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
1,412
Insurances with rates
0
CPT / HCPCS codes
1,389
Source MRF
Most expensive procedures (gross)
J2997
$22,195
ALTEPLASE (ACTIVASE) 100 MG/100 ML VIAL
Gross
$44,390
C1762
$15,980
IMPLANT CONNECTIVE TISSUE 4.0ML
Gross
$31,960
C1889
$14,750
BPH CATH BALLOON 90FRX45MM OPTILUME
Gross
$29,500
55873
$14,060
CRYOSURGERY OF THE PROSTA
Gross
$28,119
C1813
$12,500
PENILE IMPLANT INFLATABL
Gross
$25,000
C1820
$12,000
IMPLANT NEUROSTIMULATOR SYSTEM
Gross
$24,000
C2618
$11,979
PROSTATE SEEDNET DISPOSAB
Gross
$23,957
90375
$8,800
RABIES IMMUNE GLOB (300IU/ML) 5ML
Gross
$17,599
C9740
$7,125
CYSTOURETHRO W/ADDL IMPL 4TOT/1ADDITIONA
Gross
$14,250
J1306
$6,762
LEQVIO 284MG/1.5ML SYRINGE SUV, P/F
Gross
$13,523
C2596
$5,541
AQUABEAM HANDPIECE
Gross
$11,083
50590
$4,985
LITHOTRIPSY
Gross
$9,971
C9739
$4,125
CYSTOURETHRO W/IMPLANT 1-3 MEDICARE
Gross
$8,250
278
$3,100
INSTAFIX IMPLANT KIT 10X10(400-3703-SP)
Gross
$6,200
0421T
$3,000
AQUABLATION TRANSURETHRAL WATERJET
Gross
$6,000
C1778
$3,000
TINED LEAD KIT NEUROSTIMULATOR
Gross
$6,000
52441
$2,125
CYSTOURETHRO W INITIAL IMPLANT
Gross
$4,250
75635
$2,089
CTA COMPLETE AORTA W/RUNOFF
Gross
$4,178
74178
$2,022
CT ABDOMEN/PELVIS W/C & W/O
Gross
$4,044
81162
$2,000
BRCAssure: BRCA1 and BRCA2 Comp Analysis
Gross
$4,000
71275
$1,969
CT PE PROTOCOL
Gross
$3,939
E0471
$1,950
DME AUTO SERVO VENT PURCHASE
Gross
$3,900
95811
$1,912
SLEEP STAGING 4+ PARAMETE
Gross
$3,823
78452
$1,895
NM STRESS TEST MYOCARDIAL PERFUSION
Gross
$3,790
C1763
$1,885
PELVIC SOFT BIOMESH
Gross
$3,769
L8606
$1,832
TEGRESS IMPLANT & SYRINGE
Gross
$3,664
71552
$1,780
MRI CHEST W/C & W/O
Gross
$3,560
95810
$1,752
SLEEP STAGING 4 OR MORE P
Gross
$3,505
64561
$1,750
LEAD IMPLANTATION
Gross
$3,500
64590
$1,750
GENERATOR IMPLANTATION OR REPLACEMENT
Gross
$3,500
74177
$1,685
CT ABDOMEN/PELVIS W/C
Gross
$3,370
14061
$1,593
TIS TRSFR 10.1-30.0SQCM
Gross
$3,186
74183
$1,567
MRI ABDOMEN W/C & W/O
Gross
$3,134
J0897
$1,551
DENOSUMAB (PROLIA) 60 MG/ML INJ
Gross
$3,102
70543
$1,537
MRI NECK W/C & W/O
Gross
$3,073
66170
$1,534
TRABECULECTOMY
Gross
$3,068
72157
$1,530
MRI T-SPINE W/C & W/O
Gross
$3,060
J0585
$1,516
BOTULINUM (BOTOX) TOXIN TYPE A 100U/VIAL
Gross
$3,032
72148
$1,506
MRI L-SPINE W/O
Gross
$3,012
70553
$1,497
MRI BRAIN W/C & W/O
Gross
$2,994
67917
$1,494
EXTENSIVE (TARSAL STRIP)
Gross
$2,987
72158
$1,454
MRI L-SPINE W/C & W/O
Gross
$2,907
72141
$1,453
MRI C-SPINE W/O
Gross
$2,907
72142
$1,453
MRI C-SPINE W/C
Gross
$2,907
72197
$1,435
MRI PELVIS W/C & W/O
Gross
$2,870
51040
$1,431
CYSTOCYSTOM W/DRAINAGE
Gross
$2,863
72156
$1,403
MRI C-SPINE W/C & W/O
Gross
$2,806
J9280
$1,375
MITOMYCIN 40MG/40ML SOLUTION (OR ONLY)
Gross
$2,750
95783
$1,337
SLEEP TITRATION <6YRS OLD
Gross
$2,674
70549
$1,326
MRA NECK W/C & W/O
Gross
$2,653
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J2997 | ALTEPLASE (ACTIVASE) 100 MG/100 ML VIAL | $44,390 | $22,195 | — | — | 0 |
| C1762 | IMPLANT CONNECTIVE TISSUE 4.0ML | $31,960 | $15,980 | — | — | 0 |
| C1889 | BPH CATH BALLOON 90FRX45MM OPTILUME | $29,500 | $14,750 | — | — | 0 |
| 55873 | CRYOSURGERY OF THE PROSTA | $28,119 | $14,060 | — | — | 0 |
| C1813 | PENILE IMPLANT INFLATABL | $25,000 | $12,500 | — | — | 0 |
| C1820 | IMPLANT NEUROSTIMULATOR SYSTEM | $24,000 | $12,000 | — | — | 0 |
| C2618 | PROSTATE SEEDNET DISPOSAB | $23,957 | $11,979 | — | — | 0 |
| 90375 | RABIES IMMUNE GLOB (300IU/ML) 5ML | $17,599 | $8,800 | — | — | 0 |
| C9740 | CYSTOURETHRO W/ADDL IMPL 4TOT/1ADDITIONA | $14,250 | $7,125 | — | — | 0 |
| J1306 | LEQVIO 284MG/1.5ML SYRINGE SUV, P/F | $13,523 | $6,762 | — | — | 0 |
| C2596 | AQUABEAM HANDPIECE | $11,083 | $5,541 | — | — | 0 |
| 50590 | LITHOTRIPSY | $9,971 | $4,985 | — | — | 0 |
| C9739 | CYSTOURETHRO W/IMPLANT 1-3 MEDICARE | $8,250 | $4,125 | — | — | 0 |
| 278 | INSTAFIX IMPLANT KIT 10X10(400-3703-SP) | $6,200 | $3,100 | — | — | 0 |
| 0421T | AQUABLATION TRANSURETHRAL WATERJET | $6,000 | $3,000 | — | — | 0 |
| C1778 | TINED LEAD KIT NEUROSTIMULATOR | $6,000 | $3,000 | — | — | 0 |
| 52441 | CYSTOURETHRO W INITIAL IMPLANT | $4,250 | $2,125 | — | — | 0 |
| 75635 | CTA COMPLETE AORTA W/RUNOFF | $4,178 | $2,089 | — | — | 0 |
| 74178 | CT ABDOMEN/PELVIS W/C & W/O | $4,044 | $2,022 | — | — | 0 |
| 81162 | BRCAssure: BRCA1 and BRCA2 Comp Analysis | $4,000 | $2,000 | — | — | 0 |
| 71275 | CT PE PROTOCOL | $3,939 | $1,969 | — | — | 0 |
| E0471 | DME AUTO SERVO VENT PURCHASE | $3,900 | $1,950 | — | — | 0 |
| 95811 | SLEEP STAGING 4+ PARAMETE | $3,823 | $1,912 | — | — | 0 |
| 78452 | NM STRESS TEST MYOCARDIAL PERFUSION | $3,790 | $1,895 | — | — | 0 |
| C1763 | PELVIC SOFT BIOMESH | $3,769 | $1,885 | — | — | 0 |
| L8606 | TEGRESS IMPLANT & SYRINGE | $3,664 | $1,832 | — | — | 0 |
| 71552 | MRI CHEST W/C & W/O | $3,560 | $1,780 | — | — | 0 |
| 95810 | SLEEP STAGING 4 OR MORE P | $3,505 | $1,752 | — | — | 0 |
| 64561 | LEAD IMPLANTATION | $3,500 | $1,750 | — | — | 0 |
| 64590 | GENERATOR IMPLANTATION OR REPLACEMENT | $3,500 | $1,750 | — | — | 0 |
| 74177 | CT ABDOMEN/PELVIS W/C | $3,370 | $1,685 | — | — | 0 |
| 14061 | TIS TRSFR 10.1-30.0SQCM | $3,186 | $1,593 | — | — | 0 |
| 74183 | MRI ABDOMEN W/C & W/O | $3,134 | $1,567 | — | — | 0 |
| J0897 | DENOSUMAB (PROLIA) 60 MG/ML INJ | $3,102 | $1,551 | — | — | 0 |
| 70543 | MRI NECK W/C & W/O | $3,073 | $1,537 | — | — | 0 |
| 66170 | TRABECULECTOMY | $3,068 | $1,534 | — | — | 0 |
| 72157 | MRI T-SPINE W/C & W/O | $3,060 | $1,530 | — | — | 0 |
| J0585 | BOTULINUM (BOTOX) TOXIN TYPE A 100U/VIAL | $3,032 | $1,516 | — | — | 0 |
| 72148 | MRI L-SPINE W/O | $3,012 | $1,506 | — | — | 0 |
| 70553 | MRI BRAIN W/C & W/O | $2,994 | $1,497 | — | — | 0 |
| 67917 | EXTENSIVE (TARSAL STRIP) | $2,987 | $1,494 | — | — | 0 |
| 72158 | MRI L-SPINE W/C & W/O | $2,907 | $1,454 | — | — | 0 |
| 72141 | MRI C-SPINE W/O | $2,907 | $1,453 | — | — | 0 |
| 72142 | MRI C-SPINE W/C | $2,907 | $1,453 | — | — | 0 |
| 72197 | MRI PELVIS W/C & W/O | $2,870 | $1,435 | — | — | 0 |
| 51040 | CYSTOCYSTOM W/DRAINAGE | $2,863 | $1,431 | — | — | 0 |
| 72156 | MRI C-SPINE W/C & W/O | $2,806 | $1,403 | — | — | 0 |
| J9280 | MITOMYCIN 40MG/40ML SOLUTION (OR ONLY) | $2,750 | $1,375 | — | — | 0 |
| 95783 | SLEEP TITRATION <6YRS OLD | $2,674 | $1,337 | — | — | 0 |
| 70549 | MRA NECK W/C & W/O | $2,653 | $1,326 | — | — | 0 |
Showing top 50 of 1,412 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.