Medication Charges Part 3

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.

• BARIATRIC VITAMIN 9513800203 60 each each 0.408 Bottle 1 each $12.16
• BARICITINIB 1 MG ORAL TAB 0002-4732-30 30 each each 83.506 each 1 each $95.66
• BARICITINIB 2 MG ORAL TAB 0002-4182-30 30 each each 73.279 each 1 each $85.43
• BARIUM ENEMA PREP KIT 1036137640 1 each each 1.27 each 1 each $14.77
• BARIUM SULFATE   2 % (W/V) ORAL SUSPENSION 32909-756-03 450 mL Bottle 0.006 mL 450 mL $0.00
• BARIUM SULFATE   2 % (W/V) ORAL SUSPENSION 32909-724-03 450 mL Bottle 0.004 mL 450 mL $0.00
• BARIUM SULFATE   2 % (W/V) ORAL SUSPENSION 32909-711-03 450 mL Bottle 0.006 mL 450 mL $0.00
• BARIUM SULFATE  40 % (W/V) ORAL SUSPENSION 32909-115-00 240 mL Bottle 0.05 mL 240 mL $0.00
• BARIUM SULFATE  60 % (W/V) ORAL SUSPENSION 32909-186-02 355 mL Bottle 0.004 mL 355 mL $0.00
• BARIUM SULFATE  96 % ENEMA 32909-804-01 397 g KIT 0.008 g 397 g $0.00
• BARIUM SULFATE  98 % ORAL RECON. SUSP. 10361-764-01 1 each Bottle 0.00987 each 1 each $0.00
• "BARIUM SULFATE 105 % (W/V), 58 % (W/W) ORAL SUSPENSION" 32909-168-02 1900 mL Bottle 0.006 mL 1900 mL $0.00
• BARIUM SULFATE 2.1 % (W/V) 2.0 % (W/W) ORAL SUSPENSION 32909-723-01 450 mL Bottle 0.008 mL 450 mL $0.00
• "BARIUM SULFATE 40 %(W/V), 29% (W/W)(1500 CPS) ORAL SUSPENSION" 32909-121-07 250 mL Bottle 0.173 mL 250 mL $0.00
• BARIUM SULFATE 700 MG ORAL TAB 10361-778-31 100 each each 0.704 each 1 each $0.00
• B-COMPLEX WITH VITAMIN C ORAL TAB 8068115400 100 each each 0.036 each 1 each $12.19
• BEBTELOVIMAB 175 MG/2 ML (87.5 MG/ML) IV SOLUTION 0002-7589-01 2 mL Vial 0 Vial 2 mL $0.00
• BEER UHCS-0002-42 1 Can Can 0 Can 1 Can $0.00
• BELATACEPT 250 MG IV VIAL 0003-0371-13 1 each each 898.91 each 1 each "$1,809.06"
• BELIMUMAB 120 MG IV VIAL 49401-101-01 1 each each 589.52 each 1 each "$1,186.41"
• BELIMUMAB 400 MG IV VIAL 49401-102-01 1 each each 1964.97 each 1 each "$3,954.50"
• BENADRYL AND MAALOX ORAL COMPOUND UHCS-0003-23 60 mL Bottle 1.79 Bottle 60 mL $62.54
• BENAZEPRIL  5 MG ORAL TAB 50268-109-15 50 each each 0.349 each 1 each $12.50
• BENAZEPRIL 10 MG ORAL TAB 51079-145-20 100 each each 0.641 each 1 each $12.79
• BENAZEPRIL 20 MG ORAL TAB 50268-111-15 50 each each 0.403 each 1 each $12.55
• BENAZEPRIL 20 MG ORAL TAB 50268-111-11 1 each each 0.403 each 1 each $12.55
• BENDAMUSTINE  25 MG IV VIAL 63459-390-08 1 each each 580.13 each 1 each "$1,167.51"
• BENDAMUSTINE 100 MG IV VIAL 63459-391-20 1 each each 2320.53 each 1 each "$4,670.07"
• BENDAMUSTINE 25 MG/ML IV SOLUTION 63459-348-04 4 mL Vial 527.908 mL 4 mL "$4,249.66"
• BENRALIZUMAB 30 MG/ML SUBQ SYRINGE 0310-1730-30 1 mL Syringe 4877.6 mL 1 mL "$9,816.17"
• BENZOCAINE 20 % MM GEL 0283-0871-31 30 g Jar 0.229 g 30 g $60.87
• BENZOCAINE 20 % MM SPRAY 0283-0610-26 1 each PF APPLI 9.356 each 1 each $21.51
• BENZOCAINE 20 % MM SPRAY 0283-0610-43 1 each PF APPLI 9.975 each 1 each $22.13
• BENZOCAINE 20 % TP OINTMENT 6373603751 28 g Tube 0.128 g 28 g $57.58
• BENZOCAINE-MENTHOL 15-3.6 MG MM LOZENGE 0904-6255-49 18 each BLIST PACK 0.084 each 1 each $15.01
• BENZOCAINE-MENTHOL 20-0.5 % TP AEROSOL 16864-680-02 56 g CANISTER 0.075 g 56 g $58.20
• BENZOCAINE-MENTHOL 20-0.5 % TP AEROSOL 16864-680-03 85 g CANISTER 0.057 g 85 g $58.85
• BENZOCAINE-MENTHOL 6-10 MG MM LOZENGE 7811201106 18 each BLIST PACK 0.127 each 1 each $50.89
• BENZOCAINE-ZINC CL-BENZALK CL 20-0.1-0.02 % MM GEL 31031-318-05 11.9 g Tube 3.96 Tube 11.9 g $17.46
• BENZOIN COMPOUND 100 % TP SWAB 54162-099-10 1 each each 0.95 each 1 each $54.95
• BENZOIN-ALOE VERA-STORAX-TOLU 10-2-8-4 % TP TINCTURE 0395-0243-92 59 mL Bottle 0.117 mL 59 mL $61.94
• BENZONATATE 100 MG ORAL CAP 63739-029-10 100 each each 0.424 each 1 each $12.57
• BENZTROPINE 1 MG ORAL TAB 60687-368-01 100 each each 0.301 each 1 each $12.45
• BENZTROPINE 1 MG ORAL TAB 60687-368-11 1 each each 0.301 each 1 each $12.45
• BENZTROPINE 1 MG/ML INJ SOLUTION 0143-9729-05 2 mL AMPUL 21.615 mL 2 mL $211.98
• BENZYLPENICILLOYL POLYLYSINE 0.25 ML IDRM SOLUTION UHCS-0004-62 0.25 mL Syringe 599.904 mL .25 mL $318.73
• BENZYLPENICILLOYL POLYLYSINE 0.25 ML IDRM SOLUTION 49471-001-05 0.25 mL AMPUL 599.904 mL .25 mL $318.73
• BERACTANT IN 0.9 %SOD.CHLORIDE 25 MG/ML INTR SUSPENSION 0074-1040-04 4 mL Vial 61.91 mL 4 mL $321.89
• BERACTANT IN 0.9 %SOD.CHLORIDE 25 MG/ML INTR SUSPENSION 0074-1040-08 8 mL Vial 54.789 mL 8 mL $512.56
• "BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJ SUSPENSION" 0517-0791-01 5 mL Vial 6.466 mL 5 mL $282.08
• "BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJ SUSPENSION" 51754-5060-1 5 mL Vial 7.02 mL 5 mL $284.85
• BETAMETHASONE VALERATE 0.1 % TP CREAM 0168-0040-15 15 g Tube 1.378 g 15 g $74.67
• BETAMETHASONE VALERATE 0.1 % TP LOTION 54879-004-60 60 mL Bottle 0.529 mL 60 mL $85.74
• BETAMETHASONE VALERATE 0.1 % TP OINTMENT 0168-0033-15 15 g Tube 0.476 g 15 g $61.14
• BETAXOLOL 0.5 % OPHT DROPS 61314-245-01 5 mL DROP BTL 7.05 mL 5 mL $96.00
• BETHANECHOL CHLORIDE 10 MG ORAL TAB 0832-0511-01 100 each each 0.266 each 1 each $12.42
• BETHANECHOL CHLORIDE 10 MG ORAL TAB 0832-0511-89 1 each each 0.266 each 1 each $12.42
• BETHANECHOL CHLORIDE 25 MG ORAL TAB 0832-0512-01 100 each each 0.368 each 1 each $12.52
• BEVACIZUMAB 25 MG/ML IV SOLUTION 50242-060-01 4 mL Vial 199.235 mL 4 mL "$1,603.84"
• BEVACIZUMAB 25 MG/ML IV SOLUTION 16ML 50242-061-01 16 mL Vial 199.235 mL 16 mL "$6,415.37"
• BEVACIZUMAB-BVZR 25 MG/ML IV SOLUTION (100 MG VIAL) 0069-0315-01 4 mL Vial 122.928 mL 4 mL $991.21
• BEVACIZUMAB-BVZR 25 MG/ML IV SOLUTION (400MG VIAL) 0069-0342-01 16 mL Vial 122.929 mL 16 mL "$3,958.31"
• BEZLOTOXUMAB 25 MG/ML IV SOLUTION 0006-3025-00 40 mL Vial 94.999 mL 40 mL "$7,647.42"
• BICALUTAMIDE 50 MG ORAL TAB 0904-6019-46 30 each each 0.266 each 1 each $12.42
• BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG ORAL TAB 61958-2501-1 30 each each 122.713 each 1 each $134.86
• BIMATOPROST 0.03 % OPHT DROPS 60505-0583-1 5 mL DROP BTL 39.776 mL 5 mL $259.63
• BISACODYL  5 MG ORAL EC TABLET 0904-6407-61 100 each each 0.025 each 1 each $12.18
• BISACODYL 10 MG RECT SUPPOSITORY 68784-102-12 12 each each 0.244 each 1 each $24.54
• BISMUTH SUBSALICYLATE 262 MG ORAL CHEW TAB 1093939644 30 each each 0.041 each 1 each $14.73
• BISMUTH SUBSALICYLATE 262 MG ORAL CHEW TAB 0904-1315-46 30 each each 0.053 each 1 each $15.09
• BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION 37000-032-02 236 mL Bottle 0.017 mL 236 mL $17.51
• BISOPROLOL FUMARATE  5 MG ORAL TAB 29300-126-01 100 each each 0.648 each 1 each $12.80
• BISOPROLOL-HYDROCHLOROTHIAZIDE 10-6.25 MG ORAL TAB 29300-189-13 30 each each 0.559 each 1 each $12.71
• BISOPROLOL-HYDROCHLOROTHIAZIDE 2.5-6.25 MG ORAL TAB 29300-187-13 30 each each 0.559 each 1 each $12.71
• BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG ORAL TAB 42799-921-01 100 each each 0.304 each 1 each $12.45
• BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG ORAL TAB 68462-879-30 30 each each 0.315 each 1 each $12.47
• BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG ORAL TAB 42799-921-30 30 each each 0.447 each 1 each $12.60
• BISOPROLOL-HYDROCHLOROTHIAZIDE 5-6.25 MG ORAL TAB 29300-188-01 100 each each 0.491 each 1 each $12.64
• BIVALIRUDIN 250 MG IV VIAL 0781-3158-95 1 each Vial 36.209 each 1 each $204.96
• BIVALIRUDIN 250 MG IV VIAL 55111-652-37 1 each Vial 47.109 each 1 each $215.86
• BIVALIRUDIN 250 MG IV VIAL 70860-402-10 1 each Vial 48.951 each 1 each $217.70
• BIVALIRUDIN 250 MG IV VIAL 67457-256-10 1 each Vial 53.989 each 1 each $222.74
• BIVALIRUDIN 250 MG IV VIAL 63323-562-10 1 each Vial 198.596 each 1 each $399.68
• BIVALIRUDIN 250MG IV VIAL (CUPID) 0781-3158-95 1 each Vial 36.209 each 1 each $0.00
• BIVALIRUDIN 250MG IV VIAL (CUPID) 55111-652-37 1 each Vial 47.109 each 1 each $0.00
• BIVALIRUDIN 250MG IV VIAL (CUPID) 63323-562-10 1 each Vial 198.596 each 1 each $0.00
• BIVALIRUDIN 250MG IV VIAL (CUPID) 67457-256-10 1 each Vial 53.989 each 1 each $0.00
• BIVALIRUDIN 250MG IV VIAL (CUPID) 70860-402-10 1 each Vial 48.951 each 1 each $0.00
• BIVALIRUDIN 250MG/50ML BOLUS UHCS-0003-31 1 each each Vial 1 each $0.00
• BIVALRUDIN 250MG/50ML BOLUS (PRE-PCI DOSING) UHCS-0003-31 1 each each Vial 1 each $0.00
• BLEOMYCIN 15 UNITS INJ VIAL 71288-106-10 1 each each 18.59 each 1 each $518.09
• BLEOMYCIN 30 UNITS INJ VIAL 0409-0323-20 1 each each 54.96 each 1 each $554.46
• BLINATUMOMAB 35 MCG IV KIT 55513-160-01 1 each each 4899.66 each 1 each "$9,860.57"
• BORTEZOMIB 3.5 MG INJ VAIL IV 0143-9098-01 1 each Vial 18.25 each 1 each $517.75
• BORTEZOMIB 3.5 MG INJ VAIL IV 10019-991-01 1 each Vial 40.64 each 1 each $540.14
• BORTEZOMIB 3.5 MG INJ VAIL IV 63020-049-01 1 each Vial 1603 each 1 each "$3,226.04"
• BORTEZOMIB 3.5 MG INJ VIAL SUBQ 0143-9098-01 1 each each 18.25 each 1 each $517.75
• BORTEZOMIB 3.5 MG INJ VIAL SUBQ 10019-991-01 1 each each 40.64 each 1 each $540.14
• BORTEZOMIB 3.5 MG INJ VIAL SUBQ 63020-049-01 1 each each 1603 each 1 each "$3,226.04"
• BRENTUXIMAB VEDOTIN 50 MG IV VIAL 51144-050-01 1 each each 10470 each 1 each "$21,070.88"
• BRIMONIDINE 0.2 % OPHT DROPS 70069-231-01 5 mL DROP BTL 0.83 mL 5 mL $64.90
• BRIMONIDINE-TIMOLOL 0.2-0.5 % OPHT DROPS 0023-9211-05 5 mL DROP BTL 37.692 mL 5 mL $249.21
• BROMFENAC 0.09 % OPHT DROPS 62332-508-17 1.7 mL DROP BTL 68.918 mL 1.7 mL $177.91
• BROMFENAC 0.09 % OPHT DROPS 50383-249-71 1.7 mL DROP BTL 96.753 mL 1.7 mL $225.23
• BROMOCRIPTINE 2.5 MG ORAL TAB 60687-286-21 30 each each 4.99 each 1 each $17.14
• BROMPHENIRAMINE-PHENYLEPHRINE 1-2.5 MG/5 ML ORAL SOLUTION 70677-0101-1 118 mL Bottle 0.016 mL 118 mL $50.49
• BROMPHENIRAMINE-PHENYLEPHRINE 1-2.5 MG/5 ML ORAL SOLUTION 0031-2235-13 118 mL Bottle 0.035 mL 118 mL $52.73
• BROMPHENIRAMINE-PHENYLEPHRINE 1-2.5 MG/5 ML ORAL SOLUTION 5002666002 118 mL Bottle 0.035 mL 118 mL $52.73
• BUDESONIDE 0.25 MG/2 ML INHL NBSP 0487-9601-01 2 mL AMPUL 3.651 mL 2 mL $18.10
• BUDESONIDE 0.5 MG/2 ML INHL NBSP 0487-9701-01 2 mL AMPUL 2.196 mL 2 mL $15.19
• BUDESONIDE 180 MCG/ACTUATION INHL AERO.POWDER 0186-0916-12 1 each CANISTER 241.96 each 1 each $316.21
• BUDESONIDE 3 MG ORAL CECX 0378-7155-01 100 each each 4.11 each 1 each $16.26
• BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION INHL HFA INHALER 0186-0370-28 6.9 g AER W/ADAP 28.058 g 6.9 g $267.85
• BUDESONIDE-FORMOTEROL 80-4.5 MCG/ACTUATION INHL HFA INHALER 0186-0372-28 6.9 g AER W/ADAP 24.4 g 6.9 g $242.61
• BUFFERED LIDOCAINE 0.5 % 2 ML SYRINGES UHCS-0001-00 2 mL Syringe 0.06 mL 2 mL $303.87
• BUFFERED LIDOCAINE 1 % 20 ML VIAL UHCS-0001-10 20 mL Vial 0.063 mL 20 mL $305.01
• BUFFERED LIDOCAINE 1 % WITH EPI 20 ML VIALS UHCS-0001-11 1 vial vial 1.17 vial 1 vial $304.92
• BUFFERED LIDOCAINE 2% 20 ML VIAL UHCS-0004-41 1 vial Vial 1.55 vial 1 vial $305.30
• BUMETANIDE (BUMEX) IV 0.1 MG/ML (NICU) UHCS-0000-97 2.5 mL Vial 0.462 mL 2.5 mL $170.14
• BUMETANIDE 0.25 MG/ML INJ SOLUTION 0641-6008-01 4 mL Vial 0.446 mL 4 mL $170.53
• BUMETANIDE 0.25 MG/ML INJ SOLUTION 0641-6008-10 4 mL Vial 0.446 mL 4 mL $170.53
• BUMETANIDE 0.25 MG/ML INJ SOLUTION 0641-6007-01 10 mL Vial 0.193 mL 10 mL $170.68
• BUMETANIDE 0.25 MG/ML INJ SOLUTION 0641-6007-10 10 mL Vial 0.193 mL 10 mL $170.68
• BUMETANIDE 0.5 MG ORAL TAB 42799-119-01 100 each each 0.314 each 1 each $12.46
• BUMETANIDE 1 MG ORAL TAB 60687-384-25 30 each each 1.142 each 1 each $13.29
• BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLUTION 0409-1159-10 30 mL Vial 0.041 mL 30 mL $169.98
• BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLUTION 0409-1162-10 30 mL Vial 0.039 mL 30 mL $169.92
• BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLUTION 63323-472-01 30 mL Vial 0.151 Vial 30 mL $168.90
• BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLUTION 55150-171-10 10 mL Vial 0.242 mL 10 mL $171.17
• BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLUTION 55150-172-30 30 mL Vial 0.143 mL 30 mL $173.04
• BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJ SOLUTION 0409-1160-18 50 mL Vial 0.046 mL 50 mL $171.05
• BUPIVACAINE HCL 0.5 % (5 MG/ML) INJ SOLUTION 0409-1163-18 50 mL Vial 0.036 mL 50 mL $609.30
• BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSPENSION 65250-266-09 20 mL Vial 18.258 mL 20 mL $734.89
• BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJ SOLUTION 0409-3613-01 2 mL AMPUL 1.002 mL 2 mL $170.75
• BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200000 INJ SOLUTION 63323-468-37 30 mL Vial 0.283 mL 30 mL $177.24
• BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200000 INJ SOLUTION 0409-1749-29 30 mL Vial 0.142 mL 30 mL $173.01
• BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200000 INJ SOLUTION 63323-462-37 30 mL Vial 0.305 mL 30 mL $177.90
• "BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLUTION" 0409-9043-11 50 mL Vial 0.094 mL 50 mL $173.45
• BUPIVACAINE-EPINEPHRINE 0.5 %-1:200000 INJ SOLUTION 0409-9046-11 50 mL Vial 0.081 mL 50 mL $172.80
• BUPRENORPHINE 20 MCG/HR TD WEEKLY PATCH 0093-3603-40 4 each each 130.458 each 1 each $160.16
• BUPRENORPHINE HCL  2 MG SL SL TABLET 60687-481-21 30 each each 1.445 each 1 each $13.60
• BUPRENORPHINE HCL  8 MG SL SL TABLET 60687-492-21 30 each each 2.339 each 1 each $14.49
• BUPRENORPHINE-NALOXONE 8-2 MG SL FILM 0378-8767-16 1 each each 3.683 each 1 each $19.88
• BUPRENORPHINE-NALOXONE 8-2 MG SL FILM 0378-8767-93 30 each each 3.685 each 1 each $19.89

See Part 4