HCA FLORIDA LAKE CITY HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
78452	Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or	$23,745	$23,745	$3,359	$3,536	3
75736	Angiography, pelvic, selective or supraselective, radiological supervision and interpretation	$20,377	$20,377	—	—	3
75726	Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological s	$20,377	$20,377	$3,962	$4,171	3
75605	Aortography, thoracic, by serialography, radiological supervision and interpretation UNSCHEDULED	$20,377	$20,377	$2,100	$2,210	3
0042T	Cerebral perfusion analysis using computed tomography with contrast administration, including post-p	$19,240	$19,240	$968	$1,266	3
78804	Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutic	$18,904	$18,904	—	—	3
75630	Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radio	$17,459	$17,459	—	—	3
75716	Angiography, extremity, bilateral, radiological supervision and interpretation UNSCHEDULED	$15,959	$15,959	$2,100	$2,210	3
75989	Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous draina	$13,381	$13,381	$625	$658	3
75756	Angiography, internal mammary, radiological supervision and interpretation	$13,174	$13,174	—	—	3
77012	Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization d	$12,518	$12,518	$968	$1,266	3
78306	Bone and/or joint imaging; whole body	$11,167	$11,167	—	—	3
Q4108	Integra matrix, per square centimeter (add-on, list separately in addition to primary procedure)	$10,878	$10,878	$48.97	$48.97	1
J0840	Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram	$10,754	$10,754	$1,703	$1,703	4
78278	Acute gastrointestinal blood loss imaging UNSCHEDULED	$10,206	$10,206	$1,906	$2,007	3
78802	Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutic	$9,943	$9,943	—	—	3
J1162	Injection, digoxin immune fab (ovine), per vial	$9,325	$9,325	$4,820	$4,820	4
78708	Kidney imaging morphology; with vascular flow and function, single study, with pharmacological inter	$8,853	$8,853	$1,906	$2,007	3
70542	Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) UNSCHED	$8,845	$8,845	$2,070	$2,179	3
72149	Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s	$8,845	$8,845	$5,067	$5,334	3
70546	Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s)	$8,845	$8,845	$1,392	$1,816	3
72142	Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material	$8,845	$8,845	$1,392	$1,816	3
78264	Gastric emptying imaging study (eg, solid, liquid, or both); UNSCHEDULED	$8,260	$8,260	$1,906	$2,007	3
78709	Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharm	$7,903	$7,903	$1,906	$2,007	3
78707	Kidney imaging morphology; with vascular flow and function, single study without pharmacological int	$7,903	$7,903	$1,906	$2,007	3
75625	Aortography, abdominal, by serialography, radiological supervision and interpretation	$7,821	$7,821	—	—	3
78195	Lymphatics and lymph nodes imaging UNSCHEDULED	$7,527	$7,527	$1,906	$2,007	3
78451	Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or	$7,513	$7,513	$4,506	$4,743	3
78215	Liver and spleen imaging; static only UNSCHEDULED	$7,194	$7,194	$1,814	$1,910	3
78070	Parathyroid planar imaging (including subtraction, when performed);	$6,960	$6,960	—	—	3
78580	Pulmonary perfusion imaging (eg, particulate) UNSCHEDULED	$6,953	$6,953	$2,942	$3,097	3
78315	Bone and/or joint imaging; 3 phase study UNSCHEDULED	$6,410	$6,410	$1,906	$2,007	3
77301	Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical stru	$6,246	$6,246	$3,467	$3,649	3
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct s	$6,145	$6,145	$42.08	$42.08	4
73523	Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views	$6,071	$6,071	—	—	3
75774	Angiography, selective, each additional vessel studied after basic examination, radiological supervi	$5,934	$5,934	—	—	3
78803	Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutic	$5,765	$5,765	$1,906	$2,007	3
J0841	Injection, crotalidae immune f(ab')2 (equine), 120 mg	$5,544	$5,544	$1,012	$1,012	4
93923	Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more l	$5,262	$5,262	—	—	3
93320	Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately	$5,066	$5,066	$1,541	$1,622	3
93024	Ergonovine provocation test UNSCHEDULED	$4,930	$4,930	$1,252	$1,318	3
J2407	Injection, oritavancin (orbactiv), 10 mg	$4,876	$4,876	$27.67	$27.67	4
J3262	Injection, tocilizumab, 1 mg	$4,781	$4,781	$5.7	$5.7	4
74270	Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when pe	$4,542	$4,542	—	—	3
74280	Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when pe	$4,491	$4,491	—	—	3
J2325	Injection, nesiritide, 0.1 mg	$4,407	$4,407	—	—	3
74246	Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and de	$4,344	$4,344	—	—	3
78300	Bone and/or joint imaging; limited area	$4,328	$4,328	—	—	3
78012	Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression,	$4,280	$4,280	—	—	3
J0130	Injection abciximab, 10 mg	$4,122	$4,122	—	—	3

Showing top 50 of 18,304 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.