RANKEN JORDAN PEDIATRIC BRIDGE HOSPITAL

CCN 263303

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
771
Insurances with rates
11
CPT / HCPCS codes
755
Source MRF

Most expensive procedures (gross)

J0135
$13,573
00074-0124-02 - adalimumab 80 mg/0.8 mL Kit
Gross
$16,966
J2353
$6,878
00078-0818-81 - octreotide 20 mg PWDI
Gross
$8,598
93533
$4,684
Cardiac Catheterization, combined right and transseptal left through septal opening, with or w/out r
Gross
$5,855
J2802
$4,405
55513-0221-01 - romiPLOStim 250 mcg Powd
Gross
$5,506
31622
$4,152
Bronchoscopy
Gross
$5,190
93532
$4,074
Cardiac Catheterization, combined right and transseptal left through intact septum, with or w/out re
Gross
$5,092
36560
$3,828
Port-A-Cath insertion, under 5 years of age
Gross
$4,785
49441
$3,748
GJ Tube Placement, w/fluoroscopy
Gross
$4,685
49450
$3,744
Replacement of G-Tube, w/fluoroscopy
Gross
$4,679
93307
$3,668
Transthoracic ECG, 2D, M-mode color flow doppler, followup study
Gross
$4,585
36561
$3,652
Port-A-Cath insertion, 5 years+
Gross
$4,565
49452
$3,569
Replacement of G-J-Tube, w/fluoroscopy
Gross
$4,462
93531
$3,542
Cardiac Catheterization, combined right heart and retrograde left for congenital cardiac anomalies
Gross
$4,428
43870
$3,403
G-Tube, GJ-Tube, PEG Removal
Gross
$4,254
36584
$3,328
PICC Line replaced
Gross
$4,160
93306
$3,190
Transthoracic ECG, 2D, M-mode color flow doppler
Gross
$3,988
70551
$3,092
MRI Brain w/o Contrast
Gross
$3,865
93530
$3,080
Cardiac Catheterization, right heart for congenital cardiac anomalies
Gross
$3,850
J0219
$2,744
58468-0426-01 - avalglucosidase alfa ngpt 100 mg Injection
Gross
$3,430
73223
$2,730
MRI UE Joint w/ + w/o Contrast Bilateral
Gross
$3,413
73222
$2,730
MRI UE Joint w/ Contrast Bilateral
Gross
$3,413
73221
$2,730
MRI UE Joint w/o Contrast Bilateral
Gross
$3,413
93308
$2,711
Transthoracic ECG w/out color flow doppler
Gross
$3,389
0191
$2,640
ROOM/BED: Level 1
Gross
$3,300
0192
$2,640
ROOM/BED: Level 2
Gross
$3,300
0193
$2,640
ROOM/BED: Level 3
Gross
$3,300
0194
$2,640
ROOM/BED: Level 4
Gross
$3,300
72156
$2,637
MRI Spine Cervical w/ + w/o Contrast
Gross
$3,297
C9003
$2,605
66658-0230-01 - palivizumab 100 mg/mL Soln 0.5ml
Gross
$3,257
43276
$2,530
Biliary Stent Replacement
Gross
$3,163
J2941
$2,500
00169-7705-21 - somatropin 10 mg/1.5 mL Soln
Gross
$3,125
70553
$2,476
MRI Brain w/ + w/o Contrast
Gross
$3,095
72142
$2,461
MRI Spine Cervical w/ Contrast
Gross
$3,077
72147
$2,461
MRI Spine Thoracic w/ Contrast
Gross
$3,077
72158
$2,327
MRI Spine Lumbar w/ + w/o Contrast
Gross
$2,908
73220
$2,311
MRI UE Non Joint w/ + w/o Contrast Bilat
Gross
$2,888
73219
$2,311
MRI UE Non Joint w/ Contrast Bilateral
Gross
$2,888
73218
$2,311
MRI UE Non Joint w/o Contrast Bilateral
Gross
$2,888
72141
$2,285
MRI Spine Cervical w/o Contrast
Gross
$2,857
72146
$2,285
MRI Spine Thoracic w/o Contrast
Gross
$2,857
70552
$2,212
MRI Brain w/ Contrast
Gross
$2,765
36557
$2,200
Broviac insertion - under 5 years of age
Gross
$2,750
72127
$2,198
CT Spine Cervical w/ + w/o Contrast
Gross
$2,747
72130
$2,198
CT Spine Thoracic w/ + w/o Contrast
Gross
$2,747
72149
$2,151
MRI Spine Lumbar w/ Contrast
Gross
$2,688
70488
$2,113
CT Maxillofacial w/ + w/o Contrast
Gross
$2,641
72157
$2,104
MRI Spine Thoracic w/ + w/o Contrast
Gross
$2,630
31525
$2,072
Tracheoscopy, rigid or flexible, with or w/out laryngoscopy
Gross
$2,591
72194
$2,065
CT Pelvis w/ + w/o Contrast
Gross
$2,582
70470
$2,036
CT Head or Brain w/ + w/o Contrast
Gross
$2,545
Showing top 50 of 771 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.