CHSLI ST JOSEPH HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J2326	XRX ABATACEPT 250 MG IV SOLR	$1,009,463	—	$1,116	$1,009,463	124
J0225	XRX ABATACEPT 250 MG IV SOLR	$823,522	—	$5,703	$823,522	124
A9513	XRX LUTETIUM LU 177 VIPIVOTIDE TET 1000 MBQ/ML IV SOLN	$462,607	—	$272	$462,607	124
Q2043	XRX ABATACEPT 250 MG IV SOLR	$431,958	—	$52,904	$431,958	124
90288	XRX ABATACEPT 250 MG IV SOLR	$398,475	—	$79,695	$398,475	82
A9607	XRX LUTETIUM LU 177 VIPIVOTIDE TET 1000 MBQ/ML IV SOLN	$353,061	—	$280	$353,061	124
J9226	XRX ABATACEPT 250 MG IV SOLR	$346,254	—	$43,026	$346,254	124
A9604	XRX SODIUM IODIDE I-131 CAPSULE (MILLI CURIE)	$337,056	—	$1,448	$337,056	168
J2351	XRX ABATACEPT 250 MG IV SOLR	$299,658	—	—	—	0
C9293	XRX ABATACEPT 250 MG IV SOLR	$298,308	—	$349	$298,308	83
6240000009	ORMS&D RSH INTREPID TMVR	$258,750	—	—	—	0
J9269	XRX ABATACEPT 250 MG IV SOLR	$232,921	—	$293	$232,921	124
C1825	ORMS&D BAROSTIM NE02 SYSTEM	$221,375	—	$39,848	$221,375	89
J2507	XRX ABATACEPT 250 MG IV SOLR	$212,127	—	$2,884	$212,127	124
J3357	XRX ABATACEPT 250 MG IV SOLR	$211,203	—	$166	$211,203	168
J9359	XRX ATEZOLIZUMAB 1200 MG/20ML IV SOLN	$200,306	—	$246	$200,306	124
33276	HC INSJ PHRNC NRV STIM SYS	$178,530	—	$2,617	$178,530	168
J9229	XRX ABATACEPT 250 MG IV SOLR	$168,321	—	$2,411	$168,321	124
J9600	XRX ABATACEPT 250 MG IV SOLR	$160,929	—	$3,095	$160,929	124
J2350	XRX ABATACEPT 250 MG IV SOLR	$149,829	—	$58.96	$149,829	124
C1604	HC SS IMPL DETOUR SYS BYPS SYS (SI-H & NTAP),C1604	$143,750	—	$25,875	$143,750	90
J9350	XRX EPCORITAMAB-BYSP 0.16 MG/ML SUBCUTANEOUS SOLUTION (SIMPLE)	$133,615	—	$743	$133,615	124
C1824	ORMS&D OPTIMIZER SMART IPG	$132,250	—	$23,805	$132,250	89
J3241	XRX ABATACEPT 250 MG IV SOLR	$124,331	—	$325	$124,331	124
33249	HC CARD DEFB LD INS REPL	$121,925	—	$2,069	$121,925	168
33270	HC INS/REP SUBQ DEFIBRILLATOR	$121,925	—	$1,268	$121,925	168
33264	HC REM/REPL CARD DEFB GEN MUL LD	$121,925	—	$916	$121,925	168
33287	HC RMV&RPLCMT PHRNC NRV STIM PG	$118,800	—	$1,756	$118,800	168
C1736	HC SS CATH ABLATION-RENAL-PARADISE RDN 3.5, C1888	$115,000	—	$20,700	$115,000	90
408T	HC INS OR RPL CCM, GENERATOR & ELECTRODE(S)	$113,816	—	$2,999	$113,816	168
J9334	XRX ABATACEPT 250 MG IV SOLR	$113,231	—	$38.39	$113,231	168
C1722	HC SS CARDIO DEFIB SINGLE CHAMBER-C1722-109250	$109,250	—	$19,665	$109,250	89
J9298	XRX ABATACEPT 250 MG IV SOLR	$108,540	—	$225	$108,540	124
A9592	XRX SODIUM IODIDE I-123 DIAGNOSTIC CAPSULE	$106,260	—	$405	$106,260	128
J9345	XRX ABATACEPT 250 MG IV SOLR	$103,763	—	$33.94	$103,763	168
C1882	HC SS CARD DEFIB BIOTRONIC BI-V CRT-D C1882,103500	$103,500	—	$18,630	$103,500	89
J9043	XRX ABATACEPT 250 MG IV SOLR	$101,567	—	$190	$101,567	168
C1889	HC CLOS DEV WATCHMAN LAAC WFLXPRO L#120054-120059	$100,625	—	$18,113	$100,625	89
C2624	HC SS IMPL WIRELSS PULM ART PRES SENS-C2624-100625	$100,625	—	$18,113	$100,625	89
J1628	XRX ABATACEPT 250 MG IV SOLR	$100,509	—	$85.26	$100,509	168
J9316	XRX ABATACEPT 250 MG IV SOLR	$100,346	—	$74.08	$100,346	168
C2616	HC SS BRACHYTX NON-STR YTTRIUM-90 EA-C2616-96792	$96,792	—	$16,631	$96,792	168
3600000034	HC LASR EXTRCT INFC DEV WREIMPLAI	$96,591	—	—	—	0
C1735	HC SS CATH RDN SIMPLCIY SPYRAL-RFABLT-FULLSYS NTAP	$92,000	—	$16,560	$92,000	90
2790000417	HC SS CATH RENAL DEN - RDN SPYRAL NOCPT-L#	$92,000	—	$18,400	$55,200	6
J9042	XRX ABATACEPT 250 MG IV SOLR	$90,875	—	$188	$90,875	168
3600000038	HC ICD BIV ICD COMPLETE PACKAGE	$89,543	—	—	—	0
3600000021	HC BIV ICD GEN CHANGE UPGDE	$87,959	—	—	—	0
3600000028	HC ICD GEN CHANGE REMOV/REPLAC	$87,959	—	—	—	0
3600000081	HC RECALL SX FOR ICD GEN CHNG REMOV/REPLAC	$87,959	—	—	—	0

Showing top 50 of 21,229 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.