SAN JUAN HOSPITAL — Hospital Ledger

45 CFR § 180 compliance

C · 70

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

4,279

Insurances with rates

CPT / HCPCS codes

2,947

Source MRF

csv ↗

Most expensive procedures (gross)

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
2612401	DENTAL SURGERY	$10,407	$7,285	—	—	0
27791525	33285- INSJ SUBQ CAR RHYTHM MNTR -SCPF	$7,961	$5,573	—	—	0
55040	Excise of Hydrocele; Unilateral Charge	$6,094	$4,266	—	—	21
885910	Dilation and Curettage	$5,917	$4,142	—	—	0
J1162	Digoxin immune FAB 40 mg REC[SJH]	$5,306	$3,714	—	—	21
995685	Esophagogastroduodenoscopy and Colonoscopy	$5,220	$3,654	—	—	0
J0135	Adalimumab 40 mg/0.4 mL Kit	$5,128	$3,590	—	—	0
J9354	Ado-trastuzumab emtansine 100 mg REC	$4,490	$3,143	—	—	21
22461830	DEST.PERITONEAL TISSUE ProFee	$4,390	$3,073	—	—	0
44141	Colectomy Part W/Cecostom	$4,032	$2,822	—	—	21
44150	COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS	$4,025	$2,818	—	—	21
C1762	ALLOSYNC DEMINERALIZED BONE 5 CC	$4,000	$2,800	—	—	21
24336259	FISTULA PLUG SET 4.0 CM	$3,952	$2,767	—	—	0
P9037	BB Platelets Aph LR Irr PathRed, 1 Unit	$3,838	$2,687	—	—	21
885905	Cholecystectomy Laparoscopic	$3,811	$2,667	—	—	0
23464743	ENDOBLADE GASTROC RECISSION SYSTEM AR-8855DS DR HUGENTOBLER	$3,788	$2,652	—	—	0
44143	Colct Prtl W/End Clst&Cls	$3,682	$2,577	—	—	21
24185490	DILATION BALLON CATHETER 35MM	$3,540	$2,478	—	—	0
22850746	44207 Lap Colectomy Partial W/A	$3,500	$2,450	—	—	0
885907	Colonoscopy	$3,469	$2,428	—	—	0
885915	Esophagogastroduodenoscopy	$3,469	$2,428	—	—	0
75635	CT Angiography Aorta w/ Runoff	$3,456	$2,419	—	—	0
23389735	20985 COMPUTER ASSIST SURG MUSCULOSKELETAL PROC	$3,450	$2,415	—	—	0
4203894	ACL FLIPCUTTER AR-1204AF-10S	$3,439	$2,407	—	—	0
23671463	GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<	$3,332	$2,332	—	—	0
71260	CT Chest	$3,318	$2,323	—	—	21
15734	FLAP ISLAND PEDICLE	$3,287	$2,301	—	—	21
72133	CT Spine Lumbar w/ + w/o Contrast	$3,286	$2,300	—	—	0
72130	CT Spine Thoracic w/ + w/o Contrast	$3,286	$2,300	—	—	0
74174	CT Angiography Abdomen/Pelvis	$3,284	$2,299	—	—	0
74178	CT Abdomen/Pelvis w + w/o Contrast	$3,279	$2,296	—	—	0
J9047	Carfilzomib [SJH]	$3,278	$2,294	—	—	21
4202654	DISSECTOR SYSTEM 10-12MM OVAL..	$3,254	$2,278	—	—	0
70482	CT Orbit Sella etc. w/ + w/o Contrast	$3,246	$2,272	—	—	0
C1888	CLOSURE FAST CATH 60 CM CF7-7-60	$3,244	$2,271	—	—	21
71275	CT Angiography Chest/Abdomen/Pelvis	$3,214	$2,250	—	—	21
71270	CT Chest W/WO Contrast	$3,206	$2,244	—	—	0
73202	CT Upper Extremity w/+w/o Contrast Left	$3,189	$2,233	—	—	0
J9358	Fam-trastuzumab deruxtecan nxki 100 mg REC	$3,179	$2,225	—	—	21
27132	Conversion of previous hip surgery to total hip arthroplasty w/wo autograft or allograft	$3,119	$2,183	—	—	21
27130	Arthroplasty acetabular and proximal femoral prosthetic replacement w/wo autograft or allograft	$3,111	$2,178	—	—	21
27447	Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella res	$3,110	$2,177	—	—	21
74177	CT Abd/Pelvis W/Contrast	$3,095	$2,166	—	—	21
J0717	Certolizumab 200 mg Kit	$3,060	$2,142	—	—	21
16414529	DISSECTOR SYSTEM ROUND SMBTTRND	$3,046	$2,132	—	—	0
12361903	CAPIO NEEDLE FOR LAVH M0068311251	$3,043	$2,130	—	—	0
J0840	Antivenin (Crotalidae) polyvalent - Sol [SJH]	$2,998	$2,099	—	—	21
23149620	FLEXIGRAFT BONE CHIPS 5 CC BL-1200-003	$2,980	$2,086	—	—	0
22833661	Arthroplasty Glenohum Jt	$2,976	$2,083	—	—	0
44130	Enteroenterostomy anastomosis of intestine with or without cutaneous enterostomy	$2,973	$2,081	—	—	21

Showing top 50 of 4,279 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.