MADISON PARISH HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
30992	ACTIVASE 100 MG VIAL	$15,841	$7,920	—	—	14
37758	TNKase 50mg Vial	$9,957	$4,978	—	—	14
39906	DIGOXIN IMMUNE FAB 40 MG	$6,425	$3,212	—	—	14
40589	Crofab Vial	$5,756	$2,878	—	—	14
72156	CT ABDOMEN & PELVIS WO/WITH	$5,369	$2,684	—	—	17
77131	CT ANGIO HEAD AND NECK WO/W CONTRAST	$4,800	$2,400	—	—	14
72154	CT ABDOMEN & PELVIS W/	$4,466	$2,233	—	—	17
72152	CT ABDOMEN & PELVIS W/O	$3,959	$1,980	—	—	17
495649	DELIVER PLACENTA	$3,802	$1,901	—	—	14
77079	CT ANGIOGRAPHY CHEST	$3,691	$1,845	—	—	17
77119	CT ANGIO HEAD WO/W CONTRAST	$3,691	$1,845	—	—	15
77120	CT ANGIO NECK WO/W CONTRAST	$3,691	$1,845	—	—	15
77121	CT ANGIO PELVIS WO/W CONTRAST	$3,691	$1,845	—	—	14
77122	CT ANGIO ABDOMEN WO/W CONTRAST	$3,691	$1,845	—	—	14
77123	CT ANGIO ABDOMEN AND PELVIS WO/W CONTRAST	$3,691	$1,845	—	—	14
77124	CT ANGIO AORTO-ILIOFEMORAL RUNOFF	$3,691	$1,845	—	—	14
77088	CT SOFT TISSUE NECK W/O & W	$3,547	$1,774	—	—	14
495629	DRAIN SHOULDER LESION	$3,542	$1,771	—	—	14
77101	CT MAXILLOFACIAL WO/W CONTRAST	$3,444	$1,722	—	—	15
91855	MRI LUMBAR SPINE WITHOUT CONTR	$3,433	$1,717	—	—	14
70282	MRI BRAIN STEM W/O DYE	$3,318	$1,659	—	—	14
77105	CT LOWER EXTREMITY LT WO & W	$3,156	$1,578	—	—	15
72047	CT CHEST WO & W DYE	$3,156	$1,578	—	—	15
72132	CT SOFT TISSUE NECK W/	$3,156	$1,578	—	—	15
77097	CT UPPER EXT LT WO/W CONTRAST	$3,156	$1,578	—	—	14
77098	CT UPPER EXT RT WO/W CONTRAST	$3,156	$1,578	—	—	14
77108	CT LOWER EXTREMITY RT WO & W	$3,156	$1,578	—	—	15
89000	BRCA 1/2 COMPREHENSIVE ANALYSIS	$3,150	$1,575	—	—	14
40655	ALBUTEIN 5% VIAL	$2,951	$1,476	—	—	14
72040	CT ABDOMEN W/O & W DYE	$2,927	$1,463	—	—	14
72043	CT HEAD/BRAIN W/O & W DYE	$2,927	$1,463	—	—	14
72046	CT CHEST W DYE	$2,892	$1,446	—	—	17
77106	CT LOWER EXTREMITY LT WITH	$2,892	$1,446	—	—	14
77107	CT LOWER EXTREMITY RT WITH	$2,892	$1,446	—	—	14
72051	CT LUMBAR SPINE W/O CON	$2,809	$1,404	—	—	16
72146	CT SOFT TISSUE NECK WO	$2,750	$1,375	—	—	17
72039	CT ABDOMEN W DYE	$2,747	$1,374	—	—	15
72045	CT CHEST W/O DYE	$2,686	$1,343	—	—	17
77096	MRI LOWER EXTREMITY W/O CONTRAST	$2,672	$1,336	—	—	14
40500	Betamethasone 6mg/mL Inj.	$2,647	$1,324	—	—	15
482041	VAGINAL DLVRY WITH WOUT FORCEP	$2,615	$1,308	—	—	14
87966	PLT APHERESIS LEUKO REDUCED	$2,608	$1,304	—	—	14
72050	CT THORACIC SPINE; W/O C	$2,458	$1,229	—	—	14
72049	CT CERVICAL SPINE; W/O C	$2,450	$1,225	—	—	18
72042	CT HEAD/BRAIN W DYE	$2,414	$1,207	—	—	14
77094	CT MAXILLOFACIAL AREA WITH CON	$2,414	$1,207	—	—	15
72136	CT LOWER EXT LT WO CONTRAST	$2,271	$1,136	—	—	17
72218	CT LOWER EXT RT WO CON	$2,271	$1,136	—	—	17
72053	CT PELVIS W/O CONTRAST	$2,204	$1,102	—	—	16
72055	CT MAXILLOFACIAL AREA WITHOUT	$2,193	$1,096	—	—	17

Showing top 50 of 2,065 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.