RANKEN JORDAN PEDIATRIC BRIDGE HOSPITAL

45 CFR § 180 compliance

D · 65

This hospital published part 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

771

Insurances with rates

CPT / HCPCS codes

755

Source MRF

xlsx ↗

Most expensive procedures (gross)

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J0135	00074-0124-02 - adalimumab 80 mg/0.8 mL Kit	$16,966	$13,573	—	—	0
J2353	00078-0818-81 - octreotide 20 mg PWDI	$8,598	$6,878	—	—	0
93533	Cardiac Catheterization, combined right and transseptal left through septal opening, with or w/out r	$5,855	$4,684	—	—	0
J2802	55513-0221-01 - romiPLOStim 250 mcg Powd	$5,506	$4,405	—	—	0
31622	Bronchoscopy	$5,190	$4,152	—	—	0
93532	Cardiac Catheterization, combined right and transseptal left through intact septum, with or w/out re	$5,092	$4,074	—	—	0
36560	Port-A-Cath insertion, under 5 years of age	$4,785	$3,828	—	—	0
49441	GJ Tube Placement, w/fluoroscopy	$4,685	$3,748	—	—	0
49450	Replacement of G-Tube, w/fluoroscopy	$4,679	$3,744	—	—	0
93307	Transthoracic ECG, 2D, M-mode color flow doppler, followup study	$4,585	$3,668	—	—	0
36561	Port-A-Cath insertion, 5 years+	$4,565	$3,652	—	—	0
49452	Replacement of G-J-Tube, w/fluoroscopy	$4,462	$3,569	—	—	0
93531	Cardiac Catheterization, combined right heart and retrograde left for congenital cardiac anomalies	$4,428	$3,542	—	—	0
43870	G-Tube, GJ-Tube, PEG Removal	$4,254	$3,403	—	—	0
36584	PICC Line replaced	$4,160	$3,328	—	—	0
93306	Transthoracic ECG, 2D, M-mode color flow doppler	$3,988	$3,190	—	—	0
70551	MRI Brain w/o Contrast	$3,865	$3,092	—	—	0
93530	Cardiac Catheterization, right heart for congenital cardiac anomalies	$3,850	$3,080	—	—	0
J0219	58468-0426-01 - avalglucosidase alfa ngpt 100 mg Injection	$3,430	$2,744	—	—	0
73223	MRI UE Joint w/ + w/o Contrast Bilateral	$3,413	$2,730	—	—	0
73222	MRI UE Joint w/ Contrast Bilateral	$3,413	$2,730	—	—	0
73221	MRI UE Joint w/o Contrast Bilateral	$3,413	$2,730	—	—	0
93308	Transthoracic ECG w/out color flow doppler	$3,389	$2,711	—	—	0
0191	ROOM/BED: Level 1	$3,300	$2,640	—	—	15
0192	ROOM/BED: Level 2	$3,300	$2,640	—	—	15
0193	ROOM/BED: Level 3	$3,300	$2,640	—	—	15
0194	ROOM/BED: Level 4	$3,300	$2,640	—	—	15
72156	MRI Spine Cervical w/ + w/o Contrast	$3,297	$2,637	—	—	0
C9003	66658-0230-01 - palivizumab 100 mg/mL Soln 0.5ml	$3,257	$2,605	—	—	0
43276	Biliary Stent Replacement	$3,163	$2,530	—	—	0
J2941	00169-7705-21 - somatropin 10 mg/1.5 mL Soln	$3,125	$2,500	—	—	0
70553	MRI Brain w/ + w/o Contrast	$3,095	$2,476	—	—	0
72142	MRI Spine Cervical w/ Contrast	$3,077	$2,461	—	—	0
72147	MRI Spine Thoracic w/ Contrast	$3,077	$2,461	—	—	0
72158	MRI Spine Lumbar w/ + w/o Contrast	$2,908	$2,327	—	—	0
73220	MRI UE Non Joint w/ + w/o Contrast Bilat	$2,888	$2,311	—	—	0
73219	MRI UE Non Joint w/ Contrast Bilateral	$2,888	$2,311	—	—	0
73218	MRI UE Non Joint w/o Contrast Bilateral	$2,888	$2,311	—	—	0
72141	MRI Spine Cervical w/o Contrast	$2,857	$2,285	—	—	0
72146	MRI Spine Thoracic w/o Contrast	$2,857	$2,285	—	—	0
70552	MRI Brain w/ Contrast	$2,765	$2,212	—	—	0
36557	Broviac insertion - under 5 years of age	$2,750	$2,200	—	—	0
72127	CT Spine Cervical w/ + w/o Contrast	$2,747	$2,198	—	—	0
72130	CT Spine Thoracic w/ + w/o Contrast	$2,747	$2,198	—	—	0
72149	MRI Spine Lumbar w/ Contrast	$2,688	$2,151	—	—	0
70488	CT Maxillofacial w/ + w/o Contrast	$2,641	$2,113	—	—	0
72157	MRI Spine Thoracic w/ + w/o Contrast	$2,630	$2,104	—	—	0
31525	Tracheoscopy, rigid or flexible, with or w/out laryngoscopy	$2,591	$2,072	—	—	0
72194	CT Pelvis w/ + w/o Contrast	$2,582	$2,065	—	—	0
70470	CT Head or Brain w/ + w/o Contrast	$2,545	$2,036	—	—	0

Showing top 50 of 771 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.