UNION GENERAL HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J7330	MACI FINAL PRODUCT ASSEMBLED	$104,504	$52,252	—	—	10
J9217	leuprolide 45 mg/6 months Kit	$58,871	$29,435	—	—	18
J3380	vedolizumab 300 mg Pow [UGH]	$44,928	$22,464	—	—	36
J2997	alteplase 100 mg IV Inj [UGH]	$42,242	$21,121	—	—	30
J3101	tenecteplase 25 mg Pow	$39,827	$19,913	—	—	45
C1822	1080-D IPG SENZA KIT	$38,550	$19,275	—	—	13
C1820	SC-1216 PULSE GENERATOR KIT	$35,000	$17,500	—	—	13
C1767	3670 PROCLAIM PLUS 5	$33,000	$16,500	—	—	13
J0775	collagenase clostridium histolyticum 0.9 mg Pow	$31,605	$15,803	—	—	18
J2506	pegfilgrastim 6 mg/0.6 ML SubQ Inj [UGH]	$25,960	$12,980	—	—	18
J2406	oritavancin 1200 mg Pow	$25,617	$12,809	—	—	36
C1889	ABS-1102-25 CARTIFORM 20 X 25MM DISC	$22,000	$11,000	—	—	12
J1930	lanreotide 60 mg/0.2 ML Sol	$21,917	$10,958	—	—	18
J2323	natalizumab 300 mg/15 ML IV Conc [UGH]	$21,187	$10,594	—	—	18
J1459	immune globulin 10% IV Sol 200 ML [UGH]	$18,416	$9,208	—	—	54
J1162	digoxin immune FAB 40 mg Inj [UGH]	$18,341	$9,170	—	—	15
C2622	720081-01 TACTRA 11MM X 16CM-25CM	$17,830	$8,915	—	—	11
J0256	alpha 1-proteinase inhibitor human Pow	$17,244	$8,622	—	—	18
J1306	inclisiran 284 mg/1.5 ML Sol	$17,221	$8,611	—	—	36
Q5119	riTUXimab pvvr 10 mg/ML Sol	$17,203	$8,602	—	—	18
J1437	ferric derisomaltose 100 mg/ML Sol	$16,200	$8,100	—	—	36
j3101	tenecteplase 50 mg IV Inj [UGH]	$15,392	$7,696	—	—	60
J0840	antivenin (Crotalidae) polyvalent - Pow [UGH]	$15,350	$7,675	—	—	15
J2182	mepolizumab 100 mg/ML Sol	$14,756	$7,378	—	—	18
J0717	certolizumab 200 mg/ML Kit [UGH]	$14,716	$7,358	—	—	15
J1561	immune globulin 10% IV Sol 200ML [UGH]	$14,280	$7,140	—	—	36
Q4128	FLEXHD PERF LRG PLIABLE SHAPED 13X22	$13,820	$6,910	—	—	18
J0597	C1 esterase inhibitor, human 500 intl units Kit [UGH]	$13,512	$6,756	—	—	15
J1951	leuprolide 45 mg/6 months PWD	$13,009	$6,504	—	—	18
25400	25400 Repair radius or ulna	$12,162	$6,081	—	—	16
J3111	romosozumab 105 mg/1.17 ML Sol	$12,018	$6,009	—	—	108
C1786	PACER ADVISA SR MRI SURESCAN SINGLE	$11,160	$5,580	—	—	13
J0881	darbepoetin alfa 300 mcg/0.6 ML Inj Sol [UGH]	$11,148	$5,574	—	—	18
C1764	ASSERT IQ 3+	$10,200	$5,100	—	—	13
Q0222	bebtelovimab 175 mg/2 ML Sol	$10,080	$5,040	—	—	10
J3358	ustekinumab 5 mg/ML Sol	$9,718	$4,859	—	—	18
J1602	golimumab 50 mg/4 ML Sol [UGH]	$9,596	$4,798	—	—	54
J0897	denosumab 60 mg/ML Sol	$9,002	$4,501	—	—	54
J0630	calcitonin 200 intl units/ML Inj Sol [UGH]	$8,673	$4,337	—	—	78
J1451	fomepizole 1 g/ML Sol	$8,312	$4,156	—	—	30
Q4125	DECELLULARIZED DERMIS 40 X 70	$7,931	$3,966	—	—	18
C2621	PACEMAKER GENERATOR IPG SENSIA	$7,800	$3,900	—	—	13
Q5136	denosumab bbdz 60 mg/ML Sol	$7,700	$3,850	—	—	18
C1763	BBRC-23 BIOBRACE 23 X 25	$7,400	$3,700	—	—	12
V2790	AVIVE SOFT TISSUE MEMBRANE	$7,380	$3,690	—	—	13
J1439	ferric carboxymaltose (as elemental iron) 50 mg/ML Sol	$7,363	$3,681	—	—	54
C1734	45647012 OSTEOCHONDRAL CORE FS/A 12MM	$7,200	$3,600	—	—	12
J7325	hylan G-F 20 48 mg/6 ML Sol	$6,574	$3,287	—	—	30
J9280	mitoMYcin 40 mg Pow	$6,573	$3,286	—	—	54
J3262	tocilizumab 200 mg/10 ML Sol [UGH]	$6,374	$3,187	—	—	54

Showing top 50 of 1,713 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.