MAPLE GROVE HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
591	NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,EXTREME	$830,235	—	—	—	7
589	NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BI	$498,250	—	—	—	7
593	NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,MAJOR	$396,797	—	—	—	7
RX-95998	SIPULEUCEL-T IN LACTATED RINGERS 50 MILLION CELL/250 ML IV SUSPENSION	$230,208	$121,320	—	—	15
608	NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,MODERATE	$196,172	—	—	—	7
621	NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,MINOR	$192,051	—	—	—	7
622	NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY C	$184,436	—	—	—	7
611	NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,MINOR	$144,072	—	—	—	7
357	OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC	$134,837	$71,059	—	—	12
471	CERVICAL SPINAL FUSION WITH MCC	$115,912	$61,086	—	—	12
208	RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS	$115,094	$60,654	—	—	12
040	PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC	$107,927	$56,878	—	—	12
026	OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,MODERATE	$101,351	—	—	—	7
821	LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC	$91,399	$48,167	—	—	12
656	KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC	$90,035	$47,449	—	—	12
510	SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC	$88,348	$46,560	—	—	12
447	MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY	$87,444	$46,083	—	—	11
426	MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE	$83,095	$43,791	—	—	11
495	LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC	$81,878	$43,149	—	—	12
457	SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH	$78,554	$41,398	—	—	12
252	OTHER VASCULAR PROCEDURES WITH MCC	$77,490	$40,837	—	—	12
612	NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY C	$77,009	—	—	—	7
427	MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC	$73,269	$38,613	—	—	11
428	MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC	$72,548	$38,233	—	—	11
956	LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA	$70,207	$36,999	—	—	12
028	SPINAL PROCEDURES WITH MCC	$69,995	$36,887	—	—	12
790	EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE	$69,193	$36,465	—	—	12
634	NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY COND	$69,193	—	—	—	7
458	SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH	$68,815	$36,265	—	—	12
325	NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,MODERATE	$68,332	—	—	—	7
448	MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	$68,181	$35,931	—	—	11
456	SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH	$68,127	$35,903	—	—	12
450	SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY F	$65,756	$34,654	—	—	8
132	BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,MAJOR	$65,067	—	—	—	7
PX-233270	Insertion or replacement of defibrillator with electrode	$64,820	$34,160	—	—	17
826	MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC	$63,213	$33,313	—	—	12
RX-160700	LONCASTUXIMAB TESIRINE-LPYL 10 MG INTRAVENOUS SOLUTION	$62,893	$33,145	—	—	17
827	MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC	$61,860	$32,600	—	—	12
680	MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS,MAJOR	$61,860	—	—	—	7
PX-233264	Removal and replacement of multiple lead defibrillator	$60,935	$32,113	—	—	17
466	REVISION OF HIP OR KNEE REPLACEMENT WITH MCC	$60,694	$31,986	—	—	12
744	D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC	$60,531	$31,900	—	—	12
PX-233289	Insertion of wireless pressure sensor into lung artery via catheter	$60,469	$31,867	—	—	17
224	PERITONEAL ADHESIOLYSIS,MODERATE	$60,387	—	—	—	7
451	SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	$58,988	$31,087	—	—	8
723	VIRAL ILLNESS,MODERATE	$58,414	—	—	—	7
505	FOOT PROCEDURES WITHOUT CC/MCC	$57,147	$30,117	—	—	12
RX-179414	LINVOSELTAMAB-GCPT 20 MG/ML INTRAVENOUS SOLUTION	$56,400	$29,723	—	—	20
736	UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC	$55,872	$29,445	—	—	12
231	MAJOR LARGE BOWEL PROCEDURES,MINOR	$55,696	—	—	—	7

Showing top 50 of 15,215 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.