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 →

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Hospital

CHIPPEWA VALLEY HOSPITAL

Durand, WI · CCN 521307 · Rates published

15,540 distinct procedures filed
31 distinct payers
1,172,168 rate rows
2024-12-15 last MRF observed · ⚠ 18 mo old
Data quality

1,171,831 of 1,172,168 rate rows are consumer-grade (100.0%)

337 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
template filing: same amount across many unrelated codes — excluded 249
per-diem day rate — not a per-procedure price 83
exceeds 10× this hospital's gross charge — excluded from medians 5

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 18 months old.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://hospitalpricedisclosure.com/download.aspx?pi=GWQ6hVIDeHKPPO7oxssXNA*-*
Found on page https://urldefense.com/v3/__https://HospitalPriceDisclosure.com/Default.aspx?ci=RsbcVwMa5jfnDZuYpIqAxQ*-*__;Kio!!OwHQNGuS!NNxzc3gzcCDbWC_3aBKJU3Bm28st5mdzWI_DoAkJmDmhsUhsHjB8niD15jvlGIrs7b_d4aR0fJBjowy6rVbgBT5sJPyOLA$
Discovered viaCMS hospital list
Last fetch — · 2026-05-17

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
Q2055
HCPCS 		Idecabtagene Vicleucel 460000000 Cells IV Susp 31 $1,166,971.00 $2,246,821.00 $2,063,407.00 nat. median
$625,184
outlier · 3.3×
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 31 $1,141,387.00 $2,197,562.00 $2,018,169.00 nat. median
$674,188
outlier · 3.0×
Q2042
HCPCS 		Tisagenlecleucel IV Infusion (wrapped) 31 $999,898.00 $1,925,146.00 $1,767,992.00 nat. median
$754,974
outlier · 2.3×
A9520
HCPCS 		Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 31 $392,126.00 $754,978.00 $693,347.00 nat. median
$1,033
outlier · 670.9×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $554,076.00 $554,076.00 $554,076.00 nat. median
$370,174
1.5× median
A9595
HCPCS 		Piflufolastat F 18 9 Mci IV Sosy 31 $241,825.00 $465,597.00 $427,589.00 nat. median
$897
outlier · 476.7×
A9588
HCPCS 		Fluciclovine F 18 9-221 Mci/ml IV Soln 31 $234,196.00 $450,909.00 $414,100.00 nat. median
$737
outlier · 562.1×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $413,849.00 $413,849.00 $413,849.00 nat. median
$265,286
1.6× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $348,535.00 $348,535.00 $348,535.00 nat. median
$206,368
1.7× median
A9572
HCPCS 		Indium In-111 Pentetreotide IV Kit 31 $196,821.00 $378,948.00 $348,013.00 nat. median
$4,934
outlier · 70.5×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 $314,873.00 $314,873.00 $314,873.00 nat. median
$202,986
1.6× median
A9569
HCPCS 		Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection 31 $161,541.00 $311,022.00 $285,633.00 nat. median
$2,081
outlier · 137.3×
C1831
HCPCS 		Kit Imp Aprevo Spine Lvl 1 31 $115,665.00 $428,260.00 $267,444.00 nat. median
$11,688
outlier · 22.9×
13925-522-01
NDC 		Pentamidine Isethionate 300 Mg In Solr 31 $150,796.00 $290,335.00 $266,634.00 nat. median
$83,907
outlier · 3.2×
58914-501-56
NDC 		Mesalamine 1000 Mg Re Supp 31 $141,708.00 $272,836.00 $250,564.00 nat. median
$57,068
outlier · 4.4×
A9591
HCPCS 		Fluoroestradiol F 18 4-100 Mci/ml IV Soln 31 $124,068.00 $238,873.00 $219,373.00 nat. median
$1,095
outlier · 200.3×
52427-273-75
NDC 		Naproxen Sodium ER 500 Mg Po Tb24 31 $121,188.00 $233,328.00 $214,281.00 nat. median
$111,860
1.9× median
63323-877-15
NDC 		Pentamidine Isethionate 300 Mg In Solr 31 $118,272.00 $227,714.00 $209,125.00 nat. median
$65,809
outlier · 3.2×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 $207,598.00 $207,598.00 $207,598.00 nat. median
$133,176
1.6× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 3 $192,492.00 $192,492.00 $192,492.00 nat. median
$117,303
1.6× median
7
MS_DRG 		Lung Transplant 3 $192,007.00 $192,007.00 $192,007.00 nat. median
$122,708
1.6× median
58468-0132-1
NDC 		Sevelamer Carbonate 0.8 G Po Pack 31 $105,103.00 $202,359.00 $185,840.00 nat. median
$92,408
outlier · 2.0×
58468-0132-2
NDC 		Sevelamer Carbonate 0.8 G Po Pack 31 $105,103.00 $202,359.00 $185,840.00 nat. median
$94,327
2.0× median
C1825
HCPCS 		System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 31 $100,904.00 $239,826.00 $183,511.00 nat. median
$52,021
outlier · 3.5×
68382-395-01
NDC 		Ribavirin 6 G In Solr 31 $98,134.00 $188,943.00 $173,519.00 nat. median
$88,073
2.0× median
68382-395-04
NDC 		Ribavirin 6 G In Solr 31 $98,134.00 $188,943.00 $173,519.00 nat. median
$88,073
2.0× median
5834
APR_DRG 		Neonate With Ecmo 6 $170,889.00 $170,889.00 $170,889.00 nat. median
$309,665
0.6× median
C1824
HCPCS 		Generator Pul Implantable Optimizer Smt F/hrt Fail 31 $93,697.00 $222,695.00 $170,403.00 nat. median
$37,950
outlier · 4.5×
C1822
HCPCS 		Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 31 $91,198.00 $222,695.00 $168,768.00 nat. median
$31,540
outlier · 5.4×
59385-027-01
NDC 		Buprenorphine Hcl 900 Mcg Bu Film 31 $94,393.00 $181,739.00 $166,903.00 nat. median
$87,698
1.9× median
59385-027-60
NDC 		Buprenorphine Hcl 900 Mcg Bu Film 31 $94,393.00 $181,739.00 $166,903.00 nat. median
$87,698
1.9× median
C9089
HCPCS 		Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 31 $93,857.00 $185,765.00 $165,956.00 nat. median
$2
outlier · 105035.4×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 $161,901.00 $161,901.00 $161,901.00 nat. median
$108,660
1.5× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 3 $160,053.00 $160,053.00 $160,053.00 nat. median
$102,358
1.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 3 $156,461.00 $156,461.00 $156,461.00 nat. median
$100,136
1.6× median
215
MS_DRG 		Other Heart Assist System Implant 3 $155,659.00 $155,659.00 $155,659.00 nat. median
$99,019
1.6× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 $153,905.00 $153,905.00 $153,905.00 nat. median
$98,905
1.6× median
A9592
HCPCS 		Copper Cu 64 Dotatate 1 Mci/ml IV Soln 31 $86,581.00 $166,699.00 $153,091.00 nat. median
$1,740
outlier · 88.0×
5833
APR_DRG 		Neonate With Ecmo 6 $150,101.00 $150,101.00 $150,101.00 nat. median
$244,017
0.6× median
C1827
HCPCS 		Generator Imp Vivistim Vns Ipg 1001 31 $30,571.00 $252,673.00 $141,807.00 nat. median
$28,413
outlier · 5.0×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $141,794.00 $141,794.00 $141,794.00 nat. median
$93,672
1.5× median
850
MS_DRG 		Acute Leukemia With Other Procedures 3 $135,341.00 $135,341.00 $135,341.00 nat. median
$83,442
1.6× median
C1816
HCPCS 		System Stim Nerv Stimq-4 8 Elect Dl Transm Kt 31 $8,897.00 $175,587.00 $133,392.50 nat. median
$13,332
outlier · 10.0×
0187-0007-14
NDC 		Ribavirin 6 G In Solr 31 $75,265.00 $144,911.00 $133,081.00 nat. median
$69,528
1.9× median
0781-5893-31
NDC 		Nevirapine ER 400 Mg Po Tb24 31 $73,791.00 $142,073.00 $130,476.00 nat. median
$68,166
1.9× median
0008-0423-01
NDC 		Antivenin Micrurus Fulvius IV Solr 31 $73,697.00 $141,892.00 $130,309.00 nat. median
$28,054
outlier · 4.6×
0008-0423-03
NDC 		Antivenin Micrurus Fulvius IV Solr 31 $73,697.00 $141,892.00 $130,309.00 nat. median
$28,005
outlier · 4.7×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 6 $130,146.00 $130,146.00 $130,146.00 nat. median
$246,434
0.5× median
C1882
HCPCS 		Defibrillator Crdc Consulta Crt-d 31 $21.00 $295,118.00 $129,788.50 nat. median
$27,112
outlier · 4.8×
C1823
HCPCS 		Generator Implantable Remede Pul Cent Sleep Apnea 31 $42,328.00 $230,908.00 $129,591.00 nat. median
$26,775
outlier · 4.8×

Other procedures at this hospital

Browse this hospital's 15,540 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
             
0008-0423-01 NDC Antivenin Micrurus Fulvius IV Solr 41 31 $144,787.69 $56,467.20 61% off $73,697.00 $141,892.00 $130,309.00 2024-12-15
0008-0423-03 NDC Antivenin Micrurus Fulvius IV Solr 41 31 $144,787.69 $56,467.20 61% off $73,697.00 $141,892.00 $130,309.00 2024-12-15
0078-0494-71 NDC Tobramycin 300 Mg/5ml In Nebu 41 31 $56,389.72 $21,991.99 61% off $28,702.00 $55,262.00 $50,751.00 2024-12-15
0078-0697-19 NDC Eltrombopag Olamine 25 Mg Po Pack 41 31 $87,304.02 $34,048.57 61% off $44,438.00 $85,558.00 $78,574.00 2024-12-15
0078-0697-61 NDC Eltrombopag Olamine 25 Mg Po Pack 41 31 $87,304.02 $34,048.57 61% off $44,438.00 $85,558.00 $78,574.00 2024-12-15
0187-0007-14 NDC Ribavirin 6 G In Solr 41 31 $147,868.15 $57,668.58 61% off $75,265.00 $144,911.00 $133,081.00 2024-12-15
0187-3013-30 NDC Pyridostigmine Bromide ER 180 Mg Po Tbcr 41 31 $99,291.03 $38,723.50 61% off $50,539.00 $97,305.00 $89,362.00 2024-12-15
0234T CPT Hc Trluml Perip Athrc Renal Art 41 31 $70,590.18 $27,530.17 61% off $35,930.00 $69,178.00 $63,531.00 2024-12-15
0237T CPT Hc Trluml Perip Athrc Brchiocph 41 31 $70,590.18 $27,530.17 61% off $35,930.00 $69,178.00 $63,531.00 2024-12-15
0310-0283-60 NDC Quetiapine Fumarate ER 300 Mg Po Tb24 41 31 $61,297.32 $23,905.95 61% off $31,200.00 $60,071.00 $55,168.00 2024-12-15
0398T CPT Hc MRI Guided Focused US Stereo Lesion Ablate 41 31 $71,584.70 $27,918.03 61% off $36,437.00 $70,153.00 $64,426.00 2024-12-15
0408T CPT Hc Ins/repl Ccm System, Pulse Gen With Tv Electrodes 41 31 $56,505.40 $22,037.11 61% off $28,761.00 $55,375.00 $50,855.00 2024-12-15
0781-5893-31 NDC Nevirapine ER 400 Mg Po Tb24 41 31 $144,972.94 $56,539.45 61% off $73,791.00 $142,073.00 $130,476.00 2024-12-15
0955-1052-01 NDC Sevelamer Carbonate 0.8 G Po Pack 41 31 $79,130.03 $30,860.71 61% off $40,277.00 $77,547.00 $71,217.00 2024-12-15
0955-1052-90 NDC Sevelamer Carbonate 0.8 G Po Pack 41 31 $79,130.03 $30,860.71 61% off $40,277.00 $77,547.00 $71,217.00 2024-12-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 3 $0.01 — $413,849.00 $413,849.00 $413,849.00 2024-12-15
10 MS_DRG Pancreas Transplant 3 3 $0.01 — $117,139.00 $117,139.00 $117,139.00 2024-12-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 3 $0.01 — $79,277.00 $79,277.00 $79,277.00 2024-12-15
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 $0.01 — $53,492.00 $53,492.00 $53,492.00 2024-12-15
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 $0.01 — $94,134.00 $94,134.00 $94,134.00 2024-12-15
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 3 $0.01 — $60,292.00 $60,292.00 $60,292.00 2024-12-15
13925-522-01 NDC Pentamidine Isethionate 300 Mg In Solr 41 31 $296,260.07 $115,541.43 61% off $150,796.00 $290,335.00 $266,634.00 2024-12-15
14 MS_DRG Allogeneic Bone Marrow Transplant 3 3 $0.01 — $192,492.00 $192,492.00 $192,492.00 2024-12-15
14 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 $0.01 — $72,097.00 $72,097.00 $72,097.00 2024-12-15
140 MS_DRG Major Head And Neck Procedures With Mcc 3 3 $0.01 — $62,135.00 $62,135.00 $62,135.00 2024-12-15
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 3 3 $0.01 — $48,512.00 $48,512.00 $48,512.00 2024-12-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 3 3 $0.01 — $88,679.00 $88,679.00 $88,679.00 2024-12-15
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 6 $0.01 — $54,039.00 $54,039.00 $54,039.00 2024-12-15
1611 APR_DRG Implantable Heart Assist Systems 6 6 $0.01 — $52,578.00 $52,578.00 $52,578.00 2024-12-15
1612 APR_DRG Implantable Heart Assist Systems 6 6 $0.01 — $55,358.00 $55,358.00 $55,358.00 2024-12-15
1613 APR_DRG Implantable Heart Assist Systems 6 6 $0.01 — $68,108.00 $68,108.00 $68,108.00 2024-12-15
1614 APR_DRG Implantable Heart Assist Systems 6 6 $0.01 — $99,570.00 $99,570.00 $99,570.00 2024-12-15
163 MS_DRG Major Chest Procedures With Mcc 3 3 $0.01 — $67,718.00 $67,718.00 $67,718.00 2024-12-15
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 3 $0.01 — $56,569.00 $56,569.00 $56,569.00 2024-12-15
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 3 3 $0.01 — $88,679.00 $88,679.00 $88,679.00 2024-12-15
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 $0.01 — $554,076.00 $554,076.00 $554,076.00 2024-12-15
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 3 $0.01 — $116,468.00 $116,468.00 $116,468.00 2024-12-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 3 $0.01 — $161,901.00 $161,901.00 $161,901.00 2024-12-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 3 $0.01 — $118,434.00 $118,434.00 $118,434.00 2024-12-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 3 $0.01 — $95,016.00 $95,016.00 $95,016.00 2024-12-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 3 $0.01 — $81,207.00 $81,207.00 $81,207.00 2024-12-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 3 3 $0.01 — $160,053.00 $160,053.00 $160,053.00 2024-12-15
215 MS_DRG Other Heart Assist System Implant 3 3 $0.01 — $155,659.00 $155,659.00 $155,659.00 2024-12-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 $0.01 — $141,794.00 $141,794.00 $141,794.00 2024-12-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 $0.01 — $94,879.00 $94,879.00 $94,879.00 2024-12-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 $0.01 — $87,407.00 $87,407.00 $87,407.00 2024-12-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 $0.01 — $113,679.00 $113,679.00 $113,679.00 2024-12-15
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 3 $0.01 — $51,869.00 $51,869.00 $51,869.00 2024-12-15
22 APR_DRG Heart And/or Lung Transplant 6 6 $0.01 — $50,511.00 $50,511.00 $50,511.00 2024-12-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 $0.01 — $77,819.00 $77,819.00 $77,819.00 2024-12-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 $0.01 — $67,474.00 $67,474.00 $67,474.00 2024-12-15
22551 CPT Hc Arthrodesis Ant Interbody Inc Discectomy, Cervical Below C2 41 31 $55,536.41 $21,659.20 61% off $2,706.00 $54,426.00 $49,983.00 2024-12-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 3 $0.01 — $73,215.00 $73,215.00 $73,215.00 2024-12-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 $0.01 — $83,819.00 $83,819.00 $83,819.00 2024-12-15
23 APR_DRG Heart And/or Lung Transplant 6 6 $0.01 — $63,584.00 $63,584.00 $63,584.00 2024-12-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 3 $0.01 — $124,499.00 $124,499.00 $124,499.00 2024-12-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 3 $0.01 — $89,749.00 $89,749.00 $89,749.00 2024-12-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 3 $0.01 — $114,839.00 $114,839.00 $114,839.00 2024-12-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 3 3 $0.01 — $78,164.00 $78,164.00 $78,164.00 2024-12-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 3 3 $0.01 — $86,451.00 $86,451.00 $86,451.00 2024-12-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 3 $0.01 — $60,415.00 $60,415.00 $60,415.00 2024-12-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 3 $0.01 — $74,002.00 $74,002.00 $74,002.00 2024-12-15
24 APR_DRG Heart And/or Lung Transplant 6 6 $0.01 — $117,144.00 $117,144.00 $117,144.00 2024-12-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 $0.01 — $55,855.00 $55,855.00 $55,855.00 2024-12-15
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 3 3 $0.01 — $49,835.00 $49,835.00 $49,835.00 2024-12-15
24338-050-08 NDC Carmustine In Polifeprosan 7.7 Mg Il Wafr 41 31 $51,857.15 $20,224.29 61% off $26,395.00 $50,820.00 $46,671.00 2024-12-15
24341 CPT Hc Repair Tend/musc Upr Arm/elb Each 41 31 $54,655.25 $21,315.55 61% off $2,318.00 $53,562.00 $49,190.00 2024-12-15
245 MS_DRG Aicd Generator Procedures 3 3 $0.01 — $71,797.00 $71,797.00 $71,797.00 2024-12-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 3 $0.01 — $65,707.00 $65,707.00 $65,707.00 2024-12-15
252 MS_DRG Other Vascular Procedures With Mcc 3 3 $0.01 — $50,399.00 $50,399.00 $50,399.00 2024-12-15
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 3 3 $0.01 — $50,044.00 $50,044.00 $50,044.00 2024-12-15
264 MS_DRG Other Circulatory System O.r. Procedures 3 3 $0.01 — $51,350.00 $51,350.00 $51,350.00 2024-12-15
265 MS_DRG Aicd Lead Procedures 3 3 $0.01 — $52,409.00 $52,409.00 $52,409.00 2024-12-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 3 $0.01 — $88,017.00 $88,017.00 $88,017.00 2024-12-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 3 $0.01 — $69,121.00 $69,121.00 $69,121.00 2024-12-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 3 $0.01 — $97,960.00 $97,960.00 $97,960.00 2024-12-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 3 $0.01 — $61,129.00 $61,129.00 $61,129.00 2024-12-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 3 $0.01 — $75,414.00 $75,414.00 $75,414.00 2024-12-15
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 3 $0.01 — $50,605.00 $50,605.00 $50,605.00 2024-12-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 3 3 $0.01 — $57,450.00 $57,450.00 $57,450.00 2024-12-15
27446 CPT Hc Knee Arthroplasty Condyle/plateau Medial Or Lateral Comptmnt 41 31 $52,870.37 $20,619.44 61% off $4,264.00 $51,813.00 $47,583.00 2024-12-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 3 $0.01 — $103,828.00 $103,828.00 $103,828.00 2024-12-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 3 3 $0.01 — $91,008.00 $91,008.00 $91,008.00 2024-12-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 3 3 $0.01 — $68,346.00 $68,346.00 $68,346.00 2024-12-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 3 $0.01 — $73,508.00 $73,508.00 $73,508.00 2024-12-15
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 3 $0.01 — $47,079.00 $47,079.00 $47,079.00 2024-12-15
28 MS_DRG Spinal Procedures With Mcc 3 3 $0.01 — $89,320.00 $89,320.00 $89,320.00 2024-12-15
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 3 3 $0.01 — $49,317.00 $49,317.00 $49,317.00 2024-12-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 3 $0.01 — $314,873.00 $314,873.00 $314,873.00 2024-12-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 3 $0.01 — $61,568.00 $61,568.00 $61,568.00 2024-12-15
31253 CPT Hc Nasal/sinus Endo Total With Tiss Rem 41 31 $58,344.44 $22,754.33 61% off $3,288.00 $57,178.00 $52,510.00 2024-12-15
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 3 3 $0.01 — $90,891.00 $90,891.00 $90,891.00 2024-12-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 3 $0.01 — $64,539.00 $64,539.00 $64,539.00 2024-12-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 3 $0.01 — $62,579.00 $62,579.00 $62,579.00 2024-12-15
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 3 3 $0.01 — $46,942.00 $46,942.00 $46,942.00 2024-12-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 3 $0.01 — $74,621.00 $74,621.00 $74,621.00 2024-12-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 3 $0.01 — $67,464.00 $67,464.00 $67,464.00 2024-12-15
332 MS_DRG Rectal Resection With Mcc 3 3 $0.01 — $50,962.00 $50,962.00 $50,962.00 2024-12-15
33221 CPT Hc Ep Ins Pacemaker Pulse Gen Only W/exist Mult Leads 41 31 $57,226.06 $22,318.16 61% off $4,887.00 $56,082.00 $51,503.00 2024-12-15
33230 CPT Hc Ep Insj Implntbl Defib Pulse Gen W/exist Dual Leads 41 31 $73,431.05 $28,638.11 61% off $16,405.00 $71,962.00 $66,088.00 2024-12-15
33240 CPT Hc Insj Implntbl Defib Pulse Gen W/1 Existing Ld 77 31 $79,329.69 $30,938.58 61% off $20,550.00 $77,743.00 $67,430.00 2024-12-15
33249 CPT Hc Insj/rplcmt Perm Dfb W/trnsvns Lds 1/dual Chmbr 77 31 $100,001.66 $39,000.65 61% off $27,595.00 $98,002.00 $76,843.00 2024-12-15
33262 CPT Hc Rmvl Impltbl Dfb Plse Gen W/repl Plse Gen 1 Lead 77 31 $84,270.87 $32,865.64 61% off $16,405.00 $87,172.00 $76,498.00 2024-12-15
33263 CPT Hc Rmvl Impltbl Dfb Plse Gen W/rplcmt Plse Gen 2 Ld 77 31 $76,768.82 $29,939.84 61% off $16,405.00 $76,337.00 $69,092.00 2024-12-15
33264 CPT Hc Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld 77 31 $100,001.66 $39,000.65 61% off $16,405.00 $98,002.00 $72,958.00 2024-12-15
33270 CPT Hc Ins/rplcmnt Perm Subq Impltbl Dfb W/subq Eltrd 41 31 $66,011.43 $25,744.46 61% off $20,825.00 $64,691.00 $59,410.00 2024-12-15
33274 CPT Hc Tcat Insj/rpl Perm Leadless Pacemaker Rv W/img 41 31 $58,989.01 $23,005.71 61% off $10,978.00 $57,809.00 $53,090.00 2024-12-15
33289 CPT Hc Rhc W/plc Pressure Sensor 41 31 $76,652.15 $29,894.34 61% off $20,979.00 $75,119.00 $68,987.00 2024-12-15
33363 CPT Hc Replace Aortic Valve Open Axillry Artry Approach 77 31 $68,511.79 $26,719.60 61% off $33,748.00 $67,142.00 $59,672.00 2024-12-15
33365 CPT Hc Cath Replace Aortic Valve Open Transaortic Approach 41 31 $54,351.85 $21,197.22 61% off $27,665.00 $53,265.00 $48,917.00 2024-12-15
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 3 $0.01 — $53,235.00 $53,235.00 $53,235.00 2024-12-15
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 3 $0.01 — $57,133.00 $57,133.00 $57,133.00 2024-12-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 3 $0.01 — $62,672.00 $62,672.00 $62,672.00 2024-12-15
36906 CPT Hc Perq Thrmbc/nfs Dial Circuit Tcat Plmt IV Stent 41 31 $52,864.78 $20,617.26 61% off $10,992.00 $51,807.00 $47,578.00 2024-12-15
37 MS_DRG Extracranial Procedures With Mcc 3 3 $0.01 — $48,791.00 $48,791.00 $48,791.00 2024-12-15
37227 CPT Hc Revascularize Fem/pop Artery,angioplasty/stent/atherectomy 41 31 $62,141.77 $24,235.29 61% off $7,469.00 $60,899.00 $55,928.00 2024-12-15
37230 CPT Hc Revascularize Tibial/peron Artery,angioplasty/stent Initial 41 31 $58,451.40 $22,796.05 61% off $4,312.00 $57,282.00 $52,606.00 2024-12-15
37231 CPT Hc Revascularize Tibial/peron Artery,angioplasty/stent/atherectomy Init 41 31 $85,085.87 $33,183.49 61% off $7,469.00 $83,384.00 $76,577.00 2024-12-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 3 $0.01 — $207,598.00 $207,598.00 $207,598.00 2024-12-15
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 3 3 $0.01 — $55,420.00 $55,420.00 $55,420.00 2024-12-15
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 $0.01 — $57,478.00 $57,478.00 $57,478.00 2024-12-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 3 3 $0.01 — $79,758.00 $79,758.00 $79,758.00 2024-12-15
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 3 $0.01 — $51,441.00 $51,441.00 $51,441.00 2024-12-15
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 3 $0.01 — $51,478.00 $51,478.00 $51,478.00 2024-12-15
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 3 $0.01 — $51,855.00 $51,855.00 $51,855.00 2024-12-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 3 $0.01 — $59,758.00 $59,758.00 $59,758.00 2024-12-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 $0.01 — $153,905.00 $153,905.00 $153,905.00 2024-12-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 $0.01 — $104,353.00 $104,353.00 $104,353.00 2024-12-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 $0.01 — $80,866.00 $80,866.00 $80,866.00 2024-12-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 3 $0.01 — $122,540.00 $122,540.00 $122,540.00 2024-12-15
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 3 $0.01 — $80,373.00 $80,373.00 $80,373.00 2024-12-15
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 $0.01 — $68,215.00 $68,215.00 $68,215.00 2024-12-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 3 $0.01 — $98,505.00 $98,505.00 $98,505.00 2024-12-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 3 $0.01 — $59,995.00 $59,995.00 $59,995.00 2024-12-15
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 3 3 $0.01 — $75,665.00 $75,665.00 $75,665.00 2024-12-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 $0.01 — $124,429.00 $124,429.00 $124,429.00 2024-12-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 $0.01 — $84,323.00 $84,323.00 $84,323.00 2024-12-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 $0.01 — $63,440.00 $63,440.00 $63,440.00 2024-12-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 3 $0.01 — $90,160.00 $90,160.00 $90,160.00 2024-12-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 $0.01 — $79,351.00 $79,351.00 $79,351.00 2024-12-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 3 $0.01 — $74,850.00 $74,850.00 $74,850.00 2024-12-15
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 3 3 $0.01 — $50,323.00 $50,323.00 $50,323.00 2024-12-15
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 3 3 $0.01 — $48,024.00 $48,024.00 $48,024.00 2024-12-15
471 MS_DRG Cervical Spinal Fusion With Mcc 3 3 $0.01 — $71,363.00 $71,363.00 $71,363.00 2024-12-15
47335-625-60 NDC Ranolazine ER 1000 Mg Po Pack 41 31 $57,767.99 $22,529.52 61% off $29,404.00 $56,613.00 $51,991.00 2024-12-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 3 $0.01 — $65,889.00 $65,889.00 $65,889.00 2024-12-15
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 3 3 $0.01 — $50,526.00 $50,526.00 $50,526.00 2024-12-15
47781-153-01 NDC Naproxen Sodium ER 375 Mg Po Tb24 41 31 $120,240.84 $46,893.93 61% off $61,203.00 $117,836.00 $108,217.00 2024-12-15
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 3 3 $0.01 — $47,298.00 $47,298.00 $47,298.00 2024-12-15
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 3 3 $0.01 — $52,174.00 $52,174.00 $52,174.00 2024-12-15
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 3 $0.01 — $51,725.00 $51,725.00 $51,725.00 2024-12-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 3 $0.01 — $156,461.00 $156,461.00 $156,461.00 2024-12-15
500 MS_DRG Soft Tissue Procedures With Mcc 3 3 $0.01 — $46,555.00 $46,555.00 $46,555.00 2024-12-15
51167-331-01 NDC Elexacaf-tezacaf-ivacaf&ivacaf 100-50-75 (trikafta Kit Morning Dose) 41 31 $98,816.98 $38,538.62 61% off $50,298.00 $96,841.00 $88,935.00 2024-12-15
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 3 3 $0.01 — $52,656.00 $52,656.00 $52,656.00 2024-12-15
52427-273-75 NDC Naproxen Sodium ER 500 Mg Po Tb24 41 31 $238,090.06 $92,855.12 61% off $121,188.00 $233,328.00 $214,281.00 2024-12-15
55566-9800-0 NDC Fecal Microbiota, Live-jslm 150 Ml Re Susp 41 31 $70,923.59 $27,660.20 61% off $36,100.00 $69,505.00 $63,831.00 2024-12-15
55566-9800-2 NDC Fecal Microbiota, Live-jslm 150 Ml Re Susp 41 31 $70,923.59 $27,660.20 61% off $36,100.00 $69,505.00 $63,831.00 2024-12-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 3 $0.01 — $90,476.00 $90,476.00 $90,476.00 2024-12-15
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 3 $0.01 — $50,906.00 $50,906.00 $50,906.00 2024-12-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 3 $0.01 — $79,268.00 $79,268.00 $79,268.00 2024-12-15
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 3 3 $0.01 — $47,887.00 $47,887.00 $47,887.00 2024-12-15
5831 APR_DRG Neonate With Ecmo 6 6 $0.01 — $64,646.00 $64,646.00 $64,646.00 2024-12-15
5832 APR_DRG Neonate With Ecmo 6 6 $0.01 — $103,279.00 $103,279.00 $103,279.00 2024-12-15
5833 APR_DRG Neonate With Ecmo 6 6 $0.01 — $150,101.00 $150,101.00 $150,101.00 2024-12-15
5834 APR_DRG Neonate With Ecmo 6 6 $0.01 — $170,889.00 $170,889.00 $170,889.00 2024-12-15
58468-0132-1 NDC Sevelamer Carbonate 0.8 G Po Pack 41 31 $206,488.55 $80,530.54 61% off $105,103.00 $202,359.00 $185,840.00 2024-12-15
58468-0132-2 NDC Sevelamer Carbonate 0.8 G Po Pack 41 31 $206,488.55 $80,530.54 61% off $105,103.00 $202,359.00 $185,840.00 2024-12-15
58571 CPT Hc Laparoscopy W Tot Hysterectuterus <=250 Gram W Tube/ovary 41 31 $52,685.64 $20,547.40 61% off $1,960.00 $51,632.00 $47,417.00 2024-12-15
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 $0.01 — $85,228.00 $85,228.00 $85,228.00 2024-12-15
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 $0.01 — $85,228.00 $85,228.00 $85,228.00 2024-12-15
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 $0.01 — $88,944.00 $88,944.00 $88,944.00 2024-12-15
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 $0.01 — $130,146.00 $130,146.00 $130,146.00 2024-12-15
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 6 $0.01 — $51,185.00 $51,185.00 $51,185.00 2024-12-15
58914-501-56 NDC Mesalamine 1000 Mg Re Supp 41 31 $278,403.99 $108,577.56 61% off $141,708.00 $272,836.00 $250,564.00 2024-12-15
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 6 $0.01 — $49,374.00 $49,374.00 $49,374.00 2024-12-15
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 6 $0.01 — $47,006.00 $47,006.00 $47,006.00 2024-12-15
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 $0.01 — $59,039.00 $59,039.00 $59,039.00 2024-12-15
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 $0.01 — $81,894.00 $81,894.00 $81,894.00 2024-12-15
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 $0.01 — $51,271.00 $51,271.00 $51,271.00 2024-12-15
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 $0.01 — $75,464.00 $75,464.00 $75,464.00 2024-12-15
59385-027-01 NDC Buprenorphine Hcl 900 Mcg Bu Film 41 31 $185,448.22 $72,324.81 61% off $94,393.00 $181,739.00 $166,903.00 2024-12-15
59385-027-60 NDC Buprenorphine Hcl 900 Mcg Bu Film 41 31 $185,448.22 $72,324.81 61% off $94,393.00 $181,739.00 $166,903.00 2024-12-15
6 MS_DRG Liver Transplant Without Mcc 3 3 $0.01 — $71,244.00 $71,244.00 $71,244.00 2024-12-15
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 $0.01 — $55,731.00 $55,731.00 $55,731.00 2024-12-15
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 $0.01 — $69,716.00 $69,716.00 $69,716.00 2024-12-15
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 $0.01 — $79,994.00 $79,994.00 $79,994.00 2024-12-15
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 3 $0.01 — $56,785.00 $56,785.00 $56,785.00 2024-12-15
61958-1004-1 NDC Ranolazine ER 1000 Mg Po Tb12 41 31 $71,661.36 $27,947.93 61% off $36,476.00 $70,228.00 $64,495.00 2024-12-15
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 3 $0.01 — $54,977.00 $54,977.00 $54,977.00 2024-12-15
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 3 3 $0.01 — $57,970.00 $57,970.00 $57,970.00 2024-12-15
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 $0.01 — $105,825.00 $105,825.00 $105,825.00 2024-12-15
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 6 $0.01 — $80,808.00 $80,808.00 $80,808.00 2024-12-15
63323-877-15 NDC Pentamidine Isethionate 300 Mg In Solr 41 31 $232,361.15 $90,620.85 61% off $118,272.00 $227,714.00 $209,125.00 2024-12-15
64 APR_DRG Pancreas Transplant 6 6 $0.01 — $55,334.00 $55,334.00 $55,334.00 2024-12-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 3 3 $0.01 — $67,690.00 $67,690.00 $67,690.00 2024-12-15
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 3 3 $0.01 — $51,018.00 $51,018.00 $51,018.00 2024-12-15
653 MS_DRG Major Bladder Procedures With Mcc 3 3 $0.01 — $81,902.00 $81,902.00 $81,902.00 2024-12-15
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 3 3 $0.01 — $47,867.00 $47,867.00 $47,867.00 2024-12-15
665 MS_DRG Prostatectomy With Mcc 3 3 $0.01 — $50,446.00 $50,446.00 $50,446.00 2024-12-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 3 $0.01 — $61,554.00 $61,554.00 $61,554.00 2024-12-15
67546-212-21 NDC Nitazoxanide 100 Mg/5ml Po Susr Bulk 41 31 $62,648.80 $24,433.03 61% off $31,888.00 $61,396.00 $56,384.00 2024-12-15
68382-395-01 NDC Ribavirin 6 G In Solr 41 31 $192,798.62 $75,191.46 61% off $98,134.00 $188,943.00 $173,519.00 2024-12-15
68382-395-04 NDC Ribavirin 6 G In Solr 41 31 $192,798.62 $75,191.46 61% off $98,134.00 $188,943.00 $173,519.00 2024-12-15
69344-102-33 NDC Indomethacin 50 Mg Re Supp 41 31 $53,934.90 $21,034.61 61% off $27,453.00 $52,856.00 $48,541.00 2024-12-15
69468-151-04 NDC Uridine Triacetate 10 G Po Pack 41 31 $66,457.26 $25,918.33 61% off $33,827.00 $65,128.00 $59,812.00 2024-12-15
7 MS_DRG Lung Transplant 3 3 $0.01 — $192,007.00 $192,007.00 $192,007.00 2024-12-15
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 3 $0.01 — $57,851.00 $57,851.00 $57,851.00 2024-12-15
73702-140-71 NDC Indomethacin 100 Mg Re Supp 41 31 $59,103.59 $23,050.40 61% off $30,084.00 $57,922.00 $53,193.00 2024-12-15
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 3 3 $0.01 — $58,487.00 $58,487.00 $58,487.00 2024-12-15
74 APR_DRG Allogeneic Bone Marrow Transplant 6 6 $0.01 — $81,019.00 $81,019.00 $81,019.00 2024-12-15
77371 CPT Hc Tr Srs 1 Session Multi Cobalt 60 41 31 $93,660.20 $36,527.48 61% off $6,537.00 $91,787.00 $84,294.00 2024-12-15
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 3 $0.01 — $87,341.00 $87,341.00 $87,341.00 2024-12-15
791 MS_DRG Prematurity With Major Problems 3 3 $0.01 — $59,648.00 $59,648.00 $59,648.00 2024-12-15
793 MS_DRG Full Term Neonate With Major Problems 3 3 $0.01 — $61,273.00 $61,273.00 $61,273.00 2024-12-15
799 MS_DRG Splenic Procedures With Mcc 3 3 $0.01 — $69,858.00 $69,858.00 $69,858.00 2024-12-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 3 3 $0.01 — $79,941.00 $79,941.00 $79,941.00 2024-12-15
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 3 $0.01 — $52,668.00 $52,668.00 $52,668.00 2024-12-15
81416 CPT Hc Exome Sequence Analysis Each Comparator Exome 41 31 $92,610.00 $36,117.90 61% off $47,138.00 $90,758.00 $83,349.00 2024-12-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 3 $0.01 — $85,541.00 $85,541.00 $85,541.00 2024-12-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 3 $0.01 — $68,751.00 $68,751.00 $68,751.00 2024-12-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 3 $0.01 — $70,162.00 $70,162.00 $70,162.00 2024-12-15
834 MS_DRG Acute Leukemia With Mcc 3 3 $0.01 — $81,207.00 $81,207.00 $81,207.00 2024-12-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 3 $0.01 — $73,566.00 $73,566.00 $73,566.00 2024-12-15
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 3 3 $0.01 — $46,853.00 $46,853.00 $46,853.00 2024-12-15
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 $0.01 — $99,088.00 $99,088.00 $99,088.00 2024-12-15
850 MS_DRG Acute Leukemia With Other Procedures 3 3 $0.01 — $135,341.00 $135,341.00 $135,341.00 2024-12-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 $0.01 — $73,479.00 $73,479.00 $73,479.00 2024-12-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 3 $0.01 — $66,284.00 $66,284.00 $66,284.00 2024-12-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 3 $0.01 — $102,205.00 $102,205.00 $102,205.00 2024-12-15
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 3 3 $0.01 — $57,734.00 $57,734.00 $57,734.00 2024-12-15
901 MS_DRG Wound Debridements For Injuries With Mcc 3 3 $0.01 — $65,093.00 $65,093.00 $65,093.00 2024-12-15
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 3 3 $0.01 — $56,727.00 $56,727.00 $56,727.00 2024-12-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 3 $0.01 — $58,529.00 $58,529.00 $58,529.00 2024-12-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 3 $0.01 — $348,535.00 $348,535.00 $348,535.00 2024-12-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 3 $0.01 — $98,126.00 $98,126.00 $98,126.00 2024-12-15
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 3 3 $0.01 — $46,726.00 $46,726.00 $46,726.00 2024-12-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 3 3 $0.01 — $63,571.00 $63,571.00 $63,571.00 2024-12-15
93581 CPT Hc Perc Closure,cong Vsd W/implant 41 31 $58,358.87 $22,759.96 61% off $29,705.00 $57,192.00 $52,523.00 2024-12-15
93582 CPT Hc Cath Percutan Transcath Closure Pat Duct Arteriosus 41 31 $72,334.19 $28,210.33 61% off $12,752.00 $70,888.00 $65,101.00 2024-12-15
93590 CPT Hc Cath Perq Transcath Cls Paravalvr Leak 1 Mitral Valve 41 31 $72,334.19 $28,210.33 61% off $10,992.00 $70,888.00 $65,101.00 2024-12-15
93591 CPT Hc Cath Perq Transcath Cls Paravalvr Leak 1 Aortic Valve 41 31 $63,008.76 $24,573.42 61% off $10,992.00 $61,749.00 $56,708.00 2024-12-15
93653 CPT Hc Ephys Eval W/ablation Supravent Arrhythmia 41 31 $63,470.46 $24,753.48 61% off $7,535.00 $62,201.00 $57,123.00 2024-12-15
93654 CPT Hc Ephys Eval W/ablation Ventricular Tachycardia 41 31 $72,382.87 $28,229.32 61% off $7,535.00 $70,935.00 $65,145.00 2024-12-15
93656 CPT Hc Ephys Evl Trnsptl Tx Atrial Fib Isolat Pulm Vein 41 31 $75,683.76 $29,516.67 61% off $7,535.00 $74,170.00 $68,115.00 2024-12-15
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 3 $0.01 — $46,632.00 $46,632.00 $46,632.00 2024-12-15
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 $0.01 — $76,359.00 $76,359.00 $76,359.00 2024-12-15
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 3 $0.01 — $53,607.00 $53,607.00 $53,607.00 2024-12-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 3 $0.01 — $100,321.00 $100,321.00 $100,321.00 2024-12-15
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 3 $0.01 — $56,159.00 $56,159.00 $56,159.00 2024-12-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 3 $0.01 — $109,664.00 $109,664.00 $109,664.00 2024-12-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 3 $0.01 — $60,381.00 $60,381.00 $60,381.00 2024-12-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 3 $0.01 — $92,917.00 $92,917.00 $92,917.00 2024-12-15
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 3 $0.01 — $52,665.00 $52,665.00 $52,665.00 2024-12-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 $0.01 — $69,844.00 $69,844.00 $69,844.00 2024-12-15
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 $0.01 — $51,462.00 $51,462.00 $51,462.00 2024-12-15
A9520 HCPCS Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 41 31 $770,386.00 $300,450.54 61% off $392,126.00 $754,978.00 $693,347.00 2024-12-15
A9555 HCPCS Rubidium-82 (rb-82) Radio-isotope Injection 41 31 $84,001.00 $32,760.39 61% off $42,757.00 $82,321.00 $75,601.00 2024-12-15
A9569 HCPCS Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection 41 31 $317,369.80 $123,774.22 61% off $161,541.00 $311,022.00 $285,633.00 2024-12-15
A9572 HCPCS Indium In-111 Pentetreotide IV Kit 41 31 $386,681.14 $150,805.64 61% off $196,821.00 $378,948.00 $348,013.00 2024-12-15
A9584 HCPCS Ioflupane I 123 185 Mbq/2.5ml IV Soln 41 31 $56,701.00 $22,113.39 61% off $28,861.00 $55,567.00 $51,031.00 2024-12-15
A9588 HCPCS Fluciclovine F 18 9-221 Mci/ml IV Soln 41 31 $460,111.00 $179,443.29 61% off $234,196.00 $450,909.00 $414,100.00 2024-12-15
A9591 HCPCS Fluoroestradiol F 18 4-100 Mci/ml IV Soln 41 31 $243,748.00 $95,061.72 61% off $124,068.00 $238,873.00 $219,373.00 2024-12-15
A9592 HCPCS Copper Cu 64 Dotatate 1 Mci/ml IV Soln 41 31 $170,101.00 $66,339.39 61% off $86,581.00 $166,699.00 $153,091.00 2024-12-15
A9595 HCPCS Piflufolastat F 18 9 Mci IV Sosy 41 31 $475,098.80 $185,288.53 61% off $241,825.00 $465,597.00 $427,589.00 2024-12-15
C1721 HCPCS Defibrillator Protecta Dr 2chb Is1 Df1 Av 35jl 37m 1,853 31 $123,723.60 $48,252.20 61% off $37.00 $186,691.00 $105,313.00 2024-12-15
C1722 HCPCS Defibrillator Crdc Evera S Vr 1chb Is1 Df1 1,781 31 $115,500.00 $45,045.00 61% off $23,000.00 $201,931.00 $98,376.00 2024-12-15
C1767 HCPCS Stimulator Proclaim Elite 7 Rechrg-free Scs 967 31 $144,210.00 $56,241.90 61% off $45,621.00 $335,285.00 $126,074.00 2024-12-15
C1772 HCPCS Pump Inf Synchromed Ii Ti 3.4x0.78x0.78in 20ml 79 31 $100,510.00 $39,198.90 61% off $44,042.00 $98,500.00 $80,037.00 2024-12-15
C1816 HCPCS System Stim Nerv Stimq-4 8 Elect Dl Transm Kt 116 31 $157,320.00 $61,354.80 61% off $8,897.00 $175,587.00 $133,392.50 2024-12-15
C1817 HCPCS Occluder Sept Amplatzer 45deg 38x4 12fr Strl Lf 301 31 $58,070.16 $22,647.36 61% off $19,215.00 $72,125.00 $50,022.00 2024-12-15
C1820 HCPCS Stimulator Nerv Activa Sc 60x55x11mm 27ml 44gm 671 31 $114,319.20 $44,584.49 61% off $4,204.00 $218,884.00 $98,449.00 2024-12-15
C1822 HCPCS Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 116 31 $194,246.50 $75,756.14 61% off $91,198.00 $222,695.00 $168,768.00 2024-12-15
C1823 HCPCS Generator Implantable Remede Pul Cent Sleep Apnea 79 31 $235,620.00 $91,891.80 61% off $42,328.00 $230,908.00 $129,591.00 2024-12-15
C1824 HCPCS Generator Pul Implantable Optimizer Smt F/hrt Fail 79 31 $227,240.00 $88,623.60 61% off $93,697.00 $222,695.00 $170,403.00 2024-12-15
C1825 HCPCS System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 79 31 $198,240.00 $77,313.60 61% off $100,904.00 $239,826.00 $183,511.00 2024-12-15
C1827 HCPCS Generator Imp Vivistim Vns Ipg 1001 79 31 $257,830.00 $100,553.70 61% off $30,571.00 $252,673.00 $141,807.00 2024-12-15
C1831 HCPCS Kit Imp Aprevo Spine Lvl 1 190 31 $332,120.00 $129,526.80 61% off $115,665.00 $428,260.00 $267,444.00 2024-12-15
C1833 HCPCS Monitor Crdc The Guardian Amsg3-e 42 31 $72,570.00 $28,302.30 61% off $36,938.00 $71,119.00 $63,912.50 2024-12-15
C1882 HCPCS Defibrillator Crdc Consulta Crt-d 2,224 31 $148,486.80 $57,909.85 61% off $21.00 $295,118.00 $129,788.50 2024-12-15
C2616 HCPCS Sphere Embol Sir Msphre 90 79 31 $129,882.60 $50,654.21 61% off $64,849.00 $127,285.00 $114,664.00 2024-12-15
C2621 HCPCS Pacemaker Valitude Crt-p Is1 819 31 $54,516.00 $21,261.24 61% off $12,224.00 $100,049.00 $48,527.00 2024-12-15
C2622 HCPCS Prosthesis Penile Genisis Kt Semi Rgd Malle 9.5x23 116 31 $58,155.12 $22,680.50 61% off $6,032.00 $67,416.00 $48,154.00 2024-12-15
C2624 HCPCS System Cardiomems Hrt Failure Ptnt 42 31 $141,246.00 $55,085.94 61% off $71,894.00 $138,421.00 $124,395.00 2024-12-15
C9089 HCPCS Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 77 31 $184,395.59 $71,914.28 61% off $93,857.00 $185,765.00 $165,956.00 2024-12-15
C9767 HCPCS Hc Revasc Endovas Any Vessel With IV Litho/ather/stent 41 31 $51,786.22 $20,196.63 61% off $26,359.00 $50,750.00 $46,608.00 2024-12-15
C9773 HCPCS Hc Revasc Tibial/peroneal Art With IV Litho/stent 41 31 $91,588.35 $35,719.46 61% off $46,618.00 $89,757.00 $82,430.00 2024-12-15
C9774 HCPCS Hc Revasc Tibial/peroneal Art With IV Litho/ather 41 31 $91,588.35 $35,719.46 61% off $46,618.00 $89,757.00 $82,430.00 2024-12-15
C9775 HCPCS Hc Revasc Tibial/peroneal Art With IV Litho/ather/stent 41 31 $91,588.35 $35,719.46 61% off $46,618.00 $89,757.00 $82,430.00 2024-12-15
J0841 HCPCS Crotalidae Immune Fab (equine) IV Solr 41 31 $102,080.77 $39,811.50 61% off $51,959.00 $100,039.00 $91,873.00 2024-12-15
J9266 HCPCS Hc Pegaspargase/singl Dose Vial 41 31 $70,731.02 $27,585.10 61% off $36,002.00 $69,316.00 $63,658.00 2024-12-15
L7510 HCPCS Kit Audiolink 78 31 $128,709.00 $50,196.51 61% off $260.00 $126,135.00 $79,156.00 2024-12-15
L8614 HCPCS Kit Sound Nucleus 7 Procsr 2 Units 449 31 $93,810.00 $36,585.90 61% off $873.00 $145,706.00 $79,739.00 2024-12-15
L8619 HCPCS Abutment Cochlear Dermalock 3mmx8mm Strl 523 31 $85,305.15 $33,269.01 61% off $1,860.00 $145,706.00 $76,775.00 2024-12-15
Q0138 HCPCS Hc Ferumoxytol, Non-esrd 71 31 $158,303.46 $61,738.35 61% off $1.00 $155,137.00 $80,576.00 2024-12-15
Q0479 HCPCS Module Pwr Heartmate Ii Cntrlr Tethered Operation 42 31 $83,980.80 $32,752.51 61% off $42,746.00 $82,301.00 $73,962.00 2024-12-15
Q0495 HCPCS Charger Batt Heartmate Univ 79 31 $75,582.72 $29,477.26 61% off $30,180.00 $74,071.00 $56,271.50 2024-12-15
Q2042 HCPCS Tisagenlecleucel IV Infusion (wrapped) 41 31 $1,964,435.20 $766,129.73 61% off $999,898.00 $1,925,146.00 $1,767,992.00 2024-12-15
Q2054 HCPCS Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 41 31 $2,242,409.98 $874,539.89 61% off $1,141,387.00 $2,197,562.00 $2,018,169.00 2024-12-15
Q2055 HCPCS Idecabtagene Vicleucel 460000000 Cells IV Susp 41 31 $2,292,674.18 $894,142.93 61% off $1,166,971.00 $2,246,821.00 $2,063,407.00 2024-12-15
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