45 CFR § 180 compliance
B · 85
This hospital published most 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
1,246
Insurances with rates
13
CPT / HCPCS codes
935
Source MRF
Most expensive procedures (gross)
J3101
$21,126
TNKASE 50MG INJ
Gross
$35,210
A2025
$18,334
MIRO3D 100 CM3/CM3
Gross
$30,557
J2997
$14,671
ACTIVASE 50MG VIAL
Gross
$24,451
90377
$13,679
KEDRAB 1500UNIT/10ML
Gross
$22,799
J0840
$10,873
CROFAB 1 EA
Gross
$18,122
LITHOTRIPSY UNILAT 1ST 10 MIN
$8,692
LITHOTRIPSY UNILAT 1ST 10 MIN
Gross
$14,486
J2426
$8,341
INVEGA SUSTENNA SYR 234MG/1.5M
Gross
$13,902
OB SURGERY LEVEL 3 1ST 30 MINS
$6,885
OB SURGERY LEVEL 3 1ST 30 MINS
Gross
$11,475
Q4197
$6,783
PURAPLY XT 4.91X4.91(25)/SQCM
Gross
$11,305
74178
$5,270
CT ABD+PELVIS W+WO CONTRAST
Gross
$8,784
PRODIGY 1520-36-050
$5,234
PRODIGY 1520-36-050
Gross
$8,723
Q4101
$5,087
APLIGRAF DISK KIT 44 SQ CM
Gross
$8,479
Q4133
$4,828
GRAFIX PL PRIME 12 SQ CM/SQCM
Gross
$8,047
J7165
$4,688
BALFAXAR 500 UNIT VIAL
Gross
$7,814
70553
$4,603
MR HEAD W/WO CONTRAST
Gross
$7,671
Q4159
$4,589
AFFINITY 2.25 SQ CM/SQCM
Gross
$7,648
25651
$4,346
ULNAR STYLD FX W/SKELET FIX LT
Gross
$7,244
74177
$4,247
CT ABD+PELVIS W/CONTRAST
Gross
$7,079
73706
$4,195
CT ANG L EXT W OR WO CONTR BIL
Gross
$6,992
74174
$4,195
CT ANG ABD+PLVS W OR WO CNTRS
Gross
$6,992
73701
$4,136
CT LOW EXTREMITY W CON BIL
Gross
$6,893
46040
$3,991
I&D ISCHIORECTAL ABSCESS
Gross
$6,652
J1745
$3,895
INFLIXIMAB 100MG INJ
Gross
$6,491
72158
$3,755
MR LUMBAR SPINE W/WO CONTRAST
Gross
$6,258
27762
$3,410
CLS TX MED MALLEOLUS FX W/M LT
Gross
$5,683
27781
$3,410
CLS TX FIB/SHAFT FX W/MAN RT
Gross
$5,683
59409
$3,385
VAG DELIVERY
Gross
$5,641
74176
$3,231
CT ABD+PELVIS WO CONTRAST
Gross
$5,385
70551
$3,205
MR HEAD W/O CONTRAST
Gross
$5,342
72197
$3,205
MR PELVIS W/WO CONTRAST
Gross
$5,342
73221
$3,205
MR UP EXT JNT WO CON LT
Gross
$5,342
73721
$3,205
MR LOW EXT JNT WO CON LT
Gross
$5,342
73700
$3,175
CT LOW EXTREMITY WO CON BIL
Gross
$5,292
72148
$3,053
MR LUMBAR SPINE W/O CONTRAST
Gross
$5,089
72141
$3,052
MR C-SPINE W/O CONTRAST
Gross
$5,087
73718
$3,052
MR LOW EXT NON JNT WO CON LT
Gross
$5,087
72146
$3,010
MR THORACIC W/O CONTRAST
Gross
$5,017
10121
$2,959
INCISION & REMOVAL FB SC COMP
Gross
$4,931
72194
$2,918
CT PELVIS W/WO CONTRAST
Gross
$4,864
71270
$2,900
CT CHEST W/WO CONTRAST
Gross
$4,833
21315
$2,836
CLS TX NASAL BONE FX WO STAB
Gross
$4,726
21337
$2,836
CLS TX NASAL SPTL FX W OR WO S
Gross
$4,726
95811
$2,752
SLEEP STUDY>3PRMT W/CP+TCH-INT
Gross
$4,587
71275
$2,693
CT ANG CHST W OR WO CONTR
Gross
$4,489
74183
$2,667
MRI ABDOMEN W/O & W/CONTRAST M
Gross
$4,445
70544
$2,647
MR ANGIO HEAD W/O CONTRAST
Gross
$4,411
23655
$2,545
CLS TX DSLC SHLD W/MAN W/M LT
Gross
$4,242
26775
$2,545
CLS TX FNGR DSL W/MAN W/AN F4
Gross
$4,242
72125
$2,537
CT C-SPINE WO CONTRAST
Gross
$4,229
95810
$2,477
SLEEP STUDY>3PARMTRS W/T-INT
Gross
$4,128
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J3101 | TNKASE 50MG INJ | $35,210 | $21,126 | — | — | 16 |
| A2025 | MIRO3D 100 CM3/CM3 | $30,557 | $18,334 | — | — | 16 |
| J2997 | ACTIVASE 50MG VIAL | $24,451 | $14,671 | — | — | 16 |
| 90377 | KEDRAB 1500UNIT/10ML | $22,799 | $13,679 | — | — | 16 |
| J0840 | CROFAB 1 EA | $18,122 | $10,873 | — | — | 16 |
| LITHOTRIPSY UNILAT 1ST 10 MIN | LITHOTRIPSY UNILAT 1ST 10 MIN | $14,486 | $8,692 | — | — | 16 |
| J2426 | INVEGA SUSTENNA SYR 234MG/1.5M | $13,902 | $8,341 | — | — | 16 |
| OB SURGERY LEVEL 3 1ST 30 MINS | OB SURGERY LEVEL 3 1ST 30 MINS | $11,475 | $6,885 | — | — | 16 |
| Q4197 | PURAPLY XT 4.91X4.91(25)/SQCM | $11,305 | $6,783 | — | — | 16 |
| 74178 | CT ABD+PELVIS W+WO CONTRAST | $8,784 | $5,270 | — | — | 16 |
| PRODIGY 1520-36-050 | PRODIGY 1520-36-050 | $8,723 | $5,234 | — | — | 16 |
| Q4101 | APLIGRAF DISK KIT 44 SQ CM | $8,479 | $5,087 | — | — | 16 |
| Q4133 | GRAFIX PL PRIME 12 SQ CM/SQCM | $8,047 | $4,828 | — | — | 16 |
| J7165 | BALFAXAR 500 UNIT VIAL | $7,814 | $4,688 | — | — | 16 |
| 70553 | MR HEAD W/WO CONTRAST | $7,671 | $4,603 | — | — | 16 |
| Q4159 | AFFINITY 2.25 SQ CM/SQCM | $7,648 | $4,589 | — | — | 16 |
| 25651 | ULNAR STYLD FX W/SKELET FIX LT | $7,244 | $4,346 | — | — | 16 |
| 74177 | CT ABD+PELVIS W/CONTRAST | $7,079 | $4,247 | — | — | 16 |
| 73706 | CT ANG L EXT W OR WO CONTR BIL | $6,992 | $4,195 | — | — | 16 |
| 74174 | CT ANG ABD+PLVS W OR WO CNTRS | $6,992 | $4,195 | — | — | 16 |
| 73701 | CT LOW EXTREMITY W CON BIL | $6,893 | $4,136 | — | — | 16 |
| 46040 | I&D ISCHIORECTAL ABSCESS | $6,652 | $3,991 | — | — | 16 |
| J1745 | INFLIXIMAB 100MG INJ | $6,491 | $3,895 | — | — | 16 |
| 72158 | MR LUMBAR SPINE W/WO CONTRAST | $6,258 | $3,755 | — | — | 16 |
| 27762 | CLS TX MED MALLEOLUS FX W/M LT | $5,683 | $3,410 | — | — | 16 |
| 27781 | CLS TX FIB/SHAFT FX W/MAN RT | $5,683 | $3,410 | — | — | 16 |
| 59409 | VAG DELIVERY | $5,641 | $3,385 | — | — | 16 |
| 74176 | CT ABD+PELVIS WO CONTRAST | $5,385 | $3,231 | — | — | 16 |
| 70551 | MR HEAD W/O CONTRAST | $5,342 | $3,205 | — | — | 16 |
| 72197 | MR PELVIS W/WO CONTRAST | $5,342 | $3,205 | — | — | 16 |
| 73221 | MR UP EXT JNT WO CON LT | $5,342 | $3,205 | — | — | 16 |
| 73721 | MR LOW EXT JNT WO CON LT | $5,342 | $3,205 | — | — | 16 |
| 73700 | CT LOW EXTREMITY WO CON BIL | $5,292 | $3,175 | — | — | 16 |
| 72148 | MR LUMBAR SPINE W/O CONTRAST | $5,089 | $3,053 | — | — | 16 |
| 72141 | MR C-SPINE W/O CONTRAST | $5,087 | $3,052 | — | — | 16 |
| 73718 | MR LOW EXT NON JNT WO CON LT | $5,087 | $3,052 | — | — | 16 |
| 72146 | MR THORACIC W/O CONTRAST | $5,017 | $3,010 | — | — | 16 |
| 10121 | INCISION & REMOVAL FB SC COMP | $4,931 | $2,959 | — | — | 16 |
| 72194 | CT PELVIS W/WO CONTRAST | $4,864 | $2,918 | — | — | 16 |
| 71270 | CT CHEST W/WO CONTRAST | $4,833 | $2,900 | — | — | 16 |
| 21315 | CLS TX NASAL BONE FX WO STAB | $4,726 | $2,836 | — | — | 16 |
| 21337 | CLS TX NASAL SPTL FX W OR WO S | $4,726 | $2,836 | — | — | 16 |
| 95811 | SLEEP STUDY>3PRMT W/CP+TCH-INT | $4,587 | $2,752 | — | — | 16 |
| 71275 | CT ANG CHST W OR WO CONTR | $4,489 | $2,693 | — | — | 16 |
| 74183 | MRI ABDOMEN W/O & W/CONTRAST M | $4,445 | $2,667 | — | — | 16 |
| 70544 | MR ANGIO HEAD W/O CONTRAST | $4,411 | $2,647 | — | — | 16 |
| 23655 | CLS TX DSLC SHLD W/MAN W/M LT | $4,242 | $2,545 | — | — | 16 |
| 26775 | CLS TX FNGR DSL W/MAN W/AN F4 | $4,242 | $2,545 | — | — | 16 |
| 72125 | CT C-SPINE WO CONTRAST | $4,229 | $2,537 | — | — | 16 |
| 95810 | SLEEP STUDY>3PARMTRS W/T-INT | $4,128 | $2,477 | — | — | 16 |
Showing top 50 of 1,246 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.