BAXTER HEALTH FULTON COUNTY HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J2997	Activase (alteplase) Inj 100 mg	$23,233	$16,263	—	—	5
J3101	Tnkase (tenecteplace) Inj 50 mg	$16,418	$11,492	—	—	5
J0897	Prolia (denosumab) Inj 60 mg	$6,501	$4,551	—	—	5
81211	BRCA 1 AND 2	$5,069	$3,548	—	—	5
10140	I&D HEMATOMA	$3,265	$2,286	—	—	5
Q4101	APLIGRAF	$3,237	$2,266	—	—	5
J1439	Injectafer (ferric carboxyma) Inj 750 mg	$3,164	$2,215	—	—	5
65235	REMOVAL OF FOREIGN BODY	$2,864	$2,005	—	—	5
11044	DEBRIDE SK SUB TIS MS BON	$2,626	$1,838	—	—	5
74174	CTA ABD AND PELVIS W CONTRAST	$2,250	$1,575	—	—	5
73706	CTA LEG BILATERAL	$2,214	$1,550	—	—	5
43255	EGD WITH CONTROL OF BLEEDING	$2,213	$1,549	—	—	5
59409	VAGINAL DELIVERY	$2,167	$1,517	—	—	5
70496	CTA HEAD	$2,094	$1,466	—	—	5
45382	COLONOSCOPY WITH CONTROL OF BLEEDING	$2,010	$1,407	—	—	5
Q4160	NUSHIELD 2X3 CM	$1,988	$1,391	—	—	5
74175	CTA ABDOMINAL AORTA W/CONTRAST	$1,950	$1,365	—	—	5
72191	CTA PELVIS W/CONTRAST	$1,950	$1,365	—	—	5
36556	CENTRAL LINE/NON-TUNNELED	$1,912	$1,338	—	—	5
J0585	Botulinum Toxin Type A - NF	$1,900	$1,330	—	—	5
43236	UPPER GI SCOPE W/SUBMUC INJ	$1,760	$1,232	—	—	5
36569	INSERTION OF PICC LINE W/OUT IMAGING	$1,750	$1,225	—	—	5
36573	INSERTION OF 0PICC WITH IMAGING	$1,750	$1,225	—	—	5
71270	CT ABDOMEN/PELVIS W & WO CONTRAST	$1,692	$1,184	—	—	5
72194	CT PELVIS W&W/O CONTRAST	$1,692	$1,184	—	—	5
74160	CT ABDOMEN W CONTRAST	$1,688	$1,182	—	—	5
72193	CT PELVIS W CONTRAST	$1,688	$1,182	—	—	5
73206	CTA UPPER EXT W/CONTRAST	$1,673	$1,171	—	—	5
Q4282	CYGNUS DUAL 4x4 16 UNITS	$1,619	$1,133	—	—	4
15271	APP OF SKIN PRODUCT LEGS TRUNK ARMS 25SQ	$1,600	$1,120	—	—	5
M0243	REGEN-COV ANTIBODIES ADMIN	$1,575	$1,103	—	—	4
Q4159	AFFINITY 6.25 CM 7 UNITS	$1,575	$1,103	—	—	5
88374	FISH	$1,554	$1,088	—	—	5
75635	CTA AORTA W/RUNOFFS	$1,550	$1,085	—	—	5
70498	CTA NECK W/CONTRAST	$1,550	$1,085	—	—	5
71275	CTA PULMONARY ANGIOGRAM	$1,550	$1,085	—	—	5
11047	DEBRIDE BONE EACH ADDITIONAL 20 CM	$1,514	$1,060	—	—	5
27550	CLOSED TX KNEE DISLOCATION	$1,502	$1,052	—	—	5
74150	CT ABDOMEN W/O CONTRAST	$1,499	$1,049	—	—	5
72192	CT PELVIS W/O CONTRAST	$1,499	$1,049	—	—	5
11604	EXC MALIG LES 3.1TO 4.0CM	$1,427	$999	—	—	5
73701	CT LOWER EXT LT W CONT,Left side	$1,371	$960	—	—	5
70481	CT ORBITS W/CONTRAST	$1,371	$960	—	—	5
73201	CT UPPER EXT LT W CONT,Left side	$1,371	$960	—	—	5
70470	CT HEAD BRAIN W AND WO CONTRAST	$1,369	$959	—	—	5
70491	CT SOFT TISSUE NECK WITH CONTRAST	$1,369	$959	—	—	5
70492	CT SOFT TISSUE NECK W/O & W CONTRAST	$1,369	$959	—	—	5
72129	CT THORACIC SPINE W CONTRAST	$1,369	$959	—	—	5
72126	CT CERVICAL SPINE W CONTRAST	$1,369	$958	—	—	5
72132	CT L-SPINE W/ CONTRAST	$1,355	$948	—	—	5

Showing top 50 of 1,233 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.