Allen County Regional Hospital — price list
← Hospital overviewVerified from Allen County Regional Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
28 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ACAMPROSATE 333 MG TABLET DELAYED RELEASE Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML (5 ML) ORAL SOLUTION Inpatient & outpatient | A9270 HCPCS | $29.20 | $17.52 | $10.22 – $28.00 | — | |
| ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.50 | $5.70 | $3.33 – $9.00 | — | |
| ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| ACETAMINOPHEN 325 MG/10.15 ML ORAL SUSPENSION Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| ACETAZOLAMIDE 250 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION Inpatient & outpatient | A9270 HCPCS | $46.65 | $27.99 | $16.33 – $45.00 | — | |
| ACYCLOVIR 200 MG CAPSULE Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| ACYCLOVIR 800 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| ALENDRONATE 70 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| ALLOPURINOL 100 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| ALPRAZOLAM 0.5 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.50 | $5.70 | $3.33 – $9.00 | — | |
| ALUMINUM CHLORIDE 20 % TOPICAL SOLUTION Inpatient & outpatient | A9270 HCPCS | $30.65 | $18.39 | $10.73 – $30.00 | — | |
| ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP Inpatient & outpatient | A9270 HCPCS | $12.50 | $7.50 | $4.38 – $12.00 | — | |
| ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP Inpatient & outpatient | A9270 HCPCS | $3.80 | $2.28 | $1.33 – $3.00 | — | |
| AMANTADINE HCL 100 MG CAPSULE Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $9.00 | — | |
| AMILORIDE 5 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| AMITRIPTYLINE 10 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| AMITRIPTYLINE 25 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| AMLODIPINE 5 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| AMMONIUM LACTATE 12 % LOTION Inpatient & outpatient | A9270 HCPCS | $29.50 | $17.70 | $10.33 – $28.00 | — | |
| AMOXICILLIN 250 MG CAPSULE Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION Inpatient & outpatient | A9270 HCPCS | $11.05 | $6.63 | $3.87 – $11.05 | — | |
| AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION Inpatient & outpatient | A9270 HCPCS | $36.15 | $21.69 | $12.65 – $35.00 | — | |
| AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — | |
| AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET Inpatient & outpatient | A9270 HCPCS | $9.00 | $5.40 | $3.15 – $8.00 | — |