DEER LODGE MEDICAL CENTER — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-169866	OCRELIZUMAB 300 MG/10ML IV SOLN	$44,156	$35,325	—	—	11
RX-148911	VEDOLIZUMAB 300 MG IV SOLR	$20,023	$16,019	—	—	11
RX-197120	RISANKIZUMAB-RZAA 600 MG/10ML IV SOLN	$18,077	$14,461	—	—	11
RX-9002	ALTEPLASE 100 MG IV SOLR	$17,348	$13,879	—	—	11
RX-28530	TENECTEPLASE 50 MG IV KIT	$17,057	$13,645	—	—	11
RX-74707388	TENECTEPLASE 50 MG IV KIT (STROKE)	$16,357	$13,085	—	—	11
RX-40120	NATALIZUMAB 300 MG/15ML IV CONC	$16,048	$12,838	—	—	11
PX-36010208	HC Operating Room Services Level 8 First Hr	$15,691	$12,553	—	—	11
PX-75010272	HC Endoscopy/Gastrointestinal Procedure Level 6	$14,655	$11,724	—	—	11
PX-36010371	HC Pain Room Services Level 6	$13,957	$11,166	—	—	11
RX-152774	PEMBROLIZUMAB 100 MG/4ML IV SOLN	$12,869	$10,295	—	—	11
PX-36010206	HC Operating Room Services Level 6 First Hr	$12,241	$9,793	—	—	11
PX-36010207	HC Operating Room Services Level 7 First Hr	$11,956	$9,565	—	—	11
PX-75010319	HC Endoscopy/Gastrointestinal Procedure Level 5	$11,545	$9,236	—	—	11
PX-36010005	HC Pain Room Services Level 5	$11,545	$9,236	—	—	11
RX-172770	BENRALIZUMAB 30 MG/ML SUBQ SOSY	$11,070	$8,856	—	—	11
PX-36010205	HC Operating Room Services Level 5 First Hr	$10,494	$8,395	—	—	11
RX-87861	LANREOTIDE ACETATE 120 MG/0.5ML SUBQ SOLN	$10,206	$8,165	—	—	11
PX-36010204	HC Operating Room Services Level 4 First Hr	$9,326	$7,461	—	—	11
RX-9003	ALTEPLASE 50 MG IV SOLR	$8,674	$6,939	—	—	11
PX-36010203	HC Operating Room Services Level 3 First Hr	$8,356	$6,685	—	—	11
RX-168493	BEZLOTOXUMAB 1000 MG/40ML IV SOLN	$8,129	$6,503	—	—	11
PX-4050842MDL	HC Linq Device	$7,854	$6,283	—	—	11
RX-155788	DARBEPOETIN ALFA 500 MCG/ML INJECTION SOSY	$7,621	$6,097	—	—	11
RX-194718	INCLISIRAN SODIUM 284 MG/1.5ML SUBQ SOSY	$7,253	$5,802	—	—	11
PX-36010202	HC Operating Room Services Level 2 First Hr	$6,996	$5,597	—	—	11
PX-75010318	HC Endoscopy/Gastrointestinal Procedure Level 4	$6,543	$5,234	—	—	11
PX-36010004	HC Pain Room Services Level 4	$6,543	$5,234	—	—	11
PX-36010201	HC Operating Room Services Level 1 First Hr	$5,637	$4,510	—	—	11
RX-181020	ROMOSOZUMAB-AQQG 105 MG/1.17ML SUBQ SOSY	$5,623	$4,499	—	—	11
RX-183796	RITUXIMAB-ABBS 500 MG/50ML IV SOLN	$5,584	$4,467	—	—	11
RX-105843	TOCILIZUMAB 400 MG/20ML IV SOLN	$5,236	$4,188	—	—	11
PX-68310001	HC ED Trauma Activation Full With Critical Care G0390 Cdm	$5,227	$4,182	—	—	11
PX-45010507	Extensive or complicated repair wound reopening	$5,199	$4,159	—	—	11
PX-45010535	Complicated remove foreign body in deep muscle/tendon	$4,982	$3,986	—	—	11
PX-75010317	HC Endoscopy/Gastrointestinal Procedure Level 3	$4,811	$3,849	—	—	11
PX-36010003	HC Pain Room Services Level 3	$4,811	$3,849	—	—	11
PX-45010254	Remove foreign body in tissue or muscle of pelvis or hip	$4,759	$3,807	—	—	11
PX-35210054	CT scan of abdomen and pelvis before and after contrast	$4,718	$3,774	—	—	11
RX-106130	BELIMUMAB 400 MG IV SOLR	$4,617	$3,693	—	—	11
RX-155787	DARBEPOETIN ALFA 300 MCG/0.6ML INJECTION SOSY	$4,573	$3,658	—	—	11
PX-45010668	Repair of abnormal anal drainage tract	$4,539	$3,631	—	—	11
RX-167435	USTEKINUMAB 130 MG/26ML IV SOLN	$4,532	$3,626	—	—	11
PX-61210017	MRI scan of lower spinal canal before and after contrast	$4,497	$3,598	—	—	11
PX-61210013	MRI scan of upper spinal canal before and after contrast	$4,472	$3,578	—	—	11
PX-61210015	MRI scan of middle spinal canal before and after contrast	$4,440	$3,552	—	—	11
PX-61110015	MRI scan of brain before and after contrast	$4,414	$3,531	—	—	11
PX-61010087	MRI scan of abdomen before and after contrast	$4,325	$3,460	—	—	11
PX-61010025	MRI scan of chest before and after contrast	$4,295	$3,436	—	—	11
PX-61010044	MRI scan of pelvis before and after contrast	$4,292	$3,434	—	—	11

Showing top 50 of 1,873 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.