PRISMA HEALTH TUOMEY HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-223389	INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION	$180,079	$117,051	—	—	88
RX-116024	GLUCARPIDASE 1,000 UNIT INTRAVENOUS SOLUTION	$166,534	$108,247	—	—	80
PX-3613324900	HC Ins/Repl Defibrillator W/Sgl Lead	$108,000	$70,200	—	—	88
RX-199358	DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLUTION	$80,634	$52,412	—	—	52
PX-3613322400	HC Ins Electrode to Prev Pacemaker/Generator	$78,541	$51,052	—	—	88
RX-219318	POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLUTION	$75,993	$49,395	—	—	88
PX-3337737100	HC Srs Multisource 1 Session	$74,400	$48,360	—	—	88
RX-165895	SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION	$73,872	$48,017	—	—	39
RX-221727	TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION	$69,409	$45,116	—	—	88
SUP-G124	ICD MOMENTUM CRT-D DF4 (G124 148799)	$59,160	$38,454	—	—	39
PX-4810976500	HC Revascularization Intravasc Lithotripsy Stent	$57,974	$37,683	—	—	83
SUP-CM PATIENT SYSTEM	SENSOR CARDIOMEM HEART FAILURE (CM PATIENT SYSTEM 146159)	$55,963	$36,376	—	—	46
PX-3613723100	HC Revsc Tibl Prnl W/Stent & Arth	$51,721	$33,619	—	—	44
PX-3613729400	HC Rvsc Evsc Tpvt St Athr Cpx 1st Vsl	$51,721	$33,619	—	—	82
PX-4819365300	HC Ep Eval & Ablate Svt Arrhyt	$51,165	$33,257	—	—	88
PX-4810795000	HC Tcat Ins 2chmbr Ldls Pm Cmpl	$50,062	$32,540	—	—	87
RX-220726	LUSPATERCEPT-AAMT 75 MG SUBCUTANEOUS SOLUTION	$48,482	$31,513	—	—	88
PX-3613727100	HC Revsc Evsc Fpvt Athrc Sf 1st Vsl	$46,822	$30,434	—	—	82
PX-3613727500	HC Rvsc Evsc Fpvt St Athrc Sf 1st Vsl	$46,822	$30,434	—	—	82
PX-3613728900	HC Revsc Evsc Tpvt Athrc Sf Ea Add Vsl	$46,822	$30,434	—	—	41
PX-3613728400	HC Revsc Evasc Tpvt St Sf 1st Vsl	$46,822	$30,434	—	—	82
PX-4800823000	HC Tcat Ins 1chmbr Ldls Pm Ra	$45,199	$29,379	—	—	87
PX-4810981000	HC Tcat Impl Wrls Ivc Snr	$44,892	$29,180	—	—	82
PX-4810960000	HC Perc Drug-El Cor Stent Sgl	$44,208	$28,735	—	—	88
RX-233716	ANTIHEMOPHIL RFVIII FC-VWF-XTEN,BDD-EHTL 2,000 (+/-) UNIT IV SOLUTION	$43,849	$28,502	—	—	81
RX-230966	RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION	$41,978	$27,286	—	—	88
PX-3613726700	HC Revsc Evsc Fpvt Stent Sf 1st Vsl	$39,932	$25,956	—	—	82
PX-3613726900	HC Revsc Evasc Fpvt St Cplx 1st Vsl	$39,932	$25,956	—	—	82
PX-3613723600	HC Pl Stent Inravasc Artery Initl	$37,435	$24,333	—	—	83
SUP-D233	ICD VIGILANT EL DR DF4 (D233 146406)	$35,544	$23,103	—	—	39
PX-3200627000	HC Perq Njx Algc Cell &/Prdct Uni/Bi Fluor Lmbr 1st	$35,146	$22,845	—	—	63
PX-3613724400	HC Vasc Embolize/Occlude Bleed	$34,347	$22,326	—	—	88
RX-40830523	ALTEPLASE 0.9 MG/KG IV (NTE 90 MG) FOR STROKE	$33,899	$22,034	—	—	88
PX-4803327400	HC Transcath Insj/Rpl Perm Ldls Pm	$33,769	$21,950	—	—	87
PX-4803323000	HC Insrt Pulse Gen W/Dual Leads	$33,529	$21,794	—	—	88
PX-4809293700	HC Perq Revasc Byp Graft 1vsl	$32,619	$21,202	—	—	88
PX-4025172100	HC Ins Trurl Ablt Trnsdc Thr US	$32,482	$21,113	—	—	63
PX-3616171500	HC Mrgfus Strtctc Ablt Trgt Icr	$31,176	$20,264	—	—	79
PX-3612361500	HC Optx Prox Humrl Fx W/Int Fix	$29,855	$19,406	—	—	87
RX-15996	METHADONE 10 MG/ML ORAL CONCENTRATE	$29,500	$19,175	—	—	39
PX-3613729700	HC Revsc Evasc Imvt Angiop Uni Sf Les Ea Addl Vsl	$29,486	$19,166	—	—	41
PX-3613728000	HC Revsc Evsc Tpvt Angio Sf 1st Vsl	$29,486	$19,166	—	—	82
PX-3613728200	HC Rvsc Evsc Tpvt Angio Cplx 1st Vsl	$29,486	$19,166	—	—	82
PX-4819345900	HC Lhrt Art/Grft Angio	$29,266	$19,023	—	—	88
PX-4819297200	HC Perq Trluml Coronry Lithotrp	$28,987	$18,842	—	—	47
PX-3610800400	HC Sim Ang W/Prs Cath Rad Emb	$28,352	$18,429	—	—	82
PX-3610756400	HC Vein Mech Throm W/Intrvas US	$28,351	$18,428	—	—	48
PX-3616365000	HC Impl Elect Epidural Perc	$28,164	$18,307	—	—	88
PX-2780000937	HC Sup 278 W/ Hcpcs C1982	$27,823	$18,085	—	—	46
PX-3503299400	HC Ablat Tumr Pulm Uni Plr/Chs Im	$27,329	$17,764	—	—	77

Showing top 50 of 3,110 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.