GRANDE RONDE HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-198771	TREMELIMUMAB-ACTL 300 MG/15ML IV SOLN	$103,086	$103,086	—	—	8
RX-196087	NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20ML IV SOLN	$76,870	$76,870	—	—	8
RX-105853	PRALATREXATE 40 MG/2ML IV SOLN	$37,028	$37,028	—	—	8
RX-108127	CABAZITAXEL 60 MG/1.5ML IV SOLN	$36,772	$36,772	—	—	8
SUP-PTSH-021-001-SK-4	MANDIBLE CUSTOM, X-LARGE	$31,546	$31,546	—	—	8
RX-169866	OCRELIZUMAB 300 MG/10ML IV SOLN	$29,144	$29,144	—	—	8
RX-163008	ATEZOLIZUMAB 1200 MG/20ML IV SOLN	$28,436	$28,436	—	—	8
RX-112628	LEUPROLIDE ACETATE (PED)(3MON) 11.25 MG IM KIT	$26,965	$26,965	—	—	8
RX-178093	CEMIPLIMAB-RWLC 350 MG/7ML IV SOLN	$26,815	$26,815	—	—	8
RX-187062	DARATUMUMAB-HYALURONIDASE-FIHJ 1800-30000 MG-UT/15ML SUBQ SOLN	$25,126	$25,126	—	—	8
RX-112636	BRENTUXIMAB VEDOTIN 50 MG IV SOLR	$23,269	$23,269	—	—	8
RX-106242	IPILIMUMAB 50 MG/10ML IV SOLN	$22,690	$22,690	—	—	8
SUP-2030002	MESH HERNIA STRATTICE 20CM X 3	$22,626	$22,626	—	—	8
RX-148911	VEDOLIZUMAB 300 MG IV SOLR	$22,595	$22,595	—	—	8
RX-146304	OBINUTUZUMAB 1000 MG/40ML IV SOLN	$21,497	$21,497	—	—	8
SUP-511.615	AIR RECIPROCATOR	$21,335	$21,335	—	—	8
SUP-511.610	AIR OSCILLATOR	$21,335	$21,335	—	—	8
RX-187652	LURBINECTEDIN 4 MG IV SOLR	$20,949	$20,949	—	—	8
SUP-GMN-FSP-SYS	GEMINUS VOLAR DISTAL RADIUS PL	$20,800	$20,800	—	—	6
RX-173195	NIVOLUMAB 240 MG/24ML IV SOLN	$19,926	$19,926	—	—	8
RX-148494	RAMUCIRUMAB 500 MG/50ML IV SOLN	$19,019	$19,019	—	—	8
RX-100895	PRALATREXATE 20 MG/ML IV SOLN	$18,602	$18,602	—	—	8
RX-183853	LUSPATERCEPT-AAMT 75 MG SUBQ SOLR	$17,716	$17,716	—	—	8
RX-177231	ADALIMUMAB 80 MG/0.8ML SUBQ AJKT	$16,676	$16,676	—	—	8
RX-199170	MIRVETUXIMAB SORAVTANSINE-GYNX 100 MG/20ML IV SOLN	$16,266	$16,266	—	—	8
RX-152774	PEMBROLIZUMAB 100 MG/4ML IV SOLN	$14,840	$14,840	—	—	8
RX-195073	PALIPERIDONE PALMITATE ER 819 MG/2.63ML IM SUSY	$14,106	$14,106	—	—	8
SUP-03.306.010	PELVIC C-CLAMP II	$13,848	$13,848	—	—	8
SUP-356.350	RATCHET GRIP	$13,040	$13,040	—	—	8
RX-197120	RISANKIZUMAB-RZAA 600 MG/10ML IV SOLN	$12,701	$12,701	—	—	8
SUP-03.312.001	WIRE TENSIONER	$12,621	$12,621	—	—	8
RX-40120	NATALIZUMAB 300 MG/15ML IV CONC	$12,329	$12,329	—	—	8
RX-155757	RITUXIMAB 500 MG/50ML IV SOLN	$12,328	$12,328	—	—	8
SUP-03.010.200	SURELOCK AIMING ARM FOR	$12,266	$12,266	—	—	8
RX-9002	ALTEPLASE 100 MG IV SOLR	$12,117	$12,117	—	—	8
SUP-GMN-1VDR-KIT2	BILATERAL VOLAR DISTAL RADIUS	$12,029	$12,029	—	—	6
SUP-GMN-FSP-TRAY	GEMINUS VOLAR DISTAL RADIUS PL	$11,160	$11,160	—	—	6
SUP-03.033.001	RADIOLUCENT INSERTION HANDLE	$10,971	$10,971	—	—	8
RX-170567	DURVALUMAB 500 MG/10ML IV SOLN	$10,854	$10,854	—	—	8
RX-155762	PEGFILGRASTIM 6 MG/0.6ML SUBQ SOSY	$10,375	$10,375	—	—	8
RX-186240	ISATUXIMAB-IRFC 500 MG/25ML IV SOLN	$10,363	$10,363	—	—	8
SUP-03.404.035	DRIVE SHAFT FOR RIA 2	$10,320	$10,320	—	—	8
SUP-03.301.012S	LARGE EXTERNAL FIXATOR	$10,286	$10,286	—	—	8
RX-193715	NIVOLUMAB 120 MG/12ML IV SOLN	$10,000	$10,000	—	—	8
PX-36010153	HC Operating Room Services Level 8 1st 30 Mins	$9,872	$9,872	—	—	8
RX-171269	RITUXIMAB-HYALURONIDASE HUMAN 1400-23400 MG -UT/11.7ML SUBQ SOLN	$9,831	$9,831	—	—	8
RX-37894	PEMETREXED DISODIUM 500 MG IV SOLR	$9,762	$9,762	—	—	8
RX-21044	LEUPROLIDE ACETATE (3 MONTH) 11.25 MG IM KIT	$9,570	$9,570	—	—	8
RX-192440	AMIVANTAMAB-VMJW 350 MG/7ML IV SOLN	$9,558	$9,558	—	—	8
RX-24436	OCTREOTIDE ACETATE 30 MG IM KIT	$9,426	$9,426	—	—	8

Showing top 50 of 25,286 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.