DEQUINCY MEMORIAL HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
4405128	INVEGA SUS 234/1.5 J	$6,425	$4,497	—	—	86
4303912	BRCA1 & BRCA2 COMPREHENSIVE	$5,250	$3,675	—	—	86
4220004	CT ABD&PEL WO/W CONTRAST	$5,045	$3,532	—	—	87
4220055	CTA ABD&PEL W CONT	$4,788	$3,351	—	—	87
4220002	CT ABD&PEL W CONTRAST	$4,452	$3,116	—	—	87
4405204	INVEGA SUSTENNE (PALIPERIDONE) 156MG	$4,283	$2,998	—	—	86
4220059	CT EXTREMITY LOWER BILAT W/WO	$3,778	$2,645	—	—	87
4220071	CT HIPS BILAT W/WO	$3,778	$2,645	—	—	87
4220074	CT KNEE BILAT W/WO	$3,778	$2,645	—	—	87
4220003	CT ABD&PEL WO CONTRAST	$3,519	$2,463	—	—	87
4220060	CT EXTREMITY LOWER BILAT WC	$3,277	$2,294	—	—	87
4220075	CT KNEE BILAT WC	$3,277	$2,294	—	—	87
4220008	CT ANGIO ABD W&WO CONT	$2,777	$1,944	—	—	87
4220010	CT ANGIO CHEST W/W/O CON	$2,777	$1,944	—	—	87
4220037	CT MAXILO/SINUS WWO CONT	$2,777	$1,944	—	—	87
4220041	CT ORBITS/IAC/MASTOID W/WO	$2,777	$1,944	—	—	87
4220081	CTA ABDOMEN WC	$2,777	$1,944	—	—	87
4220083	CTA CHEST WC	$2,777	$1,944	—	—	87
4220062	CT EXTREMITY UPPER BILAT W/WO	$2,747	$1,923	—	—	87
4220063	CT EXTREMITY UPPER BILAT WC	$2,595	$1,816	—	—	87
4220069	CT HAND BILAT WC	$2,595	$1,816	—	—	87
4220061	CT EXTREMITY LOWER BILAT WO	$2,573	$1,801	—	—	87
4220064	CT EXTREMITY UPPER BILAT WO	$2,573	$1,801	—	—	87
4220070	CT HAND BILAT WO	$2,573	$1,801	—	—	87
4220073	CT HIP BILAT WO	$2,573	$1,801	—	—	87
4220076	CT KNEE BILAT WO	$2,573	$1,801	—	—	87
4220006	CT ABDOMEN W/W/O CONT	$2,566	$1,796	—	—	87
4220019	CT CHEST W/W/O CONTRAST	$2,564	$1,795	—	—	87
4220023	CT HEAD/BRAIN W/W/O CONT	$2,519	$1,763	—	—	87
4220030	CT LOW EXTREM WWO CTR LT	$2,519	$1,763	—	—	87
4220031	CT LOW EXTREM WWO CTR RT	$2,519	$1,763	—	—	87
4220052	CT UP EXTREM W/WO CST LT	$2,519	$1,763	—	—	87
4220053	CT UP EXTREM W/WO CTR RT	$2,519	$1,763	—	—	87
4220039	CT NECK W/W/O CONTRAST	$2,518	$1,762	—	—	87
4220035	CT MAXILO/SINUS W CONT	$2,489	$1,742	—	—	87
4220042	CT ORBITS/IAC/MASTOID W	$2,489	$1,742	—	—	87
4220044	CT PELVIS W/WO CONTRAST	$2,480	$1,736	—	—	87
4300469	PLATELETPHERSIS 1 UNIT	$2,466	$1,726	—	—	86
4300468	SHIPPING HANDLING LIFESHARE	$2,376	$1,663	—	—	86
4350003	PLTS APH	$2,376	$1,663	—	—	86
4350101	SHIPPING AND HANDLING FFP	$2,376	$1,663	—	—	86
4350102	SHIPPING AND HANDLING PRBC	$2,375	$1,663	—	—	86
4350104	SHIPPING AND HANDLING CRYO	$2,375	$1,663	—	—	86
4220007	CT ABDOMEN WITH CONT	$2,322	$1,625	—	—	87
4220020	CT CHEST WITH CONTRAST	$2,322	$1,625	—	—	87
4350105	TRANSFUSION	$2,301	$1,611	—	—	86
4220032	CT L-SPINE W/O CONTRAST	$2,256	$1,579	—	—	87
4304119	FATTY ACID PRF	$2,212	$1,548	—	—	86
4220028	CT LOW EXTREM W\ CTR RT	$2,185	$1,529	—	—	87
4220029	CT LOW EXTREM WITH CTR L	$2,185	$1,529	—	—	87

Showing top 50 of 2,293 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.