LBJ TROPICAL MEDICAL CENTER (Pago Pago, AS) prices

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
490	ABLATION, 1 OR MORE LIVER TUMOR(S), PERCUTANEOUS, RADIOFREQUENCY	$8,189	$8,189	—	—	2
360	PRQ PLMT. BILIARY DRG CATH W/IMG	$5,344	$5,344	—	—	2
481	BIOPSY OF HEART LINING	$3,151	$3,151	—	—	2
190	COVID ROOM-BOARD/ISOLATION	$3,000	$3,000	—	—	2
200	INTENSIVE CARE	$2,900	$2,900	—	—	2
404	BRAIN IMAGING (PET)	$2,571	$2,571	—	—	2
720	CESAREAN DELIVERY ONLY	$1,900	$1,900	—	—	2
740	AMBULATORY EEG MONITORING	$1,708	$1,708	—	—	2
761	INSERT CV CATH NON-TUNNLED>5YR	$1,686	$1,686	—	—	2
310	VENOGRAPHY SUPERIOR CAVAL	$1,654	$1,654	—	—	2
160	ROOM-BOARD/ISOLATION	$1,600	$1,600	—	—	2
209	INTENSIVE CARE	$1,500	$1,500	—	—	2
987	PED CRIT CARE AGE 2-5 INIT	$1,499	$1,499	—	—	2
110	ROOM-BOARD/PRIVATE	$1,440	$1,440	—	—	2
121	INPATIENT R&B	$1,440	$1,440	—	—	2
341	ABSCESS IMAGING, LTD AREA	$1,413	$1,413	—	—	2
721	ANTEPARTUM CARE ONLY	$1,305	$1,305	—	—	2
821	HEMODIALYSIS PROCED W/ SNGL MD EVAL	$1,227	$1,227	—	—	2
829	UNSCHED OR EMERGENCY DIALYSIS TX FOR AN ESRD PATIENT	$1,227	$1,227	—	—	0
111	MED/PVT	$1,200	$1,200	—	—	2
120	ROOM-BOARD/SEMI	$1,200	$1,200	—	—	2
206	INTENSIVE CARE	$1,200	$1,200	—	—	2
130	ROOM-BOARD/3&4 BED	$1,070	$1,070	—	—	2
991	CAFETERIA CHARGES	$1,000	$1,000	—	—	2
150	SURG WARD INPATIENT	$990	$990	—	—	2
123	GY/2BED	$990	$990	—	—	2
311	CHROMOSOME ANALYSIS 50-100	$990	$990	—	—	2
510	Hydration iv infusion init (1st hr)	$987	$987	—	—	2
901	ELECTROCONVULSIVE THERAPY	$892	$892	—	—	2
612	MR ANGIO PELVIS W/O&W DYE	$807	$807	—	—	2
604	PORTABLE OXYGEN CONCENTRATOR ( SINGLE DELIVERY PORT)	$804	$804	—	—	0
174	NURSERY - NEWBORN - LVL 4	$800	$800	—	—	2
202	ICU MEDICAL	$795	$795	—	—	2
333	APPLY INTERSTIT RADIAT INTER	$792	$792	—	—	2
450	DEB MUSC/FASCIA 20 SQ CM/<	$740	$740	—	—	2
173	NURSERY - NEWBORN - LVL 3	$680	$680	—	—	2
750	ACID PERFUSION OF ESOPHAGUS	$657	$657	—	—	2
170	NURSERY/ISO	$600	$600	—	—	2
610	MRI CHEST W/O DYE	$573	$573	—	—	2
611	MAGNETIC IMAGE, JAW JOINT	$573	$573	—	—	2
270	14 FR. X 24 CM SPLIT CATH III	$565	$565	—	—	2
351	CT ANGIOGRAPHY, HEAD	$564	$564	—	—	2
342	INTERSTITIAL NUCLEAR THERAPY	$554	$554	—	—	2
314	BIOPSY OF BREAST, OPEN	$532	$532	—	—	2
172	NURSERY - NEWBORN - LVL 2	$525	$525	—	—	2
306	SMEAR WET MOUNT SALINE/INK	$511	$511	—	—	2
929	DUPLEX SCAN LOWER EXT LT ARTERY UNILATERAL	$482	$482	—	—	2
359	CT SOFT TISSUE NECK W/DYE	$482	$482	—	—	2
482	CARDIAC DRUG STRESS TEST	$476	$476	—	—	2
124	PSYCH WARD R & B ALL INCL.	$475	$475	—	—	2

Showing top 50 of 165 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.