CarePrice

St John's Health

, Jackson

ProcedureCodeCash Price
PRENATAL VITAMINS, 30-DAY SUPPLYS0197$1.08
METHADONE, ORAL, 5 MGS0109$1.21
HYDROXYZINE PAMOATE, 25 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMENQ0177$1.71
PREDNISONE 5 MG TABLETJ7512$1.90
PROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMENQ0169$2.19
HB RADIANT-TECH TC 99M PERTECHNETATE PER MCIA9512$3
Naltrexone, depot formJ2315$4
PROCHLORPERAZINE MALEATE, 5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMENQ0164$4.35
INJECTION, BUPIVICAINE HYDROCHLORIDE, 30 MLS0020$5
FAMOTIDINE 20MG 20MG 2ML SNIJS0028$5
ZOFRAN TAB ONDANSETRONS0119$5
Collect sweat for test89230$6
IOPAMIDOL 200 MG IODINE/ML (41 %) INJECTION SOLUTIONQ9966$6
ALBUTEROL INHALATION SOLUTIONJ7613$6.70
BICILL CR 1,200,000J0558$7
FINASTERIDE 5MG 5MG TBS0138$7.09
DIPHENHYDRAMINE HYDROCHLORIDE, 50 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT TIME OF CHEMOTHERAPY TREATMENT NOT TO EXCEED A 48 HOUR DOSAGE REGIMENQ0163$9.67
SCREENING TEST OF VISUAL ACUITY, QUANTITATIVE, BILATERAL99173$10
INFLUENZA VIRUS VACCINE, QUADRIVALENT (IIV4), SPLIT VIRUS, PRESERVATIVE FREE, FOR INTRADERMAL USE90630$10
HB RX FLU - QUAD, RIV4 VACC RECOMBINANT DNA, PRES&ANTIBIOTIC FREE, IM USE90682$10
INFLUENZA VIRUS VACCINE90685$10
INFLUENZA VIRUS VACCINE, QUADRIVALENT (CCIIV4), DERIVED FROM CELL CULTURES, SUBUNIT, ANTIBIOTIC FREE, 0.5 ML DOSAGE, FOR INTRAMUSCULAR USE90756$10
FLUZONE VACCQ2038$10
INFLUENZA VIRUS VACCINE, NOT OTHERWISE SPECIFIEDQ2039$10
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE)J8540$10.39
BUPRENORPHINE 2 MGJ0571$10.43
PREDNISOLN 5MG 15MG 5ML SUJ7510$11.06
HEALTH BEHAVIOR INTERVENTION, GROUP (2 OR MORE PATIENTS), FACE-TO-FACE; EACH ADDITIONAL 15 MINUTES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY SERVICE)96165$12
PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL QUALIFIED BY EDUCATION, TRAINING, LICENSURE/REGULATION (WHEN APPLICABLE) EDUCATIONAL SERVICES RENDERED TO PATIENTS IN A GROUP SETTING (EG, PRENATAL, OBESITY, OR DIABETIC INSTRUCTIONS)99078$12
HEALTH BEHAVIOR INTERVENTION, FAMILY (WITH THE PATIENT PRESENT), FACE-TO-FACE; EACH ADDITIONAL 15 MINUTES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY SERVICE)96168$12
Coccidioidomycosis skin test86490$13
IQ TSTS SEQL&INCRL AIRBORNE95027$13
IPRATROPIUM .02% .5MG/2.5J7620$13.09
HB CC PYXIS-ARM SLING LGA4565$14.57
METHYLPREDNISOLONE 4 MG TABLETJ7509$14.84
CRYO DESTRUCT LESION 2-1417003$15
Skin test nos antigen86486$15
AMBL BP MNTR W/SW A/R93788$15
Ur albumin semiquantitative82044$15
INSTRUMENT-BASED OCULAR SCREENING (EG, PHOTOSCREENING, AUTOMATED-REFRACTION), BILATERAL; WITH ON-SITE ANALYSIS99177$15
INFLUENZA VIRUS VACCINE 6-35M90657$15
INFLUENZA VIRUS VACCINE 3+YRS90658$15
USE OF VERTICAL ELECTRODES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)92547$16
Histoplasmosis skin test86510$16
RHYTHM ECG TRACING93041$16
PT DIATHERMY97024$16
PERCUT ALLERGY SKIN TESTS95004$17
GADOBENATE DIMEGLUMINE 529 MG/ML(0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTIONA9577$17
EMOTIONAL BEHAVIORAL ASSESSMT96127$17.40
PHOTO PATCH TESTS95052$18
RHYTHM ECG, 1-3 LEADS; INTERPRETATION AND REPORT ONLY93042$18
DRONABINOL, 2.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMENQ0167$18.10
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSINGA6254$19
PT ULTRAVIOLET97028$19
ANTIGEN THERAPY SERVICES95165$20
END-STAGE RENAL DISEASE (ESRD) RELATED SERVICES FOR DIALYSIS LESS THAN A FULL MONTH OF SERVICE, PER DAY; FOR PATIENTS 20 YEARS OF AGE AND OLDER90970$20
LAB INFLUENZA A OR B87400$20
ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATIONJ7611$20
SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, CANVAS AND WEBBING, PREFABRICATED, OFF-THE-SHELFL3660$20
HB IMH PYXIS-POST OP SHOE MALE LL3260$20.20
ICUT ALLERGY TEST DRUG/BUG95024$21
ANTIBODY RUBELLA86762$21
ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; INTERPRETATION AND REPORT ONLY, PERFORMED AS A SCREENING FOR THE INITIAL PREVENTIVE PHYSICAL EXAMINATIONG0405$21
DIRECT (FACE-TO-FACE WITH PATIENT) SKILLED NURSING SERVICES OF A REGISTERED NURSE PROVIDED IN A COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY, EACH 10 MINUTES BEYOND THE FIRST 5 MINUTESG0128$21
URINALYSIS81002$21.25
ALL TSTG PERQ&IQ W/VENOMS95017$22
PHYSICIAN REVIEW, INTERPRETATION, AND PATIENT MANAGEMENT OF HOME INR TESTING FOR PATIENT WITH EITHER MECHANICAL HEART VALVE(S), CHRONIC ATRIAL FIBRILLATION, OR VENOUS THROMBOEMBOLISM WHO MEETS MEDICARE COVERAGE CRITERIA; TESTING NOT OCCURRING MORE FREQUENG0250$22
PHYSICIAN SERVICE REQUIRED TO ESTABLISH AND DOCUMENT THE NEED FOR A POWER MOBILITY DEVICEG0372$22
PHYSICIAN DOCUMENTATION OF FACE-TO-FACE VISIT FOR DURABLE MEDICAL EQUIPMENT DETERMINATION PERFORMED BY NURSE PRACTITIONER, PHYSICIAN ASSISTANT OR CLINICAL NURSE SPECIALISTG0454$22
GADOTERIDOL 1ML 5MMOL 10ML SNIJA9579$22
PROFESSIONAL SERVICES FOR ALLERGEN IMMUNOTHERAPY IN THE OFFICE OR INSTITUTION OF THE PRESCRIBING PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL, INCLUDING PROVISION OF ALLERGENIC EXTRACT; 2 OR MORE INJECTIONS95125$22
INFLUENZA VIRUS VACCINE90686$22.50
GLUCOSE BLOOD REAGENT STRIP82948$23
HB SP-DEVELOPMENTAL SCREENINGG0451$23
METHYLPRED LA 40MG JJ1030$24
Allg spec ige crude xtrc ea86003$24.93
ANTIGEN THERAPY SERVICES95170$25
HLTH BHV IVNTJ GRP 1ST 3096164$25
ALLERGEN IMMUNOTHRPY SNGL INJ95115$25
HAEMOPH B VAC 0.5ML J90645$25
HIB VACCINE PRP-D IM90646$25
PNEUMOCOCCAL VACC 7 VAL IM90669$25
Prolonged Services Inp/OBSG0316$25
HEPATITIS A VACCINE PED90633$25
MENINGOCOCCAL CONJUGATE VACCINE, SEROGROUPS C & Y AND HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB-MENCY), 4 DOSE SCHEDULE, WHEN ADMINISTERED TO CHILDREN 6 WEEKS-18 MONTHS OF AGE, FOR INTRAMUSCULAR USE90644$25
PEDVAXHIB INFLUENZA B VACCINE90647$25
ACTHIB INFLUENZA B VACCINE90648$25
UNLISTED ALL/IMMLG SVC/PX95199$25
HLTH BHV IVNTJ FAM 1ST 3096167$25
OCULAR FUNCTION SCREEN99172$25
Hep c screen high risk/otherG0472$25
SPLINT, PREFABRICATED, WRIST OR ANKLES8451$25
HB EKG SCREEN W INIT PRE P/E NO I&R-ONLY MCG0404$26
ELECTROMAGNETIC THERAPY, TO ONE OR MORE AREAS FOR CHRONIC STAGE III AND STAGE IV PRESSURE ULCERS, ARTERIAL ULCERS, DIABETIC ULCERS AND VENOUS STASIS ULCERS NOT DEMONSTRATING MEASURABLE SIGNS OF HEALING AFTER 30 DAYS OF CONVENTIONAL CARE AS PART OF A THERAPY PLAN OF CAREG0329$26
CAD DIAGNOSTIC77051$26
CAD SCREENING77052$26
TRIM NAIL(S) ANY NUMBER11719$26.50
HB IMH PYXIS-CERVICAL COLLAR FOAM MEDL0120$26.67
HB RX FLU -IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE (90656)90656$26.67
INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS PENJ1815$27.10