SGMC HEALTH — Hospital Ledger

45 CFR § 180 compliance

B · 85

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

624

Insurances with rates

CPT / HCPCS codes

560

Source MRF

xlsx ↗

Most expensive procedures (gross)

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
C1767	GENERATOR NEUROSTIMULATOR THK7MM 18GM 10ML VAGUS NERVE DUAL PIN CYBERNETIC PROSTHESIS DEMIPULSE	$95,409	$71,557	—	—	16
C1882	ICD DUAL CHAMBER IPERIA HF-T DF-4 PRO MRI	$61,544	$46,158	—	—	16
J9359	LONCASTUXIMAB TESIRINE-LPYL 10 MG IV SOLR	$59,436	$44,577	—	—	16
J9266	PEGASPARGASE 750 UNIT/ML IJ SOLN	$55,616	$41,712	—	—	16
J9229	INOTUZUMAB OZOGAMICIN 0.9 MG IV SOLR	$51,873	$38,905	—	—	16
J2507	PEGLOTICASE 8 MG/ML IV SOLN	$46,468	$34,851	—	—	16
C1721	ICD DUAL CHAMBER IPERIA 7 DR-T	$45,373	$34,030	—	—	16
C1722	ICD SINGLE ILIVIA 7 VR-T	$44,745	$33,559	—	—	16
C1784	GRAFT ENDOVASCULAR STENT L12CM DIA23X14.5MM RECOMMENDED INTRODUCER SHEATH 15FR EPTFE FEP NITINOL CON	$42,776	$32,082	—	—	16
C1813	PROSTHESIS PENILE L14cm Dia12.5mm INFLATABLE TWO PIECE W PREFILLED PRECONNECTED IMPLANTS AMS AMBICOR	$41,538	$31,154	—	—	16
J9309	POLATUZUMAB VEDOTIN-PIIQ 140 MG IV SOLR	$39,010	$29,258	—	—	16
C2622	CYLINDER PENILE PROSTHESIS L12CM DIA12MM CONCEALABLE SPECTRA	$34,290	$25,717	—	—	16
C1820	SPACER SPINAL 8MM GOLD INDIRECT DECOMPRESSION STERILE SUPERION	$28,260	$21,195	—	—	16
C1778	LEAD NEUROSTIMULATOR L43CM ID2MM LEFT VAGUS NERVE STIMULATION BIPOLAR SILICONE VNS THERAPY	$27,340	$20,505	—	—	16
J7170	EMICIZUMAB-KXWH 105 MG/0.7ML SC SOLN	$25,530	$19,148	—	—	16
Hc Tevar/evar	Hc Tevar/evar	$24,195	$18,146	—	—	16
J9119	CEMIPLIMAB-RWLC 350 MG/7ML IV SOLN	$24,034	$18,026	—	—	16
J1930	LANREOTIDE ACETATE 120 MG/0.5ML SC SOLN	$23,915	$17,936	—	—	16
J9043	CABAZITAXEL 60 MG/1.5ML IV SOLN	$23,817	$17,863	—	—	16
C2621	IPG VIVA CRT-P	$22,245	$16,684	—	—	16
J9203	GEMTUZUMAB OZOGAMICIN 4.5 MG IV SOLR	$21,759	$16,319	—	—	16
Q4100	GRAFT NERVE L50mm DIA4-5mm PERIPHERAL NATURAL CONNECTION CABLE PROCESSED FOR RECONSTRUCTION AVANCE	$21,562	$16,172	—	—	16
J9022	ATEZOLIZUMAB 1200 MG/20ML IV SOLN	$21,560	$16,170	—	—	16
J9037	BELANTAMAB MAFODOTIN-BLMF 100 MG IV SOLR	$21,538	$16,154	—	—	16
J9144	DARATUMUMAB-HYALURONIDASE-FIHJ 1800-30000 MG-UT/15ML SC SOLN	$20,926	$15,694	—	—	16
J2997	ALTEPLASE 100 MG IV SOLR	$20,836	$15,627	—	—	16
J3240	THYROTROPIN ALFA 0.9 MG IM SOLR	$20,219	$15,164	—	—	16
C1821	IMPL VERTEBRAL BODY CORPECTOMY 14X14MM	$20,178	$15,134	—	—	16
Q4105	MATRIX DERMAL REGENERATIVE TEMPLATE 4" X 10"	$19,868	$14,901	—	—	16
C1896	LEAD S-CID EMBLEM	$18,761	$14,070	—	—	16
J9228	IPILIMUMAB 50 MG/10ML IV SOLN	$17,679	$13,259	—	—	16
J9223	LURBINECTEDIN 4 MG IV SOLR	$17,598	$13,198	—	—	16
J9042	BRENTUXIMAB VEDOTIN 50 MG IV SOLR	$17,090	$12,818	—	—	16
C1785	PMAKER DUAL CHMBR EVIA DR-T W-CLS SYS	$16,517	$12,388	—	—	16
J1300	ECULIZUMAB 300 MG/30ML IV SOLN	$16,318	$12,238	—	—	16
J1303	RAVULIZUMAB-CWVZ 300 MG/3ML IV SOLN	$16,020	$12,015	—	—	16
J9311	RITUXIMAB-HYALURONIDASE HUMAN 1400-23400 MG -UT/11.7ML SC SOLN	$15,211	$11,408	—	—	16
V2790	GRAFT HUMAN TISSUE 3cm x 6cm MATRIX CORD AMNION	$14,948	$11,211	—	—	16
Q4128	ALGFT TISS ACELL DERM MATRIX 8X20CM	$14,505	$10,879	—	—	16
J2506	PEGFILGRASTIM 6 MG/0.6ML SC SOSY	$14,489	$10,867	—	—	16
C1786	PACEMAKER CARDIAC MR CONDITIONAL MODEL EDORA 8 DR-T	$14,168	$10,626	—	—	16
Q4131	ALLOGRAFT EPIXL FENESTRATED 4X10CM	$13,716	$10,287	—	—	16
J9271	PEMBROLIZUMAB 100 MG/4ML IV SOLN	$13,103	$9,827	—	—	16
J9302	OFATUMUMAB 1000 MG/50ML IV CONC	$12,920	$9,690	—	—	16
C1777	LEAD DEFIBRILLATION L59CM SINGLE COIL ACTIVE MR CONDITIONAL RELIANCE 4-FRONT	$11,999	$8,999	—	—	16
C1895	LEAD ONLY ICD RELIANCE SG	$11,999	$8,999	—	—	16
Q4170	PATCH AMNION CYGNUS SOLO 10X10CM	$11,680	$8,760	—	—	16
J9306	PERTUZUMAB 420 MG/14ML IV SOLN	$11,081	$8,310	—	—	16
C1763	IMPLANT BIOINDUCTIVE M BOVINE ACHILLES TENDON W ARTHROSCOPIC DELIVERY FOR ROTATOR CUFF DISEASE	$11,029	$8,272	—	—	16
J9057	COPANLISIB HCL 60 MG IV SOLR	$10,510	$7,883	—	—	16

Showing top 50 of 624 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.