45 CFR § 180 compliance
B · 85
This hospital published most 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
1,468
Insurances with rates
6
CPT / HCPCS codes
1,437
Source MRF
Most expensive procedures (gross)
64555
$109,326
ELECTRODES/LEADS
Gross
$145,768
64590
$109,326
IPG (IMPLANTABLE PLUSE GEN)
Gross
$145,768
C1767
$65,130
PROCLAIM SYSTEM
Gross
$86,840
22612
$42,000
INTERLAMINAR FIXATION DEVICE
Gross
$56,000
J3101
$37,338
TNKase injection 50mg kit
Gross
$49,784
29888
$21,429
ACL RECONSTRUCTION
Gross
$28,572
66991
$15,477
CATARACT REMOVE W INTER LENS
Gross
$20,636
22840
$15,000
SPINE FIXATION DEVICE
Gross
$20,000
750
$14,462
EGD
Gross
$19,283
J0840
$14,391
CROFAB 1GM INJ 1 vial
Gross
$19,188
66250
$12,243
ANTERIOR SCLERA REPAIR
Gross
$16,324
68320
$12,243
GRAFT/REVISE EYELID LINING
Gross
$16,324
66185
$11,970
GLAUCOMA REPAIR
Gross
$15,960
67255
$11,238
TUTOPLAST
Gross
$14,984
27427
$10,894
IMPLANT SYSTEM FIBERTAG TIGHTROPE
Gross
$14,525
29870
$9,732
KNEE ARTHROSCOPY
Gross
$12,976
29871
$9,732
ARTHO JOINT INFECTION PREVENTION
Gross
$12,976
65779
$9,381
BIOTISSUE SINGLE
Gross
$12,508
65780
$9,381
BIOTISSUE MULTI
Gross
$12,508
66174
$8,789
OMNI SURGICAL SYSTEM
Gross
$11,718
0671T
$8,663
HYDRUS MICROSTENT
Gross
$11,550
20680
$8,586
REMOVE IMPLANT HARDWARD
Gross
$11,448
0449T
$7,656
XEN GEL STENT
Gross
$10,208
G0390
$7,313
TRAUMA ACT LEVEL IV
Gross
$9,751
43239
$7,216
EGD W/BIOPSY
Gross
$9,622
J0897
$7,040
PROLIA 60MG INJ
Gross
$9,386
74177
$6,660
CT ABDOMEN AND PELVIS W/CONTRAST
Gross
$8,881
66180
$6,300
AQUEOUS SHUNT
Gross
$8,400
A9569
$5,811
NM CERETEC ISOTOPE
Gross
$7,748
45380
$5,537
COLONOSCOPY W/BIOPSY
Gross
$7,383
J0875
$5,525
DALBAVANCIN(DALVANCE)500MG INJ
Gross
$7,367
72157
$5,384
MRI SPINE THORACIC W W/O CONTRAST
Gross
$7,179
72156
$5,231
MRI SPINE CERVICAL W W/O CONTRAST
Gross
$6,974
73720
$4,873
MRI LEG (BONES) RT W/WO/CONTRAST
Gross
$6,497
65820
$4,800
IACCESS DEVICE
Gross
$6,400
J3300
$4,245
TRIESENCE OPTH. INJECTION: 40mg/1ml
Gross
$5,660
370
$4,215
GENERAL ANES 1ST HR
Gross
$5,620
88374
$3,937
PATH HER2 COMP ASST M/PHMTRC - FISH
Gross
$5,250
59899
$3,750
JADA HEMORRAGE SYSTEM
Gross
$5,000
10140
$3,687
DRAINAGE HEMATOMA OR FLUID
Gross
$4,916
72128
$3,656
CT THORACIC SPINE W/O CONTRAST
Gross
$4,875
70487
$3,588
CT FACE W/CONTRAST
Gross
$4,785
90375
$3,356
RABIES IMMUNE GLOB INJ 300IU
Gross
$4,475
78264
$3,348
NM GASTRIC EMPTYING STUDY
Gross
$4,464
36571
$3,300
PICC LINE INCERTION >5 YRS
Gross
$4,400
36596
$3,300
PICC LINE REMOVAL
Gross
$4,400
74178
$3,244
CT ABDOMEN AND PELVIS W&W/O CONTRAST
Gross
$4,326
72193
$3,237
CT PELVIS W/CONTRAST
Gross
$4,316
73218
$3,135
MRI HAND (BONES) RT W/O CONTRAST
Gross
$4,180
70544
$3,099
MRA HEAD W/O CONTRAST
Gross
$4,132
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 64555 | ELECTRODES/LEADS | $145,768 | $109,326 | — | — | 6 |
| 64590 | IPG (IMPLANTABLE PLUSE GEN) | $145,768 | $109,326 | — | — | 6 |
| C1767 | PROCLAIM SYSTEM | $86,840 | $65,130 | — | — | 6 |
| 22612 | INTERLAMINAR FIXATION DEVICE | $56,000 | $42,000 | — | — | 6 |
| J3101 | TNKase injection 50mg kit | $49,784 | $37,338 | — | — | 6 |
| 29888 | ACL RECONSTRUCTION | $28,572 | $21,429 | — | — | 6 |
| 66991 | CATARACT REMOVE W INTER LENS | $20,636 | $15,477 | — | — | 6 |
| 22840 | SPINE FIXATION DEVICE | $20,000 | $15,000 | — | — | 6 |
| 750 | EGD | $19,283 | $14,462 | — | — | 6 |
| J0840 | CROFAB 1GM INJ 1 vial | $19,188 | $14,391 | — | — | 6 |
| 66250 | ANTERIOR SCLERA REPAIR | $16,324 | $12,243 | — | — | 6 |
| 68320 | GRAFT/REVISE EYELID LINING | $16,324 | $12,243 | — | — | 6 |
| 66185 | GLAUCOMA REPAIR | $15,960 | $11,970 | — | — | 6 |
| 67255 | TUTOPLAST | $14,984 | $11,238 | — | — | 6 |
| 27427 | IMPLANT SYSTEM FIBERTAG TIGHTROPE | $14,525 | $10,894 | — | — | 6 |
| 29870 | KNEE ARTHROSCOPY | $12,976 | $9,732 | — | — | 6 |
| 29871 | ARTHO JOINT INFECTION PREVENTION | $12,976 | $9,732 | — | — | 6 |
| 65779 | BIOTISSUE SINGLE | $12,508 | $9,381 | — | — | 6 |
| 65780 | BIOTISSUE MULTI | $12,508 | $9,381 | — | — | 6 |
| 66174 | OMNI SURGICAL SYSTEM | $11,718 | $8,789 | — | — | 6 |
| 0671T | HYDRUS MICROSTENT | $11,550 | $8,663 | — | — | 6 |
| 20680 | REMOVE IMPLANT HARDWARD | $11,448 | $8,586 | — | — | 6 |
| 0449T | XEN GEL STENT | $10,208 | $7,656 | — | — | 6 |
| G0390 | TRAUMA ACT LEVEL IV | $9,751 | $7,313 | — | — | 6 |
| 43239 | EGD W/BIOPSY | $9,622 | $7,216 | — | — | 6 |
| J0897 | PROLIA 60MG INJ | $9,386 | $7,040 | — | — | 6 |
| 74177 | CT ABDOMEN AND PELVIS W/CONTRAST | $8,881 | $6,660 | — | — | 6 |
| 66180 | AQUEOUS SHUNT | $8,400 | $6,300 | — | — | 6 |
| A9569 | NM CERETEC ISOTOPE | $7,748 | $5,811 | — | — | 6 |
| 45380 | COLONOSCOPY W/BIOPSY | $7,383 | $5,537 | — | — | 6 |
| J0875 | DALBAVANCIN(DALVANCE)500MG INJ | $7,367 | $5,525 | — | — | 6 |
| 72157 | MRI SPINE THORACIC W W/O CONTRAST | $7,179 | $5,384 | — | — | 6 |
| 72156 | MRI SPINE CERVICAL W W/O CONTRAST | $6,974 | $5,231 | — | — | 6 |
| 73720 | MRI LEG (BONES) RT W/WO/CONTRAST | $6,497 | $4,873 | — | — | 6 |
| 65820 | IACCESS DEVICE | $6,400 | $4,800 | — | — | 12 |
| J3300 | TRIESENCE OPTH. INJECTION: 40mg/1ml | $5,660 | $4,245 | — | — | 6 |
| 370 | GENERAL ANES 1ST HR | $5,620 | $4,215 | — | — | 6 |
| 88374 | PATH HER2 COMP ASST M/PHMTRC - FISH | $5,250 | $3,937 | — | — | 6 |
| 59899 | JADA HEMORRAGE SYSTEM | $5,000 | $3,750 | — | — | 6 |
| 10140 | DRAINAGE HEMATOMA OR FLUID | $4,916 | $3,687 | — | — | 6 |
| 72128 | CT THORACIC SPINE W/O CONTRAST | $4,875 | $3,656 | — | — | 6 |
| 70487 | CT FACE W/CONTRAST | $4,785 | $3,588 | — | — | 6 |
| 90375 | RABIES IMMUNE GLOB INJ 300IU | $4,475 | $3,356 | — | — | 6 |
| 78264 | NM GASTRIC EMPTYING STUDY | $4,464 | $3,348 | — | — | 6 |
| 36571 | PICC LINE INCERTION >5 YRS | $4,400 | $3,300 | — | — | 6 |
| 36596 | PICC LINE REMOVAL | $4,400 | $3,300 | — | — | 6 |
| 74178 | CT ABDOMEN AND PELVIS W&W/O CONTRAST | $4,326 | $3,244 | — | — | 6 |
| 72193 | CT PELVIS W/CONTRAST | $4,316 | $3,237 | — | — | 6 |
| 73218 | MRI HAND (BONES) RT W/O CONTRAST | $4,180 | $3,135 | — | — | 6 |
| 70544 | MRA HEAD W/O CONTRAST | $4,132 | $3,099 | — | — | 6 |
Showing top 50 of 1,468 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.