PRISMA HEALTH RICHLAND HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-235131	VALOCTOCOGENE ROXAPARVOVEC-RVOX 2X10EXP13 VG/ML INTRAVENOUS SUSPENSION	$364,958	$237,223	—	—	84
RX-223389	INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION	$180,079	$117,051	—	—	92
RX-116024	GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION	$166,534	$108,247	—	—	84
PX-3613824000	HC Hpc Allogeneic	$147,856	$96,106	—	—	81
PX-3613326400	HC Rem Defibrillator W/Repl Mult Lead Sys	$125,369	$81,490	—	—	92
RX-231817	SPESOLIMAB-SBZO 60 MG/ML INTRAVENOUS SOLUTION	$124,203	$80,732	—	—	85
RX-220491	CALASPARGASE PEGOL-MKNL 750 UNIT/ML INTRAVENOUS SOLUTION	$124,197	$80,728	—	—	92
PX-3613324900	HC Ins/Repl Defibrillator W/Sgl Lead	$108,000	$70,200	—	—	91
RX-212252	INOTUZUMAB OZOGAMICIN 0.9 MG(0.25 MG/ML INITIAL CONCENTRATION) IV SOLN	$92,124	$59,881	—	—	84
PX-2780001115	HC Limflow Sysytem	$89,928	$58,453	—	—	32
SUP-S3UCM226A	TRANSCATH ULTRA S3 ULTRA 26MM (S3UCM226A 165176)	$89,375	$58,094	—	—	32
PX-4810483000	HC Tmvi Percutaneous Approach	$83,602	$54,341	—	—	53
RX-165895	SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION	$62,264	$40,472	—	—	128
PX-4819365400	HC Ep Eval & Ablate Ventric Tachy	$58,945	$38,314	—	—	91
SUP-97715	NEUROSTIMLTR INTELIS MRI (97715 146109)	$52,962	$34,425	—	—	32
PX-4810795000	HC Tcat Ins 2chmbr Ldls Pm Cmpl	$50,062	$32,540	—	—	91
PX-4800803000	HC Tcat Rmvl&Rplcmt Prm 2chmbr Ldls Pm R Vntr Cmpnt	$50,062	$32,540	—	—	91
SUP-VAMF4040C100TU	ENDO VALIANT PM 40X40X100 (VAMF4040C100TU C28249)	$48,839	$31,746	—	—	32
PX-3613727000	HC Transcatheter Biopsy	$46,822	$30,434	—	—	35
PX-3613727600	HC Revsc Evasc Fpvt St Athrc Uni Sf Les Ea Addl Vsl	$46,822	$30,434	—	—	35
RX-232868	UBLITUXIMAB-XIIY 25 MG/ML INTRAVENOUS SOLUTION	$45,578	$29,625	—	—	91
PX-4810960600	HC Perc D-E Cor Revasc W Ami Sgl	$44,654	$29,025	—	—	53
SUP-CI-1601-05	IMP COCH HI/FOCUS SLIMJ (CI-1601-05 156817)	$44,157	$28,702	—	—	32
RX-230966	RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION	$41,978	$27,286	—	—	91
RX-232242	TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLUTION	$41,733	$27,126	—	—	85
PX-4800960400	HC Revasc Cor Byp Graft Any Sgl	$41,442	$26,937	—	—	92
PX-3613726700	HC Revsc Evsc Fpvt Stent Sf 1st Vsl	$39,932	$25,956	—	—	76
PX-3613726900	HC Revsc Evasc Fpvt St Cplx 1st Vsl	$39,932	$25,956	—	—	76
PX-3610238000	HC Trluml Perip Athrc Iliac Art	$38,738	$25,180	—	—	85
PX-3613722500	HC Fem/Popl Revas W/Ather	$37,435	$24,333	—	—	41
PX-3613718300	HC Tips Revision	$37,435	$24,333	—	—	82
PX-3613724200	HC Vasc Embolize/Occlude Artery	$35,908	$23,340	—	—	90
PX-3613724100	HC Vasc Embolize/Occlude Venous	$35,908	$23,340	—	—	91
PX-2720001122	HC Cann W/Dilator Angovac C20-180	$35,750	$23,238	—	—	38
SUP-D152	DEVICE ICD DYNAGEN D152 (D152 200037)	$34,788	$22,612	—	—	32
PX-3613724400	HC Vasc Embolize/Occlude Bleed\|REDUCED SERVICES	$34,347	$22,326	—	—	35
RX-9002	ALTEPLASE 100 MG INTRAVENOUS SOLUTION	$33,899	$22,034	—	—	91
RX-40830523	ALTEPLASE 0.9 MG/KG IV (NTE 90 MG) FOR STROKE	$33,899	$22,034	—	—	182
PX-4810659000	HC Tcat Intra-C Nfs Supersat O2	$33,816	$21,980	—	—	53
RX-214622	TENECTEPLASE 50 MG INTRAVENOUS SOLUTION	$32,920	$21,398	—	—	91
RX-244427	TENECTEPLASE 25 MG INTRAVENOUS SOLUTION	$32,920	$21,398	—	—	91
PX-4810976600	HC Revascularization Intravasc Lithotripsy Atherect	$32,851	$21,353	—	—	91
PX-4809293700	HC Perq Revasc Byp Graft 1vsl	$32,619	$21,202	—	—	92
PX-3615588200	HC Ablt Trurl Prst8 Tis Trnsdcr	$32,481	$21,113	—	—	76
PX-4813328900	HC Transcath Impl Wrls P-Art Prs Snr	$32,300	$20,995	—	—	84
PX-3612098200	HC Ablation Bone Tumr Perc W/CT	$32,167	$20,909	—	—	92
PX-2780001068	HC Cannula Perfusion 72cm 21fr Tandemheart Venous Dilator Introducer Sterile Latex Free Disposable	$31,815	$20,680	—	—	32
PX-3613729700	HC Revsc Evasc Imvt Angiop Uni Sf Les Ea Addl Vsl	$29,486	$19,166	—	—	35
PX-3613725800	HC Revsc Evasc Ivt Stent Sf 1st Vsl	$29,486	$19,166	—	—	76
PX-4819345900	HC Lhrt Art/Grft Angio	$29,266	$19,023	—	—	92

Showing top 50 of 3,617 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.