45 CFR § 180 compliance
A · 100
This hospital published most 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
2,400
Insurances with rates
9
CPT / HCPCS codes
992
Source MRF
Most expensive procedures (gross)
G0495
$24,580
HH/RN TEACHING VISIT
Gross
$24,580
90471
$24,580
FLUZONE 0.5ML ADMINISTRATION
Gross
$24,580
J3380
$14,229
ENTYVIO (VEDOLIZUMAB) 300MG VIAL
Gross
$14,229
J0517
$12,474
FASENRA SUBCUTANEOUS SOLUTION 30MG/1ML
Gross
$12,474
J2353
$11,193
SANDOSTATIN LAR DEPOT : 20MG
Gross
$11,193
J9217
$10,503
LUPRON DEPOT 22.5MG : PREFILLED SYRINGE
Gross
$10,503
NM INDIUM IN-111 AUTO WBC
$10,208
NM INDIUM IN-111 AUTO WBC
Gross
$10,208
ARANESP 500mcg SINGLEJECT SYRINGE
$9,752
ARANESP 500mcg SINGLEJECT SYRINGE
Gross
$9,752
LIGAMENT PATELLA HEMI
$7,938
LIGAMENT PATELLA HEMI
Gross
$7,938
J2182
$7,304
NUCALA 100 MG: VIAL
Gross
$7,304
Q4110
$7,256
GRAFT PRIMATRIX AG 6X6 CM
Gross
$7,256
GRAFT CONNEXT MATRIX .030OZ
$7,185
GRAFT CONNEXT MATRIX .030OZ
Gross
$7,185
74178
$7,105
CT ABD & PELVIS W/WO CONTRAST
Gross
$7,105
Q4184
$6,238
GRAFT CELLESTA 4X4CM
Gross
$6,238
CATARACT EXTRACTION W/LENS INSERTION
$6,167
CATARACT EXTRACTION W/LENS INSERTION
Gross
$6,167
Q4196
$6,125
GRAFT PURAPLY AM 5X5
Gross
$6,125
73706
$5,930
CT VENOGRAM LE/RIGHT
Gross
$5,930
74174
$5,916
CTA ABD & PELVIS W/CONTRAST
Gross
$5,916
74175
$5,916
CTA ABDOMEN
Gross
$5,916
74170
$5,684
CT ABDOMEN W/WO ENHANCEMENT
Gross
$5,684
74177
$5,561
CT ABD & PELVIS W/CONTRAST
Gross
$5,561
23655
$5,465
UBDISL TX SHOULDER CLOSED W/MAN W/ANES
Gross
$5,465
70549
$5,465
MRA NECK W/WO CONTRAST
Gross
$5,465
STERI STRIP WOUND CLOSURE (LAP CHOLE)
$5,465
STERI STRIP WOUND CLOSURE (LAP CHOLE)
Gross
$5,465
#NAME?
$5,465
COLONOSCOPY W/EGD
Gross
$5,465
70546
$5,460
MRA HEAD W/WO CONTRAST
Gross
$5,460
KIT DEVICE GENESYS HTA PROCERVA
$5,400
KIT DEVICE GENESYS HTA PROCERVA
Gross
$5,400
70482
$5,367
CT ORBITS W/WO ENHANCEMENT
Gross
$5,367
78452
$5,308
NM MPI R & S MULTI SPECT W/WALL & EJECT
Gross
$5,308
G0416
$5,177
PATH PRSTAT (GROSS/MICRO) TC
Gross
$5,177
95811
$5,098
SLEEP STUDY/CPAP >= 6 hrs of recording
Gross
$5,098
78071
$5,085
NM PARATHYROID PLANAR SPECT w/subtractio
Gross
$5,085
73702
$4,956
CT EXT LOWER W/WO CONTRAST
Gross
$4,956
70488
$4,937
CT SINUSES W/WO CONTRAST
Gross
$4,937
92960
$4,850
CARDIOVERSION ER FACILITY (450)
Gross
$4,850
71270
$4,830
CT THORAX W/WO ENH
Gross
$4,830
70492
$4,813
CT NECK S.T. W/WO ENHANCEMENT
Gross
$4,813
J3111
$4,791
EVENITY SC INJ 210mg (2 SYRINGE 105mg)
Gross
$4,791
72194
$4,784
CT PELVIS W/WO ENHANCEMENT
Gross
$4,784
J1602
$4,771
SIMPONI ARIA 50MG/4ML SDV
Gross
$4,771
71552
$4,692
MRI CHEST W/WO CONTRAST
Gross
$4,692
74183
$4,596
MRI ABDOMEN W/WO CONTRAST
Gross
$4,596
72197
$4,590
MRI PELVIS W/WO CONTRAST
Gross
$4,590
25560
$4,566
UBFX TX RADIUS/ULNAR SHAFT CLOSED W/OMAN
Gross
$4,566
25565
$4,566
UB-CLSED TX RADIAL&ULNAR SHAFT FX W/MANJ
Gross
$4,566
56420
$4,563
UB-I & D BARTHOLINS GLAND ABSCESS
Gross
$4,563
65205
$4,563
UB-REMOVE FB-CONJUNCTIVA
Gross
$4,563
65220
$4,563
UB-REMOVE FB-CORNEAL,W/O SL
Gross
$4,563
65222
$4,563
UB-REMOVE FB-CORNEA,W/SL
Gross
$4,563
69200
$4,563
UB-REMOVE FB-EXT AUD CANAL
Gross
$4,563
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| G0495 | HH/RN TEACHING VISIT | $24,580 | $24,580 | $42 | $23,351 | 9 |
| 90471 | FLUZONE 0.5ML ADMINISTRATION | $24,580 | $24,580 | $2,458 | $23,351 | 10 |
| J3380 | ENTYVIO (VEDOLIZUMAB) 300MG VIAL | $14,229 | $14,229 | $1,423 | $13,518 | 10 |
| J0517 | FASENRA SUBCUTANEOUS SOLUTION 30MG/1ML | $12,474 | $12,474 | $1,247 | $11,851 | 10 |
| J2353 | SANDOSTATIN LAR DEPOT : 20MG | $11,193 | $11,193 | $1,119 | $10,633 | 10 |
| J9217 | LUPRON DEPOT 22.5MG : PREFILLED SYRINGE | $10,503 | $10,503 | $1,050 | $9,978 | 10 |
| NM INDIUM IN-111 AUTO WBC | NM INDIUM IN-111 AUTO WBC | $10,208 | $10,208 | $1,021 | $9,698 | 10 |
| ARANESP 500mcg SINGLEJECT SYRINGE | ARANESP 500mcg SINGLEJECT SYRINGE | $9,752 | $9,752 | $975 | $9,265 | 10 |
| LIGAMENT PATELLA HEMI | LIGAMENT PATELLA HEMI | $7,938 | $7,938 | $794 | $7,541 | 10 |
| J2182 | NUCALA 100 MG: VIAL | $7,304 | $7,304 | $730 | $6,939 | 10 |
| Q4110 | GRAFT PRIMATRIX AG 6X6 CM | $7,256 | $7,256 | $726 | $6,893 | 10 |
| GRAFT CONNEXT MATRIX .030OZ | GRAFT CONNEXT MATRIX .030OZ | $7,185 | $7,185 | $719 | $6,826 | 10 |
| 74178 | CT ABD & PELVIS W/WO CONTRAST | $7,105 | $7,105 | $711 | $6,750 | 10 |
| Q4184 | GRAFT CELLESTA 4X4CM | $6,238 | $6,238 | $624 | $5,926 | 10 |
| CATARACT EXTRACTION W/LENS INSERTION | CATARACT EXTRACTION W/LENS INSERTION | $6,167 | $6,167 | $617 | $5,858 | 10 |
| Q4196 | GRAFT PURAPLY AM 5X5 | $6,125 | $6,125 | $613 | $5,819 | 10 |
| 73706 | CT VENOGRAM LE/RIGHT | $5,930 | $5,930 | $593 | $5,634 | 10 |
| 74174 | CTA ABD & PELVIS W/CONTRAST | $5,916 | $5,916 | $592 | $5,620 | 10 |
| 74175 | CTA ABDOMEN | $5,916 | $5,916 | $592 | $5,620 | 10 |
| 74170 | CT ABDOMEN W/WO ENHANCEMENT | $5,684 | $5,684 | $568 | $5,400 | 10 |
| 74177 | CT ABD & PELVIS W/CONTRAST | $5,561 | $5,561 | $556 | $5,283 | 10 |
| 23655 | UBDISL TX SHOULDER CLOSED W/MAN W/ANES | $5,465 | $5,465 | $547 | $5,192 | 10 |
| 70549 | MRA NECK W/WO CONTRAST | $5,465 | $5,465 | $547 | $5,192 | 10 |
| STERI STRIP WOUND CLOSURE (LAP CHOLE) | STERI STRIP WOUND CLOSURE (LAP CHOLE) | $5,465 | $5,465 | $547 | $5,192 | 10 |
| #NAME? | COLONOSCOPY W/EGD | $5,465 | $5,465 | $547 | $5,192 | 10 |
| 70546 | MRA HEAD W/WO CONTRAST | $5,460 | $5,460 | $546 | $5,187 | 10 |
| KIT DEVICE GENESYS HTA PROCERVA | KIT DEVICE GENESYS HTA PROCERVA | $5,400 | $5,400 | $540 | $5,130 | 10 |
| 70482 | CT ORBITS W/WO ENHANCEMENT | $5,367 | $5,367 | $537 | $5,098 | 10 |
| 78452 | NM MPI R & S MULTI SPECT W/WALL & EJECT | $5,308 | $5,308 | $531 | $5,042 | 10 |
| G0416 | PATH PRSTAT (GROSS/MICRO) TC | $5,177 | $5,177 | $35 | $4,918 | 10 |
| 95811 | SLEEP STUDY/CPAP >= 6 hrs of recording | $5,098 | $5,098 | $510 | $4,843 | 10 |
| 78071 | NM PARATHYROID PLANAR SPECT w/subtractio | $5,085 | $5,085 | $508 | $4,830 | 10 |
| 73702 | CT EXT LOWER W/WO CONTRAST | $4,956 | $4,956 | $496 | $4,708 | 10 |
| 70488 | CT SINUSES W/WO CONTRAST | $4,937 | $4,937 | $494 | $4,690 | 10 |
| 92960 | CARDIOVERSION ER FACILITY (450) | $4,850 | $4,850 | $485 | $4,608 | 10 |
| 71270 | CT THORAX W/WO ENH | $4,830 | $4,830 | $483 | $4,588 | 10 |
| 70492 | CT NECK S.T. W/WO ENHANCEMENT | $4,813 | $4,813 | $481 | $4,572 | 10 |
| J3111 | EVENITY SC INJ 210mg (2 SYRINGE 105mg) | $4,791 | $4,791 | $479 | $4,551 | 10 |
| 72194 | CT PELVIS W/WO ENHANCEMENT | $4,784 | $4,784 | $478 | $4,545 | 10 |
| J1602 | SIMPONI ARIA 50MG/4ML SDV | $4,771 | $4,771 | $477 | $4,533 | 10 |
| 71552 | MRI CHEST W/WO CONTRAST | $4,692 | $4,692 | $469 | $4,458 | 10 |
| 74183 | MRI ABDOMEN W/WO CONTRAST | $4,596 | $4,596 | $460 | $4,366 | 10 |
| 72197 | MRI PELVIS W/WO CONTRAST | $4,590 | $4,590 | $459 | $4,361 | 10 |
| 25560 | UBFX TX RADIUS/ULNAR SHAFT CLOSED W/OMAN | $4,566 | $4,566 | $457 | $4,337 | 10 |
| 25565 | UB-CLSED TX RADIAL&ULNAR SHAFT FX W/MANJ | $4,566 | $4,566 | $457 | $4,337 | 10 |
| 56420 | UB-I & D BARTHOLINS GLAND ABSCESS | $4,563 | $4,563 | $456 | $4,335 | 10 |
| 65205 | UB-REMOVE FB-CONJUNCTIVA | $4,563 | $4,563 | $456 | $4,335 | 10 |
| 65220 | UB-REMOVE FB-CORNEAL,W/O SL | $4,563 | $4,563 | $456 | $4,335 | 10 |
| 65222 | UB-REMOVE FB-CORNEA,W/SL | $4,563 | $4,563 | $456 | $4,335 | 10 |
| 69200 | UB-REMOVE FB-EXT AUD CANAL | $4,563 | $4,563 | $456 | $4,335 | 10 |
Showing top 50 of 2,400 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.