673049 prices — Hospital Ledger

45 CFR § 180 compliance

F · 55

This hospital published little of what § 180 requires.

●Machine-readable file published: assessment threshold met

○Gross / standard charges: below assessment threshold

○Discounted cash price: below assessment threshold

●Payer-specific negotiated rates: assessment threshold met

○Min / max negotiated charges: below assessment threshold

●Free, public, no login required: assessment threshold met

Procedures listed

2,414

Insurances with rates

CPT / HCPCS codes

1,526

Source MRF

json ↗

File last updated: 2026-08-10 (per the hospital's file)

Retrieved: 2026-10-28

Most expensive procedures (gross)

B0401

—

Traumatic spinal cord injury M >=56.50- Tier Tier 1

Gross

—

C0401

—

Traumatic spinal cord injury M >=56.50- Tier Tier 2

Gross

—

C0103

—

Stroke M >=50.50 and M <63.50- Tier Tier 2

Gross

—

D0103

—

Stroke M >=50.50 and M <63.50- Tier Tier 3

Gross

—

A0104

—

Stroke M >=41.50 and M <50.50- Tier None

Gross

—

B0104

—

Stroke M >=41.50 and M <50.50- Tier Tier 1

Gross

—

C0104

—

Stroke M >=41.50 and M <50.50- Tier Tier 2

Gross

—

D0104

—

Stroke M >=41.50 and M <50.50- Tier Tier 3

Gross

—

A0105

—

Stroke M <41.50 and A >=84.50- Tier None

Gross

—

B0105

—

Stroke M <41.50 and A >=84.50- Tier Tier 1

Gross

—

0190

—

Subacute Care - General Classification

Gross

—

C0105

—

Stroke M <41.50 and A >=84.50- Tier Tier 2

Gross

—

D0105

—

Stroke M <41.50 and A >=84.50- Tier Tier 3

Gross

—

A0106

—

Stroke M <41.50 and A <84.50- Tier None

Gross

—

B0106

—

Stroke M <41.50 and A <84.50- Tier Tier 1

Gross

—

C0106

—

Stroke M <41.50 and A <84.50- Tier Tier 2

Gross

—

D0106

—

Stroke M <41.50 and A <84.50- Tier Tier 3

Gross

—

A0201

—

Traumatic brain injury M >=73.50- Tier None

Gross

—

B0201

—

Traumatic brain injury M >=73.50- Tier Tier 1

Gross

—

C0201

—

Traumatic brain injury M >=73.50- Tier Tier 2

Gross

—

D0201

—

Traumatic brain injury M >=73.50- Tier Tier 3

Gross

—

A0202

—

Traumatic brain injury M >=61.50 and M <73.50- Tier None

Gross

—

B0202

—

Traumatic brain injury M >=61.50 and M <73.50- Tier Tier 1

Gross

—

C0202

—

Traumatic brain injury M >=61.50 and M <73.50- Tier Tier 2

Gross

—

D0202

—

Traumatic brain injury M >=61.50 and M <73.50- Tier Tier 3

Gross

—

A0203

—

Traumatic brain injury M >=49.50 and M <61.50- Tier None

Gross

—

B0203

—

Traumatic brain injury M >=49.50 and M <61.50- Tier Tier 1

Gross

—

C0203

—

Traumatic brain injury M >=49.50 and M <61.50- Tier Tier 2

Gross

—

D0203

—

Traumatic brain injury M >=49.50 and M <61.50- Tier Tier 3

Gross

—

A0204

—

Traumatic brain injury M >=35.50 and M <49.50- Tier None

Gross

—

B0204

—

Traumatic brain injury M >=35.50 and M <49.50- Tier Tier 1

Gross

—

C0204

—

Traumatic brain injury M >=35.50 and M <49.50- Tier Tier 2

Gross

—

D0204

—

Traumatic brain injury M >=35.50 and M <49.50- Tier Tier 3

Gross

—

A0205

—

Traumatic brain injury M <35.50- Tier None

Gross

—

B0205

—

Traumatic brain injury M <35.50- Tier Tier 1

Gross

—

C0205

—

Traumatic brain injury M <35.50- Tier Tier 2

Gross

—

D0205

—

Traumatic brain injury M <35.50- Tier Tier 3

Gross

—

A0301

—

Non-traumatic brain injury M >=65.50- Tier None

Gross

—

B0301

—

Non-traumatic brain injury M >=65.50- Tier Tier 1

Gross

—

C0301

—

Non-traumatic brain injury M >=65.50- Tier Tier 2

Gross

—

D0301

—

Non-traumatic brain injury M >=65.50- Tier Tier 3

Gross

—

A0302

—

Non-traumatic brain injury M >=52.50 and M <65.50- Tier None

Gross

—

B0302

—

Non-traumatic brain injury M >=52.50 and M <65.50- Tier Tier 1

Gross

—

C0302

—

Non-traumatic brain injury M >=52.50 and M <65.50- Tier Tier 2

Gross

—

D0302

—

Non-traumatic brain injury M >=52.50 and M <65.50- Tier Tier 3

Gross

—

A0303

—

Non-traumatic brain injury M >=42.50 and M <52.50- Tier None

Gross

—

D0401

—

Traumatic spinal cord injury M >=56.50- Tier Tier 3

Gross

—

0024

—

Health Insurance Prospective Payment System (HIPPS) - Inpatient Rehabilitation Facility

Gross

—

A0101

—

Stroke M >=72.50- Tier None

Gross

—

B0101

—

Stroke M >=72.50- Tier Tier 1

Gross

—

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
B0401	Traumatic spinal cord injury M >=56.50- Tier Tier 1	—	—	—	—	33
C0401	Traumatic spinal cord injury M >=56.50- Tier Tier 2	—	—	—	—	33
C0103	Stroke M >=50.50 and M <63.50- Tier Tier 2	—	—	—	—	33
D0103	Stroke M >=50.50 and M <63.50- Tier Tier 3	—	—	$15,304	$20,942	33
A0104	Stroke M >=41.50 and M <50.50- Tier None	—	—	$25,470	$25,990	34
B0104	Stroke M >=41.50 and M <50.50- Tier Tier 1	—	—	$34,411	$34,411	33
C0104	Stroke M >=41.50 and M <50.50- Tier Tier 2	—	—	—	—	33
D0104	Stroke M >=41.50 and M <50.50- Tier Tier 3	—	—	$21,271	$30,813	33
A0105	Stroke M <41.50 and A >=84.50- Tier None	—	—	$5,687	$36,423	34
B0105	Stroke M <41.50 and A >=84.50- Tier Tier 1	—	—	—	—	33
0190	Subacute Care - General Classification	—	—	$300	$300	2
C0105	Stroke M <41.50 and A >=84.50- Tier Tier 2	—	—	—	—	33
D0105	Stroke M <41.50 and A >=84.50- Tier Tier 3	—	—	$34,101	$34,101	33
A0106	Stroke M <41.50 and A <84.50- Tier None	—	—	$2,087	$36,964	34
B0106	Stroke M <41.50 and A <84.50- Tier Tier 1	—	—	$47,963	$48,941	33
C0106	Stroke M <41.50 and A <84.50- Tier Tier 2	—	—	$42,445	$42,445	33
D0106	Stroke M <41.50 and A <84.50- Tier Tier 3	—	—	$38,012	$38,787	33
A0201	Traumatic brain injury M >=73.50- Tier None	—	—	—	—	34
B0201	Traumatic brain injury M >=73.50- Tier Tier 1	—	—	—	—	33
C0201	Traumatic brain injury M >=73.50- Tier Tier 2	—	—	—	—	33
D0201	Traumatic brain injury M >=73.50- Tier Tier 3	—	—	—	—	33
A0202	Traumatic brain injury M >=61.50 and M <73.50- Tier None	—	—	—	—	34
B0202	Traumatic brain injury M >=61.50 and M <73.50- Tier Tier 1	—	—	—	—	33
C0202	Traumatic brain injury M >=61.50 and M <73.50- Tier Tier 2	—	—	—	—	33
D0202	Traumatic brain injury M >=61.50 and M <73.50- Tier Tier 3	—	—	—	—	33
A0203	Traumatic brain injury M >=49.50 and M <61.50- Tier None	—	—	$2,273	$21,876	34
B0203	Traumatic brain injury M >=49.50 and M <61.50- Tier Tier 1	—	—	—	—	33
C0203	Traumatic brain injury M >=49.50 and M <61.50- Tier Tier 2	—	—	$25,487	$26,007	33
D0203	Traumatic brain injury M >=49.50 and M <61.50- Tier Tier 3	—	—	$20,921	$20,921	33
A0204	Traumatic brain injury M >=35.50 and M <49.50- Tier None	—	—	$24,430	$24,430	34
B0204	Traumatic brain injury M >=35.50 and M <49.50- Tier Tier 1	—	—	$30,921	$30,921	33
C0204	Traumatic brain injury M >=35.50 and M <49.50- Tier Tier 2	—	—	$28,569	$28,569	33
D0204	Traumatic brain injury M >=35.50 and M <49.50- Tier Tier 3	—	—	$25,429	$28,451	33
A0205	Traumatic brain injury M <35.50- Tier None	—	—	$31,292	$31,292	33
B0205	Traumatic brain injury M <35.50- Tier Tier 1	—	—	—	—	33
C0205	Traumatic brain injury M <35.50- Tier Tier 2	—	—	$36,593	$36,593	33
D0205	Traumatic brain injury M <35.50- Tier Tier 3	—	—	—	—	33
A0301	Non-traumatic brain injury M >=65.50- Tier None	—	—	—	—	33
B0301	Non-traumatic brain injury M >=65.50- Tier Tier 1	—	—	—	—	33
C0301	Non-traumatic brain injury M >=65.50- Tier Tier 2	—	—	—	—	33
D0301	Non-traumatic brain injury M >=65.50- Tier Tier 3	—	—	—	—	33
A0302	Non-traumatic brain injury M >=52.50 and M <65.50- Tier None	—	—	$18,077	$18,077	33
B0302	Non-traumatic brain injury M >=52.50 and M <65.50- Tier Tier 1	—	—	—	—	33
C0302	Non-traumatic brain injury M >=52.50 and M <65.50- Tier Tier 2	—	—	—	—	33
D0302	Non-traumatic brain injury M >=52.50 and M <65.50- Tier Tier 3	—	—	$19,180	$19,180	33
A0303	Non-traumatic brain injury M >=42.50 and M <52.50- Tier None	—	—	$21,751	$21,751	33
D0401	Traumatic spinal cord injury M >=56.50- Tier Tier 3	—	—	—	—	33
0024	Health Insurance Prospective Payment System (HIPPS) - Inpatient Rehabilitation Facility	—	—	—	—	34
A0101	Stroke M >=72.50- Tier None	—	—	—	—	34
B0101	Stroke M >=72.50- Tier Tier 1	—	—	—	—	33

Showing top 50 of 2,414 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.