45 CFR § 180 compliance
D · 65
This hospital published part of what § 180 requires.
●Machine-readable file published: assessment threshold met
●Gross / standard charges: assessment threshold met
●Discounted cash price: assessment threshold met
○Payer-specific negotiated rates: below assessment threshold
○Min / max negotiated charges: below assessment threshold
●Free, public, no login required: assessment threshold met
Procedures listed
1,876
Insurances with rates
4
CPT / HCPCS codes
985
Most expensive procedures (gross)
00310-3200-04
$37,515
coagulation factor Xa recombinant-zhzo 200 mg vial (G/K)
Gross
$50,020
65628-0080-03
$14,338
lansoprazole 3 mg/mL oral susp 90mL
Gross
$19,117
50242-0120-47
$12,530
tenecteplase 50mg kit (G/K)
Gross
$16,706
50242-0085-27
$12,470
alteplase 100mg vial (G/K)
Gross
$16,627
50633-0110-12
$9,754
antivenin (crotalidae) polyvalent (Crofab) inj (G/K)
Gross
$13,006
44206-0439-40
$5,811
immune globulin (Privigen) 40gm/400mL IVPB (G/K)
Gross
$7,748
00069-0249-01
$4,391
riTUXimab-pvvr (Ruxience) 10mg/mL 50mL vial (G/K)
Gross
$5,854
1TRH0120
$4,294
ROOM/BED: Swing Bed Skilled
Gross
$5,725
78206-0195-01
$4,276
denosumab-nxxp (Bilprevda) 120 mg/mL 1.7 mL soln (G/K)
Gross
$5,702
1TRH0110
$4,266
ROOM/BED: Medical
Gross
$5,688
1TRH0210ISO
$4,243
ROOM/BED: Tele Iso
Gross
$5,657
1TRH0210
$4,138
ROOM/BED: Tele
Gross
$5,517
70720-0951-30
$3,930
goserelin acetate 10.8 mg implant
Gross
$5,241
55513-0730-01
$3,861
denosumab (Xgeva) 120mg/1.7 mL vial (G/K)
Gross
$5,148
1TRH0110ISO
$3,699
ROOM/BED: Medical Iso
Gross
$4,932
1TRH0120ISO
$3,598
ROOM/BED: Swing Bed Skilled Iso
Gross
$4,797
G0390
$2,949
Trauma Team Activation
Gross
$3,932
4TRHG0390T
$2,949
Trauma Response Fee - PVH ED Trauma Response
Gross
$3,932
00069-1318-10
$2,806
epoetin alfa epbx (Retacrit) 10,000 units/mL 2mL vial (G/K)
Gross
$3,742
00065-0530-01
$2,476
balanced salt ophth sol 30mL
Gross
$3,301
25605
$2,445
25605 ED PROF COLLES FX CLD RUD-HOSPITAL
Gross
$3,260
61314-0240-63
$2,373
denosumab bbdz (Jubbonti) 60 mg/mL 1mL soln (G/K)
Gross
$3,165
55513-0710-01
$2,265
denosumab (Prolia) 60 mg/mL 1mL syringe (G/K)
Gross
$3,020
55513-0880-02
$2,212
romosozumab-aqqg 105mg/1.17mL inj (G/K)
Gross
$2,950
68682-0652-20
$2,142
diazePAM 10 mg rectal gel syringe
Gross
$2,856
72606-0037-01
$2,132
denosumab bmwo (Stoboclo) 60mg/mL 1mL (G/K)
Gross
$2,842
65219-0668-01
$2,041
denosumab-bnht (Conexxence) 60 mg/mL 1mL soln (G/K)
Gross
$2,722
32554
$2,021
32554 ED PROF Thoracentesis w/o Imaging Guidance
Gross
$2,695
66621-0790-02
$1,986
antivenin (Crotalidae) polyvalent (Anavip) 120mg inj
Gross
$2,648
45385
$1,896
45385 Colsc Flx Prox Splenic Flxr Rmvl Les Snare Tq
Gross
$2,527
66993-0087-96
$1,826
fluticasone-salmeterol HFA 115-21mcg 8gm
Gross
$2,435
70553
$1,767
MR Exam
Gross
$2,356
45384
$1,762
45384 Colsc Flx Prox Splenic Flxr Rmvl Les Caut
Gross
$2,349
P9035
$1,745
E3077 Aph Plt ACDA LR
Gross
$2,326
45380
$1,737
45380 Scope Of Colon With Biopsy
Gross
$2,316
36556
$1,659
36556 ED PROF INSERT NON TUNNEL CV CATH >5
Gross
$2,212
78206-0145-01
$1,654
etonogestrel 68 mg subdermal implant
Gross
$2,205
70543
$1,635
MR Exam
Gross
$2,180
99291
$1,547
99291 ED PROF CRITICAL CARE FIRST 30-74 MIN
Gross
$2,063
P9037
$1,500
E3046 Aph Plt ACDA LR Irr
Gross
$2,000
71275
$1,486
CT Exam
Gross
$1,981
G0390
$1,474
Trauma Activation RP
Gross
$1,966
27696
$1,458
27696 ED PROC RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS
Gross
$1,944
44206-0437-10
$1,453
immune globulin (Privigen) 10gm/100mL IVPB (G/K)
Gross
$1,937
13152
$1,452
13152 ED PROF CPX LC 2.6-7CM EAR- HOSPITAL
Gross
$1,936
27810
$1,412
27810 ED PROF CLOSED TX BIMALLEOLAR ANKLE FX W/ MANIPULATION
Gross
$1,883
70720-0950-36
$1,412
goserelin acetate 3.6 mg implant
Gross
$1,882
00597-0024-02
$1,395
albuterol-ipratropium inhaler 4gm
Gross
$1,860
13121
$1,375
13121 ED PROF CPX LC 2.6-7.5CM SCLP - HOSPITAL
Gross
$1,834
72128
$1,373
CT Exam
Gross
$1,831
| Code | Description | Gross | Cash | Min payer | Max payer | # insurers |
|---|---|---|---|---|---|---|
| 00310-3200-04 | coagulation factor Xa recombinant-zhzo 200 mg vial (G/K) | $50,020 | $37,515 | — | — | 0 |
| 65628-0080-03 | lansoprazole 3 mg/mL oral susp 90mL | $19,117 | $14,338 | — | — | 0 |
| 50242-0120-47 | tenecteplase 50mg kit (G/K) | $16,706 | $12,530 | — | — | 0 |
| 50242-0085-27 | alteplase 100mg vial (G/K) | $16,627 | $12,470 | — | — | 0 |
| 50633-0110-12 | antivenin (crotalidae) polyvalent (Crofab) inj (G/K) | $13,006 | $9,754 | — | — | 0 |
| 44206-0439-40 | immune globulin (Privigen) 40gm/400mL IVPB (G/K) | $7,748 | $5,811 | — | — | 0 |
| 00069-0249-01 | riTUXimab-pvvr (Ruxience) 10mg/mL 50mL vial (G/K) | $5,854 | $4,391 | — | — | 0 |
| 1TRH0120 | ROOM/BED: Swing Bed Skilled | $5,725 | $4,294 | — | — | 0 |
| 78206-0195-01 | denosumab-nxxp (Bilprevda) 120 mg/mL 1.7 mL soln (G/K) | $5,702 | $4,276 | — | — | 0 |
| 1TRH0110 | ROOM/BED: Medical | $5,688 | $4,266 | — | — | 0 |
| 1TRH0210ISO | ROOM/BED: Tele Iso | $5,657 | $4,243 | — | — | 0 |
| 1TRH0210 | ROOM/BED: Tele | $5,517 | $4,138 | — | — | 0 |
| 70720-0951-30 | goserelin acetate 10.8 mg implant | $5,241 | $3,930 | — | — | 0 |
| 55513-0730-01 | denosumab (Xgeva) 120mg/1.7 mL vial (G/K) | $5,148 | $3,861 | — | — | 0 |
| 1TRH0110ISO | ROOM/BED: Medical Iso | $4,932 | $3,699 | — | — | 0 |
| 1TRH0120ISO | ROOM/BED: Swing Bed Skilled Iso | $4,797 | $3,598 | — | — | 0 |
| G0390 | Trauma Team Activation | $3,932 | $2,949 | — | — | 0 |
| 4TRHG0390T | Trauma Response Fee - PVH ED Trauma Response | $3,932 | $2,949 | — | — | 0 |
| 00069-1318-10 | epoetin alfa epbx (Retacrit) 10,000 units/mL 2mL vial (G/K) | $3,742 | $2,806 | — | — | 0 |
| 00065-0530-01 | balanced salt ophth sol 30mL | $3,301 | $2,476 | — | — | 0 |
| 25605 | 25605 ED PROF COLLES FX CLD RUD-HOSPITAL | $3,260 | $2,445 | — | — | 1 |
| 61314-0240-63 | denosumab bbdz (Jubbonti) 60 mg/mL 1mL soln (G/K) | $3,165 | $2,373 | — | — | 0 |
| 55513-0710-01 | denosumab (Prolia) 60 mg/mL 1mL syringe (G/K) | $3,020 | $2,265 | — | — | 0 |
| 55513-0880-02 | romosozumab-aqqg 105mg/1.17mL inj (G/K) | $2,950 | $2,212 | — | — | 0 |
| 68682-0652-20 | diazePAM 10 mg rectal gel syringe | $2,856 | $2,142 | — | — | 0 |
| 72606-0037-01 | denosumab bmwo (Stoboclo) 60mg/mL 1mL (G/K) | $2,842 | $2,132 | — | — | 0 |
| 65219-0668-01 | denosumab-bnht (Conexxence) 60 mg/mL 1mL soln (G/K) | $2,722 | $2,041 | — | — | 0 |
| 32554 | 32554 ED PROF Thoracentesis w/o Imaging Guidance | $2,695 | $2,021 | — | — | 1 |
| 66621-0790-02 | antivenin (Crotalidae) polyvalent (Anavip) 120mg inj | $2,648 | $1,986 | — | — | 0 |
| 45385 | 45385 Colsc Flx Prox Splenic Flxr Rmvl Les Snare Tq | $2,527 | $1,896 | — | — | 1 |
| 66993-0087-96 | fluticasone-salmeterol HFA 115-21mcg 8gm | $2,435 | $1,826 | — | — | 0 |
| 70553 | MR Exam | $2,356 | $1,767 | — | — | 3 |
| 45384 | 45384 Colsc Flx Prox Splenic Flxr Rmvl Les Caut | $2,349 | $1,762 | — | — | 1 |
| P9035 | E3077 Aph Plt ACDA LR | $2,326 | $1,745 | — | — | 0 |
| 45380 | 45380 Scope Of Colon With Biopsy | $2,316 | $1,737 | — | — | 1 |
| 36556 | 36556 ED PROF INSERT NON TUNNEL CV CATH >5 | $2,212 | $1,659 | — | — | 1 |
| 78206-0145-01 | etonogestrel 68 mg subdermal implant | $2,205 | $1,654 | — | — | 0 |
| 70543 | MR Exam | $2,180 | $1,635 | — | — | 1 |
| 99291 | 99291 ED PROF CRITICAL CARE FIRST 30-74 MIN | $2,063 | $1,547 | — | — | 1 |
| P9037 | E3046 Aph Plt ACDA LR Irr | $2,000 | $1,500 | — | — | 0 |
| 71275 | CT Exam | $1,981 | $1,486 | — | — | 3 |
| G0390 | Trauma Activation RP | $1,966 | $1,474 | — | — | 0 |
| 27696 | 27696 ED PROC RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS | $1,944 | $1,458 | — | — | 0 |
| 44206-0437-10 | immune globulin (Privigen) 10gm/100mL IVPB (G/K) | $1,937 | $1,453 | — | — | 0 |
| 13152 | 13152 ED PROF CPX LC 2.6-7CM EAR- HOSPITAL | $1,936 | $1,452 | — | — | 1 |
| 27810 | 27810 ED PROF CLOSED TX BIMALLEOLAR ANKLE FX W/ MANIPULATION | $1,883 | $1,412 | — | — | 1 |
| 70720-0950-36 | goserelin acetate 3.6 mg implant | $1,882 | $1,412 | — | — | 0 |
| 00597-0024-02 | albuterol-ipratropium inhaler 4gm | $1,860 | $1,395 | — | — | 0 |
| 13121 | 13121 ED PROF CPX LC 2.6-7.5CM SCLP - HOSPITAL | $1,834 | $1,375 | — | — | 1 |
| 72128 | CT Exam | $1,831 | $1,373 | — | — | 2 |
Showing top 50 of 1,876 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.