Hospital 143030 prices — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
L5701	REPLACE SOCKET ABOVE KNEE	$7,445	$5,584	—	—	5
81408	MOPATH PROCEDURE LEVEL 9	$7,365	$5,524	—	—	5
L5649	ISCH CONTAINMT/NARROW M-I SO	$6,317	$4,738	—	—	5
49440	G TUBE INSERTION W/GUIDANCE	$6,185	$4,639	—	—	5
750	PEG TUBE PLACEMENT	$6,185	$4,639	—	—	5
L2036	KAFO PLAS DOUB FREE KNEE MOL	$5,885	$4,414	—	—	5
L0486	TLSO RIGID LINED CUST FAB TWO	$5,846	$4,385	—	—	5
L0484	TLSO RIGID PLASTIC CUST FAB	$5,495	$4,121	—	—	5
77301	RADIATION IMR PLAN	$5,009	$3,757	—	—	5
L4631	AFO, WALKING BOOT, CUSTOM	$4,669	$3,502	—	—	5
L0464	TLSO 4MOD SACRO-SCAP PRE	$4,405	$3,304	—	—	5
L5651	AK FLEX INNER SICKET EXT FRA	$4,003	$3,002	—	—	5
L2020	KAFO DBL SOLID STIRRUP BAND/	$3,702	$2,777	—	—	5
99283	EMERGENCY ROOM-MODERATE	$3,653	$2,740	—	—	5
49083	US GUIDED PARACENTESIS	$3,533	$2,650	—	—	5
L0637	LSO SAG-CORONAL PANEL PREFAB	$3,521	$2,641	—	—	5
L0650	LSO SC R ANT/POS PNL PRE OTS	$3,521	$2,641	—	—	5
73222	MRI UPPER EXTREM W CONTRAST	$3,228	$2,421	—	—	5
73722	MRI LOWER EXTREM JNT W CONTRAS	$3,228	$2,421	—	—	5
81407	MOPATH PROCEDURE LEVEL 8	$3,117	$2,338	—	—	5
L0640	LSO S/C SHELL/PANEL CUSTOM	$3,101	$2,326	—	—	5
L0631	LSO SAG-CORO RIGID FRAME PREFB	$3,043	$2,282	—	—	5
L0648	LSO SAG R AN/POS PNL PRE OTS	$3,043	$2,282	—	—	5
L0460	TLSO 2MOD SYMPHSIS-STERN PRE	$2,975	$2,231	—	—	5
L1945	AFO MOLDED PLAS RIG ANT TIB	$2,972	$2,229	—	—	5
L0456	TLSO FLEX PREFAB	$2,947	$2,210	—	—	5
L0457	TLSO FLEX TRNK SJ-SS PRE OTS	$2,947	$2,210	—	—	5
610	MRI CHEST W/ CONTRAST	$2,943	$2,207	—	—	5
L1686	HO POST-OP HIP ABDUCTION PREFB	$2,921	$2,191	—	—	5
51710	BLADDER TUBE CHANGE	$2,772	$2,079	—	—	5
L3905	WHO W/NONTORSION JNT(S) CF	$2,674	$2,006	—	—	5
77385	RADIATION IMRT SIMPLE	$2,666	$2,000	—	—	5
77386	RADIATION IMRT COMPLEX	$2,666	$2,000	—	—	5
77470	RADIATION SPECIAL TREATMENT	$2,666	$2,000	—	—	5
32555	US THORACENTESIS	$2,659	$1,994	—	—	5
L1843	KO SINGLE UPRIGHT CUSTOM FIT	$2,659	$1,994	—	—	5
L1932	AFO RIG ANT TIB PREFAB TCF/=	$2,644	$1,983	—	—	5
L0458	TLSO 2MOD SYMPHIS-XIPHO PRE	$2,643	$1,982	—	—	5
L5950	ENDO AK ULTRA-LIGHT MATERIAL	$2,549	$1,912	—	—	5
L1845	KO W/ADJ FLEX/EXT ROTAT CUS	$2,536	$1,902	—	—	5
78582	NM PULM PERFUSION W/ VENTILATI	$2,493	$1,870	—	—	5
L1951	AFO SPIRAL PREFABRICATED	$2,489	$1,867	—	—	5
93306	ECHO 2D M-MODE W/ DOPPLER	$2,473	$1,855	—	—	5
36556	CENTRAL INSERT VENOUS CATHETER	$2,400	$1,800	—	—	5
L2510	TH/WGHT BEAR QUAD-LAT BRIM M	$2,314	$1,736	—	—	5
L3764	EWHO W/JOINT(S) CF	$2,256	$1,692	—	—	5
L1970	AFO PLASTIC MOLDED W/ANKLE J	$2,230	$1,673	—	—	5
L5673	SOCKET INSERT W LOCK MECH	$2,212	$1,659	—	—	5
78306	NM BONE JOINT IMAGE WHOLE BODY	$2,127	$1,595	—	—	5
78580	NM PULMONARY PERFUSION	$2,127	$1,595	—	—	5

Showing top 50 of 1,492 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.