MERCYONE CLINTON 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	—	—	120
RX-202017	TEBENTAFUSP-TEBN 100 MCG/0.5 ML INTRAVENOUS SOLUTION	$107,550	$107,550	—	—	120
RX-127653	ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION	$89,233	$89,233	—	—	120
RX-199684	LONCASTUXIMAB TESIRINE-LPYL 10 MG INTRAVENOUS SOLUTION	$87,089	$87,089	—	—	120
RX-137896	OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION	$65,143	$65,143	—	—	37
RX-190594	POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLUTION	$59,184	$59,184	—	—	120
RX-207058	ROZANOLIXIZUMAB-NOLI 140 MG/ML SUBCUTANEOUS SOLUTION	$56,797	$56,797	—	—	120
RX-208617	TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION	$48,786	$48,786	—	—	106
RX-210073	TARLATAMAB-DLLE 10 MG INTRAVENOUS SOLUTION	$46,350	$46,350	—	—	117
PX-36137225003	HC Revascularization Endovascular Open/Perc Femoral/Popliteal Artery W/Atherectomy Bl	$45,523	$29,590	—	—	39
RX-206087	RETIFANLIMAB-DLWR 500 MG/20 ML INTRAVENOUS SOLUTION	$45,114	$45,114	—	—	120
RX-105644	CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION	$44,160	$44,160	—	—	120
RX-196883	PERTUZUMAB 1,200 MG-TRASTUZUMAB 600 MG-HYALURON-ZZXF/15 ML SUBCUT SOLN	$43,628	$43,628	—	—	120
RX-207693	ELRANATAMAB-BCMM 40 MG/ML SUBCUTANEOUS SOLUTION	$42,858	$42,858	—	—	117
PX-481C9600001	HC Placement Percutaneous Drug Eluting Stent Intracoronary W/Angiography 1 Artery/Branch	$41,495	$26,972	—	—	118
RX-110751	LEUPROLIDE ACETATE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT	$37,312	$37,312	—	—	120
PX-481C9606001	HC Revascularization Acute/Total/Subtotal to Ami/Drug Eluting Coronary Stent Percutaneous Single	$36,762	$23,895	—	—	32
RX-207664	TALQUETAMAB-TGVS 40 MG/ML SUBCUTANEOUS SOLUTION	$35,942	$35,942	—	—	117
RX-188251	CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION	$34,004	$34,004	—	—	120
RX-196290	DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN	$33,714	$33,714	—	—	37
PX-36133285001	HC Insertion Subcutaneous Cardiac Rhythm Monitor	$30,884	$20,075	—	—	118
PX-36137225001	HC Revascularization Endovascular Open/Perc Femoral/Popliteal Artery W/Atherectomy Lt	$30,348	$19,726	—	—	39
PX-36137225002	HC Revascularization Endovascular Open/Perc Femoral/Popliteal Artery W/Atherectomy Rt	$30,348	$19,726	—	—	39
RX-203310	RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION	$30,072	$30,072	—	—	120
RX-124767	OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION	$28,351	$28,351	—	—	120
PX-36136482002	HC Ablation Extremity Percutaneous Transcatheter Delivery 1st Vein Treated Bl	$27,386	$17,801	—	—	118
PX-36133228001	HC Removal/Replacement Ppm Generator Dual Lead System	$25,857	$16,807	—	—	118
RX-196642	LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION	$25,230	$25,230	—	—	120
PX-36000000026	HC or Level VI Initial 15 Minutes	$23,746	$15,435	—	—	32
RX-164818	TENECTEPLASE 50 MG INTRAVENOUS SOLUTION	$23,582	$23,582	—	—	106
RX-215376	TENECTEPLASE 25 MG INTRAVENOUS SOLUTION	$23,582	$23,582	—	—	106
PX-36137211001	HC Infusion Transcatheter Arterial Thrombolysis Not Coronary/Intracranial Initial Treatment Day Bl	$22,868	$14,864	—	—	118
RX-139635	RITUXIMAB 1,600 MG/13.4 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN	$22,548	$22,548	—	—	120
PX-36133208001	HC Insertion of New/Replacement Ppm W/Transvenous Electrode(S) Atrial & Ventricular	$22,403	$14,562	—	—	118
RX-201101	TISOTUMAB VEDOTIN-TFTV 40 MG INTRAVENOUS SOLUTION	$22,202	$22,202	—	—	120
PX-36000000025	HC or Level V Initial 15 Minutes	$21,714	$14,114	—	—	32
RX-116596	PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION	$20,666	$20,666	—	—	120
RX-204870	MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML INTRAVENOUS SOLUTION	$20,601	$20,601	—	—	120
RX-190585	MEPOLIZUMAB 100 MG/ML SUBCUTANEOUS AUTO-INJECTOR	$19,955	$19,955	—	—	37
RX-139634	RITUXIMAB 1,400 MG/11.7 ML (120 MG/ML)-HYALURONIDASE SUBCUTANEOUS SOLN	$19,730	$19,730	—	—	120
RX-188418	PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE	$19,201	$19,201	—	—	120
PX-361C9764003	HC Revascularization Endovascular Open/Perc Lower Extremity Art Excpt T/P W/Intravasc Lithotripsy Rt	$18,785	$12,210	—	—	115
PX-361C9764004	HC Revascularization Endovascular Open/Perc Lower Extremity Art Excpt T/P W/Intravasc Lithotripsy	$18,785	$12,210	—	—	115
PX-361C9764002	HC Revascularization Endovascular Open/Perc Lower Extremity Art Excpt T/P W/Intravasc Lithotripsy Lt	$18,785	$12,210	—	—	115
RX-21045	LEUPROLIDE ACETATE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT	$18,656	$18,656	—	—	120
RX-129782	DARBEPOETIN ALFA 500 MCG/ML IN POLYSORBATE INJECTION SYRINGE	$18,649	$18,649	—	—	120
PX-36136482001	HC Ablation Extremity Percutaneous Transcatheter Delivery 1st Vein Treated	$18,257	$11,867	—	—	118
PX-36136482004	HC Ablation Extremity Percutaneous Transcatheter Delivery 1st Vein Treated Rt	$18,257	$11,867	—	—	118
PX-36136482003	HC Ablation Extremity Percutaneous Transcatheter Delivery 1st Vein Treated Lt	$18,257	$11,867	—	—	118
RX-129657	PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE	$17,710	$17,710	—	—	120

Showing top 50 of 3,050 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.