Hospital

PRIMARY CHILDREN'S HOSPITAL

Salt Lake City, UT · CCN 463301 · Rates published

22,925 distinct procedures filed

44 distinct payers

4,139,187 rate rows

2026-05-22 last MRF observed

Data quality

4,129,043 of 4,139,187 rate rows are consumer-grade (99.8%)

10,144 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
placeholder amount (≤ $0.02) — excluded from medians	8,260
percent-of-charges filed in the dollar field — excluded from medians	1,446
per-diem day rate — not a per-procedure price	438

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

Source MRF file	https://intermountainhealthcare.org/-/media/files/intermountain-health/locations/hospital-prices/942854057_primary-childrens-hospital_standardcharges.ashx
Found on page	https://intermountainhealthcare.org/locations/primary-childrens-salt-lake-city/about/standard-charges
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-19
Content fingerprint	59ca96a01610681d… · 5,369,733 bytes · first seen 2026-05-15

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
J3391 OTHER	Inj Atidarsagene Autotemcel	5	$3,828,799.50	$4,865,400.00	$4,595,100.00	nat. median $4,505,000 1.0× median
J1414 OTHER	Inj Beqvez Per Tx Dose	3	$3,710,000.00	$3,710,000.00	$3,710,000.00	nat. median $3,710,000 1.0× median
J1411 OTHER	Inj Hemgenix Per Tx Dose	9	$3,132,108.14	$3,980,088.00	$3,710,000.00	nat. median $3,685,267 1.0× median
J3389 OTHER	Topi Adm Prad Zami Per Treat	4	$3,335,820.00	$3,602,685.60	$3,469,252.80	nat. median $3,469,253 1.0× median
J1413 OTHER	Inj Delandistrogene Mox Rokl	9	$2,818,661.56	$3,594,088.51	$3,327,859.73	nat. median $3,327,860 1.0× median
J3387 OTHER	Inj Elivaldogene Autotemecel	4	$3,180,000.00	$3,434,400.00	$3,307,200.00	nat. median $3,307,200 1.0× median
J3394 OTHER	Inj Lovotibeglogene Autotem	9	$2,760,854.02	$3,512,708.73	$3,252,508.08	nat. median $3,286,000 1.0× median
J3393 OTHER	Inj Betibeglogene Autotemce	9	$2,503,584.43	$3,175,166.40	$2,968,000.00	nat. median $2,968,000 1.0× median
206895 OTHER	Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit	37	$1,430,550.00	$3,496,900.00	$2,900,837.50	nat. median $2,900,838 1.0× median
J3399 OTHER	Inj Onase Abepar-xioi Treat	9	$2,086,598.51	$2,796,099.73	$2,588,981.23	nat. median $2,472,216 1.0× median
J3392 OTHER	Inj Exagamglogene Autotem	8	$1,981,966.80	$2,518,560.00	$2,332,000.00	nat. median $2,332,000 1.0× median
Q2057 OTHER	Afamitresgene Autoleucel	5	$654,949.94	$832,269.60	$786,032.40	nat. median $770,620 1.0× median
Q2056 OTHER	Ciltacabtagene Car-pos T	9	$480,932.02	$634,661.54	$587,649.57	nat. median $583,076 1.0× median
Q2042 OTHER	Tisagenlecleucel Car-pos T	9	$502,908.10	$611,853.80	$566,531.30	nat. median $591,726 1.0× median
Q2054 OTHER	Lisocabtagene Mara Car Pos T	9	$478,101.21	$607,177.34	$562,201.24	nat. median $562,538 1.0× median
Q2055 OTHER	Idecabtagene Vicleucel Car	9	$473,664.51	$602,728.27	$558,081.73	nat. median $558,082 1.0× median
Q2041 OTHER	Axicabtagene Ciloleucel Car+	9	$453,192.32	$574,767.62	$532,192.24	nat. median $533,230 1.0× median
Q2053 OTHER	Brexucabtagene Car Pos T	9	$415,859.99	$528,606.22	$489,450.20	nat. median $489,720 1.0× median
MS-001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	2	$432,530.59	$432,530.59	$432,530.59	nat. median $224,278 1.9× median
018 OTHER	Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies	4	$424,867.81	$424,867.81	$424,867.81	nat. median $424,868 1.0× median
MS-018 OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	2	$408,755.26	$408,755.26	$408,755.26	nat. median $309,559 1.3× median
MS-633 OTHER	Neonate- Birth Weight 1000-1499 Grams- With Significant O.r. Procedures- Dischar…	2	$382,956.54	$382,956.54	$382,956.54	nat. median $297,836 1.3× median
MS-612 OTHER	Neonate- Birth Weight <750 Grams- Discharged Alive	2	$350,926.74	$350,926.74	$350,926.74	nat. median $272,926 1.3× median
MS-927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	2	$296,331.36	$296,331.36	$296,331.36	nat. median $175,322 1.7× median
MS-003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	2	$290,953.29	$290,953.29	$290,953.29	nat. median $169,886 1.7× median
Q2058 OTHER	Obecbtge Autol Up To 400 Mil	5	$236,484.68	$300,510.00	$283,815.00	nat. median $281,111 1.0× median
200074 OTHER	Cerliponase Alfa 150 Mg/5 Ml Intraventricular Solution	37	$136,744.85	$334,265.18	$277,288.16	nat. median $269,691 1.0× median
J3403 OTHER	Revakinagene Per Implant	5	$218,849.25	$286,200.00	$270,300.00	nat. median $265,000 1.0× median
MS-631 OTHER	Neonate- Birth Weight 750-999 Grams- Discharged Alive	2	$254,460.34	$254,460.34	$254,460.34	nat. median $197,901 1.3× median
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	4	$237,876.58	$237,876.58	$237,876.58	nat. median $218,232 1.1× median
MS-636 OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- With Mu…	2	$225,018.86	$225,018.86	$225,018.86	nat. median $183,596 1.2× median
005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	4	$224,031.78	$224,031.78	$224,031.78	nat. median $104,489 outlier · 2.1×
198597 OTHER	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	37	$110,448.62	$269,985.50	$223,965.25	nat. median $223,965 1.0× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	4	$223,125.35	$223,125.35	$223,125.35	nat. median $146,562 1.5× median
J3402 OTHER	Inj. Remestemcel-l-rknd/ Td	5	$174,773.44	$217,802.54	$205,702.40	nat. median $205,640 1.0× median
8121024697 OTHER	Hc Living Liver Acquisition	37	$96,641.17	$236,233.97	$195,966.81	nat. median $195,967 1.0× median
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	4	$189,523.66	$189,523.66	$189,523.66	nat. median $263,894 0.7× median
MS-004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	2	$186,687.08	$186,687.08	$186,687.08	nat. median $107,587 1.7× median
8123394001 OTHER	Hc Heart Transplant Acquisition	37	$83,958.36	$205,231.54	$170,248.89	nat. median $170,249 1.0× median
002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	4	$158,369.67	$158,369.67	$158,369.67	nat. median $117,167 1.4× median
MS-005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	2	$153,381.13	$153,381.13	$153,381.13	nat. median $85,046 1.8× median
MS-681 OTHER	Neonate- Birth Weight >2499 Grams- With Significant O.r. Procedures- With Multip…	2	$153,266.34	$153,266.34	$153,266.34	nat. median $119,200 1.3× median
MS-651 OTHER	Kidney Transplant With Hemodialysis Without Mcc	2	$152,296.29	$152,296.29	$152,296.29	nat. median $29,775 outlier · 5.1×
MS-020 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	2	$146,561.49	$146,561.49	$146,561.49	nat. median $64,597 outlier · 2.3×
007 OTHER	Lung Transplant	4	$143,490.78	$143,490.78	$143,490.78	nat. median $141,082 1.0× median
MS-359 OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	2	$141,950.92	$141,950.92	$141,950.92	nat. median $25,994 outlier · 5.5×
8121024597 OTHER	Hc Living Kidney Acquisition	37	$69,434.07	$169,727.72	$140,796.86	nat. median $140,797 1.0× median
004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	4	$139,439.13	$139,439.13	$139,439.13	nat. median $150,232 0.9× median
MS-002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	2	$137,652.07	$137,652.07	$137,652.07	nat. median $91,287 1.5× median
MS-634 OTHER	Neonate- Birth Weight 1000-1499 Grams- Without Significant O.r. Procedures- Disc…	2	$137,263.82	$137,263.82	$137,263.82	nat. median $106,754 1.3× median

Other procedures at this hospital

Browse this hospital's 22,925 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

J3391	OTHER	Inj Atidarsagene Autotemcel	24	5	—	—	$3,828,799.50	$4,865,400.00	$4,595,100.00	2026-05-22
J1411	OTHER	Inj Hemgenix Per Tx Dose	36	9	—	—	$3,132,108.14	$3,980,088.00	$3,710,000.00	2026-05-22
J1414	OTHER	Inj Beqvez Per Tx Dose	9	3	—	—	$3,710,000.00	$3,710,000.00	$3,710,000.00	2026-05-22
J3389	OTHER	Topi Adm Prad Zami Per Treat	21	4	—	—	$3,335,820.00	$3,602,685.60	$3,469,252.80	2026-05-22
J1413	OTHER	Inj Delandistrogene Mox Rokl	36	9	—	—	$2,818,661.56	$3,594,088.51	$3,327,859.73	2026-05-22
J3387	OTHER	Inj Elivaldogene Autotemecel	21	4	—	—	$3,180,000.00	$3,434,400.00	$3,307,200.00	2026-05-22
J3394	OTHER	Inj Lovotibeglogene Autotem	36	9	—	—	$2,760,854.02	$3,512,708.73	$3,252,508.08	2026-05-22
J3393	OTHER	Inj Betibeglogene Autotemce	36	9	—	—	$2,503,584.43	$3,175,166.40	$2,968,000.00	2026-05-22
206895	OTHER	Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit	130	37	$3,973,750.00	$2,980,312.50 25% off	$1,430,550.00	$3,496,900.00	$2,900,837.50	2026-05-15
J3399	OTHER	Inj Onase Abepar-xioi Treat	36	9	—	—	$2,086,598.51	$2,796,099.73	$2,588,981.23	2026-05-22
J3392	OTHER	Inj Exagamglogene Autotem	33	8	—	—	$1,981,966.80	$2,518,560.00	$2,332,000.00	2026-05-22
Q2057	OTHER	Afamitresgene Autoleucel	24	5	—	—	$654,949.94	$832,269.60	$786,032.40	2026-05-22
Q2056	OTHER	Ciltacabtagene Car-pos T	36	9	—	—	$480,932.02	$634,661.54	$587,649.57	2026-05-22
Q2042	OTHER	Tisagenlecleucel Car-pos T	36	9	—	—	$502,908.10	$611,853.80	$566,531.30	2026-05-22
Q2054	OTHER	Lisocabtagene Mara Car Pos T	36	9	—	—	$478,101.21	$607,177.34	$562,201.24	2026-05-22
Q2055	OTHER	Idecabtagene Vicleucel Car	36	9	—	—	$473,664.51	$602,728.27	$558,081.73	2026-05-22
Q2041	OTHER	Axicabtagene Ciloleucel Car+	36	9	—	—	$453,192.32	$574,767.62	$532,192.24	2026-05-22
Q2053	OTHER	Brexucabtagene Car Pos T	36	9	—	—	$415,859.99	$528,606.22	$489,450.20	2026-05-22
MS-001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	6	2	—	—	$432,530.59	$432,530.59	$432,530.59	2026-05-22
018	OTHER	Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies	12	4	—	—	$424,867.81	$424,867.81	$424,867.81	2026-05-22
MS-018	OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	6	2	—	—	$408,755.26	$408,755.26	$408,755.26	2026-05-22
MS-633	OTHER	Neonate- Birth Weight 1000-1499 Grams- With Significant O.r. Procedures- Dischar…	6	2	—	—	$382,956.54	$382,956.54	$382,956.54	2026-05-22
MS-612	OTHER	Neonate- Birth Weight <750 Grams- Discharged Alive	6	2	—	—	$350,926.74	$350,926.74	$350,926.74	2026-05-22
MS-927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	6	2	—	—	$296,331.36	$296,331.36	$296,331.36	2026-05-22
MS-003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	6	2	—	—	$290,953.29	$290,953.29	$290,953.29	2026-05-22
Q2058	OTHER	Obecbtge Autol Up To 400 Mil	24	5	—	—	$236,484.68	$300,510.00	$283,815.00	2026-05-22
200074	OTHER	Cerliponase Alfa 150 Mg/5 Ml Intraventricular Solution	130	37	$379,846.80	$284,885.10 25% off	$136,744.85	$334,265.18	$277,288.16	2026-05-15
J3403	OTHER	Revakinagene Per Implant	24	5	—	—	$218,849.25	$286,200.00	$270,300.00	2026-05-22
MS-631	OTHER	Neonate- Birth Weight 750-999 Grams- Discharged Alive	6	2	—	—	$254,460.34	$254,460.34	$254,460.34	2026-05-22
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	12	4	—	—	$237,876.58	$237,876.58	$237,876.58	2026-05-22
MS-636	OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- With Mu…	6	2	—	—	$225,018.86	$225,018.86	$225,018.86	2026-05-22
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	12	4	—	—	$224,031.78	$224,031.78	$224,031.78	2026-05-22
198597	OTHER	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	130	37	$306,801.71	$230,101.28 25% off	$110,448.62	$269,985.50	$223,965.25	2026-05-15
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	12	4	—	—	$223,125.35	$223,125.35	$223,125.35	2026-05-22
J3402	OTHER	Inj. Remestemcel-l-rknd/ Td	24	5	—	—	$174,773.44	$217,802.54	$205,702.40	2026-05-22
8121024697	OTHER	Hc Living Liver Acquisition	390	37	$268,447.69	$201,335.77 25% off	$96,641.17	$236,233.97	$195,966.81	2026-05-22
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	12	4	—	—	$189,523.66	$189,523.66	$189,523.66	2026-05-22
MS-004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	6	2	—	—	$186,687.08	$186,687.08	$186,687.08	2026-05-22
8123394001	OTHER	Hc Heart Transplant Acquisition	390	37	$233,217.66	$174,913.24 25% off	$83,958.36	$205,231.54	$170,248.89	2026-05-22
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	12	4	—	—	$158,369.67	$158,369.67	$158,369.67	2026-05-22
MS-005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	6	2	—	—	$153,381.13	$153,381.13	$153,381.13	2026-05-22
MS-681	OTHER	Neonate- Birth Weight >2499 Grams- With Significant O.r. Procedures- With Multip…	6	2	—	—	$153,266.34	$153,266.34	$153,266.34	2026-05-22
MS-651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	6	2	—	—	$152,296.29	$152,296.29	$152,296.29	2026-05-22
MS-020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	6	2	—	—	$146,561.49	$146,561.49	$146,561.49	2026-05-22
007	OTHER	Lung Transplant	12	4	—	—	$143,490.78	$143,490.78	$143,490.78	2026-05-22
MS-359	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	6	2	—	—	$141,950.92	$141,950.92	$141,950.92	2026-05-22
8121024597	OTHER	Hc Living Kidney Acquisition	390	37	$192,872.41	$144,654.31 25% off	$69,434.07	$169,727.72	$140,796.86	2026-05-22
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	12	4	—	—	$139,439.13	$139,439.13	$139,439.13	2026-05-22
MS-002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	6	2	—	—	$137,652.07	$137,652.07	$137,652.07	2026-05-22
MS-634	OTHER	Neonate- Birth Weight 1000-1499 Grams- Without Significant O.r. Procedures- Disc…	6	2	—	—	$137,263.82	$137,263.82	$137,263.82	2026-05-22
MS-212	OTHER	Testes Procedures Age 0-17	6	2	—	—	$136,079.95	$136,079.95	$136,079.95	2026-05-22
MS-007	OTHER	Lung Transplant	6	2	—	—	$133,650.31	$133,650.31	$133,650.31	2026-05-22
MS-014	OTHER	Allogeneic Bone Marrow Transplant	6	2	—	—	$132,176.10	$132,176.10	$132,176.10	2026-05-22
014	OTHER	Allogeneic Bone Marrow Transplant	12	4	—	—	$131,567.94	$131,567.94	$131,567.94	2026-05-22
8121024497	OTHER	Hc Liver Cadaveric Acquisition	390	37	$179,396.49	$134,547.37 25% off	$64,582.74	$157,868.91	$130,959.44	2026-05-22
MS-216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	6	2	—	—	$129,161.28	$129,161.28	$129,161.28	2026-05-22
MS-632	OTHER	Neonate- Birth Weight 750-999 Grams- Died	6	2	—	—	$124,883.81	$124,883.81	$124,883.81	2026-05-22
215	OTHER	Other Heart Assist System Implant	12	4	—	—	$121,108.61	$121,108.61	$121,108.61	2026-05-22
MS-447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	6	2	—	—	$120,584.96	$120,584.96	$120,584.96	2026-05-22
MS-215	OTHER	Other Heart Assist System Implant	6	2	—	—	$119,361.70	$119,361.70	$119,361.70	2026-05-22
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	12	4	—	—	$114,510.60	$114,510.60	$114,510.60	2026-05-22
MS-955	OTHER	Craniotomy For Multiple Significant Trauma	6	2	—	—	$112,646.72	$112,646.72	$112,646.72	2026-05-22
Q0480	OTHER	Driver Pneumatic Vad Rep	36	9	—	—	$92,907.91	$121,329.33	$112,341.97	2026-05-22
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	12	4	—	—	$109,355.21	$109,355.21	$109,355.21	2026-05-22
MS-365	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	6	2	—	—	$108,794.64	$108,794.64	$108,794.64	2026-05-22
MS-850	OTHER	Acute Leukemia With Other Procedures	6	2	—	—	$107,942.74	$107,942.74	$107,942.74	2026-05-22
834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	12	4	—	—	$106,798.41	$106,798.41	$106,798.41	2026-05-22
MS-429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	6	2	—	—	$104,186.32	$104,186.32	$104,186.32	2026-05-22
2722109771	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 71	390	37	$140,868.25	$105,651.19 25% off	$50,712.57	$123,964.06	$102,833.82	2026-05-22
2782649771	OTHER	Hc Valve Implant Lvl 71	390	37	$140,868.25	$105,651.19 25% off	$50,712.57	$123,964.06	$102,833.82	2026-05-22
MS-834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	6	2	—	—	$102,481.41	$102,481.41	$102,481.41	2026-05-22
202663	OTHER	Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution	130	37	$136,945.20	$102,708.90 25% off	$49,300.27	$120,511.78	$99,970.00	2026-05-15
MS-010	OTHER	Pancreas Transplant	6	2	—	—	$99,593.75	$99,593.75	$99,593.75	2026-05-22
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	12	4	—	—	$99,520.29	$99,520.29	$99,520.29	2026-05-22
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	12	4	—	—	$99,316.02	$99,316.02	$99,316.02	2026-05-22
MS-019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	6	2	—	—	$99,023.20	$99,023.20	$99,023.20	2026-05-22
2721649601	OTHER	Hc Kit Pump Device Cardiac Ventricular Smartassist 5.5 S2	390	37	$135,212.00	$101,409.00 25% off	$48,676.32	$118,986.56	$98,704.76	2026-05-22
231	OTHER	Coronary Bypass With Ptca With Mcc	12	4	—	—	$98,657.96	$98,657.96	$98,657.96	2026-05-22
212	OTHER	Concomitant Aortic And Mitral Valve?Procedures	12	4	—	—	$98,459.50	$98,459.50	$98,459.50	2026-05-22
278TRIG470	OTHER	Hc Ntap Triclip G4 Vlv Rpr Systm	390	37	$134,160.15	$100,620.11 25% off	$48,297.65	$118,060.93	$97,936.91	2026-05-22
2782649770	OTHER	Hc Valve Implant Lvl 70	390	37	$134,160.15	$100,620.11 25% off	$48,297.65	$118,060.93	$97,936.91	2026-05-22
2721649701	OTHER	Hc Pump Blood Vad With Valves	390	37	$134,124.15	$100,593.11 25% off	$48,284.69	$118,029.25	$97,910.63	2026-05-22
2721040201	OTHER	Hc Berlin Heart Pump Replacement	390	37	$134,124.15	$100,593.11 25% off	$48,284.69	$118,029.25	$97,910.63	2026-05-22
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	12	4	—	—	$97,528.70	$97,528.70	$97,528.70	2026-05-22
92987	OTHER	Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous	456	42	$136,160.32	$102,120.24 25% off	$1,094.33	$146,191.27	$96,673.83	2026-05-22
8801	OTHER	945/946 - Rehab - Spinal/quad	12	4	—	—	$94,424.09	$94,424.09	$94,424.09	2026-05-22
8121024297	OTHER	Hc Kidney Cadaveric Acquisition	390	37	$128,891.54	$96,668.66 25% off	$46,400.95	$113,424.56	$94,090.82	2026-05-22
MS-233	OTHER	Coronary Bypass With Cardiac Catheterization With Mcc	6	2	—	—	$88,312.09	$88,312.09	$88,312.09	2026-05-22
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	12	4	—	—	$88,055.88	$88,055.88	$88,055.88	2026-05-22
MS-870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	6	2	—	—	$85,713.64	$85,713.64	$85,713.64	2026-05-22
MS-219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	6	2	—	—	$85,604.49	$85,604.49	$85,604.49	2026-05-22
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	12	4	—	—	$85,191.52	$85,191.52	$85,191.52	2026-05-22
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	12	4	—	—	$84,666.93	$84,666.93	$84,666.93	2026-05-22
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	12	4	—	—	$84,628.63	$84,628.63	$84,628.63	2026-05-22
275C188267	OTHER	Hc Icd Biv/crt-d Lvl 67	390	37	$115,892.50	$86,919.38 25% off	$41,721.30	$101,985.40	$84,601.52	2026-05-22
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	12	4	—	—	$83,863.80	$83,863.80	$83,863.80	2026-05-22
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	12	4	—	—	$83,080.39	$83,080.39	$83,080.39	2026-05-22
MS-366	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	6	2	—	—	$82,801.23	$82,801.23	$82,801.23	2026-05-22
216356	OTHER	Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln	130	37	$111,517.88	$83,638.41 25% off	$40,146.44	$98,135.73	$81,408.05	2026-05-15
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	12	4	—	—	$81,349.94	$81,349.94	$81,349.94	2026-05-22
278C182366	OTHER	Hc Neurostim Generator/lead Lvl 66	390	37	$110,373.80	$82,780.35 25% off	$39,734.57	$97,128.94	$80,572.87	2026-05-22
278C188966	OTHER	Hc Implantable-insertable Device Noc Lvl 66	390	37	$110,373.80	$82,780.35 25% off	$39,734.57	$97,128.94	$80,572.87	2026-05-22
2782649766	OTHER	Hc Valve Implant Lvl 66	390	37	$110,373.80	$82,780.35 25% off	$39,734.57	$97,128.94	$80,572.87	2026-05-22
MS-317	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	6	2	—	—	$80,538.15	$80,538.15	$80,538.15	2026-05-22
MS-956	OTHER	Limb Reattachment- Hip And Femur Procedures For Multiple Significant Trauma	6	2	—	—	$79,966.47	$79,966.47	$79,966.47	2026-05-22
MS-456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	6	2	—	—	$79,821.30	$79,821.30	$79,821.30	2026-05-22
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	12	4	—	—	$79,804.02	$79,804.02	$79,804.02	2026-05-22
955	OTHER	Craniotomy For Multiple Significant Trauma	12	4	—	—	$79,178.45	$79,178.45	$79,178.45	2026-05-22
MS-969	OTHER	HIV With Extensive O.r. Procedures With Mcc	6	2	—	—	$78,999.79	$78,999.79	$78,999.79	2026-05-22
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	12	4	—	—	$77,941.25	$77,941.25	$77,941.25	2026-05-22
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	12	4	—	—	$77,587.27	$77,587.27	$77,587.27	2026-05-22
MS-360	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc	6	2	—	—	$77,274.62	$77,274.62	$77,274.62	2026-05-22
MS-573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	6	2	—	—	$76,924.64	$76,924.64	$76,924.64	2026-05-22
188242	OTHER	Histrelin 50 Mg (65 Mcg/day) Implant Kit	390	37	$105,337.52	$79,003.14 25% off	$37,921.51	$92,697.02	$76,896.39	2026-05-22
2782649765	OTHER	Hc Valve Implant Lvl 65	390	37	$105,117.85	$78,838.39 25% off	$37,842.43	$92,503.71	$76,736.03	2026-05-22
MS-461	OTHER	Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc	6	2	—	—	$76,655.68	$76,655.68	$76,655.68	2026-05-22
MS-647	OTHER	Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…	6	2	—	—	$76,556.65	$76,556.65	$76,556.65	2026-05-22
MS-635	OTHER	Neonate- Birth Weight 1000-1499 Grams- Died	6	2	—	—	$76,396.85	$76,396.85	$76,396.85	2026-05-22
MS-232	OTHER	Coronary Bypass With Ptca Without Mcc	6	2	—	—	$76,306.82	$76,306.82	$76,306.82	2026-05-22
MS-207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	6	2	—	—	$75,680.00	$75,680.00	$75,680.00	2026-05-22
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	12	4	—	—	$75,407.66	$75,407.66	$75,407.66	2026-05-22
MS-017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	6	2	—	—	$75,396.41	$75,396.41	$75,396.41	2026-05-22
MS-957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	6	2	—	—	$75,055.43	$75,055.43	$75,055.43	2026-05-22
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	12	4	—	—	$74,626.58	$74,626.58	$74,626.58	2026-05-22
MS-006	OTHER	Liver Transplant Without Mcc	6	2	—	—	$74,618.79	$74,618.79	$74,618.79	2026-05-22
MS-904	OTHER	Skin Grafts For Injuries With Cc/mcc	6	2	—	—	$74,579.40	$74,579.40	$74,579.40	2026-05-22
MS-218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	6	2	—	—	$74,314.94	$74,314.94	$74,314.94	2026-05-22
MS-011	OTHER	Tracheostomy For Face- Mouth And Neck Diagnoses Or Laryngectomy With Mcc	6	2	—	—	$74,158.52	$74,158.52	$74,158.52	2026-05-22
MS-275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	6	2	—	—	$73,282.99	$73,282.99	$73,282.99	2026-05-22
2782649764	OTHER	Hc Valve Implant Lvl 64	390	37	$100,112.20	$75,084.15 25% off	$36,040.39	$88,098.74	$73,081.91	2026-05-22
2782669764	OTHER	Hc Vascular Stent Graft Implant Lvl 64	390	37	$100,112.20	$75,084.15 25% off	$36,040.39	$88,098.74	$73,081.91	2026-05-22
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc	12	4	—	—	$72,775.42	$72,775.42	$72,775.42	2026-05-22
MS-228	OTHER	Other Cardiothoracic Procedures With Mcc	6	2	—	—	$72,715.82	$72,715.82	$72,715.82	2026-05-22
MS-234	OTHER	Coronary Bypass With Cardiac Catheterization Without Mcc	6	2	—	—	$72,433.35	$72,433.35	$72,433.35	2026-05-22
016	OTHER	Autologous Bone Marrow Transplant With Cc/Mcc	12	4	—	—	$71,518.49	$71,518.49	$71,518.49	2026-05-22
MS-457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	6	2	—	—	$71,453.17	$71,453.17	$71,453.17	2026-05-22
MS-646	OTHER	Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- Without…	6	2	—	—	$71,285.49	$71,285.49	$71,285.49	2026-05-22
MS-023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	6	2	—	—	$71,229.23	$71,229.23	$71,229.23	2026-05-22
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	12	4	—	—	$70,408.96	$70,408.96	$70,408.96	2026-05-22
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	12	4	—	—	$69,806.61	$69,806.61	$69,806.61	2026-05-22
278C188963	OTHER	Hc Implantable-insertable Device Noc Lvl 63	390	37	$95,344.95	$71,508.71 25% off	$34,324.18	$83,903.56	$69,601.81	2026-05-22
2782649763	OTHER	Hc Valve Implant Lvl 63	390	37	$95,344.95	$71,508.71 25% off	$34,324.18	$83,903.56	$69,601.81	2026-05-22
028	OTHER	Spinal Procedures With Mcc	12	4	—	—	$69,087.04	$69,087.04	$69,087.04	2026-05-22
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	12	4	—	—	$69,004.63	$69,004.63	$69,004.63	2026-05-22
232	OTHER	Coronary Bypass With Ptca Without Mcc	12	4	—	—	$68,854.92	$68,854.92	$68,854.92	2026-05-22
L8702	OTHER	Ewhf S/d Uprt Micro Sensor	36	9	—	—	$57,328.02	$74,305.85	$68,801.71	2026-05-22
MS-423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	6	2	—	—	$68,761.33	$68,761.33	$68,761.33	2026-05-22
MS-450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	6	2	—	—	$68,597.02	$68,597.02	$68,597.02	2026-05-22
MS-235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	6	2	—	—	$68,054.60	$68,054.60	$68,054.60	2026-05-22
MS-008	OTHER	Simultaneous Pancreas/kidney Transplant	6	2	—	—	$67,966.83	$67,966.83	$67,966.83	2026-05-22
MS-576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	6	2	—	—	$67,395.15	$67,395.15	$67,395.15	2026-05-22
276	OTHER	Cardiac Defibrillator Implant With Mcc	12	4	—	—	$67,365.87	$67,365.87	$67,365.87	2026-05-22
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	12	4	—	—	$67,340.33	$67,340.33	$67,340.33	2026-05-22
4813324901	OTHER	Hc Implant/repos Defib Pulse Gen W/leads Sng/dual	390	37	$91,331.94	$68,498.96 25% off	$32,879.50	$80,372.11	$66,672.32	2026-05-22
MS-231	OTHER	Coronary Bypass With Ptca With Mcc	6	2	—	—	$66,669.29	$66,669.29	$66,669.29	2026-05-22
MS-260	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Mcc	6	2	—	—	$66,489.24	$66,489.24	$66,489.24	2026-05-22
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	12	4	—	—	$66,401.41	$66,401.41	$66,401.41	2026-05-22
2782669762	OTHER	Hc Vascular Stent Graft Implant Lvl 62	390	37	$90,804.65	$68,103.49 25% off	$32,689.67	$79,908.09	$66,287.39	2026-05-22
278C188962	OTHER	Hc Implantable-insertable Device Noc Lvl 62	390	37	$90,804.65	$68,103.49 25% off	$32,689.67	$79,908.09	$66,287.39	2026-05-22
278C187462	OTHER	Hc Stent Coated/covered Implant Lvl 62	390	37	$90,804.65	$68,103.49 25% off	$32,689.67	$79,908.09	$66,287.39	2026-05-22
MS-463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	6	2	—	—	$65,724.00	$65,724.00	$65,724.00	2026-05-22
008	OTHER	Simultaneous Pancreas And Kidney Transplant	12	4	—	—	$65,720.14	$65,720.14	$65,720.14	2026-05-22
MS-408	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	6	2	—	—	$65,635.09	$65,635.09	$65,635.09	2026-05-22
653	OTHER	Major Bladder Procedures With Mcc	12	4	—	—	$65,316.25	$65,316.25	$65,316.25	2026-05-22
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	12	4	—	—	$65,142.16	$65,142.16	$65,142.16	2026-05-22
MS-474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	6	2	—	—	$64,914.87	$64,914.87	$64,914.87	2026-05-22
MS-420	OTHER	Hepatobiliary Diagnostic Procedures With Mcc	6	2	—	—	$64,441.10	$64,441.10	$64,441.10	2026-05-22
J9029	OTHER	Instill Adstiladrin Tx Dose	36	9	—	—	$53,834.60	$69,416.77	$64,274.79	2026-05-22
4813326401	OTHER	Hc Remove & Replac Defib Pulse Gen Mult Leads	390	37	$87,734.85	$65,801.14 25% off	$31,584.55	$77,206.67	$64,046.44	2026-05-22
MS-430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	6	2	—	—	$63,662.35	$63,662.35	$63,662.35	2026-05-22
MS-367	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	6	2	—	—	$63,448.53	$63,448.53	$63,448.53	2026-05-22
192637	OTHER	Flutemetamol F-18 5 Mci (185 Mbq) Intravenous Solution	260	37	$129,360.00	$97,020.00 25% off	$23,284.80	$170,755.20	$63,386.40	2026-05-15
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	12	4	—	—	$63,265.47	$63,265.47	$63,265.47	2026-05-22
2722109761	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 61	390	37	$86,480.60	$64,860.45 25% off	$31,133.02	$76,102.93	$63,130.84	2026-05-22
278C182361	OTHER	Hc Neurostim Generator/lead Lvl 61	390	37	$86,480.60	$64,860.45 25% off	$31,133.02	$76,102.93	$63,130.84	2026-05-22
2782649761	OTHER	Hc Valve Implant Lvl 61	390	37	$86,480.60	$64,860.45 25% off	$31,133.02	$76,102.93	$63,130.84	2026-05-22
MS-981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	6	2	—	—	$62,995.02	$62,995.02	$62,995.02	2026-05-22
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	12	4	—	—	$62,719.98	$62,719.98	$62,719.98	2026-05-22
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	12	4	—	—	$62,505.27	$62,505.27	$62,505.27	2026-05-22
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	12	4	—	—	$61,653.39	$61,653.39	$61,653.39	2026-05-22
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	12	4	—	—	$61,612.77	$61,612.77	$61,612.77	2026-05-22
MS-021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	6	2	—	—	$61,269.85	$61,269.85	$61,269.85	2026-05-22
799	OTHER	Splenic Procedures With Mcc	12	4	—	—	$61,213.53	$61,213.53	$61,213.53	2026-05-22
MS-245	OTHER	Aicd Generator Procedures	6	2	—	—	$61,042.53	$61,042.53	$61,042.53	2026-05-22
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	12	4	—	—	$60,714.47	$60,714.47	$60,714.47	2026-05-22
MS-403	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	6	2	—	—	$60,692.54	$60,692.54	$60,692.54	2026-05-22
2721649501	OTHER	Hc Set Pump Impella Cp W/smart Assist	390	37	$82,971.00	$62,228.25 25% off	$29,869.56	$73,014.48	$60,568.83	2026-05-22
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	12	4	—	—	$60,440.57	$60,440.57	$60,440.57	2026-05-22
MS-277	OTHER	Other Major Cardiovascular Procedures With Mcc	6	2	—	—	$60,291.92	$60,291.92	$60,291.92	2026-05-22
2722109760	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 60	390	37	$82,362.45	$61,771.84 25% off	$29,650.48	$72,478.96	$60,124.59	2026-05-22
270	OTHER	Other Major Cardiovascular Procedures With Mcc	12	4	—	—	$60,095.87	$60,095.87	$60,095.87	2026-05-22
652	OTHER	Kidney Transplant	12	4	—	—	$59,892.76	$59,892.76	$59,892.76	2026-05-22
4813327001	OTHER	Hc Insert/replmnt Subq Impl Defib W Sbq Electrode	390	37	$81,986.79	$61,490.09 25% off	$29,515.24	$72,148.38	$59,850.36	2026-05-22
MS-823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	6	2	—	—	$59,837.28	$59,837.28	$59,837.28	2026-05-22
MS-323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	6	2	—	—	$59,519.93	$59,519.93	$59,519.93	2026-05-22
MS-799	OTHER	Splenic Procedures With Mcc	6	2	—	—	$59,393.89	$59,393.89	$59,393.89	2026-05-22
MS-628	OTHER	Other Endocrine- Nutritional And Metabolic O.r. Procedures With Mcc	6	2	—	—	$59,217.21	$59,217.21	$59,217.21	2026-05-22
MS-691	OTHER	Kidney Transplant With Hemodialysis With Mcc	6	2	—	—	$59,135.06	$59,135.06	$59,135.06	2026-05-22
MS-217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	6	2	—	—	$59,104.67	$59,104.67	$59,104.67	2026-05-22
MS-220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	6	2	—	—	$58,985.38	$58,985.38	$58,985.38	2026-05-22
MS-826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	6	2	—	—	$58,857.09	$58,857.09	$58,857.09	2026-05-22
MS-958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	6	2	—	—	$58,183.01	$58,183.01	$58,183.01	2026-05-22
228	OTHER	Other Cardiothoracic Procedures With Mcc	12	4	—	—	$57,929.03	$57,929.03	$57,929.03	2026-05-22
245	OTHER	Aicd Generator Procedures	12	4	—	—	$57,315.07	$57,315.07	$57,315.07	2026-05-22
272C176959	OTHER	Hc Guidewire Lvl 59	390	37	$78,440.40	$58,830.30 25% off	$28,238.54	$69,027.55	$57,261.49	2026-05-22
278LIMFW59	OTHER	Hc Ntap Limflow System	390	37	$78,440.40	$58,830.30 25% off	$28,238.54	$69,027.55	$57,261.49	2026-05-22
2782649759	OTHER	Hc Valve Implant Lvl 59	390	37	$78,440.40	$58,830.30 25% off	$28,238.54	$69,027.55	$57,261.49	2026-05-22
278C182359	OTHER	Hc Neurostim Generator/lead Lvl 59	390	37	$78,440.40	$58,830.30 25% off	$28,238.54	$69,027.55	$57,261.49	2026-05-22
275C172159	OTHER	Hc Icd Dual Chamber Lvl 59	390	37	$78,440.40	$58,830.30 25% off	$28,238.54	$69,027.55	$57,261.49	2026-05-22
2722109759	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 59	390	37	$78,440.40	$58,830.30 25% off	$28,238.54	$69,027.55	$57,261.49	2026-05-22
275C188259	OTHER	Hc Icd Biv/crt-d Lvl 59	390	37	$78,440.40	$58,830.30 25% off	$28,238.54	$69,027.55	$57,261.49	2026-05-22
278C262459	OTHER	Hc Wireless Pressure Sensor Lvl 59	390	37	$78,440.40	$58,830.30 25% off	$28,238.54	$69,027.55	$57,261.49	2026-05-22
278C188959	OTHER	Hc Implantable-insertable Device Noc Lvl 59	390	37	$78,440.40	$58,830.30 25% off	$28,238.54	$69,027.55	$57,261.49	2026-05-22
MS-837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	6	2	—	—	$57,256.84	$57,256.84	$57,256.84	2026-05-22
163	OTHER	Major Chest Procedures With Mcc	12	4	—	—	$56,935.55	$56,935.55	$56,935.55	2026-05-22
A9543	OTHER	Y90 Ibritumomab Rx	36	9	—	—	$48,295.19	$65,476.58	$56,824.55	2026-05-22
025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	12	4	—	—	$56,532.83	$56,532.83	$56,532.83	2026-05-22
006	OTHER	Liver Transplant Without Mcc	12	4	—	—	$56,530.50	$56,530.50	$56,530.50	2026-05-22
MS-016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	6	2	—	—	$56,525.36	$56,525.36	$56,525.36	2026-05-22
MS-040	OTHER	Peripheral- Cranial Nerve And Other Nervous System Procedures With Mcc	6	2	—	—	$56,305.92	$56,305.92	$56,305.92	2026-05-22
MS-273	OTHER	Percutaneous Intracardiac Procedures W Mcc	6	2	—	—	$56,304.79	$56,304.79	$56,304.79	2026-05-22
MS-577	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	6	2	—	—	$55,837.77	$55,837.77	$55,837.77	2026-05-22
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	12	4	—	—	$55,617.11	$55,617.11	$55,617.11	2026-05-22
MS-820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	6	2	—	—	$55,530.55	$55,530.55	$55,530.55	2026-05-22
200108	OTHER	Cerliponase Alfa 300 Mg/10 Ml(150 Mg/5ml X2) Intraventricular Kit	130	37	$75,969.36	$56,977.02 25% off	$27,348.97	$66,853.04	$55,457.63	2026-05-15
MS-236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	6	2	—	—	$55,002.76	$55,002.76	$55,002.76	2026-05-22
MS-458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	6	2	—	—	$55,002.76	$55,002.76	$55,002.76	2026-05-22
MS-319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	6	2	—	—	$54,872.22	$54,872.22	$54,872.22	2026-05-22
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	12	4	—	—	$54,659.62	$54,659.62	$54,659.62	2026-05-22
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	12	4	—	—	$54,586.50	$54,586.50	$54,586.50	2026-05-22
2782649758	OTHER	Hc Valve Implant Lvl 58	390	37	$74,705.10	$56,028.82 25% off	$26,893.84	$65,740.49	$54,534.72	2026-05-22
2722109758	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 58	390	37	$74,705.10	$56,028.82 25% off	$26,893.84	$65,740.49	$54,534.72	2026-05-22
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	12	4	—	—	$54,475.08	$54,475.08	$54,475.08	2026-05-22
MS-326	OTHER	Stomach- Esophageal And Duodenal Procedures With Mcc	6	2	—	—	$54,377.06	$54,377.06	$54,377.06	2026-05-22
Q2043	OTHER	Sipuleucel-t Auto Cd54+	66	9	—	—	$46,975.94	$58,756.44	$54,192.79	2026-05-22
MS-933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	6	2	—	—	$54,049.58	$54,049.58	$54,049.58	2026-05-22
MS-405	OTHER	Pancreas- Liver And Shunt Procedures With Mcc	6	2	—	—	$54,023.70	$54,023.70	$54,023.70	2026-05-22
183256	OTHER	Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln	130	37	$73,709.62	$55,282.22 25% off	$26,535.46	$64,864.47	$53,808.02	2026-05-15
MS-648	OTHER	Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…	6	2	—	—	$53,366.50	$53,366.50	$53,366.50	2026-05-22
MS-853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	6	2	—	—	$53,364.24	$53,364.24	$53,364.24	2026-05-22
MS-466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	6	2	—	—	$53,068.28	$53,068.28	$53,068.28	2026-05-22
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	12	4	—	—	$53,059.15	$53,059.15	$53,059.15	2026-05-22
4819365401	OTHER	Hc Ep & Ablate Ventricular Tachycardia	390	37	$72,114.51	$54,085.88 25% off	$25,961.22	$63,460.77	$52,643.59	2026-05-22
MS-361	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	6	2	—	—	$52,384.06	$52,384.06	$52,384.06	2026-05-22
8800	OTHER	945/946 - Rehab - Spinal/para	12	4	—	—	$52,167.81	$52,167.81	$52,167.81	2026-05-22
MS-793	OTHER	Full Term Neonate With Major Problems	6	2	—	—	$52,095.97	$52,095.97	$52,095.97	2026-05-22
MS-974	OTHER	HIV With Major Related Condition With Mcc	6	2	—	—	$52,083.59	$52,083.59	$52,083.59	2026-05-22
2722109757	OTHER	Hc Percutaneous Ventricular Assist Device Lvl 57	390	37	$71,147.70	$53,360.78 25% off	$25,613.17	$62,609.98	$51,937.82	2026-05-22
207932	OTHER	Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution	390	37	$71,138.52	$53,353.89 25% off	$25,609.87	$62,601.90	$51,931.12	2026-05-22
901	OTHER	Wound Debridements For Injuries With Mcc	12	4	—	—	$51,703.57	$51,703.57	$51,703.57	2026-05-22
017	OTHER	Autologous Bone Marrow Transplant Without Cc/Mcc	12	4	—	—	$51,368.16	$51,368.16	$51,368.16	2026-05-22
MS-037	OTHER	Extracranial Procedures With Mcc	6	2	—	—	$51,283.47	$51,283.47	$51,283.47	2026-05-22
022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	12	4	—	—	$51,232.37	$51,232.37	$51,232.37	2026-05-22
4819365601	OTHER	Hc Tx Atrial Fib Ablate Pulm Vein Isol	390	37	$69,923.18	$52,442.38 25% off	$25,172.34	$61,532.40	$51,043.92	2026-05-22
471	OTHER	Cervical Spinal Fusion With Mcc	12	4	—	—	$50,996.76	$50,996.76	$50,996.76	2026-05-22
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	12	4	—	—	$50,854.01	$50,854.01	$50,854.01	2026-05-22
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	12	4	—	—	$50,621.89	$50,621.89	$50,621.89	2026-05-22
MS-677	OTHER	Neonate- Birth Weight 2000-2499 Grams- Without Significant O.r. Procedures- With…	6	2	—	—	$50,550.86	$50,550.86	$50,550.86	2026-05-22
MS-477	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	6	2	—	—	$50,269.52	$50,269.52	$50,269.52	2026-05-22
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	12	4	—	—	$50,265.59	$50,265.59	$50,265.59	2026-05-22
MS-028	OTHER	Spinal Procedures With Mcc	6	2	—	—	$50,026.45	$50,026.45	$50,026.45	2026-05-22
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	12	4	—	—	$49,929.01	$49,929.01	$49,929.01	2026-05-22
L7181	OTHER	Electronic Elbo Simultaneous	36	9	—	—	$41,333.01	$53,869.47	$49,879.14	2026-05-22
MS-739	OTHER	Uterine- Adnexa Proc For Non-ovarian/adnexal Malig W Mcc	6	2	—	—	$49,727.10	$49,727.10	$49,727.10	2026-05-22
220151	OTHER	Leuprolide 45 Mg (pediatric 6 Month) Intramuscular Syringe Kit	130	37	$68,107.95	$51,080.96 25% off	$24,518.86	$59,935.00	$49,718.80	2026-05-15
MS-471	OTHER	Cervical Spinal Fusion With Mcc	6	2	—	—	$49,574.06	$49,574.06	$49,574.06	2026-05-22
275C172256	OTHER	Hc Icd Single Chamber Lvl 56	390	37	$67,759.70	$50,819.78 25% off	$24,393.49	$59,628.54	$49,464.58	2026-05-22
278C182656	OTHER	Hc Gen Neuro Rchg W Bat & Lds & Cmpnts Implant Lvl 56	390	37	$67,759.70	$50,819.78 25% off	$24,393.49	$59,628.54	$49,464.58	2026-05-22
275C188256	OTHER	Hc Icd Biv/crt-d Lvl 56	390	37	$67,759.70	$50,819.78 25% off	$24,393.49	$59,628.54	$49,464.58	2026-05-22
2721489756	OTHER	Hc Cardiovascular Non Implant Supply Lvl 56	390	37	$67,759.70	$50,819.78 25% off	$24,393.49	$59,628.54	$49,464.58	2026-05-22
MS-012	OTHER	Tracheostomy For Face- Mouth And Neck Diagnoses Or Laryngectomy With Cc	6	2	—	—	$49,298.34	$49,298.34	$49,298.34	2026-05-22
MS-613	OTHER	Neonate- Birth Weight <750 Grams- Died	6	2	—	—	$49,200.44	$49,200.44	$49,200.44	2026-05-22
MS-221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	6	2	—	—	$49,103.66	$49,103.66	$49,103.66	2026-05-22
MS-362	OTHER	Cardiac Defibrillator Implant Without Mcc	6	2	—	—	$48,858.33	$48,858.33	$48,858.33	2026-05-22
140	OTHER	Major Head And Neck Procedures With Mcc	12	4	—	—	$48,855.46	$48,855.46	$48,855.46	2026-05-22
277	OTHER	Cardiac Defibrillator Implant Without Mcc	12	4	—	—	$48,791.62	$48,791.62	$48,791.62	2026-05-22
010	OTHER	Pancreas Transplant	12	4	—	—	$48,742.88	$48,742.88	$48,742.88	2026-05-22
MS-034	OTHER	Carotid Artery Stent Procedures With Mcc	6	2	—	—	$48,575.87	$48,575.87	$48,575.87	2026-05-22
MS-396	OTHER	Major Head And Neck Procedures With Mcc	6	2	—	—	$48,571.37	$48,571.37	$48,571.37	2026-05-22
MS-448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	6	2	—	—	$48,445.33	$48,445.33	$48,445.33	2026-05-22
031	OTHER	Ventricular Shunt Procedures With Mcc	12	4	—	—	$48,439.96	$48,439.96	$48,439.96	2026-05-22
MS-800	OTHER	Splenic Procedures With Cc	6	2	—	—	$48,430.70	$48,430.70	$48,430.70	2026-05-22
MS-025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	6	2	—	—	$48,079.59	$48,079.59	$48,079.59	2026-05-22
323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	12	4	—	—	$48,048.84	$48,048.84	$48,048.84	2026-05-22
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	12	4	—	—	$47,849.22	$47,849.22	$47,849.22	2026-05-22
332	OTHER	Rectal Resection With Mcc	12	4	—	—	$47,726.19	$47,726.19	$47,726.19	2026-05-22
4819365301	OTHER	Hc Ep & Ablate Supravent Arryth	390	37	$65,360.58	$49,020.44 25% off	$23,529.81	$57,517.31	$47,713.22	2026-05-22
MS-480	OTHER	Hip And Femur Procedures Except Major Joint With Mcc	6	2	—	—	$47,635.07	$47,635.07	$47,635.07	2026-05-22
MS-266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	6	2	—	—	$47,270.46	$47,270.46	$47,270.46	2026-05-22
2782649755	OTHER	Hc Valve Implant Lvl 55	390	37	$64,533.00	$48,399.75 25% off	$23,231.88	$56,789.04	$47,109.09	2026-05-22
2782669755	OTHER	Hc Vascular Stent Graft Implant Lvl 55	390	37	$64,533.00	$48,399.75 25% off	$23,231.88	$56,789.04	$47,109.09	2026-05-22
275C188255	OTHER	Hc Icd Biv/crt-d Lvl 55	390	37	$64,533.00	$48,399.75 25% off	$23,231.88	$56,789.04	$47,109.09	2026-05-22
034	OTHER	Carotid Artery Stent Procedures With Mcc	12	4	—	—	$47,011.26	$47,011.26	$47,011.26	2026-05-22
MS-242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	6	2	—	—	$46,911.47	$46,911.47	$46,911.47	2026-05-22
MS-622	OTHER	Skin Grafts And Wound Debridement For Endocrine- Nutritional And Metabolic Disor…	6	2	—	—	$46,742.67	$46,742.67	$46,742.67	2026-05-22
024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	12	4	—	—	$46,415.88	$46,415.88	$46,415.88	2026-05-22
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	12	4	—	—	$46,217.41	$46,217.41	$46,217.41	2026-05-22
MS-515	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	6	2	—	—	$46,178.86	$46,178.86	$46,178.86	2026-05-22
278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	12	4	—	—	$46,034.04	$46,034.04	$46,034.04	2026-05-22
012	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	12	4	—	—	$45,953.96	$45,953.96	$45,953.96	2026-05-22

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