MADISON MEMORIAL HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
176	PULMONARY EMBOLISM WITHOUT MCC	$38,050	$32,343	—	—	2
281	ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC	$33,283	$28,291	—	—	2
539	OSTEOMYELITIS WITH MCC	$31,982	$27,185	—	—	2
480104	ALTEPLASE 0.09 MG/KG BOLUS - MHS	$31,682	$26,930	—	—	37
J2997	ALTEPLASE 100 MG IV SOLR	$31,682	$26,930	—	—	37
831	OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC	$29,080	$24,718	—	—	2
542	PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC	$27,904	$23,718	—	—	2
445	DISORDERS OF THE BILIARY TRACT WITH CC	$27,175	$23,099	—	—	2
J3101	TENECTEPLASE 50 MG IV SOLR	$26,562	$22,578	—	—	37
982	EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC	$23,669	$20,119	—	—	2
J2506	PEGFILGRASTIM 6 MG/0.6 ML SUBQ SYRG	$23,105	$19,639	—	—	37
177	RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC	$22,354	$19,001	—	—	2
J9217	LEUPROLIDE (3 MONTH) 22.5 MG IM SYKT	$21,025	$17,871	—	—	37
157	DENTAL AND ORAL DISEASES WITH MCC	$20,706	$17,600	—	—	2
J0517	BENRALIZUMAB 30 MG/ML SUBQ SYRG	$19,842	$16,866	—	—	37
J0717	CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBQ SYKT	$19,443	$16,527	—	—	37
179	RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC	$19,421	$16,508	—	—	2
191	CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC	$18,774	$15,958	—	—	2
603	CELLULITIS WITHOUT MCC	$18,538	$15,757	—	—	2
95	BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC	$18,276	$15,535	—	—	2
388	GASTROINTESTINAL OBSTRUCTION WITH MCC	$18,003	$15,303	—	—	2
J1162	DIGOXIN IMMUNE FAB 40 MG IV SOLR	$16,557	$14,073	—	—	37
292	HEART FAILURE AND SHOCK WITH CC	$15,878	$13,496	—	—	2
193	SIMPLE PNEUMONIA AND PLEURISY WITH MCC	$15,105	$12,839	—	—	2
289	ACUTE AND SUBACUTE ENDOCARDITIS WITH CC	$14,860	$12,631	—	—	2
884	ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY	$14,608	$12,417	—	—	2
918	POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC	$14,451	$12,283	—	—	2
315	OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC	$14,276	$12,135	—	—	2
69	TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC	$14,220	$12,087	—	—	2
605	TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC	$14,023	$11,920	—	—	2
390	GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC	$13,650	$11,602	—	—	2
384	UNCOMPLICATED PEPTIC ULCER WITHOUT MCC	$13,601	$11,561	—	—	2
640	MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC	$13,579	$11,542	—	—	2
809	MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS	$13,286	$11,293	—	—	2
872	SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC	$12,820	$10,897	—	—	2
57	DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC	$12,623	$10,730	—	—	2
442	DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC	$12,466	$10,596	—	—	2
J1459	IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % IV SOLN	$12,299	$10,454	—	—	37
641	MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC	$12,291	$10,447	—	—	2
178	RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC	$12,228	$10,394	—	—	2
439	DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC	$12,204	$10,373	—	—	2
897	ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC	$12,182	$10,355	—	—	2
552	MEDICAL BACK PROBLEMS WITHOUT MCC	$12,119	$10,301	—	—	2
391	ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC	$11,823	$10,050	—	—	2
540	OSTEOMYELITIS WITH CC	$11,611	$9,869	—	—	2
91	OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC	$11,451	$9,733	—	—	2
65	INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS	$11,361	$9,657	—	—	2
563	FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC	$11,018	$9,365	—	—	2
194	SIMPLE PNEUMONIA AND PLEURISY WITH CC	$10,949	$9,307	—	—	2
690	KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC	$10,917	$9,279	—	—	2

Showing top 50 of 2,807 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.