CarePrice

West Park Hospital

, Cody

ProcedureCodeCash Price
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< $1
PREDNISONE 5 MG TABLETJ7512$1.18
HEPARIN PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGEJ1642$1.25
GRADIENT COMPRESSION BANDAGE ROLL, ELASTIC LONG STRETCH, LINEAR YARD, ANY WIDTH, EACHA6597$1.70
GRADIENT COMPRESSION BANDAGE ROLL, INELASTIC SHORT STRETCH, PER LINEAR YARD, ANY WIDTH, EACHA6599$1.70
GRADIENT COMPRESSION BANDAGING SUPPLY, LOW DENSITY FLAT FOAM SHEET, PER 250 SQUARE CENTIMETERS, EACHA6604$1.70
GRADIENT COMPRESSION BANDAGING SUPPLY, PADDED FOAM, PER LINEAR YARD, ANY WIDTH, EACHA6605$1.70
GRADIENT COMPRESSION BANDAGING SUPPLY, TUBULAR PROTECTIVE ABSORPTION LAYER, PER LINEAR YARD, ANY WIDTH, EACHA6607$1.70
METHYLPREDNISOLONE 4 MG TABLETJ7509$1.83
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$2.53
GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITH ANY SIZE ADHESIVE BORDER, EACH DRESSINGA6219$2.55
GRADIENT COMPRESSION BANDAGING SUPPLY, LOW DENSITY CHANNEL FOAM SHEET, PER 250 SQUARE CENTIMETERS, EACHA6603$2.55
TACROLIMUS 0.5 MG CAPSULE IMMEDIATE-RELEASEJ7507$3.39
GRADIENT COMPRESSION BANDAGING SUPPLY, HIGH DENSITY FOAM SHEET, PER 250 SQUARE CENTIMETERS, EACHA6600$3.40
IPRATROPIUM .02% .5MG/2.5J7620$3.40
ZOFRAN TAB ONDANSETRONS0119$3.40
AZATHIOPRINE 50 MG TABLETJ7500$3.93
Inj, human-lans, per i.uJ7165$4.02
LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, WIDTH LESS THAN THREE INCHES, PER YARDA6448$4.25
LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, WIDTH GREATER THAN OR EQUAL TO THREE INCHES AND LESS THAN FIVE INCHES, PER YARDA6449$4.25
GRADIENT COMPRESSION BANDAGING SUPPLY, HIGH DENSITY FOAM PAD, ANY SIZE OR SHAPE, EACHA6601$4.25
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTIONJ1630$4.25
PENICILLIN G POTASSIUM 5 MU POWDER VIAL FOR RECONSTITUTIONJ2540$4.25
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTIONJ0687$4.38
Hiv prep, ftc/tdf 200/300mgJ0750$4.84
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$5.19
PHENYTOIN SODIUM IV SOLUTION 50 MG/MLJ1165$5.30
LIGHT COMPRESSION BANDAGE, ELASTIC, KNITTED/WOVEN, WIDTH GREATER THAN OR EQUAL TO FIVE INCHES, PER YARDA6450$5.95
GRADIENT COMPRESSION BANDAGING SUPPLY, HIGH DENSITY FOAM ROLL FOR BANDAGE, PER LINEAR YARD, ANY WIDTH, EACHA6602$5.95
GRADIENT COMPRESSION BANDAGING SUPPLY, PADDED TEXTILE, PER LINEAR YARD, ANY WIDTH, EACHA6606$5.95
GRADIENT COMPRESSION BANDAGING SUPPLY, TUBULAR PROTECTIVE ABSORPTION PADDED LAYER, PER LINEAR YARD, ANY WIDTH, EACHA6608$5.95
BLD BONE MILLA4649$6.80
ACCESSORY FOR GRADIENT COMPRESSION GARMENT OR WRAP WITH ADJUSTABLE STRAPS, NOT-OTHERWISE SPECIFIEDA6593$6.80
GRADIENT COMPRESSION BANDAGING SUPPLY, NOT OTHERWISE SPECIFIEDA6609$6.80
RANITIDINE 150MGJ2780$6.80
SPECIALTY ABSORPTIVE DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSINGA6251$7.65
AZITHROMYCIN 500 MG POWDER VIAL FOR RECONSTITUTIONJ0456$7.91
INJ ONDANSETRON HYDROCHLORIDEJ2405$8.01
HYDROMORPHONE 1MG/ML 1ML SYRINGEJ1171$8.33
METRONIDAZOLE IN NS IV SYRINGE 5 MG/ML (NICU/PEDS)J1836$8.49
SPIROMETER, NON-ELECTRONIC, INCLUDES ALL ACCESSORIESA9284$8.50
ALBUTEROL INHALATION SOLUTIONJ7613$8.50
MIDAZOLAM (PF) 5 MG/ML NASALJ2250$8.59
BUMETANIDE 0.25 MG/ML INJECTION SOLUTIONJ1939$8.81
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTIONJ2765$9.12
Thrombin time plasma85670$9.21
MSTEM MICROMTRIX\\MGQ4118$9.35
HB CC PYXIS-ARM SLING LGA4565$9.35
SPLINTA4570$9.35
FINGER SPLINT, STATICQ4049$9.35
HEARING AID OR ASSISTIVE LISTENING DEVICE/SUPPLIES/ACCESSORIES, NOT OTHERWISE SPECIFIEDV5267$9.35
MORPHINE 2 MG/ML INJECTION SYRINGEJ2270$9.82
CEFEPIME 2 GRAM SOLUTION FOR INJECTIONJ0692$10.04
DISPOSABLE COLLECTION AND STORAGE BAG FOR BREAST MILK, ANY SIZE, ANY TYPE, EACHA4287$10.20
HB DECALCIFICATION PROCEDURE88311$10.74
INJECTION DIPHENHYDRAMINE HCLJ1200$10.79
PHENYLEPH 20MCG 100MCG 1ML SNIJJ2371$11.50
AMPICILLIN 1 GRAM SOLUTION FOR INJECTIONJ0290$11.72
Microbe susceptible diffuse87181$11.90
HC COM CON DRESSING ALGINATE 4X4 $80059$11.90
REPLACEMENT, TIP, CANE, CRUTCH, WALKER, EACH.A4637$12.33
INJECTION PROMETHAZINE HCL TOJ2550$12.65
MEPERIDINE (PF) 50 MG/ML INJECTION SYRINGEJ2175$13.28
INJ KETOROLAC TROMETHAMINEJ1885$13.41
PANTOPRAZOLE 40MG 40MG PWIJJ2470$13.46
ALBUTEROL, INHALATION SOLUTION, COMPOUNDED PRODUCT, ADMINISTERED THROUGH DME, UNIT DOSE, 1 MGJ7609$13.60
INJECTION GARAMYCIN GENTAMICINJ1580$13.65
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTIONJ0713$14.03
FUROSEMIDE 10 MG/ML INJECTION SOLUTIONJ1940$14.13
GLYCOPYRROL MPI 0.1MG 0.2MG 1MLSNIJJ1596$14.43
Igg 1 2 3 or 4 each82787$14.45
AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE ISO-OSMOTIC IVJ0282$14.52
DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTIONJ1160$14.59
FOAM DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSINGA6209$15.30
INJECTION ONABOTULINUMTOXIN AJ0585$15.30
PLASTAZOTE SANDAL, EACHL3265$15.30
NAFCILLIN 20MG 50 JJ2290$15.94
LIDOCAINE HCL 20MG/ML INJECTJ2003$15.96
CIPROFLOXACIN LACTATE/D5W400MG/0.2L IVJ0744$16.78
INJECTION LORAZEPAMJ2060$16.92
INJECTION VITAMIN B-12J3420$16.92
Prothrombin test85611$17
FLUV FLUCELVAX 0.5ML90674$17
METHYLPRED LA 40MG JJ1030$17
INJ TRIAMCINOLONE ACETONIDEJ3301$17.09
SODIUM CHLORIDE 3% BOLUSJ7131$17.24
METHOTREXATE SODIUM 2.5 MG TABLETJ8610$17.30
Blood viscosity examination85810$17.66
RHYTHM ECG, 1-3 LEADS; INTERPRETATION AND REPORT ONLY93042$17.85
HB FROZEN SECTION EA ADDIT BLOCK88332$17.85
SHOULDER ORTHOSIS, FIGURE OF EIGHT DESIGN ABDUCTION RESTRAINER, PREFABRICATED, OFF-THE-SHELFL3650$17.85
IMMUNIZATION ADMIN ADDL VACC90472$18.46
INJECTION, LIDOCAINE HCL WITH EPINEPHRINE, 1 MGJ2004$18.67
IMMUNIZATION ADMIN ORAL90473$18.70
EYE PATCH, OCCLUSIVE, EACHA6412$18.70
METHYLPRED SS 1G JJ2930$18.70
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTIONJ0665$19.16
HEPARIN (PORCINE) 5 000 UNIT/ML INJECTION SOLUTIONJ1644$19.39
HB IMH PYXIS-CERVICAL COLLAR FOAM MEDL0120$19.55
LIFT, ELEVATION, INSIDE SHOE, TAPERED, UP TO ONE-HALF INCHL3332$19.55