45 CFR § 180 compliance
F · 55
This hospital published little of what § 180 requires.
●Machine-readable file published: assessment threshold met
○Gross / standard charges: below assessment threshold
○Discounted cash price: below assessment threshold
●Payer-specific negotiated rates: assessment threshold met
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
19,280
Insurances with rates
10
CPT / HCPCS codes
11,530
Most expensive procedures (gross)
53820031
$5,286
PLATE PERIARTIC PRXHUM 3.5 LCP
Gross
$13,216
50242012047
$4,843
TENECTEPLASE
Gross
$12,107
5397215-4541
$4,005
LUPRON [22.5 mg }
Gross
$10,012
5381590
$3,982
SEROSAFUSE IMPLANT KIT
Gross
$9,956
5398462-5685
$3,672
CIMZIA SUBQ INJ 200 MG
Gross
$9,180
5380169
$3,666
PLATE 3.5 LCP 6H 53 L90
Gross
$9,166
53810058
$3,618
VA PROX TIB SMALL BEND
Gross
$9,046
4420062
$3,510
PICC INSERT W/PORT
Gross
$8,775
53820036
$3,275
PLATE ULNA PROX VA-XARTC
Gross
$8,188
4639520
$3,002
CTA ABDOMEN / PELVIS
Gross
$7,504
4420010
$2,896
EGD AND CO COMBO COMPLEX
Gross
$7,239
4014680
$2,632
CRITICAL CARE FIRST HOUR
Gross
$6,581
4010285
$2,538
VAG DLVR ONLY
Gross
$6,346
5395671
$2,450
RABIES IMMUNE GLOBULIN
Gross
$6,126
53810069
$2,418
PLATE VA -CCP 2.7/3.5
Gross
$6,046
5391028-1810
$2,414
RABIES IG IM/SC
Gross
$6,034
5397206-4526
$2,414
Rabies Immune Globulin 10mL
Gross
$6,034
5388211
$2,400
IMPLANT #12
Gross
$6,000
4364178
$2,387
CT UROGRAM
Gross
$5,968
4634178
$2,387
CT UROGRAM
Gross
$5,968
4634197
$2,387
CT ABD/PELVIS WO/W CONTRAST
Gross
$5,968
53810068
$2,376
PLATE NARROW PROFILE 6 HOLE
Gross
$5,940
4420006
$2,369
EGD AND COLONOSCOPY COMBO
Gross
$5,922
5390624-1605
$2,303
CROTALIDAE POLYVALENT ANTIVEN
Gross
$5,757
50633011012
$2,303
CROTALIDAE POLYVALENT ANTIVEN
Gross
$5,757
4634195
$2,259
CT ABD/PELVIS WITH CONTRAST
Gross
$5,647
4424204
$2,240
LAPARO PARTIAL COLECTOMY
Gross
$5,600
4420437
$2,106
MAJOR OR 1ST HR
Gross
$5,265
4639509
$2,065
CTA PELVIS
Gross
$5,162
4639511
$2,065
CTA UPPER EXTREMITY
Gross
$5,162
3170011
$2,025
ISOLATION W/TELEMETRY
Gross
$5,062
4639513
$2,000
CTA ABDOMEN
Gross
$4,999
5391558-2246
$1,961
RETEVASE KIT INJ
Gross
$4,902
4634196
$1,935
CT ABD PELVIS WO CONTRAST
Gross
$4,838
4634198
$1,935
CT RENAL STONE PROTOCOL
Gross
$4,838
4426951
$1,895
AMPUTATION OF FINGER/THUMB
Gross
$4,737
3170004
$1,874
TELEMETRY ROOM
Gross
$4,684
3170106
$1,874
ISOLATION ROOM PRIVATE
Gross
$4,684
4639505
$1,806
CTA CHEST PE PROTOCOL
Gross
$4,515
4639519
$1,806
CTA THORACIC AORTA
Gross
$4,515
4631270
$1,800
CT CHEST W/WO CONTRAST
Gross
$4,500
53810080
$1,765
CLAMP MULT-PIN MR-CON 6 POST
Gross
$4,412
53810042
$1,761
EASYCLIP FIXATION DEVICE 15X12
Gross
$4,402
4632130
$1,760
CT SPINE THORACIC WO/W DYE
Gross
$4,401
4639507
$1,760
CT SPINE CERVICAL WO/W DYE
Gross
$4,401
4639508
$1,760
CT SPINE LUMBAR WO/W CONTRAST
Gross
$4,401
4634170
$1,755
CT ABDOMEN WO/W CONTRAST
Gross
$4,387
4639510
$1,742
CTA AORTO BIFEMORAL
Gross
$4,354
3170002
$1,721
STRICT ISOLATION
Gross
$4,303
4634160
$1,697
CT ABDOMEN WITH CONTRAST
Gross
$4,242
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 53820031 | PLATE PERIARTIC PRXHUM 3.5 LCP | $13,216 | $5,286 | — | — | 13 |
| 50242012047 | TENECTEPLASE | $12,107 | $4,843 | — | — | 12 |
| 5397215-4541 | LUPRON [22.5 mg } | $10,012 | $4,005 | — | — | 12 |
| 5381590 | SEROSAFUSE IMPLANT KIT | $9,956 | $3,982 | — | — | 12 |
| 5398462-5685 | CIMZIA SUBQ INJ 200 MG | $9,180 | $3,672 | — | — | 12 |
| 5380169 | PLATE 3.5 LCP 6H 53 L90 | $9,166 | $3,666 | — | — | 13 |
| 53810058 | VA PROX TIB SMALL BEND | $9,046 | $3,618 | — | — | 13 |
| 4420062 | PICC INSERT W/PORT | $8,775 | $3,510 | — | — | 13 |
| 53820036 | PLATE ULNA PROX VA-XARTC | $8,188 | $3,275 | — | — | 13 |
| 4639520 | CTA ABDOMEN / PELVIS | $7,504 | $3,002 | — | — | 13 |
| 4420010 | EGD AND CO COMBO COMPLEX | $7,239 | $2,896 | — | — | 12 |
| 4014680 | CRITICAL CARE FIRST HOUR | $6,581 | $2,632 | — | — | 13 |
| 4010285 | VAG DLVR ONLY | $6,346 | $2,538 | — | — | 13 |
| 5395671 | RABIES IMMUNE GLOBULIN | $6,126 | $2,450 | — | — | 12 |
| 53810069 | PLATE VA -CCP 2.7/3.5 | $6,046 | $2,418 | — | — | 13 |
| 5391028-1810 | RABIES IG IM/SC | $6,034 | $2,414 | — | — | 13 |
| 5397206-4526 | Rabies Immune Globulin 10mL | $6,034 | $2,414 | — | — | 13 |
| 5388211 | IMPLANT #12 | $6,000 | $2,400 | — | — | 13 |
| 4364178 | CT UROGRAM | $5,968 | $2,387 | — | — | 13 |
| 4634178 | CT UROGRAM | $5,968 | $2,387 | — | — | 13 |
| 4634197 | CT ABD/PELVIS WO/W CONTRAST | $5,968 | $2,387 | — | — | 13 |
| 53810068 | PLATE NARROW PROFILE 6 HOLE | $5,940 | $2,376 | — | — | 13 |
| 4420006 | EGD AND COLONOSCOPY COMBO | $5,922 | $2,369 | — | — | 12 |
| 5390624-1605 | CROTALIDAE POLYVALENT ANTIVEN | $5,757 | $2,303 | — | — | 13 |
| 50633011012 | CROTALIDAE POLYVALENT ANTIVEN | $5,757 | $2,303 | — | — | 12 |
| 4634195 | CT ABD/PELVIS WITH CONTRAST | $5,647 | $2,259 | — | — | 13 |
| 4424204 | LAPARO PARTIAL COLECTOMY | $5,600 | $2,240 | — | — | 12 |
| 4420437 | MAJOR OR 1ST HR | $5,265 | $2,106 | — | — | 12 |
| 4639509 | CTA PELVIS | $5,162 | $2,065 | — | — | 13 |
| 4639511 | CTA UPPER EXTREMITY | $5,162 | $2,065 | — | — | 13 |
| 3170011 | ISOLATION W/TELEMETRY | $5,062 | $2,025 | — | — | 11 |
| 4639513 | CTA ABDOMEN | $4,999 | $2,000 | — | — | 13 |
| 5391558-2246 | RETEVASE KIT INJ | $4,902 | $1,961 | — | — | 12 |
| 4634196 | CT ABD PELVIS WO CONTRAST | $4,838 | $1,935 | — | — | 13 |
| 4634198 | CT RENAL STONE PROTOCOL | $4,838 | $1,935 | — | — | 13 |
| 4426951 | AMPUTATION OF FINGER/THUMB | $4,737 | $1,895 | — | — | 13 |
| 3170004 | TELEMETRY ROOM | $4,684 | $1,874 | — | — | 11 |
| 3170106 | ISOLATION ROOM PRIVATE | $4,684 | $1,874 | — | — | 11 |
| 4639505 | CTA CHEST PE PROTOCOL | $4,515 | $1,806 | — | — | 13 |
| 4639519 | CTA THORACIC AORTA | $4,515 | $1,806 | — | — | 13 |
| 4631270 | CT CHEST W/WO CONTRAST | $4,500 | $1,800 | — | — | 13 |
| 53810080 | CLAMP MULT-PIN MR-CON 6 POST | $4,412 | $1,765 | — | — | 13 |
| 53810042 | EASYCLIP FIXATION DEVICE 15X12 | $4,402 | $1,761 | — | — | 13 |
| 4632130 | CT SPINE THORACIC WO/W DYE | $4,401 | $1,760 | — | — | 13 |
| 4639507 | CT SPINE CERVICAL WO/W DYE | $4,401 | $1,760 | — | — | 13 |
| 4639508 | CT SPINE LUMBAR WO/W CONTRAST | $4,401 | $1,760 | — | — | 13 |
| 4634170 | CT ABDOMEN WO/W CONTRAST | $4,387 | $1,755 | — | — | 13 |
| 4639510 | CTA AORTO BIFEMORAL | $4,354 | $1,742 | — | — | 13 |
| 3170002 | STRICT ISOLATION | $4,303 | $1,721 | — | — | 11 |
| 4634160 | CT ABDOMEN WITH CONTRAST | $4,242 | $1,697 | — | — | 13 |
Showing top 50 of 19,280 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.