Bellevue Medical Center — price list

← Hospital overviewVerified from Bellevue Medical Center’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)
ABILIFY MAINTENA ER 400 MG VL Outpatient	164461OP_1 CDM	$17,455	$11,346	$9,949 – $10,550	$9,949
ABIRATERONE ACETATE 250 MG TAB Outpatient	150641IP_1 CDM	$595	$387	$339 – $360	$8.32
ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM Outpatient	122IP_1 CDM	$10.99	$7.14	$6.07 – $13.19	$6.07
ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM Outpatient	123IP_1 CDM	$19.17	$12.46	$10.59 – $23.00	$10.59
ACETYLCYSTEINE, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, PER GRAM Outpatient	123OP_1 CDM	$18.56	$12.06	$10.25 – $22.27	$10.25
Acne surgery Outpatient	10040_1 CDM	$270	$176	$48.97 – $159	—
Additional incision of burn tissue Outpatient	16036_1 CDM	$238	$155	$71.58 – $234	—
ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG Outpatient	115221IP_1 CDM	$3.74	$2.43	$2.07 – $4.49	$2.07
ALBUTEROL, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, CONCENTRATED FORM, 1 MG Outpatient	115221OP_1 CDM	$2.09	$1.36	$1.15 – $2.51	$1.15
AMYVID PATIENT READY DOSE VIAL Outpatient	159318OP_1 CDM	$15,396	$10,008	$8,776 – $9,305	$33.05
ANDROGEL 1.62% GEL PUMP Outpatient	152509IP_1 CDM	$1,805	$1,173	$1,029 – $1,091	$8.32
Anesthesia for treatment of second and third degree burn, each additional 9% of total body surface area or less Outpatient	01953_1 CDM	$185	$120	$76.43 – $92.40	$92.40
ANTI-INHIBITOR, PER I.U. Outpatient	116307IP_1 CDM	$20,307	$13,199	$20,307 – $24,368	—
Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less Outpatient	15275_1 CDM	$390	$254	$88.22 – $286	—
Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less Outpatient	15275T_1 CDM	$758	$493	$88.22 – $286	—
Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 25.0 sq cm of wound 100.0 sq cm or less Outpatient	15276_1 CDM	$75.00	$48.75	$23.32 – $76.35	—
Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less Outpatient	15271_1 CDM	$280	$182	$77.27 – $252	—
Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less Outpatient	15272_1 CDM	$50.00	$32.50	$15.73 – $51.64	—
ASCLERA 10 MG/2 ML (0.5%) AMP Outpatient	155875OP_1 CDM	$27.76	$18.04	$15.82 – $16.78	$8.32
ASCLERA 20 MG/2 ML (1%) AMPULE Outpatient	155877OP_1 CDM	$31.13	$20.23	$17.74 – $18.82	$8.32
Aspiration of abscess, blood, or cyst Outpatient	10160_1 CDM	$320	$208	$88.25 – $290	—
AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM Outpatient	15797IP_1 CDM	$4.93	$3.20	$2.72 – $5.92	$2.72
AZITHROMYCIN DIHYDRATE, ORAL, CAPSULES/POWDER, 1 GRAM Outpatient	15797OP_1 CDM	$2.10	$1.37	$1.16 – $2.52	$1.16
BCG LIVE INTRAVESICAL INSTILLATION, 1 MG Outpatient	116210OP_1 CDM	$413	$268	$475 – $1,237	—
BICALUTAMIDE 50 MG TABLET Outpatient	15746IP_1 CDM	$7.45	$4.84	$4.25 – $4.50	$8.32
Biopsy of fingernail or toenail Outpatient	11755_1 CDM	$352	$229	$58.06 – $188	—
Biopsy of related skin growth, each additional growth Outpatient	11103_1 CDM	$138	$89.38	$20.56 – $66.82	—
Biopsy of related skin growth, first growth Outpatient	11102_1 CDM	$238	$154	$35.48 – $115	—
BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 3 MG, BUT LESS THAN OR EQUAL TO 6 MG BUPRENORPHINE Outpatient	162824IP_1 CDM	$39.84	$25.90	$22.00 – $47.81	$22.00
BUPRENORPHINE/NALOXONE, ORAL, GREATER THAN 3 MG, BUT LESS THAN OR EQUAL TO 6 MG BUPRENORPHINE Outpatient	162824OP_1 CDM	$17.40	$11.31	$9.61 – $20.88	$9.61