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
16
Insurances with rates
16
CPT / HCPCS codes
0
Most expensive procedures (gross)
124
$1,500
Behavioral health; acute, per diem
Gross
$1,500
100
$1,500
Behavioral health; acute, per diem
Gross
$1,500
114
$1,500
PSYCH/PVT
Gross
$1,500
134
$1,500
PSYCH /3&4 BED
Gross
$1,500
144
$1,500
PSYCH/DELUXE
Gross
$1,500
301
$50.28
8 PANEL URINE DRUG SCREEN
Gross
$50.28
780
$50
Telehealth originating site facility fee
Gross
$50
300
$19.03
LAMOTRIGINE
Gross
$19.03
350
$18.76
TRILEPTAL
Gross
$18.76
189
$10
LOA/OTHER
Gross
$10
250
$10
CLARITHROMYCIN 125MG/5ML SUSP 50ML
Gross
$10
251
$10
PALIPERIDONE SUSTENA 156MG INJ
Gross
$10
257
$10
ARTIFICIAL TEARS POLYVINYL ALCOHOL 15ML
Gross
$10
259
$10
INFANRIX
Gross
$10
270
$10
ABSORBTIVE DRESSING 6GM #740036
Gross
$10
310
$3.79
ALBUMIN
Gross
$3.79
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 124 | Behavioral health; acute, per diem | $1,500 | $1,500 | — | — | 37 |
| 100 | Behavioral health; acute, per diem | $1,500 | $1,500 | — | — | 23 |
| 114 | PSYCH/PVT | $1,500 | $1,500 | — | — | 22 |
| 134 | PSYCH /3&4 BED | $1,500 | $1,500 | — | — | 22 |
| 144 | PSYCH/DELUXE | $1,500 | $1,500 | — | — | 22 |
| 301 | 8 PANEL URINE DRUG SCREEN | $50.28 | $50.28 | — | — | 14 |
| 780 | Telehealth originating site facility fee | $50 | $50 | — | — | 14 |
| 300 | LAMOTRIGINE | $19.03 | $19.03 | — | — | 28 |
| 350 | TRILEPTAL | $18.76 | $18.76 | — | — | 14 |
| 189 | LOA/OTHER | $10 | $10 | — | — | 22 |
| 250 | CLARITHROMYCIN 125MG/5ML SUSP 50ML | $10 | $10 | — | — | 44 |
| 251 | PALIPERIDONE SUSTENA 156MG INJ | $10 | $10 | — | — | 36 |
| 257 | ARTIFICIAL TEARS POLYVINYL ALCOHOL 15ML | $10 | $10 | — | — | 44 |
| 259 | INFANRIX | $10 | $10 | — | — | 22 |
| 270 | ABSORBTIVE DRESSING 6GM #740036 | $10 | $10 | — | — | 22 |
| 310 | ALBUMIN | $3.79 | $3.79 | — | — | 14 |
Showing top 16 of 16 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.