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HANK Price Transparency. (n.d.).
New Technology - Level 50 ($115,001-$130,000) (HCPCS 1904) by State .
PPMan price-transparency data, derived from CMS-required hospital MRFs.
Retrieved June 30, 2026 , from http://ppman.hank.ai/transparency/procedure/1904/by-state?code_type=HCPCS
“New Technology - Level 50 ($115,001-$130,000) (HCPCS 1904) by State.” HANK Price Transparency ,
http://ppman.hank.ai/transparency/procedure/1904/by-state?code_type=HCPCS. Accessed
June 30, 2026 .
“New Technology - Level 50 ($115,001-$130,000) (HCPCS 1904) by State,” HANK Price Transparency ,
accessed June 30, 2026 ,
http://ppman.hank.ai/transparency/procedure/1904/by-state?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital
machine-readable files (45 CFR 180). See
methodology .
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HCPCS · across United States
1904 — New Technology - Level 50 ($115,001-$130,000)
State-by-state median negotiated rates. Lower bars are cheaper states; the
range bar shows the IQR (25th to 75th percentile within each state).
$122,500
National median
$27,874 – $126,176
IQR (p25 – p75)
23
hospitals filing
11
states
Median negotiated rate, by state
Ranked by typical (median) negotiated price. Hover for state-level IQR.
Median negotiated rate by state for 1904 (HCPCS), with interquartile range
State Median p25 p75
MS $147,421 $147,421 $147,421
CA $124,951 $122,500 $126,176
NV $122,500 $122,500 $127,401
TX $122,500 $9,405 $126,176
SD $46,353 $34,687 $48,772
MN $25,471 $18,173 $32,769
GA $13,759 $13,759 $13,759
OH $1,766 $1,766 $1,766
WV $522 $483 $525
PA $68 $68 $68
HI $23 $23 $23