Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

Export CSV
Hospital

HOLY FAMILY MEMORIAL

Manitowoc, WI · CCN 520107 · Rates published

16,315 distinct procedures filed
30 distinct payers
425,171 rate rows
2025-12-31 last MRF observed
Data quality

424,461 of 425,171 rate rows are consumer-grade (99.8%)

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

Excluded — reasonRows
percent-of-charges filed in the dollar field — excluded from medians 239
per-diem day rate — not a per-procedure price 183
placeholder amount (≤ $0.02) — excluded from medians 131
exceeds 10× this hospital's gross charge — excluded from medians 87
template filing: same amount across many unrelated codes — excluded 68
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/10297/390806395_holy-family-memorial-inc_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/HolyFamilyMemorialMedicalCenter/10297
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 0a836408608a73da… · 300,172,967 bytes · first seen 2026-05-08

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 10 $4,505,000.00 $4,865,400.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 4 $3,932,600.00 $3,932,600.00 $3,932,600.00 nat. median
$3,710,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 12 $3,685,266.67 $3,980,088.00 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 12 $3,316,462.59 $3,581,779.60 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 12 $3,248,445.72 $3,508,321.37 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 12 $2,945,740.00 $3,181,399.20 $2,945,740.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 10 $2,455,110.61 $2,651,519.45 $2,455,110.61 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 12 $2,332,000.00 $2,518,560.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 11 $770,620.00 $1,040,337.00 $770,620.00 nat. median
$824,563
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 19 $302,254.65 $1,272,338.02 $601,202.82 nat. median
$370,174
1.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 12 $591,726.20 $780,738.18 $591,726.20 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 12 $565,868.95 $747,061.42 $565,868.95 nat. median
$675,122
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 12 $547,475.13 $731,208.14 $562,538.19 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 12 $557,317.93 $730,701.61 $557,317.93 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 12 $518,888.18 $719,653.25 $533,230.17 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 12 $489,304.61 $661,122.00 $489,304.61 nat. median
$620,080
0.8× median
5834
APR_DRG 		Neonate With Ecmo 8 $399,559.09 $411,545.86 $399,559.09 nat. median
$309,665
1.3× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 19 $196,151.11 $825,696.19 $390,156.45 nat. median
$265,286
1.5× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 19 $149,441.17 $629,071.13 $297,247.54 nat. median
$206,368
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 19 $148,564.13 $625,379.29 $295,503.07 nat. median
$202,986
1.5× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 10 $278,250.00 $300,510.00 $278,250.00 nat. median
$324,450
0.9× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $260,666.67 $268,486.67 $260,666.67 nat. median
$246,434
1.1× median
5833
APR_DRG 		Neonate With Ecmo 8 $258,846.76 $266,612.16 $258,846.76 nat. median
$244,017
1.1× median
J3403
HCPCS 		Revakinagene, Per Implant 10 $257,500.00 $278,100.00 $257,500.00 nat. median
$265,000
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 8 $230,844.16 $237,769.48 $230,844.16 nat. median
$234,738
1.0× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 10 $205,640.00 $222,091.20 $205,640.00 nat. median
$209,753
1.0× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 $202,981.73 $209,071.18 $202,981.73 nat. median
$117,173
1.7× median
5832
APR_DRG 		Neonate With Ecmo 8 $198,746.94 $204,709.35 $198,746.94 nat. median
$156,126
1.3× median
1614
APR_DRG 		Implantable Heart Assist Systems 8 $197,832.03 $203,766.99 $197,832.03 nat. median
$207,730
1.0× median
4
MS_DRG 		Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And… 19 $96,951.79 $408,117.65 $192,843.00 nat. median
$133,176
1.4× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 $190,147.11 $195,851.52 $190,147.11 nat. median
$150,721
1.3× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 8 $187,542.55 $193,168.83 $187,542.55 nat. median
$160,267
1.2× median
7
MS_DRG 		Lung Transplant 19 $90,643.92 $381,564.69 $180,296.24 nat. median
$122,708
1.5× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 $171,389.57 $176,531.26 $171,389.57 nat. median
$162,982
1.1× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $169,530.81 $174,616.73 $169,530.81 nat. median
$182,736
0.9× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 $168,261.67 $173,309.52 $168,261.67 nat. median
$122,924
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 19 $84,118.35 $354,095.41 $167,316.51 nat. median
$117,303
1.4× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 8 $165,592.36 $170,560.13 $165,592.36 nat. median
$164,279
1.0× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 19 $79,316.05 $333,880.16 $157,764.44 nat. median
$108,660
1.5× median
209
MS_DRG 		Complex Aortic Arch Procedures 19 $79,225.06 $333,497.12 $157,583.45 nat. median
$98,017
1.6× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 8 $157,179.92 $161,895.32 $157,179.92 nat. median
$187,294
0.8× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 8 $156,392.23 $161,084.00 $156,392.23 nat. median
$164,834
0.9× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 8 $153,546.19 $158,152.58 $153,546.19 nat. median
$151,838
1.0× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 $77,142.03 $324,728.64 $153,440.17 nat. median
$98,905
1.6× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 19 $76,112.42 $320,394.48 $151,392.21 nat. median
$102,358
1.5× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $148,759.87 $153,222.67 $148,759.87 nat. median
$145,336
1.0× median
5831
APR_DRG 		Neonate With Ecmo 8 $144,462.62 $148,796.50 $144,462.62 nat. median
$145,122
1.0× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 19 $72,167.54 $303,788.57 $143,545.62 nat. median
$100,136
1.4× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 $142,024.89 $146,285.64 $142,024.89 nat. median
$109,499
1.3× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 8 $139,783.71 $143,977.22 $139,783.71 nat. median
$129,535
1.1× median

Other procedures at this hospital

Browse this hospital's 16,315 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
6904 APR_DRG Acute Leukemia 8 8 — — $54,069.50 $55,691.59 $54,069.50 2025-12-31
834 MS_DRG Acute Leukemia With Mcc 26 19 — — $38,426.13 $161,754.41 $76,431.89 2025-12-31
850 MS_DRG Acute Leukemia With Other Procedures 26 19 — — $60,611.50 $255,143.51 $120,559.94 2025-12-31
Q2057 HCPCS Afamitresgene Autoleucel 12 11 — — $770,620.00 $1,040,337.00 $770,620.00 2025-12-31
245 MS_DRG Aicd Generator Procedures 26 19 — — $31,934.16 $134,426.55 $63,518.99 2025-12-31
265 MS_DRG Aicd Lead Procedures 26 19 — — $25,325.31 $106,606.64 $50,373.57 2025-12-31
J0202 HCPCS Alemtuzumab 12 Mg/1.2ml Solution 1.2 Ml Vial 71 30 $125,171.40 $68,844.27 45% off $2,429.89 $110,150.83 $86,368.26 2025-12-31
14 MS_DRG Allogeneic Bone Marrow Transplant 26 19 — — $84,118.35 $354,095.41 $167,316.51 2025-12-31
74 APR_DRG Allogeneic Bone Marrow Transplant 8 8 — — $157,179.92 $161,895.32 $157,179.92 2025-12-31
73 APR_DRG Allogeneic Bone Marrow Transplant 8 8 — — $76,819.56 $79,124.15 $76,819.56 2025-12-31
72 APR_DRG Allogeneic Bone Marrow Transplant 8 8 — — $61,600.54 $63,448.56 $61,600.54 2025-12-31
71 APR_DRG Allogeneic Bone Marrow Transplant 8 8 — — $58,520.63 $60,276.25 $58,520.63 2025-12-31
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 26 19 — — $34,449.06 $145,012.97 $68,521.26 2025-12-31
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 26 19 — — $30,047.82 $126,486.01 $59,766.93 2025-12-31
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 26 19 — — $24,409.78 $102,752.75 $48,552.54 2025-12-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 26 19 — — $48,141.32 $202,650.45 $95,756.01 2025-12-31
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 26 19 — — $29,559.96 $124,432.36 $58,796.55 2025-12-31
84 APR_DRG Autologous Bone Marrow Transplant 8 8 — — $77,905.11 $80,242.26 $77,905.11 2025-12-31
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 26 19 — — $41,504.48 $174,712.68 $82,554.91 2025-12-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 26 19 — — $38,022.96 $160,057.29 $75,629.98 2025-12-31
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 14 12 — — $518,888.18 $719,653.25 $533,230.17 2025-12-31
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 26 19 — — $26,158.93 $110,115.81 $52,031.72 2025-12-31
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 26 19 — — $24,633.76 $103,695.60 $48,998.06 2025-12-31
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 11 10 — — $111,860.04 $120,808.84 $111,860.04 2025-12-31
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 26 19 — — $38,657.80 $162,729.67 $76,892.73 2025-12-31
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 26 19 — — $24,957.14 $105,056.84 $49,641.26 2025-12-31
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 26 19 — — $24,180.20 $101,786.33 $48,095.89 2025-12-31
Q2053 HCPCS Brexucabtagene Car Pos T 14 12 — — $489,304.61 $661,122.00 $489,304.61 2025-12-31
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 8 8 — — $96,047.12 $98,928.53 $96,047.12 2025-12-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 26 19 — — $49,908.68 $210,090.11 $99,271.39 2025-12-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 26 19 — — $42,042.73 $176,978.46 $83,625.54 2025-12-31
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 26 19 — — $32,326.83 $136,079.48 $64,300.03 2025-12-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 19 — — $68,473.95 $288,240.42 $136,198.84 2025-12-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 19 — — $46,023.31 $193,734.64 $91,543.14 2025-12-31
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 19 — — $46,023.31 $193,734.64 $91,543.14 2025-12-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 19 — — $53,743.66 $226,233.43 $106,899.40 2025-12-31
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 19 — — $37,326.51 $157,125.62 $74,244.71 2025-12-31
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 19 — — $35,278.49 $148,504.45 $70,171.05 2025-12-31
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 8 — — $78,796.41 $81,160.30 $78,796.41 2025-12-31
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 8 — — $50,338.26 $51,848.41 $50,338.26 2025-12-31
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 8 8 — — $65,636.50 $67,605.60 $65,636.50 2025-12-31
34 MS_DRG Carotid Artery Stent Procedures With Mcc 26 19 — — $27,092.66 $114,046.30 $53,888.95 2025-12-31
471 MS_DRG Cervical Spinal Fusion With Mcc 26 19 — — $33,798.11 $142,272.82 $67,226.49 2025-12-31
6954 APR_DRG Chemotherapy For Acute Leukemia 8 8 — — $47,915.77 $49,353.24 $47,915.77 2025-12-31
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 26 19 — — $33,627.32 $141,553.90 $66,886.79 2025-12-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 26 19 — — $302,254.65 $1,272,338.02 $601,202.82 2025-12-31
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $202,981.73 $209,071.18 $202,981.73 2025-12-31
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $118,378.96 $121,930.33 $118,378.96 2025-12-31
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $101,643.98 $104,693.30 $101,643.98 2025-12-31
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $46,349.53 $47,740.02 $46,349.53 2025-12-31
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 26 19 — — $24,936.15 $104,968.45 $49,599.50 2025-12-31
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 26 19 — — $23,121.19 $97,328.43 $45,989.45 2025-12-31
Q2056 HCPCS Ciltacabtagene Car-pos T 14 12 — — $565,868.95 $747,061.42 $565,868.95 2025-12-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 26 19 — — $63,062.00 $265,458.85 $125,434.13 2025-12-31
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 26 19 — — $40,366.37 $169,921.83 $80,291.15 2025-12-31
209 MS_DRG Complex Aortic Arch Procedures 26 19 — — $79,225.06 $333,497.12 $157,583.45 2025-12-31
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 26 19 — — $76,112.42 $320,394.48 $151,392.21 2025-12-31
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 26 19 — — $46,801.64 $197,011.04 $93,091.29 2025-12-31
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 8 8 — — $61,298.11 $63,137.05 $61,298.11 2025-12-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 26 19 — — $53,511.99 $225,258.17 $106,438.58 2025-12-31
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 26 19 — — $38,235.75 $160,952.99 $76,053.21 2025-12-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 26 19 — — $59,004.44 $248,378.57 $117,363.39 2025-12-31
232 MS_DRG Coronary Bypass With Ptca Without Mcc 26 19 — — $42,434.69 $178,628.45 $84,405.18 2025-12-31
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 8 8 — — $53,679.46 $55,289.84 $53,679.46 2025-12-31
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 26 19 — — $41,076.81 $172,912.43 $81,704.26 2025-12-31
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 26 19 — — $29,319.17 $123,418.80 $58,317.62 2025-12-31
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 26 19 — — $30,289.30 $127,502.51 $60,247.25 2025-12-31
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 26 19 — — $31,824.27 $133,963.97 $63,300.41 2025-12-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 26 19 — — $47,113.82 $198,325.13 $93,712.23 2025-12-31
9104 APR_DRG Craniotomy For Multiple Significant Trauma 8 8 — — $55,487.95 $57,152.59 $55,487.95 2025-12-31
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 19 — — $40,108.79 $168,837.56 $79,778.82 2025-12-31
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 19 — — $27,381.04 $115,260.22 $54,462.54 2025-12-31
J7330 HCPCS Cultured Chondrocytes Implnt 5 4 — — $77,165.88 $77,165.88 $77,165.88 2025-12-31
1794 APR_DRG Defibrillator Implants 8 8 — — $50,975.87 $52,505.15 $50,975.87 2025-12-31
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 8 8 — — $58,122.98 $59,866.67 $58,122.98 2025-12-31
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 8 — — $82,898.64 $85,385.60 $82,898.64 2025-12-31
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 8 — — $56,492.75 $58,187.53 $56,492.75 2025-12-31
Q0480 HCPCS Driver Pneumatic Vad, Rep 11 10 — — $129,537.54 $139,900.54 $129,537.54 2025-12-31
7594 APR_DRG Eating Disorders 8 8 — — $51,044.43 $52,575.76 $51,044.43 2025-12-31
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 26 19 — — $148,564.13 $625,379.29 $295,503.07 2025-12-31
J9334 HCPCS Efgartigimod Alfa-hyaluronidase-qvfc 1008-11200 Mg-ut/5.6 Ml Solution 5.6 Ml Via… 71 30 $68,385.95 $37,612.28 45% off $33.89 $60,179.64 $47,186.31 2025-12-31
L7181 HCPCS Electronic Elbo Simultaneous 11 10 — — $57,614.51 $62,223.67 $57,614.51 2025-12-31
L7180 HCPCS Electronic Elbow Sequential 11 10 — — $52,277.90 $56,460.13 $52,277.90 2025-12-31
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 26 19 — — $39,945.00 $168,148.10 $79,453.04 2025-12-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 26 19 — — $42,895.26 $180,567.18 $85,321.27 2025-12-31
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 26 19 — — $33,322.85 $140,272.21 $66,281.17 2025-12-31
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 11 10 — — $80,943.19 $87,418.65 $80,943.19 2025-12-31
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 8 8 — — $52,038.57 $53,599.73 $52,038.57 2025-12-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 26 19 — — $149,441.17 $629,071.13 $297,247.54 2025-12-31
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours Without Skin Graft 26 19 — — $27,257.14 $114,738.71 $54,216.12 2025-12-31
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 8 8 — — $45,737.05 $47,109.16 $45,737.05 2025-12-31
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 26 19 — — $32,839.90 $138,239.20 $65,320.53 2025-12-31
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 8 8 — — $187,542.55 $193,168.83 $187,542.55 2025-12-31
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 8 8 — — $60,017.55 $61,818.08 $60,017.55 2025-12-31
1784 APR_DRG External Heart Assist Systems 8 8 — — $62,900.16 $64,787.16 $62,900.16 2025-12-31
1783 APR_DRG External Heart Assist Systems 8 8 — — $46,332.01 $47,721.97 $46,332.01 2025-12-31
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 8 — — $156,392.23 $161,084.00 $156,392.23 2025-12-31
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 8 — — $67,400.04 $69,422.04 $67,400.04 2025-12-31
37 MS_DRG Extracranial Procedures With Mcc 26 19 — — $23,042.80 $96,998.43 $45,833.52 2025-12-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 26 19 — — $50,204.75 $211,336.43 $99,860.30 2025-12-31
2324 APR_DRG Gastric Fundoplication 8 8 — — $48,152.68 $49,597.26 $48,152.68 2025-12-31
8514 APR_DRG Gender Related Procedures 8 8 — — $97,501.37 $100,426.41 $97,501.37 2025-12-31
33249 CPT Hc Insert Replc Perm Impl Defib W Transven Lead(s) Dual Chambr 74 30 $99,497.00 $54,723.35 45% off $14,782.00 $87,557.36 $73,627.78 2025-12-31
37227 CPT Hc Revasc, Endvasc, Fem, Poplit Art, W Stent & Athrect 74 30 $64,414.00 $35,427.70 45% off $14,782.00 $56,684.32 $47,666.36 2025-12-31
24 APR_DRG Heart And/or Lung Transplant 8 8 — — $230,844.16 $237,769.48 $230,844.16 2025-12-31
23 APR_DRG Heart And/or Lung Transplant 8 8 — — $129,617.64 $133,506.17 $129,617.64 2025-12-31
22 APR_DRG Heart And/or Lung Transplant 8 8 — — $94,329.28 $97,159.16 $94,329.28 2025-12-31
21 APR_DRG Heart And/or Lung Transplant 8 8 — — $86,749.48 $89,351.96 $86,749.48 2025-12-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 26 19 — — $196,151.11 $825,696.19 $390,156.45 2025-12-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 26 19 — — $79,316.05 $333,880.16 $157,764.44 2025-12-31
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 26 19 — — $23,847.73 $100,386.79 $47,434.58 2025-12-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 26 19 — — $42,845.57 $180,357.98 $85,222.43 2025-12-31
Q2055 HCPCS Idecabtagene Vicleucel Car 14 12 — — $557,317.93 $730,701.61 $557,317.93 2025-12-31
1614 APR_DRG Implantable Heart Assist Systems 8 8 — — $197,832.03 $203,766.99 $197,832.03 2025-12-31
1613 APR_DRG Implantable Heart Assist Systems 8 8 — — $133,858.52 $137,874.28 $133,858.52 2025-12-31
1612 APR_DRG Implantable Heart Assist Systems 8 8 — — $107,450.34 $110,673.85 $107,450.34 2025-12-31
1611 APR_DRG Implantable Heart Assist Systems 8 8 — — $102,374.54 $105,445.78 $102,374.54 2025-12-31
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 26 19 — — $34,567.34 $145,510.91 $68,756.55 2025-12-31
J1413 HCPCS Inj Delandistrogene Mox Rokl 16 12 — — $3,316,462.59 $3,581,779.60 $3,316,462.59 2025-12-31
J3399 HCPCS Inj Onase Abepar-xioi Treat 11 10 — — $2,455,110.61 $2,651,519.45 $2,455,110.61 2025-12-31
J3391 HCPCS Inj, Atidarsagene Autotemcel 11 10 — — $4,505,000.00 $4,865,400.00 $4,505,000.00 2025-12-31
J1414 HCPCS Inj, Beqvez, Per Tx Dose 5 4 — — $3,932,600.00 $3,932,600.00 $3,932,600.00 2025-12-31
J3393 HCPCS Inj, Betibeglogene Autotemce 16 12 — — $2,945,740.00 $3,181,399.20 $2,945,740.00 2025-12-31
J3392 HCPCS Inj, Exagamglogene Autotem 16 12 — — $2,332,000.00 $2,518,560.00 $2,332,000.00 2025-12-31
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 16 12 — — $3,685,266.67 $3,980,088.00 $3,685,266.67 2025-12-31
J3394 HCPCS Inj, Lovotibeglogene Autotem 16 12 — — $3,248,445.72 $3,508,321.37 $3,248,445.72 2025-12-31
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 11 10 — — $205,640.00 $222,091.20 $205,640.00 2025-12-31
J9029 HCPCS Instill Adstiladrin, Tx Dose 18 14 — — $63,342.28 $85,631.92 $63,975.71 2025-12-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 26 19 — — $37,053.53 $155,976.52 $73,701.74 2025-12-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 26 19 — — $55,077.05 $231,846.32 $109,551.60 2025-12-31
J9228 HCPCS Ipilimumab 200 Mg/40ml Solution 40 Ml Vial 91 30 $145,600.75 $80,080.42 45% off $183.48 $128,128.66 $87,360.45 2025-12-31
4404 APR_DRG Kidney Transplant 8 8 — — $73,636.81 $75,845.91 $73,636.81 2025-12-31
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 26 19 — — $32,907.07 $138,522.05 $65,454.18 2025-12-31
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 26 19 — — $25,938.45 $109,187.69 $51,593.17 2025-12-31
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 26 19 — — $26,338.83 $110,873.03 $52,389.52 2025-12-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 14 12 — — $547,475.13 $731,208.14 $562,538.19 2025-12-31
14 APR_DRG Liver Transplant And/or Intestinal Transplant 8 8 — — $139,783.71 $143,977.22 $139,783.71 2025-12-31
13 APR_DRG Liver Transplant And/or Intestinal Transplant 8 8 — — $65,391.21 $67,352.95 $65,391.21 2025-12-31
12 APR_DRG Liver Transplant And/or Intestinal Transplant 8 8 — — $52,530.68 $54,106.60 $52,530.68 2025-12-31
11 APR_DRG Liver Transplant And/or Intestinal Transplant 8 8 — — $45,674.58 $47,044.82 $45,674.58 2025-12-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 26 19 — — $72,167.54 $303,788.57 $143,545.62 2025-12-31
6 MS_DRG Liver Transplant Without Mcc 26 19 — — $32,456.32 $136,624.57 $64,557.59 2025-12-31
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 26 19 — — $25,377.80 $106,827.62 $50,477.99 2025-12-31
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 26 19 — — $25,699.07 $108,180.02 $51,117.02 2025-12-31
7 MS_DRG Lung Transplant 26 19 — — $90,643.92 $381,564.69 $180,296.24 2025-12-31
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 26 19 — — $41,050.22 $172,800.47 $81,651.35 2025-12-31
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 26 19 — — $32,090.95 $135,086.55 $63,830.85 2025-12-31
1694 APR_DRG Major Abdominal Vascular Procedures 8 8 — — $47,306.34 $48,725.53 $47,306.34 2025-12-31
653 MS_DRG Major Bladder Procedures With Mcc 26 19 — — $36,371.80 $153,106.73 $72,345.71 2025-12-31
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 8 8 — — $115,421.70 $118,884.35 $115,421.70 2025-12-31
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 8 8 — — $46,747.18 $48,149.60 $46,747.18 2025-12-31
163 MS_DRG Major Chest Procedures With Mcc 26 19 — — $31,370.01 $132,051.76 $62,396.85 2025-12-31
140 MS_DRG Major Head And Neck Procedures With Mcc 26 19 — — $29,854.64 $125,672.80 $59,382.68 2025-12-31
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 8 — — $59,901.75 $61,698.80 $59,901.75 2025-12-31
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 8 8 — — $49,219.19 $50,695.77 $49,219.19 2025-12-31
1204 APR_DRG Major Respiratory And Chest Procedures 8 8 — — $49,617.60 $51,106.13 $49,617.60 2025-12-31
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 26 19 — — $32,172.84 $135,431.28 $63,993.74 2025-12-31
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 8 8 — — $47,617.15 $49,045.66 $47,617.15 2025-12-31
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 8 8 — — $54,358.98 $55,989.75 $54,358.98 2025-12-31
J9281 HCPCS mitoMYcin 80 (2 X 40) Mg Recon Soln 1 Each Box 71 30 $100,383.00 $55,210.65 45% off $318.53 $88,337.04 $69,264.27 2025-12-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 19 — — $77,142.03 $324,728.64 $153,440.17 2025-12-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 19 — — $50,526.04 $212,688.83 $100,499.33 2025-12-31
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 19 — — $39,350.75 $165,646.61 $78,271.03 2025-12-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 26 19 — — $46,767.35 $196,866.66 $93,023.07 2025-12-31
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 26 19 — — $29,683.16 $124,950.93 $59,041.58 2025-12-31
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 8 8 — — $48,664.60 $50,124.54 $48,664.60 2025-12-31
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 26 19 — — $32,741.90 $137,826.70 $65,125.61 2025-12-31
8634 APR_DRG Neonatal Aftercare 8 8 — — $72,776.75 $74,960.05 $72,776.75 2025-12-31
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 8 — — $142,024.89 $146,285.64 $142,024.89 2025-12-31
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 8 — — $62,734.09 $64,616.11 $62,734.09 2025-12-31
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $114,020.01 $117,440.61 $114,020.01 2025-12-31
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $80,878.38 $83,304.73 $80,878.38 2025-12-31
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $64,678.93 $66,619.30 $64,678.93 2025-12-31
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 8 8 — — $55,209.13 $56,865.40 $55,209.13 2025-12-31
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $87,382.53 $90,004.01 $87,382.53 2025-12-31
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $60,489.86 $62,304.56 $60,489.86 2025-12-31
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 8 8 — — $71,154.90 $73,289.55 $71,154.90 2025-12-31
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 8 8 — — $70,822.00 $72,946.66 $70,822.00 2025-12-31
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 8 8 — — $50,959.11 $52,487.88 $50,959.11 2025-12-31
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 8 8 — — $62,417.18 $64,289.70 $62,417.18 2025-12-31
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 8 — — $171,389.57 $176,531.26 $171,389.57 2025-12-31
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 8 — — $63,993.32 $65,913.12 $63,993.32 2025-12-31
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 8 8 — — $59,952.79 $61,751.37 $59,952.79 2025-12-31
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 8 8 — — $49,854.52 $51,350.16 $49,854.52 2025-12-31
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $165,592.36 $170,560.13 $165,592.36 2025-12-31
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $122,908.56 $126,595.82 $122,908.56 2025-12-31
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $93,204.12 $96,000.24 $93,204.12 2025-12-31
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 8 — — $56,027.30 $57,708.12 $56,027.30 2025-12-31
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 8 — — $153,546.19 $158,152.58 $153,546.19 2025-12-31
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 8 — — $106,489.72 $109,684.41 $106,489.72 2025-12-31
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 8 — — $87,220.27 $89,836.88 $87,220.27 2025-12-31
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $260,666.67 $268,486.67 $260,666.67 2025-12-31
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $169,530.81 $174,616.73 $169,530.81 2025-12-31
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $148,759.87 $153,222.67 $148,759.87 2025-12-31
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 8 — — $127,508.24 $131,333.49 $127,508.24 2025-12-31
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 8 8 — — $101,826.81 $104,881.61 $101,826.81 2025-12-31
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 8 8 — — $98,823.08 $101,787.77 $98,823.08 2025-12-31
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 8 8 — — $96,717.49 $99,619.01 $96,717.49 2025-12-31
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 8 8 — — $59,348.70 $61,129.16 $59,348.70 2025-12-31
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 8 — — $190,147.11 $195,851.52 $190,147.11 2025-12-31
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 8 — — $90,795.35 $93,519.21 $90,795.35 2025-12-31
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 8 — — $51,957.82 $53,516.55 $51,957.82 2025-12-31
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 8 — — $168,261.67 $173,309.52 $168,261.67 2025-12-31
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 8 — — $50,524.89 $52,040.64 $50,524.89 2025-12-31
5834 APR_DRG Neonate With Ecmo 8 8 — — $399,559.09 $411,545.86 $399,559.09 2025-12-31
5833 APR_DRG Neonate With Ecmo 8 8 — — $258,846.76 $266,612.16 $258,846.76 2025-12-31
5832 APR_DRG Neonate With Ecmo 8 8 — — $198,746.94 $204,709.35 $198,746.94 2025-12-31
5831 APR_DRG Neonate With Ecmo 8 8 — — $144,462.62 $148,796.50 $144,462.62 2025-12-31
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 26 19 — — $25,280.51 $106,418.08 $50,284.47 2025-12-31
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 26 19 — — $23,996.81 $101,014.38 $47,731.13 2025-12-31
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 26 19 — — $25,397.41 $106,910.12 $50,516.98 2025-12-31
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 25 18 — — $27,052.07 $113,875.41 $54,462.43 2025-12-31
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 11 10 — — $278,250.00 $300,510.00 $278,250.00 2025-12-31
J2350 HCPCS Ocrelizumab 300 Mg/10ml Solution 10 Ml Vial 71 30 $87,734.08 $48,253.75 45% off $59.41 $77,205.99 $60,536.51 2025-12-31
J2351 HCPCS Ocrelizumab-hyaluronidase-ocsq 920-23000 Mg-unit/23 Ml Solution 23 Ml Vial 70 30 $175,458.15 $96,501.99 45% off $47.23 $154,403.17 $121,066.12 2025-12-31
214 APR_DRG Open Craniotomy Except Trauma 8 8 — — $51,721.66 $53,273.31 $51,721.66 2025-12-31
204 APR_DRG Open Craniotomy For Trauma 8 8 — — $46,338.10 $47,728.24 $46,338.10 2025-12-31
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 8 — — $54,582.18 $56,219.65 $54,582.18 2025-12-31
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 8 8 — — $66,082.91 $68,065.40 $66,082.91 2025-12-31
228 MS_DRG Other Cardiothoracic Procedures With Mcc 26 19 — — $34,628.94 $145,770.19 $68,879.06 2025-12-31
264 MS_DRG Other Circulatory System O.r. Procedures 26 19 — — $23,382.26 $98,427.44 $46,508.75 2025-12-31
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 26 19 — — $30,747.05 $129,429.46 $61,157.77 2025-12-31
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 26 19 — — $26,224.04 $110,389.82 $52,161.19 2025-12-31
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 26 19 — — $26,085.44 $109,806.44 $51,885.54 2025-12-31
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 26 19 — — $31,237.72 $131,494.89 $62,133.72 2025-12-31
215 MS_DRG Other Heart Assist System Implant 26 19 — — $69,693.25 $293,373.05 $138,624.09 2025-12-31
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 26 19 — — $29,068.60 $122,363.99 $57,819.21 2025-12-31
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 26 19 — — $29,408.77 $123,795.94 $58,495.83 2025-12-31
271 MS_DRG Other Major Cardiovascular Procedures With Cc 26 19 — — $24,892.05 $104,782.82 $49,511.79 2025-12-31
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 26 19 — — $36,931.06 $155,460.90 $73,458.10 2025-12-31
914 APR_DRG Other Major Head And Neck Procedures 8 8 — — $52,580.20 $54,157.61 $52,580.20 2025-12-31
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 26 19 — — $26,872.89 $113,121.14 $53,451.79 2025-12-31
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 26 19 — — $29,494.86 $124,158.35 $58,667.07 2025-12-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 26 19 — — $53,334.90 $224,512.73 $106,086.34 2025-12-31
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 26 19 — — $27,886.40 $117,387.52 $55,467.74 2025-12-31
274 APR_DRG Other Open Craniotomy 8 8 — — $48,481.78 $49,936.23 $48,481.78 2025-12-31
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 26 19 — — $26,161.74 $110,127.59 $52,037.29 2025-12-31
252 MS_DRG Other Vascular Procedures With Mcc 26 19 — — $24,416.09 $102,779.27 $48,565.07 2025-12-31
64 APR_DRG Pancreas Transplant 8 8 — — $100,556.15 $103,572.83 $100,556.15 2025-12-31
10 MS_DRG Pancreas Transplant 26 19 — — $50,225.75 $211,424.82 $99,902.07 2025-12-31
63 APR_DRG Pancreas Transplant 8 8 — — $71,436.76 $73,579.86 $71,436.76 2025-12-31
62 APR_DRG Pancreas Transplant 8 8 — — $57,198.93 $58,914.90 $57,198.93 2025-12-31
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 26 19 — — $38,290.34 $161,182.81 $76,161.80 2025-12-31
J2507 HCPCS Pegloticase 8 Mg/ml Solution 1 Ml Vial 71 30 $127,605.41 $70,182.98 45% off $3,660.83 $112,292.76 $88,047.74 2025-12-31
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 26 19 — — $28,876.11 $121,553.73 $57,436.35 2025-12-31
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 26 19 — — $23,040.00 $96,986.65 $45,827.96 2025-12-31
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 26 19 — — $24,068.21 $101,314.91 $47,873.13 2025-12-31
1834 APR_DRG Percutaneous Structural Cardiac Procedures 8 8 — — $54,816.05 $56,460.53 $54,816.05 2025-12-31
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 26 19 — — $27,026.16 $113,766.40 $53,756.68 2025-12-31
335 MS_DRG Peritoneal Adhesiolysis With Mcc 26 19 — — $24,994.24 $105,213.00 $49,715.05 2025-12-31
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 26 19 — — $31,838.27 $134,022.90 $63,328.25 2025-12-31
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 8 8 — — $61,846.60 $63,702.00 $61,846.60 2025-12-31
A9606 HCPCS Radium Ra 223 Dichloride 30 Mcci/ml Solution 1 Each Vial 70 30 $90,266.68 $49,646.68 45% off $172.22 $79,434.68 $62,284.01 2025-12-31
332 MS_DRG Rectal Resection With Mcc 26 19 — — $25,342.82 $106,680.30 $50,408.38 2025-12-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 26 19 — — $45,039.17 $189,592.00 $89,585.66 2025-12-31
J3403 HCPCS Revakinagene, Per Implant 11 10 — — $257,500.00 $278,100.00 $257,500.00 2025-12-31
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 26 19 — — $24,684.16 $103,907.74 $49,098.29 2025-12-31
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 26 19 — — $36,434.79 $153,371.91 $72,471.01 2025-12-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 26 19 — — $48,378.61 $203,649.28 $96,227.99 2025-12-31
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 26 19 — — $39,228.96 $165,133.93 $78,028.78 2025-12-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 26 19 — — $49,938.07 $210,213.85 $99,329.86 2025-12-31
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 26 19 — — $28,141.18 $118,460.01 $55,974.51 2025-12-31
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 26 19 — — $37,304.12 $157,031.33 $74,200.15 2025-12-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 18 14 — — $55,272.32 $75,527.06 $55,825.04 2025-12-31
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 26 19 — — $34,305.57 $144,408.96 $68,235.85 2025-12-31
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 8 8 — — $52,737.89 $54,320.03 $52,737.89 2025-12-31
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 26 19 — — $24,297.80 $102,281.33 $48,329.79 2025-12-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 26 19 — — $45,856.01 $193,030.45 $91,210.39 2025-12-31
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 8 8 — — $54,431.35 $56,064.29 $54,431.35 2025-12-31
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 26 19 — — $24,912.34 $104,868.27 $49,552.16 2025-12-31
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 26 19 — — $25,709.58 $108,224.22 $51,137.90 2025-12-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 19 — — $58,818.95 $247,597.78 $116,994.45 2025-12-31
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 19 — — $41,738.24 $175,696.78 $83,019.92 2025-12-31
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 19 — — $29,205.79 $122,941.49 $58,092.08 2025-12-31
234 APR_DRG Spinal Procedures 8 8 — — $47,486.12 $48,910.70 $47,486.12 2025-12-31
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 26 19 — — $23,879.24 $100,519.38 $47,497.23 2025-12-31
28 MS_DRG Spinal Procedures With Mcc 26 19 — — $42,054.63 $177,028.55 $83,649.20 2025-12-31
799 MS_DRG Splenic Procedures With Mcc 26 19 — — $31,699.68 $133,439.51 $63,052.59 2025-12-31
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 26 19 — — $34,908.92 $146,948.75 $69,435.96 2025-12-31
J9269 HCPCS Tagraxofusp-erzs 1000 Mcg/ml Solution 1 Ml Vial 71 30 $138,417.27 $76,129.50 45% off $356.93 $121,807.20 $95,507.92 2025-12-31
J3241 HCPCS Teprotumumab-trbw 500 Mg Recon Soln 1 Each Vial 71 30 $74,432.30 $40,937.77 45% off $359.19 $65,500.42 $51,358.29 2025-12-31
Q2042 HCPCS Tisagenlecleucel Car-pos T 14 12 — — $591,726.20 $780,738.18 $591,726.20 2025-12-31
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 26 19 — — $29,509.57 $124,220.22 $58,696.31 2025-12-31
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 26 19 — — $38,175.54 $160,699.60 $75,933.48 2025-12-31
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 26 19 — — $96,951.79 $408,117.65 $192,843.00 2025-12-31
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $138,825.38 $142,990.14 $138,825.38 2025-12-31
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $87,052.68 $89,664.26 $87,052.68 2025-12-31
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $53,717.55 $55,329.08 $53,717.55 2025-12-31
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 8 — — $47,669.71 $49,099.80 $47,669.71 2025-12-31
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 8 — — $90,552.33 $93,268.90 $90,552.33 2025-12-31
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 8 — — $62,550.49 $64,427.00 $62,550.49 2025-12-31
38240 CPT Transplt Allo Hct/donor 18 13 — — $8,391.64 $60,750.29 $56,250.27 2025-12-31
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 26 19 — — $38,960.19 $164,002.52 $77,494.17 2025-12-31
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 26 19 — — $25,242.72 $106,258.97 $50,209.29 2025-12-31
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 26 19 — — $25,077.53 $105,563.62 $49,880.73 2025-12-31
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 26 19 — — $25,019.43 $105,319.07 $49,765.18 2025-12-31
31 MS_DRG Ventricular Shunt Procedures With Mcc 26 19 — — $31,360.92 $132,013.45 $62,378.76 2025-12-31
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 26 19 — — $39,893.20 $167,930.07 $79,350.01 2025-12-31
901 MS_DRG Wound Debridements For Injuries With Mcc 26 19 — — $29,373.78 $123,648.62 $58,426.22 2025-12-31
A9543 HCPCS Y90 Ibritumomab, Rx 11 10 — — $56,824.55 $61,370.51 $56,824.55 2025-12-31
See an error in this hospital's data? Submit a correction