45 CFR § 180 compliance
B · 85
This hospital published most 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: assessment threshold met
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
3,182
Insurances with rates
1
CPT / HCPCS codes
1,186
Most expensive procedures (gross)
50242-0085-27
$35,912
alteplase 100 mg INJ Soln
Gross
$36,645
50242-0120-47
$33,859
tenecteplase 50 mg INJ Soln
Gross
$34,550
50242-0176-01
$33,859
tenecteplase 50 mg INJ Soln
Gross
$34,550
44206-0439-40
$30,733
immune globulin (IVIG) 10%, 40 G/400 mL (Privigen) INJ Soln
Gross
$31,360
50242-0120-01
$27,448
tenecteplase 50 mg INJ Soln
Gross
$28,008
278
$25,704
CRTD COBALT XT HF QUAD MRI DF1
Gross
$26,228
50633-0120-11
$20,298
digoxin immune FAB 40 mg INJ Soln
Gross
$20,712
50242-0044-13
$17,956
alteplase 50 mg INJ Soln
Gross
$18,322
44206-0438-20
$15,366
immune globulin (IVIG) 10%, 20 G/200 mL (Privigen) INJ Soln
Gross
$15,680
13533-0318-05
$13,679
rabies immune glob, human 1,500 Intl_Units/5 mL INJ Soln
Gross
$13,959
50633-0110-12
$13,050
antivenin (Crotalidae-snake ovine) polyvalent INJ
Gross
$13,316
78831
$12,269
NM Octreo Scan Spect
Gross
$12,519
50242-0037-06
$12,004
tenecteplase 50 mg INJ Soln
Gross
$12,249
43598-0051-11
$10,860
calcitonin 400 Intl_Units/2 mL (MDV) INJ Soln
Gross
$11,082
50242-0137-01
$10,838
tocilizumab 400 mg/20 mL INJ Soln
Gross
$11,059
00597-0197-05
$10,411
idaruCIZUmab 2.5 G/ 50 mL INJ Soln
Gross
$10,623
78804
$10,339
NM Tumor Localization/Whole Body 2+ Days
Gross
$10,550
636
$8,926
DECELLULARIZED DERMIS SOFT TISSUE 8X20CM
Gross
$9,108
279
$8,759
MOP - Poly Cemented/Porous, All Sizes Depuy Synthes
Gross
$8,937
78266
$8,478
NM Gastric Emptying Study W/SMALL BOWEL&COLON TRANSIT MULTI DAYS
Gross
$8,651
81540
$8,248
81540 Oncology, mRNA, gene expression profiling by real0time RT-PCR of 92 genes
Gross
$8,416
78075
$8,202
NM Adrenal Imaging
Gross
$8,370
78227
$8,133
NM HIDA Scan with Intervention
Gross
$8,299
78452
$7,927
NM Heart Muscle Spect Multiple
Gross
$8,088
44206-0437-10
$7,683
immune globulin (IVIG) 10%, 10 G/100 mL (Privigen) INJ Soln
Gross
$7,840
63833-0386-02
$7,527
prothrombin complex concentrate (human) 500 units (range) INJ soln
Gross
$7,681
81519
$7,199
Oncotype DX Breast Cancer Assay
Gross
$7,346
00517-0710-01
$7,066
fomepizole 1.5 G/1.5 mL INJ Soln
Gross
$7,210
78265
$7,031
NM Gastric Emptying Study W/SMALL BOWEL TRANSIT
Gross
$7,174
0037U
$6,774
TRGT GEN SEQ DNA 324 GENES
Gross
$6,912
84999
$6,492
BioTheranostics Three 6420010.
Gross
$6,625
78630
$6,135
NM Cisternography/Cerebrospinal
Gross
$6,260
70710-1478-01
$6,121
fomepizole 1.5 G/1.5 mL INJ Soln
Gross
$6,246
78278
$6,066
NM Bleeding Scan-GI
Gross
$6,189
78650
$6,066
NM Cerebrospinal Fluid Leakage Detection
Gross
$6,189
78315
$5,997
NM Bone Three Phase Study
Gross
$6,119
78606
$5,997
NM Brain Imaging Comp w/ Vascular Flow
Gross
$6,119
78645
$5,997
NM Cerebro Fluid Flow Shunt Evaluation
Gross
$6,119
78264
$5,997
NM Gastric Emptying Study, SOLID, LIQUID OR BOTH
Gross
$6,119
78709
$5,997
NM Kidney Imaging w/ Flow w/ + w/o Pharm
Gross
$6,119
78195
$5,997
NM Lymphatic Imaging
Gross
$6,119
78290
$5,997
NM Meckel's Scan
Gross
$6,119
78071
$5,997
NM Parathyroid Planar Imaging W/SPECT
Gross
$6,119
A9572
$5,974
IN-111 Octreoscan / 6mCi
Gross
$6,095
78226
$5,928
NM HIDA Scan w/o Intervention
Gross
$6,049
78803
$5,859
NM Abscess Imaging Spect
Gross
$5,978
70549
$5,658
FWMC MR Charges -> FWMC MRA Neck w/wo Contrast
Gross
$5,773
78802
$5,652
NM Abscess Imaging Whole Body
Gross
$5,767
78582
$5,652
NM VQ Scan complete
Gross
$5,767
70546
$5,619
FWMC MR Charges -> FWMC MRA Head w/wo Contrast
Gross
$5,733
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 50242-0085-27 | alteplase 100 mg INJ Soln | $36,645 | $35,912 | — | — | 1 |
| 50242-0120-47 | tenecteplase 50 mg INJ Soln | $34,550 | $33,859 | — | — | 1 |
| 50242-0176-01 | tenecteplase 50 mg INJ Soln | $34,550 | $33,859 | — | — | 1 |
| 44206-0439-40 | immune globulin (IVIG) 10%, 40 G/400 mL (Privigen) INJ Soln | $31,360 | $30,733 | — | — | 1 |
| 50242-0120-01 | tenecteplase 50 mg INJ Soln | $28,008 | $27,448 | — | — | 1 |
| 278 | CRTD COBALT XT HF QUAD MRI DF1 | $26,228 | $25,704 | — | — | 2 |
| 50633-0120-11 | digoxin immune FAB 40 mg INJ Soln | $20,712 | $20,298 | — | — | 1 |
| 50242-0044-13 | alteplase 50 mg INJ Soln | $18,322 | $17,956 | — | — | 1 |
| 44206-0438-20 | immune globulin (IVIG) 10%, 20 G/200 mL (Privigen) INJ Soln | $15,680 | $15,366 | — | — | 1 |
| 13533-0318-05 | rabies immune glob, human 1,500 Intl_Units/5 mL INJ Soln | $13,959 | $13,679 | — | — | 1 |
| 50633-0110-12 | antivenin (Crotalidae-snake ovine) polyvalent INJ | $13,316 | $13,050 | — | — | 1 |
| 78831 | NM Octreo Scan Spect | $12,519 | $12,269 | — | — | 1 |
| 50242-0037-06 | tenecteplase 50 mg INJ Soln | $12,249 | $12,004 | — | — | 1 |
| 43598-0051-11 | calcitonin 400 Intl_Units/2 mL (MDV) INJ Soln | $11,082 | $10,860 | — | — | 1 |
| 50242-0137-01 | tocilizumab 400 mg/20 mL INJ Soln | $11,059 | $10,838 | — | — | 1 |
| 00597-0197-05 | idaruCIZUmab 2.5 G/ 50 mL INJ Soln | $10,623 | $10,411 | — | — | 1 |
| 78804 | NM Tumor Localization/Whole Body 2+ Days | $10,550 | $10,339 | — | — | 1 |
| 636 | DECELLULARIZED DERMIS SOFT TISSUE 8X20CM | $9,108 | $8,926 | — | — | 1 |
| 279 | MOP - Poly Cemented/Porous, All Sizes Depuy Synthes | $8,937 | $8,759 | — | — | 1 |
| 78266 | NM Gastric Emptying Study W/SMALL BOWEL&COLON TRANSIT MULTI DAYS | $8,651 | $8,478 | — | — | 1 |
| 81540 | 81540 Oncology, mRNA, gene expression profiling by real0time RT-PCR of 92 genes | $8,416 | $8,248 | — | — | 1 |
| 78075 | NM Adrenal Imaging | $8,370 | $8,202 | — | — | 1 |
| 78227 | NM HIDA Scan with Intervention | $8,299 | $8,133 | — | — | 1 |
| 78452 | NM Heart Muscle Spect Multiple | $8,088 | $7,927 | — | — | 1 |
| 44206-0437-10 | immune globulin (IVIG) 10%, 10 G/100 mL (Privigen) INJ Soln | $7,840 | $7,683 | — | — | 1 |
| 63833-0386-02 | prothrombin complex concentrate (human) 500 units (range) INJ soln | $7,681 | $7,527 | — | — | 1 |
| 81519 | Oncotype DX Breast Cancer Assay | $7,346 | $7,199 | — | — | 1 |
| 00517-0710-01 | fomepizole 1.5 G/1.5 mL INJ Soln | $7,210 | $7,066 | — | — | 1 |
| 78265 | NM Gastric Emptying Study W/SMALL BOWEL TRANSIT | $7,174 | $7,031 | — | — | 1 |
| 0037U | TRGT GEN SEQ DNA 324 GENES | $6,912 | $6,774 | — | — | 1 |
| 84999 | BioTheranostics Three 6420010. | $6,625 | $6,492 | — | — | 1 |
| 78630 | NM Cisternography/Cerebrospinal | $6,260 | $6,135 | — | — | 1 |
| 70710-1478-01 | fomepizole 1.5 G/1.5 mL INJ Soln | $6,246 | $6,121 | — | — | 1 |
| 78278 | NM Bleeding Scan-GI | $6,189 | $6,066 | — | — | 1 |
| 78650 | NM Cerebrospinal Fluid Leakage Detection | $6,189 | $6,066 | — | — | 1 |
| 78315 | NM Bone Three Phase Study | $6,119 | $5,997 | — | — | 1 |
| 78606 | NM Brain Imaging Comp w/ Vascular Flow | $6,119 | $5,997 | — | — | 1 |
| 78645 | NM Cerebro Fluid Flow Shunt Evaluation | $6,119 | $5,997 | — | — | 1 |
| 78264 | NM Gastric Emptying Study, SOLID, LIQUID OR BOTH | $6,119 | $5,997 | — | — | 1 |
| 78709 | NM Kidney Imaging w/ Flow w/ + w/o Pharm | $6,119 | $5,997 | — | — | 1 |
| 78195 | NM Lymphatic Imaging | $6,119 | $5,997 | — | — | 1 |
| 78290 | NM Meckel's Scan | $6,119 | $5,997 | — | — | 1 |
| 78071 | NM Parathyroid Planar Imaging W/SPECT | $6,119 | $5,997 | — | — | 1 |
| A9572 | IN-111 Octreoscan / 6mCi | $6,095 | $5,974 | — | — | 1 |
| 78226 | NM HIDA Scan w/o Intervention | $6,049 | $5,928 | — | — | 1 |
| 78803 | NM Abscess Imaging Spect | $5,978 | $5,859 | — | — | 1 |
| 70549 | FWMC MR Charges -> FWMC MRA Neck w/wo Contrast | $5,773 | $5,658 | — | — | 1 |
| 78802 | NM Abscess Imaging Whole Body | $5,767 | $5,652 | — | — | 1 |
| 78582 | NM VQ Scan complete | $5,767 | $5,652 | — | — | 1 |
| 70546 | FWMC MR Charges -> FWMC MRA Head w/wo Contrast | $5,733 | $5,619 | — | — | 1 |
Showing top 50 of 3,182 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.