45 CFR § 180 compliance
D · 65
This hospital published part 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
6,378
Insurances with rates
8
CPT / HCPCS codes
0
Source MRF
Most expensive procedures (gross)
4001535
$18,481
ACTIVASE 100MG VL
Gross
$26,401
4001687
$17,943
ACTIVASE VL {100MG}
Gross
$25,633
4013569
$13,162
NEULASTA 6MG/0.6 INJ
Gross
$18,803
4001692
$13,060
TNKASE INJ [50MG]
Gross
$18,657
4001240
$10,361
TENECTEPLASE INJ [50 MG]
Gross
$14,802
4013126
$8,963
CROFAB 2 VIALS
Gross
$12,805
4000711
$6,860
IMMUNE GLOBULIN INJ [10%
Gross
$9,800
4019596
$6,716
CROTALIDAE POLYVALENT IMM
Gross
$9,594
4013593
$6,607
ARANSEP AUTOINJ
Gross
$9,438
4001942
$5,631
LEQVIO 284MG/1.5ML
Gross
$8,044
4011358
$4,690
ACTIVASE 100MG INJ
Gross
$6,700
4013291
$4,462
TNKASE 50MG VIAL/KIT
Gross
$6,374
3709062
$3,937
HEMOSPRAY
Gross
$5,624
4001913
$3,858
Actemra 400mg/20ml
Gross
$5,511
3709475
$3,785
OVITEX 15 MESH
Gross
$5,408
4001827
$3,576
OCREVUS 300MG/10ML
Gross
$5,109
4503770
$3,559
CT CTA ABDOMAN W/RUN OFF
Gross
$5,084
3709816
$3,489
K-LESS T-ROPE W/DRV, SYN, REPR TI
Gross
$4,984
4001968
$3,287
Benlysta 400mg/vial
Gross
$4,696
3401005
$3,180
NM CARDIAC SPECT PERFUSION
Gross
$4,542
4503769
$3,121
CT CTA HEAD
Gross
$4,458
4503768
$3,121
CT CTA CORITID
Gross
$4,458
3308019
$3,010
FX DISTAL RADIAL TREATMENT
Gross
$4,300
4553006
$2,832
BRAIN W/O & W/CONT
Gross
$4,045
4553003
$2,814
ORB/FACE/NECK W/O&W/CONT
Gross
$4,020
4012669
$2,730
ACTIVASE 50MG INJ.
Gross
$3,900
4553036
$2,616
ABDOMEN W/O & W/CONTRAST
Gross
$3,738
4553015
$2,586
THORAC SPINE W/O & W/CONT
Gross
$3,694
4553018
$2,543
LUMBAR SPINE W/O & W/CONT
Gross
$3,632
4553021
$2,478
PELVIS W/O & W/CONTRAST
Gross
$3,540
4503018
$2,421
CT ABD/PELVIS W/ AND WOUT
Gross
$3,459
4551926
$2,393
MRI ABDOMEN WO&W CONTRAST
Gross
$3,419
4551922
$2,366
MRI JNT LWR XT WO&W CON L
Gross
$3,380
4551917
$2,283
MRI LWR XT WO&W CON RT
Gross
$3,262
4551916
$2,283
MRI LWR XT WO&W CON LT
Gross
$3,262
4403900
$2,257
MRI ABD W/ & W/OUT CON.
Gross
$3,224
4503017
$2,181
CT ABD/PELVIS W/ CONTRAST
Gross
$3,116
3706189
$2,120
KUGEL PATCH SMALL CIRCLE
Gross
$3,028
3308016
$2,100
OPEN TX ANKLE FRACTURE
Gross
$3,000
4013232
$2,014
PAMIDRONATE 90MG 10MLVIAL
Gross
$2,878
4000022
$2,011
ACYCLOVIR 5% OIN [30GM]
Gross
$2,873
4000636
$1,985
IMMUNE GLOBULIN INJ [10 G
Gross
$2,835
4553030
$1,975
LOWER EXT W/O & W/CONT
Gross
$2,821
3308005
$1,942
OR LAP SURGICAL CHOLECYST
Gross
$2,775
4553033
$1,941
MRI JNT LOW EXT W/O&W/CONT
Gross
$2,772
4553004
$1,939
BRAIN W/O CONTRAST
Gross
$2,770
4001912
$1,929
Actemra 200mg/10ml
Gross
$2,756
3308022
$1,925
AMPUTATION METACARPAL BONE
Gross
$2,750
4403484
$1,925
MRI BRAIN WITH/WITHOUT
Gross
$2,749
3709770
$1,911
VENTRIO HERNIA PATCH 5950010
Gross
$2,730
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 4001535 | ACTIVASE 100MG VL | $26,401 | $18,481 | — | — | 0 |
| 4001687 | ACTIVASE VL {100MG} | $25,633 | $17,943 | — | — | 0 |
| 4013569 | NEULASTA 6MG/0.6 INJ | $18,803 | $13,162 | — | — | 0 |
| 4001692 | TNKASE INJ [50MG] | $18,657 | $13,060 | — | — | 0 |
| 4001240 | TENECTEPLASE INJ [50 MG] | $14,802 | $10,361 | — | — | 0 |
| 4013126 | CROFAB 2 VIALS | $12,805 | $8,963 | — | — | 0 |
| 4000711 | IMMUNE GLOBULIN INJ [10% | $9,800 | $6,860 | — | — | 0 |
| 4019596 | CROTALIDAE POLYVALENT IMM | $9,594 | $6,716 | — | — | 0 |
| 4013593 | ARANSEP AUTOINJ | $9,438 | $6,607 | — | — | 0 |
| 4001942 | LEQVIO 284MG/1.5ML | $8,044 | $5,631 | — | — | 0 |
| 4011358 | ACTIVASE 100MG INJ | $6,700 | $4,690 | — | — | 0 |
| 4013291 | TNKASE 50MG VIAL/KIT | $6,374 | $4,462 | — | — | 0 |
| 3709062 | HEMOSPRAY | $5,624 | $3,937 | — | — | 0 |
| 4001913 | Actemra 400mg/20ml | $5,511 | $3,858 | — | — | 0 |
| 3709475 | OVITEX 15 MESH | $5,408 | $3,785 | — | — | 0 |
| 4001827 | OCREVUS 300MG/10ML | $5,109 | $3,576 | — | — | 0 |
| 4503770 | CT CTA ABDOMAN W/RUN OFF | $5,084 | $3,559 | — | — | 9 |
| 3709816 | K-LESS T-ROPE W/DRV, SYN, REPR TI | $4,984 | $3,489 | — | — | 0 |
| 4001968 | Benlysta 400mg/vial | $4,696 | $3,287 | — | — | 0 |
| 3401005 | NM CARDIAC SPECT PERFUSION | $4,542 | $3,180 | — | — | 9 |
| 4503769 | CT CTA HEAD | $4,458 | $3,121 | — | — | 9 |
| 4503768 | CT CTA CORITID | $4,458 | $3,121 | — | — | 9 |
| 3308019 | FX DISTAL RADIAL TREATMENT | $4,300 | $3,010 | — | — | 9 |
| 4553006 | BRAIN W/O & W/CONT | $4,045 | $2,832 | — | — | 9 |
| 4553003 | ORB/FACE/NECK W/O&W/CONT | $4,020 | $2,814 | — | — | 9 |
| 4012669 | ACTIVASE 50MG INJ. | $3,900 | $2,730 | — | — | 0 |
| 4553036 | ABDOMEN W/O & W/CONTRAST | $3,738 | $2,616 | — | — | 9 |
| 4553015 | THORAC SPINE W/O & W/CONT | $3,694 | $2,586 | — | — | 9 |
| 4553018 | LUMBAR SPINE W/O & W/CONT | $3,632 | $2,543 | — | — | 9 |
| 4553021 | PELVIS W/O & W/CONTRAST | $3,540 | $2,478 | — | — | 9 |
| 4503018 | CT ABD/PELVIS W/ AND WOUT | $3,459 | $2,421 | — | — | 9 |
| 4551926 | MRI ABDOMEN WO&W CONTRAST | $3,419 | $2,393 | — | — | 9 |
| 4551922 | MRI JNT LWR XT WO&W CON L | $3,380 | $2,366 | — | — | 9 |
| 4551917 | MRI LWR XT WO&W CON RT | $3,262 | $2,283 | — | — | 3 |
| 4551916 | MRI LWR XT WO&W CON LT | $3,262 | $2,283 | — | — | 3 |
| 4403900 | MRI ABD W/ & W/OUT CON. | $3,224 | $2,257 | — | — | 9 |
| 4503017 | CT ABD/PELVIS W/ CONTRAST | $3,116 | $2,181 | — | — | 9 |
| 3706189 | KUGEL PATCH SMALL CIRCLE | $3,028 | $2,120 | — | — | 0 |
| 3308016 | OPEN TX ANKLE FRACTURE | $3,000 | $2,100 | — | — | 9 |
| 4013232 | PAMIDRONATE 90MG 10MLVIAL | $2,878 | $2,014 | — | — | 0 |
| 4000022 | ACYCLOVIR 5% OIN [30GM] | $2,873 | $2,011 | — | — | 0 |
| 4000636 | IMMUNE GLOBULIN INJ [10 G | $2,835 | $1,985 | — | — | 0 |
| 4553030 | LOWER EXT W/O & W/CONT | $2,821 | $1,975 | — | — | 9 |
| 3308005 | OR LAP SURGICAL CHOLECYST | $2,775 | $1,942 | — | — | 9 |
| 4553033 | MRI JNT LOW EXT W/O&W/CONT | $2,772 | $1,941 | — | — | 9 |
| 4553004 | BRAIN W/O CONTRAST | $2,770 | $1,939 | — | — | 9 |
| 4001912 | Actemra 200mg/10ml | $2,756 | $1,929 | — | — | 0 |
| 3308022 | AMPUTATION METACARPAL BONE | $2,750 | $1,925 | — | — | 9 |
| 4403484 | MRI BRAIN WITH/WITHOUT | $2,749 | $1,925 | — | — | 9 |
| 3709770 | VENTRIO HERNIA PATCH 5950010 | $2,730 | $1,911 | — | — | 0 |
Showing top 50 of 6,378 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.