CARLE RICHLAND MEMORIAL HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J7181	TRETTEN 2,500 UNIT INTRAVENOUS SOLUTION	$369,210	$369,210	—	—	10
J2326	SPINRAZA (PF) 12 MG/5 ML INTRATHECAL SOLUTION	$333,562	$333,562	—	—	5
Q2043	PROVENGE 50 MILLION CELL/250 ML INTRAVENOUS SUSPENSION	$289,537	$289,537	—	—	5
J0225	AMVUTTRA 25 MG/0.5 ML SUBCUTANEOUS SYRINGE	$272,120	$272,120	—	—	5
J9347	IMJUDO 20 MG/ML INTRAVENOUS SOLUTION	$269,803	$269,803	—	—	10
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	—	—	5
64656	J/Rplcmt Bat Mod Sys Pg	$165,338	$165,338	—	—	4
J1823	UPLIZNA 10 MG/ML INTRAVENOUS SOLUTION	$150,672	$150,672	—	—	10
J9999	GLIADEL WAFER 7.7 MG IMPLANT	$131,789	$131,789	—	—	5
J2350	OCREVUS 30 MG/ML INTRAVENOUS SOLUTION	$131,277	$131,277	—	—	5
J9226	SUPPRELIN LA 50 MG (65 MCG/DAY) IMPLANT KIT	$114,414	$114,414	—	—	5
0915T	Insj Perm Ccm-D Sys Pg&Eltrd	$105,273	$105,273	—	—	4
C9293	VORAXAZE 1,000 UNIT INTRAVENOUS SOLUTION	$98,571	$98,571	—	—	5
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	—	—	10
J9028	ANKTIVA 400 MCG/0.4 ML INTRAVESICAL SOLUTION	$81,624	$81,624	—	—	5
J9269	ELZONRIS 1,000 MCG/ML INTRAVENOUS SOLUTION	$76,965	$76,965	—	—	5
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	—	—	5
J9334	VYVGART HYTRULO 1,000 MG-10,000 UNIT/5 ML SUBCUTANEOUS SYRINGE	$70,274	$70,274	—	—	8
J0202	LEMTRADA 12 MG/1.2 ML INTRAVENOUS SOLUTION	$67,817	$67,817	—	—	5
J9345	ZYNYZ 500 MG/20 ML INTRAVENOUS SOLUTION	$66,769	$66,769	—	—	5
J9359	ZYNLONTA 10 MG INTRAVENOUS SOLUTION	$66,188	$66,188	—	—	5
J1246	UNITUXIN 3.5 MG/ML INTRAVENOUS SOLUTION	$65,311	$65,311	—	—	5
J9316	PHESGO 1,200 MG-600 MG-30,000 UNIT/15 ML SUBCUTANEOUS SOLUTION	$65,129	$65,129	—	—	5
J0222	ONPATTRO 2 MG/ML INTRAVENOUS SOLUTION	$62,233	$62,233	—	—	5
37258	Sc Evasc Ivt Stent Sf 1st	$61,855	$61,855	—	—	4
37260	Sc Evasc Ivt St Cplx 1st	$61,855	$61,855	—	—	4
37267	Sc Evsc Fpvt Stent Sf 1st	$61,855	$61,855	—	—	4
37269	Sc Evasc Fpvt St Cplx 1st	$61,855	$61,855	—	—	4
37280	Sc Evsc Tpvt Angio Sf 1st	$61,855	$61,855	—	—	4
37282	C Evsc Tpvt Angio Cplx 1	$61,855	$61,855	—	—	4
37296	Sc Evasc Imvt Angio Sf 1	$61,855	$61,855	—	—	4
37298	Sc Evsc Imvt Angio Cplx 1	$61,855	$61,855	—	—	4
92945	Trl Rvs Ch Occ Ant&Rtrgr	$61,855	$61,855	—	—	4
J2267	OMVOH 300 MG/15 ML (20 MG/ML) INTRAVENOUS SOLUTION	$61,013	$61,013	—	—	5
55877	Tj Ire Prst8 1+ Tum Perq	$56,956	$56,956	—	—	8
47384	Tj Ire Liver 1+ Tum Perq	$56,956	$56,956	—	—	4

Showing top 50 of 5,124 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.