|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
1
|
1
|
—
|
—
|
$200,037.60
|
$200,037.60
|
$200,037.60
|
2025-01-22
|
|
J1823
|
HCPCS
|
Uplizna 100mg/10ml Vial
|
13
|
8
|
$287,057.00
|
$172,234.20
40% off
|
$156,446.07
|
$156,446.07
|
$156,446.07
|
2025-01-22
|
|
J9347
|
HCPCS
|
Imjudo 300mg/15ml
|
13
|
8
|
$248,820.00
|
$149,292.00
40% off
|
$135,606.90
|
$135,606.90
|
$135,606.90
|
2025-01-22
|
|
J0223
|
HCPCS
|
Givlaari 189mg/ml Vial
|
13
|
8
|
$238,739.00
|
$143,243.40
40% off
|
$130,112.76
|
$130,112.76
|
$130,112.76
|
2025-01-22
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
1
|
1
|
—
|
—
|
$94,778.36
|
$94,778.36
|
$94,778.36
|
2025-01-22
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
1
|
1
|
—
|
—
|
$94,004.06
|
$94,004.06
|
$94,004.06
|
2025-01-22
|
|
J1303
|
HCPCS
|
Ultomiris 1100mg/11ml
|
13
|
8
|
$136,838.00
|
$82,102.80
40% off
|
$74,576.71
|
$74,576.71
|
$74,576.71
|
2025-01-22
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
1
|
1
|
—
|
—
|
$68,030.47
|
$68,030.47
|
$68,030.47
|
2025-01-22
|
|
329
|
MS_DRG
|
Major Small And Large Bowel Procedures With Mcc
|
1
|
1
|
—
|
—
|
$61,464.61
|
$61,464.61
|
$61,464.61
|
2025-01-22
|
|
J9309
|
HCPCS
|
Polivy 140 Mg Vial
|
13
|
8
|
$111,925.00
|
$67,155.00
40% off
|
$60,999.12
|
$60,999.12
|
$60,999.12
|
2025-01-22
|
|
J2507
|
HCPCS
|
Krystexxa 8mg/ml Injection
|
13
|
8
|
$108,079.00
|
$64,847.40
40% off
|
$58,903.06
|
$58,903.06
|
$58,903.06
|
2025-01-22
|
|
408
|
MS_DRG
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
1
|
1
|
—
|
—
|
$50,651.70
|
$50,651.70
|
$50,651.70
|
2025-01-22
|
|
J3241
|
HCPCS
|
Tepezza 500mg
|
13
|
8
|
$86,830.00
|
$52,098.00
40% off
|
$47,322.35
|
$47,322.35
|
$47,322.35
|
2025-01-22
|
|
J2350
|
HCPCS
|
Ocrevus 300mg/10ml Injection
|
13
|
8
|
$85,995.00
|
$51,597.00
40% off
|
$46,867.28
|
$46,867.28
|
$46,867.28
|
2025-01-22
|
|
570
|
MS_DRG
|
Skin Debridement With Mcc
|
1
|
1
|
—
|
—
|
$39,765.30
|
$39,765.30
|
$39,765.30
|
2025-01-22
|
|
208
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
1
|
1
|
—
|
—
|
$36,793.31
|
$36,793.31
|
$36,793.31
|
2025-01-22
|
|
J2329
|
HCPCS
|
Briumvi 150 Mg Vial
|
13
|
8
|
$66,815.00
|
$40,089.00
40% off
|
$36,414.18
|
$36,414.18
|
$36,414.18
|
2025-01-22
|
|
288
|
MS_DRG
|
Acute And Subacute Endocarditis With Mcc
|
1
|
1
|
—
|
—
|
$35,285.54
|
$35,285.54
|
$35,285.54
|
2025-01-22
|
|
C9082
|
HCPCS
|
Jemperli 500mg/10ml Vial
|
13
|
8
|
$63,477.00
|
$38,086.20
40% off
|
$34,594.96
|
$34,594.96
|
$34,594.96
|
2025-01-22
|
|
483
|
MS_DRG
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremities
|
1
|
1
|
—
|
—
|
$33,804.99
|
$33,804.99
|
$33,804.99
|
2025-01-22
|
|
C9168
|
HCPCS
|
Omvoh 300 Mg Vial
|
13
|
8
|
$61,205.00
|
$36,723.00
40% off
|
$33,356.72
|
$33,356.72
|
$33,356.72
|
2025-01-22
|
|
56
|
MS_DRG
|
Degenerative Nervous System Disorders With Mcc
|
1
|
1
|
—
|
—
|
$32,577.55
|
$32,577.55
|
$32,577.55
|
2025-01-22
|
|
330
|
MS_DRG
|
Major Small And Large Bowel Procedures With Cc
|
1
|
1
|
—
|
—
|
$32,279.54
|
$32,279.54
|
$32,279.54
|
2025-01-22
|
|
J2327
|
HCPCS
|
Skyrizi 600mg/10ml
|
13
|
8
|
$58,711.00
|
$35,226.60
40% off
|
$31,997.49
|
$31,997.49
|
$31,997.49
|
2025-01-22
|
|
J1440
|
HCPCS
|
Rebyota 150ml
|
13
|
8
|
$57,420.00
|
$34,452.00
40% off
|
$31,293.90
|
$31,293.90
|
$31,293.90
|
2025-01-22
|
|
J0896
|
HCPCS
|
Reblozyl 75mg Vial
|
13
|
8
|
$57,342.00
|
$34,405.20
40% off
|
$31,251.39
|
$31,251.39
|
$31,251.39
|
2025-01-22
|
|
808
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
1
|
1
|
—
|
—
|
$29,802.88
|
$29,802.88
|
$29,802.88
|
2025-01-22
|
|
522
|
MS_DRG
|
Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc
|
1
|
1
|
—
|
—
|
$28,742.82
|
$28,742.82
|
$28,742.82
|
2025-01-22
|
|
J1640
|
HCPCS
|
Hemin 350mg Vial
|
13
|
8
|
$52,727.00
|
$31,636.20
40% off
|
$28,736.22
|
$28,736.22
|
$28,736.22
|
2025-01-22
|
|
314
|
MS_DRG
|
Other Circulatory System Diagnoses With Mcc
|
1
|
1
|
—
|
—
|
$28,488.35
|
$28,488.35
|
$28,488.35
|
2025-01-22
|
|
867
|
MS_DRG
|
Other Infectious And Parasitic Diseases Diagnoses With Mcc
|
1
|
1
|
—
|
—
|
$28,472.02
|
$28,472.02
|
$28,472.02
|
2025-01-22
|
|
481
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint With Cc
|
1
|
1
|
—
|
—
|
$28,235.24
|
$28,235.24
|
$28,235.24
|
2025-01-22
|
|
J9119
|
HCPCS
|
Libtayo 350mg/7ml Vial
|
13
|
8
|
$50,546.00
|
$30,327.60
40% off
|
$27,547.57
|
$27,547.57
|
$27,547.57
|
2025-01-22
|
|
486
|
MS_DRG
|
Knee Procedures With Principal Diagnosis Of Infection With Cc
|
1
|
1
|
—
|
—
|
$27,328.95
|
$27,328.95
|
$27,328.95
|
2025-01-22
|
|
64
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Mcc
|
1
|
1
|
—
|
—
|
$27,256.82
|
$27,256.82
|
$27,256.82
|
2025-01-22
|
|
J9316
|
HCPCS
|
Phesgo 600mg-600 Mg
|
13
|
8
|
$49,366.00
|
$29,619.60
40% off
|
$26,904.47
|
$26,904.47
|
$26,904.47
|
2025-01-22
|
|
415
|
MS_DRG
|
Cholecystectomy Except By Laparoscope Without C.d.e. With Cc
|
1
|
1
|
—
|
—
|
$26,886.69
|
$26,886.69
|
$26,886.69
|
2025-01-22
|
|
871
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc
|
10
|
4
|
—
|
—
|
$26,433.54
|
$26,979.22
|
$26,433.54
|
2026-01-01
|
|
100
|
MS_DRG
|
Seizures With Mcc
|
10
|
4
|
—
|
—
|
$26,355.97
|
$26,977.86
|
$26,355.97
|
2026-01-01
|
|
592
|
MS_DRG
|
Skin Ulcers With Mcc
|
9
|
3
|
—
|
—
|
$26,335.56
|
$26,335.56
|
$26,335.56
|
2026-01-01
|
|
432
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis With Mcc
|
1
|
1
|
—
|
—
|
$26,072.93
|
$26,072.93
|
$26,072.93
|
2025-01-22
|
|
J9022
|
HCPCS
|
Atezolizumab 1200mg/20ml Inj
|
13
|
8
|
$46,996.00
|
$28,197.60
40% off
|
$25,612.82
|
$25,612.82
|
$25,612.82
|
2025-01-22
|
|
470
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without …
|
1
|
1
|
—
|
—
|
$25,606.17
|
$25,606.17
|
$25,606.17
|
2025-01-22
|
|
559
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With Mcc
|
9
|
3
|
—
|
—
|
$25,377.56
|
$25,377.56
|
$25,377.56
|
2026-01-01
|
|
754
|
MS_DRG
|
Malignancy, Female Reproductive System With Mcc
|
9
|
3
|
—
|
—
|
$25,061.85
|
$25,061.85
|
$25,061.85
|
2026-01-01
|
|
205
|
MS_DRG
|
Other Respiratory System Diagnoses With Mcc
|
9
|
3
|
—
|
—
|
$24,916.25
|
$24,916.25
|
$24,916.25
|
2026-01-01
|
|
377
|
MS_DRG
|
Gastrointestinal Hemorrhage With Mcc
|
10
|
4
|
—
|
—
|
$24,362.40
|
$24,875.42
|
$24,875.42
|
2026-01-01
|
|
441
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc
|
10
|
4
|
—
|
—
|
$24,422.28
|
$24,878.15
|
$24,422.28
|
2026-01-01
|
|
896
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc
|
1
|
1
|
—
|
—
|
$24,196.38
|
$24,196.38
|
$24,196.38
|
2025-01-22
|
|
371
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections With Mcc
|
9
|
3
|
—
|
—
|
$24,128.34
|
$24,128.34
|
$24,128.34
|
2026-01-01
|
|
884
|
MS_DRG
|
Organic Disturbances And Intellectual Disability
|
1
|
1
|
—
|
—
|
$23,907.90
|
$23,907.90
|
$23,907.90
|
2025-01-22
|
|
580
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Cc
|
1
|
1
|
—
|
—
|
$23,767.73
|
$23,767.73
|
$23,767.73
|
2025-01-22
|
|
180
|
MS_DRG
|
Respiratory Neoplasms With Mcc
|
1
|
1
|
—
|
—
|
$23,653.43
|
$23,653.43
|
$23,653.43
|
2025-01-22
|
|
571
|
MS_DRG
|
Skin Debridement With Cc
|
1
|
1
|
—
|
—
|
$23,023.38
|
$23,023.38
|
$23,023.38
|
2025-01-22
|
|
J9273
|
HCPCS
|
Tisotumab 40 Mg
|
13
|
8
|
$42,102.00
|
$25,261.20
40% off
|
$22,945.59
|
$22,945.59
|
$22,945.59
|
2025-01-22
|
|
J9144
|
HCPCS
|
Darzalex Faspro
|
13
|
8
|
$42,070.00
|
$25,242.00
40% off
|
$22,928.15
|
$22,928.15
|
$22,928.15
|
2025-01-22
|
|
J0802
|
HCPCS
|
Cortrophin 400 Unit/5ml Vial
|
13
|
8
|
$41,862.00
|
$25,117.20
40% off
|
$22,814.79
|
$22,814.79
|
$22,814.79
|
2025-01-22
|
|
331
|
MS_DRG
|
Major Small And Large Bowel Procedures Without Cc/mcc
|
1
|
1
|
—
|
—
|
$22,752.58
|
$22,752.58
|
$22,752.58
|
2025-01-22
|
|
438
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Mcc
|
1
|
1
|
—
|
—
|
$22,709.03
|
$22,709.03
|
$22,709.03
|
2025-01-22
|
|
698
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses With Mcc
|
1
|
1
|
—
|
—
|
$22,513.08
|
$22,513.08
|
$22,513.08
|
2025-01-22
|
|
J2505
|
HCPCS
|
Neulasta 6mg/0.6ml Delivery Ki
|
13
|
8
|
$41,242.00
|
$24,745.20
40% off
|
$17,132.08
|
$22,476.89
|
$22,476.89
|
2025-01-22
|
|
865
|
MS_DRG
|
Viral Illness With Mcc
|
1
|
1
|
—
|
—
|
$22,315.76
|
$22,315.76
|
$22,315.76
|
2025-01-22
|
|
418
|
MS_DRG
|
Laparoscopic Cholecystectomy Without C.d.e. With Cc
|
1
|
1
|
—
|
—
|
$22,245.00
|
$22,245.00
|
$22,245.00
|
2025-01-22
|
|
444
|
MS_DRG
|
Disorders Of The Biliary Tract With Mcc
|
1
|
1
|
—
|
—
|
$22,224.59
|
$22,224.59
|
$22,224.59
|
2025-01-22
|
|
299
|
MS_DRG
|
Peripheral Vascular Disorders With Mcc
|
10
|
4
|
—
|
—
|
$21,448.93
|
$22,217.78
|
$22,217.78
|
2026-01-01
|
|
393
|
MS_DRG
|
Other Digestive System Diagnoses With Mcc
|
1
|
1
|
—
|
—
|
$22,039.52
|
$22,039.52
|
$22,039.52
|
2025-01-22
|
|
280
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Mcc
|
10
|
4
|
—
|
—
|
$21,589.09
|
$21,828.59
|
$21,828.59
|
2026-01-01
|
|
296
|
MS_DRG
|
Cardiac Arrest, Unexplained With Mcc
|
1
|
1
|
—
|
—
|
$21,816.35
|
$21,816.35
|
$21,816.35
|
2025-01-22
|
|
917
|
MS_DRG
|
Poisoning And Toxic Effects Of Drugs With Mcc
|
1
|
1
|
—
|
—
|
$21,717.01
|
$21,717.01
|
$21,717.01
|
2025-01-22
|
|
482
|
MS_DRG
|
Hip And Femur Procedures Except Major Joint Without Cc/mcc
|
1
|
1
|
—
|
—
|
$21,614.95
|
$21,614.95
|
$21,614.95
|
2025-01-22
|
|
A9604
|
HCPCS
|
Samarium Sm-153 Lexidronam
|
13
|
8
|
$39,352.00
|
$23,611.20
40% off
|
$21,446.84
|
$21,446.84
|
$21,446.84
|
2025-01-22
|
|
183
|
MS_DRG
|
Major Chest Trauma With Mcc
|
1
|
1
|
—
|
—
|
$21,425.80
|
$21,425.80
|
$21,425.80
|
2025-01-22
|
|
177
|
MS_DRG
|
Respiratory Infections And Inflammations With Mcc
|
10
|
4
|
—
|
—
|
$21,265.22
|
$23,084.61
|
$21,265.22
|
2026-01-01
|
|
813
|
MS_DRG
|
Coagulation Disorders
|
1
|
1
|
—
|
—
|
$21,228.48
|
$21,228.48
|
$21,228.48
|
2025-01-22
|
|
557
|
MS_DRG
|
Tendonitis, Myositis And Bursitis With Mcc
|
1
|
1
|
—
|
—
|
$21,184.93
|
$21,184.93
|
$21,184.93
|
2025-01-22
|
|
J1930
|
HCPCS
|
Somatuline Depot 120mg/0.5ml S
|
13
|
8
|
$38,362.00
|
$23,017.20
40% off
|
$20,907.29
|
$20,907.29
|
$20,907.29
|
2025-01-22
|
|
J9228
|
HCPCS
|
Yervoy 5mg/ml Inj 10ml
|
13
|
8
|
$37,964.00
|
$22,778.40
40% off
|
$20,690.38
|
$20,690.38
|
$20,690.38
|
2025-01-22
|
|
77
|
MS_DRG
|
Hypertensive Encephalopathy With Mcc
|
1
|
1
|
—
|
—
|
$20,560.33
|
$20,560.33
|
$20,560.33
|
2025-01-22
|
|
J9042
|
HCPCS
|
Adcetris 50mg/10ml Inj 0.2ml
|
13
|
8
|
$37,563.00
|
$22,537.80
40% off
|
$20,471.83
|
$20,471.83
|
$20,471.83
|
2025-01-22
|
|
682
|
MS_DRG
|
Renal Failure With Mcc
|
10
|
4
|
—
|
—
|
$20,153.45
|
$20,422.89
|
$20,153.45
|
2026-01-01
|
|
J9223
|
HCPCS
|
Zepzelca 4 Mg Vial
|
4
|
4
|
$36,844.00
|
$22,106.40
40% off
|
$20,079.98
|
$20,079.98
|
$20,079.98
|
2025-01-22
|
|
C9399
|
HCPCS
|
Zepzelca 4 Mg Vial
|
13
|
8
|
$36,844.00
|
$22,106.40
40% off
|
$20,079.98
|
$31,887.40
|
$20,079.98
|
2025-01-22
|
|
388
|
MS_DRG
|
Gastrointestinal Obstruction With Mcc
|
1
|
1
|
—
|
—
|
$19,779.23
|
$19,779.23
|
$19,779.23
|
2025-01-22
|
|
637
|
MS_DRG
|
Diabetes With Mcc
|
10
|
4
|
—
|
—
|
$19,550.61
|
$19,722.07
|
$19,550.61
|
2026-01-01
|
|
602
|
MS_DRG
|
Cellulitis With Mcc
|
10
|
4
|
—
|
—
|
$19,341.05
|
$20,241.90
|
$19,341.05
|
2026-01-01
|
|
811
|
MS_DRG
|
Red Blood Cell Disorders With Mcc
|
10
|
4
|
—
|
—
|
$19,100.19
|
$19,109.71
|
$19,109.71
|
2026-01-01
|
|
J9311
|
HCPCS
|
Rituxan Hyc 1400mg/11.7ml
|
13
|
8
|
$34,804.00
|
$20,882.40
40% off
|
$18,968.18
|
$18,968.18
|
$18,968.18
|
2025-01-22
|
|
J1300
|
HCPCS
|
Soliris 10mg/ml Injection
|
13
|
8
|
$34,520.00
|
$20,712.00
40% off
|
$18,813.40
|
$18,813.40
|
$18,813.40
|
2025-01-22
|
|
175
|
MS_DRG
|
Pulmonary Embolism With Mcc Or Acute Cor Pulmonale
|
10
|
4
|
—
|
—
|
$18,691.95
|
$19,092.02
|
$18,691.95
|
2026-01-01
|
|
J9301
|
HCPCS
|
Gazyva 1000mg/40ml Vial
|
13
|
8
|
$34,156.00
|
$20,493.60
40% off
|
$18,615.02
|
$18,615.02
|
$18,615.02
|
2025-01-22
|
|
885
|
MS_DRG
|
Psychoses
|
1
|
1
|
—
|
—
|
$18,593.97
|
$18,593.97
|
$18,593.97
|
2025-01-22
|
|
57
|
MS_DRG
|
Degenerative Nervous System Disorders Without Mcc
|
1
|
1
|
—
|
—
|
$18,550.43
|
$18,550.43
|
$18,550.43
|
2025-01-22
|
|
J3101
|
HCPCS
|
Tnkase 50mg Inj
|
64
|
19
|
$35,210.00
|
$21,126.00
40% off
|
$197.44
|
$30,984.80
|
$18,275.49
|
2026-01-01
|
|
640
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…
|
10
|
4
|
—
|
—
|
$17,897.24
|
$18,174.84
|
$18,174.84
|
2026-01-01
|
|
555
|
MS_DRG
|
Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc
|
9
|
3
|
—
|
—
|
$17,987.05
|
$17,987.05
|
$17,987.05
|
2026-01-01
|
|
193
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Mcc
|
10
|
4
|
—
|
—
|
$17,886.36
|
$18,052.37
|
$17,886.36
|
2026-01-01
|
|
540
|
MS_DRG
|
Osteomyelitis With Cc
|
1
|
1
|
—
|
—
|
$17,665.91
|
$17,665.91
|
$17,665.91
|
2025-01-22
|
|
535
|
MS_DRG
|
Fractures Of Hip And Pelvis With Mcc
|
1
|
1
|
—
|
—
|
$17,645.49
|
$17,645.49
|
$17,645.49
|
2025-01-22
|
|
553
|
MS_DRG
|
Bone Diseases And Arthropathies With Mcc
|
9
|
3
|
—
|
—
|
$17,640.05
|
$17,640.05
|
$17,640.05
|
2026-01-01
|
|
J3380
|
HCPCS
|
Entyvio 300mg/20ml Vial
|
13
|
8
|
$32,269.00
|
$19,361.40
40% off
|
$17,586.60
|
$17,586.60
|
$17,586.60
|
2025-01-22
|
|
291
|
MS_DRG
|
Heart Failure And Shock With Mcc
|
10
|
4
|
—
|
—
|
$17,469.95
|
$17,471.31
|
$17,469.95
|
2026-01-01
|
|
C9041
|
HCPCS
|
Andexxa 200mg Vial
|
13
|
8
|
$32,052.00
|
$19,231.20
40% off
|
$17,468.34
|
$17,468.34
|
$17,468.34
|
2025-01-22
|
|
391
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc
|
1
|
1
|
—
|
—
|
$17,359.73
|
$17,359.73
|
$17,359.73
|
2025-01-22
|
|
947
|
MS_DRG
|
Signs And Symptoms With Mcc
|
10
|
4
|
—
|
—
|
$17,031.77
|
$17,274.00
|
$17,274.00
|
2026-01-01
|
|
J2506
|
HCPCS
|
Neulasta 6mg 0.6ml Injection
|
9
|
6
|
$31,435.00
|
$18,861.00
40% off
|
$17,132.08
|
$17,132.08
|
$17,132.08
|
2025-01-22
|
|
189
|
MS_DRG
|
Pulmonary Edema And Respiratory Failure
|
10
|
4
|
—
|
—
|
$16,765.06
|
$16,811.32
|
$16,811.32
|
2026-01-01
|
|
593
|
MS_DRG
|
Skin Ulcers With Cc
|
1
|
1
|
—
|
—
|
$16,464.32
|
$16,464.32
|
$16,464.32
|
2025-01-22
|
|
308
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Mcc
|
10
|
4
|
—
|
—
|
$16,359.54
|
$16,384.03
|
$16,384.03
|
2026-01-01
|
|
949
|
MS_DRG
|
Aftercare With Cc/mcc
|
9
|
3
|
—
|
—
|
$16,189.44
|
$16,189.44
|
$16,189.44
|
2026-01-01
|
|
689
|
MS_DRG
|
Kidney And Urinary Tract Infections With Mcc
|
10
|
4
|
—
|
—
|
$15,789.36
|
$15,981.24
|
$15,789.36
|
2026-01-01
|
|
546
|
MS_DRG
|
Connective Tissue Disorders With Cc
|
9
|
3
|
—
|
—
|
$15,695.47
|
$15,695.47
|
$15,695.47
|
2026-01-01
|
|
J9307
|
HCPCS
|
Folotyn 20mg/ml Inj
|
13
|
8
|
$28,266.00
|
$16,959.60
40% off
|
$15,404.97
|
$15,404.97
|
$15,404.97
|
2025-01-22
|
|
436
|
MS_DRG
|
Malignancy Of Hepatobiliary System Or Pancreas With Cc
|
9
|
3
|
—
|
—
|
$15,392.01
|
$15,392.01
|
$15,392.01
|
2026-01-01
|
|
560
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With Cc
|
10
|
4
|
—
|
—
|
$15,323.97
|
$15,405.62
|
$15,323.97
|
2026-01-01
|
|
302
|
MS_DRG
|
Atherosclerosis With Mcc
|
1
|
1
|
—
|
—
|
$15,255.93
|
$15,255.93
|
$15,255.93
|
2025-01-22
|
|
190
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Mcc
|
10
|
4
|
—
|
—
|
$14,996.02
|
$15,073.58
|
$15,073.58
|
2026-01-01
|
|
J9204
|
HCPCS
|
Poteligeo 20mg/5ml Vial
|
13
|
8
|
$27,565.00
|
$16,539.00
40% off
|
$15,022.92
|
$15,022.92
|
$15,022.92
|
2025-01-22
|
|
181
|
MS_DRG
|
Respiratory Neoplasms With Cc
|
1
|
1
|
—
|
—
|
$14,983.77
|
$14,983.77
|
$14,983.77
|
2025-01-22
|
|
36906
|
CPT
|
Perq Thrombo Dialy Circ
|
13
|
8
|
$27,314.00
|
$16,388.40
40% off
|
$14,886.13
|
$14,886.13
|
$14,886.13
|
2025-01-22
|
|
J9356
|
HCPCS
|
Herceptin Hylecta 600mg Sdv
|
13
|
8
|
$27,246.00
|
$16,347.60
40% off
|
$14,849.07
|
$14,849.07
|
$14,849.07
|
2025-01-22
|
|
445
|
MS_DRG
|
Disorders Of The Biliary Tract With Cc
|
1
|
1
|
—
|
—
|
$14,789.17
|
$14,789.17
|
$14,789.17
|
2025-01-22
|
|
300
|
MS_DRG
|
Peripheral Vascular Disorders With Cc
|
10
|
4
|
—
|
—
|
$14,519.74
|
$14,526.54
|
$14,526.54
|
2026-01-01
|
|
J9306
|
HCPCS
|
Perjeta 420mg/14ml Injection
|
13
|
8
|
$26,527.00
|
$15,916.20
40% off
|
$14,457.22
|
$14,457.22
|
$14,457.22
|
2025-01-22
|
|
71
|
MS_DRG
|
Nonspecific Cerebrovascular Disorders With Cc
|
1
|
1
|
—
|
—
|
$14,448.97
|
$14,448.97
|
$14,448.97
|
2025-01-22
|
|
J1561
|
HCPCS
|
Gamunex-c 40000 Mg/400 Ml
|
13
|
8
|
$26,486.00
|
$15,891.60
40% off
|
$14,434.87
|
$14,434.87
|
$14,434.87
|
2025-01-22
|
|
184
|
MS_DRG
|
Major Chest Trauma With Cc
|
1
|
1
|
—
|
—
|
$14,314.26
|
$14,314.26
|
$14,314.26
|
2025-01-22
|
|
372
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections With Cc
|
1
|
1
|
—
|
—
|
$14,183.62
|
$14,183.62
|
$14,183.62
|
2025-01-22
|
|
433
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis With Cc
|
1
|
1
|
—
|
—
|
$14,029.85
|
$14,029.85
|
$14,029.85
|
2025-01-22
|
|
872
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc
|
10
|
4
|
—
|
—
|
$13,925.07
|
$14,014.88
|
$13,925.07
|
2026-01-01
|
|
92
|
MS_DRG
|
Other Disorders Of Nervous System With Cc
|
10
|
4
|
—
|
—
|
$13,920.98
|
$13,963.17
|
$13,920.98
|
2026-01-01
|
|
J0517
|
HCPCS
|
Fasenra 30 Mg/1 Ml Syringe
|
13
|
8
|
$25,526.00
|
$15,315.60
40% off
|
$13,911.67
|
$13,911.67
|
$13,911.67
|
2025-01-22
|
|
J9325
|
HCPCS
|
Imylgic 100 Million Pfu/ml Vl
|
13
|
8
|
$25,371.00
|
$15,222.60
40% off
|
$13,827.19
|
$13,827.19
|
$13,827.19
|
2025-01-22
|
|
699
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses With Cc
|
10
|
4
|
—
|
—
|
$13,812.12
|
$13,891.05
|
$13,812.12
|
2026-01-01
|
|
842
|
MS_DRG
|
Lymphoma And Non-acute Leukemia Without Cc/mcc
|
9
|
3
|
—
|
—
|
$13,749.52
|
$13,749.52
|
$13,749.52
|
2026-01-01
|
|
65
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours
|
10
|
4
|
—
|
—
|
$13,748.16
|
$13,831.17
|
$13,748.16
|
2026-01-01
|
|
596
|
MS_DRG
|
Major Skin Disorders Without Mcc
|
1
|
1
|
—
|
—
|
$13,730.47
|
$13,730.47
|
$13,730.47
|
2025-01-22
|
|
810
|
MS_DRG
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
1
|
1
|
—
|
—
|
$13,669.24
|
$13,669.24
|
$13,669.24
|
2025-01-22
|
|
J9271
|
HCPCS
|
Keytruda Vial 100mg/4ml
|
13
|
8
|
$24,976.00
|
$14,985.60
40% off
|
$13,611.92
|
$13,611.92
|
$13,611.92
|
2025-01-22
|
|
J9312
|
HCPCS
|
Rituxan 10mg/ml Inj 50ml
|
13
|
8
|
$24,860.00
|
$14,916.00
40% off
|
$13,548.70
|
$13,548.70
|
$13,548.70
|
2025-01-22
|
|
815
|
MS_DRG
|
Reticuloendothelial And Immunity Disorders With Cc
|
1
|
1
|
—
|
—
|
$13,529.07
|
$13,529.07
|
$13,529.07
|
2025-01-22
|
|
187
|
MS_DRG
|
Pleural Effusion With Cc
|
9
|
3
|
—
|
—
|
$13,459.67
|
$13,459.67
|
$13,459.67
|
2026-01-01
|
|
378
|
MS_DRG
|
Gastrointestinal Hemorrhage With Cc
|
1
|
1
|
—
|
—
|
$13,387.55
|
$13,387.55
|
$13,387.55
|
2025-01-22
|
|
178
|
MS_DRG
|
Respiratory Infections And Inflammations With Cc
|
10
|
4
|
—
|
—
|
$13,281.41
|
$13,427.01
|
$13,281.41
|
2026-01-01
|
|
386
|
MS_DRG
|
Inflammatory Bowel Disease With Cc
|
1
|
1
|
—
|
—
|
$13,221.53
|
$13,221.53
|
$13,221.53
|
2025-01-22
|
|
315
|
MS_DRG
|
Other Circulatory System Diagnoses With Cc
|
1
|
1
|
—
|
—
|
$13,163.02
|
$13,163.02
|
$13,163.02
|
2025-01-22
|
|
442
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc
|
10
|
4
|
—
|
—
|
$12,948.01
|
$13,135.80
|
$13,135.80
|
2026-01-01
|
|
552
|
MS_DRG
|
Medical Back Problems Without Mcc
|
10
|
4
|
—
|
—
|
$13,081.37
|
$13,149.41
|
$13,081.37
|
2026-01-01
|
|
881
|
MS_DRG
|
Depressive Neuroses
|
9
|
3
|
—
|
—
|
$12,803.77
|
$12,803.77
|
$12,803.77
|
2026-01-01
|
|
394
|
MS_DRG
|
Other Digestive System Diagnoses With Cc
|
1
|
1
|
—
|
—
|
$12,749.34
|
$12,749.34
|
$12,749.34
|
2025-01-22
|
|
281
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Cc
|
10
|
4
|
—
|
—
|
$12,424.10
|
$12,507.11
|
$12,507.11
|
2026-01-01
|
|
812
|
MS_DRG
|
Red Blood Cell Disorders Without Mcc
|
10
|
4
|
—
|
—
|
$12,256.73
|
$12,494.87
|
$12,494.87
|
2026-01-01
|
|
Q5122
|
HCPCS
|
Nyvepria 6mg/0.6nl
|
13
|
8
|
$22,874.00
|
$13,724.40
40% off
|
$12,466.33
|
$12,466.33
|
$12,466.33
|
2025-01-22
|
|
605
|
MS_DRG
|
Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc
|
10
|
4
|
—
|
—
|
$12,366.95
|
$12,464.93
|
$12,464.93
|
2026-01-01
|
|
101
|
MS_DRG
|
Seizures Without Mcc
|
1
|
1
|
—
|
—
|
$12,377.84
|
$12,377.84
|
$12,377.84
|
2025-01-22
|
|
J7336
|
HCPCS
|
Qutenza 8% Topical 4 Patches
|
64
|
19
|
$23,699.00
|
$14,219.40
40% off
|
$3.42
|
$20,855.12
|
$12,300.65
|
2026-01-01
|
|
683
|
MS_DRG
|
Renal Failure With Cc
|
1
|
1
|
—
|
—
|
$12,258.09
|
$12,258.09
|
$12,258.09
|
2025-01-22
|
|
638
|
MS_DRG
|
Diabetes With Cc
|
10
|
4
|
—
|
—
|
$12,195.49
|
$12,239.04
|
$12,195.49
|
2026-01-01
|
|
563
|
MS_DRG
|
Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…
|
10
|
4
|
—
|
—
|
$12,185.96
|
$12,187.32
|
$12,185.96
|
2026-01-01
|
|
J1576
|
HCPCS
|
Panzyga 10% 200ml Vial
|
13
|
8
|
$22,330.00
|
$13,398.00
40% off
|
$12,169.85
|
$12,169.85
|
$12,169.85
|
2025-01-22
|
|
914
|
MS_DRG
|
Traumatic Injury Without Mcc
|
9
|
3
|
—
|
—
|
$12,049.88
|
$12,049.88
|
$12,049.88
|
2026-01-01
|
|
Q5111
|
HCPCS
|
Udenyca 6mg Injection
|
13
|
8
|
$22,095.00
|
$13,257.00
40% off
|
$12,041.77
|
$12,041.77
|
$12,041.77
|
2025-01-22
|
|
558
|
MS_DRG
|
Tendonitis, Myositis And Bursitis Without Mcc
|
1
|
1
|
—
|
—
|
$11,953.27
|
$11,953.27
|
$11,953.27
|
2025-01-22
|
|
550
|
MS_DRG
|
Septic Arthritis Without Cc/mcc
|
9
|
3
|
—
|
—
|
$11,894.75
|
$11,894.75
|
$11,894.75
|
2026-01-01
|
|
312
|
MS_DRG
|
Syncope And Collapse
|
10
|
4
|
—
|
—
|
$11,750.51
|
$11,860.73
|
$11,860.73
|
2026-01-01
|
|
603
|
MS_DRG
|
Cellulitis Without Mcc
|
10
|
4
|
—
|
—
|
$11,851.21
|
$12,039.00
|
$11,851.21
|
2026-01-01
|
|
866
|
MS_DRG
|
Viral Illness Without Mcc
|
10
|
4
|
—
|
—
|
$11,833.52
|
$12,488.06
|
$11,833.52
|
2026-01-01
|
|
J2353
|
HCPCS
|
Sandostatin Lar 20mg Kit
|
13
|
8
|
$21,598.00
|
$12,958.80
40% off
|
$11,770.91
|
$11,770.91
|
$11,770.91
|
2025-01-22
|
|
918
|
MS_DRG
|
Poisoning And Toxic Effects Of Drugs Without Mcc
|
10
|
4
|
—
|
—
|
$11,663.42
|
$11,715.13
|
$11,663.42
|
2026-01-01
|
|
90375
|
CPT
|
Rabies S-d 1500 Unit/10ml
|
13
|
8
|
$21,387.00
|
$12,832.20
40% off
|
$11,655.92
|
$11,655.92
|
$11,655.92
|
2025-01-22
|
|
897
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc
|
1
|
1
|
—
|
—
|
$11,643.00
|
$11,643.00
|
$11,643.00
|
2025-01-22
|
|
J2427
|
HCPCS
|
Invega Trinza 273mg/0.88ml
|
13
|
8
|
$21,360.50
|
$12,816.30
40% off
|
$11,641.47
|
$17,462.35
|
$11,641.47
|
2025-01-22
|
|
292
|
MS_DRG
|
Heart Failure And Shock With Cc
|
10
|
4
|
—
|
—
|
$11,553.19
|
$11,655.25
|
$11,553.19
|
2026-01-01
|
|
191
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Cc
|
10
|
4
|
—
|
—
|
$11,471.54
|
$11,553.19
|
$11,471.54
|
2026-01-01
|
|
103
|
MS_DRG
|
Headaches Without Mcc
|
1
|
1
|
—
|
—
|
$11,463.38
|
$11,463.38
|
$11,463.38
|
2025-01-22
|
|
439
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Cc
|
10
|
4
|
—
|
—
|
$11,447.05
|
$11,637.56
|
$11,447.05
|
2026-01-01
|
|
556
|
MS_DRG
|
Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc
|
10
|
4
|
—
|
—
|
$11,218.44
|
$11,302.80
|
$11,302.80
|
2026-01-01
|
|
554
|
MS_DRG
|
Bone Diseases And Arthropathies Without Mcc
|
9
|
3
|
—
|
—
|
$11,296.00
|
$11,296.00
|
$11,296.00
|
2026-01-01
|
|
J9058
|
HCPCS
|
Belrapzo 100 Mg/4 Ml Vial
|
13
|
8
|
$20,477.00
|
$12,286.20
40% off
|
$11,159.97
|
$11,159.97
|
$11,159.97
|
2025-01-22
|
|
176
|
MS_DRG
|
Pulmonary Embolism Without Mcc
|
1
|
1
|
—
|
—
|
$11,098.68
|
$11,098.68
|
$11,098.68
|
2025-01-22
|
|
J1950
|
HCPCS
|
Lupron Depot 11.5mg Syring Kit
|
13
|
8
|
$20,319.00
|
$12,191.40
40% off
|
$11,073.85
|
$11,073.85
|
$11,073.85
|
2025-01-22
|
|
690
|
MS_DRG
|
Kidney And Urinary Tract Infections Without Mcc
|
10
|
4
|
—
|
—
|
$10,980.30
|
$11,015.68
|
$11,015.68
|
2026-01-01
|
|
536
|
MS_DRG
|
Fractures Of Hip And Pelvis Without Mcc
|
10
|
4
|
—
|
—
|
$10,710.86
|
$10,989.82
|
$10,989.82
|
2026-01-01
|
|
194
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Cc
|
10
|
4
|
—
|
—
|
$10,966.69
|
$11,188.50
|
$10,966.69
|
2026-01-01
|
|
123
|
MS_DRG
|
Neurological Eye Disorders
|
1
|
1
|
—
|
—
|
$10,940.83
|
$10,940.83
|
$10,940.83
|
2025-01-22
|
|
561
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc
|
9
|
3
|
—
|
—
|
$10,939.47
|
$10,939.47
|
$10,939.47
|
2026-01-01
|
|
948
|
MS_DRG
|
Signs And Symptoms Without Mcc
|
10
|
4
|
—
|
—
|
$10,893.20
|
$10,900.01
|
$10,893.20
|
2026-01-01
|
|
J2997
|
HCPCS
|
Activase 2mg Inj
|
112
|
19
|
$46,572.00
|
$27,943.20
40% off
|
$95.09
|
$47,388.00
|
$10,877.70
|
2026-01-01
|
|
69
|
MS_DRG
|
Transient Ischemia Without Thrombolytic
|
1
|
1
|
—
|
—
|
$10,868.71
|
$10,868.71
|
$10,868.71
|
2025-01-22
|
|
389
|
MS_DRG
|
Gastrointestinal Obstruction With Cc
|
10
|
4
|
—
|
—
|
$10,747.60
|
$10,837.41
|
$10,747.60
|
2026-01-01
|
|
694
|
MS_DRG
|
Urinary Stones Without Mcc
|
1
|
1
|
—
|
—
|
$10,650.98
|
$10,650.98
|
$10,650.98
|
2025-01-22
|
|
392
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc
|
10
|
4
|
—
|
—
|
$10,608.80
|
$10,690.44
|
$10,608.80
|
2026-01-01
|
|
641
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…
|
10
|
4
|
—
|
—
|
$10,589.75
|
$10,633.29
|
$10,589.75
|
2026-01-01
|
|
J1568
|
HCPCS
|
Octagam 10%/30gm/300ml
|
13
|
8
|
$19,311.50
|
$11,586.90
40% off
|
$10,524.76
|
$10,524.76
|
$10,524.76
|
2025-01-22
|
|
J1162
|
HCPCS
|
Digifab
|
13
|
8
|
$19,259.00
|
$11,555.40
40% off
|
$10,496.16
|
$10,496.16
|
$10,496.16
|
2025-01-22
|
|
J1437
|
HCPCS
|
Monoferric 1000 Mg/10 Ml
|
13
|
8
|
$19,180.50
|
$11,508.30
40% off
|
$10,453.38
|
$10,453.38
|
$10,453.38
|
2025-01-22
|
|
179
|
MS_DRG
|
Respiratory Infections And Inflammations Without Cc/mcc
|
1
|
1
|
—
|
—
|
$10,386.99
|
$10,386.99
|
$10,386.99
|
2025-01-22
|
|
72
|
MS_DRG
|
Nonspecific Cerebrovascular Disorders Without Cc/mcc
|
9
|
3
|
—
|
—
|
$10,290.37
|
$10,290.37
|
$10,290.37
|
2026-01-01
|
|
305
|
MS_DRG
|
Hypertension Without Mcc
|
10
|
4
|
—
|
—
|
$10,253.63
|
$10,275.40
|
$10,275.40
|
2026-01-01
|
|
J9173
|
HCPCS
|
Imfinzi 500mg/10ml Vial
|
13
|
8
|
$18,827.00
|
$11,296.20
40% off
|
$10,260.72
|
$10,260.72
|
$10,260.72
|
2025-01-22
|
|
149
|
MS_DRG
|
Dysequilibrium
|
1
|
1
|
—
|
—
|
$10,133.88
|
$10,133.88
|
$10,133.88
|
2025-01-22
|
|
309
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Cc
|
1
|
1
|
—
|
—
|
$10,133.88
|
$10,133.88
|
$10,133.88
|
2025-01-22
|
|
153
|
MS_DRG
|
Otitis Media And Uri Without Mcc
|
9
|
3
|
—
|
—
|
$10,045.43
|
$10,045.43
|
$10,045.43
|
2026-01-01
|
|
282
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive Without Cc/mcc
|
10
|
4
|
—
|
—
|
$9,771.90
|
$9,839.94
|
$9,839.94
|
2026-01-01
|
|
313
|
MS_DRG
|
Chest Pain
|
10
|
4
|
—
|
—
|
$9,797.76
|
$9,846.75
|
$9,797.76
|
2026-01-01
|
|
J9177
|
HCPCS
|
Padcev 20 Mg Vial
|
13
|
8
|
$17,921.50
|
$10,752.90
40% off
|
$9,767.22
|
$9,767.22
|
$9,767.22
|
2025-01-22
|
|
J9305
|
HCPCS
|
Alimta 500mg Inj
|
13
|
8
|
$17,901.00
|
$10,740.60
40% off
|
$9,756.05
|
$9,756.05
|
$9,756.05
|
2025-01-22
|
|
443
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C…
|
1
|
1
|
—
|
—
|
$9,725.64
|
$9,725.64
|
$9,725.64
|
2025-01-22
|
|
311
|
MS_DRG
|
Angina Pectoris
|
1
|
1
|
—
|
—
|
$9,499.74
|
$9,499.74
|
$9,499.74
|
2025-01-22
|
|
J0840
|
HCPCS
|
Crofab 1 Ea
|
64
|
19
|
$18,122.00
|
$10,873.20
40% off
|
$1,841.02
|
$15,947.36
|
$9,406.16
|
2026-01-01
|
|
156
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc
|
9
|
3
|
—
|
—
|
$9,404.49
|
$9,404.49
|
$9,404.49
|
2026-01-01
|
|
66
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc
|
9
|
3
|
—
|
—
|
$9,313.32
|
$9,313.32
|
$9,313.32
|
2026-01-01
|
|
J9036
|
HCPCS
|
Belrapzo 100 Mg/4 Ml Vial
|
13
|
8
|
$16,572.00
|
$9,943.20
40% off
|
$9,031.74
|
$9,031.74
|
$9,031.74
|
2025-01-22
|
|
Q4197
|
HCPCS
|
Puraply Xt 4.91x4.91(25)/sqcm
|
61
|
18
|
$11,305.00
|
$6,783.00
40% off
|
$2,261.00
|
$9,948.40
|
$8,930.95
|
2026-01-01
|
|
807
|
MS_DRG
|
Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc
|
1
|
1
|
—
|
—
|
$8,903.71
|
$8,903.71
|
$8,903.71
|
2025-01-22
|
|
192
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease Without Cc/mcc
|
10
|
4
|
—
|
—
|
$8,733.61
|
$8,736.34
|
$8,736.34
|
2026-01-01
|
|
J9354
|
HCPCS
|
Kadcyla 100mg Injection
|
13
|
8
|
$15,813.00
|
$9,487.80
40% off
|
$8,618.08
|
$8,618.08
|
$8,618.08
|
2025-01-22
|
|
195
|
MS_DRG
|
Simple Pneumonia And Pleurisy Without Cc/mcc
|
10
|
4
|
—
|
—
|
$8,513.16
|
$8,552.63
|
$8,552.63
|
2026-01-01
|
|
950
|
MS_DRG
|
Aftercare Without Cc/mcc
|
9
|
3
|
—
|
—
|
$8,541.74
|
$8,541.74
|
$8,541.74
|
2026-01-01
|
|
639
|
MS_DRG
|
Diabetes Without Cc/mcc
|
1
|
1
|
—
|
—
|
$8,470.98
|
$8,470.98
|
$8,470.98
|
2025-01-22
|
|
440
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy Without Cc/mcc
|
10
|
4
|
—
|
—
|
$8,377.08
|
$8,456.01
|
$8,456.01
|
2026-01-01
|
|
J2182
|
HCPCS
|
Nucala 100mg Vial
|
13
|
8
|
$15,406.00
|
$9,243.60
40% off
|
$8,396.27
|
$8,396.27
|
$8,396.27
|
2025-01-22
|
|
Q5107
|
HCPCS
|
Mvasi 400 Mg Vial
|
13
|
8
|
$15,051.00
|
$9,030.60
40% off
|
$8,202.80
|
$8,202.80
|
$8,202.80
|
2025-01-22
|
|
J9217
|
HCPCS
|
Eligard 45mg Inj Syringe
|
13
|
8
|
$14,957.00
|
$8,974.20
40% off
|
$8,151.56
|
$8,151.56
|
$8,151.56
|
2025-01-22
|
|
J9059
|
HCPCS
|
Belrapzo 100 Mg/4 Ml Vial
|
13
|
8
|
$14,929.50
|
$8,957.70
40% off
|
$8,136.58
|
$8,136.58
|
$8,136.58
|
2025-01-22
|
|
27170
|
CPT
|
Bone Graft Fem Head/nec
|
13
|
8
|
$14,259.00
|
$8,555.40
40% off
|
$7,771.15
|
$7,771.15
|
$7,771.15
|
2025-01-22
|
|
310
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc
|
10
|
4
|
—
|
—
|
$7,525.22
|
$7,703.49
|
$7,703.49
|
2026-01-01
|
|
293
|
MS_DRG
|
Heart Failure And Shock Without Cc/mcc
|
10
|
4
|
—
|
—
|
$7,640.89
|
$7,702.13
|
$7,702.13
|
2026-01-01
|
|
390
|
MS_DRG
|
Gastrointestinal Obstruction Without Cc/mcc
|
1
|
1
|
—
|
—
|
$7,606.87
|
$7,606.87
|
$7,606.87
|
2025-01-22
|
|
951
|
MS_DRG
|
Other Factors Influencing Health Status
|
10
|
4
|
—
|
—
|
$7,566.05
|
$8,028.72
|
$7,566.05
|
2026-01-01
|
|
37239
|
CPT
|
Trnscth Stent Addl Vein
|
13
|
8
|
$13,683.00
|
$8,209.80
40% off
|
$7,457.23
|
$7,457.23
|
$7,457.23
|
2025-01-22
|
|
J9358
|
HCPCS
|
Enhertu 100mg Vial
|
13
|
8
|
$13,236.00
|
$7,941.60
40% off
|
$7,213.62
|
$7,213.62
|
$7,213.62
|
2025-01-22
|
|
J9034
|
HCPCS
|
Bendeka 100mg/4ml Mdv
|
13
|
8
|
$13,092.00
|
$7,855.20
40% off
|
$7,135.14
|
$7,135.14
|
$7,135.14
|
2025-01-22
|
|
J1944
|
HCPCS
|
Aristada ER 882mmg/3.2ml Pfs
|
13
|
8
|
$12,929.00
|
$7,757.40
40% off
|
$7,046.31
|
$7,046.31
|
$7,046.31
|
2025-01-22
|
|
J3315
|
HCPCS
|
Trelstar La 11.25mg Injection
|
13
|
8
|
$12,912.00
|
$7,747.20
40% off
|
$7,037.04
|
$7,037.04
|
$7,037.04
|
2025-01-22
|
|
J0898
|
HCPCS
|
Argatroban/ns 50mg/50ml Vial
|
13
|
8
|
$12,531.00
|
$7,518.60
40% off
|
$6,829.40
|
$6,829.40
|
$6,829.40
|
2025-01-22
|
|
J0349
|
HCPCS
|
Rezzayo 200 Mg Vial
|
13
|
8
|
$12,441.00
|
$7,464.60
40% off
|
$6,780.35
|
$6,780.35
|
$6,780.35
|
2025-01-22
|
|
J9317
|
HCPCS
|
Trodelvy 180mg Vial
|
13
|
8
|
$12,080.00
|
$7,248.00
40% off
|
$6,583.60
|
$6,583.60
|
$6,583.60
|
2025-01-22
|
|
J0899
|
HCPCS
|
Argatroban/ns 50 Mg/50 Ml Vial
|
13
|
8
|
$11,934.00
|
$7,160.40
40% off
|
$6,504.03
|
$6,504.03
|
$6,504.03
|
2025-01-22
|
|
J9047
|
HCPCS
|
Carfilzomib 60mg Injection
|
13
|
8
|
$11,929.00
|
$7,157.40
40% off
|
$6,501.31
|
$6,501.31
|
$6,501.31
|
2025-01-22
|
|
J3358
|
HCPCS
|
Stelara 130 Mg Vial
|
13
|
8
|
$11,809.00
|
$7,085.40
40% off
|
$6,435.90
|
$6,435.90
|
$6,435.90
|
2025-01-22
|
|
J3262
|
HCPCS
|
Actemra 400mg/20ml Injection
|
13
|
8
|
$11,559.00
|
$6,935.40
40% off
|
$6,299.65
|
$6,299.65
|
$6,299.65
|
2025-01-22
|
|
60699
|
CPT
|
Unlisted Proc Endocrine
|
13
|
8
|
$11,465.00
|
$6,879.00
40% off
|
$6,248.43
|
$6,248.43
|
$6,248.43
|
2025-01-22
|
|
A2025
|
HCPCS
|
Miro3d 100 Cm3/cm3
|
192
|
15
|
$9,277.00
|
$5,566.20
40% off
|
$1,456.40
|
$26,890.16
|
$6,114.14
|
2026-01-01
|
|
J3032
|
HCPCS
|
Vyepti 100mg/1ml Vial
|
64
|
19
|
$11,136.00
|
$6,681.60
40% off
|
$20.55
|
$9,799.68
|
$5,779.73
|
2026-01-01
|
|
J0219
|
HCPCS
|
Nexviazyme 100mg Vial
|
13
|
8
|
$10,498.00
|
$6,298.80
40% off
|
$5,721.41
|
$5,721.41
|
$5,721.41
|
2025-01-22
|
|
J1246
|
HCPCS
|
Unituxin 3.5 Mg/1 Ml Vial
|
13
|
8
|
$10,440.00
|
$6,264.00
40% off
|
$5,689.80
|
$5,689.80
|
$5,689.80
|
2025-01-22
|
|
C8914
|
HCPCS
|
Mr Angio Leg W/wo Contrast Bil
|
26
|
8
|
$10,429.50
|
$6,257.70
40% off
|
$3,789.39
|
$7,578.77
|
$5,684.08
|
2025-01-22
|
|
J9205
|
HCPCS
|
Onivyde 43mg/10ml Vial
|
13
|
8
|
$10,362.00
|
$6,217.20
40% off
|
$5,647.29
|
$5,647.29
|
$5,647.29
|
2025-01-22
|
|
J9046
|
HCPCS
|
Bortezomib(velcade)3.5 Mg Vial
|
13
|
8
|
$10,302.00
|
$6,181.20
40% off
|
$5,614.59
|
$5,614.59
|
$5,614.59
|
2025-01-22
|
|
0037U
|
OTHER
|
Trgt Gen Seq DNA 324 Genes
|
4
|
4
|
$10,129.00
|
$6,077.40
40% off
|
$5,520.31
|
$5,520.31
|
$5,520.31
|
2025-01-22
|
|
0037U
|
CPT
|
Trgt Gen Seq DNA 324 Genes
|
11
|
7
|
$10,129.00
|
$6,077.40
40% off
|
$3,150.00
|
$5,520.31
|
$5,520.31
|
2025-01-22
|
|
J9259
|
HCPCS
|
Abraxane 100 Mg Sdv
|
13
|
8
|
$10,051.00
|
$6,030.60
40% off
|
$5,477.80
|
$5,477.80
|
$5,477.80
|
2025-01-22
|
|
J0401
|
HCPCS
|
Abilify Maintena ER 400mg Inj
|
13
|
8
|
$9,935.00
|
$5,961.00
40% off
|
$5,414.57
|
$5,414.57
|
$5,414.57
|
2025-01-22
|
|
J1943
|
HCPCS
|
Aristada Initio 675mg Syringe
|
13
|
8
|
$9,895.00
|
$5,937.00
40% off
|
$5,392.77
|
$5,392.77
|
$5,392.77
|
2025-01-22
|
|
J9176
|
HCPCS
|
Empliciti 300mg
|
13
|
8
|
$9,828.00
|
$5,896.80
40% off
|
$5,356.26
|
$5,356.26
|
$5,356.26
|
2025-01-22
|
|
87999
|
CPT
|
Trofile DNA Co-recept Tropism
|
14
|
8
|
$9,806.00
|
$5,883.60
40% off
|
$5,344.27
|
$5,344.27
|
$5,344.27
|
2025-01-22
|
|
81445
|
CPT
|
Target Genomic Sequenc Ana
|
15
|
9
|
$11,151.00
|
$6,690.60
40% off
|
$538.12
|
$5,175.50
|
$5,175.50
|
2025-01-22
|
|
81408
|
CPT
|
Molecular Path Level 9
|
14
|
8
|
$9,375.00
|
$5,625.00
40% off
|
$2,000.00
|
$5,109.38
|
$5,109.38
|
2025-01-22
|
|
A9572
|
HCPCS
|
Octrescn(in-111)up To 6 Mci
|
13
|
8
|
$9,308.00
|
$5,584.80
40% off
|
$5,072.86
|
$5,072.86
|
$5,072.86
|
2025-01-22
|
|
90377
|
CPT
|
Kedrab 1500unit/10ml
|
51
|
16
|
$22,799.00
|
$13,679.40
40% off
|
$242.18
|
$20,063.12
|
$5,015.78
|
2026-01-01
|
|
J1602
|
HCPCS
|
Simponi Aria 50mg/4ml Vial
|
13
|
8
|
$9,175.00
|
$5,505.00
40% off
|
$5,000.38
|
$5,000.38
|
$5,000.38
|
2025-01-22
|
|
78811
|
CPT
|
Pt Q0 Limited Area
|
13
|
8
|
$9,129.00
|
$5,477.40
40% off
|
$4,975.31
|
$4,975.31
|
$4,975.31
|
2025-01-22
|
|
78816
|
CPT
|
Pt/ct Pi Whole Body
|
13
|
8
|
$9,129.00
|
$5,477.40
40% off
|
$4,975.31
|
$4,975.31
|
$4,975.31
|
2025-01-22
|
|
78815
|
CPT
|
Pt/ct Pi Skull Base To Mid Thi
|
13
|
8
|
$9,129.00
|
$5,477.40
40% off
|
$4,975.31
|
$4,975.31
|
$4,975.31
|
2025-01-22
|
|
J2796
|
HCPCS
|
Nplate 250 Mcg Injection
|
13
|
8
|
$9,104.00
|
$5,462.40
40% off
|
$4,961.68
|
$4,961.68
|
$4,961.68
|
2025-01-22
|
|
J9264
|
HCPCS
|
Abraxane 100mg Sdv
|
13
|
8
|
$9,073.00
|
$5,443.80
40% off
|
$4,944.78
|
$4,944.78
|
$4,944.78
|
2025-01-22
|
|
J9023
|
HCPCS
|
Bavencio 200mg/10ml Vial
|
13
|
8
|
$9,000.00
|
$5,400.00
40% off
|
$4,905.00
|
$4,905.00
|
$4,905.00
|
2025-01-22
|
|
J9400
|
HCPCS
|
Zaltrap 100mg/4ml Inj
|
13
|
8
|
$8,468.00
|
$5,080.80
40% off
|
$4,615.06
|
$4,615.06
|
$4,615.06
|
2025-01-22
|
|
C9078
|
HCPCS
|
Cosela 300mg Vial
|
13
|
8
|
$8,258.00
|
$4,954.80
40% off
|
$4,500.61
|
$4,500.61
|
$4,500.61
|
2025-01-22
|
|
J9355
|
HCPCS
|
Trastuzumab 150mg Chrg Per
|
13
|
8
|
$8,248.00
|
$4,948.80
40% off
|
$4,495.16
|
$4,495.16
|
$4,495.16
|
2025-01-22
|
|
81450
|
CPT
|
Oncoheme Ngs
|
15
|
9
|
$9,346.00
|
$5,607.60
40% off
|
$683.58
|
$4,454.03
|
$4,454.03
|
2025-01-22
|
|
J0875
|
HCPCS
|
Dalvance 500mg Vial
|
13
|
8
|
$8,122.00
|
$4,873.20
40% off
|
$4,426.49
|
$4,426.49
|
$4,426.49
|
2025-01-22
|
|
81407
|
CPT
|
Molecular Path Level 8
|
15
|
9
|
$9,077.00
|
$5,446.20
40% off
|
$761.64
|
$4,374.70
|
$4,374.70
|
2025-01-22
|
|
74178
|
CPT
|
CT Abd+pelvis W+wo Contrast
|
61
|
18
|
$8,247.00
|
$4,948.20
40% off
|
$1,649.40
|
$7,257.36
|
$4,280.43
|
2026-01-01
|
|
81229
|
CPT
|
Chromos Microarray Congen Bld
|
15
|
9
|
$8,388.00
|
$5,032.80
40% off
|
$1,044.00
|
$4,212.72
|
$4,212.72
|
2025-01-22
|
|
Q5117
|
HCPCS
|
Kanjinti 150mg Vial
|
13
|
8
|
$7,695.00
|
$4,617.00
40% off
|
$4,193.77
|
$4,193.77
|
$4,193.77
|
2025-01-22
|
|
74174
|
CPT
|
CT Ang Abd+plvs W Or Wo Cntrs
|
61
|
18
|
$8,070.00
|
$4,842.00
40% off
|
$1,614.00
|
$7,101.60
|
$4,188.87
|
2026-01-01
|
|
70543
|
CPT
|
Mr Orbit/face/neck W/wo Cntrst
|
13
|
8
|
$7,626.00
|
$4,575.60
40% off
|
$4,156.17
|
$4,156.17
|
$4,156.17
|
2025-01-22
|
|
81228
|
CPT
|
Gene Psap Sngl Gene Lrg Del/d
|
15
|
9
|
$8,233.00
|
$4,939.80
40% off
|
$810.00
|
$4,027.52
|
$4,027.52
|
2025-01-22
|
|
72156
|
CPT
|
Mr C-spine W/wo Contrast
|
61
|
18
|
$7,614.00
|
$4,568.40
40% off
|
$1,522.80
|
$6,700.32
|
$3,951.80
|
2026-01-01
|
|
72157
|
CPT
|
Mr Thoracic W/wo Contrast
|
61
|
18
|
$7,614.00
|
$4,568.40
40% off
|
$1,522.80
|
$6,700.32
|
$3,951.80
|
2026-01-01
|
|
73222
|
CPT
|
Mr Up Ext Jnt W Con Lt
|
26
|
8
|
$7,166.50
|
$4,299.90
40% off
|
$2,604.01
|
$5,207.48
|
$3,905.74
|
2025-01-22
|
|
73722
|
CPT
|
Mr Low Ext Jnt W Con Lt
|
26
|
8
|
$7,166.50
|
$4,299.90
40% off
|
$2,604.01
|
$5,207.48
|
$3,905.74
|
2025-01-22
|
|
81455
|
CPT
|
Targeted Genomic Seq Analysis
|
15
|
9
|
$7,098.00
|
$4,258.80
40% off
|
$2,627.64
|
$4,379.40
|
$3,868.41
|
2025-01-22
|
|
78814
|
CPT
|
Pt/ct Pi Limited Area
|
13
|
8
|
$7,097.00
|
$4,258.20
40% off
|
$3,867.86
|
$3,867.86
|
$3,867.86
|
2025-01-22
|
|
J1569
|
HCPCS
|
Gammagard 10gm 100ml
|
13
|
8
|
$7,052.00
|
$4,231.20
40% off
|
$3,843.34
|
$3,843.34
|
$3,843.34
|
2025-01-22
|
|
J2315
|
HCPCS
|
Vivitrol Injection 380mg
|
13
|
8
|
$6,928.00
|
$4,156.80
40% off
|
$3,775.76
|
$3,775.76
|
$3,775.76
|
2025-01-22
|
|
44799
|
CPT
|
Unlisted Procedure Intestine
|
13
|
8
|
$6,884.00
|
$4,130.40
40% off
|
$3,751.78
|
$3,751.78
|
$3,751.78
|
2025-01-22
|
|
19499
|
CPT
|
CT Unlisted Procedure Breast
|
13
|
8
|
$6,876.00
|
$4,125.60
40% off
|
$3,747.42
|
$3,747.42
|
$3,747.42
|
2025-01-22
|
|
70553
|
CPT
|
Mr Head W/wo Contrast
|
61
|
18
|
$7,204.00
|
$4,322.40
40% off
|
$1,440.80
|
$6,339.52
|
$3,739.24
|
2026-01-01
|
|
70549
|
CPT
|
Mr Angio Neck W/wo Contrast
|
13
|
8
|
$6,829.00
|
$4,097.40
40% off
|
$3,721.80
|
$3,721.80
|
$3,721.80
|
2025-01-22
|
|
74177
|
CPT
|
CT Abd+pelvis W/contrast
|
61
|
18
|
$7,079.00
|
$4,247.40
40% off
|
$1,415.80
|
$6,229.52
|
$3,674.39
|
2026-01-01
|
|
J7327
|
HCPCS
|
Monovisc 88mg/4ml Syringe
|
13
|
8
|
$6,666.00
|
$3,999.60
40% off
|
$3,632.97
|
$3,632.97
|
$3,632.97
|
2025-01-22
|
|
81162
|
CPT
|
Brca1 Brca2
|
15
|
9
|
$6,578.00
|
$3,946.80
40% off
|
$1,642.39
|
$3,585.01
|
$3,585.01
|
2025-01-22
|
|
J7511
|
HCPCS
|
Thymoglobulin 25mg Vial
|
13
|
8
|
$6,560.00
|
$3,936.00
40% off
|
$3,575.20
|
$3,575.20
|
$3,575.20
|
2025-01-22
|
|
J9303
|
HCPCS
|
Vectibix 100mg/5ml Inj 5ml/vl
|
13
|
8
|
$6,285.00
|
$3,771.00
40% off
|
$3,425.32
|
$3,425.32
|
$3,425.32
|
2025-01-22
|
|
J0897
|
HCPCS
|
Prolia 60mg/ml Injection
|
64
|
19
|
$6,578.00
|
$3,946.80
40% off
|
$29.51
|
$5,788.64
|
$3,413.88
|
2026-01-01
|
|
Q2050
|
HCPCS
|
Doxil 2mg/ml Inj 10ml/vl
|
13
|
8
|
$6,213.00
|
$3,727.80
40% off
|
$3,386.09
|
$3,386.09
|
$3,386.09
|
2025-01-22
|
|
88309
|
CPT
|
Path Level Vi
|
14
|
8
|
$7,232.00
|
$4,339.20
40% off
|
$391.83
|
$3,377.99
|
$3,377.99
|
2025-01-22
|
|
73219
|
CPT
|
Mr Up Ext Non Jnt W Con Lt
|
26
|
8
|
$6,188.00
|
$3,712.80
40% off
|
$2,248.12
|
$4,496.80
|
$3,372.46
|
2025-01-22
|