45 CFR § 180 compliance
F · 55
This hospital published little of what § 180 requires.
●Machine-readable file published: assessment threshold met
○Gross / standard charges: below assessment threshold
○Discounted cash price: below assessment threshold
●Payer-specific negotiated rates: assessment threshold met
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
202
Insurances with rates
12
CPT / HCPCS codes
83
Most expensive procedures (gross)
0124
$1,802
C BHN ROOM PSYCH BEHAVIORAL
Gross
$4,505
0225U
$394
C INFECTIOUS DISEASE PATHOGEN-SPECIFIC DNA,RNA,21 TARGETS INC ACUTE RESP SYNDROME CORONAVIRUS,AMP PR
Gross
$985
87536
$158
O HIV 1 RNA QN
Gross
$395
93005
$142
C EKG 12-LEAD
Gross
$355
87494
$110
PR INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS AND NEISSERIA GONO
Gross
$274
86360
$87.2
C T CELLS ABS CD4/ABS CD8
Gross
$218
82652
$71.6
O VITAMIN D1,25 DIHYDROXY
Gross
$179
86359
$70
C T CELLS, TOTAL COUNT
Gross
$175
G0472
$68.8
HC HEPATITIS C ANTIBODY SCREENING FOR IND AT HIGH RISK AND OTHER COVERED INDICATION(S)
Gross
$172
87801
$68.4
C DETECT MULT AGENTS, DNA, AMP
Gross
$171
J3230
$65.5
CHLORPROMAZINE 25 MG/ML SOLN
Gross
$164
80307
$56.8
C DRUG SCREEN MULTIPLE DRUGS
Gross
$142
90471
$55.6
C INFLUENZA VACCINE ADMIN
Gross
$139
82306
$55.2
O VITAMIN D25 HYDROXY
Gross
$138
J2060
$50
LORAZEPAM 2 MG/ML SOLN
Gross
$125
J0515
$49.18
BENZTROPINE 1 MG/ML SOLN
Gross
$123
80342
$48
HC ARUP- ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 1-3
Gross
$120
J0561
$42.6
PENICILLIN G BENZATHINE 1,200,000 UNITS/2 ML SUSY
Gross
$107
87389
$40.4
PR INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HIV-1 ANTIGEN, WITH HIV-1 AND HIV-2
Gross
$101
84146
$39.2
O PROLACTIN
Gross
$98
J3490
$36.42
NALOXONE 4 MG/0.1 ML LIQD
Gross
$91.05
80305
$35.6
P POCT DRUG SCREEN URINE
Gross
$89
84443
$33.6
C TSH
Gross
$84
87481
$32
C CANDIDA DNA, AMP PROBE
Gross
$80
87661
$32
C TRICHOMONAS VAGINALIS,AMPLIFIED PROBE TECH
Gross
$80
J1200
$30.88
DIPHENHYDRAMINE 50 MG/ML SOLN
Gross
$77.2
82607
$30
O VITAMIN B12
Gross
$75
84702
$30
O HCG QUANTITATIVE
Gross
$75
82140
$29.2
O AMMONIA
Gross
$73
80173
$29.2
O HALOPERIDOL
Gross
$73
84484
$28.4
C HIGH SENSITIVITY TROPONIN
Gross
$71
84480
$28
O T3 TOTAL
Gross
$70
80164
$27.2
O VALPROIC ACID
Gross
$68
82728
$27.2
O FERRITIN
Gross
$68
82330
$27.2
O IONIZED CALCIUM
Gross
$68
80061
$26.8
O LIPID PANEL
Gross
$67
80053
$26.4
O COMPREHENSIVE METABOLIC PANEL
Gross
$66
86141
$26
O CRP HIGH SENSITIVITY
Gross
$65
86780
$26
O SYPHILIS IGG ANTIBODY
Gross
$65
J3360
$25
DIAZEPAM 5 MG/ML SOLN
Gross
$62.5
86704
$24.8
O HEPATITIS B CORE TOTAL AB
Gross
$62
G0008
$24.8
HC INFLUENZA VACCINE ADMIN
Gross
$62
82746
$24.4
O FOLATE
Gross
$61
82553
$23.6
O CK ISOENZYMES
Gross
$59
80159
$23.2
C CLOZAPINE QUANTITATIVE
Gross
$58
87808
$23.2
O TRICHOMONAS VAGINALIS AG
Gross
$58
86706
$21.6
O HEPATITIS B SURFACE AB
Gross
$54
85025
$21.6
O CBC WITH DIFF
Gross
$54
87340
$20.8
O HEPATITIS B SURFACE AG
Gross
$52
J1631
$20.5
HALOPERIDOL DECANOATE 100 MG/ML SOLN
Gross
$51.23
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 0124 | C BHN ROOM PSYCH BEHAVIORAL | $4,505 | $1,802 | — | — | 10 |
| 0225U | C INFECTIOUS DISEASE PATHOGEN-SPECIFIC DNA,RNA,21 TARGETS INC ACUTE RESP SYNDROME CORONAVIRUS,AMP PR | $985 | $394 | — | — | 0 |
| 87536 | O HIV 1 RNA QN | $395 | $158 | — | — | 0 |
| 93005 | C EKG 12-LEAD | $355 | $142 | — | — | 0 |
| 87494 | PR INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS AND NEISSERIA GONO | $274 | $110 | — | — | 0 |
| 86360 | C T CELLS ABS CD4/ABS CD8 | $218 | $87.2 | — | — | 0 |
| 82652 | O VITAMIN D1,25 DIHYDROXY | $179 | $71.6 | — | — | 0 |
| 86359 | C T CELLS, TOTAL COUNT | $175 | $70 | — | — | 0 |
| G0472 | HC HEPATITIS C ANTIBODY SCREENING FOR IND AT HIGH RISK AND OTHER COVERED INDICATION(S) | $172 | $68.8 | — | — | 0 |
| 87801 | C DETECT MULT AGENTS, DNA, AMP | $171 | $68.4 | — | — | 0 |
| J3230 | CHLORPROMAZINE 25 MG/ML SOLN | $164 | $65.5 | — | — | 0 |
| 80307 | C DRUG SCREEN MULTIPLE DRUGS | $142 | $56.8 | — | — | 0 |
| 90471 | C INFLUENZA VACCINE ADMIN | $139 | $55.6 | — | — | 0 |
| 82306 | O VITAMIN D25 HYDROXY | $138 | $55.2 | — | — | 0 |
| J2060 | LORAZEPAM 2 MG/ML SOLN | $125 | $50 | — | — | 0 |
| J0515 | BENZTROPINE 1 MG/ML SOLN | $123 | $49.18 | — | — | 0 |
| 80342 | HC ARUP- ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 1-3 | $120 | $48 | — | — | 0 |
| J0561 | PENICILLIN G BENZATHINE 1,200,000 UNITS/2 ML SUSY | $107 | $42.6 | — | — | 0 |
| 87389 | PR INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE, HIV-1 ANTIGEN, WITH HIV-1 AND HIV-2 | $101 | $40.4 | — | — | 0 |
| 84146 | O PROLACTIN | $98 | $39.2 | — | — | 0 |
| J3490 | NALOXONE 4 MG/0.1 ML LIQD | $91.05 | $36.42 | — | — | 0 |
| 80305 | P POCT DRUG SCREEN URINE | $89 | $35.6 | — | — | 0 |
| 84443 | C TSH | $84 | $33.6 | — | — | 0 |
| 87481 | C CANDIDA DNA, AMP PROBE | $80 | $32 | — | — | 0 |
| 87661 | C TRICHOMONAS VAGINALIS,AMPLIFIED PROBE TECH | $80 | $32 | — | — | 0 |
| J1200 | DIPHENHYDRAMINE 50 MG/ML SOLN | $77.2 | $30.88 | — | — | 0 |
| 82607 | O VITAMIN B12 | $75 | $30 | — | — | 0 |
| 84702 | O HCG QUANTITATIVE | $75 | $30 | — | — | 0 |
| 82140 | O AMMONIA | $73 | $29.2 | — | — | 0 |
| 80173 | O HALOPERIDOL | $73 | $29.2 | — | — | 0 |
| 84484 | C HIGH SENSITIVITY TROPONIN | $71 | $28.4 | — | — | 0 |
| 84480 | O T3 TOTAL | $70 | $28 | — | — | 0 |
| 80164 | O VALPROIC ACID | $68 | $27.2 | — | — | 0 |
| 82728 | O FERRITIN | $68 | $27.2 | — | — | 0 |
| 82330 | O IONIZED CALCIUM | $68 | $27.2 | — | — | 0 |
| 80061 | O LIPID PANEL | $67 | $26.8 | — | — | 0 |
| 80053 | O COMPREHENSIVE METABOLIC PANEL | $66 | $26.4 | — | — | 0 |
| 86141 | O CRP HIGH SENSITIVITY | $65 | $26 | — | — | 0 |
| 86780 | O SYPHILIS IGG ANTIBODY | $65 | $26 | — | — | 0 |
| J3360 | DIAZEPAM 5 MG/ML SOLN | $62.5 | $25 | — | — | 0 |
| 86704 | O HEPATITIS B CORE TOTAL AB | $62 | $24.8 | — | — | 0 |
| G0008 | HC INFLUENZA VACCINE ADMIN | $62 | $24.8 | — | — | 0 |
| 82746 | O FOLATE | $61 | $24.4 | — | — | 0 |
| 82553 | O CK ISOENZYMES | $59 | $23.6 | — | — | 0 |
| 80159 | C CLOZAPINE QUANTITATIVE | $58 | $23.2 | — | — | 0 |
| 87808 | O TRICHOMONAS VAGINALIS AG | $58 | $23.2 | — | — | 0 |
| 86706 | O HEPATITIS B SURFACE AB | $54 | $21.6 | — | — | 0 |
| 85025 | O CBC WITH DIFF | $54 | $21.6 | — | — | 0 |
| 87340 | O HEPATITIS B SURFACE AG | $52 | $20.8 | — | — | 0 |
| J1631 | HALOPERIDOL DECANOATE 100 MG/ML SOLN | $51.23 | $20.5 | — | — | 0 |
Showing top 50 of 202 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.