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
1,262
Insurances with rates
13
CPT / HCPCS codes
1,219
Most expensive procedures (gross)
43653
$26,838
LAPAROSCOPY GASTROSTOMY
Gross
$26,838
J1162
$15,819
Digifab 40 mg
Gross
$15,819
J1568
$14,300
Immun Globg(Igg)/Malt/Iga Ov50
Gross
$14,300
75860
$13,970
Venography Jugular Cath RS&I
Gross
$13,970
27301
$13,165
DRAIN THIGH/KNEE LESION
Gross
$13,165
75716
$13,164
Arter Xray Leg/Arm
Gross
$13,164
75625
$13,164
Contrast Exam Abdominl Aorta
Gross
$13,164
75710
$13,164
Angio Ext Unilat S&i
Gross
$13,164
75825
$13,164
RAD Venogrphy Caval Inferor W
Gross
$13,164
75810
$13,164
RAD Vein Spleen/Liver
Gross
$13,164
J2406
$11,976
Oritavancin (Kimyrsa) 10 mg
Gross
$11,976
J3262
$9,546
Tocilizumab 400 mg
Gross
$9,546
15002
$8,414
Wound PrepTRK/ARM/LEG
Gross
$8,414
72295
$8,070
RAD of Lower Spine Disk
Gross
$8,070
72285
$8,070
RAD Cerv/Thor Spine Disk
Gross
$8,070
14040
$7,993
TIS TRNFR F/C/C/M/N/A/G/H/F
Gross
$7,993
78815
$6,810
NM Tumor Image Pet/CT Skul-T
Gross
$6,810
J0875
$6,741
Dalbavancin HCL
Gross
$6,741
75820
$6,468
Ir-Venogram Ext Uni
Gross
$6,468
75827
$6,468
Rag Venogrphy Caval Super W/S
Gross
$6,468
33016
$6,468
Pericardiocentesis W/Img
Gross
$6,468
78452
$6,007
NM Hrt Muscle Image Spect
Gross
$6,007
78803
$6,007
NM Rp Loclzj Tum Spect 1 Area
Gross
$6,007
78804
$6,007
NM Tumor Imaging Wb; 2+days
Gross
$6,007
73702
$5,640
CT LO EXTR W/WO contrast BILAT
Gross
$5,640
81223
$4,990
CFTR Gene Full Sequence
Gross
$4,990
J1306
$4,923
Inclisiran Sodium
Gross
$4,923
87903
$4,887
Phenotype DNA HIV W/Culture
Gross
$4,887
J2407
$4,246
Oritavancin Diphosphate 400 mg
Gross
$4,246
95811
$4,231
EEG Split Night Study
Gross
$4,231
87633
$4,168
Resp VirUS 12-25 Targets
Gross
$4,168
87507
$4,168
ENTERIC PATHOGEN PANEL
Gross
$4,168
0202U
$4,168
NFCT DS 22 TRGT SARS-COV-2
Gross
$4,168
81370
$4,021
HLA I & Ii Typing Lr
Gross
$4,021
Q9967
$3,832
Iopamidol 61 %
Gross
$3,832
0124
$3,500
Psych Med Complex Private
Gross
$3,500
0180
$3,500
LOA - 3 Day Rule Billable
Gross
$3,500
81301
$3,486
Microsatellite Instability
Gross
$3,486
C8923
$3,290
2d Tte W W/O Fol W/Contrast
Gross
$3,290
J2997
$3,168
Cathflo Activase
Gross
$3,168
88348
$3,018
Electron Microscopy
Gross
$3,018
88309
$3,018
LEVEL IV SURG PATH G&M
Gross
$3,018
81225
$2,914
CYP2C19 Gene Com Variants
Gross
$2,914
10005
$2,861
FNA BX W/US Gdn 1st Les
Gross
$2,861
P9037
$2,840
Plate Pheres Leukoredu Ir
Gross
$2,840
15004
$2,816
WOUND PREP F/N/HF/G
Gross
$2,816
C1748
$2,796
Gastroscope, Disposable Ambu
Gross
$2,796
81404
$2,748
MOPATH PROCEDURE LEVEL 5
Gross
$2,748
P9073
$2,686
Platelets Pheresis Path Redu
Gross
$2,686
87506
$2,630
Cytopath Urine 3-5 Probes
Gross
$2,630
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 43653 | LAPAROSCOPY GASTROSTOMY | $26,838 | $26,838 | — | — | 0 |
| J1162 | Digifab 40 mg | $15,819 | $15,819 | — | — | 0 |
| J1568 | Immun Globg(Igg)/Malt/Iga Ov50 | $14,300 | $14,300 | — | — | 0 |
| 75860 | Venography Jugular Cath RS&I | $13,970 | $13,970 | — | — | 0 |
| 27301 | DRAIN THIGH/KNEE LESION | $13,165 | $13,165 | — | — | 0 |
| 75716 | Arter Xray Leg/Arm | $13,164 | $13,164 | — | — | 0 |
| 75625 | Contrast Exam Abdominl Aorta | $13,164 | $13,164 | — | — | 0 |
| 75710 | Angio Ext Unilat S&i | $13,164 | $13,164 | — | — | 0 |
| 75825 | RAD Venogrphy Caval Inferor W | $13,164 | $13,164 | — | — | 0 |
| 75810 | RAD Vein Spleen/Liver | $13,164 | $13,164 | — | — | 0 |
| J2406 | Oritavancin (Kimyrsa) 10 mg | $11,976 | $11,976 | — | — | 0 |
| J3262 | Tocilizumab 400 mg | $9,546 | $9,546 | — | — | 0 |
| 15002 | Wound PrepTRK/ARM/LEG | $8,414 | $8,414 | — | — | 0 |
| 72295 | RAD of Lower Spine Disk | $8,070 | $8,070 | — | — | 0 |
| 72285 | RAD Cerv/Thor Spine Disk | $8,070 | $8,070 | — | — | 0 |
| 14040 | TIS TRNFR F/C/C/M/N/A/G/H/F | $7,993 | $7,993 | — | — | 0 |
| 78815 | NM Tumor Image Pet/CT Skul-T | $6,810 | $6,810 | — | — | 0 |
| J0875 | Dalbavancin HCL | $6,741 | $6,741 | — | — | 0 |
| 75820 | Ir-Venogram Ext Uni | $6,468 | $6,468 | — | — | 0 |
| 75827 | Rag Venogrphy Caval Super W/S | $6,468 | $6,468 | — | — | 0 |
| 33016 | Pericardiocentesis W/Img | $6,468 | $6,468 | — | — | 0 |
| 78452 | NM Hrt Muscle Image Spect | $6,007 | $6,007 | — | — | 0 |
| 78803 | NM Rp Loclzj Tum Spect 1 Area | $6,007 | $6,007 | — | — | 0 |
| 78804 | NM Tumor Imaging Wb; 2+days | $6,007 | $6,007 | — | — | 0 |
| 73702 | CT LO EXTR W/WO contrast BILAT | $5,640 | $5,640 | — | — | 0 |
| 81223 | CFTR Gene Full Sequence | $4,990 | $4,990 | — | — | 0 |
| J1306 | Inclisiran Sodium | $4,923 | $4,923 | — | — | 0 |
| 87903 | Phenotype DNA HIV W/Culture | $4,887 | $4,887 | — | — | 0 |
| J2407 | Oritavancin Diphosphate 400 mg | $4,246 | $4,246 | — | — | 0 |
| 95811 | EEG Split Night Study | $4,231 | $4,231 | — | — | 0 |
| 87633 | Resp VirUS 12-25 Targets | $4,168 | $4,168 | — | — | 0 |
| 87507 | ENTERIC PATHOGEN PANEL | $4,168 | $4,168 | — | — | 0 |
| 0202U | NFCT DS 22 TRGT SARS-COV-2 | $4,168 | $4,168 | — | — | 0 |
| 81370 | HLA I & Ii Typing Lr | $4,021 | $4,021 | — | — | 0 |
| Q9967 | Iopamidol 61 % | $3,832 | $3,832 | — | — | 0 |
| 0124 | Psych Med Complex Private | $3,500 | $3,500 | — | — | 21 |
| 0180 | LOA - 3 Day Rule Billable | $3,500 | $3,500 | — | — | 0 |
| 81301 | Microsatellite Instability | $3,486 | $3,486 | — | — | 0 |
| C8923 | 2d Tte W W/O Fol W/Contrast | $3,290 | $3,290 | — | — | 0 |
| J2997 | Cathflo Activase | $3,168 | $3,168 | — | — | 0 |
| 88348 | Electron Microscopy | $3,018 | $3,018 | — | — | 0 |
| 88309 | LEVEL IV SURG PATH G&M | $3,018 | $3,018 | — | — | 0 |
| 81225 | CYP2C19 Gene Com Variants | $2,914 | $2,914 | — | — | 0 |
| 10005 | FNA BX W/US Gdn 1st Les | $2,861 | $2,861 | — | — | 0 |
| P9037 | Plate Pheres Leukoredu Ir | $2,840 | $2,840 | — | — | 0 |
| 15004 | WOUND PREP F/N/HF/G | $2,816 | $2,816 | — | — | 0 |
| C1748 | Gastroscope, Disposable Ambu | $2,796 | $2,796 | — | — | 0 |
| 81404 | MOPATH PROCEDURE LEVEL 5 | $2,748 | $2,748 | — | — | 0 |
| P9073 | Platelets Pheresis Path Redu | $2,686 | $2,686 | — | — | 0 |
| 87506 | Cytopath Urine 3-5 Probes | $2,630 | $2,630 | — | — | 0 |
Showing top 50 of 1,262 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.