Hospital

CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC

Norfolk, VA · CCN 493301 · Rates published

33,771 distinct procedures filed

27 distinct payers

685,496 rate rows

2026-05-13 last MRF observed

Data quality

678,299 of 685,496 rate rows are consumer-grade (99.0%)

7,197 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
exceeds 10× this hospital's gross charge — excluded from medians	3,358
placeholder amount (≤ $0.02) — excluded from medians	1,910
template filing: same amount across many unrelated codes — excluded	1,283
per-diem day rate — not a per-procedure price	610
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	36

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

Source MRF file	https://www.chkd.org/media/5yhlxvtl/540506321_childrens-hospital-of-the-kings-daughters_standardcharges.csv
Found on page	https://www.chkd.org/Billing/Price-Transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	a06789f7b02964a7… · 93,452,683 bytes · first seen 2026-05-13

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
1980005 OTHER	Elevidys 1.33e13 VG/mL Inj (Home Supply)	1	$2,700,000.00	$2,700,000.00	$2,700,000.00	nat. median $2,700,000 1.0× median
1980009 OTHER	Tisagenlecleucel (all) Soln	20	$57,245.42	$1,691,570.00	$1,347,914.20	nat. median $1,347,914 1.0× median
1980010 OTHER	Tisagenlecleucel (dlbcl/fl) Soln	20	$57,245.42	$1,393,441.76	$1,110,353.07	nat. median $249 outlier · 4461.9×
583-4 OTHER	Neonate With Ecmo	6	$568,011.94	$1,013,083.72	$647,307.06	nat. median $309,400 outlier · 2.1×
589-1 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	6	$520,199.00	$927,806.44	$592,819.38	nat. median $86,371 outlier · 6.9×
589-2 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	6	$501,794.23	$894,980.42	$571,845.28	nat. median $49,980 outlier · 11.4×
583-3 OTHER	Neonate With Ecmo	6	$498,915.66	$889,846.32	$568,564.85	nat. median $259,487 outlier · 2.2×
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	6	$401,286.10	$715,718.08	$457,306.10	nat. median $267,493 1.7× median
161-4 OTHER	Implantable Heart Assist Systems	6	$388,650.70	$693,182.07	$442,906.78	nat. median $202,242 outlier · 2.2×
5060001 OTHER	Kidney Acqui-lvng Dnr-sng	8	$313,024.87	$433,709.16	$424,280.70	nat. median $8 outlier · 54255.8×
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	6	$351,746.33	$627,360.89	$400,850.51	nat. median $210,669 1.9× median
583-2 OTHER	Neonate With Ecmo	6	$343,286.52	$612,272.32	$391,209.71	nat. median $191,347 outlier · 2.0×
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	$335,779.62	$598,883.30	$382,654.83	nat. median $169,856 outlier · 2.3×
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	6	$329,354.08	$587,422.97	$375,332.29	nat. median $151,691 outlier · 2.5×
011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	$312,887.22	$558,053.32	$356,566.64	nat. median $105,647 outlier · 3.4×
160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	6	$312,169.87	$556,773.89	$355,749.15	nat. median $106,926 outlier · 3.3×
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	6	$296,727.79	$529,232.00	$338,151.33	nat. median $156,696 outlier · 2.2×
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	6	$280,563.78	$500,402.49	$319,730.80	nat. median $203,379 1.6× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	6	$259,031.13	$461,997.71	$295,192.17	nat. median $151,250 2.0× median
681 OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	1	$279,457.22	$279,457.22	$279,457.22	nat. median $0
453 OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	6	$5,793.00	$279,128.73	$273,655.62	nat. median $65,342 outlier · 4.2×
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	$235,080.30	$419,279.96	$267,897.78	nat. median $150,954 1.8× median
589-3 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	6	$233,209.69	$415,943.62	$265,766.03	nat. median $87,000 outlier · 3.1×
603-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	6	$231,727.58	$413,300.18	$264,077.02	nat. median $107,050 outlier · 2.5×
004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	$225,601.83	$402,374.54	$257,096.11	nat. median $110,000 outlier · 2.3×
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	$5,793.00	$254,932.91	$249,934.22	nat. median $386,529 0.6× median
583-1 OTHER	Neonate With Ecmo	6	$214,873.75	$383,240.35	$244,870.36	nat. median $171,226 1.4× median
792-4 OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	6	$193,177.44	$344,543.67	$220,145.23	nat. median $43,650 outlier · 5.0×
161-3 OTHER	Implantable Heart Assist Systems	6	$188,471.09	$336,149.62	$214,781.87	nat. median $152,491 1.4× median
161-2 OTHER	Implantable Heart Assist Systems	6	$184,003.35	$328,181.13	$209,690.43	nat. median $109,992 1.9× median
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	6	$178,599.54	$318,543.10	$203,532.24	nat. median $112,711 1.8× median
680-4 OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	6	$177,828.66	$317,168.19	$202,653.74	nat. median $61,090 outlier · 3.3×
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	$177,798.07	$317,113.63	$202,618.89	nat. median $171,094 1.2× median
681-4 OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	6	$175,540.49	$313,087.10	$200,046.15	nat. median $52,952 outlier · 3.8×
161-1 OTHER	Implantable Heart Assist Systems	6	$174,761.96	$311,698.55	$199,158.93	nat. median $101,352 2.0× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	6	$174,757.37	$311,690.37	$199,153.71	nat. median $125,000 1.6× median
591-3 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	6	$174,235.81	$310,760.12	$198,559.32	nat. median $99,157 outlier · 2.0×
005-4 OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	6	$164,437.67	$293,284.55	$187,393.35	nat. median $88,000 outlier · 2.1×
842-4 OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	6	$162,320.81	$289,509.00	$184,980.98	nat. median $83,517 outlier · 2.2×
609-3 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	$162,218.33	$289,326.22	$184,864.20	nat. median $83,785 outlier · 2.2×
602-3 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	6	$158,076.38	$281,938.80	$180,144.02	nat. median $99,067 1.8× median
459 OTHER	Spinal Fusion Except Cervical With Mcc	6	$5,793.00	$180,513.35	$176,973.88	nat. median $50,246 outlier · 3.5×
15065851 OTHER	Set Univ Frag Elbow Impl	14	$49,375.90	$203,943.92	$176,465.16	nat. median $176,465 1.0× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	6	$147,961.63	$263,898.54	$168,617.24	nat. median $165,000 1.0× median
630-3 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	6	$145,092.24	$258,780.81	$165,347.29	nat. median $95,000 1.7× median
591-2 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	6	$143,871.68	$256,603.86	$163,956.33	nat. median $80,000 outlier · 2.0×
588-1 OTHER	Female Reproductive System Reconstructive Procedures	6	$141,780.82	$252,874.69	$161,573.58	nat. median $75,325 outlier · 2.1×
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	6	$141,780.82	$252,874.69	$161,573.58	nat. median $153,523 1.1× median
3925176 OTHER	Nusinersen 12 Mg/5 Ml Inj	21	$882.79	$562,406.84	$160,285.14	nat. median $160,285 1.0× median
5060002 OTHER	Kidney Acqui-cdvr Dnr-lnt	8	$117,528.00	$162,840.00	$159,300.00	nat. median $12 outlier · 13241.9×

Other procedures at this hospital

Browse this hospital's 33,771 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

1980005	OTHER	Elevidys 1.33e13 VG/mL Inj (Home Supply)	1	1	$0.01	—	$2,700,000.00	$2,700,000.00	$2,700,000.00	2026-05-13
1980009	OTHER	Tisagenlecleucel (all) Soln	25	20	$1,780,600.00	$1,602,540.00	$57,245.42	$1,691,570.00	$1,347,914.20	2026-05-13
1980010	OTHER	Tisagenlecleucel (dlbcl/fl) Soln	25	20	$1,466,780.80	$1,320,102.72	$57,245.42	$1,393,441.76	$1,110,353.07	2026-05-13
583-4	OTHER	Neonate With Ecmo	6	6	—	—	$568,011.94	$1,013,083.72	$647,307.06	2026-05-13
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	6	6	—	—	$520,199.00	$927,806.44	$592,819.38	2026-05-13
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	6	6	—	—	$501,794.23	$894,980.42	$571,845.28	2026-05-13
583-3	OTHER	Neonate With Ecmo	6	6	—	—	$498,915.66	$889,846.32	$568,564.85	2026-05-13
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	6	6	—	—	$401,286.10	$715,718.08	$457,306.10	2026-05-13
161-4	OTHER	Implantable Heart Assist Systems	6	6	—	—	$388,650.70	$693,182.07	$442,906.78	2026-05-13
5060001	OTHER	Kidney Acqui-lvng Dnr-sng	9	8	$471,423.00	$424,280.70	$313,024.87	$433,709.16	$424,280.70	2026-05-13
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	6	6	—	—	$351,746.33	$627,360.89	$400,850.51	2026-05-13
583-2	OTHER	Neonate With Ecmo	6	6	—	—	$343,286.52	$612,272.32	$391,209.71	2026-05-13
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	6	—	—	$335,779.62	$598,883.30	$382,654.83	2026-05-13
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	6	6	—	—	$329,354.08	$587,422.97	$375,332.29	2026-05-13
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	6	—	—	$312,887.22	$558,053.32	$356,566.64	2026-05-13
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	6	6	—	—	$312,169.87	$556,773.89	$355,749.15	2026-05-13
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	6	6	—	—	$296,727.79	$529,232.00	$338,151.33	2026-05-13
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	6	6	—	—	$280,563.78	$500,402.49	$319,730.80	2026-05-13
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	6	6	—	—	$259,031.13	$461,997.71	$295,192.17	2026-05-13
681	OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	1	1	—	—	$279,457.22	$279,457.22	$279,457.22	2026-05-13
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	7	6	—	—	$5,793.00	$279,128.73	$273,655.62	2026-05-13
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$235,080.30	$419,279.96	$267,897.78	2026-05-13
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	6	6	—	—	$233,209.69	$415,943.62	$265,766.03	2026-05-13
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	6	6	—	—	$231,727.58	$413,300.18	$264,077.02	2026-05-13
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	6	—	—	$225,601.83	$402,374.54	$257,096.11	2026-05-13
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	7	6	—	—	$5,793.00	$254,932.91	$249,934.22	2026-05-13
583-1	OTHER	Neonate With Ecmo	6	6	—	—	$214,873.75	$383,240.35	$244,870.36	2026-05-13
792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	6	6	—	—	$193,177.44	$344,543.67	$220,145.23	2026-05-13
161-3	OTHER	Implantable Heart Assist Systems	6	6	—	—	$188,471.09	$336,149.62	$214,781.87	2026-05-13
161-2	OTHER	Implantable Heart Assist Systems	6	6	—	—	$184,003.35	$328,181.13	$209,690.43	2026-05-13
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	6	6	—	—	$178,599.54	$318,543.10	$203,532.24	2026-05-13
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	6	6	—	—	$177,828.66	$317,168.19	$202,653.74	2026-05-13
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	6	—	—	$177,798.07	$317,113.63	$202,618.89	2026-05-13
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	6	6	—	—	$175,540.49	$313,087.10	$200,046.15	2026-05-13
161-1	OTHER	Implantable Heart Assist Systems	6	6	—	—	$174,761.96	$311,698.55	$199,158.93	2026-05-13
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$174,757.37	$311,690.37	$199,153.71	2026-05-13
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	6	6	—	—	$174,235.81	$310,760.12	$198,559.32	2026-05-13
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	6	6	—	—	$164,437.67	$293,284.55	$187,393.35	2026-05-13
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	6	6	—	—	$162,320.81	$289,509.00	$184,980.98	2026-05-13
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	6	—	—	$162,218.33	$289,326.22	$184,864.20	2026-05-13
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$158,076.38	$281,938.80	$180,144.02	2026-05-13
459	OTHER	Spinal Fusion Except Cervical With Mcc	7	6	—	—	$5,793.00	$180,513.35	$176,973.88	2026-05-13
15065851	OTHER	Set Univ Frag Elbow Impl	19	14	$214,677.81	$193,210.03	$49,375.90	$203,943.92	$176,465.16	2026-05-13
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	6	6	—	—	$147,961.63	$263,898.54	$168,617.24	2026-05-13
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	6	6	—	—	$145,092.24	$258,780.81	$165,347.29	2026-05-13
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	6	6	—	—	$143,871.68	$256,603.86	$163,956.33	2026-05-13
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	6	6	—	—	$141,780.82	$252,874.69	$161,573.58	2026-05-13
588-1	OTHER	Female Reproductive System Reconstructive Procedures	6	6	—	—	$141,780.82	$252,874.69	$161,573.58	2026-05-13
3925176	OTHER	Nusinersen 12 Mg/5 Ml Inj	35	21	$592,007.20	$532,806.48	$882.79	$562,406.84	$160,285.14	2026-05-13
5060002	OTHER	Kidney Acqui-cdvr Dnr-lnt	9	8	$177,000.00	$159,300.00	$117,528.00	$162,840.00	$159,300.00	2026-05-13
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$137,069.89	$244,472.45	$156,204.99	2026-05-13
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	7	6	—	—	$5,793.00	$156,811.03	$153,736.31	2026-05-13
3925127	OTHER	Nusinersen 12 Mg/5 Ml Inj (No Charge)	5	4	$0.01	—	$2,572.30	$160,285.14	$152,999.00	2026-05-13
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	6	6	—	—	$129,868.88	$231,629.02	$147,998.73	2026-05-13
455	OTHER	Combined Anterior And Posterior Spinal Fusion Without Cc/mcc	7	6	—	—	$5,793.00	$149,081.52	$146,158.35	2026-05-13
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$128,204.76	$228,660.96	$146,102.29	2026-05-13
440-4	OTHER	Kidney Transplant	6	6	—	—	$124,338.12	$221,764.58	$141,695.86	2026-05-13
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	6	—	—	$123,559.59	$220,376.02	$140,808.65	2026-05-13
440-3	OTHER	Kidney Transplant	6	6	—	—	$121,467.20	$216,644.12	$138,424.17	2026-05-13
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	6	6	—	—	$121,034.35	$215,872.10	$137,930.88	2026-05-13
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	6	—	—	$120,502.07	$214,922.75	$137,324.30	2026-05-13
850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	6	6	—	—	$120,468.42	$214,862.74	$137,285.96	2026-05-13
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	6	6	—	—	$120,220.64	$214,420.80	$137,003.58	2026-05-13
509	OTHER	Arthroscopy	7	6	—	—	$5,793.00	$138,977.74	$136,252.68	2026-05-13
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$119,302.93	$212,784.00	$135,957.75	2026-05-13
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	6	6	—	—	$118,775.24	$211,842.84	$135,356.40	2026-05-13
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	7	6	—	—	$5,793.00	$137,937.80	$135,233.14	2026-05-13
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	6	6	—	—	$115,734.55	$206,419.58	$131,891.23	2026-05-13
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$113,840.99	$203,042.31	$129,733.33	2026-05-13
14	OTHER	Allogeneic Bone Marrow Transplant	7	6	—	—	$5,793.00	$130,963.00	$128,395.10	2026-05-13
7	OTHER	Lung Transplant	7	6	—	—	$5,793.00	$130,819.29	$128,254.21	2026-05-13
690-4	OTHER	Acute Leukemia	6	6	—	—	$112,472.07	$200,600.75	$128,173.30	2026-05-13
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	6	6	—	—	$112,331.35	$200,349.78	$128,012.93	2026-05-13
863-4	OTHER	Neonatal Aftercare	6	6	—	—	$111,145.97	$198,235.58	$126,662.07	2026-05-13
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	6	6	—	—	$110,050.83	$196,282.33	$125,414.05	2026-05-13
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	6	6	—	—	$110,024.83	$196,235.95	$125,384.42	2026-05-13
910-4	OTHER	Craniotomy For Multiple Significant Trauma	6	6	—	—	$109,663.86	$195,592.14	$124,973.06	2026-05-13
630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	6	6	—	—	$108,221.52	$193,019.64	$123,329.37	2026-05-13
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	6	6	—	—	$106,643.05	$190,204.34	$121,530.54	2026-05-13
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	6	6	—	—	$104,353.35	$186,120.53	$118,921.20	2026-05-13
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	8	7	—	—	$5,793.00	$2,392,192.85	$118,685.50	2026-05-13
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	6	—	—	$103,866.96	$185,253.02	$118,366.91	2026-05-13
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	6	6	—	—	$103,839.43	$185,203.92	$118,335.54	2026-05-13
591-1	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	6	6	—	—	$103,730.84	$185,010.23	$118,211.78	2026-05-13
020-4	OTHER	Open Craniotomy For Trauma	6	6	—	—	$103,550.35	$184,688.33	$118,006.10	2026-05-13
890-4	OTHER	HIV With Multiple Major HIV Related Conditions	6	6	—	—	$103,450.93	$184,511.01	$117,892.80	2026-05-13
3925055	OTHER	Glucarpidase 10 Units Inj	47	21	$143,225.60	$128,903.04	$897.38	$160,221.02	$117,731.44	2026-05-13
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$102,078.95	$182,063.99	$116,329.29	2026-05-13
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	6	6	—	—	$99,763.25	$177,933.80	$113,690.31	2026-05-13
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	6	6	—	—	$98,868.48	$176,337.92	$112,670.63	2026-05-13
440-2	OTHER	Kidney Transplant	6	6	—	—	$98,328.55	$175,374.94	$112,055.33	2026-05-13
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	6	6	—	—	$98,252.08	$175,238.54	$111,968.18	2026-05-13
361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	6	6	—	—	$95,705.42	$170,696.42	$109,066.01	2026-05-13
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	6	6	—	—	$94,604.16	$168,732.26	$107,811.01	2026-05-13
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	6	6	—	—	$94,388.50	$168,347.61	$107,565.24	2026-05-13
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	6	6	—	—	$94,299.79	$168,189.38	$107,464.15	2026-05-13
177-4	OTHER	Cardiac Pacemaker And Defibrillator Revision Except Device Replacement	6	6	—	—	$92,904.86	$165,701.45	$105,874.49	2026-05-13
651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	6	6	—	—	$92,286.93	$164,599.34	$105,170.29	2026-05-13
441-4	OTHER	Major Bladder Procedures	6	6	—	—	$90,598.34	$161,587.62	$103,245.97	2026-05-13
183-4	OTHER	Percutaneous Structural Cardiac Procedures	6	6	—	—	$89,442.02	$159,525.26	$101,928.22	2026-05-13
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	6	6	—	—	$89,103.99	$158,922.37	$101,543.01	2026-05-13
1980024	OTHER	Emapalumab 100 Mg/20 Ml Vial	27	21	$144,774.00	$130,296.60	$768.26	$137,535.30	$101,341.80	2026-05-13
169-4	OTHER	Major Abdominal Vascular Procedures	6	6	—	—	$87,961.44	$156,884.55	$100,240.95	2026-05-13
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	6	6	—	—	$87,063.61	$155,283.22	$99,217.79	2026-05-13
15064956	OTHER	Gen Vns Duo Model 1000d	19	14	$120,369.00	$108,332.10	$27,684.87	$114,350.55	$98,943.32	2026-05-13
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	6	6	—	—	$86,364.61	$154,036.52	$98,421.21	2026-05-13
614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	6	6	—	—	$86,006.70	$153,398.17	$98,013.34	2026-05-13
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	6	6	—	—	$85,203.70	$151,965.97	$97,098.24	2026-05-13
023-4	OTHER	Spinal Procedures	6	6	—	—	$84,273.75	$150,307.34	$96,038.46	2026-05-13
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$83,912.78	$149,663.54	$95,627.10	2026-05-13
120-4	OTHER	Major Respiratory And Chest Procedures	6	6	—	—	$83,840.90	$149,535.32	$95,545.18	2026-05-13
178-4	OTHER	External Heart Assist Systems	6	6	—	—	$83,553.35	$149,022.46	$95,217.49	2026-05-13
401-4	OTHER	Adrenal Procedures	6	6	—	—	$83,498.28	$148,924.25	$95,154.74	2026-05-13
230-4	OTHER	Major Small Bowel Procedures	6	6	—	—	$83,337.68	$148,637.81	$94,971.72	2026-05-13
091-4	OTHER	Other Major Head And Neck Procedures	6	6	—	—	$83,209.20	$148,408.66	$94,825.30	2026-05-13
027-4	OTHER	Other Open Craniotomy	6	6	—	—	$82,468.91	$147,088.30	$93,981.67	2026-05-13
15030500	OTHER	Imp Cochlr Synchr	19	14	$113,775.00	$102,397.50	$26,168.25	$108,086.25	$93,523.05	2026-05-13
15026926	OTHER	Cochlr Synchrny2 Flx28	19	14	$113,775.00	$102,397.50	$26,168.25	$108,086.25	$93,523.05	2026-05-13
15069892	OTHER	Cochlear Synch 2 Flex 28	19	14	$113,775.00	$102,397.50	$26,168.25	$108,086.25	$93,523.05	2026-05-13
15030023	OTHER	Imp Cochlr Synchrny 2pin	19	14	$113,775.00	$102,397.50	$26,168.25	$108,086.25	$93,523.05	2026-05-13
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	6	6	—	—	$81,996.29	$146,245.35	$93,443.07	2026-05-13
021-4	OTHER	Open Craniotomy Except Trauma	6	6	—	—	$81,563.43	$145,473.33	$92,949.79	2026-05-13
3925337	OTHER	Cerliponase Alfa1 1mg	47	21	$115,801.80	$104,221.62	$242.40	$115,297.89	$92,641.44	2026-05-13
004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	6	—	—	$80,367.35	$143,340.03	$91,586.72	2026-05-13
092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	6	6	—	—	$79,672.94	$142,101.52	$90,795.38	2026-05-13
005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	6	6	—	—	$79,472.57	$141,744.15	$90,567.04	2026-05-13
178-3	OTHER	External Heart Assist Systems	6	6	—	—	$79,255.38	$141,356.78	$90,319.52	2026-05-13
089-4	OTHER	Major Cranial Or Facial Bone Procedures	6	6	—	—	$77,858.93	$138,866.11	$88,728.12	2026-05-13
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	6	6	—	—	$77,689.15	$138,563.30	$88,534.64	2026-05-13
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	6	6	—	—	$77,178.29	$137,652.15	$87,952.46	2026-05-13
15023076	OTHER	Generator Aspire Model 16	19	14	$106,989.00	$96,290.10	$24,607.47	$101,639.55	$87,944.96	2026-05-13
178-2	OTHER	External Heart Assist Systems	6	6	—	—	$77,084.99	$137,485.74	$87,846.14	2026-05-13
022-4	OTHER	Ventricular Shunt Procedures	6	6	—	—	$76,546.59	$136,525.49	$87,232.58	2026-05-13
404-4	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures	6	6	—	—	$76,471.65	$136,391.82	$87,147.18	2026-05-13
405-4	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	6	6	—	—	$76,275.87	$136,042.63	$86,924.07	2026-05-13
15023376	OTHER	Cochlr Synchrony Pin Fle4	19	14	$105,000.00	$94,500.00	$24,150.00	$99,750.00	$86,310.00	2026-05-13
15023262	OTHER	Implt Cochlr Synchrny Pi8	19	14	$105,000.00	$94,500.00	$24,150.00	$99,750.00	$86,310.00	2026-05-13
121-4	OTHER	Other Respiratory And Chest Procedures	6	6	—	—	$75,642.64	$134,913.24	$86,202.45	2026-05-13
611-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	6	6	—	—	$75,619.70	$134,872.32	$86,176.30	2026-05-13
15025123	OTHER	Generator Model 1000	19	14	$104,721.00	$94,248.90	$24,085.83	$99,484.95	$86,080.66	2026-05-13
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$75,069.07	$133,890.24	$85,548.80	2026-05-13
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	6	6	—	—	$75,043.07	$133,843.86	$85,519.17	2026-05-13
179-4	OTHER	Defibrillator Implants	6	6	—	—	$74,818.23	$133,442.85	$85,262.95	2026-05-13
026-4	OTHER	Other Nervous System And Related Procedures	6	6	—	—	$74,012.17	$132,005.19	$84,344.36	2026-05-13
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	8	7	—	—	$5,793.00	$111,758.76	$84,171.65	2026-05-13
261-4	OTHER	Major Biliary Tract Procedures	6	6	—	—	$73,580.84	$131,235.90	$83,852.82	2026-05-13
232-4	OTHER	Gastric Fundoplication	6	6	—	—	$73,010.33	$130,218.35	$83,202.65	2026-05-13
447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	6	6	—	—	$72,799.26	$129,841.89	$82,962.12	2026-05-13
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	6	6	—	—	$72,415.35	$129,157.16	$82,524.61	2026-05-13
229-4	OTHER	Other Digestive System And Abdominal Procedures	6	6	—	—	$71,994.73	$128,406.96	$82,045.27	2026-05-13
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	8	7	—	—	$5,793.00	$108,379.82	$81,670.57	2026-05-13
841-2	OTHER	Extensive Third Degree Burns With Skin Graft	6	6	—	—	$71,514.46	$127,550.37	$81,497.96	2026-05-13
841-1	OTHER	Chemotherapy For Acute Leukemia	6	6	—	—	$71,514.46	$127,550.37	$81,497.96	2026-05-13
45930458	OTHER	Transcath Pulm Vlv 22mm	19	14	$99,000.00	$89,100.00	$22,770.00	$94,050.00	$81,378.00	2026-05-13
45930459	OTHER	Trncath Pulm Valve 25mm	19	14	$99,000.00	$89,100.00	$22,770.00	$94,050.00	$81,378.00	2026-05-13
15030459	OTHER	Trncath Pulm Valve 25mm	19	14	$99,000.00	$89,100.00	$22,770.00	$94,050.00	$81,378.00	2026-05-13
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	8	7	—	—	$5,793.00	$106,858.27	$80,544.32	2026-05-13
009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$70,538.62	$125,809.90	$80,385.90	2026-05-13
009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$70,538.62	$125,809.90	$80,385.90	2026-05-13
181-4	OTHER	Lower Extremity Arterial Procedures	6	6	—	—	$70,384.14	$125,534.38	$80,209.85	2026-05-13
15029636	OTHER	Trnscth Sapn 3.29hrt Vlv	19	14	$97,500.00	$87,750.00	$22,425.00	$92,625.00	$80,145.00	2026-05-13
45929636	OTHER	Trnscth Sapn 3.29hrt Vlv	19	14	$97,500.00	$87,750.00	$22,425.00	$92,625.00	$80,145.00	2026-05-13
15029635	OTHER	Trnscth Sapn 3.26hrt Vlv	19	14	$97,500.00	$87,750.00	$22,425.00	$92,625.00	$80,145.00	2026-05-13
15029634	OTHER	Trnscth Sapn 3.23hrt Vlv	19	14	$97,500.00	$87,750.00	$22,425.00	$92,625.00	$80,145.00	2026-05-13
15029633	OTHER	Trnscth Sapn 3.20hrt Vlv	19	14	$97,500.00	$87,750.00	$22,425.00	$92,625.00	$80,145.00	2026-05-13
45929634	OTHER	Trnscth Sapn 3.23hrt Vlv	19	14	$97,500.00	$87,750.00	$22,425.00	$92,625.00	$80,145.00	2026-05-13
45929633	OTHER	Trnscth Sapn 3.20hrt Vlv	19	14	$97,500.00	$87,750.00	$22,425.00	$92,625.00	$80,145.00	2026-05-13
4592249	OTHER	Sapn3 Ultr Trnscth Hrtvlv	19	14	$97,500.00	$87,750.00	$22,425.00	$92,625.00	$80,145.00	2026-05-13
45929635	OTHER	Trnscth Sapn 3.26hrt Vlv	19	14	$97,500.00	$87,750.00	$22,425.00	$92,625.00	$80,145.00	2026-05-13
011-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	6	—	—	$70,266.36	$125,324.32	$80,075.63	2026-05-13
15021852	OTHER	Cochlear Synchrony Flex24	19	14	$96,900.00	$87,210.00	$22,287.00	$92,055.00	$79,651.80	2026-05-13
15021720	OTHER	Cochlear Impt-all Synchrn	19	14	$96,900.00	$87,210.00	$22,287.00	$92,055.00	$79,651.80	2026-05-13
613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	6	6	—	—	$69,798.33	$124,489.55	$79,542.26	2026-05-13
951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	6	6	—	—	$69,501.60	$123,960.32	$79,204.10	2026-05-13
176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	6	6	—	—	$68,460.00	$122,102.55	$78,017.09	2026-05-13
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	6	6	—	—	$68,386.58	$121,971.61	$77,933.43	2026-05-13
695-4	OTHER	Chemotherapy For Acute Leukemia	6	6	—	—	$67,872.66	$121,055.00	$77,347.76	2026-05-13
263-4	OTHER	Cholecystectomy	6	6	—	—	$67,817.60	$120,956.79	$77,285.01	2026-05-13
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	6	6	—	—	$67,644.76	$120,648.53	$77,088.04	2026-05-13
603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	6	6	—	—	$67,318.97	$120,067.46	$76,716.77	2026-05-13
3925608	OTHER	Calasprgse Pgl-mknl/10u	47	21	$92,902.80	$83,612.52	$164.16	$107,659.60	$76,366.10	2026-05-13
220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	6	6	—	—	$66,945.77	$119,401.83	$76,291.47	2026-05-13
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	6	6	—	—	$66,849.41	$119,229.97	$76,181.66	2026-05-13
177-3	OTHER	Cardiac Pacemaker And Defibrillator Revision Except Device Replacement	6	6	—	—	$66,439.49	$118,498.86	$75,714.52	2026-05-13
167-3	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	6	6	—	—	$66,439.49	$118,498.86	$75,714.52	2026-05-13
511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	6	6	—	—	$66,428.79	$118,479.77	$75,702.33	2026-05-13
510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	6	6	—	—	$66,413.49	$118,452.49	$75,684.90	2026-05-13
863-3	OTHER	Neonatal Aftercare	6	6	—	—	$65,697.67	$117,175.78	$74,869.15	2026-05-13
029-4	OTHER	Other Percutaneous Intracranial Procedures	6	6	—	—	$65,691.56	$117,164.87	$74,862.18	2026-05-13
318	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	1	1	—	—	$74,359.59	$74,359.59	$74,359.59	2026-05-13
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	6	—	—	$65,105.75	$116,120.05	$74,194.58	2026-05-13
609-1	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	6	—	—	$65,105.75	$116,120.05	$74,194.58	2026-05-13
589-4	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	6	6	—	—	$64,975.74	$115,888.17	$74,046.43	2026-05-13
3923554	OTHER	Ribavirin Inhalation 6 Gm	42	16	$89,890.50	$80,901.45	$20,674.82	$85,395.97	$73,889.99	2026-05-13
442-4	OTHER	Kidney And Urinary Tract Procedures For Malignancy	6	6	—	—	$64,420.52	$114,897.90	$73,413.70	2026-05-13
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	6	6	—	—	$63,484.45	$113,228.37	$72,346.95	2026-05-13
231-4	OTHER	Major Large Bowel Procedures	6	6	—	—	$63,481.39	$113,222.91	$72,343.47	2026-05-13
3925230	OTHER	Ustekinumab 1 Mg	47	21	$90,069.90	$81,062.91	$11,375.58	$89,669.74	$72,055.92	2026-05-13
049-4	OTHER	Bacterial And Tuberculous Infections Of Nervous System	6	6	—	—	$62,779.34	$111,970.76	$71,543.41	2026-05-13
325-4	OTHER	Non-elective Or Complex Knee Joint Replacement	6	6	—	—	$62,560.62	$111,580.66	$71,294.15	2026-05-13
224-4	OTHER	Peritoneal Adhesiolysis	6	6	—	—	$62,412.26	$111,316.04	$71,125.08	2026-05-13
952-4	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	6	6	—	—	$61,987.05	$110,557.66	$70,640.51	2026-05-13
15064846	OTHER	El Icd Is Df1 Drd121mmntm	19	14	$85,836.00	$77,252.40	$19,742.28	$81,544.20	$70,557.19	2026-05-13
45964846	OTHER	Icd Dr Df-1 Mmtm D121	19	14	$85,836.00	$77,252.40	$19,742.28	$81,544.20	$70,557.19	2026-05-13
178-1	OTHER	External Heart Assist Systems	6	6	—	—	$61,866.22	$110,342.14	$70,502.81	2026-05-13
660-4	OTHER	Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula…	6	6	—	—	$61,694.91	$110,036.61	$70,307.59	2026-05-13
4593900	OTHER	Ins/rplcmt Def W/lead	27	21	$87,772.13	$78,994.92	$20,187.59	$107,847.67	$70,217.70	2026-05-13
518-4	OTHER	Other Female Reproductive System And Related Procedures	6	6	—	—	$61,584.78	$109,840.19	$70,182.09	2026-05-13
170-4	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	6	6	—	—	$61,312.53	$109,354.61	$69,871.82	2026-05-13
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	6	6	—	—	$60,868.97	$108,563.49	$69,366.34	2026-05-13
454	OTHER	Combined Anterior And Posterior Spinal Fusion With Cc	8	7	—	—	$5,793.00	$91,388.54	$69,093.68	2026-05-13
180-4	OTHER	Other Circulatory System Procedures	6	6	—	—	$60,544.71	$107,985.15	$68,996.82	2026-05-13
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	6	6	—	—	$60,474.35	$107,859.66	$68,916.64	2026-05-13
200-4	OTHER	Cardiac Structural And Valvular Disorders	6	6	—	—	$60,319.87	$107,584.14	$68,740.59	2026-05-13
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	6	6	—	—	$60,307.63	$107,562.31	$68,726.64	2026-05-13
440-1	OTHER	Kidney Transplant	6	6	—	—	$59,565.81	$106,239.23	$67,881.26	2026-05-13
130-3	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	6	6	—	—	$59,481.69	$106,089.19	$67,785.39	2026-05-13
623-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	6	6	—	—	$59,385.33	$105,917.33	$67,675.58	2026-05-13
073-4	OTHER	Orbit And Eye Procedures	6	6	—	—	$59,223.20	$105,628.16	$67,490.82	2026-05-13
631-2	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	6	6	—	—	$59,181.90	$105,554.50	$67,443.76	2026-05-13
711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	6	6	—	—	$59,067.19	$105,349.90	$67,313.03	2026-05-13
514-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	6	6	—	—	$58,926.47	$105,098.93	$67,152.68	2026-05-13
313-4	OTHER	Knee And Lower Leg Procedures Except Foot	6	6	—	—	$58,562.44	$104,449.66	$66,737.82	2026-05-13
179-3	OTHER	Defibrillator Implants	6	6	—	—	$58,547.15	$104,422.38	$66,720.39	2026-05-13
690-3	OTHER	Acute Leukemia	6	6	—	—	$58,467.61	$104,280.53	$66,629.76	2026-05-13
223-4	OTHER	Other Small And Large Bowel Procedures	6	6	—	—	$58,444.67	$104,239.61	$66,603.61	2026-05-13
042-4	OTHER	Degenerative Nervous System Disorders Except Multiple Sclerosis	6	6	—	—	$58,401.84	$104,163.22	$66,554.80	2026-05-13
403-4	OTHER	Procedures For Obesity	6	6	—	—	$58,193.83	$103,792.22	$66,317.75	2026-05-13
3922983	OTHER	Pegasparginase 3750 Units	47	21	$80,152.90	$72,137.61	$18,435.17	$94,699.99	$66,190.31	2026-05-13
320-4	OTHER	Other Musculoskeletal System And Connective Tissue Procedures	6	6	—	—	$58,034.76	$103,508.50	$66,136.48	2026-05-13
910-3	OTHER	Craniotomy For Multiple Significant Trauma	6	6	—	—	$57,906.28	$103,279.35	$65,990.06	2026-05-13
621-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	6	6	—	—	$57,881.80	$103,235.70	$65,962.17	2026-05-13
652	OTHER	Kidney Transplant	8	7	—	—	$5,793.00	$414,557.01	$65,802.19	2026-05-13
183-3	OTHER	Percutaneous Structural Cardiac Procedures	6	6	—	—	$57,530.01	$102,608.26	$65,561.27	2026-05-13
162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	6	6	—	—	$57,494.83	$102,545.52	$65,521.18	2026-05-13
303-1	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	6	6	—	—	$57,332.70	$102,256.35	$65,336.41	2026-05-13
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	6	6	—	—	$57,009.97	$101,680.74	$64,968.63	2026-05-13
512-4	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	6	6	—	—	$56,814.20	$101,331.56	$64,745.52	2026-05-13
861-4	OTHER	Signs, Symptoms And Other Factors Influencing Health Status	6	6	—	—	$56,558.76	$100,875.98	$64,454.43	2026-05-13
15015593	OTHER	Gen Vns Demipls Mdl 103	19	14	$78,393.30	$70,553.97	$18,030.46	$74,473.63	$64,439.29	2026-05-13
850-3	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	6	6	—	—	$55,908.72	$99,716.58	$63,713.64	2026-05-13
222-4	OTHER	Other Stomach, Esophageal And Duodenal Procedures	6	6	—	—	$55,849.07	$99,610.19	$63,645.65	2026-05-13
024-4	OTHER	Open Extracranial Vascular Procedures	6	6	—	—	$55,849.07	$99,610.19	$63,645.65	2026-05-13
021-3	OTHER	Open Craniotomy Except Trauma	6	6	—	—	$55,608.93	$99,181.90	$63,372.00	2026-05-13
213	OTHER	Splenic Procedures Age 0-17	1	1	—	—	$63,329.06	$63,329.06	$63,329.06	2026-05-13
15018373	OTHER	Gen Vns Demipls Mdl 104	19	14	$76,995.00	$69,295.50	$17,708.85	$73,145.25	$63,289.89	2026-05-13
614-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	6	6	—	—	$55,368.79	$98,753.60	$63,098.35	2026-05-13
45920593	OTHER	Melody Trnscath Pul Vlv M	19	14	$76,500.00	$68,850.00	$17,595.00	$72,675.00	$62,883.00	2026-05-13
45916414	OTHER	Melody Trnscath Pul Valve	19	14	$76,500.00	$68,850.00	$17,595.00	$72,675.00	$62,883.00	2026-05-13
363-4	OTHER	Breast Procedures Except Mastectomy	6	6	—	—	$54,906.88	$97,929.74	$62,571.94	2026-05-13
305-4	OTHER	Amputation Of Lower Limb Except Toes	6	6	—	—	$54,876.29	$97,875.18	$62,537.08	2026-05-13
309-4	OTHER	Other Significant Hip And Femur Surgery	6	6	—	—	$54,801.34	$97,741.51	$62,451.67	2026-05-13
162-1	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	6	6	—	—	$54,396.02	$97,018.59	$61,989.76	2026-05-13
3925213	OTHER	Inotuzmb Ozogamicn0.1mg	47	21	$74,762.20	$67,285.98	$5,633.54	$88,689.43	$61,989.25	2026-05-13
460	OTHER	Spinal Fusion Except Cervical Without Mcc	8	7	—	—	$5,793.00	$81,323.46	$61,643.56	2026-05-13
930-4	OTHER	Multiple Significant Trauma Without O.r. Procedure	6	6	—	—	$54,036.58	$96,377.51	$61,580.15	2026-05-13
005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	6	6	—	—	$54,030.46	$96,366.60	$61,573.18	2026-05-13
483-4	OTHER	Penis, Testes And Scrotal Procedures	6	6	—	—	$53,897.39	$96,129.26	$61,421.53	2026-05-13
842-3	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	6	6	—	—	$53,879.04	$96,096.53	$61,400.61	2026-05-13
691-4	OTHER	Lymphoma, Myeloma And Non-acute Leukemia	6	6	—	—	$53,761.26	$95,886.47	$61,266.39	2026-05-13
304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	6	6	—	—	$53,680.20	$95,741.89	$61,174.01	2026-05-13
607-1	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$53,204.52	$94,893.48	$60,631.93	2026-05-13
15064857	OTHER	Coch Imp Sych2pn Cmps-vec	19	14	$73,500.00	$66,150.00	$16,905.00	$69,825.00	$60,417.00	2026-05-13
15022638	OTHER	Imp Cochlear Synch Flx 28	19	14	$73,500.00	$66,150.00	$16,905.00	$69,825.00	$60,417.00	2026-05-13
15064270	OTHER	Cochlr Synch2pin Fs Svpkg	19	14	$73,500.00	$66,150.00	$16,905.00	$69,825.00	$60,417.00	2026-05-13
608-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	6	6	—	—	$52,849.67	$94,260.58	$60,227.54	2026-05-13
308-4	OTHER	Hip And Femur Fracture Repair	6	6	—	—	$52,828.25	$94,222.39	$60,203.14	2026-05-13
179-2	OTHER	Defibrillator Implants	6	6	—	—	$52,653.89	$93,911.40	$60,004.43	2026-05-13
519-4	OTHER	Uterine And Adnexa Procedures For Leiomyoma	6	6	—	—	$52,594.24	$93,805.01	$59,936.46	2026-05-13
15050514	OTHER	Cochlear Impl/20elt Ci624	19	14	$72,708.00	$65,437.20	$16,722.84	$69,072.60	$59,765.98	2026-05-13
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	8	7	—	—	$5,793.00	$78,705.57	$59,705.81	2026-05-13
484-4	OTHER	Other Male Reproductive System And Related Procedures	6	6	—	—	$52,370.93	$93,406.72	$59,681.96	2026-05-13
182-4	OTHER	Other Peripheral Vascular And Related Procedures	6	6	—	—	$51,919.72	$92,601.96	$59,167.76	2026-05-13
421-4	OTHER	Malnutrition, Failure To Thrive And Other Nutritional Disorders	6	6	—	—	$51,866.18	$92,506.48	$59,106.76	2026-05-13
625-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	6	6	—	—	$51,861.59	$92,498.30	$59,101.53	2026-05-13
364-4	OTHER	Other Skin, Subcutaneous Tissue And Related Procedures	6	6	—	—	$51,754.53	$92,307.34	$58,979.52	2026-05-13
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	6	6	—	—	$51,482.27	$91,821.75	$58,669.26	2026-05-13
043-4	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	6	6	—	—	$51,462.39	$91,786.29	$58,646.60	2026-05-13
15061061	OTHER	Synchrny 2pinflex26s-vctr	19	14	$71,250.00	$64,125.00	$16,387.50	$67,687.50	$58,567.50	2026-05-13
15060587	OTHER	Cochlear Snd Prcssr	21	15	$71,250.00	$64,125.00	$8,755.40	$67,687.50	$58,567.50	2026-05-13
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	8	7	—	—	$5,793.00	$77,149.58	$58,554.07	2026-05-13
6	OTHER	Liver Transplant Without Mcc	8	7	—	—	$5,793.00	$76,929.44	$58,391.12	2026-05-13
443-4	OTHER	Kidney And Urinary Tract Procedures For Non-malignancy	6	6	—	—	$51,127.42	$91,188.86	$58,264.86	2026-05-13
612-2	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$50,983.65	$90,932.42	$58,101.02	2026-05-13
15026653	OTHER	Cochlr Model Ci632 Slim R	19	14	$70,591.50	$63,532.35	$16,236.05	$67,061.93	$58,026.21	2026-05-13
15024084	OTHER	Implnt Cochlear Ci532	19	14	$70,591.50	$63,532.35	$16,236.05	$67,061.93	$58,026.21	2026-05-13
890-3	OTHER	HIV With Multiple Major HIV Related Conditions	6	6	—	—	$50,460.55	$89,999.45	$57,504.90	2026-05-13
3925044	OTHER	Dinutuximab 3.5 mg/mL Inj	40	15	$72,098.45	$64,888.61	$14,368.86	$77,637.42	$57,340.98	2026-05-13
793-4	OTHER	Moderately Extensive O.r. Procedures For Other Complications Of Treatment	6	6	—	—	$50,263.24	$89,647.54	$57,280.04	2026-05-13
050-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	6	6	—	—	$50,231.12	$89,590.25	$57,243.45	2026-05-13
15064863	OTHER	Nl Antfemr Trch12.5x245mm	19	14	$69,492.00	$62,542.80	$15,983.16	$66,017.40	$57,122.42	2026-05-13
3925598	OTHER	Pegasprginse-nc-3750 Unt	2	1	$0.01	—	$56,848.12	$56,848.12	$56,848.12	2026-05-13
423-4	OTHER	Inborn Errors Of Metabolism	6	6	—	—	$49,756.97	$88,744.57	$56,703.10	2026-05-13
692-4	OTHER	Radiotherapy	6	6	—	—	$49,630.02	$88,518.14	$56,558.43	2026-05-13
027-3	OTHER	Other Open Craniotomy	6	6	—	—	$49,464.83	$88,223.52	$56,370.18	2026-05-13
446-4	OTHER	Urethral And Transurethral Procedures	6	6	—	—	$49,366.94	$88,048.93	$56,258.62	2026-05-13
480-4	OTHER	Major Male Pelvic Procedures	6	6	—	—	$49,232.34	$87,808.87	$56,105.23	2026-05-13
252-4	OTHER	Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure	6	6	—	—	$49,068.68	$87,516.97	$55,918.73	2026-05-13
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	6	6	—	—	$49,015.15	$87,421.49	$55,857.72	2026-05-13
15026925	OTHER	Cochlr Synchrny2 Flx26	19	14	$67,800.00	$61,020.00	$15,594.00	$64,410.00	$55,731.60	2026-05-13

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