45 CFR § 180 compliance
D · 65
This hospital published part of what § 180 requires.
●Machine-readable file published: assessment threshold met
●Gross / standard charges: assessment threshold met
●Discounted cash price: assessment threshold met
○Payer-specific negotiated rates: below assessment threshold
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
1,200
Insurances with rates
0
CPT / HCPCS codes
1,184
Most expensive procedures (gross)
J2507
$114,438
Krystexxa (pegloticase) 8mg/1mL Inj.
Gross
$114,438
J0638
$72,798
Ilaris 150mg/mL SDV
Gross
$72,798
J7205
$44,810
Eloctate 4000IU Nominal IV
Gross
$44,810
J2997
$23,998
Activase 100mg/100mL IV
Gross
$34,283
J2323
$31,965
Tysabri 300mg/15mL Inj.
Gross
$31,965
J3101
$29,870
TNKase (Tenecteplase) 50mg
Gross
$29,870
J0517
$21,681
Fasenra 30mg/1mL PFS
Gross
$21,681
J0717
$21,598
Certolizumab (Cimzia) 400mg Inj.
Gross
$21,598
J0491
$19,202
Saphnelo 300mg/2mL SDV
Gross
$19,202
J1569
$18,308
Gammagard 10% 30gm/300mL IV
Gross
$18,308
J9312
$16,911
Rituxan (Rituximab) 500mg/50mL vial
Gross
$16,911
J1306
$13,438
Leqvio 284mg/1.5mL PFS
Gross
$13,438
J2357
$11,187
Xolair 300mg PFS
Gross
$11,187
21501
$8,122
INC & DRN DEEP SFT NECK THORAX
Gross
$8,122
73223
$7,654
MRI UPPER EXT JOINT W/WO CONTRAST RT,RIGHT SIDE
Gross
$7,654
73723
$7,654
MRI LOWER EXT JOINT W/WO CONTRAST RT,RIGHT SIDE
Gross
$7,654
71551
$7,629
MRI CHEST W/CONTRAST
Gross
$7,629
73222
$7,629
MRI UPPER EXT JOINT W/CONTRAST RT,RIGHT SIDE
Gross
$7,629
73722
$7,629
MRI LOWER EXT JOINT W/CONTRAST RT,RIGHT SIDE
Gross
$7,629
J1602
$7,197
Simponi Aria 50mg/4mL vial
Gross
$7,197
Q5135
$7,050
Tyenne 400mg/20mL inj.
Gross
$7,050
J0897
$6,954
Denosumab (Prolia) 60mg/mL Inj.
Gross
$6,954
J2315
$6,085
Vivitrol ER 380mg Inj.
Gross
$6,085
72127
$5,888
CT CERVICAL SPINE W/WO CONTRAST
Gross
$5,888
73202
$5,888
CT UPPER EXT W/WO CONTRAST RT,RIGHT SIDE
Gross
$5,888
74178
$5,888
CT ABD/PELVIS W/WO CONTRAST
Gross
$5,888
72126
$5,863
CT CERVICAL SPINE W/CONTRAST
Gross
$5,863
72132
$5,863
CT LUMBAR W/CONTRAST
Gross
$5,863
73201
$5,863
CT UPPER EXT W/CONTRAST RT,RIGHT SIDE
Gross
$5,863
74177
$5,863
CT ABD/PELVIS W/CONTRAST
Gross
$5,863
J0129
$5,775
Orencia 250mg vial
Gross
$5,775
J2357
$5,594
Xolair 150mg PFS
Gross
$5,594
J7307
$5,577
Nexplanon 68mg Subdermal Implant
Gross
$5,577
J7327
$5,400
Monovisc 88mg/4mL PFS
Gross
$5,400
J1439
$5,205
Injectafer 750mg/15mL Inj.
Gross
$5,205
J3262
$4,781
Actemra 200mg/10mL Inj.
Gross
$4,781
88184
$4,676
LEUKEMIA EVALUATION
Gross
$4,676
86870
$4,676
BASIC RED CELL ANTIBODY IDENTIFICATION
Gross
$4,676
20103
$4,634
EXPLR PENTRTNG WND EXTREM SEP PROC
Gross
$4,634
25505
$4,594
CLSD TRT RADIAL SHFT FX
Gross
$4,594
32551
$4,578
TUBE THORACOSTOMY INCLUDES WATER SEAL
Gross
$4,578
J7298
$4,373
Mirena 52mg IUD
Gross
$4,373
J7296
$4,338
Kyleena 19.5mg IUD
Gross
$4,338
Q0138
$4,297
Feraheme (ferumoxytol) 510mg/17mL vial
Gross
$4,297
J1745
$4,204
Remicade 100mg vial
Gross
$4,204
J0881
$4,180
Aranesp 150mcg/0.3mL PFS
Gross
$4,180
74176
$3,736
CT ABD/PELVIS W/O CONTRAST
Gross
$3,736
70543
$3,689
MRI ORBIT FACE NECK W/WO CONTRAST
Gross
$3,689
70549
$3,689
MRA NECK W/WO CONTRAST
Gross
$3,689
70553
$3,689
MRI BRAIN W/WO CONTRAST
Gross
$3,689
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J2507 | Krystexxa (pegloticase) 8mg/1mL Inj. | $114,438 | $114,438 | — | — | 0 |
| J0638 | Ilaris 150mg/mL SDV | $72,798 | $72,798 | — | — | 0 |
| J7205 | Eloctate 4000IU Nominal IV | $44,810 | $44,810 | — | — | 0 |
| J2997 | Activase 100mg/100mL IV | $34,283 | $23,998 | — | — | 0 |
| J2323 | Tysabri 300mg/15mL Inj. | $31,965 | $31,965 | — | — | 0 |
| J3101 | TNKase (Tenecteplase) 50mg | $29,870 | $29,870 | — | — | 0 |
| J0517 | Fasenra 30mg/1mL PFS | $21,681 | $21,681 | — | — | 0 |
| J0717 | Certolizumab (Cimzia) 400mg Inj. | $21,598 | $21,598 | — | — | 0 |
| J0491 | Saphnelo 300mg/2mL SDV | $19,202 | $19,202 | — | — | 0 |
| J1569 | Gammagard 10% 30gm/300mL IV | $18,308 | $18,308 | — | — | 0 |
| J9312 | Rituxan (Rituximab) 500mg/50mL vial | $16,911 | $16,911 | — | — | 0 |
| J1306 | Leqvio 284mg/1.5mL PFS | $13,438 | $13,438 | — | — | 0 |
| J2357 | Xolair 300mg PFS | $11,187 | $11,187 | — | — | 0 |
| 21501 | INC & DRN DEEP SFT NECK THORAX | $8,122 | $8,122 | — | — | 0 |
| 73223 | MRI UPPER EXT JOINT W/WO CONTRAST RT,RIGHT SIDE | $7,654 | $7,654 | — | — | 0 |
| 73723 | MRI LOWER EXT JOINT W/WO CONTRAST RT,RIGHT SIDE | $7,654 | $7,654 | — | — | 0 |
| 71551 | MRI CHEST W/CONTRAST | $7,629 | $7,629 | — | — | 0 |
| 73222 | MRI UPPER EXT JOINT W/CONTRAST RT,RIGHT SIDE | $7,629 | $7,629 | — | — | 0 |
| 73722 | MRI LOWER EXT JOINT W/CONTRAST RT,RIGHT SIDE | $7,629 | $7,629 | — | — | 0 |
| J1602 | Simponi Aria 50mg/4mL vial | $7,197 | $7,197 | — | — | 0 |
| Q5135 | Tyenne 400mg/20mL inj. | $7,050 | $7,050 | — | — | 0 |
| J0897 | Denosumab (Prolia) 60mg/mL Inj. | $6,954 | $6,954 | — | — | 0 |
| J2315 | Vivitrol ER 380mg Inj. | $6,085 | $6,085 | — | — | 0 |
| 72127 | CT CERVICAL SPINE W/WO CONTRAST | $5,888 | $5,888 | — | — | 0 |
| 73202 | CT UPPER EXT W/WO CONTRAST RT,RIGHT SIDE | $5,888 | $5,888 | — | — | 0 |
| 74178 | CT ABD/PELVIS W/WO CONTRAST | $5,888 | $5,888 | — | — | 0 |
| 72126 | CT CERVICAL SPINE W/CONTRAST | $5,863 | $5,863 | — | — | 0 |
| 72132 | CT LUMBAR W/CONTRAST | $5,863 | $5,863 | — | — | 0 |
| 73201 | CT UPPER EXT W/CONTRAST RT,RIGHT SIDE | $5,863 | $5,863 | — | — | 0 |
| 74177 | CT ABD/PELVIS W/CONTRAST | $5,863 | $5,863 | — | — | 0 |
| J0129 | Orencia 250mg vial | $5,775 | $5,775 | — | — | 0 |
| J2357 | Xolair 150mg PFS | $5,594 | $5,594 | — | — | 0 |
| J7307 | Nexplanon 68mg Subdermal Implant | $5,577 | $5,577 | — | — | 0 |
| J7327 | Monovisc 88mg/4mL PFS | $5,400 | $5,400 | — | — | 0 |
| J1439 | Injectafer 750mg/15mL Inj. | $5,205 | $5,205 | — | — | 0 |
| J3262 | Actemra 200mg/10mL Inj. | $4,781 | $4,781 | — | — | 0 |
| 88184 | LEUKEMIA EVALUATION | $4,676 | $4,676 | — | — | 0 |
| 86870 | BASIC RED CELL ANTIBODY IDENTIFICATION | $4,676 | $4,676 | — | — | 0 |
| 20103 | EXPLR PENTRTNG WND EXTREM SEP PROC | $4,634 | $4,634 | — | — | 0 |
| 25505 | CLSD TRT RADIAL SHFT FX | $4,594 | $4,594 | — | — | 0 |
| 32551 | TUBE THORACOSTOMY INCLUDES WATER SEAL | $4,578 | $4,578 | — | — | 0 |
| J7298 | Mirena 52mg IUD | $4,373 | $4,373 | — | — | 0 |
| J7296 | Kyleena 19.5mg IUD | $4,338 | $4,338 | — | — | 0 |
| Q0138 | Feraheme (ferumoxytol) 510mg/17mL vial | $4,297 | $4,297 | — | — | 0 |
| J1745 | Remicade 100mg vial | $4,204 | $4,204 | — | — | 0 |
| J0881 | Aranesp 150mcg/0.3mL PFS | $4,180 | $4,180 | — | — | 0 |
| 74176 | CT ABD/PELVIS W/O CONTRAST | $3,736 | $3,736 | — | — | 0 |
| 70543 | MRI ORBIT FACE NECK W/WO CONTRAST | $3,689 | $3,689 | — | — | 0 |
| 70549 | MRA NECK W/WO CONTRAST | $3,689 | $3,689 | — | — | 0 |
| 70553 | MRI BRAIN W/WO CONTRAST | $3,689 | $3,689 | — | — | 0 |
Showing top 50 of 1,200 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.