THREE RIVERS MEDICAL CENTER — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
152470221	polatuzumab vedotin-piiq 140 mg/7 mL Inj	$94,740	$61,581	—	—	10
152470221	polatuzumab vedotin-piiq 140 mg/7 mL Inj	$94,740	$61,581	—	—	10
152481777	relatlimab-rmbw-nivolumab 80 mg-240 mg/20 mL	$78,476	$51,009	—	—	10
152481777	relatlimab-rmbw-nivolumab 80 mg-240 mg/20 mL	$78,476	$51,009	—	—	10
152470144	coagulation factor VIIa 5,000 mcg (5 mg) IV Inj	$72,360	$47,034	—	—	10
152470144	coagulation factor VIIa 5,000 mcg (5 mg) IV Inj	$72,360	$47,034	—	—	10
152470248	luspatercept-aamt 75 mg/1.5 mL Inj	$62,790	$40,814	—	—	10
152470248	luspatercept-aamt 75 mg/1.5 mL Inj	$62,790	$40,814	—	—	10
152470181	ocrelizumab 300 mg/10 mL Inj	$59,144	$38,444	—	—	10
152470181	ocrelizumab 300 mg/10 mL Inj	$59,144	$38,444	—	—	10
152470134	atezolizumab 1200 mg/20 mL Inj	$57,272	$37,227	—	—	10
152470134	atezolizumab 1200 mg/20 mL Inj	$57,272	$37,227	—	—	10
152470078	alteplase 100 mg Inj	$52,803	$34,322	—	—	10
152470078	alteplase 100 mg Inj	$52,803	$34,322	—	—	10
152470237	daratumumab-hyaluronidase-fihj 1800 mg-30,000 units/15 mL Inj	$52,343	$34,023	—	—	10
152470237	daratumumab-hyaluronidase-fihj 1800 mg-30,000 units/15 mL Inj	$52,343	$34,023	—	—	10
152480923	lanreotide 120 mg/0.5 mL SubQ Monthly Inj	$51,635	$33,563	—	—	10
152480923	lanreotide 120 mg/0.5 mL SubQ Monthly Inj	$51,635	$33,563	—	—	10
152481650	pertuzumab-trastuzumab-hyaluronidase 600 mg-600 mg-20,000 units/10 mL Inj - Maintenance Dose	$47,116	$30,625	—	—	10
152481650	pertuzumab-trastuzumab-hyaluronidase 600 mg-600 mg-20,000 units/10 mL Inj - Maintenance Dose	$47,116	$30,625	—	—	10
152470177	vedolizumab 300 mg Inj	$46,800	$30,420	—	—	10
152470177	vedolizumab 300 mg Inj	$46,800	$30,420	—	—	10
152470073	ipilimumab 50 mg/10 mL Inj	$46,076	$29,949	—	—	10
152470073	ipilimumab 50 mg/10 mL Inj	$46,076	$29,949	—	—	10
152470007	obinutuzumab 1000 mg/40 mL Inj	$44,506	$28,929	—	—	10
152470007	obinutuzumab 1000 mg/40 mL Inj	$44,506	$28,929	—	—	10
152470023	leuprolide depot 30 mg/4 months IM Inj Kit	$44,153	$28,699	—	—	10
152470023	leuprolide depot 30 mg/4 months IM Inj Kit	$44,153	$28,699	—	—	10
152470231	lurbinectedin 4 mg Inj	$41,256	$26,816	—	—	10
152470231	lurbinectedin 4 mg Inj	$41,256	$26,816	—	—	10
152470187	nivolumab 240 mg/24 mL Inj	$40,419	$26,272	—	—	10
152470187	nivolumab 240 mg/24 mL Inj	$40,419	$26,272	—	—	10
152470153	ramucirumab 500 mg/50 mL Inj	$38,563	$25,066	—	—	10
152470153	ramucirumab 500 mg/50 mL Inj	$38,563	$25,066	—	—	10
152470147	panitumumab 400 mg/20 mL Inj	$35,596	$23,137	—	—	10
152470147	panitumumab 400 mg/20 mL Inj	$35,596	$23,137	—	—	10
158201358	DOME TALAR FALT CUT SZ 2	$35,448	$23,041	—	—	10
158201358	DOME TALAR FALT CUT SZ 2	$35,448	$23,041	—	—	10
152470009	pertuzumab 420 mg/14 mL Inj	$35,245	$22,909	—	—	10
152470009	pertuzumab 420 mg/14 mL Inj	$35,245	$22,909	—	—	10
152480549	pegfilgrastim OBI Kit 6 mg/0.6 mL Inj	$34,658	$22,528	—	—	10
152440036	pegfilgrastim 6 mg/0.6 mL Inj	$34,658	$22,528	—	—	10
152480549	pegfilgrastim OBI Kit 6 mg/0.6 mL Inj	$34,658	$22,528	—	—	10
152440036	pegfilgrastim 6 mg/0.6 mL Inj	$34,658	$22,528	—	—	10
151598545	Tarsal Dislc W Anesthesia - Both	$33,712	$21,913	—	—	10
151598575	Talotarsal Joint Dislc W Anesthesia - Both	$33,712	$21,913	—	—	10
151598545	Tarsal Dislc W Anesthesia - Both	$33,712	$21,913	—	—	10
151598575	Talotarsal Joint Dislc W Anesthesia - Both	$33,712	$21,913	—	—	10
152481519	efgartigimod alfa-fcab 400 mg/20 mL Inj	$33,429	$21,729	—	—	10
152481519	efgartigimod alfa-fcab 400 mg/20 mL Inj	$33,429	$21,729	—	—	10

Showing top 50 of 21,431 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.