45 CFR § 180 compliance
C · 70
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
18,968
Insurances with rates
51
CPT / HCPCS codes
13,458
Source MRF
Most expensive procedures (gross)
596081
$186,822
Injection, pegloticase, 1 mg
Gross
$186,822
8904
$179,776
Injection, pegaspargase, per single dose vial
Gross
$179,776
122626
$147,404
Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
Gross
$147,404
795387
$94,986
Injection, atezolizumab, 10 mg
Gross
$94,986
796281
$88,215
Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
Gross
$88,215
798927
$85,549
Injection, vedolizumab, intravenous, 1 mg
Gross
$85,549
17196
$73,688
Not otherwise classified, antineoplastic drugs
Gross
$73,688
795971
$72,672
Injection, caplacizumab-yhdp, 1 mg
Gross
$72,672
796984
$68,445
Injection, mirvetuximab soravtansine-gynx, 1 mg
Gross
$68,445
122606
$65,036
Indium in-111 pentetate, diagnostic, per 0.5 millicurie
Gross
$65,036
159848
$65,036
Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries
Gross
$65,036
122539
$61,388
Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck)
Gross
$61,388
791167
$54,389
Injection, pertuzumab, 1 mg
Gross
$54,389
792646
$48,984
Injection, pembrolizumab, 1 mg
Gross
$48,984
8969
$38,228
Injection, pemetrexed, not otherwise specified, 10 mg
Gross
$38,228
790789
$37,014
Injection, ado-trastuzumab emtansine, 1 mg
Gross
$37,014
796431
$36,681
Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg
Gross
$36,681
121421
$35,899
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep,
Gross
$35,899
115551
$35,638
Injection, clofarabine, 1 mg
Gross
$35,638
796981
$33,567
Injection, allopurinol sodium, 1 mg
Gross
$33,567
792953
$33,429
Injection, trabectedin, 0.1 mg
Gross
$33,429
587297
$32,496
Injection, bendamustine hydrochloride, 1 mg
Gross
$32,496
278
$32,000
Brachytherapy source, non-stranded, yttrium-90, per source
Gross
$32,000
122625
$29,524
Strontium sr-89 chloride, therapeutic, per millicurie
Gross
$29,524
869152
$29,342
Integra flowable wound matrix, injectable, 1 cc
Gross
$29,342
121420
$27,646
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep,
Gross
$27,646
121532
$25,281
Induction of arrhythmia by electrical pacing
Gross
$25,281
7543
$24,339
Injection, reteplase, 18.1 mg
Gross
$24,339
122587
$22,633
Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
Gross
$22,633
8906
$22,379
Injection, pentostatin, 10 mg
Gross
$22,379
117424
$20,944
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo
Gross
$20,944
117423
$20,270
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo
Gross
$20,270
117425
$20,150
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo
Gross
$20,150
8999
$19,488
Injection, temsirolimus, 1 mg
Gross
$19,488
117411
$19,013
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, fo
Gross
$19,013
7619
$18,920
Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial
Gross
$18,920
115723
$18,229
Venography, adrenal, bilateral, selective, radiological supervision and interpretation
Gross
$18,229
115709
$18,229
Splenoportography, radiological supervision and interpretation
Gross
$18,229
115728
$18,229
Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and inte
Gross
$18,229
115693
$18,229
Angiography, adrenal, bilateral, selective, radiological supervision and interpretation UNSCHEDULED
Gross
$18,229
115683
$18,229
Angiography, spinal, selective, radiological supervision and interpretation UNSCHEDULED
Gross
$18,229
115731
$18,229
Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and int
Gross
$18,229
115720
$18,229
Venography, renal, bilateral, selective, radiological supervision and interpretation
Gross
$18,229
115691
$18,229
Angiography, adrenal, unilateral, selective, radiological supervision and interpretation
Gross
$18,229
115725
$17,694
Venography, superior sagittal sinus, radiological supervision and interpretation
Gross
$17,694
795833
$17,000
Ustekinumab, for intravenous injection, 1 mg
Gross
$17,000
117429
$16,188
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast
Gross
$16,188
117402
$16,188
Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), fol
Gross
$16,188
117472
$16,188
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with con
Gross
$16,188
121419
$16,085
Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation
Gross
$16,085
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 596081 | Injection, pegloticase, 1 mg | $186,822 | $186,822 | $3,458 | $3,458 | 4 |
| 8904 | Injection, pegaspargase, per single dose vial | $179,776 | $179,776 | $26,258 | $26,258 | 4 |
| 122626 | Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries | $147,404 | $147,404 | $5,214 | $5,214 | 1 |
| 795387 | Injection, atezolizumab, 10 mg | $94,986 | $94,986 | $86.71 | $86.71 | 4 |
| 796281 | Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine | $88,215 | $88,215 | $242 | $242 | 4 |
| 798927 | Injection, vedolizumab, intravenous, 1 mg | $85,549 | $85,549 | $20.53 | $20.53 | 4 |
| 17196 | Not otherwise classified, antineoplastic drugs | $73,688 | $73,688 | — | — | 3 |
| 795971 | Injection, caplacizumab-yhdp, 1 mg | $72,672 | $72,672 | — | — | 3 |
| 796984 | Injection, mirvetuximab soravtansine-gynx, 1 mg | $68,445 | $68,445 | $66.03 | $66.03 | 4 |
| 122606 | Indium in-111 pentetate, diagnostic, per 0.5 millicurie | $65,036 | $65,036 | $1,230 | $1,230 | 1 |
| 159848 | Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries | $65,036 | $65,036 | $3,302 | $3,302 | 1 |
| 122539 | Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) | $61,388 | $61,388 | $2,792 | $4,574 | 5 |
| 791167 | Injection, pertuzumab, 1 mg | $54,389 | $54,389 | $15.74 | $15.74 | 4 |
| 792646 | Injection, pembrolizumab, 1 mg | $48,984 | $48,984 | $57.57 | $57.57 | 4 |
| 8969 | Injection, pemetrexed, not otherwise specified, 10 mg | $38,228 | $38,228 | $3.66 | $3.66 | 4 |
| 790789 | Injection, ado-trastuzumab emtansine, 1 mg | $37,014 | $37,014 | $39.88 | $39.88 | 4 |
| 796431 | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg | $36,681 | $36,681 | $159 | $159 | 4 |
| 121421 | Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, | $35,899 | $35,899 | — | — | 3 |
| 115551 | Injection, clofarabine, 1 mg | $35,638 | $35,638 | $15.53 | $15.53 | 4 |
| 796981 | Injection, allopurinol sodium, 1 mg | $33,567 | $33,567 | $4.32 | $4.32 | 4 |
| 792953 | Injection, trabectedin, 0.1 mg | $33,429 | $33,429 | $353 | $353 | 4 |
| 587297 | Injection, bendamustine hydrochloride, 1 mg | $32,496 | $32,496 | $1.2 | $1.2 | 4 |
| 278 | Brachytherapy source, non-stranded, yttrium-90, per source | $32,000 | $32,000 | $40,000 | $40,000 | 1 |
| 122625 | Strontium sr-89 chloride, therapeutic, per millicurie | $29,524 | $29,524 | — | — | 3 |
| 869152 | Integra flowable wound matrix, injectable, 1 cc | $29,342 | $29,342 | $1,450 | $1,450 | 1 |
| 121420 | Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, | $27,646 | $27,646 | — | — | 3 |
| 121532 | Induction of arrhythmia by electrical pacing | $25,281 | $25,281 | $6,826 | $17,341 | 3 |
| 7543 | Injection, reteplase, 18.1 mg | $24,339 | $24,339 | — | — | 3 |
| 122587 | Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries | $22,633 | $22,633 | $1,531 | $1,531 | 1 |
| 8906 | Injection, pentostatin, 10 mg | $22,379 | $22,379 | $2,593 | $2,593 | 4 |
| 117424 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo | $20,944 | $20,944 | $1,116 | $2,012 | 5 |
| 117423 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo | $20,270 | $20,270 | $1,116 | $2,012 | 5 |
| 117425 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo | $20,150 | $20,150 | $1,116 | $2,012 | 5 |
| 8999 | Injection, temsirolimus, 1 mg | $19,488 | $19,488 | $29.41 | $29.41 | 4 |
| 117411 | Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, fo | $19,013 | $19,013 | $1,116 | $2,012 | 5 |
| 7619 | Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial | $18,920 | $18,920 | $2,016 | $2,016 | 4 |
| 115723 | Venography, adrenal, bilateral, selective, radiological supervision and interpretation | $18,229 | $18,229 | — | — | 1 |
| 115709 | Splenoportography, radiological supervision and interpretation | $18,229 | $18,229 | — | — | 3 |
| 115728 | Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and inte | $18,229 | $18,229 | $2,433 | $2,484 | 3 |
| 115693 | Angiography, adrenal, bilateral, selective, radiological supervision and interpretation UNSCHEDULED | $18,229 | $18,229 | $2,433 | $2,484 | 3 |
| 115683 | Angiography, spinal, selective, radiological supervision and interpretation UNSCHEDULED | $18,229 | $18,229 | $2,433 | $2,484 | 3 |
| 115731 | Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and int | $18,229 | $18,229 | $2,433 | $2,484 | 3 |
| 115720 | Venography, renal, bilateral, selective, radiological supervision and interpretation | $18,229 | $18,229 | — | — | 3 |
| 115691 | Angiography, adrenal, unilateral, selective, radiological supervision and interpretation | $18,229 | $18,229 | — | — | 3 |
| 115725 | Venography, superior sagittal sinus, radiological supervision and interpretation | $17,694 | $17,694 | — | — | 3 |
| 795833 | Ustekinumab, for intravenous injection, 1 mg | $17,000 | $17,000 | $12.43 | $12.43 | 4 |
| 117429 | Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast | $16,188 | $16,188 | $1,116 | $2,012 | 5 |
| 117402 | Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), fol | $16,188 | $16,188 | $1,116 | $2,012 | 5 |
| 117472 | Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with con | $16,188 | $16,188 | $4,437 | $4,530 | 3 |
| 121419 | Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation | $16,085 | $16,085 | — | — | 3 |
Showing top 50 of 18,968 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.