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

University Of Texas M D Anderson Cancer Center,the

Houston, TX · CCN 450076 · Rates published

28,844 distinct procedures filed
37 distinct payers
2,043,541 rate rows
2026-05-06 last MRF observed
Data quality

2,029,275 of 2,043,541 rate rows are consumer-grade (99.3%)

14,266 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
template filing: same amount across many unrelated codes — excluded 13,814
exceeds 10× this hospital's gross charge — excluded from medians 270
per-diem day rate — not a per-procedure price 164
placeholder amount (≤ $0.02) — excluded from medians 18
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.mdanderson.org/content/dam/mdanderson/documents/patients-and-family/becoming-our-patient/planning-for-care/74-6001118_MD%20Anderson%20Cancer%20Center_StandardCharges.csv
Found on page https://www.mdanderson.org/patients-family/becoming-our-patient/planning-for-care/insurance-billing-financial-support/health-care-disclosures.html
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 49b9932de844f460… · 118,314,045 bytes · first seen 2026-05-06

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
83205-0001-2 [386990]
OTHER 		Afamitresgene Autoleucel 2.68x 10exp9 To 10x 10exp9 Cell IV Suspension [205503] 26 $79,970.00 $679,745.00 $599,775.00 nat. median
$599,775
1.0× median
0078-0846-19 [301288]
OTHER 		Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension [183167] 27 $65,288.67 $927,623.10 $489,665.03 nat. median
$489,665
1.0× median
73776-001-11 [380874]
OTHER 		Lifileucel 7.5 X 10exp9 To 72 X 10exp9 Cell Intravenous Suspension [203845] 2 $432,740.00 $494,560.00 $463,650.00 nat. median
$463,650
1.0× median
73776-001-12 [380875]
OTHER 		Lifileucel 7.5 X 10exp9 To 72 X 10exp9 Cell Intravenous Suspension [203845] 2 $432,740.00 $494,560.00 $463,650.00 nat. median
$463,650
1.0× median
57894-111-01 [355195]
OTHER 		Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension [196949] 26 $61,084.15 $904,162.08 $458,131.13 nat. median
$458,131
1.0× median
57894-111-02 [355196]
OTHER 		Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension [196949] 26 $61,084.15 $904,162.08 $458,131.13 nat. median
$458,131
1.0× median
73153-900-01 [343995]
OTHER 		Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp [193841] 26 $58,448.54 $847,036.99 $438,364.09 nat. median
$438,364
1.0× median
73153-901-08 [344357]
OTHER 		Lisocabtagene Maraleucel(cd8) 1.5x To 70x 10exp6 Cell/ml IV Susp(1of2) [40800003… 26 $58,448.54 $847,036.99 $438,364.09 nat. median
$438,364
1.0× median
59572-515-03 [344808]
OTHER 		Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension [194238] 26 $72.25 $866,432.39 $435,857.78 nat. median
$435,858
1.0× median
59572-515-01 [344806]
OTHER 		Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension [194238] 26 $24.42 $866,432.39 $435,857.78 nat. median
$435,858
1.0× median
59572-515-02 [344807]
OTHER 		Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension [194238] 26 $36.80 $866,432.39 $435,857.78 nat. median
$435,858
1.0× median
71287-119-01 [302981]
OTHER 		Axicabtagene Ciloleucel Intravenous Suspension [183620] 27 $55,393.80 $802,808.13 $415,453.50 nat. median
$415,454
1.0× median
0078-0958-19 [308872]
OTHER 		Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension [185152] 27 $53,781.96 $927,623.10 $403,364.74 nat. median
$403,365
1.0× median
71287-220-02 [352195]
OTHER 		Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension [196078] 26 $50,820.00 $800,404.48 $381,150.00 nat. median
$381,150
1.0× median
71287-219-02 [336953]
OTHER 		Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension [192076] 26 $50,820.00 $800,404.48 $381,150.00 nat. median
$381,150
1.0× median
71287-220-01 [351628]
OTHER 		Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension [196078] 26 $50,820.00 $800,404.48 $381,150.00 nat. median
$381,150
1.0× median
71287-219-01 [336952]
OTHER 		Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension [192076] 26 $50,820.00 $800,404.48 $381,150.00 nat. median
$381,150
1.0× median
83047-100-10 [389041]
OTHER 		Obecabtagene Autoleucel Intravenous Suspension 100 X 10exp6 Cell Intravenous Sus… 28 $80,850.00 $525,000.00 $216,562.50 nat. median
$216,562
1.0× median
83047-010-10 [389040]
OTHER 		Obecabtagene Autoleucel Intravenous Suspension 10 X 10exp6 Cell Intravenous Susp… 28 $80,850.00 $525,000.00 $216,562.50 nat. median
$216,562
1.0× median
83047-100-30 [389042]
OTHER 		Obecabtagene Autoleucel Intravenous Suspension 100 X 10exp6 Cell Intravenous Sus… 28 $80,850.00 $525,000.00 $216,562.50 nat. median
$216,562
1.0× median
16
OTHER 		Stem Cell Transplant- Single- Allo Unrelated 4 $160,000.00 $186,960.00 $176,250.00 nat. median
$50,271
outlier · 3.5×
11
OTHER 		Stem Cell Transplant- Tandem- Auto/Allo Unrelated 2 $112,000.00 $240,000.00 $176,000.00 nat. median
$49,519
outlier · 3.6×
17
OTHER 		Stem Cell Transplant- Single- Mismatch Allo Related/Unrelated 2 $160,000.00 $180,000.00 $170,000.00 nat. median
$46,040
outlier · 3.7×
1908
OTHER 		New Technology - Level 52 ($145,001-$160,000) 1 $152,500.50 $152,500.50 $152,500.50 nat. median
$152,962
1.0× median
1907
OTHER 		New Technology - Level 52 ($145,001-$160,000) 1 $152,500.50 $152,500.50 $152,500.50 nat. median
$153,199
1.0× median
15
OTHER 		Stem Cell Transplant- Single- Allo Related With Aml, Cml, Lymphoma And Renal Cell 1 $145,000.00 $145,000.00 $145,000.00 nat. median
$1,931
outlier · 75.1×
55566-1050-1 [371473]
OTHER 		Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension [201881] 34 $53,424.00 $164,088.00 $141,192.00 nat. median
$141,192
1.0× median
55566-1050-0 [371472]
OTHER 		Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension [201881] 34 $53,424.00 $164,088.00 $141,192.00 nat. median
$141,192
1.0× median
1906
OTHER 		New Technology - Level 51 ($130,001-$145,000) 1 $137,500.50 $137,500.50 $137,500.50 nat. median
$138,020
1.0× median
1905
OTHER 		New Technology - Level 51 ($130,001-$145,000) 1 $137,500.50 $137,500.50 $137,500.50 nat. median
$137,903
1.0× median
30237-8900-6 [193937]
OTHER 		Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension [104852] 34 $51,534.38 $158,284.16 $137,118.26 nat. median
$137,118
1.0× median
9
OTHER 		Stem Cell Transplant- Tandem Auto To Auto 1 $135,000.00 $135,000.00 $135,000.00 nat. median
$1,920
outlier · 70.3×
13
OTHER 		Stem Cell Transplant- Single- Allo Related 5 $130,000.00 $145,000.00 $135,000.00 nat. median
$27,161
outlier · 5.0×
12
OTHER 		Stem Cell Transplant- Tandem- Auto/Allo Unrelated With Aml, Cml, Lymphoma And Rena… 2 $122,500.00 $137,500.00 $130,000.00 nat. median
$39,504
outlier · 3.3×
18
OTHER 		Stem Cell Transplant- Single- Mismatch Allo Related/Unrelated With Aml, Cml, Lymph… 2 $82,500.00 $175,000.00 $128,750.00 nat. median
$386,529
outlier · 0.3×
1903
OTHER 		New Technology - Level 50 ($115,001-$130,000) 1 $122,500.50 $122,500.50 $122,500.50 nat. median
$119,935
1.0× median
1904
OTHER 		New Technology - Level 50 ($115,001-$130,000) 1 $122,500.50 $122,500.50 $122,500.50 nat. median
$120,174
1.0× median
10
OTHER 		Stem Cell Transplant- Tandem Auto To Allo Related With Aml, Cml, Lymphoma And Rena… 2 $101,500.00 $129,375.00 $115,437.50 nat. median
$62,879
1.8× median
88880-5018-00 [313224]
OTHER 		Factor Xa,inactivated-zhzo (recombinant) High-dose Infusion 1760 Mg In 176 Ml (1… 34 $131.80 $132,364.32 $113,894.88 nat. median
$113,895
1.0× median
1902
OTHER 		New Technology - Level 49 ($100,001-$115,000) 1 $107,500.50 $107,500.50 $107,500.50 nat. median
$105,172
1.0× median
1901
OTHER 		New Technology - Level 49 ($100,001-$115,000) 1 $107,500.50 $107,500.50 $107,500.50 nat. median
$105,693
1.0× median
67979-002-01 [152036]
OTHER 		Histrelin 50 Mg (65 Mcg/day) Implant Kit [164961] 34 $4.35 $123,303.45 $106,098.31 nat. median
$106,098
1.0× median
19
OTHER 		Car-t Therapy Infusion 2 $82,500.00 $120,000.00 $101,250.00 nat. median
$61,133
1.7× median
50633-210-11 [229846]
OTHER 		Glucarpidase 1,000 Unit Intravenous Solution [116024] 34 $73.92 $112,602.68 $98,200.01 nat. median
$98,200
1.0× median
0310-4535-30 [363166]
OTHER 		Tremelimumab-actl 20 Mg/ml Intravenous Solution [199299] 34 $138.43 $110,966.19 $96,127.68 nat. median
$96,128
1.0× median
1599
OTHER 		New Technology - Level 48 ($90,001-$100,000) 1 $95,000.50 $95,000.50 $95,000.50 nat. median
$95,288
1.0× median
1585
OTHER 		New Technology - Level 48 ($90,001-$100,000) 1 $95,000.50 $95,000.50 $95,000.50 nat. median
$95,360
1.0× median
81900013
OTHER 		Hc Marrow Collection 34 $2,688.42 $100,170.22 $87,357.75 nat. median
$87,358
1.0× median
6
OTHER 		Ccu- Intermediate Per Diem 6 $2,659.65 $110,000.00 $86,500.00 nat. median
$52,924
1.6× median
66658-510-01 [343712]
OTHER 		Emapalumab-lzsg 5 Mg/ml Intravenous Solution [187168] 34 $376.57 $99,317.01 $85,458.83 nat. median
$85,459
1.0× median

Other procedures at this hospital

Browse this hospital's 28,844 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
             
0003-2327-11 [204100] OTHER Ipilimumab 5 Mg/ml Inj Container [40800000416] 83 34 $28,229.50 — $31.11 $24,277.37 $20,889.83 2026-05-06
0003-2328-22 [204101] OTHER Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution [108956] 83 34 $112,917.80 — $63.22 $97,109.31 $83,559.17 2026-05-06
0003-3734-13 [304768] OTHER Nivolumab 10 Mg/ml Inj Container [40800001603] 81 34 $24,763.70 — $32.30 $21,296.78 $18,325.14 2026-05-06
0003-7125-11 [355696] OTHER Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution [197151] 81 34 $48,080.30 — $193.86 $41,349.06 $35,579.42 2026-05-06
0008-0100-01 [301278] OTHER Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln [183134] 82 34 $72,847.45 — $20.07 $62,648.81 $53,907.11 2026-05-06
0008-4510-01 [301279] OTHER Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln [183174] 82 34 $31,943.10 — $53.19 $27,471.07 $23,637.89 2026-05-06
0024-5823-15 [303098] OTHER Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution [105644] 81 34 $45,660.85 — $224.09 $39,268.33 $33,789.03 2026-05-06
0024-5824-11 [195524] OTHER Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution [105644] 81 34 $45,660.85 — $224.09 $39,268.33 $33,789.03 2026-05-06
0024-5862-01 [264183] OTHER Plerixafor 24 Mg/1.2 Ml (20 Mg/ml) Subcutaneous Solution [95849] 80 34 $31,698.50 — $37.08 $27,260.71 $23,615.39 2026-05-06
0069-2522-01 [378588] OTHER Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution [202348] 81 34 $25,338.60 — $177.65 $21,791.20 $18,750.56 2026-05-06
0069-2522-02 [373281] OTHER Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution [202348] 81 34 $25,338.60 — $177.65 $21,791.20 $18,750.56 2026-05-06
0069-4494-01 [378589] OTHER Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution [202348] 81 34 $43,766.70 — $177.65 $37,639.36 $32,387.36 2026-05-06
0069-4494-02 [373282] OTHER Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution [202348] 81 34 $43,766.70 — $177.65 $37,639.36 $32,387.36 2026-05-06
0078-0748-81 [311977] OTHER Pasireotide Pamoate 10 Mg IM Suspension [186119] 80 34 $50,708.25 — $481.00 $43,609.10 $37,777.65 2026-05-06
0078-0846-19 [301288] OTHER Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension [183167] 45 27 $652,886.70 — $65,288.67 $927,623.10 $489,665.03 2026-05-06
0078-0958-19 [308872] OTHER Tisagenlecleucel 0.6 X 10exp8 To 6 X10exp8 Cell Intravenous Suspension [185152] 45 27 $537,819.65 — $53,781.96 $927,623.10 $403,364.74 2026-05-06
0169-7205-01 [238548] OTHER Coagulation Factor Viia 1 Mg/ml Inj Container [40800000404] 81 34 $44,679.00 — $2.55 $38,423.94 $33,062.46 2026-05-06
0169-7215-11 [344072] OTHER Coagulation Factor Viia Recomb 5 Mg (5,000 Mcg) Intravenous Solution [92855] 81 34 $44,679.00 — $2.55 $38,423.94 $33,062.46 2026-05-06
0173-0898-03 [346526] OTHER Dostarlimab-gxly 50 Mg/ml Intravenous Solution [194605] 81 34 $37,506.15 — $240.06 $32,255.29 $27,754.55 2026-05-06
0187-0007-14 [12582] OTHER Ribavirin 6 Gram Solution For Inhalation [11285] 79 34 $79,376.80 — $22,225.50 $68,264.05 $59,532.60 2026-05-06
0310-4535-30 [363166] OTHER Tremelimumab-actl 20 Mg/ml Intravenous Solution [199299] 80 34 $129,030.45 — $138.43 $110,966.19 $96,127.68 2026-05-06
10 OTHER Stem Cell Transplant- Tandem Auto To Allo Related With Aml, Cml, Lymphoma And Rena… 2 2 — — $101,500.00 $129,375.00 $115,437.50 2026-05-06
11 OTHER Stem Cell Transplant- Tandem- Auto/Allo Unrelated 2 2 — — $112,000.00 $240,000.00 $176,000.00 2026-05-06
12 OTHER Stem Cell Transplant- Tandem- Auto/Allo Unrelated With Aml, Cml, Lymphoma And Rena… 2 2 — — $122,500.00 $137,500.00 $130,000.00 2026-05-06
13 OTHER Stem Cell Transplant- Single- Allo Related 5 5 — — $130,000.00 $145,000.00 $135,000.00 2026-05-06
14 OTHER Stem Cell Transplant- Tandem Auto To Allo 1st Attempt Unrelated 1 1 — — $82,500.00 $82,500.00 $82,500.00 2026-05-06
15 OTHER Stem Cell Transplant- Single- Allo Related With Aml, Cml, Lymphoma And Renal Cell 1 1 — — $145,000.00 $145,000.00 $145,000.00 2026-05-06
15054-1090-4 [326079] OTHER Lanreotide 90 Mg/0.3 Ml Subcutaneous Syringe [87860] 81 34 $23,837.55 — $10.70 $20,500.29 $17,639.79 2026-05-06
15054-1120-4 [326080] OTHER Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe [87861] 81 34 $28,112.30 — $44.98 $24,176.58 $20,803.10 2026-05-06
1577 OTHER New Technology - Level 40 ($20,001-$25,000) 1 1 — — $22,500.50 $22,500.50 $22,500.50 2026-05-06
1578 OTHER New Technology - Level 41 ($25,001-$30,000) 1 1 — — $27,500.50 $27,500.50 $27,500.50 2026-05-06
1579 OTHER New Technology - Level 42 ($30,001-$40,000) 1 1 — — $35,000.50 $35,000.50 $35,000.50 2026-05-06
1580 OTHER New Technology - Level 43 ($40,001-$50,000) 1 1 — — $45,000.50 $45,000.50 $45,000.50 2026-05-06
1581 OTHER New Technology - Level 44 ($50,001-$60,000) 1 1 — — $55,000.50 $55,000.50 $55,000.50 2026-05-06
1582 OTHER New Technology - Level 45 ($60,001-$70,000) 1 1 — — $65,000.50 $65,000.50 $65,000.50 2026-05-06
1583 OTHER New Technology - Level 46 ($70,001-$80,000) 1 1 — — $75,000.50 $75,000.50 $75,000.50 2026-05-06
1584 OTHER New Technology - Level 47 ($80,001-$90,000) 1 1 — — $85,000.50 $85,000.50 $85,000.50 2026-05-06
1585 OTHER New Technology - Level 48 ($90,001-$100,000) 1 1 — — $95,000.50 $95,000.50 $95,000.50 2026-05-06
1591 OTHER New Technology - Level 40 ($20,001-$25,000) 1 1 — — $22,500.50 $22,500.50 $22,500.50 2026-05-06
1592 OTHER New Technology - Level 41 ($25,001-$30,000) 1 1 — — $27,500.50 $27,500.50 $27,500.50 2026-05-06
1593 OTHER New Technology - Level 42 ($30,001-$40,000) 1 1 — — $35,000.50 $35,000.50 $35,000.50 2026-05-06
1594 OTHER New Technology - Level 43 ($40,001-$50,000) 1 1 — — $45,000.50 $45,000.50 $45,000.50 2026-05-06
1595 OTHER New Technology - Level 44 ($50,001-$60,000) 1 1 — — $55,000.50 $55,000.50 $55,000.50 2026-05-06
1596 OTHER New Technology - Level 45 ($60,001-$70,000) 1 1 — — $65,000.50 $65,000.50 $65,000.50 2026-05-06
1597 OTHER New Technology - Level 46 ($70,001-$80,000) 1 1 — — $75,000.50 $75,000.50 $75,000.50 2026-05-06
1598 OTHER New Technology - Level 47 ($80,001-$90,000) 1 1 — — $85,000.50 $85,000.50 $85,000.50 2026-05-06
1599 OTHER New Technology - Level 48 ($90,001-$100,000) 1 1 — — $95,000.50 $95,000.50 $95,000.50 2026-05-06
16 OTHER Stem Cell Transplant- Single- Allo Unrelated 4 4 — — $160,000.00 $186,960.00 $176,250.00 2026-05-06
17 OTHER Stem Cell Transplant- Single- Mismatch Allo Related/Unrelated 2 2 — — $160,000.00 $180,000.00 $170,000.00 2026-05-06
18 OTHER Stem Cell Transplant- Single- Mismatch Allo Related/Unrelated With Aml, Cml, Lymph… 2 2 — — $82,500.00 $175,000.00 $128,750.00 2026-05-06
19 OTHER Car-t Therapy Infusion 2 2 — — $82,500.00 $120,000.00 $101,250.00 2026-05-06
1901 OTHER New Technology - Level 49 ($100,001-$115,000) 1 1 — — $107,500.50 $107,500.50 $107,500.50 2026-05-06
1902 OTHER New Technology - Level 49 ($100,001-$115,000) 1 1 — — $107,500.50 $107,500.50 $107,500.50 2026-05-06
1903 OTHER New Technology - Level 50 ($115,001-$130,000) 1 1 — — $122,500.50 $122,500.50 $122,500.50 2026-05-06
1904 OTHER New Technology - Level 50 ($115,001-$130,000) 1 1 — — $122,500.50 $122,500.50 $122,500.50 2026-05-06
1905 OTHER New Technology - Level 51 ($130,001-$145,000) 1 1 — — $137,500.50 $137,500.50 $137,500.50 2026-05-06
1906 OTHER New Technology - Level 51 ($130,001-$145,000) 1 1 — — $137,500.50 $137,500.50 $137,500.50 2026-05-06
1907 OTHER New Technology - Level 52 ($145,001-$160,000) 1 1 — — $152,500.50 $152,500.50 $152,500.50 2026-05-06
1908 OTHER New Technology - Level 52 ($145,001-$160,000) 1 1 — — $152,500.50 $152,500.50 $152,500.50 2026-05-06
25682-028-01 [339398] OTHER Ravulizumab-cwvz 100 Mg/ml Intravenous Solution [192897] 80 34 $76,164.10 — $220.59 $65,501.13 $56,742.25 2026-05-06
27500001 OTHER Hc Cardio Defib D/chamb Virt 81 34 $40,000.00 — $11,200.00 $34,400.00 $30,000.00 2026-05-06
27500002 OTHER Hc Cardio Defib S/chamb Prot 81 34 $37,359.00 — $10,460.52 $32,128.74 $28,019.25 2026-05-06
27500003 OTHER Hc Cardio Defib S/chamb Teli 81 34 $32,000.00 — $8,960.00 $27,520.00 $24,000.00 2026-05-06
27500004 OTHER Hc Cardio Defib S/chamb Virt 81 34 $38,140.00 — $10,679.20 $32,800.40 $28,605.00 2026-05-06
27500005 OTHER Hc Cardio Defib S/chambstjud 81 34 $36,529.00 — $10,228.12 $31,414.94 $27,396.75 2026-05-06
27500006 OTHER Hc Icd-vr Dvbb1d4 Evera Xt 81 34 $35,878.00 — $10,045.84 $30,855.08 $26,908.50 2026-05-06
27500023 OTHER Hc Cardio Defib S/d Concerto 81 34 $49,080.00 — $13,742.40 $42,208.80 $36,810.00 2026-05-06
27500024 OTHER Hc Cario Defib Incepta Bost 81 34 $47,000.00 — $13,160.00 $40,420.00 $35,250.00 2026-05-06
27500025 OTHER Hc Cario Defib Oth S/d Cham 81 34 $48,280.00 — $13,518.40 $41,520.80 $36,210.00 2026-05-06
27500026 OTHER Hc Cario Defib Oths/d Vivaxt 81 34 $48,312.00 — $13,527.36 $41,548.32 $36,234.00 2026-05-06
27500027 OTHER Hc Energen Crt-d/df4 Boston 81 34 $42,000.00 — $11,760.00 $36,120.00 $31,500.00 2026-05-06
27500028 OTHER Hc Hv Generator Assura Stjud 81 34 $60,000.00 — $16,800.00 $51,600.00 $45,000.00 2026-05-06
27500029 OTHER Hc Hv Generator Quadra Stjud 81 34 $65,146.00 — $18,240.88 $56,025.56 $48,859.50 2026-05-06
27500054 OTHER Hc Defib D/chamb Fortassurdr 81 34 $38,145.00 — $10,680.60 $32,804.70 $28,608.75 2026-05-06
27500057 OTHER Hc Defib D/chamb Ellipstjudec1721 81 34 $38,145.00 — $10,680.60 $32,804.70 $28,608.75 2026-05-06
27500058 OTHER Hc Defib D/chamb Medteveraxt 81 34 $42,052.00 — $11,774.56 $36,164.72 $31,539.00 2026-05-06
27500059 OTHER Hc Cardio Defib S/chamb Dvmb 81 34 $41,380.00 — $11,586.40 $35,586.80 $31,035.00 2026-05-06
27500060 OTHER Hc Inogenx4 Crtdis-1/df4bost 81 34 $41,000.00 — $11,480.00 $35,260.00 $30,750.00 2026-05-06
27500065 OTHER Hc Cardio-defibrill Single Chamber Cd1357-4q St Jude 81 34 $40,186.00 — $11,252.08 $34,559.96 $30,139.50 2026-05-06
27500066 OTHER Hc Cardio Defibrillator Single/dual Viva Xt Dtb1d1 81 34 $46,636.00 — $13,058.08 $40,106.96 $34,977.00 2026-05-06
27500068 OTHER Hc Icd Defib Ellipse Vr-36 Df4 Cd1411-36q 81 34 $35,444.00 — $9,924.32 $30,481.84 $26,583.00 2026-05-06
27500069 OTHER Hc Defib S/ch Icd MRI Evera Xt Vr Dvmb1d4 81 34 $41,380.00 — $11,586.40 $35,586.80 $31,035.00 2026-05-06
27500071 OTHER Hc Defib S/d Ch Icd Quadra Assura Cd3365-40q 81 34 $49,990.00 — $13,997.20 $42,991.40 $37,492.50 2026-05-06
27500072 OTHER Hc Defib S/d Ch Icd Unify Quadra Crt-d System 81 34 $48,455.00 — $13,567.40 $41,671.30 $36,341.25 2026-05-06
27500074 OTHER Hc Icd Defib Viva Xt Crt-d Dtba1d1 81 34 $46,636.00 — $13,058.08 $40,106.96 $34,977.00 2026-05-06
27500075 OTHER Hc Quadra Assura Mp Cd3369-4q 81 34 $53,590.00 — $15,005.20 $46,087.40 $40,192.50 2026-05-06
27500076 OTHER Hc Evera MRI Xt Dr Surescan 81 34 $47,716.00 — $13,360.48 $41,035.76 $35,787.00 2026-05-06
27500079 OTHER Hc Icd Defib Claria Crt-d 81 34 $56,468.00 — $15,811.04 $48,562.48 $42,351.00 2026-05-06
27500080 OTHER Hc Icd Defib Dynagen X4 Crt-d 81 34 $41,000.00 — $11,480.00 $35,260.00 $30,750.00 2026-05-06
27500082 OTHER Hc Icd-vr Dvfb1d4 Visia MRI Af US Df4 81 34 $44,086.00 — $12,344.08 $37,913.96 $33,064.50 2026-05-06
27500085 OTHER Hc Icd Defib Amplia MRI Quad Crt-d 81 34 $55,727.00 — $15,603.56 $47,925.22 $41,795.25 2026-05-06
27500088 OTHER Hc Icd Defib Claria MRI Quad Dtma1qq 81 34 $57,627.00 — $16,135.56 $49,559.22 $43,220.25 2026-05-06
27500092 OTHER Hc Crtd Surescan Claria MRI Generator 81 34 $56,468.00 — $15,811.04 $48,562.48 $42,351.00 2026-05-06
27500093 OTHER Hc Percepta Quad Crt-p MRI Surescan Pacemaker Generator 81 34 $23,900.00 — $6,692.00 $20,554.00 $17,925.00 2026-05-06
27500096 OTHER Hc Aicd Single Chamber Gallant Vr_icd_umri_us 81 34 $40,406.00 — $11,313.68 $34,749.16 $30,304.50 2026-05-06
27500097 OTHER Hc Cardio Defib Single Chamb Cobalt Dvpb3d4 81 34 $43,866.00 — $12,282.48 $37,724.76 $32,899.50 2026-05-06
27500098 OTHER Hc Crt-d Cobalt Hf MRI Surescan 81 34 $57,338.00 — $16,054.64 $49,310.68 $43,003.50 2026-05-06
27800089 OTHER Hc Endoprothesis K 81 34 $26,963.00 — $1,352.95 $23,188.18 $20,222.25 2026-05-06
27800186 OTHER Hc Brachytherapy Seed, Yttrium-90 81 34 $33,000.00 — $9,240.00 $28,380.00 $24,750.00 2026-05-06
27800456 OTHER Hc Ans Gene Xp8-ch Imp P-genc1767 81 34 $27,590.00 — $7,725.20 $23,727.40 $20,692.50 2026-05-06
27801249 OTHER Hc Pump Med Synchr 20/40ml 80 34 $23,600.00 — $6,608.00 $20,296.00 $17,700.00 2026-05-06
27801286 OTHER Hc Restore Neurostimc1820 81 34 $31,850.00 — $8,918.00 $27,391.00 $23,887.50 2026-05-06
27801906 OTHER Hc Cardiomems Pa Sensor Delivery System 80 34 $36,000.00 — $10,080.00 $30,960.00 $27,000.00 2026-05-06
27801981 OTHER Hc Zenith Alpha Thoracic Endovascular Graft 81 34 $31,930.00 — $2,196.10 $27,459.80 $23,947.50 2026-05-06
27802077 OTHER Hc Surpass Flow Diverter Intracranial Stent Delivery System A 81 34 $29,700.00 — $1,834.90 $25,542.00 $22,275.00 2026-05-06
27802078 OTHER Hc Surpass Flow Diverter Intracranial Stent Delivery System B 81 34 $32,300.00 — $1,834.90 $27,778.00 $24,225.00 2026-05-06
27802165 OTHER Hc Mesh Hernia Ovitex 30x25in 2s Perm Grid 81 34 $26,000.00 — $672.86 $22,360.00 $19,500.00 2026-05-06
27802166 OTHER Hc Mesh Hernia Ovitex 40x25in 2s Perm Grid 81 34 $35,000.00 — $672.86 $30,100.00 $26,250.00 2026-05-06
27802170 OTHER Hc Mesh Hernia Ovitex 40x25in 1s Perm Grid 81 34 $27,000.00 — $672.86 $23,220.00 $20,250.00 2026-05-06
3 OTHER Leukemia Per Diem 2 2 — — $49,800.00 $61,875.00 $55,837.50 2026-05-06
30237-8900-6 [193937] OTHER Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension [104852] 80 34 $184,051.35 — $51,534.38 $158,284.16 $137,118.26 2026-05-06
33300025 OTHER Hc Srs Gamma Knife 81 34 $68,704.00 — $2,216.74 $59,085.44 $51,528.00 2026-05-06
33300026 OTHER Hc Srs Stereo Radsrg Sgl Ses 81 34 $29,911.00 — $8,375.08 $25,723.46 $22,433.25 2026-05-06
33622 OTHER Pr Reconstruction Complex Cardiac Anomaly 49 28 $31,297.00 — $2,469.04 $28,167.30 $18,778.20 2026-05-06
33782 OTHER Pr A-root Tlcj Vsd Pulm Stns Rpr Without C Ost Rimpltj 49 28 $30,876.00 — $2,322.48 $27,788.40 $18,525.60 2026-05-06
33783 OTHER Pr A-root Tlcj Vsd Pulm Stns Rpr W/rimpltj C Ostia 49 28 $33,447.00 — $2,509.62 $30,102.30 $20,068.20 2026-05-06
33864 OTHER Pr Ascending Aorta Grf Valve Spare Root Remodel 49 28 $30,835.00 — $2,311.90 $30,323.71 $18,501.00 2026-05-06
33935 OTHER Pr Heart-lung Trnspl W/recipient Cardiectomy-pnumec 44 24 $40,568.00 — $3,541.25 $34,482.80 $25,638.97 2026-05-06
33945 OTHER Pr Heart Transplant W/wo Recipient Cardiectomy 44 24 $31,633.00 — $3,172.32 $26,888.05 $19,992.06 2026-05-06
36000181 OTHER Hc Brain Suite 81 34 $33,769.00 — $9,455.32 $29,041.34 $25,326.75 2026-05-06
36000183 OTHER Hc Ioct Suite 81 34 $31,353.00 — $8,778.84 $26,963.58 $23,514.75 2026-05-06
36000190 OTHER Hc Histosonics Procedure 81 34 $35,179.00 — $9,850.12 $30,253.94 $26,384.25 2026-05-06
36100019 OTHER Hc Remov/repl Pulse Multlead 81 34 $31,075.00 — $8,701.00 $31,276.70 $23,306.25 2026-05-06
36100038 OTHER Hc Fm/pop Rvsc Uni Vsl Wstnt 81 34 $29,964.00 — $8,389.92 $25,769.04 $22,473.00 2026-05-06
36100039 OTHER Hc Fm/pop Rvscuni Wstnt&athr 81 34 $51,892.00 — $14,529.76 $44,627.12 $38,919.00 2026-05-06
36100072 OTHER Hc Tib/per Rvsc Uni Vs Wstnt 81 34 $29,964.00 — $8,389.92 $29,449.02 $22,473.00 2026-05-06
36100073 OTHER Hc Tib/per Rvsc Uni W/athrct 81 34 $29,964.00 — $8,389.92 $29,449.02 $22,473.00 2026-05-06
36100075 OTHER Hc Tib/per Rvscuni Wstn&athr 81 34 $51,892.00 — $14,529.76 $44,627.12 $38,919.00 2026-05-06
36100076 OTHER Hc Tib/per Rvsun Adl Vswathr 80 34 $26,373.00 — $7,384.44 $22,680.78 $19,779.75 2026-05-06
36100077 OTHER Hc Translm Periph Renal Athr 80 34 $23,843.00 — $6,676.04 $20,504.98 $17,882.25 2026-05-06
36100078 OTHER Hc Translum Periph Visc Athr 79 34 $23,843.00 — $6,676.04 $20,504.98 $17,882.25 2026-05-06
36100079 OTHER Hc Trnslm Peri Abdaorta Athr 80 34 $23,843.00 — $6,676.04 $20,504.98 $17,882.25 2026-05-06
36100080 OTHER Hc Trnslm Peri Brchocph Athr 80 34 $23,843.00 — $656.35 $20,504.98 $17,882.25 2026-05-06
36100081 OTHER Hc Trnslm Priph Iliac Atherc 80 34 $23,843.00 — $800.83 $20,504.98 $17,882.25 2026-05-06
36100145 OTHER Hc Lv Lead Placem W/nw Genrt 80 34 $26,527.00 — $7,427.56 $22,813.22 $19,895.25 2026-05-06
36100154 OTHER Hc Ev Rpr Dta Ic Lsc Int Ep 80 34 $24,095.00 — $6,746.60 $20,721.70 $18,071.25 2026-05-06
36100172 OTHER Hc Rp Iaa+rp Artrm-f Evr Tbp 80 34 $24,095.00 — $6,746.60 $20,721.70 $18,071.25 2026-05-06
36100173 OTHER Hc Rpiaa+rp Artrm-f Evr Abip 80 34 $24,095.00 — $6,746.60 $20,721.70 $18,071.25 2026-05-06
36100174 OTHER Hc Rpiaa+rp Artrm-f Evr Abfp 80 34 $24,095.00 — $6,746.60 $20,721.70 $18,071.25 2026-05-06
36100238 OTHER Hc Trnscth Artery Stent Init 81 34 $33,627.00 — $9,415.56 $28,919.22 $25,220.25 2026-05-06
36100240 OTHER Hc Trnscth Venous Stent Init 81 34 $33,627.00 — $9,415.56 $28,919.22 $25,220.25 2026-05-06
36100242 OTHER Hc Emb Vein Wimg Notumr/hemr 81 34 $31,453.00 — $8,806.84 $27,049.58 $23,589.75 2026-05-06
36100243 OTHER Hc Emb Artry Wimg Notumr/hmr 81 34 $31,453.00 — $8,806.84 $29,449.02 $23,589.75 2026-05-06
36100244 OTHER Hc Emb Organ/tumorhae/tace 81 34 $31,453.00 — $8,806.84 $27,049.58 $23,589.75 2026-05-06
36100245 OTHER Hc Emb Vascgi Bleed/lymext 81 34 $31,453.00 — $8,806.84 $27,049.58 $23,589.75 2026-05-06
36100299 OTHER Hc Tc Perm Occlu/embol P Cns 80 34 $24,922.00 — $6,978.16 $21,432.92 $18,691.50 2026-05-06
36100300 OTHER Hc Tc Prm Oclu/embl P Ncnshn 81 34 $24,922.00 — $6,978.16 $21,432.92 $18,691.50 2026-05-06
36100334 OTHER Hc Arth Brach-ceph Trk/brnch 80 34 $23,843.00 — $656.35 $20,504.98 $17,882.25 2026-05-06
36100343 OTHER Hc Ins/rpl Pm S/ld Art W/gen 81 34 $25,125.00 — $7,035.00 $21,607.50 $18,843.75 2026-05-06
36100345 OTHER Hc Ins/rpl Pm D/ld A&v W/gen 81 34 $23,836.00 — $6,674.08 $20,498.96 $17,877.00 2026-05-06
36100347 OTHER Hc Upgrade Pm Sys Sngl-dual 81 34 $33,904.00 — $9,493.12 $29,157.44 $25,428.00 2026-05-06
36100352 OTHER Hc Rem/repl Pm Gen Dual 81 34 $26,403.00 — $7,392.84 $22,706.58 $19,802.25 2026-05-06
36100427 OTHER Hc Thoracoscopy W/therapeutic Wedge Resection, Initial Unilateral 80 34 $24,456.00 — $6,847.68 $21,032.16 $18,342.00 2026-05-06
36100428 OTHER Hc Thoracoscopy With Lobectomy Single Lobe 80 34 $29,563.00 — $8,277.64 $25,424.18 $22,172.25 2026-05-06
36100429 OTHER Hc Thoracoscopy With Mediastinal & Regional Lymphdenectomy 80 34 $27,917.00 — $7,816.76 $24,008.62 $20,937.75 2026-05-06
36100431 OTHER Hc Laparoscopic Procedure Liver 81 34 $43,493.00 — $9,568.35 $37,403.98 $32,619.75 2026-05-06
36100432 OTHER Hc Hepatectomy Resection Of Liver; Partial Lopectomy 80 34 $61,257.00 — $17,151.96 $52,681.02 $45,942.75 2026-05-06
36100433 OTHER Hc Exploratory Laparotomy Celiotomy W/wo Biopsy 80 34 $58,109.00 — $16,270.52 $49,973.74 $43,581.75 2026-05-06
36100434 OTHER Hc Enterolysis Freeing Intestinal Adhesion 80 34 $73,919.00 — $20,697.32 $63,570.34 $55,439.25 2026-05-06
36100458 OTHER Hc Evasc Rpr Dplmnt Aorto-aortic Ndgf, S & I 80 34 $28,224.00 — $7,902.72 $24,272.64 $21,168.00 2026-05-06
36100459 OTHER Hc Evasc Rpr Dplmnt Aorto-aortic Ndgft Rupture, S & I 80 34 $28,224.00 — $7,902.72 $24,272.64 $21,168.00 2026-05-06
36100460 OTHER Hc Evasc Rpr Dplmnt Aorto-un-iliac Ndgft, S & I 80 34 $28,224.00 — $7,902.72 $24,272.64 $21,168.00 2026-05-06
36100461 OTHER Hc Evasc Rpr Dplmnt Aorto-un-iliac Ndgft Rupture, S & I 80 34 $28,224.00 — $7,902.72 $24,272.64 $21,168.00 2026-05-06
36100462 OTHER Hc Evasc Rpr Dplmnt Aorto-bi-iliac Ndgft, S & I 80 34 $28,224.00 — $7,902.72 $24,272.64 $21,168.00 2026-05-06
36100463 OTHER Hc Evasc Rpr Dplmnt Aorto-bi-iliac Ndgft Rupture, S & I 80 34 $28,224.00 — $7,902.72 $24,272.64 $21,168.00 2026-05-06
36100464 OTHER Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft, S & I 80 34 $28,224.00 — $7,902.72 $24,272.64 $21,168.00 2026-05-06
36100465 OTHER Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft Rupture, S & I 80 34 $28,224.00 — $7,902.72 $24,272.64 $21,168.00 2026-05-06
36100533 OTHER Hc Endovascular Venous Arterialization Tibl/prnl Vn, Rs&i 80 34 $33,627.00 — $9,415.56 $57,400.82 $25,220.25 2026-05-06
36200007 OTHER Hc Txprep Tumorcell Dep 81 34 $39,010.00 — $76.37 $33,548.60 $29,257.50 2026-05-06
36200030 OTHER Hc Auto Txprep Tcell Dep 81 34 $35,718.00 — $83.59 $30,717.48 $26,788.50 2026-05-06
38779-0330-5 [44708] OTHER Haloperidol (bulk) Powder [17126] 80 34 $37,295.60 — $22.08 $32,074.22 $27,971.70 2026-05-06
38779-1754-8 [148958] OTHER Ketamine (bulk) 100 % Powder [23101] 80 34 $45,297.70 — $20.74 $38,956.02 $33,973.28 2026-05-06
3877924718 [234682] OTHER Glutamine (bulk) Powder [13713] 80 34 $35,949.90 — $62.55 $30,916.91 $26,962.42 2026-05-06
3877924719 [234683] OTHER Glutamine (bulk) Powder [13713] 80 34 $71,899.80 — $94.33 $61,833.83 $53,924.85 2026-05-06
4 OTHER Medical/Surgical Per Diem 1 1 — — $84,360.00 $84,360.00 $84,360.00 2026-05-06
43287 OTHER Pr Esophagectomy Distal 2/3 W/laparoscopic Moblj 49 28 $33,829.00 — $2,584.63 $30,446.10 $20,297.40 2026-05-06
43288 OTHER Pr Esophagectomy Total Near Total W/thrsc Moblj 49 28 $37,036.00 — $2,725.79 $33,332.40 $22,221.60 2026-05-06
47135 OTHER Pr Lvr Altrnsplj Orthotopic Prtl/whl Don Any Age 44 24 $36,455.00 — $3,972.11 $36,025.43 $23,039.56 2026-05-06
4737910 OTHER Pr Unlisted Laparoscopic Proc, Liver, Mis Extended Hepatectomy W/ultrasound 28 21 $23,491.00 — $2,448.59 $19,967.35 $17,618.25 2026-05-06
4757903 OTHER Pr Unlisted Laparoscopy Px, Biliary Tract (lap Hepaticoduodenostomy) 28 21 $29,213.00 — $1,106.24 $24,831.05 $21,909.75 2026-05-06
48100025 OTHER Hc Rhc Coronary Angio Grafts 81 34 $24,403.00 — $5,274.91 $20,986.58 $18,302.25 2026-05-06
48100028 OTHER Hc R/l Cath Coronary Angio Lv 81 34 $26,104.00 — $5,274.91 $22,449.44 $19,578.00 2026-05-06
48100029 OTHER Hc R/l Cat Coron Ang Graf Lv 81 34 $26,343.00 — $5,274.91 $22,654.98 $19,757.25 2026-05-06
48100076 OTHER Hc Tcat Impl Wrls P-art Prs Snr L-t Hemodyn Mntr 81 34 $32,691.00 — $9,153.48 $46,622.46 $24,518.25 2026-05-06
48818-001-02 [188564] OTHER Pralatrexate 20 Mg/ml Inj Container [40800000211] 80 34 $43,168.65 — $373.77 $37,125.04 $32,160.65 2026-05-06
49190 OTHER Pr Open Exc/dstrj Intra-abdl Tumor/cyst >30 Cm 49 28 $27,711.00 — $2,127.21 $24,939.90 $18,400.10 2026-05-06
5 OTHER Ccu/picu Per Diem 2 2 $4,266.00 — $3,626.10 $94,500.00 $49,063.05 2026-05-06
50242-070-01 [251664] OTHER Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution [132573] 81 34 $27,388.50 — $74.83 $23,554.11 $20,267.49 2026-05-06
50242-105-01 [323683] OTHER Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution [188465] 80 34 $59,184.30 — $132.92 $50,898.50 $44,092.30 2026-05-06
50242-109-01 [299247] OTHER Rituximab 1,600 Mg/13.4 Ml (120 Mg/ml)-hyaluronidase Subcutaneous Soln [182432] 80 34 $23,901.20 — $36.58 $20,555.03 $17,806.40 2026-05-06
50242-120-47 [327335] OTHER Tenecteplase 50 Mg Intravenous Solution [184741] 80 34 $24,393.95 — $162.43 $20,978.80 $18,173.49 2026-05-06
50242-127-01 [370395] OTHER Glofitamab-gxbm 1 Mg/ml Intravenous Solution [201679] 81 34 $33,471.25 — $11.71 $28,785.28 $24,768.72 2026-05-06
50242-142-01 [364462] OTHER Mosunetuzumab-axgb 1 Mg/ml Intravenous Solution [199784] 81 34 $59,553.95 — $641.07 $51,216.40 $44,069.92 2026-05-06
50242-245-01 [335798] OTHER Pertuzumab 1,200 Mg-trastuzumab 600 Mg-hyaluron-zzxf/15 Ml Subcut Soln [191789] 80 34 $44,254.55 — $63.88 $38,058.91 $32,969.64 2026-05-06
50242-260-01 [335799] OTHER Pertuzumab 600 Mg-trastuzumab 600 Mg-hyaluronid-zzxf/10 Ml Subcut Soln [191790] 80 34 $29,501.90 — $63.88 $25,371.63 $21,978.92 2026-05-06
50242-917-01 [288227] OTHER Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution [178549] 81 34 $35,780.80 — $88.22 $30,771.49 $26,477.79 2026-05-06
50242-918-01 [320144] OTHER Atezolizumab 60 Mg/ml Injection Container [40800003336] 81 34 $25,046.55 — $88.22 $21,540.03 $18,534.45 2026-05-06
50633-210-11 [229846] OTHER Glucarpidase 1,000 Unit Intravenous Solution [116024] 81 34 $130,933.35 — $73.92 $112,602.68 $98,200.01 2026-05-06
50881-006-03 [367267] OTHER Retifanlimab-dlwr 500 Mg/20 Ml Intravenous Solution [200729] 80 34 $45,963.75 — $29.26 $39,528.82 $34,242.99 2026-05-06
50881-023-11 [392113] OTHER Axatilimab-csfr 50 Mg/ml Intravenous Solution [207071] 80 34 $36,729.00 — $10,284.12 $31,586.94 $27,546.75 2026-05-06
51144-050-01 [212963] OTHER Brentuximab Vedotin 50 Mg Intravenous Solution [111348] 81 34 $38,796.00 — $248.93 $33,364.56 $28,709.04 2026-05-06
5116 OTHER Level 6 Musculoskeletal Procedures 1 1 — — $18,390.05 $18,390.05 $18,390.05 2026-05-06
5166 OTHER Cochlear Implant Procedure 1 1 — — $31,807.82 $31,807.82 $31,807.82 2026-05-06
51927-2909-0 [101816] OTHER Ursodiol (bulk) 100 % Powder [35168] 79 34 $25,010.70 — $7,003.00 $21,509.20 $18,758.03 2026-05-06
5194 OTHER Level 4 Endovascular Procedures 1 1 — — $17,956.72 $17,956.72 $17,956.72 2026-05-06
5199902 OTHER Pr Unlisted Robotic-assisted Radical Cystectomy W/ileal Conduit Urinary Diversio… 28 21 $26,910.00 — $16,146.00 $24,219.00 $20,182.50 2026-05-06
5199903 OTHER Pr Unlisted Robotic-assisted Radical Cystectomy With Ileal Conduit Urinary Diversi… 28 21 $24,542.00 — $14,725.20 $22,087.80 $18,406.50 2026-05-06
5199904 OTHER Pr Unlisted Laparoscopy Proc, Bladder (robotic-assisted Cystectomy & Bilateral L… 28 21 $28,202.00 — $16,921.20 $25,381.80 $21,151.50 2026-05-06
5199908 OTHER Pr Robotic Pelvic Exenteration, Complete, For Vesical, Prostatic Orurethral Mali… 28 21 $39,879.00 — $23,927.40 $35,891.10 $29,909.25 2026-05-06
5200 OTHER Implantation Wireless Pa Pressure Monitor 1 1 — — $28,428.33 $28,428.33 $28,428.33 2026-05-06
5213 OTHER Level 3 Electrophysiologic Procedures 1 1 — — $24,532.30 $24,532.30 $24,532.30 2026-05-06
5224 OTHER Level 4 Pacemaker And Similar Procedures 1 1 — — $19,071.16 $19,071.16 $19,071.16 2026-05-06
5231 OTHER Level 1 Icd And Similar Procedures 1 1 — — $22,446.19 $22,446.19 $22,446.19 2026-05-06
5232 OTHER Level 2 Icd And Similar Procedures 1 1 — — $32,061.58 $32,061.58 $32,061.58 2026-05-06
5244 OTHER Level 4 Blood Product Exchange And Related Services 1 1 — — $59,142.33 $59,142.33 $59,142.33 2026-05-06
5378 OTHER Level 8 Urology And Related Services 1 1 — — $20,128.56 $20,128.56 $20,128.56 2026-05-06
5389911 OTHER Pr Unlisted Proc Urinary System Removal & Replacement Of Neobladder 28 21 $23,845.00 — $1,386.92 $20,268.25 $17,883.75 2026-05-06
5464 OTHER Level 4 Neurostimulator And Related Procedures 1 1 — — $21,444.39 $21,444.39 $21,444.39 2026-05-06
5465 OTHER Level 5 Neurostimulator And Related Procedures 1 1 — — $30,473.59 $30,473.59 $30,473.59 2026-05-06
5471 OTHER Implantation Of Drug Infusion Device 1 1 — — $17,674.12 $17,674.12 $17,674.12 2026-05-06
55292-702-54 [299297] OTHER Hemin Ivpb 7 Mg/ml [40800000366] 81 34 $34,790.80 — $23.08 $29,920.09 $25,745.19 2026-05-06
55292-702-55 [299298] OTHER Hemin Ivpb 7 Mg/ml [40800000366] 81 34 $34,790.80 — $8.70 $29,920.09 $25,745.19 2026-05-06
55513-069-01 [384410] OTHER Tarlatamab-dlle 2.4 Mg/ml Injection [40800003635] 80 34 $47,700.00 — $1,575.42 $41,022.00 $35,536.50 2026-05-06
55513-077-01 [383509] OTHER Tarlatamab-dlle 10 Mg Intravenous Solution [204733] 80 34 $47,700.00 — $1,575.42 $41,022.00 $35,536.50 2026-05-06
55566-1050-0 [371472] OTHER Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension [201881] 81 34 $190,800.00 — $53,424.00 $164,088.00 $141,192.00 2026-05-06
55566-1050-1 [371473] OTHER Nadofaragene Firadenovec-vncg 3x10exp11 Vp/ml Intravesical Suspension [201881] 81 34 $190,800.00 — $53,424.00 $164,088.00 $141,192.00 2026-05-06
55566-9800-0 [364485] OTHER Fecal Microbiota, Live-jslm 150 Ml Rectal Suspension Enema [199654] 81 34 $29,049.30 — $33.78 $24,982.40 $21,496.48 2026-05-06
55566-9800-2 [364486] OTHER Fecal Microbiota, Live-jslm 150 Ml Rectal Suspension Enema [199654] 81 34 $29,049.30 — $36.13 $24,982.40 $21,496.48 2026-05-06
57894-060-02 [296511] OTHER Ustekinumab 45 Mg/0.5 Ml Subcutaneous Solution [99447] 80 34 $46,350.90 — $155.88 $39,861.77 $34,531.43 2026-05-06
57894-060-03 [189874] OTHER Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe [129587] 80 34 $46,350.90 — $155.88 $39,861.77 $34,531.43 2026-05-06
57894-061-03 [189875] OTHER Ustekinumab 90 Mg/ml Subcutaneous Syringe [108054] 80 34 $92,701.65 — $155.88 $79,723.42 $69,062.73 2026-05-06
57894-111-01 [355195] OTHER Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension [196949] 44 26 $610,841.50 — $61,084.15 $904,162.08 $458,131.13 2026-05-06
57894-111-02 [355196] OTHER Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension [196949] 44 26 $610,841.50 — $61,084.15 $904,162.08 $458,131.13 2026-05-06
57894-450-01 [362636] OTHER Teclistamab-cqyv 90 Mg/ml Subcutaneous Solution [199303] 80 34 $32,037.80 — $32.55 $27,552.51 $23,868.16 2026-05-06
57894-470-01 [372789] OTHER Talquetamab-tgvs 40 Mg/ml Subcutaneous Solution [202319] 80 34 $35,427.85 — $69.97 $30,467.95 $26,393.75 2026-05-06
57894-503-01 [334654] OTHER Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln [408000026… 81 34 $26,604.45 — $51.39 $22,879.83 $19,687.29 2026-05-06
59572-515-01 [344806] OTHER Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension [194238] 44 26 $581,143.70 — $24.42 $866,432.39 $435,857.78 2026-05-06
59572-515-02 [344807] OTHER Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension [194238] 44 26 $581,143.70 — $36.80 $866,432.39 $435,857.78 2026-05-06
59572-515-03 [344808] OTHER Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension [194238] 44 26 $581,143.70 — $72.25 $866,432.39 $435,857.78 2026-05-06
59572-775-01 [329189] OTHER Luspatercept-aamt 50 Mg/ml Subcutaneous Injection [40800003411] 81 34 $38,469.80 — $41.28 $33,084.03 $28,467.65 2026-05-06
6 OTHER Ccu- Intermediate Per Diem 6 6 $3,129.00 — $2,659.65 $110,000.00 $86,500.00 2026-05-06
61553-287-50 [293849] OTHER Bupivacaine 0.075%-fentanyl 5 Mcg/ml Epidural Infusion (premix) [40800000704] 80 34 $25,608.20 — $7,170.30 $22,023.05 $19,206.15 2026-05-06
61755-008-01 [313044] OTHER Cemiplimab-rwlc 50 Mg/ml Intravenous Solution [186523] 81 34 $33,729.55 — $28.21 $29,007.41 $24,959.87 2026-05-06
64764-300-20 [263056] OTHER Vedolizumab 300 Mg Intravenous Solution [164372] 80 34 $29,764.55 — $21.67 $25,597.51 $22,174.59 2026-05-06
66302-014-01 [279600] OTHER Dinutuximab 3.5 Mg/ml Intravenous Solution [173725] 80 34 $60,570.35 — $16,959.70 $52,090.50 $45,427.76 2026-05-06
66658-505-01 [343711] OTHER Emapalumab-lzsg 5 Mg/ml Intravenous Solution [187168] 81 34 $57,742.45 — $376.57 $49,658.51 $42,729.41 2026-05-06
66658-510-01 [343712] OTHER Emapalumab-lzsg 5 Mg/ml Intravenous Solution [187168] 81 34 $115,484.90 — $376.57 $99,317.01 $85,458.83 2026-05-06
67979-002-01 [152036] OTHER Histrelin 50 Mg (65 Mcg/day) Implant Kit [164961] 81 34 $143,376.10 — $4.35 $123,303.45 $106,098.31 2026-05-06
68382-395-04 [295657] OTHER Ribavirin 6 Gram Solution For Inhalation [11285] 79 34 $63,600.00 — $17,808.00 $54,696.00 $47,700.00 2026-05-06
68727-712-01 [335635] OTHER Lurbinectedin 0.5 Mg/ml Intravenous Solution [40800003600] 81 34 $25,789.80 — $204.90 $22,179.23 $19,084.45 2026-05-06
68727-745-01 [301067] OTHER Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution [183121] 81 34 $34,240.65 — $248.41 $29,446.96 $25,338.08 2026-05-06
68727-745-02 [301068] OTHER Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution [183121] 81 34 $34,240.65 — $248.41 $29,446.96 $25,338.08 2026-05-06
7 OTHER Stem Cell Transplant- Tandem Auto To Auto 1st Atempt 3 3 — — $82,500.00 $135,000.00 $83,000.00 2026-05-06
70114-340-01 [376722] OTHER Toripalimab-tpzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution [203182] 80 34 $29,553.15 — $39.32 $25,415.71 $22,017.10 2026-05-06
71287-119-01 [302981] OTHER Axicabtagene Ciloleucel Intravenous Suspension [183620] 45 27 $553,938.00 — $55,393.80 $802,808.13 $415,453.50 2026-05-06
71287-219-01 [336952] OTHER Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension [192076] 44 26 $508,200.00 — $50,820.00 $800,404.48 $381,150.00 2026-05-06
71287-219-02 [336953] OTHER Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension [192076] 44 26 $508,200.00 — $50,820.00 $800,404.48 $381,150.00 2026-05-06
71287-220-01 [351628] OTHER Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension [196078] 44 26 $508,200.00 — $50,820.00 $800,404.48 $381,150.00 2026-05-06
71287-220-02 [352195] OTHER Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension [196078] 44 26 $508,200.00 — $50,820.00 $800,404.48 $381,150.00 2026-05-06
72187-0401-1 [317962] OTHER Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution [187739] 80 34 $107,346.15 — $338.89 $92,317.69 $79,972.88 2026-05-06
72493-101-40 [335605] OTHER Mitomycin 4 Mg/ml Intra-pyelocalyceal Solution [40800003543] 81 34 $38,923.20 — $311.36 $33,473.95 $28,803.17 2026-05-06
72493-103-03 [334342] OTHER Mitomycin 4 Mg/ml Intra-pyelocalyceal Solution [40800003543] 81 34 $77,846.40 — $311.36 $66,947.90 $57,606.34 2026-05-06
72694-515-01 [327796] OTHER Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution [189288] 80 34 $92,334.90 — $25,853.77 $79,408.01 $69,251.18 2026-05-06
72694-954-01 [333316] OTHER Pegaspargase 750 Unit/ml Injection Solution [12519] 80 34 $85,272.20 — $23,876.22 $73,334.09 $63,527.79 2026-05-06
72893-005-01 [353232] OTHER Pralatrexate 20 Mg/ml Inj Container [40800000211] 80 34 $46,659.70 — $373.77 $40,127.34 $34,761.48 2026-05-06
73042-201-01 [341976] OTHER Naxitamab-gqgk 4 Mg/ml Intravenous Solution [193283] 81 34 $82,889.60 — $642.29 $71,285.06 $61,338.30 2026-05-06
73153-900-01 [343995] OTHER Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp [193841] 44 26 $584,485.45 — $58,448.54 $847,036.99 $438,364.09 2026-05-06
73153-901-08 [344357] OTHER Lisocabtagene Maraleucel(cd8) 1.5x To 70x 10exp6 Cell/ml IV Susp(1of2) [40800003… 44 26 $584,485.45 — $58,448.54 $847,036.99 $438,364.09 2026-05-06
73776-001-11 [380874] OTHER Lifileucel 7.5 X 10exp9 To 72 X 10exp9 Cell Intravenous Suspension [203845] 2 2 $618,200.00 — $432,740.00 $494,560.00 $463,650.00 2026-05-06
73776-001-12 [380875] OTHER Lifileucel 7.5 X 10exp9 To 72 X 10exp9 Cell Intravenous Suspension [203845] 2 2 $618,200.00 — $432,740.00 $494,560.00 $463,650.00 2026-05-06
76100567 OTHER Hc Implnt/repl Dev Epi Resv 81 34 $29,623.00 — $8,294.44 $28,985.56 $22,217.25 2026-05-06
76100568 OTHER Hc Impl/re Dev-epi Inf Noprg 81 34 $29,656.00 — $8,303.68 $28,985.56 $22,242.00 2026-05-06
76100575 OTHER Hc Percu Implt Elc Arry Epi 81 34 $24,451.00 — $6,846.28 $21,027.86 $18,338.25 2026-05-06
76100578 OTHER Hc Inc&plct Spinl Neu Gen 81 34 $42,066.00 — $11,778.48 $49,976.69 $31,549.50 2026-05-06
79952-110-01 [346488] OTHER Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution [194597] 81 34 $88,297.20 — $212.12 $75,935.59 $65,339.93 2026-05-06
8 OTHER Stem Cell Transplant- Tandem Auto To Allo 1st Attempt Related 3 3 — — $82,500.00 $195,000.00 $83,000.00 2026-05-06
80446-401-01 [354755] OTHER Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution [196717] 80 34 $65,126.40 — $214.76 $56,008.70 $48,519.17 2026-05-06
80803-153-50 [353245] OTHER Sirolimus-protein Bound 5 Mg/ml Intravenous Suspension [40800003820] 80 34 $25,371.75 — $117.45 $21,819.71 $18,901.96 2026-05-06
81481-803-01 [383019] OTHER Nogapendekin Alfa Inbakicept-pmln 400 Mcg/0.4 Ml Intravesical Solution [204422] 81 34 $113,844.00 — $94.87 $97,905.84 $84,244.56 2026-05-06
81900005 OTHER Hc Primary Pbsc Collection 80 34 $101,773.00 — $28,496.44 $87,524.78 $76,329.75 2026-05-06
81900007 OTHER Hc Secondary Pbsc Collection 80 34 $101,773.00 — $28,496.44 $87,524.78 $76,329.75 2026-05-06
81900011 OTHER Hc Allo Txprep Tcell Dep 81 34 $36,878.00 — $83.59 $31,715.08 $27,658.50 2026-05-06
81900013 OTHER Hc Marrow Collection 81 34 $116,477.00 — $2,688.42 $100,170.22 $87,357.75 2026-05-06
81900028 OTHER Hc Cord Blood Unit Shipment 81 34 $78,137.00 — $716.98 $67,197.82 $58,602.75 2026-05-06
81900158 OTHER Hc Mnc Aperhersis T-cells Mnc(a) 80 34 $56,466.00 — $15,810.48 $48,560.76 $42,349.50 2026-05-06
82705-010-01 [369963] OTHER Epcoritamab-bysp 48 Mg/0.8 Ml Subcutaneous Solution [201328] 81 34 $51,379.80 — $55.19 $44,186.63 $38,021.05 2026-05-06
82959-111-01 [384942] OTHER Imetelstat 188 Mg Intravenous Solution [205019] 82 34 $32,374.10 — $23.08 $27,841.73 $23,956.83 2026-05-06
83047-010-10 [389040] OTHER Obecabtagene Autoleucel Intravenous Suspension 10 X 10exp6 Cell Intravenous Susp… 48 28 $288,750.00 — $80,850.00 $525,000.00 $216,562.50 2026-05-06
83047-100-10 [389041] OTHER Obecabtagene Autoleucel Intravenous Suspension 100 X 10exp6 Cell Intravenous Sus… 48 28 $288,750.00 — $80,850.00 $525,000.00 $216,562.50 2026-05-06
83047-100-30 [389042] OTHER Obecabtagene Autoleucel Intravenous Suspension 100 X 10exp6 Cell Intravenous Sus… 48 28 $288,750.00 — $80,850.00 $525,000.00 $216,562.50 2026-05-06
83205-0001-2 [386990] OTHER Afamitresgene Autoleucel 2.68x 10exp9 To 10x 10exp9 Cell IV Suspension [205503] 45 26 $799,700.00 — $79,970.00 $679,745.00 $599,775.00 2026-05-06
88880-1008-01 [282149] OTHER Ribavirin Inh 40 Mg/ml (ip-cmpd) [40800001008] 79 34 $63,600.00 — $17,808.00 $54,696.00 $47,700.00 2026-05-06
88880-2871-01 [313059] OTHER Yttrium-90 Therasphere Injection [40800002871] 80 34 $51,132.00 — $14,316.96 $43,973.52 $38,349.00 2026-05-06
88880-2872-01 [313060] OTHER Yttrium-90 Sir-spheres Injection [40800002872] 80 34 $50,082.00 — $14,022.96 $43,070.52 $37,561.50 2026-05-06
88880-3330-01 [317963] OTHER Tagraxofusp-erzs Injection 100 Mcg/ml (ip-cmpd) [40800003330] 80 34 $107,412.30 — $338.89 $92,374.58 $80,022.17 2026-05-06
88880-5018-00 [313224] OTHER Factor Xa,inactivated-zhzo (recombinant) High-dose Infusion 1760 Mg In 176 Ml (1… 81 34 $153,912.00 — $131.80 $132,364.32 $113,894.88 2026-05-06
88880-5020-00 [313235] OTHER Factor Xa,inactivated-zhzo (recombinant) Low-dose Infusion 880 Mg In 88 Ml (10 M… 81 34 $76,956.00 — $131.80 $66,182.16 $56,947.44 2026-05-06
9 OTHER Stem Cell Transplant- Tandem Auto To Auto 1 1 — — $135,000.00 $135,000.00 $135,000.00 2026-05-06
93581 OTHER Pr Prq Tcat Clsr Cgen Ventr Septal Dfct W/implt 49 28 $29,851.00 — $948.27 $26,865.90 $17,910.60 2026-05-06
D7949 OTHER Pr Lefort Ii Or Lefort Iii - With Bone Graft 40 23 $24,916.00 — $4,999.34 $22,424.40 $18,562.42 2026-05-06
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