WRAY COMMUNITY DISTRICT HOSPITAL

CCN 061309

45 CFR § 180 compliance
B · 80
This hospital published most of what § 180 requires.
●Machine-readable file published
●Gross / standard charges
●Discounted cash price
○Payer-specific negotiated rates
●Min / max negotiated charges
●Free, public, no login required
Procedures listed
3,061
Insurances with rates
0
CPT / HCPCS codes
1,189
Source MRF

Most expensive procedures (gross)

J2350
$38,111
ocrelizumab 300 mg/10 mL Sol [WCDH]
Gross
$50,815
J2997
$20,640
alteplase 100 mg IV Inj 1/box (UD)[WCDH]
Gross
$27,520
J3380
$17,066
vedolizumab 300 mg SDV Inj. 1/box [WCDH]
Gross
$22,755
J2505
$14,614
pegfilgrastim 6 mg/0.6 mL Inj SubQ SDV 1/box[WCDH]
Gross
$19,485
J1602
$14,205
golimumab 100 mg/mL Sol [WCDH]
Gross
$18,940
J3101
$14,160
tenecteplase 50 mg IV Inj (UD)[WCDH]
Gross
$18,881
J9217
$12,436
leuprolide 22.5 mg/3 months Kit(Lupron Depot)[WCDH]
Gross
$16,581
J9306
$12,050
pertuzumab 420 mg/14 mL Sol [WCDH]
Gross
$16,067
J9271
$11,806
pembrolizumab 25 mg/mL [WCDH]
Gross
$15,741
ethacrynic acid 50 mg IV Inj 1/box(UD)[WCDH]
$11,761
ethacrynic acid 50 mg IV Inj 1/box(UD)[WCDH]
Gross
$15,681
J9312
$11,017
rituximab 10 mg/mL(50ml 1/box) IV SDV[WCDH]
Gross
$14,690
J2323
$10,352
natalizumab 300 mg/15 mL IV SDV 1/box [WCDH]
Gross
$13,803
Q5111
$9,792
pegfilgrastim cbqv 6 mg/0.6 mL Sol [WCDH]
Gross
$13,056
J2353
$9,550
octreotide 30 mg REC 1/box [WCDH]
Gross
$12,733
J1162
$9,320
digoxin immune FAB 40 mg Inj. SDV 1/box[WCDH]
Gross
$12,427
Q5117
$8,671
trastuzumab anns 420 mg REC [WCDH]
Gross
$11,562
SPECIAL CARE COVID 19
$8,084
SPECIAL CARE COVID 19
Gross
$10,778
J0840
$7,500
antivenin 1gm Inj SDV 2/box [WCDH]
Gross
$10,001
J9035
$7,476
bevacizumab 25 mg/mL (16ml) IV Sol 1/box (UD) [WCDH]
Gross
$9,968
mineral oil 100% Oral Liq 480 mL(BLK) [WCDH]
$7,268
mineral oil 100% Oral Liq 480 mL(BLK) [WCDH]
Gross
$9,690
J9354
$7,183
ado-trastuzumab 100 mg SDV Inj.1/box[WCDH]
Gross
$9,577
J9033
$6,970
bendamustine 100 mg REC 1/box [WCDH]
Gross
$9,293
J1951
$6,356
leuprolide 45 mg/6 months PWD[WCDH]
Gross
$8,475
Lithotripsy W/ Laser and Stent
$5,968
Lithotripsy W/ Laser and Stent
Gross
$7,957
Lithotripsy W/ Laser
$5,968
Lithotripsy W/ Laser
Gross
$7,957
Extracorporeal Shock Wave Lithotripsy
$5,968
Extracorporeal Shock Wave Lithotripsy
Gross
$7,957
J0897
$5,842
denosumab 120 mg/1.7 mL Sol [WCDH]
Gross
$7,790
J9034
$5,802
bendamustine 25 mg/mL Sol[WCDH]
Gross
$7,736
SURGIMESH (Large Rectangle) 5.9x8.6'' Tintra E15
$5,076
SURGIMESH (Large Rectangle) 5.9x8.6'' Tintra E1522
Gross
$6,767
J9202
$4,912
goserelin 10.8 mg Imp [WCDH]
Gross
$6,550
J9263
$4,544
oxaliplatin 100 mg SDV IV 1/box[WCDH]
Gross
$6,059
J1569
$4,534
immune globulin IV 10% Sol. 200ml [WCDH]
Gross
$6,045
J0630
$4,238
calcitonin 200 intl units/mL Sol MDV[WCDH]
Gross
$5,650
73719
$3,773
MRI LE Non Joint w/ Contrast Bilateral
Gross
$5,030
J9041
$3,760
bortezomib 3.5 mg/vial Inj 1/box (UD)[WCDH]
Gross
$5,013
J9355
$3,655
trastuzumab 150mg SDV [WCDH]
Gross
$4,873
J0881
$3,631
darbepoetin alfa 200 mcg/mL SDV inj. [WCDH]
Gross
$4,841
J1451
$3,518
fomepizole 1.5g/1.5mL IV Sol 1/box(UD) [WCDH]
Gross
$4,691
J1950
$3,479
leuprolide 3.75 mg/month PWD[WCDH]
Gross
$4,638
J9357
$3,298
valrubicin 40 mg/mL Sol[WCDH]
Gross
$4,397
J9055
$3,189
cetuximab 2 mg/mL SDV inj. (100mL)[WCDH]
Gross
$4,252
J9303
$3,187
panitumumab 100mg/5mL Sol [WCDH]
Gross
$4,249
75635
$3,182
CT Angiography Aorta w/ Runoff
Gross
$4,242
74178
$3,061
CT Abdomen/Pelvis w + w/o Contrast
Gross
$4,082
73702
$3,061
CT Ankle w/ + w/o Contrast Bilateral
Gross
$4,082
Cataract Extraction with Intraocular Lens Implan
$3,034
Cataract Extraction with Intraocular Lens Implantation
Gross
$4,046
J9179
$2,847
eriBULin 1 mg/2 mL Sol [WCDH]
Gross
$3,796
KIT ENDOSCOPIC CHOLECYSTECTOMY(MIN-4)
$2,830
KIT ENDOSCOPIC CHOLECYSTECTOMY(MIN-4)
Gross
$3,774
81229
$2,804
Cytogenomic Microarray PSPC
Gross
$3,738
J0129
$2,757
abatacept 250 mg Inj. SDV 1/box[WCDH]
Gross
$3,676
Showing top 50 of 3,061 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.