Saint Luke's East Hospital — price list
← Hospital overviewVerified from Saint Luke's East 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.
33 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ABACAVIR 300 MG TABLET Inpatient & outpatient | A9270 HCPCS | $47.65 | $28.59 | $6.24 – $47.65 | — | |
| ABORTION WITH D&C ASPIRATION CURETTAGE OR HYSTEROTOMY Inpatient | 770 MS-DRG | $38,563 | $23,138 | $1,777 – $38,563 | — | |
| ABORTION WITHOUT D&C Inpatient | 779 MS-DRG | $21,908 | $13,145 | $1,777 – $21,908 | — | |
| ACAMPROSATE 333 MG TABLET DELAYED RELEASE Inpatient & outpatient | A9270 HCPCS | $15.65 | $9.39 | $2.05 – $14.00 | — | |
| ACARBOSE 50 MG TABLET Inpatient & outpatient | A9270 HCPCS | $7.00 | $4.20 | $0.92 – $6.00 | — | |
| ACEBUTOLOL 200 MG CAPSULE Inpatient & outpatient | A9270 HCPCS | $14.45 | $8.67 | $1.89 – $14.45 | — | |
| ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY Inpatient & outpatient | A9270 HCPCS | $17.80 | $10.68 | $2.33 – $16.00 | — | |
| ACETAMINOPHEN 120 MG-CODEINE 12 MG/5 ML (5 ML) ORAL SOLUTION Inpatient & outpatient | A9270 HCPCS | $257 | $154 | $33.67 – $244 | — | |
| ACETAMINOPHEN 160 MG/5 ML ORAL LIQUID Inpatient & outpatient | A9270 HCPCS | $12.50 | $7.50 | $1.64 – $12.50 | — | |
| ACETAMINOPHEN 300 MG-CODEINE 30 MG TABLET Inpatient & outpatient | A9270 HCPCS | $8.75 | $5.25 | $1.15 – $8.75 | — | |
| ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY Inpatient & outpatient | A9270 HCPCS | $19.40 | $11.64 | $2.54 – $18.00 | — | |
| ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY Inpatient & outpatient | A9270 HCPCS | $7.00 | $4.20 | $0.92 – $6.00 | — | |
| ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLUTION Inpatient & outpatient | A9270 HCPCS | $38.70 | $23.22 | $5.07 – $38.70 | — | |
| ACETAZOLAMIDE 250 MG TABLET Inpatient & outpatient | A9270 HCPCS | $7.00 | $4.20 | $0.92 – $7.00 | — | |
| ACETAZOLAMIDE 50 MG/ML INJ SOLN (NICU) Inpatient & outpatient | J1120 HCPCS | $5,478 | $3,287 | $19.84 – $5,478 | — | |
| ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION Inpatient & outpatient | J1120 HCPCS | $666 | $400 | $19.84 – $666 | — | |
| ACETAZOLAMIDE ER 500 MG CAPSULE EXTENDED RELEASE Inpatient & outpatient | A9270 HCPCS | $7.00 | $4.20 | $0.92 – $7.00 | — | |
| ACETIC ACID (BULK) 3 % LIQUID Inpatient & outpatient | 25000003 HCPCS | $150 | $90.00 | $16.50 – $142 | — | |
| ACETIC ACID (BULK) 5 % LIQUID Inpatient & outpatient | 25000003 HCPCS | $12.00 | $7.20 | $1.32 – $11.00 | — | |
| ACETIC ACID 0.25 % IRRIGATION SOLUTION Inpatient & outpatient | 25000003 HCPCS | $70.75 | $42.45 | $7.78 – $67.00 | — | |
| ACETYLCHOLINE 2 MCG/ML INTRACORONARY INJECTION SYRINGE TEST DOSE Inpatient & outpatient | 25000003 HCPCS | $12.50 | $7.50 | $1.38 – $11.00 | — | |
| ACETYLCHOLINE 20 MCG/ML INJECTION SYRINGE INJECTION Inpatient & outpatient | 25000003 HCPCS | $12.50 | $7.50 | $1.38 – $11.00 | — | |
| ACETYLCYSTEINE (20 %) MISC SOLN (NEB) Inpatient & outpatient | J7608 HCPCS | $144 | $86.22 | $5.69 – $144 | — | |
| ACETYLCYSTEINE (20%) SOLUTION (CONTRAST NEPHROPATHY) Inpatient & outpatient | J7608 HCPCS | $485 | $291 | $34.14 – $461 | — | |
| ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION Inpatient & outpatient | J0132 HCPCS | $87.85 | $52.71 | $2.28 – $87.85 | — | |
| ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION Inpatient & outpatient | J7608 HCPCS | $14.90 | $8.94 | $1.64 – $14.90 | — | |
| Acromioplasty/Acromionectomy Prtl +-Ligament Rls Outpatient | 23130 CPT | $27,816 | $16,690 | $1,049 – $9,912 | — | |
| Acromioplasty/Acromionectomy Prtl +-Ligament Rls|RIGHT SIDE|DISTINCT PROCEDURAL SERVICE Outpatient | 23130 CPT | $31,386 | $18,831 | $1,049 – $9,912 | — | |
| ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSPENSION Inpatient & outpatient | 25000003 HCPCS | $254 | $152 | $27.92 – $241 | — | |
| ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML ORAL SUSPENSION Inpatient & outpatient | A9270 HCPCS | $627 | $376 | $82.08 – $595 | — |