CARLE HEALTH METHODIST HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J7181	TRETTEN 2,500 UNIT INTRAVENOUS SOLUTION	$369,210	$369,210	—	—	6
J2326	SPINRAZA (PF) 12 MG/5 ML INTRATHECAL SOLUTION	$333,562	$333,562	—	—	3
Q2043	PROVENGE 50 MILLION CELL/250 ML INTRAVENOUS SUSPENSION	$289,537	$289,537	—	—	3
J0225	AMVUTTRA 25 MG/0.5 ML SUBCUTANEOUS SYRINGE	$272,120	$272,120	—	—	3
J9347	IMJUDO 20 MG/ML INTRAVENOUS SOLUTION	$269,803	$269,803	—	—	6
64654	Opn Implt Bat Modulj Sys	$236,005	$236,005	—	—	4
J2351	OCREVUS ZUNOVO 920 MG-23,000 UNIT/23 ML SUBCUTANEOUS SOLUTION	$193,199	$193,199	—	—	3
64656	J/Rplcmt Bat Mod Sys Pg	$165,338	$165,338	—	—	4
J1823	UPLIZNA 10 MG/ML INTRAVENOUS SOLUTION	$150,672	$150,672	—	—	6
33418	BUNDLE 1 MITRA 1 R & 1 SGC0301 R / CDS0601-NTR MBR0101	$135,000	$135,000	—	—	4
33419	BUNDLE 2 MITRA 2 R & 1 SGC0301 R / CDS0601-NTR MBR0102	$135,000	$135,000	—	—	4
J9999	GLIADEL WAFER 7.7 MG IMPLANT	$131,789	$131,789	—	—	4
J2350	OCREVUS 30 MG/ML INTRAVENOUS SOLUTION	$131,277	$131,277	—	—	3
0408T	Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd	$120,509	$120,509	—	—	4
J9226	SUPPRELIN LA 50 MG (65 MCG/DAY) IMPLANT KIT	$114,414	$114,414	—	—	3
0915T	Insj Perm Ccm-D Sys Pg&Eltrd	$105,273	$105,273	—	—	4
C1822	HC Generator Neuro Rechg Bat Sys Hf	$104,740	$104,740	—	—	4
C2624	SYSTEM SENSOR CARDIOMEMS SYSTEM DEVICE MONITOR / PILLO CM PATIENT SYSTEM	$101,588	$101,588	—	—	4
0571T	HC Insj/Rplcmt Icds W/Substernal Electrode	$100,989	$100,989	—	—	4
C9293	VORAXAZE 1,000 UNIT INTRAVENOUS SOLUTION	$98,571	$98,571	—	—	3
37271	Sc Evsc Fpvt Athrc Sf 1st	$98,223	$98,223	—	—	4
37273	Sc Evsc Fpvt Athrc Cplx 1	$98,223	$98,223	—	—	4
37275	C Evsc Fpvt St Athrc Sf 1	$98,223	$98,223	—	—	4
37277	C Evsc Fpvt St Athr Cpx 1	$98,223	$98,223	—	—	4
37284	Sc Evasc Tpvt St Sf 1st	$98,223	$98,223	—	—	4
37286	Sc Evasc Tpvt St Cplx 1st	$98,223	$98,223	—	—	4
37288	Sc Evsc Tpvt Athrc Sf 1st	$98,223	$98,223	—	—	4
37290	Sc Evsc Tpvt Athrc Cplx 1	$98,223	$98,223	—	—	4
37292	C Evsc Tpvt St Athrc Sf 1	$98,223	$98,223	—	—	4
37294	C Evsc Tpvt St Athr Cpx 1	$98,223	$98,223	—	—	4
92930	Tcat Plmt Ntrac St 2+Les	$98,223	$98,223	—	—	4
J1628	TREMFYA 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION	$92,643	$92,643	—	—	6
C1882	ICD ASSURA MP CRT-D CD3369-40C	$83,250	$83,250	—	—	4
37242	Vasc Embolize/Occlude Artery	$82,499	$82,499	—	—	8
J9028	ANKTIVA 400 MCG/0.4 ML INTRAVESICAL SOLUTION	$81,624	$81,624	—	—	3
C1767	GENERATOR PROCLAIM ELITE 7 3662 CONTROLSYS	$81,340	$81,340	—	—	4
J9269	ELZONRIS 1,000 MCG/ML INTRAVENOUS SOLUTION	$76,965	$76,965	—	—	3
0916T	Insj Perm Ccm-D Sys Pg Only	$73,700	$73,700	—	—	4
0923T	Rmvl&Rplcmt Perm Ccm-D Pg	$73,700	$73,700	—	—	4
J2507	KRYSTEXXA 8 MG/ML INTRAVENOUS SOLUTION	$72,477	$72,477	—	—	3
J9334	VYVGART HYTRULO 1,000 MG-10,000 UNIT/5 ML SUBCUTANEOUS SYRINGE	$70,274	$70,274	—	—	6
J0202	LEMTRADA 12 MG/1.2 ML INTRAVENOUS SOLUTION	$67,817	$67,817	—	—	3
J9345	ZYNYZ 500 MG/20 ML INTRAVENOUS SOLUTION	$66,769	$66,769	—	—	3
33262	Rmvl Pcd W/Rplc Sngl Lead	$66,749	$66,749	—	—	4
33264	Rmvl Pcd W/Rplc Mult Lead	$66,749	$66,749	—	—	4
33249	Ins/Rpos Dual Chmb Pcg Lds&Gen	$66,749	$66,749	—	—	4
J9359	ZYNLONTA 10 MG INTRAVENOUS SOLUTION	$66,188	$66,188	—	—	3
J1246	UNITUXIN 3.5 MG/ML INTRAVENOUS SOLUTION	$65,311	$65,311	—	—	3
J9316	PHESGO 1,200 MG-600 MG-30,000 UNIT/15 ML SUBCUTANEOUS SOLUTION	$65,129	$65,129	—	—	3
37227	Fem/Pop Art Stent/Arthrect/Pta	$62,853	$62,853	—	—	4

Showing top 50 of 15,666 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.