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

TRISTAR CENTENNIAL MEDICAL CENTER

Nashville, TN · CCN 440161 · Rates published

29,716 distinct procedures filed
50 distinct payers
1,135,463 rate rows
2026-03-01 last MRF observed
Data quality

1,093,670 of 1,135,463 rate rows are consumer-grade (96.3%)

41,793 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
per-diem day rate — not a per-procedure price 24,292
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 17,083
placeholder amount (≤ $0.02) — excluded from medians 236
template filing: same amount across many unrelated codes — excluded 170
exceeds 10× this hospital's gross charge — excluded from medians 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hcah-p-001-delivery.stylelabs.cloud/api/public/content/fe023408e5d149039a9e3f473be277e9
Found on page https://www.tristarhealth.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-04-30

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
845
OTHER 		Inj, Atidarsagene Autotem 18 $4,726.94 $4,955,500.00 $4,550,050.00 nat. median
$9,966
outlier · 456.6×
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 $4,200,000.00 $4,200,000.00 $4,200,000.00 nat. median
$3,710,000
1.1× median
J1414
HCPCS 		Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 1 $4,200,000.00 $4,200,000.00 $4,200,000.00 nat. median
$3,710,000
1.1× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 $3,840,000.00 $3,840,000.00 $3,840,000.00 nat. median
$3,325,455
1.2× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 19 $3,501,003.65 $4,238,057.05 $3,722,119.67 nat. median
$3,746,358
1.0× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 1 $3,720,000.00 $3,720,000.00 $3,720,000.00 nat. median
$3,286,000
1.1× median
908
OTHER 		Topi Adm Prad Zami Per Tr 22 $8,558.79 $4,903,655.40 $3,369,178.20 nat. median
$22,747
outlier · 148.1×
714
OTHER 		Inj Delandistrogene Mox R 22 $5,559.52 $4,891,954.20 $3,361,138.60 nat. median
$13,041
outlier · 257.7×
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $3,360,000.00 $3,360,000.00 $3,360,000.00 nat. median
$3,006,423
1.1× median
748
OTHER 		Inj, Lovotibeglogene Auto 22 $10,582.48 $4,781,186.76 $3,285,033.08 nat. median
$17,963
outlier · 182.9×
906
OTHER 		Inj Elivaldogene Autoteme 22 $7,562.70 $4,674,600.00 $3,211,800.00 nat. median
$20,756
outlier · 154.7×
746
OTHER 		Inj, Betibeglogene Autote 22 $9,788.91 $4,321,754.43 $2,969,368.69 nat. median
$21,896
outlier · 135.6×
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $2,870,046.83 $2,870,046.83 $2,870,046.83 nat. median
$2,469,189
1.2× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 22 $2,459,531.95 $3,805,802.07 $2,627,815.71 nat. median
$2,588,981
1.0× median
J3392
HCPCS 		Exagamglogene Inj 16 $1,699,999.83 $4,999,999.50 $2,469,999.75 nat. median
$2,448,600
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Adult 27 $951,600.00 $4,975,202.25 $2,444,000.00 nat. median
$754,974
outlier · 3.2×
824
OTHER 		Inj, Exagamglogene Autote 22 $11,462.56 $3,428,040.00 $2,355,320.00 nat. median
$25,250
outlier · 93.3×
Q2053
HCPCS 		Brexucabtagene 24 $598,359.73 $4,879,690.20 $1,791,133.34 nat. median
$620,080
outlier · 2.9×
Q2055
HCPCS 		Idecabtagene 25 $645,093.12 $4,962,756.00 $1,774,185.27 nat. median
$625,184
outlier · 2.8×
Q2054
HCPCS 		Lisocabtagene 22 $631,423.78 $4,770,198.00 $1,771,333.52 nat. median
$674,188
outlier · 2.6×
Q2056
HCPCS 		Ciltacabtagene 100 Mil 22 $676,327.75 $4,747,900.50 $1,763,053.71 nat. median
$675,122
outlier · 2.6×
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 3 $872,400.00 $2,042,143.00 $1,749,707.25 nat. median
$824,563
outlier · 2.1×
Q2041
HCPCS 		Axicabtagene Adult 22 $614,793.95 $4,693,095.00 $1,742,702.61 nat. median
$634,511
outlier · 2.7×
Q2058
HCPCS 		Obecabtagene Inj 28 $548,288.31 $2,996,111.00 $1,234,397.73 nat. median
$324,450
outlier · 3.8×
2067
OTHER 		Afamitresgene Autoleucel 22 $732,089.00 $1,132,811.40 $782,179.30 nat. median
$786,032
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 22 $558,267.12 $863,844.91 $596,464.34 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 22 $538,204.73 $832,801.01 $575,029.27 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 22 $534,091.14 $826,435.76 $570,634.21 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 22 $530,177.71 $820,380.25 $566,453.03 nat. median
$558,082
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 22 $505,582.59 $782,322.53 $540,175.08 nat. median
$532,192
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $534,422.90 $534,422.90 $534,422.90 nat. median
$209,753
outlier · 2.5×
9391
OTHER 		Brexucabtagene Car Pos T 22 $464,977.69 $719,491.79 $496,791.95 nat. median
$489,450
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 28 $1,854.72 $1,072,056.19 $325,101.74 nat. median
$370,174
0.9× median
831
OTHER 		Obecbtge Autol Up To 400 22 $3,236.80 $409,027.50 $281,032.50 nat. median
$12,362
outlier · 22.7×
897
OTHER 		Revakinagene, Per Implant 22 $251,750.00 $389,550.00 $268,975.00 nat. median
$9,577
outlier · 28.1×
30233X4
OTHER 		Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Peripheral Vein… 1 $202,345.00 $296,860.00 $249,602.50 nat. median
$301,078
0.8× median
30260X1
OTHER 		Transfusion Of Nonautologous Cord Blood Stem Cells Into Central Artery, Open App… 1 $202,345.00 $296,860.00 $249,602.50 nat. median
$275,325
0.9× median
30263X1
OTHER 		Transfusion Of Nonautologous Cord Blood Stem Cells Into Central Artery, Percutan… 1 $202,345.00 $296,860.00 $249,602.50 nat. median
$275,325
0.9× median
30230X4
OTHER 		Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Peripheral Vein… 1 $202,345.00 $296,860.00 $249,602.50 nat. median
$301,078
0.8× median
30243X4
OTHER 		Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Central Vein, P… 1 $202,345.00 $296,860.00 $249,602.50 nat. median
$301,078
0.8× median
30250X1
OTHER 		Transfusion Of Nonautologous Cord Blood Stem Cells Into Peripheral Artery, Open… 1 $202,345.00 $296,860.00 $249,602.50 nat. median
$275,325
0.9× median
30240X4
OTHER 		Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Central Vein, O… 1 $202,345.00 $296,860.00 $249,602.50 nat. median
$301,078
0.8× median
30253X1
OTHER 		Transfusion Of Nonautologous Cord Blood Stem Cells Into Peripheral Artery, Percu… 1 $202,345.00 $296,860.00 $249,602.50 nat. median
$275,325
0.9× median
30240Y3
OTHER 		Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein,… 7 $21,700.00 $372,381.00 $236,900.00 nat. median
$255,150
0.9× median
30230Y3
OTHER 		Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Peripheral Vei… 7 $21,700.00 $372,381.00 $236,900.00 nat. median
$255,150
0.9× median
30233U3
OTHER 		Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 7 $21,700.00 $372,381.00 $236,900.00 nat. median
$247,431
1.0× median
30240U3
OTHER 		Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 7 $21,700.00 $372,381.00 $236,900.00 nat. median
$247,431
1.0× median
30230U3
OTHER 		Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 7 $21,700.00 $372,381.00 $236,900.00 nat. median
$250,002
0.9× median
30243X3
OTHER 		Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Per… 7 $21,700.00 $372,381.00 $236,900.00 nat. median
$270,000
0.9× median
30243Y3
OTHER 		Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein,… 7 $21,700.00 $372,381.00 $236,900.00 nat. median
$252,547
0.9× median

Other procedures at this hospital

Browse this hospital's 29,716 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
0815 RC — 1 1 — — $104,905.00 $104,905.00 $104,905.00 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 54 27 — — $12,480.00 $214,980.75 $66,770.58 2026-03-01
2067 OTHER Afamitresgene Autoleucel 32 22 — — $732,089.00 $1,132,811.40 $782,179.30 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 6 3 — — $872,400.00 $2,042,143.00 $1,749,707.25 2026-03-01
14 MS_DRG Allogeneic Bone Marrow Transplant 59 32 — — $1,854.72 $298,356.39 $92,504.91 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $60,576.62 $60,576.62 $60,576.62 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 5 2 — — $76,729.09 $221,874.56 $221,874.56 2026-03-01
Q2041 HCPCS Axicabtagene Adult 30 22 — — $614,793.95 $4,693,095.00 $1,742,702.61 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 32 22 — — $505,582.59 $782,322.53 $540,175.08 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 32 22 — — $90,326.95 $139,769.07 $96,507.21 2026-03-01
90288 CPT Botulism Ig Human IV 33 23 $353,368.14 $353,368.14 $53,005.22 $353,368.14 $176,684.07 2026-03-01
Q2053 HCPCS Brexucabtagene 33 24 — — $598,359.73 $4,879,690.20 $1,791,133.34 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 32 22 — — $464,977.69 $719,491.79 $496,791.95 2026-03-01
430930 CDM Cage Spn 18d 8x36x22mm 32 24 $121,798.00 $121,798.00 $18,269.70 $121,798.00 $63,943.95 2026-03-01
J9118 HCPCS Calaspar 3750 U Inj 31 21 $116,389.22 $116,389.22 $94.72 $116,389.22 $58,194.61 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 61 30 — — $2,253.12 $264,336.00 $55,527.59 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 60 30 — — $2,253.12 $242,867.79 $75,594.83 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 60 30 — — $2,253.12 $253,492.35 $59,672.83 2026-03-01
J9999 HCPCS Carmustine 7.7mg Implant 37 28 $249,749.05 $249,749.05 $37,462.36 $249,749.05 $124,874.52 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 48 28 — — $1,854.72 $1,072,056.19 $325,101.74 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $190,848.68 $190,848.68 $190,848.68 2026-03-01
Q2056 HCPCS Ciltacabtagene 100 Mil 30 22 — — $676,327.75 $4,747,900.50 $1,763,053.71 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 32 22 — — $558,267.12 $863,844.91 $596,464.34 2026-03-01
93656 CPT Com Ep Repo Cth Tx Afib 44 26 $233,407.32 $233,407.32 $3,723.00 $233,407.32 $60,802.60 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 54 27 — — $44,943.94 $194,335.98 $69,745.04 2026-03-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 7 4 — — $2,253.12 $92,326.93 $74,471.21 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 54 27 — — $18,507.00 $281,000.53 $87,215.74 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 61 30 — — $2,253.12 $269,960.41 $83,851.28 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 61 30 — — $2,253.12 $189,799.74 $59,422.41 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 61 30 — — $2,253.12 $225,064.00 $65,359.21 2026-03-01
335038 CDM Dialysis Circ Thrmb/bln 38 26 $135,783.37 $135,783.37 $20,367.51 $135,783.37 $67,212.76 2026-03-01
335039 CDM Dialysis Circ Thrmb/stnt 38 26 $135,783.37 $135,783.37 $20,367.51 $135,783.37 $67,212.76 2026-03-01
106020 CDM Donr Stem Cell Acq 44 30 $178,880.42 $178,880.42 $26,832.06 $178,880.42 $77,097.46 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 32 22 — — $105,927.85 $163,909.41 $113,175.54 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 61 30 — — $2,253.12 $526,936.82 $162,164.54 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $118,239.96 $118,239.96 $118,239.96 2026-03-01
93654 CPT Ep Repos Ele Vt 3d Map 44 26 $218,395.69 $218,395.69 $3,723.00 $218,395.69 $56,892.07 2026-03-01
336224 CDM Evas Rpr Ilioiliac Norup 38 26 $159,900.81 $159,900.81 $23,985.12 $159,900.81 $79,150.90 2026-03-01
J3392 HCPCS Exagamglogene Inj 22 16 — — $1,699,999.83 $4,999,999.50 $2,469,999.75 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 54 29 — — $2,253.12 $530,047.51 $161,528.93 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 54 29 — — $2,253.12 $178,069.45 $55,305.40 2026-03-01
C9293 HCPCS Glucarpidase 1000 U Inj 35 23 $284,862.25 $284,862.25 $486.70 $284,862.25 $139,582.50 2026-03-01
199895 CDM Graft Art St Tis 6-32mm 32 24 $110,703.00 $110,703.00 $16,605.45 $110,703.00 $58,119.07 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 56 29 — — $2,253.12 $695,721.34 $213,601.40 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $167,759.05 $167,759.05 $167,759.05 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 56 29 — — $2,253.12 $547,133.00 $87,314.09 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $62,897.34 $62,897.34 $62,897.34 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 6 3 — — $54,756.23 $114,441.15 $88,352.14 2026-03-01
Q2055 HCPCS Idecabtagene 37 25 — — $645,093.12 $4,962,756.00 $1,774,185.27 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 32 22 — — $530,177.71 $820,380.25 $566,453.03 2026-03-01
105307 CDM Imp Wrls P-art Pres Snsr 38 26 $163,305.80 $163,305.80 $24,495.87 $163,305.80 $80,836.37 2026-03-01
J1823 HCPCS Inebiliz-cdon 100 Mg Inj 31 21 $201,643.73 $201,643.73 $592.25 $201,643.73 $100,821.87 2026-03-01
714 OTHER Inj Delandistrogene Mox R 33 22 — — $5,559.52 $4,891,954.20 $3,361,138.60 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 33 22 — — $7,562.70 $4,674,600.00 $3,211,800.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 32 22 — — $2,459,531.95 $3,805,802.07 $2,627,815.71 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 29 18 — — $4,726.94 $4,955,500.00 $4,550,050.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 33 22 — — $9,788.91 $4,321,754.43 $2,969,368.69 2026-03-01
824 OTHER Inj, Exagamglogene Autote 33 22 — — $11,462.56 $3,428,040.00 $2,355,320.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 29 19 — — $3,501,003.65 $4,238,057.05 $3,722,119.67 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 33 22 — — $10,582.48 $4,781,186.76 $3,285,033.08 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 33 22 — — $7,082.66 $296,453.43 $203,685.69 2026-03-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 1 — — $3,360,000.00 $3,360,000.00 $3,360,000.00 2026-03-01
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 1 1 — — $3,840,000.00 $3,840,000.00 $3,840,000.00 2026-03-01
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 1 1 — — $4,200,000.00 $4,200,000.00 $4,200,000.00 2026-03-01
J1414 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 1 1 — — $4,200,000.00 $4,200,000.00 $4,200,000.00 2026-03-01
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 1 1 — — $3,720,000.00 $3,720,000.00 $3,720,000.00 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 1 — — $2,870,046.83 $2,870,046.83 $2,870,046.83 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 1 — — $534,422.90 $534,422.90 $534,422.90 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 33 22 — — $10,493.47 $94,483.94 $64,917.54 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 61 30 — — $2,253.12 $195,350.83 $61,114.09 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 6 3 — — $77,314.48 $170,328.19 $132,540.10 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $82,752.18 $82,752.18 $82,752.18 2026-03-01
488096 CDM Kit Aor Vlv 14fr 20mm 32 24 $124,963.00 $124,963.00 $18,744.45 $124,963.00 $65,605.57 2026-03-01
488744 CDM Kit Aor Vlv 14fr 23mm 32 24 $124,963.00 $124,963.00 $18,744.45 $124,963.00 $65,605.57 2026-03-01
488745 CDM Kit Aor Vlv 14fr 26mm 32 24 $124,963.00 $124,963.00 $18,744.45 $124,963.00 $65,605.57 2026-03-01
488746 CDM Kit Aor Vlv 14fr 29mm 32 24 $124,963.00 $124,963.00 $18,744.45 $124,963.00 $65,605.57 2026-03-01
502299 CDM Kit Cath Rt Heart 44 30 $168,649.50 $168,649.50 $25,297.42 $168,649.50 $72,687.93 2026-03-01
475415 CDM Kit Hrt Implant Lvas 32 24 $384,517.00 $384,517.00 $57,677.55 $384,517.00 $201,871.42 2026-03-01
480309 CDM Kit Vlv Aor 18fr 26mm 32 24 $143,943.00 $143,943.00 $21,591.45 $143,943.00 $75,570.07 2026-03-01
457507 CDM Kit Vlv Aor 18fr 29mm 32 24 $124,963.00 $124,963.00 $18,744.45 $124,963.00 $65,605.57 2026-03-01
5244 OTHER Level 4 Blood Product Exc 32 22 — — $57,328.72 $88,708.65 $61,251.21 2026-03-01
Q2054 HCPCS Lisocabtagene 30 22 — — $631,423.78 $4,770,198.00 $1,771,333.52 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 32 22 — — $534,091.14 $826,435.76 $570,634.21 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 50 29 — — $2,253.12 $255,968.47 $79,200.90 2026-03-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $59,938.56 $59,938.56 $59,938.56 2026-03-01
J9359 HCPCS Loncast-lpyl 10 Mg Inj 31 21 $142,460.60 $142,460.60 $255.95 $142,460.60 $71,230.30 2026-03-01
7 MS_DRG Lung Transplant 50 29 — — $2,253.12 $321,501.67 $99,075.12 2026-03-01
007 OTHER Lung Transplant 1 1 — — $70,966.58 $70,966.58 $70,966.58 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 54 27 — — $54,978.71 $244,076.82 $84,964.18 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 54 27 — — $36,009.63 $165,492.91 $56,194.88 2026-03-01
1582 OTHER New Technology - Level 45 32 22 — — $57,986.17 $89,725.96 $61,953.64 2026-03-01
1596 OTHER New Technology - Level 45 32 22 — — $57,986.17 $89,725.96 $61,953.64 2026-03-01
1583 OTHER New Technology - Level 46 32 22 — — $66,907.05 $103,529.85 $71,484.89 2026-03-01
1597 OTHER New Technology - Level 46 32 22 — — $66,907.05 $103,529.85 $71,484.89 2026-03-01
1598 OTHER New Technology - Level 47 32 22 — — $75,827.93 $117,333.74 $81,016.15 2026-03-01
1584 OTHER New Technology - Level 47 32 22 — — $75,827.93 $117,333.74 $81,016.15 2026-03-01
1585 OTHER New Technology - Level 48 32 22 — — $84,748.81 $131,137.63 $90,547.41 2026-03-01
1599 OTHER New Technology - Level 48 32 22 — — $84,748.81 $131,137.63 $90,547.41 2026-03-01
1902 OTHER New Technology - Level 49 32 22 — — $95,899.93 $148,392.53 $102,461.51 2026-03-01
1901 OTHER New Technology - Level 49 32 22 — — $95,899.93 $148,392.53 $102,461.51 2026-03-01
1904 OTHER New Technology - Level 50 32 22 — — $109,281.25 $169,098.36 $116,758.39 2026-03-01
1903 OTHER New Technology - Level 50 32 22 — — $109,281.25 $169,098.36 $116,758.39 2026-03-01
1906 OTHER New Technology - Level 51 32 22 — — $122,662.57 $189,804.20 $131,055.27 2026-03-01
1905 OTHER New Technology - Level 51 32 22 — — $122,662.57 $189,804.20 $131,055.27 2026-03-01
1907 OTHER New Technology - Level 52 32 22 — — $136,043.89 $210,510.03 $145,352.16 2026-03-01
1908 OTHER New Technology - Level 52 32 22 — — $136,043.89 $210,510.03 $145,352.16 2026-03-01
Q2058 HCPCS Obecabtagene Inj 43 28 $2,996,111.00 $2,996,111.00 $548,288.31 $2,996,111.00 $1,234,397.73 2026-03-01
831 OTHER Obecbtge Autol Up To 400 33 22 — — $3,236.80 $409,027.50 $281,032.50 2026-03-01
215 MS_DRG Other Heart Assist System Implant 60 30 — — $2,253.12 $461,974.00 $76,912.78 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $56,172.71 $56,172.71 $56,172.71 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 61 30 — — $2,253.12 $189,171.64 $59,230.99 2026-03-01
10 MS_DRG Pancreas Transplant 50 29 — — $2,253.12 $178,143.93 $55,327.88 2026-03-01
J9266 HCPCS Pegasparga Single Vl Inj 31 21 $135,957.01 $135,957.01 $25,029.69 $135,957.01 $75,323.76 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 32 22 — — $65,361.61 $101,138.50 $69,833.73 2026-03-01
490915 CDM Pump Heart 21fr 85mm 44 30 $168,649.50 $168,649.50 $25,297.42 $168,649.50 $72,687.93 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $123,742.09 $123,742.09 $123,742.09 2026-03-01
326651 CDM Rem/replace Icd Gen Mult 38 26 $115,456.88 $115,456.88 $17,318.53 $115,456.88 $57,151.15 2026-03-01
897 OTHER Revakinagene, Per Implant 32 22 — — $251,750.00 $389,550.00 $268,975.00 2026-03-01
105921 CDM Revsc Tib/per Ivl St/ath 38 26 $239,197.51 $239,197.51 $35,879.63 $239,197.51 $118,402.77 2026-03-01
105920 CDM Revsc Tib/per Ivl/ath 38 26 $160,434.10 $160,434.10 $24,065.12 $160,434.10 $79,414.88 2026-03-01
105919 CDM Revsc Tib/per Ivl/stnt 38 26 $160,434.10 $160,434.10 $24,065.12 $160,434.10 $79,414.88 2026-03-01
108728 CDM Rv Fpvt Stn/ath Cl Ea 38 26 $119,598.96 $119,598.96 $17,939.84 $119,598.96 $59,201.49 2026-03-01
108764 CDM Rv Fpvt Stn/ath Cl Ea 38 26 $119,598.96 $119,598.96 $17,939.84 $119,598.96 $59,201.49 2026-03-01
108763 CDM Rv Fpvt Stn/ath Cl In 38 26 $239,197.92 $239,197.92 $35,879.69 $239,197.92 $118,402.97 2026-03-01
108727 CDM Rv Fpvt Stn/ath Cl In 38 26 $239,197.92 $239,197.92 $35,879.69 $239,197.92 $118,402.97 2026-03-01
108726 CDM Rv Fpvt Stn/ath Sfl Ea 38 26 $119,598.96 $119,598.96 $17,939.84 $119,598.96 $59,201.49 2026-03-01
108762 CDM Rv Fpvt Stn/ath Sfl Ea 38 26 $119,598.96 $119,598.96 $17,939.84 $119,598.96 $59,201.49 2026-03-01
108725 CDM Rv Fpvt Stn/ath Sfl In 38 26 $239,197.92 $239,197.92 $35,879.69 $239,197.92 $118,402.97 2026-03-01
108761 CDM Rv Fpvt Stn/ath Sfl In 38 26 $239,197.92 $239,197.92 $35,879.69 $239,197.92 $118,402.97 2026-03-01
108740 CDM Rv Tpvt St/ath Cl Ea 38 26 $111,952.29 $111,952.29 $16,792.84 $111,952.29 $55,416.38 2026-03-01
108776 CDM Rv Tpvt St/ath Cl Ea 38 26 $111,952.29 $111,952.29 $16,792.84 $111,952.29 $55,416.38 2026-03-01
108739 CDM Rvs Tpvt St/ath Cl In 38 26 $223,904.57 $223,904.57 $33,585.69 $223,904.57 $110,832.76 2026-03-01
108775 CDM Rvs Tpvt St/ath Cl In 38 26 $223,904.57 $223,904.57 $33,585.69 $223,904.57 $110,832.76 2026-03-01
108759 CDM Rvsc Fpvt Ath Cl In 38 26 $153,973.81 $153,973.81 $23,096.07 $153,973.81 $76,217.04 2026-03-01
108723 CDM Rvsc Fpvt Ath Cl In 38 26 $153,973.81 $153,973.81 $23,096.07 $153,973.81 $76,217.04 2026-03-01
108721 CDM Rvsc Fpvt Ath Sfl In 38 26 $153,973.81 $153,973.81 $23,096.07 $153,973.81 $76,217.04 2026-03-01
108757 CDM Rvsc Fpvt Ath Sfl In 38 26 $153,973.81 $153,973.81 $23,096.07 $153,973.81 $76,217.04 2026-03-01
108755 CDM Rvsc Fpvt Stn Cl In 38 26 $160,434.10 $160,434.10 $24,065.12 $160,434.10 $79,414.88 2026-03-01
108719 CDM Rvsc Fpvt Stn Cl In 38 26 $160,434.10 $160,434.10 $24,065.12 $160,434.10 $79,414.88 2026-03-01
108753 CDM Rvsc Fpvt Stnt Sfl In 38 26 $160,434.10 $160,434.10 $24,065.12 $160,434.10 $79,414.88 2026-03-01
108717 CDM Rvsc Fpvt Stnt Sfl In 38 26 $160,434.10 $160,434.10 $24,065.12 $160,434.10 $79,414.88 2026-03-01
108737 CDM Rvsc Tpvt Ath Cl In 38 26 $153,973.81 $153,973.81 $23,096.07 $153,973.81 $76,217.04 2026-03-01
108773 CDM Rvsc Tpvt Ath Cl In 38 26 $153,973.81 $153,973.81 $23,096.07 $153,973.81 $76,217.04 2026-03-01
108735 CDM Rvsc Tpvt Ath Sfl In 38 26 $153,973.81 $153,973.81 $23,096.07 $153,973.81 $76,217.04 2026-03-01
108771 CDM Rvsc Tpvt Ath Sfl In 38 26 $153,973.81 $153,973.81 $23,096.07 $153,973.81 $76,217.04 2026-03-01
108769 CDM Rvsc Tpvt Stnt Sfl In 38 26 $160,434.10 $160,434.10 $24,065.12 $160,434.10 $79,414.88 2026-03-01
108733 CDM Rvsc Tpvt Stnt Sfl In 38 26 $160,434.10 $160,434.10 $24,065.12 $160,434.10 $79,414.88 2026-03-01
457289 CDM Set Pump 21fr 5.0 44 30 $143,248.00 $143,248.00 $21,487.20 $143,248.00 $61,739.89 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 6 3 — — $68,835.85 $144,170.89 $111,221.96 2026-03-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 7 4 — — $2,253.12 $69,101.93 $55,737.85 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 61 30 — — $2,253.12 $307,671.84 $65,158.72 2026-03-01
406086 CDM Stent Eprsth 12x37mm 32 24 $123,040.00 $123,040.00 $18,456.00 $123,040.00 $64,596.00 2026-03-01
373521 CDM Stent Eprsth 15cm 40mm 32 24 $123,040.00 $123,040.00 $18,456.00 $123,040.00 $64,596.00 2026-03-01
432099 CDM Stent Eprsth 15cm 8mm 32 24 $123,040.00 $123,040.00 $18,456.00 $123,040.00 $64,596.00 2026-03-01
430406 CDM Stent Eprsth 24f 34mm 32 24 $123,040.00 $123,040.00 $18,456.00 $123,040.00 $64,596.00 2026-03-01
407179 CDM Stent Eprsth 28x8mm 20cm 32 24 $141,728.00 $141,728.00 $21,259.20 $141,728.00 $74,407.20 2026-03-01
367513 CDM Stent Eprsth 8x40mm 15cm 32 24 $141,728.00 $141,728.00 $21,259.20 $141,728.00 $74,407.20 2026-03-01
365278 CDM Stent Eprsth 8x40mm 15cm 32 24 $141,728.00 $141,728.00 $21,259.20 $141,728.00 $74,407.20 2026-03-01
501285 CDM Sys Valve Aor 26mm 32 24 $124,963.00 $124,963.00 $18,744.45 $124,963.00 $65,605.57 2026-03-01
500090 CDM System Dlv 1 Cath 1 Clip 44 30 $148,364.00 $148,364.00 $22,254.60 $148,364.00 $63,944.89 2026-03-01
406136 CDM System Dlv Cath 1 Clip 44 30 $148,364.00 $148,364.00 $22,254.60 $148,364.00 $63,944.89 2026-03-01
494818 CDM System Tavr 5 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
366333 CDM System Trcsd 1clip 1cath 32 24 $123,040.00 $123,040.00 $18,456.00 $123,040.00 $64,596.00 2026-03-01
432390 CDM System Valve Mitral 29mm 32 24 $215,320.00 $215,320.00 $32,298.00 $215,320.00 $113,043.00 2026-03-01
Q2042 HCPCS Tisagenlecleucel Adult 62 27 — — $951,600.00 $4,975,202.25 $2,444,000.00 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 32 22 — — $538,204.73 $832,801.01 $575,029.27 2026-03-01
105862 CDM Tmvi Trnsthor Aprch 38 26 $134,510.58 $134,510.58 $20,176.59 $134,510.58 $66,582.73 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 33 22 — — $8,558.79 $4,903,655.40 $3,369,178.20 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 63 30 — — $2,253.12 $343,874.86 $106,376.65 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $92,336.06 $92,336.06 $92,336.06 2026-03-01
332179 CDM Transcth Stnt Plc Ia 38 26 $124,503.06 $124,503.06 $18,675.46 $124,503.06 $61,629.01 2026-03-01
332281 CDM Transcth Stnt Plc Ia 38 26 $113,184.60 $113,184.60 $16,977.69 $113,184.60 $56,026.38 2026-03-01
332183 CDM Transcth Stnt Plc In Vn 38 26 $124,503.06 $124,503.06 $18,675.46 $124,503.06 $61,629.01 2026-03-01
332283 CDM Transcth Stnt Plc In Vn 38 26 $124,503.06 $124,503.06 $18,675.46 $124,503.06 $61,629.01 2026-03-01
30240G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Open Approach 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30243G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Central Vein, Percutaneous Ap… 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30230G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Open Approac… 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30233G2 OTHER Transfusion Of Allogeneic Related Bone Marrow Into Peripheral Vein, Percutaneous… 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30240X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Open … 28 7 — — $83,298.00 $372,160.00 $208,972.50 2026-03-01
30243X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Central Vein, Percu… 28 7 — — $83,298.00 $372,160.00 $208,972.50 2026-03-01
30230X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Op… 28 7 — — $83,298.00 $372,160.00 $208,972.50 2026-03-01
30233X2 OTHER Transfusion Of Allogeneic Related Cord Blood Stem Cells Into Peripheral Vein, Pe… 28 7 — — $83,298.00 $372,160.00 $208,972.50 2026-03-01
30240Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Op… 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30243Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Central Vein, Pe… 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30233Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30230Y2 OTHER Transfusion Of Allogeneic Related Hematopoietic Stem Cells Into Peripheral Vein,… 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30243U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30233U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30240U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30230U2 OTHER Transfusion Of Allogeneic Related T-cell Depleted Hematopoietic Stem Cells Into … 26 7 — — $83,298.00 $372,160.00 $206,976.00 2026-03-01
30240G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Open Approach… 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30243G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Central Vein, Percutaneous … 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30230G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Open Appro… 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30233G3 OTHER Transfusion Of Allogeneic Unrelated Bone Marrow Into Peripheral Vein, Percutaneo… 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30240X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Ope… 29 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30243X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Central Vein, Per… 29 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30233X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 29 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30230X3 OTHER Transfusion Of Allogeneic Unrelated Cord Blood Stem Cells Into Peripheral Vein, … 29 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30233Y3 OTHER Transfusion Of Allogeneic Unrelated Hamatopoietic Stem Cells Into Peripheral Vei… 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30240Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30243Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Central Vein, … 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30230Y3 OTHER Transfusion Of Allogeneic Unrelated Hematopoietic Stem Cells Into Peripheral Vei… 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30240U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30243U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30233U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30230U3 OTHER Transfusion Of Allogeneic Unrelated T-cell Depleted Hematopoietic Stem Cells Int… 27 7 — — $21,700.00 $372,381.00 $236,900.00 2026-03-01
30240X4 OTHER Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Central Vein, O… 2 1 — — $202,345.00 $296,860.00 $249,602.50 2026-03-01
30243X4 OTHER Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Central Vein, P… 2 1 — — $202,345.00 $296,860.00 $249,602.50 2026-03-01
30230X4 OTHER Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Peripheral Vein… 2 1 — — $202,345.00 $296,860.00 $249,602.50 2026-03-01
30233X4 OTHER Transfusion Of Allogeneic Unspecified Cord Blood Stem Cells Into Peripheral Vein… 2 1 — — $202,345.00 $296,860.00 $249,602.50 2026-03-01
30260G0 OTHER Transfusion Of Autologous Bone Marrow Into Central Artery, Open Approach 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30263G0 OTHER Transfusion Of Autologous Bone Marrow Into Central Artery, Percutaneous Approach… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30240G0 OTHER Transfusion Of Autologous Bone Marrow Into Central Vein, Open Approach 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30243G0 OTHER Transfusion Of Autologous Bone Marrow Into Central Vein, Percutaneous Approach 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30250G0 OTHER Transfusion Of Autologous Bone Marrow Into Peripheral Artery, Open Approach 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30253G0 OTHER Transfusion Of Autologous Bone Marrow Into Peripheral Artery, Percutaneous Appro… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30230G0 OTHER Transfusion Of Autologous Bone Marrow Into Peripheral Vein, Open Approach 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30233G0 OTHER Transfusion Of Autologous Bone Marrow Into Peripheral Vein, Percutaneous Approac… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30260X0 OTHER Transfusion Of Autologous Cord Blood Stem Cells Into Central Artery, Open Approa… 42 6 — — $21,700.00 $372,381.00 $168,119.50 2026-03-01
30263X0 OTHER Transfusion Of Autologous Cord Blood Stem Cells Into Central Artery, Percutaneou… 42 6 — — $21,700.00 $372,381.00 $168,119.50 2026-03-01
30240X0 OTHER Transfusion Of Autologous Cord Blood Stem Cells Into Central Vein, Open Approach… 42 6 — — $21,700.00 $372,381.00 $168,119.50 2026-03-01
30243X0 OTHER Transfusion Of Autologous Cord Blood Stem Cells Into Central Vein, Percutaneous … 42 6 — — $21,700.00 $372,381.00 $168,119.50 2026-03-01
30250X0 OTHER Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Artery, Open App… 42 6 — — $21,700.00 $372,381.00 $168,119.50 2026-03-01
30253X0 OTHER Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Artery, Percutan… 42 6 — — $21,700.00 $372,381.00 $168,119.50 2026-03-01
30230X0 OTHER Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Vein, Open Appro… 42 6 — — $21,700.00 $372,381.00 $168,119.50 2026-03-01
30233X0 OTHER Transfusion Of Autologous Cord Blood Stem Cells Into Peripheral Vein, Percutaneo… 42 6 — — $21,700.00 $372,381.00 $168,119.50 2026-03-01
30260Y0 OTHER Transfusion Of Autologous Hematopoietic Stem Cells Into Central Artery, Open App… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30263Y0 OTHER Transfusion Of Autologous Hematopoietic Stem Cells Into Central Artery, Percutan… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30240Y0 OTHER Transfusion Of Autologous Hematopoietic Stem Cells Into Central Vein, Open Appro… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30243Y0 OTHER Transfusion Of Autologous Hematopoietic Stem Cells Into Central Vein, Percutaneo… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30250Y0 OTHER Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Artery, Open … 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30253Y0 OTHER Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Artery, Percu… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30230Y0 OTHER Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Vein, Open Ap… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30233Y0 OTHER Transfusion Of Autologous Hematopoietic Stem Cells Into Peripheral Vein, Percuta… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30233C0 OTHER Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30243C0 OTHER Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30240C0 OTHER Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30230C0 OTHER Transfusion Of Autologous Hematopoietic Stem/Progenitor Cells, Genetically Modif… 40 6 — — $21,700.00 $372,381.00 $162,869.50 2026-03-01
30260X1 OTHER Transfusion Of Nonautologous Cord Blood Stem Cells Into Central Artery, Open App… 2 1 — — $202,345.00 $296,860.00 $249,602.50 2026-03-01
30263X1 OTHER Transfusion Of Nonautologous Cord Blood Stem Cells Into Central Artery, Percutan… 2 1 — — $202,345.00 $296,860.00 $249,602.50 2026-03-01
30250X1 OTHER Transfusion Of Nonautologous Cord Blood Stem Cells Into Peripheral Artery, Open … 2 1 — — $202,345.00 $296,860.00 $249,602.50 2026-03-01
30253X1 OTHER Transfusion Of Nonautologous Cord Blood Stem Cells Into Peripheral Artery, Percu… 2 1 — — $202,345.00 $296,860.00 $249,602.50 2026-03-01
205832 CDM Valve Aor 23x18-20mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
273466 CDM Valve Aor 26x20-23mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
205856 CDM Valve Aor 26x20-23mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
205833 CDM Valve Aor 29x23-26mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
272539 CDM Valve Aor 31x26-29mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
205834 CDM Valve Aor 31x26-29mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
377516 CDM Valve Aor 56mm 32 24 $165,335.00 $165,335.00 $24,800.25 $165,335.00 $86,800.88 2026-03-01
473909 CDM Valve Aor Tavr 23mm 32 24 $124,012.00 $124,012.00 $18,601.80 $124,012.00 $65,106.30 2026-03-01
473908 CDM Valve Aor Tavr 25mm 32 24 $124,012.00 $124,012.00 $18,601.80 $124,012.00 $65,106.30 2026-03-01
473988 CDM Valve Aor Tavr 27mm 32 24 $124,012.00 $124,012.00 $18,601.80 $124,012.00 $65,106.30 2026-03-01
373582 CDM Valve Aor Tavr 44mm 32 24 $165,335.00 $165,335.00 $24,800.25 $165,335.00 $86,800.88 2026-03-01
373584 CDM Valve Aor Tavr 48mm 32 24 $165,335.00 $165,335.00 $24,800.25 $165,335.00 $86,800.88 2026-03-01
373583 CDM Valve Aor Tavr 52mm 32 24 $165,335.00 $165,335.00 $24,800.25 $165,335.00 $86,800.88 2026-03-01
481744 CDM Valve Aor With Intro 23mm 32 24 $143,943.00 $143,943.00 $21,591.45 $143,943.00 $75,570.07 2026-03-01
481732 CDM Valve Aor With Intro 25mm 32 24 $124,963.00 $124,963.00 $18,744.45 $124,963.00 $65,605.57 2026-03-01
481733 CDM Valve Aor With Intro 27mm 32 24 $143,943.00 $143,943.00 $21,591.45 $143,943.00 $75,570.07 2026-03-01
481753 CDM Valve Bndl 1cds 32 24 $132,870.00 $132,870.00 $19,930.50 $132,870.00 $69,756.75 2026-03-01
481755 CDM Valve Bndl 3cds 32 24 $132,870.00 $132,870.00 $19,930.50 $132,870.00 $69,756.75 2026-03-01
481756 CDM Valve Bndl 4cds 32 24 $132,870.00 $132,870.00 $19,930.50 $132,870.00 $69,756.75 2026-03-01
494885 CDM Valve Heart Trnscth 20mm 32 24 $143,943.00 $143,943.00 $21,591.45 $143,943.00 $75,570.07 2026-03-01
480789 CDM Valve Heart Trnscth 23mm 32 24 $143,943.00 $143,943.00 $21,591.45 $143,943.00 $75,570.07 2026-03-01
480791 CDM Valve Heart Trnscth 26mm 32 24 $143,943.00 $143,943.00 $21,591.45 $143,943.00 $75,570.07 2026-03-01
432389 CDM Valve Mitral 29mm 32 24 $177,144.00 $177,144.00 $26,571.60 $177,144.00 $93,000.60 2026-03-01
362844 CDM Valve Mitral 29x42.5mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
481779 CDM Valve Mitral 36.5x49.5mm 32 24 $132,870.00 $132,870.00 $19,930.50 $132,870.00 $69,756.75 2026-03-01
502573 CDM Valve Tavr 20mm 32 24 $150,586.00 $150,586.00 $22,587.90 $150,586.00 $79,057.65 2026-03-01
502574 CDM Valve Tavr 23mm 32 24 $130,730.00 $130,730.00 $19,609.50 $130,730.00 $68,633.25 2026-03-01
199416 CDM Valve Tavr 23mm 32 24 $124,963.00 $124,963.00 $18,744.45 $124,963.00 $65,605.57 2026-03-01
374014 CDM Valve Tavr 23mm 32 24 $116,802.00 $116,802.00 $17,520.30 $116,802.00 $61,321.05 2026-03-01
488547 CDM Valve Tavr 23mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
455710 CDM Valve Tavr 23mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
502575 CDM Valve Tavr 26mm 32 24 $130,730.00 $130,730.00 $19,609.50 $130,730.00 $68,633.25 2026-03-01
374015 CDM Valve Tavr 26mm 32 24 $116,802.00 $116,802.00 $17,520.30 $116,802.00 $61,321.05 2026-03-01
488548 CDM Valve Tavr 26mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
502371 CDM Valve Tavr 29mm 32 24 $130,730.00 $130,730.00 $19,609.50 $130,730.00 $68,633.25 2026-03-01
502576 CDM Valve Tavr 29mm 32 24 $130,730.00 $130,730.00 $19,609.50 $130,730.00 $68,633.25 2026-03-01
374016 CDM Valve Tavr 29mm 32 24 $121,118.00 $121,118.00 $18,167.70 $121,118.00 $63,586.95 2026-03-01
488549 CDM Valve Tavr 29mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
374017 CDM Valve Tavr 34mm 32 24 $121,118.00 $121,118.00 $18,167.70 $121,118.00 $63,586.95 2026-03-01
452129 CDM Valve Tavr 34mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
502241 CDM Valve Tavr Size 34mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
502238 CDM Valve Tavr Sz 23mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
502240 CDM Valve Tavr Sz 26mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
502239 CDM Valve Tavr Sz 29mm 32 24 $115,350.00 $115,350.00 $17,302.50 $115,350.00 $60,558.75 2026-03-01
481754 CDM Valve Triclip 1sgc 2cds 32 24 $132,870.00 $132,870.00 $19,930.50 $132,870.00 $69,756.75 2026-03-01
377513 CDM Valve Tricuspid 44mm 32 24 $165,335.00 $165,335.00 $24,800.25 $165,335.00 $86,800.88 2026-03-01
377514 CDM Valve Tricuspid 48mm 32 24 $165,335.00 $165,335.00 $24,800.25 $165,335.00 $86,800.88 2026-03-01
377515 CDM Valve Tricuspid 52mm 32 24 $165,335.00 $165,335.00 $24,800.25 $165,335.00 $86,800.88 2026-03-01
332188 CDM Vasc Embol Art Ven Hem 38 26 $120,721.70 $120,721.70 $18,108.26 $120,721.70 $59,757.24 2026-03-01
332423 CDM Vasc Embol Art Ven Hem 38 26 $120,721.70 $120,721.70 $18,108.26 $120,721.70 $59,757.24 2026-03-01
332422 CDM Vasc Embol Tum/org/inf 38 26 $120,721.70 $120,721.70 $18,108.26 $120,721.70 $59,757.24 2026-03-01
332421 CDM Vasc Emboliz Arterial 38 26 $120,721.70 $120,721.70 $18,108.26 $120,721.70 $59,757.24 2026-03-01
332186 CDM Vasc Emboliz Arterial 38 26 $120,721.70 $120,721.70 $18,108.26 $120,721.70 $59,757.24 2026-03-01
332420 CDM Vasc Emboliz Venous 38 26 $120,721.70 $120,721.70 $18,108.26 $120,721.70 $59,757.24 2026-03-01
332185 CDM Vasc Emboliz Venous 38 26 $120,721.70 $120,721.70 $18,108.26 $120,721.70 $59,757.24 2026-03-01
C9150 HCPCS Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose 2 1 — — $65,769.60 $74,786.40 $70,278.00 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 32 22 — — $53,983.32 $83,532.09 $57,676.92 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 6 3 — — $78,127.16 $150,585.06 $119,711.60 2026-03-01
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