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

CHRISTUS GOOD SHEPHERD MEDICAL CENTER

Longview, TX · CCN 450032 · Rates published

18,880 distinct procedures filed
24 distinct payers
1,966,361 rate rows
2026-01-14 last MRF observed
Data quality

1,689,303 of 1,966,361 rate rows are consumer-grade (85.9%)

277,058 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 262,702
per-diem day rate — not a per-procedure price 7,797
placeholder amount (≤ $0.02) — excluded from medians 4,422
template filing: same amount across many unrelated codes — excluded 2,137
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/machine-readable-files/750974351_christus_good_shepherd_hospital_northpark_standardcharges.ashx
Found on page https://www.christushealth.org/plan-care/bill-pay/pricing-transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint d72179c1cc7225c8… · 127,469,094 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 16 $3,365,897.50 $4,960,270.00 $3,543,050.00 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 16 $3,365,897.50 $4,960,270.00 $3,543,050.00 nat. median
$3,710,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 24 $2,180,537.95 $4,590,606.22 $3,385,572.08 nat. median
$2,468,984
1.4× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 24 $2,115,707.00 $4,454,120.00 $3,284,913.50 nat. median
$2,448,600
1.3× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 16 $3,013,686.27 $4,441,221.88 $3,172,301.34 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 16 $2,896,849.25 $4,269,041.00 $3,049,315.00 nat. median
$3,286,000
0.9× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 16 $2,692,718.00 $3,968,216.00 $2,834,440.00 nat. median
$3,004,655
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 24 $513,162.23 $2,616,333.90 $1,080,341.54 nat. median
$753,246
1.4× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 24 $500,183.56 $3,153,983.40 $1,053,018.02 nat. median
$674,867
1.6× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 24 $479,311.45 $2,845,367.82 $1,009,076.74 nat. median
$625,184
1.6× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 24 $468,581.90 $2,782,966.43 $986,488.20 nat. median
$673,137
1.5× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 24 $444,114.44 $2,413,123.50 $934,977.76 nat. median
$634,303
1.5× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 24 $442,784.73 $2,529,969.48 $932,178.38 nat. median
$619,808
1.5× median
5834
APR_DRG 		5 $287,870.62 $302,264.11 $287,870.62 nat. median
$309,665
0.9× median
74
APR_DRG 		4 $280,040.80 $294,042.81 $287,041.80 nat. median
$187,061
1.5× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 19 $225,671.70 $578,363.50 $249,426.62 nat. median
$370,174
0.7× median
5833
APR_DRG 		5 $243,758.26 $255,946.14 $243,758.26 nat. median
$244,017
1.0× median
24
APR_DRG 		4 $234,488.54 $246,212.94 $240,350.74 nat. median
$234,729
1.0× median
5884
APR_DRG 		5 $182,217.38 $191,328.22 $182,217.38 nat. median
$246,434
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 17 $168,557.84 $408,087.39 $180,977.89 nat. median
$265,286
0.7× median
1614
APR_DRG 		5 $176,945.57 $185,792.83 $176,945.57 nat. median
$207,730
0.9× median
94
APR_DRG 		5 $165,770.14 $174,058.63 $165,770.14 nat. median
$164,834
1.0× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 16 $51,415.97 $259,998.99 $155,707.48 nat. median
$76,329
outlier · 2.0×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 18 $141,956.16 $343,683.34 $149,427.54 nat. median
$206,474
0.7× median
Q0480
HCPCS 		Dme Pos 24 $94,999.96 $199,999.92 $147,499.94 nat. median
$111,989
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 19 $128,245.73 $328,675.02 $141,745.29 nat. median
$202,976
0.7× median
6304
APR_DRG 		5 $135,581.88 $142,360.95 $135,581.88 nat. median
$150,721
0.9× median
6094
APR_DRG 		5 $134,380.38 $141,099.38 $134,380.38 nat. median
$162,982
0.8× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 24 $80,080.00 $186,433.40 $123,970.00 nat. median
$96,983
1.3× median
5832
APR_DRG 		5 $121,459.17 $127,532.12 $121,459.17 nat. median
$156,126
0.8× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 24 $51,554.08 $371,385.46 $108,534.90 nat. median
$62,507
1.7× median
2004
APR_DRG 		5 $107,176.53 $112,535.34 $107,176.53 nat. median
$32,541
outlier · 3.3×
5831
APR_DRG 		5 $106,947.22 $112,294.57 $106,947.22 nat. median
$144,745
0.7× median
100T
CPT 		Prosth Retina Receive&gen 4 $1,426.53 $632,877.08 $104,856.76 —
E0767
HCPCS 		Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 16 $79,501.97 $123,075.16 $101,288.57 nat. median
$85,235
1.2× median
73
APR_DRG 		4 $98,815.70 $103,756.47 $101,286.08 nat. median
$89,273
1.1× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 23 $64,080.03 $134,905.32 $99,492.68 nat. median
$70,825
1.4× median
5883
APR_DRG 		5 $97,771.88 $102,660.46 $97,771.88 nat. median
$182,665
0.5× median
5882
APR_DRG 		5 $97,325.01 $102,191.25 $97,325.01 nat. median
$145,336
0.7× median
44
APR_DRG 		5 $97,073.34 $101,927.00 $97,073.34 nat. median
$105,658
0.9× median
8414
APR_DRG 		5 $96,656.04 $101,488.83 $96,656.04 nat. median
$160,267
0.6× median
6314
APR_DRG 		5 $95,690.67 $100,475.19 $95,690.67 nat. median
$122,924
0.8× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 19 $84,553.29 $216,697.68 $93,453.63 nat. median
$133,161
0.7× median
8504
APR_DRG 		5 $93,169.81 $97,828.28 $93,169.81 nat. median
$73,845
1.3× median
5914
APR_DRG 		5 $92,335.20 $96,951.95 $92,335.20 nat. median
$164,289
0.6× median
1613
APR_DRG 		5 $92,226.42 $96,837.73 $92,226.42 nat. median
$119,796
0.8× median
5881
APR_DRG 		5 $91,739.00 $96,325.94 $91,739.00 nat. median
$124,573
0.7× median
14
APR_DRG 		4 $83,997.88 $88,197.76 $86,097.82 nat. median
$129,535
0.7× median
7
MS_DRG 		Lung Transplant 17 $78,203.11 $189,333.84 $83,965.44 nat. median
$122,708
0.7× median
84
APR_DRG 		5 $83,661.31 $87,844.36 $83,661.31 nat. median
$79,774
1.0× median

Other procedures at this hospital

Browse this hospital's 18,880 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
             
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 63 17 — — $168,557.84 $408,087.39 $180,977.89 2026-01-14
10 MS_DRG Pancreas Transplant 90 20 — — $47,710.07 $115,508.60 $54,741.03 2026-01-14
100T CPT Prosth Retina Receive&gen 30 4 — — $1,426.53 $632,877.08 $104,856.76 2026-01-14
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 90 20 — — $32,288.82 $82,751.52 $36,583.69 2026-01-14
11 APR_DRG — 24 4 — — $31,993.16 $33,592.82 $32,792.99 2026-01-14
12 APR_DRG — 24 4 — — $33,241.28 $34,903.34 $34,072.31 2026-01-14
1204 APR_DRG — 30 5 — — $38,099.57 $40,004.54 $38,099.57 2026-01-14
1214 APR_DRG — 30 5 — — $35,556.72 $37,334.55 $35,556.72 2026-01-14
13 APR_DRG — 24 4 — — $43,277.75 $45,441.64 $44,359.69 2026-01-14
1304 APR_DRG — 30 5 — — $37,488.59 $39,363.01 $37,488.59 2026-01-14
14 APR_DRG — 24 4 — — $83,997.88 $88,197.76 $86,097.82 2026-01-14
14 MS_DRG Allogeneic Bone Marrow Transplant 66 18 — — $78,400.58 $189,811.94 $82,526.93 2026-01-14
140 MS_DRG Major Head And Neck Procedures With Mcc 90 20 — — $25,307.34 $64,859.01 $28,673.58 2026-01-14
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 66 18 — — $36,118.55 $87,444.92 $38,019.53 2026-01-14
1603 APR_DRG — 30 5 — — $34,706.95 $36,442.30 $34,706.95 2026-01-14
1604 APR_DRG — 30 5 — — $82,128.92 $86,235.36 $82,128.92 2026-01-14
1611 APR_DRG — 30 5 — — $62,876.17 $66,019.97 $62,876.17 2026-01-14
1612 APR_DRG — 30 5 — — $66,296.46 $69,611.27 $66,296.46 2026-01-14
1613 APR_DRG — 30 5 — — $92,226.42 $96,837.73 $92,226.42 2026-01-14
1614 APR_DRG — 30 5 — — $176,945.57 $185,792.83 $176,945.57 2026-01-14
1622 APR_DRG — 30 5 — — $30,099.95 $31,604.95 $30,099.95 2026-01-14
1623 APR_DRG — 30 5 — — $40,310.02 $42,325.52 $40,310.02 2026-01-14
1624 APR_DRG — 30 5 — — $71,643.69 $75,225.86 $71,643.69 2026-01-14
163 MS_DRG Major Chest Procedures With Mcc 90 20 — — $27,581.25 $70,686.69 $31,249.94 2026-01-14
1633 APR_DRG — 30 5 — — $28,596.76 $30,026.59 $28,596.76 2026-01-14
1634 APR_DRG — 30 5 — — $42,698.99 $44,833.93 $42,698.99 2026-01-14
1654 APR_DRG — 30 5 — — $36,930.29 $38,776.80 $36,930.29 2026-01-14
1664 APR_DRG — 30 5 — — $28,540.28 $29,967.29 $28,540.28 2026-01-14
1674 APR_DRG — 30 5 — — $54,444.09 $57,166.29 $54,444.09 2026-01-14
1694 APR_DRG — 30 5 — — $38,254.97 $40,167.71 $38,254.97 2026-01-14
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 66 18 — — $36,118.55 $87,444.92 $38,019.53 2026-01-14
1782 APR_DRG — 30 5 — — $30,534.69 $32,061.42 $30,534.69 2026-01-14
1783 APR_DRG — 30 5 — — $35,577.19 $37,356.04 $35,577.19 2026-01-14
1784 APR_DRG — 30 5 — — $55,594.04 $58,373.74 $55,594.04 2026-01-14
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 81 19 — — $225,671.70 $578,363.50 $249,426.62 2026-01-14
1814 APR_DRG — 30 5 — — $33,227.63 $34,889.01 $33,227.63 2026-01-14
1824 APR_DRG — 30 5 — — $42,724.38 $44,860.60 $42,724.38 2026-01-14
1833 APR_DRG — 30 5 — — $31,343.52 $32,910.69 $31,343.52 2026-01-14
1834 APR_DRG — 30 5 — — $32,132.64 $33,739.27 $32,132.64 2026-01-14
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 90 20 — — $47,436.61 $114,846.52 $54,427.26 2026-01-14
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 87 20 — — $65,941.39 $159,647.58 $76,353.19 2026-01-14
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 81 19 — — $48,237.26 $123,625.03 $53,314.86 2026-01-14
2004 APR_DRG — 30 5 — — $107,176.53 $112,535.34 $107,176.53 2026-01-14
204 APR_DRG — 30 5 — — $33,781.00 $35,470.05 $33,781.00 2026-01-14
2054 APR_DRG — 30 5 — — $41,871.21 $43,964.76 $41,871.21 2026-01-14
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 81 19 — — $38,699.44 $99,180.98 $42,773.06 2026-01-14
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 90 20 — — $33,075.11 $81,908.04 $37,078.94 2026-01-14
21 APR_DRG — 24 4 — — $35,936.88 $37,733.72 $36,835.30 2026-01-14
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 81 19 — — $65,188.61 $167,068.85 $72,050.57 2026-01-14
214 APR_DRG — 30 5 — — $40,214.51 $42,225.23 $40,214.51 2026-01-14
215 MS_DRG Other Heart Assist System Implant 96 20 — — $17,941.00 $162,481.85 $70,830.71 2026-01-14
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 96 20 — — $57,751.74 $148,009.27 $66,262.52 2026-01-14
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 96 20 — — $38,643.79 $99,038.35 $44,338.66 2026-01-14
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 81 19 — — $35,600.35 $91,238.46 $39,347.75 2026-01-14
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 96 20 — — $46,300.85 $118,662.30 $53,124.14 2026-01-14
22 APR_DRG — 24 4 — — $46,395.96 $48,715.75 $47,555.85 2026-01-14
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 96 20 — — $31,695.21 $81,230.19 $36,366.08 2026-01-14
2204 APR_DRG — 30 5 — — $47,370.04 $49,738.54 $47,370.04 2026-01-14
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 90 20 — — $27,481.91 $70,432.11 $31,137.40 2026-01-14
2234 APR_DRG — 30 5 — — $29,752.77 $31,240.40 $29,752.77 2026-01-14
224 APR_DRG — 30 5 — — $39,911.29 $41,906.85 $39,911.29 2026-01-14
2244 APR_DRG — 30 5 — — $34,651.62 $36,384.19 $34,651.62 2026-01-14
2274 APR_DRG — 30 5 — — $33,126.06 $34,782.35 $33,126.06 2026-01-14
228 MS_DRG Other Cardiothoracic Procedures With Mcc 96 20 — — $29,819.84 $76,423.89 $33,786.31 2026-01-14
23 APR_DRG — 24 4 — — $57,754.46 $60,642.18 $59,198.32 2026-01-14
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 90 20 — — $34,139.06 $87,493.41 $38,680.04 2026-01-14
2304 APR_DRG — 30 5 — — $40,069.34 $42,072.80 $40,069.34 2026-01-14
231 MS_DRG Coronary Bypass With Ptca With Mcc 96 20 — — $41,390.00 $129,955.73 $56,651.60 2026-01-14
232 MS_DRG Coronary Bypass With Ptca Without Mcc 96 20 — — $36,554.19 $93,683.02 $41,926.17 2026-01-14
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 96 20 — — $46,772.98 $119,872.31 $53,518.75 2026-01-14
234 APR_DRG — 30 5 — — $46,305.37 $48,620.64 $46,305.37 2026-01-14
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 96 20 — — $31,835.84 $81,590.59 $36,527.43 2026-01-14
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 96 20 — — $35,210.79 $90,240.09 $40,399.75 2026-01-14
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 90 20 — — $30,140.58 $77,245.90 $34,149.71 2026-01-14
24 APR_DRG — 24 4 — — $234,488.54 $246,212.94 $240,350.74 2026-01-14
245 MS_DRG Aicd Generator Procedures 90 20 — — $29,242.39 $74,943.96 $33,132.04 2026-01-14
2464 APR_DRG — 30 5 — — $79,642.17 $83,624.26 $79,642.17 2026-01-14
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 90 20 — — $26,762.04 $68,587.19 $30,321.78 2026-01-14
2604 APR_DRG — 30 5 — — $35,998.66 $37,798.58 $35,998.66 2026-01-14
2614 APR_DRG — 30 5 — — $31,622.86 $33,204.00 $31,622.86 2026-01-14
264 APR_DRG — 30 5 — — $43,200.43 $45,360.45 $43,200.43 2026-01-14
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 96 20 — — $35,848.68 $91,874.91 $41,131.65 2026-01-14
266T CPT Implt/rpl Crtd Sns Dev Total 84 18 — — $2,052.00 $120,842.77 $42,975.48 2026-01-14
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 96 20 — — $28,152.71 $72,151.28 $32,301.53 2026-01-14
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 96 20 — — $30,911.00 $102,254.31 $44,575.73 2026-01-14
268T CPT Implt/rpl Crtd Sns Dev Gen 84 18 — — $2,052.00 $120,842.77 $29,829.84 2026-01-14
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 96 20 — — $23,302.00 $78,719.69 $34,316.27 2026-01-14
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 96 20 — — $24,383.00 $108,379.51 $47,245.89 2026-01-14
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 96 20 — — $12,934.00 $94,997.32 $41,412.18 2026-01-14
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 96 20 — — $12,934.00 $71,341.54 $31,099.92 2026-01-14
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 96 20 — — $24,063.00 $76,730.61 $33,449.18 2026-01-14
28 MS_DRG Spinal Procedures With Mcc 81 19 — — $36,379.45 $93,235.21 $40,208.87 2026-01-14
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 81 19 — — $128,245.73 $328,675.02 $141,745.29 2026-01-14
3032 APR_DRG — 30 5 — — $31,023.63 $32,574.80 $31,023.63 2026-01-14
3033 APR_DRG — 30 5 — — $42,758.88 $44,896.81 $42,758.88 2026-01-14
3034 APR_DRG — 30 5 — — $50,544.72 $53,071.95 $50,544.72 2026-01-14
3044 APR_DRG — 30 5 — — $41,989.84 $44,089.33 $41,989.84 2026-01-14
31 MS_DRG Ventricular Shunt Procedures With Mcc 90 20 — — $25,076.36 $64,267.04 $28,411.87 2026-01-14
3154 APR_DRG — 30 5 — — $38,385.35 $40,304.61 $38,385.35 2026-01-14
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 96 20 — — $28,166.00 $94,874.63 $41,358.70 2026-01-14
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 96 20 — — $26,166.00 $67,367.98 $29,782.77 2026-01-14
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 90 20 — — $25,488.05 $65,322.16 $28,878.33 2026-01-14
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 90 20 — — $30,392.50 $77,891.54 $34,435.14 2026-01-14
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 90 20 — — $27,477.72 $70,421.38 $31,132.65 2026-01-14
33276 CPT Insj Phrnc Nrv Stim Sys 111 22 — — $2,052.00 $186,752.08 $42,975.48 2026-01-14
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 111 22 — — $2,052.00 $122,783.10 $29,102.28 2026-01-14
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 90 20 — — $25,525.76 $65,418.78 $28,921.04 2026-01-14
3614 APR_DRG — 30 5 — — $34,313.91 $36,029.60 $34,313.91 2026-01-14
38240 CPT Transplt Allo Hct/donor 87 19 — — $2,052.00 $155,358.90 $56,480.93 2026-01-14
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 81 19 — — $84,553.29 $216,697.68 $93,453.63 2026-01-14
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 90 20 — — $32,485.10 $83,254.54 $36,806.08 2026-01-14
408T CPT Insj/rplc Cardiac Modulj Sys 84 18 — — $2,052.00 $94,258.49 $30,618.81 2026-01-14
41 APR_DRG — 30 5 — — $33,486.88 $35,161.22 $33,486.88 2026-01-14
42 APR_DRG — 30 5 — — $40,807.30 $42,847.66 $40,807.30 2026-01-14
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 81 19 — — $62,684.33 $160,650.73 $69,282.68 2026-01-14
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 81 19 — — $42,502.24 $108,927.01 $46,976.16 2026-01-14
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 90 20 — — $32,936.29 $84,410.88 $37,317.28 2026-01-14
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 81 19 — — $49,909.78 $127,911.44 $55,163.44 2026-01-14
43 APR_DRG — 30 5 — — $62,413.01 $65,533.65 $62,413.01 2026-01-14
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 90 20 — — $32,735.22 $83,895.59 $37,089.47 2026-01-14
434 APR_DRG — 30 5 — — $53,624.65 $56,305.87 $53,624.65 2026-01-14
44 APR_DRG — 30 5 — — $97,073.34 $101,927.00 $97,073.34 2026-01-14
4403 APR_DRG — 24 4 — — $38,388.00 $40,307.40 $39,347.70 2026-01-14
4404 APR_DRG — 24 4 — — $62,720.77 $65,856.80 $64,288.79 2026-01-14
4414 APR_DRG — 30 5 — — $59,356.58 $62,324.41 $59,356.58 2026-01-14
4424 APR_DRG — 30 5 — — $39,692.60 $41,677.22 $39,692.60 2026-01-14
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 81 19 — — $40,120.62 $102,823.28 $44,343.84 2026-01-14
4474 APR_DRG — 30 5 — — $47,001.64 $49,351.71 $47,001.64 2026-01-14
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 90 20 — — $30,817.96 $78,981.93 $34,917.20 2026-01-14
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 81 19 — — $50,679.31 $129,883.65 $56,013.97 2026-01-14
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 81 19 — — $34,344.31 $88,019.44 $37,959.51 2026-01-14
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 90 20 — — $25,838.72 $66,220.85 $29,275.64 2026-01-14
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 81 19 — — $36,721.74 $91,874.91 $40,479.84 2026-01-14
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 90 20 — — $32,319.34 $82,829.74 $36,618.27 2026-01-14
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 90 20 — — $30,485.86 $78,130.79 $34,540.91 2026-01-14
471 MS_DRG Cervical Spinal Fusion With Mcc 90 20 — — $29,065.87 $74,491.55 $32,932.04 2026-01-14
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 90 20 — — $26,836.25 $68,777.36 $30,405.85 2026-01-14
4834 APR_DRG — 30 5 — — $37,954.78 $39,852.52 $37,954.78 2026-01-14
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 87 20 — — $63,725.53 $154,282.87 $73,787.46 2026-01-14
504 APR_DRG — 30 5 — — $30,710.18 $32,245.68 $30,710.18 2026-01-14
51 APR_DRG — 30 5 — — $33,551.32 $35,228.88 $33,551.32 2026-01-14
52 APR_DRG — 30 5 — — $41,072.61 $43,126.24 $41,072.61 2026-01-14
53 APR_DRG — 30 5 — — $44,975.39 $47,224.15 $44,975.39 2026-01-14
54 APR_DRG — 30 5 — — $62,434.23 $65,555.94 $62,434.23 2026-01-14
571T CPT Insj/rplcmt Icds Ss Eltrd 84 18 — — $2,052.00 $133,972.96 $31,384.28 2026-01-14
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 81 19 — — $36,850.40 $94,442.16 $40,729.38 2026-01-14
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 90 20 — — $32,285.24 $82,742.32 $36,579.63 2026-01-14
5831 APR_DRG — 30 5 — — $106,947.22 $112,294.57 $106,947.22 2026-01-14
5832 APR_DRG — 30 5 — — $121,459.17 $127,532.12 $121,459.17 2026-01-14
5833 APR_DRG — 30 5 — — $243,758.26 $255,946.14 $243,758.26 2026-01-14
5834 APR_DRG — 30 5 — — $287,870.62 $302,264.11 $287,870.62 2026-01-14
5881 APR_DRG — 30 5 — — $91,739.00 $96,325.94 $91,739.00 2026-01-14
5882 APR_DRG — 30 5 — — $97,325.01 $102,191.25 $97,325.01 2026-01-14
5883 APR_DRG — 30 5 — — $97,771.88 $102,660.46 $97,771.88 2026-01-14
5884 APR_DRG — 30 5 — — $182,217.38 $191,328.22 $182,217.38 2026-01-14
5891 APR_DRG — 30 5 — — $76,885.55 $80,729.81 $76,885.55 2026-01-14
5892 APR_DRG — 30 5 — — $74,517.80 $78,243.68 $74,517.80 2026-01-14
5893 APR_DRG — 30 5 — — $69,896.02 $73,390.81 $69,896.02 2026-01-14
5911 APR_DRG — 30 5 — — $36,196.13 $38,005.93 $36,196.13 2026-01-14
5912 APR_DRG — 30 5 — — $50,202.09 $52,712.19 $50,202.09 2026-01-14
5913 APR_DRG — 30 5 — — $60,802.55 $63,842.67 $60,802.55 2026-01-14
5914 APR_DRG — 30 5 — — $92,335.20 $96,951.95 $92,335.20 2026-01-14
5932 APR_DRG — 30 5 — — $43,013.96 $45,164.65 $43,013.96 2026-01-14
5933 APR_DRG — 30 5 — — $54,748.83 $57,486.26 $54,748.83 2026-01-14
5934 APR_DRG — 30 5 — — $76,655.48 $80,488.25 $76,655.48 2026-01-14
6 MS_DRG Liver Transplant Without Mcc 87 20 — — $29,017.40 $70,252.65 $33,599.09 2026-01-14
6022 APR_DRG — 30 5 — — $34,410.18 $36,130.68 $34,410.18 2026-01-14
6023 APR_DRG — 30 5 — — $45,543.16 $47,820.32 $45,543.16 2026-01-14
6024 APR_DRG — 30 5 — — $70,467.96 $73,991.35 $70,467.96 2026-01-14
6033 APR_DRG — 30 5 — — $30,215.18 $31,725.93 $30,215.18 2026-01-14
6034 APR_DRG — 30 5 — — $79,231.31 $83,192.86 $79,231.31 2026-01-14
6073 APR_DRG — 30 5 — — $31,509.91 $33,085.40 $31,509.91 2026-01-14
6074 APR_DRG — 30 5 — — $49,710.88 $52,196.42 $49,710.88 2026-01-14
6084 APR_DRG — 30 5 — — $60,630.09 $63,661.59 $60,630.09 2026-01-14
6093 APR_DRG — 30 5 — — $43,226.59 $45,387.91 $43,226.59 2026-01-14
6094 APR_DRG — 30 5 — — $134,380.38 $141,099.38 $134,380.38 2026-01-14
61 APR_DRG — 24 4 — — $44,364.03 $46,582.22 $45,473.12 2026-01-14
6114 APR_DRG — 30 5 — — $54,685.91 $57,420.20 $54,685.91 2026-01-14
6124 APR_DRG — 30 5 — — $35,039.35 $36,791.32 $35,039.35 2026-01-14
6134 APR_DRG — 30 5 — — $47,111.93 $49,467.52 $47,111.93 2026-01-14
6144 APR_DRG — 30 5 — — $40,378.62 $42,397.55 $40,378.62 2026-01-14
61886 CPT Implant Neurostim Arrays 117 22 — — $424.92 $120,842.77 $29,102.28 2026-01-14
62 APR_DRG — 24 4 — — $44,944.31 $47,191.52 $46,067.91 2026-01-14
620T CPT Evasc Ven Artlz Tibl/prnl Vn 84 18 — — $2,052.00 $66,850.96 $33,425.48 2026-01-14
6214 APR_DRG — 30 5 — — $66,917.29 $70,263.15 $66,917.29 2026-01-14
6234 APR_DRG — 30 5 — — $33,010.45 $34,660.97 $33,010.45 2026-01-14
6254 APR_DRG — 30 5 — — $35,140.55 $36,897.58 $35,140.55 2026-01-14
63 APR_DRG — 24 4 — — $49,690.41 $52,174.93 $50,932.67 2026-01-14
6303 APR_DRG — 30 5 — — $63,902.18 $67,097.28 $63,902.18 2026-01-14
6304 APR_DRG — 30 5 — — $135,581.88 $142,360.95 $135,581.88 2026-01-14
6313 APR_DRG — 30 5 — — $35,426.71 $37,198.04 $35,426.71 2026-01-14
6314 APR_DRG — 30 5 — — $95,690.67 $100,475.19 $95,690.67 2026-01-14
6334 APR_DRG — 30 5 — — $50,854.76 $53,397.50 $50,854.76 2026-01-14
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 117 22 — — $370.51 $120,842.77 $29,102.28 2026-01-14
64 APR_DRG — 24 4 — — $76,891.61 $80,736.18 $78,813.89 2026-01-14
64568 CPT Opn Impltj Crnl Nrv Nea&pg 117 22 — — $1,078.72 $120,842.77 $29,102.28 2026-01-14
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 111 22 — — $2,052.00 $124,763.44 $29,102.28 2026-01-14
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 90 20 — — $27,569.87 $66,748.12 $31,632.80 2026-01-14
6514 APR_DRG — 30 5 — — $40,935.03 $42,981.77 $40,935.03 2026-01-14
653 MS_DRG Major Bladder Procedures With Mcc 90 20 — — $33,358.16 $85,492.07 $37,795.26 2026-01-14
6604 APR_DRG — 30 5 — — $33,017.28 $34,668.14 $33,017.28 2026-01-14
674T CPT Laps Insj Nw/rpcmt Prm Isdss 84 18 — — $1,124.28 $58,204.56 $29,102.28 2026-01-14
6804 APR_DRG — 30 5 — — $60,802.55 $63,842.67 $60,802.55 2026-01-14
6814 APR_DRG — 30 5 — — $82,174.78 $86,283.51 $82,174.78 2026-01-14
6904 APR_DRG — 30 5 — — $53,955.16 $56,652.91 $53,955.16 2026-01-14
6914 APR_DRG — 30 5 — — $29,569.70 $31,048.18 $29,569.70 2026-01-14
6944 APR_DRG — 30 5 — — $29,270.28 $30,733.79 $29,270.28 2026-01-14
6954 APR_DRG — 30 5 — — $41,817.39 $43,908.25 $41,817.39 2026-01-14
69930 CPT Implant Cochlear Device 117 22 — — $828.27 $137,399.53 $30,376.47 2026-01-14
7 MS_DRG Lung Transplant 63 17 — — $78,203.11 $189,333.84 $83,965.44 2026-01-14
71 APR_DRG — 24 4 — — $43,596.13 $45,775.93 $44,686.03 2026-01-14
7104 APR_DRG — 30 5 — — $30,482.76 $32,006.90 $30,482.76 2026-01-14
72 APR_DRG — 24 4 — — $66,393.11 $69,712.76 $68,052.93 2026-01-14
7234 APR_DRG — 30 5 — — $29,230.48 $30,692.00 $29,230.48 2026-01-14
73 APR_DRG — 24 4 — — $98,815.70 $103,756.47 $101,286.08 2026-01-14
74 APR_DRG — 24 4 — — $280,040.80 $294,042.81 $287,041.80 2026-01-14
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 57 17 — — $35,573.42 $86,125.11 $37,445.70 2026-01-14
7924 APR_DRG — 30 5 — — $42,000.08 $44,100.07 $42,000.08 2026-01-14
799 MS_DRG Splenic Procedures With Mcc 90 20 — — $28,452.51 $72,919.61 $32,237.10 2026-01-14
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 87 20 — — $32,559.29 $78,827.76 $37,700.23 2026-01-14
82 APR_DRG — 30 5 — — $29,436.67 $30,908.50 $29,436.67 2026-01-14
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 81 19 — — $34,840.39 $89,290.79 $38,507.79 2026-01-14
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 90 20 — — $28,001.92 $71,764.81 $31,726.57 2026-01-14
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 90 20 — — $28,576.38 $73,237.07 $32,377.44 2026-01-14
83 APR_DRG — 30 5 — — $56,548.80 $59,376.23 $56,548.80 2026-01-14
834 MS_DRG Acute Leukemia With Mcc 81 19 — — $33,075.11 $84,766.67 $36,556.71 2026-01-14
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 81 19 — — $29,962.86 $76,790.42 $33,116.84 2026-01-14
84 APR_DRG — 30 5 — — $83,661.31 $87,844.36 $83,661.31 2026-01-14
8413 APR_DRG — 30 5 — — $41,774.56 $43,863.28 $41,774.56 2026-01-14
8414 APR_DRG — 30 5 — — $96,656.04 $101,488.83 $96,656.04 2026-01-14
8424 APR_DRG — 30 5 — — $32,973.31 $34,621.97 $32,973.31 2026-01-14
850 MS_DRG Acute Leukemia With Other Procedures 81 19 — — $55,123.60 $141,273.70 $60,926.08 2026-01-14
8504 APR_DRG — 30 5 — — $93,169.81 $97,828.28 $93,169.81 2026-01-14
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 90 20 — — $29,927.56 $76,699.94 $33,908.35 2026-01-14
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 90 20 — — $26,997.21 $69,189.90 $30,588.22 2026-01-14
8634 APR_DRG — 30 5 — — $64,521.88 $67,747.97 $64,521.88 2026-01-14
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 81 19 — — $41,627.39 $106,684.88 $46,009.22 2026-01-14
888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 129 24 — — $15,877.33 $72,627.08 $44,252.21 2026-01-14
894 APR_DRG — 30 5 — — $37,547.72 $39,425.10 $37,547.72 2026-01-14
901 MS_DRG Wound Debridements For Injuries With Mcc 90 20 — — $26,511.92 $67,946.15 $30,038.38 2026-01-14
91 APR_DRG — 30 5 — — $51,946.72 $54,544.05 $51,946.72 2026-01-14
9104 APR_DRG — 30 5 — — $46,137.85 $48,444.73 $46,137.85 2026-01-14
9114 APR_DRG — 30 5 — — $39,088.44 $41,042.85 $39,088.44 2026-01-14
9124 APR_DRG — 30 5 — — $37,498.06 $39,372.96 $37,498.06 2026-01-14
914 APR_DRG — 30 5 — — $34,129.32 $35,835.79 $34,129.32 2026-01-14
915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 84 18 — — $2,052.00 $133,055.56 $31,384.28 2026-01-14
92 APR_DRG — 30 5 — — $53,564.38 $56,242.60 $53,564.38 2026-01-14
924 APR_DRG — 30 5 — — $28,916.27 $30,362.08 $28,916.27 2026-01-14
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 66 18 — — $141,956.16 $343,683.34 $149,427.54 2026-01-14
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 66 18 — — $39,966.23 $96,760.36 $42,069.72 2026-01-14
93 APR_DRG — 30 5 — — $81,442.52 $85,514.63 $81,442.52 2026-01-14
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 90 20 — — $25,891.97 $62,685.83 $29,707.64 2026-01-14
94 APR_DRG — 30 5 — — $165,770.14 $174,058.63 $165,770.14 2026-01-14
9504 APR_DRG — 30 5 — — $44,768.07 $47,006.46 $44,768.07 2026-01-14
9514 APR_DRG — 30 5 — — $31,220.72 $32,781.75 $31,220.72 2026-01-14
9524 APR_DRG — 30 5 — — $39,448.88 $41,421.32 $39,448.88 2026-01-14
955 MS_DRG Craniotomy For Multiple Significant Trauma 81 19 — — $40,860.24 $104,718.81 $45,161.32 2026-01-14
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 81 19 — — $44,665.44 $114,470.97 $49,367.06 2026-01-14
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 81 19 — — $37,844.32 $96,989.46 $41,827.94 2026-01-14
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 90 20 — — $28,447.12 $72,905.81 $32,230.99 2026-01-14
A9543 HCPCS Y90 Ibritumomab, Rx 129 24 — — $51,554.08 $371,385.46 $108,534.90 2026-01-14
A9699 HCPCS Radiopharm Rx Agent Noc 96 16 — — $45,221.05 $45,221.05 $45,221.05 2026-01-14
C2616 HCPCS Brachytx, Non-str,yttrium-90 129 24 — — $15,863.36 $58,965.92 $37,414.64 2026-01-14
C9150 HCPCS Xe129 Xenon, Diagnostic 96 16 — — $51,168.00 $51,168.00 $51,168.00 2026-01-14
E0767 HCPCS Intrabuccal, Systemic Delivery Of Amplitude-modulated, Radiofrequency Electromag… 96 16 — — $79,501.97 $123,075.16 $101,288.57 2026-01-14
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 60 16 — — $3,365,897.50 $4,960,270.00 $3,543,050.00 2026-01-14
J1413 HCPCS Inj Delandistrogene Mox Rokl 60 16 — — $3,013,686.27 $4,441,221.88 $3,172,301.34 2026-01-14
J1414 HCPCS Injection, Fidanacogene Elaparvovec-dzkt, Per Therapeutic Dose 60 16 — — $3,365,897.50 $4,960,270.00 $3,543,050.00 2026-01-14
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 129 24 — — $2,115,707.00 $4,454,120.00 $3,284,913.50 2026-01-14
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 60 16 — — $2,692,718.00 $3,968,216.00 $2,834,440.00 2026-01-14
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 60 16 — — $2,896,849.25 $4,269,041.00 $3,049,315.00 2026-01-14
J3399 HCPCS Inj Onase Abepar-xioi Treat 129 24 — — $2,180,537.95 $4,590,606.22 $3,385,572.08 2026-01-14
J7310 HCPCS Ganciclovir Long Act Implant 24 3 — — $3,439.00 $108,524.16 $58,724.16 2026-01-14
J7330 HCPCS Cultured Chondrocytes Implnt 96 16 — — $51,415.97 $259,998.99 $155,707.48 2026-01-14
J9029 HCPCS Instill Adstiladrin, Tx Dose 84 18 — — $6.22 $1,089,600.00 $62,800.51 2026-01-14
J9226 HCPCS Supprelin La Implant 84 18 — — $13.77 $250,260.83 $44,866.90 2026-01-14
J9600 HCPCS Porfimer Sodium Injection 129 24 — — $21,981.23 $147,580.87 $46,276.28 2026-01-14
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 129 24 — — $80,080.00 $186,433.40 $123,970.00 2026-01-14
L2006 HCPCS Dme Pos 72 18 — — $2,339.59 $77,501.20 $38,750.60 2026-01-14
L5856 HCPCS Dme Pos 129 24 — — $27,677.78 $58,269.02 $42,973.40 2026-01-14
L5858 HCPCS Dme Pos 129 24 — — $21,428.00 $45,111.58 $33,269.79 2026-01-14
L5973 HCPCS Dme Pos 129 24 — — $19,836.32 $41,760.68 $30,798.50 2026-01-14
L6880 HCPCS Dme Pos 129 24 — — $27,547.06 $57,993.80 $42,770.43 2026-01-14
L6965 HCPCS Dme Pos 129 24 — — $21,546.73 $45,361.54 $33,454.14 2026-01-14
L6970 HCPCS Dme Pos 129 24 — — $21,900.79 $46,106.92 $34,003.86 2026-01-14
L6975 HCPCS Dme Pos 129 24 — — $22,018.33 $46,354.38 $34,186.36 2026-01-14
L7180 HCPCS Dme Pos 129 24 — — $46,575.29 $98,053.24 $72,314.26 2026-01-14
L7181 HCPCS Dme Pos 129 24 — — $46,196.85 $97,256.52 $71,726.68 2026-01-14
L8701 HCPCS Ewh S/d Uprt Micro Sensor 114 23 — — $32,570.22 $68,568.88 $50,569.55 2026-01-14
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 114 23 — — $64,080.03 $134,905.32 $99,492.68 2026-01-14
Q0480 HCPCS Dme Pos 129 24 — — $94,999.96 $199,999.92 $147,499.94 2026-01-14
Q0483 HCPCS Dme Pos 129 24 — — $21,617.37 $45,510.26 $33,563.82 2026-01-14
Q0489 HCPCS Dme Pos 129 24 — — $18,741.11 $39,454.96 $29,098.03 2026-01-14
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 129 24 — — $444,114.44 $2,413,123.50 $934,977.76 2026-01-14
Q2042 HCPCS Tisagenlecleucel Car-pos T 129 24 — — $513,162.23 $2,616,333.90 $1,080,341.54 2026-01-14
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 84 18 — — $46.06 $414,648.57 $55,158.86 2026-01-14
Q2053 HCPCS Brexucabtagene Car Pos T 129 24 — — $442,784.73 $2,529,969.48 $932,178.38 2026-01-14
Q2054 HCPCS Lisocabtagene Mara Car Pos T 129 24 — — $468,581.90 $2,782,966.43 $986,488.20 2026-01-14
Q2055 HCPCS Idecabtagene Vicleucel Car 129 24 — — $479,311.45 $2,845,367.82 $1,009,076.74 2026-01-14
Q2056 HCPCS Ciltacabtagene Car-pos T 129 24 — — $500,183.56 $3,153,983.40 $1,053,018.02 2026-01-14
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