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
26,002
Insurances with rates
11
CPT / HCPCS codes
18,379
Source MRF
Most expensive procedures (gross)
3530878
$13,921
Ustekinumab (Stelara) SQ 90MG/1ML - NF
Gross
$27,843
3528620
$11,810
Nystatin (NYSTOP) Powder(NF)
Gross
$23,619
2011862
$8,125
RESTORE 37711
Gross
$16,250
2011833
$6,148
RESTORE PRIME 37701
Gross
$12,295
L8687
$6,000
RESTORE ADVANCED 37713
Gross
$12,000
C1772
$5,000
SYNCHROMED II INFUSION PUMP 8637-20
Gross
$10,000
C2621
$4,500
*PACEMAKER, INSYNC III 8042
Gross
$9,000
3530802
$3,293
Ixekizumab 80MG/1ML SQ Inj (Taltz) -(NF)
Gross
$6,586
C1785
$3,248
*PACEMAKER DDDR KDR921
Gross
$6,495
C1786
$3,148
*PACEMAKER, INSIGNIA I PLUS 1194
Gross
$6,295
8399999
$3,059
MISCELLANEOUS - FISCAL SERVICES
Gross
$6,118
C1764
$2,500
ASSERT IQ3+_ICM_UMRI_US
Gross
$5,000
J2182
$1,995
MEPOLIZUMAB (NUCALA) 100MG /1ML PFS
Gross
$3,991
3530904
$1,731
Adalimumab (Humira) SQ 40MG/0.4mL (NF)
Gross
$3,461
3529104
$1,647
TERIPARATIDE (FORTEO) 250MCG/1(NF)
Gross
$3,295
J0840
$1,618
CROTALIDAE POLVALENT (CROFAB)
Gross
$3,237
3529477
$1,477
NUCALA (MEPOLIZUMAB) 100MG PWD(NF)
Gross
$2,955
3519700
$1,461
RABIES IMMUNE GLOB.(HYPERAB) 10ML MDV
Gross
$2,921
2007305
$1,385
11G 15MM AVAFLEX KIT
Gross
$2,769
2007278
$1,371
15MM 11G IVAS ELITE BI-PED KIT
Gross
$2,741
2007300
$1,371
IVAS KIT, 11G, 10MM 705310
Gross
$2,741
2007178
$1,371
11G 10MM IVAS KIT 0705310000
Gross
$2,741
J2506
$1,357
PEGFILGRASTIN (NEULASTA) 6MG/0.6ML(NF)
Gross
$2,713
J3111
$1,314
ROMOSOZUMAB-AQQG (EVENITY)210MG(105MGX2)
Gross
$2,629
3528647
$1,243
Nystatin (NYSTOP) Powder(NF)
Gross
$2,486
2017991
$1,228
SURGIMESH XB 22X15X10 TINTRAE
Gross
$2,455
2017995
$1,228
SURGIMESH XB 22X26 TINTRAE
Gross
$2,455
2011832
$1,195
LEAD KIT COMPACT 3778-75
Gross
$2,390
3199999
$1,015
MISCELLANEOUS - RADIOLOGY
Gross
$2,030
J1602
$1,011
GOLIMUMAB (SIMPONI ARIA) 50MG/4ML IV
Gross
$2,023
Q4341
$1,000
SIMPLIMAX AA 2X2CM
Gross
$2,000
2406295
$945
AUTOIMMUNE NEUROL COMP PARANEO PF 1OF3
Gross
$1,890
2406300
$945
AUTOIMMUNE NEUROL COMP PARANEO PF 2OF3
Gross
$1,890
2406305
$945
AUTOIMMUNE NEUROL COMP PARANEO PF 3OF3
Gross
$1,890
2406220
$885
BLEEDING DIATHESIS W NORM PTT/PT PF 1 OF
Gross
$1,770
J2993
$873
RETAVASE KIT(NF)
Gross
$1,746
1599999
$846
MISCELLANEOUS - ONCOLOGY
Gross
$1,693
2011861
$845
LEAD, 33CM 3890
Gross
$1,690
J0350
$838
ANISTREPLASE (EMINASE) 30 UNITS
Gross
$1,675
3528609
$834
PALIPERIDONE (INVEGA SUSTENNA) 234MG(NF)
Gross
$1,668
2014974
$814
MESH VENTRIO MEDIUM OVAL 4.3 X 5.5
Gross
$1,628
J0129
$785
ABATACEPT (ORENCIA) 250MG (NF)
Gross
$1,569
2404003
$774
HYPERCOAGULABILITY PROFILE
Gross
$1,549
2404007
$738
HYPERCOAGULABILITY PROFILE 3 of 3
Gross
$1,475
3527833
$730
PALIPERIDONE (INVEGA SUSTENNA) 156MG(NF)
Gross
$1,460
2017990
$728
SURGIMESH XB 15RND TINTRAC
Gross
$1,455
3529795
$709
ETANERCEPT (ENBREL) 50MG/1ML SQ SOL(NF)
Gross
$1,418
81229
$693
CHROMOSOMAL MICROARRAY,CONGENITAL,BLD
Gross
$1,385
3528560
$686
Forteo Subcutaneous Solut 250MCG/1(NF)
Gross
$1,373
2017993
$678
SURGIMESH XB MESH TINTRAC12
Gross
$1,355
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 3530878 | Ustekinumab (Stelara) SQ 90MG/1ML - NF | $27,843 | $13,921 | — | — | 0 |
| 3528620 | Nystatin (NYSTOP) Powder(NF) | $23,619 | $11,810 | — | — | 0 |
| 2011862 | RESTORE 37711 | $16,250 | $8,125 | — | — | 0 |
| 2011833 | RESTORE PRIME 37701 | $12,295 | $6,148 | — | — | 0 |
| L8687 | RESTORE ADVANCED 37713 | $12,000 | $6,000 | $4,800 | $10,800 | 16 |
| C1772 | SYNCHROMED II INFUSION PUMP 8637-20 | $10,000 | $5,000 | $4,000 | $9,000 | 16 |
| C2621 | *PACEMAKER, INSYNC III 8042 | $9,000 | $4,500 | $3,600 | $8,100 | 16 |
| 3530802 | Ixekizumab 80MG/1ML SQ Inj (Taltz) -(NF) | $6,586 | $3,293 | — | — | 0 |
| C1785 | *PACEMAKER DDDR KDR921 | $6,495 | $3,248 | $2,598 | $5,846 | 16 |
| C1786 | *PACEMAKER, INSIGNIA I PLUS 1194 | $6,295 | $3,148 | $2,518 | $5,666 | 16 |
| 8399999 | MISCELLANEOUS - FISCAL SERVICES | $6,118 | $3,059 | — | — | 0 |
| C1764 | ASSERT IQ3+_ICM_UMRI_US | $5,000 | $2,500 | $2,000 | $4,500 | 16 |
| J2182 | MEPOLIZUMAB (NUCALA) 100MG /1ML PFS | $3,991 | $1,995 | $30.69 | $3,592 | 18 |
| 3530904 | Adalimumab (Humira) SQ 40MG/0.4mL (NF) | $3,461 | $1,731 | — | — | 0 |
| 3529104 | TERIPARATIDE (FORTEO) 250MCG/1(NF) | $3,295 | $1,647 | — | — | 0 |
| J0840 | CROTALIDAE POLVALENT (CROFAB) | $3,237 | $1,618 | $1,295 | $2,913 | 18 |
| 3529477 | NUCALA (MEPOLIZUMAB) 100MG PWD(NF) | $2,955 | $1,477 | — | — | 0 |
| 3519700 | RABIES IMMUNE GLOB.(HYPERAB) 10ML MDV | $2,921 | $1,461 | — | — | 0 |
| 2007305 | 11G 15MM AVAFLEX KIT | $2,769 | $1,385 | — | — | 0 |
| 2007278 | 15MM 11G IVAS ELITE BI-PED KIT | $2,741 | $1,371 | — | — | 0 |
| 2007300 | IVAS KIT, 11G, 10MM 705310 | $2,741 | $1,371 | — | — | 0 |
| 2007178 | 11G 10MM IVAS KIT 0705310000 | $2,741 | $1,371 | — | — | 0 |
| J2506 | PEGFILGRASTIN (NEULASTA) 6MG/0.6ML(NF) | $2,713 | $1,357 | $19.98 | $2,442 | 18 |
| J3111 | ROMOSOZUMAB-AQQG (EVENITY)210MG(105MGX2) | $2,629 | $1,314 | $1,052 | $2,366 | 16 |
| 3528647 | Nystatin (NYSTOP) Powder(NF) | $2,486 | $1,243 | — | — | 0 |
| 2017991 | SURGIMESH XB 22X15X10 TINTRAE | $2,455 | $1,228 | — | — | 0 |
| 2017995 | SURGIMESH XB 22X26 TINTRAE | $2,455 | $1,228 | — | — | 0 |
| 2011832 | LEAD KIT COMPACT 3778-75 | $2,390 | $1,195 | — | — | 0 |
| 3199999 | MISCELLANEOUS - RADIOLOGY | $2,030 | $1,015 | — | — | 0 |
| J1602 | GOLIMUMAB (SIMPONI ARIA) 50MG/4ML IV | $2,023 | $1,011 | $10.54 | $1,820 | 18 |
| Q4341 | SIMPLIMAX AA 2X2CM | $2,000 | $1,000 | $800 | $1,800 | 16 |
| 2406295 | AUTOIMMUNE NEUROL COMP PARANEO PF 1OF3 | $1,890 | $945 | — | — | 0 |
| 2406300 | AUTOIMMUNE NEUROL COMP PARANEO PF 2OF3 | $1,890 | $945 | — | — | 0 |
| 2406305 | AUTOIMMUNE NEUROL COMP PARANEO PF 3OF3 | $1,890 | $945 | — | — | 0 |
| 2406220 | BLEEDING DIATHESIS W NORM PTT/PT PF 1 OF | $1,770 | $885 | — | — | 0 |
| J2993 | RETAVASE KIT(NF) | $1,746 | $873 | $699 | $2,734 | 18 |
| 1599999 | MISCELLANEOUS - ONCOLOGY | $1,693 | $846 | — | — | 0 |
| 2011861 | LEAD, 33CM 3890 | $1,690 | $845 | — | — | 0 |
| J0350 | ANISTREPLASE (EMINASE) 30 UNITS | $1,675 | $838 | $670 | $2,385 | 18 |
| 3528609 | PALIPERIDONE (INVEGA SUSTENNA) 234MG(NF) | $1,668 | $834 | — | — | 0 |
| 2014974 | MESH VENTRIO MEDIUM OVAL 4.3 X 5.5 | $1,628 | $814 | — | — | 0 |
| J0129 | ABATACEPT (ORENCIA) 250MG (NF) | $1,569 | $785 | $43.8 | $1,412 | 18 |
| 2404003 | HYPERCOAGULABILITY PROFILE | $1,549 | $774 | — | — | 0 |
| 2404007 | HYPERCOAGULABILITY PROFILE 3 of 3 | $1,475 | $738 | — | — | 0 |
| 3527833 | PALIPERIDONE (INVEGA SUSTENNA) 156MG(NF) | $1,460 | $730 | — | — | 0 |
| 2017990 | SURGIMESH XB 15RND TINTRAC | $1,455 | $728 | — | — | 0 |
| 3529795 | ETANERCEPT (ENBREL) 50MG/1ML SQ SOL(NF) | $1,418 | $709 | — | — | 0 |
| 81229 | CHROMOSOMAL MICROARRAY,CONGENITAL,BLD | $1,385 | $693 | $554 | $2,371 | 18 |
| 3528560 | Forteo Subcutaneous Solut 250MCG/1(NF) | $1,373 | $686 | — | — | 0 |
| 2017993 | SURGIMESH XB MESH TINTRAC12 | $1,355 | $678 | — | — | 0 |
Showing top 50 of 26,002 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.