CARLE EUREKA HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J7181	TRETTEN 2,500 UNIT INTRAVENOUS SOLUTION	$369,210	$369,210	—	—	2
J0225	AMVUTTRA 25 MG/0.5 ML SUBCUTANEOUS SYRINGE	$272,120	$272,120	—	—	1
J2351	OCREVUS ZUNOVO 920 MG-23,000 UNIT/23 ML SUBCUTANEOUS SOLUTION	$193,199	$193,199	—	—	2
J9228	YERVOY 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION	$160,812	$160,812	—	—	6
J9999	GLIADEL WAFER 7.7 MG IMPLANT	$131,789	$131,789	—	—	4
J9226	SUPPRELIN LA 50 MG (65 MCG/DAY) IMPLANT KIT	$114,414	$114,414	—	—	4
A9540	DRAXIMAGE MAA 2.5 MG INTRAVENOUS SOLUTION	$105,719	$105,719	—	—	4
33264	Rmvl Pcd W/Rplc Mult Lead	$96,185	$96,185	—	—	6
33231	Insrt Icd Genrtr W/Exst Mult Leads	$96,185	$96,185	—	—	2
J9028	ANKTIVA 400 MCG/0.4 ML INTRAVESICAL SOLUTION	$81,624	$81,624	—	—	2
0916T	Insj Perm Ccm-D Sys Pg Only	$70,706	$70,706	—	—	21
0923T	Rmvl&Rplcmt Perm Ccm-D Pg	$70,706	$70,706	—	—	2
J0202	LEMTRADA 12 MG/1.2 ML INTRAVENOUS SOLUTION	$67,817	$67,817	—	—	11
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	—	—	15
J9316	PHESGO 1,200 MG-600 MG-30,000 UNIT/15 ML SUBCUTANEOUS SOLUTION	$65,129	$65,129	—	—	2
J2267	OMVOH 300 MG/15 ML (20 MG/ML) INTRAVENOUS SOLUTION	$61,013	$61,013	—	—	18
J7209	NUWIQ 4,000 UNIT INTRAVENOUS SOLUTION	$58,032	$58,032	—	—	24
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	—	—	25
J3316	TRIPTODUR 22.5 MG IM SUSPENSION	$52,364	$52,364	—	—	18
J9022	TECENTRIQ 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION	$51,457	$51,457	—	—	2
J9024	TECENTRIQ HYBREZA 1,875 MG-30,000 UNIT/15 ML SUBCUTANEOUS SOLUTION	$51,457	$51,457	—	—	4
J0638	ILARIS (PF) 150 MG/ML SUBCUTANEOUS SOLUTION	$51,121	$51,121	—	—	2
C1882	DEFIB CBLT SURESCN XT CRTD MRI 1/EA DTPA2D4	$50,850	$50,850	—	—	2
J7198	FEIBA NF 1,750 UNIT-3,250 UNIT INTRAVENOUS SOLUTION	$50,220	$50,220	—	—	24
J9274	KIMMTRAK 100 MCG/0.5 ML INTRAVENOUS SOLUTION	$49,043	$49,043	—	—	1
C2616	Y90 Dose	$48,421	$48,421	—	—	4
0636	IMBRUVICA 140 MG TABLET	$47,568	$47,568	—	—	18
J1323	ELREXFIO 40 MG/ML SUBCUTANEOUS SOLUTION	$46,356	$46,356	—	—	14
J1561	GAMUNEX-C 40 GRAM/400 ML (10 %) INJECTION SOLUTION	$45,592	$45,592	—	—	6
93654	Comp Ep Eval W/Ablation for V-Tach	$44,953	$44,953	—	—	19
J3263	LOQTORZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION	$43,322	$43,322	—	—	5
J0139	HUMIRA(CF) PEN 80 MG/0.8 ML SUBCUTANEOUS KIT	$43,197	$43,197	—	—	19
J3245	ILUMYA 100 MG/ML SUBCUTANEOUS SYRINGE	$40,952	$40,952	—	—	2
J9228	YERVOY 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION	$40,203	$40,203	—	—	18
J9332	VYVGART 20 MG/ML INTRAVENOUS SOLUTION	$40,158	$40,158	—	—	6
J9301	GAZYVA 1,000 MG/40 ML INTRAVENOUS SOLUTION	$39,961	$39,961	—	—	2
C9767	Fem/Pop Art Stent/Arthrect/Pta	$39,114	$39,114	—	—	5
C9775	Revasc Lith-Sten-Ath Tib/Per	$39,114	$39,114	—	—	2
27759	Treat Tibial Shaft Fx, Intramed Implant	$38,600	$38,600	—	—	2
36906	Perq Thrmbc/Nfs Dial Circuit Tcat Plmt IV Stent	$38,263	$38,263	—	—	6
33274	Tcat Insj/Rpl Perm Leadless Pacemaker Rv W/Img	$38,000	$38,000	—	—	6
93582	Perq Transcath Closure Pda	$37,893	$37,893	—	—	19
92937	Cor Graft Athrctmy W/Stent - 1 Vsl	$37,226	$37,226	—	—	2
J7209	NUWIQ 2,500 UNIT INTRAVENOUS SOLUTION	$36,270	$36,270	—	—	2
J0491	SAPHNELO 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION	$35,122	$35,122	—	—	2
J3357	STELARA 45 MG/0.5 ML SUBCUTANEOUS SOLUTION	$34,894	$34,894	—	—	6
C1721	DEFIB COBALT SURESCN XT DR MRI 1/EA DDPA2D4	$34,458	$34,458	—	—	2

Showing top 50 of 8,322 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.