HEGG MEMORIAL HEALTH CENTER — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J2350	Ocrelizumab 300 Mg/10 Ml	$34,516	—	—	—	7
J2350	Ocrelizumab 300 Mg/10 Ml	$34,516	—	—	—	7
J9144	Daratumumab Hyaluronida 1800Mg	$17,567	—	—	—	7
J9144	Daratumumab Hyaluronida 1800Mg	$17,567	—	—	—	7
J3380	Vedolizumab 300 MG Vial	$15,683	—	—	—	7
J3380	Vedolizumab 300 MG Vial	$15,683	—	—	—	7
J9380	Teclistamab-Cqyv 153 Mg/1.7 Ml	$14,924	—	—	—	7
J9380	Teclistamab-Cqyv 153 Mg/1.7 Ml	$14,924	—	—	—	7
J3101	Tenecteplase 50 Mg/10 Ml Syrng	$12,256	—	—	—	7
J3101	Tenecteplase 50 Mg/10 Ml Syrng	$12,256	—	—	—	7
J9271	Pembrolizumab 100 MG/4 ML Vial	$10,081	—	—	—	7
J9271	Pembrolizumab 100 MG/4 ML Vial	$10,081	—	—	—	7
Q5119	Rituximab-PVVR 500Mg/50Ml Vial	$4,510	—	—	—	7
Q5119	Rituximab-PVVR 500Mg/50Ml Vial	$4,510	—	—	—	7
70553	MRI Brain WWO Contrast	$4,386	—	—	—	7
70553	MRI Brain WWO Contrast	$4,386	—	—	—	5
Q5115	Rituximab-ABBS 500Mg/50Ml Vial	$4,365	—	—	—	7
Q5115	Rituximab-ABBS 500Mg/50Ml Vial	$4,365	—	—	—	7
J3111	Romosozumab-AQQG 210 Mg/2.34Ml	$4,210	—	—	—	7
J3111	Romosozumab-AQQG 210 Mg/2.34Ml	$4,210	—	—	—	7
74178	CT Abd & Pelv WWO Contrast	$3,985	—	—	—	7
74178	CT Abd & Pelv WWO Contrast	$3,985	—	—	—	5
J9176	Elotuzumab 300 MG Vial	$3,846	—	—	—	7
J9176	Elotuzumab 300 MG Vial	$3,846	—	—	—	7
J1569	Immune Glob Gamagar 20GR/200ML	$3,784	—	—	—	7
J1569	Immune Glob Gamagar 20GR/200ML	$3,784	—	—	—	7
95811	Polysomnogram W CPap	$3,741	—	—	—	7
95811	Polysomnogram W CPap	$3,741	—	—	—	6
74183	MRI Abdomen WWO Dye	$3,629	—	—	—	7
74183	MRI Abdomen WWO Dye	$3,629	—	—	—	5
73723	MRI Joint LE WWO Dye LT	$3,552	—	—	—	7
73723	MRI Joint LE WWO Dye RT	$3,552	—	—	—	5
74174	CTA Abd&Pelv WWO Dye	$3,548	—	—	—	7
74174	CTA Abd&Pelv WWO Dye	$3,548	—	—	—	5
J0349	Rezafungin 200 Mg Vial	$3,538	—	—	—	7
J0349	Rezafungin 200 Mg Vial	$3,538	—	—	—	7
72158	MRI Lumbar Spine WWO Dye	$3,501	—	—	—	7
72158	MRI Lumbar Spine WWO Dye	$3,501	—	—	—	5
74177	CT Abd & Pelv W Contrast	$3,494	—	—	—	7
74177	CT Abd & Pelv W Contrast	$3,494	—	—	—	6
72157	MRI Chest Spine WWO Dye	$3,380	—	—	—	7
72157	MRI Chest Spine WWO Dye	$3,380	—	—	—	5
95810	Polysomnogram	$3,284	—	—	—	7
95810	Polysomnogram	$3,284	—	—	—	5
73223	MRI Joint UE WWO Dye RT	$3,241	—	—	—	7
73223	MRI Joint UE WWO Dye RT	$3,241	—	—	—	5
70546	MRA Head WWO Contrast	$3,193	—	—	—	7
70546	MRA Head WWO Contrast	$3,193	—	—	—	5
72156	MRI Neck Spine WWO Dye	$3,148	—	—	—	7
72156	MRI Neck Spine WWO Dye	$3,148	—	—	—	5

Showing top 50 of 2,179 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.