Price Transparencybeta Hospital negotiated rates

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

FORT LOUDOUN MEDICAL CENTER

Lenoir City, TN · CCN 440110 · Rates published

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You selected 93306 (CPT)

CA ECHO WITH DOPPLER/COLOR FLOW

This hospital’s price: $485 across 31 payers · range $108-$1,125

Source: https://ssl.covhlth.com/coldfusionapplication/JSON/621373691_fort-loudoun-medical-center_standardcharges.json · observed 2025-12-23

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.

22,554 distinct procedures filed
31 distinct payers
2,466,710 rate rows
2025-12-23 last MRF observed
Data quality

2,081,381 of 2,466,710 rate rows are consumer-grade (84.4%)

385,329 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 336,594
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 29,208
per-diem day rate — not a per-procedure price 16,530
template filing: same amount across many unrelated codes — excluded 1,398
placeholder amount (≤ $0.02) — excluded from medians 751
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 356
exceeds 10× this hospital's gross charge — excluded from medians 296
percent-of-charges filed in the dollar field — excluded from medians 191
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 5
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mrfs.hyvehealthcare.com/CovenantHealth/621373691_fort-loudoun-medical-center_standardcharges.json
Found on page https://www.covenanthealth.com/patients-visitors/price-estimation/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-15
Content fingerprint a0e6c4733c17bc38… · 337,713,200 bytes · first seen 2026-05-11

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
J1414
HCPCS 		Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 24 $3,276,739.52 $3,932,600.00 $3,604,669.76 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 28 $112,999.74 $3,932,600.00 $3,489,305.46 nat. median
$3,703,693
0.9× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 28 $112,999.74 $3,521,088.40 $3,184,844.39 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 11 $112,999.74 $3,384,580.00 $3,061,371.77 nat. median
$3,286,000
0.9× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 11 $112,999.74 $3,146,080.00 $2,845,647.17 nat. median
$2,994,107
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 24 $2,119,655.08 $2,471,920.00 $2,295,787.54 nat. median
$2,401,960
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge… 28 $112,999.74 $2,784,090.00 $2,126,902.50 nat. median
$2,466,282
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 31 $140,999.68 $584,397.44 $452,842.06 nat. median
$646,415
0.7× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 31 $112,999.74 $599,561.27 $449,559.81 nat. median
$738,272
0.6× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (… 31 $140,999.68 $629,250.00 $443,407.09 nat. median
$622,245
0.7× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 31 $140,999.68 $615,450.00 $433,493.34 nat. median
$640,950
0.7× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 31 $140,999.68 $598,500.00 $411,159.22 nat. median
$591,650
0.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 31 $140,999.68 $598,500.00 $411,159.22 nat. median
$608,101
0.7× median
C9081
HCPCS 		Idecabtagene Car Pos T 1 $392,740.64 $392,740.64 $392,740.64 nat. median
$27,427
outlier · 14.3×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 15 $122,207.24 $581,078.82 $250,292.44 nat. median
$359,358
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 15 $89,886.06 $434,017.17 $184,095.48 nat. median
$249,124
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 $40,958.62 $374,926.16 $179,068.94 nat. median
$198,433
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 15 $70,719.44 $330,218.09 $144,840.34 nat. median
$190,557
0.8× median
J9999
HCPCS 		Not Otherwise Classified, Antineoplastic Drugs 16 $140,999.68 $140,999.68 $140,999.68 nat. median
$2,702
outlier · 52.2×
J8999
HCPCS 		Prescription Drug, Oral, Chemotherapeutic, Nos 16 $112,999.86 $112,999.86 $112,999.86 nat. median
$196
outlier · 576.8×
J8499
HCPCS 		Prescription Drug, Oral, Non Chemotherapeutic, Nos 16 $112,999.86 $112,999.86 $112,999.86 nat. median
$60
outlier · 1872.7×
Q0181
HCPCS 		Unspecified Oral Dosage Form, Fda Approved Prescription Anti-emetic, For Use As… 16 $112,999.86 $112,999.86 $112,999.86 nat. median
$34
outlier · 3368.1×
J8498
HCPCS 		Antiemetic Drug, Rectal/suppository, Not Otherwise Specified 16 $112,999.86 $112,999.86 $112,999.86 nat. median
$27
outlier · 4248.1×
J8597
HCPCS 		Antiemetic Drug, Oral, Not Otherwise Specified 16 $112,999.86 $112,999.86 $112,999.86 nat. median
$9
outlier · 12811.8×
J7304
HCPCS 		Contraceptive Supply, Hormone Containing Patch, Each 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$96
outlier · 1182.4×
J3590
HCPCS 		Unclassified Biologics 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$775
outlier · 145.8×
J3490
HCPCS 		Drugs Unclassified Injection 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$47
outlier · 2385.0×
S5001
HCPCS 		Prescription Drug,brand Name 17 $112,999.74 $112,999.74 $112,999.74 nat. median
$115
outlier · 982.6×
C9399
HCPCS 		Unclassified Drugs Or Biologicals 17 $112,999.74 $112,999.74 $112,999.74 nat. median
$2,001
outlier · 56.5×
J7599
HCPCS 		Immunosuppressive Drug, Not Otherwise Classified 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$155
outlier · 728.0×
J7199
HCPCS 		Hemophilia Clotting Factor, Not Otherwise Classified 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$238
outlier · 475.1×
J7999
HCPCS 		Compounded Drug, Not Otherwise Classified 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$56
outlier · 2023.3×
S5000
HCPCS 		Prescription Drug, Generic 17 $112,999.74 $112,999.74 $112,999.74 nat. median
$118
outlier · 955.2×
790151091
CDM 		Sys Tricuspid Evoque Valve Sz48 3 $47,300.00 $107,500.00 $107,500.00 nat. median
$107,500
1.0× median
790151090
CDM 		Sys Tricuspid Evoque Valve Sz44 3 $47,300.00 $107,500.00 $107,500.00 nat. median
$107,500
1.0× median
790151092
CDM 		Sys Tricuspid Evoque Valve Sz52 3 $47,300.00 $107,500.00 $107,500.00 nat. median
$107,500
1.0× median
Q0480
HCPCS 		Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 31 $99,999.92 $104,999.92 $102,499.92 nat. median
$111,503
0.9× median
J3570
HCPCS 		Laetrile, Amygdalin, Vitamin B17 16 $100,444.43 $100,444.43 $100,444.43 nat. median
$127
outlier · 792.9×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 15 $48,759.90 $217,715.04 $99,865.07 nat. median
$126,722
0.8× median
790151782
CDM 		Sys Triclip G4 Steer Cath Guide 3 $42,900.00 $97,500.00 $97,500.00 nat. median
$97,500
1.0× median
K1007
HCPCS 		Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 24 $93,216.70 $97,877.54 $95,547.12 nat. median
$97,020
1.0× median
790146438
CDM 		Kit Valve Sapien 3 Ultra Thv Sz23 3 $37,400.00 $85,000.00 $85,000.00 nat. median
$85,000
1.0× median
790146436
CDM 		Kit Valve Sapien 3 Ultra Thv Sz29 3 $37,400.00 $85,000.00 $85,000.00 nat. median
$85,000
1.0× median
790146437
CDM 		Kit Valve Sapien 3 Ultra Thv Sz26 3 $37,400.00 $85,000.00 $85,000.00 nat. median
$85,000
1.0× median
790146439
CDM 		Kit Valve Sapien 3 Ultra Thv Sz20 3 $37,400.00 $85,000.00 $85,000.00 nat. median
$85,000
1.0× median
7
MS_DRG 		Lung Transplant 15 $43,206.63 $201,364.07 $83,332.31 nat. median
$117,894
0.7× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $40,613.68 $299,738.00 $83,180.81 nat. median
$103,967
0.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 11 $36,852.46 $161,404.96 $81,729.66 nat. median
$93,270
0.9× median
790133755
CDM 		Valve Aortic Trnscath 23 Sapien 3 $35,750.00 $81,250.00 $81,250.00 nat. median
$81,250
1.0× median
790133756
CDM 		Valve Aortic Trnscath 26 Sapien 3 $35,750.00 $81,250.00 $81,250.00 nat. median
$81,250
1.0× median

Other procedures at this hospital

Browse this hospital's 22,554 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
             
J1414 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 49 24 — — $3,276,739.52 $3,932,600.00 $3,604,669.76 2025-12-23
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 123 28 — — $112,999.74 $3,932,600.00 $3,489,305.46 2025-12-23
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 133 28 — — $112,999.74 $3,521,088.40 $3,184,844.39 2025-12-23
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 35 11 — — $112,999.74 $3,384,580.00 $3,061,371.77 2025-12-23
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 35 11 — — $112,999.74 $3,146,080.00 $2,845,647.17 2025-12-23
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 49 24 — — $2,119,655.08 $2,471,920.00 $2,295,787.54 2025-12-23
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge… 126 28 — — $112,999.74 $2,784,090.00 $2,126,902.50 2025-12-23
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 140 31 — — $140,999.68 $584,397.44 $452,842.06 2025-12-23
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 144 31 — — $112,999.74 $599,561.27 $449,559.81 2025-12-23
Q2055 HCPCS Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (… 140 31 — — $140,999.68 $629,250.00 $443,407.09 2025-12-23
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 140 31 — — $140,999.68 $615,450.00 $433,493.34 2025-12-23
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 140 31 — — $140,999.68 $598,500.00 $411,159.22 2025-12-23
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 140 31 — — $140,999.68 $598,500.00 $411,159.22 2025-12-23
C9081 HCPCS Idecabtagene Car Pos T 1 1 — — $392,740.64 $392,740.64 $392,740.64 2025-12-23
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 93 15 — — $122,207.24 $581,078.82 $250,292.44 2025-12-23
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 92 15 — — $89,886.06 $434,017.17 $184,095.48 2025-12-23
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 93 15 — — $40,958.62 $374,926.16 $179,068.94 2025-12-23
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 93 15 — — $70,719.44 $330,218.09 $144,840.34 2025-12-23
J9999 HCPCS Not Otherwise Classified, Antineoplastic Drugs 22 16 — — $140,999.68 $140,999.68 $140,999.68 2025-12-23
J8499 HCPCS Prescription Drug, Oral, Non Chemotherapeutic, Nos 22 16 — — $112,999.86 $112,999.86 $112,999.86 2025-12-23
J8498 HCPCS Antiemetic Drug, Rectal/suppository, Not Otherwise Specified 22 16 — — $112,999.86 $112,999.86 $112,999.86 2025-12-23
J8597 HCPCS Antiemetic Drug, Oral, Not Otherwise Specified 22 16 — — $112,999.86 $112,999.86 $112,999.86 2025-12-23
Q0181 HCPCS Unspecified Oral Dosage Form, Fda Approved Prescription Anti-emetic, For Use As … 22 16 — — $112,999.86 $112,999.86 $112,999.86 2025-12-23
J8999 HCPCS Prescription Drug, Oral, Chemotherapeutic, Nos 22 16 — — $112,999.86 $112,999.86 $112,999.86 2025-12-23
J7999 HCPCS Compounded Drug, Not Otherwise Classified 22 16 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
J7304 HCPCS Contraceptive Supply, Hormone Containing Patch, Each 22 16 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
J3590 HCPCS Unclassified Biologics 22 16 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
S5001 HCPCS Prescription Drug,brand Name 25 17 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
J7599 HCPCS Immunosuppressive Drug, Not Otherwise Classified 22 16 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
C9399 HCPCS Unclassified Drugs Or Biologicals 25 17 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
S5000 HCPCS Prescription Drug, Generic 25 17 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
J7199 HCPCS Hemophilia Clotting Factor, Not Otherwise Classified 22 16 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
J3490 HCPCS Drugs Unclassified Injection 22 16 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
790151091 CDM Sys Tricuspid Evoque Valve Sz48 7 3 $215,000.00 $68,800.00 68% off $47,300.00 $107,500.00 $107,500.00 2025-12-23
790151090 CDM Sys Tricuspid Evoque Valve Sz44 7 3 $215,000.00 $68,800.00 68% off $47,300.00 $107,500.00 $107,500.00 2025-12-23
790151092 CDM Sys Tricuspid Evoque Valve Sz52 7 3 $215,000.00 $68,800.00 68% off $47,300.00 $107,500.00 $107,500.00 2025-12-23
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 146 31 — — $99,999.92 $104,999.92 $102,499.92 2025-12-23
J3570 HCPCS Laetrile, Amygdalin, Vitamin B17 22 16 — — $100,444.43 $100,444.43 $100,444.43 2025-12-23
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 93 15 — — $48,759.90 $217,715.04 $99,865.07 2025-12-23
790151782 CDM Sys Triclip G4 Steer Cath Guide 7 3 $195,000.00 $62,400.00 68% off $42,900.00 $97,500.00 $97,500.00 2025-12-23
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 48 24 — — $93,216.70 $97,877.54 $95,547.12 2025-12-23
790146438 CDM Kit Valve Sapien 3 Ultra Thv Sz23 7 3 $170,000.00 $54,400.00 68% off $37,400.00 $85,000.00 $85,000.00 2025-12-23
790146437 CDM Kit Valve Sapien 3 Ultra Thv Sz26 7 3 $170,000.00 $54,400.00 68% off $37,400.00 $85,000.00 $85,000.00 2025-12-23
790146436 CDM Kit Valve Sapien 3 Ultra Thv Sz29 7 3 $170,000.00 $54,400.00 68% off $37,400.00 $85,000.00 $85,000.00 2025-12-23
790146439 CDM Kit Valve Sapien 3 Ultra Thv Sz20 7 3 $170,000.00 $54,400.00 68% off $37,400.00 $85,000.00 $85,000.00 2025-12-23
7 MS_DRG Lung Transplant 84 15 — — $43,206.63 $201,364.07 $83,332.31 2025-12-23
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 92 15 — — $40,613.68 $299,738.00 $83,180.81 2025-12-23
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 11 — — $36,852.46 $161,404.96 $81,729.66 2025-12-23
790140304 CDM Kit Valve Commander+s3 Ultra Sz26 7 3 $162,500.00 $52,000.00 68% off $35,750.00 $81,250.00 $81,250.00 2025-12-23
790140303 CDM Kit Valve Commander+s3 Ultra Sz23 7 3 $162,500.00 $52,000.00 68% off $35,750.00 $81,250.00 $81,250.00 2025-12-23
790128801 CDM Valve Thv Sz3-29 Sapien Commander 7 3 $162,500.00 $52,000.00 68% off $35,750.00 $81,250.00 $81,250.00 2025-12-23
790133755 CDM Valve Aortic Trnscath 23 Sapien 7 3 $162,500.00 $52,000.00 68% off $35,750.00 $81,250.00 $81,250.00 2025-12-23
790133756 CDM Valve Aortic Trnscath 26 Sapien 7 3 $162,500.00 $52,000.00 68% off $35,750.00 $81,250.00 $81,250.00 2025-12-23
790140302 CDM Kit Valve Commander+s3 Ultra Sz20 7 3 $162,500.00 $52,000.00 68% off $35,750.00 $81,250.00 $81,250.00 2025-12-23
14 MS_DRG Allogeneic Bone Marrow Transplant 84 15 — — $49,893.79 $201,872.53 $77,860.10 2025-12-23
790142866 CDM Sys Mitraclip G4 Steer Cath Guide 7 3 $150,000.00 $48,000.00 68% off $33,000.00 $75,000.00 $75,000.00 2025-12-23
790152256 CDM Valve Aortic Transcath Fx+ Sz26 7 3 $150,000.00 $48,000.00 68% off $33,000.00 $75,000.00 $75,000.00 2025-12-23
790152255 CDM Valve Aortic Transcath Fx+ Sz23 7 3 $150,000.00 $48,000.00 68% off $33,000.00 $75,000.00 $75,000.00 2025-12-23
790152257 CDM Valve Aortic Transcath Fx+ Sz29 7 3 $150,000.00 $48,000.00 68% off $33,000.00 $75,000.00 $75,000.00 2025-12-23
790152258 CDM Valve Aortic Transcath Fx+ Sz34 7 3 $150,000.00 $48,000.00 68% off $33,000.00 $75,000.00 $75,000.00 2025-12-23
212 MS_DRG Concomitant Aortic And Mitral Valve�procedures 92 15 — — $35,726.41 $167,853.21 $73,171.20 2025-12-23
850 MS_DRG Acute Leukemia With Other Procedures 30 11 — — $32,407.46 $141,936.96 $71,871.77 2025-12-23
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 84 15 — — $48,980.58 $164,085.96 $70,313.16 2025-12-23
215 MS_DRG Other Heart Assist System Implant 93 15 — — $33,882.49 $163,244.68 $69,394.67 2025-12-23
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 48 24 — — $67,452.66 $70,825.29 $69,138.98 2025-12-23
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 93 15 — — $32,192.48 $148,704.15 $65,933.36 2025-12-23
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 78 21 $228,480.00 $73,113.60 68% off $47,980.80 $205,632.00 $65,603.62 2025-12-23
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 30 11 — — $29,342.23 $128,511.96 $65,073.83 2025-12-23
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 63 11 — — $29,393.26 $126,044.55 $60,200.29 2025-12-23
C2624 HCPCS Implantable Wireless Pulmonary Artery Pressure Sensor With Delivery Catheter, In… 25 17 $100,250.00 $32,080.00 68% off $21,052.50 $90,225.00 $60,150.00 2025-12-23
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 48 17 — — $59,935.20 $59,935.20 $59,935.20 2025-12-23
J9029 HCPCS Injection, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 146 31 — — $54,361.75 $69,214.27 $59,880.88 2025-12-23
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 93 15 — — $28,036.61 $124,205.43 $57,421.74 2025-12-23
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 93 15 — — $27,960.32 $130,493.43 $57,265.49 2025-12-23
C1822 HCPCS Generator, Neurostimulator (implantable), High Frequency, With Rechargeable Batt… 50 17 $97,500.00 $31,200.00 68% off $19,425.00 $92,250.00 $56,425.00 2025-12-23
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 11 — — $24,987.30 $109,438.40 $55,415.67 2025-12-23
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 148 31 — — $21,848.24 $88,838.14 $55,343.19 2025-12-23
231 MS_DRG Coronary Bypass With Ptca With Mcc 93 15 — — $26,918.12 $130,565.85 $55,130.95 2025-12-23
90288 CPT Botulinum Human Antitoxin For Infusion Into Vein 64 20 — — $55,036.65 $55,036.65 $55,036.65 2025-12-23
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 87 15 — — $26,514.44 $122,143.84 $54,304.17 2025-12-23
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 93 15 — — $24,517.55 $120,435.09 $52,986.91 2025-12-23
790147117 CDM Kit MRI Perc Intellis 7 3 $104,980.30 $33,593.70 68% off $23,095.66 $52,490.15 $52,490.15 2025-12-23
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 93 15 — — $25,578.05 $119,219.40 $52,386.36 2025-12-23
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 30 11 — — $23,587.13 $103,306.02 $52,310.44 2025-12-23
C1820 HCPCS Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging… 150 17 $91,875.00 $29,400.00 68% off $10,626.00 $114,671.70 $50,331.60 2025-12-23
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 146 31 — — $47,492.96 $51,064.43 $49,848.61 2025-12-23
Q2043 HCPCS Sipuleucel-t 250ml 150 31 $190,238.96 $95,119.48 50% off $18,970.96 $171,216.00 $49,346.03 2025-12-23
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 93 15 — — $23,990.20 $115,008.39 $49,134.29 2025-12-23
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 30 11 — — $21,763.76 $95,320.05 $48,266.64 2025-12-23
790113529 CDM Valve Pulmonary W Conduit Sz29 7 3 $96,425.00 $30,856.00 68% off $21,213.50 $48,212.50 $48,212.50 2025-12-23
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 92 15 — — $23,337.75 $108,888.34 $47,798.01 2025-12-23
38240 CPT Transplantation Of Donor Stem Cells, Per Donor 112 16 — — $1,848.28 $56,704.24 $47,631.47 2025-12-23
C1882 HCPCS Cardioverter-defibrillator, Other Than Single Or Dual Chamber (implantable) 325 17 $84,500.00 $27,040.00 68% off $12,705.00 $88,006.50 $47,567.50 2025-12-23
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 93 15 — — $23,102.57 $107,185.75 $47,316.34 2025-12-23
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 93 15 — — $18,835.72 $102,908.49 $47,009.28 2025-12-23
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 93 15 — — $22,751.61 $99,646.62 $46,929.79 2025-12-23
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 93 15 — — $22,248.89 $97,755.86 $46,689.30 2025-12-23
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 93 15 — — $22,737.04 $102,734.38 $46,567.69 2025-12-23
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 93 15 — — $18,022.15 $96,986.34 $46,321.77 2025-12-23
C1767 HCPCS Generator, Neurostimulator (implantable), Non-rechargeable 375 17 $82,500.00 $26,400.00 68% off $8,627.85 $105,919.11 $45,562.50 2025-12-23
459 MS_DRG Spinal Fusion Except Cervical With Mcc 63 11 — — $21,999.34 $94,337.84 $45,056.81 2025-12-23
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $43,633.91 $43,633.91 $43,633.91 2025-12-23
790148600 CDM Stent Flow Divert 4.5x20 Fredx 27 7 3 $86,750.00 $27,760.00 68% off $19,085.00 $43,375.00 $43,375.00 2025-12-23
790143872 CDM Stent Flow Divert 4.5x20 Fred 27 7 3 $86,600.00 $27,712.00 68% off $19,052.00 $43,300.00 $43,300.00 2025-12-23
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 93 15 — — $21,113.70 $99,503.32 $43,242.94 2025-12-23
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 11 — — $19,363.42 $84,807.17 $42,943.30 2025-12-23
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 30 11 — — $19,245.22 $84,289.46 $42,681.15 2025-12-23
790151926 CDM Device Watchman Flx Pro 7 3 $85,000.00 $27,200.00 68% off $18,700.00 $42,500.00 $42,500.00 2025-12-23
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 93 15 — — $20,718.31 $92,306.25 $42,433.15 2025-12-23
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 93 15 — — $20,625.44 $94,885.55 $42,242.93 2025-12-23
276 MS_DRG Cardiac Defibrillator Implant With Mcc 92 15 — — $20,599.23 $95,443.32 $42,189.25 2025-12-23
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 84 15 — — $28,342.88 $93,001.15 $41,963.71 2025-12-23
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 84 15 — — $20,165.82 $93,001.15 $41,963.71 2025-12-23
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 93 15 — — $19,445.04 $87,355.27 $41,721.86 2025-12-23
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 63 11 — — $20,287.77 $86,998.25 $41,551.35 2025-12-23
955 MS_DRG Craniotomy For Multiple Significant Trauma 93 15 — — $20,201.19 $105,210.45 $41,374.03 2025-12-23
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 93 15 — — $20,151.77 $88,432.68 $41,272.80 2025-12-23
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 150 31 — — $13,881.22 $65,163.50 $41,171.32 2025-12-23
33276 CPT Insertion Of Phrenic Nerve Stimulator System (pulse Generator And Stimulating Le… 111 16 — — $1,587.60 $43,145.40 $41,090.86 2025-12-23
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 93 15 — — $20,056.90 $89,710.00 $41,078.51 2025-12-23
28 MS_DRG Spinal Procedures With Mcc 93 15 — — $14,558.72 $93,672.94 $40,938.57 2025-12-23
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 81 15 — — $14,982.19 $46,381.66 $40,761.93 2025-12-23
232 MS_DRG Coronary Bypass With Ptca Without Mcc 93 15 — — $19,731.51 $94,122.85 $40,412.06 2025-12-23
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device 146 31 — — $38,289.48 $41,168.84 $40,188.63 2025-12-23
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 30 11 — — $18,118.05 $79,352.74 $40,181.37 2025-12-23
0266T CPT Insertion Or Replacement Of Carotid Sinus Baroreflex Activation Device 72 12 — — $1,848.28 $41,563.45 $40,178.00 2024-12-10
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 93 15 — — $19,505.95 $90,663.75 $39,950.11 2025-12-23
790071089 CDM Valve Aortic W Conduit Sz23-30 7 3 $79,650.00 $25,488.00 68% off $17,523.00 $39,825.00 $39,825.00 2025-12-23
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 146 31 — — $37,701.48 $40,536.64 $39,571.48 2025-12-23
790148800 CDM Stent Flow Divert 5x36 Fredx 27 7 3 $78,500.00 $25,120.00 68% off $17,270.00 $39,250.00 $39,250.00 2025-12-23
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 93 15 — — $18,895.95 $91,666.81 $38,700.77 2025-12-23
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $38,674.73 $38,674.73 $38,674.73 2025-12-23
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 93 15 — — $11,640.02 $83,130.78 $38,608.37 2025-12-23
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 93 15 — — $18,803.41 $87,904.18 $38,511.23 2025-12-23
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 93 15 — — $18,786.49 $83,218.61 $38,476.59 2025-12-23
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 93 15 — — $18,571.88 $85,164.64 $38,037.04 2025-12-23
790145652 CDM Conduit Aortic Valve Sz21 Konect 7 3 $75,000.00 $24,000.00 68% off $16,500.00 $37,500.00 $37,500.00 2025-12-23
790147902 CDM Conduit Aortic Valve Sz27 Konect 7 3 $75,000.00 $24,000.00 68% off $16,500.00 $37,500.00 $37,500.00 2025-12-23
790148093 CDM Conduit Aortic Valve Sz23 Konect 7 3 $75,000.00 $24,000.00 68% off $16,500.00 $37,500.00 $37,500.00 2025-12-23
790142924 CDM Conduit Aortic Valve Sz25 Konect 7 3 $75,000.00 $24,000.00 68% off $16,500.00 $37,500.00 $37,500.00 2025-12-23
790148094 CDM Conduit Aortic Valve Sz29 Konect 7 3 $75,000.00 $24,000.00 68% off $16,500.00 $37,500.00 $37,500.00 2025-12-23
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 93 15 — — $14,194.47 $83,645.41 $37,399.80 2025-12-23
790130142 CDM Stent 5x40 Surpass Evolve 7 3 $74,609.10 $23,874.91 68% off $16,414.00 $37,304.55 $37,304.55 2025-12-23
790150770 CDM Stent Vantage W Shield 5x25 Pipel 7 3 $74,420.00 $23,814.40 68% off $16,372.40 $37,210.00 $37,210.00 2025-12-23
790151014 CDM Stent Vantage W Shield 6x50 Pipel 7 3 $74,420.00 $23,814.40 68% off $16,372.40 $37,210.00 $37,210.00 2025-12-23
790151013 CDM Stent Vantage W Shield 6x40 Pipel 7 3 $74,420.00 $23,814.40 68% off $16,372.40 $37,210.00 $37,210.00 2025-12-23
653 MS_DRG Major Bladder Procedures With Mcc 93 15 — — $17,956.91 $85,893.44 $36,777.52 2025-12-23
790148274 CDM Stent Flex W Shield 4.25x25pipeli 7 3 $73,500.00 $23,520.00 68% off $16,170.00 $36,750.00 $36,750.00 2025-12-23
790144027 CDM Stent Flex W Shield 5x35 Pipeli 7 3 $73,500.00 $23,520.00 68% off $16,170.00 $36,750.00 $36,750.00 2025-12-23
790144208 CDM Stent Flex W Shield 5x25 Pipeli 7 3 $73,500.00 $23,520.00 68% off $16,170.00 $36,750.00 $36,750.00 2025-12-23
790142146 CDM Stent Flex W Shield 4x25 Pipeli 7 3 $73,500.00 $23,520.00 68% off $16,170.00 $36,750.00 $36,750.00 2025-12-23
C1813 HCPCS Prosthesis, Penile, Inflatable 75 17 $61,168.35 $19,573.87 68% off $12,492.75 $55,723.14 $36,701.01 2025-12-23
790148939 CDM Stent Vista Silk 2.25x15 7 3 $72,500.00 $23,200.00 68% off $15,950.00 $36,250.00 $36,250.00 2025-12-23
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 84 15 — — $24,217.69 $83,836.47 $35,745.58 2025-12-23
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 93 15 — — $17,396.34 $81,611.55 $35,629.41 2025-12-23
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 93 15 — — $16,620.61 $81,973.64 $35,312.15 2025-12-23
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 93 15 — — $16,641.76 $78,497.60 $35,235.39 2025-12-23
L8701 HCPCS Ewh S/d Uprt Micro Sensor 48 24 — — $34,284.44 $35,998.66 $35,141.55 2025-12-23
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 93 15 — — $17,103.45 $83,140.03 $35,029.54 2025-12-23
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 1 — — $34,969.98 $34,969.98 $34,969.98 2025-12-23
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 93 15 — — $16,847.04 $78,257.23 $34,504.40 2025-12-23
790151353 CDM Stent Vantage Wshield 3.5x14pipel 7 3 $68,905.00 $22,049.60 68% off $15,159.10 $34,452.50 $34,452.50 2025-12-23
790151875 CDM Stent Vantage W Shield 5.5x20 7 3 $68,905.00 $22,049.60 68% off $15,159.10 $34,452.50 $34,452.50 2025-12-23
790150942 CDM Stent Vantage W Shield 3x12 Pipel 7 3 $68,905.00 $22,049.60 68% off $15,159.10 $34,452.50 $34,452.50 2025-12-23
790151646 CDM Stent Vantage W Shield 4.5x14 7 3 $68,905.00 $22,049.60 68% off $15,159.10 $34,452.50 $34,452.50 2025-12-23
790151585 CDM Stent Vantage W Shield 4x16 Pipel 7 3 $68,905.00 $22,049.60 68% off $15,159.10 $34,452.50 $34,452.50 2025-12-23
790151026 CDM Stent Vantage W Shield 4x20 Pipel 7 3 $68,905.00 $22,049.60 68% off $15,159.10 $34,452.50 $34,452.50 2025-12-23
790151874 CDM Stent Vantage W Shield 4.5x16 7 3 $68,905.00 $22,049.60 68% off $15,159.10 $34,452.50 $34,452.50 2025-12-23
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 93 15 — — $16,773.74 $79,089.26 $34,354.27 2025-12-23
790141862 CDM Stent 4.5x25 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143951 CDM Stent 3.25x12 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143956 CDM Stent 4.5x12 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143958 CDM Stent 4.5x20 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143499 CDM Stent 4x12 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143953 CDM Stent 3.25x20 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790144043 CDM Stent 4.5x17 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143954 CDM Stent 4x20 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143952 CDM Stent 3.25x15 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790141863 CDM Stent 4.5x30 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143607 CDM Stent 5x30 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143617 CDM Stent 4x15 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790141864 CDM Stent 5x15 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790141865 CDM Stent 5x20 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143955 CDM Stent 4x25 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143957 CDM Stent 4.5x15 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790143606 CDM Stent 5x25 Surpass Evolve 7 3 $68,602.95 $21,952.94 68% off $15,092.64 $34,301.47 $34,301.47 2025-12-23
790145234 CDM Stent Flex W Shield 3x14 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790144011 CDM Stent Flex W Shield 4.5x12 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145278 CDM Stent Flex W Shield 5x12 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790148684 CDM Stent Flex W Shield 3x16 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145043 CDM Stent Flex W Shield 4x20 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145022 CDM Stent Flex W Shield 5x14 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145044 CDM Stent Flex W Shield 4.25x14pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145046 CDM Stent Flex W Shield 4.50x14pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790144827 CDM Stent Flex W Shield 4x12 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790148158 CDM Stent Flex W Shield 4.75x20pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145113 CDM Stent Flex W Shield 3.50x12pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145120 CDM Stent Flex W Shield 4.25x12pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145024 CDM Stent Flex W Shield 4.75x14pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145045 CDM Stent Flex W Shield 4.25x16pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790148273 CDM Stent Flex W Shield 5x20 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145036 CDM Stent Flex W Shield 2.5x16 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790148809 CDM Stent Flex W Shield 3.25x12pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145037 CDM Stent Flex W Shield 3.5x14 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145034 CDM Stent Flex W Shield 2.5x10 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145040 CDM Stent Flex W Shield 3.75x18pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790148686 CDM Stent Flex W Shield 2.75x12pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790143853 CDM Stent Flex W Shield 2.5x12 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145025 CDM Stent Flex W Shield 4.75x16pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145033 CDM Stent Flex W Shield 4x14 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145041 CDM Stent Flex W Shield 4x16 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790147331 CDM Stent Flex W Shield 2.75x14pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145042 CDM Stent Flex W Shield 4x18 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145035 CDM Stent Flex W Shield 2.5x14 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790144025 CDM Stent Flex W Shield 5x18 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145023 CDM Stent Flex W Shield 4.50x16pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790150267 CDM Stent Flex W Shield 4.25x10pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145038 CDM Stent Flex W Shield 3.75x12pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790145039 CDM Stent Flex W Shield 3.75x14pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
790148687 CDM Stent Flex W Shield 4.5x20 Pipeli 7 3 $68,525.00 $21,928.00 68% off $15,075.50 $34,262.50 $34,262.50 2025-12-23
228 MS_DRG Other Cardiothoracic Procedures With Mcc 93 15 — — $16,713.37 $76,782.69 $34,230.62 2025-12-23
C1721 HCPCS Icd Cobalt Xt Dr MRI Df-1 349 21 $62,500.00 $20,328.00 67% off $8,925.00 $69,403.50 $34,026.00 2025-12-23
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 93 15 — — $16,582.68 $77,060.03 $33,962.95 2025-12-23
799 MS_DRG Splenectomy With Mcc 92 15 — — $10,929.00 $70,474.23 $33,659.28 2025-12-23
471 MS_DRG Cervical Spinal Fusion With Mcc 93 15 — — $16,316.32 $74,841.28 $33,417.44 2025-12-23
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 93 15 — — $16,187.62 $72,490.02 $33,153.84 2025-12-23
C1722 HCPCS Cardioverter-defibrillator, Single Chamber (implantable) 300 17 $58,530.00 $18,729.60 68% off $8,127.00 $93,375.00 $33,150.00 2025-12-23
C1772 HCPCS Infusion Pump, Programmable (implantable) 50 17 $57,640.00 $18,444.80 68% off $10,290.00 $59,652.00 $33,140.00 2025-12-23
6 MS_DRG Liver Transplant Without Mcc 84 15 — — $22,390.33 $74,716.47 $32,859.69 2025-12-23
10 MS_DRG Pancreas Transplant 84 15 — — $19,530.38 $122,847.98 $32,701.39 2025-12-23
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 93 15 — — $15,944.16 $77,608.56 $32,655.20 2025-12-23
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 92 15 — — $15,863.22 $71,676.48 $32,489.44 2025-12-23
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 93 15 — — $15,777.64 $77,150.94 $32,314.16 2025-12-23
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 93 15 — — $15,723.91 $73,248.09 $32,204.11 2025-12-23
163 MS_DRG Major Chest Procedures With Mcc 93 15 — — $15,635.01 $71,018.55 $32,022.04 2025-12-23
790129519 CDM Stent Embolic Flex 4.75x25 Pipeli 7 3 $63,750.00 $20,400.00 68% off $14,025.00 $31,875.00 $31,875.00 2025-12-23
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 30 11 — — $14,365.75 $62,918.57 $31,859.70 2025-12-23
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 93 15 — — $15,419.41 $70,762.78 $31,580.46 2025-12-23
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $31,389.16 $31,389.16 $31,389.16 2025-12-23
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 63 11 — — $15,276.78 $65,510.05 $31,288.34 2025-12-23
245 MS_DRG Aicd Generator Procedures 93 15 — — $15,030.65 $75,295.81 $30,784.26 2025-12-23
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 93 15 — — $15,029.33 $66,531.74 $30,781.54 2025-12-23
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 93 15 — — $14,982.23 $70,752.00 $30,685.07 2025-12-23
790138326 CDM Stent Embolic Flex 2.5x12 Pipeln 7 3 $61,250.00 $19,600.00 68% off $13,475.00 $30,625.00 $30,625.00 2025-12-23
790129513 CDM Stent Embolic Flex 4.5x14 Pipeli 7 3 $61,250.00 $19,600.00 68% off $13,475.00 $30,625.00 $30,625.00 2025-12-23
790129514 CDM Stent Embolic Flex 4.5x16 Pipeli 7 3 $61,250.00 $19,600.00 68% off $13,475.00 $30,625.00 $30,625.00 2025-12-23
790129521 CDM Stent Embolic Flex 5x14 Pipeline 7 3 $61,250.00 $19,600.00 68% off $13,475.00 $30,625.00 $30,625.00 2025-12-23
790127116 CDM Stent Embolic Flex 5x20 Pipeline 7 3 $61,250.00 $19,600.00 68% off $13,475.00 $30,625.00 $30,625.00 2025-12-23
790126886 CDM Stent Embolic Flex 4x16 Pipeline 7 3 $61,250.00 $19,600.00 68% off $13,475.00 $30,625.00 $30,625.00 2025-12-23
790129499 CDM Stent Embolic Flex 3x14 Pipeline 7 3 $61,250.00 $19,600.00 68% off $13,475.00 $30,625.00 $30,625.00 2025-12-23
790129508 CDM Stent Embolic Flex 4x20 Pipeline 7 3 $61,250.00 $19,600.00 68% off $13,475.00 $30,625.00 $30,625.00 2025-12-23
790129504 CDM Stent Embolic Flex 3.75x14 Pipeli 7 3 $61,250.00 $19,600.00 68% off $13,475.00 $30,625.00 $30,625.00 2025-12-23
790138329 CDM Stent Embolic Flex 4.25x14 Pipeli 7 3 $61,250.00 $19,600.00 68% off $13,475.00 $30,625.00 $30,625.00 2025-12-23
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 93 15 — — $14,932.80 $72,101.74 $30,583.84 2025-12-23
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 92 15 — — $14,918.21 $70,989.28 $30,553.95 2025-12-23
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 30 11 — — $13,763.12 $60,279.18 $30,523.21 2025-12-23
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 92 15 — — $14,795.15 $77,090.85 $30,301.92 2025-12-23
571T OTHER Icd Ins/rep W Substernal Electro 55 25 $44,296.00 $14,174.72 68% off $475.00 $40,582.00 $30,154.35 2025-12-23
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 93 15 — — $14,689.00 $69,514.73 $30,084.53 2025-12-23
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 93 15 — — $14,647.87 $68,909.20 $30,000.29 2025-12-23
L5856 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc… 146 31 — — $28,454.32 $30,594.08 $29,865.65 2025-12-23
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 93 15 — — $14,557.65 $73,580.90 $29,815.50 2025-12-23
L6880 HCPCS Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi… 146 31 — — $28,320.00 $30,449.66 $29,724.67 2025-12-23
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 93 15 — — $14,468.42 $67,684.26 $29,632.75 2025-12-23
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $29,537.58 $29,537.58 $29,537.58 2025-12-23
901 MS_DRG Wound Debridements For Injuries With Mcc 93 15 — — $13,410.98 $68,265.14 $29,401.09 2025-12-23
915T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 49 24 — — $2,396.00 $40,582.00 $29,276.07 2025-12-23
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 93 15 — — $14,272.39 $69,100.26 $29,231.25 2025-12-23
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 93 15 — — $14,192.45 $65,725.91 $29,067.53 2025-12-23
33231 CPT Insertion Of Pacing Defibrillator Pulse Generator With Existing Multiple Leads 127 28 $38,339.00 $12,268.48 68% off $475.00 $40,582.00 $28,951.84 2025-12-23
408T OTHER Insj/rplc Cardiac Modulj Sys 52 25 — — $2,281.00 $40,582.00 $28,676.11 2025-12-23
33270 CPT Insertion Or Replacement Of Defibrillator With Electrode 127 28 $28,813.00 $9,220.16 68% off $475.00 $40,582.00 $28,676.11 2025-12-23
33264 CPT Removal And Replacement Of Defibrillator Pulse Generator, Multiple Wires (leads) 127 28 $28,813.00 $9,220.16 68% off $475.00 $40,582.00 $28,676.11 2025-12-23
33249 CPT Insertion Or Replacement Of Single Or Dual Chamber Pacing Defibrillator Leads 127 28 $28,813.00 $9,220.16 68% off $475.00 $40,582.00 $28,676.11 2025-12-23
793 MS_DRG Full Term Neonate With Major Problems 81 15 — — $2,927.16 $32,538.48 $28,596.06 2025-12-23
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With E… 72 12 — — $1,848.28 $37,712.00 $28,538.25 2024-12-10
0408T CPT Insertion Or Replacement Of Pulse Generator And Electrodes Of Heart Contractilit… 72 12 — — $1,848.28 $37,712.00 $28,538.25 2024-12-10
69930 CPT Implantation Of Cochlear Device 138 28 — — $1,941.00 $40,582.00 $28,290.86 2025-12-23
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 93 15 — — $13,794.08 $64,108.07 $28,251.63 2025-12-23
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 92 15 — — $13,732.38 $65,628.84 $28,125.27 2025-12-23
31 MS_DRG Ventricular Shunt Procedures With Mcc 93 15 — — $13,654.76 $67,630.52 $27,966.30 2025-12-23
791 MS_DRG Prematurity With Major Problems 81 15 — — $10,573.12 $31,675.57 $27,837.89 2025-12-23
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 93 15 — — $13,459.72 $59,325.42 $27,566.84 2025-12-23
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 93 15 — — $13,416.60 $63,323.80 $27,478.52 2025-12-23
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 93 15 — — $13,404.66 $63,359.24 $27,454.07 2025-12-23
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 1 1 — — $27,343.49 $27,343.49 $27,343.49 2025-12-23
64568 CPT Implantation Of Cranial Nerve Neurostimulator Electrodes And Generator 112 16 — — $1,722.16 $40,582.00 $27,326.54 2025-12-23
61886 CPT Insertion Or Replacement Of Brain Neurostimulator Generator Or Receiver With Con… 112 16 — — $1,692.00 $40,582.00 $27,326.54 2025-12-23
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 93 15 — — $13,316.10 $60,795.35 $27,272.68 2025-12-23
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 93 15 — — $13,284.25 $63,229.81 $27,207.45 2025-12-23
790152731 CDM Stent Cover 16fr 5.7x26x6 G Amour 7 3 $54,265.85 $17,365.07 68% off $11,938.48 $27,132.92 $27,132.92 2025-12-23
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 93 15 — — $13,127.69 $59,551.92 $26,886.80 2025-12-23
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 93 15 — — $12,972.46 $62,670.50 $26,568.86 2025-12-23
34 MS_DRG Carotid Artery Stent Procedures With Mcc 93 15 — — $11,955.86 $59,917.09 $26,504.32 2025-12-23
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 93 15 — — $12,926.35 $60,249.90 $26,474.44 2025-12-23
312T OTHER Implantation Of Neurostimulator Electrodes And Pulse Generator For Vagus Nerve B… 1 1 — — $26,467.27 $26,467.27 $26,467.27 2025-12-23
316T OTHER Replacement Of Pulse Generator For Vagus Nerve Blocking Therapy For Treatment Of… 1 1 — — $26,467.27 $26,467.27 $26,467.27 2025-12-23
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 93 15 — — $11,092.94 $60,670.54 $26,407.86 2025-12-23
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 93 15 — — $12,863.99 $78,988.68 $26,346.72 2025-12-23
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 93 15 — — $12,772.11 $58,120.52 $26,158.53 2025-12-23
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