Medication Charges Part 2

Our Commitment to Quality

Helping ensure our patients receive the highest level of care, delivered with dignity and compassion, is our goal with every patient and family member, every time. Our Board challenges us to remain in the Top 10 percent of hospitals in the country in quality scores, and they meet monthly with physicians and clinical staff to analyze the data and develop a plan to better serve our patients. It is this goal-driven mindset that has earned us recognition in key areas for our quality strides. Learn more about our quality awards and recognition.

NOTE: When reviewing the pricing for Lab or Pathology tests, if the section below a test is blank, the test is repeated again and these are additional charges (for example - Glucose four-hour tolerance test will have the test repeated one hour, two hours and then three hours after the initial blood work is collected for a total of four hours. Each test is charged separately). If your lab work is a panel, then several tests may be performed from one blood sample. You may be charged for each test separately.

  • AMLODIPINE 10 MG ORAL TAB 0904-6371-61 100 each each 0.052 each 1 each $12.20
  • AMLODIPINE 10 MG ORAL TAB 50268-085-11 1 each each 0.075 each 1 each $12.23
  • AMLODIPINE 10 MG ORAL TAB 68645-580-54 30 each each 0.075 each 1 each $12.23
  • AMLODIPINE-BENAZEPRIL 2.5-10 MG ORAL CAP 55111-338-01 100 each each 0.135 each 1 each $12.29
  • AMLODIPINE-BENAZEPRIL 5-10 MG ORAL CAP 55111-339-01 100 each each 0.138 each 1 each $12.29
  • AMLODIPINE-BENAZEPRIL 5-20 MG ORAL CAP 55111-340-01 100 each each 0.146 each 1 each $12.30
  • AMMONIA AROMATIC 15 % (W/V) INHL SOLUTION 39822-9900-1 1 each AMPUL 0.396 each 1 each $0.00
  • AMMONIUM LACTATE 12 % TP LOTION 904598426 225 g Bottle 0.012 g 225 g $56.70
  • AMNIOCENTESIS TRAY REF 4379-20 UHCS-0005-37 1 each each 17.861 each 1 each $339.16
  • AMOXICILLIN 125 MG/5 ML ORAL RECON. SUSP. 0781-6039-55 150 mL Bottle 0.018 mL 150 mL $51.30
  • AMOXICILLIN 250 MG ORAL CAP 65862-016-01 100 each each 0.047 each 1 each $12.20
  • AMOXICILLIN 250 MG/5 ML ORAL RECON. SUSP. 0093-4155-80 150 mL Bottle 0.032 mL 150 mL $53.40
  • AMOXICILLIN 400 MG/5 ML ORAL RECON. SUSP. 0143-9887-01 100 mL Bottle 0.06 mL 100 mL $54.60
  • AMOXICILLIN 400 MG/5 ML ORAL RECON. SUSP. 0781-6157-46 100 mL Bottle 0.06 mL 100 mL $54.60
  • AMOXICILLIN 500 MG ORAL CAP 16714-299-03 100 each each 0.065 each 1 each $12.22
  • AMOXICILLIN 875 MG ORAL TAB 65862-015-01 100 each each 0.323 each 1 each $12.47
  • AMOXICILLIN-POT CLAVULANATE 125-31.25 MG/5 ML ORAL RECON. SUSP. 72508-012-01 75 mL Bottle 5.145 mL 75 mL $434.48
  • AMOXICILLIN-POT CLAVULANATE 200-28.5 MG/5 ML ORAL RECON. SUSP. 16714-292-01 50 mL Bottle 0.077 mL 50 mL $52.45
  • AMOXICILLIN-POT CLAVULANATE 250-125 MG ORAL TAB 16714-476-01 30 each each 2.809 each 1 each $14.96
  • AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5 ML ORAL RECON. SUSP. 60432-065-75 75 mL Bottle 0.253 mL 75 mL $67.58
  • AMOXICILLIN-POT CLAVULANATE 400-57 MG/5 ML ORAL RECON. SUSP. 16714-293-01 50 mL Bottle 0.072 mL 50 mL $52.20
  • AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB 65862-502-20 20 each each 0.407 each 1 each $12.56
  • AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB 16714-477-01 20 each each 0.415 each 1 each $12.57
  • AMOXICILLIN-POT CLAVULANATE 500-125 MG ORAL TAB 16714-494-01 20 each each 0.597 each 1 each $12.75
  • AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL RECON. SUSP. 16714-294-01 75 mL Bottle 0.07 mL 75 mL $53.85
  • AMOXICILLIN-POT CLAVULANATE 600-42.9 MG/5 ML ORAL RECON. SUSP. 0781-6139-57 75 mL Bottle 0.277 mL 75 mL $69.38
  • AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB 16714-478-02 100 each each 0.32 each 1 each $12.47
  • AMOXICILLIN-POT CLAVULANATE 875-125 MG ORAL TAB 65862-503-01 100 each each 0.347 each 1 each $12.50
  • AMPHOTERICIN 50 MCG/ML EYE INJECTION UHCS-0004-76 1 mL Syringe 33.51 mL 1 mL $202.26
  • AMPHOTERICIN B 50 MG INJ VIAL 39822-1055-5 1 each each 35.05 each 1 each $203.80
  • AMPHOTERICIN B LIPOSOME (AMBISOME) 50 MCG/ML EYE INJECTION UHCS-0005-52 1 mL Syringe 0.11 mL 1 mL $24.41
  • AMPHOTERICIN B LIPOSOME 1 MG/ML IN D15W (NICU) SYRINGE UHCS-0003-56 20 mL Vial 2.716 mL 20 mL $223.07
  • AMPHOTERICIN B LIPOSOME 1 MG/ML IN D5W (NICU) SYRINGE UHCS-0003-57 20 mL Vial 2.716 mL 20 mL $223.07
  • AMPHOTERICIN B LIPOSOME 1MG/ML IN D10W (NICU) SYRINGE UHCS-0003-55 20 mL Vial 2.716 mL 20 mL $223.07
  • AMPHOTERICIN B LIPOSOME 2 MG/ML IN D10W (NICU) SYRINGE UHCS-0003-58 10 mL Vial 5.431 mL 10 mL $223.06
  • AMPHOTERICIN B LIPOSOME 2 MG/ML IN D15W (NICU) SYRINGE UHCS-0003-59 10 mL Vial 5.431 mL 10 mL $223.06
  • AMPHOTERICIN B LIPOSOME 2 MG/ML IN D5W (NICU) SYRINGE UHCS-0003-60 10 mL Vial 5.431 mL 10 mL $223.06
  • AMPHOTERICIN B LIPOSOME 50 MG IV RECON. SUSP. 0469-3051-30 1 each each 110 each 1 each $278.75
  • AMPICILLIN 500 MG ORAL CAP 0781-2145-01 100 each each 0.314 each 1 each $12.46
  • AMPICILLIN SODIUM  1 G INJ VIAL 0781-9404-95 1 each each 1.409 each 1 each $170.16
  • AMPICILLIN SODIUM  2 G INJ VIAL 0781-9408-95 1 each each 2.386 each 1 each $171.14
  • AMPICILLIN SODIUM 125 MG INJ VIAL 0781-3400-95 1 each each 3.085 each 1 each $171.84
  • AMPICILLIN SODIUM 250 MG INJ VIAL 0781-9402-95 1 each each 0.582 each 1 each $169.33
  • AMPICILLIN SODIUM 500 MG INJ VIAL 0781-9407-95 1 each each 0.716 each 1 each $169.47
  • AMPICILLIN-SULBACTAM  1.5 G INJ VIAL 55150-116-20 1 each each 1.075 each 1 each $169.83
  • AMPICILLIN-SULBACTAM  1.5 G INJ VIAL 0049-0013-83 1 each each 6.995 each 1 each $175.75
  • AMPICILLIN-SULBACTAM  3 G INJ VIAL 55150-117-20 1 each each 2.509 each 1 each $171.26
  • AMPICILLIN-SULBACTAM (UNASYN) PEDIATRIC SYRINGE UHCS-0002-89 1 each each 5.612 each 1 each $174.36
  • ANAKINRA 100 MG/0.67 ML SUBQ SYRINGE 66658-234-07 0.67 mL Syringe 274.657 mL .67 mL $370.34
  • ANASTROZOLE 1 MG ORAL TAB 60687-112-21 30 each each 0.656 each 1 each $12.81
  • ANASTROZOLE 1 MG ORAL TAB 60687-112-11 1 each each 0.656 each 1 each $12.81
  • "ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT IV VIAL" 63833-617-02 1 each each 1.03 each 1 each $169.78
  • ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT IV VIAL 13533-602-50 500 units Vial 3.42 units 500 units "$3,441.38"
  • APIXABAN 2.5 MG ORAL TAB 0003-0893-31 100 each each 6.475 each 1 each $18.63
  • APIXABAN 5 MG ORAL TAB 0003-0894-31 100 each each 6.475 each 1 each $18.63
  • APRACLONIDINE 1 % OPHT DROPPERETTE 0065-0660-10 1 each each 25.589 each 1 each $49.89
  • APREPITANT  80 MG ORAL CAP 68462-584-58 2 each each 65.38 each 1 each $77.53
  • ARFORMOTEROL 15 MCG/2 ML INHL NEBULIZER 70748-175-30 2 mL Vial 1.605 mL 2 mL $14.01
  • ARFORMOTEROL 15 MCG/2 ML INHL NEBULIZER 63402-911-30 2 mL Vial 2.069 mL 2 mL $14.94
  • ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLUTION 55150-241-01 50 mL Vial 1.434 mL 50 mL $240.45
  • ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLUTION 55150-241-10 50 mL Vial 1.434 mL 50 mL $240.45
  • ARGATROBAN IN 0.9 % SOD CHLOR 1 MG/ML IV SOLUTION 0143-9377-01 50 mL Vial 1.803 mL 50 mL $258.90
  • ARGATROBAN IN NACL (ISO-OS) 50 MG/50 ML (1 MG/ML) IV SOLUTION 0781-9314-95 50 mL Vial 4.066 mL 50 mL $409.14
  • ARIPIPRAZOLE   2 MG ORAL TAB 16714-141-01 30 each each 0.207 each 1 each $12.36
  • ARIPIPRAZOLE   2 MG ORAL TAB 0904-6509-04 30 each each 22.323 each 1 each $34.47
  • ARIPIPRAZOLE   5 MG ORAL TAB 16714-784-01 30 each each 1.107 each 1 each $13.26
  • ARIPIPRAZOLE   5 MG ORAL TAB 50268-088-15 50 each each 3.298 each 1 each $15.45
  • ARIPIPRAZOLE  10 MG ORAL TAB 72865-182-30 30 each each 0.111 each 1 each $12.26
  • ARIPIPRAZOLE  10 MG ORAL TAB 43598-556-30 30 each each 1.374 each 1 each $13.52
  • ARIPIPRAZOLE  10 MG ORAL TAB 50268-089-15 50 each each 4.183 each 1 each $16.33
  • ARIPIPRAZOLE  15 MG ORAL TAB 16714-786-01 30 each each 1.065 each 1 each $13.22
  • ARIPIPRAZOLE  15 MG ORAL TAB 50268-090-12 20 each each 3.831 each 1 each $15.98
  • ARTERIAL LINE KIT REF AK-04510-S UHCS-0005-35 1 each each 11 each 1 each $332.30
  • ARTIFICIAL SALIVA (CMCE-LYTES) MM SPRP 5529960104 120 mL SQUEEZ BTL 0.068 mL 120 mL $56.76
  • ASCORBIC ACID (VITAMIN C)  500 MG ORAL TAB 904052361 100 each each 0.023 each 1 each $12.17
  • ASCORBIC ACID (VITAMIN C) 500 MG/ML INJ SOLUTION 67457-118-50 50 mL Vial 1.673 mL 50 mL $252.40
  • ASPIRIN   81 MG ORAL CHEW TAB 66553-002-01 500 each each 0.075 each 1 each $2.11
  • ASPIRIN   81 MG ORAL EC TABLET 49483-481-12 120 each each 0.012 each 1 each $2.04
  • ASPIRIN  300 MG RECT SUPPOSITORY 0574-7034-12 12 each each 0.843 each 1 each $25.14
  • ASPIRIN  325 MG ORAL EC TABLET 57896-921-10 1000 each each 0.01 each 1 each $2.04
  • ASPIRIN  325 MG ORAL EC TABLET 63739-523-01 750 each each 0.018 each 1 each $2.05
  • ASPIRIN  325 MG ORAL TAB 66553-001-01 500 each each 0.072 each 1 each $2.10
  • ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG ORAL TAB 0067-2000-24 24 each each 0.156 each 1 each $12.31
  • ASPIRIN-DIPYRIDAMOLE 25-200 MG ORAL CM12 62559-850-60 60 each each 0.743 each 1 each $12.89
  • ATAZANAVIR 300 MG ORAL CAP 0003-3622-12 30 each each 46.865 each 1 each $59.02
  • ATENOLOL  25 MG ORAL TAB 51079-759-20 100 each each 0.161 each 1 each $12.31
  • ATENOLOL  50 MG ORAL TAB 51079-684-20 100 each each 0.084 each 1 each $12.23
  • "ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLUTION" 50242-917-01 20 mL Vial 504.743 mL 20 mL "$20,315.91"
  • ATORVASTATIN 10 MG ORAL TAB 0904-6290-61 100 each each 0.106 each 1 each $12.26
  • ATORVASTATIN 20 MG ORAL TAB 0904-6291-61 100 each each 0.135 each 1 each $12.29
  • ATORVASTATIN 40 MG ORAL TAB 0904-6292-61 100 each each 0.148 each 1 each $12.30
  • ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION 0121-0898-42 5 mL Cup 2.138 mL 5 mL $22.84
  • ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION 0904-7064-53 5 mL Cup 2.337 mL 5 mL $23.84
  • ATROPINE 0.1 MG/ML INJ SYRINGE 76329-3339-1 10 mL Syringe 0.8 mL 10 mL $176.75
  • ATROPINE 0.4 MG/ML INJ SOLUTION 0517-0401-25 1 mL Vial 4.525 mL 1 mL $173.28
  • ATROPINE 1 % OPHT DROPS 17478-215-02 2 mL DROP BTL 13.855 mL 2 mL $88.46
  • ATROPINE 1 % OPHT DROPS 60505-6226-0 2 mL DROP BTL 16.795 mL 2 mL $94.34
  • ATROPINE 1 MG/ML INJ SOLUTION 0517-1010-25 1 mL Vial 6.928 mL 1 mL $175.68
  • AUTOMATED PD PHYSICIAN ORDER UHCS-0004-94 1 each each 1 each $0.00
  • AUTO-MIX BAG 1000 ML UHCS-0001-20 1 each each 6.967 each 1 each $47.47
  • AUTO-MIX BAG 2000 ML UHCS-0001-21 1 each each 7.694 each 1 each $48.19
  • AUTO-MIX BAG 250 ML 17191-007-37 50 each each 6.155 each 1 each $6.97
  • AUTO-MIX BAG 250 ML UHCS-0001-18 1 each each 6.155 each 1 each $46.66
  • AUTO-MIX BAG 3000 ML UHCS-0001-22 1 each each 7.286 each 1 each $47.79
  • AUTO-MIX BAG 4000 ML UHCS-0003-33 1 each each 9.264 each 1 each $49.76
  • AUTO-MIX BAG 500 ML UHCS-0001-19 1 each each 6.528 each 1 each $47.03
  • AUTO-MIX BAG 5000 ML UHCS-0001-23 1 each each 10.15 each 1 each $50.65
  • AVELUMAB 20 MG/ML IV SOLUTION 44087-3535-1 10 mL Vial 178.912 mL 10 mL "$3,600.60"
  • AZACITIDINE 100 MG INJ VIAL 71288-115-30 1 each each 32.04 each 1 each $531.54
  • AZACITIDINE 100 MG INJ VIAL SUBCUTANEOUS 0781-3253-94 1 each each 44.36 each 1 each $543.86
  • AZATHIOPRINE  50 MG ORAL TAB 68084-229-01 100 each each 0.329 each 1 each $12.48
  • AZATHIOPRINE (IMURAN) 50 MG/ML PO SUSPENSION UHCS-0004-69 30 mL Bottle 0.44 mL 30 mL $40.20
  • AZELASTINE 137 MCG (0.1 %) NASL AERO. SPRAY 60505-0833-5 30 mL SQUEEZ BTL 0.469 mL 30 mL $88.32
  • AZELASTINE-FLUTICASONE 137-50 MCG/SPRAY NASL SPRAY 0037-0245-23 23 g SQUEEZ BTL 8.418 g 23 g $267.86
  • AZITHROMYCIN (ZITHROMYCIN) IV 2 MG/ML (PEDS) UHCS-0003-15 1 each each 6.854 each 1 each $175.60
  • AZITHROMYCIN 200 MG/5 ML ORAL RECON. SUSP. 59762-3130-1 22.5 mL Bottle 0.306 mL 22.5 mL $55.49
  • AZITHROMYCIN 250 MG ORAL TAB 0904-6708-06 50 each each 0.538 each 1 each $12.69
  • AZITHROMYCIN 500 MG IV VIAL 55150-174-10 1 each each 1.792 each 1 each $170.54
  • AZITHROMYCIN 500 MG IV VIAL 70860-125-66 1 each each 2.697 each 1 each $171.45
  • AZITHROMYCIN 500 MG IV VIAL 67457-860-00 1 each each 5.542 each 1 each $174.29
  • AZITHROMYCIN 600 MG ORAL TAB 50111-789-10 30 each each 1.751 each 1 each $13.90
  • AZTREONAM (AZACTAM) IV 100 MG/ML (NICU) UHCS-0000-88 1 each each 26.782 each 1 each $195.53
  • AZTREONAM 1 G INJ VIAL 63323-401-21 1 each each 24.977 each 1 each $193.73
  • AZTREONAM 1 G INJ VIAL 63323-401-26 1 each each 24.977 each 1 each $193.73
  • AZTREONAM 1 G INJ VIAL FOR PUSH 63323-401-26 1 each each 24.977 each 1 each $193.73
  • AZTREONAM 2 G INJ VIAL 63323-402-30 1 each each 49.954 each 1 each $218.70
  • AZTREONAM 2 G INJ VIAL FOR PUSH 63323-402-30 1 each each 49.954 each 1 each $218.70
  • B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG ORAL TAB 536730001 100 each each 0.05 each 1 each $12.20
  • B COMPLEX-VITAMIN C-FOLIC ACID 5 MG ORAL TAB 5199108290 90 each each 0.264 each 1 each $12.41
  • "B1,B2,B3,B6,B12-DEXPAN-ZN-MANG 0.5-0.6-7-0.7 MG ORAL ELIXIR" UHCS-0001-46 120 mL Bottle 0.043 mL 120 mL $53.76
  • "B1,B2,B3,B6,B12-DEXPAN-ZN-MANG 0.5-0.6-7-0.7 MG ORAL ELIXIR" 259035116 473 mL Bottle 0.043 mL 473 mL $68.94
  • BACITRACIN 500 UNIT/GRAM TP OINTMENT 0713-0280-31 28.4 g Tube 0.056 g 28.4 g $55.59
  • BACITRACIN 500 UNIT/GRAM TP PACKET 45802-060-70 144 each each 0.123 each 1 each $24.42
  • BACITRACIN 500 UNIT/GRAM TP PACKET 45802-060-00 1 each each 0.123 each 1 each $24.42
  • "BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINTMENT" 81079887 28.3 g Tube 0.31 g 28.3 g $62.77
  • "BACITRACIN ZINC-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINTMENT" 0168-0021-31 28.35 g Tube 0.31 g 28.35 g $62.79
  • "BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM OPHT OINTMENT" 24208-555-55 3.5 g Tube 1.531 g 3.5 g $66.11
  • "BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM TP OINTMENT" 49348-274-72 28.4 g TUBE/KIT 0.08 g 28.4 g $56.27
  • "BACITRACIN-POLYMYXIN B 500-10,000 UNIT/GRAM TP PACKET" 0168-0021-09 144 each each 0.176 each 1 each $0.55
  • BACLOFEN (LIORESAL) PO 5 MG/ML (NICU) UHCS-0000-87 60 mL Vial 2.2 Vial 60 mL $23.80
  • BACLOFEN 10 MG ORAL TAB 50268-106-15 50 each each 0.319 each 1 each $12.47
  • BALANCED SALT SOLN NO.2 IRRIG. IO SOLUTION 0065-0795-15 15 mL Bottle 0.339 mL 15 mL $29.39
  • BALANCED SALT SOLN NO.2 IRRIG. IO SOLUTION 0065-0795-50 500 mL Bottle 0.019 mL 500 mL $33.80
  • BALSALAZIDE 750 MG ORAL CAP 0054-0079-28 280 each each 0.422 each 1 each $12.57
  • BAMLANIVIMAB 700 MG/20 ML (35 MG/ML) IV SOLUTION 0002-7910-01 20 mL Vial 0 mL 20 mL $0.00

See Part 3