MODOC MEDICAL CENTER — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
10020764_1	NEOSTIM TL, PER SQUARE CENTIMETER	$161,196	$161,196	—	—	25
10020760_1	DERM-MAXX, PER SQUARE CENTIMETER	$121,200	$121,200	—	—	25
10020584_1	NEOSTIM TL, PER SQUARE CENTIMETER	$120,897	$120,897	—	—	25
10020759_1	DERM-MAXX, PER SQUARE CENTIMETER	$106,050	$106,050	—	—	25
10020763_1	NEOSTIM TL, PER SQUARE CENTIMETER	$80,598	$80,598	—	—	25
10020581_1	DERM-MAXX, PER SQUARE CENTIMETER	$60,600	$60,600	—	—	25
9015992_1	INJECTION, OCRELIZUMAB, 1 MG	$35,486	$35,486	—	—	28
10020758_1	DERM-MAXX, PER SQUARE CENTIMETER	$30,300	$30,300	—	—	25
10020762_1	NEOSTIM TL, PER SQUARE CENTIMETER	$30,224	$30,224	—	—	25
175	PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE	$25,378	$25,378	—	—	28
565	OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC	$24,060	$24,060	—	—	28
602	CELLULITIS WITH MCC	$22,431	$22,431	—	—	28
9891846_1	INJECTION, LUSPATERCEPT-AAMT, 0.25 MG	$20,930	$20,930	—	—	28
194	SIMPLE PNEUMONIA AND PLEURISY WITH CC	$20,302	$20,302	—	—	28
10020583_1	NEOSTIM TL, PER SQUARE CENTIMETER	$20,150	$20,150	—	—	25
593	SKIN ULCERS WITH CC	$19,853	$19,853	—	—	28
292	HEART FAILURE AND SHOCK WITH CC	$18,345	$18,345	—	—	28
9983251_1	INJECTION, RISANKIZUMAB-RZAA, INTRAVENOUS, 1 MG	$18,215	$18,215	—	—	28
9016882_1	INJECTION, DARATUMUMAB, 10 MG AND HYALURONIDASE-FIHJ	$18,041	$18,041	—	—	28
178	RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC	$17,697	$17,697	—	—	28
158	DENTAL AND ORAL DISEASES WITH CC	$17,157	$17,157	—	—	28
073	CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC	$16,557	$16,557	—	—	28
377	GASTROINTESTINAL HEMORRHAGE WITH MCC	$16,156	$16,156	—	—	28
9016090_1	INJECTION, ALTEPLASE RECOMBINANT, 1 MG	$15,841	$15,841	—	—	28
083	TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC	$15,819	$15,819	—	—	28
9561829_1	INJECTION, VEDOLIZUMAB, INTRAVENOUS, 1 MG	$15,600	$15,600	—	—	28
177	RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC	$15,586	$15,586	—	—	28
066	INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC	$15,399	$15,399	—	—	28
9413296_1	INJECTION, NATALIZUMAB, 1 MG	$15,368	$15,368	—	—	28
872	SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC	$15,354	$15,354	—	—	28
433	CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC	$15,247	$15,247	—	—	28
10020757_1	DERM-MAXX, PER SQUARE CENTIMETER	$15,150	$15,150	—	—	25
603	CELLULITIS WITHOUT MCC	$14,978	$14,978	—	—	28
871	SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC	$14,786	$14,786	—	—	28
690	KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC	$14,784	$14,784	—	—	28
191	CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC	$14,610	$14,610	—	—	28
193	SIMPLE PNEUMONIA AND PLEURISY WITH MCC	$14,462	$14,462	—	—	28
554	BONE DISEASES AND ARTHROPATHIES WITHOUT MCC	$14,358	$14,358	—	—	28
605	TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC	$14,313	$14,313	—	—	28
9016187_1	INJECTION, TENECTEPLASE, 1 MG	$14,090	$14,090	—	—	28
313	CHEST PAIN	$13,817	$13,817	—	—	28
445	DISORDERS OF THE BILIARY TRACT WITH CC	$13,383	$13,383	—	—	28
689	KIDNEY AND URINARY TRACT INFECTIONS WITH MCC	$13,143	$13,143	—	—	28
536	FRACTURES OF HIP AND PELVIS WITHOUT MCC	$13,099	$13,099	—	—	28
189	PULMONARY EDEMA AND RESPIRATORY FAILURE	$12,990	$12,990	—	—	28
088	CONCUSSION WITH MCC	$12,817	$12,817	—	—	28
9015990_1	INJECTION, PEGFILGRASTIM-JMDB (FULPHILA), BIOSIMILAR, 0.5 MG	$12,525	$12,525	—	—	28
195	SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC	$12,523	$12,523	—	—	28
641	MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC	$12,381	$12,381	—	—	28
884	ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY	$11,766	$11,766	—	—	28

Showing top 50 of 2,545 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.