45 CFR § 180 compliance
D · 65
This hospital published part of what § 180 requires.
●Machine-readable file published
●Gross / standard charges
●Discounted cash price
○Payer-specific negotiated rates
○Min / max negotiated charges
●Free, public, no login required
Procedures listed
604
Insurances with rates
0
CPT / HCPCS codes
475
Source MRF
Most expensive procedures (gross)
J3380
$21,838
ENTYVIO 300 MG IN 250 ML NS,340B
Gross
$31,197
J3358
$20,999
STELARA(USTEKINUMAB) INJ 1 MG,340B
Gross
$29,999
J3101
$19,725
TNKASE KIT 50MG/10ML STERILE WATER INJ.,340B
Gross
$28,179
J0717
$14,412
CIMZIA SQ PREFILLED SYRINGE 2X200MG/1ML
Gross
$20,589
J0517
$14,305
FASENRA 30MG/ML PEN SQ,340B, ZERO DRUG WASTE
Gross
$20,436
J1561
$14,000
GAMUNEX-C 40GM/400ML,ZERO DRUG WASTE
Gross
$20,000
J9312
$11,838
RITUXAN (RITUXIMAB) 500MG/50ML,340B
Gross
$16,911
J1162
$11,589
DIGIBIND(DIGOXIN IMMUNE FAB)INJ:40MG 4ML,340B
Gross
$16,556
790
$11,231
LITHOTRIPSY UNILATERAL
Gross
$16,045
J1306
$8,501
LEQVIO (INCLISIRAN) 284MG/1.5ML PFS INJ,340B
Gross
$12,144
J0840
$8,059
CROFAB:1GM VIAL(ANTIVENIN CROT) INJ,340B
Gross
$11,513
J0490
$5,438
BENLYSTA 400MG/250ML NS INFUSION,ZERO DRUG WASTE
Gross
$7,769
J2993
$5,084
RETAVASE KIT(TISS PLASM ACTIV)10 UNITS,340B
Gross
$7,263
64582
$4,550
INSPIRE STIMULATION LEAD 4063
Gross
$6,500
J0897
$4,376
PROLIA(DENOSUMAB) INJECTION 60MG,ZERO DRUG WASTE, 340B
Gross
$6,252
J0129
$4,043
ORENCIA (ABATACEPT) 250MG IV VIAL
Gross
$5,775
Q5136
$4,043
JUBBONTI SUBQ 60MG/1ML (PROLIA GENERIC),340B, ZERO DRUG WASTE
Gross
$5,775
J1439
$3,644
INJECTAFER IV 750MG/15ML,340B, ZERO DRUG WASTE
Gross
$5,205
J2507
$3,499
KRYSTEXXA(PEGLOTICASE)INFUSION:8MG 1ML,340B
Gross
$4,999
J1745
$2,943
REMICADE (INFLIXIMAB)100MG IN 250 ML NS,ZERO DRUG WASTE, 340B
Gross
$4,204
A9566
$2,100
NM NEUTROSPEC 99m
Gross
$4,200
Q4101
$2,076
GRAFT SKIN APLIGRAF 1978-0001-99
Gross
$4,152
75710
$1,978
ANGIOGRAM EXTREMITY UNILATERAL LEFT
Gross
$3,955
Q5103
$2,385
INFLECTRA 100 MG IN 250 ML NS INFUSION,340B
Gross
$3,407
C8905
$2,064
MRI BREAST W and W/O CONTRAST UNILATERAL
Gross
$2,949
619
$2,063
MRI UPPER EXT JOINT W
Gross
$2,947
611
$2,055
MRI BRAIN W/O
Gross
$2,935
612
$2,017
MRI L-SPINE W/O CONTRAST
Gross
$2,882
J1602
$1,959
SIMPONI ARIAS (GOLUMIMAB)INJ:50MG/4ML,340B
Gross
$2,799
J1950
$1,931
LUPRON (LEUPROLIDE ACET)INJ: 11.25MG,340B
Gross
$2,759
J1451
$1,837
ANTIZOL(FOMEPIZOLE)1000MG/ML:1.5ML VIAL,340B
Gross
$2,625
J1670
$1,636
TETANUS IMMUNE GLOBULIN INJ:250 UNIT,340B
Gross
$2,337
J2407
$1,629
ORBACTIV(ORITAVANCIN)INJVIAL:400MG,340B
Gross
$2,327
J2794
$1,549
RISPERDAL CONSTA(RISPERIDONE)INJ: 25MG,340B
Gross
$2,212
43235
$1,096
ENDOSCOPY UPPER GI
Gross
$2,191
278
$1,063
TRACHIAL BRONCHIAL Y-STEN
Gross
$2,126
350
$1,463
CT GUIDED NEEDLE BIOPSY
Gross
$2,090
43200
$1,040
ESOPHAGOSCOPY
Gross
$2,081
341
$1,418
NM V-Q LUNG
Gross
$2,026
351
$1,324
CT HEAD/BRAIN W/O CONTRAS
Gross
$1,891
610
$1,270
MRI BREAST W/O CONTRAST UNILATERAL
Gross
$1,814
C8901
$1,252
MRA ABDOMEN
Gross
$1,788
99291
$1,230
ER CRITICAL CAREW/MODIFIER,SAME DAY EM VISIT
Gross
$1,757
J1430
$1,211
ETHAMOLIN (ETHANOLAMINE OLEATE)INJ:100MG,340B
Gross
$1,729
91020
$846
MOTILITY GASTRIC
Gross
$1,692
J9217
$1,175
LUPRON DEPO (LEUPROLIDE ACET)INJ: 7.5MG,340B
Gross
$1,678
323
$1,162
AORTOGRAM ABDOMINAL
Gross
$1,661
A9504
$821
NM ACUTECT
Gross
$1,642
90675
$1,093
RABIES VACCINE (IMOVAX) 2.5 UNITS:1ML,340B
Gross
$1,562
J2325
$1,032
NATRECOR 1.5MG (NESIRITIDE):INJ,340B
Gross
$1,474
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J3380 | ENTYVIO 300 MG IN 250 ML NS,340B | $31,197 | $21,838 | — | — | 0 |
| J3358 | STELARA(USTEKINUMAB) INJ 1 MG,340B | $29,999 | $20,999 | — | — | 0 |
| J3101 | TNKASE KIT 50MG/10ML STERILE WATER INJ.,340B | $28,179 | $19,725 | — | — | 0 |
| J0717 | CIMZIA SQ PREFILLED SYRINGE 2X200MG/1ML | $20,589 | $14,412 | — | — | 0 |
| J0517 | FASENRA 30MG/ML PEN SQ,340B, ZERO DRUG WASTE | $20,436 | $14,305 | — | — | 0 |
| J1561 | GAMUNEX-C 40GM/400ML,ZERO DRUG WASTE | $20,000 | $14,000 | — | — | 0 |
| J9312 | RITUXAN (RITUXIMAB) 500MG/50ML,340B | $16,911 | $11,838 | — | — | 0 |
| J1162 | DIGIBIND(DIGOXIN IMMUNE FAB)INJ:40MG 4ML,340B | $16,556 | $11,589 | — | — | 0 |
| 790 | LITHOTRIPSY UNILATERAL | $16,045 | $11,231 | — | — | 0 |
| J1306 | LEQVIO (INCLISIRAN) 284MG/1.5ML PFS INJ,340B | $12,144 | $8,501 | — | — | 0 |
| J0840 | CROFAB:1GM VIAL(ANTIVENIN CROT) INJ,340B | $11,513 | $8,059 | — | — | 0 |
| J0490 | BENLYSTA 400MG/250ML NS INFUSION,ZERO DRUG WASTE | $7,769 | $5,438 | — | — | 0 |
| J2993 | RETAVASE KIT(TISS PLASM ACTIV)10 UNITS,340B | $7,263 | $5,084 | — | — | 0 |
| 64582 | INSPIRE STIMULATION LEAD 4063 | $6,500 | $4,550 | — | — | 0 |
| J0897 | PROLIA(DENOSUMAB) INJECTION 60MG,ZERO DRUG WASTE, 340B | $6,252 | $4,376 | — | — | 0 |
| J0129 | ORENCIA (ABATACEPT) 250MG IV VIAL | $5,775 | $4,043 | — | — | 0 |
| Q5136 | JUBBONTI SUBQ 60MG/1ML (PROLIA GENERIC),340B, ZERO DRUG WASTE | $5,775 | $4,043 | — | — | 0 |
| J1439 | INJECTAFER IV 750MG/15ML,340B, ZERO DRUG WASTE | $5,205 | $3,644 | — | — | 0 |
| J2507 | KRYSTEXXA(PEGLOTICASE)INFUSION:8MG 1ML,340B | $4,999 | $3,499 | — | — | 0 |
| J1745 | REMICADE (INFLIXIMAB)100MG IN 250 ML NS,ZERO DRUG WASTE, 340B | $4,204 | $2,943 | — | — | 0 |
| A9566 | NM NEUTROSPEC 99m | $4,200 | $2,100 | — | — | 0 |
| Q4101 | GRAFT SKIN APLIGRAF 1978-0001-99 | $4,152 | $2,076 | — | — | 0 |
| 75710 | ANGIOGRAM EXTREMITY UNILATERAL LEFT | $3,955 | $1,978 | — | — | 0 |
| Q5103 | INFLECTRA 100 MG IN 250 ML NS INFUSION,340B | $3,407 | $2,385 | — | — | 0 |
| C8905 | MRI BREAST W and W/O CONTRAST UNILATERAL | $2,949 | $2,064 | — | — | 0 |
| 619 | MRI UPPER EXT JOINT W | $2,947 | $2,063 | — | — | 0 |
| 611 | MRI BRAIN W/O | $2,935 | $2,055 | — | — | 0 |
| 612 | MRI L-SPINE W/O CONTRAST | $2,882 | $2,017 | — | — | 0 |
| J1602 | SIMPONI ARIAS (GOLUMIMAB)INJ:50MG/4ML,340B | $2,799 | $1,959 | — | — | 0 |
| J1950 | LUPRON (LEUPROLIDE ACET)INJ: 11.25MG,340B | $2,759 | $1,931 | — | — | 0 |
| J1451 | ANTIZOL(FOMEPIZOLE)1000MG/ML:1.5ML VIAL,340B | $2,625 | $1,837 | — | — | 0 |
| J1670 | TETANUS IMMUNE GLOBULIN INJ:250 UNIT,340B | $2,337 | $1,636 | — | — | 0 |
| J2407 | ORBACTIV(ORITAVANCIN)INJVIAL:400MG,340B | $2,327 | $1,629 | — | — | 0 |
| J2794 | RISPERDAL CONSTA(RISPERIDONE)INJ: 25MG,340B | $2,212 | $1,549 | — | — | 0 |
| 43235 | ENDOSCOPY UPPER GI | $2,191 | $1,096 | — | — | 0 |
| 278 | TRACHIAL BRONCHIAL Y-STEN | $2,126 | $1,063 | — | — | 0 |
| 350 | CT GUIDED NEEDLE BIOPSY | $2,090 | $1,463 | — | — | 0 |
| 43200 | ESOPHAGOSCOPY | $2,081 | $1,040 | — | — | 0 |
| 341 | NM V-Q LUNG | $2,026 | $1,418 | — | — | 0 |
| 351 | CT HEAD/BRAIN W/O CONTRAS | $1,891 | $1,324 | — | — | 0 |
| 610 | MRI BREAST W/O CONTRAST UNILATERAL | $1,814 | $1,270 | — | — | 0 |
| C8901 | MRA ABDOMEN | $1,788 | $1,252 | — | — | 0 |
| 99291 | ER CRITICAL CAREW/MODIFIER,SAME DAY EM VISIT | $1,757 | $1,230 | — | — | 0 |
| J1430 | ETHAMOLIN (ETHANOLAMINE OLEATE)INJ:100MG,340B | $1,729 | $1,211 | — | — | 0 |
| 91020 | MOTILITY GASTRIC | $1,692 | $846 | — | — | 0 |
| J9217 | LUPRON DEPO (LEUPROLIDE ACET)INJ: 7.5MG,340B | $1,678 | $1,175 | — | — | 0 |
| 323 | AORTOGRAM ABDOMINAL | $1,661 | $1,162 | — | — | 0 |
| A9504 | NM ACUTECT | $1,642 | $821 | — | — | 0 |
| 90675 | RABIES VACCINE (IMOVAX) 2.5 UNITS:1ML,340B | $1,562 | $1,093 | — | — | 0 |
| J2325 | NATRECOR 1.5MG (NESIRITIDE):INJ,340B | $1,474 | $1,032 | — | — | 0 |
Showing top 50 of 604 priced procedures, sorted by gross charge.
Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.