45 CFR § 180 compliance
D · 65
This hospital published part 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
962
Insurances with rates
0
CPT / HCPCS codes
944
Source MRF
Most expensive procedures (gross)
J2997
$43,560
ALTEPLASE (ACTIVASE) 100
Gross
$43,560
258
$13,000
CROTALIDAE POLY FAB/NS IVPB : 1VIAL/250M
Gross
$13,000
86052
$9,213
EPILEPSY ANTIBODY EVAULUATION WITH REFLE
Gross
$9,213
95810
$5,234
POLYSOMNOGRAPHY 4 OR MORE ATTENDED
Gross
$5,234
45378
$5,133
DIAGNOSTIC COLONOSCOPY
Gross
$5,133
43245
$3,866
EGD DIALATION WITH BALLOON OR BOUGIE
Gross
$3,866
43251
$3,866
EGD WITH REMOVAL SNARE TECHNIQUE
Gross
$3,866
43246
$3,866
EGD WITH PEG TUBE PLC
Gross
$3,866
74177
$3,822
CT ABDOMEN/PELVIS W/ CONTRAST
Gross
$3,822
45385
$3,435
COLONOSCOPY RE W/SNARE
Gross
$3,435
74178
$3,321
CT ABDOMEN/PELVIS WWO CONTRAST
Gross
$3,321
95811
$3,271
POLYSOMNOGRAPHY >6 SLEEP STAGING 4 MORE
Gross
$3,271
43235
$3,242
EGD
Gross
$3,242
43250
$3,093
EGD WITH REMOVAL WITH HOT BIOP FORCEPS
Gross
$3,093
110
$3,000
Room & Board
Gross
$3,000
160
$3,000
Room & Board
Gross
$3,000
121
$3,000
Room & Board
Gross
$3,000
124
$3,000
Room & Board
Gross
$3,000
114
$3,000
Room & Board
Gross
$3,000
74170
$2,932
CT 3 PHASE LIVER
Gross
$2,932
99291
$2,755
ER CRITICAL CARE LEVEL 1ST HOUR
Gross
$2,755
45380
$2,748
COLONOSCOPY WITH BIOP
Gross
$2,748
45384
$2,748
COLONOSCOPY W/ REMOVAL B FORCEPS
Gross
$2,748
73702
$2,658
CT LOWER EXTREMITY WWO CONTRAST RIGHT
Gross
$2,658
43239
$2,635
EGD WITH BIOPSY
Gross
$2,635
71275
$2,630
CTA CHEST WITH AND WITHOUT
Gross
$2,630
27252
$2,587
CLTX HIP DISLOCATION TRAUMATIC REQ ANEST
Gross
$2,587
74176
$2,468
CT ABDOMEN/PELVIS W/O CONTRAST
Gross
$2,468
99285
$2,411
ER LEVEL 5
Gross
$2,411
72125
$2,325
CT CERVICAL SPINE W/O CONTRAST
Gross
$2,325
74160
$2,310
CT ABDOMEN W/CONTRAST
Gross
$2,310
75635
$2,088
CTA ABD AORTA/BILAT ILIOFEM W/CONT POS
Gross
$2,088
74174
$2,086
CTA ABD/PELVIS CONTRAST WWO
Gross
$2,086
70491
$1,992
CT SOFT TISSUE NECK W/CONTRAST
Gross
$1,992
24605
$1,918
TREATMENT CLOSED ELBOW DISLOCATION REQ A
Gross
$1,918
70498
$1,913
CTA NECK W/CONTRAST/NONCONTRA
Gross
$1,913
74175
$1,884
CTA ABDOMEN W/CONTRAST/NONCON
Gross
$1,884
73706
$1,881
CTA LOWER EXTREMITY RIGHT
Gross
$1,881
72191
$1,859
CTA PELVIS W/CONTRAST/NONCONT
Gross
$1,859
70496
$1,851
CTA HEAD W/CONTRAST/NONCONTRA
Gross
$1,851
75573
$1,786
CT HRT CONTRST CARDIAC STRUCT&MORPH CONG
Gross
$1,786
75574
$1,755
CTA HRT CORNRY ART/BYPASS GRFTS CONTRST
Gross
$1,755
87633
$1,750
RESPIRATORY VIRAL PANEL
Gross
$1,750
70486
$1,716
CT MAXILLOFACIAL W/O CONTRAST
Gross
$1,716
73206
$1,700
CTA UPPER EXTREMITY RIGHT
Gross
$1,700
73700
$1,699
CT LOWER EXTREMITY W/O CONTRAST RIGHT
Gross
$1,699
99284
$1,695
ER LEVEL 4
Gross
$1,695
27842
$1,671
CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL
Gross
$1,671
70482
$1,646
CT ORBIT SELLA/POST FOSSA/EAR WWO CONT
Gross
$1,646
70470
$1,630
CT HEAD/BRAIN WWO CONTRAST
Gross
$1,630
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J2997 | ALTEPLASE (ACTIVASE) 100 | $43,560 | $43,560 | — | — | 0 |
| 258 | CROTALIDAE POLY FAB/NS IVPB : 1VIAL/250M | $13,000 | $13,000 | — | — | 0 |
| 86052 | EPILEPSY ANTIBODY EVAULUATION WITH REFLE | $9,213 | $9,213 | — | — | 0 |
| 95810 | POLYSOMNOGRAPHY 4 OR MORE ATTENDED | $5,234 | $5,234 | — | — | 0 |
| 45378 | DIAGNOSTIC COLONOSCOPY | $5,133 | $5,133 | — | — | 0 |
| 43245 | EGD DIALATION WITH BALLOON OR BOUGIE | $3,866 | $3,866 | — | — | 0 |
| 43251 | EGD WITH REMOVAL SNARE TECHNIQUE | $3,866 | $3,866 | — | — | 0 |
| 43246 | EGD WITH PEG TUBE PLC | $3,866 | $3,866 | — | — | 0 |
| 74177 | CT ABDOMEN/PELVIS W/ CONTRAST | $3,822 | $3,822 | — | — | 0 |
| 45385 | COLONOSCOPY RE W/SNARE | $3,435 | $3,435 | — | — | 0 |
| 74178 | CT ABDOMEN/PELVIS WWO CONTRAST | $3,321 | $3,321 | — | — | 0 |
| 95811 | POLYSOMNOGRAPHY >6 SLEEP STAGING 4 MORE | $3,271 | $3,271 | — | — | 0 |
| 43235 | EGD | $3,242 | $3,242 | — | — | 0 |
| 43250 | EGD WITH REMOVAL WITH HOT BIOP FORCEPS | $3,093 | $3,093 | — | — | 0 |
| 110 | Room & Board | $3,000 | $3,000 | — | — | 0 |
| 160 | Room & Board | $3,000 | $3,000 | — | — | 0 |
| 121 | Room & Board | $3,000 | $3,000 | — | — | 0 |
| 124 | Room & Board | $3,000 | $3,000 | — | — | 0 |
| 114 | Room & Board | $3,000 | $3,000 | — | — | 0 |
| 74170 | CT 3 PHASE LIVER | $2,932 | $2,932 | — | — | 0 |
| 99291 | ER CRITICAL CARE LEVEL 1ST HOUR | $2,755 | $2,755 | — | — | 0 |
| 45380 | COLONOSCOPY WITH BIOP | $2,748 | $2,748 | — | — | 0 |
| 45384 | COLONOSCOPY W/ REMOVAL B FORCEPS | $2,748 | $2,748 | — | — | 0 |
| 73702 | CT LOWER EXTREMITY WWO CONTRAST RIGHT | $2,658 | $2,658 | — | — | 0 |
| 43239 | EGD WITH BIOPSY | $2,635 | $2,635 | — | — | 0 |
| 71275 | CTA CHEST WITH AND WITHOUT | $2,630 | $2,630 | — | — | 0 |
| 27252 | CLTX HIP DISLOCATION TRAUMATIC REQ ANEST | $2,587 | $2,587 | — | — | 0 |
| 74176 | CT ABDOMEN/PELVIS W/O CONTRAST | $2,468 | $2,468 | — | — | 0 |
| 99285 | ER LEVEL 5 | $2,411 | $2,411 | — | — | 0 |
| 72125 | CT CERVICAL SPINE W/O CONTRAST | $2,325 | $2,325 | — | — | 0 |
| 74160 | CT ABDOMEN W/CONTRAST | $2,310 | $2,310 | — | — | 0 |
| 75635 | CTA ABD AORTA/BILAT ILIOFEM W/CONT POS | $2,088 | $2,088 | — | — | 0 |
| 74174 | CTA ABD/PELVIS CONTRAST WWO | $2,086 | $2,086 | — | — | 0 |
| 70491 | CT SOFT TISSUE NECK W/CONTRAST | $1,992 | $1,992 | — | — | 0 |
| 24605 | TREATMENT CLOSED ELBOW DISLOCATION REQ A | $1,918 | $1,918 | — | — | 0 |
| 70498 | CTA NECK W/CONTRAST/NONCONTRA | $1,913 | $1,913 | — | — | 0 |
| 74175 | CTA ABDOMEN W/CONTRAST/NONCON | $1,884 | $1,884 | — | — | 0 |
| 73706 | CTA LOWER EXTREMITY RIGHT | $1,881 | $1,881 | — | — | 0 |
| 72191 | CTA PELVIS W/CONTRAST/NONCONT | $1,859 | $1,859 | — | — | 0 |
| 70496 | CTA HEAD W/CONTRAST/NONCONTRA | $1,851 | $1,851 | — | — | 0 |
| 75573 | CT HRT CONTRST CARDIAC STRUCT&MORPH CONG | $1,786 | $1,786 | — | — | 0 |
| 75574 | CTA HRT CORNRY ART/BYPASS GRFTS CONTRST | $1,755 | $1,755 | — | — | 0 |
| 87633 | RESPIRATORY VIRAL PANEL | $1,750 | $1,750 | — | — | 0 |
| 70486 | CT MAXILLOFACIAL W/O CONTRAST | $1,716 | $1,716 | — | — | 0 |
| 73206 | CTA UPPER EXTREMITY RIGHT | $1,700 | $1,700 | — | — | 0 |
| 73700 | CT LOWER EXTREMITY W/O CONTRAST RIGHT | $1,699 | $1,699 | — | — | 0 |
| 99284 | ER LEVEL 4 | $1,695 | $1,695 | — | — | 0 |
| 27842 | CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL | $1,671 | $1,671 | — | — | 0 |
| 70482 | CT ORBIT SELLA/POST FOSSA/EAR WWO CONT | $1,646 | $1,646 | — | — | 0 |
| 70470 | CT HEAD/BRAIN WWO CONTRAST | $1,630 | $1,630 | — | — | 0 |
Showing top 50 of 962 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.