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
17,843
Insurances with rates
41
CPT / HCPCS codes
12,432
Source MRF
Most expensive procedures (gross)
4283
$27,183
Injection, digoxin immune fab (ovine), per vial
Gross
$27,183
595765
$26,158
Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram
Gross
$26,158
115504
$25,025
Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff,
Gross
$25,025
115499
$24,886
Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calc
Gross
$24,886
594773
$23,351
Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, foll
Gross
$23,351
122587
$21,872
Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
Gross
$21,872
7611
$21,662
Injection, tenecteplase, 1 mg
Gross
$21,662
595786
$21,621
Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontra
Gross
$21,621
594772
$21,100
Computed tomography, abdomen and pelvis; with contrast material(s)
Gross
$21,100
122475
$19,549
Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or
Gross
$19,549
115503
$18,976
Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with co
Gross
$18,976
594771
$18,870
Computed tomography, abdomen and pelvis; without contrast material
Gross
$18,870
115501
$18,298
Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morpholo
Gross
$18,298
121420
$17,561
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep,
Gross
$17,561
122474
$16,467
Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or
Gross
$16,467
879554
$15,680
Allowrap ds or dry, per square centimeter (add-on, list separately in addition to primary procedure)
Gross
$15,680
117424
$15,405
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo
Gross
$15,405
117425
$15,187
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo
Gross
$15,187
117423
$14,803
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo
Gross
$14,803
115462
$14,506
Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, i
Gross
$14,506
117418
$14,413
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material
Gross
$14,413
117102
$14,370
Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, rec
Gross
$14,370
117422
$14,326
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s
Gross
$14,326
117472
$14,217
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with con
Gross
$14,217
117411
$13,866
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, fo
Gross
$13,866
117402
$13,787
Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), fol
Gross
$13,787
117429
$13,787
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast
Gross
$13,787
117416
$13,787
Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphade
Gross
$13,787
115494
$13,777
Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images,
Gross
$13,777
117534
$13,756
Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardi
Gross
$13,756
117420
$13,617
Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material
Gross
$13,617
115452
$13,573
Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontr
Gross
$13,573
115448
$13,413
Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if
Gross
$13,413
121916
$13,379
Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording,
Gross
$13,379
117405
$12,857
Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s)
Gross
$12,857
117531
$12,767
Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral
Gross
$12,767
117546
$12,691
Magnetic resonance angiography without contrast followed by with contrast, pelvis
Gross
$12,691
117521
$12,691
Magnetic resonance angiography without contrast followed by with contrast, abdomen
Gross
$12,691
116325
$12,451
Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thor
Gross
$12,451
117520
$12,356
Magnetic resonance angiography without contrast, abdomen
Gross
$12,356
121421
$12,106
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep,
Gross
$12,106
121419
$12,106
Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation
Gross
$12,106
115455
$12,094
Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and
Gross
$12,094
115465
$12,041
Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further
Gross
$12,041
115461
$12,041
Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and f
Gross
$12,041
116820
$11,973
Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retr
Gross
$11,973
117417
$11,666
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast mater
Gross
$11,666
117404
$11,620
Magnetic resonance angiography, head; with contrast material(s)
Gross
$11,620
117410
$11,620
Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)
Gross
$11,620
117421
$11,587
Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast materia
Gross
$11,587
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 4283 | Injection, digoxin immune fab (ovine), per vial | $27,183 | $27,183 | $4,919 | $4,919 | 4 |
| 595765 | Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram | $26,158 | $26,158 | $3,014 | $3,014 | 1 |
| 115504 | Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, | $25,025 | $25,025 | $402 | $3,879 | 9 |
| 115499 | Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calc | $24,886 | $24,886 | $1,087 | $13,970 | 16 |
| 594773 | Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, foll | $23,351 | $23,351 | $1,087 | $1,462 | 5 |
| 122587 | Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries | $21,872 | $21,872 | $1,531 | $1,531 | 1 |
| 7611 | Injection, tenecteplase, 1 mg | $21,662 | $21,662 | $161 | $161 | 4 |
| 595786 | Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontra | $21,621 | $21,621 | $1,087 | $1,462 | 5 |
| 594772 | Computed tomography, abdomen and pelvis; with contrast material(s) | $21,100 | $21,100 | $1,087 | $1,462 | 5 |
| 122475 | Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or | $19,549 | $19,549 | $3,359 | $3,430 | 3 |
| 115503 | Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with co | $18,976 | $18,976 | $402 | $4,630 | 11 |
| 594771 | Computed tomography, abdomen and pelvis; without contrast material | $18,870 | $18,870 | $1,087 | $1,462 | 5 |
| 115501 | Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morpholo | $18,298 | $18,298 | $1,087 | $13,970 | 16 |
| 121420 | Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, | $17,561 | $17,561 | — | — | 3 |
| 122474 | Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or | $16,467 | $16,467 | $4,506 | $4,601 | 3 |
| 879554 | Allowrap ds or dry, per square centimeter (add-on, list separately in addition to primary procedure) | $15,680 | $15,680 | $81.93 | $81.93 | 1 |
| 117424 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo | $15,405 | $15,405 | $828 | $3,879 | 9 |
| 117425 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo | $15,187 | $15,187 | $828 | $3,879 | 9 |
| 117423 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo | $14,803 | $14,803 | $828 | $3,879 | 9 |
| 115462 | Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, i | $14,506 | $14,506 | $402 | $3,879 | 9 |
| 117418 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material | $14,413 | $14,413 | $828 | $3,879 | 9 |
| 117102 | Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH electrode placement, rec | $14,370 | $14,370 | $405 | $413 | 3 |
| 117422 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s | $14,326 | $14,326 | $1,499 | $2,012 | 5 |
| 117472 | Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with con | $14,217 | $14,217 | $828 | $3,879 | 9 |
| 117411 | Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, fo | $13,866 | $13,866 | $828 | $3,879 | 9 |
| 117402 | Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), fol | $13,787 | $13,787 | $828 | $3,879 | 9 |
| 117429 | Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast | $13,787 | $13,787 | $828 | $3,879 | 9 |
| 117416 | Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphade | $13,787 | $13,787 | $1,499 | $2,012 | 5 |
| 115494 | Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, | $13,777 | $13,777 | $1,087 | $1,462 | 5 |
| 117534 | Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardi | $13,756 | $13,756 | $1,499 | $2,012 | 5 |
| 117420 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material | $13,617 | $13,617 | $1,941 | $1,982 | 3 |
| 115452 | Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontr | $13,573 | $13,573 | $402 | $3,879 | 9 |
| 115448 | Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if | $13,413 | $13,413 | $402 | $3,879 | 9 |
| 121916 | Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, | $13,379 | $13,379 | — | — | 3 |
| 117405 | Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) | $12,857 | $12,857 | $828 | $3,879 | 9 |
| 117531 | Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral | $12,767 | $12,767 | $1,499 | $2,012 | 5 |
| 117546 | Magnetic resonance angiography without contrast followed by with contrast, pelvis | $12,691 | $12,691 | $1,499 | $2,012 | 5 |
| 117521 | Magnetic resonance angiography without contrast followed by with contrast, abdomen | $12,691 | $12,691 | $828 | $828 | 1 |
| 116325 | Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thor | $12,451 | $12,451 | — | — | 3 |
| 117520 | Magnetic resonance angiography without contrast, abdomen | $12,356 | $12,356 | $518 | $518 | 1 |
| 121421 | Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, | $12,106 | $12,106 | $516 | $527 | 3 |
| 121419 | Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation | $12,106 | $12,106 | $5,017 | $5,123 | 3 |
| 115455 | Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and | $12,094 | $12,094 | $1,087 | $1,462 | 5 |
| 115465 | Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further | $12,041 | $12,041 | $402 | $3,879 | 9 |
| 115461 | Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and f | $12,041 | $12,041 | $1,087 | $1,462 | 5 |
| 116820 | Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retr | $11,973 | $11,973 | — | — | 3 |
| 117417 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast mater | $11,666 | $11,666 | $518 | $3,879 | 9 |
| 117404 | Magnetic resonance angiography, head; with contrast material(s) | $11,620 | $11,620 | $828 | $3,879 | 9 |
| 117410 | Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) | $11,620 | $11,620 | $828 | $3,879 | 9 |
| 117421 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast materia | $11,587 | $11,587 | $518 | $3,879 | 9 |
Showing top 50 of 17,843 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.