VIRTUA MOUNT HOLLY HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J9228	ipilimumab 200 mg/40 mL (5 mg/mL) solution 40 mL Vial	$396,576	$39,658	—	—	26
C1820	KIT IPG	$276,770	$27,677	—	—	0
L2616	HC Yttrium Y-90 Non Stranded Brachytherapy per Source	$203,694	$20,369	—	—	0
C2624	PATIENT SYSTEM CARDIOMEMS	$201,787	$20,179	—	—	0
C1822	IPG KIT	$196,933	$19,693	—	—	0
C1882	DEFIB UNIT UNIFY QD CRT-D DF4	$159,675	$15,968	—	—	0
Q4116	ALLODERM SELECT 16X20	$158,504	$15,850	—	—	0
J9043	cabazitaxeL 10 mg/mL (first dilution) solution 1.5 mL Vial	$147,233	$14,723	—	—	4
33365	HC Replace Aortic Valve Open Transaortic Approach	$127,017	$12,702	—	—	17
33366	HC Transcatheter Transapical Replacement Aortic Valve	$127,017	$12,702	—	—	17
33361	HC Replace Aortic Valve Percutaneous Femoral Artery Approach	$127,017	$12,702	—	—	13
J9217	leuprolide acetate (6 month) per 7.5 mg	$124,729	$12,473	—	—	26
C1721	DEFIBRILLATOR CARDIOVERTER .99CM SM THN 5.23X7.03CM DYNAGEN MINI EASYVIEW	$123,535	$12,354	—	—	0
C1722	DEFIBRILLATOR CARDIOVERTER .99CM SM THN 5.23X6.71CM DYNAGEN MINI EASYVIEW	$114,881	$11,488	—	—	0
0571T	HC Insert / Replace Implantable Cardioverter Defibrilator W Substernal Electrode	$107,585	$10,759	—	—	29
33231	HC Insert Implantable Defibrillator Pulse Generator W Existing Multiple Leads	$106,939	$10,694	—	—	29
J3380	vedolizumab 300 mg recon soln 1 each Vial	$103,473	$10,347	—	—	4
J9042	brentuximab vedotin 50 mg recon soln 50 mg Vial	$95,220	$9,522	—	—	25
A9543	HC Yttrium Y-90 Zevalin per TX Dose up to 40mci	$94,628	$9,463	—	—	25
33289	HC Implant Wireless Pulmonary Artery Pressure Sensor W Right Heart Cath Selective Pulmonary Cath and	$94,436	$9,444	—	—	33
0483T	HC Tmvi Implant / Replace Transcatheter Mitral Valve W Prostetic Valve W Transseptal Puncture Percut	$90,297	$9,030	—	—	17
33249	HC Insert / Replace Defribrillator W Transvenous Leads Single / Dual Chamber	$90,260	$9,026	—	—	33
33264	HC Remove & Replace Defribillator Pulse Generator Multiple Lead	$90,260	$9,026	—	—	29
33270	HC Insert / Replace Subcutaneous Defribrillator W Evaluation	$90,260	$9,026	—	—	29
C1767	NEUROSTIMULATOR GASTROPARESIS ENTERRA	$89,950	$8,995	—	—	3
J2323	natalizumab per 1 mg	$88,810	$8,881	—	—	4
J9311	riTUXimab-hyaluronidase,human 1400 mg/11.7 mL (120 mg/mL) solution 11.7 mL Vial	$88,225	$8,822	—	—	26
J9301	obinutuzumab 1,000 mg/40 mL solution 40 mL Vial	$87,882	$8,788	—	—	26
J3101	tenecteplase per 1 mg	$80,996	$8,100	—	—	4
33230	HC Insert Implantable Defibrillator Pulse Generator W Existing Dual Leads	$76,385	$7,639	—	—	33
33240	HC Insert Implantable Defibrillator Pulse Generator Only Existing Single Lead	$75,503	$7,550	—	—	33
0414T	HC Remove and Replace Permanent Cardiac Contractility Modulation System Pulse Generator Only	$75,503	$7,550	—	—	29
J9015	aldesleukin per vial	$74,473	$7,447	—	—	4
0408T	HC Insert / Replace Cardiac Contractility Modulator Pulse Generator W Transvenous Electrodes	$71,208	$7,121	—	—	33
J9306	pertuzumab 420 mg/14 mL (30 mg/mL) solution 14 mL Vial	$68,925	$6,892	—	—	26
0543T	HC Transapical Mitral Valve Repair W Tte Placement	$68,465	$6,847	—	—	17
33418	HC Tmvr Mitral Valve Repair Initial Prosthesis	$66,827	$6,683	—	—	17
33419	HC Tmvr Mitral Valve Repair Additional Prosthesis / Mitraclip	$66,827	$6,683	—	—	17
0345T	HC Transcatheter Mitral Valve Repair via Coronary Sinus	$66,827	$6,683	—	—	17
J0391	artesunate 110 mg recon soln 1 each Vial	$66,807	$6,681	—	—	4
33262	HC Remove & Replace Defribillator Pulse Generator Single Lead	$66,805	$6,681	—	—	33
33263	HC Remove / Replace Implantable Defibrillator Dual Lead System	$66,805	$6,681	—	—	33
J1561	immune globul G-gly-IgA avg 46 40 gram/400 mL (10 %) solution 400 mL Vial	$65,562	$6,556	—	—	26
J9271	pembrolizumab 25 mg/mL solution 4 mL Vial	$64,261	$6,426	—	—	4
33221	HC Insert Pacemaker Pulse Generator Only w Existing Multi Leads	$63,851	$6,385	—	—	27
37227	HC Atherectomy Fem-Pop W/ Stent Unilateral	$62,193	$6,219	—	—	33
C9610	CATHETER BALLOON DILATATION AGENT 2.25MM 12MM RADIOPAQUE HYPOTUBE ULTRA LOW TIP PROFILE SHARP EDGE	$60,144	$6,014	—	—	0
33229	HC Remove & Replace Pacemaker Pulse Generator Multiple Leads	$59,315	$5,932	—	—	33
0796T	HC Transcatheter Insertion of Permanent Dual-Chamber Leadless Pacemaker, Including Imaging Guidance	$57,308	$5,731	—	—	33
A9603	pafolacianine 3.2 mg/1.6 mL solution 1.6 mL Vial	$57,014	$5,701	—	—	4

Showing top 50 of 5,787 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.