MERCYONE NEWTON MEDICAL CENTER

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-137245	NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION	$455,356	$455,356	—	—	112
RX-203302	VUTRISIRAN 25 MG/0.5 ML SUBCUTANEOUS SYRINGE	$272,037	$272,037	—	—	112
RX-211159	OCRELIZUMAB 920 MG-HYALURONIDASE-OCSQ 23,000 UNIT/23 ML SUBCUT SOLN	$130,286	$130,286	—	—	109
RX-204671	TREMELIMUMAB-ACTL 20 MG/ML INTRAVENOUS SOLUTION	$127,265	$127,265	—	—	224
RX-500112	IPILIMUMAB 5 MG/ML INTRAVENOUS SOLUTION (WRAPPER)	$110,830	$110,830	—	—	224
RX-202017	TEBENTAFUSP-TEBN 100 MCG/0.5 ML INTRAVENOUS SOLUTION	$107,550	$107,550	—	—	112
RX-107664	PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION	$95,365	$95,365	—	—	112
RX-202466	NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION	$94,383	$94,383	—	—	112
RX-127653	ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION	$89,233	$89,233	—	—	112
RX-131323	TALIMOGENE LAHERPAREPVEC 10EXP8 (100 MILLION)PFU/ML SUSP FOR INJECTION	$88,021	$88,021	—	—	112
RX-199684	LONCASTUXIMAB TESIRINE-LPYL 10 MG INTRAVENOUS SOLUTION	$87,089	$87,089	—	—	112
RX-192695	CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION	$77,352	$77,352	—	—	29
RX-146166	INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN	$73,183	$73,183	—	—	112
PX-36163685001	HC Insertion/Replacement Spine Neurostim Pulse Generator or Receiver Require Pocket Creation & Cnct	$66,147	$42,996	—	—	29
RX-137896	OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION	$65,143	$65,143	—	—	32
RX-190594	POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLUTION	$59,184	$59,184	—	—	112
RX-207058	ROZANOLIXIZUMAB-NOLI 140 MG/ML SUBCUTANEOUS SOLUTION	$56,797	$56,797	—	—	112
RX-187815	TILDRAKIZUMAB-ASMN 100 MG/ML SUBCUTANEOUS SYRINGE	$53,884	$53,884	—	—	32
RX-206664	EPCORITAMAB-BYSP 48 MG/0.8 ML SUBCUTANEOUS SOLUTION	$50,430	$50,430	—	—	112
RX-207040	EFGARTIGIMOD ALFA 1008 MG-HYALURON-QVFC 11,200 UNIT/5.6 ML SUBCUT SOLN	$49,231	$49,231	—	—	112
RX-208617	TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION	$48,786	$48,786	—	—	96
RX-210073	TARLATAMAB-DLLE 10 MG INTRAVENOUS SOLUTION	$46,350	$46,350	—	—	109
RX-206087	RETIFANLIMAB-DLWR 500 MG/20 ML INTRAVENOUS SOLUTION	$45,114	$45,114	—	—	112
RX-105644	CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION	$44,160	$44,160	—	—	5
RX-196883	PERTUZUMAB 1,200 MG-TRASTUZUMAB 600 MG-HYALURON-ZZXF/15 ML SUBCUT SOLN	$43,628	$43,628	—	—	112
RX-201759	SIROLIMUS-PROTEIN BOUND 100 MG INTRAVENOUS SUSPENSION	$42,939	$42,939	—	—	96
RX-207693	ELRANATAMAB-BCMM 40 MG/ML SUBCUTANEOUS SOLUTION	$42,858	$42,858	—	—	218
RX-111348	BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION	$39,511	$39,511	—	—	112
RX-193445	LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLUTION	$37,759	$37,759	—	—	112
RX-110751	LEUPROLIDE ACETATE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT	$37,312	$37,312	—	—	112
RX-199692	DOSTARLIMAB-GXLY 50 MG/ML INTRAVENOUS SOLUTION	$36,813	$36,813	—	—	112
RX-207664	TALQUETAMAB-TGVS 40 MG/ML SUBCUTANEOUS SOLUTION	$35,942	$35,942	—	—	109
PX-36162362001	HC Implantation/Replacement Intrathecal or Epidural Drug Infusion Device/Pump W/ or W/O Programming	$35,807	$23,275	—	—	29
RX-205403	UBLITUXIMAB-XIIY 25 MG/ML INTRAVENOUS SOLUTION	$35,496	$35,496	—	—	112
RX-146072	DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION	$34,410	$34,410	—	—	112
RX-139620	HEMIN 350 MG INTRAVENOUS POWDER FOR SOLUTION	$34,282	$34,282	—	—	109
RX-188251	CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION	$34,004	$34,004	—	—	112
RX-196290	DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN	$33,714	$33,714	—	—	32
RX-210391	IMETELSTAT 188 MG INTRAVENOUS SOLUTION	$31,931	$31,931	—	—	109
RX-146231	GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONCENTRATION) IV SOLN	$31,505	$31,505	—	—	96
RX-126219	VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION	$30,326	$30,326	—	—	112
RX-203310	RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION	$30,072	$30,072	—	—	112
RX-196884	PERTUZUMAB 600 MG-TRASTUZUMAB 600 MG-HYALURONID-ZZXF/10 ML SUBCUT SOLN	$29,084	$29,084	—	—	112
RX-124767	OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION	$28,351	$28,351	—	—	112
RX-205074	FECAL MICROBIOTA, LIVE-JSLM 150 ML RECTAL SUSPENSION ENEMA	$28,233	$28,233	—	—	112
RX-205988	ANTIHEMOPHIL RFVIII FC-VWF-XTEN,BDD-EHTL 1,000 (+/-) UNIT IV SOLUTION	$28,109	$28,109	—	—	112
RX-199898	ORITAVANCIN 1,200 MG INTRAVENOUS SOLUTION	$28,019	$28,019	—	—	112
RX-196642	LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION	$25,230	$25,230	—	—	112
RX-21108	LEUPROLIDE 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT	$24,875	$24,875	—	—	112
RX-500129	NIVOLUMAB 10 MG/ML INTRAVENOUS SOLUTION (WRAPPER)	$24,306	$24,306	—	—	336

Showing top 50 of 3,040 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.