45 CFR § 180 compliance
F · 55
This hospital published little 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
282
Insurances with rates
9
CPT / HCPCS codes
275
Source MRF
Most expensive procedures (gross)
8604
$20,609
REHABILITATION
Gross
$26,522
8603
$17,546
REHABILITATION
Gross
$22,579
8602
$17,473
REHABILITATION
Gross
$22,487
945
$16,468
REHABILITATION WITH CC/MCC
Gross
$21,193
8601
$13,829
REHABILITATION
Gross
$17,796
946
$12,195
REHABILITATION WITHOUT CC/MCC
Gross
$15,694
Q4125
$4,760
ARTHROFLEX DECELLULARIZED DERMIS GRAFT
Gross
$6,346
J7312
$2,001
OZURDEX
Gross
$2,668
Q4186
$1,717
EPIFIX 2X3CM
Gross
$2,289
Q4173
$1,650
PALINGEN MEMBRANE 4X4
Gross
$2,200
Q4235
$1,458
AMNIOREPAIR 2X3 CM
Gross
$1,944
G0379
$900
DIRECT REFER HOSPITAL OBSERVATION
Gross
$1,200
Q4163
$750
BIOSKIN 2X2CM
Gross
$1,000
Q4128
$612
ALLOPATCH HD 1X12CM
Gross
$816
78231
$533
X-RAY SALIVARY GLAND
Gross
$710
J7311
$484
RETISERT
Gross
$646
96413
$413
ADMIN CHEMO IV
Gross
$550
Q4116
$362
ALLODERM REGENERATIVE TISSUE MATRIX 1X2
Gross
$482
70130
$169
X-RAY MASTOID-CMPLETE
Gross
$225
70110
$169
X-RAY MANDIBLE COMPLETE
Gross
$225
70150
$169
X-RAY FACIAL BONES-COMPLETE
Gross
$225
70200
$169
XRAY ORBITS-COMPLETE
Gross
$225
70240
$169
X-RAY SELLATURCICA
Gross
$225
72070
$169
X-RAY THORACIC-2 VIEW
Gross
$225
72170
$169
X-RAY PELVIS-1 VIEW
Gross
$225
72190
$169
X-RAY PELVIS-COMPLETE
Gross
$225
72202
$169
X-RAY SI JOINTS-3 VIEW
Gross
$225
73010
$169
X-RAY SCAPULA
Gross
$225
73521
$169
X-RAY HIP-COMPLETE
Gross
$225
71110
$169
X-RAY RIB BILATERAL-3 VEW
Gross
$225
72050
$169
X-RAY CERVICAL SPINE 4 OR 5 VIEWS
Gross
$225
72052
$169
X-RAY CERVICAL 6 OR MORE VIEWS COMPLETE
Gross
$225
72110
$169
X-RAY LUMBAR SPINE MIN 4 VIEWS
Gross
$225
72114
$169
X-RAY LUMBAR BENDING MIN 6 VIEWS-COMPLETE
Gross
$225
72120
$169
X-RAY LUMBOSACRAL, BEND ONLY 2-3 VIEW
Gross
$225
73564
$169
X-RAY KNEE 4 OR MORE VIEWS, COMPLETE
Gross
$225
72100
$169
X-RAY LUMBAR 2 OR 3 VIEWS
Gross
$225
73523
$169
X-RAY HIP BILATERAL WITH PELVIS 5 VIEWS
Gross
$225
74022
$169
X-RAY ABDOMEN, SUPINE AND SINGLE CHEST VIEW
Gross
$225
70250
$169
X-RAY SKULL LESS THAN 4 VIEWS
Gross
$225
72074
$169
X-RAY THORACIC MIN 4 VIEWS
Gross
$225
76942
$113
ULTRASOUND PROCEDURE
Gross
$150
77002
$113
FLUOROGUIDE, NON-SPINAL PROCEDURES
Gross
$150
77003
$113
FLUOROSCOPIC GUIDANCE, SPINAL PROCEDURES
Gross
$150
88305
$102
LAB - PATHOLOGY
Gross
$136
97161
$97.5
P T TREATMENT
Gross
$130
97165
$97.5
O T EVALUATION
Gross
$130
70160
$93.75
X-RAY NASAL BONES-COMPLETE
Gross
$125
70220
$93.75
X-RAY SINUSES-COMPLETE
Gross
$125
71045
$93.75
X-RAY CHEST-1 VIEW
Gross
$125
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 8604 | REHABILITATION | $26,522 | $20,609 | — | — | 6 |
| 8603 | REHABILITATION | $22,579 | $17,546 | — | — | 6 |
| 8602 | REHABILITATION | $22,487 | $17,473 | — | — | 6 |
| 945 | REHABILITATION WITH CC/MCC | $21,193 | $16,468 | — | — | 12 |
| 8601 | REHABILITATION | $17,796 | $13,829 | — | — | 6 |
| 946 | REHABILITATION WITHOUT CC/MCC | $15,694 | $12,195 | — | — | 12 |
| Q4125 | ARTHROFLEX DECELLULARIZED DERMIS GRAFT | $6,346 | $4,760 | — | — | 19 |
| J7312 | OZURDEX | $2,668 | $2,001 | — | — | 1 |
| Q4186 | EPIFIX 2X3CM | $2,289 | $1,717 | — | — | 20 |
| Q4173 | PALINGEN MEMBRANE 4X4 | $2,200 | $1,650 | — | — | 19 |
| Q4235 | AMNIOREPAIR 2X3 CM | $1,944 | $1,458 | — | — | 19 |
| G0379 | DIRECT REFER HOSPITAL OBSERVATION | $1,200 | $900 | — | — | 19 |
| Q4163 | BIOSKIN 2X2CM | $1,000 | $750 | — | — | 19 |
| Q4128 | ALLOPATCH HD 1X12CM | $816 | $612 | — | — | 20 |
| 78231 | X-RAY SALIVARY GLAND | $710 | $533 | — | — | 20 |
| J7311 | RETISERT | $646 | $484 | — | — | 1 |
| 96413 | ADMIN CHEMO IV | $550 | $413 | — | — | 19 |
| Q4116 | ALLODERM REGENERATIVE TISSUE MATRIX 1X2 | $482 | $362 | — | — | 20 |
| 70130 | X-RAY MASTOID-CMPLETE | $225 | $169 | — | — | 20 |
| 70110 | X-RAY MANDIBLE COMPLETE | $225 | $169 | — | — | 20 |
| 70150 | X-RAY FACIAL BONES-COMPLETE | $225 | $169 | — | — | 20 |
| 70200 | XRAY ORBITS-COMPLETE | $225 | $169 | — | — | 20 |
| 70240 | X-RAY SELLATURCICA | $225 | $169 | — | — | 20 |
| 72070 | X-RAY THORACIC-2 VIEW | $225 | $169 | — | — | 20 |
| 72170 | X-RAY PELVIS-1 VIEW | $225 | $169 | — | — | 20 |
| 72190 | X-RAY PELVIS-COMPLETE | $225 | $169 | — | — | 20 |
| 72202 | X-RAY SI JOINTS-3 VIEW | $225 | $169 | — | — | 20 |
| 73010 | X-RAY SCAPULA | $225 | $169 | — | — | 20 |
| 73521 | X-RAY HIP-COMPLETE | $225 | $169 | — | — | 20 |
| 71110 | X-RAY RIB BILATERAL-3 VEW | $225 | $169 | — | — | 20 |
| 72050 | X-RAY CERVICAL SPINE 4 OR 5 VIEWS | $225 | $169 | — | — | 20 |
| 72052 | X-RAY CERVICAL 6 OR MORE VIEWS COMPLETE | $225 | $169 | — | — | 20 |
| 72110 | X-RAY LUMBAR SPINE MIN 4 VIEWS | $225 | $169 | — | — | 20 |
| 72114 | X-RAY LUMBAR BENDING MIN 6 VIEWS-COMPLETE | $225 | $169 | — | — | 20 |
| 72120 | X-RAY LUMBOSACRAL, BEND ONLY 2-3 VIEW | $225 | $169 | — | — | 20 |
| 73564 | X-RAY KNEE 4 OR MORE VIEWS, COMPLETE | $225 | $169 | — | — | 20 |
| 72100 | X-RAY LUMBAR 2 OR 3 VIEWS | $225 | $169 | — | — | 20 |
| 73523 | X-RAY HIP BILATERAL WITH PELVIS 5 VIEWS | $225 | $169 | — | — | 20 |
| 74022 | X-RAY ABDOMEN, SUPINE AND SINGLE CHEST VIEW | $225 | $169 | — | — | 20 |
| 70250 | X-RAY SKULL LESS THAN 4 VIEWS | $225 | $169 | — | — | 20 |
| 72074 | X-RAY THORACIC MIN 4 VIEWS | $225 | $169 | — | — | 20 |
| 76942 | ULTRASOUND PROCEDURE | $150 | $113 | — | — | 1 |
| 77002 | FLUOROGUIDE, NON-SPINAL PROCEDURES | $150 | $113 | — | — | 1 |
| 77003 | FLUOROSCOPIC GUIDANCE, SPINAL PROCEDURES | $150 | $113 | — | — | 1 |
| 88305 | LAB - PATHOLOGY | $136 | $102 | — | — | 19 |
| 97161 | P T TREATMENT | $130 | $97.5 | — | — | 1 |
| 97165 | O T EVALUATION | $130 | $97.5 | — | — | 1 |
| 70160 | X-RAY NASAL BONES-COMPLETE | $125 | $93.75 | — | — | 20 |
| 70220 | X-RAY SINUSES-COMPLETE | $125 | $93.75 | — | — | 20 |
| 71045 | X-RAY CHEST-1 VIEW | $125 | $93.75 | — | — | 20 |
Showing top 50 of 282 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.