363036 prices — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
Q2053	BREXUCABTAGENE AUTOLEUCEL 2X 10EXP6 TO 2X 10EXP8 CELL IV SUSPENSION [174591]	$1,967,070	$1,475,303	—	—	0
Q2041	AXICABTAGENE CILOLEUCEL INTRAVENOUS SUSPENSION [150802]	$1,967,070	$1,475,303	—	—	0
Q2042	TISAGENLECLEUCEL 0.6 X 10EXP8 TO 6 X10EXP8 CELL INTRAVENOUS SUSPENSION [187046]	$1,838,890	$1,379,168	—	—	0
J2326	NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION [137245]	$657,305	$492,978	—	—	0
J9226	HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT [93924]	$247,395	$185,547	—	—	0
0812	HC CADAVER DONOR - HEART	$231,462	$173,597	—	—	0
J1823	INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION [173589]	$230,475	$172,856	—	—	0
J0223	GIVOSIRAN 189 MG/ML SUBCUTANEOUS SOLUTION [171689]	$216,397	$162,298	—	—	0
C9293	GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION [116024]	$213,139	$159,854	—	—	0
J7330	IMPLANT, MACI FINAL, PRODUCT ASSEMBLED, SINGLE	$181,995	$136,496	—	—	1
J9228	IPILIMUMAB 200 MG/40 ML (5 MG/ML) INTRAVENOUS SOLUTION [108956]	$178,559	$133,919	—	—	0
0811	HC LIVE DONOR - KIDNEY	$170,893	$128,170	—	—	0
J9269	TAGRAXOFUSP-ERZS 1,000 MCG/ML INTRAVENOUS SOLUTION [166309]	$166,422	$124,817	—	—	0
J2507	PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION [107664]	$151,563	$113,672	—	—	0
J0202	ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION [127653]	$149,381	$112,036	—	—	0
J3357	USTEKINUMAB (STELARA) 90 MG/ML SUBCUTANEOUS SYRINGE [126168]	$146,375	$109,782	—	—	0
J9359	LONCASTUXIMAB TESIRINE-LPYL 10 MG INTRAVENOUS SOLUTION [209786]	$139,626	$104,720	—	—	0
38230	HC BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC	$137,236	$102,927	—	—	0
J9348	NAXITAMAB-GQGK 4 MG/ML INTRAVENOUS SOLUTION [188469]	$128,505	$96,379	—	—	0
Q2043	SIPULEUCEL-T IN LACTATED RINGERS 50 MILLION CELL/250 ML IV SUSPENSION [104852]	$127,667	$95,750	—	—	0
J1303	RAVULIZUMAB-CWVZ 100 MG/ML INTRAVENOUS SOLUTION [176160]	$118,078	$88,559	—	—	0
J9229	INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN [146166]	$117,906	$88,429	—	—	0
J9266	PEGASPARGASE 750 UNIT/ML INJECTION SOLUTION [117842]	$109,655	$82,242	—	—	0
0815	HC CORD BLOOD PROCUREMENT	$109,162	$81,872	—	—	0
J0638	CANAKINUMAB (PF) 150 MG/ML SUBCUTANEOUS SOLUTION [137302]	$105,425	$79,069	—	—	0
J2350	OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION [137896]	$101,760	$76,320	—	—	0
J9600	PORFIMER 75 MG INTRAVENOUS SOLUTION [14472]	$100,705	$75,529	—	—	0
J7311	FLUOCINOLONE 0.59 MG INTRAVITREAL IMPLANT [139661]	$93,793	$70,345	—	—	0
J9309	POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLUTION [168184]	$91,754	$68,816	—	—	0
J3241	TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION [171841]	$88,833	$66,625	—	—	0
0424T	HC INSJ/RPLC NSTIM SYSTEM SLEEP APNEA COMPLETE	$82,501	$61,876	—	—	0
J7170	EMICIZUMAB-KXWH 150 MG/ML SUBCUTANEOUS SOLUTION [150908]	$78,456	$58,842	—	—	0
0408T	HC INSJ/RPLC CAR MODULJ SYS PLS GEN TRANSVNS ELTRD	$77,750	$58,313	—	—	0
0409T	HC INSJ/RPLC CARDIAC MODULJ SYS PLS GENERATOR ONLY	$77,750	$58,313	—	—	0
33477	HC CATH TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH	$76,954	$57,716	—	—	0
C1822	KIT, IPG, MODEL IPG2000	$76,839	$57,629	—	—	1
C1823	GENERATOR, IMPLANTABLE PULSE, REMEDE	$76,500	$57,375	—	—	1
77371	HC GAMMA KNIFE TREATMENT	$74,868	$56,151	—	—	0
33276	HC INSERTION PHRENIC NERVE STIMULATOR SYSTEM	$73,009	$54,757	—	—	0
J9043	CABAZITAXEL 60 MG/1.5 ML (MUST BE DILUTED TO 10 MG/ML)INTRAVENOUS SOLN [105644]	$71,850	$53,888	—	—	0
C1824	GENERATOR, PULSE, OPTIMIZER SMART IPG	$69,000	$51,750	—	—	1
93654	HC EP EPHYS EVAL W/ABLATION VENTRICULAR TACHYCARDIA	$67,426	$50,570	—	—	0
A9572	INDIUM 111-PENTETREOTIDE 3 MCI/ML-10 MCG INTRAVENOUS KIT [13545]	$63,390	$47,542	—	—	0
C1721	DEFIBRILLATOR, ICD, SINGLE CHAMBER, GEM DR	$63,345	$47,509	—	—	1
J9042	BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION [111348]	$62,492	$46,869	—	—	0
J9307	PRALATREXATE 40 MG/2 ML (20 MG/ML) INTRAVENOUS SOLUTION [108073]	$62,279	$46,709	—	—	0
J0896	LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLUTION [170336]	$60,833	$45,625	—	—	0
33364	HC CATH REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH	$59,959	$44,969	—	—	0
33367	HC CATH REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH	$59,959	$44,969	—	—	0
33902	HC PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL	$59,038	$44,279	—	—	0

Showing top 50 of 6,048 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.