Hospital

DE TAR HOSPITAL NAVARRO

Victoria, TX · CCN 450147 · Rates published

7,614 distinct procedures filed

56 distinct payers

367,658 rate rows

2026-05-08 last MRF observed

Data quality

298,505 of 367,658 rate rows are consumer-grade (81.2%)

69,153 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 — reason	Rows
per-diem day rate — not a per-procedure price	62,006
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	5,418
template filing: same amount across many unrelated codes — excluded	1,281
placeholder amount (≤ $0.02) — excluded from medians	435
exceeds 10× this hospital's gross charge — excluded from medians	13

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.detar.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/621754940_detar-healthcare-system-navarro_standardcharges.csv
Found on page	https://www.detar.com/pricing-information
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	22ed1b52abbdc265… · 170,454,465 bytes · first seen 2026-05-08

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
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	21	$237,505.40	$751,383.88	$327,354.85	nat. median $386,529 0.8× median
583-4 OTHER	Neonate With Ecmo	19	$289,229.38	$750,116.40	$299,352.41	nat. median $309,400 1.0× median
681 OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	2	$288,894.73	$304,099.72	$296,497.22	nat. median $0
583-3 OTHER	Neonate With Ecmo	19	$244,908.81	$635,171.00	$253,480.62	nat. median $259,487 1.0× median
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	22	$7,328.28	$488,720.65	$215,352.83	nat. median $239,422 0.9× median
002-4 OTHER	Heart And/or Lung Transplant	16	$200,000.00	$518,700.00	$210,000.00	nat. median $216,800 1.0× median
007-4 OTHER	Allogeneic Bone Marrow Transplant	19	$200,000.00	$518,700.00	$207,000.00	nat. median $172,311 1.2× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	19	$183,077.45	$474,811.37	$189,485.16	nat. median $267,493 0.7× median
161-4 OTHER	Implantable Heart Assist Systems	19	$177,780.77	$461,074.43	$184,003.10	nat. median $202,242 0.9× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	19	$166,552.58	$431,954.12	$172,381.92	nat. median $150,954 1.1× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	23	$11,129.96	$373,088.50	$162,611.66	nat. median $146,562 1.1× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	24	$9,053.30	$370,917.36	$161,666.15	nat. median $181,005 0.9× median
7 OTHER	Lung Transplant	20	$25,276.18	$332,518.49	$148,328.49	nat. median $169,933 0.9× median
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	19	$136,221.83	$353,291.32	$140,989.60	nat. median $210,669 0.7× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	19	$135,014.66	$350,160.52	$139,740.17	nat. median $169,856 0.8× median
583-2 OTHER	Neonate With Ecmo	19	$122,032.47	$316,491.21	$126,303.60	nat. median $191,347 0.7× median
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	19	$115,877.82	$300,529.13	$119,933.55	nat. median $105,647 1.1× median
200-4 OTHER	Cardiac Structural And Valvular Disorders	19	$107,682.41	$279,274.33	$111,451.29	nat. median $19,067 outlier · 5.8×
583-1 OTHER	Neonate With Ecmo	19	$107,452.02	$278,676.81	$111,212.84	nat. median $171,226 0.6× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	24	$5,886.96	$243,149.13	$106,024.59	nat. median $134,983 0.8× median
007-3 OTHER	Allogeneic Bone Marrow Transplant	19	$99,282.12	$257,488.18	$102,756.99	nat. median $104,111 1.0× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	19	$98,233.37	$254,768.25	$101,671.54	nat. median $165,000 0.6× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	19	$97,784.39	$253,603.82	$101,206.85	nat. median $153,523 0.7× median
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	19	$97,531.53	$252,948.02	$100,945.14	nat. median $110,000 0.9× median
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	19	$97,112.26	$251,860.65	$100,511.19	nat. median $151,691 0.7× median
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	19	$96,142.34	$249,345.16	$99,507.33	nat. median $203,379 outlier · 0.5×
850-4 OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	19	$93,609.57	$242,776.42	$96,885.90	nat. median $54,797 1.8× median
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	19	$92,771.03	$240,601.67	$96,018.01	nat. median $156,696 0.6× median
161-3 OTHER	Implantable Heart Assist Systems	19	$92,661.74	$240,318.22	$95,904.90	nat. median $152,491 0.6× median
588-1 OTHER	Female Reproductive System Reconstructive Procedures	19	$92,172.01	$239,048.11	$95,398.03	nat. median $75,325 1.3× median
14 OTHER	Allogeneic Bone Marrow Transplant	21	$5,773.49	$211,379.48	$92,189.27	nat. median $100,915 0.9× median
001-4 OTHER	Liver Transplant And/or Intestinal Transplant	16	$84,394.35	$218,876.75	$88,614.07	nat. median $124,561 0.7× median
2 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	22	$14,866.86	$199,491.21	$87,955.52	nat. median $111,558 0.8× median
008-4 OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	19	$84,056.19	$217,999.73	$86,998.15	nat. median $81,385 1.1× median
681-4 OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	19	$82,562.65	$214,126.23	$85,452.34	nat. median $52,952 1.6× median
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	19	$82,516.58	$214,006.75	$85,404.66	nat. median $106,926 0.8× median
009-3 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	19	$81,826.93	$212,218.14	$84,690.88	nat. median $87,912 1.0× median
212 OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	23	$6,569.41	$191,560.51	$83,558.34	nat. median $90,581 0.9× median
246-4 OTHER	Gastrointestinal Vascular Insufficiency	19	$80,018.08	$207,526.89	$82,818.71	nat. median $14,775 outlier · 5.6×
603-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	19	$79,605.28	$206,456.29	$82,391.46	nat. median $107,050 0.8× median
006-4 OTHER	Pancreas Transplant	16	$77,254.54	$200,359.65	$81,117.27	nat. median $92,449 0.9× median
5 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	20	$7,749.18	$181,794.82	$80,160.77	nat. median $94,894 0.8× median
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	19	$77,248.45	$200,343.86	$79,952.14	nat. median $86,371 0.9× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	19	$77,017.30	$199,744.37	$79,712.91	nat. median $151,250 0.5× median
215 OTHER	Other Heart Assist System Implant	24	$54,763.50	$181,297.65	$78,287.53	nat. median $92,359 0.8× median
589-2 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	19	$74,869.53	$194,174.13	$77,489.96	nat. median $49,980 1.6× median
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	25	$10,393.00	$172,651.19	$76,133.27	nat. median $90,130 0.8× median
162-4 OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	19	$71,981.85	$186,684.93	$74,501.21	nat. median $80,850 0.9× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	19	$70,800.58	$183,621.30	$73,278.60	nat. median $125,000 0.6× median
589-3 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	19	$70,225.93	$182,130.95	$72,683.84	nat. median $87,000 0.8× median

Other procedures at this hospital

Browse this hospital's 7,614 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	28	24	—	—	$6,416.63	$84,437.80	$38,014.37	2026-05-08
97	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	27	24	—	—	$5,985.08	$65,724.27	$29,311.90	2026-05-08
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	27	24	—	—	$14,087.32	$109,207.19	$48,563.14	2026-05-08
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	27	24	—	—	$9,221.29	$76,157.07	$33,409.48	2026-05-08
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	27	24	—	—	$9,237.94	$135,173.96	$59,002.68	2026-05-08
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	27	24	—	—	$9,737.45	$68,344.17	$30,478.94	2026-05-08
955	OTHER	Craniotomy For Multiple Significant Trauma	27	24	—	—	$37,021.05	$119,773.43	$54,522.03	2026-05-08
952-4	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	20	19	—	—	$39,635.09	$102,793.61	$41,022.32	2026-05-08
951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	20	19	—	—	$31,368.08	$81,353.12	$32,465.96	2026-05-08
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	20	19	—	—	$44,979.37	$116,654.00	$46,553.65	2026-05-08
94	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	27	24	—	—	$4,950.77	$64,123.24	$28,598.71	2026-05-08
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	27	24	—	—	$6,456.38	$66,013.62	$29,440.79	2026-05-08
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	25	23	—	—	$11,058.68	$70,617.51	$30,889.09	2026-05-08
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	25	23	—	—	$5,011.13	$127,425.17	$55,628.16	2026-05-08
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	25	23	—	—	$11,129.96	$373,088.50	$162,611.66	2026-05-08
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	20	19	—	—	$37,675.06	$97,710.27	$38,993.68	2026-05-08
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	20	19	—	—	$39,272.94	$101,854.37	$40,647.49	2026-05-08
910-4	OTHER	Craniotomy For Multiple Significant Trauma	20	19	—	—	$46,355.62	$120,223.30	$47,978.07	2026-05-08
907	OTHER	Other O.r. Procedures For Injuries With Mcc	28	25	—	—	$8,255.95	$69,666.23	$30,771.34	2026-05-08
904	OTHER	Skin Grafts For Injuries With Cc/mcc	27	24	—	—	$20,202.05	$66,786.45	$29,785.05	2026-05-08
901	OTHER	Wound Debridements For Injuries With Mcc	27	24	—	—	$6,211.88	$75,857.26	$33,825.68	2026-05-08
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	24	22	—	—	$1,595.57	$70,109.82	$30,966.73	2026-05-08
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	27	24	—	—	$7,169.44	$122,904.45	$54,783.07	2026-05-08
863-4	OTHER	Neonatal Aftercare	20	19	—	—	$64,826.43	$168,127.35	$67,095.36	2026-05-08
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	27	24	—	—	$6,636.14	$81,958.25	$35,827.86	2026-05-08
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	28	25	—	—	$10,920.11	$88,714.17	$39,161.40	2026-05-08
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	20	19	—	—	$93,609.57	$242,776.42	$96,885.90	2026-05-08
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	20	19	—	—	$33,128.95	$85,919.93	$34,288.46	2026-05-08
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	20	19	—	—	$97,112.26	$251,860.65	$100,511.19	2026-05-08
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	20	19	—	—	$41,971.74	$108,853.71	$43,440.75	2026-05-08
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	27	24	—	—	$4,303.56	$86,387.11	$38,345.69	2026-05-08
834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	27	24	—	—	$5,436.38	$98,266.72	$43,808.08	2026-05-08
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	27	24	—	—	$8,774.92	$84,195.19	$37,539.85	2026-05-08
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	28	24	—	—	$4,583.24	$82,583.73	$37,180.04	2026-05-08
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	27	24	—	—	$7,527.59	$104,762.74	$46,701.76	2026-05-08
802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	27	24	—	—	$5,533.96	$72,175.22	$32,185.50	2026-05-08
8	OTHER	Simultaneous Pancreas And Kidney Transplant	22	20	—	—	$10,496.56	$100,254.17	$44,244.46	2026-05-08
799	OTHER	Splenectomy With Mcc	27	24	—	—	$9,361.29	$81,615.19	$36,390.57	2026-05-08
793	OTHER	Full Term Neonate With Major Problems	27	24	—	—	$11,633.76	$75,389.46	$32,967.22	2026-05-08
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	20	19	—	—	$42,198.32	$109,441.34	$43,675.26	2026-05-08
791	OTHER	Prematurity With Major Problems	25	23	—	—	$2,069.36	$73,473.07	$32,132.65	2026-05-08
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	28	25	—	—	$3,171.24	$106,126.39	$46,352.80	2026-05-08
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	27	24	—	—	$9,034.75	$65,077.96	$29,023.99	2026-05-08
723-4	OTHER	Viral Illness	20	19	—	—	$29,368.45	$76,167.08	$30,396.35	2026-05-08
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	20	19	—	—	$30,626.64	$79,430.19	$31,698.57	2026-05-08
7	OTHER	Lung Transplant	22	20	—	—	$25,276.18	$332,518.49	$148,328.49	2026-05-08
695-4	OTHER	Chemotherapy For Acute Leukemia	20	19	—	—	$42,014.77	$108,965.31	$43,485.29	2026-05-08
694-4	OTHER	Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior	20	19	—	—	$29,408.43	$76,270.76	$30,437.72	2026-05-08
691-4	OTHER	Lymphoma, Myeloma And Non-acute Leukemia	20	19	—	—	$29,709.27	$77,050.99	$30,749.10	2026-05-08
690-4	OTHER	Acute Leukemia	20	19	—	—	$54,209.83	$140,593.19	$56,107.18	2026-05-08
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	20	19	—	—	$82,562.65	$214,126.23	$85,452.34	2026-05-08
681	OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	2	2	—	—	$288,894.73	$304,099.72	$296,497.22	2026-05-08
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	20	19	—	—	$61,089.54	$158,435.72	$63,227.68	2026-05-08
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	27	24	—	—	$5,656.41	$75,943.92	$33,208.69	2026-05-08
661-4	OTHER	Coagulation And Platelet Disorders	20	19	—	—	$28,414.52	$73,693.06	$29,409.03	2026-05-08
660-4	OTHER	Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…	20	19	—	—	$33,173.12	$86,034.49	$34,334.18	2026-05-08
653	OTHER	Major Bladder Procedures With Mcc	27	24	—	—	$6,395.11	$93,181.15	$41,542.69	2026-05-08
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	20	19	—	—	$41,128.24	$106,666.09	$42,567.73	2026-05-08
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	22	20	—	—	$3,507.95	$67,353.04	$29,752.44	2026-05-08
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	22	20	—	—	$2,799.80	$84,604.15	$37,351.07	2026-05-08
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	20	19	—	—	$51,094.80	$132,514.36	$52,883.12	2026-05-08
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	20	19	—	—	$96,142.34	$249,345.16	$99,507.33	2026-05-08
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	20	19	—	—	$35,593.93	$92,312.86	$36,839.72	2026-05-08
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	20	19	—	—	$136,221.83	$353,291.32	$140,989.60	2026-05-08
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	20	19	—	—	$64,203.80	$166,512.56	$66,450.93	2026-05-08
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	28	24	—	—	$5,062.11	$126,273.67	$29,912.72	2026-05-08
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	20	19	—	—	$35,306.42	$91,567.20	$36,542.15	2026-05-08
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	20	19	—	—	$33,166.27	$86,016.72	$34,327.09	2026-05-08
622	OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	27	24	—	—	$19,575.60	$64,812.86	$29,539.95	2026-05-08
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	20	19	—	—	$67,233.15	$174,369.17	$69,586.31	2026-05-08
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	20	19	—	—	$40,569.21	$105,216.25	$41,989.13	2026-05-08
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	20	19	—	—	$47,334.30	$122,761.51	$48,991.00	2026-05-08
613	OTHER	Neonate, Birth Weight <750 Grams, Died	2	2	—	—	$42,693.30	$44,940.31	$43,816.81	2026-05-08
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	20	19	—	—	$35,204.74	$91,303.49	$36,436.90	2026-05-08
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	20	19	—	—	$54,944.03	$142,497.34	$56,867.07	2026-05-08
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	20	19	—	—	$135,014.66	$350,160.52	$139,740.17	2026-05-08
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	20	19	—	—	$43,430.62	$112,637.31	$44,950.69	2026-05-08
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	20	19	—	—	$60,916.27	$157,986.35	$63,048.34	2026-05-08
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	20	19	—	—	$49,945.52	$129,533.71	$51,693.62	2026-05-08
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	20	19	—	—	$31,658.64	$82,106.68	$32,766.69	2026-05-08
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	20	19	—	—	$79,605.28	$206,456.29	$82,391.46	2026-05-08
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	20	19	—	—	$30,357.79	$78,732.93	$31,420.32	2026-05-08
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	20	19	—	—	$70,800.58	$183,621.30	$73,278.60	2026-05-08
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	20	19	—	—	$45,758.13	$118,673.71	$47,359.67	2026-05-08
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	20	19	—	—	$34,572.60	$89,664.04	$35,782.64	2026-05-08
6	OTHER	Liver Transplant Without Mcc	22	20	—	—	$11,189.60	$83,488.24	$36,859.54	2026-05-08
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	20	19	—	—	$77,017.30	$199,744.37	$79,712.91	2026-05-08
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	20	19	—	—	$55,007.24	$142,661.28	$56,932.49	2026-05-08
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	20	19	—	—	$43,216.98	$112,083.24	$44,729.57	2026-05-08
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	20	19	—	—	$92,771.03	$240,601.67	$96,018.01	2026-05-08
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	20	19	—	—	$61,089.54	$158,435.72	$63,227.68	2026-05-08
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	20	19	—	—	$50,439.05	$130,813.68	$52,204.42	2026-05-08
591-1	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	20	19	—	—	$36,366.97	$94,317.74	$37,639.82	2026-05-08
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	20	19	—	—	$70,225.93	$182,130.95	$72,683.84	2026-05-08
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	20	19	—	—	$74,869.53	$194,174.13	$77,489.96	2026-05-08
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	20	19	—	—	$77,248.45	$200,343.86	$79,952.14	2026-05-08
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	20	19	—	—	$183,077.45	$474,811.37	$189,485.16	2026-05-08
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	20	19	—	—	$98,233.37	$254,768.25	$101,671.54	2026-05-08
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	20	19	—	—	$97,784.39	$253,603.82	$101,206.85	2026-05-08
588-1	OTHER	Female Reproductive System Reconstructive Procedures	20	19	—	—	$92,172.01	$239,048.11	$95,398.03	2026-05-08
583-4	OTHER	Neonate With Ecmo	20	19	—	—	$289,229.38	$750,116.40	$299,352.41	2026-05-08
583-3	OTHER	Neonate With Ecmo	20	19	—	—	$244,908.81	$635,171.00	$253,480.62	2026-05-08
583-2	OTHER	Neonate With Ecmo	20	19	—	—	$122,032.47	$316,491.21	$126,303.60	2026-05-08
583-1	OTHER	Neonate With Ecmo	20	19	—	—	$107,452.02	$278,676.81	$111,212.84	2026-05-08
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	27	24	—	—	$7,254.84	$88,066.13	$38,487.76	2026-05-08
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	27	24	—	—	$7,109.97	$116,659.67	$50,939.92	2026-05-08
518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	28	25	—	—	$11,400.00	$67,898.82	$29,636.66	2026-05-08
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	22	20	—	—	$7,749.18	$181,794.82	$80,160.77	2026-05-08
495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	27	24	—	—	$6,862.24	$65,965.12	$28,863.02	2026-05-08
492	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	27	24	—	—	$7,962.26	$66,760.47	$29,209.39	2026-05-08
483-4	OTHER	Penis, Testes And Scrotal Procedures	20	19	—	—	$38,133.93	$98,900.35	$39,468.62	2026-05-08
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	27	24	—	—	$6,555.21	$77,525.89	$34,568.98	2026-05-08
471	OTHER	Cervical Spinal Fusion With Mcc	27	24	—	—	$10,632.36	$86,809.89	$37,940.69	2026-05-08
467	OTHER	Revision Of Hip Or Knee Replacement With Cc	27	24	—	—	$19,396.30	$64,247.97	$28,654.27	2026-05-08
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	27	24	—	—	$11,329.37	$93,337.07	$40,783.19	2026-05-08
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	28	25	—	—	$6,472.23	$101,898.51	$45,079.57	2026-05-08
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	27	24	—	—	$13,767.56	$98,840.28	$44,063.57	2026-05-08
460	OTHER	Spinal Fusion Except Cervical Without Mcc	26	24	—	—	$25,222.25	$66,523.03	$29,952.72	2026-05-08
459	OTHER	Spinal Fusion Except Cervical With Mcc	26	24	—	—	$16,605.24	$118,061.46	$52,965.02	2026-05-08
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	27	24	—	—	$22,478.40	$75,441.46	$33,640.46	2026-05-08
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	27	24	—	—	$16,368.95	$106,466.01	$47,460.49	2026-05-08
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	27	24	—	—	$13,988.50	$148,749.88	$66,296.03	2026-05-08
455	OTHER	Combined Anterior And Posterior Spinal Fusion Without Cc/mcc	26	24	—	—	$34,532.35	$82,944.20	$37,452.17	2026-05-08
454	OTHER	Combined Anterior And Posterior Spinal Fusion With Cc	26	24	—	—	$28,669.02	$109,120.55	$49,121.60	2026-05-08
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	26	24	—	—	$24,046.80	$156,685.78	$70,525.96	2026-05-08
447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	20	19	—	—	$47,223.49	$122,474.12	$48,876.31	2026-05-08
442-4	OTHER	Kidney And Urinary Tract Procedures For Malignancy	20	19	—	—	$39,879.95	$103,428.65	$41,275.75	2026-05-08
441-4	OTHER	Major Bladder Procedures	20	19	—	—	$59,636.75	$154,667.91	$61,724.04	2026-05-08
440-4	OTHER	Kidney Transplant	16	16	—	—	$63,016.82	$163,434.12	$66,167.66	2026-05-08
440-3	OTHER	Kidney Transplant	16	16	—	—	$38,569.20	$100,029.22	$40,497.66	2026-05-08
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	27	24	—	—	$22,841.50	$75,101.82	$33,489.17	2026-05-08
414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	27	24	—	—	$19,594.30	$71,262.07	$28,932.14	2026-05-08
408	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	27	24	—	—	$5,148.56	$64,923.74	$28,955.29	2026-05-08
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	27	24	—	—	$7,577.34	$97,930.57	$42,783.62	2026-05-08
40	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	27	24	—	—	$7,302.53	$70,045.68	$30,640.07	2026-05-08
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	27	24	—	—	$5,886.96	$243,149.13	$106,024.59	2026-05-08
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	20	19	—	—	$34,475.87	$89,413.17	$35,682.53	2026-05-08
356	OTHER	Other Digestive System O.r. Procedures With Mcc	27	24	—	—	$7,363.08	$79,256.92	$34,651.46	2026-05-08
34	OTHER	Carotid Artery Stent Procedures With Mcc	27	24	—	—	$10,991.91	$70,210.30	$31,310.21	2026-05-08
335	OTHER	Peritoneal Adhesiolysis With Mcc	27	24	—	—	$5,658.37	$65,015.58	$28,996.21	2026-05-08
332	OTHER	Rectal Resection With Mcc	27	24	—	—	$7,659.57	$65,878.45	$29,380.58	2026-05-08
329	OTHER	Major Small And Large Bowel Procedures With Mcc	28	24	—	—	$6,114.55	$82,786.48	$36,188.54	2026-05-08
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	28	24	—	—	$7,487.95	$89,559.73	$40,319.24	2026-05-08
323	OTHER	Urinary Stones W Cc, &/or Esw Lithotripsy	25	23	—	—	$8,426.03	$78,123.73	$34,157.94	2026-05-08
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	25	23	—	—	$8,186.52	$80,471.55	$35,180.41	2026-05-08
318	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	2	2	—	—	$44,944.10	$47,309.58	$46,126.84	2026-05-08
317	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	2	2	—	—	$31,233.05	$32,876.89	$32,054.97	2026-05-08
315-4	OTHER	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	20	19	—	—	$38,566.53	$100,022.30	$39,916.36	2026-05-08
31	OTHER	Ventricular Shunt Procedures With Mcc	27	24	—	—	$6,084.97	$80,776.51	$35,313.22	2026-05-08
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	20	19	—	—	$42,188.04	$109,414.68	$43,664.62	2026-05-08
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	20	19	—	—	$50,783.30	$131,706.49	$52,560.72	2026-05-08
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	20	19	—	—	$42,960.70	$111,418.58	$44,464.32	2026-05-08
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	20	19	—	—	$31,170.06	$80,839.55	$32,261.01	2026-05-08
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	27	24	—	—	$9,053.30	$370,917.36	$161,666.15	2026-05-08
28	OTHER	Spinal Procedures With Mcc	27	24	—	—	$8,005.42	$107,249.21	$46,841.76	2026-05-08
279	OTHER	Cellulitis Age 0-17	25	23	—	—	$16,876.84	$65,630.68	$28,717.38	2026-05-08
278	OTHER	Cellulitis Age >17 Without Cc	25	23	—	—	$13,557.50	$99,588.81	$43,505.75	2026-05-08
277	OTHER	Cellulitis Age >17 W Cc	25	23	—	—	$10,147.08	$83,167.68	$36,354.54	2026-05-08
276	OTHER	Non-maligant Breast Disorders	25	23	—	—	$19,493.74	$107,219.75	$46,828.93	2026-05-08
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	25	23	—	—	$11,194.77	$126,692.19	$55,308.96	2026-05-08
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	27	24	—	—	$13,866.83	$74,625.30	$33,276.90	2026-05-08
270	OTHER	Other Major Cardiovascular Procedures With Mcc	27	24	—	—	$3,929.55	$94,565.58	$41,318.21	2026-05-08
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	27	24	—	—	$4,253.73	$76,318.19	$33,371.67	2026-05-08
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	27	24	—	—	$5,040.24	$122,317.03	$53,403.62	2026-05-08
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	27	24	—	—	$3,172.71	$85,633.37	$38,180.49	2026-05-08
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	27	24	—	—	$33,706.20	$109,330.23	$49,775.12	2026-05-08
265	OTHER	Aicd Lead Procedures	27	24	—	—	$10,947.91	$65,835.17	$28,806.46	2026-05-08
261-4	OTHER	Major Biliary Tract Procedures	20	19	—	—	$31,772.12	$82,400.99	$32,884.15	2026-05-08
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	20	19	—	—	$36,168.57	$93,803.19	$37,434.47	2026-05-08
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	27	24	—	—	$10,822.04	$81,923.60	$35,812.77	2026-05-08
246-4	OTHER	Gastrointestinal Vascular Insufficiency	20	19	—	—	$80,018.08	$207,526.89	$82,818.71	2026-05-08
245	OTHER	Aicd Generator Procedures	27	24	—	—	$14,034.27	$82,195.65	$36,649.15	2026-05-08
24	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	27	24	—	—	$14,467.94	$70,924.20	$31,628.22	2026-05-08
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	27	24	—	—	$17,422.15	$88,421.34	$39,422.41	2026-05-08
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	27	24	—	—	$13,437.22	$75,722.09	$33,765.47	2026-05-08
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	27	24	—	—	$14,522.75	$104,828.60	$45,787.62	2026-05-08
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	27	24	—	—	$13,724.38	$97,795.44	$43,598.15	2026-05-08
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	28	25	—	—	$13,682.48	$137,588.28	$60,049.93	2026-05-08
232	OTHER	Coronary Bypass With Ptca Without Mcc	27	24	—	—	$13,291.84	$108,190.06	$48,228.47	2026-05-08
231	OTHER	Coronary Bypass With Ptca With Mcc	27	24	—	—	$13,029.81	$149,209.08	$66,500.58	2026-05-08
230-4	OTHER	Major Small Bowel Procedures	20	19	—	—	$40,258.47	$104,410.34	$41,667.51	2026-05-08
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	27	24	—	—	$8,337.06	$102,432.21	$44,744.02	2026-05-08
228	OTHER	Other Cardiothoracic Procedures With Mcc	27	24	—	—	$11,863.63	$88,866.64	$39,620.77	2026-05-08
227-4	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical	20	19	—	—	$33,282.41	$86,317.93	$34,447.29	2026-05-08
224-4	OTHER	Peritoneal Adhesiolysis	20	19	—	—	$34,815.17	$90,293.14	$36,033.70	2026-05-08
223-4	OTHER	Other Small And Large Bowel Procedures	20	19	—	—	$29,893.20	$77,528.02	$30,939.46	2026-05-08
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	28	25	—	—	$10,393.00	$90,474.64	$39,936.85	2026-05-08
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	20	19	—	—	$47,593.63	$123,434.08	$49,259.40	2026-05-08
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	28	25	—	—	$10,393.00	$95,544.60	$42,170.02	2026-05-08
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	28	25	—	—	$10,393.00	$136,185.84	$60,071.33	2026-05-08
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	28	25	—	—	$10,393.00	$117,073.81	$51,653.02	2026-05-08
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	28	25	—	—	$10,393.00	$117,073.81	$51,653.02	2026-05-08
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	28	25	—	—	$10,393.00	$172,651.19	$76,133.27	2026-05-08
215	OTHER	Other Heart Assist System Implant	27	24	—	—	$54,763.50	$181,297.65	$78,287.53	2026-05-08
213	OTHER	Splenic Procedures Age 0-17	2	2	—	—	$38,117.21	$40,123.37	$39,120.29	2026-05-08
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	25	23	—	—	$6,569.41	$191,560.51	$83,558.34	2026-05-08
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	27	24	—	—	$7,675.96	$94,868.86	$42,294.49	2026-05-08
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	27	24	—	—	$6,625.33	$114,637.57	$51,100.55	2026-05-08
205-4	OTHER	Cardiomyopathy	20	19	—	—	$42,068.84	$109,105.54	$43,541.25	2026-05-08
200-4	OTHER	Cardiac Structural And Valvular Disorders	20	19	—	—	$107,682.41	$279,274.33	$111,451.29	2026-05-08
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	27	24	—	—	$9,018.14	$139,486.70	$62,169.71	2026-05-08
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	24	22	—	—	$14,866.86	$199,491.21	$87,955.52	2026-05-08
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	22	20	—	—	$11,225.51	$126,764.94	$55,921.68	2026-05-08
183-4	OTHER	Percutaneous Structural Cardiac Procedures	20	19	—	—	$32,284.31	$83,729.36	$33,414.26	2026-05-08
183-3	OTHER	Percutaneous Structural Cardiac Procedures	20	19	—	—	$31,491.46	$81,673.10	$32,593.66	2026-05-08
182-4	OTHER	Other Peripheral Vascular And Related Procedures	20	19	—	—	$42,926.05	$111,328.71	$44,428.46	2026-05-08
181-4	OTHER	Lower Extremity Arterial Procedures	20	19	—	—	$33,384.47	$86,582.62	$34,552.93	2026-05-08
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	23	21	—	—	$237,505.40	$751,383.88	$327,354.85	2026-05-08
178-4	OTHER	External Heart Assist Systems	20	19	—	—	$55,856.45	$144,863.70	$57,811.43	2026-05-08
178-3	OTHER	External Heart Assist Systems	20	19	—	—	$35,745.11	$92,704.94	$36,996.19	2026-05-08
178-2	OTHER	External Heart Assist Systems	20	19	—	—	$30,678.82	$79,565.52	$31,752.58	2026-05-08
178-1	OTHER	External Heart Assist Systems	20	19	—	—	$28,122.82	$72,936.53	$29,107.12	2026-05-08
176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	20	19	—	—	$27,857.01	$72,247.16	$28,832.01	2026-05-08
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	22	20	—	—	$8,782.96	$97,268.66	$42,929.43	2026-05-08
169-4	OTHER	Major Abdominal Vascular Procedures	20	19	—	—	$38,435.53	$99,682.55	$39,780.77	2026-05-08
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	20	19	—	—	$54,701.07	$141,867.23	$56,615.60	2026-05-08
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	20	19	—	—	$28,674.99	$74,368.59	$29,678.62	2026-05-08
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	27	24	—	—	$20,557.35	$276,633.03	$30,945.82	2026-05-08
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	20	19	—	—	$37,104.60	$96,230.78	$38,403.26	2026-05-08
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	20	19	—	—	$42,900.53	$111,262.52	$44,402.05	2026-05-08
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	20	19	—	—	$28,731.73	$74,515.74	$29,737.34	2026-05-08
163	OTHER	Major Chest Procedures With Mcc	27	24	—	—	$10,434.65	$80,799.01	$36,027.00	2026-05-08
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	20	19	—	—	$71,981.85	$186,684.93	$74,501.21	2026-05-08
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	20	19	—	—	$40,500.29	$105,037.50	$41,917.80	2026-05-08
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	20	19	—	—	$30,242.03	$78,432.70	$31,300.50	2026-05-08
161-4	OTHER	Implantable Heart Assist Systems	20	19	—	—	$177,780.77	$461,074.43	$184,003.10	2026-05-08
161-3	OTHER	Implantable Heart Assist Systems	20	19	—	—	$92,661.74	$240,318.22	$95,904.90	2026-05-08
161-2	OTHER	Implantable Heart Assist Systems	20	19	—	—	$66,609.38	$172,751.43	$68,940.71	2026-05-08
161-1	OTHER	Implantable Heart Assist Systems	20	19	—	—	$63,172.95	$163,839.05	$65,384.01	2026-05-08
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	20	19	—	—	$82,516.58	$214,006.75	$85,404.66	2026-05-08
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	20	19	—	—	$34,870.77	$90,437.34	$36,091.25	2026-05-08
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	22	20	—	—	$4,950.14	$105,887.28	$46,725.68	2026-05-08
143	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	27	24	—	—	$7,372.83	$68,060.00	$29,775.33	2026-05-08
1418038	OTHER	Genrate Neuro Rech 6	25	16	$99,999.99	$30,000.00 70% off	$10,000.00	$79,999.99	$33,000.00	2026-05-08
1418037	OTHER	Genrate Neuro Rech 5	25	16	$87,488.00	$26,246.40 70% off	$8,748.80	$69,990.40	$28,871.04	2026-05-08
1417274	OTHER	Wireless Press Sens	25	16	$99,999.61	$29,999.88 70% off	$9,999.96	$79,999.69	$32,999.87	2026-05-08
1417059	OTHER	Tissue Non-human 11	25	16	$93,592.00	$28,077.60 70% off	$9,359.20	$74,873.60	$30,885.36	2026-05-08
1414904	OTHER	Watchman Atr App L1	25	16	$99,999.00	$29,999.70 70% off	$9,999.90	$79,999.20	$32,999.67	2026-05-08
1414709	OTHER	Joint Device Implt10	25	16	$99,999.00	$29,999.70 70% off	$9,999.90	$79,999.20	$32,999.67	2026-05-08
1414708	OTHER	Joint Device Implt 9	25	16	$99,999.00	$29,999.70 70% off	$9,999.90	$79,999.20	$32,999.67	2026-05-08
1414707	OTHER	Joint Device Implt 8	25	16	$88,135.00	$26,440.50 70% off	$8,813.50	$70,508.00	$29,084.55	2026-05-08
1414579	OTHER	Genratr Neurostm 6	25	16	$99,999.99	$30,000.00 70% off	$10,000.00	$79,999.99	$33,000.00	2026-05-08
1414578	OTHER	Genratr Neurostm 5	25	16	$96,240.00	$28,872.00 70% off	$9,624.00	$76,992.00	$31,759.20	2026-05-08
1413125	OTHER	Genrate Neuro Rech 4	25	16	$99,999.00	$29,999.70 70% off	$9,999.90	$79,999.20	$32,999.67	2026-05-08
1410730	OTHER	Lead Neurostimulat 7	25	16	$99,999.99	$30,000.00 70% off	$10,000.00	$79,999.99	$33,000.00	2026-05-08
140	OTHER	Major Head And Neck Procedures With Mcc	27	24	—	—	$3,444.04	$77,047.67	$33,689.35	2026-05-08
14	OTHER	Allogeneic Bone Marrow Transplant	23	21	—	—	$5,773.49	$211,379.48	$92,189.27	2026-05-08
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	20	19	—	—	$37,665.54	$97,685.58	$38,983.83	2026-05-08
121-4	OTHER	Other Respiratory And Chest Procedures	20	19	—	—	$35,724.55	$92,651.62	$36,974.91	2026-05-08
120-4	OTHER	Major Respiratory And Chest Procedures	20	19	—	—	$38,279.40	$99,277.62	$39,619.18	2026-05-08
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	27	24	—	—	$7,384.36	$76,193.46	$33,167.12	2026-05-08
1110865	OTHER	Bilat Lithotripsy	26	19	$99,999.00	$20,999.79 79% off	$5,056.00	$100,159.00	$32,999.67	2026-05-08
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	27	24	—	—	$9,128.65	$97,646.40	$42,659.85	2026-05-08
10	OTHER	Pancreas Transplant	22	20	—	—	$22,830.09	$127,477.12	$56,235.38	2026-05-08
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	24	22	—	—	$7,328.28	$488,720.65	$215,352.83	2026-05-08
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	20	19	—	—	$29,052.76	$75,348.33	$30,069.61	2026-05-08
092-3	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	20	19	—	—	$28,022.28	$72,675.78	$29,003.06	2026-05-08
091-4	OTHER	Other Major Head And Neck Procedures	20	19	—	—	$34,290.42	$88,932.20	$35,490.59	2026-05-08
089-4	OTHER	Major Cranial Or Facial Bone Procedures	20	19	—	—	$37,724.94	$97,839.63	$39,045.32	2026-05-08
050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	20	19	—	—	$30,855.13	$80,022.78	$31,935.06	2026-05-08
043-4	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	20	19	—	—	$53,877.76	$139,731.97	$55,763.49	2026-05-08
026-4	OTHER	Other Nervous System And Related Procedures	20	19	—	—	$43,404.34	$112,569.16	$44,923.49	2026-05-08
023-4	OTHER	Spinal Procedures	20	19	—	—	$46,523.94	$120,659.84	$48,152.28	2026-05-08
022-4	OTHER	Ventricular Shunt Procedures	20	19	—	—	$40,099.67	$103,998.49	$41,503.15	2026-05-08
021-4	OTHER	Open Craniotomy Except Trauma	20	19	—	—	$40,404.32	$104,788.60	$41,818.48	2026-05-08
020-4	OTHER	Open Craniotomy For Trauma	20	19	—	—	$33,940.45	$88,024.56	$35,128.37	2026-05-08
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	20	19	—	—	$115,877.82	$300,529.13	$119,933.55	2026-05-08
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	20	19	—	—	$65,847.76	$170,776.17	$68,152.43	2026-05-08
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	20	19	—	—	$45,760.03	$118,678.64	$47,361.63	2026-05-08
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	20	19	—	—	$166,552.58	$431,954.12	$172,381.92	2026-05-08
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	20	19	—	—	$81,826.93	$212,218.14	$84,690.88	2026-05-08
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	20	19	—	—	$53,817.21	$139,574.93	$55,700.81	2026-05-08
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	20	19	—	—	$52,191.91	$135,359.72	$54,018.63	2026-05-08
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	20	19	—	—	$84,056.19	$217,999.73	$86,998.15	2026-05-08
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	20	19	—	—	$56,815.71	$147,351.54	$58,804.26	2026-05-08
008-2	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	20	19	—	—	$29,575.61	$76,704.34	$30,610.75	2026-05-08
007-4	OTHER	Allogeneic Bone Marrow Transplant	20	19	—	—	$200,000.00	$518,700.00	$207,000.00	2026-05-08
007-3	OTHER	Allogeneic Bone Marrow Transplant	20	19	—	—	$99,282.12	$257,488.18	$102,756.99	2026-05-08
007-2	OTHER	Allogeneic Bone Marrow Transplant	20	19	—	—	$66,706.49	$173,003.28	$69,041.21	2026-05-08
007-1	OTHER	Allogeneic Bone Marrow Transplant	20	19	—	—	$43,801.91	$113,600.25	$45,334.98	2026-05-08
006-4	OTHER	Pancreas Transplant	16	16	—	—	$77,254.54	$200,359.65	$81,117.27	2026-05-08
006-3	OTHER	Pancreas Transplant	16	16	—	—	$49,924.95	$129,480.36	$52,421.20	2026-05-08
006-2	OTHER	Pancreas Transplant	16	16	—	—	$45,156.45	$117,113.25	$47,414.27	2026-05-08
006-1	OTHER	Pancreas Transplant	16	16	—	—	$44,573.43	$115,601.19	$46,802.10	2026-05-08
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	20	19	—	—	$62,728.93	$162,687.48	$64,924.45	2026-05-08
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	20	19	—	—	$45,187.68	$117,194.25	$46,769.24	2026-05-08
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	20	19	—	—	$41,266.48	$107,024.62	$42,710.81	2026-05-08
005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	20	19	—	—	$33,709.68	$87,426.06	$34,889.51	2026-05-08
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	20	19	—	—	$97,531.53	$252,948.02	$100,945.14	2026-05-08
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	20	19	—	—	$62,707.60	$162,632.16	$64,902.36	2026-05-08
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	20	19	—	—	$40,999.91	$106,333.27	$42,434.91	2026-05-08
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	20	19	—	—	$33,644.94	$87,258.15	$34,822.51	2026-05-08
002-4	OTHER	Heart And/or Lung Transplant	16	16	—	—	$200,000.00	$518,700.00	$210,000.00	2026-05-08
002-3	OTHER	Heart And/or Lung Transplant	16	16	—	—	$58,027.07	$150,493.21	$60,928.42	2026-05-08
002-2	OTHER	Heart And/or Lung Transplant	16	16	—	—	$46,614.95	$120,895.87	$48,945.70	2026-05-08
002-1	OTHER	Heart And/or Lung Transplant	16	16	—	—	$36,106.50	$93,642.21	$37,911.83	2026-05-08
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	16	16	—	—	$84,394.35	$218,876.75	$88,614.07	2026-05-08
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	16	16	—	—	$43,482.03	$112,770.64	$45,656.13	2026-05-08
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	16	16	—	—	$33,398.18	$86,618.18	$35,068.09	2026-05-08
001-1	OTHER	Liver Transplant And/or Intestinal Transplant	16	16	—	—	$32,144.17	$83,365.90	$33,751.38	2026-05-08

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