Hospital

WELLFOUND BEHAVIORAL HEALTH HOSPITAL

Tacoma, WA · CCN 504016 · Rates published

9,655 distinct procedures filed

12 distinct payers

16,787 rate rows

2025-07-29 last MRF observed · ⚠ 12 mo old

Data quality

9,745 of 16,787 rate rows are consumer-grade (58.1%)

7,042 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	6,681
per-diem day rate — not a per-procedure price	360
placeholder amount (≤ $0.02) — excluded from medians	1

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/8174/474654897-1891298980_alliance-for-south-sound-health_standardcharges.csv
Found on page	https://www.wellfound.org/cms-hpt.txt
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-19
Content fingerprint	27c31fa65486e949… · 21,477,699 bytes · first seen 2026-05-14

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
Q2057 HCPCS	Afamitresgene Autoleucel	1	$1,944,659.57	$1,944,659.57	$1,944,659.57	nat. median $824,563 outlier · 2.4×
Q2042 HCPCS	Tisagenlecleucel Car-pos T	1	$1,460,528.93	$1,460,528.93	$1,460,528.93	nat. median $753,246 1.9× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	1	$1,395,922.73	$1,395,922.73	$1,395,922.73	nat. median $674,867 outlier · 2.1×
Q2055 HCPCS	Idecabtagene Vicleucel Car	1	$1,331,455.28	$1,331,455.28	$1,331,455.28	nat. median $625,184 outlier · 2.1×
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	1	$1,303,242.11	$1,303,242.11	$1,303,242.11	nat. median $673,137 1.9× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	1	$1,268,918.58	$1,268,918.58	$1,268,918.58	nat. median $634,303 outlier · 2.0×
Q2053 HCPCS	Brexucabtagene Car Pos T	1	$1,234,998.77	$1,234,998.77	$1,234,998.77	nat. median $619,808 2.0× median
C9301 HCPCS	Apc	1	$702,163.88	$702,163.88	$702,163.88	nat. median $459,112 1.5× median
Q0480 HCPCS	Driver Pneumatic Vad, Rep	1	$252,349.77	$252,349.77	$252,349.77	nat. median $111,989 outlier · 2.3×
L8702 HCPCS	Ewhf S/d Uprt Micro Sensor	1	$170,216.79	$170,216.79	$170,216.79	nat. median $70,825 outlier · 2.4×
38240 CPT	Transplt Allo Hct/donor	1	$169,161.01	$169,161.01	$169,161.01	nat. median $15,979 outlier · 10.6×
J9029 HCPCS	Instill Adstiladrin, Tx Dose	1	$159,575.05	$159,575.05	$159,575.05	nat. median $69,774 outlier · 2.3×
Q2043 HCPCS	Sipuleucel-t Auto Cd54+	1	$143,882.66	$143,882.66	$143,882.66	nat. median $66,682 outlier · 2.2×
A9543 HCPCS	Y90 Ibritumomab, Rx	1	$143,396.75	$143,396.75	$143,396.75	nat. median $62,507 outlier · 2.3×
33276 CPT	Insj Phrnc Nrv Stim Sys	1	$128,712.04	$128,712.04	$128,712.04	nat. median $43,787 outlier · 2.9×
0266T CPT	Apc	1	$128,712.04	$128,712.04	$128,712.04	nat. median $42,941 outlier · 3.0×
L7181 HCPCS	Electronic Elbo Simultaneous	1	$119,137.64	$119,137.64	$119,137.64	nat. median $50,598 outlier · 2.4×
J9226 HCPCS	Supprelin La Implant	1	$114,092.58	$114,092.58	$114,092.58	nat. median $60,368 1.9× median
L7180 HCPCS	Electronic Elbow Sequential	1	$110,968.62	$110,968.62	$110,968.62	nat. median $49,027 outlier · 2.3×
0620T CPT	Evasc Ven Artlz Tibl/prnl Vn	1	$100,109.68	$100,109.68	$100,109.68	nat. median $33,076 outlier · 3.0×
L2006 HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	1	$96,581.87	$96,581.87	$96,581.87	nat. median $39,823 outlier · 2.4×
33231 CPT	Insrt Pulse Gen W/mult Leads	1	$91,703.68	$91,703.68	$91,703.68	nat. median $30,121 outlier · 3.0×
0915T CPT	Insj Perm Ccm-d Sys Pg&eltrd	1	$91,703.68	$91,703.68	$91,703.68	nat. median $32,560 outlier · 2.8×
33249 CPT	Insj/rplcmt Defib W/lead(s)	1	$91,703.68	$91,703.68	$91,703.68	nat. median $31,833 outlier · 2.9×
0408T CPT	Insj/rplc Cardiac Modulj Sys	1	$91,703.68	$91,703.68	$91,703.68	nat. median $32,221 outlier · 2.8×
33264 CPT	Rmvl & Rplcmt Dfb Gen Mlt Ld	1	$91,703.68	$91,703.68	$91,703.68	nat. median $31,873 outlier · 2.9×
33270 CPT	Ins/rep Subq Defibrillator	1	$91,703.68	$91,703.68	$91,703.68	nat. median $32,221 outlier · 2.8×
0571T CPT	Insj/rplcmt Icds Ss Eltrd	1	$91,703.68	$91,703.68	$91,703.68	nat. median $32,221 outlier · 2.8×
69930 CPT	Implant Cochlear Device	1	$90,977.87	$90,977.87	$90,977.87	nat. median $29,690 outlier · 3.1×
64582 CPT	Opn Mpltj Hpglsl Nstm Ary Pg	1	$87,161.65	$87,161.65	$87,161.65	nat. median $28,316 outlier · 3.1×
0674T CPT	Laps Insj Nw/rpcmt Prm Isdss	1	$87,161.65	$87,161.65	$87,161.65	nat. median $25,200 outlier · 3.5×
33287 CPT	Rmv&rplcmt Phrnc Nrv Stim Pg	1	$87,161.65	$87,161.65	$87,161.65	nat. median $29,698 outlier · 2.9×
0268T CPT	Apc	1	$87,161.65	$87,161.65	$87,161.65	nat. median $30,333 outlier · 2.9×
63685 CPT	Ins/rplc Spi Npg/rcvr Pocket	1	$87,161.65	$87,161.65	$87,161.65	nat. median $21,357 outlier · 4.1×
64568 CPT	Opn Impltj Crnl Nrv Nea&pg	1	$87,161.65	$87,161.65	$87,161.65	nat. median $27,591 outlier · 3.2×
61886 CPT	Implant Neurostim Arrays	1	$87,161.65	$87,161.65	$87,161.65	nat. median $27,109 outlier · 3.2×
L8701 HCPCS	Ewh S/d Uprt Micro Sensor	1	$86,516.78	$86,516.78	$86,516.78	nat. median $35,999 outlier · 2.4×
33289 CPT	Tcat Impl Wrls P-art Prs Snr	1	$81,311.73	$81,311.73	$81,311.73	nat. median $28,318 outlier · 2.9×
C9760 HCPCS	Non-blind Interatrial Shunt	1	$78,657.92	$78,657.92	$78,657.92	nat. median $28,405 outlier · 2.8×
L5856 HCPCS	Elec Knee-shin Swing/stance	1	$71,378.51	$71,378.51	$71,378.51	nat. median $30,273 outlier · 2.4×
L6880 HCPCS	Elec Hand Ind Art Digits	1	$71,041.47	$71,041.47	$71,041.47	nat. median $30,168 outlier · 2.4×
93653 CPT	Compre Ep Eval Tx Svt	1	$70,168.16	$70,168.16	$70,168.16	nat. median $26,156 outlier · 2.7×
93654 CPT	Compre Ep Eval Tx Vt	1	$70,168.16	$70,168.16	$70,168.16	nat. median $26,704 outlier · 2.6×
93656 CPT	Compre Ep Eval Abltj Atr Fib	1	$70,168.16	$70,168.16	$70,168.16	nat. median $26,811 outlier · 2.6×
J9266 HCPCS	Pegaspargase Injection	1	$68,312.49	$68,312.49	$68,312.49	nat. median $34,109 outlier · 2.0×
0923T CPT	Rmvl&rplcmt Perm Ccm-d Pg	1	$64,201.40	$64,201.40	$64,201.40	nat. median $22,482 outlier · 2.9×
0409T CPT	Insj/rplc Car Modulj Pls Gn	1	$64,201.40	$64,201.40	$64,201.40	nat. median $22,946 outlier · 2.8×
0515T CPT	Insj Wcs Lv Compl Sys	1	$64,201.40	$64,201.40	$64,201.40	nat. median $22,512 outlier · 2.9×
33263 CPT	Rmvl & Rplcmt Dfb Gen 2 Lead	1	$64,201.40	$64,201.40	$64,201.40	nat. median $23,504 outlier · 2.7×
0916T CPT	Insj Perm Ccm-d Sys Pg Only	1	$64,201.40	$64,201.40	$64,201.40	nat. median $23,439 outlier · 2.7×

Other procedures at this hospital

Browse this hospital's 9,655 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

0519T	CPT	Rmv&rplcmt Pg Wcs Lv Both	1	1	—	—	$29,933.31	$29,933.31	$29,933.31	2025-07-29
0520T	CPT	Rmv&rplcmt Pg Wcs Lv Battery	1	1	—	—	$29,933.31	$29,933.31	$29,933.31	2025-07-29
33228	CPT	Remv&replc Pm Gen Dual Lead	1	1	—	—	$29,933.31	$29,933.31	$29,933.31	2025-07-29
33224	CPT	Insert Pacing Lead & Connect	1	1	—	—	$29,933.31	$29,933.31	$29,933.31	2025-07-29
33214	CPT	Upgrade Of Pacemaker System	1	1	—	—	$29,933.31	$29,933.31	$29,933.31	2025-07-29
33213	CPT	Insert Pulse Gen Dual Leads	1	1	—	—	$29,933.31	$29,933.31	$29,933.31	2025-07-29
0517T	CPT	Insj Wcs Lv Both Compnt Pg	1	1	—	—	$29,933.31	$29,933.31	$29,933.31	2025-07-29
81416	CPT	Exome Sequence Analysis	1	1	—	—	$30,282.00	$30,282.00	$30,282.00	2025-07-29
J1412	HCPCS	Inj Roctavian Ml 2x10^13vc G	1	1	—	—	$30,301.72	$30,301.72	$30,301.72	2025-07-29
L6940	HCPCS	Elbow Disarticulation Switch	1	1	—	—	$30,616.06	$30,616.06	$30,616.06	2025-07-29
L6950	HCPCS	Above Elbow Switch Control	1	1	—	—	$31,977.49	$31,977.49	$31,977.49	2025-07-29
61623	CPT	Evasc Temp Balo Artl Occ H/n	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
61626	CPT	Tcat Perm Occls/embol Noncns	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
0237T	CPT	Trluml Perip Athrc Brchiocph	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
0236T	CPT	Trluml Perip Athrc Abd Aorta	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
0234T	CPT	Trluml Perip Athrc Renal Art	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
92924	CPT	Prq Trluml C Athrc 1 Art&/br	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
92997	CPT	Pul Art Balloon Repr Percut	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
92990	CPT	Revision Of Pulmonary Valve	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
0505T	CPT	Ev Fempop Artl Revsc	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
92937	CPT	Prq Trluml Revsc Cab Grf 1	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
92928	CPT	Prq Tcat Plmt Ntrac St 1 Les	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
92943	CPT	Prq Trluml Revsc Ch Occ Ant	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
C9600	HCPCS	Perc Drug-el Cor Stent Sing	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
92987	CPT	Revision Of Mitral Valve	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
C9783	HCPCS	Blind Cor Sinus Reducer Impl	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
C9764	HCPCS	Revasc Intravasc Lithotripsy	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
37243	CPT	Vasc Embolize/occlude Organ	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
37244	CPT	Vasc Embolize/occlude Bleed	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
37241	CPT	Vasc Embolize/occlude Venous	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
37236	CPT	Open/perq Place Stent 1st	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
37238	CPT	Open/perq Place Stent Same	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
37228	CPT	Apc	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
37187	CPT	Venous Mech Thrombectomy	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
36903	CPT	Intro Cath Dialysis Circuit	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
36905	CPT	Thrmbc/nfs Dialysis Circuit	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
37221	CPT	Apc	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
33903	CPT	Perq P-art Revsc 1 Abnor Bi	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
37226	CPT	Apc	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
33900	CPT	Perq P-art Revsc 1 Nm Nt Uni	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
33901	CPT	Perq P-art Revsc 1 Nm Nt Bi	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
C8004	HCPCS	Sim Ang W/prs Cath Rad Emb	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
C9604	HCPCS	Perc D-e Cor Revasc T Cabg S	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
C9772	HCPCS	Revasc Lithotrip Tibi/perone	1	1	—	—	$32,436.70	$32,436.70	$32,436.70	2025-07-29
L6945	HCPCS	Elbow Disart Myoelectronic C	1	1	—	—	$33,922.38	$33,922.38	$33,922.38	2025-07-29
Q0479	HCPCS	Power Module Combo Vad, Rep	1	1	—	—	$35,600.30	$35,600.30	$35,600.30	2025-07-29
64553	CPT	Implant Neuroelectrodes	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
61715	CPT	Mrgfus Strtctc Ablt Trgt Icr	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
64569	CPT	Revise/repl Vagus N Eltrd	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
63664	CPT	Revise Spine Eltrd Plate	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
61888	CPT	Revise/remove Neuroreceiver	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
64575	CPT	Opn Impltj Nea Perph Nerve	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
0784T	CPT	Ins/rplmt Eltrd Ra Spi Nstim	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
43647	CPT	Lap Impl Electrode Antrum	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
33288	CPT	Rmv&rplcmt Phrnc Nrv Stim Ld	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
64596	CPT	Ins/rplcmt Prq Eltrd Ra Pn 1	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
64583	CPT	Rev/rplct Hpglsl Nstm Ary Pg	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
0675T	CPT	Laps Insj Nw/rpcmt Isdss 1ld	1	1	—	—	$35,668.03	$35,668.03	$35,668.03	2025-07-29
L6955	HCPCS	Above Elbow Myoelectronic CT	1	1	—	—	$36,174.65	$36,174.65	$36,174.65	2025-07-29
24587	CPT	Optx Partclr Fx&/dslc Elbw W	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
0737T	CPT	Xenograft Impltj Artclr Surf	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
23615	CPT	Optx Prox Humrl Fx W/int Fix	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24410	CPT	Mlt Osteot Rlgnm Imed Rd Hum	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24366	CPT	Reconstruct Head Of Radius	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
22869	CPT	Insj Stablj Dev Without Dcmprn	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24546	CPT	Optx Hum Fx W/ntrcndylr Xtn	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
23680	CPT	Optx Sho Dislc Neck Fx Fixj	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24579	CPT	Optx Humrl Cndylr Fracture	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24430	CPT	Rpr Non/mal Humerus Wo Graft	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27438	CPT	Revise Kneecap With Implant	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
23491	CPT	Reinforce Shoulder Bones	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24346	CPT	Reconstruct Elbow Med Ligmnt	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
0627T	CPT	Perq Njx Algc Fluor Lmbr 1st	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27442	CPT	Revision Of Knee Joint	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
25810	CPT	Arthrd Wrst Iliac/oth Agrft	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
23473	CPT	Revis Reconst Shoulder Joint	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
23485	CPT	Revision Of Collar Bone	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24362	CPT	Reconstruct Elbow Joint	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24802	CPT	Arthrd Elbow Jt Autog Graft	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
C9781	HCPCS	Arthro/shoul Surg; W/spacer	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
0629T	CPT	Perq Njx Algc CT Lmbr 1st	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24515	CPT	Optx Humrl Shft Fx Plate/scr	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
20982	CPT	Ablate Bone Tumor(s) Perq	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24365	CPT	Reconstruct Head Of Radius	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
C9757	HCPCS	Spine Device Implant Surgery	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
69719	CPT	Rplcm Oi Implt Sk Tc Esp<100	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
69730	CPT	Rplc Oi Implt Sk Tc Esp>=100	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
28725	CPT	Arthrodesis Subtalar	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27356	CPT	Remove Femur Lesion/graft	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24370	CPT	Revise Reconst Elbow Joint	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
69729	CPT	Impl Oi Implt Sk Tc Esp>=100	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27870	CPT	Fusion Of Ankle Joint Open	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
25491	CPT	Prophylactic Tx Ulna	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
69716	CPT	Impl Oi Implt Sk Tc Esp<100	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
23470	CPT	Reconstruct Shoulder Joint	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
28737	CPT	Revision Of Foot Bones	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
25444	CPT	Arthrp W/prostc Lunate	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24435	CPT	Rpr Non/mal Hum With Agrft	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24545	CPT	Optx Hum Fx Wo Ntrcndylr Xtn	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
28735	CPT	Fusion Of Foot Bones	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27828	CPT	Treat Lower Leg Fracture	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24498	CPT	Proph Tx W/wo Mthylmthcrylt	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
25441	CPT	Arthrp W/prostc Dstl Rds	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
25365	CPT	Revise Radius & Ulna	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
64628	CPT	Trml Dstrj Ios Bvn 1st 2 L/s	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
25391	CPT	Lengthen Radius Or Ulna	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24586	CPT	Optx Partclr Fx&/dislc Elbow	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24516	CPT	Tx Humrl Shaft Fx Imed Implt	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
20692	CPT	Appl Mltpln Uni Ext Fixj Sys	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
69714	CPT	Impl Oi Implt Skull Perq Esp	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
C9734	HCPCS	U/s Trtmt, Not Leiomyomata	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
29907	CPT	Subtalar Arthro W/fusion	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
29889	CPT	Arthrs Aid Pcl Rpr/agmntj	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
29856	CPT	Tibial Arthroscopy/surgery	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27130	CPT	Total Hip Arthroplasty	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
28730	CPT	Fusion Of Foot Bones	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
29867	CPT	Allgrft Implnt Knee W/scope	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
22554	CPT	Arthrd Ant Ntrbd Min Dsc Crv	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
28320	CPT	Repair Of Foot Bones	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
28420	CPT	Optx Calcaneal Fx W/bone Grf	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27871	CPT	Fusion Of Tibiofibular Joint	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
22551	CPT	Arthrd Ant Ntrbdy Cervical	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27827	CPT	Treat Lower Leg Fracture	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
28297	CPT	Cor Hlx Vlgs Jt Arthrd	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
28715	CPT	Arthrodesis Triple	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27447	CPT	Total Knee Arthroplasty	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27709	CPT	Osteotomy Tibia & Fibula	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27443	CPT	Revision Of Knee Joint	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24666	CPT	Optx Radial Head/nck Fx Rplc	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27446	CPT	Revision Of Knee Joint	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27758	CPT	Treatment Of Tibia Fracture	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27440	CPT	Revision Of Knee Joint	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27429	CPT	Reconstruction Knee	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27759	CPT	Treatment Of Tibia Fracture	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
24575	CPT	Optx Humeral Epcndylr Fx	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27415	CPT	Osteochondral Knee Allograft	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
23802	CPT	Arthrd Glenohumeral Jt W/grf	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27428	CPT	Reconstruction Knee	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
27441	CPT	Revision Of Knee Joint	1	1	—	—	$36,802.14	$36,802.14	$36,802.14	2025-07-29
55882	CPT	Ablt Trurl Prst8 Tis Trnsdcr	1	1	—	—	$37,161.39	$37,161.39	$37,161.39	2025-07-29
54400	CPT	Insert Semi-rigid Prosthesis	1	1	—	—	$37,161.39	$37,161.39	$37,161.39	2025-07-29
53451	CPT	Tprnl Balo Cntnc Dev Bi	1	1	—	—	$37,161.39	$37,161.39	$37,161.39	2025-07-29
53440	CPT	Male Sling Procedure	1	1	—	—	$37,161.39	$37,161.39	$37,161.39	2025-07-29
54417	CPT	Remv/replc Penis Pros Compl	1	1	—	—	$37,161.39	$37,161.39	$37,161.39	2025-07-29
L6960	HCPCS	Shldr Disartic Switch Contro	1	1	—	—	$39,398.32	$39,398.32	$39,398.32	2025-07-29
65770	CPT	Keratoprosthesis	1	1	—	—	$40,870.80	$40,870.80	$40,870.80	2025-07-29
Q0481	HCPCS	Microprcsr Cu Elec Vad, Rep	1	1	—	—	$43,205.73	$43,205.73	$43,205.73	2025-07-29
67027	CPT	Implant Eye Drug System	1	1	—	—	$43,947.04	$43,947.04	$43,947.04	2025-07-29
L6970	HCPCS	Interscapular-thor Switch CT	1	1	—	—	$44,174.98	$44,174.98	$44,174.98	2025-07-29
L6965	HCPCS	Shldr Disartic Myoelectronic	1	1	—	—	$44,491.83	$44,491.83	$44,491.83	2025-07-29
L5859	HCPCS	Knee-shin Pro Flex/ext Cont	1	1	—	—	$45,717.67	$45,717.67	$45,717.67	2025-07-29
66683	CPT	Implantation Iris Prosthesis	1	1	—	—	$46,954.89	$46,954.89	$46,954.89	2025-07-29
0308T	CPT	Insj Ocular Telescope Prosth	1	1	—	—	$46,954.89	$46,954.89	$46,954.89	2025-07-29
Q0489	HCPCS	Pwr Pck Base Combo Vad, Rep	1	1	—	—	$48,331.64	$48,331.64	$48,331.64	2025-07-29
L6975	HCPCS	Interscap-thor Myoelectronic	1	1	—	—	$48,401.76	$48,401.76	$48,401.76	2025-07-29
19357	CPT	Tiss Xpndr Plmt Brst Rcnstj	1	1	—	—	$49,763.38	$49,763.38	$49,763.38	2025-07-29
C2616	HCPCS	Brachytx, Non-str,yttrium-90	1	1	—	—	$50,011.51	$50,011.51	$50,011.51	2025-07-29
0686T	CPT	Histotripsy Mal Hepatcel Tis	1	1	—	—	$50,055.56	$50,055.56	$50,055.56	2025-07-29
C9782	HCPCS	Blind Myocar Trpl Bon Marrow	1	1	—	—	$50,055.56	$50,055.56	$50,055.56	2025-07-29
C9758	HCPCS	Blind Interatrial Shunt Ide	1	1	—	—	$50,055.56	$50,055.56	$50,055.56	2025-07-29
0888T	CPT	Histotripsy Mal Renal Tissue	1	1	—	—	$50,055.56	$50,055.56	$50,055.56	2025-07-29
62361	CPT	Implant Spine Infusion Pump	1	1	—	—	$50,552.15	$50,552.15	$50,552.15	2025-07-29
62362	CPT	Implant Spine Infusion Pump	1	1	—	—	$50,552.15	$50,552.15	$50,552.15	2025-07-29
62360	CPT	Insert Spine Infusion Device	1	1	—	—	$50,552.15	$50,552.15	$50,552.15	2025-07-29
0632T	CPT	Perq Tcat US Abltj Nrv P-art	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
37225	CPT	Apc	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
93590	CPT	Perq Transcath Cls Mitral	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
93580	CPT	Transcath Closure Of Asd	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
37184	CPT	Prim Art M-thrmbc 1st Vsl	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
93581	CPT	Transcath Closure Of Vsd	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
37230	CPT	Apc	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
C9774	HCPCS	Revasc Lithotr-ather Tib/per	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
C9765	HCPCS	Revasc Intra Lithotrip-stent	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
0793T	CPT	Prq Tcat Thrm Ablt Nrv P-art	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
37242	CPT	Vasc Embolize/occlude Artery	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
C9766	HCPCS	Revasc Intra Lithotrip-ather	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
37229	CPT	Apc	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
37231	CPT	Apc	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
37227	CPT	Apc	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
C9773	HCPCS	Revasc Lithotr-stent Tib/per	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
36906	CPT	Thrmbc/nfs Dialysis Circuit	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
C9602	HCPCS	Perc D-e Cor Stent Ather S	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
36836	CPT	Prq Av Fstl Crtj Uxtr 1 Acs	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
36837	CPT	Prq Av Fstl Crt Uxtr Sep Acs	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
C9797	HCPCS	Vasc Emb/occ W/prs Cath	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
C9775	HCPCS	Revasc Lith-sten-ath Tib/per	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
33902	CPT	Perq P-art Revsc 1 Abnor Uni	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
0645T	CPT	Tcat Impltj C Sins Rdctj Dev	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
C9767	HCPCS	Revasc Lithotrip-stent-ather	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
92933	CPT	Prq Trlml C Athrc St Angiop1	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
C9607	HCPCS	Perc D-e Cor Revasc Chro Sin	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
93591	CPT	Perq Transcath Cls Aortic	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
93582	CPT	Perq Transcath Closure Pda	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
0238T	CPT	Trluml Perip Athrc Iliac Art	1	1	—	—	$51,360.45	$51,360.45	$51,360.45	2025-07-29
L5973	HCPCS	Ank-foot Sys Dors-plant Flex	1	1	—	—	$52,270.24	$52,270.24	$52,270.24	2025-07-29
27279	CPT	Arthrd Si Jt Plmt Tartclr Dv	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
25446	CPT	Arthrp W/prostc Dst Rds&crps	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
22633	CPT	Arthrd Cmbn 1ntrspc Lumbar	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
20696	CPT	App Mltpln Uni Xtrnl Fix 1st	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
22856	CPT	Tot Disc Arthrp 1ntrspc Crv	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
27702	CPT	Reconstruct Ankle Joint	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
28705	CPT	Arthrodesis Pantalar	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
24371	CPT	Revise Reconst Elbow Joint	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
23472	CPT	Reconstruct Shoulder Joint	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
24363	CPT	Replace Elbow Joint	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
21243	CPT	Reconstruction Of Jaw Joint	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
22867	CPT	Insj Stablj Dev W/dcmprn	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
27278	CPT	Arthrd Si Jt Plmt Iartic Dev	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
C8003	HCPCS	Imp Extar Knee Shck Absrb	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
22630	CPT	Arthrd Pst Tq 1ntrspc Lum	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
22612	CPT	Arthrd Pst Tq 1ntrspc Lumbar	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
24361	CPT	Reconstruct Elbow Joint	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
25442	CPT	Arthrp W/prostc Dstl Ulna	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
23616	CPT	Optx Prx Hmrl Fx Fix Rpr Rpl	1	1	—	—	$52,599.88	$52,599.88	$52,599.88	2025-07-29
0823T	CPT	Tcat Ins 1chmbr Ldls Pm Ra	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
0825T	CPT	Tcat Rmv&rpl1chmb Ldls Pm Ra	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
0801T	CPT	Tcat Rmv&rpl 2chmbr Ldls Pm	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
0795T	CPT	Tcat Ins 2chmbr Ldls Pm Cmpl	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
0803T	CPT	Tcat Rmv&rpl2chmb Ldls Pm Rv	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
0797T	CPT	Tcat Ins 2chmbr Ldls Pm Rv	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
0802T	CPT	Tcat Rmv&rpl2chmb Ldls Pm Ra	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
33274	CPT	Tcat Insj/rpl Perm Ldls Pm	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
0796T	CPT	Tcat Ins 2chmbr Ldls Pm Ra	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
0525T	CPT	Insj/rplcmt Compl Iims	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
33229	CPT	Remv&replc Pm Gen Mult Leads	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
33221	CPT	Insert Pulse Gen Mult Leads	1	1	—	—	$54,548.02	$54,548.02	$54,548.02	2025-07-29
L5858	HCPCS	Stance Phase Only	1	1	—	—	$55,260.86	$55,260.86	$55,260.86	2025-07-29
Q0483	HCPCS	Monitor Elec Vad, Rep	1	1	—	—	$55,749.36	$55,749.36	$55,749.36	2025-07-29
54410	CPT	Remove/replace Penis Prosth	1	1	—	—	$57,572.43	$57,572.43	$57,572.43	2025-07-29
53447	CPT	Remove/replace Ur Sphincter	1	1	—	—	$57,572.43	$57,572.43	$57,572.43	2025-07-29
53445	CPT	Insert Uro/ves Nck Sphincter	1	1	—	—	$57,572.43	$57,572.43	$57,572.43	2025-07-29
53444	CPT	Insert Tandem Cuff	1	1	—	—	$57,572.43	$57,572.43	$57,572.43	2025-07-29
54411	CPT	Remov/replc Penis Pros Comp	1	1	—	—	$57,572.43	$57,572.43	$57,572.43	2025-07-29
54401	CPT	Insert Self-contd Prosthesis	1	1	—	—	$57,572.43	$57,572.43	$57,572.43	2025-07-29
54405	CPT	Insert Multi-comp Penis Pros	1	1	—	—	$57,572.43	$57,572.43	$57,572.43	2025-07-29
54416	CPT	Remv/repl Penis Contain Pros	1	1	—	—	$57,572.43	$57,572.43	$57,572.43	2025-07-29
J9600	HCPCS	Porfimer Sodium Injection	1	1	—	—	$61,140.42	$61,140.42	$61,140.42	2025-07-29
61891	CPT	Rev/rplcmt Sk-mnt Crnl Nstm	1	1	—	—	$61,336.01	$61,336.01	$61,336.01	2025-07-29
64590	CPT	Ins/rpl Prph Sac/gstr Npg/r	1	1	—	—	$61,336.01	$61,336.01	$61,336.01	2025-07-29
63655	CPT	Implant Neuroelectrodes	1	1	—	—	$61,336.01	$61,336.01	$61,336.01	2025-07-29
0816T	CPT	Opn Insj/rplcmt Ins Ptn Subq	1	1	—	—	$61,336.01	$61,336.01	$61,336.01	2025-07-29
64580	CPT	Opn Impltj Nea Neuromuscular	1	1	—	—	$61,336.01	$61,336.01	$61,336.01	2025-07-29
61885	CPT	Insrt/redo Neurostim 1 Array	1	1	—	—	$61,336.01	$61,336.01	$61,336.01	2025-07-29
0817T	CPT	Opn Insj/rplcmt Ins Ptn Subf	1	1	—	—	$61,336.01	$61,336.01	$61,336.01	2025-07-29
0680T	CPT	Insj/rplcmt Pg Only Isdss	1	1	—	—	$61,336.01	$61,336.01	$61,336.01	2025-07-29
33263	CPT	Rmvl & Rplcmt Dfb Gen 2 Lead	1	1	—	—	$64,201.40	$64,201.40	$64,201.40	2025-07-29
0614T	CPT	Rmvl&rplcmt Ss Impl Dfb Pg	1	1	—	—	$64,201.40	$64,201.40	$64,201.40	2025-07-29
0409T	CPT	Insj/rplc Car Modulj Pls Gn	1	1	—	—	$64,201.40	$64,201.40	$64,201.40	2025-07-29
0916T	CPT	Insj Perm Ccm-d Sys Pg Only	1	1	—	—	$64,201.40	$64,201.40	$64,201.40	2025-07-29
0515T	CPT	Insj Wcs Lv Compl Sys	1	1	—	—	$64,201.40	$64,201.40	$64,201.40	2025-07-29
0414T	CPT	Rmvl & Rpl Car Modulj Pls Gn	1	1	—	—	$64,201.40	$64,201.40	$64,201.40	2025-07-29
33262	CPT	Rmvl& Replc Pulse Gen 1 Lead	1	1	—	—	$64,201.40	$64,201.40	$64,201.40	2025-07-29
33240	CPT	Insrt Pulse Gen W/singl Lead	1	1	—	—	$64,201.40	$64,201.40	$64,201.40	2025-07-29
33230	CPT	Insrt Pulse Gen W/dual Leads	1	1	—	—	$64,201.40	$64,201.40	$64,201.40	2025-07-29
0923T	CPT	Rmvl&rplcmt Perm Ccm-d Pg	1	1	—	—	$64,201.40	$64,201.40	$64,201.40	2025-07-29
J9266	HCPCS	Pegaspargase Injection	1	1	—	—	$68,312.49	$68,312.49	$68,312.49	2025-07-29
93656	CPT	Compre Ep Eval Abltj Atr Fib	1	1	—	—	$70,168.16	$70,168.16	$70,168.16	2025-07-29
93653	CPT	Compre Ep Eval Tx Svt	1	1	—	—	$70,168.16	$70,168.16	$70,168.16	2025-07-29
93654	CPT	Compre Ep Eval Tx Vt	1	1	—	—	$70,168.16	$70,168.16	$70,168.16	2025-07-29
L6880	HCPCS	Elec Hand Ind Art Digits	1	1	—	—	$71,041.47	$71,041.47	$71,041.47	2025-07-29
L5856	HCPCS	Elec Knee-shin Swing/stance	1	1	—	—	$71,378.51	$71,378.51	$71,378.51	2025-07-29
C9760	HCPCS	Non-blind Interatrial Shunt	1	1	—	—	$78,657.92	$78,657.92	$78,657.92	2025-07-29
33289	CPT	Tcat Impl Wrls P-art Prs Snr	1	1	—	—	$81,311.73	$81,311.73	$81,311.73	2025-07-29
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	1	1	—	—	$86,516.78	$86,516.78	$86,516.78	2025-07-29
64582	CPT	Opn Mpltj Hpglsl Nstm Ary Pg	1	1	—	—	$87,161.65	$87,161.65	$87,161.65	2025-07-29
0674T	CPT	Laps Insj Nw/rpcmt Prm Isdss	1	1	—	—	$87,161.65	$87,161.65	$87,161.65	2025-07-29
64568	CPT	Opn Impltj Crnl Nrv Nea&pg	1	1	—	—	$87,161.65	$87,161.65	$87,161.65	2025-07-29
0268T	CPT	Apc	1	1	—	—	$87,161.65	$87,161.65	$87,161.65	2025-07-29
63685	CPT	Ins/rplc Spi Npg/rcvr Pocket	1	1	—	—	$87,161.65	$87,161.65	$87,161.65	2025-07-29
33287	CPT	Rmv&rplcmt Phrnc Nrv Stim Pg	1	1	—	—	$87,161.65	$87,161.65	$87,161.65	2025-07-29
61886	CPT	Implant Neurostim Arrays	1	1	—	—	$87,161.65	$87,161.65	$87,161.65	2025-07-29
69930	CPT	Implant Cochlear Device	1	1	—	—	$90,977.87	$90,977.87	$90,977.87	2025-07-29
33249	CPT	Insj/rplcmt Defib W/lead(s)	1	1	—	—	$91,703.68	$91,703.68	$91,703.68	2025-07-29
33231	CPT	Insrt Pulse Gen W/mult Leads	1	1	—	—	$91,703.68	$91,703.68	$91,703.68	2025-07-29
33270	CPT	Ins/rep Subq Defibrillator	1	1	—	—	$91,703.68	$91,703.68	$91,703.68	2025-07-29
33264	CPT	Rmvl & Rplcmt Dfb Gen Mlt Ld	1	1	—	—	$91,703.68	$91,703.68	$91,703.68	2025-07-29
0571T	CPT	Insj/rplcmt Icds Ss Eltrd	1	1	—	—	$91,703.68	$91,703.68	$91,703.68	2025-07-29
0915T	CPT	Insj Perm Ccm-d Sys Pg&eltrd	1	1	—	—	$91,703.68	$91,703.68	$91,703.68	2025-07-29
0408T	CPT	Insj/rplc Cardiac Modulj Sys	1	1	—	—	$91,703.68	$91,703.68	$91,703.68	2025-07-29
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	1	1	—	—	$96,581.87	$96,581.87	$96,581.87	2025-07-29
0620T	CPT	Evasc Ven Artlz Tibl/prnl Vn	1	1	—	—	$100,109.68	$100,109.68	$100,109.68	2025-07-29
L7180	HCPCS	Electronic Elbow Sequential	1	1	—	—	$110,968.62	$110,968.62	$110,968.62	2025-07-29
J9226	HCPCS	Supprelin La Implant	1	1	—	—	$114,092.58	$114,092.58	$114,092.58	2025-07-29
L7181	HCPCS	Electronic Elbo Simultaneous	1	1	—	—	$119,137.64	$119,137.64	$119,137.64	2025-07-29
33276	CPT	Insj Phrnc Nrv Stim Sys	1	1	—	—	$128,712.04	$128,712.04	$128,712.04	2025-07-29
0266T	CPT	Apc	1	1	—	—	$128,712.04	$128,712.04	$128,712.04	2025-07-29
A9543	HCPCS	Y90 Ibritumomab, Rx	1	1	—	—	$143,396.75	$143,396.75	$143,396.75	2025-07-29
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	1	1	—	—	$143,882.66	$143,882.66	$143,882.66	2025-07-29
J9029	HCPCS	Instill Adstiladrin, Tx Dose	1	1	—	—	$159,575.05	$159,575.05	$159,575.05	2025-07-29
38240	CPT	Transplt Allo Hct/donor	1	1	—	—	$169,161.01	$169,161.01	$169,161.01	2025-07-29
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	1	1	—	—	$170,216.79	$170,216.79	$170,216.79	2025-07-29
Q0480	HCPCS	Driver Pneumatic Vad, Rep	1	1	—	—	$252,349.77	$252,349.77	$252,349.77	2025-07-29
C9301	HCPCS	Apc	1	1	—	—	$702,163.88	$702,163.88	$702,163.88	2025-07-29
Q2053	HCPCS	Brexucabtagene Car Pos T	1	1	—	—	$1,234,998.77	$1,234,998.77	$1,234,998.77	2025-07-29
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	1	1	—	—	$1,268,918.58	$1,268,918.58	$1,268,918.58	2025-07-29
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	1	1	—	—	$1,303,242.11	$1,303,242.11	$1,303,242.11	2025-07-29
Q2055	HCPCS	Idecabtagene Vicleucel Car	1	1	—	—	$1,331,455.28	$1,331,455.28	$1,331,455.28	2025-07-29
Q2056	HCPCS	Ciltacabtagene Car-pos T	1	1	—	—	$1,395,922.73	$1,395,922.73	$1,395,922.73	2025-07-29
Q2042	HCPCS	Tisagenlecleucel Car-pos T	1	1	—	—	$1,460,528.93	$1,460,528.93	$1,460,528.93	2025-07-29
Q2057	HCPCS	Afamitresgene Autoleucel	1	1	—	—	$1,944,659.57	$1,944,659.57	$1,944,659.57	2025-07-29

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