CarePrice

Hot Springs County Memorial Hospital

, Thermopolis

ProcedureCodeCash Price
ANESTHESIA FOR CESAREAN DELIVERY FOLLOWING NEURAXIAL LABOR ANALGESIA/ANESTHESIA (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE PERFORMED)01968$4
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTIONJ1630$6.97
INJECTION LORAZEPAMJ2060$6.97
MIDAZOLAM (PF) 5 MG/ML NASALJ2250$6.97
INJ ONDANSETRON HYDROCHLORIDEJ2405$6.97
PREDNISONE 5 MG TABLETJ7512$6.97
DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE)J8540$6.97
METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTIONJ2765$7.08
FUROSEMIDE 10 MG/ML INJECTION SOLUTIONJ1940$8.12
TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTIONJ3105$8.72
PHENYLEPH 20MCG 100MCG 1ML SNIJJ2371$9.26
HEPARIN PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGEJ1642$9.47
INJ KETOROLAC TROMETHAMINEJ1885$9.93
METRONIDAZOLE IN NS IV SYRINGE 5 MG/ML (NICU/PEDS)J1836$10.56
INJ DEXAMETHASONE SOD PHOSPHJ1100$11
INJECTION PROMETHAZINE HCL TOJ2550$11.30
FENTANYL INFUSION 2500 MCG/50 MLJ3010$11.92
HYDROMORPHONE 1MG/ML 1ML SYRINGEJ1171$12.07
IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTIONQ9967$12.95
BUMETANIDE 0.25 MG/ML INJECTION SOLUTIONJ1939$13.14
AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE ISO-OSMOTIC IVJ0282$13.62
BUDESONIDE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, UP TO 0.5 MGJ7626$13.63
MORPHINE 2 MG/ML INJECTION SYRINGEJ2270$13.78
AMPICILLIN 1 GRAM SOLUTION FOR INJECTIONJ0290$13.99
Prothrombin complex KcentraJ7168$14.22
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTIONJ0665$14.93
LEVETIRACETAM 1 000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACKJ1953$15.87
GADOTERIDOL 1ML 5MMOL 10ML SNIJA9579$16
LIDOCAINE HCL 20MG/ML INJECTJ2003$16.06
SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACKJ7050$16.70
CEFAZOLIN 1 G/10 ML IV (WET SOLR VIAL)J0690$16.92
GLYCOPYRROL MPI 0.1MG 0.2MG 1MLSNIJJ1596$16.92
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTIONJ7060$18.07
INJECTION DIPHENHYDRAMINE HCLJ1200$18.65
PHENYLEPHRINE 10MG/ML 1ML (HIKMA) VIALJ2373$19.29
CIPROFLOXACIN LACTATE/D5W400MG/0.2L IVJ0744$19.71
Fungi identification yeast87106$21
HYDRALAZINE 20 MG/ML INJECTION SOLUTIONJ0360$23.08
VANCOMYCIN 1 000 MG INTRAVENOUS INJECTIONJ3370$23.93
INJECTION GARAMYCIN GENTAMICINJ1580$24.03
PIPERACILLIN-TAZOBACTAM 2.25 GRAM INTRAVENOUS SOLUTIONJ2543$24.26
MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SYRINGEJ3475$24.82
ANESTHESIA FOR INTRAORAL PROCEDURES, INCLUDING BIOPSY; NOT OTHERWISE SPECIFIED00170$25
ANESTHESIA FOR ALL PROCEDURES ON THE INTEGUMENTARY SYSTEM, MUSCLES AND NERVES OF HEAD, NECK, AND POSTERIOR TRUNK, NOT OTHERWISE SPECIFIED00300$25
ANESTHESIA FOR PROCEDURES ON THE INTEGUMENTARY SYSTEM ON THE EXTREMITIES, ANTERIOR TRUNK AND PERINEUM; NOT OTHERWISE SPECIFIED00400$25
ANESTHESIA FOR PROCEDURES ON THE INTEGUMENTARY SYSTEM ON THE EXTREMITIES, ANTERIOR TRUNK AND PERINEUM; ELECTRICAL CONVERSION OF ARRHYTHMIAS00410$25
ANESTHESIA FOR ACCESS TO CENTRAL VENOUS CIRCULATION00532$25
ANESTHESIA FOR PROCEDURES ON UPPER ANTERIOR ABDOMINAL WALL; NOT OTHERWISE SPECIFIED00700$25
SARGRAMOSTIM INJECTION00731$25
DACTINOMYCIN INJECTION00752$25
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN UPPER ABDOMEN INCLUDING LAPAROSCOPY; NOT OTHERWISE SPECIFIED00790$25
CARMUSTINE INJECTION00812$25
ANESTHESIA FOR COMBINED UPPER AND LOWER GASTROINTESTINAL ENDOSCOPIC PROCEDURES, ENDOSCOPE INTRODUCED BOTH PROXIMAL TO AND DISTAL TO THE DUODENUM00813$25
ANESTHESIA FOR HERNIA REPAIRS IN LOWER ABDOMEN; NOT OTHERWISE SPECIFIED00830$25
ANESTHESIA FOR HERNIA REPAIRS IN LOWER ABDOMEN; VENTRAL AND INCISIONAL HERNIAS00832$25
INJ MELPHA HYDROCH NOS 50 MG00840$25
ANESTHESIA FOR INTRAPERITONEAL PROCEDURES IN LOWER ABDOMEN INCLUDING LAPAROSCOPY; TUBAL LIGATION/TRANSECTION00851$25
ANESTHESIA FOR VAGINAL PROCEDURES (INCLUDING BIOPSY OF LABIA, VAGINA, CERVIX OR ENDOMETRIUM); NOT OTHERWISE SPECIFIED00940$25
ANESTHESIA FOR OPEN PROCEDURES INVOLVING HIP JOINT; NOT OTHERWISE SPECIFIED01210$25
INJ IVIG PRIVIGEN 500 MG01214$25
ANESTHESIA FOR ALL CLOSED PROCEDURES ON KNEE JOINT01380$25
ANESTHESIA FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES OF KNEE JOINT01382$25
ANESTHESIA FOR ALL OPEN PROCEDURES ON UPPER ENDS OF TIBIA, FIBULA, AND/OR PATELLA01392$25
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON KNEE JOINT; NOT OTHERWISE SPECIFIED01400$25
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON KNEE JOINT; TOTAL KNEE ARTHROPLASTY01402$25
ANESTHESIA FOR ALL CLOSED PROCEDURES ON LOWER LEG, ANKLE, AND FOOT01462$25
ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, AND FASCIA OF LOWER LEG, ANKLE, AND FOOT; NOT OTHERWISE SPECIFIED01470$25
INJ BETA INTERFERON IM 1 MCG01472$25
ELOSULFASE ALFA, INJECTION01480$25
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF SHOULDER AND AXILLA01610$25
ANESTHESIA FOR ALL CLOSED PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR JOINT, ACROMIOCLAVICULAR JOINT, AND SHOULDER JOINT01620$25
HEP B IG, IM01630$25
ANESTHESIA FOR OPEN OR SURGICAL ARTHROSCOPIC PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR JOINT, ACROMIOCLAVICULAR JOINT, AND SHOULDER JOINT; TOTAL SHOULDER REPLACEMENT01638$25
CLOFARABINE INJECTION01710$25
ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF FOREARM, WRIST, AND HAND01810$25
ANESTHESIA FOR ALL CLOSED PROCEDURES ON RADIUS, ULNA, WRIST, OR HAND BONES01820$25
ANES DISTAL RADIUS ULNA WRIST HAND JTS01830$25
ANESTHESIA FOR NON-INVASIVE IMAGING OR RADIATION THERAPY01922$25
ANESTHESIA FOR VAGINAL DELIVERY ONLY01960$25
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTIONJ0295$25.17
INJECTION, LIDOCAINE HCL WITH EPINEPHRINE, 1 MGJ2004$25.44
INJECTION VITAMIN B-12J3420$25.48
PROPOFOL 10 MG/ML INTRAVENOUS EMULSIONJ2704$26.69
HB EMS-GROUND MILEAGEA0425$27
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTIONJ0780$29.09
POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IVJ3480$29.37
Assay of neonatal thyroxine84437$29.50
Assay of biotinidase82261$30
Assay galactose transferase82775$30
PENICILLIN G POTASSIUM 5 MU POWDER VIAL FOR RECONSTITUTIONJ2540$30.15
MEROPENEM 1 GRAM INTRAVENOUS SOLUTIONJ2185$30.62
CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACKJ0736$31.47
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTIONJ2919$31.69
CEFEPIME 2 GRAM SOLUTION FOR INJECTIONJ0692$32.20
ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGEJ1650$33.28
PANTOPRAZOLE 40MG 40MG PWIJJ2470$34.04
HB CAPILLARY DRAWING CHARGE36416$35
HB POTASSIUM FECES84999$35
INJECTION CEFTRIAXONE SODIUMJ0696$35.76
COLLECTION VENOUS BLOOD36415$37