Hospital 313036 prices — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
81408	MOPATH PROCEDURE LEVEL 9	$6,366	$4,775	—	—	5
L2036	KAFO PLAS DOUB FREE KNEE MOL	$5,885	$4,414	—	—	5
49440	G TUBE INSERTION W/GUIDANCE	$4,959	$3,719	—	—	5
L0464	TLSO4mod Sacro-Scap pre	$4,405	$3,304	—	—	5
333	RADIATION 3D RADIOTHERAPY PLAN	$4,019	$3,014	—	—	5
77301	RADIATION IMR PLAN	$4,019	$3,014	—	—	5
99283	EMERGENCY ROOM-MODERATE	$3,876	$2,907	—	—	5
L2020	KAFO DBL SOLID STIRRUP BAND/	$3,702	$2,777	—	—	5
610	MRI CHEST W/ CONTRAST	$3,123	$2,342	—	—	5
49083	US GUIDED PARACENTESIS	$3,108	$2,331	—	—	5
L0648	LSO SAG R AN/POS PNL PRE OTS	$3,043	$2,282	—	—	5
L0460	BILATERAL CARBON AFO (L)	$2,975	$2,231	—	—	5
L1945	AFO MOLDED PLAS RIG ANT TIB	$2,972	$2,229	—	—	5
384	PLATELETS 1 UNIT	$2,951	$2,213	—	—	5
L0456	PREFAB POST OP BLEDSOE BRACE L	$2,947	$2,210	—	—	5
L0457	TLSO FLEX TRNK SJ-SS PRE OTS	$2,947	$2,210	—	—	5
L1686	HO POST-OP HIP ABDUCTION PREFB	$2,921	$2,191	—	—	5
73222	MRI UPPER EXTREM W CONTRAST	$2,890	$2,168	—	—	5
73722	MRI LOWER EXTREM JNT W CONTRAS	$2,890	$2,168	—	—	5
81407	MOPATH PROCEDURE LEVEL 8	$2,695	$2,021	—	—	5
L1843	KO SINGLE UPRIGHT CUSTOM FIT	$2,659	$1,994	—	—	5
L1932	AFO RIG ANT TIB PREFAB TCF/=	$2,644	$1,983	—	—	5
L0458	PREFAB KNIGHT-TAYLOR BRACE	$2,643	$1,982	—	—	5
32555	US THORACENTESIS	$2,586	$1,940	—	—	5
51710	BLADDER TUBE CHANGE	$2,568	$1,926	—	—	5
36556	CENTRAL INSERT VENOUS CATHETER	$2,547	$1,910	—	—	5
L1845	KO W/ADJ FLEX/EXT ROTAT CUS	$2,536	$1,902	—	—	5
L1951	AFO SPIRAL PREFABRICATED	$2,489	$1,867	—	—	5
78582	NM PULM PERFUSION W/ VENTILATI	$2,355	$1,766	—	—	5
L3764	EWHO W/JOINT(S) CF	$2,256	$1,692	—	—	5
L1970	AFO PLASTIC MOLDED W/ANKLE J	$2,230	$1,673	—	—	5
36573	PICC W/ IMAGE GUIDANCE	$2,228	$1,671	—	—	5
74230	VIDEOFLUOROSCOPIC SWALLOW STUD	$2,070	$1,553	—	—	5
P9037	PLATELETS IRRADIATED 1 UNIT	$2,025	$1,519	—	—	5
L1832	KO ADJ JNT POS RIGID PRE-FAB	$2,014	$1,511	—	—	5
L1833	KO ADJ JNT POS R SUP PRE OTS	$2,014	$1,511	—	—	5
72126	CT SPINE CERVICAL W/ CONTRAST	$2,012	$1,509	—	—	5
72147	MRI SPINE THORACIC W/ CONTRAST	$2,012	$1,509	—	—	5
74178	CT ABDOMEN/PELVIS W/ + W/O CON	$2,012	$1,509	—	—	5
70553	MRI BRAIN W/ + W/O CONTRAST	$2,009	$1,507	—	—	5
72149	MRI SPINE LUMBAR W/ CONTRAST	$2,009	$1,507	—	—	5
72156	MRI SPINE CERVICAL W/ + W/O CO	$2,009	$1,507	—	—	5
72158	MRI SPINE LUMBAR W/ + W/O CONT	$2,009	$1,507	—	—	5
74177	CT ABDOMEN/PELVIS W/ CONTRAST	$2,009	$1,507	—	—	5
70542	MRI FACE NECK ORBIT W CONTRAST	$2,008	$1,506	—	—	5
70543	MRI FACE NECK ORBIT W + W/O CO	$2,008	$1,506	—	—	5
70545	MRA HEAD W CONTRAST	$2,008	$1,506	—	—	5
70546	MRA HEAD W + W/O CONTRAST	$2,008	$1,506	—	—	5
70548	MRA NECK W CONTRAST	$2,008	$1,506	—	—	5
70549	MRA NECK W + W/O CONTRAST	$2,008	$1,506	—	—	5

Showing top 50 of 1,399 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.