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
1,311
Insurances with rates
16
CPT / HCPCS codes
1,026
Source MRF
Most expensive procedures (gross)
J3101
$21,126
TNKASE 50MG INJ
Gross
$35,210
J2353
$19,353
OCTREOTIDE LAR 30MG INJ
Gross
$32,255
A2025
$18,334
MIRO3D 100 CM3/CM3
Gross
$30,557
J0840
$10,873
CROFAB 1 EA
Gross
$18,122
LITHOTRIPSY UNILAT 1ST 10 MIN
$8,692
LITHOTRIPSY UNILAT 1ST 10 MIN
Gross
$14,486
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
Q4101
$5,087
APLIGRAF DISK KIT 44 SQ CM
Gross
$8,479
74178
$5,020
CT ABD+PELVIS W+WO CONTRAST
Gross
$8,366
70543
$4,873
MR ORBIT/FACE/NECK W/WO CNTRST
Gross
$8,122
Q4133
$4,828
GRAFIX PL PRIME 12 SQ CM/SQCM
Gross
$8,047
72156
$4,633
MR C-SPINE W/WO CONTRAST
Gross
$7,722
72157
$4,633
MR THORACIC W/WO CONTRAST
Gross
$7,722
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
81162
$4,144
BRCA 1/2 COMP ANALYSIS
Gross
$6,907
74177
$4,045
CT ABD+PELVIS W/CONTRAST
Gross
$6,742
74174
$3,995
CT ANG ABD+PLVS W OR WO CNTRS
Gross
$6,659
J0897
$3,947
PROLIA 60MG/ML INJECTION
Gross
$6,578
J3262
$3,641
ACTEMRA 200MG/10ML VIAL
Gross
$6,069
72158
$3,576
MR LUMBAR SPINE W/WO CONTRAST
Gross
$5,960
J0129
$3,489
ORENCIA 250MG/10ML INJECTION
Gross
$5,815
24620
$3,410
CLS TX RADIAL HEAD DSLC W/M LT
Gross
$5,683
27825
$3,410
LOW LEG FX W/TRCT +/OR MAN RT
Gross
$5,683
J1439
$3,310
INJECTAFER 750MG/15ML VIAL
Gross
$5,517
70551
$3,205
MR HEAD W/O CONTRAST
Gross
$5,342
74176
$3,077
CT ABD+PELVIS WO CONTRAST
Gross
$5,129
72146
$3,053
MR THORACIC W/O CONTRAST
Gross
$5,088
73220
$3,053
MR UP EXT NON JNT W+WO CON LT
Gross
$5,088
73221
$3,053
MR UP EXT JNT WO CON LT
Gross
$5,088
73223
$3,053
MR UP EXT JNT W+WO CON LT
Gross
$5,088
73720
$3,053
MR LOW EXT NON JNT W+WO CON LT
Gross
$5,088
73721
$3,053
MR LOW EXT JNT WO CON LT
Gross
$5,088
73700
$3,025
CT LOW EXTREMITY WO CON BIL
Gross
$5,041
90377
$2,997
KEDRAB 300UNIT/2ML VIAL
Gross
$4,995
99285
$2,976
CRITICAL CARE 1ST 30-74M
Gross
$4,960
10121
$2,959
INCISION & REMOVAL FB SC COMP
Gross
$4,931
28192
$2,959
RMVL FB FOOT DEEP
Gross
$4,931
72148
$2,908
MR LUMBAR SPINE W/O CONTRAST
Gross
$4,847
72141
$2,907
MR C-SPINE W/O CONTRAST
Gross
$4,845
72195
$2,907
MR PELVIS W/O CONTRAST
Gross
$4,845
73718
$2,907
MR LOW EXT NON JNT WO CON LT
Gross
$4,845
21315
$2,836
CLS TX NASAL BONE FX WO STAB
Gross
$4,726
71270
$2,762
CT CHEST W/WO CONTRAST
Gross
$4,603
95811
$2,752
SLEEP STUDY>3PRMT W/CP+TCH-INT
Gross
$4,587
70546
$2,647
MR ANGIO HEAD W/WO CONTRAST
Gross
$4,411
71275
$2,565
CT ANG CHST W OR WO CONTR
Gross
$4,275
23655
$2,545
CLS TX DSLC SHLD W/MAN W/M LT
Gross
$4,242
24605
$2,545
CLS RED DISLC ELBOW W/ANES RT
Gross
$4,242
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J3101 | TNKASE 50MG INJ | $35,210 | $21,126 | — | — | 20 |
| J2353 | OCTREOTIDE LAR 30MG INJ | $32,255 | $19,353 | — | — | 20 |
| A2025 | MIRO3D 100 CM3/CM3 | $30,557 | $18,334 | — | — | 20 |
| J0840 | CROFAB 1 EA | $18,122 | $10,873 | — | — | 20 |
| LITHOTRIPSY UNILAT 1ST 10 MIN | LITHOTRIPSY UNILAT 1ST 10 MIN | $14,486 | $8,692 | — | — | 20 |
| OB SURGERY LEVEL 3 1ST 30 MINS | OB SURGERY LEVEL 3 1ST 30 MINS | $11,475 | $6,885 | — | — | 20 |
| Q4197 | PURAPLY XT 4.91X4.91(25)/SQCM | $11,305 | $6,783 | — | — | 20 |
| Q4101 | APLIGRAF DISK KIT 44 SQ CM | $8,479 | $5,087 | — | — | 20 |
| 74178 | CT ABD+PELVIS W+WO CONTRAST | $8,366 | $5,020 | — | — | 20 |
| 70543 | MR ORBIT/FACE/NECK W/WO CNTRST | $8,122 | $4,873 | — | — | 20 |
| Q4133 | GRAFIX PL PRIME 12 SQ CM/SQCM | $8,047 | $4,828 | — | — | 20 |
| 72156 | MR C-SPINE W/WO CONTRAST | $7,722 | $4,633 | — | — | 20 |
| 72157 | MR THORACIC W/WO CONTRAST | $7,722 | $4,633 | — | — | 20 |
| 70553 | MR HEAD W/WO CONTRAST | $7,671 | $4,603 | — | — | 20 |
| Q4159 | AFFINITY 2.25 SQ CM/SQCM | $7,648 | $4,589 | — | — | 20 |
| 25651 | ULNAR STYLD FX W/SKELET FIX LT | $7,244 | $4,346 | — | — | 20 |
| 81162 | BRCA 1/2 COMP ANALYSIS | $6,907 | $4,144 | — | — | 20 |
| 74177 | CT ABD+PELVIS W/CONTRAST | $6,742 | $4,045 | — | — | 20 |
| 74174 | CT ANG ABD+PLVS W OR WO CNTRS | $6,659 | $3,995 | — | — | 20 |
| J0897 | PROLIA 60MG/ML INJECTION | $6,578 | $3,947 | — | — | 20 |
| J3262 | ACTEMRA 200MG/10ML VIAL | $6,069 | $3,641 | — | — | 20 |
| 72158 | MR LUMBAR SPINE W/WO CONTRAST | $5,960 | $3,576 | — | — | 20 |
| J0129 | ORENCIA 250MG/10ML INJECTION | $5,815 | $3,489 | — | — | 20 |
| 24620 | CLS TX RADIAL HEAD DSLC W/M LT | $5,683 | $3,410 | — | — | 20 |
| 27825 | LOW LEG FX W/TRCT +/OR MAN RT | $5,683 | $3,410 | — | — | 20 |
| J1439 | INJECTAFER 750MG/15ML VIAL | $5,517 | $3,310 | — | — | 20 |
| 70551 | MR HEAD W/O CONTRAST | $5,342 | $3,205 | — | — | 20 |
| 74176 | CT ABD+PELVIS WO CONTRAST | $5,129 | $3,077 | — | — | 20 |
| 72146 | MR THORACIC W/O CONTRAST | $5,088 | $3,053 | — | — | 20 |
| 73220 | MR UP EXT NON JNT W+WO CON LT | $5,088 | $3,053 | — | — | 20 |
| 73221 | MR UP EXT JNT WO CON LT | $5,088 | $3,053 | — | — | 20 |
| 73223 | MR UP EXT JNT W+WO CON LT | $5,088 | $3,053 | — | — | 20 |
| 73720 | MR LOW EXT NON JNT W+WO CON LT | $5,088 | $3,053 | — | — | 20 |
| 73721 | MR LOW EXT JNT WO CON LT | $5,088 | $3,053 | — | — | 20 |
| 73700 | CT LOW EXTREMITY WO CON BIL | $5,041 | $3,025 | — | — | 20 |
| 90377 | KEDRAB 300UNIT/2ML VIAL | $4,995 | $2,997 | — | — | 20 |
| 99285 | CRITICAL CARE 1ST 30-74M | $4,960 | $2,976 | — | — | 20 |
| 10121 | INCISION & REMOVAL FB SC COMP | $4,931 | $2,959 | — | — | 20 |
| 28192 | RMVL FB FOOT DEEP | $4,931 | $2,959 | — | — | 20 |
| 72148 | MR LUMBAR SPINE W/O CONTRAST | $4,847 | $2,908 | — | — | 20 |
| 72141 | MR C-SPINE W/O CONTRAST | $4,845 | $2,907 | — | — | 20 |
| 72195 | MR PELVIS W/O CONTRAST | $4,845 | $2,907 | — | — | 20 |
| 73718 | MR LOW EXT NON JNT WO CON LT | $4,845 | $2,907 | — | — | 20 |
| 21315 | CLS TX NASAL BONE FX WO STAB | $4,726 | $2,836 | — | — | 20 |
| 71270 | CT CHEST W/WO CONTRAST | $4,603 | $2,762 | — | — | 20 |
| 95811 | SLEEP STUDY>3PRMT W/CP+TCH-INT | $4,587 | $2,752 | — | — | 20 |
| 70546 | MR ANGIO HEAD W/WO CONTRAST | $4,411 | $2,647 | — | — | 20 |
| 71275 | CT ANG CHST W OR WO CONTR | $4,275 | $2,565 | — | — | 20 |
| 23655 | CLS TX DSLC SHLD W/MAN W/M LT | $4,242 | $2,545 | — | — | 20 |
| 24605 | CLS RED DISLC ELBOW W/ANES RT | $4,242 | $2,545 | — | — | 20 |
Showing top 50 of 1,311 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.