JEWELL COUNTY HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
4989496_1	INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG	$16,267	$12,201	—	—	7
6168023_1	INJECTION, ALTEPLASE RECOMBINANT, 1 MG	$15,841	$11,880	—	—	7
4989272_1	INJECTION, TENECTEPLASE, 1 MG	$12,107	$9,080	—	—	7
6455756_1	INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG	$11,552	$8,664	—	—	7
4474097_1	Removal of growth of muscle of neck or front of chest, 5.0 cm or more	$7,975	$5,981	—	—	7
6545752_1	INJECTION, PEGFILGRASTIM-JMDB (FULPHILA), BIOSIMILAR, 0.5 MG	$4,509	$3,382	—	—	7
6436365_1	Biopsy or removal of lymph nodes of neck with removal of fat pad	$4,000	$3,000	—	—	7
4989301_1	LEUPROLIDE ACETATE (FOR DEPOT SUSPENSION), 7.5 MG	$3,863	$2,898	—	—	7
5159916_1	Repair of tendon on top side of finger	$3,750	$2,813	—	—	7
4353138_1	Insertion of non-tunneled central venous tube for infusion (5 years or older)	$3,550	$2,663	—	—	7
4656334_1	Removal of first cyst of wrist	$3,550	$2,663	—	—	7
4352978_1	Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 3.1-4.0 cm	$3,436	$2,577	—	—	7
4989531_1	INJECTION, DENOSUMAB, 1 MG	$3,376	$2,532	—	—	7
6510788_1	INJECTION, DENOSUMAB, 1 MG	$3,376	$2,532	—	—	7
6326926_1	INJECTION, FERRIC CARBOXYMALTOSE, 1 MG	$3,313	$2,485	—	—	7
4352977_1	Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm	$3,131	$2,348	—	—	7
4337901_1	Insertion of non-tunneled central venous tube for infusion (5 years or older)	$3,125	$2,344	—	—	7
4617107_1	Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	$2,628	$1,971	—	—	7
4352976_1	Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	$2,627	$1,970	—	—	7
4350900_1	Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	$2,626	$1,970	—	—	7
4353328_1	Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	$2,626	$1,970	—	—	7
4353141_1	Removal of central venous tube with port or pump	$2,577	$1,933	—	—	7
4337810_1	Amputation of finger or thumb with direct closure	$2,475	$1,856	—	—	7
4352981_1	Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	$2,414	$1,811	—	—	7
6397096_1	INJECTION, ROMOSOZUMAB-AQQG, 1 MG	$2,366	$1,775	—	—	7
6421065_1	INJECTION, ROMOSOZUMAB-AQQG, 1 MG	$2,366	$1,775	—	—	7
4352980_1	Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	$2,357	$1,768	—	—	7
4352975_1	Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	$2,343	$1,757	—	—	7
4989466_1	INJECTION, ZOLEDRONIC ACID, 1 MG	$2,341	$1,756	—	—	7
6516638_1	Release and/or relocation of hand nerve	$2,200	$1,650	—	—	7
6284321_1	LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM (MIRENA), 52 MG	$2,186	$1,640	—	—	7
6184558_1	ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANT AND SUPPLIES	$2,186	$1,640	—	—	7
6185531_1	Incision of tendon covering of finger	$2,130	$1,598	—	—	7
6355130_1	NON-COVERED ITEM OR SERVICE	$2,032	$1,524	—	—	7
4337686_1	Drainage of blood or fluid accumulation	$2,000	$1,500	—	—	7
4410417_1	Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	$1,985	$1,489	—	—	7
6051954_1	Rabies immune globulin for injection beneath the skin and/or into muscle	$1,955	$1,466	—	—	7
6342910_1	INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS	$1,924	$1,443	—	—	7
2384299_1	CT scan of blood vessels of abdomen and pelvis with contrast	$1,800	$1,350	—	—	7
4663505_1	CT scan of blood vessels of chest with contrast	$1,800	$1,350	—	—	7
5401674_1	MRI scan of leg before and after contrast	$1,800	$1,350	—	—	7
5401677_1	MRI scan of leg joint before and after contrast	$1,800	$1,350	—	—	7
5401678_1	MRI scan of blood vessels of leg	$1,800	$1,350	—	—	7
625604_1	MRI scan of abdomen before and after contrast	$1,800	$1,350	—	—	7
627680_1	MRI scan of brain before and after contrast	$1,800	$1,350	—	—	7
629594_1	MRI scan of upper spinal canal before and after contrast	$1,800	$1,350	—	—	7
629708_1	MRI scan of chest before and after contrast	$1,800	$1,350	—	—	7
629770_1	CT scan of blood vessels of neck with contrast	$1,800	$1,350	—	—	7
630719_1	MRI scan of blood vessels of head before and after contrast	$1,800	$1,350	—	—	7
630737_1	MRI scan of blood vessels of neck before and after contrast	$1,800	$1,350	—	—	7

Showing top 50 of 4,159 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.