IVINSON MEMORIAL HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
Q2043	SIPULEUCEL-T IN LACTATED RINGERS 50 MILLION CELL/250 ML IV SUSPENSION	$140,330	$140,330	—	—	31
J9043	CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION	$112,310	$112,310	—	—	31
J9228	IPILIMUMAB 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION	$70,679	$70,679	—	—	31
J2507	PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION	$58,372	$58,372	—	—	31
J3357	USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRINGE	$57,154	$57,154	—	—	31
J2350	OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION	$39,893	$39,893	—	—	31
J9298	NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION	$31,716	$31,716	—	—	31
J9307	PRALATREXATE 40 MG/2 ML (20 MG/ML) INTRAVENOUS SOLUTION	$29,344	$29,344	—	—	31
J0896	LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLUTION	$25,001	$25,001	—	—	31
77372	HB SRS TX CRANIAL LESION(S) 1 SESSION LINEAR BASED	$23,569	$23,569	—	—	31
J9042	BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION	$22,465	$22,465	—	—	31
J1930	LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE	$22,146	$22,146	—	—	31
J9119	CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION	$21,820	$21,820	—	—	31
J2997	ALTEPLASE IV 100 MG (FOR STROKE)	$19,650	$19,650	—	—	31
J9316	PERTUZUMAB 600 MG-TRASTUZUMAB 600 MG-HYALURONID-ZZXF/10 ML SUBCUT SOLN	$19,619	$19,619	—	—	31
J9228	IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION	$19,429	$19,429	—	—	31
J9144	DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN	$19,376	$19,376	—	—	31
J2323	NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION	$19,363	$19,363	—	—	31
J3380	VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION	$19,012	$19,012	—	—	31
J9301	OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION	$17,556	$17,556	—	—	31
J9299	NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION	$17,044	$17,044	—	—	31
J2506	PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE	$16,959	$16,959	—	—	31
J3101	TENECTEPLASE 50 MG IV SOLUTION (FOR STROKE)	$16,579	$16,579	—	—	31
J9311	RITUXIMAB 1,400 MG/11.7 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN	$16,210	$16,210	—	—	31
J1299	ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION	$16,078	$16,078	—	—	31
J9308	RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION	$15,947	$15,947	—	—	31
J9306	PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION	$14,244	$14,244	—	—	31
J9271	PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION	$12,655	$12,655	—	—	31
J1162	DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION	$12,434	$12,434	—	—	31
J9342	THIOTEPA 100 MG SOLUTION FOR INJECTION	$11,585	$11,585	—	—	31
J9356	TRASTUZUMAB 600 MG-HYALURONIDASE-OYSK 10,000 UNIT/5 ML SUBCUT SOLUTION	$11,524	$11,524	—	—	31
J9173	DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION	$10,580	$10,580	—	—	62
Q5111	PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE	$10,291	$10,291	—	—	31
J0896	LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLUTION	$10,083	$10,083	—	—	31
0721	HB LABOR IV	$9,884	$9,884	—	—	30
J2353	OCTREOTIDE,MICROSPHERES ER 10 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE	$9,793	$9,793	—	—	31
J9354	ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION	$9,652	$9,652	—	—	31
J0630	CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION	$9,423	$9,423	—	—	31
33210	HB INSERT/REPLACE TEMP SINGLE C. PM	$9,260	$9,260	—	—	31
63685	HB INSERT/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ	$9,252	$9,252	—	—	31
J9355	TRASTUZUMAB 150 MG INTRAVENOUS SOLUTION	$8,733	$8,733	—	—	31
77301	HB IMRT PLANNING	$8,554	$8,554	—	—	31
93602	HB INTRA ARTERIAL RECORDING	$8,048	$8,048	—	—	31
78816	HB RADIANT PET/CT TUMOR IMAGE FULL BODY	$7,825	$7,825	—	—	31
78815	HB RADIANT PET/CT TUMOR IMAGE SKUL-THIGH	$7,654	$7,654	—	—	31
J9047	CARFILZOMIB 60 MG INTRAVENOUS SOLUTION	$7,653	$7,653	—	—	31
J7168	HUM PROTHROMBIN CPLX 4 FACTOR 1000 UNITS (VOLUME)	$7,612	$7,612	—	—	31
J9217	LEUPROLIDE ACETATE 45 MG (6 MONTH) SUBCUTANEOUS SYRINGE	$7,594	$7,594	—	—	31
J9145	DARATUMUMAB 20 MG/ML INTRAVENOUS SOLUTION	$7,498	$7,498	—	—	62
J1561	IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN	$7,476	$7,476	—	—	31

Showing top 50 of 12,320 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.