ALLIANCEHEALTH DURANT — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
103958918-3940313	69866-1030-05 - autologous cultured chondrocytes 1	$319,872	$67,173	—	—	7
103958918-3940313	69866-1030-05 - autologous cultured chondrocytes 1	$319,872	$38,385	—	—	7
103958919-3940313	69866-1030-08 - autologous cultured chondrocytes 1	$319,872	$67,173	—	—	7
103958919-3940313	69866-1030-08 - autologous cultured chondrocytes 1	$319,872	$38,385	—	—	7
102534551-3940297	71336-1001-01 - givosiran 189 mg/mL Soln	$253,500	$53,235	—	—	7
102534551-3940297	71336-1001-01 - givosiran 189 mg/mL Soln	$253,500	$30,420	—	—	7
113173740-4084411	S-REM-REP CVD MULT[OKAH]	$250,899	$52,689	—	—	7
113173740-4084411	S-REM-REP CVD MULT[OKAH]	$250,899	$30,108	—	—	7
51905029-3938512	30237-8900-06 - sipuleucel-T - Susp	$247,856	$52,050	—	—	7
51905029-3938512	30237-8900-06 - sipuleucel-T - Susp	$247,856	$29,743	—	—	7
1279402-3940297	00003-2328-22 - ipilimumab Soln	$228,040	$47,888	—	—	7
1279402-3940297	00003-2328-22 - ipilimumab Soln	$228,040	$27,365	—	—	7
113173733-4084411	S-INS-REP PACE-DEFIB[OKAH]	$218,806	$45,949	—	—	7
113173733-4084411	S-INS-REP PACE-DEFIB[OKAH]	$218,806	$26,257	—	—	7
1286149-3940297	54396-0801-01 - pegloticase Soln	$185,845	$39,027	—	—	7
1286149-3940297	54396-0801-01 - pegloticase Soln	$185,845	$22,301	—	—	7
95367892-3940297	60809-0801-01 - pegloticase 8 mg/mL Soln	$185,845	$39,027	—	—	7
95367892-3940297	60809-0801-01 - pegloticase 8 mg/mL Soln	$185,845	$22,301	—	—	7
113173735-4084411	S-REM-REP CVD DUAL[OKAH]	$179,170	$37,626	—	—	7
113173735-4084411	S-REM-REP CVD DUAL[OKAH]	$179,170	$21,500	—	—	7
113173738-4084411	S-INS PULSE GEN DUAL[OKAH]	$179,170	$37,626	—	—	7
113173738-4084411	S-INS PULSE GEN DUAL[OKAH]	$179,170	$21,500	—	—	7
113173739-4084411	S-REM-REP CVD SINGLE[OKAH]	$179,170	$37,626	—	—	7
113173739-4084411	S-REM-REP CVD SINGLE[OKAH]	$179,170	$21,500	—	—	7
94990000-3940297	57894-0061-03 - ustekinumab 90 mg/mL Soln	$168,491	$35,383	—	—	7
94990000-3940297	57894-0061-03 - ustekinumab 90 mg/mL Soln	$168,491	$20,219	—	—	7
1282361-3940297	57665-0002-02 - pegaspargase 3750. Soln	$165,999	$34,860	—	—	7
1282361-3940297	57665-0002-02 - pegaspargase 3750. Soln	$165,999	$19,920	—	—	7
1282362-3940297	54482-0301-01 - pegaspargase 3750. Soln	$165,999	$34,860	—	—	7
1282362-3940297	54482-0301-01 - pegaspargase 3750. Soln	$165,999	$19,920	—	—	7
102525788-3940297	25682-0028-01 - ravulizumab 100 mg/mL Soln	$152,629	$32,052	—	—	7
102525788-3940297	25682-0028-01 - ravulizumab 100 mg/mL Soln	$152,629	$18,315	—	—	7
114297202-4084411	DEV IMPELLA CP 14FRX04.7X75MM - 0048-0003[OKAH]	$143,113	$30,054	—	—	7
114297202-4084411	DEV IMPELLA CP 14FRX04.7X75MM - 0048-0003[OKAH]	$143,113	$17,174	—	—	7
114770124-4084411	ABIO-SET VNTRC IMPELLA 2.5 9F[OKAH]	$143,113	$30,054	—	—	7
114770124-4084411	ABIO-SET VNTRC IMPELLA 2.5 9F[OKAH]	$143,113	$17,174	—	—	7
114782687-4084411	ABIO-DSC-USE #2358147 PMP SET IMPELLA RP US 11F-US	$143,113	$30,054	—	—	7
114782687-4084411	ABIO-DSC-USE #2358147 PMP SET IMPELLA RP US 11F-US	$143,113	$17,174	—	—	7
114804929-4084411	BNDL IMPL W IMPLL PMP C9+ COMP - 4000021[OKAH]	$143,113	$30,054	—	—	7
114804929-4084411	BNDL IMPL W IMPLL PMP C9+ COMP - 4000021[OKAH]	$143,113	$17,174	—	—	7
113173730-4084411	S-TIB PER REV STN AT[OKAH]	$142,203	$29,863	—	—	7
113173730-4084411	S-TIB PER REV STN AT[OKAH]	$142,203	$17,064	—	—	7
127538326-3938512	00310-4535-30 - tremelimumab actl 20 mg/mL Soln	$136,309	$28,625	—	—	7
127538326-3938512	00310-4535-30 - tremelimumab actl 20 mg/mL Soln	$136,309	$16,357	—	—	7
114770903-4084411	ABBO-ANCH LD CNCH SPNL CORD STM 3.8[OKAH]	$132,734	$27,874	—	—	7
114770903-4084411	ABBO-ANCH LD CNCH SPNL CORD STM 3.8[OKAH]	$132,734	$15,928	—	—	7
112954234-4084411	IC-PRQ DE CR STNT AR[OKAH]	$129,819	$27,262	—	—	7
112954234-4084411	IC-PRQ DE CR STNT AR[OKAH]	$129,819	$15,578	—	—	7
112954235-4084411	IC-PRQ DE CR REV AMI[OKAH]	$129,819	$27,262	—	—	7
112954235-4084411	IC-PRQ DE CR REV AMI[OKAH]	$129,819	$15,578	—	—	7

Showing top 50 of 176,863 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.