Price Transparency 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

29,307 distinct procedures filed
31 distinct payers
2,466,710 rate rows
2025-12-23 last MRF observed
Data quality

2,105,961 of 2,466,710 rate rows are consumer-grade (85.4%)

360,749 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 341,562
per-diem day rate — not a per-procedure price 16,530
template filing: same amount across many unrelated codes — excluded 1,419
placeholder amount (≤ $0.02) — excluded from medians 751
exceeds 10× this hospital's gross charge — excluded from medians 296
percent-of-charges filed in the dollar field — excluded from medians 191
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 · 2026-05-17
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 		Inj, Hemgenix, Per Tx Dose 12 $112,999.74 $3,932,600.00 $3,557,058.96 nat. median
$3,710,000
1.0× median
J1411
CPT 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 24 $3,263,464.50 $3,815,000.00 $3,426,637.50 nat. median
$3,710,000
0.9× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 12 $112,999.74 $3,521,088.40 $3,184,844.39 nat. median
$3,325,455
1.0× median
J1413
CPT 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 24 $2,899,293.50 $3,488,000.00 $3,118,952.38 nat. median
$3,325,455
0.9× 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
$3,006,423
0.9× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 12 $112,999.74 $2,547,666.28 $2,304,378.56 nat. median
$2,469,189
0.9× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 24 $2,119,655.08 $2,471,920.00 $2,295,787.54 nat. median
$2,448,600
0.9× median
J3399
CPT 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge… 24 $1,111,445.25 $2,784,090.00 $2,086,390.13 nat. median
$2,469,189
0.8× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 25 $112,999.74 $599,561.27 $516,482.44 nat. median
$754,974
0.7× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 25 $140,999.68 $629,250.00 $489,648.84 nat. median
$625,184
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 25 $140,999.68 $584,397.44 $483,707.80 nat. median
$675,122
0.7× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 25 $140,999.68 $615,450.00 $478,687.88 nat. median
$674,188
0.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 25 $140,999.68 $598,500.00 $453,692.72 nat. median
$634,511
0.7× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 25 $140,999.68 $598,500.00 $452,334.34 nat. median
$620,080
0.7× median
Q2042
CPT 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 24 $219,694.16 $504,744.78 $449,559.81 nat. median
$754,974
0.6× median
Q2056
CPT 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 24 $246,450.00 $522,474.00 $446,149.81 nat. median
$675,122
0.7× median
Q2055
CPT 		Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (… 24 $222,335.00 $629,250.00 $439,143.56 nat. median
$625,184
0.7× median
Q2054
CPT 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 24 $217,459.00 $615,450.00 $429,325.13 nat. median
$674,188
0.6× median
Q2041
CPT 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 24 $197,690.00 $598,500.00 $407,205.75 nat. median
$634,511
0.6× median
Q2053
CPT 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 24 $197,690.00 $598,500.00 $407,205.75 nat. median
$620,080
0.7× median
C9081
HCPCS 		Idecabtagene Car Pos T 1 $392,740.64 $392,740.64 $392,740.64 nat. median
$30,475
outlier · 12.9×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 15 $122,207.24 $581,078.82 $250,292.44 nat. median
$370,174
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
$265,286
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
$206,368
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
$202,986
0.7× median
J9999
HCPCS 		Chemotherapy Drug 16 $140,999.68 $140,999.68 $140,999.68 nat. median
$1,829
outlier · 77.1×
J7330
HCPCS 		Implant Maci Graft Vericel 17 $47,980.80 $205,632.00 $114,240.00 nat. median
$76,377
1.5× median
Q0181
HCPCS 		Unspecified Oral Anti-emetic 16 $112,999.86 $112,999.86 $112,999.86 nat. median
$38
outlier · 2979.2×
J8999
HCPCS 		Oral Prescription Drug Chemo 16 $112,999.86 $112,999.86 $112,999.86 nat. median
$194
outlier · 583.0×
J8597
HCPCS 		Antiemetic Drug Oral Nos 16 $112,999.86 $112,999.86 $112,999.86 nat. median
$8
outlier · 13294.1×
J8498
HCPCS 		Antiemetic Rectal/supp Nos 16 $112,999.86 $112,999.86 $112,999.86 nat. median
$26
outlier · 4299.8×
J8499
HCPCS 		Oral Prescrip Drug Non Chemo 16 $112,999.86 $112,999.86 $112,999.86 nat. median
$83
outlier · 1366.2×
J7199
HCPCS 		Hemophilia Clot Factor Noc 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$250
outlier · 452.2×
J7304
HCPCS 		Contraceptive Hormone Patch 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$116
outlier · 974.3×
J7999
HCPCS 		Compounded Drug, Noc 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$55
outlier · 2049.7×
J3590
HCPCS 		Unclassified Biologics 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$682
outlier · 165.6×
J3490
HCPCS 		Drugs Unclassified Injection 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$48
outlier · 2349.8×
J0574
HCPCS 		Bupren/nal 6.1 To 10mg Bupre 2 $5.86 $112,999.74 $112,999.74 nat. median
$13
outlier · 8800.6×
C9399
HCPCS 		Unclassified Drugs Or Biolog 17 $112,999.74 $112,999.74 $112,999.74 nat. median
$2,476
outlier · 45.6×
J7599
HCPCS 		Immunosuppressive Drug Noc 16 $112,999.74 $112,999.74 $112,999.74 nat. median
$153
outlier · 737.5×
J0573
HCPCS 		Bupren/nal 3.1 To 6mg Bupren 2 $5.31 $112,999.74 $112,999.74 nat. median
$17
outlier · 6531.8×
J0575
HCPCS 		Bupren/nal Over 10mg Bupreno 2 $7.76 $112,999.74 $112,999.74 nat. median
$30
outlier · 3724.4×
J0572
HCPCS 		Bupren/nal Up To 3mg Bupreno 2 $3.79 $112,999.74 $112,999.74 nat. median
$10
outlier · 11530.6×
S5000
HCPCS 		Prescription Drug, Generic 17 $112,999.74 $112,999.74 $112,999.74 nat. median
$124
outlier · 911.7×
S5001
HCPCS 		Prescription Drug,brand Name 17 $112,999.74 $112,999.74 $112,999.74 nat. median
$29
outlier · 3896.5×
790151090
CDM 		Sys Tricuspid Evoque Valve Sz44 3 $47,300.00 $107,500.00 $107,500.00 nat. median
$107,500
1.0× median
790151091
CDM 		Sys Tricuspid Evoque Valve Sz48 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

Other procedures at this hospital

Browse this hospital's 29,307 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
             
850 MS_DRG Acute Leukemia With Other Procedures 30 11 — — $32,407.46 $141,936.96 $71,871.77 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
L5856 CPT Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc… 96 24 — — $28,454.32 $29,877.04 $29,165.68 2024-12-10
245 MS_DRG Aicd Generator Procedures 93 15 — — $15,030.65 $75,295.81 $30,784.26 2025-12-23
14 MS_DRG Allogeneic Bone Marrow Transplant 84 15 — — $49,893.79 $201,872.53 $77,860.10 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
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
J8597 HCPCS Antiemetic Drug Oral Nos 22 16 — — $112,999.86 $112,999.86 $112,999.86 2025-12-23
J8498 HCPCS Antiemetic Rectal/supp Nos 22 16 — — $112,999.86 $112,999.86 $112,999.86 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
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
J7330 CPT Autologous Cultured Chondrocytes, Implant 48 17 — — $64,742.69 $66,464.54 $65,603.62 2024-12-10
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 52 25 — — $140,999.68 $598,500.00 $453,692.72 2025-12-23
Q2041 CPT Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 88 24 — — $197,690.00 $598,500.00 $407,205.75 2024-12-10
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 48 24 — — $93,216.70 $97,877.54 $95,547.12 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
90288 CPT Botulinum Human Antitoxin For Infusion Into Vein 64 20 — — $55,036.65 $55,036.65 $55,036.65 2025-12-23
Q2053 CPT Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 88 24 — — $197,690.00 $598,500.00 $407,205.75 2024-12-10
Q2053 HCPCS Brexucabtagene Car Pos T 52 25 — — $140,999.68 $598,500.00 $452,334.34 2025-12-23
J0573 HCPCS Bupren/nal 3.1 To 6mg Bupren 9 2 — — $5.31 $112,999.74 $112,999.74 2025-12-23
J0574 HCPCS Bupren/nal 6.1 To 10mg Bupre 9 2 — — $5.86 $112,999.74 $112,999.74 2025-12-23
J0575 HCPCS Bupren/nal Over 10mg Bupreno 9 2 — — $7.76 $112,999.74 $112,999.74 2025-12-23
J0572 HCPCS Bupren/nal Up To 3mg Bupreno 9 2 — — $3.79 $112,999.74 $112,999.74 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
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
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
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
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
276 MS_DRG Cardiac Defibrillator Implant With Mcc 92 15 — — $20,599.23 $95,443.32 $42,189.25 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
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 92 15 — — $15,863.22 $71,676.48 $32,489.44 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
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
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
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
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
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
471 MS_DRG Cervical Spinal Fusion With Mcc 93 15 — — $16,316.32 $74,841.28 $33,417.44 2025-12-23
J9999 HCPCS Chemotherapy Drug 22 16 — — $140,999.68 $140,999.68 $140,999.68 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
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 93 15 — — $122,207.24 $581,078.82 $250,292.44 2025-12-23
Q2056 CPT Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 88 24 — — $246,450.00 $522,474.00 $446,149.81 2024-12-10
Q2056 HCPCS Ciltacabtagene Car-pos T 52 25 — — $140,999.68 $584,397.44 $483,707.80 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
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
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
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
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
J7999 HCPCS Compounded Drug, Noc 22 16 — — $112,999.74 $112,999.74 $112,999.74 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
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
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
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
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
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
J7304 HCPCS Contraceptive Hormone Patch 22 16 — — $112,999.74 $112,999.74 $112,999.74 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
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
231 MS_DRG Coronary Bypass With Ptca With Mcc 93 15 — — $26,918.12 $130,565.85 $55,130.95 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
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 93 15 — — $19,505.95 $90,663.75 $39,950.11 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
955 MS_DRG Craniotomy For Multiple Significant Trauma 93 15 — — $20,201.19 $105,210.45 $41,374.03 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
C1882 HCPCS Defib Quad Polar Hf-t Rivacor 325 17 $84,500.00 $27,040.00 68% off $12,705.00 $88,006.50 $47,567.50 2025-12-23
C1767 HCPCS Device Pulse Generator Proclaim 375 17 $82,500.00 $26,400.00 68% off $8,627.85 $105,919.11 $45,562.50 2025-12-23
C1820 HCPCS Device Stimulation Ipg Eterna 150 17 $91,875.00 $29,400.00 68% off $10,626.00 $114,671.70 $50,331.60 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
Q0480 HCPCS Dme Pos 50 25 — — $99,999.92 $104,999.92 $102,499.92 2025-12-23
L7181 HCPCS Dme Pos 50 25 — — $48,632.79 $51,064.43 $49,848.61 2025-12-23
L7180 HCPCS Dme Pos 50 25 — — $39,208.42 $41,168.84 $40,188.63 2025-12-23
L2006 HCPCS Dme Pos 50 25 — — $38,606.32 $40,536.64 $39,571.48 2025-12-23
L5856 HCPCS Dme Pos 50 25 — — $29,137.22 $30,594.08 $29,865.65 2025-12-23
L6880 HCPCS Dme Pos 50 25 — — $28,999.68 $30,449.66 $29,724.67 2025-12-23
Q0480 CPT Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 96 24 — — $99,999.92 $104,999.92 $102,499.92 2024-12-10
J3490 HCPCS Drugs Unclassified Injection 22 16 — — $112,999.74 $112,999.74 $112,999.74 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
L6880 CPT Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi… 96 24 — — $28,320.00 $29,736.00 $29,028.00 2024-12-10
L7180 CPT Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device 96 24 — — $38,289.48 $40,203.95 $39,246.71 2024-12-10
L7181 CPT Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 96 24 — — $47,492.96 $49,867.61 $48,680.29 2024-12-10
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
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
L8701 HCPCS Ewh S/d Uprt Micro Sensor 48 24 — — $34,284.44 $35,998.66 $35,141.55 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
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
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
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 81 15 — — $14,982.19 $46,381.66 $40,761.93 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
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
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
J7199 HCPCS Hemophilia Clot Factor Noc 22 16 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
J9226 CPT Histrelin Implant (supprelin La), 50 Mg 98 24 — — $13,881.22 $65,163.50 $40,779.21 2024-12-10
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
C1721 HCPCS Icd Cobalt Dr MRI Df1 325 17 $62,820.00 $20,102.40 68% off $8,925.00 $69,403.50 $34,701.75 2025-12-23
C1722 HCPCS Icd Cobalt Vr MRI Df1 300 17 $58,530.00 $18,729.60 68% off $8,127.00 $93,375.00 $33,150.00 2025-12-23
C1721 CPT Icd Cobalt Xt Dr MRI Df-1 24 17 $54,000.00 $27,000.00 50% off $24,300.00 $48,600.00 $33,480.00 2024-12-10
571T CPT 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
C9081 HCPCS Idecabtagene Car Pos T 1 1 — — $392,740.64 $392,740.64 $392,740.64 2025-12-23
Q2055 HCPCS Idecabtagene Vicleucel Car 52 25 — — $140,999.68 $629,250.00 $489,648.84 2025-12-23
Q2055 CPT Idecabtagene Vicleucel, Up To 460 Million Autologous B-cell Maturation Antigen (… 88 24 — — $222,335.00 $629,250.00 $439,143.56 2024-12-10
J7599 HCPCS Immunosuppressive Drug Noc 22 16 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
L8614 HCPCS Implant Cochlear Model Ci612 129 25 $88,500.00 $28,320.00 68% off $16,593.15 $81,900.00 $41,562.50 2025-12-23
J7330 HCPCS Implant Maci Graft Vericel 30 17 $228,480.00 $73,113.60 68% off $47,980.80 $205,632.00 $114,240.00 2025-12-23
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 106 27 — — $16,582.68 $77,060.03 $33,962.95 2025-12-23
J1413 HCPCS Inj Delandistrogene Mox Rokl 37 12 — — $112,999.74 $3,521,088.40 $3,184,844.39 2025-12-23
J3399 HCPCS Inj Onase Abepar-xioi Treat 38 12 — — $112,999.74 $2,547,666.28 $2,304,378.56 2025-12-23
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 37 12 — — $112,999.74 $3,932,600.00 $3,557,058.96 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
J1413 CPT Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 96 24 — — $2,899,293.50 $3,488,000.00 $3,118,952.38 2024-12-10
J1411 CPT Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 86 24 — — $3,263,464.50 $3,815,000.00 $3,426,637.50 2024-12-10
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 49 24 — — $2,119,655.08 $2,471,920.00 $2,295,787.54 2025-12-23
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
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 35 11 — — $112,999.74 $3,384,580.00 $3,061,371.77 2025-12-23
J9029 CPT Injection, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 96 24 — — $54,361.75 $65,400.00 $58,480.36 2024-12-10
J3399 CPT Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge… 88 24 — — $1,111,445.25 $2,784,090.00 $2,086,390.13 2024-12-10
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
915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 49 24 — — $2,396.00 $40,582.00 $29,276.07 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
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
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
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
408T CPT Insj/rplc Cardiac Modulj Sys 52 25 — — $2,281.00 $40,582.00 $28,676.11 2025-12-23
J9029 HCPCS Instill Adstiladrin, Tx Dose 50 25 — — $56,536.22 $69,214.27 $61,831.80 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
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
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 92 15 — — $14,918.21 $70,989.28 $30,553.95 2025-12-23
C1822 HCPCS Kit Ipg Senza Omnia 50 17 $97,500.00 $31,200.00 68% off $19,425.00 $92,250.00 $56,425.00 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
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
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
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
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
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
L2006 CPT Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 96 24 — — $37,701.48 $39,586.55 $38,644.01 2024-12-10
J3570 HCPCS Laetrile Amygdalin Vit B17 22 16 — — $100,444.43 $100,444.43 $100,444.43 2025-12-23
Q2054 HCPCS Lisocabtagene Mara Car Pos T 52 25 — — $140,999.68 $615,450.00 $478,687.88 2025-12-23
Q2054 CPT Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 88 24 — — $217,459.00 $615,450.00 $429,325.13 2024-12-10
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 84 15 — — $48,980.58 $164,085.96 $70,313.16 2025-12-23
6 MS_DRG Liver Transplant Without Mcc 84 15 — — $22,390.33 $74,716.47 $32,859.69 2025-12-23
7 MS_DRG Lung Transplant 84 15 — — $43,206.63 $201,364.07 $83,332.31 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
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
653 MS_DRG Major Bladder Procedures With Mcc 93 15 — — $17,956.91 $85,893.44 $36,777.52 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
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 106 27 — — $14,982.23 $70,752.00 $30,685.07 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
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
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
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
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
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
J8499 HCPCS Oral Prescrip Drug Non Chemo 22 16 — — $112,999.86 $112,999.86 $112,999.86 2025-12-23
J8999 HCPCS Oral Prescription Drug Chemo 22 16 — — $112,999.86 $112,999.86 $112,999.86 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
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
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 93 15 — — $14,468.42 $67,684.26 $29,632.75 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
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 93 15 — — $16,773.74 $79,089.26 $34,354.27 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
10 MS_DRG Pancreas Transplant 84 15 — — $19,530.38 $122,847.98 $32,701.39 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
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
S5000 HCPCS Prescription Drug, Generic 25 17 — — $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
C1813 HCPCS Pros Penile Ms Pump Ip Iz 15 75 17 $61,168.35 $19,573.87 68% off $12,492.75 $55,723.14 $36,701.01 2025-12-23
C1772 HCPCS Pump Implant Sz20 Synchromed Ii 50 17 $57,640.00 $18,444.80 68% off $10,290.00 $59,652.00 $33,140.00 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
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
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
C2624 HCPCS Sensor Pulmonary Art W Del Sys 25 17 $100,250.00 $32,080.00 68% off $21,052.50 $90,225.00 $60,150.00 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
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 84 15 — — $24,217.69 $83,836.47 $35,745.58 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
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
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
Q2043 CPT Sipuleucel-t 250ml 98 24 $190,238.96 $95,119.48 50% off $18,970.96 $171,216.00 $49,346.03 2024-12-10
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 52 25 — — $18,970.96 $77,571.47 $53,247.06 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
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
459 MS_DRG Spinal Fusion Except Cervical With Mcc 63 11 — — $21,999.34 $94,337.84 $45,056.81 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
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
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
28 MS_DRG Spinal Procedures With Mcc 93 15 — — $14,558.72 $93,672.94 $40,938.57 2025-12-23
799 MS_DRG Splenectomy With Mcc 105 27 — — $3,518.00 $70,474.23 $33,659.28 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 93 15 — — $16,847.04 $78,257.23 $34,504.40 2025-12-23
J9226 HCPCS Supprelin La Implant 52 25 — — $13,881.22 $65,163.50 $42,982.62 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
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
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
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
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
Q2042 HCPCS Tisagenlecleucel Car-pos T 50 25 — — $112,999.74 $599,561.27 $516,482.44 2025-12-23
Q2042 CPT Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 94 24 — — $219,694.16 $504,744.78 $449,559.81 2024-12-10
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
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
38240 CPT Transplantation Of Donor Stem Cells, Per Donor 112 16 — — $1,848.28 $56,704.24 $47,631.47 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
J3590 HCPCS Unclassified Biologics 22 16 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
C9399 HCPCS Unclassified Drugs Or Biolog 25 17 — — $112,999.74 $112,999.74 $112,999.74 2025-12-23
Q0181 HCPCS Unspecified Oral Anti-emetic 22 16 — — $112,999.86 $112,999.86 $112,999.86 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
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
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
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
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
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
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
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
901 MS_DRG Wound Debridements For Injuries With Mcc 93 15 — — $13,410.98 $68,265.14 $29,401.09 2025-12-23
C9150 CPT Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 48 17 — — $59,935.20 $59,935.20 $59,935.20 2024-12-10
A9543 HCPCS Y90 Ibritumomab, Rx 52 25 — — $21,848.24 $88,838.14 $55,343.19 2025-12-23
A9543 CPT Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 96 24 — — $21,848.24 $88,838.14 $59,323.69 2024-12-10
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