healthcosts.net

UPMC Western Psychiatric

3811 Ohara St, Pittsburgh, PA · UPMC · · NPI 1174962435

Source: hospital's published price file ↗ · Published Mar 6, 2026 · Ingested Aug 13, 2026

Published prices by procedure

Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.

Procedure Cash price Gross charge Negotiated range Payers
Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 $213.00 $355.00 $37.73 – $301.75 7
Abobotulinumtoxina HCPCS J0586 $51.15 $85.25 $8.75 – $72.46 7
Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 $0.60 $1.00 $0.06 – $0.85 7
Acetazolamide 500 mg solution for injection HCPCS J1120 $1,307.40 $2,179.00 $19.84 – $1,852.15 7
Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 $81.60 $136.00 $0.39 – $66.09 7
Acetylcysteine non-comp unit HCPCS J7608 $81.60 $136.00 $4.69 – $18.00 6
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 $20.25 $33.75 $0.04 – $28.69 7
Adapt behavior tx phys/qhp CPT 97155 $114.00 $190.00 $14.32 – $85.00 6
Adenosine 3 mg/250 ml bag for osm HCPCS J0153 $214.80 $358.00 $0.56 – $304.30 7
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 $3,000.00 $5,000.00 $0.63 – $2.12 6
Afamelanotide implant, 1 mg HCPCS J7352 $140,689.80 $234,483.00 $1,350.12 – $199,310.55 6
Agalsidase beta 35 mg intravenous solution HCPCS J0180 $955.20 $1,592.00 $230.15 – $1,353.20 7
Albumin (human), 25%, 50ml HCPCS P9047 $1,577.40 $2,629.00 $53.08 – $1,117.75 7
Albumin (human), 5%, 250 ml HCPCS P9045 $609.00 $1,015.00 $53.08 – $814.30 7
Albuterol ipratrop non-comp HCPCS J7620 $38.25 $63.75 $1.47 – $8.29 6
Albuterol non-comp con HCPCS J7611 $3.60 $6.00 $0.17 – $5.10 7
Albuterol non-comp unit HCPCS J7613 $7.20 $12.00 $1.45 – $10.20 6
Aldesleukin injection HCPCS J9015 $8,184.00 $13,640.00 $482.33 – $5,725.36 6
Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 $55.50 $92.50 $27.47 – $2,624.28 7
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 $59.40 $99.00 $5.46 – $84.15 7
Alteplase 100 mg infusion from pyxis vial HCPCS J2997 $285.00 $475.00 $48.05 – $370.60 7
Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 $44.55 $74.25 $0.63 – $13.60 7
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 $9.15 $15.25 $1.71 – $12.96 7
Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 $11.40 $19.00 $2.02 – $16.15 7
Amiodarone 50 mg/ml intravenous solution HCPCS J0282 $102.60 $171.00 $0.43 – $30.36 7
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 $175.20 $292.00 $43.41 – $248.20 7
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 $592.80 $988.00 $21.48 – $839.80 7
Ampicillin 1 gram solution for injection HCPCS J0290 $93.60 $156.00 $0.55 – $132.60 7
Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 $246.60 $411.00 $1.39 – $347.65 7
Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 $8,383.20 $13,972.00 $0.25 – $1.89 6
Anti-inhibitor HCPCS J7198 $8.70 $14.50 $2.41 – $12.32 7
Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 $3,726.60 $6,211.00 $533.82 – $5,545.90 7
Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 $30.60 $51.00 $1.49 – $43.35 7
Antithrombin iii injection HCPCS J7197 $70.20 $117.00 $1.51 – $99.45 7
Antithymocyte globuln rabbit HCPCS J7511 $4,183.80 $6,973.00 $462.92 – $5,927.05 7
Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 $10.20 $17.00 $1.64 – $14.45 7
Argatroban nonesrd use 1mg HCPCS J0883 $25.50 $42.50 $0.80 – $31.66 7
Aripiprazole 441 mg/1.6 ml inj HCPCS J1944 $9.60 $16.00 $1.86 – $12.75 7
Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 $268.80 $448.00 $8.15 – $380.80 7
Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 $273.60 $456.00 $48.56 – $387.60 7
Atropine 0.1 mg/ml injection syringe HCPCS J0461 $2.70 $4.50 $0.10 – $0.85 7
Azacitidine injection HCPCS J9025 $19.20 $32.00 $0.57 – $27.20 7
Azathioprine 50 mg tablet HCPCS J7500 $29.25 $48.75 $0.06 – $41.44 7
Azithromycin 500 mg intravenous solution HCPCS J0456 $1,063.80 $1,773.00 $2.04 – $1,507.05 7
Aztreonam 1 gram solution for injection HCPCS J0457 $34.20 $57.00 $1.25 – $48.45 7
Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 $1,320.00 $2,200.00 $181.22 – $1,870.00 7
Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 $420.00 $700.00 $49.95 – $595.00 7
Basiliximab HCPCS J0480 $7,420.80 $12,368.00 $2,970.29 – $10,512.80 7
Belatacept 250 mg intravenous solution HCPCS J0485 $20.25 $33.75 $3.55 – $28.69 7
Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 $87.00 $145.00 $13.49 – $123.25 7
Benztropine 1 mg/ml injection solution HCPCS J0515 $126.60 $211.00 $11.42 – $179.35 7
Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 $160.80 $268.00 $6.96 – $227.80 7
Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 $671.40 $1,119.00 $73.20 – $950.30 7
Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 $459.00 $765.00 $27.86 – $650.25 7
Bivalirudin HCPCS J0583 $12.90 $21.50 $0.17 – $18.27 7
Bleomycin 15 unit solution for injection HCPCS J9040 $2,601.60 $4,336.00 $21.52 – $3,685.60 7
Blinatumomab 35 mcg intravenous solution HCPCS J9039 $417.00 $695.00 $71.57 – $590.75 7
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 $320.40 $534.00 $2.79 – $453.90 7
Brentuximab vedotin 50 mg intravenous solution HCPCS J9042 $513.60 $856.00 $89.59 – $727.60 7
Budesonide non-comp unit HCPCS J7626 $1,843.20 $3,072.00 $1.35 – $2,611.20 7
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 $58.80 $98.00 $0.37 – $83.30 7
Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 $1.95 $3.25 $0.01 – $0.14 6
Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet HCPCS J0572 $20.25 $33.75 $3.55 – $28.69 6
Buprenorphine 8 mg-naloxone 2 mg sublingual tablet HCPCS J0574 $36.60 $61.00 $6.36 – $51.85 6
Buprenorphine X-ray over 100 mg HCPCS Q9992 $11,436.60 $19,061.00 $1,088.20 – $16,201.85 7
Buprenorphine hydrochloride HCPCS J0592 $29.85 $49.75 $1.77 – $42.29 7
Busulfan injection HCPCS J0594 $40.80 $68.00 $0.88 – $57.80 7
Butorphanol tartrate 1 mg HCPCS J0595 $90.60 $151.00 $6.43 – $128.35 7
C-1 esterase, berinert HCPCS J0597 $168.60 $281.00 $75.86 – $238.85 7
Cabergoline, oral 0.25mg HCPCS J8515 $70.80 $118.00 $29.50 – $100.30 6
Caffeine citrate 20 mg/ml inj for po HCPCS J0706 $22.95 $38.25 $5.63 – $32.51 6
Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 $9,436.20 $15,727.00 $81.96 – $13,367.95 6
Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 $0.60 $1.00 $0.04 – $0.85 7
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 $0.60 $1.00 $0.09 – $0.85 7
Capsaicin 8% patch HCPCS J7336 $9.75 $16.25 $3.42 – $551.16 7
Carboplatin 10 mg/ml desensitization HCPCS J9045 $1,600.20 $2,667.00 $2.47 – $2,266.95 7
Carfilzomib 10 mg intravenous solution HCPCS J9047 $149.40 $249.00 $22.98 – $211.65 7
Carmustine 100 mg intravenous powder for solution HCPCS J9050 $2,713.80 $4,523.00 $238.46 – $3,844.55 7
Caspofungin acetate HCPCS J0637 $240.00 $400.00 $3.54 – $340.00 7
Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 $19.65 $32.75 $0.80 – $27.84 7
Cefepime 1 gram solution for injection HCPCS J0692 $85.20 $142.00 $1.22 – $120.70 7
Cefoxitin 1 gram intravenous solution HCPCS J0694 $216.60 $361.00 $4.78 – $306.00 7
Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 $13.80 $23.00 $1.23 – $5.74 7
Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 $115.20 $192.00 $1.57 – $38.25 7
Ceftazidime and avibactam HCPCS J0714 $312.00 $520.00 $50.97 – $442.00 7
Ceftriaxone 1 gram solution for injection HCPCS J0696 $257.40 $429.00 $0.43 – $165.75 7
Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 $93.60 $156.00 $1.85 – $130.90 7
Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 $34.80 $58.00 $3.91 – $47.60 7
Chloroprocaine hcl injection HCPCS J2401 $1.80 $3.00 $0.02 – $2.55 7
Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 $2,846.40 $4,744.00 $14.80 – $4,032.40 7
Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 $64.80 $108.00 $3.75 – $91.80 7
Chlorpromazine 100 mg tablet HCPCS Q0161 $2.40 $4.00 $0.31 – $3.40 6
Cidofovir injection HCPCS J0740 $27,738.00 $46,230.00 $546.29 – $39,295.50 7
Cilastatin sodium injection HCPCS J0743 $626.40 $1,044.00 $10.25 – $887.40 7
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 $513.00 $855.00 $2.90 – $726.75 7
Ciprofloxacin otic susp 6 mg HCPCS J7342 $876.00 $1,460.00 $54.00 – $207.12 6
Cisplatin 1 mg/ml desensitization HCPCS J9060 $749.40 $1,249.00 $2.29 – $1,061.65 7
Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 $576.60 $961.00 $10.68 – $816.85 7
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 $43.80 $73.00 $0.50 – $60.77 7
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 $348.60 $581.00 $18.17 – $465.80 7
Clozapine, 25 mg HCPCS S0136 $18.60 $31.00 $2.19 – $7.44 6
Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 $8.70 $14.50 $2.65 – $12.32 7
Colistimethate sodium inj HCPCS J0770 $1,284.60 $2,141.00 $13.06 – $1,819.85 7
Conjugated estrogens 25 mg solution for injection HCPCS J1410 $1,431.00 $2,385.00 $59.04 – $2,027.25 7
Cosyntropin 0.25 mg solution for injection HCPCS J0834 $480.00 $800.00 $25.37 – $680.00 7
Counseling smoke cess interm >10mins CPT 99407 $50.40 $84.00 $20.00 – $68.00 6
Crisis psychotherapy 90839 CPT 90839 $424.20 $707.00 $176.75 – $600.95 6
Crisis psychotherapy additional 30 mins 90840 CPT 90840 $212.40 $354.00 $88.50 – $300.90 6
Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 $436.20 $727.00 $99.22 – $617.95 7
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 $10.80 $18.00 $1.00 – $15.30 7
Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 $3.75 $6.25 $0.48 – $5.31 7
Cyclophosphamide 25 mg capsule HCPCS J8530 $67.20 $112.00 $1.10 – $95.20 7
Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 $268.20 $447.00 $50.93 – $379.95 7
Cyclosporine modified 25 mg capsule HCPCS J7515 $51.45 $85.75 $0.80 – $72.89 7
Cyclosporine oral 100 mg HCPCS J7502 $198.60 $331.00 $2.04 – $281.35 7
Cytarabine 20 mg/ml injection solution HCPCS J9100 $112.20 $187.00 $0.83 – $158.95 7
Cytomegalovirus imm IV /vial HCPCS J0850 $5,413.80 $9,023.00 $1,359.41 – $7,669.55 7
Dacarbazine 100 mg intravenous solution HCPCS J9130 $198.60 $331.00 $3.45 – $281.35 7
Dactinomycin 0.5 mg intravenous solution HCPCS J9120 $166.20 $277.00 $25.08 – $354.61 7
Dalbavancin 500 mg intravenous solution HCPCS J0875 $68.40 $114.00 $11.75 – $96.90 7
Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 $2.25 $3.75 $0.03 – $2.76 7
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 $134.40 $224.00 $32.38 – $190.40 7
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 $52.50 $87.50 $2.93 – $74.38 7
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 $681.00 $1,135.00 $117.13 – $964.75 7
Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 $808.20 $1,347.00 $21.70 – $1,144.95 7
Decitabine 50 mg intravenous solution HCPCS J0894 $292.80 $488.00 $1.22 – $414.80 7
Deferoxamine 500 mg solution for injection HCPCS J0895 $112.80 $188.00 $9.01 – $159.80 7
Degarelix 120 mg subcutaneous solution HCPCS J9155 $20.40 $34.00 $4.45 – $28.90 7
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 $61.80 $103.00 $19.75 – $87.55 7
Desmopressin 4 mcg/ml injection solution HCPCS J2597 $59.70 $99.50 $3.52 – $79.69 7
Device intraute mirena HCPCS J7298 $2,289.60 $3,816.00 $638.73 – $3,243.60 6
Dexametha opth insert 0.1 mg HCPCS J1096 $505.80 $843.00 $85.04 – $716.55 7
Dexamethasone 4 mg tablet HCPCS J8540 $0.60 $1.00 $0.02 – $0.85 7
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 $11.40 $19.00 $0.09 – $15.30 7
Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 $2,170.80 $3,618.00 $63.06 – $3,075.30 7
Dextrose 5 % IV bolus HCPCS J7070 $60.60 $101.00 $3.11 – $85.85 7
Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 $96.60 $161.00 $1.41 – $113.05 7
Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 $118.20 $197.00 $1.65 – $167.45 6
Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 $119.40 $199.00 $1.81 – $20.17 7
Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 $0.60 $1.00 $0.08 – $0.85 7
Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 $33.45 $55.75 $1.95 – $46.33 7
Dicyclomine injection HCPCS J0500 $691.20 $1,152.00 $3.31 – $979.20 7
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 $29.85 $49.75 $3.09 – $42.29 7
Digoxin immune fab 40 mg intravenous solution HCPCS J1162 $11,176.20 $18,627.00 $1,271.55 – $15,832.95 7
Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 $1,414.20 $2,357.00 $15.39 – $2,003.45 7
Dimenhydrinate injection HCPCS J1240 $33.90 $56.50 $1.31 – $48.02 7
Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 $13.80 $23.00 $0.76 – $19.55 7
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 $138.60 $231.00 $7.08 – $50.36 7
Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 $86.40 $144.00 $0.63 – $122.40 7
Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 $26.40 $44.00 $0.75 – $3.83 7
Dornase alfa non-comp unit HCPCS J7639 $571.80 $953.00 $11.12 – $810.05 7
Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 $631.20 $1,052.00 $3.02 – $890.80 7
Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 $1.65 $2.75 $0.11 – $2.34 7
Droperidol 2.5 mg/ml injection solution HCPCS J1790 $126.60 $211.00 $4.69 – $89.25 7
Drug of abuse screen urine CPT 80305 $1,074.00 $1,790.00 $10.28 – $1,521.50 7
Ecg 12 lead tracing only CPT 93005 $436.20 $727.00 $16.44 – $617.95 6
Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 $414.00 $690.00 $44.82 – $586.50 7
Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 $85.80 $143.00 $13.37 – $121.55 7
Electroconvulsive therapy 90870 CPT 90870 $1,226.40 $2,044.00 $321.75 – $1,737.40 6
Elranatamab-bcmm 40 mg/ml subcutaneous solution HCPCS J1323 $463.20 $772.00 $184.07 – $656.20 7
Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 $66.00 $110.00 $0.59 – $93.50 7
Epcoritamab-bysp 48 mg/0.8 ml subcutaneous solution HCPCS J9321 $102.60 $171.00 $21.37 – $145.35 7
Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 $1,009.20 $1,682.00 $0.44 – $1.49 7
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 $143.40 $239.00 $8.54 – $201.45 7
Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 $30.75 $51.25 $7.59 – $28.05 7
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 $253.20 $422.00 $16.20 – $195.50 7
Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 $204.00 $340.00 $23.11 – $289.00 6
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 $1,000.80 $1,668.00 $9.86 – $1,417.80 7
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 $109.20 $182.00 $11.92 – $130.05 7
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 $10.95 $18.25 $0.22 – $15.51 7
Established Patient Office Visit (level 1) CPT 99211 $186.60 $311.00 $33.36 – $118.15 6
Established Patient Office Visit (level 2) CPT 99212 $283.20 $472.00 $39.83 – $148.75 6
Established Patient Office Visit (level 3) CPT 99213 $426.00 $710.00 $53.29 – $209.10 6
Established Patient Office Visit (level 4) CPT 99214 $568.20 $947.00 $62.45 – $238.00 6
Established Patient Office Visit (level 5) CPT 99215 $709.20 $1,182.00 $72.83 – $283.90 6
Estradiol valerate 10 mg inj HCPCS J1380 $51.00 $85.00 $1.18 – $72.25 7
Etanercept injection HCPCS J1438 $1,801.80 $3,003.00 $240.20 – $2,551.70 6
Etonogestrel implant system HCPCS J7307 $2,545.20 $4,242.00 $1,060.50 – $3,605.70 6
Etoposide 20 mg/ml intravenous solution HCPCS J9181 $44.40 $74.00 $0.94 – $62.90 7
Evaluation psychiatric diagnostic CPT 90791 $993.00 $1,655.00 $25.00 – $285.01 6
Factor ix complex HCPCS J7194 $7.80 $13.00 $0.96 – $11.05 7
Factor ix recombinant nos HCPCS J7195 $34.65 $57.75 $1.85 – $49.09 7
Factor viii recomb novoeight HCPCS J7182 $3.15 $5.25 $1.25 – $4.46 7
Factor viii recombinant nos HCPCS J7192 $21.60 $36.00 $1.61 – $30.60 7
Family therapy with patient 50 min 90847 CPT 90847 $308.40 $514.00 $28.00 – $95.20 6
Family therapy without pt 50min 90846 CPT 90846 $287.40 $479.00 $28.00 – $95.20 6
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 $0.30 $0.50 $0.01 – $0.12 7
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 $16.20 $27.00 $1.10 – $21.68 7
Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 $4.95 $8.25 $0.85 – $7.01 7
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 $4.65 $7.75 $0.32 – $6.59 7
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 $3.75 $6.25 $0.81 – $5.31 7
Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 $1.95 $3.25 $0.30 – $1.70 7
Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 $6.90 $11.50 $0.46 – $9.78 7
Finasteride, 5 mg HCPCS S0138 $35.55 $59.25 $4.65 – $19.12 6
Floxuridine injection HCPCS J9200 $8,522.40 $14,204.00 $217.27 – $12,073.40 7
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 $2,662.80 $4,438.00 $2.26 – $1,998.35 7
Fludarabine 50 mg intravenous solution HCPCS J9185 $2,164.80 $3,608.00 $68.20 – $3,066.80 7
Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 $106.20 $177.00 $1.99 – $150.45 7
Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 $299.40 $499.00 $7.30 – $423.30 7
Folic acid 5 mg/ml injection solution HCPCS J1808 $1.05 $1.75 $0.06 – $1.49 7
Fomepizole 1 gram/ml intravenous solution HCPCS J1451 $74.40 $124.00 $6.78 – $105.40 6
Fondaparinux sodium HCPCS J1652 $60.60 $101.00 $0.72 – $85.85 7
Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 $10.20 $17.00 $0.10 – $14.45 7
Foscarnet sodium injection HCPCS J1455 $393.00 $655.00 $16.08 – $291.55 7
Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 $51.30 $85.50 $13.07 – $72.46 6
Furosemide 10 mg/ml injection solution HCPCS J1938 $0.60 $1.00 $0.02 – $0.85 7
Gamunex-c/gammaked HCPCS J1561 $259.20 $432.00 $48.96 – $364.65 7
Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 $1,251.60 $2,086.00 $39.54 – $1,773.10 7
Gemcitabine 1 gram intravenous solution HCPCS J9201 $1,333.20 $2,222.00 $3.13 – $1,888.70 7
Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 $704.40 $1,174.00 $130.33 – $997.90 7
Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 $80.40 $134.00 $2.21 – $113.90 7
Ghs IV infusion casirivimab/imdevimab HCPCS M0243 $1,020.00 $1,700.00 $274.35 – $1,445.00 6
Glucagon 1 mg solution for injection HCPCS J1610 $2,251.20 $3,752.00 $129.69 – $3,189.20 7
Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 $11.70 $19.50 $0.46 – $16.36 7
Granisetron hcl injection HCPCS J1626 $181.80 $303.00 $0.19 – $257.55 7
Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 $715.80 $1,193.00 $4.40 – $507.45 7
Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 $421.80 $703.00 $0.80 – $59.71 7
Hemin 350 mg intravenous powder for solution HCPCS J1640 $85.20 $142.00 $13.72 – $120.70 7
Heparin bolus from bag HCPCS J1644 $9.60 $16.00 $0.21 – $1.70 7
Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 $6.45 $10.75 $0.02 – $9.14 7
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 $355.80 $593.00 $134.19 – $504.05 7
Hocm 250-299mg/ml iodine,1ml HCPCS Q9961 $2.70 $4.50 $0.18 – $3.83 7
Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 $0.90 $1.50 $0.18 – $0.85 7
Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 $2.85 $4.75 $0.36 – $4.04 7
Hydralazine 20 mg/ml injection solution HCPCS J0360 $236.40 $394.00 $5.60 – $334.90 7
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 $53.85 $89.75 $9.05 – $76.29 7
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 $12.75 $21.25 $0.04 – $0.13 7
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 $1,343.40 $2,239.00 $0.25 – $0.85 6
Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 $17.55 $29.25 $1.84 – $15.94 7
Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 $150.00 $250.00 $62.50 – $212.50 6
Icatibant injection HCPCS J1744 $1,200.00 $2,000.00 $140.82 – $1,700.00 6
Idarubicin hcl injection HCPCS J9211 $3,685.20 $6,142.00 $36.67 – $5,220.70 7
Ifosfamide 1 gram intravenous solution HCPCS J9208 $1,083.60 $1,806.00 $25.20 – $1,535.10 7
Imatinib 100 mg tab HCPCS S0088 $120.60 $201.00 $34.39 – $170.85 6
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 $629.40 $1,049.00 $45.31 – $609.45 7
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 $920.40 $1,534.00 $47.52 – $1,303.90 7
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 $629.40 $1,049.00 $78.80 – $890.80 7
Imuglucerase injection HCPCS J1786 $343.20 $572.00 $43.19 – $486.20 7
Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 $24.00 $40.00 $10.76 – $34.00 6
Infliximab 100 mg intravenous solution HCPCS J1745 $633.00 $1,055.00 $31.09 – $895.05 7
Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 $141.60 $236.00 $20.41 – $200.60 7
Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 $202.80 $338.00 $19.99 – $287.30 7
Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 $30.00 $50.00 $12.50 – $98.16 7
Inj anifrolumab-fnia 1mg HCPCS J0491 $41.85 $69.75 $6.90 – $59.29 7
Inj aval alfa-nqpt 4mg HCPCS J0219 $5,248.20 $8,747.00 $30.84 – $7,434.95 7
Inj brixadi, more than 7 day HCPCS J0578 $4,345.20 $7,242.00 $1,682.55 – $6,155.70 7
Inj calcitriol per 0.1 mcg HCPCS J0636 $44.40 $74.00 $2.28 – $62.90 6
Inj ceftolozane tazobactam HCPCS J0695 $19.05 $31.75 $3.27 – $26.99 7
Inj cyclophosphamd (ingenus) HCPCS J9073 $3.75 $6.25 $0.78 – $5.31 7
Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 $79.80 $133.00 $13.18 – $113.05 7
Inj glofitamab gxbm, 2.5 mg HCPCS J9286 $6,717.00 $11,195.00 $1,075.73 – $9,515.75 7
Inj imip 4 cilas 4 releb 2mg HCPCS J0742 $7.35 $12.25 $1.80 – $10.41 7
Inj ivig privigen 500 mg HCPCS J1459 $199.80 $333.00 $50.74 – $216.75 7
Inj levocarnitine per 1 gm HCPCS J1955 $1,039.80 $1,733.00 $23.61 – $1,473.05 7
Inj melpha hydroch nos 50 mg HCPCS J9245 $6,460.20 $10,767.00 $95.90 – $9,151.95 7
Inj mepivacaine hcl/10 ml HCPCS J0670 $33.30 $55.50 $0.53 – $21.46 7
Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 $691.20 $1,152.00 $119.63 – $979.20 7
Inj multihance HCPCS A9577 $86.40 $144.00 $1.74 – $122.40 7
Inj progesterone per 50 mg HCPCS J2675 $11.40 $19.00 $0.70 – $16.15 7
Inj secretin synthetic human HCPCS J2850 $169.20 $282.00 $42.59 – $239.70 6
Inj secukinumab intrav 1mg HCPCS J3247 $43.50 $72.50 $17.84 – $61.62 7
Inj sulf hexa lipid microsph HCPCS Q9950 $105.60 $176.00 $18.59 – $149.60 7
Inj teclistamab cqyv 0.5 mg HCPCS J9380 $85.20 $142.00 $12.43 – $120.70 7
Inj testostero enanthate 1mg HCPCS J3121 $0.60 $1.00 $0.05 – $0.85 7
Inj testosterone cypionate HCPCS J1071 $0.60 $1.00 $0.03 – $0.85 7
Inj, abilify maintena, 1 mg HCPCS J0401 $19.65 $32.75 $3.02 – $27.84 7
Inj, bezlotoxumab, 10 mg HCPCS J0565 $156.00 $260.00 $27.18 – $221.00 7
Inj, brixadi, 7 days or less HCPCS J0577 $1,086.00 $1,810.00 $420.64 – $1,538.50 7
Inj, bupivacaine liposome HCPCS J0666 $4.35 $7.25 $1.47 – $6.16 7
Inj, cefepime hcl (b braun) HCPCS J0703 $85.20 $142.00 $3.27 – $120.70 7
Inj, cefiderocol, 10 mg HCPCS J0699 $6.00 $10.00 $0.90 – $8.50 7
Inj, cipaglucosidase, 5 mg HCPCS J1203 $229.20 $382.00 $91.21 – $324.70 7
Inj, factor x, (human), 1iu HCPCS J7175 $20.85 $34.75 $5.66 – $29.54 7
Inj, tyenne, 1 mg HCPCS Q5135 $12.75 $21.25 $4.42 – $18.06 7
Inj. fe derisomaltose 10 mg HCPCS J1437 $181.20 $302.00 $18.55 – $256.70 7
Inj., benralizumab, 1 mg HCPCS J0517 $576.60 $961.00 $109.10 – $816.85 7
Inj., emapalumab-lzsg, 1 mg HCPCS J9210 $1,929.00 $3,215.00 $304.56 – $2,732.75 7
Inj., guselkumab, 1 mg HCPCS J1628 $675.00 $1,125.00 $64.39 – $956.25 7
Inj., meropenem, vaborbactam HCPCS J2186 $36.45 $60.75 $2.35 – $51.64 6
Injection glatiramer acetate HCPCS J1595 $775.80 $1,293.00 $70.55 – $401.20 6
Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 $134.40 $224.00 $31.88 – $190.40 6
Injection, cangrelor HCPCS C9460 $61.80 $103.00 $10.98 – $87.55 6
Injection, daratumumab 10 mg HCPCS J9145 $198.60 $331.00 $33.83 – $280.50 7
Injection, doxercalciferol HCPCS J1270 $98.40 $164.00 $0.35 – $139.40 7
Injection, fulvestrant HCPCS J9395 $921.60 $1,536.00 $6.73 – $1,305.60 7
Injection, inclisiran, 1 mg HCPCS J1306 $53.85 $89.75 $5.15 – $76.29 7
Injection, isavuconazonium HCPCS J1833 $2.85 $4.75 $0.40 – $4.04 6
Injection, peramivir HCPCS J2547 $6.75 $11.25 $1.25 – $9.56 6
Injection, renflexis HCPCS Q5104 $229.20 $382.00 $27.00 – $324.70 7
Injection,onabotulinumtoxina HCPCS J0585 $41.55 $69.25 $6.33 – $58.86 7
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 $8,027.40 $13,379.00 $1,382.98 – $11,372.15 7
Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 $173.40 $289.00 $0.45 – $15.30 7
Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 $2,178.60 $3,631.00 $0.15 – $6.16 7
Ipratropium bromide non-comp HCPCS J7644 $49.35 $82.25 $0.39 – $69.91 7
Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 $1,572.00 $2,620.00 $1.75 – $2,227.00 7
Iron dextran 50 mg/ml injection solution HCPCS J1750 $194.40 $324.00 $18.11 – $275.40 7
Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 $6.75 $11.25 $0.23 – $9.56 7
Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 $126.60 $211.00 $0.30 – $179.35 7
Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 $4.50 $7.50 $0.11 – $6.38 7
Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 $0.90 $1.50 $0.38 – $1.27 6
Lactated ringers intravenous solution HCPCS J7120 $108.00 $180.00 $2.41 – $153.00 7
Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 $115.20 $192.00 $3.22 – $162.35 7
Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 $3,559.80 $5,933.00 $934.99 – $5,043.05 7
Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 $2,967.00 $4,945.00 $176.45 – $3,964.40 7
Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 $12.15 $20.25 $0.04 – $5.31 7
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 $325.80 $543.00 $2.54 – $461.55 7
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 $0.45 $0.75 $0.00 – $0.64 6
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 $883.80 $1,473.00 $3.57 – $1,019.15 7
Locm 100-199mg/ml iodine,1ml HCPCS Q9965 $9.75 $16.25 $0.96 – $4.89 7
Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 $96.00 $160.00 $1.38 – $136.00 7
Lumizyme injection HCPCS J0221 $966.60 $1,611.00 $201.09 – $1,369.35 7
Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 $310.80 $518.00 $28.96 – $119.00 7
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 $3.60 $6.00 $0.48 – $5.10 7
Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 $3.30 $5.50 $0.31 – $4.67 6
Megestrol 20 mg tabs 100 each bottle HCPCS S0179 $13.65 $22.75 $0.50 – $1.70 6
Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 $10.80 $18.00 $1.84 – $15.69 7
Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 $108.00 $180.00 $18.83 – $153.00 7
Meropenem 1 gram intravenous solution HCPCS J2185 $177.00 $295.00 $0.42 – $250.75 7
Mesna 100 mg/ml intravenous solution HCPCS J9209 $642.60 $1,071.00 $1.86 – $910.35 7
Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 $2.70 $4.50 $0.86 – $3.83 7
Methadone injection HCPCS J1230 $55.95 $93.25 $3.48 – $19.33 7
Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 $155.40 $259.00 $4.79 – $220.15 7
Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 $441.60 $736.00 $2.82 – $58.01 7
Methotrexate sodium 2.5 mg tablet HCPCS J8610 $28.65 $47.75 $0.19 – $40.59 7
Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 $406.80 $678.00 $0.53 – $9.43 6
Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 $42.45 $70.75 $3.95 – $60.14 7
Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 $5.10 $8.50 $0.50 – $3.40 6
Methylprednisolone 4 mg tablet HCPCS J7509 $114.60 $191.00 $0.11 – $7.44 7
Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 $0.90 $1.50 $0.07 – $0.21 7
Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 $10.80 $18.00 $0.21 – $0.64 7
Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 $10.35 $17.25 $1.08 – $14.66 7
Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 $3.15 $5.25 $0.02 – $4.46 7
Micafungin 100 mg intravenous solution HCPCS J2248 $36.60 $61.00 $0.26 – $51.64 7
Midazolam 1 mg/ml injection solution HCPCS J2250 $24.00 $40.00 $0.15 – $34.00 7
Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 $724.80 $1,208.00 $1.45 – $1,026.80 7
Minocycline hydrochloride HCPCS J2265 $1.05 $1.75 $0.52 – $2.88 6
Mitomycin 40 mg intravenous solution HCPCS J9280 $1,714.80 $2,858.00 $20.35 – $2,429.30 7
Mitomycin instillation HCPCS J9281 $858.00 $1,430.00 $208.39 – $1,215.50 7
Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 $2,986.80 $4,978.00 $23.88 – $4,231.30 7
Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 $43.80 $73.00 $6.18 – $62.05 7
Morphine 4 mg/ml injection (wrapper) HCPCS J2270 $11.40 $19.00 $1.95 – $16.15 7
Mycophenolate mofetil 250 mg capsule HCPCS J7517 $100.20 $167.00 $0.16 – $130.05 7
Mycophenolic acid HCPCS J7518 $19.05 $31.75 $0.34 – $26.56 7
Nafcillin 2 gram solution for injection HCPCS J2290 $5.55 $9.25 $0.05 – $7.86 7
Nalbuphine 10 mg/ml injection solution HCPCS J2300 $12.30 $20.50 $1.99 – $17.43 7
Naltrexone, depot form HCPCS J2315 $33.60 $56.00 $3.82 – $47.60 7
Nelarabine injection HCPCS J9261 $748.80 $1,248.00 $79.86 – $1,060.80 7
Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 $34.65 $57.75 $1.84 – $10.20 6
New Patient Office Visit (level 2) CPT 99202 $200.40 $334.00 $73.52 – $252.45 6
New Patient Office Visit (level 3) CPT 99203 $259.20 $432.00 $94.97 – $346.80 6
New Patient Office Visit (level 4) CPT 99204 $400.80 $668.00 $121.78 – $425.00 6
New Patient Office Visit (level 5) CPT 99205 $505.80 $843.00 $147.82 – $513.40 6
Nicardipine 25 mg/10 ml intravenous solution HCPCS J2404 $17.55 $29.25 $0.04 – $5.31 7
Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 $4.05 $6.75 $0.66 – $5.74 7
Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 $104.40 $174.00 $19.18 – $107.10 7
Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 $213.60 $356.00 $39.33 – $302.60 7
Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 $53.40 $89.00 $0.61 – $75.22 7
Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 $1,515.00 $2,525.00 $170.42 – $1,430.55 7
Olanzapine 10 mg intramuscular solution HCPCS J2359 $38.55 $64.25 $0.68 – $54.19 7
Olanzapine long-acting inj HCPCS J2358 $76.20 $127.00 $2.92 – $107.95 7
Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 $131.40 $219.00 $33.08 – $150.45 7
Ondansetron 4 mg s0119 HCPCS S0119 $428.40 $714.00 $14.38 – $164.05 6
Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 $66.00 $110.00 $0.09 – $93.50 7
Ophthalmic mitomycin HCPCS J7315 $1,930.20 $3,217.00 $345.20 – $2,734.45 6
Oral aprepitant HCPCS J8501 $73.80 $123.00 $2.73 – $102.85 7
Oral everolimus HCPCS J7527 $30.30 $50.50 $1.37 – $42.92 7
Oritavancin 400 mg intravenous solution HCPCS J2407 $105.60 $176.00 $17.14 – $149.60 7
Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 $366.00 $610.00 $3.05 – $518.50 7
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 $69.60 $116.00 $0.79 – $98.60 7
Oxaliplatin 5 mg/ml desensitization HCPCS J9263 $97.20 $162.00 $0.08 – $137.70 7
Oxytocin 10 unit/ml injection solution HCPCS J2590 $7.35 $12.25 $1.84 – $10.41 6
Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 $75.00 $125.00 $0.14 – $21.25 7
Paliperidone 117 mg/0.75 ml inj HCPCS J2426 $38.85 $64.75 $13.28 – $54.40 7
Palonosetron hcl HCPCS J2469 $332.40 $554.00 $0.36 – $470.90 7
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 $2,325.00 $3,875.00 $9.64 – $3,292.05 7
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 $165.00 $275.00 $68.75 – $233.75 6
Papaverin hcl injection HCPCS J2440 $61.20 $102.00 $2.65 – $34.85 6
Paricalcitol HCPCS J2501 $192.00 $320.00 $0.95 – $245.65 7
Pegaspargase injection HCPCS J9266 $19,415.40 $32,359.00 $2,430.25 – $30,697.98 7
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 $2,401.80 $4,003.00 $89.34 – $3,402.55 7
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 $1,189.20 $1,982.00 $106.33 – $1,684.70 7
Pegunigalsidase alfa-iwxj HCPCS J2508 $526.20 $877.00 $87.07 – $745.45 7
Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 $154.80 $258.00 $30.60 – $219.30 7
Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 $476.40 $794.00 $4.36 – $674.90 7
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 $68.40 $114.00 $9.67 – $58.65 7
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 $16.20 $27.00 $0.79 – $22.95 7
Pentamidine non-comp unit HCPCS J2545 $1,311.00 $2,185.00 $69.73 – $1,857.25 7
Pentobarbital sodium inj HCPCS J2515 $63.60 $106.00 $3.29 – $32.30 6
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 $1,422.60 $2,371.00 $40.65 – $2,015.35 7
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 $42.15 $70.25 $3.40 – $59.71 7
Phentolaine mesylate inj HCPCS J2760 $1,032.60 $1,721.00 $47.39 – $1,462.85 7
Phenylephrine 10 mg/ml injection solution HCPCS J2371 $0.14 $0.23 $0.00 – $0.01 6
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 $44.25 $73.75 $0.45 – $62.69 7
Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 $52.65 $87.75 $2.73 – $74.38 7
Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 $165.60 $276.00 $1.07 – $234.60 7
Plerixafor injection HCPCS J2562 $1,570.80 $2,618.00 $25.33 – $2,225.30 7
Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 $369.00 $615.00 $51.23 – $522.75 7
Porfimer sodium injection HCPCS J9600 $105,045.60 $175,076.00 $4,732.02 – $148,814.60 6
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 $11.40 $19.00 $0.11 – $0.64 7
Pr assessment emotional/behavioral per instrument brief CPT 96127 $11.40 $19.00 $3.35 – $16.15 6
Pr evaluation psychiatric diagnostic w/medical services CPT 90792 $1,276.20 $2,127.00 $165.43 – $872.10 6
Pr management transitional care high w/in 7 days of discharge CPT 99496 $1,831.20 $3,052.00 $132.69 – $2,594.20 6
Pr management transitional care moderate w/in 14 days of discharge CPT 99495 $1,295.40 $2,159.00 $132.39 – $1,835.15 6
Pralatrexate injection HCPCS J9307 $723.60 $1,206.00 $327.55 – $1,025.10 7
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 $4.05 $6.75 $0.15 – $0.85 7
Prednisone 1 mg tablet HCPCS J7512 $0.60 $1.00 $0.01 – $0.85 7
Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 $225.00 $375.00 $24.47 – $318.27 7
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 $30.30 $50.50 $1.81 – $42.92 7
Prolng off/op e/m ea 15 min 99417 CPT 99417 $162.00 $270.00 $7.74 – $227.80 6
Promethazine hcl injection HCPCS J2550 $39.75 $66.25 $1.84 – $47.39 7
Propofol infusion 10 mg/ml HCPCS J2704 $21.45 $35.75 $0.09 – $0.85 7
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 $197.40 $329.00 $11.49 – $279.65 6
Protamine 10 mg/ml intravenous solution HCPCS J2720 $6.15 $10.25 $1.53 – $8.71 7
Prothrombin complex kcentra HCPCS J7168 $8.25 $13.75 $1.31 – $11.69 6
Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 $433.80 $723.00 $27.93 – $614.55 6
Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 $857.40 $1,429.00 $25.74 – $1,214.65 6
Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 $857.40 $1,429.00 $22.03 – $1,214.65 6
Psych test eval svc phys/qhp 1st hr CPT 96130 $559.80 $933.00 $71.03 – $793.05 6
Psych test eval svc phys/qhp ea addl hr CPT 96131 $559.80 $933.00 $54.02 – $793.05 6
Psychotherapy group therapy CPT 90853 $46.80 $78.00 $19.50 – $106.45 6
Psychotherapy patient individual therapy 30 minutes CPT 90832 $168.00 $280.00 $51.00 – $173.40 6
Psychotherapy patient individual therapy 45 minutes CPT 90834 $287.40 $479.00 $88.50 – $300.90 6
Psychotherapy patient individual therapy 60 minutes CPT 90837 $254.40 $424.00 $100.00 – $340.00 6
Psychthrp grp 45-50min mcr HCPCS G0410 $46.80 $78.00 $19.50 – $66.30 6
Psycl/nrpsyc tech 1st CPT 96138 $857.40 $1,429.00 $22.03 – $1,214.65 6
Psytx complex interactive CPT 90785 $89.40 $149.00 $9.19 – $60.35 6
Psytx pt w/e&m 16-37 min CPT 90833 $178.20 $297.00 $70.00 – $238.00 6
Psytx pt w/e&m 38-52 min CPT 90836 $287.40 $479.00 $93.75 – $318.75 6
Psytx pt w/e&m 53+ min CPT 90838 $324.00 $540.00 $127.25 – $432.65 6
Pyridoxine hcl 100 mg HCPCS J3415 $58.80 $98.00 $0.90 – $83.30 7
Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 $880.20 $1,467.00 $279.85 – $1,246.95 7
Rasburicase 1.5 mg intravenous solution HCPCS J2783 $4,959.00 $8,265.00 $377.52 – $7,025.25 7
Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 $71,857.80 $119,763.00 $134.77 – $980.90 7
Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 $310.20 $517.00 $3.02 – $439.45 7
Remdesivir 100 mg intravenous powder for solution HCPCS J0248 $16.80 $28.00 $2.34 – $23.80 7
Reslizumab 10 mg/ml intravenous solution HCPCS J2786 $34.05 $56.75 $6.10 – $48.24 7
Rezafungin 200 mg intravenous solution HCPCS J0349 $26.25 $43.75 $4.10 – $37.19 7
Rho d immune globulin inj HCPCS J2790 $822.00 $1,370.00 $78.48 – $1,164.50 7
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 $224.40 $374.00 $4.86 – $317.90 7
Rho(d) immune globulin h, sd HCPCS J2792 $223.20 $372.00 $25.46 – $316.20 7
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 $4.20 $7.00 $0.14 – $5.95 7
Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 $20.25 $33.75 $6.84 – $28.69 7
Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 $64.20 $107.00 $9.54 – $90.95 7
Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 $432.00 $720.00 $64.71 – $612.00 7
Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 $537.60 $896.00 $29.38 – $761.60 7
Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 $210.00 $350.00 $27.84 – $297.50 7
Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 $127.20 $212.00 $15.30 – $180.20 7
Romiplostim 125 mcg subcutaneous solution HCPCS J2802 $25.95 $43.25 $11.01 – $36.76 7
Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 $2.70 $4.50 $0.05 – $3.40 7
Sarscov coronavirus ag ia CPT 87426 $34.80 $58.00 $17.23 – $83.17 7
Sincalide 5 mcg solution for injection HCPCS J2805 $753.00 $1,255.00 $95.89 – $1,066.75 7
Sirolimus, oral HCPCS J7520 $300.00 $500.00 $0.87 – $425.00 7
Sodium chloride 0.9 % IV bolus HCPCS J7040 $76.20 $127.00 $1.26 – $43.99 7
Sodium chloride 0.9 % IV bolus HCPCS J7050 $76.20 $127.00 $0.65 – $102.00 7
Sodium chloride 0.9 % intravenous solution HCPCS J7030 $55.65 $92.75 $1.95 – $39.52 7
Sodium chloride 3 % ivpb HCPCS J7131 $0.60 $1.00 $0.02 – $0.21 6
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 $89.40 $149.00 $2.02 – $126.65 7
Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 $6.75 $11.25 $1.84 – $9.56 6
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 $0.60 $1.00 $0.05 – $0.43 7
Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 $1,520.40 $2,534.00 $90.40 – $2,153.90 6
Tacrol astagraf ex rel oral HCPCS J7508 $3.15 $5.25 $0.33 – $4.46 7
Tacrol envarsus ex rel oral HCPCS J7503 $3.45 $5.75 $0.77 – $3.83 7
Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 $91.80 $153.00 $0.17 – $38.25 7
Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 $2,712.00 $4,520.00 $208.06 – $3,842.00 7
Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 $175.20 $292.00 $72.62 – $248.20 7
Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 $48.60 $81.00 $1.94 – $6.59 6
Tcran magn stim redetemine CPT 90869 $512.40 $854.00 $253.64 – $725.90 6
Tcranial magn stim tx deli CPT 90868 $478.80 $798.00 $210.67 – $678.30 6
Tcranial magn stim tx plan CPT 90867 $639.00 $1,065.00 $316.31 – $905.25 6
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 $539.40 $899.00 $26.71 – $764.15 7
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 $211.80 $353.00 $104.84 – $300.05 7
Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 $33.90 $56.50 $3.16 – $48.02 7
Teriparatide injection HCPCS J3110 $36.75 $61.25 $14.66 – $52.06 6
Tetanus immune globulin inj HCPCS J1670 $1,524.00 $2,540.00 $183.88 – $2,159.00 7
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 $47.25 $78.75 $7.78 – $66.94 7
Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 $64.80 $108.00 $0.50 – $91.80 7
Tigecycline injection HCPCS J3243 $34.65 $57.75 $0.39 – $49.09 7
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 $84.60 $141.00 $2.37 – $119.85 7
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 $17.70 $29.50 $5.71 – $20.40 7
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 $130.80 $218.00 $2.54 – $185.30 7
Trabectedin 1 mg intravenous solution HCPCS J9352 $1,172.40 $1,954.00 $197.47 – $1,660.90 7
Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 $198.00 $330.00 $27.99 – $280.50 7
Treprostinil injection HCPCS J3285 $1,570.80 $2,618.00 $54.71 – $1,335.35 7
Triamcinolone a inj prs-free HCPCS J3300 $21.15 $35.25 $6.49 – $29.96 7
Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 $16.80 $28.00 $0.84 – $23.80 7
Trimethobenzamide hcl inj HCPCS J3250 $98.40 $164.00 $4.16 – $139.40 7
Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 $52.50 $87.50 $8.81 – $74.38 7
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 $340.20 $567.00 $141.75 – $481.95 7
Vaccine hepatitis a (hepa) adult im CPT 90632 $81.00 $135.00 $33.75 – $114.75 7
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 $117.60 $196.00 $49.00 – $173.58 6
Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 $64.80 $108.00 $27.00 – $102.99 7
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 $126.60 $211.00 $52.75 – $179.35 7
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 $18.00 $30.00 $7.50 – $49.49 7
Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 $82.20 $137.00 $34.25 – $126.58 6
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 $91.80 $153.00 $34.00 – $171.89 6
Vaccine mmr live subcutaneous CPT 90707 $48.60 $81.00 $20.25 – $68.85 6
Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 $144.00 $240.00 $60.00 – $312.90 7
Vaccine rabies im CPT 90675 $600.00 $1,000.00 $252.84 – $850.00 7
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 $1,195.80 $1,993.00 $16.69 – $1,201.47 6
Vaccine td preservative free >= 7 years im CPT 90714 $55.80 $93.00 $23.25 – $79.05 7
Vaccine tdap >=7 years im CPT 90715 $31.80 $53.00 $13.25 – $73.11 7
Vasopressin 20 unit/ml intravenous solution HCPCS J2598 $7.95 $13.25 $0.93 – $11.26 7
Vedolizumab 300 mg intravenous solution HCPCS J3380 $73.80 $123.00 $11.38 – $104.55 7
Vinblastine 1 mg/ml intravenous solution HCPCS J9360 $141.00 $235.00 $5.30 – $199.75 7
Vincristine 1 mg/ml intravenous solution HCPCS J9370 $306.00 $510.00 $8.22 – $375.70 7
Vinorelbine 10 mg/ml intravenous solution (wrapper) HCPCS J9390 $1,020.60 $1,701.00 $7.68 – $1,445.85 7
Vonvendi inj 1 iu vwf:rco HCPCS J7179 $10.80 $18.00 $1.45 – $15.30 7
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr HCPCS J3465 $137.40 $229.00 $0.77 – $192.95 7
Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 $295.80 $493.00 $6.83 – $419.05 7
Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 $802.20 $1,337.00 $5.06 – $1,136.45 7

A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.