CLINCH MEMORIAL HOSPITAL — 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

3,087

Insurances with rates

CPT / HCPCS codes

1,744

Source MRF

csv ↗

Most expensive procedures (gross)

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J2997	50242-0085-27 - alteplase 100 mg intravenous injection [CLMH]	$31,681	$31,681	—	—	19
J2997	50242-0085-27 - alteplase 100 mg intravenous injection [CLMH]	$31,681	$31,681	—	—	19
45347	45347 Sigmoidoscopy, flexible; with placement of endoscopic stent	$13,075	$6,538	—	—	19
45347	45347 Sigmoidoscopy, flexible; with placement of endoscopic stent	$13,075	$6,538	—	—	19
J0840	50633-0110-12 - antivenin (Crotalidae ovine) polyvalent intravenous injection [CLMH]	$11,513	$11,513	—	—	19
J0840	50633-0110-12 - antivenin (Crotalidae ovine) polyvalent intravenous injection [CLMH]	$11,513	$11,513	—	—	19
42367-0540-32 - dantrolene 250 mg intravenous in	42367-0540-32 - dantrolene 250 mg intravenous injection [CLMH]	$11,256	$11,256	—	—	19
42367-0540-32 - dantrolene 250 mg intravenous in	42367-0540-32 - dantrolene 250 mg intravenous injection [CLMH]	$11,256	$11,256	—	—	19
31622	31622 BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG CHARGE	$10,475	$5,237	—	—	19
31623	31623 BRNCHSC BRUSHING/PROTECTED BRUSHINGS CHARGE	$10,475	$5,237	—	—	19
31624	31624 BRNCHSC W/BRNCL ALVEOLAR LAVAGE CHARGE	$10,475	$5,237	—	—	19
31625	31625 BRNCHSC/ENDOBRNCL BX 1+ SITES CHARGE	$10,475	$5,237	—	—	19
31622	31622 BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG CHARGE	$10,475	$5,237	—	—	19
31623	31623 BRNCHSC BRUSHING/PROTECTED BRUSHINGS CHARGE	$10,475	$5,237	—	—	19
31624	31624 BRNCHSC W/BRNCL ALVEOLAR LAVAGE CHARGE	$10,475	$5,237	—	—	19
31625	31625 BRNCHSC/ENDOBRNCL BX 1+ SITES CHARGE	$10,475	$5,237	—	—	19
J0897	55513-0730-01 - denosumab 120 mg/1.7 mL subcutaneous solution 1.7 mL [CLMH]	$6,765	$6,765	—	—	19
J0897	55513-0730-01 - denosumab 120 mg/1.7 mL subcutaneous solution 1.7 mL [CLMH]	$6,765	$6,765	—	—	19
J0875	57970-0100-01 - dalbavancin 500 mg intravenous injection [CLMH]	$6,405	$6,405	—	—	19
J0875	57970-0100-01 - dalbavancin 500 mg intravenous injection [CLMH]	$6,405	$6,405	—	—	19
G0105	G0105 COLORECTAL CA SCREEN HIGH RISK	$5,817	$2,909	—	—	19
G0105	G0105 COLORECTAL CA SCREEN HIGH RISK	$5,817	$2,909	—	—	19
J0129	00003-2187-13 - abatacept 250 mg intravenous injection [CLMH]	$5,142	$5,142	—	—	19
J0129	00003-2187-13 - abatacept 250 mg intravenous injection [CLMH]	$5,142	$5,142	—	—	19
J9217	62935-0223-05 - leuprolide 22.5 mg/3 months subcutaneous injection, extended release [CLMH]	$4,878	$4,878	—	—	19
J9217	62935-0223-05 - leuprolide 22.5 mg/3 months subcutaneous injection, extended release [CLMH]	$4,878	$4,878	—	—	19
44363	44363 SMALL ENDO W/ REMOVE FOREIGN BDY CHARGE	$4,255	$2,128	—	—	19
44363	44363 SMALL ENDO W/ REMOVE FOREIGN BDY CHARGE	$4,255	$2,128	—	—	19
43244	43244 EGD FLEX TRANSORAL W/BAND LIGATION ESOPHAGEAL/GASTRIC VARICES	$4,225	$2,113	—	—	19
43246	43246 EGD FLEX TRANSORAL W/DIRECTED PLCMNT PERC GASTROSTOMY TUBE	$4,225	$2,113	—	—	19
43249	43249 Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esop	$4,225	$2,113	—	—	19
43250	43250 EGD CAUTERY TUMOR POLYP CHARGE	$4,225	$2,113	—	—	19
43251	43251 EGD REMOVE LESION SNARE CHARGE	$4,225	$2,113	—	—	19
43255	43255 EGD BLEEDING CONTROL ANY METHOD	$4,225	$2,113	—	—	19
44360	44360 ENDOSCOPY UPPER SMALL INTESTINE CHARGE	$4,225	$2,113	—	—	19
44361	44361 ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY CHARGE	$4,225	$2,113	—	—	19
44364	44364 SMALL BOWEL ENDOSCOPY/ SNARE POLYP CHARGE	$4,225	$2,113	—	—	19
44366	44366 SMALL BOWEL ENDOSCOP W/ CONTROL OF BLEED CHARGE	$4,225	$2,113	—	—	19
44369	44369 SMALL BWL ENDO W/ABLATION TUMOR POLY CHARGE	$4,225	$2,113	—	—	19
44372	44372 SMALL ENDO W/PERQ JEJ PLC CHARGE	$4,225	$2,113	—	—	19
44373	44373 SMALL ENDO CONV GSTRST TUBE CHARGE	$4,225	$2,113	—	—	19
43244	43244 EGD FLEX TRANSORAL W/BAND LIGATION ESOPHAGEAL/GASTRIC VARICES	$4,225	$2,113	—	—	19
43246	43246 EGD FLEX TRANSORAL W/DIRECTED PLCMNT PERC GASTROSTOMY TUBE	$4,225	$2,113	—	—	19
43249	43249 Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esop	$4,225	$2,113	—	—	19
43250	43250 EGD CAUTERY TUMOR POLYP CHARGE	$4,225	$2,113	—	—	19
43251	43251 EGD REMOVE LESION SNARE CHARGE	$4,225	$2,113	—	—	19
43255	43255 EGD BLEEDING CONTROL ANY METHOD	$4,225	$2,113	—	—	19
44360	44360 ENDOSCOPY UPPER SMALL INTESTINE CHARGE	$4,225	$2,113	—	—	19
44361	44361 ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY CHARGE	$4,225	$2,113	—	—	19
44364	44364 SMALL BOWEL ENDOSCOPY/ SNARE POLYP CHARGE	$4,225	$2,113	—	—	19

Showing top 50 of 3,087 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.