45 CFR § 180 compliance
B · 85
This hospital published most 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
205
Insurances with rates
14
CPT / HCPCS codes
205
Source MRF
Most expensive procedures (gross)
J7298
$1,907
LEVONORGESTREL IU 52MG 5 YR
Gross
$1,907
44055
$1,589
CORRECT BOWEL MALROTATION
Gross
$1,589
44025
$1,532
COLOTOMY, EXPLORE/BX/FB REMOVAL
Gross
$1,532
44020
$1,511
ENTEROTOMY SM INTESTINE, EXPLORE/BX/FB
Gross
$1,511
44050
$1,460
REDUCE VOLV/INTUSS/HERN, LAP
Gross
$1,460
44021
$1,448
ENTEROTOMY, SM BOWEL, DECOMPRESS
Gross
$1,448
J7307
$1,237
ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, IMPLANT/SUPPLY
Gross
$1,237
J7302
$1,175
LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM
Gross
$1,175
58661
$1,142
LAPAROSCOPY, SURGICAL; WITH REMOVAL OF ADNEXAL STRUCTURES
Gross
$1,142
J7300
$1,062
INTRAUT COPPER CONTRACEPTIVE
Gross
$1,062
90378
$885
RSV-IGIM, FOR IM USE, 50MG EACH
Gross
$885
S4989
$880
CONTRACEPTIVE INTRAUTERINE DEVICE (E.G. PROGESTACERT IUD)
Gross
$880
90734
$808
MCV, SEROGROUPS A, C, Y AND W-135, IM USE
Gross
$808
90677
$770
PCV20 VACCINE IM
Gross
$770
17004
$706
DESTRUCT BENIGN/PREMALIG LESION; 15 OR >
Gross
$706
90732
$702
PNEUMOCOCCAL VACCINE, 23-VALENT, ADULT DOSE SQ/IM USE
Gross
$702
90736
$693
ZOSTER (SHINGLES) VACCINE, LIVE, FOR SUBCUTANEOUS INJECTION
Gross
$693
25500
$654
CLOSED TREATMENT OF RADIAL SHAFT FX
Gross
$654
90670
$557
PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT, FOR IM USE
Gross
$557
90723
$537
DTAP, TDS, HEPB, AND IPV, INACTIVATED; FOR IM USE
Gross
$537
44015
$472
TUBE/NEEDLE CATH JEJUNOSTOMY
Gross
$472
90716
$453
VARICELLA VIRUS VACCINE, LIVE, FOR SUBCUTANEOUS USE
Gross
$453
90719
$446
DIPHTHERIA TOXOID, FOR INTRAMUSCULAR USE
Gross
$446
J7324
$435
HYALURONAN/DERIVATIVE, ORTHOVISC, INTRA-ARTICULAR INJECT, DS
Gross
$435
90710
$391
MMR-VARICELLA VACCINE, LIVE FOR SQ USE(PROQUAD)
Gross
$391
99245
$384
OFFICE CONSULT NEW OR ESTAB PT - LEVEL 5
Gross
$384
17000
$367
DESTRUCTION OF BENIGN/PREMALIGANT LESIONS; FIRST LESIONS
Gross
$367
90651
$364
HPV VACCINE NON VALENT IM
Gross
$364
99387
$346
INITIAL PREVENTIVE CARE, NEW PT, =/+ 65Y
Gross
$346
90696
$340
DTAP-IPV (KINRIX) CHILDREN 4-6 YRS, FOR IM USE
Gross
$340
99397
$334
PERIODIC PREVENTIVE CARE ESTAB PT =/+65Y
Gross
$334
99205
$332
OFFICE VISIT - NEW PT, LEVEL 5
Gross
$332
90707
$318
MMR VACCINE, LIVE, FOR SQ OR JET INJECTION USE
Gross
$318
90698
$317
DTAP, HIB, IPV,(PENTACEL) FOR IM USE
Gross
$317
99386
$304
INITIAL PREVENTIVE CARE, NEW PT, 40-64YR
Gross
$304
99244
$304
OFFICE CONSULT NEW OR ESTAB PT - LEVEL 4
Gross
$304
58301
$290
REMOVE IUD
Gross
$290
90715
$287
TDAP VACCINE,(BOOSTRIX) 7 YEARS+, FOR IM USE
Gross
$287
G0438
$281
ANNUAL WELLNESS VISIT; INCLUDES A PPS, INITIAL VISIT
Gross
$281
G0439
$281
ANNUAL WELLNESS VISIT, INCLUDES A PPS, SUBSEQUENT VISIT
Gross
$281
99385
$276
INITIAL PREVENTIVE CARE, NEW PT, 18-39YR
Gross
$276
17111
$273
DESTRUCT FLAT WARTS; 15 OR MORE LESIONS
Gross
$273
99396
$264
PERIODIC PREVENTIVE CARE ESTAB PT 40-64Y
Gross
$264
99243
$254
OFFICE CONSULT NEW OR ESTAB PT - LEVEL 3
Gross
$254
99204
$247
OFFICE VISIT - NEW PT, LEVEL 4
Gross
$247
58300
$240
INSERT IUD
Gross
$240
99215
$240
OFFICE VISIT - ESTABLISHED PT, LEVEL 5
Gross
$240
11981
$236
INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
Gross
$236
11983
$234
REMOVAL W/REINSERT, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
Gross
$234
99350
$234
HOME VISIT, FOR E&M ESTAB PT - LEVEL 4
Gross
$234
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J7298 | LEVONORGESTREL IU 52MG 5 YR | $1,907 | $1,907 | — | — | 20 |
| 44055 | CORRECT BOWEL MALROTATION | $1,589 | $1,589 | — | — | 20 |
| 44025 | COLOTOMY, EXPLORE/BX/FB REMOVAL | $1,532 | $1,532 | — | — | 20 |
| 44020 | ENTEROTOMY SM INTESTINE, EXPLORE/BX/FB | $1,511 | $1,511 | — | — | 20 |
| 44050 | REDUCE VOLV/INTUSS/HERN, LAP | $1,460 | $1,460 | — | — | 20 |
| 44021 | ENTEROTOMY, SM BOWEL, DECOMPRESS | $1,448 | $1,448 | — | — | 20 |
| J7307 | ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, IMPLANT/SUPPLY | $1,237 | $1,237 | — | — | 20 |
| J7302 | LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM | $1,175 | $1,175 | — | — | 20 |
| 58661 | LAPAROSCOPY, SURGICAL; WITH REMOVAL OF ADNEXAL STRUCTURES | $1,142 | $1,142 | — | — | 20 |
| J7300 | INTRAUT COPPER CONTRACEPTIVE | $1,062 | $1,062 | — | — | 20 |
| 90378 | RSV-IGIM, FOR IM USE, 50MG EACH | $885 | $885 | — | — | 20 |
| S4989 | CONTRACEPTIVE INTRAUTERINE DEVICE (E.G. PROGESTACERT IUD) | $880 | $880 | — | — | 20 |
| 90734 | MCV, SEROGROUPS A, C, Y AND W-135, IM USE | $808 | $808 | — | — | 20 |
| 90677 | PCV20 VACCINE IM | $770 | $770 | — | — | 20 |
| 17004 | DESTRUCT BENIGN/PREMALIG LESION; 15 OR > | $706 | $706 | — | — | 20 |
| 90732 | PNEUMOCOCCAL VACCINE, 23-VALENT, ADULT DOSE SQ/IM USE | $702 | $702 | — | — | 20 |
| 90736 | ZOSTER (SHINGLES) VACCINE, LIVE, FOR SUBCUTANEOUS INJECTION | $693 | $693 | — | — | 20 |
| 25500 | CLOSED TREATMENT OF RADIAL SHAFT FX | $654 | $654 | — | — | 20 |
| 90670 | PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT, FOR IM USE | $557 | $557 | — | — | 20 |
| 90723 | DTAP, TDS, HEPB, AND IPV, INACTIVATED; FOR IM USE | $537 | $537 | — | — | 20 |
| 44015 | TUBE/NEEDLE CATH JEJUNOSTOMY | $472 | $472 | — | — | 20 |
| 90716 | VARICELLA VIRUS VACCINE, LIVE, FOR SUBCUTANEOUS USE | $453 | $453 | — | — | 20 |
| 90719 | DIPHTHERIA TOXOID, FOR INTRAMUSCULAR USE | $446 | $446 | — | — | 20 |
| J7324 | HYALURONAN/DERIVATIVE, ORTHOVISC, INTRA-ARTICULAR INJECT, DS | $435 | $435 | — | — | 20 |
| 90710 | MMR-VARICELLA VACCINE, LIVE FOR SQ USE(PROQUAD) | $391 | $391 | — | — | 20 |
| 99245 | OFFICE CONSULT NEW OR ESTAB PT - LEVEL 5 | $384 | $384 | — | — | 20 |
| 17000 | DESTRUCTION OF BENIGN/PREMALIGANT LESIONS; FIRST LESIONS | $367 | $367 | — | — | 20 |
| 90651 | HPV VACCINE NON VALENT IM | $364 | $364 | — | — | 20 |
| 99387 | INITIAL PREVENTIVE CARE, NEW PT, =/+ 65Y | $346 | $346 | — | — | 20 |
| 90696 | DTAP-IPV (KINRIX) CHILDREN 4-6 YRS, FOR IM USE | $340 | $340 | — | — | 20 |
| 99397 | PERIODIC PREVENTIVE CARE ESTAB PT =/+65Y | $334 | $334 | — | — | 20 |
| 99205 | OFFICE VISIT - NEW PT, LEVEL 5 | $332 | $332 | — | — | 20 |
| 90707 | MMR VACCINE, LIVE, FOR SQ OR JET INJECTION USE | $318 | $318 | — | — | 20 |
| 90698 | DTAP, HIB, IPV,(PENTACEL) FOR IM USE | $317 | $317 | — | — | 20 |
| 99386 | INITIAL PREVENTIVE CARE, NEW PT, 40-64YR | $304 | $304 | — | — | 20 |
| 99244 | OFFICE CONSULT NEW OR ESTAB PT - LEVEL 4 | $304 | $304 | — | — | 20 |
| 58301 | REMOVE IUD | $290 | $290 | — | — | 20 |
| 90715 | TDAP VACCINE,(BOOSTRIX) 7 YEARS+, FOR IM USE | $287 | $287 | — | — | 20 |
| G0438 | ANNUAL WELLNESS VISIT; INCLUDES A PPS, INITIAL VISIT | $281 | $281 | — | — | 20 |
| G0439 | ANNUAL WELLNESS VISIT, INCLUDES A PPS, SUBSEQUENT VISIT | $281 | $281 | — | — | 20 |
| 99385 | INITIAL PREVENTIVE CARE, NEW PT, 18-39YR | $276 | $276 | — | — | 20 |
| 17111 | DESTRUCT FLAT WARTS; 15 OR MORE LESIONS | $273 | $273 | — | — | 20 |
| 99396 | PERIODIC PREVENTIVE CARE ESTAB PT 40-64Y | $264 | $264 | — | — | 20 |
| 99243 | OFFICE CONSULT NEW OR ESTAB PT - LEVEL 3 | $254 | $254 | — | — | 20 |
| 99204 | OFFICE VISIT - NEW PT, LEVEL 4 | $247 | $247 | — | — | 20 |
| 58300 | INSERT IUD | $240 | $240 | — | — | 20 |
| 99215 | OFFICE VISIT - ESTABLISHED PT, LEVEL 5 | $240 | $240 | — | — | 20 |
| 11981 | INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT | $236 | $236 | — | — | 20 |
| 11983 | REMOVAL W/REINSERT, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT | $234 | $234 | — | — | 20 |
| 99350 | HOME VISIT, FOR E&M ESTAB PT - LEVEL 4 | $234 | $234 | — | — | 20 |
Showing top 50 of 205 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.