BELLVILLE MEDICAL CENTER — Hospital Ledger

45 CFR § 180 compliance

B · 85

This hospital published most of what § 180 requires.

●Machine-readable file published

●Gross / standard charges

●Discounted cash price

●Payer-specific negotiated rates

○Min / max negotiated charges

●Free, public, no login required

Procedures listed

2,373

Insurances with rates

312

CPT / HCPCS codes

Source MRF

csv ↗

Most expensive procedures (gross)

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-137245	NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLUTION	$455,356	$295,981	—	—	55
RX-190594	POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLUTION	$59,184	$38,470	—	—	152
PX-48193653001	HC Evaluation Electrophysiologic W/Svt Ablation	$54,569	$35,470	—	—	118
SUP-220555	GENERATOR EMBLEM SICD PULSE	$54,403	$35,362	—	—	45
SUP-984582	DEFIBRILLATOR GALLANT BIPOLAR DF4 HF	$39,771	$25,851	—	—	45
SUP-220346	ICD ITREVIA HF-T DF-1 HGH ENRG W/CLS HOME MONITORING	$38,214	$24,839	—	—	45
PX-481C9602001	HC Ptca W/Drug Eluting Stent W/Angioplasty Single Artery Branch	$35,028	$22,768	—	—	152
PX-481C9606001	HC Revascularization Acute/Total/Subtotal to Ami/Drug Eluting Coronary Stent Percutaneous Single	$35,028	$22,768	—	—	44
SUP-203975	VEIN SAPHENOUS 60-79CM	$33,498	$21,774	—	—	45
SUP-1122.0045	ELSA SPACER 20X45X7-14MM	$27,145	$17,644	—	—	45
SUP-10010741	KIT CATH ASPIR 12 100CM XT	$26,400	$17,160	—	—	44
SUP-217730	DEFIB DEV FORTIFY SNGL VR DF1 SINGLE CHAMBER FORTIFY ASSURA	$26,272	$17,077	—	—	45
RX-9002	ALTEPLASE 100 MG INTRAVENOUS SOLUTION	$25,477	$16,560	—	—	54
SUP-219707	STENT ENDUR AAA BIF 28X14X103	$25,345	$16,475	—	—	45
RX-196642	LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION	$25,230	$16,400	—	—	91
PX-481C9604001	HC Revascularization Cabg/Drug Eluting Coronary Stent Atherectomy/Angioplasty Single Vessel	$23,497	$15,273	—	—	152
PX-481C9600001	HC Placement Percutaneous Drug Eluting Stent Intracoronary W/Angiography 1 Artery/Branch	$23,497	$15,273	—	—	42
SUP-202189	VEIN SAPHENOUS TISSUE >80CM	$21,975	$14,284	—	—	45
SUP-10005701	SPACER IDENTITI NANOTEC LIF POROUS TI 10 X 18 X 55 MM 10DEG	$21,615	$14,050	—	—	45
PX-48193580001	HC Closure Percutaneous Transcatheter Congenital Interatrial Communication W/Implant	$21,205	$13,783	—	—	152
SUP-10000557	IMPL CAGE CERV CRPCTMY SCREW ST 13X16MM 32-46MM 0DEG 0-20DEG	$19,940	$12,961	—	—	45
SUP-10005711	SPACER IDENTITI NANOTEC LIF POROUS TI 6 X 22 X 55 MM 15DEG	$19,886	$12,926	—	—	45
SUP-10014746	SPACER IDENTITI 6X22X45MM 10DEG NANOTEC LIF POROUS	$19,886	$12,926	—	—	45
SUP-10005712	SPACER IDENTITI NANOTEC LIF POROUS TI 8 X 22 X 45 MM 10DEG	$19,670	$12,785	—	—	45
SUP-972874	KIT SHEATH POUNCE VENOUS THROMB SYS	$19,250	$12,513	—	—	44
SUP-974653	SYSTEM LINQ SI JOINT FUSION W/DELIVERY UNILAT	$19,250	$12,513	—	—	45
SUP-10005669	SPACER IDENTITI ALIF SA 9 X 42 X 30 MM 10DEG	$19,181	$12,468	—	—	45
SUP-10000441	CAGE LUMBAR ANT 14X25X33MM 15DEG MONTEREY	$19,147	$12,446	—	—	45
SUP-218771	RETRIEVER TREVO XP 3X20 PROVUE RETRIEVAL SYSTEM	$19,138	$12,439	—	—	44
SUP-982737	SPACER IDENTITI ALIF SA 15DEG 8X42X30MM	$18,438	$11,985	—	—	10
SUP-983712	SPACER IDENTITI ALIF SA 15DEG 10X42X30MM	$18,438	$11,985	—	—	45
SUP-10000433	CAGE LUMBAR ANT 12X31X36MM 15DEG MONTEREY	$18,415	$11,970	—	—	45
SUP-151.103	FORTIFY 16X28-41MM	$17,606	$11,444	—	—	8
SUP-10005769	SPACER IDENTITI LIF 6 H 22 W 50 L 10DEG	$17,172	$11,162	—	—	45
PX-481C9603001	HC Ptca W/Drug Eluting Stent W/Angioplasty Each Additional Branch Major Coronary Artery	$16,944	$11,014	—	—	44
SUP-981632	SPACER IDENTITI LIF 8X22X60MM 10DEG	$16,752	$10,889	—	—	45
SUP-L98116	CORAIL REVISION STEM HO 16	$16,694	$10,851	—	—	45
SUP-212228	STENT NEUROFORM EZ 3.5X30MM	$16,280	$10,582	—	—	45
SUP-101396	CUFF BELT URNRY 4.0CM	$15,989	$10,393	—	—	45
SUP-1124.1032	EXPANDABLE SPACER 10X26X9-13MM 15?	$15,954	$10,370	—	—	45
SUP-217031	STENT ENDUR II LIMB 16X16X156 CONTRALATERAL LIMB	$15,840	$10,296	—	—	45
SUP-982598	SPACER SABLE 15X22MM 8DEG STER LF	$15,730	$10,225	—	—	33
SUP-179982	VALVE AORT PERICARD 23MM	$15,675	$10,189	—	—	32
SUP-10014811	SPACER TRANSCEND LIF PEEK 60X22X10MM 10DEG	$15,398	$10,009	—	—	45
SUP-154923	SHEATH INTRODCR TEAR AWAY 8FR DISP	$14,536	$9,448	—	—	44
SUP-221657	TALAR DOME SZ 2	$14,465	$9,402	—	—	45
SUP-162451	CONDUIT VALVED AORTIC 23MM V ACCEND VALSALVA CARBO SEAL	$14,300	$9,295	—	—	45
SUP-982970	BOLT SPINAL INTERFIX ALIF 6X38X28MM 15DEG	$14,132	$9,186	—	—	35
SUP-198789	HIP FEM HEAD RESURF CMNT 42MM	$14,097	$9,163	—	—	45
SUP-10013477	IMPLANT CNCLC REV HYB CEM PAT J2	$13,750	$8,938	—	—	14

Showing top 50 of 2,373 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.