45 CFR § 180 compliance
F · 55
This hospital published little of what § 180 requires.
●Machine-readable file published: assessment threshold met
○Gross / standard charges: below assessment threshold
○Discounted cash price: below assessment threshold
●Payer-specific negotiated rates: assessment threshold met
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
706
Insurances with rates
10
CPT / HCPCS codes
608
Most expensive procedures (gross)
2124
—
Inpatient Room & Board-Psychiatric
Gross
$1,200
3126
—
Inpatient Room & Board-Detoxification
Gross
$1,200
810081
—
PC Incision and drainage pilonidal cyst (complicated)
Gross
$1,058
4762
—
23 Hr. Observation Stay
Gross
$900
4999496
—
PC Transitional Care face to face w/in 7 days d/c
Gross
$830
910121
—
Foreign body, skin, complex
Gross
$807
710080
—
Incision and drainage pilonidal cyst (simple)
Gross
$770
610061
—
Incision and drainage abscess (complicated or multiple)
Gross
$649
4899495
—
Transitional Care face to face w/in 14 days d/c
Gross
$617
50G0427
—
Routine foot care (DM sensory neuropathy)
Gross
$598
51G0438
—
Wellness Visit - Initial
Gross
$503
1990791
—
Psych - Diagnostic Evaluation
Gross
$480
2090792
—
Psych - Diagnostic Evaluation Non-MD
Gross
$480
4699487
—
Complex CCM, 60 minutes
Gross
$396
52G0439
—
Wellness Visit - Subsequent
Gross
$392
90S9480
—
IOP Per Diem
Gross
$390
510060
—
Incision and drainage abscess (cutaneous or subcutaneous)
Gross
$374
1211730
—
Nail removal partial
Gross
$346
1011100
—
Lesion, biopsy, one
Gross
$318
1312001
—
Repair of superficial wound
Gross
$288
1111200
—
Skin tag, 1-15
Gross
$271
2892002
—
Basic Eye Exam
Gross
$255
61H0001
—
In-Depth Assessment - Established Client
Gross
$240
62H0001
—
In-Depth Assessment - Established Client
Gross
$240
63H0001
—
In-Depth Assessment - New Client
Gross
$240
64H0001
—
In-Depth Assessment - New Client
Gross
$240
73H0031
—
In-Depth Assessment - New Client
Gross
$240
74H0031
—
In-Depth Assessment - New Client
Gross
$240
1416000
—
Burn Care Initial
Gross
$232
3799205
—
Office Visit - New Pt. (High Complexity)
Gross
$210
71H0031
—
In-Depth Assessment - Established Client
Gross
$210
72H0031
—
In-Depth Assessment - Established Client
Gross
$210
4799490
—
Chronic Care management (CCM) 20 minutes
Gross
$191
59G0506
—
Add to CCM initiation visit (care plan formulation)
Gross
$186
3699204
—
Office Visit - New Pt. (Moderate Complexity)
Gross
$180
4299215
—
Office Visit - Est. Pt. (High Complexity)
Gross
$180
2490839
—
Therapy for Crisis-first 60 mins
Gross
$180
60H0001
—
Bio-Psychosocial
Gross
$180
68H0031
—
Bio-Psychosocial
Gross
$180
69H0031
—
Bio-Psychosocial
Gross
$180
77H0032
—
Treatment Plan - new or reopened
Gross
$180
91T1007
—
Treatment Plan - new or reopened client
Gross
$180
3599203
—
Office Visit - New Pt. Detailed (Low Complexity)
Gross
$150
4199214
—
Office Visit - Est. Pt. Detailed (Moderate Complexity)
Gross
$150
4599408
—
Vivitrol Service-SA
Gross
$150
1669210
—
Cerumen removal
Gross
$145
3499202
—
Office Visit - New Pt. (Low Complexity)
Gross
$120
4099213
—
Office Visit - Est. Pt. Focus (Low Complexity)
Gross
$120
78H0032
—
Treatment Plan Review
Gross
$108
92T1007
—
Treatment Plan Review
Gross
$108
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 2124 | Inpatient Room & Board-Psychiatric | $1,200 | — | — | — | 18 |
| 3126 | Inpatient Room & Board-Detoxification | $1,200 | — | — | — | 11 |
| 810081 | PC Incision and drainage pilonidal cyst (complicated) | $1,058 | — | — | — | 12 |
| 4762 | 23 Hr. Observation Stay | $900 | — | — | — | 8 |
| 4999496 | PC Transitional Care face to face w/in 7 days d/c | $830 | — | — | — | 10 |
| 910121 | Foreign body, skin, complex | $807 | — | — | — | 12 |
| 710080 | Incision and drainage pilonidal cyst (simple) | $770 | — | — | — | 12 |
| 610061 | Incision and drainage abscess (complicated or multiple) | $649 | — | — | — | 12 |
| 4899495 | Transitional Care face to face w/in 14 days d/c | $617 | — | — | — | 10 |
| 50G0427 | Routine foot care (DM sensory neuropathy) | $598 | — | — | — | 10 |
| 51G0438 | Wellness Visit - Initial | $503 | — | — | — | 10 |
| 1990791 | Psych - Diagnostic Evaluation | $480 | — | — | — | 13 |
| 2090792 | Psych - Diagnostic Evaluation Non-MD | $480 | — | — | — | 11 |
| 4699487 | Complex CCM, 60 minutes | $396 | — | — | — | 10 |
| 52G0439 | Wellness Visit - Subsequent | $392 | — | — | — | 10 |
| 90S9480 | IOP Per Diem | $390 | — | — | — | 4 |
| 510060 | Incision and drainage abscess (cutaneous or subcutaneous) | $374 | — | — | — | 12 |
| 1211730 | Nail removal partial | $346 | — | — | — | 12 |
| 1011100 | Lesion, biopsy, one | $318 | — | — | — | 0 |
| 1312001 | Repair of superficial wound | $288 | — | — | — | 12 |
| 1111200 | Skin tag, 1-15 | $271 | — | — | — | 12 |
| 2892002 | Basic Eye Exam | $255 | — | — | — | 12 |
| 61H0001 | In-Depth Assessment - Established Client | $240 | — | — | — | 1 |
| 62H0001 | In-Depth Assessment - Established Client | $240 | — | — | — | 1 |
| 63H0001 | In-Depth Assessment - New Client | $240 | — | — | — | 1 |
| 64H0001 | In-Depth Assessment - New Client | $240 | — | — | — | 2 |
| 73H0031 | In-Depth Assessment - New Client | $240 | — | — | — | 1 |
| 74H0031 | In-Depth Assessment - New Client | $240 | — | — | — | 2 |
| 1416000 | Burn Care Initial | $232 | — | — | — | 10 |
| 3799205 | Office Visit - New Pt. (High Complexity) | $210 | — | — | — | 16 |
| 71H0031 | In-Depth Assessment - Established Client | $210 | — | — | — | 1 |
| 72H0031 | In-Depth Assessment - Established Client | $210 | — | — | — | 1 |
| 4799490 | Chronic Care management (CCM) 20 minutes | $191 | — | — | — | 12 |
| 59G0506 | Add to CCM initiation visit (care plan formulation) | $186 | — | — | — | 10 |
| 3699204 | Office Visit - New Pt. (Moderate Complexity) | $180 | — | — | — | 9 |
| 4299215 | Office Visit - Est. Pt. (High Complexity) | $180 | — | — | — | 9 |
| 2490839 | Therapy for Crisis-first 60 mins | $180 | — | — | — | 14 |
| 60H0001 | Bio-Psychosocial | $180 | — | — | — | 1 |
| 68H0031 | Bio-Psychosocial | $180 | — | — | — | 1 |
| 69H0031 | Bio-Psychosocial | $180 | — | — | — | 1 |
| 77H0032 | Treatment Plan - new or reopened | $180 | — | — | — | 2 |
| 91T1007 | Treatment Plan - new or reopened client | $180 | — | — | — | 2 |
| 3599203 | Office Visit - New Pt. Detailed (Low Complexity) | $150 | — | — | — | 9 |
| 4199214 | Office Visit - Est. Pt. Detailed (Moderate Complexity) | $150 | — | — | — | 9 |
| 4599408 | Vivitrol Service-SA | $150 | — | — | — | 5 |
| 1669210 | Cerumen removal | $145 | — | — | — | 12 |
| 3499202 | Office Visit - New Pt. (Low Complexity) | $120 | — | — | — | 7 |
| 4099213 | Office Visit - Est. Pt. Focus (Low Complexity) | $120 | — | — | — | 11 |
| 78H0032 | Treatment Plan Review | $108 | — | — | — | 2 |
| 92T1007 | Treatment Plan Review | $108 | — | — | — | 2 |
Showing top 50 of 706 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.