45 CFR § 180 compliance
F · 50
This hospital published little 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
934
Insurances with rates
0
CPT / HCPCS codes
168
Source MRF
Most expensive procedures (gross)
8115
$1,336
IP Psych Per Diem
Gross
$6,796
77333094025
—
PYRIDOXINE (VITAMIN B6) 50 MG TABLET
Gross
$4,251
77333093410
—
THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET
Gross
$3,203
77333051625
—
MELATONIN 3 MG TABLET
Gross
$2,403
99285
—
HB EMERGENCY ROOM VISIT LEVEL 5
Gross
$2,150
76385012401
—
METHOCARBAMOL 750 MG TABLET
Gross
$1,604
95816
—
HB EEG AWAKE & DROWSY
Gross
$1,128
76329301305
—
LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR
Gross
$1,063
M0243
—
HB IV INFUS/SUBQ ADMIN & MONITOR CASIRIVIMAB & IMDEVIMAB
Gross
$1,040
74312013168
—
VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 400 MCG TABLET
Gross
$929
74300001067
—
PEG 400-HYPROMELLOSE-GLYCERIN 1 %-0.2 %-0.2 % EYE DROPS
Gross
$856
74300000071
—
ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE
Gross
$822
72140003868
—
LANOLIN ALCOHOLS-MINERAL OIL-W.PETROLATUM-CERESIN TOPICAL CREAM
Gross
$776
72140000022
—
LANOLIN ALCOHOLS-MINERAL OIL-W.PETROLATUM-CERESIN TOPICAL CREAM
Gross
$763
71093013502
—
QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR
Gross
$755
99236
—
PR OBSERVATION HOSP SAME DATE SVC LVL 5
Gross
$682
87505
—
HB LAB STOOL BACTERIAL PCR
Gross
$664
70860070141
—
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION
Gross
$664
70501009200
—
COAL TAR 0.5 % SHAMPOO
Gross
$648
99223
—
PR INITIAL HOSPITAL CARE LVL 3
Gross
$640
70069005101
—
DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS
Gross
$581
99235
—
PR OBSERVATION HOSP SAME DATE SVC LVL 4
Gross
$531
70010075405
—
METHOCARBAMOL 500 MG TABLET
Gross
$520
69238183607
—
LEVOTHYROXINE 125 MCG TABLET
Gross
$510
69543013004
—
ALENDRONATE 35 MG TABLET
Gross
$510
69238126601
—
OSELTAMIVIR 75 MG CAPSULE
Gross
$470
69097022316
—
ALENDRONATE 35 MG TABLET
Gross
$442
87536
—
HB LAB HIV-1 QN NAP
Gross
$440
87502
—
HB LAB INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES
Gross
$440
68682071001
—
ENALAPRIL MALEATE 2.5 MG TABLET
Gross
$435
99222
—
PR INITIAL HOSPITAL CARE LVL 2
Gross
$432
99234
—
PR OBSERVATION HOSP SAME DATE SVC LVL 3
Gross
$419
68462029305
—
VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE
Gross
$418
68462026001
—
VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE
Gross
$418
68462010910
—
TOPIRAMATE 100 MG TABLET
Gross
$408
68462010810
—
TOPIRAMATE 25 MG TABLET
Gross
$372
68462010130
—
FLUCONAZOLE 50 MG TABLET
Gross
$370
68382091818
—
METHYLPREDNISOLONE 16 MG TABLET
Gross
$356
68382009801
—
PAROXETINE 20 MG TABLET
Gross
$351
68382013201
—
TAMSULOSIN 0.4 MG CAPSULE
Gross
$351
68382009706
—
PAROXETINE 10 MG TABLET
Gross
$350
68382009601
—
HYDROXYCHLOROQUINE 200 MG TABLET
Gross
$347
68180098001
—
LISINOPRIL 10 MG TABLET
Gross
$341
68382007910
—
HALOPERIDOL 5 MG TABLET
Gross
$341
99239
—
PR HOSPITAL DISCHARGE DAY >30 MIN
Gross
$335
99233
—
PR SBSQT HOSPITAL CARE LVL 3
Gross
$326
99221
—
PR INITIAL HOSPITAL CARE LVL 1
Gross
$320
G0408
—
PR FOLLOW UP INPT CONSULT COMPLEX 35 MIN (TELEHLTH)
Gross
$320
68180052001
—
LISINOPRIL 20 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET
Gross
$320
68180051901
—
LISINOPRIL 20 MG-HYDROCHLOROTHIAZIDE 12.5 MG TABLET
Gross
$310
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 8115 | IP Psych Per Diem | $6,796 | $1,336 | $1,336 | $1,336 | 0 |
| 77333094025 | PYRIDOXINE (VITAMIN B6) 50 MG TABLET | $4,251 | — | — | — | 0 |
| 77333093410 | THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET | $3,203 | — | — | — | 0 |
| 77333051625 | MELATONIN 3 MG TABLET | $2,403 | — | — | — | 0 |
| 99285 | HB EMERGENCY ROOM VISIT LEVEL 5 | $2,150 | — | — | — | 0 |
| 76385012401 | METHOCARBAMOL 750 MG TABLET | $1,604 | — | — | — | 0 |
| 95816 | HB EEG AWAKE & DROWSY | $1,128 | — | — | — | 0 |
| 76329301305 | LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR | $1,063 | — | — | — | 0 |
| M0243 | HB IV INFUS/SUBQ ADMIN & MONITOR CASIRIVIMAB & IMDEVIMAB | $1,040 | — | — | — | 0 |
| 74312013168 | VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 400 MCG TABLET | $929 | — | — | — | 0 |
| 74300001067 | PEG 400-HYPROMELLOSE-GLYCERIN 1 %-0.2 %-0.2 % EYE DROPS | $856 | — | — | — | 0 |
| 74300000071 | ZINC OXIDE-COD LIVER OIL 40 % TOPICAL PASTE | $822 | — | — | — | 0 |
| 72140003868 | LANOLIN ALCOHOLS-MINERAL OIL-W.PETROLATUM-CERESIN TOPICAL CREAM | $776 | — | — | — | 0 |
| 72140000022 | LANOLIN ALCOHOLS-MINERAL OIL-W.PETROLATUM-CERESIN TOPICAL CREAM | $763 | — | — | — | 0 |
| 71093013502 | QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR | $755 | — | — | — | 0 |
| 99236 | PR OBSERVATION HOSP SAME DATE SVC LVL 5 | $682 | — | — | — | 0 |
| 87505 | HB LAB STOOL BACTERIAL PCR | $664 | — | — | — | 0 |
| 70860070141 | KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION | $664 | — | — | — | 0 |
| 70501009200 | COAL TAR 0.5 % SHAMPOO | $648 | — | — | — | 0 |
| 99223 | PR INITIAL HOSPITAL CARE LVL 3 | $640 | — | — | — | 0 |
| 70069005101 | DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS | $581 | — | — | — | 0 |
| 99235 | PR OBSERVATION HOSP SAME DATE SVC LVL 4 | $531 | — | — | — | 0 |
| 70010075405 | METHOCARBAMOL 500 MG TABLET | $520 | — | — | — | 0 |
| 69238183607 | LEVOTHYROXINE 125 MCG TABLET | $510 | — | — | — | 0 |
| 69543013004 | ALENDRONATE 35 MG TABLET | $510 | — | — | — | 0 |
| 69238126601 | OSELTAMIVIR 75 MG CAPSULE | $470 | — | — | — | 0 |
| 69097022316 | ALENDRONATE 35 MG TABLET | $442 | — | — | — | 0 |
| 87536 | HB LAB HIV-1 QN NAP | $440 | — | — | — | 0 |
| 87502 | HB LAB INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES | $440 | — | — | — | 0 |
| 68682071001 | ENALAPRIL MALEATE 2.5 MG TABLET | $435 | — | — | — | 0 |
| 99222 | PR INITIAL HOSPITAL CARE LVL 2 | $432 | — | — | — | 0 |
| 99234 | PR OBSERVATION HOSP SAME DATE SVC LVL 3 | $419 | — | — | — | 0 |
| 68462029305 | VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE | $418 | — | — | — | 0 |
| 68462026001 | VERAPAMIL ER (SR) 240 MG TABLET,EXTENDED RELEASE | $418 | — | — | — | 0 |
| 68462010910 | TOPIRAMATE 100 MG TABLET | $408 | — | — | — | 0 |
| 68462010810 | TOPIRAMATE 25 MG TABLET | $372 | — | — | — | 0 |
| 68462010130 | FLUCONAZOLE 50 MG TABLET | $370 | — | — | — | 0 |
| 68382091818 | METHYLPREDNISOLONE 16 MG TABLET | $356 | — | — | — | 0 |
| 68382009801 | PAROXETINE 20 MG TABLET | $351 | — | — | — | 0 |
| 68382013201 | TAMSULOSIN 0.4 MG CAPSULE | $351 | — | — | — | 0 |
| 68382009706 | PAROXETINE 10 MG TABLET | $350 | — | — | — | 0 |
| 68382009601 | HYDROXYCHLOROQUINE 200 MG TABLET | $347 | — | — | — | 0 |
| 68180098001 | LISINOPRIL 10 MG TABLET | $341 | — | — | — | 0 |
| 68382007910 | HALOPERIDOL 5 MG TABLET | $341 | — | — | — | 0 |
| 99239 | PR HOSPITAL DISCHARGE DAY >30 MIN | $335 | — | — | — | 0 |
| 99233 | PR SBSQT HOSPITAL CARE LVL 3 | $326 | — | — | — | 0 |
| 99221 | PR INITIAL HOSPITAL CARE LVL 1 | $320 | — | — | — | 0 |
| G0408 | PR FOLLOW UP INPT CONSULT COMPLEX 35 MIN (TELEHLTH) | $320 | — | — | — | 0 |
| 68180052001 | LISINOPRIL 20 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET | $320 | — | — | — | 0 |
| 68180051901 | LISINOPRIL 20 MG-HYDROCHLOROTHIAZIDE 12.5 MG TABLET | $310 | — | — | — | 0 |
Showing top 50 of 934 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.