BEAR RIVER VALLEY HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
202663	LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLUTION	$157,627	$118,220	—	—	33
202663	LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLUTION	$157,627	$118,220	—	—	29
216356	LUTETIUM LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN	$128,359	$96,270	—	—	33
216356	LUTETIUM LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN	$128,359	$96,270	—	—	29
2722109771	HC PERCUTANEOUS VENTRICULAR ASSIST DEVICE LVL 71	$124,870	$93,652	—	—	33
2782649771	HC VALVE IMPLANT LVL 71	$124,870	$93,652	—	—	33
2722109771	HC PERCUTANEOUS VENTRICULAR ASSIST DEVICE LVL 71	$124,870	$93,652	—	—	29
2782649771	HC VALVE IMPLANT LVL 71	$124,870	$93,652	—	—	29
2721649601	HC KIT PUMP DEVICE CARDIAC VENTRICULAR SMARTASSIST 5.5 S2	$119,856	$89,892	—	—	33
2721649601	HC KIT PUMP DEVICE CARDIAC VENTRICULAR SMARTASSIST 5.5 S2	$119,856	$89,892	—	—	29
2782649770	HC VALVE IMPLANT LVL 70	$118,924	$89,193	—	—	33
278TRIG470	HC NTAP TRICLIP G4 VLV RPR SYSTM	$118,924	$89,193	—	—	33
2782649770	HC VALVE IMPLANT LVL 70	$118,924	$89,193	—	—	29
278TRIG470	HC NTAP TRICLIP G4 VLV RPR SYSTM	$118,924	$89,193	—	—	29
2721040201	HC BERLIN HEART PUMP REPLACEMENT	$118,892	$89,169	—	—	33
2721649701	HC PUMP BLOOD VAD W/ VALVES	$118,892	$89,169	—	—	33
2721040201	HC BERLIN HEART PUMP REPLACEMENT	$118,892	$89,169	—	—	29
2721649701	HC PUMP BLOOD VAD W/ VALVES	$118,892	$89,169	—	—	29
275C188267	HC ICD BIV/CRT-D LVL 67	$102,731	$77,048	—	—	33
275C188267	HC ICD BIV/CRT-D LVL 67	$102,731	$77,048	—	—	29
278C188966	HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 66	$97,839	$73,379	—	—	33
278C182366	HC NEUROSTIM GENERATOR/LEAD LVL 66	$97,839	$73,379	—	—	33
2782649766	HC VALVE IMPLANT LVL 66	$97,839	$73,379	—	—	33
278C188966	HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 66	$97,839	$73,379	—	—	29
278C182366	HC NEUROSTIM GENERATOR/LEAD LVL 66	$97,839	$73,379	—	—	29
2782649766	HC VALVE IMPLANT LVL 66	$97,839	$73,379	—	—	29
2782649765	HC VALVE IMPLANT LVL 65	$93,180	$69,885	—	—	33
2782649765	HC VALVE IMPLANT LVL 65	$93,180	$69,885	—	—	29
2782669764	HC VASCULAR STENT GRAFT IMPLANT LVL 64	$88,743	$66,557	—	—	33
2782649764	HC VALVE IMPLANT LVL 64	$88,743	$66,557	—	—	33
2782669764	HC VASCULAR STENT GRAFT IMPLANT LVL 64	$88,743	$66,557	—	—	29
2782649764	HC VALVE IMPLANT LVL 64	$88,743	$66,557	—	—	29
183256	RADIUM RA 223 DICHLOR 1,100 KBQ/ML (30 MICROCURIE/ML) INTRAVENOUS SOLN	$84,841	$63,631	—	—	33
183256	RADIUM RA 223 DICHLOR 1,100 KBQ/ML (30 MICROCURIE/ML) INTRAVENOUS SOLN	$84,841	$63,631	—	—	29
278C188963	HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 63	$84,517	$63,387	—	—	33
2782649763	HC VALVE IMPLANT LVL 63	$84,517	$63,387	—	—	33
278C188963	HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 63	$84,517	$63,387	—	—	29
2782649763	HC VALVE IMPLANT LVL 63	$84,517	$63,387	—	—	29
278C188962	HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 62	$80,492	$60,369	—	—	33
278C187462	HC STENT COATED/COVERED IMPLANT LVL 62	$80,492	$60,369	—	—	33
2782669762	HC VASCULAR STENT GRAFT IMPLANT LVL 62	$80,492	$60,369	—	—	33
278C188962	HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 62	$80,492	$60,369	—	—	29
278C187462	HC STENT COATED/COVERED IMPLANT LVL 62	$80,492	$60,369	—	—	29
2782669762	HC VASCULAR STENT GRAFT IMPLANT LVL 62	$80,492	$60,369	—	—	29
278C182361	HC NEUROSTIM GENERATOR/LEAD LVL 61	$76,659	$57,494	—	—	33
2782649761	HC VALVE IMPLANT LVL 61	$76,659	$57,494	—	—	33
2722109761	HC PERCUTANEOUS VENTRICULAR ASSIST DEVICE LVL 61	$76,659	$57,494	—	—	33
278C182361	HC NEUROSTIM GENERATOR/LEAD LVL 61	$76,659	$57,494	—	—	29
2782649761	HC VALVE IMPLANT LVL 61	$76,659	$57,494	—	—	29
2722109761	HC PERCUTANEOUS VENTRICULAR ASSIST DEVICE LVL 61	$76,659	$57,494	—	—	29

Showing top 50 of 34,875 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.