CHILDREN'S HOSPITAL COLORADO - COLORADO SPRINGS

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J1413	DELANDISTROGENE MOXEPARVO-ROKL 10 X 10 ML IV KIT	$5,333,333	$3,466,667	—	—	5
J3394	HB=LOVOTIBEGLOGENE AUTOTEMCEL PER TX	$5,166,667	$3,358,333	—	—	5
J3393	HB=BETIBEGLOGENE AUTOTEMCEL PER TX	$4,666,667	$3,033,333	—	—	5
J3399	ONASEMNOGENE ABEPARVOVEC-XIOI 2X8.3 ML IV KIT	$4,072,917	$2,647,396	—	—	2
J3392	HB=EXAGAMGLOGENE AUTOTEMCEL PER TX	$3,666,667	$2,383,333	—	—	5
Q2042	HB=CAR-T AGENT (PALL)	$878,227	$570,848	—	—	5
J3402	HB=REMESTEMCEL-L-RKND PER TX DOSE	$323,333	$210,167	—	—	5
J9226	HISTRELIN ACETATE (CPP) 50 MG SC KIT	$240,877	$156,570	—	—	5
J2326	NUSINERSEN 12 MG/5ML IT SOLUTION	$228,175	$148,314	—	—	5
C9293	GLUCARPIDASE 1000 UNITS IV RECON SOLN	$207,528	$134,893	—	—	5
Q0508	KIT IMPLANT HEARTMATE 3 LVAD 106524US ABBOTT EA	$199,850	$129,903	—	—	6
J0801	CORTICOTROPIN 80 UNIT/ML INJ GEL	$163,373	$106,193	—	—	10
J9118	CALASPARGASE PEGOL-MKNL 3750 UNIT/5ML IV SOLUTION	$139,403	$90,612	—	—	5
J1951	LEUPROLIDE ACETATE (PED)(6MON) 45 MG SC KIT	$131,737	$85,629	—	—	10
J9266	PEGASPARGASE 750 UNIT/ML INJ SOLUTION	$128,743	$83,683	—	—	5
J9348	NAXITAMAB-GQGK 40 MG/10ML IV SOLUTION	$125,131	$81,335	—	—	5
J3401	BEREMAGENE GEPERPAVEC-SVDT (VYJUVEK) (5X10^9 PFU/2.5 ML) TOPICAL SOLUTION	$121,114	$78,724	—	—	10
0320	HB=IR PURCHASED SERVICES	$115,226	$74,897	—	—	5
J9229	INOTUZUMAB OZOGAMICIN 0.9 MG IV RECON SOLN	$114,827	$74,637	—	—	5
J3316	TRIPTORELIN PAMOATE ER (CPP) 22.5 MG IM REC SUSP ER	$107,044	$69,578	—	—	5
0811	QOR=LIVING DONOR	$103,857	$67,507	—	—	5
J0638	CANAKINUMAB 150 MG/ML SC SOLUTION	$102,655	$66,726	—	—	5
J9274	TEBENTAFUSP-TEBN 100 MCG/0.5ML IV SOLUTION	$100,782	$65,508	—	—	5
J2350	OCRELIZUMAB 300 MG/10ML IV SOLUTION	$99,092	$64,410	—	—	5
0812	QOR=LIVER PROCUREMENT	$98,000	$63,700	—	—	5
93654	HB=COMP EP EVAL W ABLATION VENTRIC TACHYCARDIA	$92,566	$60,168	—	—	6
93656	HB=COMP EP EVAL W ABLATION PULM VEIN ISOLATION	$92,235	$59,953	—	—	6
J9999	DINUTUXIMAB 17.5 MG/5ML IV SOLUTION	$91,442	$59,437	—	—	5
0681	HB=TRAUMA 1 ACTIVATE RED	$80,878	$52,571	—	—	5
33880	HB=ENDOVASC REPAIR TA W/SUBCLAV	$79,456	$51,646	—	—	6
38210	HB=CD34 SELECTION	$76,747	$49,886	—	—	5
0483T	HB=TRANSCATH MITRAL VALVE PERC PLACEMENT	$76,040	$49,426	—	—	6
J0567	CERLIPONASE ALFA 2 X 150 MG/5ML VE KIT	$75,900	$49,335	—	—	5
33249	HB=INSERT/REPLACE DEFIB W/LEADS SGL/DUAL	$75,100	$48,815	—	—	6
0646T	HB=TRANSCATH TRICUSPID VALVE IMPL/REPL PERC W/RHC ANGIO	$74,289	$48,288	—	—	6
C1767	RNS STIMULATOR RNS-320-K NEUROPACE EA	$70,500	$45,825	—	—	6
J3357	USTEKINUMAB 90 MG/ML SC SOL PFIL SYR	$69,974	$45,483	—	—	5
J9043	CABAZITAXEL 60 MG/1.5ML IV SOLUTION	$69,971	$45,481	—	—	5
90951	HB=ESRD RELATED SVC MTHLY < 2 YR OLD 4/> VISITS	$65,604	$42,643	—	—	5
33956	HB=INSERT CENTRAL CANNULA STERN/THORA => 6 YRS	$64,582	$41,978	—	—	5
93590	HB=PERC TRANSCATH CLOSURE PARAVALV LEAK MITRAL INITIAL DEVICE	$61,227	$39,798	—	—	6
J9042	BRENTUXIMAB VEDOTIN 50 MG IV RECON SOLN	$60,874	$39,568	—	—	5
93581	HB=PERC TRANSCATH CLOSURE CONGEN VSD W/IMP	$58,965	$38,327	—	—	6
33477	HB=TRANSCATH PULM VALVE IMPLANT PERC INCL PRE-STENT	$58,171	$37,811	—	—	6
90288	BOTULISM IMMUNE GLOBULIN HUMAN 100 MG IV RECON SOLN	$57,300	$37,245	—	—	10
90957	HB=ESRD RELATED SVC MTHLY 12-19 YR OLD 4/> VISITS	$57,198	$37,179	—	—	5
33214	HB=UPGRADE SGL TO DUAL PPM	$56,505	$36,728	—	—	6
33229	HB=REMOVE/REPLACE PPM GEN MULT LEAD SYS	$55,207	$35,885	—	—	6
33208	HB=INSERT/REPLACE PERM PMKR ATRIAL/VENT	$55,197	$35,878	—	—	6
93653	HB=COMP EP EVAL W ABLATION SUPRAVENT ARRHYTHMIA	$54,818	$35,632	—	—	6

Showing top 50 of 5,495 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.