CARLE FOUNDATION HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J7181	TRETTEN 2,500 UNIT INTRAVENOUS SOLUTION	$369,210	$369,210	—	—	4
J2326	SPINRAZA (PF) 12 MG/5 ML INTRATHECAL SOLUTION	$333,562	$333,562	—	—	2
Q2043	PROVENGE 50 MILLION CELL/250 ML INTRAVENOUS SUSPENSION	$289,537	$289,537	—	—	2
J0225	AMVUTTRA 25 MG/0.5 ML SUBCUTANEOUS SYRINGE	$272,120	$272,120	—	—	2
J9347	IMJUDO 20 MG/ML INTRAVENOUS SOLUTION	$269,803	$269,803	—	—	4
J2351	OCREVUS ZUNOVO 920 MG-23,000 UNIT/23 ML SUBCUTANEOUS SOLUTION	$193,199	$193,199	—	—	2
J1823	UPLIZNA 10 MG/ML INTRAVENOUS SOLUTION	$150,672	$150,672	—	—	4
0915T	Insj Perm Ccm-D Sys Pg&Eltrd	$140,364	$140,364	—	—	2
J9999	GLIADEL WAFER 7.7 MG IMPLANT	$131,789	$131,789	—	—	2
J2350	OCREVUS 30 MG/ML INTRAVENOUS SOLUTION	$131,277	$131,277	—	—	2
0408T	Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd	$120,372	$120,372	—	—	2
J9226	SUPPRELIN LA 50 MG (65 MCG/DAY) IMPLANT KIT	$114,414	$114,414	—	—	2
C2624	Wireless Pressure Sensor	$101,590	$101,590	—	—	2
C9293	VORAXAZE 1,000 UNIT INTRAVENOUS SOLUTION	$98,571	$98,571	—	—	2
0916T	Insj Perm Ccm-D Sys Pg Only	$98,270	$98,270	—	—	2
0923T	Rmvl&Rplcmt Perm Ccm-D Pg	$98,270	$98,270	—	—	2
J1628	TREMFYA 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION	$92,643	$92,643	—	—	4
Q4116	ALLODERM THICK PERFERATED 1519320PBP	$83,799	$83,799	—	—	2
C9741	Impl Pressure Sensor W/Angio	$83,696	$83,696	—	—	2
J9028	ANKTIVA 400 MCG/0.4 ML INTRAVESICAL SOLUTION	$81,624	$81,624	—	—	2
33270	Insrtn Subq Implnt Defib Systm	$80,105	$80,105	—	—	2
J9269	ELZONRIS 1,000 MCG/ML INTRAVENOUS SOLUTION	$76,965	$76,965	—	—	2
33249	Ins/Rpos Dual Chmb Pcg Lds&Gen	$76,808	$76,808	—	—	2
93590	Perq Transcath Cls Paravalvr Leak 1 Mitral Valve	$74,855	$74,855	—	—	2
93591	Perq Transcath Cls Paravalvr Leak 1 Aortic Valve	$74,855	$74,855	—	—	2
J2507	KRYSTEXXA 8 MG/ML INTRAVENOUS SOLUTION	$72,477	$72,477	—	—	2
J9334	VYVGART HYTRULO 1,000 MG-10,000 UNIT/5 ML SUBCUTANEOUS SYRINGE	$70,274	$70,274	—	—	4
C9767	Fem/Pop Art Stent/Arthrect/Pta	$69,972	$69,972	—	—	2
J0202	LEMTRADA 12 MG/1.2 ML INTRAVENOUS SOLUTION	$67,817	$67,817	—	—	2
J9345	ZYNYZ 500 MG/20 ML INTRAVENOUS SOLUTION	$66,769	$66,769	—	—	2
J9359	ZYNLONTA 10 MG INTRAVENOUS SOLUTION	$66,188	$66,188	—	—	2
J1246	UNITUXIN 3.5 MG/ML INTRAVENOUS SOLUTION	$65,311	$65,311	—	—	2
J9316	PHESGO 1,200 MG-600 MG-30,000 UNIT/15 ML SUBCUTANEOUS SOLUTION	$65,129	$65,129	—	—	2
J0222	ONPATTRO 2 MG/ML INTRAVENOUS SOLUTION	$62,233	$62,233	—	—	2
J2267	OMVOH 300 MG/15 ML (20 MG/ML) INTRAVENOUS SOLUTION	$61,013	$61,013	—	—	2
93654	Comp Ep Eval W/Ablation for V-Tach	$59,861	$59,861	—	—	2
33262	Rmvl Pcd W/Rplc Sngl Lead	$56,826	$56,826	—	—	2
J2323	TYSABRI 300 MG/15 ML INTRAVENOUS SOLUTION	$56,472	$56,472	—	—	2
33263	Rmvl Pcd W/ Rplc Dual Lead	$56,396	$56,396	—	—	2
33418	Tcat Mitral Valve Repair Initial Prosthesis	$56,280	$56,280	—	—	2
93583	Perq Transcath Septal Reductn Tx	$56,144	$56,144	—	—	2
J9229	BESPONSA 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) INTRAVENOUS SOLUTION	$55,619	$55,619	—	—	2
J2329	BRIUMVI 25 MG/ML INTRAVENOUS SOLUTION	$55,374	$55,374	—	—	2
J9272	JEMPERLI 50 MG/ML INTRAVENOUS SOLUTION	$54,483	$54,483	—	—	2
G2170	Avf by Tissue W Thermal Energy	$54,422	$54,422	—	—	2
G2171	Avf Use Magnetic/Art/Ven	$54,422	$54,422	—	—	2
J2327	SKYRIZI 360 MG/2.4 ML (150 MG/ML) SUBCUTANEOUS WEARABLE INJECTOR	$54,352	$54,352	—	—	4
C2616	Y90 Dose	$54,150	$54,150	—	—	2
J3316	TRIPTODUR 22.5 MG IM SUSPENSION	$52,364	$52,364	—	—	4
C1767	Generator, Neurostimulator(Imp)	$51,507	$51,507	—	—	2

Showing top 50 of 20,567 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.