SARAH D CULBERTSON MEMORIAL HOSPITAL (Rushville, IL) prices

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
636	RABIES IMMUNE GOBULIN VIAL 10 ML	$4,769	—	$2,113	$4,769	13
740	POLYSOMNOGRAM W/4 OR MORE ADDL SLP PAR	$4,107	—	$262	$4,107	12
352	CT ANGIOGRAPHY HEAD	$3,925	—	$247	$3,925	12
616	MRA LOW EXT BILATERAL W/CONTRAST	$3,441	—	$297	$3,441	12
612	MRI CERV SP W/O CONTRAST	$3,414	—	$297	$3,414	12
615	MRA HEAD W/O CONTRAST	$2,871	—	$297	$2,871	12
483	ECHO 2D SPEC DISP COLOR FLOW VELOCITY	$2,639	—	$91	$2,639	12
350	CT MASTOIDS W/O CONTRAST	$2,299	—	$62.7	$2,299	12
618	MRA CHEST W/O CONTRAST	$2,297	—	$448	$2,297	12
610	MRI CHEST W/O CONTRAST	$2,276	—	$297	$2,276	12
611	MRI TEMPOROMANDIBULAR JT	$2,196	—	$297	$2,196	12
351	CT HEAD W/O CONTRAST	$2,182	—	$247	$2,182	12
359	..CT LTD W & W/O CONTRAST	$2,066	—	$59.55	$2,066	12
343	.NM CARDIOLITE/SESTAMIBI	$1,551	—	$687	$1,551	12
TB ISOLATION BED	TB ISOLATION BED	$1,530	—	$850	$1,530	12
722	DELIVERY-LEV II COMP	$1,514	—	$670	$1,514	12
110	ROOM/CARE-PRIVATE	$1,362	—	$850	$1,362	12
271	WOUND CARE SET	$1,345	—	$596	$1,345	12
120	ROOM/CARE-2 BED	$1,299	—	$850	$1,299	12
724	BIRTHING RM-LEV I N/DEL	$1,271	—	$563	$1,271	12
250	.RABIES VAC 2.5 U/1 ML VIAL	$1,258	—	$557	$1,258	12
920	US ARTERIAL UNILAT LEFT LOWER EXT	$1,235	—	$52.7	$1,235	12
276	TORIC LENS SPECIAL IOL	$1,184	—	$525	$1,184	13
731	HOLTER MONITOR 24-48 HOURS	$1,137	—	$136	$1,137	12
482	CARDIAC STRESS TEST TRAC	$1,135	—	$27.9	$1,135	12
319	..IGVH (BCELL) MUTATION ANALYSIS	$1,030	—	$456	$1,030	12
391	BLOOD TRANSFUSION	$958	—	$424	$958	12
982	OCCIPITAL NERVE BLOCK-PF	$928	—	$80.18	$928	11
312	.CLINICAL PATH CONSULT W/O REV HX OR REC	$883	—	$391	$883	12
490	US GUIDED FNA 1ST LESION	$820	—	$363	$820	12
SWING BED PRIVATE	SWING BED PRIVATE	$765	—	$627	$765	14
450	I&D SIMPLE-LEVEL I	$706	—	$36	$706	12
310	.BONE MARROW MICRO INTERP	$698	—	$309	$698	12
335	CHEMOTHERAPY IV INITL HR	$649	—	$25.4	$649	12
341	NM THYROID SCAN SNGL OR MULTI	$643	—	$45.8	$643	12
390	.BB RBC LR UNIT	$639	—	$283	$639	12
SKILLED NON COV MED	SKILLED NON COV MED	$636	—	$522	$636	11
HOSPICE IP	HOSPICE IP	$554	—	$454	$554	11
929	US TBI LOWER EXTREMITY LIMITED	$531	—	$50.05	$531	12
311	.FLT3 GENE ANALYSIS ITD VARIANT	$525	—	$233	$525	12
402	US GUIDED CYST ASPIRATION BREAST	$502	—	$222	$502	12
444	ST SPEECH COMMUNICATION EVAL	$500	—	$37.4	$500	12
320	T TUBE CHOLANGIO	$495	—	$219	$495	12
940	INJECTION KNEE JOINT OR BURSA	$485	—	$31.8	$485	12
480	CPR ADMIN IP	$434	—	$113	$434	12
401	.DIG BIL DIAG MAMMOGRAM W/CAD	$414	—	$97.87	$414	12
761	MAINTENANCE AND/OR REFILL PORT PUMP	$374	—	$32.9	$374	12
623	TCC-EZ CASTING TOTAL-WC	$365	—	$91.65	$365	12
370	.INTRATHECAL ANEST/OBSTETRIC	$364	—	$161	$364	12
700	CASTING RM ADLT SHRT ARM	$361	—	$160	$361	12

Showing top 50 of 108 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.