HOLY CROSS HOSPITAL-DAVIS — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
C1786	HC FDA IDE G130138	$157,440	$62,976	—	—	7
33264	HC REPLACE GENERATOR ONLY (ICD) MULTIPLE	$130,648	$52,259	—	—	8
33249	HC INSERT/REPLACE (ICD) SINGLE/DUAL LEAD/S SYSTEM	$129,993	$51,997	—	—	8
33263	HC REPLACE GENERATOR ONLY (ICD) DUAL	$117,835	$47,134	—	—	8
C1767	HC IMPLANT NEUROSTIM GENERATOR	$108,537	$43,415	—	—	8
J9269	TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION	$108,194	$43,278	—	—	8
J2507	PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION	$100,211	$40,084	—	—	16
J3357	USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRINGE	$97,450	$38,980	—	—	8
C1882	HC IMPLANT AICD OTHER	$96,827	$38,731	—	—	8
0266T	HC INSERT/REPL CAROTID SINUS BAROFLEX ACTIVATION SYSTEM	$92,239	$36,896	—	—	8
33240	HC INSERT GENERATOR ONLY (ICD) TO EXISTING SINGLE LEAD	$85,551	$34,220	—	—	7
33230	HC INSERT GENERATOR ONLY (ICD) TO EXISTING DUAL LEADS	$85,551	$34,220	—	—	8
J9281	MITOMYCIN 40 MG X 2 INTRA-PYELOCALYCEAL KIT	$82,845	$33,138	—	—	8
37231	HC REVASC ARTERIAL TIB/PER W ATHERECT & STENT W/WO ANGIOPLAS INITIAL VES	$82,610	$33,044	—	—	8
37227	HC REVASC ARTERIAL FEM/POP W ATHERECT & STENT W/WO ANGIOPLAS	$82,610	$33,044	—	—	8
C1820	HC IMPLANT NEUROSTM GEN RECHRG	$80,409	$32,164	—	—	8
C2616	YTTRIUM-90 BRACHYTX SRC NON-STRANDED	$79,875	$31,950	—	—	8
37233	HC REVASC ARTERIAL TIB/PER W ATHRECT W/WO ANGIOPLAS ADDL VES	$71,550	$28,620	—	—	15
33262	HC REPLACE GENERATOR ONLY (ICD) SINGLE	$71,354	$28,541	—	—	8
A9543	Y-90 ZEVALIN	$70,810	$28,324	—	—	8
J2350	OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION	$69,000	$27,600	—	—	7
33229	HC REPLACE GENERATOR ONLY (PACEMAKER) MULTIPLE	$68,761	$27,504	—	—	8
33221	HC INSERT GENERATOR ONLY (PACEMAKER) TO EXISTING MULTIPLE LEADS	$68,761	$27,504	—	—	8
J7311	FLUOCINOLONE 0.59 MG INTRAVITREAL IMPLANT	$66,588	$26,635	—	—	8
61645	HC MTHROMB &OR LYSIS INTRACRAN	$66,104	$26,442	—	—	8
J9266	PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION	$65,105	$26,042	—	—	8
C1721	HC IMPLANT AICD DUAL	$64,119	$25,647	—	—	7
33340	HC CLOSURE LEFT ATRIAL APPENDAGE WITH IMPLANT INCLUDING IMAGING	$63,417	$25,367	—	—	8
C9607	HC COR REVASC CHRONIC OCC DRUG-ELUTING STENT/PTA/ATHERECT INITIAL VES	$63,004	$25,202	—	—	8
93656	HC COMP EP EVAL W PV ISO ABL	$61,625	$24,650	—	—	8
C9602	HC COR ATHERECTOMY & DRUG-ELUTING STENT INITAL VES	$61,292	$24,517	—	—	8
C9606	HC COR REVASC ACUTE MI DRUG-ELUTING STENT/PTA/ATHERECT INITIAL VES	$60,727	$24,291	—	—	8
92933	HC COR ATHERECTOMY & BARE METAL STENT INITIAL VESSEL	$60,585	$24,234	—	—	8
92943	HC COR REVASC CHRONIC OCC BARE METAL STENT/PTA/ATHERECT INITIAL VES	$60,585	$24,234	—	—	8
92941	HC COR REVASC ACUTE MI BARE METAL STENT/PTA/ATHERECT INITIAL VES	$60,585	$24,234	—	—	8
J3245	TILDRAKIZUMAB-ASMN 100 MG/ML SUBCUTANEOUS SYRINGE	$60,331	$24,132	—	—	7
33274	HC INSERT/REPLACE (PACEMAKER) LEADLESS RT VENTRICULAR SYSTEM	$60,076	$24,031	—	—	8
C9603	HC COR ATHERECTOMY & DRUG-ELUTING STENT ADD'L VES	$60,008	$24,003	—	—	8
92944	HC COR REVASC CHRONIC OCC BARE METAL STENT/PTA/ATHERECT ADDL VES	$60,008	$24,003	—	—	8
G2170	HC DIALYSIS CIRCUIT PERC DIRECT CREATION	$58,613	$23,445	—	—	8
J3241	TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION	$55,721	$22,288	—	—	8
C9608	HC COR REVASC CHRONIC OCC DRUG-ELUTING STENT/PTA/ATHERECT ADDL VES	$54,789	$21,916	—	—	7
33270	HC INSERT/REPLACE (SICD) SUBCUTANEOUS ICD SYSTEM	$52,797	$21,119	—	—	7
J9298	NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION	$50,864	$20,345	—	—	8
37230	HC REVASC ARTERIAL TIB/PER W STENT W/WO ANGIOPLAS INITIAL VES	$50,562	$20,225	—	—	8
37236	HC PLC STENT ART W/WO ANPL INI	$50,143	$20,057	—	—	32
33231	HC INSERT GENERATOR ONLY (ICD) TO EXISTING MULTIPLE LEADS	$49,203	$19,681	—	—	7
37244	HC EMBO HEMORG/LYMPH TRAUMA	$48,620	$19,448	—	—	8
L8670	HC IMPLANT VASCULAR GRAFT SYN	$48,100	$19,240	—	—	7
37226	HC REVASC ARTERIAL FEM/POP W STENT W/WO ANGIOPLAS	$47,700	$19,080	—	—	8

Showing top 50 of 2,917 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.