Deaconess Gateway Hospital — price list
← Hospital overviewVerified from Deaconess Gateway 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.
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.
79 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ALLOPURINOL 100 MG PO TABS Inpatient | 0637 RC | $2.50 | $0.83 | $0.83 – $2.20 | — | |
| AMIODARONE HCL 100 MG PO TABS Inpatient | 0637 RC | $22.50 | $7.43 | $7.43 – $19.80 | — | |
| AMITRIPTYLINE HCL 100 MG PO TABS Inpatient | 0637 RC | $3.50 | $1.16 | $1.16 – $3.08 | — | |
| BENZONATATE 100 MG PO CAPS Inpatient | 0637 RC | $3.50 | $1.16 | $1.16 – $3.08 | — | |
| BEVACIZUMAB 100 MG/4ML IV SOLN Inpatient | J9035 HCPCS | $2,546 | $840 | $840 – $2,240 | — | |
| BEVACIZUMAB-BVZR 100 MG/4ML IV SOLN Inpatient | Q5118 HCPCS | $2,050 | $677 | $677 – $1,804 | — | |
| BRIVARACETAM 100 MG PO TABS Inpatient | 0637 RC | $76.00 | $25.08 | $25.08 – $66.88 | — | |
| BUPROPION HCL 100 MG PO TABS Inpatient | 0637 RC | $6.00 | $1.98 | $1.98 – $5.28 | — | |
| CARBAMAZEPINE 100 MG PO CHEW Inpatient | 0637 RC | $3.50 | $1.16 | $1.16 – $3.08 | — | |
| CARBIDOPA-LEVODOPA 10-100 MG PO TABS Inpatient | 0637 RC | $3.50 | $1.16 | $1.16 – $3.08 | — | |
| CIPROFLOXACIN IN D5W 200 MG/100ML IV SOLN Inpatient | J0744 HCPCS | $79.50 | $26.24 | $26.24 – $69.96 | — | |
| CYANOCOBALAMIN 1000 MCG/ML IJ SOLN Inpatient | J3420 HCPCS | $101 | $33.17 | $33.17 – $88.44 | — | |
| CYCLOSPORINE MODIFIED 100 MG PO CAPS Inpatient | J7502 HCPCS | $18.50 | $6.11 | $6.11 – $16.28 | — | |
| CYTARABINE (PF) 20 MG/ML IJ SOLN Inpatient | J9100 HCPCS | $419 | $138 | $138 – $369 | — | |
| DAPSONE 100 MG PO TABS Inpatient | 0637 RC | $10.00 | $3.30 | $3.30 – $8.80 | — | |
| DEXAMETHASONE SOD PHOSPHATE PF 10 MG/ML IJ SOLN Inpatient | J1100 HCPCS | $92.50 | $30.53 | $30.53 – $81.40 | $44.39 | |
| DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML IJ SOLN (WRAPPER) Inpatient | J1100 HCPCS | $73.50 | $24.26 | $24.26 – $64.68 | $44.39 | |
| DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML IJ SOLN Inpatient | J1100 HCPCS | $74.00 | $24.42 | $24.42 – $65.12 | $44.39 | |
| DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML IJ SOLN (WRAPPER) Inpatient | J1100 HCPCS | $72.50 | $23.93 | $23.93 – $63.80 | $44.39 | |
| DOCUSATE SODIUM 100 MG PO CAPS Inpatient | 0637 RC | $0.50 | $0.17 | $0.17 – $0.44 | — | |
| DOXYCYCLINE HYCLATE 100 MG IV SOLR Inpatient | J1271 HCPCS | $172 | $56.60 | $56.60 – $151 | — | |
| DOXYCYCLINE HYCLATE 100 MG PO CAPS Inpatient | 0637 RC | $18.50 | $6.11 | $6.11 – $16.28 | — | |
| DROXIDOPA 100 MG PO CAPS Inpatient | 0637 RC | $88.50 | $29.21 | $29.21 – $77.88 | — | |
| ENOXAPARIN SODIUM 100 MG/ML IJ SOSY Inpatient | J1650 HCPCS | $99.50 | $32.84 | $32.84 – $87.56 | — | |
| EPOETIN ALFA-EPBX 10000 UNIT/ML IJ SOLN Inpatient | Q5106 HCPCS | $409 | $135 | $135 – $360 | — | |
| EPTIFIBATIDE 75 MG/100ML IV SOLN Inpatient | J1327 HCPCS | $341 | $112 | $112 – $300 | — | |
| ESMOLOL HCL 100 MG/10ML IV SOLN Inpatient | 0250 RC | $120 | $39.60 | $39.60 – $106 | — | |
| FENTANYL 100 MCG/HR TD PT72 Inpatient | 0637 RC | $183 | $60.23 | $60.23 – $161 | — | |
| FENTANYL CITRATE (PF) 100 MCG/2ML IJ SOLN Inpatient | J3010 HCPCS | $83.00 | $27.39 | $27.39 – $73.04 | $47.72 | |
| FLUCONAZOLE IN SODIUM CHLORIDE 200-0.9 MG/100ML-% IV SOLN Inpatient | J1450 HCPCS | $88.00 | $29.04 | $29.04 – $77.44 | — |