MARY IMMACULATE HOSPITAL

CCN 490041

45 CFR § 180 compliance
D · 65
This hospital published part 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
58,718
Insurances with rates
29
CPT / HCPCS codes
0
Source MRF

Most expensive procedures (gross)

SUP-2713805
$737,646
LASER SURG W/ SCANNER ULTRAPULSE DUO
Gross
$1,229,410
SUP-2713804
$691,326
LASER SURG ULTRAPULSE DUO
Gross
$1,152,210
SUP-2356026
$499,881
KIT VENT ASST FOR HEARTMATE III IMPL
Gross
$833,135
SUP-2927338
$444,672
IMPLANT HUM TISS L 11 X W 10 CM PLCNTA MEMBRN MULTILAYERED
Gross
$741,120
SUP-2713770
$440,040
LASER SURG SELECTA TRIO
Gross
$733,400
SUP-2356020
$405,300
DEVICE VENTRICULAR ASST KT
Gross
$675,500
SUP-2356046
$368,244
KIT PMP LT VENT ASST DEV W/ PKT CTRL HEARTMATE II
Gross
$613,740
SUP-2721188
$346,419
AMSCO 7052HP 460 480V 3 PH 60 HZ STEAM HEATED
Gross
$577,365
SUP-2282536
$345,779
PUMP VENT ASST BLD L PERICARD MINIATURIZED FULL OUTPT LESS
Gross
$576,298
SUP-2713806
$324,240
LASER SURG W/ 3 YR WARR SELECTA DUET
Gross
$540,400
SUP-2705836
$287,293
INSTRUMENT SET HOFFMANN3 MILITARY EXTERNAL FIXATOR
Gross
$478,821
SUP-2177062
$280,551
SET TRAUMA FIXATION 3.5MM DISTAL HUMERAL F/LCP PLATE
Gross
$467,585
SUP-2183094
$258,580
SET IMPL PELV INT FIX W/ ST SCR
Gross
$430,966
CASE-C7505
$246,225
Perq ls&cvt inj vert bodies
Gross
$410,375
SUP-2496129
$238,115
SET IMPL PELVIC PRO STRYKER
Gross
$396,859
SUP-2817736
$236,232
UNIVERS II HUMERAL INSTRUMENTATION SET
Gross
$393,720
SUP-2912826
$231,600
KIT CAGE SPINAL APREVO 5-LEVEL
Gross
$386,000
SUP-2462704
$229,094
FIBER LASER 30 W SM FLX POWERFUL ENERGY FOR COAG HOLM
Gross
$381,823
SUP-2838623
$213,859
GRAFT HUMAN TISSUE 45X25 CM BIOLOGIC TISSUE MATRIX STERILE X
Gross
$356,432
SUP-2540076
$210,566
LASER ENDOSCP 20 W HOLM
Gross
$350,943
SUP-2713801
$208,440
LASER SURG FOR SLT GLAUCOMA THER W/ 3 YR WARR SELECTA II
Gross
$347,400
SUP-2853216
$208,440
PUMP HEART IMPELLA 5.5 W/SMART ASSIST S2
Gross
$347,400
SUP-2106273
$208,440
CANNULA VENT ASST 32FR L10MM LT ART AB KT BYPS FOR BLD PMP
Gross
$347,400
SUP-2183060
$208,127
SET INSTR IMPL SCR DIA6.5/7.3MM COMBINED CANN
Gross
$346,879
SUP-2912825
$203,808
KIT CAGE SPINAL APREVO 4-LEVEL
Gross
$339,680
SUP-2177061
$200,970
SET IMPL 3.5MM LO PROF PELV SYS
Gross
$334,950
SUP-2930358
$199,176
VALVE TRICSP EVOQUE SZ 44 MM NIT SELF EXPANDABLE THERMAFIX
Gross
$331,960
CASE-27766
$196,840
Open Treatment Medial Malleolus Fracture|RIGHT SIDE
Gross
$328,067
SUP-2420211
$195,887
ALLOGRAFT HUM TISS PORCINE CLLGN MEMBRN VERICEL MACI
Gross
$326,479
CASE-28715
$194,888
Whmc Arthrodesis Triple|LEFT SIDE
Gross
$324,813
SUP-2859842
$190,422
PLATE BNE RADIAL DSTL
Gross
$317,369
SUP-2838622
$190,096
GRAFT HUMAN TISSUE 40X25 CM BIOLOGIC TISSUE MATRIX STERILE X
Gross
$316,827
SUP-2177067
$188,868
SET ORTH GRPHC CA W/ K WIRE FOR MOD MINI FRAG INSTR AND
Gross
$314,780
SUP-2895994
$180,648
SYSTEM VLV REP TRICLIP G4 TRICSP VLV TRANSCATHETER EDGE TO
Gross
$301,080
SUP-2175903
$180,273
GENERATOR NEUROSTIMULATOR W/SINGLE LEAD FOR MODEL 1000
Gross
$300,455
SUP-2912824
$176,016
KIT CAGE SPINAL APREVO 3-LEVEL
Gross
$293,360
SUP-2183070
$167,796
SET IMPL GRPHC CA INSTR W/ DRL BIT COUNTSINK SCR HNDL SL
Gross
$279,659
SUP-2183074
$165,599
SET INSTR IMPL S STL W/ 2.4MM DSTL RAD PLT LCP
Gross
$275,998
SUP-2177071
$163,792
SET ORTH IMPL 3.5MM MEDL PROX TIB S STL PLT LCP
Gross
$272,986
SUP-2177076
$162,960
PLATE BONE S STL FOR 5MM SCR PERIARTC SYS LCP
Gross
$271,600
SUP-2894037
$162,120
KIT NERVE STIM BARORECEPTOR NEUROMODULATION GENRTR CSL LD
Gross
$270,200
SUP-2815582
$162,120
UNIVERS II GLENOID INSTRUMENTATION SET
Gross
$270,200
SUP-2882185
$157,488
KIT AORT VLV SAPIEN 3 ULTRA RESILIA DIA29 MM BOV PERICARD
Gross
$262,480
SUP-2265164
$156,932
STIMULATOR NERVE VAGEL ASPIRE GEN
Gross
$261,554
SUP-2397725
$156,034
SCREW BNE COMPR 3-4.3 MM MULTI-USE CHARLOTTE
Gross
$260,056
SUP-2875397
$155,685
NAIL IM TROCHANTERIC 9X265 MM STRL FITBONE
Gross
$259,476
SUP-2811209
$154,686
TIBIAL NAIL INSTRUMENTS
Gross
$257,809
SUP-2660820
$152,856
SYSTEM VLV REP MITRACLIP G4 EDGE TO EDGE BNDL SGC0701 STEER
Gross
$254,760
SUP-2838620
$152,074
GRAFT HUMAN TISSUE 40X20 CM BIOLOGIC TISSUE MATRIX STERILE X
Gross
$253,457
CASE-22634
$150,792
Arthrodesis Cmbn Tq 1ntrspc Each Additional
Gross
$251,321
Showing top 50 of 58,718 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.