UPLAND HILLS HEALTH — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
5024214201	MOSUNETUZUMAB-AXGB 1 MG/ML IV SOLN - SSM SO	$41,827	$22,587	—	—	27
4733517795	TILDRAKIZUMAB-ASMN 100 MG/ML SC SOSY	$38,797	$20,950	—	—	27
8270501001	EPCORITAMAB-BYSP 48 MG/0.8ML SC SOLN	$36,310	$19,607	—	—	27
6345910450	RITUXIMAB-ABBS 10 MG/ML SSM SO	$25,214	$13,616	—	—	27
7315015006	UBLITUXIMAB-XIIY 150 MG/6ML IV SOLN	$23,998	$12,959	—	—	27
0006302500	BEZLOTOXUMAB 1000 MG/40ML IV SOLN	$22,663	$12,238	—	—	27
0006302501	BEZLOTOXUMAB 1000 MG/40ML IV SOLN	$22,663	$12,238	—	—	27
6476430020	VEDOLIZUMAB 300 MG IV SOLR	$21,835	$11,791	—	—	27
830795	HP PERCUT IMPLANT NEUROSTIM ELEC ARRAY	$21,640	$11,686	—	—	12
833269	HP PERC IMPLNT NEUROSTIM ELECTRD PERIPH NRV	$20,241	$10,930	—	—	12
833269-983	HP PERC IMPLNT NEUROSTIM ELECTRD PERIPH NRV	$20,241	$10,930	—	—	12
5024208527	ALTEPLASE 1 MG/ML IV BOLUS (FOR STROKE)	$19,009	$10,265	—	—	27
5024208527_2	ALTEPLASE 1 MG/ML IV INFUSION (FOR STROKE) USING 100 MG VIAL	$19,009	$10,265	—	—	27
5024208527_3	ALTEPLASE 100 MG IV SOLR	$19,009	$10,265	—	—	27
5024208527_4	ALTEPLASE 100 MG/100 ML IV INFUSION (FOR PE) USING 100 MG VIAL	$19,009	$10,265	—	—	27
0074368303	LEUPROLIDE ACETATE (4 MONTH) 30 MG IM KIT	$18,544	$10,014	—	—	27
5024217601	TENECTEPLASE 50 MG IV KIT	$18,460	$9,968	—	—	27
5024212047	TENECTEPLASE 50 MG IN 10 ML FOR STROKE IV	$17,922	$9,678	—	—	27
5024212047_2	TENECTEPLASE 50 MG IV KIT	$17,922	$9,678	—	—	27
0597019705	IDARUCIZUMAB 2.5 GM/50ML IV SOLN	$15,520	$8,381	—	—	23
5551319001	PEGFILGRASTIM 6 MG/0.6ML SC SOSY	$13,863	$7,486	—	—	27
833837	HP FULL ROUT OBSTE CARE,CESAREAN DELIV	$13,217	$7,137	—	—	12
3877912768	FDC BLUE 2 POWD	$12,654	$6,833	—	—	23
833838	HP ROUT OB CARE AFTER VAG DELIV	$12,448	$6,722	—	—	12
0074366303	LEUPROLIDE ACETATE (3 MONTH) 11.25 MG IM KIT	$11,671	$6,302	—	—	27
833923	HP ARTHROPLASTY TOTAL HIP	$10,773	$5,817	—	—	12
5063312011	DIGOXIN IMMUNE FAB 40 MG IV SOLR	$10,744	$5,802	—	—	27
0078079761	OCTREOTIDE ACETATE 20 MG IM KIT	$9,971	$5,384	—	—	27
0078081881	OCTREOTIDE ACETATE 20 MG IM KIT	$9,971	$5,384	—	—	27
833924	HP REVISE TOTAL HIP ARTHROPL BOTH COMP	$9,695	$5,235	—	—	12
0517065001	FERRIC CARBOXYMALTOSE 50 MG/ML IV SOLN - SSM SO	$9,606	$5,187	—	—	27
8101717	HC FULL ROUT OB CARE VAGINAL DELIV TWIN	$9,580	$5,173	—	—	26
833836	HP ROUTINE OB CARE VAGINAL DELIVERY	$9,580	$5,173	—	—	12
833836-987	HP ROUTINE OB CARE VAGINAL DELIVERY	$9,580	$5,173	—	—	12
833929	HP ARTHROPLASTY TOTAL KNEE	$9,450	$5,103	—	—	12
833930	HP REVISE REPLACE KNEE JOINT 1 COMPONENT	$9,449	$5,103	—	—	12
5551311201	TEZEPELUMAB-EKKO 210 MG/1.91ML SC SOSY	$9,437	$5,096	—	—	27
833379	HP REPLANTATION THUMB DISTAL COMPLETE	$9,313	$5,029	—	—	12
833233	HP LAP COLECTOMY PARTIAL W COLOPROCTOSTMY	$9,091	$4,909	—	—	12
833233-983	HP LAP COLECTOMY PARTIAL W COLOPROCTOSTMY	$9,091	$4,909	—	—	12
7011410101	PEGFILGRASTIM-CBQV 6 MG/0.6ML SC SOSY	$9,018	$4,870	—	—	27
833931	HP REVISE TOT KNEE ARTHROPL FEM & TIB COMP	$8,956	$4,836	—	—	12
832800	HP PART REMOV COLON W OSTOMY MUCOFIST	$8,801	$4,753	—	—	12
832800-975	HP PART REMOV COLON W OSTOMY MUCOFIST	$8,801	$4,753	—	—	12
4420643820	IMMUNE GLOBULIN 10 % (PRIVIGEN) IV SOLN SSM SO	$8,537	$4,610	—	—	27
6131486601	PEGFILGRASTIM-BMEZ 6 MG/0.6ML SC SOSY	$8,479	$4,579	—	—	27
800475	HC NM MYOCARD PERFUSION SPECT STRESS AND REST	$8,388	$4,530	—	—	26
833823	HP HYSTER STERIL W/BIL FALLOPIAN CANNULAT	$8,275	$4,468	—	—	12
801127	HC NM PET/CT SKULL TO MID THIGH	$8,243	$4,451	—	—	26
803121	HC NM PET CT WHOLE BODY	$8,243	$4,451	—	—	26

Showing top 50 of 28,546 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.