SOUTHWEST MEMORIAL HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
27644	Pegloticase 8 Mg/ml Sol	$72,054	$36,027	$2,719	$69,172	8
7330325	Ravulizumab 100 Mg/ml Sol	$57,482	$28,741	$2,719	$55,183	8
27646	Ocrelizumab 300 Mg/10 Ml Sol	$49,538	$24,769	$2,719	$47,556	8
26997	Leuprolide 45 Mg/6 Months Pwd	$30,907	$15,454	$2,719	$29,671	8
CP17497697282310369	Major joint replacement or reattachment of lower extremity without MCC	$29,578	$14,789	$2,719	$28,395	7
7330382	Pembrolizumab 25 Mg/ml Sol	$28,309	$14,155	$2,719	$27,177	8
7330404	Cemiplimab Rwlc 350 Mg/7 Ml Sol	$27,203	$13,602	$2,719	$26,115	8
7330329	Ublituximab Xiiy 150 Mg/6 Ml Sol	$26,664	$13,332	$2,719	$25,597	8
7330320	Risankizumab Rzaa 60 Mg/ml Sol	$24,894	$12,447	$2,701	$23,898	8
7330386	Daratumumab-hyaluronidase Fihj 1800 Mg-30,000 Units/15 Ml Sol	$24,054	$12,027	$2,610	$23,092	8
7330405	Octreotide 20 Mg Pwd	$23,266	$11,633	$2,524	$22,335	8
7330290	Lanreotide 120 Mg/0.5 Ml Sol	$22,949	$11,475	$2,490	$22,031	8
73301	Vedolizumab 300 Mg Pow	$22,464	$11,232	$2,437	$21,565	8
CP17497697282303147	Shaving of shoulder bone using endoscope	$22,364	$11,182	$2,426	$21,469	7
CP17497697282313237	Uterine and adnexa procedures for non-malignancy without CC or MCC	$21,471	$10,736	$2,719	$20,612	7
25168	Alteplase 1mg [Swmh]	$21,121	$10,561	$2,292	$20,276	8
27569	Leuprolide 30 Mg/4 Months Kit	$20,604	$10,302	$2,236	$19,780	8
25684	Natalizumab 300 Mg/15 Ml Con	$20,491	$10,246	$2,223	$19,671	8
7330139	Tenecteplase 50 Mg Pow	$19,913	$9,957	$2,161	$19,116	8
CP17497697282300449	Removal of one knee cartilage using an endoscope	$19,804	$9,902	$2,149	$19,012	7
CP17497697282314035	Removal of gallbladder using an endoscope	$19,164	$9,582	$2,079	$18,397	7
7330242	Immune Globulin Intravenous 10% Sol	$18,416	$9,208	$1,998	$17,679	8
CP17497697282319655	Spinal fusion except cervical without MCC	$18,379	$9,190	$2,719	$17,644	7
7330131	Dantrolene 250 Mg Pow	$16,704	$8,352	$1,812	$16,036	8
7330400	Pertuzumab 420 Mg/14 Ml Sol	$16,369	$8,185	$1,776	$15,714	8
7330237	Ferric Derisomaltose 100 Mg/ml Sol	$16,364	$8,182	$1,775	$15,709	8
26326	Leuprolide 22.5 Mg/3 Months Pwd	$15,453	$7,727	$1,677	$14,835	8
26143	Pegfilgrastim 6 Mg/0.6 Ml Sol	$15,403	$7,702	$1,671	$14,787	8
CP17497697282311289	Repair of groin hernia patient age 5 years or older	$15,189	$7,595	$1,648	$14,581	7
26942	Certolizumab 200 Mg/ml Kit	$14,399	$7,200	$1,562	$13,823	8
27564	Benralizumab 30 Mg/ml Sol	$13,624	$6,812	$1,478	$13,079	8
7330407	Romiplostim 500 Mcg Pow	$13,214	$6,607	$1,434	$12,685	8
26332	Leuprolide 11.25 Mg/3 Months Pwd	$12,968	$6,484	$1,407	$12,449	8
27132	Conversion Of Previous Hip Surgery To Total Hip Arthroplasty, With Or Without Autograft Or Allograft	$12,893	$6,447	$1,399	$12,377	7
685027268	27268 Closed Treatment Of Femoral Fracture, Proximal End, Head; With Manipulation	$12,811	$6,406	$1,390	$12,299	7
733012	Coagulation Factor Xa Recombinant, Inactivated 200 Mg Pow	$12,600	$6,300	$1,367	$12,096	8
7330212	Immune Globulin Intravenous And Subcutaneous 10% Sol	$12,572	$6,286	$1,364	$12,069	8
26974	Idarucizumab 2.5 G/50 Ml Sol	$12,246	$6,123	$1,329	$11,756	8
25564	Digoxin Immune 40mg [Swmh]	$11,938	$5,969	$1,295	$11,460	8
27568	Triptorelin 22.5 Mg/6 Months Pow	$11,711	$5,856	$1,271	$11,243	8
25678	Rituximab 10 Mg/ml Sol	$11,274	$5,637	$1,223	$10,823	8
7330359	Hyaluronidase-trastuzumab 10,000 Units-600 Mg/5 Ml Sol	$11,221	$5,611	$1,217	$10,772	8
36145	Radiofrequency Ablation Saphenous Vein Ablation, Second Vein	$10,995	$5,498	$1,193	$10,555	7
26712	Trastuzumab 440 Mg Pow	$10,971	$5,486	$1,190	$10,532	8
7330122	Basiliximab 20 Mg Pow	$10,942	$5,471	$1,187	$10,504	8
26049	Leuprolide 15 Mg/month Pwd	$10,398	$5,199	$1,128	$9,982	8
733052	C1 Esterase Inhibitor, Human 500 Intl Units Kit	$10,252	$5,126	$1,112	$9,842	8
7330355	Rituximab Abbs 10 Mg/ml Sol	$10,147	$5,074	$1,101	$9,741	8
7330395	Pegfilgrastim Cbqv 6 Mg/0.6 Ml Sol	$10,020	$5,010	$1,087	$9,619	8
7330373	Durvalumab 50 Mg/ml Sol	$9,665	$4,833	$1,049	$9,278	8

Showing top 50 of 5,807 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.