45 CFR § 180 compliance
D · 65
This hospital published part 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
134
Insurances with rates
0
CPT / HCPCS codes
133
Source MRF
Most expensive procedures (gross)
95783
$4,558
Polysom w Bi/Cpap 5yrs or less
Gross
$5,071
95782
$4,014
Polysomnography 5yrs or less
Gross
$4,481
95811
$2,367
Polysom w Bi/Cpap >6yrs
Gross
$2,800
95810
$2,239
Polysomnography 6yrs or older
Gross
$2,657
74230
$709
Flouroscopy MBS/SWALLOWING FUNCTION
Gross
$806
76830
$633
Ultrasound pelvis through vagina
Gross
$753
76700
$582
Ultrasound of abdomen
Gross
$718
74240
$557
Fluoroscopy UGI w or w/o KUB
Gross
$687
92587
$668
Hearing Screen of inner ear
Gross
$682
93306
$236
TRANSTHORACIC ECHO W/COLOR DOPPLER
Gross
$664
92557
$573
Hearing test of different pitches with words
Gross
$584
92579
$573
Hearing response to sounds, 6 mos to 3 years
Gross
$584
90837
$495
Telepsychology individual therapy, 60 min
Gross
$505
99204
$0
Office/Outpatient Visit, New, Level 4, pro fee
Gross
$396
92550
$382
Audiology test of acoustic reflex and eardrum
Gross
$390
72082
$329
XR SCOLIOSIS, 2 OR 3 VIEWS
Gross
$386
64644
$0
Botox Injection, Chemodenervation >/5 Muscles
Gross
$380
90791
$371
Psychology Diagnostic Interview
Gross
$379
64616
$0
Botox Injection, Neck Muscles Unilateral
Gross
$357
64642
$0
Botox Injection, Chemodenervation 1-4 Muscles
Gross
$347
76942
$239
US Guided Needle Placement
Gross
$342
64611
$0
Botox Injection, Salivary Gland
Gross
$341
92553
$334
Air and bone conduction testing
Gross
$341
99245
$0
Office consultation, pro fee, typically 80 min
Gross
$339
11313
$0
Shave Skn Lsn Face,Ear,Lip>2cm
Gross
$318
95990
$0
Baclofen pump maintenance and refill
Gross
$295
92556
$286
Hearing test with words
Gross
$292
Various
$28.48
Psychiatry Office Visit
Gross
$279
72110
$228
X-Ray, lower back, minimum four views
Gross
$269
96130
$248
Psychological Test Interpretation, First Hour
Gross
$253
96131
$248
Psychological Test Interpretation, Additional Hours
Gross
$253
96132
$248
Neuropsychological Test Interpretation, First Hour
Gross
$253
96133
$248
Neuropsychological Test Interpretation, Additional Hours
Gross
$253
96113
$248
Developmental Psychological Testing, Additional Hours
Gross
$253
92567
$239
Audiology test of eardrum
Gross
$243
73521
$203
XR HIP BILATERAL
Gross
$242
99244
$0
Office consultation, pro fee, typically 60 min
Gross
$241
99203
$0
Office/Outpatient Visit, New, Level 3, pro fee
Gross
$234
99381
$0
Well Child, Initial Visit
Gross
$234
99382
$0
Well Child Age 1-4, New
Gross
$234
99383
$0
Well Child Age 5-11, New
Gross
$234
99384
$0
Well Child Adolescent ( Age 12-17), New
Gross
$234
99391
$0
Periodic Comprehensive Preventive Medicine visit
Gross
$234
99392
$0
Well Child Age 1-4, Established
Gross
$234
99393
$0
Well Child Age 5-11, Established
Gross
$234
99394
$0
Compre Prev Med Re-eval/mgmt
Gross
$234
99395
$0
Periodic Comprehensive Preventive Medicine visit
Gross
$234
97750
$227
PT Blalance Testing, 15 minutes
Gross
$232
92610
$226
OT Feeding Evaluation, 15 minutes
Gross
$231
92521
$226
Speech Fluency Re-Evaluation, 15 minutes
Gross
$231
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 95783 | Polysom w Bi/Cpap 5yrs or less | $5,071 | $4,558 | — | — | 0 |
| 95782 | Polysomnography 5yrs or less | $4,481 | $4,014 | — | — | 0 |
| 95811 | Polysom w Bi/Cpap >6yrs | $2,800 | $2,367 | — | — | 0 |
| 95810 | Polysomnography 6yrs or older | $2,657 | $2,239 | — | — | 0 |
| 74230 | Flouroscopy MBS/SWALLOWING FUNCTION | $806 | $709 | — | — | 0 |
| 76830 | Ultrasound pelvis through vagina | $753 | $633 | — | — | 0 |
| 76700 | Ultrasound of abdomen | $718 | $582 | — | — | 0 |
| 74240 | Fluoroscopy UGI w or w/o KUB | $687 | $557 | — | — | 0 |
| 92587 | Hearing Screen of inner ear | $682 | $668 | — | — | 0 |
| 93306 | TRANSTHORACIC ECHO W/COLOR DOPPLER | $664 | $236 | — | — | 0 |
| 92557 | Hearing test of different pitches with words | $584 | $573 | — | — | 0 |
| 92579 | Hearing response to sounds, 6 mos to 3 years | $584 | $573 | — | — | 0 |
| 90837 | Telepsychology individual therapy, 60 min | $505 | $495 | — | — | 0 |
| 99204 | Office/Outpatient Visit, New, Level 4, pro fee | $396 | $0 | — | — | 0 |
| 92550 | Audiology test of acoustic reflex and eardrum | $390 | $382 | — | — | 0 |
| 72082 | XR SCOLIOSIS, 2 OR 3 VIEWS | $386 | $329 | — | — | 0 |
| 64644 | Botox Injection, Chemodenervation >/5 Muscles | $380 | $0 | — | — | 0 |
| 90791 | Psychology Diagnostic Interview | $379 | $371 | — | — | 0 |
| 64616 | Botox Injection, Neck Muscles Unilateral | $357 | $0 | — | — | 0 |
| 64642 | Botox Injection, Chemodenervation 1-4 Muscles | $347 | $0 | — | — | 0 |
| 76942 | US Guided Needle Placement | $342 | $239 | — | — | 0 |
| 64611 | Botox Injection, Salivary Gland | $341 | $0 | — | — | 0 |
| 92553 | Air and bone conduction testing | $341 | $334 | — | — | 0 |
| 99245 | Office consultation, pro fee, typically 80 min | $339 | $0 | — | — | 0 |
| 11313 | Shave Skn Lsn Face,Ear,Lip>2cm | $318 | $0 | — | — | 0 |
| 95990 | Baclofen pump maintenance and refill | $295 | $0 | — | — | 0 |
| 92556 | Hearing test with words | $292 | $286 | — | — | 0 |
| Various | Psychiatry Office Visit | $279 | $28.48 | — | — | 0 |
| 72110 | X-Ray, lower back, minimum four views | $269 | $228 | — | — | 0 |
| 96130 | Psychological Test Interpretation, First Hour | $253 | $248 | — | — | 0 |
| 96131 | Psychological Test Interpretation, Additional Hours | $253 | $248 | — | — | 0 |
| 96132 | Neuropsychological Test Interpretation, First Hour | $253 | $248 | — | — | 0 |
| 96133 | Neuropsychological Test Interpretation, Additional Hours | $253 | $248 | — | — | 0 |
| 96113 | Developmental Psychological Testing, Additional Hours | $253 | $248 | — | — | 0 |
| 92567 | Audiology test of eardrum | $243 | $239 | — | — | 0 |
| 73521 | XR HIP BILATERAL | $242 | $203 | — | — | 0 |
| 99244 | Office consultation, pro fee, typically 60 min | $241 | $0 | — | — | 0 |
| 99203 | Office/Outpatient Visit, New, Level 3, pro fee | $234 | $0 | — | — | 0 |
| 99381 | Well Child, Initial Visit | $234 | $0 | — | — | 0 |
| 99382 | Well Child Age 1-4, New | $234 | $0 | — | — | 0 |
| 99383 | Well Child Age 5-11, New | $234 | $0 | — | — | 0 |
| 99384 | Well Child Adolescent ( Age 12-17), New | $234 | $0 | — | — | 0 |
| 99391 | Periodic Comprehensive Preventive Medicine visit | $234 | $0 | — | — | 0 |
| 99392 | Well Child Age 1-4, Established | $234 | $0 | — | — | 0 |
| 99393 | Well Child Age 5-11, Established | $234 | $0 | — | — | 0 |
| 99394 | Compre Prev Med Re-eval/mgmt | $234 | $0 | — | — | 0 |
| 99395 | Periodic Comprehensive Preventive Medicine visit | $234 | $0 | — | — | 0 |
| 97750 | PT Blalance Testing, 15 minutes | $232 | $227 | — | — | 0 |
| 92610 | OT Feeding Evaluation, 15 minutes | $231 | $226 | — | — | 0 |
| 92521 | Speech Fluency Re-Evaluation, 15 minutes | $231 | $226 | — | — | 0 |
Showing top 50 of 134 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.