UPMC MUNCY — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
636nanJ1413nan	ELEVIDYS (13.5-14.4 KG) KIT	$3,427,200	$2,056,320	—	—	17
621nanA9543nan	Y90 ZEVALIN TX P/DSE (<=40MCI)	$157,779	$94,667	—	—	15
636nanJ9266nan	PEGASPERGASE 750 IU/ML 5ML INJ	$103,953	$62,372	—	—	17
278nanC1822nan	KIT HFX IQ IPG NEVRO	$92,031	$55,219	—	—	15
636nanJ9309nan	POLIVY 140MG SDV INJ	$60,907	$36,544	—	—	17
278nanL8614nan	NUCLEUS COCHLEAR IMPL COCHL	$60,862	$36,517	—	—	15
636nanJ3241nan	TEPEZZA 500MG/ML SDV INJ	$60,501	$36,301	—	—	17
636nanJ1930nan	LANREOTIDE 120MG/5ML DEP INJ	$55,956	$33,574	—	—	17
278nanL8679nan	NEURSTM PRODIGY 5.3X4.8CM STJ	$55,519	$33,311	—	—	15
636nanJ2505nan	NEULASTA DELIVERY KIT 6MG	$48,097	$28,858	—	—	30
278nanC1772nan	PUMP IT SYNCHROMED VAR MEDTRN	$42,776	$25,666	—	—	15
278nanC1767nan	BATTERY INTERSTIM II MEDTRON	$37,195	$22,317	—	—	17
636nanJ9050nan	CARMUSTINE 100MG VIAL INJ	$36,411	$21,847	—	—	19
636nanJ9271nan	KEYTRUDA 100MG/4ML INJ	$35,890	$21,534	—	—	17
636nanJ2997nan	ALTEPLASE TPA 50MG INJ	$33,964	$20,378	—	—	38
636nanJ9315nan	ROMIDEPSIN 10MG INJ KIT	$29,629	$17,777	—	—	15
636nanJ0565nan	ZINPLAVA 1000MG/40ML (25MG/ML)	$29,332	$17,599	—	—	17
636nanJ1632nan	BREXANOLONE 5MG/ML 20ML SDV	$28,811	$17,287	—	—	17
636nanJ1162nan	DIGOXIN IMMUNE 40MG VIAL	$27,403	$16,442	—	—	38
33571555	CALCITONIN SALMON 400U 2ML INJ	$25,038	$20,030	—	—	17
636nanJ0630nan	CALCITONIN SALMON 400U 2ML INJ	$25,038	$15,023	—	—	17
636nanJ0840nan	ANTIVENIN CROTALIDAE FAB INJ	$24,084	$14,450	—	—	19
36165778nannan	COVER EYE W/MEMBRANE W/O SUT	$24,064	$14,438	—	—	17
278nanQ4172nan	PURAPLYAM MATRIX 6X9CM ORGAN	$23,157	$13,894	—	—	15
344nanA9604nan	SM 153 LXDRNM THR UP TO 150MCI	$20,684	$12,410	—	—	15
621nanA9542nan	IN 111 ZEVALIN DX (<=5 MCI)	$20,272	$12,163	—	—	17
636nanJ9299nan	NIVOLUMAB 100MG/10ML INJ	$20,240	$12,144	—	—	17
636nanJ2507nan	PEGLOTICASE 1MG/0.125ML	$19,706	$11,824	—	—	17
636nanQ2049nan	LIPODOX 2MG/ML 25ML INJ	$18,701	$11,221	—	—	15
272nanC1728nan	MAMMOSITE INSERTION KIT	$18,345	$11,007	—	—	15
636nanJ0897nan	DENOSUMAB 120MG/1.7ML VIAL	$17,115	$10,269	—	—	19
278nanQ4104nan	DRESSING WOUND BILYR INTEG	$14,093	$8,456	—	—	17
278nanC1734nan	AUGMENT BONE VAR WRIMED	$13,381	$8,029	—	—	17
33518300	DOPTELET (10 TAB PK) 20 MG TAB	$12,965	$10,372	—	—	17
636nanJ2182nan	MEPOLIZUMAB 100MG/ML PF SYR	$12,797	$7,678	—	—	17
33572124	DIGOXIN IMMUNE 40MG VIAL	$12,692	$10,154	—	—	19
343nanA9582nan	I 123 MIBG IV	$12,582	$7,549	—	—	17
636nanJ3358nan	USTEKINUMAB 130MG INJ	$12,350	$7,410	—	—	17
3190120Unannan	LYMPH 3CX	$12,251	$7,351	—	—	15
31981439nannan	ARRHYTHMOGENIC CARDIOMYOPATHY	$12,207	$7,324	—	—	17
35274174nannan	CTA ABD&PLV W/WO CON W/POSTPRC	$12,197	$7,318	—	—	19
31981448nannan	COMPRE PERIPH NEURO GN PN VAR	$12,000	$7,200	—	—	17
36169005nannan	ABCESS EAR LOBE COMPLICATED	$11,878	$7,127	—	—	19
36167700nannan	BLEPHAROTOMY DRN.ABSC.EYELID	$11,878	$7,127	—	—	17
36146320nannan	EXC EXT THROMBOTIC HEMORRHOID	$11,878	$7,127	—	—	19
36111770nannan	EXC PILONIDAL CYST/SINUS SMPL	$11,878	$7,127	—	—	19
36154700nannan	I & D OF SCROTAL ABSCESS	$11,878	$7,127	—	—	19
45069436nannan	MYRINGOTOMY W TUBE UNILATERAL	$11,878	$7,127	—	—	17
36128192nannan	REM FOREIGN BODY FOOT, DEEP	$11,878	$7,127	—	—	17
36149520nannan	REP RECURR INGUINAL HERNIA/RED	$11,878	$7,127	—	—	17

Showing top 50 of 6,908 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.