RUBY VALLEY MEDICAL CENTER (Sheridan, MT) prices

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
8004195	CYGNUS DUAL - 7X15 SQ CENTIMETER	$262,500	$236,250	—	—	32
8004194	CYGNUS DUAL - 4X6 SQ CENTIMETER	$60,000	$54,000	—	—	32
8004193	CYGNUS DUAL - 4X4 SQ CENTIMETER	$40,000	$36,000	—	—	32
3000602	PRIVIGEN 80GM/800ML SDV SPECIAL ORDER	$24,332	$21,899	—	—	32
90197083	SIEMENS EXL SERVICE CONTRACT	$17,500	$15,750	—	—	32
3000020	D/C ALTEPLASE INJ [100 MG]	$15,524	$13,972	—	—	32
8004192	CYGNUS DUAL- 2X3 SQ CENTIMETER	$15,000	$13,500	—	—	32
3000443	TENECTEPLASE INJ [50 MG]	$12,221	$10,999	—	—	32
3000601	PRIVIGEN 40GM/400 ML	$12,166	$10,949	—	—	32
3007127	PRIVIGEN 40GM/400ML SDV SPECIAL ORDER	$12,166	$10,949	—	—	32
3000380	PEGFILGRASTIM SYR [6 MG/0.6 ML] SPEC ORD	$10,782	$9,704	—	—	32
90197134	ID NOW INFLUENZA BUNDLE	$7,991	$7,192	—	—	32
90197114	ID NOW STREP BUNDLE	$5,935	$5,341	—	—	32
3007126	PRIVIGEN 20GM/200ML SDV SPEC ORDER	$5,736	$5,162	—	—	32
90197016	CEPHEID GENEXPERT SERVICE AGREEMENT	$5,571	$5,014	—	—	32
8004201	EPIFIX, 4X4.5 CM	$5,436	$4,892	—	—	32
3007361	PROTHROMBIN COMPLEX 1000IU (KCENTRA)	$5,228	$4,705	—	—	32
3000229	IMMUNE GLOBULIN [20 G] 10% 200ML SDV	$5,116	$4,604	—	—	32
1036561	INSERT DEVICE CENTRAL VENOUS W/PORT >5YR	$5,115	$4,604	—	—	32
1564625	RF ABLTJ NRV NRVTG SI JT W/I 64625	$5,053	$4,548	—	—	32
1564624	DESTRUCTION NEUROLYTIC AGT GENICULAR NE	$4,759	$4,283	—	—	32
1500213	PAIN ROOM FACILITY LEVEL 3	$4,509	$4,058	—	—	32
90197108	CEPHEID CTNG STARTPAK	$4,300	$3,870	—	—	32
90197126	PATHFAST SERVICE CONTRACT	$3,995	$3,596	—	—	32
1010110	TRAUMA ACTIVATION	$3,936	$3,542	—	—	32
1020525	ER REMOVE FB DEEP OR COMLICATED	$3,792	$3,413	—	—	32
5300086	MR CERVICAL SPINE W WO CONTRAST	$3,680	$3,312	—	—	32
5300105	MR LUMBAR SPINE W WO CONTRAST	$3,680	$3,312	—	—	32
5300120	MR THORACIC SPINE W WO CONTRAST	$3,680	$3,312	—	—	32
5300083	MR BRAIN W WO CONTRAST	$3,657	$3,291	—	—	32
5200010	CT ABDOMEN PELVIS W WO CONTRAST	$3,559	$3,203	—	—	32
1500212	PAIN ROOM FACILITY LEVEL 2	$3,557	$3,201	—	—	32
5300080	MR ABDOMEN W WO CONTRAST	$3,519	$3,167	—	—	32
3000582	PEGFILGRASTIM SYR [6 MG/0.6 ML] SPEC ORD	$3,508	$3,157	—	—	32
5300013	MR HIP LT W WO CONTRAST	$3,478	$3,130	—	—	32
5300014	MR KNEE LT W WO CONTRAST	$3,478	$3,130	—	—	32
5300015	MR ANKLE LT W WO CONTRAST	$3,478	$3,130	—	—	32
5300016	MR HIP RT W WO CONTRAST	$3,478	$3,130	—	—	32
5300017	MR KNEE RT W WO CONTRAST	$3,478	$3,130	—	—	32
5300018	MR ANKLE RT W WO CONTRAST	$3,478	$3,130	—	—	32
5300095	MR JNT LWR XT WO&W CON L	$3,478	$3,130	—	—	32
5300096	MR JNT LWR XT WO&W CON R	$3,478	$3,130	—	—	32
300571	BUPRENORPHINE INJ [300 MG/1.5 ML] SP ORD	$3,444	$3,100	—	—	32
5300116	MR PELVIS W WO CONTRAST	$3,426	$3,083	—	—	32
5300031	MR SHOULDER LT W WO CONTRAST	$3,397	$3,057	—	—	32
5300032	MR ELBOW LT W WO CONTRAST	$3,397	$3,057	—	—	32
5300033	MR WRIST LT W WO CONTRAST	$3,397	$3,057	—	—	32
5300034	MR SHOULDER RT W WO CONTRAST	$3,397	$3,057	—	—	32
5300035	MR ELBOW RT W WO CONTRAST	$3,397	$3,057	—	—	32
5300036	MR WRIST RT W WO CONTRAST	$3,397	$3,057	—	—	32

Showing top 50 of 3,305 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.