|
004983LWJH
|
CDM
|
Hc Medtronic Generator 3023
|
18
|
18
|
$25,570.67
|
$20,456.54
|
$7,988.28
|
$23,013.60
|
$10,564.52
|
2026-05-04
|
|
008078LWJH
|
CDM
|
Hc Eswl Lithotripsy Bilateral
|
18
|
18
|
$7,692.43
|
$6,153.94
20% off
|
$2,403.12
|
$6,923.19
|
$3,178.13
|
2026-05-04
|
|
008081LWJH
|
CDM
|
Hc Cryosurgery
|
18
|
18
|
$12,670.86
|
$10,136.69
|
$3,958.38
|
$11,403.77
|
$5,234.97
|
2026-05-04
|
|
100
|
MS_DRG
|
Seizures With Mcc
|
11
|
11
|
$11,987.05
|
$9,589.64
20% off
|
$7,422.38
|
$10,788.35
|
$10,188.99
|
2026-05-04
|
|
101
|
MS_DRG
|
Seizures Without Mcc
|
11
|
11
|
$55,338.00
|
$44,270.40
20% off
|
$34,265.29
|
$49,804.20
|
$47,037.30
|
2026-05-04
|
|
103
|
MS_DRG
|
Headaches Without Mcc
|
11
|
11
|
$6,179.55
|
$4,943.64
20% off
|
$3,826.38
|
$5,561.60
|
$5,252.62
|
2026-05-04
|
|
109969
|
CDM
|
Endopath Linear Cutter Refill
|
18
|
18
|
$9,917.86
|
$7,934.29
|
$3,098.34
|
$8,926.07
|
$4,097.56
|
2026-05-04
|
|
114269
|
CDM
|
Pacemaker Device
|
18
|
18
|
$9,650.00
|
$7,720.00
20% off
|
$3,014.66
|
$8,685.00
|
$3,986.90
|
2026-05-04
|
|
114319
|
CDM
|
Loop Recorder St.jude
|
18
|
18
|
$7,720.00
|
$6,176.00
20% off
|
$2,411.73
|
$6,948.00
|
$3,189.52
|
2026-05-04
|
|
11626
|
HCPCS
|
Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha…
|
33
|
18
|
$8,121.00
|
$6,496.80
20% off
|
$178.11
|
$7,308.90
|
$2,842.35
|
2026-05-04
|
|
11646
|
HCPCS
|
Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More…
|
33
|
18
|
$8,683.51
|
$6,946.81
|
$231.02
|
$7,815.16
|
$2,771.78
|
2026-05-04
|
|
12010011
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
11
|
11
|
$3,640.00
|
$2,912.00
20% off
|
$2,253.89
|
$3,276.00
|
$3,094.00
|
2026-05-04
|
|
12010012
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
11
|
11
|
$3,285.00
|
$2,628.00
20% off
|
$2,034.07
|
$2,956.50
|
$2,792.25
|
2026-05-04
|
|
12010014
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
11
|
11
|
$3,905.00
|
$3,124.00
20% off
|
$2,417.98
|
$3,514.50
|
$3,319.25
|
2026-05-04
|
|
125
|
MS_DRG
|
Other Disorders Of The Eye Without Mcc
|
11
|
11
|
$26,854.75
|
$21,483.80
20% off
|
$16,628.46
|
$24,169.28
|
$22,826.54
|
2026-05-04
|
|
149
|
MS_DRG
|
Dysequilibrium
|
11
|
11
|
$11,886.52
|
$9,509.21
20% off
|
$7,360.13
|
$10,697.86
|
$10,103.54
|
2026-05-04
|
|
15273
|
HCPCS
|
Skin Substitute Graft To Wound 100.0 Sq Cm Or More Of Trunk, Arms, Or Legs, 100.…
|
33
|
18
|
$10,883.45
|
$8,706.76
20% off
|
$113.39
|
$9,795.11
|
$3,474.00
|
2026-05-04
|
|
175
|
MS_DRG
|
Pulmonary Embolism With Mcc Or Acute Cor Pulmonale
|
11
|
11
|
$27,704.00
|
$22,163.20
20% off
|
$17,154.32
|
$24,933.60
|
$23,548.40
|
2026-05-04
|
|
176
|
MS_DRG
|
Pulmonary Embolism Without Mcc
|
11
|
11
|
$12,949.68
|
$10,359.74
20% off
|
$8,018.44
|
$11,654.71
|
$11,007.22
|
2026-05-04
|
|
177
|
MS_DRG
|
Respiratory Infections And Inflammations With Mcc
|
11
|
11
|
$30,307.42
|
$24,245.93
20% off
|
$18,766.35
|
$27,276.68
|
$25,761.30
|
2026-05-04
|
|
177128
|
CDM
|
Greenlight Laser Greenlight Laser With Fiber
|
18
|
18
|
$7,334.00
|
$5,867.20
20% off
|
$2,291.14
|
$6,600.60
|
$3,030.05
|
2026-05-04
|
|
178
|
MS_DRG
|
Respiratory Infections And Inflammations With Cc
|
11
|
11
|
$22,626.61
|
$18,101.29
|
$14,010.40
|
$20,363.95
|
$19,232.62
|
2026-05-04
|
|
179
|
MS_DRG
|
Respiratory Infections And Inflammations Without Cc/mcc
|
11
|
11
|
$11,171.20
|
$8,936.96
20% off
|
$6,917.21
|
$10,054.08
|
$9,495.52
|
2026-05-04
|
|
184
|
MS_DRG
|
Major Chest Trauma With Cc
|
11
|
11
|
$14,502.89
|
$11,602.31
20% off
|
$8,980.19
|
$13,052.60
|
$12,327.45
|
2026-05-04
|
|
186
|
MS_DRG
|
Pleural Effusion With Mcc
|
11
|
11
|
$37,699.20
|
$30,159.36
|
$23,343.34
|
$33,929.28
|
$32,044.32
|
2026-05-04
|
|
187
|
MS_DRG
|
Pleural Effusion With Cc
|
11
|
11
|
$22,454.05
|
$17,963.24
|
$13,903.54
|
$20,208.64
|
$19,085.94
|
2026-05-04
|
|
189
|
MS_DRG
|
Pulmonary Edema And Respiratory Failure
|
11
|
11
|
$20,412.56
|
$16,330.05
|
$12,639.46
|
$18,371.31
|
$17,350.68
|
2026-05-04
|
|
190
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Mcc
|
11
|
11
|
$27,515.11
|
$22,012.08
20% off
|
$17,037.35
|
$24,763.59
|
$23,387.84
|
2026-05-04
|
|
191
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Cc
|
11
|
11
|
$25,215.75
|
$20,172.60
20% off
|
$15,613.59
|
$22,694.18
|
$21,433.39
|
2026-05-04
|
|
19120
|
HCPCS
|
Removal Of Growth And Tissue Of Breast, Duct, Or Nipple
|
51
|
18
|
$6,667.89
|
$5,334.31
20% off
|
$315.34
|
$9,805.50
|
$3,403.60
|
2026-05-04
|
|
192
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease Without Cc/mcc
|
11
|
11
|
$8,403.99
|
$6,723.19
20% off
|
$5,203.75
|
$7,563.59
|
$7,143.39
|
2026-05-04
|
|
19296
|
HCPCS
|
Insertion Of Expandable Tube In Breast For Radiation Treatment Using Imaging Gui…
|
33
|
18
|
$27,300.00
|
$21,840.00
20% off
|
$122.83
|
$24,570.00
|
$8,714.16
|
2026-05-04
|
|
193
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Mcc
|
11
|
11
|
$26,735.08
|
$21,388.06
20% off
|
$16,554.36
|
$24,061.57
|
$22,724.82
|
2026-05-04
|
|
194
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Cc
|
11
|
11
|
$14,733.41
|
$11,786.73
|
$9,122.93
|
$13,260.07
|
$12,523.40
|
2026-05-04
|
|
195
|
MS_DRG
|
Simple Pneumonia And Pleurisy Without Cc/mcc
|
11
|
11
|
$23,388.21
|
$18,710.57
|
$14,481.98
|
$21,049.39
|
$19,879.98
|
2026-05-04
|
|
199
|
MS_DRG
|
Pneumothorax With Mcc
|
11
|
11
|
$9,074.32
|
$7,259.46
|
$5,618.82
|
$8,166.89
|
$7,713.17
|
2026-05-04
|
|
200
|
MS_DRG
|
Pneumothorax With Cc
|
11
|
11
|
$18,091.00
|
$14,472.80
20% off
|
$11,201.95
|
$16,281.90
|
$15,377.35
|
2026-05-04
|
|
20010001
|
CDM
|
Intensive Care Unit - General Classification
|
11
|
11
|
$4,900.00
|
$3,920.00
20% off
|
$3,034.08
|
$4,410.00
|
$4,165.00
|
2026-05-04
|
|
20010011
|
CDM
|
Intensive Care Unit - General Classification
|
11
|
11
|
$4,900.00
|
$3,920.00
20% off
|
$3,034.08
|
$4,410.00
|
$4,165.00
|
2026-05-04
|
|
20101
|
HCPCS
|
Exploration Of Wound Of Chest
|
33
|
18
|
$13,967.22
|
$11,173.78
|
$123.98
|
$12,570.50
|
$4,458.34
|
2026-05-04
|
|
202
|
MS_DRG
|
Bronchitis And Asthma With Cc/mcc
|
11
|
11
|
$24,028.90
|
$19,223.12
20% off
|
$14,878.69
|
$21,626.01
|
$20,424.57
|
2026-05-04
|
|
20600001
|
CDM
|
Intensive Care Unit - Intermediate ICU
|
11
|
11
|
$3,645.00
|
$2,916.00
20% off
|
$2,256.98
|
$3,280.50
|
$3,098.25
|
2026-05-04
|
|
208
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
11
|
11
|
$35,659.79
|
$28,527.83
20% off
|
$22,080.54
|
$32,093.81
|
$30,310.82
|
2026-05-04
|
|
22510
|
HCPCS
|
Stabilization Of Upper Spine Bone
|
33
|
18
|
$8,676.00
|
$6,940.80
20% off
|
$381.81
|
$7,808.40
|
$2,769.38
|
2026-05-04
|
|
22511
|
HCPCS
|
Stabilization Of Lower Spine Bone
|
33
|
18
|
$8,676.00
|
$6,940.80
20% off
|
$360.56
|
$7,808.40
|
$2,769.38
|
2026-05-04
|
|
27532
|
HCPCS
|
Closed Treatment Of Broken Shin Bone With Traction
|
33
|
18
|
$8,676.00
|
$6,940.80
20% off
|
$358.09
|
$7,808.40
|
$2,769.38
|
2026-05-04
|
|
280
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Mcc
|
11
|
11
|
$19,701.73
|
$15,761.38
20% off
|
$12,199.31
|
$17,731.56
|
$16,746.47
|
2026-05-04
|
|
281
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Cc
|
11
|
11
|
$10,595.82
|
$8,476.65
20% off
|
$6,560.93
|
$9,536.24
|
$9,006.44
|
2026-05-04
|
|
282
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive Without Cc/mcc
|
11
|
11
|
$6,401.00
|
$5,120.80
20% off
|
$3,963.50
|
$5,760.90
|
$5,440.85
|
2026-05-04
|
|
283
|
MS_DRG
|
Acute Myocardial Infarction, Expired With Mcc
|
11
|
11
|
$28,196.68
|
$22,557.34
20% off
|
$17,459.38
|
$25,377.01
|
$23,967.18
|
2026-05-04
|
|
284
|
MS_DRG
|
Acute Myocardial Infarction, Expired With Cc
|
11
|
11
|
$10,329.05
|
$8,263.24
|
$6,395.75
|
$9,296.15
|
$8,779.69
|
2026-05-04
|
|
288
|
MS_DRG
|
Acute And Subacute Endocarditis With Mcc
|
11
|
11
|
$14,163.65
|
$11,330.92
20% off
|
$8,770.13
|
$12,747.29
|
$12,039.10
|
2026-05-04
|
|
291
|
MS_DRG
|
Heart Failure And Shock With Mcc
|
11
|
11
|
$30,121.45
|
$24,097.16
20% off
|
$18,651.20
|
$27,109.31
|
$25,603.24
|
2026-05-04
|
|
292
|
MS_DRG
|
Heart Failure And Shock With Cc
|
11
|
11
|
$7,338.85
|
$5,871.08
20% off
|
$4,544.22
|
$6,604.97
|
$6,238.02
|
2026-05-04
|
|
299
|
MS_DRG
|
Peripheral Vascular Disorders With Mcc
|
11
|
11
|
$21,454.60
|
$17,163.68
|
$13,284.69
|
$19,309.14
|
$18,236.41
|
2026-05-04
|
|
301
|
MS_DRG
|
Peripheral Vascular Disorders Without Cc/mcc
|
11
|
11
|
$11,138.20
|
$8,910.56
20% off
|
$6,896.77
|
$10,024.38
|
$9,467.47
|
2026-05-04
|
|
305
|
MS_DRG
|
Hypertension Without Mcc
|
11
|
11
|
$20,142.66
|
$16,114.13
|
$12,472.34
|
$18,128.39
|
$17,121.26
|
2026-05-04
|
|
306
|
MS_DRG
|
Cardiac Congenital And Valvular Disorders With Mcc
|
11
|
11
|
$18,762.20
|
$15,009.76
20% off
|
$11,617.55
|
$16,885.98
|
$15,947.87
|
2026-05-04
|
|
307
|
MS_DRG
|
Cardiac Congenital And Valvular Disorders Without Mcc
|
11
|
11
|
$12,369.25
|
$9,895.40
20% off
|
$7,659.04
|
$11,132.32
|
$10,513.86
|
2026-05-04
|
|
308
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Mcc
|
11
|
11
|
$24,240.21
|
$19,392.16
20% off
|
$15,009.54
|
$21,816.18
|
$20,604.17
|
2026-05-04
|
|
309
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Cc
|
11
|
11
|
$11,017.73
|
$8,814.18
20% off
|
$6,822.18
|
$9,915.95
|
$9,365.07
|
2026-05-04
|
|
311
|
MS_DRG
|
Angina Pectoris
|
11
|
11
|
$5,322.45
|
$4,257.96
|
$3,295.66
|
$4,790.21
|
$4,524.08
|
2026-05-04
|
|
312
|
MS_DRG
|
Syncope And Collapse
|
11
|
11
|
$18,318.52
|
$14,654.81
20% off
|
$11,342.82
|
$16,486.66
|
$15,570.74
|
2026-05-04
|
|
314
|
MS_DRG
|
Other Circulatory System Diagnoses With Mcc
|
11
|
11
|
$14,330.48
|
$11,464.38
20% off
|
$8,873.43
|
$12,897.43
|
$12,180.90
|
2026-05-04
|
|
315
|
MS_DRG
|
Other Circulatory System Diagnoses With Cc
|
11
|
11
|
$30,546.86
|
$24,437.49
|
$18,914.62
|
$27,492.17
|
$25,964.83
|
2026-05-04
|
|
328
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures Without Cc/mcc
|
11
|
11
|
$37,183.08
|
$29,746.46
20% off
|
$23,023.76
|
$33,464.77
|
$31,605.62
|
2026-05-04
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
11
|
11
|
$88,569.69
|
$70,855.75
20% off
|
$54,842.35
|
$79,712.72
|
$75,284.23
|
2026-05-04
|
|
330
|
MS_DRG
|
Major Small And Large Bowel Procedures With Cc
|
11
|
11
|
$123,941.51
|
$99,153.21
|
$76,744.59
|
$111,547.36
|
$105,350.29
|
2026-05-04
|
|
331
|
MS_DRG
|
Major Small And Large Bowel Procedures Without Cc/mcc
|
11
|
11
|
$95,451.54
|
$76,361.23
20% off
|
$59,103.60
|
$85,906.39
|
$81,133.81
|
2026-05-04
|
|
33285
|
HCPCS
|
Insertion Of Heart Rhythm Monitor Under Skin
|
33
|
18
|
$14,456.00
|
$11,564.80
20% off
|
$50.24
|
$13,010.40
|
$4,614.36
|
2026-05-04
|
|
35207
|
HCPCS
|
Repair Of Blood Vessel Of Hand Or Finger
|
33
|
18
|
$8,795.00
|
$7,036.00
20% off
|
$456.66
|
$7,915.50
|
$2,807.36
|
2026-05-04
|
|
354
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral With Cc
|
11
|
11
|
$117,208.24
|
$93,766.59
20% off
|
$72,575.34
|
$105,487.42
|
$99,627.00
|
2026-05-04
|
|
355
|
MS_DRG
|
Hernia Procedures Except Inguinal And Femoral Without Cc/mcc
|
11
|
11
|
$49,464.63
|
$39,571.70
20% off
|
$30,628.50
|
$44,518.16
|
$42,044.93
|
2026-05-04
|
|
357
|
MS_DRG
|
Other Digestive System O.r. Procedures With Cc
|
11
|
11
|
$67,239.26
|
$53,791.41
|
$41,634.55
|
$60,515.33
|
$57,153.37
|
2026-05-04
|
|
369
|
MS_DRG
|
Major Esophageal Disorders With Cc
|
11
|
11
|
$26,337.88
|
$21,070.31
|
$16,308.42
|
$23,704.09
|
$22,387.20
|
2026-05-04
|
|
371
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections With Mcc
|
11
|
11
|
$25,410.16
|
$20,328.13
|
$15,733.97
|
$22,869.14
|
$21,598.64
|
2026-05-04
|
|
372
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections With Cc
|
11
|
11
|
$19,187.40
|
$15,349.92
20% off
|
$11,880.84
|
$17,268.66
|
$16,309.29
|
2026-05-04
|
|
373
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc
|
11
|
11
|
$12,261.50
|
$9,809.20
|
$7,592.32
|
$11,035.35
|
$10,422.28
|
2026-05-04
|
|
375
|
MS_DRG
|
Digestive Malignancy With Cc
|
11
|
11
|
$35,504.39
|
$28,403.51
20% off
|
$21,984.32
|
$31,953.95
|
$30,178.73
|
2026-05-04
|
|
377
|
MS_DRG
|
Gastrointestinal Hemorrhage With Mcc
|
11
|
11
|
$44,281.04
|
$35,424.83
20% off
|
$27,418.82
|
$39,852.94
|
$37,638.88
|
2026-05-04
|
|
378
|
MS_DRG
|
Gastrointestinal Hemorrhage With Cc
|
11
|
11
|
$14,415.90
|
$11,532.72
20% off
|
$8,926.32
|
$12,974.31
|
$12,253.51
|
2026-05-04
|
|
379
|
MS_DRG
|
Gastrointestinal Hemorrhage Without Cc/mcc
|
11
|
11
|
$13,970.48
|
$11,176.38
20% off
|
$8,650.52
|
$12,573.43
|
$11,874.91
|
2026-05-04
|
|
38500
|
HCPCS
|
Biopsy Or Removal Of Lymph Nodes
|
33
|
18
|
$11,453.00
|
$9,162.40
20% off
|
$152.29
|
$10,307.70
|
$3,655.80
|
2026-05-04
|
|
386
|
MS_DRG
|
Inflammatory Bowel Disease With Cc
|
11
|
11
|
$14,115.35
|
$11,292.28
20% off
|
$8,740.22
|
$12,703.81
|
$11,998.05
|
2026-05-04
|
|
38760
|
HCPCS
|
Removal Of Lymph Nodes Of Groin
|
33
|
18
|
$18,640.00
|
$14,912.00
20% off
|
$497.09
|
$16,776.00
|
$5,949.89
|
2026-05-04
|
|
389
|
MS_DRG
|
Gastrointestinal Obstruction With Cc
|
11
|
11
|
$13,935.82
|
$11,148.66
|
$8,629.06
|
$12,542.24
|
$11,845.45
|
2026-05-04
|
|
390
|
MS_DRG
|
Gastrointestinal Obstruction Without Cc/mcc
|
11
|
11
|
$10,372.30
|
$8,297.84
|
$6,422.53
|
$9,335.07
|
$8,816.45
|
2026-05-04
|
|
391
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc
|
11
|
11
|
$12,955.52
|
$10,364.41
20% off
|
$8,022.06
|
$11,659.96
|
$11,012.19
|
2026-05-04
|
|
392
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc
|
11
|
11
|
$14,461.88
|
$11,569.51
|
$8,954.80
|
$13,015.70
|
$12,292.60
|
2026-05-04
|
|
393
|
MS_DRG
|
Other Digestive System Diagnoses With Mcc
|
11
|
11
|
$53,409.20
|
$42,727.36
|
$33,070.98
|
$48,068.28
|
$45,397.82
|
2026-05-04
|
|
394
|
MS_DRG
|
Other Digestive System Diagnoses With Cc
|
11
|
11
|
$12,463.17
|
$9,970.54
|
$7,717.20
|
$11,216.86
|
$10,593.70
|
2026-05-04
|
|
416
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/mcc
|
11
|
11
|
$51,037.83
|
$40,830.26
20% off
|
$31,602.62
|
$45,934.05
|
$43,382.16
|
2026-05-04
|
|
418
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. With Cc
|
11
|
11
|
$50,853.31
|
$40,682.64
20% off
|
$31,488.37
|
$45,767.98
|
$43,225.31
|
2026-05-04
|
|
419
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc
|
11
|
11
|
$46,319.25
|
$37,055.40
|
$28,680.88
|
$41,687.33
|
$39,371.36
|
2026-05-04
|
|
433
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis With Cc
|
11
|
11
|
$9,998.95
|
$7,999.16
20% off
|
$6,191.35
|
$8,999.06
|
$8,499.11
|
2026-05-04
|
|
436
|
MS_DRG
|
Malignancy Of Hepatobiliary System Or Pancreas With Cc
|
11
|
11
|
$17,554.05
|
$14,043.24
20% off
|
$10,869.47
|
$15,798.65
|
$14,920.94
|
2026-05-04
|
|
43659
|
HCPCS
|
Other Procedure On Stomach Using An Endoscope
|
7
|
7
|
$4,263.00
|
$3,410.40
20% off
|
$50.50
|
$4,518.78
|
$3,836.70
|
2026-05-04
|
|
439
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Cc
|
11
|
11
|
$26,835.47
|
$21,468.37
20% off
|
$16,616.52
|
$24,151.92
|
$22,810.15
|
2026-05-04
|
|
440
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy Without Cc/mcc
|
11
|
11
|
$17,657.94
|
$14,126.35
20% off
|
$10,933.80
|
$15,892.15
|
$15,009.25
|
2026-05-04
|
|
442
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc
|
11
|
11
|
$35,919.44
|
$28,735.55
20% off
|
$22,241.32
|
$32,327.49
|
$30,531.52
|
2026-05-04
|
|
444
|
MS_DRG
|
Disorders Of The Biliary Tract With Mcc
|
11
|
11
|
$22,128.30
|
$17,702.64
20% off
|
$13,701.84
|
$19,915.47
|
$18,809.06
|
2026-05-04
|
|
445
|
MS_DRG
|
Disorders Of The Biliary Tract With Cc
|
11
|
11
|
$13,674.80
|
$10,939.84
|
$8,467.44
|
$12,307.32
|
$11,623.58
|
2026-05-04
|
|
446
|
MS_DRG
|
Disorders Of The Biliary Tract Without Cc/mcc
|
11
|
11
|
$12,933.77
|
$10,347.02
|
$8,008.59
|
$11,640.39
|
$10,993.70
|
2026-05-04
|
|
46250
|
HCPCS
|
Removal Of Multiple External Hemorrhoids
|
51
|
18
|
$8,026.00
|
$6,420.80
20% off
|
$194.64
|
$8,381.58
|
$3,059.28
|
2026-05-04
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
11
|
11
|
$60,877.63
|
$48,702.10
20% off
|
$37,695.43
|
$54,789.87
|
$51,745.99
|
2026-05-04
|
|
470
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without …
|
11
|
11
|
$122,198.89
|
$97,759.11
20% off
|
$75,665.55
|
$109,979.00
|
$103,869.06
|
2026-05-04
|
|
47541
|
HCPCS
|
Placement Of Access Device Into Biliary Tract Using Imaging Guidance With Review…
|
33
|
18
|
$9,747.00
|
$7,797.60
|
$192.71
|
$8,772.30
|
$3,111.24
|
2026-05-04
|
|
47554
|
HCPCS
|
Removal Of Bile Duct Stones Using An Endoscope
|
33
|
18
|
$10,102.00
|
$8,081.60
|
$258.94
|
$9,091.80
|
$3,224.56
|
2026-05-04
|
|
481
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Cc
|
11
|
11
|
$82,449.57
|
$65,959.65
20% off
|
$51,052.77
|
$74,204.61
|
$70,082.13
|
2026-05-04
|
|
482
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint Without Cc/mcc
|
11
|
11
|
$49,783.20
|
$39,826.56
20% off
|
$30,825.76
|
$44,804.88
|
$42,315.72
|
2026-05-04
|
|
49190
|
HCPCS
|
Removal Or Destruction Of Growth(s) In The Abdomen, More Than 30.0 Cm
|
15
|
15
|
$9,090.00
|
$7,272.00
20% off
|
$1,688.78
|
$8,181.00
|
$2,998.59
|
2026-05-04
|
|
49329
|
HCPCS
|
Other Procedure On Abdomen Using An Endoscope
|
7
|
7
|
$4,400.31
|
$3,520.25
|
$50.50
|
$4,664.33
|
$3,960.28
|
2026-05-04
|
|
494
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc
|
11
|
11
|
$167,550.34
|
$134,040.27
20% off
|
$103,747.17
|
$150,795.31
|
$142,417.79
|
2026-05-04
|
|
49418
|
HCPCS
|
Insertion Of Abdominal Tube Using Imaging Guidance With Review By Radiologist
|
33
|
18
|
$9,747.00
|
$7,797.60
|
$116.47
|
$8,772.30
|
$3,111.24
|
2026-05-04
|
|
49422
|
HCPCS
|
Removal Of Abdominal Cavity Tube
|
33
|
18
|
$8,769.00
|
$7,015.20
20% off
|
$127.83
|
$7,892.10
|
$2,799.06
|
2026-05-04
|
|
49605
|
HCPCS
|
Repair Of Large Defect Of Abdominal Wall At Navel
|
15
|
15
|
$14,130.00
|
$11,304.00
20% off
|
$2,853.14
|
$12,717.00
|
$5,052.97
|
2026-05-04
|
|
49659
|
HCPCS
|
Other Repair Of Hernia Using An Endoscope
|
7
|
7
|
$3,288.99
|
$2,631.19
20% off
|
$1,085.12
|
$3,486.33
|
$2,960.09
|
2026-05-04
|
|
522
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc
|
11
|
11
|
$87,287.43
|
$69,829.94
20% off
|
$54,048.37
|
$78,558.68
|
$74,194.31
|
2026-05-04
|
|
533
|
MS_DRG
|
Fractures Of Femur With Mcc
|
11
|
11
|
$38,371.20
|
$30,696.96
|
$23,759.45
|
$34,534.08
|
$32,615.52
|
2026-05-04
|
|
534
|
MS_DRG
|
Fractures Of Femur Without Mcc
|
11
|
11
|
$23,450.55
|
$18,760.44
20% off
|
$14,520.58
|
$21,105.49
|
$19,932.97
|
2026-05-04
|
|
535
|
MS_DRG
|
Fractures Of Hip And Pelvis With Mcc
|
11
|
11
|
$26,306.85
|
$21,045.48
20% off
|
$16,289.20
|
$23,676.17
|
$22,360.82
|
2026-05-04
|
|
536
|
MS_DRG
|
Fractures Of Hip And Pelvis Without Mcc
|
11
|
11
|
$14,918.90
|
$11,935.12
|
$9,237.78
|
$13,427.01
|
$12,681.07
|
2026-05-04
|
|
55
|
MS_DRG
|
Nervous System Neoplasms Without Mcc
|
11
|
11
|
$10,104.41
|
$8,083.53
|
$6,256.65
|
$9,093.97
|
$8,588.75
|
2026-05-04
|
|
551
|
MS_DRG
|
Medical Back Problems With Mcc
|
11
|
11
|
$19,429.57
|
$15,543.66
|
$12,030.79
|
$17,486.61
|
$16,515.14
|
2026-05-04
|
|
552
|
MS_DRG
|
Medical Back Problems Without Mcc
|
11
|
11
|
$13,295.87
|
$10,636.70
|
$8,232.80
|
$11,966.28
|
$11,301.49
|
2026-05-04
|
|
554
|
MS_DRG
|
Bone Diseases And Arthropathies Without Mcc
|
11
|
11
|
$6,630.08
|
$5,304.06
20% off
|
$4,105.34
|
$5,967.07
|
$5,635.56
|
2026-05-04
|
|
556
|
MS_DRG
|
Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc
|
11
|
11
|
$22,706.31
|
$18,165.05
|
$14,059.75
|
$20,435.68
|
$19,300.36
|
2026-05-04
|
|
557
|
MS_DRG
|
Tendonitis, Myositis And Bursitis With Mcc
|
11
|
11
|
$45,972.54
|
$36,778.03
20% off
|
$28,466.20
|
$41,375.29
|
$39,076.66
|
2026-05-04
|
|
558
|
MS_DRG
|
Tendonitis, Myositis And Bursitis Without Mcc
|
11
|
11
|
$16,952.46
|
$13,561.97
|
$10,496.96
|
$15,257.21
|
$14,409.59
|
2026-05-04
|
|
560
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With Cc
|
11
|
11
|
$34,281.47
|
$27,425.17
20% off
|
$21,227.08
|
$30,853.32
|
$29,139.25
|
2026-05-04
|
|
561
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc
|
11
|
11
|
$14,427.65
|
$11,542.12
|
$8,933.60
|
$12,984.89
|
$12,263.50
|
2026-05-04
|
|
563
|
MS_DRG
|
Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…
|
11
|
11
|
$24,620.88
|
$19,696.71
|
$15,245.25
|
$22,158.79
|
$20,927.75
|
2026-05-04
|
|
57
|
MS_DRG
|
Degenerative Nervous System Disorders Without Mcc
|
11
|
11
|
$12,628.74
|
$10,102.99
20% off
|
$7,819.72
|
$11,365.87
|
$10,734.43
|
2026-05-04
|
|
57105
|
HCPCS
|
Biopsy Of Extensive Area Of Vaginal Mucous Membrane
|
33
|
18
|
$8,934.00
|
$7,147.20
20% off
|
$88.94
|
$8,040.60
|
$2,851.73
|
2026-05-04
|
|
57460
|
HCPCS
|
Biopsy Of Cervix Using An Endoscope With Loop Electrode
|
33
|
18
|
$8,934.00
|
$7,147.20
20% off
|
$94.34
|
$8,040.60
|
$2,851.73
|
2026-05-04
|
|
580
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Cc
|
11
|
11
|
$65,967.84
|
$52,774.27
20% off
|
$40,847.29
|
$59,371.06
|
$56,072.66
|
2026-05-04
|
|
58120
|
HCPCS
|
Dilation And Scraping Of Uterus
|
33
|
18
|
$8,936.00
|
$7,148.80
20% off
|
$139.77
|
$8,042.40
|
$2,852.37
|
2026-05-04
|
|
59
|
MS_DRG
|
Multiple Sclerosis And Cerebellar Ataxia With Cc
|
11
|
11
|
$28,945.20
|
$23,156.16
20% off
|
$17,922.87
|
$26,050.68
|
$24,603.42
|
2026-05-04
|
|
59510
|
HCPCS
|
Cesarean Delivery With Care Before And After Delivery
|
15
|
15
|
$8,986.68
|
$7,189.34
20% off
|
$2,422.79
|
$8,088.01
|
$2,786.21
|
2026-05-04
|
|
59618
|
HCPCS
|
Cesarean Delivery And Care Before And After Delivery Following Attempted Vaginal…
|
15
|
15
|
$9,039.70
|
$7,231.76
20% off
|
$2,447.07
|
$8,135.73
|
$2,855.28
|
2026-05-04
|
|
597
|
MS_DRG
|
Malignant Breast Disorders With Mcc
|
11
|
11
|
$12,596.35
|
$10,077.08
20% off
|
$7,799.66
|
$11,336.72
|
$10,706.90
|
2026-05-04
|
|
598
|
MS_DRG
|
Malignant Breast Disorders With Cc
|
11
|
11
|
$7,390.78
|
$5,912.62
20% off
|
$4,576.37
|
$6,651.70
|
$6,282.16
|
2026-05-04
|
|
602
|
MS_DRG
|
Cellulitis With Mcc
|
11
|
11
|
$19,718.49
|
$15,774.79
20% off
|
$12,209.69
|
$17,746.64
|
$16,760.72
|
2026-05-04
|
|
603
|
MS_DRG
|
Cellulitis Without Mcc
|
11
|
11
|
$20,038.09
|
$16,030.47
20% off
|
$12,407.59
|
$18,034.28
|
$17,032.38
|
2026-05-04
|
|
605
|
MS_DRG
|
Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc
|
11
|
11
|
$15,592.10
|
$12,473.68
20% off
|
$9,654.63
|
$14,032.89
|
$13,253.29
|
2026-05-04
|
|
62305
|
HCPCS
|
X-ray Of Multiple Regions Of Spinal Canal With Review By Radiologist
|
33
|
18
|
$9,147.00
|
$7,317.60
|
$73.90
|
$8,232.30
|
$2,919.72
|
2026-05-04
|
|
637
|
MS_DRG
|
Diabetes With Mcc
|
11
|
11
|
$7,795.20
|
$6,236.16
20% off
|
$4,826.79
|
$7,015.68
|
$6,625.92
|
2026-05-04
|
|
638
|
MS_DRG
|
Diabetes With Cc
|
11
|
11
|
$37,135.82
|
$29,708.65
20% off
|
$22,994.50
|
$33,422.23
|
$31,565.44
|
2026-05-04
|
|
64
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Mcc
|
11
|
11
|
$15,661.26
|
$12,529.01
|
$9,697.45
|
$14,095.13
|
$13,312.07
|
2026-05-04
|
|
640
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…
|
11
|
11
|
$18,903.17
|
$15,122.53
20% off
|
$11,704.84
|
$17,012.85
|
$16,067.69
|
2026-05-04
|
|
641
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…
|
11
|
11
|
$12,974.18
|
$10,379.34
20% off
|
$8,033.61
|
$11,676.76
|
$11,028.05
|
2026-05-04
|
|
642
|
MS_DRG
|
Inborn And Other Disorders Of Metabolism
|
11
|
11
|
$25,929.73
|
$20,743.78
20% off
|
$16,055.69
|
$23,336.76
|
$22,040.27
|
2026-05-04
|
|
644
|
MS_DRG
|
Endocrine Disorders With Cc
|
11
|
11
|
$25,458.08
|
$20,366.46
20% off
|
$15,763.64
|
$22,912.27
|
$21,639.37
|
2026-05-04
|
|
646082
|
CDM
|
Allograft Placental Tissue Am200
|
18
|
18
|
$7,665.96
|
$6,132.77
|
$2,394.85
|
$6,899.36
|
$3,167.20
|
2026-05-04
|
|
65
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours
|
11
|
11
|
$22,501.13
|
$18,000.90
20% off
|
$13,932.70
|
$20,251.02
|
$19,125.96
|
2026-05-04
|
|
659
|
MS_DRG
|
Kidney And Ureter Procedures For Non-neoplasm With Mcc
|
11
|
11
|
$19,045.75
|
$15,236.60
20% off
|
$11,793.13
|
$17,141.18
|
$16,188.89
|
2026-05-04
|
|
66
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc
|
11
|
11
|
$13,121.55
|
$10,497.24
20% off
|
$8,124.87
|
$11,809.40
|
$11,153.32
|
2026-05-04
|
|
660
|
MS_DRG
|
Kidney And Ureter Procedures For Non-neoplasm With Cc
|
11
|
11
|
$27,512.06
|
$22,009.65
|
$17,035.47
|
$24,760.85
|
$23,385.25
|
2026-05-04
|
|
663
|
MS_DRG
|
Minor Bladder Procedures With Cc
|
11
|
11
|
$35,258.48
|
$28,206.78
20% off
|
$21,832.05
|
$31,732.63
|
$29,969.71
|
2026-05-04
|
|
669
|
MS_DRG
|
Transurethral Procedures With Cc
|
11
|
11
|
$42,197.11
|
$33,757.69
|
$26,128.45
|
$37,977.40
|
$35,867.54
|
2026-05-04
|
|
682
|
MS_DRG
|
Renal Failure With Mcc
|
11
|
11
|
$20,673.94
|
$16,539.15
20% off
|
$12,801.31
|
$18,606.55
|
$17,572.85
|
2026-05-04
|
|
683
|
MS_DRG
|
Renal Failure With Cc
|
11
|
11
|
$28,362.60
|
$22,690.08
|
$17,562.12
|
$25,526.34
|
$24,108.21
|
2026-05-04
|
|
684
|
MS_DRG
|
Renal Failure Without Cc/mcc
|
11
|
11
|
$11,928.59
|
$9,542.87
20% off
|
$7,386.18
|
$10,735.73
|
$10,139.30
|
2026-05-04
|
|
687
|
MS_DRG
|
Kidney And Urinary Tract Neoplasms With Cc
|
11
|
11
|
$6,399.85
|
$5,119.88
20% off
|
$3,962.79
|
$5,759.87
|
$5,439.87
|
2026-05-04
|
|
689
|
MS_DRG
|
Kidney And Urinary Tract Infections With Mcc
|
11
|
11
|
$17,914.19
|
$14,331.35
20% off
|
$11,092.46
|
$16,122.77
|
$15,227.06
|
2026-05-04
|
|
69
|
MS_DRG
|
Transient Ischemia Without Thrombolytic
|
11
|
11
|
$13,744.30
|
$10,995.44
|
$8,510.47
|
$12,369.87
|
$11,682.65
|
2026-05-04
|
|
690
|
MS_DRG
|
Kidney And Urinary Tract Infections Without Mcc
|
11
|
11
|
$15,261.34
|
$12,209.07
20% off
|
$9,449.82
|
$13,735.21
|
$12,972.14
|
2026-05-04
|
|
693
|
MS_DRG
|
Urinary Stones With Mcc
|
11
|
11
|
$3,458.95
|
$2,767.16
20% off
|
$2,141.78
|
$3,113.06
|
$2,940.11
|
2026-05-04
|
|
696
|
MS_DRG
|
Kidney And Urinary Tract Signs And Symptoms Without Mcc
|
11
|
11
|
$3,506.40
|
$2,805.12
20% off
|
$2,171.16
|
$3,155.76
|
$2,980.44
|
2026-05-04
|
|
699
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses With Cc
|
11
|
11
|
$16,347.23
|
$13,077.78
20% off
|
$10,122.20
|
$14,712.50
|
$13,895.14
|
2026-05-04
|
|
70
|
MS_DRG
|
Other Cerebrovascular Disorders With Mcc
|
11
|
11
|
$36,604.69
|
$29,283.75
20% off
|
$22,665.63
|
$32,944.22
|
$31,113.99
|
2026-05-04
|
|
71
|
MS_DRG
|
Other Cerebrovascular Disorders With Cc
|
11
|
11
|
$16,537.28
|
$13,229.82
20% off
|
$10,239.88
|
$14,883.55
|
$14,056.68
|
2026-05-04
|
|
72
|
MS_DRG
|
Other Cerebrovascular Disorders Without Cc/mcc
|
11
|
11
|
$22,671.63
|
$18,137.31
|
$14,038.28
|
$20,404.47
|
$19,270.89
|
2026-05-04
|
|
726
|
MS_DRG
|
Benign Prostatic Hypertrophy Without Mcc
|
11
|
11
|
$3,563.45
|
$2,850.76
|
$2,206.49
|
$3,207.11
|
$3,028.93
|
2026-05-04
|
|
743
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc
|
11
|
11
|
$63,843.65
|
$51,074.92
20% off
|
$39,531.99
|
$57,459.28
|
$54,267.10
|
2026-05-04
|
|
74704349_ERX
|
CDM
|
Curosurf 240 Mg/3 Ml Vial
|
18
|
18
|
$120,570.50
|
$96,456.40
20% off
|
$37,666.22
|
$108,513.45
|
$49,813.70
|
2026-05-04
|
|
755
|
MS_DRG
|
Malignancy, Female Reproductive System With Cc
|
11
|
11
|
$5,098.70
|
$4,078.96
|
$3,157.12
|
$4,588.83
|
$4,333.90
|
2026-05-04
|
|
768
|
MS_DRG
|
Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c
|
11
|
11
|
$13,634.56
|
$10,907.65
|
$8,442.52
|
$12,271.11
|
$11,589.38
|
2026-05-04
|
|
785
|
MS_DRG
|
Cesarean Section With Sterilization Without Cc/mcc
|
11
|
11
|
$34,303.81
|
$27,443.04
20% off
|
$21,240.92
|
$30,873.42
|
$29,158.23
|
2026-05-04
|
|
787
|
MS_DRG
|
Cesarean Section Without Sterilization With Cc
|
11
|
11
|
$33,772.42
|
$27,017.94
|
$20,911.88
|
$30,395.18
|
$28,706.56
|
2026-05-04
|
|
788
|
MS_DRG
|
Cesarean Section Without Sterilization Without Cc/mcc
|
11
|
11
|
$28,973.67
|
$23,178.94
|
$17,940.50
|
$26,076.31
|
$24,627.62
|
2026-05-04
|
|
789
|
MS_DRG
|
Neonates, Died Or Transferred To Another Acute Care Facility
|
11
|
11
|
$6,662.00
|
$5,329.60
|
$4,125.11
|
$5,995.80
|
$5,662.70
|
2026-05-04
|
|
792
|
MS_DRG
|
Prematurity Without Major Problems
|
11
|
11
|
$5,180.91
|
$4,144.73
|
$3,208.02
|
$4,662.82
|
$4,403.78
|
2026-05-04
|
|
793
|
MS_DRG
|
Full Term Neonate With Major Problems
|
11
|
11
|
$4,450.88
|
$3,560.71
|
$2,755.99
|
$4,005.79
|
$3,783.25
|
2026-05-04
|
|
794
|
MS_DRG
|
Neonate With Other Significant Problems
|
11
|
11
|
$3,984.27
|
$3,187.42
|
$2,467.06
|
$3,585.84
|
$3,386.63
|
2026-05-04
|
|
795
|
MS_DRG
|
Normal Newborn
|
11
|
11
|
$3,563.88
|
$2,851.11
|
$2,206.76
|
$3,207.49
|
$3,029.30
|
2026-05-04
|
|
805
|
MS_DRG
|
Vaginal Delivery Without Sterilization Or D&c With Mcc
|
11
|
11
|
$12,541.61
|
$10,033.29
|
$7,765.76
|
$11,287.45
|
$10,660.37
|
2026-05-04
|
|
806
|
MS_DRG
|
Vaginal Delivery Without Sterilization Or D&c With Cc
|
11
|
11
|
$11,938.04
|
$9,550.43
20% off
|
$7,392.04
|
$10,744.24
|
$10,147.34
|
2026-05-04
|
|
807
|
MS_DRG
|
Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc
|
11
|
11
|
$10,490.41
|
$8,392.33
|
$6,495.66
|
$9,441.37
|
$8,916.85
|
2026-05-04
|
|
808
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
11
|
11
|
$31,585.18
|
$25,268.14
20% off
|
$19,557.54
|
$28,426.66
|
$26,847.40
|
2026-05-04
|
|
809
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
11
|
11
|
$16,505.06
|
$13,204.05
|
$10,219.93
|
$14,854.55
|
$14,029.30
|
2026-05-04
|
|
811
|
MS_DRG
|
Red Blood Cell Disorders With Mcc
|
11
|
11
|
$32,731.25
|
$26,185.00
20% off
|
$20,267.19
|
$29,458.13
|
$27,821.56
|
2026-05-04
|
|
812
|
MS_DRG
|
Red Blood Cell Disorders Without Mcc
|
11
|
11
|
$25,284.74
|
$20,227.79
20% off
|
$15,656.31
|
$22,756.26
|
$21,492.02
|
2026-05-04
|
|
835
|
MS_DRG
|
Acute Leukemia With Cc
|
11
|
11
|
$25,971.51
|
$20,777.21
|
$16,081.56
|
$23,374.36
|
$22,075.78
|
2026-05-04
|
|
854
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Cc
|
11
|
11
|
$77,023.09
|
$61,618.47
20% off
|
$47,692.70
|
$69,320.78
|
$65,469.63
|
2026-05-04
|
|
86
|
MS_DRG
|
Traumatic Stupor And Coma <1 Hour With Cc
|
11
|
11
|
$13,361.26
|
$10,689.01
|
$8,273.29
|
$12,025.13
|
$11,357.07
|
2026-05-04
|
|
862
|
MS_DRG
|
Postoperative And Post-traumatic Infections With Mcc
|
11
|
11
|
$19,999.42
|
$15,999.54
|
$12,383.64
|
$17,999.48
|
$16,999.51
|
2026-05-04
|
|
864
|
MS_DRG
|
Fever And Inflammatory Conditions
|
11
|
11
|
$16,640.65
|
$13,312.52
20% off
|
$10,303.89
|
$14,976.59
|
$14,144.55
|
2026-05-04
|
|
871
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc
|
11
|
11
|
$27,632.92
|
$22,106.34
|
$17,110.30
|
$24,869.63
|
$23,487.98
|
2026-05-04
|
|
872
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc
|
11
|
11
|
$19,001.84
|
$15,201.48
|
$11,765.94
|
$17,101.66
|
$16,151.57
|
2026-05-04
|
|
880
|
MS_DRG
|
Acute Adjustment Reaction And Psychosocial Dysfunction
|
11
|
11
|
$21,053.10
|
$16,842.48
|
$13,036.08
|
$18,947.79
|
$17,895.14
|
2026-05-04
|
|
884
|
MS_DRG
|
Organic Disturbances And Intellectual Disability
|
11
|
11
|
$65,144.43
|
$52,115.54
20% off
|
$40,337.43
|
$58,629.98
|
$55,372.76
|
2026-05-04
|
|
896
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc
|
11
|
11
|
$3,360.45
|
$2,688.36
|
$2,080.79
|
$3,024.41
|
$2,856.38
|
2026-05-04
|
|
897
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc
|
11
|
11
|
$23,217.85
|
$18,574.28
20% off
|
$14,376.49
|
$20,896.07
|
$19,735.17
|
2026-05-04
|
|
90378
|
HCPCS
|
Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle
|
36
|
18
|
$135,765.10
|
$108,612.08
|
$38,834.80
|
$132,497.15
|
$55,812.45
|
2026-05-04
|
|
91
|
MS_DRG
|
Other Disorders Of Nervous System With Mcc
|
11
|
11
|
$19,785.55
|
$15,828.44
|
$12,251.21
|
$17,807.00
|
$16,817.72
|
2026-05-04
|
|
914
|
MS_DRG
|
Traumatic Injury Without Mcc
|
11
|
11
|
$27,965.64
|
$22,372.51
20% off
|
$17,316.32
|
$25,169.08
|
$23,770.79
|
2026-05-04
|
|
917
|
MS_DRG
|
Poisoning And Toxic Effects Of Drugs With Mcc
|
11
|
11
|
$18,036.33
|
$14,429.06
20% off
|
$11,168.09
|
$16,232.69
|
$15,330.88
|
2026-05-04
|
|
918
|
MS_DRG
|
Poisoning And Toxic Effects Of Drugs Without Mcc
|
11
|
11
|
$37,701.52
|
$30,161.22
|
$23,344.78
|
$33,931.37
|
$32,046.29
|
2026-05-04
|
|
92
|
MS_DRG
|
Other Disorders Of Nervous System With Cc
|
11
|
11
|
$12,659.59
|
$10,127.68
|
$7,838.82
|
$11,393.63
|
$10,760.65
|
2026-05-04
|
|
93
|
MS_DRG
|
Other Disorders Of Nervous System Without Cc/mcc
|
11
|
11
|
$7,041.70
|
$5,633.36
20% off
|
$4,360.22
|
$6,337.53
|
$5,985.44
|
2026-05-04
|
|
948
|
MS_DRG
|
Signs And Symptoms Without Mcc
|
11
|
11
|
$7,663.28
|
$6,130.62
20% off
|
$4,745.10
|
$6,896.95
|
$6,513.79
|
2026-05-04
|
|
951
|
MS_DRG
|
Other Factors Influencing Health Status
|
11
|
11
|
$8,432.92
|
$6,746.34
|
$5,221.67
|
$7,589.63
|
$7,167.98
|
2026-05-04
|
|
964
|
MS_DRG
|
Other Multiple Significant Trauma With Cc
|
11
|
11
|
$11,366.40
|
$9,093.12
|
$7,038.07
|
$10,229.76
|
$9,661.44
|
2026-05-04
|
|
965
|
MS_DRG
|
Other Multiple Significant Trauma Without Cc/mcc
|
11
|
11
|
$9,544.57
|
$7,635.66
|
$5,910.00
|
$8,590.11
|
$8,112.88
|
2026-05-04
|
|
97510077_FAC{2}
|
CDM
|
Hc Pr 11426 Exc H-f-nk-sp B9+marg > 4 Cm
|
3
|
3
|
$4,123.00
|
$3,298.40
20% off
|
$3,092.25
|
$3,710.70
|
$3,504.55
|
2026-05-04
|
|
97510786_FAC{2}
|
CDM
|
Hc Pr 46220 Excise Anal External Tag/papilla
|
3
|
3
|
$4,419.00
|
$3,535.20
20% off
|
$3,314.25
|
$3,977.10
|
$3,756.15
|
2026-05-04
|
|
98
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc
|
11
|
11
|
$30,675.55
|
$24,540.44
20% off
|
$18,994.30
|
$27,608.00
|
$26,074.22
|
2026-05-04
|
|
98110235_FAC{2}
|
CDM
|
Hc Pr Ed 10121 Remove Foreign Body Complicated Cdm
|
3
|
3
|
$3,833.50
|
$3,066.80
|
$2,875.13
|
$3,450.15
|
$3,258.48
|
2026-05-04
|
|
98110236_FAC
|
CDM
|
Hc Pr Ed 10140 Drainage Of Hematoma/fluid Cdm
|
3
|
3
|
$4,634.00
|
$3,707.20
20% off
|
$3,475.50
|
$4,170.60
|
$3,938.90
|
2026-05-04
|
|
98110386_FAC{2}
|
CDM
|
Hc Pr Ed 46320 Removal Of Hemorrhoid Clot Cdm
|
3
|
3
|
$3,289.00
|
$2,631.20
20% off
|
$2,466.75
|
$2,960.10
|
$2,795.65
|
2026-05-04
|
|
C1747
|
HCPCS
|
Endoscope, Single-use (i.e. Disposable), Urinary Tract, Imaging/illumination Dev…
|
18
|
18
|
$11,985.00
|
$9,588.00
20% off
|
$3,744.11
|
$10,786.50
|
$4,951.60
|
2026-05-04
|
|
C1764
|
HCPCS
|
Event Recorder, Cardiac (implantable)
|
18
|
18
|
$10,372.96
|
$8,298.37
|
$3,240.51
|
$9,335.66
|
$4,285.59
|
2026-05-04
|
|
C1778
|
HCPCS
|
Lead, Neurostimulator (implantable)
|
18
|
18
|
$10,091.74
|
$8,073.39
20% off
|
$3,152.66
|
$9,082.57
|
$4,169.41
|
2026-05-04
|
|
C1781
|
HCPCS
|
Mesh (implantable)
|
234
|
18
|
$11,197.00
|
$8,957.60
|
$94.39
|
$30,045.60
|
$6,679.72
|
2026-05-04
|
|
C1785
|
HCPCS
|
Pacemaker, Dual Chamber, Rate-responsive (implantable)
|
18
|
18
|
$12,964.64
|
$10,371.71
20% off
|
$4,050.15
|
$11,668.18
|
$5,356.34
|
2026-05-04
|
|
C1815
|
HCPCS
|
Prosthesis, Urinary Sphincter (implantable)
|
54
|
18
|
$6,284.21
|
$5,027.37
|
$1,484.39
|
$8,959.30
|
$3,484.17
|
2026-05-04
|
|
C5273
|
HCPCS
|
Application Of Low Cost Skin Substitute Graft To Trunk, Arms, Legs, Total Wound …
|
25
|
18
|
$10,883.45
|
$8,706.76
20% off
|
$50.50
|
$9,795.11
|
$3,809.21
|
2026-05-04
|
|
J0129
|
HCPCS
|
Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere…
|
18
|
18
|
$9,821.00
|
$7,856.80
20% off
|
$3,068.08
|
$8,838.90
|
$4,057.55
|
2026-05-04
|
|
J0180
|
HCPCS
|
Injection, Agalsidase Beta, 1 Mg
|
18
|
18
|
$25,459.55
|
$20,367.64
20% off
|
$7,953.56
|
$22,913.60
|
$10,518.61
|
2026-05-04
|
|
J0222
|
HCPCS
|
Injection, Patisiran, 0.1 Mg
|
18
|
18
|
$40,292.75
|
$32,234.20
20% off
|
$12,587.46
|
$36,263.48
|
$16,646.95
|
2026-05-04
|
|
J0256
|
HCPCS
|
Injection, Alpha 1 Proteinase Inhibitor (human), Not Otherwise Specified, 10 Mg
|
18
|
18
|
$7,760.65
|
$6,208.52
|
$2,424.43
|
$6,984.59
|
$3,206.31
|
2026-05-04
|
|
J0565
|
HCPCS
|
Injection, Bezlotoxumab, 10 Mg
|
18
|
18
|
$10,303.15
|
$8,242.52
|
$3,218.70
|
$9,272.84
|
$4,256.74
|
2026-05-04
|
|
J0717
|
HCPCS
|
Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm…
|
54
|
18
|
$8,176.10
|
$6,540.88
20% off
|
$7.90
|
$8,627.22
|
$3,027.19
|
2026-05-04
|
|
J0739
|
HCPCS
|
Injection, Cabotegravir, 1mg, Fda Approved Prescription, Only For Use As HIV Pre…
|
18
|
18
|
$14,167.25
|
$11,333.80
20% off
|
$4,425.85
|
$12,750.53
|
$5,853.20
|
2026-05-04
|
|
J0741
|
HCPCS
|
Injection, Cabotegravir And Rilpivirine, 2mg/3mg
|
36
|
18
|
$11,979.31
|
$9,583.45
|
$23.47
|
$21,495.15
|
$3,764.41
|
2026-05-04
|
|
J0875
|
HCPCS
|
Injection, Dalbavancin, 5 Mg
|
18
|
18
|
$8,113.30
|
$6,490.64
20% off
|
$2,534.59
|
$7,301.97
|
$3,352.01
|
2026-05-04
|
|
J0896
|
HCPCS
|
Injection, Luspatercept-aamt, 0.25 Mg
|
36
|
18
|
$43,209.28
|
$34,567.42
20% off
|
$13,485.26
|
$38,926.71
|
$17,850.88
|
2026-05-04
|
|
J0897
|
HCPCS
|
Injection, Denosumab, 1 Mg
|
36
|
18
|
$9,369.75
|
$7,495.80
20% off
|
$2,533.33
|
$9,567.23
|
$3,964.02
|
2026-05-04
|
|
J1300
|
HCPCS
|
Injection, Eculizumab, 10 Mg
|
18
|
18
|
$68,807.25
|
$55,045.80
|
$21,495.38
|
$61,926.53
|
$28,427.71
|
2026-05-04
|
|
J1303
|
HCPCS
|
Injection, Ravulizumab-cwvz, 10 Mg
|
36
|
18
|
$33,622.32
|
$26,897.86
|
$4,516.66
|
$47,508.03
|
$14,751.36
|
2026-05-04
|
|
J1306
|
HCPCS
|
Injection, Inclisiran, 1 Mg
|
18
|
18
|
$12,023.05
|
$9,618.44
|
$3,756.00
|
$10,820.75
|
$4,967.32
|
2026-05-04
|
|
J1459
|
HCPCS
|
Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui…
|
72
|
18
|
$9,911.48
|
$7,929.18
20% off
|
$1,636.44
|
$23,566.14
|
$4,714.47
|
2026-05-04
|
|
J1930
|
HCPCS
|
Injection, Lanreotide, 1 Mg
|
18
|
18
|
$33,630.35
|
$26,904.28
20% off
|
$10,506.12
|
$30,267.32
|
$13,894.38
|
2026-05-04
|
|
J1950
|
HCPCS
|
Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg
|
36
|
18
|
$9,746.02
|
$7,796.82
20% off
|
$1,874.81
|
$12,141.68
|
$4,721.76
|
2026-05-04
|
|
J2323
|
HCPCS
|
Injection, Natalizumab, 1 Mg
|
18
|
18
|
$18,602.50
|
$14,882.00
20% off
|
$5,811.42
|
$16,742.25
|
$7,685.62
|
2026-05-04
|
|
J2327
|
HCPCS
|
Injection, Risankizumab-rzaa, Intravenous, 1 Mg
|
36
|
18
|
$15,027.54
|
$12,022.03
20% off
|
$49.32
|
$26,907.48
|
$4,740.99
|
2026-05-04
|
|
J2350
|
HCPCS
|
Injection, Ocrelizumab, 1 Mg
|
18
|
18
|
$46,411.70
|
$37,129.36
|
$14,499.02
|
$41,770.53
|
$19,174.99
|
2026-05-04
|
|
J2353
|
HCPCS
|
Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg
|
36
|
18
|
$18,497.70
|
$14,798.16
20% off
|
$4,628.82
|
$19,960.61
|
$8,107.60
|
2026-05-04
|
|
J2356
|
HCPCS
|
Injection, Tezepelumab-ekko, 1 Mg
|
18
|
18
|
$15,374.05
|
$12,299.24
20% off
|
$4,802.85
|
$13,836.65
|
$6,351.79
|
2026-05-04
|
|
J2506
|
HCPCS
|
Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg
|
18
|
18
|
$13,942.20
|
$11,153.76
20% off
|
$4,355.54
|
$12,547.98
|
$5,760.22
|
2026-05-04
|
|
J2507
|
HCPCS
|
Injection, Pegloticase, 1 Mg
|
18
|
18
|
$105,553.65
|
$84,442.92
20% off
|
$32,974.96
|
$94,998.29
|
$43,609.49
|
2026-05-04
|
|
J2783
|
HCPCS
|
Injection, Rasburicase, 0.5 Mg
|
36
|
18
|
$12,156.27
|
$9,725.02
|
$1,601.28
|
$17,268.12
|
$5,303.57
|
2026-05-04
|
|
J2792
|
HCPCS
|
Injection, Rho D Immune Globulin, Intravenous, Human, Solvent Detergent, 100 Iu
|
18
|
18
|
$9,128.60
|
$7,302.88
20% off
|
$2,851.77
|
$8,215.74
|
$3,771.48
|
2026-05-04
|
|
J3101
|
HCPCS
|
Injection, Tenecteplase, 1 Mg
|
36
|
18
|
$13,452.00
|
$10,761.60
20% off
|
$3,363.03
|
$14,524.97
|
$5,895.02
|
2026-05-04
|
|
J3111
|
HCPCS
|
Injection, Romosozumab-aqqg, 1 Mg
|
18
|
18
|
$8,818.90
|
$7,055.12
20% off
|
$2,755.02
|
$7,937.01
|
$3,643.53
|
2026-05-04
|
|
J3240
|
HCPCS
|
Injection, Thyrotropin Alpha, 0.9 Mg, Provided In 1.1 Mg Vial
|
18
|
18
|
$8,372.90
|
$6,698.32
20% off
|
$2,615.69
|
$7,535.61
|
$3,459.26
|
2026-05-04
|
|
J3245
|
HCPCS
|
Injection, Tildrakizumab, 1 Mg
|
18
|
18
|
$46,832.85
|
$37,466.28
20% off
|
$14,630.58
|
$42,149.57
|
$19,348.99
|
2026-05-04
|
|
J3247
|
HCPCS
|
Injection, Secukinumab, Intravenous, 1 Mg
|
18
|
18
|
$7,563.90
|
$6,051.12
20% off
|
$2,362.96
|
$6,807.51
|
$3,125.03
|
2026-05-04
|
|
J3358
|
HCPCS
|
Ustekinumab, For Intravenous Injection, 1 Mg
|
18
|
18
|
$7,468.80
|
$5,975.04
20% off
|
$2,333.25
|
$6,721.92
|
$3,085.73
|
2026-05-04
|
|
J3380
|
HCPCS
|
Injection, Vedolizumab, Intravenous, 1 Mg
|
18
|
18
|
$21,092.25
|
$16,873.80
20% off
|
$6,589.22
|
$18,983.03
|
$8,714.26
|
2026-05-04
|
|
J3590
|
HCPCS
|
Unclassified Biologics
|
18
|
18
|
$11,536.65
|
$9,229.32
20% off
|
$3,604.05
|
$10,382.99
|
$4,766.36
|
2026-05-04
|
|
J7168
|
HCPCS
|
Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity
|
36
|
18
|
$11,450.97
|
$9,160.78
|
$2,549.39
|
$13,267.17
|
$5,211.05
|
2026-05-04
|
|
J7187
|
HCPCS
|
Injection, Von Willebrand Factor Complex (humate-p), Per Iu Vwf:rco
|
36
|
18
|
$12,526.72
|
$10,021.38
|
$3,856.86
|
$11,436.80
|
$5,171.01
|
2026-05-04
|
|
J9022
|
HCPCS
|
Injection, Atezolizumab, 10 Mg
|
18
|
18
|
$39,570.45
|
$31,656.36
|
$12,361.81
|
$35,613.41
|
$16,348.53
|
2026-05-04
|
|
J9023
|
HCPCS
|
Injection, Avelumab, 10 Mg
|
18
|
18
|
$7,095.50
|
$5,676.40
20% off
|
$2,216.63
|
$6,385.95
|
$2,931.51
|
2026-05-04
|
|
J9032
|
HCPCS
|
Injection, Belinostat, 10 Mg
|
18
|
18
|
$8,448.10
|
$6,758.48
20% off
|
$2,639.19
|
$7,603.29
|
$3,490.33
|
2026-05-04
|
|
J9035
|
HCPCS
|
Injection, Bevacizumab, 10 Mg
|
18
|
18
|
$9,036.20
|
$7,228.96
20% off
|
$2,822.91
|
$8,132.58
|
$3,733.31
|
2026-05-04
|
|
J9043
|
HCPCS
|
Injection, Cabazitaxel, 1 Mg
|
36
|
18
|
$23,402.22
|
$18,721.78
20% off
|
$4,527.52
|
$29,080.58
|
$11,309.11
|
2026-05-04
|
|
J9047
|
HCPCS
|
Injection, Carfilzomib, 1 Mg
|
36
|
18
|
$12,272.42
|
$9,817.94
20% off
|
$3,129.14
|
$13,075.56
|
$5,397.93
|
2026-05-04
|
|
J9063
|
HCPCS
|
Injection, Mirvetuximab Soravtansine-gynx, 1 Mg
|
18
|
18
|
$42,663.60
|
$34,130.88
20% off
|
$13,328.11
|
$38,397.24
|
$17,626.47
|
2026-05-04
|
|
J9144
|
HCPCS
|
Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj
|
18
|
18
|
$22,467.25
|
$17,973.80
20% off
|
$7,018.77
|
$20,220.53
|
$9,282.35
|
2026-05-04
|
|
J9145
|
HCPCS
|
Injection, Daratumumab, 10 Mg
|
18
|
18
|
$8,753.20
|
$7,002.56
20% off
|
$2,734.50
|
$7,877.88
|
$3,616.39
|
2026-05-04
|
|
J9176
|
HCPCS
|
Injection, Elotuzumab, 1 Mg
|
18
|
18
|
$10,683.55
|
$8,546.84
|
$3,337.54
|
$9,615.20
|
$4,413.91
|
2026-05-04
|
|
J9177
|
HCPCS
|
Injection, Enfortumab Vedotin-ejfv, 0.25 Mg
|
18
|
18
|
$12,023.95
|
$9,619.16
20% off
|
$3,756.28
|
$10,821.56
|
$4,967.69
|
2026-05-04
|
|
J9207
|
HCPCS
|
Injection, Ixabepilone, 1 Mg
|
18
|
18
|
$13,649.25
|
$10,919.40
20% off
|
$4,264.03
|
$12,284.33
|
$5,639.19
|
2026-05-04
|
|
J9227
|
HCPCS
|
Injection, Isatuximab-irfc, 10 Mg
|
18
|
18
|
$11,920.00
|
$9,536.00
20% off
|
$3,723.81
|
$10,728.00
|
$4,924.75
|
2026-05-04
|
|
J9228
|
HCPCS
|
Injection, Ipilimumab, 1 Mg
|
18
|
18
|
$79,781.25
|
$63,825.00
20% off
|
$24,923.66
|
$71,803.13
|
$32,961.62
|
2026-05-04
|
|
J9268
|
HCPCS
|
Injection, Pentostatin, 10 Mg
|
18
|
18
|
$7,981.95
|
$6,385.56
|
$2,493.56
|
$7,183.76
|
$3,297.74
|
2026-05-04
|
|
J9299
|
HCPCS
|
Injection, Nivolumab, 1 Mg
|
54
|
18
|
$11,018.40
|
$8,814.72
20% off
|
$2,872.86
|
$15,806.48
|
$6,146.96
|
2026-05-04
|
|
J9302
|
HCPCS
|
Injection, Ofatumumab, 10 Mg
|
18
|
18
|
$12,663.25
|
$10,130.60
20% off
|
$3,956.00
|
$11,396.93
|
$5,231.82
|
2026-05-04
|
|
J9303
|
HCPCS
|
Injection, Panitumumab, 10 Mg
|
18
|
18
|
$15,066.10
|
$12,052.88
20% off
|
$4,706.65
|
$13,559.49
|
$6,224.56
|
2026-05-04
|
|
J9306
|
HCPCS
|
Injection, Pertuzumab, 1 Mg
|
18
|
18
|
$15,392.75
|
$12,314.20
|
$4,808.70
|
$13,853.48
|
$6,359.51
|
2026-05-04
|
|
J9307
|
HCPCS
|
Injection, Pralatrexate, 1 Mg
|
36
|
18
|
$21,098.05
|
$16,878.44
|
$4,785.58
|
$24,189.62
|
$9,501.14
|
2026-05-04
|
|
J9308
|
HCPCS
|
Injection, Ramucirumab, 5 Mg
|
18
|
18
|
$25,878.50
|
$20,702.80
20% off
|
$8,084.44
|
$23,290.65
|
$10,691.70
|
2026-05-04
|
|
J9311
|
HCPCS
|
Injection, Rituximab 10 Mg And Hyaluronidase
|
36
|
18
|
$13,263.05
|
$10,610.43
20% off
|
$27.36
|
$23,794.65
|
$4,169.11
|
2026-05-04
|
|
J9312
|
HCPCS
|
Injection, Rituximab, 10 Mg
|
36
|
18
|
$14,166.08
|
$11,332.86
20% off
|
$4,147.39
|
$13,550.63
|
$5,831.04
|
2026-05-04
|
|
J9316
|
HCPCS
|
Injection, Pertuzumab, Trastuzumab, And Hyaluronidase-zzxf, Per 10 Mg
|
36
|
18
|
$10,534.29
|
$8,427.43
|
$50.51
|
$18,816.21
|
$3,338.41
|
2026-05-04
|
|
J9319
|
HCPCS
|
Injection, Romidepsin, Lyophilized, 0.1 Mg
|
18
|
18
|
$9,066.80
|
$7,253.44
20% off
|
$2,832.47
|
$8,160.12
|
$3,745.95
|
2026-05-04
|
|
J9333
|
HCPCS
|
Injection, Rozanolixizumab-noli, 1 Mg
|
18
|
18
|
$32,317.20
|
$25,853.76
20% off
|
$10,095.89
|
$29,085.48
|
$13,351.85
|
2026-05-04
|
|
J9354
|
HCPCS
|
Injection, Ado-trastuzumab Emtansine, 1 Mg
|
18
|
18
|
$14,411.70
|
$11,529.36
20% off
|
$4,502.22
|
$12,970.53
|
$5,954.19
|
2026-05-04
|
|
J9359
|
HCPCS
|
Injection, Loncastuximab Tesirine-lpyl, 0.075 Mg
|
18
|
18
|
$30,190.90
|
$24,152.72
20% off
|
$9,431.64
|
$27,171.81
|
$12,473.37
|
2026-05-04
|
|
Q0249
|
HCPCS
|
Injection, Tocilizumab, For Hospitalized Adults And Pediatric Patients (2 Years …
|
54
|
18
|
$5,086.40
|
$4,069.12
|
$1,314.97
|
$7,500.47
|
$2,916.85
|
2026-05-04
|
|
Q3027
|
HCPCS
|
Injection, Interferon Beta-1a, 1 Mcg For Intramuscular Use
|
18
|
18
|
$9,334.70
|
$7,467.76
20% off
|
$2,916.16
|
$8,401.23
|
$3,856.63
|
2026-05-04
|
|
Q5107
|
HCPCS
|
Injection, Bevacizumab-awwb, Biosimilar, (mvasi), 10 Mg
|
18
|
18
|
$7,159.85
|
$5,727.88
20% off
|
$2,236.74
|
$6,443.87
|
$2,958.09
|
2026-05-04
|
|
Q5111
|
HCPCS
|
Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg
|
36
|
18
|
$8,194.75
|
$6,555.80
20% off
|
$1,676.03
|
$9,922.05
|
$3,897.16
|
2026-05-04
|
|
Q5115
|
HCPCS
|
Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg
|
36
|
18
|
$8,686.20
|
$6,948.96
20% off
|
$2,247.20
|
$9,161.15
|
$3,795.77
|
2026-05-04
|
|
Q5119
|
HCPCS
|
Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg
|
36
|
18
|
$9,317.65
|
$7,454.12
20% off
|
$2,669.47
|
$9,081.23
|
$3,830.78
|
2026-05-04
|
|
Q5120
|
HCPCS
|
Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg
|
18
|
18
|
$8,179.05
|
$6,543.24
20% off
|
$2,555.14
|
$7,361.15
|
$3,379.17
|
2026-05-04
|
|
Q9992
|
HCPCS
|
Injection, Buprenorphine Extended-release (sublocade), Greater Than 100 Mg
|
18
|
18
|
$13,699.65
|
$10,959.72
20% off
|
$4,279.77
|
$12,329.69
|
$5,660.01
|
2026-05-04
|