POWELL VALLEY HOSPITAL — Hospital Ledger

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
60006582423	IPILIMUMAB 5MG/ML 40ML VIAL (G/K)	$67,559	$57,425	—	—	5
60006592082	USTEKINUMAB 90MG/ML SYRINGE (G/K)	$42,497	$36,123	—	—	5
60006591924	INOTUZUMAB OZOGAMICIN 0.9MG VIAL (G/K)	$42,138	$35,817	—	—	5
60006591610	DAUNORUBICIN/CYTARABINE LIPOSOMAL 44 MG-100 MG INJ (G/K)	$37,025	$31,471	—	—	5
60006591374	OCRELIZUMAB 30MG/ML 10ML VIAL (G/K)	$35,614	$30,272	—	—	5
60006591992	POLATUZUMAB VEDOTIN 140MG VIAL (G/K)	$31,220	$26,537	—	—	5
635022514	PERQ VERTEBRAL AUGMENTATION LUMBAR	$26,059	$22,150	—	—	5
60006575906	CABAZITAXEL 60MG (G/K)	$25,025	$21,271	—	—	5
60006591223	BRENTUXIMAB VEDOTIN 50MG VIAL (G/K)	$25,025	$21,271	—	—	5
6827258347	HEMI-CONDYLE MEDLIAL FEMORAL	$24,978	$21,231	—	—	5
630027134	REVJ TOT HIP ARTHRP BTH +-AGRFT/ALGRFT	$23,876	$20,295	—	—	5
60006594217	DOSTARLIMAB GXLY 50MG/ML 10ML VIAL (G/K)	$23,146	$19,674	—	—	5
60006592110	LUSPATERCEPT-AAMT (REBLOZYL) 75 MG INJ (G/K)	$23,030	$19,575	—	—	5
60006591785	CEMIPLIMAB-RWLC 50 MG/ML 7ML SOLN (G/K)	$21,234	$18,049	—	—	5
60006590997	LEUPROLIDE 45MG/6MONTH KIT (URO) (G/K)	$20,489	$17,416	—	—	5
60006591218	ATEZOLIZUMAB 60MG/ML 20ML SOLN (G/K)	$19,718	$16,760	—	—	5
635022861	REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC CRV	$18,695	$15,890	—	—	5
6827261553	CONE PROXIMAL BODY HIGH OFFST SIZE A 60MM	$18,648	$15,851	—	—	5
6827262442	IMPLANT INTERBODY LATERAL	$18,540	$15,759	—	—	5
60006592219	LURBINECTEDIN 4MG VIAL (G/K)	$18,050	$15,343	—	—	5
6827258589	MINERVA SURGICAL RF CONTRLER	$18,025	$15,321	—	—	5
6827254064	STEM REVERSE SHOULDER TM 10X130MM	$17,922	$15,234	—	—	5
6827254333	STEM REVERSE SHOULDER TM 12X170MM	$17,922	$15,234	—	—	5
6827255070	STEM REVERSE SHOULDER TM 16X17MM	$17,922	$15,234	—	—	5
6827255111	STEM REVERSE SHOULDER TM 8X170MM	$17,922	$15,234	—	—	5
630027137	REVJ TOT HIP ARTHRP ACTBLR ONLY +-AGRFT/ALGRFT	$17,856	$15,178	—	—	5
60006593233	DARATUMUMAB-HYALURON 1800 MG-30,000 UNITS/15 ML SOLN (G/K)	$17,739	$15,078	—	—	5
6827261505	IMPLANT LORDOTIC LATERAL POROUS TITANIUM CASCADIA 10X28X13MM	$17,150	$14,577	—	—	5
60006581953	IPILIMUMAB 5MG/ML 10ML VIAL (G/K)	$16,905	$14,369	—	—	5
6827253056	STEM APEX ARC SIZE 3	$16,686	$14,183	—	—	5
60006593664	TEZEPELUMAB 210MG/1.91ML SYRINGE (G/K)	$16,534	$14,053	—	—	5
6827263291	STEMLESS HUM COMP LASER CG SZ	$16,346	$13,894	—	—	5
60006538680	ALTEPLASE 100MG VIAL (G/K)	$16,213	$13,781	—	—	5
635022633	ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR	$15,965	$13,570	—	—	5
630027228	OPTX ACTBLR FX INVG ANT&PST 2 COLUMNS FX W/INT	$15,947	$13,555	—	—	5
630027132	CONV PREVIOUS HIP TOT HIP ARTHRP +-AGRFT/ALGRFT	$15,907	$13,521	—	—	5
6827254549	STEM TAPER M/L KINECTIV SIZE 9	$15,800	$13,430	—	—	5
60006563951	NATALIZUMAB 20MG/ML 15ML VIAL (G/K)	$15,732	$13,372	—	—	5
6827257892	STEM VERSYS COLLARLESS FIBER NETAL MIDCOAT 16X160MM	$15,584	$13,246	—	—	5
6827262398	SPHERE FEMUR CEMENTED LEFT S4	$15,466	$13,146	—	—	5
6827262406	SPHERE FEMUR CEMENTED LEFT S3	$15,466	$13,146	—	—	5
60006590806	VEDOLIZUMAB 300MG VIAL (G/K)	$15,447	$13,130	—	—	5
6827262403	PUTTY DBM ACTIVE BARRIER 200	$15,435	$13,119	—	—	5
6827253462	STEM FEMORAL MID LENGTH APEX K2 POROUS C SIZE 8	$15,244	$12,957	—	—	5
6827253472	STEM FEMORAL MID LENGTH APEX K2 POROUS SIZE 5	$15,244	$12,957	—	—	5
6827257746	TAPER M/L 10 STANDARD	$15,242	$12,956	—	—	5
6827257840	TAPER M/L 15 STANDARD	$15,242	$12,956	—	—	5
6827258744	TROCHLEA FEMORAL 10.0X4.0	$14,929	$12,689	—	—	5
60006591686	NIVOLUMAB 10MG/ML 24ML SOLN (G/K)	$14,832	$12,607	—	—	5
60006590897	OBINUTUZUMAB 25MG/ML 40ML SOLN (G/K)	$14,622	$12,428	—	—	5

Showing top 50 of 9,463 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.