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
1,831
Insurances with rates
5
CPT / HCPCS codes
0
Source MRF
Most expensive procedures (gross)
4001726
$17,209
Tenecteplase 50 Mg Iv Inj[cdh]
Gross
$19,121
4000188
$16,470
Cygnus Dual 4x6cm 24 Units
Gross
$18,300
4000073
$13,817
Leuprolide 22.5 Mg/3 Months Intramuscular Kit
Gross
$15,352
4002223
$11,962
Certolizumab 200 Mg Subcutaneous Kit [Cdh]
Gross
$13,291
4001385
$11,784
Pegfilgrastim 6 Mg/0.6 Ml Subq Inj[cdh]
Gross
$13,093
4000187
$11,489
Cyngus 4x4cm 16 Units
Gross
$12,766
4000008
$11,029
Immune Globulin 10% Iv Sol 400 Ml[cdh]
Gross
$12,254
4000293
$8,748
Eflapegrastim Xnst 13.2 Mg/0.6 Ml Sol [Cdh]
Gross
$9,720
4000569
$8,289
Antivenin (Crotalidae) Polyvalentpow[cdh]
Gross
$9,210
73725-50
$6,809
Mra Lower Extremity W/ + W/o Cnt Bilat
Gross
$7,565
4000053
$6,557
Tocilizumab 20 Mg/ml Sol [Cdh]
Gross
$7,285
4000294
$6,084
Via Matrix 2 X 3 2/3 Cm Film
Gross
$6,760
4001851
$5,869
Denosumab 120 Mg/1.7 Ml[cdh]
Gross
$6,521
71555
$5,451
Mra Chest W/ + W/o Contrast
Gross
$6,057
73725-LT
$5,447
Mra Lower Extremity W/ + W/o Cnt Left
Gross
$6,052
73725-RT
$5,447
Mra Lower Extremity W/ + W/o Cnt Right
Gross
$6,052
72157
$5,416
Mri Spine Thoracic W/ + W/o Contrast
Gross
$6,018
74174
$5,365
Ct Angio Abdomen And Pelvis
Gross
$5,961
74178
$5,091
Ct Abdomen And Pelvis W/ + W/o Contrast
Gross
$5,657
73223-50
$4,851
Mri Ue Joint W/ + W/o Contrast Bilat
Gross
$5,390
4000186
$4,662
Cygnus Dual 2x3cm 6 Units
Gross
$5,180
4000057
$4,569
Dupilumab 300 Mg/2 Ml Subcutaneous Solution 2 Ml
Gross
$5,077
73720-50
$4,499
Mri Lower Extremity W/ + W/o Cnt Bilat
Gross
$4,999
74177
$4,416
CT scan of abdomen and pelvis with contrast
Gross
$4,907
74183
$4,368
Mri Abdomen W/ + W/o Contrast
Gross
$4,853
72158
$4,181
Mri Spine Lumbar W/ + W/o Contrast
Gross
$4,646
74175
$4,136
Ct Angio Abdomen
Gross
$4,595
4000168
$4,095
Novachor [Cdh]
Gross
$4,550
72149
$4,089
Mri Spine Lumbar W/ Contrast
Gross
$4,543
73220-50
$4,089
Mri Upper Extremity W/ + W/o Cnt Bilat
Gross
$4,543
70553
$4,055
MRI Scan
Gross
$4,506
72156
$4,016
Mri Spine Cervical W/ + W/o Contrast
Gross
$4,462
73718-50
$4,008
Mri Lower Extremity W/o Contrast Bilat
Gross
$4,453
72198
$3,915
Mra Pelvis W/ + W/o Contrast
Gross
$4,350
73223-LT
$3,881
Mri Ue Joint W/ + W/o Contrast Left
Gross
$4,312
73223-RT
$3,881
Mri Ue Joint W/ + W/o Contrast Right
Gross
$4,312
4001949
$3,858
Denosumab 60 Mg/ml[cdh]
Gross
$4,287
73218-50
$3,817
Mri Upper Extremity W/o Contrast Bilat
Gross
$4,241
74176
$3,794
Ct Abdomen And Pelvis W/o Contrast
Gross
$4,215
71551
$3,793
Mri Chest W/ Contrast
Gross
$4,214
73700-50
$3,744
Ct Lower Extremity W/o Contrast Bilat
Gross
$4,160
73702-50
$3,686
Ct Lower Extremity W/+w/o Contrast Bilat
Gross
$4,095
73723-50
$3,597
Mri Le Joint W/ + W/o Contrast Bilat
Gross
$3,997
73721-50
$3,597
MRI scan of leg joint
Gross
$3,997
4000166
$3,560
Puraply Xt 4.91 Cm X 4.91 Cm 24.11 Each
Gross
$3,955
72146
$3,557
Mri Spine Thoracic W/o Contrast
Gross
$3,952
73221-50
$3,556
Mri Ue Joint W/o Contrast Bilat
Gross
$3,951
4000050
$3,515
Romosozumab-aqqg 105 Mg/1.17 Ml Subcut Soln 1.17 Ml [Cdh]
Gross
$3,906
71550
$3,457
Mri Chest W/o Contrast
Gross
$3,841
74185
$3,456
Mra Abdomen W/ + W/o Contrast
Gross
$3,840
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 4001726 | Tenecteplase 50 Mg Iv Inj[cdh] | $19,121 | $17,209 | $10,134 | $18,739 | 9 |
| 4000188 | Cygnus Dual 4x6cm 24 Units | $18,300 | $16,470 | $9,699 | $17,934 | 9 |
| 4000073 | Leuprolide 22.5 Mg/3 Months Intramuscular Kit | $15,352 | $13,817 | $8,137 | $15,045 | 9 |
| 4002223 | Certolizumab 200 Mg Subcutaneous Kit [Cdh] | $13,291 | $11,962 | $7,044 | $13,025 | 9 |
| 4001385 | Pegfilgrastim 6 Mg/0.6 Ml Subq Inj[cdh] | $13,093 | $11,784 | $6,939 | $12,831 | 9 |
| 4000187 | Cyngus 4x4cm 16 Units | $12,766 | $11,489 | $6,766 | $12,511 | 9 |
| 4000008 | Immune Globulin 10% Iv Sol 400 Ml[cdh] | $12,254 | $11,029 | $6,495 | $12,009 | 9 |
| 4000293 | Eflapegrastim Xnst 13.2 Mg/0.6 Ml Sol [Cdh] | $9,720 | $8,748 | $5,152 | $9,526 | 9 |
| 4000569 | Antivenin (Crotalidae) Polyvalentpow[cdh] | $9,210 | $8,289 | $4,881 | $9,026 | 9 |
| 73725-50 | Mra Lower Extremity W/ + W/o Cnt Bilat | $7,565 | $6,809 | $4,009 | $7,414 | 9 |
| 4000053 | Tocilizumab 20 Mg/ml Sol [Cdh] | $7,285 | $6,557 | $3,861 | $7,139 | 9 |
| 4000294 | Via Matrix 2 X 3 2/3 Cm Film | $6,760 | $6,084 | $3,583 | $6,625 | 9 |
| 4001851 | Denosumab 120 Mg/1.7 Ml[cdh] | $6,521 | $5,869 | $3,456 | $6,391 | 9 |
| 71555 | Mra Chest W/ + W/o Contrast | $6,057 | $5,451 | $3,210 | $5,936 | 9 |
| 73725-LT | Mra Lower Extremity W/ + W/o Cnt Left | $6,052 | $5,447 | $3,208 | $5,931 | 9 |
| 73725-RT | Mra Lower Extremity W/ + W/o Cnt Right | $6,052 | $5,447 | $3,208 | $5,931 | 9 |
| 72157 | Mri Spine Thoracic W/ + W/o Contrast | $6,018 | $5,416 | $3,190 | $5,898 | 9 |
| 74174 | Ct Angio Abdomen And Pelvis | $5,961 | $5,365 | $3,159 | $5,842 | 9 |
| 74178 | Ct Abdomen And Pelvis W/ + W/o Contrast | $5,657 | $5,091 | $2,998 | $5,544 | 9 |
| 73223-50 | Mri Ue Joint W/ + W/o Contrast Bilat | $5,390 | $4,851 | $2,857 | $5,282 | 9 |
| 4000186 | Cygnus Dual 2x3cm 6 Units | $5,180 | $4,662 | $2,745 | $5,076 | 9 |
| 4000057 | Dupilumab 300 Mg/2 Ml Subcutaneous Solution 2 Ml | $5,077 | $4,569 | $2,691 | $4,975 | 9 |
| 73720-50 | Mri Lower Extremity W/ + W/o Cnt Bilat | $4,999 | $4,499 | $2,649 | $4,899 | 9 |
| 74177 | CT scan of abdomen and pelvis with contrast | $4,907 | $4,416 | $2,601 | $4,809 | 9 |
| 74183 | Mri Abdomen W/ + W/o Contrast | $4,853 | $4,368 | $2,572 | $4,756 | 9 |
| 72158 | Mri Spine Lumbar W/ + W/o Contrast | $4,646 | $4,181 | $2,462 | $4,553 | 9 |
| 74175 | Ct Angio Abdomen | $4,595 | $4,136 | $2,435 | $4,503 | 9 |
| 4000168 | Novachor [Cdh] | $4,550 | $4,095 | $2,412 | $4,459 | 9 |
| 72149 | Mri Spine Lumbar W/ Contrast | $4,543 | $4,089 | $2,408 | $4,452 | 9 |
| 73220-50 | Mri Upper Extremity W/ + W/o Cnt Bilat | $4,543 | $4,089 | $2,408 | $4,452 | 9 |
| 70553 | MRI Scan | $4,506 | $4,055 | $2,388 | $4,416 | 9 |
| 72156 | Mri Spine Cervical W/ + W/o Contrast | $4,462 | $4,016 | $2,365 | $4,373 | 9 |
| 73718-50 | Mri Lower Extremity W/o Contrast Bilat | $4,453 | $4,008 | $2,360 | $4,364 | 9 |
| 72198 | Mra Pelvis W/ + W/o Contrast | $4,350 | $3,915 | $2,306 | $4,263 | 9 |
| 73223-LT | Mri Ue Joint W/ + W/o Contrast Left | $4,312 | $3,881 | $2,285 | $4,226 | 9 |
| 73223-RT | Mri Ue Joint W/ + W/o Contrast Right | $4,312 | $3,881 | $2,285 | $4,226 | 9 |
| 4001949 | Denosumab 60 Mg/ml[cdh] | $4,287 | $3,858 | $2,272 | $4,201 | 9 |
| 73218-50 | Mri Upper Extremity W/o Contrast Bilat | $4,241 | $3,817 | $2,248 | $4,156 | 9 |
| 74176 | Ct Abdomen And Pelvis W/o Contrast | $4,215 | $3,794 | $2,234 | $4,131 | 9 |
| 71551 | Mri Chest W/ Contrast | $4,214 | $3,793 | $2,233 | $4,130 | 9 |
| 73700-50 | Ct Lower Extremity W/o Contrast Bilat | $4,160 | $3,744 | $2,205 | $4,077 | 9 |
| 73702-50 | Ct Lower Extremity W/+w/o Contrast Bilat | $4,095 | $3,686 | $2,170 | $4,013 | 9 |
| 73723-50 | Mri Le Joint W/ + W/o Contrast Bilat | $3,997 | $3,597 | $2,118 | $3,917 | 9 |
| 73721-50 | MRI scan of leg joint | $3,997 | $3,597 | $2,118 | $3,917 | 9 |
| 4000166 | Puraply Xt 4.91 Cm X 4.91 Cm 24.11 Each | $3,955 | $3,560 | $2,096 | $3,876 | 9 |
| 72146 | Mri Spine Thoracic W/o Contrast | $3,952 | $3,557 | $2,095 | $3,873 | 9 |
| 73221-50 | Mri Ue Joint W/o Contrast Bilat | $3,951 | $3,556 | $2,094 | $3,872 | 9 |
| 4000050 | Romosozumab-aqqg 105 Mg/1.17 Ml Subcut Soln 1.17 Ml [Cdh] | $3,906 | $3,515 | $2,070 | $3,828 | 9 |
| 71550 | Mri Chest W/o Contrast | $3,841 | $3,457 | $2,036 | $3,764 | 9 |
| 74185 | Mra Abdomen W/ + W/o Contrast | $3,840 | $3,456 | $2,035 | $3,763 | 9 |
Showing top 50 of 1,831 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.