NORTHWEST FLORIDA COMMUNITY HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
10085414	CAGE LORDOTIC X-PAC TLIF 10X28MM	$117,020	$93,616	—	—	7
25395946	RAVULIZUMAB(ULTOMIRIS)INJ:1100MG	$114,965	$91,972	—	—	5
6000002	SPINAL CORD STIMULATOR - IMPLANT	$74,649	$59,719	—	—	5
25394407	ANDEXXA VIAL(5) :1000MG	$56,250	$45,000	—	—	5
10085382	MicroFiber Flowable Allograft 10.0cc	$52,210	$41,768	—	—	5
10085166	Ventana L - 18mm x 40mm x 6Deg Cage, 8m	$51,340	$41,072	—	—	7
6063685	INSERTION/REPLACEMENT SPINAL NEURO PULSE	$48,140	$38,512	—	—	6
25386794	ALTEPLASE (ACTIVASE)INJ: 100 MG	$37,500	$30,000	—	—	6
25394835	TENECTEPLASE(TNKase)INJ: 50 MG	$36,500	$29,200	—	—	8
25391921	ENTYVIO(VEDOLIZUMAB):300MG	$31,650	$25,320	—	—	5
25395945	RAVULIZUMAB(ULTOMIRIS)INJ:300MG	$31,354	$25,083	—	—	5
10085516	4 WEB Two HOLE Plate	$31,330	$25,064	—	—	9
10085540	4 WEB SHORT Two HOLE Plate	$31,330	$25,064	—	—	9
10085161	Ti-Bond 10mm x 27mm x 8mm, 10-15 degree	$28,180	$22,544	—	—	5
10085185	Ti-Bond 10mm x 24mm x 7mm, 5-10 degree	$28,180	$22,544	—	—	5
10085186	Ti-Bond 10mm x 24mm x 8mm, 10-15 degree	$28,180	$22,544	—	—	5
10085284	CAGE 7mm x 27mm x 10MM	$28,180	$22,544	—	—	7
10085432	CAGE 8X10X32	$28,180	$22,544	—	—	7
10085480	CAGE 10mm x 24mm x 8mm, 5-10 degree	$28,180	$22,544	—	—	7
10085483	CAGE 9X10X32	$28,180	$22,544	—	—	7
10085499	CAGE 28X10X9X14MM 6DEG	$28,180	$22,544	—	—	7
10085504	CAGE 28MMX8X9X13MM 3DEG	$28,180	$22,544	—	—	7
10085508	CAGE 24MMX10X7X11MM 3DEG	$28,180	$22,544	—	—	7
10085585	CAGE 24MMX10X9X14MM 6DEG	$28,180	$22,544	—	—	7
10085620	CAGE 24MMX10X8X13MM 3DEG	$28,180	$22,544	—	—	7
10085482	MicroFiber Flowable Allograft 5.0cc	$26,110	$20,888	—	—	5
10085423	SPINAL ELECAGE 8X18X45MM	$25,670	$20,536	—	—	7
10085502	CAGE 8X18X50	$25,670	$20,536	—	—	7
10085503	CAGE 7X18X50	$25,670	$20,536	—	—	7
10085543	CAGE 18X50X10MM	$25,670	$20,536	—	—	7
10085544	CAGE 18X45X10MM	$25,670	$20,536	—	—	7
10085545	CAGE 18X40X10MM	$25,670	$20,536	—	—	7
10085623	CAGE ACUITY 18X52X7 16-18500707-SP	$25,670	$20,536	—	—	7
10085624	Cage, 18X55X7MM 41855-607	$25,670	$20,536	—	—	7
10086540	CAGE ACUITY 18X40X7% 16-18401007-SP	$25,670	$20,536	—	—	7
10085173	3D Lumbar Interbody, 10X 27x7mm 5	$25,390	$20,312	—	—	7
10085632	CERVICAL DISC PROSTHESIS 15X17H6	$23,500	$18,800	—	—	9
10085488	FiberTak Achilles SpeedBridge	$23,170	$18,536	—	—	9
10086503	FRACTURE STEM SZ 9 L. 130MM	$23,130	$18,504	—	—	9
25394770	GAMUNEX-C 10%(IVIG) 40 GRAM: 400 ML	$22,355	$17,884	—	—	5
10085579	DEMINERALIZED BONE FIBERS 10CC	$21,760	$17,408	—	—	6
10085630	CAGE ASTURA 18X45X10X7DEG	$21,760	$17,408	—	—	7
10085381	ACUPAC X TISSUE	$21,200	$16,960	—	—	5
10086510	CAGE 45mm x 18mm x 10MMX 120	$21,080	$16,864	—	—	7
25391648	RITUXAN(RITUXIMAB)500MG:50ML	$21,000	$16,800	—	—	5
25130071	RETAVASE(RETEPLASE)INJ:20 UNITS(2 VIAL)	$20,847	$16,678	—	—	5
6000360	SURGERY 6 HOURS	$20,023	$16,018	—	—	5
10085428	IFUSE BEDROCK 9.5X80MM GRANITE IMPLANT	$19,580	$15,664	—	—	9
10085487	IFUSE BEDROCK 9.5X60MM GRANITE IMPLANT	$19,580	$15,664	—	—	7
10085501	IFUSE BEDROCK 9.5X90MM GRANITE IMPLANT	$19,580	$15,664	—	—	7

Showing top 50 of 10,489 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.