45 CFR § 180 compliance
B · 85
This hospital published most 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
2,287
Insurances with rates
9
CPT / HCPCS codes
2,232
Source MRF
Most expensive procedures (gross)
Q4341
$80,000
WC-SIMPLIMAX 4X4 ALLOGRAFT
Gross
$80,000
C1882
$64,500
AICD OTHE THAN SING/DUAL
Gross
$64,500
C1721
$57,000
AICD DUAL CHAMBER
Gross
$57,000
J2997
$31,681
ALTEPLASE (ACTIVASE) FOR INJ [100MG]
Gross
$31,681
J3101
$29,870
TENECTEPLASE IV KIT [50MG]
Gross
$29,870
37244
$26,539
REBOA
Gross
$26,539
40804
$21,260
SOFT TISS FB REMOV VESTIBULE OF MOUTH
Gross
$21,260
J3380
$20,990
VEDOLIZUMAB (ENTYVIO) INJ [300MG]
Gross
$20,990
C1785
$15,885
ACCENT DR RFPACEMAKER
Gross
$15,885
19307
$15,534
MAST MOD RAD
Gross
$15,534
J2505
$9,140
PEGFILGRASTIM (NEULASTA SYR[6MG\0.6ML]##
Gross
$15,233
J1162
$15,020
DIGOXIN IMMUNE FAB INJ [40MG] (DIGIFAB)*
Gross
$15,020
Q4197
$13,500
PURAPLY XT 25 SQ CM
Gross
$13,500
Q4309
$13,000
VIA MATRIX 2X3
Gross
$13,000
C1777
$12,000
LEAD AICD ENDO SING COL
Gross
$12,000
J0840
$11,740
CROTALIDAE POLYVA IMMUNE FAB(CROFAB)VIAL
Gross
$11,740
Q4196
$10,688
PURAPLY AM 25 SQ CM
Gross
$10,688
Q4159
$10,621
AFFINITY 7 SQ CM
Gross
$10,621
J1306
$9,750
INCLISIRAN (LEQVIO) INJ [284MG/1.5ML]
Gross
$9,750
275
$9,553
PACEMAKER
Gross
$9,553
15273
$8,991
WC SKIN SUB GRFT T/ARM/LG CHILD
Gross
$8,991
47531
$8,855
XR CHOLANGIOGRAM T-TUBE
Gross
$8,855
Q4194
$8,125
WC-NOVACHOR [1.5cmx2.75cm}
Gross
$8,125
29880
$7,711
KNEE ARTHROSCOPY
Gross
$7,711
27087
$7,711
SFT TISS FB REMVL LFT PELVIS OR HIP DEEP
Gross
$7,711
27087
$7,711
SFT TISS FB REMVL LFT PELVIS OR HIP DEEP,LEFT SIDE
Gross
$7,711
36555
$7,593
CENTRAL LINE <5 YEARS
Gross
$7,593
36555
$7,593
CENTRAL LINE <5 YEARS MOD 51,MULTIPLE PROCEDURES
Gross
$7,593
59409
$7,447
VAGINAL DELIVERY
Gross
$7,447
59414
$7,447
DELIVERY OF PLACENTA
Gross
$7,447
J3111
$7,382
ROMOSOZUMAB (EVENITY) INJ [210MG/2.34ML]
Gross
$7,382
49560
$7,278
PF HERNIA INCARCER REPAIR
Gross
$7,278
Q4197
$7,063
WC-PURAPLYAM XT {4.9x4.91} DRESSING
Gross
$7,063
J0630
$7,047
CALCITONIN (MIACALCIN) INJ [400UNIT/2ML]
Gross
$7,047
19120
$7,043
REMOVAL OF BREAST LESION
Gross
$7,043
23333
$6,769
SOFT TISS FB REMVL LFT SHLDR DEEP
Gross
$6,769
23333
$6,769
SOFT TISS FB REMVL LFT SHLDR DEEP,LEFT SIDE
Gross
$6,769
24201
$6,769
SOFT TISS FB REMVL RIGHT UPPER ARM DEEP
Gross
$6,769
24201
$6,769
SOFT TISS FB REMVL RIGHT UPPER ARM DEEP,RIGHT SIDE
Gross
$6,769
27086
$6,769
SFT TISS FB REMOVAL LEFT PELVIS OR HIP
Gross
$6,769
27086
$6,769
SFT TISS FB REMOVAL LEFT PELVIS OR HIP,LEFT SIDE
Gross
$6,769
J3262
$6,730
TOCILIZUMAB (ACTEMRA) INJ [400MG/20ML]
Gross
$6,730
Q0249
$6,730
TOCILIZUMAB (ACTEMRA) INJ [400MG/20ML]
Gross
$6,730
56740
$6,699
BARTHOLIN GLAND-CYST
Gross
$6,699
58600
$6,699
LAP TUBAL
Gross
$6,699
Q4196
$6,500
WC-PURAPLYAM-COM 5X5
Gross
$6,500
20240
$6,054
BONE BIOPSY - EXCISIONAL
Gross
$6,054
Q4101
$5,828
APLIGRAF 44 SQ CM
Gross
$5,828
Q4106
$5,625
DERMAGRAFT 38 SQ CM
Gross
$5,625
Q5136
$4,600
DENOSUMAB bbdz (JUBBONTI) INJ [60MG/ML]
Gross
$4,600
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| Q4341 | WC-SIMPLIMAX 4X4 ALLOGRAFT | $80,000 | $80,000 | — | — | 9 |
| C1882 | AICD OTHE THAN SING/DUAL | $64,500 | $64,500 | — | — | 8 |
| C1721 | AICD DUAL CHAMBER | $57,000 | $57,000 | — | — | 8 |
| J2997 | ALTEPLASE (ACTIVASE) FOR INJ [100MG] | $31,681 | $31,681 | — | — | 10 |
| J3101 | TENECTEPLASE IV KIT [50MG] | $29,870 | $29,870 | — | — | 10 |
| 37244 | REBOA | $26,539 | $26,539 | — | — | 10 |
| 40804 | SOFT TISS FB REMOV VESTIBULE OF MOUTH | $21,260 | $21,260 | — | — | 10 |
| J3380 | VEDOLIZUMAB (ENTYVIO) INJ [300MG] | $20,990 | $20,990 | — | — | 10 |
| C1785 | ACCENT DR RFPACEMAKER | $15,885 | $15,885 | — | — | 8 |
| 19307 | MAST MOD RAD | $15,534 | $15,534 | — | — | 10 |
| J2505 | PEGFILGRASTIM (NEULASTA SYR[6MG\0.6ML]## | $15,233 | $9,140 | — | — | 10 |
| J1162 | DIGOXIN IMMUNE FAB INJ [40MG] (DIGIFAB)* | $15,020 | $15,020 | — | — | 10 |
| Q4197 | PURAPLY XT 25 SQ CM | $13,500 | $13,500 | — | — | 9 |
| Q4309 | VIA MATRIX 2X3 | $13,000 | $13,000 | — | — | 9 |
| C1777 | LEAD AICD ENDO SING COL | $12,000 | $12,000 | — | — | 8 |
| J0840 | CROTALIDAE POLYVA IMMUNE FAB(CROFAB)VIAL | $11,740 | $11,740 | — | — | 9 |
| Q4196 | PURAPLY AM 25 SQ CM | $10,688 | $10,688 | — | — | 9 |
| Q4159 | AFFINITY 7 SQ CM | $10,621 | $10,621 | — | — | 9 |
| J1306 | INCLISIRAN (LEQVIO) INJ [284MG/1.5ML] | $9,750 | $9,750 | — | — | 10 |
| 275 | PACEMAKER | $9,553 | $9,553 | — | — | 8 |
| 15273 | WC SKIN SUB GRFT T/ARM/LG CHILD | $8,991 | $8,991 | — | — | 10 |
| 47531 | XR CHOLANGIOGRAM T-TUBE | $8,855 | $8,855 | — | — | 10 |
| Q4194 | WC-NOVACHOR [1.5cmx2.75cm} | $8,125 | $8,125 | — | — | 8 |
| 29880 | KNEE ARTHROSCOPY | $7,711 | $7,711 | — | — | 10 |
| 27087 | SFT TISS FB REMVL LFT PELVIS OR HIP DEEP | $7,711 | $7,711 | — | — | 10 |
| 27087 | SFT TISS FB REMVL LFT PELVIS OR HIP DEEP,LEFT SIDE | $7,711 | $7,711 | — | — | 10 |
| 36555 | CENTRAL LINE <5 YEARS | $7,593 | $7,593 | — | — | 10 |
| 36555 | CENTRAL LINE <5 YEARS MOD 51,MULTIPLE PROCEDURES | $7,593 | $7,593 | — | — | 10 |
| 59409 | VAGINAL DELIVERY | $7,447 | $7,447 | — | — | 10 |
| 59414 | DELIVERY OF PLACENTA | $7,447 | $7,447 | — | — | 10 |
| J3111 | ROMOSOZUMAB (EVENITY) INJ [210MG/2.34ML] | $7,382 | $7,382 | — | — | 10 |
| 49560 | PF HERNIA INCARCER REPAIR | $7,278 | $7,278 | — | — | 18 |
| Q4197 | WC-PURAPLYAM XT {4.9x4.91} DRESSING | $7,063 | $7,063 | — | — | 9 |
| J0630 | CALCITONIN (MIACALCIN) INJ [400UNIT/2ML] | $7,047 | $7,047 | — | — | 10 |
| 19120 | REMOVAL OF BREAST LESION | $7,043 | $7,043 | — | — | 19 |
| 23333 | SOFT TISS FB REMVL LFT SHLDR DEEP | $6,769 | $6,769 | — | — | 10 |
| 23333 | SOFT TISS FB REMVL LFT SHLDR DEEP,LEFT SIDE | $6,769 | $6,769 | — | — | 10 |
| 24201 | SOFT TISS FB REMVL RIGHT UPPER ARM DEEP | $6,769 | $6,769 | — | — | 10 |
| 24201 | SOFT TISS FB REMVL RIGHT UPPER ARM DEEP,RIGHT SIDE | $6,769 | $6,769 | — | — | 10 |
| 27086 | SFT TISS FB REMOVAL LEFT PELVIS OR HIP | $6,769 | $6,769 | — | — | 10 |
| 27086 | SFT TISS FB REMOVAL LEFT PELVIS OR HIP,LEFT SIDE | $6,769 | $6,769 | — | — | 10 |
| J3262 | TOCILIZUMAB (ACTEMRA) INJ [400MG/20ML] | $6,730 | $6,730 | — | — | 10 |
| Q0249 | TOCILIZUMAB (ACTEMRA) INJ [400MG/20ML] | $6,730 | $6,730 | — | — | 10 |
| 56740 | BARTHOLIN GLAND-CYST | $6,699 | $6,699 | — | — | 10 |
| 58600 | LAP TUBAL | $6,699 | $6,699 | — | — | 10 |
| Q4196 | WC-PURAPLYAM-COM 5X5 | $6,500 | $6,500 | — | — | 9 |
| 20240 | BONE BIOPSY - EXCISIONAL | $6,054 | $6,054 | — | — | 10 |
| Q4101 | APLIGRAF 44 SQ CM | $5,828 | $5,828 | — | — | 10 |
| Q4106 | DERMAGRAFT 38 SQ CM | $5,625 | $5,625 | — | — | 10 |
| Q5136 | DENOSUMAB bbdz (JUBBONTI) INJ [60MG/ML] | $4,600 | $4,600 | — | — | 9 |
Showing top 50 of 2,287 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.