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
1,337
Insurances with rates
5
CPT / HCPCS codes
1,314
Source MRF
Most expensive procedures (gross)
J3380
$16,174
VEDOLIZUMAB (ENTYVIO) 300 MG INJ
Gross
$16,848
J2997
$15,509
ALTEPLASE (ACTIVASE) 100 MG INJ
Gross
$16,156
J3101
$14,338
TENECTEPLASE (TNKASE) 50 MG INJ
Gross
$14,935
J2506
$11,393
PEGFILGRASTIM (NEULASTA) 6 MG/0.6 ML INJ
Gross
$11,867
Q5108
$7,517
PEGFILGRASTIM-JMDB(FULPHILA) 6MG/0.6ML
Gross
$7,830
78816
$7,200
PET/CT WHOLEBODY
Gross
$7,500
78815
$6,720
PET/CT SKULL TO THIGH
Gross
$7,000
49593
$6,480
REPAIR HERNIA 3CM-10CM REDUCIBLE
Gross
$6,750
49591
$6,240
REPAIR EPIGASTRIC HERNIA W/ MESH
Gross
$6,500
49592
$6,240
INITIAL REP HERN <3 CM DIA
Gross
$6,500
29882
$5,760
ARTHROSCOPIC KNEE W/ MENISC RPR MED/LAT
Gross
$6,000
29883
$5,760
ARTHROSCOPY KNEE W/ MENISCUS RPR MEDIAL
Gross
$6,000
11772
$5,760
REMOVAL PILONIDAL CYST COMPLICATED
Gross
$6,000
J7165
$5,715
PROTHROMBIN CPLX CONC (BALFAXAR) 1000 UN
Gross
$5,953
59514
$5,280
CESAREAN DELIVERY ONLY
Gross
$5,500
11771
$5,280
EXCISION PILONIDAL CYST
Gross
$5,500
74178
$5,280
CT UROGRAM
Gross
$5,500
J0717
$5,215
CERTOLIZUMAB PEGOL 200 MG SYR
Gross
$5,432
44970
$5,040
LAPAROSCOPIC APPENDECTOMY
Gross
$5,250
49321
$5,040
LAPROSCOPY SURG W/ BX SIGLE / MUTLI
Gross
$5,250
49520
$5,040
REPAIR REOCC ING HERNIA ANY AGE REDUCIB
Gross
$5,250
49507
$5,040
HERNIA INCARC/STRANGULATED
Gross
$5,250
74174
$4,933
CTA ABD PELVIS W/ AND W/O IV CONTRAST
Gross
$5,139
74178
$4,920
CT ABD PELVIS W/ AND W/O IV CONTRAST
Gross
$5,125
29875
$4,800
ARTHOSCOPY KNEE SYNOVECTOMY
Gross
$5,000
47562
$4,800
LAPAROSCOPIC CHLOECYSTECTOMY
Gross
$5,000
11770
$4,800
REMOVAL OF PILONIDAL CYST SIMPLE
Gross
$5,000
78452
$4,800
NM NUCLEAR PERFUSION
Gross
$5,000
58661
$4,656
LAPAROSCOPY REMOVE ADNEXAL STRUC
Gross
$4,850
95811
$4,416
SPLIT NIGHT SLEEP STUDY
Gross
$4,600
J0401
$4,411
ARIPiprazole (ABILIFY MAINTENA)400MG SYR
Gross
$4,594
49505
$4,320
REPAIR INT INQU HERNIA 5YRSOR+ REDUCIABL
Gross
$4,500
95810
$4,128
FULL SLEEP STUDY/CPAP
Gross
$4,300
59160
$4,080
D & C AFTER DELIVERY
Gross
$4,250
58120
$4,080
D & C, NON-OB
Gross
$4,250
59820
$4,080
D & C AFTER MISSED ABORTION
Gross
$4,250
74177
$4,080
CT ABD PELVIS W/ IV CONTRAST
Gross
$4,250
24071
$4,032
EXCESION ARM / ELBOW LESION >3CM
Gross
$4,200
71552
$4,032
MRI CHEST W/ AND W/O IV CONTRAST
Gross
$4,200
J1944
$3,980
ARIPiprazole (ARISTADA) 662MG/2.4ML SYR
Gross
$4,146
72156
$3,936
MRI C-SPINE W/ AND W/O CONTRAST
Gross
$4,100
73723
$3,936
MRI LOWER EXT JOINT W&W/O CONTRAST RT,RIGHT SIDE
Gross
$4,100
72158
$3,936
MRI L-SPINE W/ AND W/O CONTRAST
Gross
$4,100
J2802
$3,870
romiPLOStim (NPLATE) 375 MCG/0.75 ML INJ
Gross
$4,031
70553
$3,864
MRI BRAIN W/ AND W/O CONTRAST
Gross
$4,025
38510
$3,840
BIOPSY OF EXCISION OF LYMPHNODE OPEN D
Gross
$4,000
49320
$3,840
DIAG LAPROSCOPIC SEPERATE PROCEDURE
Gross
$4,000
54830
$3,840
EXCISION LOCAL LESION EPIDIDYMIS
Gross
$4,000
46922
$3,840
EXCISION OF ANAL LESIONS
Gross
$4,000
29881
$3,840
KNEE ARTHROSCOPY / SURGERY
Gross
$4,000
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J3380 | VEDOLIZUMAB (ENTYVIO) 300 MG INJ | $16,848 | $16,174 | — | — | 0 |
| J2997 | ALTEPLASE (ACTIVASE) 100 MG INJ | $16,156 | $15,509 | — | — | 0 |
| J3101 | TENECTEPLASE (TNKASE) 50 MG INJ | $14,935 | $14,338 | — | — | 0 |
| J2506 | PEGFILGRASTIM (NEULASTA) 6 MG/0.6 ML INJ | $11,867 | $11,393 | — | — | 0 |
| Q5108 | PEGFILGRASTIM-JMDB(FULPHILA) 6MG/0.6ML | $7,830 | $7,517 | — | — | 0 |
| 78816 | PET/CT WHOLEBODY | $7,500 | $7,200 | — | — | 0 |
| 78815 | PET/CT SKULL TO THIGH | $7,000 | $6,720 | — | — | 0 |
| 49593 | REPAIR HERNIA 3CM-10CM REDUCIBLE | $6,750 | $6,480 | — | — | 0 |
| 49591 | REPAIR EPIGASTRIC HERNIA W/ MESH | $6,500 | $6,240 | — | — | 0 |
| 49592 | INITIAL REP HERN <3 CM DIA | $6,500 | $6,240 | — | — | 0 |
| 29882 | ARTHROSCOPIC KNEE W/ MENISC RPR MED/LAT | $6,000 | $5,760 | — | — | 0 |
| 29883 | ARTHROSCOPY KNEE W/ MENISCUS RPR MEDIAL | $6,000 | $5,760 | — | — | 0 |
| 11772 | REMOVAL PILONIDAL CYST COMPLICATED | $6,000 | $5,760 | — | — | 0 |
| J7165 | PROTHROMBIN CPLX CONC (BALFAXAR) 1000 UN | $5,953 | $5,715 | — | — | 0 |
| 59514 | CESAREAN DELIVERY ONLY | $5,500 | $5,280 | — | — | 0 |
| 11771 | EXCISION PILONIDAL CYST | $5,500 | $5,280 | — | — | 0 |
| 74178 | CT UROGRAM | $5,500 | $5,280 | — | — | 0 |
| J0717 | CERTOLIZUMAB PEGOL 200 MG SYR | $5,432 | $5,215 | — | — | 0 |
| 44970 | LAPAROSCOPIC APPENDECTOMY | $5,250 | $5,040 | — | — | 0 |
| 49321 | LAPROSCOPY SURG W/ BX SIGLE / MUTLI | $5,250 | $5,040 | — | — | 0 |
| 49520 | REPAIR REOCC ING HERNIA ANY AGE REDUCIB | $5,250 | $5,040 | — | — | 0 |
| 49507 | HERNIA INCARC/STRANGULATED | $5,250 | $5,040 | — | — | 0 |
| 74174 | CTA ABD PELVIS W/ AND W/O IV CONTRAST | $5,139 | $4,933 | — | — | 0 |
| 74178 | CT ABD PELVIS W/ AND W/O IV CONTRAST | $5,125 | $4,920 | — | — | 0 |
| 29875 | ARTHOSCOPY KNEE SYNOVECTOMY | $5,000 | $4,800 | — | — | 0 |
| 47562 | LAPAROSCOPIC CHLOECYSTECTOMY | $5,000 | $4,800 | — | — | 0 |
| 11770 | REMOVAL OF PILONIDAL CYST SIMPLE | $5,000 | $4,800 | — | — | 0 |
| 78452 | NM NUCLEAR PERFUSION | $5,000 | $4,800 | — | — | 0 |
| 58661 | LAPAROSCOPY REMOVE ADNEXAL STRUC | $4,850 | $4,656 | — | — | 0 |
| 95811 | SPLIT NIGHT SLEEP STUDY | $4,600 | $4,416 | — | — | 0 |
| J0401 | ARIPiprazole (ABILIFY MAINTENA)400MG SYR | $4,594 | $4,411 | — | — | 0 |
| 49505 | REPAIR INT INQU HERNIA 5YRSOR+ REDUCIABL | $4,500 | $4,320 | — | — | 0 |
| 95810 | FULL SLEEP STUDY/CPAP | $4,300 | $4,128 | — | — | 0 |
| 59160 | D & C AFTER DELIVERY | $4,250 | $4,080 | — | — | 0 |
| 58120 | D & C, NON-OB | $4,250 | $4,080 | — | — | 0 |
| 59820 | D & C AFTER MISSED ABORTION | $4,250 | $4,080 | — | — | 0 |
| 74177 | CT ABD PELVIS W/ IV CONTRAST | $4,250 | $4,080 | — | — | 0 |
| 24071 | EXCESION ARM / ELBOW LESION >3CM | $4,200 | $4,032 | — | — | 0 |
| 71552 | MRI CHEST W/ AND W/O IV CONTRAST | $4,200 | $4,032 | — | — | 0 |
| J1944 | ARIPiprazole (ARISTADA) 662MG/2.4ML SYR | $4,146 | $3,980 | — | — | 0 |
| 72156 | MRI C-SPINE W/ AND W/O CONTRAST | $4,100 | $3,936 | — | — | 0 |
| 73723 | MRI LOWER EXT JOINT W&W/O CONTRAST RT,RIGHT SIDE | $4,100 | $3,936 | — | — | 0 |
| 72158 | MRI L-SPINE W/ AND W/O CONTRAST | $4,100 | $3,936 | — | — | 0 |
| J2802 | romiPLOStim (NPLATE) 375 MCG/0.75 ML INJ | $4,031 | $3,870 | — | — | 0 |
| 70553 | MRI BRAIN W/ AND W/O CONTRAST | $4,025 | $3,864 | — | — | 0 |
| 38510 | BIOPSY OF EXCISION OF LYMPHNODE OPEN D | $4,000 | $3,840 | — | — | 0 |
| 49320 | DIAG LAPROSCOPIC SEPERATE PROCEDURE | $4,000 | $3,840 | — | — | 0 |
| 54830 | EXCISION LOCAL LESION EPIDIDYMIS | $4,000 | $3,840 | — | — | 0 |
| 46922 | EXCISION OF ANAL LESIONS | $4,000 | $3,840 | — | — | 0 |
| 29881 | KNEE ARTHROSCOPY / SURGERY | $4,000 | $3,840 | — | — | 0 |
Showing top 50 of 1,337 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.