THROCKMORTON COUNTY MEMORIAL HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
3274400	Ivp X-ray	$11,990	$11,990	$38	$11,750	8
2591822	Veklury Iv Pwdforsoln 100mg	$11,620	$11,620	$4,648	$11,388	8
2590810	Tnkase Iv Powder For Solution 50mg	$5,417	$5,417	$2,167	$5,309	8
2500266	Crofab Solution I Gm Vial Iv	$5,331	$5,331	$2,132	$5,224	8
3272156	Mri Spinal Can & Con Ce	$5,301	$5,301	$32	$5,195	8
3273220	Mri Ue Other Than Joint W & W/o Contrast	$5,232	$5,232	$32	$5,127	8
3272158	Mri Spin Can & Con Lumbar W	$5,204	$5,204	$32	$5,100	8
3273723	Mri Low Extr Of Any Join	$5,139	$5,139	$32	$5,036	8
3272157	Mri Spinal Can & Con Thor W/	$5,023	$5,023	$32	$4,923	8
3274183	Mri Abdomen W/o & With	$4,988	$4,988	$32	$4,888	8
3274185	Mri Angio Abd W/o Or W	$4,978	$4,978	$32	$4,878	8
3273223	Mri Ue Other Than Any Jnt W&w/o Contrast	$4,964	$4,964	$32	$4,865	8
4512003	Trauma Activation	$4,785	$4,785	$1,914	$4,689	8
3270543	Mri Orbt/fac/nck W/o&w Dy	$4,527	$4,527	$32	$4,436	8
3272197	Mri Pelvis W/o Or With	$4,445	$4,445	$32	$4,356	8
3273706	Ct/angio Lower Ext W/wo C	$4,401	$4,401	$38	$4,313	8
3273720	Mri Low Ext W/o & W Dye	$4,384	$4,384	$32	$4,296	8
3271552	Mri Chest W/o & With	$4,168	$4,168	$32	$4,085	8
3270549	Mri Angio Neck W/o & W	$4,011	$4,011	$32	$3,931	8
2590763	Synvisc One 6ml	$3,995	$3,995	$1,598	$3,915	8
3274175	Ct/angio Abd W & W/o Cont	$3,971	$3,971	$38	$3,892	8
3273722	Mri Low Joint W/dye	$3,915	$3,915	$32	$3,837	8
3273222	Mri Up Ext Of Any Joint With Contrast	$3,912	$3,912	$32	$3,834	8
3270552	Mri Brain With	$3,845	$3,845	$32	$3,768	8
3270548	Mri Angio Neck With	$3,829	$3,829	$32	$3,752	8
4510140	Drainage Of Hematoma/flu	$3,672	$3,672	$54	$3,599	8
3270496	Ct/angio Head W/wo Contra	$3,636	$3,636	$38	$3,563	8
3273218	Mri Ue Other Than Jnt W/o Contrast	$3,607	$3,607	$32	$3,535	8
3274181	Mri Abdomen W/o	$3,580	$3,580	$32	$3,508	8
3270540	Mri Orbit/face/neck W/o D	$3,477	$3,477	$32	$3,407	8
3273718	Mri Low Ext W/o Dye	$3,430	$3,430	$32	$3,361	8
3270546	Mri Angio Head W/o & W	$3,402	$3,402	$32	$3,334	8
3272142	Mri Spinal Canal & Con C	$3,362	$3,362	$32	$3,295	8
3270544	Mri Angio Head W/o	$3,306	$3,306	$32	$3,240	8
3272195	Mri Pelvis W/o	$3,245	$3,245	$32	$3,180	8
3272147	Mri Spinal Canal & Con Tho	$3,193	$3,193	$32	$3,129	8
3272191	Ct/angio Pelvis W/wo Cont	$3,184	$3,184	$38	$3,120	8
3270547	Mri Angio Neck W/o	$3,152	$3,152	$32	$3,089	8
6049082	Abdominal Paracentesis	$3,046	$3,046	$54	$2,985	8
3270545	Mri Angio Head With	$3,044	$3,044	$32	$2,983	8
3272149	Mri Spinal Can & Cont Lumba	$2,965	$2,965	$32	$2,906	8
3272193	CT scan of pelvis with contrast	$2,858	$2,858	$32	$2,801	8
3272194	Pelvis Ctw/wo Contr	$2,828	$2,828	$32	$2,771	8
4536556	Fac Insertion, Central Iv Catheter, > 5	$2,822	$2,822	$54	$2,766	8
2591727	Rituxan Injection 10mg/ml	$2,819	$2,819	$1,128	$2,763	8
3271555	Mri Angio Chest W/o Or	$2,781	$2,781	$32	$2,725	8
2591284	Simponi Aria Intravenous Soln 50mg/4ml	$2,780	$2,780	$1,112	$2,724	8
3270553	MRI Scan	$2,632	$2,632	$32	$2,579	8
3273700	Ct Lower Extremity	$2,448	$2,448	$32	$2,399	8
3274182	Mri Abdomen With	$2,325	$2,325	$32	$2,279	8

Showing top 50 of 2,250 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.