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
18,994
Insurances with rates
45
CPT / HCPCS codes
13,781
Source MRF
Most expensive procedures (gross)
17196
$222,230
Not otherwise classified, antineoplastic drugs
Gross
$222,230
794549
$47,524
Injection, gemtuzumab ozogamicin, 0.1 mg
Gross
$47,524
799194
$38,968
Injection, edetate calcium disodium, up to 1000 mg
Gross
$38,968
122624
$38,881
Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries
Gross
$38,881
594773
$38,736
Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, foll
Gross
$38,736
159848
$36,573
Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries
Gross
$36,573
122606
$36,573
Indium in-111 pentetate, diagnostic, per 0.5 millicurie
Gross
$36,573
595786
$36,390
Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontra
Gross
$36,390
596251
$35,616
Injection, eculizumab, 2 mg
Gross
$35,616
798840
$34,239
Injection, ecallantide, 1 mg
Gross
$34,239
594772
$32,279
Computed tomography, abdomen and pelvis; with contrast material(s) UNSCHEDULED
Gross
$32,279
594771
$29,346
Computed tomography, abdomen and pelvis; without contrast material
Gross
$29,346
869152
$26,264
Integra flowable wound matrix, injectable, 1 cc
Gross
$26,264
791652
$22,962
Injection, bupivacaine liposome, 1 mg
Gross
$22,962
115551
$21,932
Injection, clofarabine, 1 mg
Gross
$21,932
117408
$19,981
Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s)
Gross
$19,981
117472
$19,981
Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with con
Gross
$19,981
117423
$19,981
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo
Gross
$19,981
117546
$19,981
Magnetic resonance angiography without contrast followed by with contrast, pelvis
Gross
$19,981
588311
$19,981
Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code fo
Gross
$19,981
117475
$19,981
Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followe
Gross
$19,981
117429
$19,981
Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast
Gross
$19,981
117425
$19,981
Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo
Gross
$19,981
117405
$19,981
Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s)
Gross
$19,981
117534
$19,981
Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardi
Gross
$19,981
117402
$19,981
Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), fol
Gross
$19,981
117541
$19,981
Magnetic resonance angiography without contrast followed by with contrast, lower extremity
Gross
$19,981
117416
$19,981
Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphade
Gross
$19,981
117521
$19,981
Magnetic resonance angiography without contrast followed by with contrast, abdomen
Gross
$19,981
117411
$19,981
Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, fo
Gross
$19,981
798770
$19,532
Injection, bendamustine hydrochloride, 1 mg
Gross
$19,532
4283
$19,426
Injection, digoxin immune fab (ovine), per vial
Gross
$19,426
115493
$19,365
Computed tomography, abdomen; without contrast material, followed by contrast material(s) and furthe
Gross
$19,365
115465
$19,365
Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further
Gross
$19,365
700447
$18,676
Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interp
Gross
$18,676
115451
$18,630
Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s)
Gross
$18,630
792953
$18,584
Injection, trabectedin, 0.1 mg
Gross
$18,584
7611
$18,449
Injection, tenecteplase, 1 mg
Gross
$18,449
115452
$18,197
Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontr
Gross
$18,197
115494
$18,197
Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images,
Gross
$18,197
115462
$18,197
Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, i
Gross
$18,197
115448
$18,197
Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if
Gross
$18,197
115504
$18,197
Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff,
Gross
$18,197
115447
$18,197
Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if
Gross
$18,197
115446
$17,689
Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) an
Gross
$17,689
121430
$17,423
Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radio
Gross
$17,423
117471
$16,617
Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)
Gross
$16,617
117404
$16,617
Magnetic resonance angiography, head; with contrast material(s)
Gross
$16,617
117417
$16,617
Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast mater
Gross
$16,617
117464
$16,617
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)
Gross
$16,617
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 17196 | Not otherwise classified, antineoplastic drugs | $222,230 | $222,230 | — | — | 3 |
| 794549 | Injection, gemtuzumab ozogamicin, 0.1 mg | $47,524 | $47,524 | $226 | $226 | 4 |
| 799194 | Injection, edetate calcium disodium, up to 1000 mg | $38,968 | $38,968 | $6,266 | $6,266 | 4 |
| 122624 | Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries | $38,881 | $38,881 | $3,824 | $3,824 | 1 |
| 594773 | Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, foll | $38,736 | $38,736 | $5,140 | $5,248 | 3 |
| 159848 | Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries | $36,573 | $36,573 | $3,302 | $3,302 | 1 |
| 122606 | Indium in-111 pentetate, diagnostic, per 0.5 millicurie | $36,573 | $36,573 | $1,230 | $1,230 | 1 |
| 595786 | Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontra | $36,390 | $36,390 | $868 | $1,462 | 5 |
| 596251 | Injection, eculizumab, 2 mg | $35,616 | $35,616 | $74.3 | $74.3 | 1 |
| 798840 | Injection, ecallantide, 1 mg | $34,239 | $34,239 | $548 | $548 | 4 |
| 594772 | Computed tomography, abdomen and pelvis; with contrast material(s) UNSCHEDULED | $32,279 | $32,279 | $4,756 | $4,857 | 3 |
| 594771 | Computed tomography, abdomen and pelvis; without contrast material | $29,346 | $29,346 | $868 | $1,462 | 5 |
| 869152 | Integra flowable wound matrix, injectable, 1 cc | $26,264 | $26,264 | $1,450 | $1,450 | 1 |
| 791652 | Injection, bupivacaine liposome, 1 mg | $22,962 | $22,962 | $1.38 | $1.38 | 4 |
| 115551 | Injection, clofarabine, 1 mg | $21,932 | $21,932 | $15.53 | $15.53 | 4 |
| 117408 | Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) | $19,981 | $19,981 | $3,063 | $3,127 | 3 |
| 117472 | Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with con | $19,981 | $19,981 | $828 | $2,329 | 9 |
| 117423 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo | $19,981 | $19,981 | $828 | $2,329 | 9 |
| 117546 | Magnetic resonance angiography without contrast followed by with contrast, pelvis | $19,981 | $19,981 | $1,200 | $2,012 | 5 |
| 588311 | Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code fo | $19,981 | $19,981 | $1,088 | $2,329 | 8 |
| 117475 | Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followe | $19,981 | $19,981 | $828 | $2,329 | 9 |
| 117429 | Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast | $19,981 | $19,981 | $828 | $2,329 | 9 |
| 117425 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, follo | $19,981 | $19,981 | $828 | $2,329 | 9 |
| 117405 | Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) | $19,981 | $19,981 | $1,200 | $2,012 | 5 |
| 117534 | Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardi | $19,981 | $19,981 | $1,200 | $2,012 | 5 |
| 117402 | Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), fol | $19,981 | $19,981 | $828 | $2,329 | 9 |
| 117541 | Magnetic resonance angiography without contrast followed by with contrast, lower extremity | $19,981 | $19,981 | $1,200 | $2,012 | 5 |
| 117416 | Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphade | $19,981 | $19,981 | $828 | $2,329 | 9 |
| 117521 | Magnetic resonance angiography without contrast followed by with contrast, abdomen | $19,981 | $19,981 | $828 | $828 | 1 |
| 117411 | Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, fo | $19,981 | $19,981 | $828 | $2,329 | 9 |
| 798770 | Injection, bendamustine hydrochloride, 1 mg | $19,532 | $19,532 | $1.2 | $1.2 | 4 |
| 4283 | Injection, digoxin immune fab (ovine), per vial | $19,426 | $19,426 | $4,820 | $4,820 | 4 |
| 115493 | Computed tomography, abdomen; without contrast material, followed by contrast material(s) and furthe | $19,365 | $19,365 | $402 | $2,329 | 9 |
| 115465 | Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further | $19,365 | $19,365 | $868 | $1,462 | 5 |
| 700447 | Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interp | $18,676 | $18,676 | $2,343 | $2,392 | 3 |
| 115451 | Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) | $18,630 | $18,630 | $402 | $2,329 | 9 |
| 792953 | Injection, trabectedin, 0.1 mg | $18,584 | $18,584 | $353 | $353 | 4 |
| 7611 | Injection, tenecteplase, 1 mg | $18,449 | $18,449 | $158 | $158 | 4 |
| 115452 | Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontr | $18,197 | $18,197 | $402 | $2,329 | 9 |
| 115494 | Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, | $18,197 | $18,197 | $402 | $2,329 | 9 |
| 115462 | Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, i | $18,197 | $18,197 | $3,273 | $3,342 | 3 |
| 115448 | Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if | $18,197 | $18,197 | $402 | $2,329 | 9 |
| 115504 | Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, | $18,197 | $18,197 | $402 | $2,329 | 9 |
| 115447 | Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if | $18,197 | $18,197 | $402 | $2,329 | 9 |
| 115446 | Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) an | $17,689 | $17,689 | $7,022 | $7,170 | 3 |
| 121430 | Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radio | $17,423 | $17,423 | $2,343 | $2,392 | 3 |
| 117471 | Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) | $16,617 | $16,617 | $828 | $2,329 | 9 |
| 117404 | Magnetic resonance angiography, head; with contrast material(s) | $16,617 | $16,617 | $828 | $2,329 | 9 |
| 117417 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast mater | $16,617 | $16,617 | $518 | $2,329 | 9 |
| 117464 | Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s) | $16,617 | $16,617 | $1,088 | $2,329 | 9 |
Showing top 50 of 18,994 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.