45 CFR § 180 compliance
D · 65
This hospital published part of what § 180 requires.
●Machine-readable file published: assessment threshold met
●Gross / standard charges: assessment threshold met
●Discounted cash price: assessment threshold met
○Payer-specific negotiated rates: below assessment threshold
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
981
Insurances with rates
0
CPT / HCPCS codes
957
Most expensive procedures (gross)
J2997
$12,871
ALTEPLASE (ACTIVASE) 100MG VIAL
Gross
$12,871
J3101
$9,872
TENECTEPLASE (TNKase) 50MG VIAL
Gross
$9,872
10180
$4,746
I&D POSTOP WOUND COM
Gross
$4,746
95783
$4,032
POLYSOM <6 YRSSLEEP W/CPAP/BILVL VENT 4/,TECHNICAL COMPONENT
Gross
$4,032
95805
$4,032
MULTIPLE SLEEP LATENCY TEST,TECHNICAL COMPONENT
Gross
$4,032
95811
$4,032
POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PAR,TECHNICAL COMPONENT
Gross
$4,032
95810
$4,032
POLYSOM 6/>YRS SLEEP 4/>ADDL PARAM ATTND,TECHNICAL COMPONENT
Gross
$4,032
95782
$4,002
POLYSOM<6YRS SLEEP STAGE 4/>ADDL PARAM A,TECHNICAL COMPONENT
Gross
$4,002
71551
$3,940
MRI CHEST W CONTRAST,TECHNICAL COMPONENT
Gross
$3,940
73222
$3,940
MRI LT UPPER EXT JOINT W CONTRAST,TECHNICAL COMPONENT, LEFT
Gross
$3,940
73722
$3,940
MRI LT LOWER EXT JOINT W CONTRAST,TECHNICAL COMPONENT, LEFT
Gross
$3,940
32556
$3,785
THRORACENTISIS W/TUB
Gross
$3,785
23655
$3,463
TX CL SHLDR DISLW MN
Gross
$3,463
93306
$3,241
US ECHOCARDIOGRAM
Gross
$3,241
72196
$3,037
MRI PELVIS W/ CONTRAST,TECHNICAL COMPONENT
Gross
$3,037
87902
$2,724
HEPATITIS C VIRAL RN
Gross
$2,724
72126
$2,704
CT C-SPINE WITH CONTRAST,TECHNICAL COMPONENT
Gross
$2,704
71270
$2,704
CT CHEST W/WO CONTRAST,TECHNICAL COMPONENT
Gross
$2,704
72132
$2,704
CT L-SPINE W CONTRAST,TECHNICAL COMPONENT
Gross
$2,704
73201
$2,704
CT UPR EXT LT W/CONT,TECHNICAL COMPONENT, LEFT
Gross
$2,704
70542
$2,558
MRI ORBIT FACE NECK W CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
70543
$2,558
MRI ORBIT FACE NECK W & W/O CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
70546
$2,558
MRA HEAD W & W/O CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
70549
$2,558
MRA NECK W & W/O CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
70552
$2,558
MRI BRAIN W/ CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
70553
$2,558
MRI BRAIN W & W/O CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
72142
$2,558
MRI CERVICAL W CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
72147
$2,558
MRI THORACIC SPINE W/ CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
72149
$2,558
MRI LUMBAR W CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
72156
$2,558
MRI CERVICAL W & W/O CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
72157
$2,558
MRI THORACIC SPINE W & W/O CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
72158
$2,558
MRI LUMBAR W & WO CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
72197
$2,558
MRI PELVIS W & W/O CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
73219
$2,558
MRI RT UPPER EXT NON JOINT W CONTRAST,TECHNICAL COMPONENT, RIGHT
Gross
$2,558
73220
$2,558
MRI LT UPPER EXT NON JOINT W &W/O CONT,TECHNICAL COMPONENT, LEFT
Gross
$2,558
73223
$2,558
MRI LT UPPER EXT JOINT W & W/O CONTRAST,TECHNICAL COMPONENT, LEFT
Gross
$2,558
73720
$2,558
MRI LT LOWER EXT NON JOINT W & W/O CONT,TECHNICAL COMPONENT, LEFT
Gross
$2,558
73723
$2,558
MRI LT LOWER EXT JOINT W & W/O CONTRAST,TECHNICAL COMPONENT, LEFT
Gross
$2,558
74182
$2,558
MRI ABDOMEN W CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
74183
$2,558
MRI ABDOMEN W & WO CONTRAST,TECHNICAL COMPONENT
Gross
$2,558
59409
$2,447
DELIVERY ONLY
Gross
$2,447
G0390
$2,394
TRAUMA ACTIVATION
Gross
$2,394
684
$2,394
TRAUMA TEAM ACTIVATI
Gross
$2,394
99291
$2,385
CRITICAL CARE=<74 MI
Gross
$2,385
21451
$2,179
CLSD TX MANDIBULAR W
Gross
$2,179
25605
$2,108
CLSD TX RADIAL FX W/
Gross
$2,108
27250
$2,052
CLSD REDUCTION OF HI
Gross
$2,052
31605
$2,048
CRICOTHYROID MEMBRAN
Gross
$2,048
74177
$2,045
CT ABD/PEL WITH CONTRAST,TECHNICAL COMPONENT
Gross
$2,045
71275
$2,045
CTA CHEST,TECHNICAL COMPONENT
Gross
$2,045
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| J2997 | ALTEPLASE (ACTIVASE) 100MG VIAL | $12,871 | $12,871 | — | — | 0 |
| J3101 | TENECTEPLASE (TNKase) 50MG VIAL | $9,872 | $9,872 | — | — | 0 |
| 10180 | I&D POSTOP WOUND COM | $4,746 | $4,746 | — | — | 0 |
| 95783 | POLYSOM <6 YRSSLEEP W/CPAP/BILVL VENT 4/,TECHNICAL COMPONENT | $4,032 | $4,032 | — | — | 0 |
| 95805 | MULTIPLE SLEEP LATENCY TEST,TECHNICAL COMPONENT | $4,032 | $4,032 | — | — | 0 |
| 95811 | POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PAR,TECHNICAL COMPONENT | $4,032 | $4,032 | — | — | 0 |
| 95810 | POLYSOM 6/>YRS SLEEP 4/>ADDL PARAM ATTND,TECHNICAL COMPONENT | $4,032 | $4,032 | — | — | 0 |
| 95782 | POLYSOM<6YRS SLEEP STAGE 4/>ADDL PARAM A,TECHNICAL COMPONENT | $4,002 | $4,002 | — | — | 0 |
| 71551 | MRI CHEST W CONTRAST,TECHNICAL COMPONENT | $3,940 | $3,940 | — | — | 0 |
| 73222 | MRI LT UPPER EXT JOINT W CONTRAST,TECHNICAL COMPONENT, LEFT | $3,940 | $3,940 | — | — | 0 |
| 73722 | MRI LT LOWER EXT JOINT W CONTRAST,TECHNICAL COMPONENT, LEFT | $3,940 | $3,940 | — | — | 0 |
| 32556 | THRORACENTISIS W/TUB | $3,785 | $3,785 | — | — | 0 |
| 23655 | TX CL SHLDR DISLW MN | $3,463 | $3,463 | — | — | 0 |
| 93306 | US ECHOCARDIOGRAM | $3,241 | $3,241 | — | — | 0 |
| 72196 | MRI PELVIS W/ CONTRAST,TECHNICAL COMPONENT | $3,037 | $3,037 | — | — | 0 |
| 87902 | HEPATITIS C VIRAL RN | $2,724 | $2,724 | — | — | 0 |
| 72126 | CT C-SPINE WITH CONTRAST,TECHNICAL COMPONENT | $2,704 | $2,704 | — | — | 0 |
| 71270 | CT CHEST W/WO CONTRAST,TECHNICAL COMPONENT | $2,704 | $2,704 | — | — | 0 |
| 72132 | CT L-SPINE W CONTRAST,TECHNICAL COMPONENT | $2,704 | $2,704 | — | — | 0 |
| 73201 | CT UPR EXT LT W/CONT,TECHNICAL COMPONENT, LEFT | $2,704 | $2,704 | — | — | 0 |
| 70542 | MRI ORBIT FACE NECK W CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 70543 | MRI ORBIT FACE NECK W & W/O CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 70546 | MRA HEAD W & W/O CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 70549 | MRA NECK W & W/O CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 70552 | MRI BRAIN W/ CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 70553 | MRI BRAIN W & W/O CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 72142 | MRI CERVICAL W CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 72147 | MRI THORACIC SPINE W/ CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 72149 | MRI LUMBAR W CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 72156 | MRI CERVICAL W & W/O CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 72157 | MRI THORACIC SPINE W & W/O CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 72158 | MRI LUMBAR W & WO CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 72197 | MRI PELVIS W & W/O CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 73219 | MRI RT UPPER EXT NON JOINT W CONTRAST,TECHNICAL COMPONENT, RIGHT | $2,558 | $2,558 | — | — | 0 |
| 73220 | MRI LT UPPER EXT NON JOINT W &W/O CONT,TECHNICAL COMPONENT, LEFT | $2,558 | $2,558 | — | — | 0 |
| 73223 | MRI LT UPPER EXT JOINT W & W/O CONTRAST,TECHNICAL COMPONENT, LEFT | $2,558 | $2,558 | — | — | 0 |
| 73720 | MRI LT LOWER EXT NON JOINT W & W/O CONT,TECHNICAL COMPONENT, LEFT | $2,558 | $2,558 | — | — | 0 |
| 73723 | MRI LT LOWER EXT JOINT W & W/O CONTRAST,TECHNICAL COMPONENT, LEFT | $2,558 | $2,558 | — | — | 0 |
| 74182 | MRI ABDOMEN W CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 74183 | MRI ABDOMEN W & WO CONTRAST,TECHNICAL COMPONENT | $2,558 | $2,558 | — | — | 0 |
| 59409 | DELIVERY ONLY | $2,447 | $2,447 | — | — | 0 |
| G0390 | TRAUMA ACTIVATION | $2,394 | $2,394 | — | — | 0 |
| 684 | TRAUMA TEAM ACTIVATI | $2,394 | $2,394 | — | — | 0 |
| 99291 | CRITICAL CARE=<74 MI | $2,385 | $2,385 | — | — | 0 |
| 21451 | CLSD TX MANDIBULAR W | $2,179 | $2,179 | — | — | 0 |
| 25605 | CLSD TX RADIAL FX W/ | $2,108 | $2,108 | — | — | 0 |
| 27250 | CLSD REDUCTION OF HI | $2,052 | $2,052 | — | — | 0 |
| 31605 | CRICOTHYROID MEMBRAN | $2,048 | $2,048 | — | — | 0 |
| 74177 | CT ABD/PEL WITH CONTRAST,TECHNICAL COMPONENT | $2,045 | $2,045 | — | — | 0 |
| 71275 | CTA CHEST,TECHNICAL COMPONENT | $2,045 | $2,045 | — | — | 0 |
Showing top 50 of 981 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.