HACKENSACK MERIDIAN HEALTH PASCACK VALLEY MEDICAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
PX-36037231	Removal of plaque and insertion of stents in artery of leg, initial vessel	$58,220	$24,618	—	—	46
PX-36037227	Removal of plaque and insertion of stents in arteries of leg	$45,847	$24,618	—	—	88
PX-36037241	Occlusion of vein with review by radiologist	$38,207	$15,547	—	—	46
PX-36037243	Occlusion of growths or obstructed vessels with review by radiologist	$38,207	$15,547	—	—	88
PX-36037184	Primary removal and dissolving of blood clot from artery or artery graft using fluoroscopic guidance	$36,399	$24,618	—	—	46
PX-36037238	Insertion of stent in vein with review by radiologist, initial vein	$36,399	$15,547	—	—	88
PX-36037242	Occlusion of artery with review by radiologist	$34,838	$24,618	—	—	46
SUP-165235	ACCESSORY NEUROSTIMULATOR VANTA SPINAL CORD STIMULATION CHRONIC PAIN	$30,940	$30,940	—	—	38
PX-36033224	Insertion of left lower heart electrode and attachment to pacemaker or defibrillator	$30,016	$14,347	—	—	50
PX-36033210	Insertion of temporary pacemaker lead in single heart chamber	$29,547	$11,346	—	—	50
SUP-303862	AXONICS NON-RECHARGEABLE FULL IMPLANT PACKAGE	$29,435	$29,435	—	—	40
PX-36037226	Insertion of stent in arteries of leg	$27,169	$15,547	—	—	46
PX-36037230	Insertion of stent in artery of leg, initial vessel	$27,169	$24,618	—	—	46
PX-36037225	Removal of plaque in arteries of leg	$26,472	$24,618	—	—	88
PX-36037229	Removal of plaque in artery of leg, initial vessel	$26,472	$24,618	—	—	46
PX-36037233	Removal of plaque in artery of leg, each additional vessel	$26,472	$26,472	—	—	46
PX-36033208	Insertion of pacemaker and upper and lower heart chamber electrode	$26,072	$14,347	—	—	50
PX-36033285	HC Insertion Subq Cardiac Rhythm Monitor W/Prgrmg	$26,015	$11,346	—	—	46
PX-36036905	Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis seg	$24,318	$15,547	—	—	46
SUP-156144	GRAFT ENDOVASCULAR EXCLUDER L12 CM L5.5 CM OD14.5 MM ODSEC28.5MM TRUNK IPSILATERAL LEG CONFORMABLE A	$22,650	$22,650	—	—	55
PX-36036906	Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis seg	$21,271	$21,271	—	—	46
PX-36033228	Removal and replacement of dual lead permanent pacemaker	$20,079	$14,347	—	—	50
PX-36033207	Insertion of pacemaker and lower heart chamber electrode	$19,884	$14,347	—	—	50
PX-36037239	Insertion of stent in vein with review by radiologist, each additional vein	$19,672	$19,672	—	—	88
PX-36026765	Treatment of broken end of finger or thumb	$19,384	$4,448	—	—	46
PX-36036253	Insertion of tube into second or third order branches of arteries of kidney for imaging with review	$18,500	$7,411	—	—	46
PX-36037220	Balloon dilation of groin artery, initial vessel	$18,309	$7,816	—	—	88
PX-36033227	Removal and replacement of single lead permanent pacemaker	$18,307	$11,346	—	—	50
PX-36043265	Destruction of stone of bile or pancreatic duct using a flexible endoscope	$18,225	$8,161	—	—	50
PX-36037211	Insertion of tube into artery for drug infusion for blood clot with review by radiologist, initial t	$17,616	$7,411	—	—	46
SUP-129561	GRAFT ENDOVASCULAR ENDURANT NITINOL POLYESTER 2 BRANCH L166 MM OD28-20 MM ID18 FR DELIVERY SYSTEM C	$17,610	$17,610	—	—	45
PX-36037187	Removal and dissolving of blood clot from vein using fluoroscopic guidance, initial treatment	$17,418	$15,547	—	—	46
PX-36037191	HC Insert Ivc Filtr W/Acces/Image	$17,289	$7,411	—	—	46
PX-36043274	Insertion of stent into pancreatic or bile duct using a flexible endoscope	$16,809	$8,161	—	—	50
PX-36036902	Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment w	$16,467	$7,816	—	—	46
PX-36022513	Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance	$14,317	$9,794	—	—	46
RX-126579	DANTROLENE 250 MG INTRAVENOUS SUSPENSION	$14,092	$14,092	—	—	112
PX-36037246	Balloon dilation of artery with review by radiologist, initial artery	$13,712	$7,816	—	—	46
PX-36037248	Balloon dilation of vein with review by radiologist, initial vein	$13,712	$7,816	—	—	46
PX-36037222	Balloon dilation of groin artery, each additional vessel	$13,544	$13,544	—	—	46
PX-36036903	Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment	$13,420	$13,420	—	—	46
PX-36036908	Insertion of stent in dialysis segment with review by radiologist	$13,060	$13,060	—	—	46
PX-36034707	HC Evasc Rpr Dplmnt Ilio-Iliac Endogrft	$12,797	$12,797	—	—	46
PX-36037221	Insertion of stent in groin artery, initial vessel	$12,797	$12,797	—	—	46
PX-36037224	Balloon dilation of artery of leg	$12,797	$7,816	—	—	46
PX-36037228	Balloon dilation of artery of leg, initial vessel	$12,797	$12,797	—	—	46
PX-36037232	Balloon dilation of artery of leg, each additional vessel	$12,797	$12,797	—	—	88
SUP-303479	CAGE SPINAL MODULUS 15 D L38 MM X W28 MM X H10 MM STERILE LATEX FREE ALIF	$12,743	$12,743	—	—	39
SUP-303317	CAGE 3DP FXTD ALIF 6X38X28M	$12,743	$12,743	—	—	40
SUP-168974	CAGE SPINAL MODULUS 10 D L34 MM X W24 MM X H10 MM STERILE LATEX FREE ALIF	$12,743	$12,743	—	—	26

Showing top 50 of 5,483 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.