COTEAU DES PRAIRIES HEALTH CARE SYSTEM (Sisseton, SD) prices

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J2427	Paliperidone Palmitate ER Susp Pref Syr 1,560 MG/5ML	$30,778	$30,778	—	—	16
J1628	Guselkumab IV Soln 200 MG/20ML (10 MG/ML)	$23,227	$23,227	—	—	16
J9217	Leuprolide Acetate (6 Month) For Inj Kit 45 MG	$20,298	$20,298	—	—	16
J2327	Risankizumab-rzaa IV Soln 600 MG/10ML (60 MG/ML)	$16,662	$16,662	—	—	16
J3380	Vedolizumab For IV Solution 300 MG	$14,713	$14,713	—	—	16
J2997	Alteplase For Inj 100 MG	$13,052	$13,052	—	—	32
J3101	Tenecteplase For IV Soln Kit 25 MG	$12,285	$12,285	—	—	16
J0717	Certolizumab Pegol Prefilled Syringe Kit 200 MG/ML	$9,825	$9,825	—	—	16
28112	ED 28112 OSTECTOMY COMP EXC OTHER METATARSAL HEAD (2ND 3RD 4TH)	$8,220	$8,220	—	—	16
78452	NM MYOCARDIAL SPECT MULT STDY	$7,640	$7,640	—	—	16
J2356	Tezepelumab-ekko Subcutaneous Soln Pref Syr 210 MG/1.91ML	$7,593	$7,593	—	—	16
J2506	Pegfilgrastim Soln Prefilled Syringe 6 MG/0.6ML	$7,529	$7,529	—	—	16
20816	REPLANTATION DIGIT WO THUMB (INC METACARPOPHALANG JOINT TO INSERT FLE	$7,024	$7,024	—	—	16
J0896	Luspatercept-aamt For Subcutaneous Inj 25 MG	$7,009	$7,009	—	—	16
C1874	STNT AXIOS W ELECCAUT 15X15MM	$6,798	$6,798	—	—	16
20822	REPLANTATION DIGIT WO THUMB (DISTAL TIP TO SUBLIMIS TENDON INSERT) CO	$6,172	$6,172	—	—	16
J1306	Inclisiran Sodium Subcutaneous Soln Pref Syr 284 MG/1.5ML	$5,957	$5,957	—	—	16
72197	MRI PELVIS WO THEN W CONT	$5,581	$5,581	—	—	16
J3111	Romosozumab-aqqg Inj Soln Prefilled Syringe 105 MG/1.17ML	$5,567	$5,567	—	—	32
0750	COLON POLYP BX	$5,456	$5,456	—	—	16
Q5111	Pegfilgrastim-cbqv Soln Prefilled Syringe 6 MG/0.6ML	$5,452	$5,452	—	—	16
74183	MRI ABDOMEN WO THEN W CONT	$5,432	$5,432	—	—	16
72158	MRI L SPINE WO THEN W CONT	$5,269	$5,269	—	—	16
70553	MRI BRAIN WO THEN W CONT	$5,234	$5,234	—	—	16
72157	MRI T SPINE WO THEN W CONT	$5,195	$5,195	—	—	16
73220	MRI UPPER EXT WO THEN W CONT	$5,111	$5,111	—	—	16
72156	MRI C SPINE WO THEN W CONT	$5,096	$5,096	—	—	16
70543	MRI FACE NECK ORB WO THEN W CONT	$5,060	$5,060	—	—	16
71552	MRI CHEST WO THEN W CONT	$5,006	$5,006	—	—	16
70546	MRA HEAD WO THEN W CONT	$4,858	$4,858	—	—	16
70549	MRA NECK WO THEN W CONT	$4,858	$4,858	—	—	16
71555	MRA CHEST WO CONTRAST	$4,858	$4,858	—	—	16
72198	MRA PELVIS W CONTRAST	$4,858	$4,858	—	—	16
73725	MRA LOWER EXT WO CONTRAST	$4,858	$4,858	—	—	16
74185	MRA ABDOMEN WO CONTRAST	$4,858	$4,858	—	—	16
73225	MRA UPPER EXT WO THEN W CONT	$4,851	$4,851	—	—	16
78264	NM GASTRIC EMPTYING IMG STUDY	$4,776	$4,776	—	—	16
73223	MRI UPPER EXT JT WO THEN W CONT	$4,728	$4,728	—	—	16
73720	MRI LOWER EXT WO THEN W CONT	$4,728	$4,728	—	—	16
73723	MRI LOWER EXT JT WO THEN W CONT	$4,728	$4,728	—	—	16
70552	MRI BRAIN W CONTRAST	$4,662	$4,662	—	—	16
72142	MRI C SPINE W CONTRAST	$4,662	$4,662	—	—	16
95805	MULTIPLE SLEEP LATENCY 95805	$4,548	$4,548	—	—	16
95811	PSG CPAP BIPAP 4+ PARAMETERS	$4,548	$4,548	—	—	16
72196	MRI PELVIS W CONTRAST	$4,517	$4,517	—	—	16
74182	MRI ABDOMEN W CONTRAST	$4,517	$4,517	—	—	16
73222	MRI UP EXT JT WCONT	$4,479	$4,479	—	—	16
73722	MRI LOWER EXT JT W CONTRAST	$4,479	$4,479	—	—	16
73719	MRI LOWER EXT W CONTRAST	$4,479	$4,479	—	—	16
73219	MRI UPPER EXT W CONTRAST	$4,479	$4,479	—	—	16

Showing top 50 of 2,085 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.