45 CFR § 180 compliance
B · 85
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
117
Insurances with rates
1
CPT / HCPCS codes
0
Source MRF
Most expensive procedures (gross)
278
$11,638
DM3500 CONFIRM Rx
Gross
$23,276
360
$4,515
NEOPROBE RENTAL FEE
Gross
$9,030
279
$2,802
6721-0837 HIP STEM #8 127
Gross
$5,605
352
$2,168
CT Abdomen and Pelvis w/ + w/o Contrast
Gross
$4,336
975
$2,123
54055 Destruction of lesion(s), penis, simple; ele
Gross
$4,247
614
$1,999
MRI Chest w/ Contrast
Gross
$3,997
612
$1,721
MRI Spine Cervical w/ + w/o Contrast
Gross
$3,442
610
$1,662
MRA Abdomen w/ + w/o Contrast
Gross
$3,323
520
$1,618
52287 - Cystourethroscopy, with injection(s) for
Gross
$3,236
750
$1,605
43249 EGD W/ BALLOON DILATION Charge
Gross
$3,210
202
$1,552
ICU
Gross
$3,103
122
$1,425
IP - Isolation
Gross
$2,850
760
$1,400
95810 W/4+ PARAM 6+YRS
Gross
$2,800
611
$1,344
MRI Brain w/ + w/o Contrast
Gross
$2,689
340
$1,298
NM Lung Vent/Perf Imaging
Gross
$2,595
140
$1,138
Swingbed
Gross
$2,275
141
$1,138
Inpatient
Gross
$2,275
142
$1,138
Inpatient
Gross
$2,275
143
$1,138
Inpatient
Gross
$2,275
329
$1,110
US Guided Breast Biopsy Core Left
Gross
$2,220
410
$1,000
95805 TESTING LATENCY SLEEP MULT
Gross
$2,000
350
$945
CT Angio Abdomen Aorta + Iliofemoral
Gross
$1,889
483
$939
US Echocardiogram 2D + M-Mode
Gross
$1,877
351
$840
CT Brain/Head w/ + w/o Contrast
Gross
$1,680
920
$790
95810 PSG/PARASOMNIA CHARGE
Gross
$1,580
172
$731
Nursery Level 2
Gross
$1,462
480
$670
RT Cardiopulmonary Resuscitation CHARGE
Gross
$1,340
762
$606
G0379- Direct admission of patient for hospital ob
Gross
$1,212
381
$595
E0224 RBC CPDA1 500 LR Irr
Gross
$1,189
171
$581
Nursery Level 1
Gross
$1,162
482
$565
Stress Test Treadmill
Gross
$1,130
341
$559
NM Bone Imaging Multiple Areas
Gross
$1,117
722
$537
Fetal Contraction Stress Test HUMB
Gross
$1,075
960
$529
TEL 90951 Esrd serv 4 visits p mo <2yr
Gross
$1,058
976
$521
CT Angio Upper Extremity Right
Gross
$1,042
391
$505
TRANSFUSE RED BLOOD CELLS
Gross
$1,009
170
$351
92650 Auditory evoked potentials; screening of aud
Gross
$703
322
$351
XR Arthrogram Hip Left
Gross
$702
510
$340
Selective Cath Placement, Arterial, Abdominal/pelv
Gross
$680
731
$340
Holter Monitor RT
Gross
$680
276
$338
INTRAOCULAR LES SA4
Gross
$675
402
$313
HUMB US OB < 14 Weeks Addl Fetus
Gross
$627
987
$299
US Echo TEE
Gross
$598
255
$295
DEFINITY 4 VIAL KIT - ECHO
Gross
$590
981
$287
31500 Intubation, endotracheal, emergency procedur
Gross
$573
720
$261
FETAL NON-STRESS TEST
Gross
$522
320
$254
MG Breast Tissue Specimen Surgical Right
Gross
$507
310
$238
.P210 BCR-ABL1 QST
Gross
$475
710
$225
HUMB PACU/Phase II
Gross
$450
421
$197
90839 Psychotherapy for crisis, 1st 60 min. Charge
Gross
$394
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 278 | DM3500 CONFIRM Rx | $23,276 | $11,638 | — | — | 2 |
| 360 | NEOPROBE RENTAL FEE | $9,030 | $4,515 | — | — | 1 |
| 279 | 6721-0837 HIP STEM #8 127 | $5,605 | $2,802 | — | — | 1 |
| 352 | CT Abdomen and Pelvis w/ + w/o Contrast | $4,336 | $2,168 | — | — | 1 |
| 975 | 54055 Destruction of lesion(s), penis, simple; ele | $4,247 | $2,123 | — | — | 1 |
| 614 | MRI Chest w/ Contrast | $3,997 | $1,999 | — | — | 1 |
| 612 | MRI Spine Cervical w/ + w/o Contrast | $3,442 | $1,721 | — | — | 1 |
| 610 | MRA Abdomen w/ + w/o Contrast | $3,323 | $1,662 | — | — | 1 |
| 520 | 52287 - Cystourethroscopy, with injection(s) for | $3,236 | $1,618 | — | — | 1 |
| 750 | 43249 EGD W/ BALLOON DILATION Charge | $3,210 | $1,605 | — | — | 1 |
| 202 | ICU | $3,103 | $1,552 | — | — | 1 |
| 122 | IP - Isolation | $2,850 | $1,425 | — | — | 1 |
| 760 | 95810 W/4+ PARAM 6+YRS | $2,800 | $1,400 | — | — | 4 |
| 611 | MRI Brain w/ + w/o Contrast | $2,689 | $1,344 | — | — | 1 |
| 340 | NM Lung Vent/Perf Imaging | $2,595 | $1,298 | — | — | 1 |
| 140 | Swingbed | $2,275 | $1,138 | — | — | 1 |
| 141 | Inpatient | $2,275 | $1,138 | — | — | 1 |
| 142 | Inpatient | $2,275 | $1,138 | — | — | 1 |
| 143 | Inpatient | $2,275 | $1,138 | — | — | 1 |
| 329 | US Guided Breast Biopsy Core Left | $2,220 | $1,110 | — | — | 1 |
| 410 | 95805 TESTING LATENCY SLEEP MULT | $2,000 | $1,000 | — | — | 2 |
| 350 | CT Angio Abdomen Aorta + Iliofemoral | $1,889 | $945 | — | — | 1 |
| 483 | US Echocardiogram 2D + M-Mode | $1,877 | $939 | — | — | 1 |
| 351 | CT Brain/Head w/ + w/o Contrast | $1,680 | $840 | — | — | 1 |
| 920 | 95810 PSG/PARASOMNIA CHARGE | $1,580 | $790 | — | — | 1 |
| 172 | Nursery Level 2 | $1,462 | $731 | — | — | 1 |
| 480 | RT Cardiopulmonary Resuscitation CHARGE | $1,340 | $670 | — | — | 1 |
| 762 | G0379- Direct admission of patient for hospital ob | $1,212 | $606 | — | — | 1 |
| 381 | E0224 RBC CPDA1 500 LR Irr | $1,189 | $595 | — | — | 1 |
| 171 | Nursery Level 1 | $1,162 | $581 | — | — | 1 |
| 482 | Stress Test Treadmill | $1,130 | $565 | — | — | 1 |
| 341 | NM Bone Imaging Multiple Areas | $1,117 | $559 | — | — | 1 |
| 722 | Fetal Contraction Stress Test HUMB | $1,075 | $537 | — | — | 1 |
| 960 | TEL 90951 Esrd serv 4 visits p mo <2yr | $1,058 | $529 | — | — | 2 |
| 976 | CT Angio Upper Extremity Right | $1,042 | $521 | — | — | 1 |
| 391 | TRANSFUSE RED BLOOD CELLS | $1,009 | $505 | — | — | 1 |
| 170 | 92650 Auditory evoked potentials; screening of aud | $703 | $351 | — | — | 1 |
| 322 | XR Arthrogram Hip Left | $702 | $351 | — | — | 1 |
| 510 | Selective Cath Placement, Arterial, Abdominal/pelv | $680 | $340 | — | — | 4 |
| 731 | Holter Monitor RT | $680 | $340 | — | — | 1 |
| 276 | INTRAOCULAR LES SA4 | $675 | $338 | — | — | 1 |
| 402 | HUMB US OB < 14 Weeks Addl Fetus | $627 | $313 | — | — | 1 |
| 987 | US Echo TEE | $598 | $299 | — | — | 1 |
| 255 | DEFINITY 4 VIAL KIT - ECHO | $590 | $295 | — | — | 1 |
| 981 | 31500 Intubation, endotracheal, emergency procedur | $573 | $287 | — | — | 1 |
| 720 | FETAL NON-STRESS TEST | $522 | $261 | — | — | 1 |
| 320 | MG Breast Tissue Specimen Surgical Right | $507 | $254 | — | — | 2 |
| 310 | .P210 BCR-ABL1 QST | $475 | $238 | — | — | 1 |
| 710 | HUMB PACU/Phase II | $450 | $225 | — | — | 1 |
| 421 | 90839 Psychotherapy for crisis, 1st 60 min. Charge | $394 | $197 | — | — | 1 |
Showing top 50 of 117 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.