RAINY LAKE MEDICAL CENTER (International Falls, MN) prices

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J2507	Pegloticase Inj 8 MG/ML (For IV Infusion)	$43,958	$33,848	—	—	19
J2350	Ocrelizumab Soln For IV Infusion 300 MG/10ML	$33,803	$26,029	—	—	19
J9309	Polatuzumab Vedotin-piiq For IV Solution 140 MG	$27,010	$20,798	—	—	19
J3241	Teprotumumab-trbw For IV Soln 500 MG	$26,207	$20,180	—	—	19
J9043	Cabazitaxel Inj 60 MG/1.5ML (For IV Infusion)	$22,541	$17,357	—	—	19
J0896	Luspatercept-aamt For Subcutaneous Inj 75 MG	$21,407	$16,484	—	—	19
J9272	Dostarlimab-gxly IV Soln 500 MG/10ML (50 MG/ML)	$20,601	$15,863	—	—	19
J9119	Cemiplimab-rwlc IV Soln 350 MG/7ML (50 MG/ML)	$17,717	$13,642	—	—	19
J9022	Atezolizumab IV Soln 1200 MG/20ML	$17,596	$13,549	—	—	19
J9144	Daratumumab-Hyaluronidase-fihj Inj 1800-30000 MG-Unit/15ML	$17,489	$13,466	—	—	19
J2327	Risankizumab-rzaa IV Soln 600 MG/10ML (60 MG/ML)	$15,695	$12,085	—	—	19
J3380	Vedolizumab For IV Solution 300 MG	$15,468	$11,911	—	—	19
J9316	Pertuzumab-Trastuz-Hyaluron-zzxf Inj 60 MG-60 MG-2000 UNT/ML	$15,270	$11,758	—	—	19
J9301	Obinutuzumab Soln for IV Infusion 1000 MG/40ML (25 MG/ML)	$14,353	$11,052	—	—	19
J2997	Alteplase For Inj 100 MG	$13,771	$10,604	—	—	19
27487	REVISION TOTAL KNEE ARTHROPLASTY FEMORAL & ENTIRE TIBIAL COMPONENT	$13,675	$10,530	—	—	40
27487	PF 27487 REV ARTHROPL KNEE TTL	$13,675	$10,530	—	—	21
J9228	Ipilimumab Soln for IV Infusion 50 MG/10ML (5 MG/ML)	$13,102	$10,088	—	—	19
J3101	Tenecteplase For IV Soln Kit 50 MG	$13,037	$10,039	—	—	38
J9223	Lurbinectedin For IV Soln 4 MG	$12,903	$9,935	—	—	19
J2323	Natalizumab for IV Inj Conc 300 MG/15ML	$12,138	$9,346	—	—	19
J1932	Lanreotide Acetate Extended Release Inj 120 MG/0.5ML	$12,000	$9,240	—	—	19
J9308	Ramucirumab IV Soln 500 MG/50ML (For Infusion)	$10,996	$8,467	—	—	19
J9306	Pertuzumab Soln for IV Infusion 420 MG/14ML (30 MG/ML)	$10,978	$8,453	—	—	19
27486	REVISION TOTAL KNEE ARTHROPLASTY WWO ALLOGRAFT 1 COMPONENT	$10,593	$8,157	—	—	40
27486	PF 27486 REV TOT KNEE PLASTY 1	$10,593	$8,157	—	—	21
27447	ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL & LAT COMPARTMENTS WWO PAT	$10,500	$8,085	—	—	20
27447	PF 27447 ARTHROPL KNE TIB FEM	$10,500	$8,085	—	—	7
J2353	Octreotide Acetate For IM Inj Kit 30 MG	$10,492	$8,079	—	—	19
27170	BONE GRFT FEMORAL HEAD NECK INTERTROCHANTERIC SUBTROCHANTERIC AREA(INC	$8,811	$6,784	—	—	40
27170	PF 27170 BONE GRAFT	$8,811	$6,784	—	—	21
J1162	Digoxin Immune Fab For Inj 40 MG	$8,416	$6,481	—	—	19
J2506	Pegfilgrastim Soln Prefilled Syringe 6 MG/0.6ML	$8,279	$6,375	—	—	19
J9271	Pembrolizumab IV Soln 100 MG/4ML (25 MG/ML)	$8,202	$6,316	—	—	57
J2356	Tezepelumab-ekko Subcutaneous Soln Pref Syr 210 MG/1.91ML	$8,019	$6,175	—	—	19
76497	CT LOW DOSE WHOLE BODY	$7,600	$5,852	—	—	20
27130	ARTHROPLASTY ACETABULAR PROXIMAL FEMORAL PROSTHETIC REPLACE WWO AUTOG	$7,388	$5,689	—	—	40
27130	PF 27130 ARTHROPL HIP TTL	$7,388	$5,689	—	—	21
25609	FX W INTERN FIXN 3+ FRAG	$7,339	$5,651	—	—	40
25609	PF 25609 TX FX RAD DIS 3+ FRG	$7,339	$5,651	—	—	21
23420	RECONSTRUCT COMP SHLDR(ROTATOR)CUFF AVULSION CHRONIC(INC ACROMIOPLSTY)	$7,296	$5,618	—	—	40
23420	PF 23420 REP SHOULDER CUFF AVUL	$7,296	$5,618	—	—	21
29827	ARTHROSCOPY SHLDR SURGICAL WROTATOR CUFF RPR	$7,268	$5,596	—	—	20
29827	PF 29827 ARTHROSCOPY SHOULDER WROTATOR CUFF RPR	$7,268	$5,596	—	—	7
J1437	Ferric Derisomaltose (One Dose) IV Sol 1000 MG/10ML (Fe Eq)	$7,169	$5,520	—	—	19
58552	LAPAROSCPY SURG WVAGINAL HYSTERECTOMY UTERUS 250GMS < WREMVL TUBE &	$7,159	$5,512	—	—	40
58552	PF 58552 VAG HYST<250G WTUBE	$7,159	$5,512	—	—	21
49591	RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$6,940	$5,344	—	—	40
49591	PF 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$6,940	$5,344	—	—	21
23472	ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHLDR	$6,911	$5,322	—	—	40

Showing top 50 of 3,140 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.