45 CFR § 180 compliance
B · 85
This hospital published most of what § 180 requires.
●Machine-readable file published: assessment threshold met
●Gross / standard charges: assessment threshold met
●Discounted cash price: assessment threshold met
●Payer-specific negotiated rates: assessment threshold met
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
104
Insurances with rates
18
CPT / HCPCS codes
101
Most expensive procedures (gross)
124
$1,200
Inpatient Room and Board
Gross
$1,200
J3490
$900
Spravato 56 MG
Gross
$900
S9485
$366
Mobile Crisis, 3 hours or more with transportation
Gross
$366
99387
$289
Preventative Medicine - New Patient Ages 65 and Up
Gross
$289
99220
$288
Inpatient Observation - level 3
Gross
$288
99236
$288
Inpatient Same day admit/discharge - level 3
Gross
$288
90838
$280
Psychiatrist Psychotherapy, 53 min or more
Gross
$280
99205
$272
Psychiatrist or Nurse Practioner New Patient - level 5
Gross
$272
99386
$257
Preventative Medicine - New Patient Ages 40-64
Gross
$257
99204
$252
Psychiatrist or Nurse Practioner New Patient - level 4
Gross
$252
99397
$242
Preventative Medicine - Established Patient Ages 65 and up
Gross
$242
G2067
$236
Methadone Bundle (Weekly)
Gross
$236
99385
$235
Preventative Medicine - New Patient Ages 18-39
Gross
$235
90792
$232
Psychiatrist Evaluation
Gross
$232
99203
$232
Psychiatrist or Nurse Practioner New Patient - level 3
Gross
$232
99217
$232
Inpatient Observation discharge
Gross
$232
99219
$232
Inpatient Observation - level 2
Gross
$232
99223
$232
Inpatient Admission - level 3
Gross
$232
99235
$232
Inpatient Same day admit/discharge - level 2
Gross
$232
99254
$232
Inpatient Consults - level 4
Gross
$232
99255
$232
Inpatient Consults - level 5
Gross
$232
90791
$230
Therapy Initial Evaluation-Psychologist
Gross
$230
99202
$216
Psychiatrist or Nurse Practioner New Patient - level 2
Gross
$216
99396
$213
Preventative Medicine - Established Patient Ages 40-64
Gross
$213
99215
$211
Psychiatrist or Nurse Practioner Office visit - level 5
Gross
$211
96130
$208
Psych testing First Hour
Gross
$208
96131
$208
Psych Testing Additional Hours
Gross
$208
96132
$208
Neuropsych testing First Hour
Gross
$208
96133
$208
Neuropsych Testing Additional Hours
Gross
$208
S9484
$205
Mobile Crisis, less than 3 hours with transportation
Gross
$205
90836
$200
Psychiatrist Psychotherapy, 38 to 52 min
Gross
$200
90839
$200
Psychotherapy for Crisis, 30 to 74 min
Gross
$200
99234
$200
Inpatient Same day admit/discharge - level 1
Gross
$200
99285
$200
Inpatient Psychiatrist or Nurse Practioner ER Consult - Level 5
Gross
$200
99395
$195
Preventative Medicine - Established Patient Ages 18-39
Gross
$195
99222
$190
Inpatient Admission - Level 2
Gross
$190
H0015
$176
Intensive Outpatient Program (IOP) Per session
Gross
$176
99284
$175
Inpatient Psychiatrist or Nurse Practioner ER Consult - Level 4
Gross
$175
90887
$172
Psychiatrist or Nurse Practioner Consultation with Family
Gross
$172
99218
$172
Inpatient Observation - level 1
Gross
$172
99239
$172
Inpatient Discharge - level 2
Gross
$172
99253
$172
Inpatient Consults - level 3
Gross
$172
90837
$168
Therapy Individual, 53 min or more - Therapists
Gross
$168
90840
$167
Additional 30 min Crisis
Gross
$167
99214
$163
Psychiatrist or Nurse Practioner Office visit - level 4
Gross
$163
99232
$160
Inpatient Round - Level 2
Gross
$160
99238
$152
Inpatient Discharge - level 1
Gross
$152
99221
$150
Inpatient Admission - Level 1
Gross
$150
99283
$150
Inpatient Psychiatrist or Nurse Practioner ER Consult - Level 3
Gross
$150
99233
$144
Inpatient Round - Level 3
Gross
$144
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 124 | Inpatient Room and Board | $1,200 | $1,200 | — | — | 15 |
| J3490 | Spravato 56 MG | $900 | $900 | — | — | 0 |
| S9485 | Mobile Crisis, 3 hours or more with transportation | $366 | $366 | — | — | 0 |
| 99387 | Preventative Medicine - New Patient Ages 65 and Up | $289 | $289 | — | — | 10 |
| 99220 | Inpatient Observation - level 3 | $288 | $288 | — | — | 10 |
| 99236 | Inpatient Same day admit/discharge - level 3 | $288 | $288 | — | — | 12 |
| 90838 | Psychiatrist Psychotherapy, 53 min or more | $280 | $280 | — | — | 10 |
| 99205 | Psychiatrist or Nurse Practioner New Patient - level 5 | $272 | $272 | — | — | 11 |
| 99386 | Preventative Medicine - New Patient Ages 40-64 | $257 | $257 | — | — | 13 |
| 99204 | Psychiatrist or Nurse Practioner New Patient - level 4 | $252 | $252 | — | — | 16 |
| 99397 | Preventative Medicine - Established Patient Ages 65 and up | $242 | $242 | — | — | 12 |
| G2067 | Methadone Bundle (Weekly) | $236 | $236 | — | — | 5 |
| 99385 | Preventative Medicine - New Patient Ages 18-39 | $235 | $235 | — | — | 10 |
| 90792 | Psychiatrist Evaluation | $232 | $232 | — | — | 19 |
| 99203 | Psychiatrist or Nurse Practioner New Patient - level 3 | $232 | $232 | — | — | 15 |
| 99217 | Inpatient Observation discharge | $232 | $232 | — | — | 10 |
| 99219 | Inpatient Observation - level 2 | $232 | $232 | — | — | 10 |
| 99223 | Inpatient Admission - level 3 | $232 | $232 | — | — | 15 |
| 99235 | Inpatient Same day admit/discharge - level 2 | $232 | $232 | — | — | 14 |
| 99254 | Inpatient Consults - level 4 | $232 | $232 | — | — | 6 |
| 99255 | Inpatient Consults - level 5 | $232 | $232 | — | — | 4 |
| 90791 | Therapy Initial Evaluation-Psychologist | $230 | $230 | — | — | 19 |
| 99202 | Psychiatrist or Nurse Practioner New Patient - level 2 | $216 | $216 | — | — | 17 |
| 99396 | Preventative Medicine - Established Patient Ages 40-64 | $213 | $213 | — | — | 13 |
| 99215 | Psychiatrist or Nurse Practioner Office visit - level 5 | $211 | $211 | — | — | 15 |
| 96130 | Psych testing First Hour | $208 | $208 | — | — | 17 |
| 96131 | Psych Testing Additional Hours | $208 | $208 | — | — | 17 |
| 96132 | Neuropsych testing First Hour | $208 | $208 | — | — | 15 |
| 96133 | Neuropsych Testing Additional Hours | $208 | $208 | — | — | 14 |
| S9484 | Mobile Crisis, less than 3 hours with transportation | $205 | $205 | — | — | 0 |
| 90836 | Psychiatrist Psychotherapy, 38 to 52 min | $200 | $200 | — | — | 13 |
| 90839 | Psychotherapy for Crisis, 30 to 74 min | $200 | $200 | — | — | 10 |
| 99234 | Inpatient Same day admit/discharge - level 1 | $200 | $200 | — | — | 14 |
| 99285 | Inpatient Psychiatrist or Nurse Practioner ER Consult - Level 5 | $200 | $200 | — | — | 12 |
| 99395 | Preventative Medicine - Established Patient Ages 18-39 | $195 | $195 | — | — | 15 |
| 99222 | Inpatient Admission - Level 2 | $190 | $190 | — | — | 16 |
| H0015 | Intensive Outpatient Program (IOP) Per session | $176 | $176 | — | — | 16 |
| 99284 | Inpatient Psychiatrist or Nurse Practioner ER Consult - Level 4 | $175 | $175 | — | — | 10 |
| 90887 | Psychiatrist or Nurse Practioner Consultation with Family | $172 | $172 | — | — | 4 |
| 99218 | Inpatient Observation - level 1 | $172 | $172 | — | — | 10 |
| 99239 | Inpatient Discharge - level 2 | $172 | $172 | — | — | 16 |
| 99253 | Inpatient Consults - level 3 | $172 | $172 | — | — | 9 |
| 90837 | Therapy Individual, 53 min or more - Therapists | $168 | $168 | — | — | 17 |
| 90840 | Additional 30 min Crisis | $167 | $167 | — | — | 10 |
| 99214 | Psychiatrist or Nurse Practioner Office visit - level 4 | $163 | $163 | — | — | 17 |
| 99232 | Inpatient Round - Level 2 | $160 | $160 | — | — | 16 |
| 99238 | Inpatient Discharge - level 1 | $152 | $152 | — | — | 16 |
| 99221 | Inpatient Admission - Level 1 | $150 | $150 | — | — | 16 |
| 99283 | Inpatient Psychiatrist or Nurse Practioner ER Consult - Level 3 | $150 | $150 | — | — | 10 |
| 99233 | Inpatient Round - Level 3 | $144 | $144 | — | — | 16 |
Showing top 50 of 104 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.