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

INOVA FAIRFAX HOSPITAL

Falls Church, VA · CCN 490063 · Rates published

2,068 distinct procedures filed
10 distinct payers
381,913 rate rows
2026-05-22 last MRF observed
Data quality

380,030 of 381,913 rate rows are consumer-grade (99.5%)

1,883 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 1,308
exceeds 10× this hospital's gross charge — excluded from medians 504
placeholder amount (≤ $0.02) — excluded from medians 37
percent-of-charges filed in the dollar field — excluded from medians 31
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.inova.org/sites/default/files/patient_visitor/price_transparency/2026/540620889_inova-fairfax-hospital_standardcharges.csv
Found on page https://www.inova.org/patient-and-visitor-information/hospital-charges
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 57210a6ef1935181… · 20,875,742 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
18
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 $314,176.39 $1,019,867.25 $727,159.35 nat. median
$386,529
1.9× median
583 SOI-4
OTHER 		Neonate With Ecmo 7 $543,795.74 $611,322.92 $572,420.55 nat. median
$578,384
1.0× median
891
OTHER 		Axicabtagene Ciloleucel 200000000 Cells Susp 1 Each Package 8 $55,195.16 $1,374,773.40 $549,227.07 nat. median
$30
outlier · 18592.7×
1
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 9 $242,490.50 $761,755.34 $544,211.05 nat. median
$239,422
outlier · 2.3×
589 SOI-1
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 7 $498,021.22 $559,864.24 $524,236.51 nat. median
$529,698
1.0× median
589 SOI-2
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 7 $480,401.10 $540,056.10 $505,688.89 nat. median
$510,957
1.0× median
583 SOI-3
OTHER 		Neonate With Ecmo 7 $477,645.26 $536,958.04 $502,787.99 nat. median
$508,026
1.0× median
588 SOI-4
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 7 $384,177.97 $431,884.21 $404,400.67 nat. median
$408,613
1.0× median
161 SOI-4
OTHER 		Implantable Heart Assist Systems 7 $372,081.25 $418,285.36 $391,667.20 nat. median
$395,747
1.0× median
927
OTHER 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 9 $168,117.55 $543,896.93 $386,827.04 nat. median
$146,562
outlier · 2.6×
630 SOI-4
OTHER 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 7 $336,750.23 $378,567.03 $354,476.40 nat. median
$358,169
1.0× median
3
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 9 $90,363.00 $587,692.80 $346,827.06 nat. median
$181,005
1.9× median
583 SOI-2
OTHER 		Neonate With Ecmo 7 $328,651.10 $369,462.16 $345,950.93 nat. median
$349,555
1.0× median
609 SOI-4
OTHER 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 7 $321,464.24 $361,382.85 $338,385.76 nat. median
$341,911
1.0× median
841 SOI-4
OTHER 		Extensive Third Degree Burns With Skin Graft 7 $315,312.64 $354,467.37 $331,910.36 nat. median
$335,368
1.0× median
160 SOI-4
OTHER 		Major Cardiothoracic Repair Of Heart Anomaly 7 $298,861.05 $335,972.86 $314,592.77 nat. median
$317,870
1.0× median
591 SOI-4
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 7 $284,077.32 $319,353.32 $299,030.84 nat. median
$302,146
1.0× median
631 SOI-4
OTHER 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 7 $268,602.43 $301,956.80 $282,741.36 nat. median
$285,687
1.0× median
7
OTHER 		Lung Transplant 9 $113,411.56 $416,988.97 $264,930.71 nat. median
$169,933
1.6× median
593 SOI-4
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 7 $247,987.78 $278,782.28 $261,041.59 nat. median
$263,761
1.0× median
4
OTHER 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 8 $118,473.06 $2,379,509.90 $240,474.98 nat. median
$134,983
1.8× median
009 SOI-4
OTHER 		Extracorporeal Membrane Oxygenation (ecmo) 7 $225,058.06 $253,005.20 $236,904.87 nat. median
$239,373
1.0× median
589 SOI-3
OTHER 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 7 $223,267.20 $250,991.96 $235,019.74 nat. median
$237,468
1.0× median
603 SOI-4
OTHER 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 7 $221,848.28 $249,396.84 $233,526.13 nat. median
$235,959
1.0× median
004 SOI-4
OTHER 		Tracheostomy With Mv >96 Hours With Extensive Procedure 7 $215,983.69 $242,804.00 $227,352.84 nat. median
$229,721
1.0× median
14
OTHER 		Allogeneic Bone Marrow Transplant 9 $113,693.66 $354,311.98 $227,093.50 nat. median
$100,915
outlier · 2.3×
583 SOI-1
OTHER 		Neonate With Ecmo 7 $205,712.98 $231,257.90 $216,541.49 nat. median
$218,797
1.0× median
212
OTHER 		Concomitant Aortic And Mitral Valve�procedures 9 $94,819.31 $294,603.74 $208,689.81 nat. median
$90,581
outlier · 2.3×
426
OTHER 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 $91,241.73 $283,286.24 $205,777.24 nat. median
$80,273
outlier · 2.6×
215
OTHER 		Other Heart Assist System Implant 9 $89,135.98 $286,515.18 $195,092.64 nat. median
$92,359
outlier · 2.1×
792 SOI-4
OTHER 		Extensive O.r. Procedures For Other Complications Of Treatment 7 $184,941.66 $207,907.24 $194,676.78 nat. median
$196,705
1.0× median
2
OTHER 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 9 $82,087.08 $645,542.00 $190,648.02 nat. median
$111,558
1.7× median
161 SOI-3
OTHER 		Implantable Heart Assist Systems 7 $180,435.96 $202,842.04 $189,933.91 nat. median
$191,912
1.0× median
5
OTHER 		Liver Transplant With Mcc Or Intestinal Transplant 9 $92,729.18 $287,991.72 $186,351.98 nat. median
$94,894
2.0× median
216
OTHER 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 $81,304.63 $507,782.24 $186,073.21 nat. median
$90,130
outlier · 2.1×
161 SOI-2
OTHER 		Implantable Heart Assist Systems 7 $176,158.69 $198,033.63 $185,431.49 nat. median
$187,363
1.0× median
593 SOI-3
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 7 $170,985.26 $192,217.78 $179,985.74 nat. median
$181,861
1.0× median
680 SOI-4
OTHER 		Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 7 $170,247.24 $191,388.12 $179,208.87 nat. median
$181,076
1.0× median
681 SOI-4
OTHER 		Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 7 $168,056.63 $188,925.47 $176,902.94 nat. median
$178,746
1.0× median
161 SOI-1
OTHER 		Implantable Heart Assist Systems 7 $167,311.29 $188,087.58 $176,118.37 nat. median
$177,953
1.0× median
602 SOI-4
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 $167,306.90 $188,082.65 $176,113.75 nat. median
$177,948
1.0× median
591 SOI-3
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 7 $166,807.57 $187,521.31 $175,588.13 nat. median
$177,417
1.0× median
005 SOI-4
OTHER 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 7 $157,427.16 $176,976.06 $165,713.95 nat. median
$167,440
1.0× median
842 SOI-4
OTHER 		Burns With Skin Graft Except Extensive Third Degree Burns 7 $155,400.54 $174,697.79 $163,580.66 nat. median
$165,285
1.0× median
609 SOI-3
OTHER 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 7 $155,302.43 $174,587.50 $163,477.38 nat. median
$165,180
1.0× median
850
OTHER 		Acute Leukemia With Other Procedures 9 $80,440.63 $249,117.41 $159,669.86 nat. median
$407
outlier · 392.1×
602 SOI-3
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 7 $151,337.07 $170,129.72 $159,303.28 nat. median
$160,963
1.0× median
231
OTHER 		Coronary Bypass With Ptca With Mcc 9 $71,535.56 $229,159.68 $157,869.40 nat. median
$74,989
outlier · 2.1×
456
OTHER 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 9 $71,496.56 $229,032.58 $157,584.61 nat. median
$76,493
outlier · 2.1×
20
OTHER 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 9 $68,109.92 $331,138.32 $155,418.01 nat. median
$74,209
outlier · 2.1×

Other procedures at this hospital

Browse this hospital's 2,068 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
             
515 OTHER Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 80 9 — — $26,876.85 $83,627.77 $58,610.75 2026-05-22
403 SOI-4 OTHER Procedures For Obesity 19 7 — — $55,712.83 $62,631.11 $58,645.50 2026-05-22
042 SOI-4 OTHER Degenerative Nervous System Disorders Except Multiple Sclerosis 19 7 — — $55,911.98 $62,854.99 $58,855.13 2026-05-22
223 SOI-4 OTHER Other Small And Large Bowel Procedures 19 7 — — $55,952.98 $62,901.08 $58,898.29 2026-05-22
690 SOI-3 OTHER Acute Leukemia 19 7 — — $55,974.95 $62,925.77 $58,921.41 2026-05-22
179 SOI-3 OTHER Defibrillator Implants 19 7 — — $56,051.09 $63,011.37 $59,001.56 2026-05-22
313 SOI-4 OTHER Knee And Lower Leg Procedures Except Foot 19 7 — — $56,065.73 $63,027.84 $59,016.97 2026-05-22
500 OTHER Soft Tissue Procedures With Mcc 80 9 — — $27,510.03 $85,691.15 $59,146.57 2026-05-22
514 SOI-4 OTHER Female Reproductive System Reconstructive Procedures 19 7 — — $56,414.24 $63,419.62 $59,383.83 2026-05-22
242 OTHER Permanent Cardiac Pacemaker Implant With Mcc 82 9 — — $29,363.10 $91,729.86 $59,522.82 2026-05-22
711 SOI-4 OTHER Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 19 7 — — $56,548.96 $63,571.06 $59,525.63 2026-05-22
631 SOI-2 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 19 7 — — $56,658.78 $63,694.53 $59,641.24 2026-05-22
073 SOI-4 OTHER Orbit And Eye Procedures 19 7 — — $56,698.32 $63,738.97 $59,682.86 2026-05-22
623 SOI-3 OTHER Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 19 7 — — $56,853.54 $63,913.46 $59,846.24 2026-05-22
130 SOI-3 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 19 7 — — $56,945.79 $64,017.17 $59,943.35 2026-05-22
440 SOI-1 OTHER Kidney Transplant 19 7 — — $57,026.33 $64,107.71 $60,028.13 2026-05-22
656 OTHER Kidney And Ureter Procedures For Neoplasm With Mcc 80 9 — — $28,251.09 $88,106.09 $60,179.12 2026-05-22
485 OTHER Knee Procedures With Principal Diagnosis Of Infection With Mcc 80 9 — — $27,929.94 $87,059.53 $60,197.35 2026-05-22
451 OTHER Single Level Spinal Fusion Except Cervical Without Mcc 52 9 — — $28,073.03 $83,454.70 $60,472.82 2026-05-22
634 SOI-4 OTHER Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 19 7 — — $57,736.52 $64,906.09 $60,775.71 2026-05-22
200 SOI-4 OTHER Cardiac Structural And Valvular Disorders 19 7 — — $57,748.23 $64,919.26 $60,788.04 2026-05-22
030 SOI-4 OTHER Percutaneous Intracranial And Extracranial Vascular Procedures 19 7 — — $57,896.13 $65,085.52 $60,943.72 2026-05-22
180 SOI-4 OTHER Other Circulatory System Procedures 19 7 — — $57,963.49 $65,161.25 $61,014.62 2026-05-22
939 OTHER O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 80 9 — — $27,554.02 $85,834.48 $61,199.48 2026-05-22
303 SOI-2 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 19 7 — — $58,273.92 $65,510.23 $61,341.40 2026-05-22
37 OTHER Extracranial Procedures With Mcc 80 9 — — $28,773.07 $89,807.10 $61,764.18 2026-05-22
170 SOI-4 OTHER Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 19 7 — — $58,698.57 $65,987.61 $61,788.40 2026-05-22
518 SOI-4 OTHER Other Female Reproductive System And Related Procedures 19 7 — — $58,959.22 $66,280.63 $62,062.77 2026-05-22
660 SOI-4 OTHER Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 19 7 — — $59,064.65 $66,399.15 $62,173.75 2026-05-22
652 OTHER Kidney Transplant 48 9 — — $27,948.22 $186,902.73 $62,263.42 2026-05-22
178 SOI-1 OTHER External Heart Assist Systems 19 7 — — $59,228.66 $66,583.52 $62,346.39 2026-05-22
952 SOI-4 OTHER Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 19 7 — — $59,344.34 $66,713.57 $62,468.16 2026-05-22
224 SOI-4 OTHER Peritoneal Adhesiolysis 19 7 — — $59,751.42 $67,171.20 $62,896.67 2026-05-22
325 SOI-4 OTHER Non-elective Or Complex Knee Joint Replacement 19 7 — — $59,893.46 $67,330.87 $63,046.18 2026-05-22
29 OTHER Spinal Procedures With Cc Or Spinal Neurostimulators 80 9 — — $29,070.16 $90,775.24 $63,189.22 2026-05-22
665 OTHER Prostatectomy With Mcc 80 9 — — $29,708.32 $92,854.84 $63,226.31 2026-05-22
049 SOI-4 OTHER Bacterial And Tuberculous Infections Of Nervous System 19 7 — — $60,102.85 $67,566.27 $63,266.60 2026-05-22
143 OTHER Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 80 9 — — $28,615.40 $89,293.28 $63,665.58 2026-05-22
231 SOI-4 OTHER Major Large Bowel Procedures 19 7 — — $60,774.97 $68,321.86 $63,974.10 2026-05-22
303 SOI-3 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 19 7 — — $60,777.90 $68,325.15 $63,977.19 2026-05-22
94 OTHER Bacterial And Tuberculous Infections Of Nervous System With Mcc 82 9 — — $16,764.39 $98,671.79 $64,027.39 2026-05-22
264 OTHER Other Circulatory System O.r. Procedures 80 9 — — $30,218.68 $94,517.99 $64,358.77 2026-05-22
477 OTHER Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 80 9 — — $29,753.13 $93,000.88 $64,371.18 2026-05-22
252 OTHER Other Vascular Procedures With Mcc 80 9 — — $29,681.77 $92,768.31 $64,592.82 2026-05-22
574 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Cc 80 9 — — $29,968.07 $93,701.29 $64,772.68 2026-05-22
467 OTHER Revision Of Hip Or Knee Replacement With Cc 80 9 — — $29,638.61 $92,627.68 $64,888.82 2026-05-22
442 SOI-4 OTHER Kidney And Urinary Tract Procedures For Malignancy 19 7 — — $61,674.06 $69,332.59 $64,920.52 2026-05-22
279 OTHER Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 52 9 — — $29,085.18 $86,656.59 $64,959.60 2026-05-22
589 SOI-4 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 19 7 — — $62,205.61 $69,930.15 $65,480.05 2026-05-22
609 SOI-1 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 19 7 — — $62,330.08 $70,070.07 $65,611.07 2026-05-22
609 SOI-2 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 19 7 — — $62,330.08 $70,070.07 $65,611.07 2026-05-22
414 OTHER Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 80 9 — — $30,290.88 $94,753.26 $65,971.85 2026-05-22
408 OTHER Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 80 9 — — $30,270.13 $94,685.66 $65,974.85 2026-05-22
332 OTHER Rectal Resection With Mcc 80 9 — — $29,999.60 $93,804.05 $66,158.54 2026-05-22
029 SOI-4 OTHER Other Percutaneous Intracranial Procedures 19 7 — — $62,890.91 $70,700.55 $66,201.42 2026-05-22
863 SOI-3 OTHER Neonatal Aftercare 19 7 — — $62,896.77 $70,707.13 $66,207.59 2026-05-22
495 OTHER Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 80 9 — — $30,430.30 $95,207.59 $66,704.04 2026-05-22
510 SOI-4 OTHER Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 19 7 — — $63,582.07 $71,477.53 $66,928.96 2026-05-22
511 SOI-4 OTHER Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 19 7 — — $63,596.71 $71,493.99 $66,944.37 2026-05-22
177 SOI-3 OTHER Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 19 7 — — $63,606.96 $71,505.51 $66,955.16 2026-05-22
167 SOI-3 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 19 7 — — $63,606.96 $71,505.51 $66,955.16 2026-05-22
265 OTHER Aicd Lead Procedures 80 9 — — $30,817.01 $96,467.79 $67,085.49 2026-05-22
97 OTHER Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 80 9 — — $30,961.41 $96,938.34 $67,195.38 2026-05-22
163 SOI-3 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 19 7 — — $63,999.40 $71,946.68 $67,368.26 2026-05-22
492 OTHER Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 80 9 — — $30,684.23 $96,035.10 $67,413.82 2026-05-22
220 SOI-4 OTHER Major Stomach, Esophageal And Duodenal Procedures 19 7 — — $64,091.65 $72,050.39 $67,465.36 2026-05-22
987 OTHER Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 82 9 — — $30,281.75 $94,723.52 $67,532.06 2026-05-22
166 OTHER Other Respiratory System O.r. Procedures With Mcc 82 9 — — $33,166.33 $104,123.66 $67,565.06 2026-05-22
603 SOI-2 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 19 7 — — $64,448.94 $72,452.05 $67,841.47 2026-05-22
260 SOI-4 OTHER Major Pancreas, Liver And Shunt Procedures 19 7 — — $64,760.84 $72,802.68 $68,169.78 2026-05-22
518 OTHER Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 80 9 — — $30,956.43 $96,922.11 $68,323.74 2026-05-22
263 SOI-4 OTHER Cholecystectomy 19 7 — — $64,926.31 $72,988.70 $68,343.96 2026-05-22
695 SOI-4 OTHER Chemotherapy For Acute Leukemia 19 7 — — $64,979.03 $73,047.96 $68,399.45 2026-05-22
24 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 84 9 — — $27,087.18 $102,809.37 $68,707.95 2026-05-22
622 OTHER Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 80 9 — — $32,267.60 $101,194.91 $68,905.19 2026-05-22
710 SOI-4 OTHER Infectious And Parasitic Diseases Including HIV With O.r. Procedure 19 7 — — $65,471.04 $73,601.06 $68,917.36 2026-05-22
176 SOI-4 OTHER Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 19 7 — — $65,541.32 $73,680.08 $68,991.35 2026-05-22
802 OTHER Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 80 9 — — $30,963.06 $96,943.75 $69,120.32 2026-05-22
951 SOI-4 OTHER Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 19 7 — — $66,538.52 $74,801.11 $70,041.04 2026-05-22
613 SOI-3 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 19 7 — — $66,822.60 $75,120.46 $70,340.07 2026-05-22
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 46 9 — — $31,377.04 $157,810.65 $70,394.52 2026-05-22
181 SOI-4 OTHER Lower Extremity Arterial Procedures 19 7 — — $67,383.43 $75,750.94 $70,930.42 2026-05-22
009 SOI-2 OTHER Extracorporeal Membrane Oxygenation (ecmo) 19 7 — — $67,531.33 $75,917.20 $71,086.10 2026-05-22
009 SOI-1 OTHER Extracorporeal Membrane Oxygenation (ecmo) 19 7 — — $67,531.33 $75,917.20 $71,086.10 2026-05-22
40 OTHER Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 80 9 — — $32,517.39 $102,008.90 $71,256.71 2026-05-22
876 OTHER O.r. Procedures With Principal Diagnosis Of Mental Illness 80 9 — — $33,824.41 $106,268.17 $71,380.04 2026-05-22
841 SOI-1 OTHER Extensive Third Degree Burns With Skin Graft 19 7 — — $68,465.56 $76,967.44 $72,069.51 2026-05-22
841 SOI-2 OTHER Extensive Third Degree Burns With Skin Graft 19 7 — — $68,465.56 $76,967.44 $72,069.51 2026-05-22
34 OTHER Carotid Artery Stent Procedures With Mcc 80 9 — — $33,485.00 $105,162.11 $72,466.58 2026-05-22
736 OTHER Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 80 9 — — $33,890.80 $106,484.52 $72,506.96 2026-05-22
229 SOI-4 OTHER Other Digestive System And Abdominal Procedures 19 7 — — $68,925.36 $77,484.33 $72,553.51 2026-05-22
628 OTHER Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 80 9 — — $33,958.02 $106,703.57 $72,656.12 2026-05-22
623 SOI-4 OTHER Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 19 7 — — $69,328.04 $77,937.03 $72,977.40 2026-05-22
739 OTHER Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 80 9 — — $34,250.13 $107,655.48 $73,304.29 2026-05-22
907 OTHER Other O.r. Procedures For Injuries With Mcc 80 9 — — $34,273.36 $107,731.20 $73,355.86 2026-05-22
447 SOI-4 OTHER Other Kidney, Urinary Tract And Related Procedures 19 7 — — $69,695.59 $78,350.21 $73,364.29 2026-05-22
232 SOI-4 OTHER Gastric Fundoplication 19 7 — — $69,897.66 $78,577.38 $73,577.00 2026-05-22
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 82 9 — — $32,934.80 $153,380.57 $73,695.87 2026-05-22
261 SOI-4 OTHER Major Biliary Tract Procedures 19 7 — — $70,443.85 $79,191.39 $74,151.94 2026-05-22
026 SOI-4 OTHER Other Nervous System And Related Procedures 19 7 — — $70,856.79 $79,655.61 $74,586.61 2026-05-22
273 OTHER Percutaneous And Other Intracardiac Procedures With Mcc 80 9 — — $33,664.25 $105,746.24 $74,977.43 2026-05-22
329 OTHER Major Small And Large Bowel Procedures With Mcc 112 10 $13,479.00 $6,739.50 50% off $282.50 $124,178.75 $74,981.14 2026-05-22
179 SOI-4 OTHER Defibrillator Implants 19 7 — — $71,628.49 $80,523.13 $75,398.93 2026-05-22
608 SOI-3 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 19 7 — — $71,843.74 $80,765.11 $75,625.52 2026-05-22
607 SOI-2 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 19 7 — — $71,868.63 $80,793.10 $75,651.72 2026-05-22
958 OTHER Other O.r. Procedures For Multiple Significant Trauma With Cc 82 9 — — $35,319.81 $111,141.32 $76,162.03 2026-05-22
611 SOI-3 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 19 7 — — $72,395.79 $81,385.71 $76,206.62 2026-05-22
121 SOI-4 OTHER Other Respiratory And Chest Procedures 19 7 — — $72,417.75 $81,410.40 $76,229.74 2026-05-22
405 SOI-4 OTHER Other Procedures For Endocrine, Nutritional And Metabolic Disorders 19 7 — — $73,023.98 $82,091.91 $76,867.88 2026-05-22
404 SOI-4 OTHER Thyroid, Parathyroid And Thyroglossal Procedures 19 7 — — $73,211.41 $82,302.62 $77,065.18 2026-05-22
022 SOI-4 OTHER Ventricular Shunt Procedures 19 7 — — $73,283.16 $82,383.28 $77,140.71 2026-05-22
236 OTHER Coronary Bypass Without Cardiac Catheterization Without Mcc 80 9 — — $35,338.90 $111,203.52 $77,494.83 2026-05-22
12 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 80 9 — — $35,269.19 $110,976.36 $77,659.66 2026-05-22
178 SOI-2 OTHER External Heart Assist Systems 19 7 — — $73,798.60 $82,962.73 $77,683.28 2026-05-22
165 SOI-4 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 19 7 — — $73,887.92 $83,063.14 $77,777.30 2026-05-22
269 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 80 9 — — $35,742.21 $112,517.81 $78,274.21 2026-05-22
160 SOI-3 OTHER Major Cardiothoracic Repair Of Heart Anomaly 19 7 — — $74,377.01 $83,612.96 $78,292.13 2026-05-22
673 OTHER Other Kidney And Urinary Tract Procedures With Mcc 80 9 — — $35,982.04 $113,299.35 $78,357.61 2026-05-22
089 SOI-4 OTHER Major Cranial Or Facial Bone Procedures 19 7 — — $74,539.55 $83,795.68 $78,463.23 2026-05-22
140 OTHER Major Head And Neck Procedures With Mcc 80 9 — — $36,310.66 $114,370.26 $79,315.01 2026-05-22
356 OTHER Other Digestive System O.r. Procedures With Mcc 82 9 — — $36,613.56 $115,357.33 $79,395.47 2026-05-22
458 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 84 9 — — $37,047.57 $116,771.67 $79,511.65 2026-05-22
933 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 80 9 — — $37,121.43 $117,012.36 $79,675.54 2026-05-22
448 OTHER Multiple Level Spinal Fusion Except Cervical Without Mcc 52 9 — — $36,600.21 $110,430.09 $79,714.46 2026-05-22
178 SOI-3 OTHER External Heart Assist Systems 19 7 — — $75,876.47 $85,298.61 $79,870.52 2026-05-22
005 SOI-2 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 19 7 — — $76,084.40 $85,532.37 $80,089.40 2026-05-22
092 SOI-4 OTHER Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 19 7 — — $76,276.22 $85,748.01 $80,291.32 2026-05-22
31 OTHER Ventricular Shunt Procedures With Mcc 80 9 — — $35,990.33 $113,326.40 $80,801.05 2026-05-22
004 SOI-1 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 19 7 — — $76,941.02 $86,495.37 $80,991.12 2026-05-22
021 SOI-4 OTHER Open Craniotomy Except Trauma 19 7 — — $78,086.12 $87,782.66 $82,196.49 2026-05-22
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 80 9 — — $38,430.94 $121,279.74 $82,581.27 2026-05-22
912 SOI-4 OTHER Musculoskeletal And Other Procedures For Multiple Significant Trauma 19 7 — — $78,500.52 $88,248.52 $82,632.70 2026-05-22
319 OTHER Other Endovascular Cardiac Valve Procedures With Mcc 80 9 — — $37,668.30 $118,794.49 $82,677.82 2026-05-22
027 SOI-4 OTHER Other Open Craniotomy 19 7 — — $78,952.99 $88,757.18 $83,108.99 2026-05-22
091 SOI-4 OTHER Other Major Head And Neck Procedures 19 7 — — $79,661.72 $89,553.91 $83,855.03 2026-05-22
230 SOI-4 OTHER Major Small Bowel Procedures 19 7 — — $79,784.73 $89,692.19 $83,984.51 2026-05-22
6 OTHER Liver Transplant Without Mcc 46 9 — — $43,145.84 $131,136.92 $84,051.18 2026-05-22
401 SOI-4 OTHER Adrenal Procedures 19 7 — — $79,938.48 $89,865.04 $84,146.35 2026-05-22
178 SOI-4 OTHER External Heart Assist Systems 19 7 — — $79,991.19 $89,924.30 $84,201.84 2026-05-22
120 SOI-4 OTHER Major Respiratory And Chest Procedures 19 7 — — $80,266.49 $90,233.78 $84,491.63 2026-05-22
612 SOI-3 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 19 7 — — $80,335.31 $90,311.14 $84,564.07 2026-05-22
856 OTHER Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 80 9 — — $38,654.17 $122,007.20 $84,598.42 2026-05-22
981 OTHER Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 82 9 — — $40,664.91 $128,559.72 $84,799.59 2026-05-22
023 SOI-4 OTHER Spinal Procedures 19 7 — — $80,680.89 $90,699.64 $84,927.84 2026-05-22
163 OTHER Major Chest Procedures With Mcc 84 9 — — $39,464.11 $128,327.88 $84,934.71 2026-05-22
130 SOI-4 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 19 7 — — $81,571.19 $91,700.50 $85,865.01 2026-05-22
25 OTHER Craniotomy And Endovascular Intracranial Procedures With Mcc 82 9 — — $38,328.04 $316,730.53 $86,225.94 2026-05-22
823 OTHER Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 80 9 — — $40,047.50 $126,547.72 $86,543.22 2026-05-22
614 SOI-4 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 19 7 — — $82,339.96 $92,564.73 $86,674.24 2026-05-22
167 SOI-4 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 19 7 — — $82,682.61 $92,949.92 $87,034.93 2026-05-22
799 OTHER Splenic Procedures With Mcc 80 9 — — $40,672.38 $128,584.06 $87,554.88 2026-05-22
911 SOI-4 OTHER Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 19 7 — — $83,351.80 $93,702.22 $87,739.35 2026-05-22
826 OTHER Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 80 9 — — $40,844.16 $129,143.85 $88,309.10 2026-05-22
267 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 80 9 — — $40,256.62 $127,229.20 $88,376.66 2026-05-22
221 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 80 9 — — $39,326.36 $124,197.68 $88,552.22 2026-05-22
169 SOI-4 OTHER Major Abdominal Vascular Procedures 19 7 — — $84,211.35 $94,668.51 $88,644.15 2026-05-22
277 OTHER Cardiac Defibrillator Implant Without Mcc 52 9 — — $41,459.21 $125,801.33 $88,889.05 2026-05-22
162 SOI-3 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 19 7 — — $85,305.20 $95,898.18 $89,795.57 2026-05-22
245 OTHER Aicd Generator Procedures 80 9 — — $41,767.79 $132,153.73 $89,985.54 2026-05-22
183 SOI-4 OTHER Percutaneous Structural Cardiac Procedures 19 7 — — $85,628.81 $96,261.98 $90,136.22 2026-05-22
326 OTHER Stomach, Esophageal And Duodenal Procedures With Mcc 82 9 — — $43,362.78 $137,351.40 $90,142.27 2026-05-22
441 SOI-4 OTHER Major Bladder Procedures 19 7 — — $86,735.83 $97,506.47 $91,301.51 2026-05-22
837 OTHER Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 80 9 — — $42,766.94 $135,409.71 $92,202.59 2026-05-22
228 OTHER Other Cardiothoracic Procedures With Mcc 80 9 — — $42,568.60 $134,763.38 $92,748.67 2026-05-22
853 OTHER Infectious And Parasitic Diseases With O.r. Procedures With Mcc 84 9 — — $42,717.98 $251,938.08 $92,842.66 2026-05-22
651 SOI-4 OTHER Other Procedures Of Blood And Blood-forming Organs 19 7 — — $88,352.44 $99,323.82 $93,003.21 2026-05-22
239 OTHER Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 80 9 — — $43,013.41 $136,212.89 $93,033.12 2026-05-22
650 OTHER Kidney Transplant With Hemodialysis With Mcc 48 9 — — $41,077.95 $206,660.16 $93,399.19 2026-05-22
177 SOI-4 OTHER Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 19 7 — — $88,944.02 $99,988.87 $93,625.94 2026-05-22
005 SOI-3 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 19 7 — — $90,279.48 $101,490.16 $95,031.69 2026-05-22
950 SOI-4 OTHER Extensive O.r. Procedure Unrelated To Principal Diagnosis 19 7 — — $90,364.41 $101,585.63 $95,121.09 2026-05-22
621 SOI-4 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 19 7 — — $90,570.88 $101,817.74 $95,338.43 2026-05-22
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 80 9 — — $43,492.23 $137,773.27 $96,153.14 2026-05-22
361 SOI-4 OTHER Skin Graft For Skin And Subcutaneous Tissue Diagnoses 19 7 — — $91,625.19 $103,002.97 $96,448.24 2026-05-22
11 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 82 9 — — $45,992.59 $145,921.32 $98,577.40 2026-05-22
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 82 9 — — $46,264.78 $146,808.33 $98,873.82 2026-05-22
608 SOI-4 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 19 7 — — $94,063.27 $105,743.81 $99,014.66 2026-05-22
440 SOI-2 OTHER Kidney Transplant 19 7 — — $94,136.49 $105,826.12 $99,091.73 2026-05-22
834 OTHER Acute Leukemia Without Major O.r. Procedures With Mcc 82 9 — — $47,083.02 $149,474.77 $99,224.45 2026-05-22
576 OTHER Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 80 9 — — $45,987.61 $145,905.10 $99,349.05 2026-05-22
163 SOI-4 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 19 7 — — $94,653.39 $106,407.21 $99,635.84 2026-05-22
633 SOI-4 OTHER Neonate Birth Weight > 2499 Grams With Major Anomaly 19 7 — — $95,510.02 $107,370.21 $100,537.56 2026-05-22
234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 80 9 — — $45,364.39 $143,874.17 $100,653.15 2026-05-22
23 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 84 9 — — $48,558.51 $154,283.02 $101,841.26 2026-05-22
220 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 82 9 — — $45,169.37 $328,383.70 $102,120.38 2026-05-22
653 OTHER Major Bladder Procedures With Mcc 80 9 — — $47,475.54 $150,753.91 $102,650.68 2026-05-22
607 SOI-3 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 19 7 — — $97,726.99 $109,862.48 $102,871.23 2026-05-22
21 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 82 9 — — $45,536.17 $365,085.74 $102,972.55 2026-05-22
463 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 80 9 — — $46,034.91 $146,059.24 $103,572.02 2026-05-22
890 SOI-4 OTHER HIV With Multiple Major HIV Related Conditions 19 7 — — $99,040.48 $111,339.08 $104,253.86 2026-05-22
020 SOI-4 OTHER Open Craniotomy For Trauma 19 7 — — $99,135.66 $111,446.08 $104,354.06 2026-05-22
591 SOI-1 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 19 7 — — $99,308.45 $111,640.32 $104,535.94 2026-05-22
17 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 46 9 — — $53,290.42 $163,228.84 $104,620.25 2026-05-22
625 SOI-4 OTHER Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 19 7 — — $99,412.42 $111,757.20 $104,645.38 2026-05-22
004 SOI-2 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 19 7 — — $99,438.78 $111,786.83 $104,673.12 2026-05-22
304 SOI-4 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 19 7 — — $99,904.43 $112,310.31 $105,163.29 2026-05-22
790 OTHER Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 54 9 — — $25,116.00 $316,280.25 $105,554.68 2026-05-22
428 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 52 9 — — $48,744.29 $148,847.38 $106,595.57 2026-05-22
16 OTHER Autologous Bone Marrow Transplant With Cc/mcc 46 9 — — $53,290.42 $163,228.84 $107,173.40 2026-05-22
312 SOI-4 OTHER Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 19 7 — — $102,096.51 $114,774.60 $107,470.76 2026-05-22
630 SOI-2 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 19 7 — — $103,607.68 $116,473.42 $109,061.48 2026-05-22
820 OTHER Lymphoma And Leukemia With Major O.r. Procedures With Mcc 80 9 — — $49,531.10 $157,452.46 $109,127.17 2026-05-22
457 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 80 9 — — $48,843.15 $155,210.59 $109,216.35 2026-05-22
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 80 9 — — $50,044.78 $159,126.42 $109,758.23 2026-05-22
8 OTHER Simultaneous Pancreas And Kidney Transplant 46 9 — — $48,205.73 $254,880.14 $110,301.98 2026-05-22
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 80 9 — — $50,929.40 $162,009.20 $110,314.59 2026-05-22
910 SOI-4 OTHER Craniotomy For Multiple Significant Trauma 19 7 — — $104,988.53 $118,025.74 $110,515.02 2026-05-22
611 SOI-4 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 19 7 — — $105,334.11 $118,414.24 $110,878.79 2026-05-22
841 SOI-3 OTHER Extensive Third Degree Burns With Skin Graft 19 7 — — $105,359.01 $118,442.22 $110,904.99 2026-05-22
863 SOI-4 OTHER Neonatal Aftercare 19 7 — — $106,407.46 $119,620.87 $112,008.63 2026-05-22
28 OTHER Spinal Procedures With Mcc 80 9 — — $51,665.49 $164,407.92 $112,903.38 2026-05-22
266 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 80 9 — — $50,929.40 $162,009.20 $113,133.66 2026-05-22
162 SOI-4 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 19 7 — — $107,542.30 $120,896.63 $113,203.21 2026-05-22
690 SOI-4 OTHER Acute Leukemia 19 7 — — $107,677.02 $121,048.08 $113,345.02 2026-05-22
232 OTHER Coronary Bypass With Ptca Without Mcc 80 9 — — $51,907.81 $165,197.57 $113,675.58 2026-05-22
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 80 9 — — $50,585.01 $160,886.92 $114,711.43 2026-05-22
009 SOI-3 OTHER Extracorporeal Membrane Oxygenation (ecmo) 19 7 — — $108,987.58 $122,521.38 $114,724.57 2026-05-22
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 82 9 — — $54,882.84 $174,892.49 $116,300.77 2026-05-22
969 OTHER HIV With Extensive O.r. Procedures With Mcc 80 9 — — $53,696.98 $171,028.04 $116,455.66 2026-05-22
603 SOI-3 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 19 7 — — $110,800.40 $124,559.32 $116,632.82 2026-05-22
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 80 9 — — $52,318.58 $166,536.20 $118,570.05 2026-05-22
303 SOI-4 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 19 7 — — $113,711.46 $127,831.87 $119,697.11 2026-05-22
602 SOI-2 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 19 7 — — $114,216.65 $128,399.79 $120,228.89 2026-05-22
631 SOI-3 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 19 7 — — $115,095.24 $129,387.48 $121,153.73 2026-05-22
850 SOI-4 OTHER Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 19 7 — — $115,332.46 $129,654.16 $121,403.44 2026-05-22
004 SOI-3 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 19 7 — — $115,364.68 $129,690.37 $121,437.35 2026-05-22
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 80 9 — — $54,805.66 $174,640.99 $121,675.14 2026-05-22
593 SOI-2 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 19 7 — — $115,874.26 $130,263.23 $121,973.75 2026-05-22
440 SOI-3 OTHER Kidney Transplant 19 7 — — $116,288.66 $130,729.09 $122,409.97 2026-05-22
317 OTHER Concomitant Left Atrial Appendage Closure And Cardiac Ablation 52 9 — — $54,576.97 $167,298.82 $123,131.25 2026-05-22
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 82 9 — — $58,943.33 $188,124.63 $124,923.87 2026-05-22
440 SOI-4 OTHER Kidney Transplant 19 7 — — $119,037.18 $133,818.92 $125,303.17 2026-05-22
268 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 84 9 — — $56,545.87 $277,321.86 $126,431.24 2026-05-22
955 OTHER Craniotomy For Multiple Significant Trauma 80 9 — — $57,879.45 $184,657.72 $126,653.76 2026-05-22
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 52 9 — — $59,007.69 $181,315.20 $128,340.46 2026-05-22
928 OTHER Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 80 9 — — $56,639.65 $180,617.49 $128,779.21 2026-05-22
612 SOI-4 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 19 7 — — $122,738.97 $137,980.39 $129,199.82 2026-05-22
613 SOI-4 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 19 7 — — $124,332.15 $139,771.40 $130,876.86 2026-05-22
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 84 9 — — $63,156.51 $201,854.36 $134,351.92 2026-05-22
427 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 52 9 — — $62,410.02 $192,078.32 $137,227.45 2026-05-22
19 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 46 9 — — $69,459.16 $214,377.97 $137,403.89 2026-05-22
607 SOI-4 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 19 7 — — $131,226.15 $147,521.48 $138,133.75 2026-05-22
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 82 9 — — $66,079.26 $211,378.91 $138,179.34 2026-05-22
588 SOI-1 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 19 7 — — $135,736.24 $152,591.63 $142,881.25 2026-05-22
588 SOI-2 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 19 7 — — $135,736.24 $152,591.63 $142,881.25 2026-05-22
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 84 9 — — $65,424.50 $354,355.62 $143,978.29 2026-05-22
591 SOI-2 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 19 7 — — $137,737.96 $154,841.92 $144,988.34 2026-05-22
630 SOI-3 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 19 7 — — $138,906.49 $156,155.54 $146,218.37 2026-05-22
588 SOI-3 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 19 7 — — $141,653.54 $159,243.72 $149,110.03 2026-05-22
10 OTHER Pancreas Transplant 46 9 — — $69,849.83 $215,613.84 $154,635.72 2026-05-22
20 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 82 9 — — $68,109.92 $331,138.32 $155,418.01 2026-05-22
456 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 80 9 — — $71,496.56 $229,032.58 $157,584.61 2026-05-22
231 OTHER Coronary Bypass With Ptca With Mcc 80 9 — — $71,535.56 $229,159.68 $157,869.40 2026-05-22
602 SOI-3 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 19 7 — — $151,337.07 $170,129.72 $159,303.28 2026-05-22
850 OTHER Acute Leukemia With Other Procedures 54 9 — — $80,440.63 $249,117.41 $159,669.86 2026-05-22
609 SOI-3 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 19 7 — — $155,302.43 $174,587.50 $163,477.38 2026-05-22
842 SOI-4 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 19 7 — — $155,400.54 $174,697.79 $163,580.66 2026-05-22
005 SOI-4 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 19 7 — — $157,427.16 $176,976.06 $165,713.95 2026-05-22
591 SOI-3 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 19 7 — — $166,807.57 $187,521.31 $175,588.13 2026-05-22
602 SOI-4 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 19 7 — — $167,306.90 $188,082.65 $176,113.75 2026-05-22
161 SOI-1 OTHER Implantable Heart Assist Systems 19 7 — — $167,311.29 $188,087.58 $176,118.37 2026-05-22
681 SOI-4 OTHER Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 19 7 — — $168,056.63 $188,925.47 $176,902.94 2026-05-22
680 SOI-4 OTHER Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 19 7 — — $170,247.24 $191,388.12 $179,208.87 2026-05-22
593 SOI-3 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 19 7 — — $170,985.26 $192,217.78 $179,985.74 2026-05-22
161 SOI-2 OTHER Implantable Heart Assist Systems 19 7 — — $176,158.69 $198,033.63 $185,431.49 2026-05-22
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 82 9 — — $81,304.63 $507,782.24 $186,073.21 2026-05-22
5 OTHER Liver Transplant With Mcc Or Intestinal Transplant 46 9 — — $92,729.18 $287,991.72 $186,351.98 2026-05-22
161 SOI-3 OTHER Implantable Heart Assist Systems 19 7 — — $180,435.96 $202,842.04 $189,933.91 2026-05-22
2 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 46 9 — — $82,087.08 $645,542.00 $190,648.02 2026-05-22
792 SOI-4 OTHER Extensive O.r. Procedures For Other Complications Of Treatment 19 7 — — $184,941.66 $207,907.24 $194,676.78 2026-05-22
215 OTHER Other Heart Assist System Implant 80 9 — — $89,135.98 $286,515.18 $195,092.64 2026-05-22
426 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 52 9 — — $91,241.73 $283,286.24 $205,777.24 2026-05-22
212 OTHER Concomitant Aortic And Mitral Valve�procedures 52 9 — — $94,819.31 $294,603.74 $208,689.81 2026-05-22
583 SOI-1 OTHER Neonate With Ecmo 19 7 — — $205,712.98 $231,257.90 $216,541.49 2026-05-22
14 OTHER Allogeneic Bone Marrow Transplant 46 9 — — $113,693.66 $354,311.98 $227,093.50 2026-05-22
004 SOI-4 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 19 7 — — $215,983.69 $242,804.00 $227,352.84 2026-05-22
603 SOI-4 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 19 7 — — $221,848.28 $249,396.84 $233,526.13 2026-05-22
589 SOI-3 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 19 7 — — $223,267.20 $250,991.96 $235,019.74 2026-05-22
009 SOI-4 OTHER Extracorporeal Membrane Oxygenation (ecmo) 19 7 — — $225,058.06 $253,005.20 $236,904.87 2026-05-22
4 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 57 8 — — $118,473.06 $2,379,509.90 $240,474.98 2026-05-22
593 SOI-4 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 19 7 — — $247,987.78 $278,782.28 $261,041.59 2026-05-22
7 OTHER Lung Transplant 48 9 — — $113,411.56 $416,988.97 $264,930.71 2026-05-22
631 SOI-4 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 19 7 — — $268,602.43 $301,956.80 $282,741.36 2026-05-22
591 SOI-4 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 19 7 — — $284,077.32 $319,353.32 $299,030.84 2026-05-22
160 SOI-4 OTHER Major Cardiothoracic Repair Of Heart Anomaly 19 7 — — $298,861.05 $335,972.86 $314,592.77 2026-05-22
841 SOI-4 OTHER Extensive Third Degree Burns With Skin Graft 19 7 — — $315,312.64 $354,467.37 $331,910.36 2026-05-22
609 SOI-4 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 19 7 — — $321,464.24 $361,382.85 $338,385.76 2026-05-22
583 SOI-2 OTHER Neonate With Ecmo 19 7 — — $328,651.10 $369,462.16 $345,950.93 2026-05-22
3 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 65 9 — — $90,363.00 $587,692.80 $346,827.06 2026-05-22
630 SOI-4 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 19 7 — — $336,750.23 $378,567.03 $354,476.40 2026-05-22
927 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 80 9 — — $168,117.55 $543,896.93 $386,827.04 2026-05-22
161 SOI-4 OTHER Implantable Heart Assist Systems 19 7 — — $372,081.25 $418,285.36 $391,667.20 2026-05-22
588 SOI-4 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 19 7 — — $384,177.97 $431,884.21 $404,400.67 2026-05-22
583 SOI-3 OTHER Neonate With Ecmo 19 7 — — $477,645.26 $536,958.04 $502,787.99 2026-05-22
589 SOI-2 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 19 7 — — $480,401.10 $540,056.10 $505,688.89 2026-05-22
589 SOI-1 OTHER Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 19 7 — — $498,021.22 $559,864.24 $524,236.51 2026-05-22
1 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 48 9 — — $242,490.50 $761,755.34 $544,211.05 2026-05-22
891 OTHER Axicabtagene Ciloleucel 200000000 Cells Susp 1 Each Package 40 8 $1,762,530.00 $881,265.00 50% off $55,195.16 $1,374,773.40 $549,227.07 2026-05-22
583 SOI-4 OTHER Neonate With Ecmo 19 7 — — $543,795.74 $611,322.92 $572,420.55 2026-05-22
18 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 80 9 — — $314,176.39 $1,019,867.25 $727,159.35 2026-05-22
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