JAY HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
04387205-522	TIME INITIAL HOUR	$5,000	$750	—	—	30
32040024-445	ENDO RESOLUTION CLIP	$4,627	$694	—	—	30
02309011-743	MRI UPPER EXT BILATERAL W/O	$4,220	$633	—	—	37
03082401-559	COLONOSCOPY WITH BIOPSY	$3,800	$570	—	—	30
03038098-576	COLONOSCOPY	$3,600	$540	—	—	30
03038338-573	C/POLYPECTOMY	$3,600	$540	—	—	30
00290122-1180	VAGINAL DELIVERY EMERGENCY	$3,535	$530	—	—	42
03085107-558	ESOPHAGEAL VARICES BANDING	$3,400	$510	—	—	30
00284703-1198	I&D HEMATOMA/SEROMA	$3,361	$504	—	—	42
03082385-560	EGD W/BIOPSY	$3,200	$480	—	—	30
41070377-152	HEREDITARY CARDIOMYOPATHY GENE PANEL	$2,950	$443	—	—	42
00280826-1243	INSERTION OF CHEST TUBE	$2,477	$372	—	—	42
04475265-518	MESH (IMPLANTABLE)	$2,413	$362	—	—	30
09360116-452	TIME PM CASE MINOR 0-60 MINUTES	$2,400	$360	—	—	30
33030050-398	ER PRO FEE - INSERT NON-TUNNEL CENTRAL CVC =>5 YRS	$2,246	$337	—	—	42
00282491-1215	LEVEL 6 CRIT CARE 30-74MIN W/MOD	$2,149	$322	—	—	30
00290072-1182	LEVEL 6 CRITICAL CARE 30-74MIN	$2,149	$322	—	—	35
02309037-742	MRI UPPER EXTREM JOINT BILATERAL W/O	$2,131	$320	—	—	37
02309045-741	MRI LOW EXT JOINT BILAT W/O	$2,131	$320	—	—	37
02309052-740	MRI LOWER EXTREMITY W/O CONTRAST BILATERAL	$2,131	$320	—	—	37
02390128-653	MRA HEAD W/O CONT	$2,131	$320	—	—	42
02390151-652	MRA NECK W/O CONT	$2,131	$320	—	—	42
02390201-651	MRI PELVIS W/O CONT	$2,131	$320	—	—	42
02390219-650	MRI PELVIS W/WO CONT	$2,131	$320	—	—	42
02390227-649	MRI UPPER EXTREM W/O CONT	$2,131	$320	—	—	42
02390250-648	MRI JOINT UPPER EXT W/WO CONT	$2,131	$320	—	—	42
02390268-647	MRI LOWER EXTREM W/O CONT	$2,131	$320	—	—	42
02390292-646	MRI JOINT LOW EXTREM W/WO CONT	$2,131	$320	—	—	42
02391522-645	MRI BRAIN/BRAIN STEM WO CON	$2,131	$320	—	—	42
02391548-644	MRI LOWER EXTREM W/WO CONT	$2,131	$320	—	—	42
02391597-643	MRI/CERVICAL W/O CONTRAST	$2,131	$320	—	—	42
02391605-642	MRI THORACIC WITHOUT CONTRAST	$2,131	$320	—	—	42
02391613-641	MRI LUMBAR WITHOUT CONTRAST	$2,131	$320	—	—	42
02391639-640	MRI UPPER EXTREME W/WO CONTRST	$2,131	$320	—	—	42
02394542-639	MRI JOINT UPPER EXT W/O CONT	$2,131	$320	—	—	42
02394559-638	MRI JOINT LOWER EXTREM W/O CON	$2,131	$320	—	—	42
02395390-635	MRCP	$2,131	$320	—	—	42
02399780-634	MRI CERVICAL W/WO CONTRAST	$2,131	$320	—	—	42
02399798-633	MRI THORACIC W/WO CONTRAST	$2,131	$320	—	—	42
02399806-632	MRI/LUMBAR W/WO CONTRAST	$2,131	$320	—	—	42
02399814-631	MRI/BRAIN W/WO CONTRAST	$2,131	$320	—	—	42
41040000-357	PLATELETS PHERESIS PATHOGEN REDUCED	$2,059	$309	—	—	42
41070199-297	BRCA1 BRCA2 GENE ALYS FULL SEQ FULL DUP/DEL ALYS	$2,050	$308	—	—	42
33000040-441	LAC REPAIR SIMPLE SCALP/NECK/EXT 12.6-20.0 CM	$2,020	$303	—	—	42
33000048-438	LAC REPAIR SIMPLE FACE/EARS/EYELIDS 20.1-30.0 CM	$2,020	$303	—	—	42
43050202-122	ECHO 2D W/DOPPLER COLOR FLOW	$2,000	$300	—	—	42
07132855-471	REMOVAL TUNNELED CV CATH W/O P	$1,997	$300	—	—	42
46290059-114	TLSO ELASTIC FLEX LUMBAR CONSET	$1,996	$299	—	—	31
33000039-442	LAC REPAIR SIMPLE SCALP/NECK/EXT 7.6-12.5 CM	$1,919	$288	—	—	42
33000056-434	LAC REPAIR INTERMEDIATE NECK/HANDS 2.6-7.5 CM	$1,898	$285	—	—	42

Showing top 50 of 13,578 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.