HILLCREST HOSPITAL HENRYETTA

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-9002	ALTEPLASE 100 MG INTRAVENOUS SOLUTION	$23,012	$6,904	—	—	48
RX-172314	TENECTEPLASE 50 MG INTRAVENOUS SOLUTION	$21,697	$6,509	—	—	7
SUP-107171	TENDON PATELLE W/BONE BLOCK	$12,865	$3,860	—	—	4
SUP-875350	GRAFT BONE PATELLAR LIGAMENT L10 MM KNEE FROZEN IRRADIATE PRESHAPE STERILE	$12,611	$3,783	—	—	45
SUP-158834	TISSUE PATELLAR LGMNT PS 10-10	$12,450	$3,735	—	—	45
SUP-104172	GRAFT BONE LO-RAD HEMI BONE TENDON BONE 10 MM ALLOGRAFT PRESHAPE	$12,450	$3,735	—	—	45
PX-36045380	Biopsy of large bowel using a flexible endoscope	$11,684	$3,505	—	—	20
PX-36045388	Destruction of polyp or growth of large bowel using a flexible endoscope	$11,684	$3,505	—	—	20
PX-74095811	Sleep study in sleep lab with continuous airway pressure (6 years or older)	$10,891	$3,267	—	—	43
PX-36045385	Removal of polyps or growths of large bowel using an endoscope with mechanical snare	$10,834	$3,250	—	—	20
SUP-162071	TISSUE HYD ACELLR DERMAL 4X4CM	$10,790	$3,237	—	—	4
PX-36045378	Diagnostic exam of large bowel using a flexible endoscope	$10,620	$3,186	—	—	20
PX-75000121	HC Colonoscopy Screen Not High Risk	$10,620	$3,186	—	—	43
PX-75000105	HC Colonoscopy Screening High Risk	$10,620	$3,186	—	—	43
SUP-857402	TENDON PATELLA PRE SHAPED 10MM	$10,479	$3,144	—	—	45
RX-13545	INDIUM 111-PENTETREOTIDE 3 MCI/ML-10 MCG INTRAVENOUS KIT	$10,415	$3,125	—	—	43
SUP-836948	STEM HUMERAL REUNION L123 MM OD11 MM SHOULDER PRESS FIT STERILE TOTAL SHOULDER ARTHROPLASTY	$9,886	$2,966	—	—	45
SUP-120094	STEM HUMERAL REUNION STANDARD L140 MM OD17 MM PRESS FIT TOTAL SHOULDER ARTHROPLASTY	$9,886	$2,966	—	—	45
PX-74095810	Sleep study in sleep lab (6 years or older)	$9,799	$2,940	—	—	43
SUP-125905	STEM FEMORAL ACCOLADE II V40 PUREFIX TITANIUM 127 D 6 35 MM HIGH OFFSET L111 MM HIP PRESS FIT STERIL	$8,715	$2,615	—	—	45
SUP-126601	STEM FEMORAL ACCOLADE II V40 PUREFIX TITANIUM 127 D 8 51 MM HIGH OFFSET L117 MM HIP PRESS FIT STERIL	$8,715	$2,615	—	—	45
SUP-127230	STEM FEMORAL ACCOLADE II V40 PUREFIX TITANIUM 127 D 7 50 MM HIGH OFFSET L114 MM HIP PRESS FIT STERIL	$8,715	$2,615	—	—	45
SUP-127253	STEM FEMORAL ACCOLADE II V40 PUREFIX TITANIUM 127 D 4 42 MM HIGH OFFSET L105 MM L35 MM HIP PRESS FIT	$8,715	$2,615	—	—	45
PX-36044390	Removal of foreign bodies from large bowel using an endoscope inserted through surgically created op	$8,495	$2,549	—	—	2
PX-74095805	Sleep study, multiple trials	$8,379	$2,514	—	—	43
PX-74000399	HC Home Sleep Test Type 3 Portable	$8,379	$2,514	—	—	43
RX-29313	CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION	$8,362	$2,509	—	—	7
RX-189816	HUMAN PROTHROMBIN CMPLX (PCC)-LANS 4FACTOR 1,000 UNIT (800-1280 UNIT) IV SOLUTION	$8,237	$2,471	—	—	7
SUP-78292	NAIL INTRAMEDULLARY GAMMA3 TITANIUM 125 D R1.5 L400 MM OD10 MM FEMUR RIGHT KIT LOCK STERILE LATEX FR	$8,216	$2,465	—	—	45
SUP-855743	STENT OPHTHALMIC ISTENT INJECT TITANIUM STEARALKONIUM HEPARIN OD50 UM H360 UM OD230 UM ODSEC80 UM IN	$8,093	$2,428	—	—	45
PX-36001230	HC or Acuity Lvl 4 1st Hr	$7,976	$2,393	—	—	7
PX-36027825	Closed treatment of broken shin bone at lower weight bearing joint with manipulation and/or traction	$7,957	$2,387	—	—	2
PX-37000004	HC Anes General Level 2 1st Hr	$7,672	$2,302	—	—	7
PX-36055100	Drainage of abscess of scrotum	$7,618	$2,285	—	—	2
PX-36045381	Injection beneath lining of large bowel using a flexible endoscope	$7,613	$2,284	—	—	20
PX-36001184	HC or Acuity Lvl 3 1st Hr	$7,250	$2,175	—	—	7
PX-71000039	HC Pacu > 300 Min	$7,121	$2,136	—	—	7
PX-36010121	Removal of foreign body from tissue, accessed beneath the skin, complex	$6,725	$2,018	—	—	2
RX-108781	NM ISO IOFLUPANE (DATSCAN) PER DOSE UP TO 5 MCI	$6,631	$1,989	—	—	2
PX-61073720	MRI scan of leg before and after contrast	$6,453	$1,936	—	—	20
PX-36051102	HC Place Suprapubic Cath	$6,407	$1,922	—	—	20
PX-35274174	CT scan of blood vessels of abdomen and pelvis with contrast	$6,371	$1,911	—	—	20
RX-40840129	NM ISO IN-111 ZEVALIN PER DOSE UP TO 5 MCI	$6,371	$1,911	—	—	2
RX-98451	NM ISO I-123 IOBENGUANE (MIBG) PER DOSE UP TO 15MCI	$6,299	$1,890	—	—	7
PX-36046050	Drainage of superficial rectal abscess surrounding anus	$6,273	$1,882	—	—	2
PX-36045384	Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	$6,257	$1,877	—	—	20
PX-61073723	MRI scan of leg joint before and after contrast	$6,230	$1,869	—	—	20
PX-61272156	MRI scan of upper spinal canal before and after contrast	$6,011	$1,803	—	—	20
SUP-106776	COMPONENT FEMORAL TRIATHLON PA 3 KNEE LEFT CRUCIATE RETAIN BEAD STERILE LATEX FREE	$5,935	$1,780	—	—	43
SUP-106777	COMPONENT FEMORAL TRIATHLON PA 3 KNEE RIGHT CRUCIATE RETAIN BEAD STERILE LATEX FREE	$5,935	$1,780	—	—	43

Showing top 50 of 3,986 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.