45 CFR § 180 compliance
B · 85
This hospital published most of what § 180 requires.
●Machine-readable file published: assessment threshold met
●Gross / standard charges: assessment threshold met
●Discounted cash price: assessment threshold met
●Payer-specific negotiated rates: assessment threshold met
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
1,548
Insurances with rates
5
CPT / HCPCS codes
317
Most expensive procedures (gross)
42367054032
$5,206
DANTROLENE 250 MG INTRAVENOUS SUSPENSION
Gross
$10,846
59148001971
$4,562
ARIPIPRAZOLE ER 400 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE
Gross
$9,505
59148001871
$3,422
ARIPIPRAZOLE ER 300 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE
Gross
$7,128
69315070150
$2,984
ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION
Gross
$6,218
70552
$1,969
LC MRI BRAIN WITH CONTRAST
Gross
$4,315
50458030811
$2,027
RISPERIDONE MICROSPHERES ER 50 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE
Gross
$4,224
70553
$1,916
LC MRI BRAIN WITH AND W/O CONTRAST
Gross
$4,199
50458030711
$1,520
RISPERIDONE MICROSPHERES ER 37.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS
Gross
$3,168
70551
$1,393
LC MRI BRAIN WITHOUT CONTRAST
Gross
$3,053
00002763611
$1,323
OLANZAPINE PAMOATE 300 MG IM SUSPENSION
Gross
$2,757
114
$1,101
LC INPATIENT CHEM DEP ROOM AND BOARD
Gross
$2,413
50458030611
$1,014
RISPERIDONE MICROSPHERES ER 25 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE
Gross
$2,112
90870
$825
LC ECT FACILITY
Gross
$1,930
00143956410
$770
PHENTOLAMINE 5 MG INJECTION SOLUTION
Gross
$1,603
47426020101
$714
APREPITANT 130 MG/18 ML (7.2 MG/ML) INTRAVENOUS EMULSION
Gross
$1,488
66215060806
$625
SELEXIPAG 800 MCG TABLET
Gross
$1,302
66215071801
$624
SELEXIPAG 1,800 MCG INTRAVENOUS SOLUTION
Gross
$1,299
00574113304
$587
SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION
Gross
$1,224
70727052925
$555
NETARSUDIL 0.02 %-LATANOPROST 0.005 % EYE DROPS
Gross
$1,157
70727049725
$525
NETARSUDIL 0.02 % EYE DROPS
Gross
$1,094
95819
$498
LC EEG
Gross
$1,092
00006411903
$516
HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION
Gross
$1,075
00006412102
$516
HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE
Gross
$1,075
49502050002
$478
EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR
Gross
$996
90867
$426
LC TMS MD TREATMENT PLAN
Gross
$933
00005200010
$430
PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE
Gross
$896
90869
$404
LC TMS MD TX SUBSEQ MOTOR
Gross
$885
90869
$510
PR REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN
Gross
$880
00597019261
$421
OLODATEROL 2.5 MCG/ACTUATION MIST FOR INHALATION
Gross
$877
66215060206
$402
SELEXIPAG 200 MCG TABLET
Gross
$837
63323059303
$397
GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION
Gross
$827
00006542515
$392
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION
Gross
$816
4080258502
$392
GABAPENTIN 100 MG/ML ORAL SUSPENSION
Gross
$816
86255
$347
HC FLORESCENT NONINFECTIOUS AGENT ANTIBODY EACH
Gross
$784
90868
$358
LC TMS DELIVERY MGMT PER SESSION
Gross
$784
90867
$415
PR REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M
Gross
$715
92523
$299
LC EVAL SPEECH SOUND PRD W/LNG COMP & EXPR
Gross
$654
63323028110
$302
FLUPHENAZINE 2.5 MG/ML INJECTION SOLUTION
Gross
$629
75834029501
$265
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION
Gross
$552
58160082730
$261
MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION
Gross
$543
00186037028
$250
BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER
Gross
$521
59676080030
$247
DARUNAVIR 800 MG-COB 150 MG-EMTRICIT 200 MG-TENOFO ALAFEN 10 MG TABLET
Gross
$515
00591231215
$247
ALVIMOPAN 12 MG CAPSULE
Gross
$514
99408228810
$245
INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION
Gross
$510
63323027205
$243
FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION
Gross
$507
61958190101
$221
ELVITEG 150 MG-COB 150 MG-EMTRICIT 200 MG-TENOFO ALAFENAM 10 MG TABLET
Gross
$460
61958250101
$221
BICTEGRAVIR 50 MG-EMTRICITABINE 200 MG-TENOFOVIR ALAFENAM 25 MG TABLET
Gross
$460
00186037228
$217
BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER
Gross
$453
00006542312
$214
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION
Gross
$446
99205
$244
PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES
Gross
$420
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 42367054032 | DANTROLENE 250 MG INTRAVENOUS SUSPENSION | $10,846 | $5,206 | — | — | 1 |
| 59148001971 | ARIPIPRAZOLE ER 400 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE | $9,505 | $4,562 | — | — | 1 |
| 59148001871 | ARIPIPRAZOLE ER 300 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE | $7,128 | $3,422 | — | — | 1 |
| 69315070150 | ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION | $6,218 | $2,984 | — | — | 1 |
| 70552 | LC MRI BRAIN WITH CONTRAST | $4,315 | $1,969 | — | — | 2 |
| 50458030811 | RISPERIDONE MICROSPHERES ER 50 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE | $4,224 | $2,027 | — | — | 1 |
| 70553 | LC MRI BRAIN WITH AND W/O CONTRAST | $4,199 | $1,916 | — | — | 2 |
| 50458030711 | RISPERIDONE MICROSPHERES ER 37.5 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEAS | $3,168 | $1,520 | — | — | 1 |
| 70551 | LC MRI BRAIN WITHOUT CONTRAST | $3,053 | $1,393 | — | — | 2 |
| 00002763611 | OLANZAPINE PAMOATE 300 MG IM SUSPENSION | $2,757 | $1,323 | — | — | 1 |
| 114 | LC INPATIENT CHEM DEP ROOM AND BOARD | $2,413 | $1,101 | — | — | 5 |
| 50458030611 | RISPERIDONE MICROSPHERES ER 25 MG/2 ML INTRAMUSCULAR SUSP,EXT RELEASE | $2,112 | $1,014 | — | — | 1 |
| 90870 | LC ECT FACILITY | $1,930 | $825 | — | — | 6 |
| 00143956410 | PHENTOLAMINE 5 MG INJECTION SOLUTION | $1,603 | $770 | — | — | 1 |
| 47426020101 | APREPITANT 130 MG/18 ML (7.2 MG/ML) INTRAVENOUS EMULSION | $1,488 | $714 | — | — | 1 |
| 66215060806 | SELEXIPAG 800 MCG TABLET | $1,302 | $625 | — | — | 1 |
| 66215071801 | SELEXIPAG 1,800 MCG INTRAVENOUS SOLUTION | $1,299 | $624 | — | — | 1 |
| 00574113304 | SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION | $1,224 | $587 | — | — | 1 |
| 70727052925 | NETARSUDIL 0.02 %-LATANOPROST 0.005 % EYE DROPS | $1,157 | $555 | — | — | 1 |
| 70727049725 | NETARSUDIL 0.02 % EYE DROPS | $1,094 | $525 | — | — | 1 |
| 95819 | LC EEG | $1,092 | $498 | — | — | 1 |
| 00006411903 | HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION | $1,075 | $516 | — | — | 1 |
| 00006412102 | HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE | $1,075 | $516 | — | — | 1 |
| 49502050002 | EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR | $996 | $478 | — | — | 1 |
| 90867 | LC TMS MD TREATMENT PLAN | $933 | $426 | — | — | 4 |
| 00005200010 | PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE | $896 | $430 | — | — | 1 |
| 90869 | LC TMS MD TX SUBSEQ MOTOR | $885 | $404 | — | — | 4 |
| 90869 | PR REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN | $880 | $510 | — | — | 4 |
| 00597019261 | OLODATEROL 2.5 MCG/ACTUATION MIST FOR INHALATION | $877 | $421 | — | — | 1 |
| 66215060206 | SELEXIPAG 200 MCG TABLET | $837 | $402 | — | — | 1 |
| 63323059303 | GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION | $827 | $397 | — | — | 1 |
| 00006542515 | SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION | $816 | $392 | — | — | 1 |
| 4080258502 | GABAPENTIN 100 MG/ML ORAL SUSPENSION | $816 | $392 | — | — | 1 |
| 86255 | HC FLORESCENT NONINFECTIOUS AGENT ANTIBODY EACH | $784 | $347 | — | — | 1 |
| 90868 | LC TMS DELIVERY MGMT PER SESSION | $784 | $358 | — | — | 4 |
| 90867 | PR REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M | $715 | $415 | — | — | 4 |
| 92523 | LC EVAL SPEECH SOUND PRD W/LNG COMP & EXPR | $654 | $299 | — | — | 1 |
| 63323028110 | FLUPHENAZINE 2.5 MG/ML INJECTION SOLUTION | $629 | $302 | — | — | 1 |
| 75834029501 | ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION | $552 | $265 | — | — | 1 |
| 58160082730 | MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION | $543 | $261 | — | — | 1 |
| 00186037028 | BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER | $521 | $250 | — | — | 1 |
| 59676080030 | DARUNAVIR 800 MG-COB 150 MG-EMTRICIT 200 MG-TENOFO ALAFEN 10 MG TABLET | $515 | $247 | — | — | 1 |
| 00591231215 | ALVIMOPAN 12 MG CAPSULE | $514 | $247 | — | — | 1 |
| 99408228810 | INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION | $510 | $245 | — | — | 1 |
| 63323027205 | FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLUTION | $507 | $243 | — | — | 1 |
| 61958190101 | ELVITEG 150 MG-COB 150 MG-EMTRICIT 200 MG-TENOFO ALAFENAM 10 MG TABLET | $460 | $221 | — | — | 1 |
| 61958250101 | BICTEGRAVIR 50 MG-EMTRICITABINE 200 MG-TENOFOVIR ALAFENAM 25 MG TABLET | $460 | $221 | — | — | 1 |
| 00186037228 | BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER | $453 | $217 | — | — | 1 |
| 00006542312 | SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION | $446 | $214 | — | — | 1 |
| 99205 | PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $420 | $244 | — | — | 7 |
Showing top 50 of 1,548 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.