Aspirus St. Luke's Hospital — price list
← Hospital overviewVerified from Aspirus St. Luke's Hospital’s published price file
Includes cash prices, list prices. 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) | |
|---|---|---|---|---|---|---|
| Abatacept 250 mg IV solr Inpatient & outpatient | 00003-2187-13 NDC | $9,331 | $5,076 | — | — | |
| Ablysinol ia soln Inpatient & outpatient | 54288-0105-15 NDC | $5,134 | $2,793 | — | — | |
| Acarbose 25 mg po tabs Inpatient & outpatient | 23155-0147-01 NDC | $4.62 | $2.51 | — | — | |
| Acd formula a 0.73-2.45-2.2 gm/100ml vi soln Inpatient & outpatient | 00942-0641-04 NDC | $61.65 | $33.54 | — | — | |
| Acebutolol hcl 200 mg po caps Inpatient & outpatient | 53746-0669-01 NDC | $7.24 | $3.94 | — | — | |
| Acetaminophen 10 mg/ml IV soln Inpatient & outpatient | 63323-0434-00 NDC | $59.08 | $32.14 | — | — | |
| Acetaminophen 10 mg/ml ivpb Inpatient & outpatient | 00001-1205-01 NDC | $16.68 | $9.07 | — | — | |
| Acetaminophen 120 mg re supp Inpatient & outpatient | 51672-2115-02 NDC | $4.12 | $2.24 | — | — | |
| Acetaminophen 160 mg/5ml po soln Inpatient & outpatient | 00904-7321-76 NDC | $6.63 | $3.61 | — | — | |
| Acetaminophen 325 mg po tabs Inpatient & outpatient | 50580-0458-11 NDC | $0.42 | $0.23 | — | — | |
| Acetaminophen 325 mg re supp Inpatient & outpatient | 51672-2116-02 NDC | $4.12 | $2.24 | — | — | |
| Acetaminophen 500 mg po tabs Inpatient & outpatient | 00904-6730-61 NDC | $0.42 | $0.23 | — | — | |
| Acetaminophen 650 mg re supp Inpatient & outpatient | 45802-0730-30 NDC | $3.43 | $1.87 | — | — | |
| Acetaminophen-codeine 300-30 mg po tabs Inpatient & outpatient | 00406-0484-62 NDC | $4.71 | $2.56 | — | — | |
| Acetazolamide 100 mg/ml injection syringe Inpatient & outpatient | 39822-0190-01 NDC | $405 | $220 | — | — | |
| Acetazolamide 25 mg/ml oral suspension Inpatient & outpatient | 00001-1105-01 NDC | $294 | $160 | — | — | |
| Acetazolamide 250 mg po tabs Inpatient & outpatient | 00904-6663-61 NDC | $22.26 | $12.11 | — | — | |
| Acetazolamide ER 500 mg po cp12 Inpatient & outpatient | 42571-0243-01 NDC | $22.06 | $12.00 | — | — | |
| Acetazolamide sodium 500 mg ij solr Inpatient & outpatient | 23155-0313-31 NDC | $122 | $66.57 | — | — | |
| Acetic acid 0.5% solution Inpatient & outpatient | 00001-0013-01 NDC | $24.66 | $13.42 | — | — | |
| Acetic acid 2 % OT soln Inpatient & outpatient | 52817-0816-15 NDC | $247 | $134 | — | — | |
| Acetic acid 3 % soln Inpatient & outpatient | 00001-1066-01 NDC | $82.61 | $44.94 | — | — | |
| Acetic acid 5 % soln Inpatient & outpatient | 51552-0055-06 NDC | $360 | $196 | — | — | |
| Acetylcysteine 20 % inh soln Inpatient & outpatient | 00409-3308-03 NDC | $95.09 | $51.73 | — | — | |
| Acetylcysteine 20 % inh soln Inpatient & outpatient | 00517-7604-25 NDC | $89.02 | $48.43 | — | — | |
| Acetylcysteine 200 mg/ml IV soln Inpatient & outpatient | 70594-0111-02 NDC | $370 | $201 | — | — | |
| Acyclovir 200 mg po caps Inpatient & outpatient | 00904-5789-61 NDC | $7.86 | $4.28 | — | — | |
| Acyclovir 200 mg/5ml po susp Inpatient & outpatient | 00472-0082-16 NDC | $24.17 | $13.15 | — | — | |
| Acyclovir 400 mg po tabs Inpatient & outpatient | 00904-5790-61 NDC | $11.14 | $6.06 | — | — | |
| Acyclovir 5 % ex oint Inpatient & outpatient | 65162-0835-94 NDC | $2,049 | $1,114 | — | — |