45 CFR § 180 compliance
B · 85
This hospital published most of what § 180 requires.
●Machine-readable file published: assessment threshold met
●Gross / standard charges: assessment threshold met
●Discounted cash price: assessment threshold met
●Payer-specific negotiated rates: assessment threshold met
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
976
Insurances with rates
4
CPT / HCPCS codes
967
Most expensive procedures (gross)
J3101
$8,487
TNKase (TENECTEPLASE) 50MG
Gross
$16,974
90376
$5,471
IMOGAM RABIES IMMUNE GLOB 150U/ML 2ml
Gross
$10,941
J1162
$5,267
DIGIFAB (DIGOXIN IMMUNE FAB) INJ
Gross
$10,533
49406
$3,588
PERCUTANEOUS FLUID DRAINAGE BY CATHETER
Gross
$7,175
J0897
$3,221
PROLIA (DENOSUMAB) INJ 60MG/ML
Gross
$6,442
19083
$2,814
BREAST BIOPSY 1ST LESION W/US GUIDANCE
Gross
$5,628
J2916
$2,532
INJECTAFER 750MG/15ML
Gross
$5,064
50200
$2,213
RENAL BIOPSY PROCEDURE
Gross
$4,425
73580
$2,001
KNEE ARTHOGRAM BILATERAL
Gross
$4,001
81405
$1,949
GENETIC TESTING FOR BETA THALASSEMIA
Gross
$3,899
74174
$1,947
CTA ABDOMEN/PELVIS W/ & W/O CONTRAST
Gross
$3,894
74178
$1,947
CT ABDOMEN/PELVIS W/ & W/O CONTRAST
Gross
$3,894
74177
$1,859
CT ABDOMEN/PELVIS W/ CONTRAST
Gross
$3,718
95782
$1,840
SLEEP STUDY - 6 YEARS AND UNDER
Gross
$3,679
95810
$1,840
SLEEP STUDY - INITIAL
Gross
$3,679
95811
$1,840
SLEEP STUDY - CPAP
Gross
$3,679
20220
$1,770
BONE BIOPSY PROCEDURE
Gross
$3,541
74176
$1,770
CT ABDOMEN/PELVIS W/O CONTRAST
Gross
$3,541
95806
$1,719
HOME SLEEP STUDY
Gross
$3,437
99291
$1,590
ER Visit Critical - 30 to 74 min
Gross
$3,180
95805
$1,547
SLEEP STUDY - MSLT
Gross
$3,094
76098
$1,521
STEREO - DIAG BREAST SPECIMEN
Gross
$3,043
93306
$1,405
US ECHO DOPPLER M MODE & COLOR FLOW
Gross
$2,810
81490
$1,261
VECTRA DA
Gross
$2,522
71270
$1,151
CT THORAX W/ & W/O CONTRAST
Gross
$2,302
71275
$1,151
CTA CHEST W/WITHOUT
Gross
$2,302
74175
$1,151
CTA ABDOMEN W/WITHOUT
Gross
$2,302
74170
$1,124
CT ABDOMEN W/ & W/O CONTRAST
Gross
$2,248
Q4106
$1,112
DERMAGRAFT 5X71/2
Gross
$2,225
73702
$1,107
CT EXTREMITY LOWER W/ & W/O CONTRAST
Gross
$2,214
10021
$1,062
FINE NEEDLE ASPIRATION
Gross
$2,125
72191
$1,062
CTA PELVIS W/WITHOUT
Gross
$2,125
76870
$1,062
US SCROTUM AND CONTENTS
Gross
$2,125
70492
$1,019
CT SOFT TISSUE NECK W/ & W/O CONTRAST
Gross
$2,037
70498
$1,019
CTA NECK W/WITHOUT
Gross
$2,037
99285
$989
ER VISIT LEVEL 5
Gross
$1,977
88309
$984
TISSUE LEVEL VI
Gross
$1,968
73202
$978
CT EXTREMITY UPPER W/ & W/O CONTRAST
Gross
$1,956
70496
$974
CTA HEAD W/WITHOUT
Gross
$1,948
71250
$974
CT CHEST HIGH RESOLUTION
Gross
$1,948
73206
$974
CTA UPPER EXTREMITY W/WITHOUT
Gross
$1,948
73706
$974
CTA LOWER EXTREMITY W/WITHOUT
Gross
$1,948
70482
$970
CT SELLA/ORBIT, MID/INNER EAR W/ & W/O
Gross
$1,940
81229
$955
CNV DETECTION
Gross
$1,910
72194
$946
CT PELVIS W/ & W/O CONTRAST
Gross
$1,892
L8606
$946
SYRINGE COAPTITE INJECTABLE 1ML
Gross
$1,891
71260
$943
CT THORAX W/ CONTRAST
Gross
$1,886
72126
$940
CT SPINE CERVICAL W/ CONTRAST
Gross
$1,880
72129
$940
CT SPINE THORACIC W/ CONTRAST
Gross
$1,880
72132
$940
CT SPINE LUMBAR W/ CONTRAST
Gross
$1,880
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J3101 | TNKase (TENECTEPLASE) 50MG | $16,974 | $8,487 | — | — | 4 |
| 90376 | IMOGAM RABIES IMMUNE GLOB 150U/ML 2ml | $10,941 | $5,471 | — | — | 4 |
| J1162 | DIGIFAB (DIGOXIN IMMUNE FAB) INJ | $10,533 | $5,267 | — | — | 4 |
| 49406 | PERCUTANEOUS FLUID DRAINAGE BY CATHETER | $7,175 | $3,588 | — | — | 4 |
| J0897 | PROLIA (DENOSUMAB) INJ 60MG/ML | $6,442 | $3,221 | — | — | 4 |
| 19083 | BREAST BIOPSY 1ST LESION W/US GUIDANCE | $5,628 | $2,814 | — | — | 4 |
| J2916 | INJECTAFER 750MG/15ML | $5,064 | $2,532 | — | — | 4 |
| 50200 | RENAL BIOPSY PROCEDURE | $4,425 | $2,213 | — | — | 4 |
| 73580 | KNEE ARTHOGRAM BILATERAL | $4,001 | $2,001 | — | — | 4 |
| 81405 | GENETIC TESTING FOR BETA THALASSEMIA | $3,899 | $1,949 | — | — | 4 |
| 74174 | CTA ABDOMEN/PELVIS W/ & W/O CONTRAST | $3,894 | $1,947 | — | — | 4 |
| 74178 | CT ABDOMEN/PELVIS W/ & W/O CONTRAST | $3,894 | $1,947 | — | — | 4 |
| 74177 | CT ABDOMEN/PELVIS W/ CONTRAST | $3,718 | $1,859 | — | — | 4 |
| 95782 | SLEEP STUDY - 6 YEARS AND UNDER | $3,679 | $1,840 | — | — | 4 |
| 95810 | SLEEP STUDY - INITIAL | $3,679 | $1,840 | — | — | 4 |
| 95811 | SLEEP STUDY - CPAP | $3,679 | $1,840 | — | — | 4 |
| 20220 | BONE BIOPSY PROCEDURE | $3,541 | $1,770 | — | — | 4 |
| 74176 | CT ABDOMEN/PELVIS W/O CONTRAST | $3,541 | $1,770 | — | — | 4 |
| 95806 | HOME SLEEP STUDY | $3,437 | $1,719 | — | — | 4 |
| 99291 | ER Visit Critical - 30 to 74 min | $3,180 | $1,590 | — | — | 4 |
| 95805 | SLEEP STUDY - MSLT | $3,094 | $1,547 | — | — | 4 |
| 76098 | STEREO - DIAG BREAST SPECIMEN | $3,043 | $1,521 | — | — | 4 |
| 93306 | US ECHO DOPPLER M MODE & COLOR FLOW | $2,810 | $1,405 | — | — | 4 |
| 81490 | VECTRA DA | $2,522 | $1,261 | — | — | 4 |
| 71270 | CT THORAX W/ & W/O CONTRAST | $2,302 | $1,151 | — | — | 4 |
| 71275 | CTA CHEST W/WITHOUT | $2,302 | $1,151 | — | — | 4 |
| 74175 | CTA ABDOMEN W/WITHOUT | $2,302 | $1,151 | — | — | 4 |
| 74170 | CT ABDOMEN W/ & W/O CONTRAST | $2,248 | $1,124 | — | — | 4 |
| Q4106 | DERMAGRAFT 5X71/2 | $2,225 | $1,112 | — | — | 4 |
| 73702 | CT EXTREMITY LOWER W/ & W/O CONTRAST | $2,214 | $1,107 | — | — | 4 |
| 10021 | FINE NEEDLE ASPIRATION | $2,125 | $1,062 | — | — | 4 |
| 72191 | CTA PELVIS W/WITHOUT | $2,125 | $1,062 | — | — | 4 |
| 76870 | US SCROTUM AND CONTENTS | $2,125 | $1,062 | — | — | 4 |
| 70492 | CT SOFT TISSUE NECK W/ & W/O CONTRAST | $2,037 | $1,019 | — | — | 4 |
| 70498 | CTA NECK W/WITHOUT | $2,037 | $1,019 | — | — | 4 |
| 99285 | ER VISIT LEVEL 5 | $1,977 | $989 | — | — | 4 |
| 88309 | TISSUE LEVEL VI | $1,968 | $984 | — | — | 4 |
| 73202 | CT EXTREMITY UPPER W/ & W/O CONTRAST | $1,956 | $978 | — | — | 4 |
| 70496 | CTA HEAD W/WITHOUT | $1,948 | $974 | — | — | 4 |
| 71250 | CT CHEST HIGH RESOLUTION | $1,948 | $974 | — | — | 4 |
| 73206 | CTA UPPER EXTREMITY W/WITHOUT | $1,948 | $974 | — | — | 4 |
| 73706 | CTA LOWER EXTREMITY W/WITHOUT | $1,948 | $974 | — | — | 4 |
| 70482 | CT SELLA/ORBIT, MID/INNER EAR W/ & W/O | $1,940 | $970 | — | — | 4 |
| 81229 | CNV DETECTION | $1,910 | $955 | — | — | 4 |
| 72194 | CT PELVIS W/ & W/O CONTRAST | $1,892 | $946 | — | — | 4 |
| L8606 | SYRINGE COAPTITE INJECTABLE 1ML | $1,891 | $946 | — | — | 4 |
| 71260 | CT THORAX W/ CONTRAST | $1,886 | $943 | — | — | 4 |
| 72126 | CT SPINE CERVICAL W/ CONTRAST | $1,880 | $940 | — | — | 4 |
| 72129 | CT SPINE THORACIC W/ CONTRAST | $1,880 | $940 | — | — | 4 |
| 72132 | CT SPINE LUMBAR W/ CONTRAST | $1,880 | $940 | — | — | 4 |
Showing top 50 of 976 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.