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
1,759
Insurances with rates
4
CPT / HCPCS codes
1,552
Source MRF
Most expensive procedures (gross)
J2997
$11,228
ALTEPLASE [ACTIVASE] INJ 100MG
Gross
$22,456
J3101
$9,931
TENECTEPLASE (TNKASE) INJ [50 MG]
Gross
$19,863
J2505
$4,551
PEGFILGRASTIM [NEULASTA] 0.6ML
Gross
$9,103
J0840
$4,071
CROTALIDAE IMMUNE FAB [CROFAB] INJ/VIAL
Gross
$8,142
60220
$4,377
TOTAL THYROID LOBECTOMY
Gross
$7,295
74178
$3,395
CT ABD & PELVIS W W/O
Gross
$5,659
81162
$3,468
BRCA Panel (BRCA1, BRCA2)
Gross
$4,954
74177
$3,395
CT ABD & PELVIS W
Gross
$4,850
74176
$3,056
CT ABD & PELVIS WO
Gross
$4,365
78452
$3,006
NM SPECT MULT REST STRESS
Gross
$4,294
72158
$2,977
MRI SPINE LUMBAR WWO
Gross
$4,253
78451
$2,890
NM SPECT SING REST STRESS
Gross
$4,128
70553
$2,874
MRI BRAIN W WO
Gross
$4,106
71275
$2,856
CT ANGIOGRAPHY CHEST W
Gross
$4,080
72159
$2,825
MRA SPINAL CANAL WWO
Gross
$4,035
21556
$2,807
EXC TUMOR DP SUBFAS IM
Gross
$4,010
71555
$2,739
MRA CHEST W WO
Gross
$3,913
71552
$2,739
MRI CHEST W WO
Gross
$3,913
38500
$2,726
BIOPSY LYMPH NODE SUPER
Gross
$3,894
95811
$2,722
POLYSOMNOGRAPHY 6+ W POSITIVE AIRWAY PRE
Gross
$3,889
72156
$2,718
MRI SPINE CERV WWO
Gross
$3,883
72142
$2,609
MRI SPINE CERV W
Gross
$3,727
73723LT
$2,568
MRI EXT LOW LT JT WWO
Gross
$3,669
73723RT
$2,568
MRI EXT LOW RT JT WWO
Gross
$3,669
74175
$2,519
CT ANGOABDOMEN W
Gross
$3,599
74174
$2,519
CT ANGIO ABD & PELVIS W
Gross
$3,599
72149
$2,503
MRI SPINE LUMBAR W
Gross
$3,576
71551
$2,475
MRI CHEST W
Gross
$3,535
71550
$2,475
MRI CHEST WO
Gross
$3,535
72197
$2,411
MRI PELVIS W WO
Gross
$3,444
72141
$2,406
MRI SPINE CERV WO
Gross
$3,437
70546
$2,395
MRA HEAD W WO
Gross
$3,421
74183
$2,393
MRI ABDOMEN W WO
Gross
$3,418
74185
$2,393
MRA ABDOMEN W WO
Gross
$3,418
72198
$2,383
MRA PELVIS W OR WO
Gross
$3,404
72196
$2,383
MRI PELVIS W
Gross
$3,404
95810
$2,376
POLYSOMNOGRAPHY 6+
Gross
$3,394
71270
$2,374
CT CHEST/THORAX W WO
Gross
$3,392
71271
$2,374
CT LOW DOSE LUNG CA SCREEN
Gross
$3,392
36245
$2,372
CATH PLACEMENT ABD/L EXT
Gross
$3,389
72157
$2,349
MRI SPINE THORAC WWO
Gross
$3,356
78454
$2,342
NM THALL MULT REST STRESS
Gross
$3,346
73725LT
$2,341
MRA EXT LOW LT WWO
Gross
$3,344
73725RT
$2,341
MRA EXT LOW RT WWO
Gross
$3,344
73225LT
$2,341
MRA EXT UPP LT WWO
Gross
$3,344
73225RT
$2,341
MRA EXT UPP RT WWO
Gross
$3,344
75561
$2,341
MRI CARDIAC W
Gross
$3,344
75557
$2,341
MRI CARDIAC WO
Gross
$3,344
73720LT
$2,341
MRI EXT LOW LT WWO
Gross
$3,344
73720RT
$2,341
MRI EXT LOW RT WWO
Gross
$3,344
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J2997 | ALTEPLASE [ACTIVASE] INJ 100MG | $22,456 | $11,228 | — | — | 0 |
| J3101 | TENECTEPLASE (TNKASE) INJ [50 MG] | $19,863 | $9,931 | — | — | 0 |
| J2505 | PEGFILGRASTIM [NEULASTA] 0.6ML | $9,103 | $4,551 | — | — | 0 |
| J0840 | CROTALIDAE IMMUNE FAB [CROFAB] INJ/VIAL | $8,142 | $4,071 | — | — | 0 |
| 60220 | TOTAL THYROID LOBECTOMY | $7,295 | $4,377 | — | — | 0 |
| 74178 | CT ABD & PELVIS W W/O | $5,659 | $3,395 | — | — | 0 |
| 81162 | BRCA Panel (BRCA1, BRCA2) | $4,954 | $3,468 | — | — | 0 |
| 74177 | CT ABD & PELVIS W | $4,850 | $3,395 | — | — | 0 |
| 74176 | CT ABD & PELVIS WO | $4,365 | $3,056 | — | — | 0 |
| 78452 | NM SPECT MULT REST STRESS | $4,294 | $3,006 | — | — | 0 |
| 72158 | MRI SPINE LUMBAR WWO | $4,253 | $2,977 | — | — | 0 |
| 78451 | NM SPECT SING REST STRESS | $4,128 | $2,890 | — | — | 0 |
| 70553 | MRI BRAIN W WO | $4,106 | $2,874 | — | — | 0 |
| 71275 | CT ANGIOGRAPHY CHEST W | $4,080 | $2,856 | — | — | 0 |
| 72159 | MRA SPINAL CANAL WWO | $4,035 | $2,825 | — | — | 0 |
| 21556 | EXC TUMOR DP SUBFAS IM | $4,010 | $2,807 | — | — | 0 |
| 71555 | MRA CHEST W WO | $3,913 | $2,739 | — | — | 0 |
| 71552 | MRI CHEST W WO | $3,913 | $2,739 | — | — | 0 |
| 38500 | BIOPSY LYMPH NODE SUPER | $3,894 | $2,726 | — | — | 0 |
| 95811 | POLYSOMNOGRAPHY 6+ W POSITIVE AIRWAY PRE | $3,889 | $2,722 | — | — | 0 |
| 72156 | MRI SPINE CERV WWO | $3,883 | $2,718 | — | — | 0 |
| 72142 | MRI SPINE CERV W | $3,727 | $2,609 | — | — | 0 |
| 73723LT | MRI EXT LOW LT JT WWO | $3,669 | $2,568 | — | — | 0 |
| 73723RT | MRI EXT LOW RT JT WWO | $3,669 | $2,568 | — | — | 0 |
| 74175 | CT ANGOABDOMEN W | $3,599 | $2,519 | — | — | 0 |
| 74174 | CT ANGIO ABD & PELVIS W | $3,599 | $2,519 | — | — | 0 |
| 72149 | MRI SPINE LUMBAR W | $3,576 | $2,503 | — | — | 0 |
| 71551 | MRI CHEST W | $3,535 | $2,475 | — | — | 0 |
| 71550 | MRI CHEST WO | $3,535 | $2,475 | — | — | 0 |
| 72197 | MRI PELVIS W WO | $3,444 | $2,411 | — | — | 0 |
| 72141 | MRI SPINE CERV WO | $3,437 | $2,406 | — | — | 0 |
| 70546 | MRA HEAD W WO | $3,421 | $2,395 | — | — | 0 |
| 74183 | MRI ABDOMEN W WO | $3,418 | $2,393 | — | — | 0 |
| 74185 | MRA ABDOMEN W WO | $3,418 | $2,393 | — | — | 0 |
| 72198 | MRA PELVIS W OR WO | $3,404 | $2,383 | — | — | 0 |
| 72196 | MRI PELVIS W | $3,404 | $2,383 | — | — | 0 |
| 95810 | POLYSOMNOGRAPHY 6+ | $3,394 | $2,376 | — | — | 0 |
| 71270 | CT CHEST/THORAX W WO | $3,392 | $2,374 | — | — | 0 |
| 71271 | CT LOW DOSE LUNG CA SCREEN | $3,392 | $2,374 | — | — | 0 |
| 36245 | CATH PLACEMENT ABD/L EXT | $3,389 | $2,372 | — | — | 0 |
| 72157 | MRI SPINE THORAC WWO | $3,356 | $2,349 | — | — | 0 |
| 78454 | NM THALL MULT REST STRESS | $3,346 | $2,342 | — | — | 0 |
| 73725LT | MRA EXT LOW LT WWO | $3,344 | $2,341 | — | — | 0 |
| 73725RT | MRA EXT LOW RT WWO | $3,344 | $2,341 | — | — | 0 |
| 73225LT | MRA EXT UPP LT WWO | $3,344 | $2,341 | — | — | 0 |
| 73225RT | MRA EXT UPP RT WWO | $3,344 | $2,341 | — | — | 0 |
| 75561 | MRI CARDIAC W | $3,344 | $2,341 | — | — | 0 |
| 75557 | MRI CARDIAC WO | $3,344 | $2,341 | — | — | 0 |
| 73720LT | MRI EXT LOW LT WWO | $3,344 | $2,341 | — | — | 0 |
| 73720RT | MRI EXT LOW RT WWO | $3,344 | $2,341 | — | — | 0 |
Showing top 50 of 1,759 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.