	—	—	$7,528.15	$7,528.15	$7,528.15	2026-07-15
2533	APR_DRG	Apr-DRG 2533	2	1	—	—	$7,364.00	$7,364.00	$7,364.00	2026-07-15
6331	APR_DRG	Apr-DRG 6331	2	1	—	—	$7,354.07	$7,354.07	$7,354.07	2026-07-15
Q5111	HCPCS	Pegfilgrastim-cbqv 6 Mg/0.6 Ml	8	5	$8,925.00	$8,657.25	$1,112.40	$8,657.25	$7,251.57	2026-07-15
556	MS_DRG	Ms-DRG 556	2	1	—	—	$7,112.20	$7,112.20	$7,112.20	2026-07-15
795	MS_DRG	Ms-DRG 795	2	2	—	—	$6,989.33	$7,149.33	$7,069.33	2026-07-15
536	MS_DRG	Ms-DRG 536	3	2	—	—	$7,064.54	$23,248.53	$7,064.54	2026-07-15
74178	CPT	CT Abd & Pelv Wwo Contrast	11	5	$8,278.00	$8,029.66	$479.88	$8,029.66	$7,061.13	2026-07-15
J1602	HCPCS	Golimumab 50 Mg/4 Ml Vial	8	5	$8,593.00	$8,335.92	$43.11	$8,335.92	$6,982.40	2026-07-15
6261	APR_DRG	Apr-DRG 6261	2	1	—	—	$6,971.39	$6,971.39	$6,971.39	2026-07-15
1902	APR_DRG	Apr-DRG 1902	2	1	—	—	$6,923.00	$6,923.00	$6,923.00	2026-07-15
1901	APR_DRG	Apr-DRG 1901	2	1	—	—	$6,923.00	$6,923.00	$6,923.00	2026-07-15
948	MS_DRG	Ms-DRG 948	1	1	—	—	$6,922.34	$6,922.34	$6,922.34	2026-07-15
446	MS_DRG	Ms-DRG 446	2	1	—	—	$6,911.70	$6,911.70	$6,911.70	2026-07-15
5813	APR_DRG	Apr-DRG 5813	2	1	—	—	$6,878.25	$6,878.25	$6,878.25	2026-07-15
392	MS_DRG	Ms-DRG 392	3	2	—	—	$6,799.20	$41,401.94	$6,799.20	2026-07-15
194	MS_DRG	Ms-DRG 194	3	2	—	—	$6,752.17	$62,835.44	$6,752.17	2026-07-15
74177	CPT	CT Abd & Pelv W Contrast	13	5	$7,761.00	$7,528.17	$227.52	$7,528.17	$6,620.13	2026-07-15
1151	APR_DRG	Apr-DRG 1151	2	1	—	—	$6,589.53	$6,589.53	$6,589.53	2026-07-15
Q5116	HCPCS	Trastuzumab Qyyp 420Mg Vial	8	5	$8,101.00	$7,858.11	$2,896.88	$7,858.11	$6,582.18	2026-07-15
305	MS_DRG	Ms-DRG 305	3	2	—	—	$6,542.55	$26,487.36	$6,542.55	2026-07-15
Q5108	HCPCS	Pegfilgrastim-jmdb 6 Mg/0.6 Ml	10	5	$8,047.00	$7,806.07	$1,626.36	$7,806.08	$6,538.60	2026-07-15
794	MS_DRG	Ms-DRG 794	3	2	—	—	$6,519.11	$9,452.05	$6,519.11	2026-07-15
309	MS_DRG	Ms-DRG 309	3	2	—	—	$6,443.73	$27,479.82	$6,443.73	2026-07-15
Q5112	HCPCS	Trastuzumab-dttb 420 Mg Vial	8	5	$7,913.00	$7,675.65	$3,051.38	$7,675.65	$6,429.34	2026-07-15
95811	CPT	Polysomnogram W CPap	11	5	$7,497.00	$7,272.09	$2,507.27	$7,272.09	$6,394.94	2026-07-15
282	MS_DRG	Ms-DRG 282	2	1	—	—	$6,287.07	$6,287.07	$6,287.07	2026-07-15
153	MS_DRG	Ms-DRG 153	2	1	—	—	$6,204.41	$6,204.41	$6,204.41	2026-07-15
Q5122	HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Syr	10	5	$7,555.00	$7,328.37	$786.12	$7,328.37	$6,138.45	2026-07-15
J0897	HCPCS	Denosumab 60 Mg/ml Syringe	20	5	$7,432.00	$7,209.62	$9.69	$13,322.09	$6,038.99	2026-07-15
311	MS_DRG	Ms-DRG 311	1	1	—	—	$6,005.22	$6,005.22	$6,005.22	2026-07-15
95810	CPT	Polysomnogram	13	5	$6,524.00	$6,328.28	$2,507.27	$6,328.28	$5,564.97	2026-07-15
72197	CPT	MRI Pelvis Wwo Dye	11	5	$6,321.00	$6,131.37	$618.17	$6,131.37	$5,562.48	2026-07-15
74176	CPT	CT Abd & Pelvis Wo Contrast	13	5	$6,472.00	$6,277.84	$95.04	$6,277.84	$5,520.62	2026-07-15
6402	APR_DRG	Apr-DRG 6402	2	1	—	—	$5,438.61	$5,438.61	$5,438.61	2026-07-15

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