192004

CCN 192004

45 CFR § 180 compliance
D · 65
This hospital published part of what § 180 requires.
●Machine-readable file published: assessment threshold met
●Gross / standard charges: assessment threshold met
●Discounted cash price: assessment threshold met
○Payer-specific negotiated rates: below assessment threshold
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
108
Insurances with rates
0
CPT / HCPCS codes
0
Source MRF
Retrieved: 2026-10-28

Most expensive procedures (gross)

790
$14,623
LITHOTRIPSY UNILATERAL
Gross
$14,623
206
$3,150
ROOM & BOARD HIGH OBSERVATION
Gross
$3,150
200
$3,150
ROOM & BOARD INTENSIVE CARE
Gross
$3,150
202
$2,625
R&B ICU MEDICAL
Gross
$2,625
820
$2,475
INP HEMODIALYSIS 1 EVAL
Gross
$2,475
481
$2,341
CARDIAC CATH LAB ROOM SETUP
Gross
$2,341
612
$2,169
CT Cervical Spine w/ Contrast
Gross
$2,169
320
$2,151
ARTERIOGRAM PULMONARY, BILAT
Gross
$2,151
164
$2,100
ROOM & BOARD ISOLATION
Gross
$2,100
618
$1,950
MRA ABD WO/W CONTRAST
Gross
$1,950
615
$1,826
MRA HEAD W/O CONTRAST
Gross
$1,826
110
$1,812
ROOM & BOARD PRIVATE
Gross
$1,812
111
$1,812
ROOM & BOARD PRIVATE MED/SURG
Gross
$1,812
802
$1,786
INP PERITONEAL DIALYSIS
Gross
$1,786
614
$1,734
CARDIAC FOR MORPHOLOGY W/O CON
Gross
$1,734
352
$1,675
CT Thoracic Spine w/ Contrast
Gross
$1,675
351
$1,580
CT MASTOIDS W/CONTRAST
Gross
$1,580
120
$1,575
ROOM & BOARD SEMI PRIVATE
Gross
$1,575
160
$1,575
ROOM & BOARD TELEMETRY
Gross
$1,575
190
$1,470
ROOM & BOARD SUB ACUTE
Gross
$1,470
610
$1,404
BX BREAST 1ST LESION MR IMAG
Gross
$1,404
616
$1,400
MRA Lower Ext w/wo Contrast
Gross
$1,400
350
$1,364
CT Abd & Pelvis w/ Contrast
Gross
$1,364
940
$1,350
AUTOL PRP FOR WOUND/ULCER
Gross
$1,350
611
$1,153
INTRACRANIAL VESSELS W/O CONT
Gross
$1,153
801
$1,152
Hemodialysis
Gross
$1,152
384
$1,055
PLATE PHERES LEUKO IRRAD
Gross
$1,055
340
$1,041
ABCESS IMAGING WHOLE BODY
Gross
$1,041
901
$1,020
ELECTROCONVULSIVE THERAPY
Gross
$1,020
360
$958
ACCESS AV DIAL GRFT FOR EVAL
Gross
$958
341
$825
CYSTERNOGRAM
Gross
$825
278
$743
CATH ANGIOPLASTY TRANSLUMINAL
Gross
$743
710
$720
PACU 1ST HR
Gross
$720
419
$700
VENTILATOR MGMT EACH ADDL DAY
Gross
$700
370
$667
ANES GENERAL 1ST HR
Gross
$667
381
$601
Packed RBC
Gross
$601
471
$549
AUDITORY EVOKE POTENT
Gross
$549
542
$476
AMBULANCE ALS 1
Gross
$476
483
$465
CARDIAC DOPPLER
Gross
$465
361
$455
APPLY TOT CONTACT LEG CAST
Gross
$455
230
$450
TELEMETRY PER DAY
Gross
$450
322
$432
ARTHROGRAM TMJ
Gross
$432
750
$430
ANORECTAL MANOMETRY
Gross
$430
480
$420
CARDIOPULMONARY RESUSCITATION
Gross
$420
762
$406
OBSEV/HOSPITAL SAME DATE HIGH
Gross
$406
260
$395
HYDRATION IV INF 31MIN-1HR
Gross
$395
740
$393
CEREBRAL DEATH EEG
Gross
$393
912
$380
ADHC REGULAR DAY
Gross
$380
413
$375
HYPERBARIC O2 15 MIN (MCD)
Gross
$375
276
$375
MED SUPPLY-INTRAOCULAR LENS
Gross
$375
Showing top 50 of 108 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.