Community Hospital

, Torrington

ProcedureCodeCash Price
FAMOTIDINE 20MG 20MG 2ML SNIJS0028< $1
FINASTERIDE 5MG 5MG TBS0138< $1
BUPROPION SR 150MG 150MG TBERS0106< $1
METRONIDAZOLE IN NS IV SYRINGE 5 MG/ML (NICU/PEDS)J1836< $1
Chloroprocaine hcl injectionJ2401< $1
ATROPINE 1 MG/ML INTRAVENOUS SOLUTIONJ0461< $1
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTIONJ0665< $1
IOTHALAMATE MEGLUMINE 17.2 % URETHRAL SOLUTIONQ9958< $1
PROPOFOL 10 MG/ML INTRAVENOUS EMULSIONJ2704< $1
ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTIONJ2795< $1
DAPTOMYCIN 350 MG INTRAVENOUS SOLUTIONJ0878< $1
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTIONJ1010< $1
DAPTOMYCIN 1MG 350MG 7ML PWIJJ0873< $1
IOTHALAMT 60 PERC 1ML 50ML SNIJQ9961< $1
Calcium glucon (wg critical)J0613< $1
GADOTERATE MEGLUMINE 0.5 MMOL/ML 20ML VIA9575$1.10
IRON SUCROSE IV INJECTION 100 MG/5 MLJ1756$1.11
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTIONJ2919$1.15
Inj, calcium gluconate, nosJ0612$1.18
LIDOCAINE IN D5W 4 MG/ML INFUSION PREMIX (FOR PAIN)J2001$1.20
BIVALIRUDIN 1MG 250MG 5ML PWIJJ0583$1.21
NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTIONJ2404$1.21
GADOBUTRL 0.1ML 30MMOL 30ML SN MDVA9585$1.23
INJ METHYLPREDNISOLONE ACETATEJ1050$1.25
PREDNISONE 5 MG TABLETJ7512$1.28
IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTIONQ9967$1.54
MIDAZOL WCC 1MG 50MG 50ML SNIVJ2251$1.55
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTIONJ9263$1.55
ESMOLOL 2 000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IVJ1805$1.59
FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGEQ5101$1.67
BUPRENORPHINE 2 MGJ0571$1.68
DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTIONQ9963$1.71
GLYCOPYRROL MPI 0.1MG 0.2MG 1MLSNIJJ1596$1.77
NivestymQ5110$1.77
Ferumoxytol, esrd useQ0139$1.77
MIDAZOLAM (PF) 5 MG/ML NASALJ2250$1.92
MICAFUNGIN 100 MG INTRAVENOUS SOLUTIONJ2248$2.21
Ferumoxytol, non-esrdQ0138$2.23
Argatroban esrd dialysis 1mgJ0884$2.23
PACLITAXEL 1MG 30MG 5ML CN MDVJ9267$2.26
Inj esmolol hcl wg crit careJ1806$2.27
PHENYLEPH 20MCG 100MCG 1ML SNIJJ2371$2.34
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE)J8540$2.43
Dexmedetomidine film, 1 mcgJ1105$2.63
SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTIONJ0209$2.65
INJ ONDANSETRON HYDROCHLORIDEJ2405$2.65
PHENYTOIN SODIUM IV SOLUTION 50 MG/MLJ1165$2.73
Wilate injectionJ7183$2.93
Inj filgrastim excl biosimilJ1442$3.09
Factor viiiJ7190$3.12
Factor ix recombinant nosJ7195$3.12
ANTIHEMOPHILIC FACTOR-VWF 1 000 UNIT-2 400 UNIT INTRAVENOUS SOLUTIONJ7187$3.18
IOPAMIDOL 200 MG IODINE/ML (41 %) INJECTION SOLUTIONQ9966$3.20
Argatroban nonesrd use 1mgJ0883$3.26
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTIONJ0132$3.31
Inj ferric carboxymaltos 1mgJ1439$3.35
INJ KETOROLAC TROMETHAMINEJ1885$3.39
COCAINE 4 % NASAL SOLUTIONC9046$3.46
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGEJ1650$3.47
ADENOSINE 3MG/ML IVJ0153$3.56
Inj, afstyla, 1 i.u.J7210$3.73
Inj retacrit esrd on dialysiQ5105$3.81
METHYLPREDNISOLONE 4 MG TABLETJ7509$3.82
Factor ix complexJ7194$3.87
Inj, lecanemab-irmb, 1 mgJ0174$3.91
Methylnaltrexone injectionJ2212$3.92
Inj, cyclophosphamide, nosJ9075$3.94
NEOSTIGMINE 3MG SIMPJ2710$4.05
VASOPRESSIN 20 UNITJ2599$4.05
GADOTERIDOL 1ML 25MMOL 50ML SNIVMDVA9576$4.05
Inj, epinephrine (belcher)J0173$4.17
Factor viii recombinant NOSJ7192$4.22
D5W-NS IV BOLUSJ7042$4.42
COCAINE NUMBRINO 1MG 160MG 4ML SNNSC9143$4.79
NITROGLYCERIN 50 MG/250 ML (200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUSJ2305$5.08
INJECTION DIPHENHYDRAMINE HCLJ1200$5.08
LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGEJ1920$5.20
FENTANYL INFUSION 2500 MCG/50 MLJ3010$5.23
TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLUTIONJ9351$5.30
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTIONJ2469$5.38
DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTIONJ9171$5.55
GADOB DIME 1ML 52.9GM 100ML SNIJMDVA9578$5.60
PROTAMINE 10 MG/ML INTRAVENOUS SOLUTIONJ2720$5.67
Prothrombin complex KcentraJ7168$5.77
Gel-syn injection 0.1 mgJ7328$5.86
NAFCILLIN 2GM 2GM PWIJS0032$5.87
EPIRUBICIN 50 MG/25 ML INTRAVENOUS SOLUTIONJ9178$6.04
IOHEXOL 180MG 1ML 3.6GM 20ML SNIJQ9965$6.08
INJ DEXAMETHASONE SOD PHOSPHJ1100$6.15
Factor viia recomb novosevenJ7189$6.32
SODIUM CHLORIDE 3% BOLUSJ7131$6.39
TACROLIMUS 0.5 MG CAPSULE IMMEDIATE-RELEASEJ7507$6.41
GADOTERIDOL 1ML 5MMOL 10ML SNIJA9579$6.58
BUMETANIDE 0.25 MG/ML INJECTION SOLUTIONJ1939$6.63
METHACHOLINE 1MG 63.94MG 18ML SNIHJ7674$6.63
BORTEZOMIB 2.5 MG/ML SUBCUT INJECTIONJ9041$6.69
INJECTION LORAZEPAMJ2060$6.83
INSULIN LIS DME LESS THAN1M 50U 300U 3ML MDVJ1817$6.83
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTIONJ2765$6.85
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTIONJ1630$6.85