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
16,878
Insurances with rates
25
CPT / HCPCS codes
8,498
Source MRF
Most expensive procedures (gross)
253770078
$34,322
alteplase 100 mg Inj
Gross
$52,803
253770078
$34,322
alteplase 100 mg Inj
Gross
$52,803
253770177
$30,420
vedolizumab 300 mg Inj
Gross
$46,800
253770177
$30,420
vedolizumab 300 mg Inj
Gross
$46,800
253740027
$29,639
tenecteplase 50 mg powd Inj
Gross
$45,598
253740027
$29,639
tenecteplase 50 mg powd Inj
Gross
$45,598
253770170
$14,136
durvalumab 500 mg/10 mL Inj
Gross
$21,747
253770170
$14,136
durvalumab 500 mg/10 mL Inj
Gross
$21,747
253770242
$12,580
riTUXimab-pvvr 500 mg/50 mL Inj
Gross
$19,354
253770242
$12,580
riTUXimab-pvvr 500 mg/50 mL Inj
Gross
$19,354
256404384
$12,353
GRAFT BIO-4 VIABLE BONE MATRIX 10CC
Gross
$19,005
256404384
$12,353
GRAFT BIO-4 VIABLE BONE MATRIX 10CC
Gross
$19,005
253780864
$11,976
mepolizumab 100 mg Powder Inj
Gross
$18,424
253780864
$11,976
mepolizumab 100 mg Powder Inj
Gross
$18,424
253770218
$11,766
rabies immune globulin, human 1500 intl_units/5 mL IM Inj
Gross
$18,102
253770218
$11,766
rabies immune globulin, human 1500 intl_units/5 mL IM Inj
Gross
$18,102
256400104
$10,121
ALLOGRAFT PROCHRONDRIX OSTEOCONDRAL 11MM
Gross
$15,571
256400104
$10,121
ALLOGRAFT PROCHRONDRIX OSTEOCONDRAL 11MM
Gross
$15,571
253770215
$9,322
tocilizumab 400 mg/20 mL Inj
Gross
$14,342
253770215
$9,322
tocilizumab 400 mg/20 mL Inj
Gross
$14,342
256414584
$8,741
STAPLE EASYFUSE NITINOL 2 LEG 18X20
Gross
$13,448
256414584
$8,741
STAPLE EASYFUSE NITINOL 2 LEG 18X20
Gross
$13,448
251142440
$8,691
Excision of submandibular (submaxillary) gland
Gross
$13,371
251142440
$8,691
Excision of submandibular (submaxillary) gland
Gross
$13,371
256401388
$8,556
SHELL ACETABULAR MULTI HOLE CEMENTLESS 50MM
Gross
$13,163
256401388
$8,556
SHELL ACETABULAR MULTI HOLE CEMENTLESS 50MM
Gross
$13,163
256400314
$8,550
GRAFT BIO-4 VIABLE BONE MATRIX 5CC
Gross
$13,154
256400314
$8,550
GRAFT BIO-4 VIABLE BONE MATRIX 5CC
Gross
$13,154
253770201
$8,545
romosozumab-aqqg 210 mg/2.34 mL Inj
Gross
$13,146
253770201
$8,545
romosozumab-aqqg 210 mg/2.34 mL Inj
Gross
$13,146
251146060
$8,371
INCISION DRNAGE OF ISCHIORECTAL/INTRAMUR
Gross
$12,879
251146060
$8,371
INCISION DRNAGE OF ISCHIORECTAL/INTRAMUR
Gross
$12,879
256400212
$8,329
KIT AUGMENT INJECTABLE 3CC
Gross
$12,814
256400212
$8,329
KIT AUGMENT INJECTABLE 3CC
Gross
$12,814
256411188
$8,313
MATRIX FLOW PLACENTAL TISSUE VIAFLOW
Gross
$12,789
256411188
$8,313
MATRIX FLOW PLACENTAL TISSUE VIAFLOW
Gross
$12,789
251159409
$8,231
Vaginal Delivery W or WO Episiotomy or Forceps
Gross
$12,663
251159409
$8,231
Vaginal Delivery W or WO Episiotomy or Forceps
Gross
$12,663
256400411
$7,508
HUMERAL STEM MINI 13MM COMPREHENSIVE
Gross
$11,550
256402662
$7,508
HUMERAL STEM MINI 11MM COMPREHENSIVE
Gross
$11,550
256402552
$7,508
HUMERAL STEM MINI 10MM COMPREHENSIVE
Gross
$11,550
256403768
$7,508
HUMERAL STEM MINI 16MM COMPREHENSIVE
Gross
$11,550
256402924
$7,508
HUMERAL STEM MINI 15MM COMPREHENSIVE
Gross
$11,550
256403470
$7,508
STEM HUMERAL PRIMARY COMPHSVE STD 14MM
Gross
$11,550
256400411
$7,508
HUMERAL STEM MINI 13MM COMPREHENSIVE
Gross
$11,550
256402662
$7,508
HUMERAL STEM MINI 11MM COMPREHENSIVE
Gross
$11,550
256402552
$7,508
HUMERAL STEM MINI 10MM COMPREHENSIVE
Gross
$11,550
256403768
$7,508
HUMERAL STEM MINI 16MM COMPREHENSIVE
Gross
$11,550
256402924
$7,508
HUMERAL STEM MINI 15MM COMPREHENSIVE
Gross
$11,550
256403470
$7,508
STEM HUMERAL PRIMARY COMPHSVE STD 14MM
Gross
$11,550
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 253770078 | alteplase 100 mg Inj | $52,803 | $34,322 | — | — | 15 |
| 253770078 | alteplase 100 mg Inj | $52,803 | $34,322 | — | — | 25 |
| 253770177 | vedolizumab 300 mg Inj | $46,800 | $30,420 | — | — | 15 |
| 253770177 | vedolizumab 300 mg Inj | $46,800 | $30,420 | — | — | 25 |
| 253740027 | tenecteplase 50 mg powd Inj | $45,598 | $29,639 | — | — | 15 |
| 253740027 | tenecteplase 50 mg powd Inj | $45,598 | $29,639 | — | — | 25 |
| 253770170 | durvalumab 500 mg/10 mL Inj | $21,747 | $14,136 | — | — | 15 |
| 253770170 | durvalumab 500 mg/10 mL Inj | $21,747 | $14,136 | — | — | 25 |
| 253770242 | riTUXimab-pvvr 500 mg/50 mL Inj | $19,354 | $12,580 | — | — | 15 |
| 253770242 | riTUXimab-pvvr 500 mg/50 mL Inj | $19,354 | $12,580 | — | — | 25 |
| 256404384 | GRAFT BIO-4 VIABLE BONE MATRIX 10CC | $19,005 | $12,353 | — | — | 15 |
| 256404384 | GRAFT BIO-4 VIABLE BONE MATRIX 10CC | $19,005 | $12,353 | — | — | 25 |
| 253780864 | mepolizumab 100 mg Powder Inj | $18,424 | $11,976 | — | — | 15 |
| 253780864 | mepolizumab 100 mg Powder Inj | $18,424 | $11,976 | — | — | 25 |
| 253770218 | rabies immune globulin, human 1500 intl_units/5 mL IM Inj | $18,102 | $11,766 | — | — | 15 |
| 253770218 | rabies immune globulin, human 1500 intl_units/5 mL IM Inj | $18,102 | $11,766 | — | — | 25 |
| 256400104 | ALLOGRAFT PROCHRONDRIX OSTEOCONDRAL 11MM | $15,571 | $10,121 | — | — | 15 |
| 256400104 | ALLOGRAFT PROCHRONDRIX OSTEOCONDRAL 11MM | $15,571 | $10,121 | — | — | 25 |
| 253770215 | tocilizumab 400 mg/20 mL Inj | $14,342 | $9,322 | — | — | 15 |
| 253770215 | tocilizumab 400 mg/20 mL Inj | $14,342 | $9,322 | — | — | 25 |
| 256414584 | STAPLE EASYFUSE NITINOL 2 LEG 18X20 | $13,448 | $8,741 | — | — | 15 |
| 256414584 | STAPLE EASYFUSE NITINOL 2 LEG 18X20 | $13,448 | $8,741 | — | — | 25 |
| 251142440 | Excision of submandibular (submaxillary) gland | $13,371 | $8,691 | — | — | 15 |
| 251142440 | Excision of submandibular (submaxillary) gland | $13,371 | $8,691 | — | — | 25 |
| 256401388 | SHELL ACETABULAR MULTI HOLE CEMENTLESS 50MM | $13,163 | $8,556 | — | — | 15 |
| 256401388 | SHELL ACETABULAR MULTI HOLE CEMENTLESS 50MM | $13,163 | $8,556 | — | — | 25 |
| 256400314 | GRAFT BIO-4 VIABLE BONE MATRIX 5CC | $13,154 | $8,550 | — | — | 15 |
| 256400314 | GRAFT BIO-4 VIABLE BONE MATRIX 5CC | $13,154 | $8,550 | — | — | 25 |
| 253770201 | romosozumab-aqqg 210 mg/2.34 mL Inj | $13,146 | $8,545 | — | — | 15 |
| 253770201 | romosozumab-aqqg 210 mg/2.34 mL Inj | $13,146 | $8,545 | — | — | 25 |
| 251146060 | INCISION DRNAGE OF ISCHIORECTAL/INTRAMUR | $12,879 | $8,371 | — | — | 15 |
| 251146060 | INCISION DRNAGE OF ISCHIORECTAL/INTRAMUR | $12,879 | $8,371 | — | — | 25 |
| 256400212 | KIT AUGMENT INJECTABLE 3CC | $12,814 | $8,329 | — | — | 15 |
| 256400212 | KIT AUGMENT INJECTABLE 3CC | $12,814 | $8,329 | — | — | 25 |
| 256411188 | MATRIX FLOW PLACENTAL TISSUE VIAFLOW | $12,789 | $8,313 | — | — | 15 |
| 256411188 | MATRIX FLOW PLACENTAL TISSUE VIAFLOW | $12,789 | $8,313 | — | — | 25 |
| 251159409 | Vaginal Delivery W or WO Episiotomy or Forceps | $12,663 | $8,231 | — | — | 15 |
| 251159409 | Vaginal Delivery W or WO Episiotomy or Forceps | $12,663 | $8,231 | — | — | 25 |
| 256400411 | HUMERAL STEM MINI 13MM COMPREHENSIVE | $11,550 | $7,508 | — | — | 15 |
| 256402662 | HUMERAL STEM MINI 11MM COMPREHENSIVE | $11,550 | $7,508 | — | — | 15 |
| 256402552 | HUMERAL STEM MINI 10MM COMPREHENSIVE | $11,550 | $7,508 | — | — | 15 |
| 256403768 | HUMERAL STEM MINI 16MM COMPREHENSIVE | $11,550 | $7,508 | — | — | 15 |
| 256402924 | HUMERAL STEM MINI 15MM COMPREHENSIVE | $11,550 | $7,508 | — | — | 15 |
| 256403470 | STEM HUMERAL PRIMARY COMPHSVE STD 14MM | $11,550 | $7,508 | — | — | 15 |
| 256400411 | HUMERAL STEM MINI 13MM COMPREHENSIVE | $11,550 | $7,508 | — | — | 25 |
| 256402662 | HUMERAL STEM MINI 11MM COMPREHENSIVE | $11,550 | $7,508 | — | — | 25 |
| 256402552 | HUMERAL STEM MINI 10MM COMPREHENSIVE | $11,550 | $7,508 | — | — | 25 |
| 256403768 | HUMERAL STEM MINI 16MM COMPREHENSIVE | $11,550 | $7,508 | — | — | 25 |
| 256402924 | HUMERAL STEM MINI 15MM COMPREHENSIVE | $11,550 | $7,508 | — | — | 25 |
| 256403470 | STEM HUMERAL PRIMARY COMPHSVE STD 14MM | $11,550 | $7,508 | — | — | 25 |
Showing top 50 of 16,878 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.