45 CFR § 180 compliance
F · 55
This hospital published little of what § 180 requires.
●Machine-readable file published
○Gross / standard charges
○Discounted cash price
●Payer-specific negotiated rates
○Min / max negotiated charges
●Free, public, no login required
Procedures listed
5,026
Insurances with rates
15
CPT / HCPCS codes
2,206
Source MRF
Most expensive procedures (gross)
J2350
$115,992
OCREVUS 300MG SDV 10ML
Gross
$115,992
C1813
$66,387
BS AMS700 LGX MS PUMP
Gross
$66,387
J2327
$50,712
RISANKIZUMAB-RZAA (SKYRIZI) INJ : 600MG
Gross
$50,712
J2997
$44,493
ALTEPLASE (ACTIVASE) INJ : 100MG/100ML
Gross
$44,493
J0717
$40,238
CERTOLIZUMAB (CIMZIA) SYRINGE KIT
Gross
$40,238
J9271
$40,152
PEMBROLIZUMAB (KEYTRUDA) VIAL : 100MG
Gross
$40,152
J3380
$35,679
ENTYVIO 300MG SDV INJECTION
Gross
$35,679
J0517
$34,616
FASENRA 30MG INJ
Gross
$34,616
A9572
$33,872
NM INDIU PENETREOTICE PER MCI
Gross
$33,872
J0565
$29,717
BEZLOTOXUMAB (ZINPLAVA) 1000MG/40ML VIAL
Gross
$29,717
J2356
$28,411
TEZSPIRE (TEZEPELUMAB-EKKO) PFS : 210MG
Gross
$28,411
J3101
$25,288
TENECTEPLASE (TNKase) KIT : 50MG
Gross
$25,288
J2506
$22,567
PEGFILGRASTIM (NEULASTA) 6MG INJ
Gross
$22,567
J9217
$18,589
LEUPROLIDE DEPOT 45MG KIT
Gross
$18,589
52648
$18,509
GREEN LIGHT LASER
Gross
$18,509
J3111
$18,290
romosozumab-aqqg (EVENITY) INJ : 210MG
Gross
$18,290
J3262
$18,032
TOCILIZUMAB(ACTEMRA) INJ : 400MG/20ML
Gross
$18,032
J1602
$14,094
SIMPONI ARIA 50MG/4ML
Gross
$14,094
A9548
$13,919
NM INDIUM DPTA
Gross
$13,919
33300
$13,769
PHY-REPAIR CARDIAC WOUND W/O BYPASS
Gross
$13,769
J1162
$13,496
DIGOXIN IMMUNE FAB INJ : 40MG
Gross
$13,496
C1768
$13,481
GRAFT FENESTRATED 4X4 (PER DR REQUEST)
Gross
$13,481
J2796
$13,234
ROMIPLOSTIM (NPLATE) : 250MCG
Gross
$13,234
63650
$13,009
EPIDURAL NEUROSTIMULATER IMPLANT
Gross
$13,009
J7168
$12,111
PROTHROMBIN COMPLEX CONC : PER 1000 UNIT
Gross
$12,111
C1771
$11,223
TVT DEVICE EXACT-DO NOT SWITCH
Gross
$11,223
J2182
$10,652
MEPOLIZUMAB (NUCALA) : 100MG
Gross
$10,652
Q5108
$10,644
FULPHILA (PEGFILGRASTIM-JMDB) INJ : 6MG
Gross
$10,644
J0897
$10,596
DENOSUMAB (PROLIA) : 60MG/ML SYRG
Gross
$10,596
J2357
$10,566
OMALIZUMAB (XOLAIR) 150MG INJ
Gross
$10,566
27087
$10,117
ER-REMOVAL FOREIGN BODY PELVIS/HIP DEEP
Gross
$10,117
A4649
$9,446
TISSUE REMOVAL DEVICE MYOSURE
Gross
$9,446
G0390
$9,297
TRAUMA RESPONSE TEAM ACTIVATION
Gross
$9,297
24201
$9,071
ER-REMOVAL FOREIGN BODY UPPER ARM W/ELBO
Gross
$9,071
72157
$8,833
MRI THORACIC W/WO
Gross
$8,833
54150
$8,666
CIRCUMCISION
Gross
$8,666
J0630
$8,448
CALCITONIN SALMON INJ : 200 IU/ML 2ML
Gross
$8,448
28193
$8,319
ER-REMOVAL FOREIGN BODY FOOT COMPLICATED
Gross
$8,319
32110
$8,181
PHY-THORACTOMY W/CONTROL TRAUMATIC HEMOR
Gross
$8,181
32160
$8,169
ER-THORACTOMY W/CARDIAC MASSAGE
Gross
$8,169
28192
$7,930
ER-REMOVAL FOREIGN BODY FOOT DEEP
Gross
$7,930
74174
$7,870
CTA ABD/PEL W/WO CONTRAST
Gross
$7,870
74178
$7,799
CT ABD W/WO/PELVIS W
Gross
$7,799
V5258
$7,708
**HEARING AID DIGITAL PREMUIM
Gross
$7,708
70543
$7,569
MRI ORB/FACE OR NECK W/WO
Gross
$7,569
95811
$7,488
POLYSOMNOGRAPHY WITH CPAP
Gross
$7,488
70549
$7,457
MRA NECK W/WO
Gross
$7,457
70546
$7,205
MRA HEAD W/WO
Gross
$7,205
72158
$7,080
MRI LUMBAR W/WO
Gross
$7,080
23333
$7,046
ER-REMOVAL SHOULDER FOREIGN BODY DEEP SU
Gross
$7,046
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J2350 | OCREVUS 300MG SDV 10ML | $115,992 | $115,992 | — | — | 38 |
| C1813 | BS AMS700 LGX MS PUMP | $66,387 | $66,387 | — | — | 38 |
| J2327 | RISANKIZUMAB-RZAA (SKYRIZI) INJ : 600MG | $50,712 | $50,712 | — | — | 38 |
| J2997 | ALTEPLASE (ACTIVASE) INJ : 100MG/100ML | $44,493 | $44,493 | — | — | 38 |
| J0717 | CERTOLIZUMAB (CIMZIA) SYRINGE KIT | $40,238 | $40,238 | — | — | 38 |
| J9271 | PEMBROLIZUMAB (KEYTRUDA) VIAL : 100MG | $40,152 | $40,152 | — | — | 38 |
| J3380 | ENTYVIO 300MG SDV INJECTION | $35,679 | $35,679 | — | — | 38 |
| J0517 | FASENRA 30MG INJ | $34,616 | $34,616 | — | — | 38 |
| A9572 | NM INDIU PENETREOTICE PER MCI | $33,872 | $33,872 | — | — | 38 |
| J0565 | BEZLOTOXUMAB (ZINPLAVA) 1000MG/40ML VIAL | $29,717 | $29,717 | — | — | 38 |
| J2356 | TEZSPIRE (TEZEPELUMAB-EKKO) PFS : 210MG | $28,411 | $28,411 | — | — | 38 |
| J3101 | TENECTEPLASE (TNKase) KIT : 50MG | $25,288 | $25,288 | — | — | 38 |
| J2506 | PEGFILGRASTIM (NEULASTA) 6MG INJ | $22,567 | $22,567 | — | — | 38 |
| J9217 | LEUPROLIDE DEPOT 45MG KIT | $18,589 | $18,589 | — | — | 38 |
| 52648 | GREEN LIGHT LASER | $18,509 | $18,509 | — | — | 38 |
| J3111 | romosozumab-aqqg (EVENITY) INJ : 210MG | $18,290 | $18,290 | — | — | 38 |
| J3262 | TOCILIZUMAB(ACTEMRA) INJ : 400MG/20ML | $18,032 | $18,032 | — | — | 38 |
| J1602 | SIMPONI ARIA 50MG/4ML | $14,094 | $14,094 | — | — | 38 |
| A9548 | NM INDIUM DPTA | $13,919 | $13,919 | — | — | 38 |
| 33300 | PHY-REPAIR CARDIAC WOUND W/O BYPASS | $13,769 | $13,769 | — | — | 38 |
| J1162 | DIGOXIN IMMUNE FAB INJ : 40MG | $13,496 | $13,496 | — | — | 38 |
| C1768 | GRAFT FENESTRATED 4X4 (PER DR REQUEST) | $13,481 | $13,481 | — | — | 38 |
| J2796 | ROMIPLOSTIM (NPLATE) : 250MCG | $13,234 | $13,234 | — | — | 38 |
| 63650 | EPIDURAL NEUROSTIMULATER IMPLANT | $13,009 | $13,009 | — | — | 38 |
| J7168 | PROTHROMBIN COMPLEX CONC : PER 1000 UNIT | $12,111 | $12,111 | — | — | 38 |
| C1771 | TVT DEVICE EXACT-DO NOT SWITCH | $11,223 | $11,223 | — | — | 38 |
| J2182 | MEPOLIZUMAB (NUCALA) : 100MG | $10,652 | $10,652 | — | — | 38 |
| Q5108 | FULPHILA (PEGFILGRASTIM-JMDB) INJ : 6MG | $10,644 | $10,644 | — | — | 38 |
| J0897 | DENOSUMAB (PROLIA) : 60MG/ML SYRG | $10,596 | $10,596 | — | — | 38 |
| J2357 | OMALIZUMAB (XOLAIR) 150MG INJ | $10,566 | $10,566 | — | — | 38 |
| 27087 | ER-REMOVAL FOREIGN BODY PELVIS/HIP DEEP | $10,117 | $10,117 | — | — | 38 |
| A4649 | TISSUE REMOVAL DEVICE MYOSURE | $9,446 | $9,446 | — | — | 38 |
| G0390 | TRAUMA RESPONSE TEAM ACTIVATION | $9,297 | $9,297 | — | — | 38 |
| 24201 | ER-REMOVAL FOREIGN BODY UPPER ARM W/ELBO | $9,071 | $9,071 | — | — | 38 |
| 72157 | MRI THORACIC W/WO | $8,833 | $8,833 | — | — | 38 |
| 54150 | CIRCUMCISION | $8,666 | $8,666 | — | — | 38 |
| J0630 | CALCITONIN SALMON INJ : 200 IU/ML 2ML | $8,448 | $8,448 | — | — | 38 |
| 28193 | ER-REMOVAL FOREIGN BODY FOOT COMPLICATED | $8,319 | $8,319 | — | — | 38 |
| 32110 | PHY-THORACTOMY W/CONTROL TRAUMATIC HEMOR | $8,181 | $8,181 | — | — | 38 |
| 32160 | ER-THORACTOMY W/CARDIAC MASSAGE | $8,169 | $8,169 | — | — | 38 |
| 28192 | ER-REMOVAL FOREIGN BODY FOOT DEEP | $7,930 | $7,930 | — | — | 38 |
| 74174 | CTA ABD/PEL W/WO CONTRAST | $7,870 | $7,870 | — | — | 38 |
| 74178 | CT ABD W/WO/PELVIS W | $7,799 | $7,799 | — | — | 38 |
| V5258 | **HEARING AID DIGITAL PREMUIM | $7,708 | $7,708 | — | — | 38 |
| 70543 | MRI ORB/FACE OR NECK W/WO | $7,569 | $7,569 | — | — | 38 |
| 95811 | POLYSOMNOGRAPHY WITH CPAP | $7,488 | $7,488 | — | — | 38 |
| 70549 | MRA NECK W/WO | $7,457 | $7,457 | — | — | 38 |
| 70546 | MRA HEAD W/WO | $7,205 | $7,205 | — | — | 38 |
| 72158 | MRI LUMBAR W/WO | $7,080 | $7,080 | — | — | 38 |
| 23333 | ER-REMOVAL SHOULDER FOREIGN BODY DEEP SU | $7,046 | $7,046 | — | — | 38 |
Showing top 50 of 5,026 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.