MADISON COUNTY MEMORIAL HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
3061789	WINREVAIR SubQ INJ KIT [2X45MG]-NF	$50,400	$25,200	—	—	7
3061585	NF-Nystatin Not Applicable Powder 5BILLI	$41,681	$20,841	—	—	7
3061932	NF-Nystatin Not Applicable Powder 5BILLI	$41,681	$20,841	—	—	7
2562272	EPIFIX 5X6	$26,045	$13,023	—	—	9
3061874	TENECTEPLASE INJ [ MG/10 ML] *AIS	$24,214	$12,107	—	—	8
2562271	EPIFIX 5X6	$15,565	$7,783	—	—	9
3000017	ALTEPLASE - tPA [100 MG] INJ (BOLUS)	$13,639	$6,820	—	—	8
3060778	ALTEPLASE - tPA [100 MG] IV	$13,639	$6,820	—	—	8
2962088	PACEMAKER 2 LEADS	$12,764	$6,382	—	—	17
3061900	NF-Humira PEN SubQ Soln 40MG/0.4ML	$12,460	$6,230	—	—	7
3000603	TENECTEPLASE [ MG/10ML] INJ	$11,145	$5,573	—	—	8
2962087	PACEMAKER 1 LEAD	$9,751	$4,876	—	—	17
2962029	REPAIR RECURRENT INGUIN HERNIA INCARCERA	$9,181	$4,591	—	—	17
3061936	NF-Invega Sustenna IM Susp ER 156MG	$8,349	$4,175	—	—	7
2562270	EPIFIX 4X4	$8,200	$4,100	—	—	9
2962030	LAP CHOLECYSTECTOMY	$7,950	$3,975	—	—	17
2962032	REP INIT INGUIN HERNIA AGE > 5 REDUCIBLE	$7,605	$3,803	—	—	10
3061906	LEQVIO(INCLISIRAN) SUBQ [284 MG/1.5 ML]	$7,604	$3,802	—	—	8
2962023	LAP REPAIR RECURRENT INGUINAL HERNIA	$7,027	$3,513	—	—	17
2962022	LAP REPAIR INITIAL INGUINAL HERNIA	$6,874	$3,437	—	—	1
2962090	LAPAROSCOPIC CYST ASPIRATION	$6,806	$3,403	—	—	17
25629	EPIFIX 3X4	$6,485	$3,243	—	—	9
3000133	Crotalidae Polyvalent Immune Fab	$5,731	$2,866	—	—	8
22014	HEMORRHOIDECTOMY INTERNAL/EXTERNAL 2 >	$5,500	$2,750	—	—	11
2962037	LAP APPENDECTOMY	$5,082	$2,541	—	—	17
2962025	LAP CHOLECYSTECTOMY WITH CHOLANGIOGRAM	$5,035	$2,518	—	—	17
2962128	REPAIR OF ANTERIOR ABD HERNIA 3CM-10CM	$4,800	$2,400	—	—	1
2962057	PINCH GRAFT SINGLE/MULTIPLE	$4,752	$2,376	—	—	1
2962028	REPAIR RECURRENT INGUIN HERNIA REDUCIBLE	$4,550	$2,275	—	—	17
30612	KEDRAB INJ [1 IU/ML] SDV IM 10 ML	$4,500	$2,250	—	—	9
2962027	REPAIR INITIAL INGUIN HERNIA INCARCERATD	$4,424	$2,212	—	—	1
2962063	REP INIT INGUIN HERNIA AGE > 5 REDUCIBLE	$4,424	$2,212	—	—	1
3062023	NF-Pomalyst Oral Capsule 4MG	$4,109	$2,055	—	—	7
2962062	AMPUTATION TOE TRANSMET	$4,060	$2,030	—	—	17
2962086	INSERT INDWL TUNNLD PLEURAL CATH	$4,051	$2,026	—	—	1
3061703	NF-Pomalyst Oral Capsule 4MG	$3,932	$1,966	—	—	7
3061836	NF-Pomalyst Oral Capsule 4MG	$3,932	$1,966	—	—	7
5220092	CTA ABDOMINAL AORTA	$3,914	$1,957	—	—	10
2962008	PORTACATH	$3,893	$1,947	—	—	17
200001	POWER PORT 8FR INS	$3,893	$1,947	—	—	17
2962052	EXCISION PILONIDAL CYST/SINUS COMPLICATD	$3,803	$1,902	—	—	17
2962084	AMPUTATION TOE MP JOINT	$3,777	$1,889	—	—	17
2962085	AMPUTATION TOE INTERPHALANGEAL JOINT	$3,773	$1,886	—	—	17
2960203	CATARACT AMBUL SURG	$3,770	$1,885	—	—	11
5220093	CT ABD & PELV 1+ SEC/REG	$3,739	$1,870	—	—	11
5220094	CT ABDOMEN/PELVIS W/WO CONTRAST	$3,739	$1,870	—	—	11
90062789	MESH HERNIA UMB 30x20	$3,728	$1,864	—	—	9
5221071	CT UPPER EXTR W/WO CONTRAST RIGHT	$3,687	$1,844	—	—	11
2962014	HEMORRHOIDECTOMY INTERNAL/EXTERNAL 2 >	$3,655	$1,828	—	—	1
2962051	EXCISION PILONIDAL CYST/SINUS EXTENSIVE	$3,655	$1,828	—	—	17

Showing top 50 of 5,104 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.