45 CFR § 180 compliance
B · 85
This hospital published most 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
6,407
Insurances with rates
16
CPT / HCPCS codes
1
Source MRF
Most expensive procedures (gross)
5074594
$45,849
NF-Nystatin Powder
Gross
$91,698
5074599
$45,849
NF-Nystatin Powder
Gross
$91,698
5074658
$13,707
NF-Humira Pen Citrate-Free Soln 80MG/0.8
Gross
$27,413
5073009
$12,872
ALTEPLASE (ACTIVASE) 100MG (NF)
Gross
$25,745
5071341
$9,588
PEGFILGRASTIM (NEULASTA) 6MG INJ
Gross
$19,175
5062003
$8,217
TENECTEPLASE (TNKASE) INJECTION
Gross
$16,434
5074172
$7,642
ORITAVANCIN/NS (KIMYRSA) 1200MG/250ML
Gross
$15,284
5073412
$7,642
ORITAVANCIN (ORBACTIV) 1200MG
Gross
$15,284
5061408
$7,403
DIGOXIN IMMUNE FAB (DIGIFAB) 40MG V (NF)
Gross
$14,806
5060489
$6,721
RABIES IG (HYPERRAB) 300 U/ML 5ML
Gross
$13,442
5071121
$5,415
NF-NYSTATIN POWDER
Gross
$10,830
1650442
$4,897
SULTZER HIP PROSTHESIS
Gross
$9,794
5072899
$4,529
NF-Humira Subcutaneous Solution 20MG/0.4
Gross
$9,058
5073132
$4,418
ABILIFY MAINTENA 400MG INJ (NF)
Gross
$8,837
5073797
$4,356
NF-Nystatin Powder
Gross
$8,711
5073798
$4,270
NF-Formoterol Fumarate Powder
Gross
$8,541
5071753
$3,848
GLATIRAMER (COPAXONE) 20MG/ML INJ (NF)
Gross
$7,697
5071164
$3,657
TOCILIZUMAB (ACTEMRA) 400MG/20ML VL
Gross
$7,313
5073084
$3,401
NF-INVEGA SUSTENNA IM SUSP ER 234MG
Gross
$6,803
1600001
$2,937
KUGEL MESH 10 X 13
Gross
$5,875
1600002
$2,929
KUGEL MESH 5 X 7
Gross
$5,858
5073074
$2,920
TENECTEPLASE (TNKASE) 50MG KIT (DNU)
Gross
$5,840
1654360
$2,724
EXPANSION CUP
Gross
$5,447
1662063
$2,703
POWERPORT 8FR
Gross
$5,406
4240001
$2,650
MRI THORACIC WO CONTR W CONTR
Gross
$5,299
4240002
$2,650
MRI C-SPINE WO CONTR & W CONT
Gross
$5,299
4240003
$2,650
MRI BRAIN WO CONTRAST W CONTR
Gross
$5,299
4240060
$2,650
MRI SPINAL CANAL WO CONT W CO
Gross
$5,299
5534015
$2,639
POLYSOM <6YRS CPAP/BILVL
Gross
$5,279
4240064
$2,616
MRI LUMBAR SPINE WO CONT W CO
Gross
$5,233
4240070
$2,616
MRI ABDOMEN WO CONTRAST W CON
Gross
$5,233
4240072
$2,610
MRI LOWER EXT JOINT WO & W CONTRA LEFT
Gross
$5,221
4240074
$2,610
MRI LOW EXT N JOINT WO & W CO LEFT
Gross
$5,221
4240075
$2,610
MRI UPPER EXT WO CONT W CONTR LEFT
Gross
$5,221
4240077
$2,610
MRI UPPER EXT N J WO C W CONT LEFT
Gross
$5,221
4273220
$2,610
MRI UPPER EXT N J WO C W CONT RIGHT
Gross
$5,221
4273223
$2,610
MRI UPPER EXT WO CONT W CONTR RIGHT
Gross
$5,221
4273720
$2,610
MRI LOW EXT N JOINT WO & W CO RIGHT
Gross
$5,221
4273723
$2,610
MRI LOWER EXT JOINT W & W/O CONTRA RIGHT
Gross
$5,221
5073065
$2,496
NALTREXONE (VIVITROL) 380MG INJ
Gross
$4,992
5073898
$2,378
HYALURONIC ACID (DUROLANE) 60MG/3ML INJ
Gross
$4,756
1650000
$2,351
KUGEL MESH 8 X 10
Gross
$4,703
5072698
$2,329
NF-CALCITONIN (SALMON) INJ SOLN 200IU/1M
Gross
$4,657
5072770
$2,318
TERIPARATIDE (FORTEO) PREFILL PEN (NF)
Gross
$4,636
5072071
$2,294
LEDI-SOF (HARVONI) 90MG-400MG TAB (NF)
Gross
$4,589
7073065
$2,269
NALTREXONE (VIVITROL) 380MG INJ (NF)
Gross
$4,538
5640702
$2,262
POLYSOM<6YRS4/>PARAMTRS
Gross
$4,525
1650449
$2,238
SMALL GLENOID DWB001
Gross
$4,476
5071422
$2,233
ADALIMUMAB (HUMIRA) 40MG INJ (NF)
Gross
$4,466
5072499
$2,142
FULVESTRANT (FASLODEX) 250MG/5ML INJ (NF
Gross
$4,284
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 5074594 | NF-Nystatin Powder | $91,698 | $45,849 | — | — | 12 |
| 5074599 | NF-Nystatin Powder | $91,698 | $45,849 | — | — | 12 |
| 5074658 | NF-Humira Pen Citrate-Free Soln 80MG/0.8 | $27,413 | $13,707 | — | — | 12 |
| 5073009 | ALTEPLASE (ACTIVASE) 100MG (NF) | $25,745 | $12,872 | — | — | 12 |
| 5071341 | PEGFILGRASTIM (NEULASTA) 6MG INJ | $19,175 | $9,588 | — | — | 12 |
| 5062003 | TENECTEPLASE (TNKASE) INJECTION | $16,434 | $8,217 | — | — | 14 |
| 5074172 | ORITAVANCIN/NS (KIMYRSA) 1200MG/250ML | $15,284 | $7,642 | — | — | 12 |
| 5073412 | ORITAVANCIN (ORBACTIV) 1200MG | $15,284 | $7,642 | — | — | 12 |
| 5061408 | DIGOXIN IMMUNE FAB (DIGIFAB) 40MG V (NF) | $14,806 | $7,403 | — | — | 12 |
| 5060489 | RABIES IG (HYPERRAB) 300 U/ML 5ML | $13,442 | $6,721 | — | — | 13 |
| 5071121 | NF-NYSTATIN POWDER | $10,830 | $5,415 | — | — | 12 |
| 1650442 | SULTZER HIP PROSTHESIS | $9,794 | $4,897 | — | — | 12 |
| 5072899 | NF-Humira Subcutaneous Solution 20MG/0.4 | $9,058 | $4,529 | — | — | 12 |
| 5073132 | ABILIFY MAINTENA 400MG INJ (NF) | $8,837 | $4,418 | — | — | 12 |
| 5073797 | NF-Nystatin Powder | $8,711 | $4,356 | — | — | 12 |
| 5073798 | NF-Formoterol Fumarate Powder | $8,541 | $4,270 | — | — | 12 |
| 5071753 | GLATIRAMER (COPAXONE) 20MG/ML INJ (NF) | $7,697 | $3,848 | — | — | 12 |
| 5071164 | TOCILIZUMAB (ACTEMRA) 400MG/20ML VL | $7,313 | $3,657 | — | — | 12 |
| 5073084 | NF-INVEGA SUSTENNA IM SUSP ER 234MG | $6,803 | $3,401 | — | — | 12 |
| 1600001 | KUGEL MESH 10 X 13 | $5,875 | $2,937 | — | — | 12 |
| 1600002 | KUGEL MESH 5 X 7 | $5,858 | $2,929 | — | — | 12 |
| 5073074 | TENECTEPLASE (TNKASE) 50MG KIT (DNU) | $5,840 | $2,920 | — | — | 12 |
| 1654360 | EXPANSION CUP | $5,447 | $2,724 | — | — | 12 |
| 1662063 | POWERPORT 8FR | $5,406 | $2,703 | — | — | 12 |
| 4240001 | MRI THORACIC WO CONTR W CONTR | $5,299 | $2,650 | — | — | 12 |
| 4240002 | MRI C-SPINE WO CONTR & W CONT | $5,299 | $2,650 | — | — | 12 |
| 4240003 | MRI BRAIN WO CONTRAST W CONTR | $5,299 | $2,650 | — | — | 12 |
| 4240060 | MRI SPINAL CANAL WO CONT W CO | $5,299 | $2,650 | — | — | 12 |
| 5534015 | POLYSOM <6YRS CPAP/BILVL | $5,279 | $2,639 | — | — | 12 |
| 4240064 | MRI LUMBAR SPINE WO CONT W CO | $5,233 | $2,616 | — | — | 12 |
| 4240070 | MRI ABDOMEN WO CONTRAST W CON | $5,233 | $2,616 | — | — | 12 |
| 4240072 | MRI LOWER EXT JOINT WO & W CONTRA LEFT | $5,221 | $2,610 | — | — | 12 |
| 4240074 | MRI LOW EXT N JOINT WO & W CO LEFT | $5,221 | $2,610 | — | — | 12 |
| 4240075 | MRI UPPER EXT WO CONT W CONTR LEFT | $5,221 | $2,610 | — | — | 12 |
| 4240077 | MRI UPPER EXT N J WO C W CONT LEFT | $5,221 | $2,610 | — | — | 12 |
| 4273220 | MRI UPPER EXT N J WO C W CONT RIGHT | $5,221 | $2,610 | — | — | 12 |
| 4273223 | MRI UPPER EXT WO CONT W CONTR RIGHT | $5,221 | $2,610 | — | — | 12 |
| 4273720 | MRI LOW EXT N JOINT WO & W CO RIGHT | $5,221 | $2,610 | — | — | 12 |
| 4273723 | MRI LOWER EXT JOINT W & W/O CONTRA RIGHT | $5,221 | $2,610 | — | — | 12 |
| 5073065 | NALTREXONE (VIVITROL) 380MG INJ | $4,992 | $2,496 | — | — | 12 |
| 5073898 | HYALURONIC ACID (DUROLANE) 60MG/3ML INJ | $4,756 | $2,378 | — | — | 12 |
| 1650000 | KUGEL MESH 8 X 10 | $4,703 | $2,351 | — | — | 12 |
| 5072698 | NF-CALCITONIN (SALMON) INJ SOLN 200IU/1M | $4,657 | $2,329 | — | — | 12 |
| 5072770 | TERIPARATIDE (FORTEO) PREFILL PEN (NF) | $4,636 | $2,318 | — | — | 12 |
| 5072071 | LEDI-SOF (HARVONI) 90MG-400MG TAB (NF) | $4,589 | $2,294 | — | — | 12 |
| 7073065 | NALTREXONE (VIVITROL) 380MG INJ (NF) | $4,538 | $2,269 | — | — | 12 |
| 5640702 | POLYSOM<6YRS4/>PARAMTRS | $4,525 | $2,262 | — | — | 12 |
| 1650449 | SMALL GLENOID DWB001 | $4,476 | $2,238 | — | — | 12 |
| 5071422 | ADALIMUMAB (HUMIRA) 40MG INJ (NF) | $4,466 | $2,233 | — | — | 12 |
| 5072499 | FULVESTRANT (FASLODEX) 250MG/5ML INJ (NF | $4,284 | $2,142 | — | — | 12 |
Showing top 50 of 6,407 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.