NORTHERN COCHISE COMMUNITY HOSPITAL, INC.

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
S0077	CLINDAMYCIN ORAL SOLN 75MG/5ML 5 ML SOLN	$8,608	$5,165	—	—	6
J0840	Crotalidae Polyvalent Immune Fab (Ovine) For IV Infusion	$5,756	$3,454	—	—	16
41805	REM EMB FB DENTAL	$5,615	$3,369	—	—	7
J1569	Immune Globulin (Human) IV or Subcutaneous Soln 20 GM/200ML	$5,374	$3,224	—	—	16
76094	MRI BREAST BILATERAL	$4,453	$2,672	—	—	6
77058	MRI BREAST UNILATER	$4,107	$2,464	—	—	6
0120	SEMI-PRIVATE ROOM	$3,938	$2,363	—	—	4
23505	REDUCTION CLAVICLE	$3,808	$2,285	—	—	7
23655	CLD TRT SHLD ANTH	$3,808	$2,285	—	—	7
C8909	MRA CHEST	$3,272	$1,963	—	—	7
10140	I&D HERATOMA/SEROMA	$3,271	$1,963	—	—	7
28190	REMOVAL OF FB FOOT	$3,271	$1,963	—	—	7
26011	DRAIN FINGER ABCESS	$3,271	$1,963	—	—	7
J1602	Golimumab IV Soln 50 MG/4ML	$3,120	$1,872	—	—	16
43244	EGD W/BAND LIGATION	$3,090	$1,854	—	—	9
43270	EGD W ABLATION POLYP	$3,090	$1,854	—	—	9
44361	ENDO BIO SING/MULT	$3,090	$1,854	—	—	9
43251	EGD W/POLYPECTOMY; S	$3,090	$1,854	—	—	9
43249	EGD W/BALLOON DILATI	$3,090	$1,854	—	—	9
43249	Swing Bed	$3,090	$1,854	—	—	2
44361	Swing Bed	$3,090	$1,854	—	—	2
43244	Swing Bed	$3,090	$1,854	—	—	2
43270	Swing Bed	$3,090	$1,854	—	—	2
43251	Swing Bed	$3,090	$1,854	—	—	2
36556	CENTRAL LINE OVER 5Y	$2,996	$1,798	—	—	7
36555	CENTRAL LINE <5	$2,996	$1,798	—	—	7
36568	PICC LINE INSERT <5Y	$2,996	$1,798	—	—	7
81162	BRCA ADVANTAGE (TM)	$2,889	$1,733	—	—	7
43246	PERCUT GASTRO TUBE	$2,784	$1,670	—	—	9
43246	Swing Bed	$2,784	$1,670	—	—	2
59612	VBAC DELIVERY ONLY	$2,733	$1,640	—	—	7
75820	RAD VENOGRAM EXT UNI	$2,731	$1,639	—	—	7
75822	RAD VENOGRAM EXT BIL	$2,731	$1,639	—	—	7
75553	MRI CARDIA MORP W/CN	$2,726	$1,635	—	—	6
75554	MRI CARD FUNCT COMP	$2,691	$1,615	—	—	6
75555	MRI CARD FUNCT LMTD	$2,674	$1,604	—	—	6
75552	MRI CARDIA MORP W/O	$2,639	$1,584	—	—	6
C8900	MRA ABDOMEN	$2,539	$1,523	—	—	7
75556	MRI CARD VELOCITY FL	$2,527	$1,516	—	—	6
72159	MRA SPINAL CANAL	$2,493	$1,496	—	—	6
73225	MRA UPPER EXTRM	$2,436	$1,462	—	—	6
40654	VERM LAC 2.6CM	$2,395	$1,437	—	—	7
40652	VERM LAC 0-2.5CM	$2,395	$1,437	—	—	7
J0841	Crotalidae Immune F(ab')2 (Equine) For IV Infusion	$2,376	$1,426	—	—	8
71552	MRI CHEST WO/W CNTR	$2,376	$1,426	—	—	7
99291	CRITICAL CARE 30-74	$2,314	$1,388	—	—	7
99292	CRITCAL CARE ADD 30	$2,313	$1,388	—	—	6
76360	CT GUID NEEDLE PLACE	$2,259	$1,355	—	—	6
P9034	PLATELETS, PHERESIS	$2,170	$1,302	—	—	7
C8905	MRI W/O FOLW/CONT BR	$2,155	$1,293	—	—	7

Showing top 50 of 12,929 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.