MOUNT DESERT ISLAND HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
437790	ipilimumab 5 mg/mL 40 mL [MDIH]	$161,264	$145,137	—	—	10
438145	ocrelizumab 300 mg/10 mL [MDIH]	$88,715	$79,843	—	—	10
436183	rabies immune globulin, human 300 intl units/mL (5 mL) [MDIH]	$72,710	$65,439	—	—	10
13227490	cabazitaxel 60 mg/1.5 mL Sol [MDIH]	$68,863	$61,976	—	—	10
10067963	paliperidone 1092 mg/3.5 mL Sus [MDIH]	$61,366	$55,229	—	—	10
439013	luspatercept-aamt 75 mg Pow [MDIH]	$58,304	$52,473	—	—	10
437781	brentuximab vedotin 50 mg Pow [MDIH]	$53,402	$48,062	—	—	10
12147409	dostarlimab-gxly 500 mg/10 mL Sol [MDIH]	$52,034	$46,831	—	—	10
11811057	leuprolide pediatric 11.25 mg/3 months Kit [MDIH]	$48,548	$43,693	—	—	10
12124313	cemiplimab-rwlc 350 mg/7 mL Sol [MDIH]	$46,340	$41,706	—	—	10
13372793	gemtuzumab ozogamicin 4.5 mg Pow[MDIH]	$45,881	$41,293	—	—	10
12367516	risankizumab rzaa 600mg/ 10mL Sol [MDIH]	$45,539	$40,985	—	—	10
11555787	paliperidone 819 mg/2.63 mL Sus [MDIH]	$44,262	$39,836	—	—	10
439231	daratumumab-hyaluronidase 1800 mg-30,000 units/15 mL [MDIH]	$43,401	$39,061	—	—	10
437789	ipilimumab 5 mg/mL 10 mL [MDIH]	$40,316	$36,284	—	—	10
436771	vedolizumab 300 mg Pow [MDIH]	$39,000	$35,100	—	—	10
433154	alteplase 100 mg IV Inj [MDIH]	$38,014	$34,212	—	—	10
437822	obinutuzumab 25 mg/mL (40 mL) [MDIH]	$37,088	$33,379	—	—	10
435785	natalizumab 300 mg/15 mL IV Conc [MDIH]	$36,942	$33,248	—	—	10
13301978	tenecteplase 25 mg Pow [MDIH]	$35,762	$32,186	—	—	10
13157286	tenecteplase 50 mg Pow [MDIH]	$35,762	$32,186	—	—	10
437883	nivolumab 10 mg/mL 24 mL [MDIH]	$35,366	$31,830	—	—	10
12931905	olipudase alfa rpcp 20 mg Pow	$34,093	$30,684	—	—	10
435437	tenecteplase 50 mg IV Inj [MDIH]	$32,827	$29,544	—	—	10
439647	ramucirumab 10 mg/mL (50 mL) Sol [MDIH]	$31,518	$28,366	—	—	10
10499359	PULSAVAC PLUS FAN KIT	$30,810	$27,729	—	—	14
438539	panitumumab 20 mg/mL IV Sol 20 mL [MDIH]	$30,277	$27,250	—	—	10
9671275	octreotide 30 mg IM Inj [MDIH]	$29,915	$26,924	—	—	10
12744896	VENTIX LINK 4.75MM DISP DRILL	$29,679	$26,711	—	—	14
436710	collagenase clostridium histolyticum 0.9 mg Pow [MDIH]	$29,630	$26,667	—	—	10
439123	paliperidone 546 mg/1.75 mL [MDIH]	$29,453	$26,507	—	—	10
436977	pertuzumab 420 mg/14 mL [MDIH]	$29,371	$26,433	—	—	10
436349	ado-trastuzumab emtansine 160 mg Pow [MDIH]	$28,021	$25,219	—	—	10
13043964	efgartigimod alfa fcab 400 mg/20 mL Sol	$27,857	$25,071	—	—	10
12866723	lanreotide 60 mg/0.2 mL Sol [MDIH]	$27,396	$24,656	—	—	10
437905	lanreotide 120 mg/0.5 mL SC Sol [MDIH]	$27,213	$24,492	—	—	10
9934481	X RX BAG NACL .9P 500ML	$27,009	$24,308	—	—	14
9842187	X RX BOTTLE STERILE WATER FOR IRRIG	$27,009	$24,308	—	—	14
438983	ixabepilone 45 mg IV Inj [MDIH]	$26,140	$23,526	—	—	10
437324	pembrolizumab 25 mg/mL [MDIH]	$25,509	$22,958	—	—	20
437501	golimumab 50 mg/0.5 mL [MDIH]	$25,434	$22,891	—	—	10
439098	ustekinumab 90 mg/mL [MDIH]	$25,358	$22,822	—	—	10
12215848	pegfilgrastim 6 mg / 0.6 mL OnBody [MDIH]	$24,854	$22,368	—	—	10
438567	certolizumab 200 mg/mL Kit [MDIH]	$24,717	$22,245	—	—	10
438625	romiPLOStim 500 mcg Pow [MDIH]	$23,595	$21,235	—	—	10
9843296	PSN TIB STM 5 DEG SZ E L	$23,219	$20,897	—	—	14
438316	benralizumab 30 mg/mL [MDIH]	$22,608	$20,347	—	—	10
436083	riTUXimab 10 mg/mL IV Sol 50 mL [MDIH]	$21,139	$19,025	—	—	10
439361	trastuzumab-hyalyuronidase-oysk 600 mg-10,000 units/5 mL Inj [MDIH]	$21,039	$18,935	—	—	10
9843257	PSN ASF CR 12MM VE L 3-9 CD	$20,776	$18,698	—	—	14

Showing top 50 of 8,115 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.