EXCELSIOR SPRINGS HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
Signs & symptoms with major complications	Signs & symptoms with major complications	$108,590	$108,590	—	—	2
General symptoms of illness such as fever, pain,	General symptoms of illness such as fever, pain, shortness of breath	$88,429	$88,429	—	—	2
Brain contusion/laceration & complicated skull F	Brain contusion/laceration & complicated skull Fx, coma < 1 hr or no coma [Minor Severity]	$86,115	$86,115	—	—	1
Fractures of hip & pelvis without major complica	Fractures of hip & pelvis without major complications	$80,837	$80,837	—	—	2
Craniotomy for trauma [Catastrophic Severity]	Craniotomy for trauma [Catastrophic Severity]	$79,434	$79,434	—	—	1
Respiratory infections and inflammations with ma	Respiratory infections and inflammations with major complications	$71,125	$71,125	—	—	1
Other disorders of nervous system with complicat	Other disorders of nervous system with complications	$68,351	$68,351	—	—	1
Total Knee or Hip Replacement	Total Knee or Hip Replacement	$47,767	$47,767	—	—	1
9108494	50242-0085-27 - alteplase 100 mg intravenous injection [EXSP]	$38,058	$38,058	—	—	2
Chronic Lung Disease with major complications	Chronic Lung Disease with major complications	$35,549	$35,549	—	—	1
9109518	64764-0300-20 - vedolizumab 300 mg intravenous injection [EXSP]	$35,360	$35,360	—	—	6
Disorders of pancreas except malignancy without	Disorders of pancreas except malignancy without complications	$34,941	$34,941	—	—	1
9109176	00078-0825-81 - octreotide 30 mg intramuscular injection, extended release [EXSP]	$28,180	$28,180	—	—	2
Infection of the skin	Infection of the skin	$27,137	$27,137	—	—	1
Respiratory Failure	Respiratory Failure	$25,435	$25,435	—	—	1
9108641	50474-0710-79 - certolizumab 200 mg/mL subcutaneous kit [EXSP]	$23,370	$23,370	—	—	4
9109175	00078-0818-81 - octreotide 20 mg intramuscular injection, extended release [EXSP]	$18,832	$18,832	—	—	2
Ungroupable Inpatient Condition	Ungroupable Inpatient Condition	$18,596	$18,596	—	—	2
Degenerative nervous system disorders without co	Degenerative nervous system disorders without complications	$18,390	$18,390	—	—	2
Migraine & other headaches [Minor Severity]	Migraine & other headaches [Minor Severity]	$17,832	$17,832	—	—	1
Esophagitis, gastroent & misc digest disorders w	Esophagitis, gastroent & misc digest disorders with major complications	$17,536	$17,536	—	—	1
Pulmonary embolism with major complications	Pulmonary embolism with major complications	$16,660	$16,660	—	—	1
9200082	00069-0249-01 - riTUXimab pvvr 10 mg/mL Sol [EXSP]	$15,578	$15,578	—	—	2
Mental Illness [MSDRG 885]	Mental Illness [MSDRG 885]	$14,093	$14,093	—	—	1
9108700	55513-0730-01 - denosumab 120 mg/1.7 mL subcutaneous solution 1.7 mL [EXSP]	$12,471	$12,471	—	—	10
9956631	13533-0318-03 - rabies immune globulin, human 300 intl units/mL injectable solution 3 mL [EXSP]	$8,729	$8,729	—	—	2
10087255	55513-0710-21 - denosumab 60 mg/mL subcutaneous solution 1 mL [EXSP]	$8,142	$8,142	—	—	10
8231157	ROOM/BED: Inpatient	$7,972	$7,972	—	—	9
9108699	55513-0710-01 - denosumab 60 mg/mL subcutaneous solution 1 mL [EXSP]	$6,798	$6,798	—	—	10
9108881	59676-0820-01 - hyaluronan 88 mg/4 mL intra-articular solution 4 mL [EXSP]	$6,688	$6,688	—	—	2
9108883	58468-0090-03 - hylan G-F 20 48 mg/6 mL intra-articular solution 6 mL [EXSP]	$5,957	$5,957	—	—	2
9108468	00003-2187-13 - abatacept 250 mg intravenous injection [EXSP]	$5,861	$5,861	—	—	4
8337656	43249 Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esop	$5,706	$5,706	—	—	1
9108807	00517-0650-01 - ferric carboxymaltose (as elemental iron) 50 mg/mL intravenous solution 15 mL [EXSP]	$5,581	$5,581	—	—	6
9929898	55513-0998-02 - romosozumab-aqqg 105 mg/1.17 mL subcutaneous solution 1.17 mL [EXSP]	$5,448	$5,448	—	—	4
2644301	99285 - Level 5	$5,388	$5,388	—	—	18
8345561	99285 EMERGENCY DEPT VISIT HIGH SEVERITY&THREAT FUNCJ Tech Fee	$5,388	$5,388	—	—	18
8696679	.HCV RT-PCR, Quant (Non-Graph) 550362 LC	$5,383	$5,383	—	—	4
8085548	ROOM/BED: Swing Bed	$5,133	$5,133	—	—	9
8554707	60 mg/1ml inj denosumab - AMB denosumab Charge	$4,982	$4,982	—	—	5
1168836	MRI Elbow w/ + w/o Contrast Left	$4,878	$4,878	—	—	1
1168838	MRI Elbow w/ + w/o Contrast Right	$4,878	$4,878	—	—	1
1169032	MRI Shoulder w/ + w/o Contrast Left	$4,878	$4,878	—	—	1
1169034	MRI Shoulder w/ + w/o Contrast Right	$4,878	$4,878	—	—	1
1169128	MRI Wrist w/ + w/o Contrast Left	$4,878	$4,878	—	—	1
1169130	MRI Wrist w/ + w/o Contrast Right	$4,878	$4,878	—	—	1
9109350	55513-0880-02 - romosozumab-aqqg 105 mg/1.17 mL subcutaneous solution 1.17 mL [EXSP]	$4,862	$4,862	—	—	4
8060002	MRI Forearm w/ + w/o Contrast Left	$4,727	$4,727	—	—	4
8060004	MRI Forearm w/ + w/o Contrast Right	$4,727	$4,727	—	—	4
1168920	MRI Hand w/ + w/o Contrast Right	$4,727	$4,727	—	—	4

Showing top 50 of 1,844 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.