FRANCISCAN HEALTH RENSSELAER, INC

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-209301	OCRELIZUMAB 920 MG-HYALURONIDASE-OCSQ 23,000 UNIT/23 ML SUBCUT SOLN\|JW DISCARDED DRUG NOT ADMINISTER	$456,434	$163,404	—	—	22
RX-163245	GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION	$451,549	$161,654	—	—	16
RX-213646	PEMBROLIZUMAB 790 MG-BERAHYALURONID-PMPH 9,600 UNIT/4.8 ML SUBCUT SOLN\|JW DISCARDED DRUG NOT ADMINIS	$251,255	$89,949	—	—	16
SUP-249.683	PLATE BONE LC SS 2.7MM 7 HOLE 67MM	$235,370	$84,262	—	—	19
RX-185417	OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$228,217	$81,702	—	—	30
RX-192573	POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$207,342	$74,229	—	—	33
RX-203575	MOSUNETUZUMAB-AXGB 1 MG/ML INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$203,520	$72,860	—	—	30
RX-194405	TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$195,486	$69,984	—	—	22
SUP-222ETCTRSY33	KIT SPIN CORD STIM ETERNA IPG CONTRL CHRGR	$169,232	$60,585	—	—	12
RX-201068	NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$164,252	$58,802	—	—	30
SUP-32400	GENERATOR PULSE ETERNA IMPLANTABLE 16CH IPG	$153,843	$55,076	—	—	16
RX-141641	COAGULATION FACTOR VIIA RECOMB 5 MG (5,000 MCG) INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTE	$151,147	$54,111	—	—	16
SUP-3660 CTRLSYS XX	STIMULATOR SPINAL CORD PROCLAIM ELITE 5 IPG PAT CONTROLLER	$140,732	$50,382	—	—	18
RX-154653	BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$137,519	$49,232	—	—	33
548	SEPTIC ARTHRITIS WITH MCC	$134,932	$48,306	—	—	14
CASE-23472	Arthroplasty Glenohumeral Joint Total Shoulder	$134,272	$48,069	—	—	16
SUP-3150	GENERATOR V PULSE INSPIRE IMPLANTABLE RESP SENSING	$131,594	$47,111	—	—	19
RX-193905	LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$131,421	$47,049	—	—	30
SUP-3664	GENERATOR PULSE PROCLAIM DRG	$130,680	$46,783	—	—	19
SUP-3662	GENERATOR PULSE PROCLAIM 7 ELITE	$126,111	$45,148	—	—	19
RX-213645	PEMBROLIZUMAB 395 MG-BERAHYALURONID-PMPH 4,800 UNIT/2.4 ML SUBCUT SOLN\|JW DISCARDED DRUG NOT ADMINIS	$125,628	$44,975	—	—	16
RX-182788	ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$125,458	$44,914	—	—	33
RX-203761	UBLITUXIMAB-XIIY 25 MG/ML INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$123,548	$44,230	—	—	30
SUP-3772	GENERATOR PRODIGY MRI IPG	$121,237	$43,403	—	—	19
CASE-23430	Tenodesis Long Tendon Biceps	$118,939	$42,580	—	—	16
SUP-3660	GENERATOR PULSE PROCLAIM XR 5	$112,555	$40,295	—	—	19
SUP-3028	GENERATOR PULSE INSPIRE IMPLABLE	$111,032	$39,750	—	—	19
RX-201832	RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$110,527	$39,569	—	—	30
CASE-27447	Arthrp Kne Condyle&Platu Medial&Lat Compartments	$105,899	$37,912	—	—	16
RX-174175	VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$105,552	$37,788	—	—	30
CASE-27130	Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$102,341	$36,638	—	—	16
RX-172383	OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$99,323	$35,558	—	—	30
SUP-11060A23	CONDUIT AORTIC VALVED KONECT RESILIA 23MM	$97,477	$34,897	—	—	12
SUP-11060A25	CONDUIT AORTIC VALVED KONECT RESILIA 25MM	$97,477	$34,897	—	—	12
RX-152479	IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$96,438	$34,525	—	—	33
RX-9002	ALTEPLASE 100 MG INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$89,255	$31,953	—	—	33
RX-195607	LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$87,815	$31,438	—	—	33
SUP-15-8020/12	PROSTHESIS KNEE ROT ENDOMODEL ANTILUX DEV LFT XS 17MM	$87,166	$31,206	—	—	19
RX-188486	NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$84,598	$30,286	—	—	33
RX-601800	TENECTEPLASE 50 MG INTRAVENOUS SOLN FOR MI OR PE\|JW DISCARDED DRUG NOT ADMINISTERED	$82,844	$29,658	—	—	22
RX-191920	ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION\|JW DISCARDED DRUG NOT ADMINISTERED	$81,966	$29,344	—	—	33
RX-601799	TENECTEPLASE 25 MG INTRAVENOUS SOLUTION FOR ACUTE ISCHEMIC STROKE (AI)\|JW DISCARDED DRUG NOT ADMINIS	$81,835	$29,297	—	—	22
SUP-33680031	DOME ANKLE FLATCUT TALAR INFINITY ADAPTIS SZ 1	$79,407	$28,428	—	—	19
RX-186573	RITUXIMAB 1,600 MG/13.4 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN\|JW DISCARDED DRUG NOT ADMINIS	$78,994	$28,280	—	—	30
SUP-1212.0111S	SPACER SPINAL HEDRON IA 8DEG 24 X 30 X 11MM	$76,763	$27,481	—	—	16
SUP-1212.0213S	SPACER SPINAL HEDRON IA 15DEG 24 X 30 X 13MM	$76,763	$27,481	—	—	16
SUP-33680001	TRAY TIBIAL INFINITY ADAPTIS STD SZ 1	$74,844	$26,794	—	—	19
SUP-33680004	TIBIAL INFINITY ADAPTIS SZ 4	$74,844	$26,794	—	—	19
SUP-4101	NEUROSTIMULATOR SACRAL NEUROMOD RECHARGEABLE F15	$74,021	$26,500	—	—	16
RX-186494	RITUXIMAB 1,400 MG/11.7 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN\|JW DISCARDED DRUG NOT ADMINIS	$69,120	$24,745	—	—	30

Showing top 50 of 9,758 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.