REPUBLIC COUNTY HOSPITAL (Belleville, KS) prices

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J3101	VTENECTEPLASE 50MG INJ KT 1MG X	$44,562	—	$35,650	$43,671	12
J3100	TENECTEPLASE 50MG INJ	$21,500	—	$17,200	$21,070	12
J3380	VEDOLIZUMAB-ENTYVIO	$20,848	—	$16,678	$20,431	12
J2505	PEGFILGRASTIM 6MG/0.6ML INJ	$15,982	—	$12,785	$15,662	12
74174	CTA ABD/PEL W&W/O CONTRAST	$6,882	—	$5,505	$6,744	12
74178	CT ABD/PELVIS W/WO CONTRAST	$6,515	—	$5,212	$6,384	12
70553	MRI BRAIN W/WO CONTRAST	$6,335	—	$5,068	$6,208	12
72158	MRI L-SPINE W/WO CONTRAST	$6,311	—	$5,049	$6,185	12
G0390	TRAUMA RESP TM W/CRITCARE	$5,409	—	$4,327	$5,301	12
74177	CT ABD/PELVIS WITH CONTRAST	$4,963	—	$3,970	$4,864	12
74183	MRI ABD W/WO CONTRAST	$4,941	—	$3,953	$4,842	12
72157	MRI T-SPINE W/WO CONTRAST	$4,912	—	$3,930	$4,814	12
72156	MRI C-SPINE W/WO CONTRAST	$4,739	—	$3,791	$4,645	12
70546	MRA HEAD W/WO CONTRAST	$4,719	—	$3,776	$4,625	12
73720	MRI LO EXT W/WO JNT W/WO	$4,667	—	$3,733	$4,574	12
72197	MRI PELVIS W/WO CONTRAST	$4,647	—	$3,717	$4,554	12
71552	MRI CHEST W/WO CONTRAST	$4,622	—	$3,697	$4,529	12
70549	MRA NECK W/WO CONTRAST	$4,566	—	$3,652	$4,474	12
72142	MRI C SPINE WC	$4,503	—	$3,602	$4,413	12
43247	EGD W/ FB REMOVAL	$4,433	—	$3,547	$4,345	12
71275	CTA CHEST	$4,288	—	$3,430	$4,202	12
72127	CT CERVICAL W/WO CONTRAST	$4,222	—	$3,378	$4,138	12
73223	MRI UP EXT W/JNT W/WO	$4,190	—	$3,352	$4,106	12
64999	NERVOUS SYS OTH SURG/PROC	$4,101	—	$3,281	$4,019	12
70543	MRI ORB/FACE/NECK W/WO	$4,097	—	$3,277	$4,015	12
70552	MRI-BRAIN WITH CONTRAST	$4,061	—	$3,249	$3,980	12
73723	MRI LO EXT W/JNT W/WO	$4,002	—	$3,201	$3,922	12
24101	PF ARTHROTOMY ELBW W/EXP	$3,999	—	$3,199	$3,919	12
74175	CTA ABDOMEN	$3,951	—	$3,161	$3,872	12
73220	MRI UP EXT W/O JNT W/WO	$3,933	—	$3,146	$3,854	12
72148	MRI L-SPINE W/O CONTRAST	$3,897	—	$3,117	$3,819	12
24000	PF ARTHRO ELBW EXP/DRAIN/RO FB	$3,882	—	$3,105	$3,804	12
75635	CTA ABD AOR/BI ILIOFEM LO	$3,877	—	$3,102	$3,799	12
15940	EXC ISCHIAL PRESS ULCR W/SUTRE	$3,875	—	$3,100	$3,798	12
74176	CT ABD/PELVIS WO CONTRAST	$3,855	—	$3,084	$3,778	12
70498	CTA CARTOID	$3,830	—	$3,064	$3,754	12
11047	DEBRIDE BONE EA ADD 20 SQ CM	$3,711	—	$2,969	$3,636	12
70496	CTA HEAD (COW)	$3,701	—	$2,961	$3,627	12
72141	MRI C-SPINE W/O CONTRAST	$3,686	—	$2,949	$3,612	12
72130	CT THORACIC WITH/WO CONTRAST	$3,684	—	$2,947	$3,611	12
70551	MRI BRAIN W/O CONTRAST	$3,643	—	$2,914	$3,570	12
26350	PF REPAIR FLEX TENDON WO GRAFT	$3,614	—	$2,891	$3,542	12
72149	MRI L SPINE W/CONTRAST	$3,594	—	$2,876	$3,523	12
73202	CT UP EXT W/WO CONTRAST	$3,586	—	$2,869	$3,514	12
44389	COLON STOMA W/BX SINGLE MULT	$3,553	—	$2,842	$3,482	12
71270	CT CHEST W/WO CONTRAST DIAG	$3,546	—	$2,837	$3,475	12
72133	CT LUMBAR WITH/WO CONTRAST	$3,538	—	$2,830	$3,467	12
70492	CT ST NECK W/WO CONTRAST	$3,527	—	$2,821	$3,456	12
73706	CTA LOWER EXTREMITY	$3,503	—	$2,802	$3,433	12
72146	MRI T-SPINE W/O CONTRAST	$3,477	—	$2,781	$3,407	12

Showing top 50 of 1,411 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.