SANFORD HILLSBORO — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J2350	Ocrelizumab Soln For IV Infusion 300 MG/10ML	$21,608	$17,286	—	—	35
J3101	Tenecteplase For IV Soln Kit 50 MG	$7,515	$6,012	—	—	35
J0717	Certolizumab Pegol Prefilled Syringe Kit 200 MG/ML	$6,267	$5,013	—	—	35
J0517	Benralizumab Subcutaneous Soln Prefilled Syringe 30 MG/ML	$5,976	$4,781	—	—	35
74174	CTA ABD PELVIS W CONTRAST+WO IF PERFORM	$5,658	$4,526	—	—	35
95811	PSG CPAP BIPAP 4+ PARAMETERS	$5,367	$4,294	—	—	35
Q5127	Pegfilgrastim-fpgk Soln Prefilled Syringe 6 MG/0.6ML	$5,219	$4,175	—	—	35
66984	SURG 66984 EXTRACAP CATARCT RMVL INSERT IO LENS PROSTH W/O ECP	$5,201	$4,161	—	—	35
66982	SURG 66982 RMVL ECCR IOL INSRT CMPLX	$5,201	$4,161	—	—	35
95810	PSG 4+ PARAMETERS	$4,956	$3,965	—	—	35
Q5111	Pegfilgrastim-cbqv Soln Prefilled Syringe 6 MG/0.6ML	$4,944	$3,955	—	—	35
72158	MRI L SPINE WO THEN W CONT	$4,905	$3,924	—	—	35
72157	MRI T SPINE WO THEN W CONT	$4,820	$3,856	—	—	35
J1301	Edaravone Inj 30 MG/100ML (0.3 MG/ML)	$4,772	$3,818	—	—	70
72156	MRI C SPINE WO THEN W CONT	$4,748	$3,798	—	—	35
72197	MRI PELVIS WO THEN W CONT	$4,730	$3,784	—	—	35
0474T	SURG 0474T INSERT ANT SEG AQUEOUS DRG DEV W/IO RSVR	$4,697	$3,758	—	—	35
70553	MRI BRAIN WO THEN W CONT	$4,663	$3,730	—	—	35
65235	ED 65235 REMV FB EYE INTRAOCULAR	$4,603	$3,682	—	—	35
71552	MRI CHEST WO THEN W CONT	$4,585	$3,668	—	—	35
70543	MRI FACE NECK ORB WO THEN W CONT	$4,570	$3,656	—	—	35
74183	MRI ABDOMEN WO THEN W CONT	$4,543	$3,634	—	—	35
70546	MRA HEAD WO THEN W CONT	$4,504	$3,603	—	—	35
67904	SURG 67904 RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL	$4,477	$3,582	—	—	35
73223	MRI UPPER EXT JT WO THEN W CONT	$4,458	$3,566	—	—	35
73723	MRI LOWER EXT JT WO THEN W CONT	$4,389	$3,511	—	—	35
70549	MRA NECK WO THEN W CONT	$4,346	$3,477	—	—	35
15823	SURG 15823 BLEPHROPL UPPER EXC SKIN	$4,280	$3,424	—	—	35
73220	MRI UPPER EXT WO THEN W CONT	$4,249	$3,399	—	—	35
59409	ED 59409 ED DELIVERY VAGINAL ONLY	$4,173	$3,338	—	—	35
73720	MRI LOWER EXT WO THEN W CONT	$4,131	$3,305	—	—	35
72147	MRI T SPINE W CONTRAST	$3,979	$3,183	—	—	35
26607	ED 26607 CLSD TX MTCRPAL FX WMANIP	$3,955	$3,164	—	—	35
72149	MRI L SPINE W CONTRAST	$3,953	$3,162	—	—	35
72142	MRI C SPINE W CONTRAST	$3,951	$3,161	—	—	35
70552	MRI BRAIN W CONTRAST	$3,861	$3,089	—	—	35
73222	MRI UP EXT JT WCONT	$3,855	$3,084	—	—	35
12037	ED 12037 LYR CLSR OF WND >30.0CM	$3,838	$3,070	—	—	35
52281	CYSTO WDILATATION OFURETHRA	$3,795	$3,036	—	—	35
74178	CT ABD PELVIS WO THEN W CONT	$3,755	$3,004	—	—	35
37609	SURG 37609 LIGATION/BIOPSY TEMPORAL ARTERY	$3,710	$2,968	—	—	35
74170	CT ABDOMEN WO THEN W CONT	$3,673	$2,938	—	—	35
J3262	Tocilizumab IV Inj 400 MG/20ML	$3,669	$2,936	—	—	35
67917	SURG 67917 REPAIR ECTROPION EXTENSIVE	$3,656	$2,925	—	—	35
27603	TX RM 27603 I&D ABSCESS HEMATOMA LEG ANKLE DEEP	$3,650	$2,920	—	—	35
J3111	Romosozumab-aqqg Inj Soln Prefilled Syringe 105 MG/1.17ML	$3,571	$2,857	—	—	70
67924	SURG 67924 REPAIR ENTROPION EXTENSIVE	$3,571	$2,857	—	—	35
21337	ED 21337 CLSD TX NOSE FXW WO STABL	$3,443	$2,754	—	—	35
70545	MRA HEAD W CONTRAST	$3,415	$2,732	—	—	35
71550	MRI CHEST WO CONTRAST	$3,312	$2,650	—	—	35

Showing top 50 of 1,639 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.