COULEE MEDICAL CENTER (Grand Coulee, WA) prices

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
ocrelizumab 300 mg/10 mL IV Soln [CCH]	ocrelizumab 300 mg/10 mL IV Soln [CCH]	$60,585	$54,527	—	—	19
27880	AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; ProFee	$46,316	$41,684	—	—	19
20692	APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE THAN 1 PLANE), UNILATERAL, EXTERNAL ProFee	$31,298	$28,169	—	—	19
lanreotide 120 mg/0.5 mL Sub-Q Soln [CCH]	lanreotide 120 mg/0.5 mL Sub-Q Soln [CCH]	$30,856	$27,770	—	—	19
alteplase 100 mg IV Inj [CCH]	alteplase 100 mg IV Inj [CCH]	$27,870	$25,083	—	—	19
vedolizumab 300 mg Inj Vial [CCH]	vedolizumab 300 mg Inj Vial [CCH]	$27,447	$24,702	—	—	19
Epifix 7x7 Graft	Epifix 7x7 Graft	$26,244	$23,619	—	—	19
49010	EXPLORATION, RETROPERITONEAL AREA WITH OR WITHOUT BIOPSY(S) (SEPARATE PROCEDURE) ProFee	$26,188	$23,569	—	—	19
paliperidone 819 mg/2.625 mL Syringe [CCH]	paliperidone 819 mg/2.625 mL Syringe [CCH]	$25,890	$23,301	—	—	19
tenecteplase 50 mg Powder Kit [CCH]	tenecteplase 50 mg Powder Kit [CCH]	$24,524	$22,072	—	—	19
44603	SUTURE OF SMALL INTESTINE (ENTERORRHAPHY) FOR PERFORATED ULCER, DIVERTICULUM, WOUND, I ProFee	$22,235	$20,011	—	—	19
pegfilgrastim 6 mg/0.6 mL SubQ Inj Syringe [CCH]	pegfilgrastim 6 mg/0.6 mL SubQ Inj Syringe [CCH]	$20,711	$18,640	—	—	19
44661	CLOSURE OF ENTEROVESICAL FISTULA; WITH INTESTINE AND/OR BLADDER RESECTION ProFee	$19,280	$17,352	—	—	19
49204	EXCISION OR DESTRUCTION, OPEN, INTRA-ABDOMINAL TUMORS, CYSTS OR ENDOMETRIOMAS, 1 OR MO ProFee	$18,420	$16,578	—	—	19
44602	SUTURE OF SMALL INTESTINE (ENTERORRHAPHY) FOR PERFORATED ULCER, DIVERTICULUM, WOUND, I ProFee	$17,428	$15,685	—	—	19
27654	REPAIR, SECONDARY, ACHILLES TENDON, WITH OR WITHOUT GRAFT ProFee	$17,097	$15,387	—	—	19
23515	OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED ProFee	$17,096	$15,386	—	—	19
27405	REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE; COLLATERAL ProFee	$17,096	$15,386	—	—	19
27700	ARTHROPLASTY, ANKLE; ProFee	$17,096	$15,386	—	—	19
27829	OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, INCLUDES INTERNA ProFee	$17,096	$15,386	—	—	19
29888	ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTIO ProFee	$17,096	$15,386	—	—	19
27524	OPEN TREATMENT OF PATELLAR FRACTURE, WITH INTERNAL FIXATION AND/OR PARTIAL OR COMPLETE ProFee	$17,095	$15,386	—	—	19
27695	REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL ProFee	$17,095	$15,386	—	—	19
29807	ARTHROSCOPY, SHOULDER, SURGICAL; REPAIR OF SLAP LESION ProFee	$17,095	$15,386	—	—	19
romosozumab 2 syringe kit 105 mg/1.17 mL per Syr	romosozumab 2 syringe kit 105 mg/1.17 mL per Syringe [CCH]	$16,160	$14,544	—	—	19
leuprolide 22.5 mg IM/3 months Kit [CCH]	leuprolide 22.5 mg IM/3 months Kit [CCH]	$16,113	$14,501	—	—	19
Revita 6x8 Graft	Revita 6x8 Graft	$15,994	$14,394	—	—	19
Epifix 5x6 Graft	Epifix 5x6 Graft	$15,688	$14,119	—	—	19
44130	ENTEROENTEROSTOMY, ANASTOMOSIS OF INTESTINE, WITH OR WITHOUT CUTANEOUS ENTEROSTOMY (SE ProFee	$15,587	$14,029	—	—	19
digoxin immune FAB 40 mg Inj [CCH]	digoxin immune FAB 40 mg Inj [CCH]	$15,149	$13,634	—	—	19
certolizumab 200 mg Kit [CCH]	certolizumab 200 mg Kit [CCH]	$14,943	$13,449	—	—	19
44160	COLECTOMY, PARTIAL, WITH REMOVAL OF TERMINAL ILEUM WITH ILEOCOLOSTOMY ProFee	$14,726	$13,254	—	—	19
58573	LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH RE ProFee	$14,205	$12,785	—	—	19
immune globulin 10% (100 mg/ml) 300 mL IV Sol [C	immune globulin 10% (100 mg/ml) 300 mL IV Sol [CCH]	$13,421	$12,079	—	—	19
Revita 6x6 Graft	Revita 6x6 Graft	$13,361	$12,025	—	—	19
58570	LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; ProFee	$13,022	$11,720	—	—	19
49561	REPAIR INITIAL INCISIONAL OR VENTRAL HERNIA; INCARCERATED OR STRANGULATED ProFee	$12,144	$10,930	—	—	19
44960	APPENDECTOMY; FOR RUPTURED APPENDIX WITH ABSCESS OR GENERALIZED PERITONITIS ProFee	$11,449	$10,304	—	—	19
antivenin - Crotalidae (Crofab) Vial [CCH]	antivenin - Crotalidae (Crofab) Vial [CCH]	$10,321	$9,289	—	—	19
58542	LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; WITH REMO ProFee	$10,212	$9,191	—	—	19
49402	REMOVAL OF PERITONEAL FOREIGN BODY FROM PERITONEAL CAVITY ProFee	$9,934	$8,941	—	—	19
20103	Exploration of penetrating wound (separate procedure); extremity;	$9,653	$8,687	—	—	19
49525	REPAIR INGUINAL HERNIA, SLIDING, ANY AGE ProFee	$9,374	$8,437	—	—	19
15273	APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA GR ProFee	$9,321	$8,389	—	—	19
44204	LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS ProFee	$9,316	$8,384	—	—	19
27822	OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFOR ProFee	$9,146	$8,231	—	—	19
27792	OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), INCLUDES INTERNAL FIXAT ProFee	$9,111	$8,200	—	—	19
Epicord 3x5	Epicord 3x5	$9,072	$8,165	—	—	19
adalimumab 40 mg/0.8 mL SubQ Syringe [CCH]	adalimumab 40 mg/0.8 mL SubQ Syringe [CCH]	$8,968	$8,071	—	—	19
immune globulin 10% (100 mg/ml) 200 mL IV Sol [C	immune globulin 10% (100 mg/ml) 200 mL IV Sol [CCH]	$8,948	$8,053	—	—	19

Showing top 50 of 2,140 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.