CHOCTAW REGIONAL MEDICAL CENTER (Ackerman, MS) prices

Code	Description	Gross	Cash	Min payer	Max payer
ALTEPLASE (ACTIVASE) 100MG VIAL	ALTEPLASE (ACTIVASE) 100MG VIAL	$23,131	—	—	—
TENECTEPLASE (TNKASE) 50MG KIT	TENECTEPLASE (TNKASE) 50MG KIT	$12,387	—	—	—
ABILIFY MAINTENA 400MG PREFILLED SYRINGE	ABILIFY MAINTENA 400MG PREFILLED SYRINGE	$4,370	—	—	—
MRA CAROTIDS WITH AND WITHOUT	MRA CAROTIDS WITH AND WITHOUT	$2,887	—	—	—
MRA HEAD WITHOUT AND WITH CONTRAST	MRA HEAD WITHOUT AND WITH CONTRAST	$2,886	—	—	—
MRI CHEST W/WOUT CONTRAST	MRI CHEST W/WOUT CONTRAST	$2,833	—	—	—
MRI LOWER EXT NON JOINT WITH CONTRAST	MRI LOWER EXT NON JOINT WITH CONTRAST	$2,700	—	—	—
MRA LOWER EXTREMITY WO/O CONTRAST LT	MRA LOWER EXTREMITY WO/O CONTRAST LT	$2,600	—	—	—
MRI L-SPINE WITH AND WITHOUT	MRI L-SPINE WITH AND WITHOUT	$2,600	—	—	—
MRI ORBIT FACE NECK WO CONTRAST	MRI ORBIT FACE NECK WO CONTRAST	$2,600	—	—	—
MRI ABD WITH AND WITHOUT CONTRAST	MRI ABD WITH AND WITHOUT CONTRAST	$2,513	—	—	—
MRI PELVIS WO/W CONTRAST	MRI PELVIS WO/W CONTRAST	$2,509	—	—	—
MRI LOWER EXT NOT JOINT W/WO CONTRAST LT	MRI LOWER EXT NOT JOINT W/WO CONTRAST LT	$2,502	—	—	—
MRI LOWER EXT NOT JOINT W/WO CONTRAST RT	MRI LOWER EXT NOT JOINT W/WO CONTRAST RT	$2,502	—	—	—
MRI UPPER EXT NOT JOINT W/WO CONTRAST LT	MRI UPPER EXT NOT JOINT W/WO CONTRAST LT	$2,501	—	—	—
MRI UPPER EXT NOT JOINT W/WO CONTRAST RT	MRI UPPER EXT NOT JOINT W/WO CONTRAST RT	$2,501	—	—	—
MRI BRAIN W/WO CONTRAST	MRI BRAIN W/WO CONTRAST	$2,452	—	—	—
MRI C-SPINE WITH AND WITHOUT	MRI C-SPINE WITH AND WITHOUT	$2,414	—	—	—
MRI LOWER EXT JOINT WITH AND WITHOUT	MRI LOWER EXT JOINT WITH AND WITHOUT	$2,370	—	—	—
VAG DELIV ONLY	VAG DELIV ONLY	$2,352	—	—	—
MRI T-SPINE WITH AND WITHOUT	MRI T-SPINE WITH AND WITHOUT	$2,310	—	—	—
MRI L-SPINE WITH	MRI L-SPINE WITH	$2,200	—	—	—
PROLIA 60MG/ML INJECTION	PROLIA 60MG/ML INJECTION	$2,200	—	—	—
PLATELETS, PHERESIS LEUKOREDUCED	PLATELETS, PHERESIS LEUKOREDUCED	$2,160	—	—	—
MRI CHEST WITH	MRI CHEST WITH	$2,150	—	—	—
MRI ABDOMEN WITH CONTRAST	MRI ABDOMEN WITH CONTRAST	$2,104	—	—	—
MRI ORBIT FACE AND NECK W/	MRI ORBIT FACE AND NECK W/	$2,100	—	—	—
MRI BRAIN WO CONTRAST	MRI BRAIN WO CONTRAST	$2,100	—	—	—
MRI JOINT LOWER EXT W/O LT	MRI JOINT LOWER EXT W/O LT	$2,013	—	—	—
MRI JOINT LOWER EXT WO CONTRAST RT	MRI JOINT LOWER EXT WO CONTRAST RT	$2,013	—	—	—
MRI ABDOMEN WO CONTRAST	MRI ABDOMEN WO CONTRAST	$2,000	—	—	—
MRI C-SPINE WITH	MRI C-SPINE WITH	$1,975	—	—	—
MRI BRAIN CONTRAST ONLY	MRI BRAIN CONTRAST ONLY	$1,951	—	—	—
MRA CAROTIDS WITH	MRA CAROTIDS WITH	$1,932	—	—	—
MRA NECK W/OUT CONTRAST	MRA NECK W/OUT CONTRAST	$1,932	—	—	—
MRA NECK WITH CONTRAST	MRA NECK WITH CONTRAST	$1,932	—	—	—
MRI PELVIS W	MRI PELVIS W	$1,926	—	—	—
MRI CHEST W/O MEDISTERNUM	MRI CHEST W/O MEDISTERNUM	$1,908	—	—	—
MRI C-SPINE W/O	MRI C-SPINE W/O	$1,895	—	—	—
REMOVE FOREIGN BODY COMPLICATED	REMOVE FOREIGN BODY COMPLICATED	$1,890	—	—	—
MRI FACE/ORBITS/NECK WITH AND WITHOUT	MRI FACE/ORBITS/NECK WITH AND WITHOUT	$1,888	—	—	—
MRA LOWER EXTREMITY WO/O CONTRAST RT	MRA LOWER EXTREMITY WO/O CONTRAST RT	$1,873	—	—	—
CTA ABD/PELVIS WO/W CONTRAST	CTA ABD/PELVIS WO/W CONTRAST	$1,872	—	—	—
MRA ABDOMEN W OR WO CONTRAST	MRA ABDOMEN W OR WO CONTRAST	$1,865	—	—	—
PF VAG DELIV ONLY	PF VAG DELIV ONLY	$1,860	—	—	—
MRA HEAD WO CONTRAST	MRA HEAD WO CONTRAST	$1,844	—	—	—
MRA CAROTIDS W/O	MRA CAROTIDS W/O	$1,841	—	—	—
MRA HEAD WITH CONTRAST	MRA HEAD WITH CONTRAST	$1,832	—	—	—
BB PLATELETS EA UNIT	BB PLATELETS EA UNIT	$1,803	—	—	—
MRI L-SPINE WITHOUT	MRI L-SPINE WITHOUT	$1,800	—	—	—

Showing top 50 of 3,209 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.