WESTFIELDS HOSPITAL AND CLINIC

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
RX-346382	LUTETIUM LU 177 DOTATATE 370 MBQ/ML IV SOLN	$362,040	$190,433	—	—	11
RX-339056	RADIUM RA 223 DICHLORIDE 30 MCCI/ML IV SOLN	$135,443	$71,243	—	—	12
RX-332269	USTEKINUMAB 90 MG/ML SC SOSY	$121,227	$63,765	—	—	11
RX-373211	OCRELIZUMAB-HYALURONIDASE-OCSQ 920-23000 MG-UT/23ML SC SOLN	$104,289	$54,856	—	—	10
RX-365419	TREMELIMUMAB-ACTL 300 MG/15ML IV SOLN	$101,873	$53,585	—	—	12
335	Peritoneal Adhesiolysis With McC	$88,957	$46,791	—	—	7
RX-313560	IPILIMUMAB 200 MG/40ML IV SOLN	$88,724	$46,669	—	—	12
RX-350177	TAGRAXOFUSP-ERZS 1000 MCG/ML IV SOLN	$81,076	$42,646	—	—	12
653	Major Bladder Procedures With McC	$78,784	$41,440	—	—	7
289	Acute And Subacute Endocarditis With Cc	$78,164	$41,114	—	—	3
RX-359644	LONCASTUXIMAB TESIRINE-LPYL 10 MG IV SOLR	$69,732	$36,679	—	—	12
RX-430359644	LONCASTUXIMAB TESIRINE-LPYL 10 MG/2ML IV (WET SOLR VIAL)	$69,732	$36,679	—	—	12
RX-255737	PEGASPARGASE 750 UNIT/ML IJ SOLN	$67,635	$35,576	—	—	12
331	Major Small And Large Bowel Procedures Without Cc/McC	$61,136	$32,158	—	—	7
RX-344974	INOTUZUMAB OZOGAMICIN 0.9 MG IV SOLR	$58,607	$30,827	—	—	12
RX-430344974	INOTUZUMAB OZOGAMICIN 0.9 MG/3.6ML IV (WET SOLR VIAL)	$58,607	$30,827	—	—	12
828	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures Without C	$52,387	$27,555	—	—	7
RX-343282	OCRELIZUMAB 300 MG/10ML IV SOLN	$52,175	$27,444	—	—	12
787	Cesarean Section Without Sterilization With Cc	$51,810	$27,252	—	—	7
522	Hip Replacement With Principal Diagnosis Of Hip Fracture Without McC	$48,841	$25,690	—	—	7
RX-351870	POLATUZUMAB VEDOTIN-PIIQ 140 MG IV SOLR	$47,408	$24,937	—	—	12
RX-430351870	POLATUZUMAB VEDOTIN-PIIQ 140 MG/7ML IV (WET SOLR VIAL)	$47,408	$24,937	—	—	12
RX-366179	MOSUNETUZUMAB-AXGB 30 MG/30ML IV SOLN	$46,535	$24,477	—	—	12
570	Skin Debridement With McC	$46,407	$24,410	—	—	6
RX-362065	EFGARTIGIMOD ALFA-FCAB 400 MG/20ML IV SOLN	$45,643	$24,008	—	—	12
469	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With McC Or Total Ankle Repl	$45,386	$23,873	—	—	7
417	Laparoscopic Cholecystectomy Without C.D.E. With McC	$44,866	$23,600	—	—	7
580	Other Skin, Subcutaneous Tissue And Breast Procedures With Cc	$44,623	$23,472	—	—	7
256	Upper Limb And Toe Amputation For Circulatory System Disorders With Cc	$44,450	$23,381	—	—	7
784	Cesarean Section With Sterilization With Cc	$44,445	$23,378	—	—	7
470	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without McC	$44,146	$23,221	—	—	7
623	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Cc	$43,405	$22,831	—	—	7
481	Hip And Femur Procedures Except Major Joint With Cc	$42,735	$22,479	—	—	7
934	Full Thickness Burn Without Skin Graft Or Inhalation Injury	$42,445	$22,326	—	—	7
157	Dental And Oral Diseases With McC	$42,383	$22,293	—	—	7
559	Aftercare, Musculoskeletal System And Connective Tissue With McC	$42,216	$22,206	—	—	6
786	Cesarean Section Without Sterilization With McC	$41,359	$21,755	—	—	7
783	Cesarean Section With Sterilization With McC	$40,273	$21,184	—	—	7
RX-362809	NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20ML IV SOLN	$37,813	$19,890	—	—	12
RX-313170	PRALATREXATE 40 MG/2ML IV SOLN	$37,425	$19,686	—	—	12
RX-408401163	TARLATAMAB-DLLE 10 MG/4.2ML IV (WET SOLR VIAL)	$37,140	$19,536	—	—	12
785	Cesarean Section With Sterilization Without Cc/McC	$36,821	$19,368	—	—	7
RX-332268	USTEKINUMAB 45 MG/0.5ML SC SOSY	$36,791	$19,352	—	—	11
416	Cholecystectomy Except By Laparoscope Without C.D.E. Without Cc/McC	$36,478	$19,187	—	—	7
788	Cesarean Section Without Sterilization Without Cc/McC	$36,395	$19,144	—	—	7
RX-367032	RETIFANLIMAB-DLWR 500 MG/20ML IV SOLN	$36,152	$19,016	—	—	12
805	Vaginal Delivery Without Sterilization Or D&C With McC	$34,514	$18,154	—	—	7
166	Other Respiratory System O.R. Procedures With McC	$34,287	$18,035	—	—	7
433	Cirrhosis And Alcoholic Hepatitis With Cc	$33,890	$17,826	—	—	7
RX-310263	CABAZITAXEL 60 MG/1.5ML IV SOLN	$33,346	$17,540	—	—	12

Showing top 50 of 5,980 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.