45 CFR § 180 compliance
D · 65
This hospital published part 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
551
Insurances with rates
0
CPT / HCPCS codes
531
Source MRF
Most expensive procedures (gross)
J9217
$10
Leuprolide Acetate 45 MG Syr
Gross
$33,229
J0717
$10
Certolizumab Pegol 400 Mg Kit
Gross
$18,859
J9312
$10
Rituximab 500 MG/50 ML Vial
Gross
$18,087
J2356
$10
Tezepelumab-EKKO 210 Mg/1.9 Ml
Gross
$14,814
J3101
$10
Tenecteplase 50 Mg/10 Ml Syrng
Gross
$11,886
J1561
$10
Immune Glob Gamunex 20GR/200ML
Gross
$6,918
70553
$10
MRI Brain WWO Contrast
Gross
$6,082
72158
$10
MRI Lumbar Spine WWO Dye
Gross
$6,082
74183
$10
MRI Abdomen WWO Dye
Gross
$6,082
73720
$10
MRI LE WWO Dye RT
Gross
$6,082
95810
$10
Polysomnogram
Gross
$6,036
74174
$10
CTA Abd&Pelv WWO Dye
Gross
$5,405
70551
$10
MRI Brain WO Contrast
Gross
$5,017
72141
$10
MRI Neck Spine WO Dye
Gross
$5,017
72148
$10
MRI Lumbar Spine WO Dye
Gross
$5,017
74181
$10
MRI Abdomen WO Dye
Gross
$5,017
73221
$10
MRI Joint UE WO Dye LT
Gross
$5,017
73718
$10
MRI LE WO Dye LT
Gross
$5,017
73721
$10
MRI Joint LE WO Dye LT
Gross
$5,017
73218
$10
MRI UE WO Dye RT
Gross
$5,017
74178
$10
CT Abd & Pelv WWO Contrast
Gross
$4,921
95811
$10
Polysomnogram W CPap
Gross
$4,682
J0897
$10
Denosumab 60 MG/ML Syringe
Gross
$4,359
74177
$10
CT Abd & Pelv W Contrast
Gross
$4,059
750
$10
EGD
Gross
$3,957
70491
$10
CT Soft Tissue Neck W Cont
Gross
$3,909
74176
$10
CT Abd & Pelvis WO Contrast
Gross
$3,878
99291
$10
Critical Care 1st 30-74 Min
Gross
$3,614
72131
$10
CT Lumbar Spine WO Contrast
Gross
$3,609
74170
$10
CT Abdomen WWO Dye
Gross
$3,421
70470
$10
CT Head/Brain WWO Contrast
Gross
$3,038
70496
$10
CT Angiography Head W Cont
Gross
$3,038
70498
$10
CT Angiography Neck W Cont
Gross
$3,038
71260
$10
CT Thorax W Contrast
Gross
$2,970
73700
$10
CT LE WO Dye RT
Gross
$2,867
72125
$10
CT Cervical Spine WO Contrast
Gross
$2,771
G0175
$10
Geriatric Assessment
Gross
$2,704
71250
$10
CT Thorax WO Contrast
Gross
$2,634
71275
$10
CTA Chest WWO Contrast
Gross
$2,634
71271
$10
LDCT For Lung Cancer Screen
Gross
$2,634
70486
$10
CT Maxillofacial WO Contrast
Gross
$2,601
70460
$10
CT Head/Brain W Contrast
Gross
$2,587
72192
$10
CT Pelvis WO Dye
Gross
$2,569
115
$10
Room Hospice IP
Gross
$2,563
111
$10
Room Medical Unit Priv
Gross
$2,563
70450
$10
CT Head/Brain WO Contrast
Gross
$2,455
70490
$10
CT Soft Tissue Neck WO Cont
Gross
$2,377
72128
$10
CT Thoracic Spine WO Contrast
Gross
$2,377
93306
$10
TTE W Doppler Complete
Gross
$2,372
93303
$10
Echo Congenital Abn Complete
Gross
$2,372
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J9217 | Leuprolide Acetate 45 MG Syr | $33,229 | $10 | — | — | 0 |
| J0717 | Certolizumab Pegol 400 Mg Kit | $18,859 | $10 | — | — | 0 |
| J9312 | Rituximab 500 MG/50 ML Vial | $18,087 | $10 | — | — | 0 |
| J2356 | Tezepelumab-EKKO 210 Mg/1.9 Ml | $14,814 | $10 | — | — | 0 |
| J3101 | Tenecteplase 50 Mg/10 Ml Syrng | $11,886 | $10 | — | — | 0 |
| J1561 | Immune Glob Gamunex 20GR/200ML | $6,918 | $10 | — | — | 0 |
| 70553 | MRI Brain WWO Contrast | $6,082 | $10 | — | — | 0 |
| 72158 | MRI Lumbar Spine WWO Dye | $6,082 | $10 | — | — | 0 |
| 74183 | MRI Abdomen WWO Dye | $6,082 | $10 | — | — | 0 |
| 73720 | MRI LE WWO Dye RT | $6,082 | $10 | — | — | 0 |
| 95810 | Polysomnogram | $6,036 | $10 | — | — | 0 |
| 74174 | CTA Abd&Pelv WWO Dye | $5,405 | $10 | — | — | 0 |
| 70551 | MRI Brain WO Contrast | $5,017 | $10 | — | — | 0 |
| 72141 | MRI Neck Spine WO Dye | $5,017 | $10 | — | — | 0 |
| 72148 | MRI Lumbar Spine WO Dye | $5,017 | $10 | — | — | 0 |
| 74181 | MRI Abdomen WO Dye | $5,017 | $10 | — | — | 0 |
| 73221 | MRI Joint UE WO Dye LT | $5,017 | $10 | — | — | 0 |
| 73718 | MRI LE WO Dye LT | $5,017 | $10 | — | — | 0 |
| 73721 | MRI Joint LE WO Dye LT | $5,017 | $10 | — | — | 0 |
| 73218 | MRI UE WO Dye RT | $5,017 | $10 | — | — | 0 |
| 74178 | CT Abd & Pelv WWO Contrast | $4,921 | $10 | — | — | 0 |
| 95811 | Polysomnogram W CPap | $4,682 | $10 | — | — | 0 |
| J0897 | Denosumab 60 MG/ML Syringe | $4,359 | $10 | — | — | 0 |
| 74177 | CT Abd & Pelv W Contrast | $4,059 | $10 | — | — | 0 |
| 750 | EGD | $3,957 | $10 | — | — | 0 |
| 70491 | CT Soft Tissue Neck W Cont | $3,909 | $10 | — | — | 0 |
| 74176 | CT Abd & Pelvis WO Contrast | $3,878 | $10 | — | — | 0 |
| 99291 | Critical Care 1st 30-74 Min | $3,614 | $10 | — | — | 0 |
| 72131 | CT Lumbar Spine WO Contrast | $3,609 | $10 | — | — | 0 |
| 74170 | CT Abdomen WWO Dye | $3,421 | $10 | — | — | 0 |
| 70470 | CT Head/Brain WWO Contrast | $3,038 | $10 | — | — | 0 |
| 70496 | CT Angiography Head W Cont | $3,038 | $10 | — | — | 0 |
| 70498 | CT Angiography Neck W Cont | $3,038 | $10 | — | — | 0 |
| 71260 | CT Thorax W Contrast | $2,970 | $10 | — | — | 0 |
| 73700 | CT LE WO Dye RT | $2,867 | $10 | — | — | 0 |
| 72125 | CT Cervical Spine WO Contrast | $2,771 | $10 | — | — | 0 |
| G0175 | Geriatric Assessment | $2,704 | $10 | — | — | 0 |
| 71250 | CT Thorax WO Contrast | $2,634 | $10 | — | — | 0 |
| 71275 | CTA Chest WWO Contrast | $2,634 | $10 | — | — | 0 |
| 71271 | LDCT For Lung Cancer Screen | $2,634 | $10 | — | — | 0 |
| 70486 | CT Maxillofacial WO Contrast | $2,601 | $10 | — | — | 0 |
| 70460 | CT Head/Brain W Contrast | $2,587 | $10 | — | — | 0 |
| 72192 | CT Pelvis WO Dye | $2,569 | $10 | — | — | 0 |
| 115 | Room Hospice IP | $2,563 | $10 | — | — | 0 |
| 111 | Room Medical Unit Priv | $2,563 | $10 | — | — | 0 |
| 70450 | CT Head/Brain WO Contrast | $2,455 | $10 | — | — | 0 |
| 70490 | CT Soft Tissue Neck WO Cont | $2,377 | $10 | — | — | 0 |
| 72128 | CT Thoracic Spine WO Contrast | $2,377 | $10 | — | — | 0 |
| 93306 | TTE W Doppler Complete | $2,372 | $10 | — | — | 0 |
| 93303 | Echo Congenital Abn Complete | $2,372 | $10 | — | — | 0 |
Showing top 50 of 551 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.