45 CFR § 180 compliance
B · 85
This hospital published most of what § 180 requires.
●Machine-readable file published
●Gross / standard charges
●Discounted cash price
●Payer-specific negotiated rates
○Min / max negotiated charges
●Free, public, no login required
Procedures listed
4,422
Insurances with rates
5
CPT / HCPCS codes
1
Source MRF
Most expensive procedures (gross)
2512705
$30,036
LUPRON DEPOT 45 MG (6 MONTH) (LEUPROLIDE ACETATE) IM SYR. KIT
Gross
$40,048
2519155
$23,761
Activase 100 mg IV (alteplase)
Gross
$31,681
2512416
$18,788
Fulphila (pegfilgrastim-jmdb) subQ syringe
Gross
$25,050
2510840
$17,547
TNK-ASE 25MG INJ. (TENECTEPLASE) IV (STROKE)
Gross
$23,395
2513828
$17,547
TNK-ASE 50 MG INJ. (TENECTEPLASE) (HEART)
Gross
$23,395
2513802
$16,859
NEULASTA 6 MG INJ.
Gross
$22,478
2519148
$14,787
Gamunex-C 40 GM 10% inj solution
Gross
$19,716
2519296
$12,091
GAMMAGARD LIQUID 30GM (immun glob G(IgG)-gly-IgA ov50) inj solution
Gross
$16,121
2511046
$11,273
UDENYCA 6MG SQ (PEGFILGRASTIM-CBQV) SYRINGE
Gross
$15,030
2500486
$8,635
CROFAB RATTLESNAKE (CROTALIDAE POLYVALENT IMMUNE FAB)
Gross
$11,512
2510006
$8,551
Nucala 100 mg/ml (mepolizumab) subQ syringe
Gross
$11,401
2512341
$7,655
Cimzia (certolizumab pegol) 200 mg/ml subQ syringe kit
Gross
$10,206
2519130
$7,650
Gamunex-C 20 GM
Gross
$10,200
Q4196235
$7,427
PURAPLY AM 2X4CM PER SQ CM
Gross
$9,903
2519288
$6,726
Xgeva 120 mg/ 1.7 ml vial(denosumab)
Gross
$8,967
2510204
$5,398
Simponi ARIA (golimumab) IV solution
Gross
$7,197
2513307
$5,023
Evenity (romosozumab-aqqg) subQ syringe
Gross
$6,697
6236500
$4,634
REMOVE SPINE INFUSION DEVICE
Gross
$6,179
2510113
$4,396
Dalvance (dalbavancin) 500 mg IV solution
Gross
$5,861
Q4196233
$4,232
PURAPLY AM 6X9CM PER SQ CM
Gross
$5,643
2503547
$3,988
Prolia (denosumab) SubQ Syringe 60mg/ml
Gross
$5,317
3721100
$3,863
THROMBOLYTIC ART THERAPY
Gross
$5,150
2511053
$3,827
Gamunex-C 10 GM
Gross
$5,103
2519882
$3,699
Synvisc-One 6 ml syringe/48 mg
Gross
$4,931
Q419723
$3,506
PURAPLY XT 4.91X4.91 PER SQ CM
Gross
$4,675
2513548
$3,503
INJECTAFER 750 MG (FERRIC CARBOXYMALTOSE) IV
Gross
$4,670
2511541
$3,470
Mirena 52mg (levonorgestrel) utrn intrauterine device
Gross
$4,627
2511848
$3,375
Kcentra 500 unit range IV recon soln
Gross
$4,500
2513000
$3,366
PrePack PAXLOVID (EUA) ORAL TABS, DOSE PACK
Gross
$4,488
2673500
$3,225
OPEN TX PHALANGEAL FX W/WO FIX
Gross
$4,300
2676500
$3,225
OPEN TX DIST PHALANG FX W/WO F
Gross
$4,300
2513059
$3,223
FERAHEME 510 MG/17 ML INJ. (FERUMOXYTOL) IV
Gross
$4,297
2519692
$3,174
Orencia (with maltose) (abatacept (with maltose)) IV recon soln
Gross
$4,232
7563500
$3,142
CTA ABD/PEL with runoff
Gross
$4,189
3850000
$3,000
BIOPSY/EXCISION OF LYMPH NODE
Gross
$4,000
5525000
$3,000
EXCISION-VASOTOMY UNIL OR BILA
Gross
$4,000
2516789
$2,926
RECLAST 5 MG/100 ML IV (ZOLEDRONIC ACID)
Gross
$3,901
2510543
$2,903
Durolane (hyaluronate sodium, stabilized) IAtc syringe
Gross
$3,870
2511905
$2,890
Procrit 40,000 U/ML (epoetin alfa) Inj Solution
Gross
$3,853
2518074
$2,890
PROCRIT 40,000 UNITS/DIALYSIS
Gross
$3,853
1512023
$2,698
SPLT THCKNS AUTOGRFT,F/H/FT100
Gross
$3,597
1527323
$2,698
APPL SKIN CHILD T/A/L =>100CM
Gross
$3,597
7417800
$2,661
CT ABD/PEL WO/W CONTRAST
Gross
$3,548
2193000
$2,625
EXCISION TUMOR S TISSUE BACK/
Gross
$3,500
1527123
$2,419
APPL SKIN T/A/L =<25CM
Gross
$3,225
2737200
$2,419
REMOV FOREIGN BODY,DEEP THIGH
Gross
$3,225
6478800
$2,419
EXCISION OF NEUROFIBROMA OR
Gross
$3,225
2517183
$2,418
Zometa 4 mg/5 ml (zoledronic acid)
Gross
$3,224
2517175
$2,410
ARANESP 40 MCG INJ (NO DIALYSI
Gross
$3,213
5226000
$2,400
CYSTOURETHROSCOPY/DILAT BLADER
Gross
$3,200
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 2512705 | LUPRON DEPOT 45 MG (6 MONTH) (LEUPROLIDE ACETATE) IM SYR. KIT | $40,048 | $30,036 | — | — | 7 |
| 2519155 | Activase 100 mg IV (alteplase) | $31,681 | $23,761 | — | — | 7 |
| 2512416 | Fulphila (pegfilgrastim-jmdb) subQ syringe | $25,050 | $18,788 | — | — | 7 |
| 2510840 | TNK-ASE 25MG INJ. (TENECTEPLASE) IV (STROKE) | $23,395 | $17,547 | — | — | 7 |
| 2513828 | TNK-ASE 50 MG INJ. (TENECTEPLASE) (HEART) | $23,395 | $17,547 | — | — | 7 |
| 2513802 | NEULASTA 6 MG INJ. | $22,478 | $16,859 | — | — | 7 |
| 2519148 | Gamunex-C 40 GM 10% inj solution | $19,716 | $14,787 | — | — | 7 |
| 2519296 | GAMMAGARD LIQUID 30GM (immun glob G(IgG)-gly-IgA ov50) inj solution | $16,121 | $12,091 | — | — | 7 |
| 2511046 | UDENYCA 6MG SQ (PEGFILGRASTIM-CBQV) SYRINGE | $15,030 | $11,273 | — | — | 7 |
| 2500486 | CROFAB RATTLESNAKE (CROTALIDAE POLYVALENT IMMUNE FAB) | $11,512 | $8,635 | — | — | 7 |
| 2510006 | Nucala 100 mg/ml (mepolizumab) subQ syringe | $11,401 | $8,551 | — | — | 7 |
| 2512341 | Cimzia (certolizumab pegol) 200 mg/ml subQ syringe kit | $10,206 | $7,655 | — | — | 7 |
| 2519130 | Gamunex-C 20 GM | $10,200 | $7,650 | — | — | 7 |
| Q4196235 | PURAPLY AM 2X4CM PER SQ CM | $9,903 | $7,427 | — | — | 7 |
| 2519288 | Xgeva 120 mg/ 1.7 ml vial(denosumab) | $8,967 | $6,726 | — | — | 7 |
| 2510204 | Simponi ARIA (golimumab) IV solution | $7,197 | $5,398 | — | — | 7 |
| 2513307 | Evenity (romosozumab-aqqg) subQ syringe | $6,697 | $5,023 | — | — | 7 |
| 6236500 | REMOVE SPINE INFUSION DEVICE | $6,179 | $4,634 | — | — | 8 |
| 2510113 | Dalvance (dalbavancin) 500 mg IV solution | $5,861 | $4,396 | — | — | 7 |
| Q4196233 | PURAPLY AM 6X9CM PER SQ CM | $5,643 | $4,232 | — | — | 7 |
| 2503547 | Prolia (denosumab) SubQ Syringe 60mg/ml | $5,317 | $3,988 | — | — | 7 |
| 3721100 | THROMBOLYTIC ART THERAPY | $5,150 | $3,863 | — | — | 7 |
| 2511053 | Gamunex-C 10 GM | $5,103 | $3,827 | — | — | 7 |
| 2519882 | Synvisc-One 6 ml syringe/48 mg | $4,931 | $3,699 | — | — | 7 |
| Q419723 | PURAPLY XT 4.91X4.91 PER SQ CM | $4,675 | $3,506 | — | — | 7 |
| 2513548 | INJECTAFER 750 MG (FERRIC CARBOXYMALTOSE) IV | $4,670 | $3,503 | — | — | 7 |
| 2511541 | Mirena 52mg (levonorgestrel) utrn intrauterine device | $4,627 | $3,470 | — | — | 7 |
| 2511848 | Kcentra 500 unit range IV recon soln | $4,500 | $3,375 | — | — | 7 |
| 2513000 | PrePack PAXLOVID (EUA) ORAL TABS, DOSE PACK | $4,488 | $3,366 | — | — | 7 |
| 2673500 | OPEN TX PHALANGEAL FX W/WO FIX | $4,300 | $3,225 | — | — | 8 |
| 2676500 | OPEN TX DIST PHALANG FX W/WO F | $4,300 | $3,225 | — | — | 8 |
| 2513059 | FERAHEME 510 MG/17 ML INJ. (FERUMOXYTOL) IV | $4,297 | $3,223 | — | — | 7 |
| 2519692 | Orencia (with maltose) (abatacept (with maltose)) IV recon soln | $4,232 | $3,174 | — | — | 7 |
| 7563500 | CTA ABD/PEL with runoff | $4,189 | $3,142 | — | — | 8 |
| 3850000 | BIOPSY/EXCISION OF LYMPH NODE | $4,000 | $3,000 | — | — | 8 |
| 5525000 | EXCISION-VASOTOMY UNIL OR BILA | $4,000 | $3,000 | — | — | 8 |
| 2516789 | RECLAST 5 MG/100 ML IV (ZOLEDRONIC ACID) | $3,901 | $2,926 | — | — | 7 |
| 2510543 | Durolane (hyaluronate sodium, stabilized) IAtc syringe | $3,870 | $2,903 | — | — | 7 |
| 2511905 | Procrit 40,000 U/ML (epoetin alfa) Inj Solution | $3,853 | $2,890 | — | — | 7 |
| 2518074 | PROCRIT 40,000 UNITS/DIALYSIS | $3,853 | $2,890 | — | — | 7 |
| 1512023 | SPLT THCKNS AUTOGRFT,F/H/FT100 | $3,597 | $2,698 | — | — | 8 |
| 1527323 | APPL SKIN CHILD T/A/L =>100CM | $3,597 | $2,698 | — | — | 8 |
| 7417800 | CT ABD/PEL WO/W CONTRAST | $3,548 | $2,661 | — | — | 8 |
| 2193000 | EXCISION TUMOR S TISSUE BACK/ | $3,500 | $2,625 | — | — | 8 |
| 1527123 | APPL SKIN T/A/L =<25CM | $3,225 | $2,419 | — | — | 8 |
| 2737200 | REMOV FOREIGN BODY,DEEP THIGH | $3,225 | $2,419 | — | — | 8 |
| 6478800 | EXCISION OF NEUROFIBROMA OR | $3,225 | $2,419 | — | — | 8 |
| 2517183 | Zometa 4 mg/5 ml (zoledronic acid) | $3,224 | $2,418 | — | — | 7 |
| 2517175 | ARANESP 40 MCG INJ (NO DIALYSI | $3,213 | $2,410 | — | — | 7 |
| 5226000 | CYSTOURETHROSCOPY/DILAT BLADER | $3,200 | $2,400 | — | — | 8 |
Showing top 50 of 4,422 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.