EXCELA HEALTH - FRICK HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
100002801	ALEMTUZUMAB 12MG/1.2ML SOLN	$90,184	$54,110	—	—	33
100002907	TEPROTUM TRBW 500MG/10.5ML VIAL	$60,339	$36,204	—	—	33
100002880	MITOMYCIN-JELMYTO 40MG PWD VIAL	$43,115	$25,869	—	—	33
660086042	CONDUIT KONECT RES AORTIC 21-29M	$37,500	$22,500	—	—	1
100002383	JEVTANA INJECTION 60MG	$34,323	$20,594	—	—	33
100000084	ALTEPLASE 100MG POWDER-INJ	$34,321	$20,593	—	—	34
100003032	TENECTEPLASE 1MG INJ SDV	$32,359	$19,416	—	—	34
100002585	VEDOLIZUMAB 300MG POWD-INJ VIAL	$31,886	$19,132	—	—	33
660086057	CARTIFORM 20X25MM DISC	$27,500	$16,500	—	—	4
100000527	COAGULATION FACTOR VIIA 5000MCG	$25,188	$15,113	—	—	34
100002809	BENRALIZUMAB 30 MG/1 ML INJ	$21,495	$12,897	—	—	33
660086055	CARTIFORM 20MM DISC	$21,250	$12,750	—	—	4
660082955	HEART VALVE	$19,157	$11,494	—	—	1
660086023	VALVE AORTIC INSP RESI 19MM-29MM	$18,500	$11,100	—	—	1
660086025	VALVE MITRAL RESILIA 25-33MM	$18,500	$11,100	—	—	1
100000083	ALTEPLASE 50MG POWDER-INJ	$17,161	$10,296	—	—	34
660086024	VALVE MITRAL PERIMNT MAG 25-33MM	$16,000	$9,600	—	—	1
100001633	PEMETREXED 500MG POWDER-INJ	$15,768	$9,461	—	—	34
721717392	ZZ CT RFA RENAL TUMOR	$15,050	$9,030	—	—	31
721729794	CT KYPHOPLASTY TSP 1ST VERT	$14,605	$8,763	—	—	32
721729795	CT KYPHOPLASTY LSP 1ST VERT	$14,605	$8,763	—	—	32
721729796	CT KYPHOPLSTY EA ADD VERT	$14,605	$8,763	—	—	2
660036282	ADVISA MRI DR GENERATOR	$14,073	$8,444	—	—	4
721518021	ZZ NM QUADRAMET/TX DOSE TO 150	$13,802	$8,281	—	—	32
660085975	ATRICLIP PRO-V 35MM-50MM	$13,750	$8,250	—	—	1
100002016	TENECTEPLASE 50MG POWDER-INJ	$13,631	$8,179	—	—	34
100002996	SPESOLIMAB-SBZO 1MG INJ	$13,295	$7,977	—	—	33
100002934	MEPOLIZUMAB 100MG SDV	$13,109	$7,865	—	—	33
701120742	RARE DS WHL GEN SEQ FETA	$13,062	$7,837	—	—	31
721418517	US PLACE RADIOTX CATH, BREAST	$12,932	$7,759	—	—	31
100000167	ANTIVENIN (CROTALIDAE) POLYV 1GM	$12,472	$7,483	—	—	33
100002523	SYNAGIS INJECTION 50MG	$12,271	$7,363	—	—	32
738019144	ERCP INSERT STENT	$12,000	$7,200	—	—	32
738019146	ERCP DESTRUCT STONE	$12,000	$7,200	—	—	33
738020408	ERCP-STENT CHANGE	$12,000	$7,200	—	—	32
738025452	EGD W/ENDOSCOPIC INSERT STENT	$12,000	$7,200	—	—	31
660085921	LAPIPLASTY SYSTEM 2, SK14	$11,988	$7,193	—	—	4
100002732	CARFILZOMIB 60MG POWDER-INJ	$11,619	$6,971	—	—	33
100000247	BENDAMUSTINE HCL 1MG INJ	$11,590	$6,954	—	—	34
100002595	RYANODEX 250MG INJECTION	$11,408	$6,845	—	—	3
660085885	LAPIPLSTY SYS 2 ANATMC IMPLANT	$11,388	$6,833	—	—	4
660034756	PACEMAKER MEDTRONIC-DDD SDR303B	$11,173	$6,704	—	—	4
100002997	EFGAR-ALF 2MG HYA-QVFCINJ	$10,985	$6,591	—	—	33
660085812	KIT CNTRL 360 DGR SYSTM LPLSTY	$10,789	$6,473	—	—	4
721417391	ZZ US RFA LIVER TUMOR	$10,056	$6,034	—	—	31
721717390	ZZ CT RFA LIVER TUMOR	$10,056	$6,034	—	—	31
721717794	CT LUNG TUMOR RFA	$10,056	$6,034	—	—	31
660021309	OR FIRST HOUR	$10,000	$6,000	—	—	1
721717372	ZZ CT BIOPSY ADRENAL	$9,920	$5,952	—	—	32
660085636	MESH SYNTHETIC LV13	$9,350	$5,610	—	—	4

Showing top 50 of 8,927 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.