AdventHealth Four Corners ER — price list
← Hospital overviewVerified from AdventHealth Four Corners ER’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.
Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.
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.
1,500 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| 12 hour decongestant 0.05 % na soln Inpatient & outpatient | 259 RC | $189 | $189 | — | — | |
| 7 day vaginal 2 % va crea Inpatient & outpatient | 259 RC | $178 | $178 | — | — | |
| Acetaminophen 1000 mg/100 ml IV soln Inpatient & outpatient | J0131 HCPCS | $412 | $412 | — | — | |
| Acetaminophen 1000 mg/100 ml IV soln Inpatient & outpatient | J0134 HCPCS | $131 | $131 | — | — | |
| Acetaminophen 1000 mg/100 ml IV soln Inpatient & outpatient | J0137 HCPCS | $340 | $340 | — | — | |
| Acetaminophen 1000 mg/100 ml IV soln Inpatient & outpatient | J0136 HCPCS | $155 | $155 | — | — | |
| Acetaminophen 160 mg/5ml po soln Inpatient & outpatient | 259 RC | $222 | $222 | — | — | |
| Acetaminophen 500 mg/50 ml IV soln Inpatient & outpatient | J0136 HCPCS | $265 | $265 | — | — | |
| Acetaminophen 650 mg/20.3ml po soln Inpatient & outpatient | 259 RC | $72.90 | $72.90 | — | — | |
| Acetazolamide sodium 500 mg ij solr Inpatient & outpatient | J1120 HCPCS | $1,483 | $1,483 | — | — | |
| Acetic acid 3 % soln Inpatient & outpatient | 259 RC | $8.77 | $8.77 | — | — | |
| Acetylcysteine 20 % in soln Inpatient & outpatient | 259 RC | $332 | $332 | — | — | |
| Acetylcysteine 200 mg/ml IV soln Inpatient & outpatient | J0132 HCPCS | $628 | $628 | — | — | |
| Actemra 200 mg/10ml IV soln Inpatient & outpatient | J3262 HCPCS | $3,414 | $3,414 | — | — | |
| Actemra 400 mg/20ml IV soln Inpatient & outpatient | J3262 HCPCS | $29,807 | $29,807 | — | — | |
| Actemra 80 mg/4ml IV soln Inpatient & outpatient | J3262 HCPCS | $3,414 | $3,414 | — | — | |
| Actidose with sorbitol 25 gm/120ml po susp Inpatient & outpatient | 259 RC | $1,254 | $1,254 | — | — | |
| Actidose-aqua 25 gm/120ml po liqd Inpatient & outpatient | 259 RC | $1,254 | $1,254 | — | — | |
| Acyclovir sodium 50 mg/ml IV soln Inpatient & outpatient | J0133 HCPCS | $277 | $277 | — | — | |
| Adacel 5-2-15.5 lf-mcg/0.5 IM susp Inpatient & outpatient | 90715 HCPCS | $2,418 | $2,418 | — | — | |
| Adenosine (diagnostic) 3 mg/ml IV soln Inpatient & outpatient | J0153 HCPCS | $4,724 | $4,724 | — | — | |
| Adenosine 12 mg/4ml IV soln Inpatient & outpatient | J0153 HCPCS | $672 | $672 | — | — | |
| Adenosine 6 mg/2ml IV soln Inpatient & outpatient | J0153 HCPCS | $353 | $353 | — | — | |
| Adrenalin 0.1 % na soln Inpatient & outpatient | 259 RC | $3,025 | $3,025 | — | — | |
| Adrenalin-nacl 4-0.9 mg/250ml-% IV soln Inpatient & outpatient | J3490 HCPCS | $1,098 | $1,098 | — | — | |
| Afluria preservative free 0.5 ml IM susy Inpatient & outpatient | 90656 HCPCS | $789 | $789 | — | — | |
| Afrin nodrip extra moisture 0.05 % na soln Inpatient & outpatient | 259 RC | $355 | $355 | — | — | |
| Akten 3.5 % op gel Inpatient & outpatient | 259 RC | $648 | $648 | — | — | |
| Alaway 0.035 % op soln Inpatient & outpatient | 259 RC | $433 | $433 | — | — | |
| Albuked 25 25 % IV soln Inpatient & outpatient | P9046 HCPCS | $1,530 | $1,530 | — | — |