WELIA HEALTH — Hospital Ledger

45 CFR § 180 compliance

B · 85

This hospital published most 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

1,531

Insurances with rates

CPT / HCPCS codes

1,394

Source MRF

csv ↗

Most expensive procedures (gross)

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J9228	ipilimumab 200 mg/40 mL (5 mg/mL) Soln 40 mL VIAL	$63,953	$44,767	—	—	1
J3357	Ustekinumab 90 mg/mL Syrg 1 mL SYRINGE	$50,154	$35,108	—	—	1
J2350	ocrelizumab 30 mg/mL Soln 10 mL VIAL	$37,191	$26,034	—	—	1
J9309	polatuzumab vedotin-piiq 140 mg Solr 1 Each VIAL	$33,538	$23,476	—	—	1
J9043	cabazitaxel 10 mg/mL (first dilution) Soln 6 mL VIAL	$25,501	$17,851	—	—	1
J1628	guselkumab 100 mg/mL Syrg 1 mL SYRINGE	$25,008	$17,506	—	—	1
790	HCHG LITHOTRIPSY CONTRACTED AFFILIATE ONLY	$24,920	$17,444	—	—	1
J9173	durvalumab 50 mg/mL Soln 10 mL VIAL	$22,773	$15,941	—	—	1
J9042	brentuximab vedotin 50 mg Solr 1 Each VIAL	$21,997	$15,398	—	—	1
J9347	tremelimumab-actl 20 mg/mL Soln 15 mL VIAL	$18,296	$12,807	—	—	1
J9144	daratumumab-hyaluronidase-fihj 1,800 mg-30,000 unit/15 mL Soln 15 mL VIAL	$18,078	$12,654	—	—	1
J3380	vedolizumab 300 mg Solr 1 Each VIAL	$16,885	$11,819	—	—	1
J9316	pertuzumab-trastuzumab-hyaluronidase-zzxf 600 mg-600 mg- 20000 unit/10mL Soln 10 mL VIAL	$16,736	$11,715	—	—	1
J9301	obinutuzumab 1,000 mg/40 mL Soln 40 mL VIAL	$15,540	$10,878	—	—	1
J3101	tenecteplase 50 mg Solr 1 Each VIAL	$14,972	$10,480	—	—	1
J9022	atezolizumab 1,200 mg/20 mL (60 mg/mL) Soln 20 mL VIAL	$14,214	$9,950	—	—	1
J9023	avelumab 20 mg/mL Soln 10 mL VIAL	$13,977	$9,784	—	—	1
J0402	ARIPiprazole ER (2 month) 960 mg/3.2 mL Sers 3.2 mL SYRINGE	$13,941	$9,759	—	—	1
J9299	nivolumab 240 mg/24 mL Soln 24 mL VIAL	$13,779	$9,646	—	—	1
J2406	oritavancin 1,200 mg Solr 1 Each VIAL	$12,809	$8,966	—	—	1
J9303	panitumumab 400 mg/20 mL (20 mg/mL) Soln 20 mL VIAL	$12,460	$8,722	—	—	1
J9311	riTUXimab-hyaluronidase,human 1400 mg/11.7 mL (120 mg/mL) Soln 11.7 mL VIAL	$11,875	$8,312	—	—	1
J9354	ado-trastuzumab emtansine 160 mg Solr 1 Each VIAL	$11,527	$8,069	—	—	1
J1162	digoxin immune fab 40 mg Solr 1 Each VIAL	$11,479	$8,035	—	—	1
J2353	octreotide,microspheres 20 mg Serr 1 Each VIAL	$11,079	$7,755	—	—	1
J0717	Certolizumab Pegol 400 mg/2 mL (200 mg/mL x 2) Sykt 1 Each KIT	$10,836	$7,585	—	—	1
J9271	pembrolizumab 25 mg/mL Soln 4 mL VIAL	$10,445	$7,311	—	—	1
22513	HCHG RAD KYPHOPLASTY THORACIC INCLUDING GUIDE	$10,435	$7,305	—	—	1
22514	HCHG RAD KYPHOPLASTY LUMBAR 1 LEVEL INCLUDING GUIDE	$10,435	$7,305	—	—	1
J9217	leuprolide pediatric (1 month) 15 mg Kit 1 Each KIT	$9,903	$6,932	—	—	1
J1569	immune globulin (human IGG) 10% (PF) 10 % Soln 300 mL VIAL	$9,466	$6,626	—	—	1
J2182	mepolizumab 100 mg/mL Syrg 1 mL SYRINGE	$9,119	$6,383	—	—	1
J2802	romiPLOStim 500 mcg Solr 1 Each VIAL	$9,052	$6,337	—	—	1
J1944	ARIPiprazole lauroxil ER 1,064 mg/3.9 mL Sers 3.9 mL SYRINGE	$8,944	$6,261	—	—	1
J9057	copanlisib 60 mg Solr 1 Each VIAL	$8,773	$6,141	—	—	1
J9312	riTUXimab 10 mg/mL Conc 50 mL VIAL	$8,493	$5,945	—	—	1
J9356	trastuzumab and hyaluronidase-oysk 600 mg-10,000 unit/5 mL Soln 5 mL VIAL	$8,452	$5,917	—	—	1
J1437	ferric derisomaltose 100 mg iron/mL Soln 10 mL VIAL	$8,104	$5,673	—	—	1
Q5115	riTUXimab-abbs 10 mg/mL Soln 50 mL VIAL	$7,647	$5,353	—	—	1
J0630	calcitonin (salmon) 200 unit/mL Soln 2 mL VIAL	$7,517	$5,262	—	—	1
J9305	PEMEtrexed disodium 500 mg Solr 1 Each VIAL	$7,314	$5,120	—	—	1
J3262	tocilizumab 20 mg/mL Soln 20 mL VIAL	$7,208	$5,045	—	—	1
78452	HCHG RAD NM CARDIAC MYOCARD MULT SPECT WWO EF AND WM	$7,036	$4,925	—	—	1
J0565	bezlotoxumab 25 mg/mL Soln 40 mL VIAL	$6,877	$4,814	—	—	1
81455	HCHG NGS 50 PLUS GENES	$6,765	$4,736	—	—	1
770	PR ANESTHESIA MAJOR ABDOMINAL BLOOD VESSELS	$6,517	$4,562	—	—	0
Q5123	riTUXimab-arrx 10 mg/mL Soln 50 mL VIAL	$6,488	$4,542	—	—	1
J0139	adalimumab 40 mg/0.8 mL Sykt 2 Each KIT	$6,267	$4,387	—	—	1
J9047	carfilzomib 60 mg Solr 60 mg VIAL	$5,932	$4,153	—	—	1
J9400	ziv-aflibercept 200 mg/8 mL (25 mg/mL) Soln 8 mL VIAL	$5,797	$4,058	—	—	1

Showing top 50 of 1,531 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.