BSA HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
SUP-202439	AIRWAY PHARYNGEAL BERMAN L70 MM OPEN CHANNEL FLAT SURFACE LATEX FREE DISPOSABLE WHITE	$68,912	$6,891	—	—	18
SUP-181028	OXYGENATOR PERFUSION CENTRIMAG PRECONNECTED PACK FOR CPB	$55,146	$5,515	—	—	17
PX-36002380	Catheter removal of plaque from groin artery, accessed through the skin or open procedure including	$54,231	$5,423	—	—	134
SUP-168882	SET THROMBECTOMY LIGHTNING FLASH SELECT BER CURVE L100 CM L135 CM OD6 FR HTORQ CATHETER ASPIRATION T	$39,419	$3,942	—	—	12
SUP-168789	KIT CATH ASPIRATION FLASH 100C	$39,419	$3,942	—	—	14
SUP-176013	ADAPTER 3XL SULU 60 PURPLE	$39,254	$3,925	—	—	14
PX-36000750	Insertion of stents into vertebral artery via catheter, open or accessed through the skin including	$35,383	$3,538	—	—	100
PX-36002370	Catheter removal of plaque from upper arm artery, accessed through the skin or open procedure includ	$35,111	$3,511	—	—	134
PX-36002340	Catheter removal of plaque from kidney artery, accessed through the skin or open procedure including	$34,200	$3,420	—	—	98
SUP-306005	CATHETER THROMBECTOMY SUPER TORQUE PLUS OD7 FR ASPIRATION TUBE	$32,434	$3,243	—	—	19
PX-36022514	Treatment of broken lower spine bone with placement of stabilizing device	$32,243	$3,224	—	—	121
SUP-878351	CATHETER THROMBECTOMY INDIGO CAT LIGHTNING L100 CM OD12 FR HTORQ STERILE LATEX FREE	$27,328	$2,733	—	—	19
RX-169719	BLINATUMOMAB 35 MCG INTRAVENOUS SOLUTION	$26,506	$2,651	—	—	99
PX-36022513	Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance	$25,548	$2,555	—	—	121
SUP-109133	SET TISSUE CLOSURE ABRA SILICONE ABDOMINAL WALL 13 HOLE RETAINER BUTTON ANCHOR TAIL CANNULATOR	$25,429	$2,543	—	—	11
PX-36005050	Reopening of arteries in thigh and behind knee with placement of stent via catheter using imaging gu	$25,007	$2,501	—	—	98
SUP-885874	KIT CATH INGIGO 7 LGTN ASP TUB	$22,426	$2,243	—	—	23
SUP-36462	VALVE SHUNT CODMAN HAKIM SIPHONGUARD STAINLESS STEEL RIGHT ANGLE PROGRAMMABLE STYLET STERILE	$18,940	$1,894	—	—	17
SUP-886679	KIT THROMBOLYTIC JETI OD8 FR STERILE DISPOSABLE	$18,823	$1,882	—	—	20
SUP-164122	PROBE ENDOSCOPIC 20MHZ SLIM MINIATURE OD1.4 MM ULTRASONIC STRETCH SHEATH REVERT	$18,791	$1,879	—	—	26
SUP-174996	PROBE ELECTROSURGICAL OPTABLATE L15 MM 2 KIT STERILE LATEX FREE DISPOSABLE	$17,867	$1,787	—	—	19
SUP-173220	KIT OPTABLATE DUAL20MM PROBE	$17,867	$1,787	—	—	21
SUP-203183	HANDPIECE ELECTROSURGICAL MYRIAD L25 CM OD15 GA TISSUE AUTOMATE RESECTION STERILE LATEX FREE DISPOSA	$17,787	$1,779	—	—	20
SUP-138347	SEALER ELECTROSURGICAL ENDO SH2.0 0 D HOOK L.223 IN L12.5 IN OD2 MM MONOPOLAR DISSECT BLUNT ELECTROD	$17,565	$1,757	—	—	24
PX-36006440	HC Tcat Rmvl/Debulk Icar Mass Suction Device Perq	$16,876	$1,688	—	—	99
PX-36022515	Treatment of broken spine bone with stabilizing device, each additional segment	$16,121	$1,612	—	—	134
SUP-168605	PROBE MEDISTIM 3MM TTFM	$15,727	$1,573	—	—	21
SUP-166561	SHEATH ACCESS PROTRIEVE 20FR	$15,318	$1,532	—	—	16
RX-126579	DANTROLENE 250 MG INTRAVENOUS SUSPENSION	$14,915	$1,491	—	—	100
SUP-886678	JETI STERILE KIT 6FR 120CM	$14,297	$1,430	—	—	19
SUP-177406	PROBE ELECTROSURGICAL OPTABLATE L20 MM 1 KIT STERILE LATEX FREE DISPOSABLE	$13,974	$1,397	—	—	16
SUP-179307	PROBE ELECTROSURGICAL OPTABLATE L15 MM 1 KIT STERILE LATEX FREE DISPOSABLE	$13,974	$1,397	—	—	25
SUP-97788	SCISSORS LAPAROSCOPIC HOT SHEARS DA VINCI S/SI ENDOWRIST 38- D CURVE L55.9 CM L1.3 CM OD8 MM CAUTERY	$13,725	$1,373	—	—	18
SUP-110898	KIT INTERVENTIONAL ENROUTE TRANSCAROTID NEUROPROTECTION	$13,676	$1,368	—	—	21
SUP-37822	VALVULOTOME ANGIOSCOPIC HYDRO LEMAITRE L98 CM OD1.5 MM IRRIGATION PORT CUT BLADE BULLET HEAD HANDLE	$13,476	$1,348	—	—	17
PX-36022510	Stabilization of upper spine bone	$13,272	$1,327	—	—	121
PX-36022511	Stabilization of lower spine bone	$13,272	$1,327	—	—	121
PX-36022512	Stabilization of spine bone, each additional bone	$13,272	$1,327	—	—	98
SUP-84074	DEVICE ATHERECTOMY HAWKONE UNIVERSAL CUTTER DRIVER STERILE LATEX FREE DISPOSABLE	$12,316	$1,232	—	—	24
SUP-858134	CATHETER CHOLANGIOGRAM SPYSCOPE DS II ACCESS DELIVERY	$12,050	$1,205	—	—	15
PX-36019105	Removal of growth of breast using ultrasound, each growth	$11,667	$1,167	—	—	98
SUP-97789	FORCEPS ENDOSCOPIC DA VINCI SI ENDOWRIST OD8 MM BIPOLAR FENESTRATE NONSTERILE REUSABLE	$11,581	$1,158	—	—	19
SUP-876292	KIT GRAFT HARVEST RIA 2	$11,519	$1,152	—	—	21
SUP-160086	CATHETER THROMBECTOMY RED 68 L132 CM REPERFUSION CATHETER PENUMBRA ASPIRATION TUBING NO CE STERILE	$11,233	$1,123	—	—	28
SUP-881388	CATHETER CHOLANGIOGRAM SPYGLASS L65 CM CHOLANGIOSCOPY	$11,233	$1,123	—	—	17
SUP-160087	CATHETER THROMBECTOMY RED 72 L132 CM REPERFUSION CATHETER PENUMBRA ASPIRATION TUBING NO CE STERILE	$11,233	$1,123	—	—	29
SUP-302873	PIN FIXATION ELEOS FEMUR DISTAL AXIAL	$11,145	$1,114	—	—	22
SUP-99603	BODY EXTERNAL FIXATION DJD II COMPONENT NONSTERILE	$10,719	$1,072	—	—	19
SUP-21405	CLAMP ELECTROSURGICAL ISOLATOR SYNERGY SHORT JAW LEFT CURVE ABLATION STERILE	$10,621	$1,062	—	—	26
SUP-11213	CLAMP ELECTROSURGICAL ISOLATOR SYNERGY LONG JAW LEFT CURVE ABLATION STERILE	$10,621	$1,062	—	—	22

Showing top 50 of 5,284 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.