RIVERWOOD HEALTHCARE CENTER — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
G0390	HC TRAUMA RESPONSE LEVEL 1	$13,544	$7,585	—	—	3
72146	HC MRI, DORSAL SPINE - MRI THORACIC SPINE WO CONTRAST	$7,724	$4,325	—	—	6
70553	MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL	$7,644	$4,281	—	—	18
70549	MRA NECK W/O &W/CONTRAST MATERIAL	$7,343	$4,112	—	—	9
93306	HC TTE W/DOPPLER COMPLETE - TTE COMPLETE	$6,832	$3,826	—	—	32
3430000001	TC-99M SESTAMIBI SOLR	$5,741	$3,215	—	—	11
74177	CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$5,441	$3,047	—	—	69
70498	CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST	$5,434	$3,043	—	—	16
*	Max Procedure Name	$5,163	$2,891	—	—	15
70551	HC MRI BRAIN - MRI BRAIN WO CONTRAST	$4,602	$2,577	—	—	16
73723	MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL	$4,208	$2,356	—	—	1
71552	MRI CHEST W/O & W/CONTRAST MATERIAL	$4,139	$2,318	—	—	2
36573	HC INSERT PICC W/O SUB-Q PORT W/IMAGE GUIDE >5 Y/O	$3,778	$2,115	—	—	4
74176	CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL	$3,727	$2,087	—	—	27
74174	CTA ABD&PLVS W/CNTRST & IMG POSTPROCESSING	$3,686	$2,064	—	—	7
71275	CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST	$3,641	$2,039	—	—	3
93350	HC STRESS TTE ONLY - ECHOCARDIOGRAM DOBUTAMINE STRESS TEST	$3,340	$1,870	—	—	9
74183	MRI ABDOMEN W/O CONTRAST FLWD BY W/CONTRAST	$3,331	$1,865	—	—	8
73720	MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR	$3,313	$1,855	—	—	6
78816	PET IMAGING FOR CT ATTENUATION WHOLE BODY	$3,275	$1,834	—	—	3
78227	HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ	$2,897	$1,622	—	—	4
74181	HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST MRCP	$2,858	$1,600	—	—	5
72158	MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL	$2,804	$1,570	—	—	2
72193	CT PELVIS W/CONTRAST MATERIAL	$2,739	$1,534	—	—	2
70486	CT MAXILLOFACIAL W/O CONTRAST MATERIAL	$2,493	$1,396	—	—	10
72131	CT LUMBAR SPINE W/O CONTRAST MATERIAL	$2,413	$1,351	—	—	4
74178	CT ABDOMEN & PELVIS WITH & WITHOUT CONTRAST	$2,361	$1,322	—	—	9
72148	HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST	$2,336	$1,308	—	—	27
73200	CT UPPER EXTREMITY W/O CONTRAST MATERIAL	$2,333	$1,306	—	—	17
78815	PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH	$2,265	$1,269	—	—	7
78264	GASTRIC EMPTYING IMAGING STUDY	$2,148	$1,203	—	—	5
72157	HC MRI, DORSAL SPINE COMBO - MRI THORACIC SPINE W WO CONTRAST	$2,143	$1,200	—	—	3
72141	HC MRI, CERV SPINE - MRI CERVICAL SPINE WO CONTRAST	$2,139	$1,198	—	—	16
72197	MRI PELVIS W/O & W/CONTRAST MATERIAL	$2,130	$1,193	—	—	18
72156	MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL	$2,128	$1,192	—	—	1
78306	BONE &/JOINT IMAGING WHOLE BODY	$2,114	$1,184	—	—	1
70450	CT HEAD/BRAIN W/O CONTRAST MATERIAL	$1,790	$1,002	—	—	25
99291	CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$1,770	$991	—	—	6
71250	DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST	$1,704	$954	—	—	22
93880	DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$1,698	$951	—	—	5
62321	NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN	$1,693	$948	—	—	1
93970	DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,681	$941	—	—	4
72125	CT CERVICAL SPINE W/O CONTRAST MATERIAL	$1,663	$931	—	—	13
62323	HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN	$1,612	$903	—	—	2
72192	CT PELVIS W/O CONTRAST MATERIAL	$1,534	$859	—	—	7
32555	HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,475	$826	—	—	2
76830	US TRANSVAGINAL	$1,471	$824	—	—	14
71260	DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST	$1,453	$814	—	—	29
70491	CT SOFT TISSUE NECK W/CONTRAST MATERIAL	$1,429	$800	—	—	12
73721	HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE LT WO CONT	$1,428	$800	—	—	25

Showing top 50 of 356 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.