SIBLEY MEMORIAL HOSPITAL — Hospital Ledger

45 CFR § 180 compliance

A · 100

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

3,198

Insurances with rates

CPT / HCPCS codes

2,708

Source MRF

json ↗

Most expensive procedures (gross)

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
A9616	GALLIUM-68 GOZETOTIDE (GOZELLIX) 25 MCG INTRAVENOUS SOLUTION	$1,629,875	$977,925	$1,171	$1,629,875	63
003	ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR	$624,106	$374,463	$1,011	$751,654	73
004	TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R.	$466,486	$279,892	$1,011	$543,396	73
J0225	VUTRISIRAN 25 MG/0.5 ML SUBCUTANEOUS SYRINGE	$387,891	$232,734	$5,010	$387,891	72
097	NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC	$291,016	$174,609	$1,011	$291,016	73
429	COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC	$277,049	$166,229	$34,505	$322,585	73
456	SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH	$273,966	$164,379	$35,578	$411,752	73
427	MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC	$260,409	$156,245	$29,270	$275,955	73
870	SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS	$255,146	$153,088	$1,011	$255,146	73
426	MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE	$250,099	$150,060	$24,487	$571,465	73
577	SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC	$249,264	$149,559	$4,214	$249,264	73
447	MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY	$245,389	$147,233	$1,197	$245,389	73
430	COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC	$243,520	$146,112	$22,631	$243,520	73
906	HAND PROCEDURES FOR INJURIES	$217,314	$130,388	$5,621	$217,314	73
457	SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH	$213,023	$127,814	$26,874	$241,414	73
500	SOFT TISSUE PROCEDURES WITH MCC	$210,113	$126,068	$1,011	$210,113	73
207	RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS	$209,414	$125,649	$1,011	$254,899	73
279	ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC	$196,268	$117,761	$1,011	$196,268	73
450	SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY F	$186,644	$111,987	$1,197	$245,231	73
275	CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC	$182,214	$109,328	$1,011	$205,049	73
428	MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC	$179,928	$107,957	$22,770	$179,928	73
533	FRACTURES OF FEMUR WITH MCC	$154,449	$92,669	$1,011	$154,449	73
J2351	OCRELIZUMAB 920 MG-HYALURONIDASE-OCSQ 23,000 UNIT/23 ML SUBCUT SOLN	$150,860	$90,516	$47.05	$150,860	72
C9765	Revasc intra lithotrip-stent\|BILATERAL PROCEDURE	$143,389	$86,033	$3,756	$143,389	72
270	OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC	$142,322	$85,393	$1,011	$146,097	73
47382	Abltj 1/> Lvr Tum Prq Rf	$141,895	$85,137	$3,756	$141,895	72
278	ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC	$140,408	$84,245	$39,182	$265,747	73
276	CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR	$140,089	$84,053	$1,011	$174,568	73
402	SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL	$138,658	$83,195	$16,185	$149,137	73
239	AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC	$136,366	$81,820	$1,011	$141,982	73
142	MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC	$134,967	$80,980	$11,238	$134,967	73
518	BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR	$132,953	$79,772	$1,197	$132,953	73
356	OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC	$131,716	$79,030	$1,011	$144,285	73
448	MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	$131,647	$78,988	$16,893	$150,733	73
265	AICD LEAD PROCEDURES	$131,055	$78,633	$1,197	$131,055	73
271	OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC	$130,393	$78,236	$25,034	$130,393	73
C9767	Revasc lithotrip-stent-ather\|LEFT SIDE	$128,619	$77,171	$3,756	$128,619	72
324	CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC	$126,123	$75,674	$1,011	$126,123	73
283	ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC	$124,352	$74,611	$1,011	$124,352	73
353	HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC	$122,523	$73,514	$1,011	$122,523	73
360	PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC	$121,361	$72,817	$1,011	$121,361	70
472	CERVICAL SPINAL FUSION WITH CC	$120,998	$72,599	$12,633	$120,998	73
37223	Revsc Opn/Prq Iliac Art W/Stnt & Angiop Ipsilatl\|LEFT SIDE	$119,045	$71,427	$26.51	$119,045	72
656	KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC	$118,170	$70,902	$20,586	$118,170	73
023	CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLA	$117,963	$70,778	$250	$345,441	73
J2507	PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION	$117,716	$70,630	$3,769	$166,702	72
498	LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC	$116,543	$69,926	$14,234	$116,930	73
829	MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC	$115,789	$69,473	$22,244	$115,789	73
260	CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC	$115,407	$69,244	$1,011	$115,407	73
37230	Revsc Opn/Prq Tib/Pero W/Stnt/Angiop Sm Vsl\|LEFT SIDE	$115,167	$69,100	$3,163	$115,167	72

Showing top 50 of 3,198 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.