45 CFR § 180 compliance
F · 55
This hospital published little of what § 180 requires.
●Machine-readable file published: assessment threshold met
○Gross / standard charges: below assessment threshold
○Discounted cash price: below assessment threshold
●Payer-specific negotiated rates: assessment threshold met
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
15,369
Insurances with rates
20
CPT / HCPCS codes
9,194
Most expensive procedures (gross)
40412549
$25,662
LEUKOCYTE ALKALINE PHOSPHATASE
Gross
$85,540
1626337
$9,884
DIGOXIN IMMUN FAB 40MG/4ML INJ
Gross
$32,947
1716301
$6,720
DANTROLENE 250 MG/5ML INJ
Gross
$22,400
1706462
$5,122
IDARUCIZUMAB 2.5 GM INJ
Gross
$17,073
57400764
$4,401
LERMAR MINERVA (2139.52)
Gross
$14,672
40414010
$4,066
NEOCOMP MYELOID DISORDERS PROF
Gross
$13,554
57401169
$3,837
CTLSO CUSTOM
Gross
$12,790
57401146
$3,114
TLSO BI VALVE CUSTOM
Gross
$10,381
57400746
$3,007
AIRPLANE SPLINT
Gross
$10,023
1718339
$2,837
ANAVIP 1 VIAL
Gross
$9,457
1719440
$2,453
TOCILIZUMAB 162 MG/0.9 ML INJ
Gross
$8,177
40413723
$2,379
MYELOID DISORDERS PROFILE
Gross
$7,930
57400930
$2,273
AFO CUSTOM
Gross
$7,577
57400886
$2,266
TLSO PEC KIT (1101.42)
Gross
$7,553
40413758
$2,197
NEOTYPE MDS/CMMLPROFILE
Gross
$7,322
57401261
$2,197
HIP ABDUCTION CUSTOM
Gross
$7,322
4100081
$1,994
ABD & PELVIC W/WO CT
Gross
$6,647
41814284
$1,911
NM REST & STRESS W/WM W/EF
Gross
$6,369
4100115
$1,837
CTA ABDOMEN PELVIS
Gross
$6,124
4040134
$1,812
MRI BRAIN BOTH
Gross
$6,042
4090009
$1,730
MRI BRAIN BOTH
Gross
$5,768
40900102
$1,681
MRI BRAIN IAC W/WO
Gross
$5,602
40900104
$1,681
MRI BRAIN PITUITARY W/WO
Gross
$5,602
41802383
$1,673
NM REST ONLY W/WM W/EF
Gross
$5,576
42406481
$1,608
US BIOPSY LUNG W NDL GUIDANCE
Gross
$5,360
4040135
$1,584
MRI S THORACIC BOTH
Gross
$5,279
4040147
$1,584
MRI S CERV BOTH
Gross
$5,279
4040150
$1,584
MRI S LUMBAR BOTH
Gross
$5,279
4090010
$1,584
MRI THORACIC BOTH
Gross
$5,279
4090021
$1,584
MRI CERVICAL BOTH
Gross
$5,279
4090024
$1,584
MRI LUMBAR BOTH
Gross
$5,279
4040133
$1,576
MRI BRAIN WITH
Gross
$5,254
4090008
$1,576
MRI BRAIN WITH
Gross
$5,254
1627155
$1,571
HEPATITIS B IMMUNE GLOB 5ML
Gross
$5,236
4090075
$1,565
MRA EXTREMITY UPPER W/WO LEFT
Gross
$5,217
4090076
$1,565
MRA EXTREMITY UPPER W/WO RIGHT
Gross
$5,217
4100080
$1,537
ABD & PELVIC WITH CT
Gross
$5,122
41099986
$1,517
CT RENAL STONE ABD PELVIS
Gross
$5,055
1690647
$1,494
DIMETHYL SULFOXIDE 50 ML IN
Gross
$4,979
4040128
$1,492
MRI ABDOMEN BOTH
Gross
$4,974
4090003
$1,492
MRI ABD BOTH
Gross
$4,974
4100079
$1,479
ABD & PELVIC W/O CT
Gross
$4,929
39200067
$1,419
PICC LINE INSERT W IMAG GUID
Gross
$4,731
4040155
$1,418
MRI CHEST BOTH
Gross
$4,727
4090029
$1,418
MRI CHEST BOTH
Gross
$4,727
37850381
$1,413
CRITICAL CARE 30-74
Gross
$4,710
4040143
$1,395
MRI LOWER EXT BOTH
Gross
$4,651
4090017
$1,395
MRI LOWER EXT BOTH LEFT
Gross
$4,651
4090058
$1,395
MRI LOWER EXT BOTH RIGHT
Gross
$4,651
4040137
$1,377
MRI S THORACIC WITH
Gross
$4,591
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 40412549 | LEUKOCYTE ALKALINE PHOSPHATASE | $85,540 | $25,662 | — | — | 1 |
| 1626337 | DIGOXIN IMMUN FAB 40MG/4ML INJ | $32,947 | $9,884 | — | — | 1 |
| 1716301 | DANTROLENE 250 MG/5ML INJ | $22,400 | $6,720 | — | — | 1 |
| 1706462 | IDARUCIZUMAB 2.5 GM INJ | $17,073 | $5,122 | — | — | 1 |
| 57400764 | LERMAR MINERVA (2139.52) | $14,672 | $4,401 | — | — | 1 |
| 40414010 | NEOCOMP MYELOID DISORDERS PROF | $13,554 | $4,066 | — | — | 1 |
| 57401169 | CTLSO CUSTOM | $12,790 | $3,837 | — | — | 1 |
| 57401146 | TLSO BI VALVE CUSTOM | $10,381 | $3,114 | — | — | 1 |
| 57400746 | AIRPLANE SPLINT | $10,023 | $3,007 | — | — | 1 |
| 1718339 | ANAVIP 1 VIAL | $9,457 | $2,837 | — | — | 1 |
| 1719440 | TOCILIZUMAB 162 MG/0.9 ML INJ | $8,177 | $2,453 | — | — | 1 |
| 40413723 | MYELOID DISORDERS PROFILE | $7,930 | $2,379 | — | — | 1 |
| 57400930 | AFO CUSTOM | $7,577 | $2,273 | — | — | 1 |
| 57400886 | TLSO PEC KIT (1101.42) | $7,553 | $2,266 | — | — | 1 |
| 40413758 | NEOTYPE MDS/CMMLPROFILE | $7,322 | $2,197 | — | — | 1 |
| 57401261 | HIP ABDUCTION CUSTOM | $7,322 | $2,197 | — | — | 1 |
| 4100081 | ABD & PELVIC W/WO CT | $6,647 | $1,994 | — | — | 1 |
| 41814284 | NM REST & STRESS W/WM W/EF | $6,369 | $1,911 | — | — | 1 |
| 4100115 | CTA ABDOMEN PELVIS | $6,124 | $1,837 | — | — | 1 |
| 4040134 | MRI BRAIN BOTH | $6,042 | $1,812 | — | — | 1 |
| 4090009 | MRI BRAIN BOTH | $5,768 | $1,730 | — | — | 1 |
| 40900102 | MRI BRAIN IAC W/WO | $5,602 | $1,681 | — | — | 1 |
| 40900104 | MRI BRAIN PITUITARY W/WO | $5,602 | $1,681 | — | — | 1 |
| 41802383 | NM REST ONLY W/WM W/EF | $5,576 | $1,673 | — | — | 1 |
| 42406481 | US BIOPSY LUNG W NDL GUIDANCE | $5,360 | $1,608 | — | — | 1 |
| 4040135 | MRI S THORACIC BOTH | $5,279 | $1,584 | — | — | 1 |
| 4040147 | MRI S CERV BOTH | $5,279 | $1,584 | — | — | 1 |
| 4040150 | MRI S LUMBAR BOTH | $5,279 | $1,584 | — | — | 1 |
| 4090010 | MRI THORACIC BOTH | $5,279 | $1,584 | — | — | 1 |
| 4090021 | MRI CERVICAL BOTH | $5,279 | $1,584 | — | — | 1 |
| 4090024 | MRI LUMBAR BOTH | $5,279 | $1,584 | — | — | 1 |
| 4040133 | MRI BRAIN WITH | $5,254 | $1,576 | — | — | 1 |
| 4090008 | MRI BRAIN WITH | $5,254 | $1,576 | — | — | 1 |
| 1627155 | HEPATITIS B IMMUNE GLOB 5ML | $5,236 | $1,571 | — | — | 1 |
| 4090075 | MRA EXTREMITY UPPER W/WO LEFT | $5,217 | $1,565 | — | — | 1 |
| 4090076 | MRA EXTREMITY UPPER W/WO RIGHT | $5,217 | $1,565 | — | — | 1 |
| 4100080 | ABD & PELVIC WITH CT | $5,122 | $1,537 | — | — | 1 |
| 41099986 | CT RENAL STONE ABD PELVIS | $5,055 | $1,517 | — | — | 1 |
| 1690647 | DIMETHYL SULFOXIDE 50 ML IN | $4,979 | $1,494 | — | — | 1 |
| 4040128 | MRI ABDOMEN BOTH | $4,974 | $1,492 | — | — | 1 |
| 4090003 | MRI ABD BOTH | $4,974 | $1,492 | — | — | 1 |
| 4100079 | ABD & PELVIC W/O CT | $4,929 | $1,479 | — | — | 1 |
| 39200067 | PICC LINE INSERT W IMAG GUID | $4,731 | $1,419 | — | — | 1 |
| 4040155 | MRI CHEST BOTH | $4,727 | $1,418 | — | — | 1 |
| 4090029 | MRI CHEST BOTH | $4,727 | $1,418 | — | — | 1 |
| 37850381 | CRITICAL CARE 30-74 | $4,710 | $1,413 | — | — | 1 |
| 4040143 | MRI LOWER EXT BOTH | $4,651 | $1,395 | — | — | 1 |
| 4090017 | MRI LOWER EXT BOTH LEFT | $4,651 | $1,395 | — | — | 1 |
| 4090058 | MRI LOWER EXT BOTH RIGHT | $4,651 | $1,395 | — | — | 1 |
| 4040137 | MRI S THORACIC WITH | $4,591 | $1,377 | — | — | 1 |
Showing top 50 of 15,369 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.