MISSOURI BAPTIST SULLIVAN HOSPITAL

45 CFR § 180 compliance

A · 100

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

2,108

Insurances with rates

CPT / HCPCS codes

1,862

Source MRF

json ↗

Most expensive procedures (gross)

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
A9616	GALLIUM-68 GOZETOTIDE (GOZELLIX) 25 MCG INTRAVENOUS SOLUTION	$1,629,875	$977,925	$1,171	$1,629,875	71
579	OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC	$223,502	$134,101	$1,011	$223,502	73
A9800	GALLIUM-68 GOZETOTIDE (ILLUCCIX) 25 MCG INTRAVENOUS SOLUTION	$168,919	$101,351	$363	$146,960	71
J9347	TREMELIMUMAB-ACTL 20 MG/ML INTRAVENOUS SOLUTION	$167,566	$100,540	$143	$237,227	74
A9607	LUTETIUM LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN	$150,946	$90,568	$259	$133,872	74
827	MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC	$146,901	$88,140	$15,643	$146,901	73
J9298	NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION	$132,037	$79,222	$202	$178,388	74
799	SPLENIC PROCEDURES WITH MCC	$123,253	$73,952	$1,011	$136,172	61
J2507	PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION	$117,716	$70,630	$3,769	$166,702	74
J0202	ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION	$98,538	$59,123	$2,447	$162,360	74
J3357	USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRINGE	$95,998	$57,599	$21,119	$83,518	45
331	MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC	$95,856	$57,513	$1,011	$95,856	74
329	MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC	$94,984	$56,990	$1,011	$144,799	73
619	O.R. PROCEDURES FOR OBESITY WITH MCC	$94,478	$56,687	$18,579	$94,478	73
981	EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC	$89,854	$53,912	$1,011	$127,951	62
870	SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS	$88,563	$53,138	$1,011	$255,146	74
239	AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC	$88,213	$52,928	$1,011	$141,982	73
856	POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC	$85,787	$51,472	$8,107	$108,319	73
J9309	POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLUTION	$83,216	$49,929	$137	$105,868	74
J2350	OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION	$80,818	$48,491	$59.32	$98,394	74
157	DENTAL AND ORAL DISEASES WITH MCC	$77,284	$46,370	$1,011	$77,284	73
908	OTHER O.R. PROCEDURES FOR INJURIES WITH CC	$71,083	$42,650	$1,011	$71,083	73
616	AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC	$69,609	$41,765	$1,011	$134,390	74
J9026	TARLATAMAB-DLLE 10 MG INTRAVENOUS SOLUTION	$64,842	$38,905	$1,567	$86,617	74
488	KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC	$63,434	$38,060	$10,884	$63,434	73
C1874	GRAFT ENDOVASC ZENITH ALPHA THORACIC DISTAL	$63,000	$37,800	$13,860	$63,000	296
330	MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC	$61,611	$36,966	$1,011	$98,229	73
183	MAJOR CHEST TRAUMA WITH MCC	$61,178	$36,707	$1,011	$61,178	73
J9043	CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION	$61,166	$36,699	$231	$76,566	74
J1628	GUSELKUMAB 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLUTION	$60,414	$36,249	$72.94	$80,657	74
326	STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC	$58,957	$35,374	$1,011	$114,055	73
854	INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC	$58,541	$35,124	$1,011	$67,586	74
570	SKIN DEBRIDEMENT WITH MCC	$56,990	$34,194	$1,011	$71,205	73
821	LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC	$56,319	$33,791	$13,893	$103,223	73
165	MAJOR CHEST PROCEDURES WITHOUT CC/MCC	$56,314	$33,789	$1,011	$87,766	74
C1876	STENT ZENITH DISSECTION ENDOVASCULAR ZDES- 36-120-US	$56,000	$33,600	$12,320	$56,000	74
559	AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC	$55,832	$33,499	$250	$68,598	73
041	PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR	$55,370	$33,222	$1,011	$80,380	73
853	INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC	$55,353	$33,212	$1,011	$122,574	73
J9042	BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION	$53,199	$31,919	$268	$74,213	74
350	INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC	$51,420	$30,852	$1,011	$70,517	73
354	HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC	$51,176	$30,705	$1,011	$57,915	74
J9022	ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION	$50,352	$30,211	$93.91	$62,307	74
605	TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC	$50,330	$30,198	$1,011	$50,330	73
15273	App Skn Subgrft T/a/L Area/100sq Cm 1st 100sq Cm	$49,170	$29,502	$2,067	$42,778	74
15274	App Skn Sub Grft T/a/L Area>/=100scm Adl 100sqcm	$49,170	$29,502	$125	$42,778	74
620	O.R. PROCEDURES FOR OBESITY WITH CC	$47,499	$28,500	$10,830	$51,419	73
602	CELLULITIS WITH MCC	$47,398	$28,439	$1,011	$47,398	73
J9144	DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN	$47,164	$28,298	$55.06	$54,797	74
J1640	HEMIN 350 MG INTRAVENOUS POWDER FOR SOLUTION	$46,972	$28,183	$10,334	$30,532	24

Showing top 50 of 2,108 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.