ANTELOPE VALLEY HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
50122	PUMP IMPELLA 5.5 WITH SMART ASSIST S2 SET 1000100	$225,000	$225,000	—	—	2
96977	SYSTEM EVOQUE TRICUSPID VALVE 58MM SYNTHETIC EVQ1A2US58	$215,000	$215,000	—	—	0
93137	GENERATOR SENTIVA DUE 1000-D	$190,950	$190,950	—	—	0
95776	GENERATOR SENTIVA SINGLE PIN MODEL 1000 1000	$181,403	$181,403	—	—	0
33249	INSERTION OF IMPLANTABLE DEFIBRILLATOR SYSTEM	$180,000	$180,000	—	—	21
96974	SYSTEM BUNDLE TRICLIP G5 TCG50100	$180,000	$180,000	—	—	0
33270	INS/REP SUBQ DEFIBRILLATOR	$179,290	$179,290	—	—	20
33231	INSRT PULSE GEN W/MULT LEADS	$179,245	$179,245	—	—	20
0571T	INSJ/RPLCMT ICDS SS ELTRD	$179,245	$179,245	—	—	20
33264	REMOVAL AND REPLACEMENT OF MULTIPLE LEAD DEFIBRILLATOR	$170,752	$170,752	—	—	22
96909	VALVE SAPIEN 3 ULTRA THV CERTITUDE 26MM S3USTA126A	$170,000	$170,000	—	—	0
96973	SYSTEM BUNDLE MITRACLIP G5 MCG50100	$165,000	$165,000	—	—	0
96741	SYSTEM SAPIEN 3 ULTRA THV COMMANDER 26MM BOVINE S3UCM226A	$162,500	$162,500	—	—	0
95777	GENERATOR MODEL 106 ASPIRE SR SINGLE PIN RECEPTACLE VOL 14CC 106	$161,402	$161,402	—	—	0
96940	CL STEERABLE MITRACLIP G4 GUIDE	$150,000	$150,000	—	—	0
90154	ICD MRI S EMBLEM MODEL A219 A219	$142,500	$142,500	—	—	0
93654	COMPRE EP EVAL TX VT	$137,151	$137,151	—	—	20
93656	COMPRE EP EVAL ABLTJ ATR FIB	$137,151	$137,151	—	—	20
93653	COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH CATHETER DESTRUCTION OF ABNORMALITY OF UPPER CHAMBE	$137,151	$137,151	—	—	20
50633-0210-11	Voraxaze	$135,013	$135,013	—	—	15
00409-6510-01	Vancomycin HCl	$130,381	$130,381	—	—	1
63323-0314-68	Vancomycin HCl	$127,541	$127,541	—	—	1
63323-0314-61	Vancomycin HCl	$127,541	$127,541	—	—	1
33240	INSRT PULSE GEN W/SINGL LEAD	$125,489	$125,489	—	—	20
33230	INSRT PULSE GEN W/DUAL LEADS	$125,489	$125,489	—	—	20
55011	PUMP IMPELLA RP 0046-0035	$125,000	$125,000	—	—	2
96640	ICD ILIVIA NEO 7 DR TT 429529	$124,000	$124,000	—	—	0
96979	DEFIBRILLATOR SINGLE CHAMBER ICD INTICA NEO 7 CR-T DX 429559	$124,000	$124,000	—	—	0
90072	ICD QUADRA ASSURA CD3369-40Q CD3369-40Q	$122,325	$122,325	—	—	0
96796	ICD GALLANT HF CDHFA500Q	$121,150	$121,150	—	—	0
33263	REMOVAL AND REPLACEMENT OF DUAL LEAD DEFIBRILLATOR	$120,135	$120,135	—	—	21
90178	AICD S-ICD CARDIO-DEFIB SNGL B/S	$117,500	$117,500	—	—	0
90161	AICD EMBLEM PULSE S-ICD A209 B/S	$117,500	$117,500	—	—	0
33262	REMOVAL AND REPLACEMENT OF SINGLE LEAD DEFIBRILLATOR	$117,434	$117,434	—	—	21
90078	AICD QUADRA ASSURA ST JUDE	$116,325	$116,325	—	—	0
90163	ICD AMPLIA MRI QUAD CRT-D DTMB1QQ	$114,650	$114,650	—	—	0
96991	ICD RIVACOR 7 VR-T DF4 PROMRI 429536	$113,000	$113,000	—	—	0
90039	ICD AMPLIA MRI CRT-D C1882 DTMB1D4	$112,150	$112,150	—	—	0
96657	STENT GRAFT THORACIC TAG CONF 37MMX37MMX15CM 22FR TGMR373715	$111,495	$111,495	—	—	0
96754	CL ICD COBALT MRI QUAD CRT-D ALL SIZES	$110,064	$110,064	—	—	0
C1767	GENERATOR; NEUROSTIMULATOR (IMPLANTABLE); NON-RECHARGEABLE	$110,000	$110,000	—	—	1
96686	GRAFT XENMATRIX BA 25CM X 30CM 1152530	$108,550	$108,550	—	—	0
96756	CL ICD COBALT HF MRI CRT-D ALL SIZES	$107,664	$107,664	—	—	0
96959	DEVICE AURORA EV ICD DVEA3E4	$107,500	$107,500	—	—	0
33274	TCAT INSJ/RPL PERM LDLS PM	$107,120	$107,120	—	—	20
33221	INSERT PULSE GEN MULT LEADS	$106,620	$106,620	—	—	20
33229	REMV&REPLC PM GEN MULT LEADS	$106,620	$106,620	—	—	20
90142	AICD ELLIPSE VR SNGL COATED	$106,163	$106,163	—	—	0
96753	ICD COBALT XT MRI QUAD CRT-D QQ DTPA2QQ	$104,640	$104,640	—	—	0
C1882	CARDIOVERTER-DEFIBRILLATOR; OTHER THAN SINGLE OR DUAL CHAMBER (IMPLANTABLE)	$104,640	$104,640	—	—	1

Showing top 50 of 14,696 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.