MERCY HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
C1767	HC IMPLANT NEUROSTIM GENERATOR	$124,841	$49,937	—	—	6
C1882	HC IMPLANT AICD OTHER	$113,573	$45,429	—	—	5
J9269	TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION	$108,194	$43,278	—	—	6
J2507	PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION	$100,211	$40,084	—	—	12
33249	HC INSERT/REPLACE (ICD) SINGLE/DUAL LEAD/S SYSTEM	$98,945	$39,578	—	—	6
J3357	USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRINGE	$97,450	$38,980	—	—	5
J9281	MITOMYCIN 40 MG X 2 INTRA-PYELOCALYCEAL KIT	$82,845	$33,138	—	—	7
J1303	RAVULIZUMAB-CWVZ 100 MG/ML INTRAVENOUS SOLUTION	$82,185	$32,874	—	—	12
C2616	YTTRIUM-90 BRACHYTX SRC NON-STRANDED	$79,875	$31,950	—	—	7
C1813	HC IMPLANT GU PENILE INFL	$72,611	$29,045	—	—	5
A9543	Y-90 ZEVALIN	$70,810	$28,324	—	—	7
J2350	OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION	$69,000	$27,600	—	—	7
33287	HC RMVL & REPLCMNT PHRENIC NERVE STIM PULSE GEN	$67,856	$27,142	—	—	7
33276	HC INSERT PHRENIC NERVE STIM SYS W/ IMAGING GDNCE	$67,856	$27,142	—	—	7
64568	HC INCIS/IMPLANT CRANIAL NERVE STIM ELECTRODE	$66,735	$26,694	—	—	6
J7311	FLUOCINOLONE 0.59 MG INTRAVITREAL IMPLANT	$66,588	$26,635	—	—	6
J9266	PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION	$65,105	$26,042	—	—	6
C1722	HC IMPLANT AICD SINGLE	$60,527	$24,211	—	—	5
J3245	TILDRAKIZUMAB-ASMN 100 MG/ML SUBCUTANEOUS SYRINGE	$60,331	$24,132	—	—	6
C1721	HC IMPLANT AICD DUAL	$58,891	$23,556	—	—	5
J3241	TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION	$55,721	$22,288	—	—	7
37227	HC REVASC ARTERIAL FEM/POP W ATHERECT & STENT W/WO ANGIOPLAS	$51,717	$20,687	—	—	12
J9298	NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION	$50,864	$20,345	—	—	6
Q4104	HC SKIN SUBST INTEGRA BMWD SQ CM	$48,816	$19,526	—	—	6
J9307	PRALATREXATE 40 MG/2 ML (20 MG/ML) INTRAVENOUS SOLUTION	$47,513	$19,005	—	—	7
50695	HC URET PLACE STENT NEW W NEPH	$46,700	$18,680	—	—	13
33264	HC REPLACE GENERATOR ONLY (ICD) MULTIPLE	$45,898	$18,359	—	—	7
C9602	HC COR ATHERECTOMY & DRUG-ELUTING STENT INITAL VES	$43,555	$17,422	—	—	6
C9775	HC REVASC INTRAVASC LITHOTRIPSY W/WO PTA W/STENT W/ ATHERECTOMY TIB/PERO ARTERY(IES) ONLY	$41,588	$16,635	—	—	7
C9767	HC REVASC INTRAVASCULAR LITHOTRIPSY W/WO PTA W/STENT & ATHERECTOMY ILIO/FEM/POP VESSEL(S)	$41,588	$16,635	—	—	6
33263	HC REPLACE GENERATOR ONLY (ICD) DUAL	$41,279	$16,511	—	—	7
33262	HC REPLACE GENERATOR ONLY (ICD) SINGLE	$41,279	$16,511	—	—	7
J9042	BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION	$39,557	$15,823	—	—	7
J9043	CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION	$37,846	$15,138	—	—	6
J9022	ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION	$37,121	$14,848	—	—	7
37238	HC PLC STENT VEN W/WO ANPL INI	$36,700	$14,680	—	—	19
J2329	UBLITUXIMAB-XIIY 25 MG/ML INTRAVENOUS SOLUTION	$36,654	$14,662	—	—	7
C2621	HC IMPLANT PACER OTHER	$36,641	$14,656	—	—	6
J3285	TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION	$36,290	$14,516	—	—	13
47540	HC BILIARY PLACE STENT NEW W DRN	$36,196	$14,478	—	—	7
C9774	HC REVASC INTRAVASC LITHOTRIPSY W/WO PTA W/ATHERECTOMY TIB/PERO ARTERY(IES) ONLY	$35,614	$14,246	—	—	6
C9766	HC REVASC INTRAVASCULAR LITHOTRIPSY W/WO PTA W/ATHERECTOMY ILIO/FEM/POP VESSEL(S)	$35,614	$14,246	—	—	6
36225	HC CATH PLC SUBCLV W VERT	$35,474	$14,189	—	—	12
J9119	CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION	$34,993	$13,997	—	—	6
37231	HC REVASC ARTERIAL TIB/PER W ATHERECT & STENT W/WO ANGIOPLAS INITIAL VES	$34,518	$13,807	—	—	6
A9604	SAMARIUM-153 LEXIDRONAM	$34,493	$13,797	—	—	6
0620T	HC REVASC VENOUS TIB/PER ARTERIALIZATION	$34,478	$13,791	—	—	7
J2327	RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION	$34,321	$13,728	—	—	6
J9203	GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONCENTRATION) IV SOLN	$34,126	$13,650	—	—	6
J9144	DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN	$33,926	$13,570	—	—	6

Showing top 50 of 14,730 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.