45 CFR § 180 compliance
D · 65
This hospital published part of what § 180 requires.
●Machine-readable file published: assessment threshold met
●Gross / standard charges: assessment threshold met
●Discounted cash price: assessment threshold met
○Payer-specific negotiated rates: below assessment threshold
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
4,896
Insurances with rates
0
CPT / HCPCS codes
8
Most expensive procedures (gross)
1200398
$4,633
LUPRON DEPOT SUSP 22.5MG
Gross
$13,236
1200095
$3,931
CROTALIDAE POLYVALENT 1GM/2ML INJ
Gross
$11,232
12000391
$2,997
ALTEPLASE 100MG VIAL
Gross
$8,562
2604178
$2,573
CTA ABD PELVIS W & WO CONT
Gross
$7,350
2803423
$2,573
CT ABDOMEN PELVIS W & WO CONT
Gross
$7,350
2815008
$2,332
IMRT PLAN
Gross
$6,663
1220560
$1,996
TENECTEPLASE 50MG INJ KIT
Gross
$5,704
1200853
$1,863
ORENCIA IV 250 MG
Gross
$5,323
107011
$1,838
OR LEVEL III INTIAL 30
Gross
$5,250
8000729
$1,801
OPEN\PERCU TX FX\DISLOCT
Gross
$5,147
2815006
$1,707
3D TREATMENT PLAN/SIM
Gross
$4,878
1200026
$1,679
PROLIA (DENOSUMAB) 60MG/1ML INJ
Gross
$4,797
107007
$1,654
OR LEVEL II INITIAL 30 M
Gross
$4,725
2603391
$1,544
CT WWO CONT
Gross
$4,410
2803422
$1,544
...
Gross
$4,410
1800898
$1,540
MESH VENTRIO ST CIRCLE
Gross
$4,400
1801420
$1,518
PATCH HERNIA 7.7X 9.7
Gross
$4,338
107003
$1,470
OR LEVEL I INITIAL 30
Gross
$4,200
2603433
$1,432
CTA HEAD CAROTID/ COW W
Gross
$4,090
3408385
$1,412
MRI CHEST W/CONTRAST
Gross
$4,034
1801744
$1,372
MEDIUM OVAL VENTRO HERNIA PATCH
Gross
$3,920
3409123
$1,357
MRI T-SPINE W/WO CNTRST
Gross
$3,878
3409137
$1,343
MRI ABDOMEN W/W/O CONTR
Gross
$3,836
2603394
$1,340
CT C-SPINE W/WO CONTRAST
Gross
$3,829
2603397
$1,340
CT T-SPINE W/WO CONTRAST
Gross
$3,829
2603399
$1,340
CT L-SPINE W/WO CONTRAST
Gross
$3,829
3409122
$1,340
MRI C-SPINE W/WO CNTRST
Gross
$3,829
3408382
$1,325
MRI PITUITARY W/WO CONT
Gross
$3,785
3409012
$1,325
MRI BRAIN W/W/O CONTRAST
Gross
$3,785
3408395
$1,311
MRI LUMBAR SPINE W/WO CONT
Gross
$3,747
3408399
$1,306
MRI PELVIS W/WO CONT
Gross
$3,730
3409015
$1,296
MRI CHEST W/W/O CONTRAST
Gross
$3,702
2603360
$1,266
CT HEAD/BRAIN W/W/O CONT
Gross
$3,618
2603388
$1,252
CT CHEST WO/W CONT
Gross
$3,577
1801416
$1,230
PATCH HERNIA LG 22X27cm VENTRALEX
Gross
$3,513
2603411
$1,213
CT UPPER EXT LT W/WO CONT
Gross
$3,465
2603412
$1,213
CT UPPER EXT RT W/WO CONT
Gross
$3,465
8000571
$1,206
VAGINAL DELIVERY
Gross
$3,447
1801454
$1,194
PATCH HERNIA 8.7X10.7 OVAL KUGEL
Gross
$3,410
2802300
$1,174
CTA CHEST PE STUDY W/ CONTRAST
Gross
$3,353
3408361
$1,166
MRI NECK W/CONT
Gross
$3,332
3408370
$1,166
MRI NECK W/W/O CONTRAST
Gross
$3,332
3408373
$1,154
MRA NECK W/WO CONTRAST
Gross
$3,297
3408403
$1,149
MRI UP EX NON-JT LT W/WO CONT
Gross
$3,284
8020035
$1,149
VAG DELIVERY
Gross
$3,283
1801736
$1,141
MESH MULTI/LAYER 6X8 JJ
Gross
$3,261
2603405
$1,139
CT PELVIS W/ CONT
Gross
$3,255
2603390
$1,138
CT ABDOMEN PELVIS W CONT
Gross
$3,250
3408369
$1,126
MRA BRAIN W/W/O CONTRAST
Gross
$3,218
3409019
$1,104
MRI T-SPINE W/CONT
Gross
$3,155
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 1200398 | LUPRON DEPOT SUSP 22.5MG | $13,236 | $4,633 | — | — | 0 |
| 1200095 | CROTALIDAE POLYVALENT 1GM/2ML INJ | $11,232 | $3,931 | — | — | 0 |
| 12000391 | ALTEPLASE 100MG VIAL | $8,562 | $2,997 | — | — | 0 |
| 2604178 | CTA ABD PELVIS W & WO CONT | $7,350 | $2,573 | — | — | 0 |
| 2803423 | CT ABDOMEN PELVIS W & WO CONT | $7,350 | $2,573 | — | — | 0 |
| 2815008 | IMRT PLAN | $6,663 | $2,332 | — | — | 0 |
| 1220560 | TENECTEPLASE 50MG INJ KIT | $5,704 | $1,996 | — | — | 0 |
| 1200853 | ORENCIA IV 250 MG | $5,323 | $1,863 | — | — | 0 |
| 107011 | OR LEVEL III INTIAL 30 | $5,250 | $1,838 | — | — | 0 |
| 8000729 | OPEN\PERCU TX FX\DISLOCT | $5,147 | $1,801 | — | — | 0 |
| 2815006 | 3D TREATMENT PLAN/SIM | $4,878 | $1,707 | — | — | 0 |
| 1200026 | PROLIA (DENOSUMAB) 60MG/1ML INJ | $4,797 | $1,679 | — | — | 0 |
| 107007 | OR LEVEL II INITIAL 30 M | $4,725 | $1,654 | — | — | 0 |
| 2603391 | CT WWO CONT | $4,410 | $1,544 | — | — | 0 |
| 2803422 | ... | $4,410 | $1,544 | — | — | 0 |
| 1800898 | MESH VENTRIO ST CIRCLE | $4,400 | $1,540 | — | — | 0 |
| 1801420 | PATCH HERNIA 7.7X 9.7 | $4,338 | $1,518 | — | — | 0 |
| 107003 | OR LEVEL I INITIAL 30 | $4,200 | $1,470 | — | — | 0 |
| 2603433 | CTA HEAD CAROTID/ COW W | $4,090 | $1,432 | — | — | 0 |
| 3408385 | MRI CHEST W/CONTRAST | $4,034 | $1,412 | — | — | 0 |
| 1801744 | MEDIUM OVAL VENTRO HERNIA PATCH | $3,920 | $1,372 | — | — | 0 |
| 3409123 | MRI T-SPINE W/WO CNTRST | $3,878 | $1,357 | — | — | 0 |
| 3409137 | MRI ABDOMEN W/W/O CONTR | $3,836 | $1,343 | — | — | 0 |
| 2603394 | CT C-SPINE W/WO CONTRAST | $3,829 | $1,340 | — | — | 0 |
| 2603397 | CT T-SPINE W/WO CONTRAST | $3,829 | $1,340 | — | — | 0 |
| 2603399 | CT L-SPINE W/WO CONTRAST | $3,829 | $1,340 | — | — | 0 |
| 3409122 | MRI C-SPINE W/WO CNTRST | $3,829 | $1,340 | — | — | 0 |
| 3408382 | MRI PITUITARY W/WO CONT | $3,785 | $1,325 | — | — | 0 |
| 3409012 | MRI BRAIN W/W/O CONTRAST | $3,785 | $1,325 | — | — | 0 |
| 3408395 | MRI LUMBAR SPINE W/WO CONT | $3,747 | $1,311 | — | — | 0 |
| 3408399 | MRI PELVIS W/WO CONT | $3,730 | $1,306 | — | — | 0 |
| 3409015 | MRI CHEST W/W/O CONTRAST | $3,702 | $1,296 | — | — | 0 |
| 2603360 | CT HEAD/BRAIN W/W/O CONT | $3,618 | $1,266 | — | — | 0 |
| 2603388 | CT CHEST WO/W CONT | $3,577 | $1,252 | — | — | 0 |
| 1801416 | PATCH HERNIA LG 22X27cm VENTRALEX | $3,513 | $1,230 | — | — | 0 |
| 2603411 | CT UPPER EXT LT W/WO CONT | $3,465 | $1,213 | — | — | 0 |
| 2603412 | CT UPPER EXT RT W/WO CONT | $3,465 | $1,213 | — | — | 0 |
| 8000571 | VAGINAL DELIVERY | $3,447 | $1,206 | — | — | 0 |
| 1801454 | PATCH HERNIA 8.7X10.7 OVAL KUGEL | $3,410 | $1,194 | — | — | 0 |
| 2802300 | CTA CHEST PE STUDY W/ CONTRAST | $3,353 | $1,174 | — | — | 0 |
| 3408361 | MRI NECK W/CONT | $3,332 | $1,166 | — | — | 0 |
| 3408370 | MRI NECK W/W/O CONTRAST | $3,332 | $1,166 | — | — | 0 |
| 3408373 | MRA NECK W/WO CONTRAST | $3,297 | $1,154 | — | — | 0 |
| 3408403 | MRI UP EX NON-JT LT W/WO CONT | $3,284 | $1,149 | — | — | 0 |
| 8020035 | VAG DELIVERY | $3,283 | $1,149 | — | — | 0 |
| 1801736 | MESH MULTI/LAYER 6X8 JJ | $3,261 | $1,141 | — | — | 0 |
| 2603405 | CT PELVIS W/ CONT | $3,255 | $1,139 | — | — | 0 |
| 2603390 | CT ABDOMEN PELVIS W CONT | $3,250 | $1,138 | — | — | 0 |
| 3408369 | MRA BRAIN W/W/O CONTRAST | $3,218 | $1,126 | — | — | 0 |
| 3409019 | MRI T-SPINE W/CONT | $3,155 | $1,104 | — | — | 0 |
Showing top 50 of 4,896 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.