ASHE MEMORIAL HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
2504344	KEYTRUDA INJ.100MG/4ML 2 PACK	$69,099	$55,279	—	—	8
2504281	ADCETRIS 50 MG SDV	$61,709	$49,367	—	—	1
2504215	LUPRON DEPOT 45 MG. SYRINGE	$57,750	$46,200	—	—	2
2504173	SOMATULINE 120MG/0.5ML PFS	$47,500	$38,000	—	—	1
2503571	TECENTRIQ 320MG/20ML INJ SOL	$41,383	$33,106	—	—	3
2504126	DARZALEX 1800MG/15ML. INJ.	$41,206	$32,964	—	—	1
Major small & large bowel procedures with compli	Major small & large bowel procedures with complications	$38,873	$31,098	—	—	2
Pneumonia with major complications	Pneumonia with major complications	$37,154	$29,723	—	—	2
2504027	OPDIVO 240MG SDV	$34,991	$27,993	—	—	2
2503581	ENTYVIO 300MG/20ML SDV	$25,026	$20,021	—	—	1
1680001	VTIOSS BETRAUMA FOAM PACK 10CC	$22,536	$18,029	—	—	1
Non-bacterial infect of nervous sys exc viral me	Non-bacterial infect of nervous sys exc viral meningitis without complications	$22,499	$17,999	—	—	1
2504031	IMFINZI 500MG SDV	$22,412	$17,930	—	—	1
OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES	OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC	$22,154	$17,723	—	—	1
Infection of the skin	Infection of the skin	$22,099	$17,679	—	—	1
2504061	LUPRON 11.25MG SYRINGE KIT	$20,252	$16,201	—	—	1
2504144	KANJINTI 420MG MUV	$19,193	$15,355	—	—	1
2504243	OPDIVO 120 MG/12 ML SDV	$19,143	$15,315	—	—	2
Tendonitis, myositis & bursitis without major co	Tendonitis, myositis & bursitis without major complications	$18,997	$15,198	—	—	1
2504249	OCREVUS (OCRELIZUMAB)300MG/10	$18,776	$15,020	—	—	1
Chronic Lung Disease without complications	Chronic Lung Disease without complications	$18,654	$14,923	—	—	1
2504129	RUXIENCE 500MG/50ML	$18,606	$14,884	—	—	2
Head trauma w coma >1 hr or hemorrhage [Minor Se	Head trauma w coma >1 hr or hemorrhage [Minor Severity]	$18,140	$14,512	—	—	1
1675060	SUTURELOCK MENISCAL REPAIR KIT	$17,387	$13,909	—	—	7
1675047	ANCHOR IMPLANT SYSTEM MPFL	$17,340	$13,872	—	—	7
2503565	KEYTRUDA 100MG/4ML SDV	$16,808	$13,446	—	—	8
2504024	OPDIVO 100MG SDV	$16,767	$13,414	—	—	2
2503558	HERCEPTIN 440 MG MDV	$16,567	$13,253	—	—	1
1680024	FIBULA NAIL LEFT 3.0 X 130 MM	$16,382	$13,106	—	—	7
1677671	VITOSS BBT FOAMPACK5CC GRAFT	$16,230	$12,984	—	—	1
Hypertension without major complications	Hypertension without major complications	$15,489	$12,392	—	—	1
2504295	UDENYCA 6 MG./0.6 ML ONBODYKIT	$15,435	$12,348	—	—	6
1677845	KNOTLESS FIBERTAK IMPLANT	$15,196	$12,157	—	—	7
CESAREAN SECTION WITH STERILIZATION WITHOUT CC/M	CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC	$14,537	$11,629	—	—	1
1680102	STMULAN RAPID CURE 20 CC	$14,352	$11,482	—	—	7
2504238	ELIGARD 45 MG. SYR KIT	$14,082	$11,265	—	—	2
CESAREAN SECTION WITHOUT STERILIZATION WITHOUT C	CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC	$13,668	$10,934	—	—	2
2504234	ENHERTU 100 MG. SDV	$13,250	$10,600	—	—	3
1675056	FHL IMPLANT SYSTEM 7.0 MM	$13,005	$10,404	—	—	7
1640979	LIGAMENT AUGMENT/REPAIR/INTERN	$12,996	$10,397	—	—	7
1675048	IMPLANT SYSTEM 6.25 MM FHL	$12,996	$10,397	—	—	7
1640663	DISTAL MED/TIBIA PLATE LT 8HOL	$12,941	$10,353	—	—	7
2504145	BENDEKA 25 MG./ML (100MG MUV)	$12,842	$10,274	—	—	1
1675046	GRACILIS TENDON 3.5 DAI 24CML	$12,292	$9,833	—	—	1
2503501	NEULASTA 6 MG ONPRO INJ.	$12,265	$9,812	—	—	6
1640707	WRIST FUSION PLATE 629579	$12,067	$9,654	—	—	7
1675041	PLATE 2.4MM VOLAR DIST RAD KIT	$11,779	$9,423	—	—	7
1675117	2.4MM VA LCP 2 COL DSTL RAD RT	$11,779	$9,423	—	—	7
1677877	PROLINE STEM +2	$11,466	$9,172	—	—	7
2504134	VELCADE 3.5 MG. IV SDV	$11,326	$9,061	—	—	1

Showing top 50 of 3,924 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.