LADD MEMORIAL HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
J9043	CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION	$56,586	$39,610	—	—	10
J9042	BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION	$46,968	$32,878	—	—	10
J9271	PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION	$46,257	$32,380	—	—	10
J9022	ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION	$43,696	$30,587	—	—	10
J9119	CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION	$42,427	$29,699	—	—	10
J9144	DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN	$40,091	$28,063	—	—	10
J2997	ALTEPLASE 100 MG INTRAVENOUS SOLUTION	$35,201	$24,641	—	—	10
J9228	IPILIMUMAB 5 MG/ML INTRAVENOUS SOLUTION (WRAPPED)	$34,813	$24,369	—	—	10
J3380	VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION	$34,666	$24,266	—	—	10
J9223	LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION	$32,120	$22,484	—	—	10
J3101	TENECTEPLASE 50 MG INTRAVENOUS SOLUTION	$31,310	$21,917	—	—	10
J9308	RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION	$29,136	$20,395	—	—	10
J1459	PRIVIGEN 10 % INTRAVENOUS SOLUTION	$28,966	$20,276	—	—	10
J9306	PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION	$26,107	$18,275	—	—	10
J2506	PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR	$25,672	$17,970	—	—	10
J9217	LEUPROLIDE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT	$24,529	$17,170	—	—	10
J0717	CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X2) SUBCUTANEOUS SYRINGE KIT	$22,877	$16,014	—	—	10
J1950	LEUPROLIDE 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT	$20,584	$14,409	—	—	10
J1162	DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION	$19,132	$13,392	—	—	10
J9312	RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS	$18,790	$13,153	—	—	10
22513	HC Pro Perq Vert Agmntj Cavity Crtj Uni/Bi Cannulation	$18,730	$13,111	—	—	10
22514	HC Pro Perq Vert Agmntj Cavity Crtj Uni/Bi Cannulj Lmbr	$18,730	$13,111	—	—	10
J2353	OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE	$18,465	$12,926	—	—	10
Q5115	RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION	$16,911	$11,838	—	—	10
Q5111	PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE	$16,700	$11,690	—	—	10
J9173	DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION	$16,512	$11,558	—	—	10
J9305	PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION	$16,172	$11,320	—	—	10
J9354	ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION	$15,723	$11,006	—	—	10
Q5119	RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS SOLUTION	$14,336	$10,035	—	—	10
Q5123	RITUXIMAB-ARRX 10 MG/ML INTRAVENOUS SOLUTION	$14,336	$10,035	—	—	10
J2182	MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION	$13,852	$9,696	—	—	10
J9299	NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION	$12,724	$8,907	—	—	10
J0630	CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION	$12,528	$8,770	—	—	10
7500000006	HC Endo Level 6	$12,500	$8,750	—	—	10
J9033	BENDAMUSTINE 100 MG INTRAVENOUS POWDER FOR SOLUTION	$11,887	$8,321	—	—	10
J9027	CLOFARABINE 1 MG/ML INTRAVENOUS SOLUTION	$11,739	$8,217	—	—	10
J0129	ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION	$11,700	$8,190	—	—	10
J9205	IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS	$11,646	$8,152	—	—	10
Q5107	BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLUTION	$11,164	$7,814	—	—	10
L8699	LINX 15 TITANIUM BEAD DEVICE IMPLANT 1.5 TESLA STATIC MAGNETIC FIELD STERILE	$11,000	$7,700	—	—	10
C1889	SEROSAFUSE FASTNR KIT	$10,990	$7,693	—	—	10
J3111	ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE	$10,015	$7,010	—	—	10
3600000005	Or Time - Initial Base Charge - Procedure Level Five	$10,000	$7,000	—	—	10
7500000005	HC Endo Level 5	$10,000	$7,000	—	—	10
22515	HC Pro Perq Vert Agmntj Cavity Crtj Uni/Bi Cannulj Each	$9,979	$6,985	—	—	10
J9036	BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION	$9,895	$6,927	—	—	10
Q5108	PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE	$8,350	$5,845	—	—	10
J3358	USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION	$8,098	$5,669	—	—	10
J9207	IXABEPILONE 15 MG INTRAVENOUS SOLUTION	$7,900	$5,530	—	—	10
3600000004	Or Time - Initial Base Charge - Procedure Level Four	$7,500	$5,250	—	—	10

Showing top 50 of 2,018 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.