STAFFORD COUNTY HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
6183710_1	INJECTION, TENECTEPLASE, 1 MG	$17,017	$17,017	—	—	5
5749359_1	epi/lidocai/tetracai topical 180 mg-4000 mg-500 mg/100 mL Sol [SFKS]	$14,594	$14,594	—	—	5
4990285_1	INJECTION, PEGFILGRASTIM, EXCLUDES BIOSIMILAR, 0.5 MG	$10,655	$10,655	—	—	5
5910802_1	INJECTION, MEPOLIZUMAB, 1 MG	$7,581	$7,581	—	—	5
6175430_1	INJECTION, TOCILIZUMAB, 1 MG	$6,385	$6,385	—	—	5
5443329_1	INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE	$4,945	$4,945	—	—	5
4990040_1	INJECTION, DENOSUMAB, 1 MG	$4,632	$4,632	—	—	5
4337901_1	Insertion of non-tunneled central venous tube for infusion (5 years or older)	$3,800	$3,800	—	—	5
6599681_1	Gene analysis (breast cancer 1 and 2) of full sequence and analysis for duplication or deletion vari	$3,686	$3,686	—	—	5
5401684_1	INJECTION, CERTOLIZUMAB PEGOL, 1 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE	$3,630	$3,630	—	—	5
5540701_1	INJECTION, ABATACEPT, 10 MG (CODE MAY BE USED FOR MEDICARE WHEN DRUG ADMINISTERED UNDER THE DIRECT S	$3,316	$3,316	—	—	5
6196536_1	INJECTION, ROMOSOZUMAB-AQQG, 1 MG	$3,292	$3,292	—	—	5
4989760_1	INJECTION, INFLIXIMAB, EXCLUDES BIOSIMILAR, 10 MG	$2,947	$2,947	—	—	5
6184866_1	INJECTION, IMMUNE GLOBULIN, (GAMMAGARD LIQUID), NON-LYOPHILIZED, (E.G., LIQUID), 500 MG	$2,860	$2,860	—	—	5
4989966_1	INJECTION, ZOLEDRONIC ACID, 1 MG	$2,682	$2,682	—	—	5
4990121_1	INJECTION, FULVESTRANT, 25 MG	$2,399	$2,399	—	—	5
4350900_1	Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	$2,185	$2,185	—	—	5
4353328_1	Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	$2,185	$2,185	—	—	5
4617107_1	Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	$2,185	$2,185	—	—	5
4350876_1	Removal of skin tag, 1-15 skin tags	$2,100	$2,100	—	—	5
4989853_1	INJECTION, FERRIC CARBOXYMALTOSE, 1 MG	$2,096	$2,096	—	—	5
4649072_1	CT scan of abdominal aorta and both leg arteries with contrast	$2,092	$2,092	—	—	5
625588_1	CT scan of abdominal aorta and both leg arteries with contrast	$2,092	$2,092	—	—	5
2384299_1	CT scan of blood vessels of abdomen and pelvis with contrast	$2,025	$2,025	—	—	5
4337571_1	Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using a flexible endoscope	$2,022	$2,022	—	—	5
625596_1	CT scan of blood vessels of abdomen with contrast	$1,990	$1,990	—	—	5
5404220_1	ROOM & BOARD - SEMI-PRIVATE (TWO BEDS) - GENERAL CLASSIFICATION	$1,985	$1,985	—	—	5
5466148_1	Insertion of tube for infusion (5 years or older)	$1,950	$1,950	—	—	5
5466149_1	Insertion of tube for infusion (5 years or older)	$1,950	$1,950	—	—	5
4337850_1	Removal of foreign body of foot tissue, accessed beneath the skin	$1,900	$1,900	—	—	5
5404236_1	ROOM & BOARD - PRIVATE (ONE BED) - GENERAL CLASSIFICATION	$1,890	$1,890	—	—	5
4990006_1	Rabies immune globulin for injection beneath the skin and/or into muscle	$1,877	$1,877	—	—	5
4337718_1	Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 20.1-30.0 cm	$1,825	$1,825	—	—	5
4337719_1	Simple repair of surface wound to scalp, neck, underarms, trunk, arms, or legs, more than 30.0 cm	$1,825	$1,825	—	—	5
4337724_1	Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 20.1-30.0 cm	$1,820	$1,820	—	—	5
2404377_1	Emergency department visit with high level of medical decision making	$1,809	$1,809	—	—	5
4633396_1	Emergency department visit with high level of medical decision making	$1,809	$1,809	—	—	5
4634657_1	ROOM & BOARD - SEMI-PRIVATE (TWO BEDS) - GENERAL CLASSIFICATION	$1,785	$1,785	—	—	5
2404378_1	Critical care, first 30-74 minutes	$1,710	$1,710	—	—	5
4322715_1	Single contrast X-ray of large intestine	$1,685	$1,685	—	—	5
5894896_1	INJECTION, REMDESIVIR, 1 MG	$1,672	$1,672	—	—	5
4352969_1	Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less	$1,650	$1,650	—	—	5
4633410_1	Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	$1,600	$1,600	—	—	5
4663505_1	CT scan of blood vessels of chest with contrast	$1,600	$1,600	—	—	5
629700_1	CT scan of blood vessels of chest with contrast	$1,600	$1,600	—	—	5
629762_1	CT scan of blood vessels of head with contrast	$1,600	$1,600	—	—	5
629770_1	CT scan of blood vessels of neck with contrast	$1,600	$1,600	—	—	5
4353092_1	Destruction of skin growth, 1-14 growths	$1,532	$1,532	—	—	5
1844782_1	Ultrasound of heart	$1,525	$1,525	—	—	5
4350901_1	Ultrasound of heart	$1,525	$1,525	—	—	5

Showing top 50 of 3,069 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.