Medication Charges Part 4

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.

BUPRENORPHINE-NALOXONE 8-2 MG SL FILM 47781-357-11 1 each each 3.748 each 1 each $19.95
BUPRENORPHINE-NALOXONE 8-2 MG SL FILM 47781-357-03 30 each each 3.748 each 1 each $19.95
BUPROPION HCL 75 MG ORAL TAB 51079-943-20 100 each each 1.135 each 1 each $13.29
BUPROPION HCL 100 MG ORAL SR12 68084-697-01 100 each each 0.501 each 1 each $12.65
BUPROPION HCL 100 MG ORAL TAB 60687-351-01 100 each each 1.06 each 1 each $13.21
BUPROPION HCL 150 MG ORAL SR12 0904-7214-61 100 each each 0.364 each 1 each $12.51
BUPROPION HCL 150 MG ORAL SR12 0904-6585-61 100 each each 0.487 each 1 each $12.64
BUSPIRONE 5 MG ORAL TAB 51079-985-20 100 each each 0.073 each 1 each $12.22
BUSPIRONE 10 MG ORAL TAB 51079-986-20 100 each each 0.1 each 1 each $12.25
BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB 68084-396-65 50 each each 1.501 each 1 each $17.70
BUTALBITAL-ACETAMINOPHEN-CAFF 50-325-40 MG ORAL TAB 68084-396-11 1 each each 1.501 each 1 each $17.70
BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TP AERO. SPRAY 10223-0201-4 5 g Bottle 10.706 g 5 g $107.53
BUTORPHANOL 1 MG/ML INJ SOLUTION 0409-1623-01 1 mL Vial 4.886 mL 1 mL $173.64
BUTORPHANOL 2 MG/ML INJ SOLUTION 0409-1626-01 1 mL Vial 5.967 mL 1 mL $174.72
BUTORPHANOL 2 MG/ML INJ SOLUTION 0409-1626-21 1 mL Vial 5.967 mL 1 mL $174.72
BUTORPHANOL 10 MG/ML NASL SPRAY 0054-3090-36 2.5 mL SQUEEZ BTL 20.84 mL 2.5 mL $119.60
BUTORPHANOL TARTRATE 2 MG/ML INJ SOLUTION (ANESTHESIA) UHCS-ANES-12 1 vial vial Vial 1 vial $0.00
BUTORPHANOL TARTRATE 1 MG/ML INJ SOLUTION (ANESTHESIA) UHCS-ANES-11 1 Syringe Syringe Syringe 1 Syringe $0.00
CABAZITAXEL 10 MG/ML (FIRST DILUTION) IV SOLUTION 0024-5824-11 1.5 mL Vial 8536.753 mL 1.5 mL "$25,770.32"
CADD ADMINISTRATION SET UHCS-0003-19 1 each each 6.42 each 1 each $99.57
CADD EXTENSION SET UHCS-0001-29 1 each each 1.48 each 1 each $94.63
CADD RESERVOIR 100 ML UHCS-0001-28 1 each each 7.76 each 1 each $48.26
CADD RESERVOIR 50 ML UHCS-0001-27 1 each each 4.55 each 1 each $45.05
CAFFEINE 200 MG ORAL TAB 70677-0021-1 16 each each 0.064 each 1 each $12.21
CAFFEINE CITRATE (BULK) MISC POWDER 51552-178-05 100 g Jar 0.128 g 100 g $61.40
CAFFEINE CITRATE (CAFCIT) IV 20 MG/ML (NICU) UHCS-0000-85 3 mL Vial 1.62 mL 3 mL $173.61
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLUTION 25021-601-03 3 mL Vial 1.54 mL 3 mL $173.37
CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) IV SOLUTION 51754-0502-1 3 mL Vial 7.387 mL 3 mL $190.91
CAFFEINE CITRATE PO 20 MG/ML (NICU) UHCS-0000-83 16 mL Bottle 69.44 Bottle 16 mL $91.04
CAFFEINE-SODIUM BENZOATE 250 MG/ML (125 MG/ML CAFFEINE) INJ SOLUTION 0517-2502-10 2 mL Vial 11.468 mL 2 mL $191.69
CALAMINE-ZINC OXIDE 8-8 % TP LOTION 0904-2533-21 177 mL Bottle 0.006 mL 177 mL $55.06
CALCITONIN (SALMON) 200 UNIT/ACTUATION NASL SPRAY 60505-0823-6 3.7 mL SQUEEZ BTL 9.168 mL 3.7 mL $108.17
CALCITONIN (SALMON) 200 UNITS/ML INJ SOLUTION 24201-400-02 2 mL Vial 411.045 mL 2 mL "$1,654.46"
CALCITONIN (SALMON) 200 UNITS/ML INJ SOLUTION 42023-205-01 2 mL Vial 496.49 mL 2 mL "$1,998.37"
CALCITONIN (SALMON) 200 UNITS/ML INJ SOLUTION UHCS-0003-54 2 mL Vial 552.805 mL 2 mL "$2,225.04"
CALCITONIN (SALMON) 200 UNITS/ML INJ SOLUTION 67457-675-02 2 mL Vial 552.805 mL 2 mL "$2,225.04"
CALCITRIOL 0.25 MCG ORAL CAP 69452-207-20 100 each each 0.196 each 1 each $12.35
CALCITRIOL 0.25 MCG ORAL CAP 60687-345-01 100 each each 0.534 each 1 each $12.68
CALCITRIOL 0.25 MCG ORAL CAP 60687-345-11 1 each each 0.534 each 1 each $12.68
CALCITRIOL 0.5 MCG ORAL CAP 63629-8742-1 100 each each 0.289 each 1 each $12.44
CALCITRIOL 0.5 MCG ORAL CAP 23155-663-01 100 each each 0.392 each 1 each $12.54
CALCITRIOL 1 MCG/ML ORAL SOLUTION 63304-241-59 15 mL Bottle 8.375 mL 15 mL $137.78
CALCIUM ACETATE 667 MG ORAL TAB 7132180320 200 each each 0.08 each 1 each $12.23
CALCIUM ACETATE 667 MG ORAL TAB 5952803312 200 each each 0.136 each 1 each $12.29
"CALCIUM ACETATE-ALUMINUM SULF 952-1,347 MG TP POWDER PACK" 51224-162-12 12 each each 0.544 each 1 each $12.69
CALCIUM CARB-MAGNESIUM CARB 80-115 MG ORAL TAB 5952804165 150 each each 0.2 each 1 each $12.35
CALCIUM CARBONATE 1250 MG/5 ML ORAL SUSPENSION UHCS-0001-33 60 mL Bottle 0.017 mL 60 mL $49.62
CALCIUM CARBONATE 1250 MG/5 ML ORAL SUSPENSION 0121-0766-16 473 mL Bottle 0.019 mL 473 mL $58.44
CALCIUM CARBONATE 250 MG/ML ORAL SUSPENSION (NICU) UHCS-0001-33 60 mL Bottle 0.017 mL 60 mL $49.62
CALCIUM CARBONATE 500 MG CALCIUM (1250 MG) ORAL TAB 904188392 150 each each 0.015 each 1 each $12.17
CALCIUM CARBONATE 500 MG ORAL CHEW TAB 66553-004-01 500 each each 0.076 each 1 each $12.23
CALCIUM CARBONATE-VITAMIN D3 250 MG-3.125 MCG (125 UNIT) ORAL TAB 904188261 100 each each 0.03 each 1 each $12.18
CALCIUM CARBONATE-VITAMIN D3 250 MG-3.125 MCG (125 UNIT) ORAL TAB 2055502500 100 each each 0.035 each 1 each $12.19
CALCIUM CARBONATE-VITAMIN D3 500 MG(1250MG) -200 UNIT ORAL TAB 1000670038 100 each each 0.03 each 1 each $12.18
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SOLUTION 0517-6710-10 10 mL Vial 0.74 mL 10 mL $176.15
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE 0409-1631-10 10 mL Syringe 0.834 mL 10 mL $177.09
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE 0409-1631-40 10 mL Syringe 0.834 mL 10 mL $177.09
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE 76329-3304-1 10 mL Syringe 0.885 mL 10 mL $177.60
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE 0409-4928-34 10 mL Syringe 1.127 mL 10 mL $180.02
CALCIUM CHLORIDE 100 MG/ML (10 %) IV SYRINGE 0409-4928-11 10 mL Syringe 1.127 mL 10 mL $180.02
"CALCIUM GLUC IN NACL, ISO-OSM 1 G/100 ML IV SOLUTION" 44567-622-24 100 mL Bag 0.084 mL 100 mL $147.45
"CALCIUM GLUC IN NACL, ISO-OSM 1 G/100 ML IV SOLUTION" 44567-622-01 100 mL Bag 0.084 mL 100 mL $147.45
CALCIUM GLUCONATE 100 MG/ML (10%) IV SOLUTION 63323-360-19 10 mL Vial 0.878 mL 10 mL $177.53
CALCIUM GLUCONATE 2.5% GEL UHCS-0005-21 25 g Tube 39.99 Tube 25 g $93.99
"CALCIUM GLUCONATE IN NACL, ISO-OSM 2 G/100 ML IV SOLUTION" 44567-621-24 100 mL Bag 0.167 mL 100 mL $155.75
"CALCIUM GLUCONATE IN NACL, ISO-OSM 2 G/100 ML IV SOLUTION" 44567-621-01 100 mL Bag 0.167 mL 100 mL $155.75
CALCIUM GLUCONATE IV 100 MG/ML IV (NICU) UHCS-0000-84 10 mL Vial 0.305 mL 10 mL $171.80
CALCIUM POLYCARBOPHIL 625 MG ORAL TAB 0536-4306-08 60 each each 0.046 each 1 each $16.26
CALCIUM POLYCARBOPHIL 625 MG ORAL TAB 0005-2500-02 36 each each 0.114 each 1 each $17.60
CAL-D3-MAG11-ZINC-COP-MANG-BOR 600 MG CALCIUM- 800 UNIT-50 MG ORAL TAB 5555619 60 each each 0.103 each 1 each $12.25
CAMPHOR-MENTHOL 0.5-0.5 % TP LOTION 54162-550-07 222 mL Bottle 0.016 mL 222 mL $57.55
CAMPHOR-MENTHOL TP OINTMENT 10742-00013 30 g Jar 0.055 g 30 g $15.15
CANAGLIFLOZIN 100 MG ORAL TAB 50458-140-30 30 each each 0.009 each 1 each $12.16
CANDESARTAN 4 MG ORAL TAB 33342-114-07 30 each each 0.916 each 1 each $13.07
CANDESARTAN 16 MG ORAL TAB 49884-660-09 90 each each 2.173 each 1 each $14.32
CANGRELOR 50 MG IV VIAL 10122-620-10 1 each each 822.086 each 1 each "$1,654.45"
CANGRELOR 50MG/250ML BOLUS UHCS-0004-86 1 each each 1 each $0.00
CANNABIDIOL 100 MG/ML ORAL SOLUTION 70127-100-01 100 mL Bottle 13.1 mL 100 mL "$1,377.50"
CAPLACIZUMAB-YHDP 11 MG INJ KIT 58468-0225-1 1 each each 7925 each 1 each "$15,949.06"
CAPSAICIN 0.025 % TP CREAM 0536-2525-25 60 g Tube 0.084 g 60 g $59.04
CAPTOPRIL 12.5 MG ORAL TAB 51079-863-20 100 each each 1.322 each 1 each $13.47
CAPTOPRIL 25 MG ORAL TAB 51079-864-20 100 each each 1.435 each 1 each $13.59
CAPTOPRIL (CAPOTEN) PO 1MG/ML (NICU) UHCS-0000-82 25 mL Bottle 0.25 Bottle 25 mL $21.85
CARBACHOL 0.01 % IO SOLUTION 0065-0023-15 1.5 mL Vial 8.461 mL 1.5 mL $36.99
CARBAMAZEPINE 100 MG ORAL CHEW TAB 0904-3854-61 100 each each 0.329 each 1 each $12.48
CARBAMAZEPINE 100 MG ORAL TB12 0781-8016-01 100 each each 0.458 each 1 each $12.61
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION UHCS-0001-34 120 mL Bottle 0.123 mL 120 mL $63.36
CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION 60432-129-16 450 mL Bottle 0.123 mL 450 mL $103.95
CARBAMAZEPINE 200 MG ORAL CM12 54092-172-12 120 each each 1.637 each 1 each $13.79
CARBAMAZEPINE 200 MG ORAL TAB 51079-385-20 100 each each 0.828 each 1 each $12.98
CARBAMIDE PEROXIDE 6.5 % OTIC DROPS 0904-6627-35 15 mL DROP BTL 0.057 mL 15 mL $61.61
CARBIDOPA-LEVODOPA 10-100 MG ORAL TAB 63739-107-10 100 each each 0.201 each 1 each $12.35
CARBIDOPA-LEVODOPA 25-100 MG ORAL TAB 0904-6237-61 100 each each 0.174 each 1 each $12.32
CARBIDOPA-LEVODOPA 25-250 MG ORAL TAB 0904-6238-61 100 each each 0.173 each 1 each $12.32
CARBIDOPA-LEVODOPA 36.25-145 MG ORAL CPER 64896-662-01 100 each each 3.553 each 1 each $15.70
CARBIDOPA-LEVODOPA 50-200 MG ORAL TBER 51079-923-20 100 each each 0.535 each 1 each $12.69
CARBOPLATIN 10 MG/ML IV SOLUTION 0703-4244-01 5 mL Vial 1.22 mL 5 mL $505.60
CARBOPLATIN 10 MG/ML IV SOLUTION 0703-4246-01 15 mL Vial 0.561 mL 15 mL $507.92
CARBOPLATIN 10 MG/ML IV SOLUTION 61703-339-22 15 mL Vial 0.585 mL 15 mL $508.28
CARBOPLATIN 10 MG/ML IV SOLUTION 0703-4248-91 45 mL Vial 1.334 mL 45 mL $559.53
CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLUTION 43598-917-58 1 mL Vial 128.126 mL 1 mL $296.88
CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT GEL DROP 0023-4554-30 30 each each 0.298 each 1 each $24.60
CARDIOPLEGIA SOLUTION UHCS-0004-44 3000 mL Bag 166.57 Bag 3000 mL $416.32
CARDIOPLEGIA SOLUTION WARM UHCS-0004-45 3000 mL Bag 166.57 Bag 3000 mL $0.00
CARDIOPLEGIC SOLN 16 MEQ/L (= K+) PERF SOLUTION 0409-7969-05 1000 mL Flex Cont 0.051 mL 1000 mL $190.05
CARFILZOMIB 30 MG IV VIAL 76075-102-01 1 each each 1489.45 each 1 each "$2,997.52"
CARFILZOMIB 60 MG IV VIAL 76075-101-01 1 each each 2978.9 each 1 each "$5,995.04"
CARISOPRODOL 350 MG ORAL TAB 63739-049-10 100 each each 0.294 each 1 each $12.44
CARMUSTINE 100 MG IV VIAL 23155-261-41 1 each Vial 2558.27 each 1 each "$5,148.52"
CARMUSTINE IN POLIFEPROSAN 7.7 MG IMPL WAFER 24338-050-08 8 each each 4404.066 each 1 each "$8,863.18"
CARVEDILOL 3.125 MG ORAL TAB 0904-6300-61 100 each each 0.06 each 1 each $12.21
CARVEDILOL 6.25 MG ORAL TAB 0904-6301-61 100 each each 0.056 each 1 each $12.21
CARVEDILOL 12.5 MG ORAL TAB 0904-6302-61 100 each each 0.06 each 1 each $12.21
CARVEDILOL 25 MG ORAL TAB 0904-6303-61 100 each each 0.06 each 1 each $12.21
CARVEDILOL PHOSPHATE 10 MG ORAL CM24 60505-4713-3 30 each each 7.321 each 1 each $19.47
CARVEDILOL PHOSPHATE 10 MG ORAL CM24 60505-3678-3 30 each each 7.327 each 1 each $19.48
CARVEDILOL PHOSPHATE 20 MG ORAL CM24 60505-4714-3 30 each each 7.321 each 1 each $19.47
CARVEDILOL PHOSPHATE 40 MG ORAL CM24 60505-4715-3 30 each each 7.321 each 1 each $19.47
CARVEDILOL PHOSPHATE 40 MG ORAL CM24 60505-3680-3 30 each each 7.326 each 1 each $19.48
CASIRIVIMAB (REGN10933) 120 MG/ML IV SOLUTION 61755-024-00 11.1 mL Vial 0 Vial 11.1 mL $0.00
CASIRIVIMAB-IMDEVIMAB 120 MG/ML- 120 MG/ML IV SOLUTION 61755-039-00 10 mL Vial 0 Vial 10 mL $0.00
CASIRIVIMAB-IMDEVIMAB 120 MG/ML- 120 MG/ML IV SOLUTION 61755-039-01 10 mL Vial 0 Vial 10 mL $0.00
CASPOFUNGIN 70 MG IV VIAL 0781-3423-94 1 each each 45.1 each 1 each $215.56
CEFADROXIL 500 MG ORAL CAP 16714-388-02 100 each each 0.306 each 1 each $12.46
CEFAZOLIN 1 G INJ VIAL 0143-9262-25 1 each each 0.665 each 1 each $169.42
CEFAZOLIN 1 G INJ VIAL 0143-9262-01 1 each each 0.665 each 1 each $169.42
CEFAZOLIN 1 G IV VIAL 0409-2585-01 1 each each 2.162 each 1 each $170.91
CEFAZOLIN 2 G INJ VIAL 60505-6231-0 1 each each 4.157 each 1 each $172.91
CEFAZOLIN 2 G INJ VIAL 60505-6231-5 1 each each 4.157 each 1 each $172.91
CEFAZOLIN 10 G INJ VIAL 0143-9261-10 1 each each 4.683 each 1 each $173.43
CEFAZOLIN 10 G INJ VIAL 0143-9983-03 1 each each 4.683 each 1 each $173.43
CEFAZOLIN 10 G INJ VIAL 0781-3452-95 1 each each 5.852 each 1 each $174.60
CEFAZOLIN (ANCEF) 200 MG/ML EYE INJECTION UHCS-0004-72 1 mL Syringe 3.33 mL 1 mL $172.08
CEFAZOLIN (ANCEF) IV 100 MG/ML (NICU) UHCS-0000-81 1 each each 1.016 each 1 each $169.77
CEFAZOLIN (ANCEF) IV 20 MG/ML (PEDS) UHCS-0002-00 1 each each 1.326 each 1 each $170.08
CEFAZOLIN 1 G IV VIAL FOR PUSH 0409-2585-01 1 each each 2.162 each 1 each $170.91
CEFAZOLIN IN 0.9% SOD CHLORIDE 2 G/100 ML IV SOLUTION 70092-1018-03 100 mL Bag 0.116 mL 100 mL $180.35
CEFAZOLIN IN 0.9% SOD CHLORIDE 2 G/100 ML IV SOLUTION 70092-1622-03 100 mL Bag 0.116 mL 100 mL $180.35
CEFAZOLIN IN 0.9% SOD CHLORIDE 2 GRAM/50 ML IV IVPB UHCS-0005-47 50 mL Bag 0.166 Bag 50 mL $168.92
CEFAZOLIN IN 0.9% SOD CHLORIDE 3 G/100 ML IV IVPB 70092-1623-03 100 mL Bag 16.63 Bag 100 mL $185.38
CEFAZOLIN IN DEXTROSE (ISO-OS) 2 G/100 ML IV IVPB 0338-3508-41 100 mL Bag 0.116 mL 100 mL $180.35
CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV IVPB 0264-3105-11 1 each each 9.55 each 1 each $178.30
CEFDINIR 125 MG/5 ML ORAL RECON. SUSP. 16714-392-01 60 mL Bottle 0.438 mL 60 mL $74.88
CEFDINIR 300 MG ORAL CAP 16714-391-01 30 each each 1.425 each 1 each $13.58

See Part 5