GRAND ISLAND REGIONAL MEDICAL CENTER

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J0225	VUTRISIRAN 25 MG/0.5 ML SUBCUTANEOUS SYRINGE	$238,702	$109,803	$169,478	$179,027	2
J0225	VUTRISIRAN 25 MG/0.5 ML SUBCUTANEOUS SYRINGE	$238,702	$109,803	$57,288	$195,736	15
0424T	HC INS RPLC NSTIM SYSTEM SLEEP APNEA COMPLETE	$94,161	$43,314	$66,854	$70,621	2
0424T	HC INS RPLC NSTIM SYSTEM SLEEP APNEA COMPLETE	$94,161	$43,314	$22,599	$77,212	17
33276	HC INSJ PHRNC NRV STIM SYS	$94,161	$43,314	$66,854	$70,621	2
33276	HC INSJ PHRNC NRV STIM SYS	$94,161	$43,314	$22,599	$77,212	13
C1721	DEFIB CURRENT DR 36J 2207-36	$80,520	$37,039	$57,169	$60,390	2
C1721	DEFIB CURRENT DR 36J 2207-36	$80,520	$37,039	$19,325	$66,026	13
C1772	DEFIBRILLATOR EMBLEM MRI S-ICD	$69,540	$31,988	$49,373	$52,155	2
C1772	DEFIBRILLATOR EMBLEM MRI S-ICD	$69,540	$31,988	$16,690	$57,023	13
37221	HC STENT INSERT ILIAC INITIAL	$66,384	$30,537	$47,133	$49,788	2
37221	HC STENT INSERT ILIAC INITIAL	$66,384	$30,537	$867	$54,435	29
93656	HC ABL AF W EP STDY TRANSEPT	$55,862	$25,697	$39,662	$41,897	2
93656	HC ABL AF W EP STDY TRANSEPT	$55,862	$25,697	$1,680	$52,563	29
27820331	HC MITRACLIP 1 CLIP EA	$52,500	$24,150	$37,275	$39,375	2
27820331	HC MITRACLIP 1 CLIP EA	$52,500	$24,150	$12,600	$43,050	13
0431T	HC RMVL/RPLC NSTIM APNEA PLS GMN	$51,846	$23,849	$36,811	$38,885	2
0431T	HC RMVL/RPLC NSTIM APNEA PLS GMN	$51,846	$23,849	$12,443	$48,015	16
33287	HC RMV&RPLCMT PHRNC NRV STIM PGM	$51,846	$23,849	$36,811	$38,885	2
33287	HC RMV&RPLCMT PHRNC NRV STIM PGM	$51,846	$23,849	$12,443	$42,514	13
33270	HC INSERT SUBQ DEFIB W ELTRD	$49,158	$22,613	$34,902	$36,869	2
33270	HC INSERT SUBQ DEFIB W ELTRD	$49,158	$22,613	$1,006	$68,695	29
38240	HC ARC BN MRRW STM TRANSP ALLO	$47,639	$21,914	$33,824	$35,729	2
38240	HC ARC BN MRRW STM TRANSP ALLO	$47,639	$21,914	$463	$126,719	29
A9513	LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLUTION	$47,500	$21,850	$33,725	$35,625	2
A9513	LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLUTION	$47,500	$21,850	$267	$38,950	29
C9765	HC REVASC INTRA LITHOTRIP-STENT	$46,640	$21,454	$33,114	$34,980	2
C9765	HC REVASC INTRA LITHOTRIP-STENT	$46,640	$21,454	$9,496	$38,474	26
33249	HC ICD INITIAL SYS W LEAD	$46,071	$21,193	$32,710	$34,553	2
33249	HC ICD INITIAL SYS W LEAD	$46,071	$21,193	$1,635	$68,695	29
0915T	HC INSJ PERM CCM-D SYS PGM&ELTRD	$44,886	$20,648	$31,869	$33,665	2
0915T	HC INSJ PERM CCM-D SYS PGM&ELTRD	$44,886	$20,648	$10,773	$36,807	14
C1823	HC REMEDE IMPLANTABLE PULSE GMENERATOR	$44,625	$20,528	$31,684	$33,469	2
C1823	HC REMEDE IMPLANTABLE PULSE GMENERATOR	$44,625	$20,528	$10,710	$36,593	13
33231	HC INSRT PULSE GMEN W/MULT LEADS	$43,772	$20,135	$31,078	$32,829	2
33231	HC INSRT PULSE GMEN W/MULT LEADS	$43,772	$20,135	$722	$68,695	29
27825869	HC CATH IMPELLA 2.5	$43,750	$20,125	$31,063	$32,813	2
27825869	HC CATH IMPELLA 2.5	$43,750	$20,125	$10,500	$35,875	13
33230	HC LD INS ICD DUAL GMEN ONLY	$43,233	$19,887	$30,695	$32,425	2
33230	HC LD INS ICD DUAL GMEN ONLY	$43,233	$19,887	$672	$63,861	29
33240	HC INSRT PULSE GMEN W/EXIST LEAD	$43,233	$19,887	$30,695	$32,425	2
33240	HC INSRT PULSE GMEN W/EXIST LEAD	$43,233	$19,887	$663	$63,861	29
27225538	HC IMPELLA RP US PUMP SET	$42,500	$19,550	$30,175	$31,875	2
27225538	HC IMPELLA RP US PUMP SET	$42,500	$19,550	$10,200	$34,850	13
37223	HC STENT INSERT ILIAC ADDL	$42,486	$19,544	$30,165	$31,865	2
37223	HC STENT INSERT ILIAC ADDL	$42,486	$19,544	$371	$34,839	17
C1605	HC PACER SYS AVEIR DUAL CHAMBER	$42,000	$19,320	$29,820	$31,500	2
C1605	HC PACER SYS AVEIR DUAL CHAMBER	$42,000	$19,320	$10,080	$34,440	13
93590	HC PERQ TRANSCATH CLS MITRAL	$41,426	$19,056	$29,412	$31,070	2
93590	HC PERQ TRANSCATH CLS MITRAL	$41,426	$19,056	$2,021	$48,015	29

Showing top 50 of 12,077 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.