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
65,635
Insurances with rates
44
CPT / HCPCS codes
0
Source MRF
Most expensive procedures (gross)
51905029-2255250
$392,179
30237-8900-06 - sipuleucel-T - Susp
Gross
$1,005,587
51905029-2255250
$211,173
30237-8900-06 - sipuleucel-T - Susp
Gross
$1,005,587
108087544-2255248
$219,027
67979-0002-01 - histrelin 50 mg Implan
Gross
$561,607
108087544-2255248
$117,937
67979-0002-01 - histrelin 50 mg Implan
Gross
$561,607
109228707-2255250
$215,680
00310-4535-30 - tremelimumab actl 20 mg/mL Soln
Gross
$553,025
109228707-2255250
$116,135
00310-4535-30 - tremelimumab actl 20 mg/mL Soln
Gross
$553,025
108963946-2255248
$211,184
69866-1025-01 - autologous cultured chondrocytes 0
Gross
$541,498
108963946-2255248
$113,715
69866-1025-01 - autologous cultured chondrocytes 0
Gross
$541,498
108963947-2255248
$211,184
69866-1030-05 - autologous cultured chondrocytes i
Gross
$541,498
108963947-2255248
$113,715
69866-1030-05 - autologous cultured chondrocytes i
Gross
$541,498
108978003-2255248
$211,184
69866-1030-08 - autologous cultured chondrocytes 1
Gross
$541,498
108978003-2255248
$113,715
69866-1030-08 - autologous cultured chondrocytes 1
Gross
$541,498
108329173-2255253
$185,562
71336-1001-01 - givosiran 189 mg/mL Soln
Gross
$475,800
108329173-2255253
$99,918
71336-1001-01 - givosiran 189 mg/mL Soln
Gross
$475,800
108290516-2255250
$171,194
72187-0401-01 - tagraxofusp 1000 mcg/mL Soln
Gross
$438,960
108290516-2255250
$92,182
72187-0401-01 - tagraxofusp 1000 mcg/mL Soln
Gross
$438,960
1279402-2255253
$162,163
00003-2328-22 - ipilimumab Soln
Gross
$415,802
1279402-2255253
$87,318
00003-2328-22 - ipilimumab Soln
Gross
$415,802
108290269-2255250
$145,649
79952-0110-01 - loncastuximab tesirine 10 mg Injec
Gross
$373,460
108290269-2255250
$78,427
79952-0110-01 - loncastuximab tesirine 10 mg Injec
Gross
$373,460
1279159-2255237
$136,449
63004-7731-01 - corticotropin 400. Soln
Gross
$349,870
1279159-2255237
$73,473
63004-7731-01 - corticotropin 400. Soln
Gross
$349,870
1287035-2255250
$135,750
76128-0155-75 - porfimer 75. mg REC Injection
Gross
$348,076
1287035-2255250
$73,096
76128-0155-75 - porfimer 75. mg REC Injection
Gross
$348,076
104437516-2255253
$132,850
75987-0080-10 - pegloticase 8 mg/mL Soln
Gross
$340,641
104437516-2255253
$71,535
75987-0080-10 - pegloticase 8 mg/mL Soln
Gross
$340,641
1286149-2255253
$132,850
54396-0801-01 - pegloticase Soln
Gross
$340,641
1286149-2255253
$71,535
54396-0801-01 - pegloticase Soln
Gross
$340,641
95367892-2255253
$132,850
60809-0801-01 - pegloticase 8 mg/mL Soln
Gross
$340,641
95367892-2255253
$71,535
60809-0801-01 - pegloticase 8 mg/mL Soln
Gross
$340,641
108503656-2255250
$131,084
72493-0103-03 - mitoMYcin 40 mg Kit
Gross
$336,114
108503656-2255250
$70,584
72493-0103-03 - mitoMYcin 40 mg Kit
Gross
$336,114
108819334-2255250
$122,968
00008-0100-01 - inotuzumab ozogamicin 0.9 mg Powde
Gross
$315,302
108819334-2255250
$66,213
00008-0100-01 - inotuzumab ozogamicin 0.9 mg Powde
Gross
$315,302
108107889-2255253
$121,511
72694-0954-01 - pegaspargase 3,750 IntlUnit(s) / 5
Gross
$311,567
108107889-2255253
$65,429
72694-0954-01 - pegaspargase 3,750 IntlUnit(s) / 5
Gross
$311,567
1282361-2255253
$121,511
57665-0002-02 - pegaspargase 3750. Soln
Gross
$311,567
1282361-2255253
$65,429
57665-0002-02 - pegaspargase 3750. Soln
Gross
$311,567
1282362-2255253
$121,511
54482-0301-01 - pegaspargase 3750. Soln
Gross
$311,567
1282362-2255253
$65,429
54482-0301-01 - pegaspargase 3750. Soln
Gross
$311,567
94990000-2255253
$117,525
57894-0061-03 - ustekinumab 90 mg/mL Soln
Gross
$301,347
94990000-2255253
$63,283
57894-0061-03 - ustekinumab 90 mg/mL Soln
Gross
$301,347
108326359-2255253
$111,724
25682-0028-01 - ravulizumab 100 mg/mL Soln
Gross
$286,472
108326359-2255253
$60,159
25682-0028-01 - ravulizumab 100 mg/mL Soln
Gross
$286,472
100133675-2120377
$104,983
4060018 OTH STER SUPP LVL 18[Omnicell Cath Lab]
Gross
$269,188
100133675-2120377
$56,529
4060018 OTH STER SUPP LVL 18[Omnicell Cath Lab]
Gross
$269,188
108031526-2255250
$97,017
50242-0105-01 - polatuzumab vedotin 140 mg Powder
Gross
$248,762
108031526-2255250
$52,240
50242-0105-01 - polatuzumab vedotin 140 mg Powder
Gross
$248,762
96694815-2255253
$93,670
50242-0150-01 - ocrelizumab 300 mg/10 mL Soln
Gross
$240,179
96694815-2255253
$50,438
50242-0150-01 - ocrelizumab 300 mg/10 mL Soln
Gross
$240,179
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 51905029-2255250 | 30237-8900-06 - sipuleucel-T - Susp | $1,005,587 | $392,179 | — | — | 11 |
| 51905029-2255250 | 30237-8900-06 - sipuleucel-T - Susp | $1,005,587 | $211,173 | — | — | 12 |
| 108087544-2255248 | 67979-0002-01 - histrelin 50 mg Implan | $561,607 | $219,027 | — | — | 11 |
| 108087544-2255248 | 67979-0002-01 - histrelin 50 mg Implan | $561,607 | $117,937 | — | — | 12 |
| 109228707-2255250 | 00310-4535-30 - tremelimumab actl 20 mg/mL Soln | $553,025 | $215,680 | — | — | 11 |
| 109228707-2255250 | 00310-4535-30 - tremelimumab actl 20 mg/mL Soln | $553,025 | $116,135 | — | — | 12 |
| 108963946-2255248 | 69866-1025-01 - autologous cultured chondrocytes 0 | $541,498 | $211,184 | — | — | 11 |
| 108963946-2255248 | 69866-1025-01 - autologous cultured chondrocytes 0 | $541,498 | $113,715 | — | — | 12 |
| 108963947-2255248 | 69866-1030-05 - autologous cultured chondrocytes i | $541,498 | $211,184 | — | — | 11 |
| 108963947-2255248 | 69866-1030-05 - autologous cultured chondrocytes i | $541,498 | $113,715 | — | — | 12 |
| 108978003-2255248 | 69866-1030-08 - autologous cultured chondrocytes 1 | $541,498 | $211,184 | — | — | 11 |
| 108978003-2255248 | 69866-1030-08 - autologous cultured chondrocytes 1 | $541,498 | $113,715 | — | — | 12 |
| 108329173-2255253 | 71336-1001-01 - givosiran 189 mg/mL Soln | $475,800 | $185,562 | — | — | 11 |
| 108329173-2255253 | 71336-1001-01 - givosiran 189 mg/mL Soln | $475,800 | $99,918 | — | — | 12 |
| 108290516-2255250 | 72187-0401-01 - tagraxofusp 1000 mcg/mL Soln | $438,960 | $171,194 | — | — | 11 |
| 108290516-2255250 | 72187-0401-01 - tagraxofusp 1000 mcg/mL Soln | $438,960 | $92,182 | — | — | 12 |
| 1279402-2255253 | 00003-2328-22 - ipilimumab Soln | $415,802 | $162,163 | — | — | 11 |
| 1279402-2255253 | 00003-2328-22 - ipilimumab Soln | $415,802 | $87,318 | — | — | 12 |
| 108290269-2255250 | 79952-0110-01 - loncastuximab tesirine 10 mg Injec | $373,460 | $145,649 | — | — | 11 |
| 108290269-2255250 | 79952-0110-01 - loncastuximab tesirine 10 mg Injec | $373,460 | $78,427 | — | — | 12 |
| 1279159-2255237 | 63004-7731-01 - corticotropin 400. Soln | $349,870 | $136,449 | — | — | 11 |
| 1279159-2255237 | 63004-7731-01 - corticotropin 400. Soln | $349,870 | $73,473 | — | — | 12 |
| 1287035-2255250 | 76128-0155-75 - porfimer 75. mg REC Injection | $348,076 | $135,750 | — | — | 11 |
| 1287035-2255250 | 76128-0155-75 - porfimer 75. mg REC Injection | $348,076 | $73,096 | — | — | 12 |
| 104437516-2255253 | 75987-0080-10 - pegloticase 8 mg/mL Soln | $340,641 | $132,850 | — | — | 11 |
| 104437516-2255253 | 75987-0080-10 - pegloticase 8 mg/mL Soln | $340,641 | $71,535 | — | — | 12 |
| 1286149-2255253 | 54396-0801-01 - pegloticase Soln | $340,641 | $132,850 | — | — | 11 |
| 1286149-2255253 | 54396-0801-01 - pegloticase Soln | $340,641 | $71,535 | — | — | 12 |
| 95367892-2255253 | 60809-0801-01 - pegloticase 8 mg/mL Soln | $340,641 | $132,850 | — | — | 11 |
| 95367892-2255253 | 60809-0801-01 - pegloticase 8 mg/mL Soln | $340,641 | $71,535 | — | — | 12 |
| 108503656-2255250 | 72493-0103-03 - mitoMYcin 40 mg Kit | $336,114 | $131,084 | — | — | 11 |
| 108503656-2255250 | 72493-0103-03 - mitoMYcin 40 mg Kit | $336,114 | $70,584 | — | — | 12 |
| 108819334-2255250 | 00008-0100-01 - inotuzumab ozogamicin 0.9 mg Powde | $315,302 | $122,968 | — | — | 11 |
| 108819334-2255250 | 00008-0100-01 - inotuzumab ozogamicin 0.9 mg Powde | $315,302 | $66,213 | — | — | 14 |
| 108107889-2255253 | 72694-0954-01 - pegaspargase 3,750 IntlUnit(s) / 5 | $311,567 | $121,511 | — | — | 11 |
| 108107889-2255253 | 72694-0954-01 - pegaspargase 3,750 IntlUnit(s) / 5 | $311,567 | $65,429 | — | — | 12 |
| 1282361-2255253 | 57665-0002-02 - pegaspargase 3750. Soln | $311,567 | $121,511 | — | — | 11 |
| 1282361-2255253 | 57665-0002-02 - pegaspargase 3750. Soln | $311,567 | $65,429 | — | — | 12 |
| 1282362-2255253 | 54482-0301-01 - pegaspargase 3750. Soln | $311,567 | $121,511 | — | — | 11 |
| 1282362-2255253 | 54482-0301-01 - pegaspargase 3750. Soln | $311,567 | $65,429 | — | — | 12 |
| 94990000-2255253 | 57894-0061-03 - ustekinumab 90 mg/mL Soln | $301,347 | $117,525 | — | — | 11 |
| 94990000-2255253 | 57894-0061-03 - ustekinumab 90 mg/mL Soln | $301,347 | $63,283 | — | — | 12 |
| 108326359-2255253 | 25682-0028-01 - ravulizumab 100 mg/mL Soln | $286,472 | $111,724 | — | — | 11 |
| 108326359-2255253 | 25682-0028-01 - ravulizumab 100 mg/mL Soln | $286,472 | $60,159 | — | — | 12 |
| 100133675-2120377 | 4060018 OTH STER SUPP LVL 18[Omnicell Cath Lab] | $269,188 | $104,983 | — | — | 11 |
| 100133675-2120377 | 4060018 OTH STER SUPP LVL 18[Omnicell Cath Lab] | $269,188 | $56,529 | — | — | 12 |
| 108031526-2255250 | 50242-0105-01 - polatuzumab vedotin 140 mg Powder | $248,762 | $97,017 | — | — | 11 |
| 108031526-2255250 | 50242-0105-01 - polatuzumab vedotin 140 mg Powder | $248,762 | $52,240 | — | — | 12 |
| 96694815-2255253 | 50242-0150-01 - ocrelizumab 300 mg/10 mL Soln | $240,179 | $93,670 | — | — | 11 |
| 96694815-2255253 | 50242-0150-01 - ocrelizumab 300 mg/10 mL Soln | $240,179 | $50,438 | — | — | 22 |
Showing top 50 of 65,635 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.