CARLE BROMENN MEDICAL CENTER

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J2326	SPINRAZA (PF) 12 MG/5 ML INTRATHECAL SOLUTION	$333,562	$333,562	—	—	1
Q2043	PROVENGE 50 MILLION CELL/250 ML INTRAVENOUS SUSPENSION	$289,537	$289,537	—	—	0
J0225	AMVUTTRA 25 MG/0.5 ML SUBCUTANEOUS SYRINGE	$272,120	$272,120	—	—	0
J2351	OCREVUS ZUNOVO 920 MG-23,000 UNIT/23 ML SUBCUTANEOUS SOLUTION	$193,199	$193,199	—	—	3
J1823	UPLIZNA 10 MG/ML INTRAVENOUS SOLUTION	$150,672	$150,672	—	—	3
J9999	GLIADEL WAFER 7.7 MG IMPLANT	$131,789	$131,789	—	—	7
J8999	LENVIMA 20 MG/DAY (10 MG X 2) CAPSULE	$119,918	$119,918	—	—	21
0915T	Insj Perm Ccm-D Sys Pg&Eltrd	$100,994	$100,994	—	—	4
33264	Rmvl Pcd W/Rplc Mult Lead	$96,185	$96,185	—	—	13
63685	Implant Spinal Neurostim/Receiver	$91,421	$91,421	—	—	6
C2624	Wireless Pressure Sensor	$90,846	$90,846	—	—	3
J9269	ELZONRIS 1,000 MCG/ML INTRAVENOUS SOLUTION	$76,965	$76,965	—	—	19
0636	KISQALI 400 MG/DAY (200 MG X 2) TABLET	$73,345	$73,345	—	—	7
J8499	XTANDI 40 MG CAPSULE	$71,548	$71,548	—	—	16
J9334	VYVGART HYTRULO 1,000 MG-10,000 UNIT/5 ML SUBCUTANEOUS SYRINGE	$70,274	$70,274	—	—	12
33240	Insrt Single Chmbr Icd Genratr	$67,339	$67,339	—	—	1
C9741	Impl Pressure Sensor W/Angio	$67,094	$67,094	—	—	12
J9359	ZYNLONTA 10 MG INTRAVENOUS SOLUTION	$66,188	$66,188	—	—	1
J1246	UNITUXIN 3.5 MG/ML INTRAVENOUS SOLUTION	$65,311	$65,311	—	—	5
J2267	OMVOH 300 MG/15 ML (20 MG/ML) INTRAVENOUS SOLUTION	$61,013	$61,013	—	—	22
33270	Insrtn Subq Implnt Defib Systm	$60,155	$60,155	—	—	13
J1459	PRIVIGEN 10 % INTRAVENOUS SOLUTION	$58,811	$58,811	—	—	14
33249	Ins/Rpos Dual Chmb Pcg Lds&Gen	$57,686	$57,686	—	—	5
33229	Rmvl Perm Pcmkr W/Rplcmnt Mult Lead	$57,213	$57,213	—	—	3
J2323	TYSABRI 300 MG/15 ML INTRAVENOUS SOLUTION	$56,472	$56,472	—	—	1
93591	Perq Transcath Cls Paravalvr Leak 1 Aortic Valve	$56,208	$56,208	—	—	1
J0717	CIMZIA STARTER KIT 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT	$56,155	$56,155	—	—	19
J2329	BRIUMVI 25 MG/ML INTRAVENOUS SOLUTION	$55,374	$55,374	—	—	3
J9272	JEMPERLI 50 MG/ML INTRAVENOUS SOLUTION	$54,483	$54,483	—	—	3
J2327	SKYRIZI 360 MG/2.4 ML (150 MG/ML) SUBCUTANEOUS WEARABLE INJECTOR	$54,352	$54,352	—	—	20
37184	Percutaneous Thrombectomy Prim	$53,870	$53,870	—	—	4
0238T	Iliac Artery Atherectomy	$53,870	$53,870	—	—	1
J3316	TRIPTODUR 22.5 MG IM SUSPENSION	$52,364	$52,364	—	—	6
J9022	TECENTRIQ 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION	$51,457	$51,457	—	—	3
J9024	TECENTRIQ HYBREZA 1,875 MG-30,000 UNIT/15 ML SUBCUTANEOUS SOLUTION	$51,457	$51,457	—	—	11
J0638	ILARIS (PF) 150 MG/ML SUBCUTANEOUS SOLUTION	$51,121	$51,121	—	—	1
J1428	EXONDYS-51 50 MG/ML INTRAVENOUS SOLUTION	$50,880	$50,880	—	—	9
C1882	DEFIB CBLT XT HF QUAD CRTD MRI 1/EA DTPA2QQ	$50,850	$50,850	—	—	2
J9119	LIBTAYO 50 MG/ML INTRAVENOUS SOLUTION	$50,326	$50,326	—	—	9
J7198	FEIBA NF 1,750 UNIT-3,250 UNIT INTRAVENOUS SOLUTION	$50,220	$50,220	—	—	5
C2616	Y90 Dose	$48,421	$48,421	—	—	1
93654	Comp Ep Eval W/Ablation for V-Tach	$44,953	$44,953	—	—	1
J3241	TEPEZZA 500 MG INTRAVENOUS SOLUTION	$42,685	$42,685	—	—	19
33262	Rmvl Pcd W/Rplc Sngl Lead	$42,663	$42,663	—	—	5
J9309	POLIVY 140 MG INTRAVENOUS SOLUTION	$42,434	$42,434	—	—	1
J9600	PHOTOFRIN 75 MG INTRAVENOUS SOLUTION	$42,417	$42,417	—	—	7
93583	Perq Transcath Septal Reductn Tx	$42,151	$42,151	—	—	1
J3245	ILUMYA 100 MG/ML SUBCUTANEOUS SYRINGE	$40,952	$40,952	—	—	3
S0088	GLEEVEC 100 MG TABLET	$40,452	$40,452	—	—	7
J9332	VYVGART 20 MG/ML INTRAVENOUS SOLUTION	$40,158	$40,158	—	—	5

Showing top 50 of 7,831 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.