ASPEN VALLEY HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-126168	USTEKINUMAB 90 MG/ML SC SOSY	$78,541	$78,541	—	—	33
RX-108956	IPILIMUMAB 200 MG/40ML IV SOLN	$66,637	$66,637	—	—	33
RX-168184	POLATUZUMAB VEDOTIN-PIIQ 140 MG IV SOLR	$51,786	$51,786	—	—	33
RX-137896	OCRELIZUMAB 300 MG/10ML IV SOLN	$44,357	$44,357	—	—	33
RX-188206	EFGARTIGIMOD ALFA-HYALUR-QVFC 180-2000 MG-UNIT/ML SC SOLN	$43,077	$43,077	—	—	33
RX-171841	TEPROTUMUMAB-TRBW 500 MG IV SOLR	$42,570	$42,570	—	—	33
PX-5116455501	Prq Impltj Neurostimulator Eltrd Peripheral Nrv	$29,982	$29,982	—	—	33
RX-181877	NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20ML IV SOLN	$28,338	$28,338	—	—	33
RX-105644	CABAZITAXEL 60 MG/1.5ML IV SOLN	$27,123	$27,123	—	—	33
RX-410132	CABAZITAXEL 10 MG/ML IV SOLN (DILUTED) - COMPOUNDED	$27,123	$27,123	—	—	33
RX-174456	PERTUZ-TRASTUZ-HYALURON-ZZXF 80-40-2000 MG-MG-U/ML SC SOLN	$26,807	$26,807	—	—	33
RX-186263	UBLITUXIMAB-XIIY 150 MG/6ML IV SOLN	$26,247	$26,247	—	—	33
RX-124767	OBINUTUZUMAB 1000 MG/40ML IV SOLN	$24,832	$24,832	—	—	33
RX-182420	RISANKIZUMAB-RZAA 600 MG/10ML IV SOLN	$24,553	$24,553	—	—	33
RX-111348	BRENTUXIMAB VEDOTIN 50 MG IV SOLR	$24,275	$24,275	—	—	33
PX-278C980701	Nerve stim non-opioid dev	$24,180	$24,180	—	—	33
RX-126219	VEDOLIZUMAB 300 MG IV SOLR	$23,882	$23,882	—	—	33
RX-127844	NIVOLUMAB 100 MG/10ML IV SOLN	$23,457	$23,457	—	—	33
RX-127964	PEMBROLIZUMAB 100 MG/4ML IV SOLN	$22,183	$22,183	—	—	33
RX-132613	ATEZOLIZUMAB 1200 MG/20ML IV SOLN	$22,019	$22,019	—	—	33
RX-108955	IPILIMUMAB 50 MG/10ML IV SOLN	$21,392	$21,392	—	—	33
RX-164576	CEMIPLIMAB-RWLC 350 MG/7ML IV SOLN	$20,912	$20,912	—	—	33
PX-7613328501	Insertion Subq Cardiac Rhythm Monitor W/Prgrmg	$20,274	$20,274	—	—	33
RX-9002	ALTEPLASE 100 MG IV SOLR	$20,076	$20,076	—	—	33
RX-125687	RAMUCIRUMAB 500 MG/50ML IV SOLN	$19,723	$19,723	—	—	33
RX-197363	TENECTEPLASE 25 MG IV KIT (FOR AMI)	$19,496	$19,496	—	—	33
RX-197593	TENECTEPLASE 25 MG IV KIT (FOR AIS)	$19,496	$19,496	—	—	33
RX-28530	TENECTEPLASE 50 MG IV KIT	$19,496	$19,496	—	—	33
RX-173322	DARATUMUMAB-HYALURONIDASE-FIHJ 1800-30000 MG-UT/15ML SC SOLN	$19,414	$19,414	—	—	33
RX-40120	NATALIZUMAB 300 MG/15ML IV CONC	$19,395	$19,395	—	—	33
RX-35775	AGALSIDASE BETA 35 MG IV SOLR	$19,047	$19,047	—	—	33
RX-708530	TENECTEPLASE 50 MG IV KIT (FOR AIS)	$18,928	$18,928	—	—	33
RX-127843	NIVOLUMAB 40 MG/4ML IV SOLN	$18,766	$18,766	—	—	33
RX-151108	NIVOLUMAB 240 MG/24ML IV SOLN	$18,766	$18,766	—	—	33
PX-9753129801	HC Nasal/Sinus Ndsc Surg W/Dilation Frnt&Sphn Sinus	$18,128	$18,128	—	—	32
RX-24436	OCTREOTIDE ACETATE 30 MG IM KIT	$17,560	$17,560	—	—	33
RX-139634	RITUXIMAB-HYALURONIDASE HUMAN 1400-23400 MG -UT/11.7ML SC SOLN	$17,264	$17,264	—	—	33
RX-98452	INDIUM IN 111 OXYQUINOLINE 1 MCI/ML IV SOLN (OXINE/WBC)	$16,683	$16,683	—	—	31
RX-91495	CERTOLIZUMAB PEGOL 2 X 200 MG SC KIT	$16,536	$16,536	—	—	33
RX-116596	PERTUZUMAB 420 MG/14ML IV SOLN	$16,275	$16,275	—	—	33
SUP-5913	CERAMENT BONE VOID FILLER 18ML	$16,200	$16,200	—	—	33
RX-191424	CERTOLIZUMAB PEGOL 200 MG/ML SC PSKT	$15,921	$15,921	—	—	33
RX-181508	EFGARTIGIMOD ALFA-FCAB 400 MG/20ML IV SOLN	$14,917	$14,917	—	—	33
RX-180989	TISOTUMAB VEDOTIN-TFTV 40 MG IV SOLR	$13,674	$13,674	—	—	33
PX-9752286501	Rmvl Tot Disc Arthrp Ant 1 Interspace Lumbar	$13,501	$13,501	—	—	33
RX-180666	ANIFROLUMAB-FNIA 300 MG/2ML IV SOLN	$13,046	$13,046	—	—	33
SUP-3823	NAIL FEMORAL EX 10MM X 360MM	$12,843	$12,843	—	—	33
SUP-3825	NAIL FEMORAL EX 10MM X 380MM	$12,843	$12,843	—	—	33
SUP-3828	NAIL FEMORAL EX 10MM X 420MM	$12,843	$12,843	—	—	33
SUP-3830	NAIL FEMORAL EX 10MM X 440MM	$12,843	$12,843	—	—	33

Showing top 50 of 5,602 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.