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
1,210
Insurances with rates
6
CPT / HCPCS codes
1,190
Source MRF
Most expensive procedures (gross)
J3101
$20,743
TNKase (TENECTEPLASE) 50 MG KIT
Gross
$20,743
J2997
$17,601
ACTIVASE (ALTEPLASE) 100 MG IV
Gross
$17,601
J3358
$15,214
STELARA 390 MG/78 ML VIAL
Gross
$15,214
J2506
$11,925
Neulasta (PEGFILGRASTIM)6 MG/0.6 ML VIAL
Gross
$11,925
J2353
$9,427
SANDOSTATIN LAR(OCTREOTIDE) 20MG VIAL IM
Gross
$9,427
J1569
$9,089
GAMMAGARD(IMMUNE GLOBULIN)45 GM VIAL 10%
Gross
$9,089
Q5108
$7,469
Fulphila Subcutaneous Solution 6MG/0.
Gross
$7,469
J3590
$6,923
Yusimry SubQ Solution 40MG/0.8ML
Gross
$6,923
J9217
$6,500
ELIGARD (LEUPROLIDE ACETATE)6 MNTH 45 MG
Gross
$6,500
49561
$5,624
HERNIA REPAIR INIT BLOCK
Gross
$5,624
49587
$5,624
REPAIR UMBILICAL HERNIA
Gross
$5,624
49585
$5,603
HERNIA REPAIR UMBILICAL
Gross
$5,603
71552
$5,483
MRI CHEST W&W/O CONT
Gross
$5,483
49505
$5,348
HERNIA REPAIR
Gross
$5,348
19120
$5,051
REMOVE BREAST LESION
Gross
$5,051
64721
$4,816
CARPAL TUNNEL
Gross
$4,816
J0897
$4,794
PROLIA (DENOSUMAB) 60 MG / ML VIAL
Gross
$4,794
70553
$4,624
MRI BRAIN W&W/O CONTRAST
Gross
$4,624
72158
$4,624
MRI L SPINE W&W/O - LUMBAR
Gross
$4,624
73220
$4,606
MRI EXT UPPER LT NON-JOINT WO/W,Left
Gross
$4,606
72157
$4,598
MRI T SPINE W & W/O - THORACIC
Gross
$4,598
72197
$4,556
MRI PELVIS W&W/O
Gross
$4,556
74183
$4,556
MRI ABDOMEN W&W/O
Gross
$4,556
70543
$4,540
MRI ORBIT/FACE/NECK W&W/O CONTRAST
Gross
$4,540
73720
$4,540
MRI EXT LOWER LT NON-JOINT W&W/O,Left
Gross
$4,540
73723
$4,540
MRI EXT LOWER LT JOINT W&W/O,Left
Gross
$4,540
46080
$4,317
INC ANAL SPHINCTER
Gross
$4,317
22901
$4,306
EXCISION ADDTL DEEP 5CM
Gross
$4,306
24071
$4,306
ESCISION ARM/ELBOW
Gross
$4,306
27047
$4,306
EXC HIP/PELVIS <3CM
Gross
$4,306
72156
$4,272
MRI C SPINE W&W/O - CERVICAL
Gross
$4,272
11646
$4,026
EXCISION FACE 4.0 CM
Gross
$4,026
71550
$4,022
MRI CHEST W/O
Gross
$4,022
70548
$4,001
MRA NECK W CONTRAST
Gross
$4,001
66920
$3,986
EXTRACTION OF LENS MATERIAL
Gross
$3,986
70547
$3,784
MRA NECK W/O CONTRAST
Gross
$3,784
70552
$3,714
MRI BRAIN W CONTRAST
Gross
$3,714
73223
$3,705
MRI EXT UPPER LT JOINT W&W/O,Left
Gross
$3,705
72196
$3,667
MRI PELVIS W
Gross
$3,667
87507
$3,618
GI PANEL BY PCR,Ref Lab
Gross
$3,618
G0121
$3,593
COLONOSCOPY (SCREENING)
Gross
$3,593
G0105
$3,593
COLONOSCOPY (SCREEN HI RISK)
Gross
$3,593
45384
$3,593
COLONOSCOPY W LESION REMOVAL HOT SNARE
Gross
$3,593
45385
$3,593
COLONOSCOPY W LESION REMOVAL
Gross
$3,593
70549
$3,529
MRA NECK W&W/O CONTRAST
Gross
$3,529
73218
$3,526
MRI EXT UPPER LT NON-JOINT WO,Left
Gross
$3,526
70544
$3,464
MRA HEAD W/O CONTRAST
Gross
$3,464
J1750
$3,461
INFED(IRON DEXTRAN 50MG/ML)2G/40 ML DOSE
Gross
$3,461
72195
$3,422
MRI PELVIS W/O CONTRAST
Gross
$3,422
73718
$3,403
MRI EXT LOWER LT NON-JOINT WO,Left
Gross
$3,403
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J3101 | TNKase (TENECTEPLASE) 50 MG KIT | $20,743 | $20,743 | — | — | 0 |
| J2997 | ACTIVASE (ALTEPLASE) 100 MG IV | $17,601 | $17,601 | — | — | 0 |
| J3358 | STELARA 390 MG/78 ML VIAL | $15,214 | $15,214 | — | — | 0 |
| J2506 | Neulasta (PEGFILGRASTIM)6 MG/0.6 ML VIAL | $11,925 | $11,925 | — | — | 0 |
| J2353 | SANDOSTATIN LAR(OCTREOTIDE) 20MG VIAL IM | $9,427 | $9,427 | — | — | 0 |
| J1569 | GAMMAGARD(IMMUNE GLOBULIN)45 GM VIAL 10% | $9,089 | $9,089 | — | — | 0 |
| Q5108 | Fulphila Subcutaneous Solution 6MG/0. | $7,469 | $7,469 | — | — | 0 |
| J3590 | Yusimry SubQ Solution 40MG/0.8ML | $6,923 | $6,923 | — | — | 0 |
| J9217 | ELIGARD (LEUPROLIDE ACETATE)6 MNTH 45 MG | $6,500 | $6,500 | — | — | 0 |
| 49561 | HERNIA REPAIR INIT BLOCK | $5,624 | $5,624 | — | — | 0 |
| 49587 | REPAIR UMBILICAL HERNIA | $5,624 | $5,624 | — | — | 0 |
| 49585 | HERNIA REPAIR UMBILICAL | $5,603 | $5,603 | — | — | 0 |
| 71552 | MRI CHEST W&W/O CONT | $5,483 | $5,483 | — | — | 0 |
| 49505 | HERNIA REPAIR | $5,348 | $5,348 | — | — | 0 |
| 19120 | REMOVE BREAST LESION | $5,051 | $5,051 | — | — | 0 |
| 64721 | CARPAL TUNNEL | $4,816 | $4,816 | — | — | 0 |
| J0897 | PROLIA (DENOSUMAB) 60 MG / ML VIAL | $4,794 | $4,794 | — | — | 0 |
| 70553 | MRI BRAIN W&W/O CONTRAST | $4,624 | $4,624 | — | — | 0 |
| 72158 | MRI L SPINE W&W/O - LUMBAR | $4,624 | $4,624 | — | — | 0 |
| 73220 | MRI EXT UPPER LT NON-JOINT WO/W,Left | $4,606 | $4,606 | — | — | 0 |
| 72157 | MRI T SPINE W & W/O - THORACIC | $4,598 | $4,598 | — | — | 0 |
| 72197 | MRI PELVIS W&W/O | $4,556 | $4,556 | — | — | 0 |
| 74183 | MRI ABDOMEN W&W/O | $4,556 | $4,556 | — | — | 0 |
| 70543 | MRI ORBIT/FACE/NECK W&W/O CONTRAST | $4,540 | $4,540 | — | — | 0 |
| 73720 | MRI EXT LOWER LT NON-JOINT W&W/O,Left | $4,540 | $4,540 | — | — | 0 |
| 73723 | MRI EXT LOWER LT JOINT W&W/O,Left | $4,540 | $4,540 | — | — | 0 |
| 46080 | INC ANAL SPHINCTER | $4,317 | $4,317 | — | — | 0 |
| 22901 | EXCISION ADDTL DEEP 5CM | $4,306 | $4,306 | — | — | 0 |
| 24071 | ESCISION ARM/ELBOW | $4,306 | $4,306 | — | — | 0 |
| 27047 | EXC HIP/PELVIS <3CM | $4,306 | $4,306 | — | — | 0 |
| 72156 | MRI C SPINE W&W/O - CERVICAL | $4,272 | $4,272 | — | — | 0 |
| 11646 | EXCISION FACE 4.0 CM | $4,026 | $4,026 | — | — | 0 |
| 71550 | MRI CHEST W/O | $4,022 | $4,022 | — | — | 0 |
| 70548 | MRA NECK W CONTRAST | $4,001 | $4,001 | — | — | 0 |
| 66920 | EXTRACTION OF LENS MATERIAL | $3,986 | $3,986 | — | — | 0 |
| 70547 | MRA NECK W/O CONTRAST | $3,784 | $3,784 | — | — | 0 |
| 70552 | MRI BRAIN W CONTRAST | $3,714 | $3,714 | — | — | 0 |
| 73223 | MRI EXT UPPER LT JOINT W&W/O,Left | $3,705 | $3,705 | — | — | 0 |
| 72196 | MRI PELVIS W | $3,667 | $3,667 | — | — | 0 |
| 87507 | GI PANEL BY PCR,Ref Lab | $3,618 | $3,618 | — | — | 0 |
| G0121 | COLONOSCOPY (SCREENING) | $3,593 | $3,593 | — | — | 0 |
| G0105 | COLONOSCOPY (SCREEN HI RISK) | $3,593 | $3,593 | — | — | 0 |
| 45384 | COLONOSCOPY W LESION REMOVAL HOT SNARE | $3,593 | $3,593 | — | — | 0 |
| 45385 | COLONOSCOPY W LESION REMOVAL | $3,593 | $3,593 | — | — | 0 |
| 70549 | MRA NECK W&W/O CONTRAST | $3,529 | $3,529 | — | — | 0 |
| 73218 | MRI EXT UPPER LT NON-JOINT WO,Left | $3,526 | $3,526 | — | — | 0 |
| 70544 | MRA HEAD W/O CONTRAST | $3,464 | $3,464 | — | — | 0 |
| J1750 | INFED(IRON DEXTRAN 50MG/ML)2G/40 ML DOSE | $3,461 | $3,461 | — | — | 0 |
| 72195 | MRI PELVIS W/O CONTRAST | $3,422 | $3,422 | — | — | 0 |
| 73718 | MRI EXT LOWER LT NON-JOINT WO,Left | $3,403 | $3,403 | — | — | 0 |
Showing top 50 of 1,210 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.