Deaconess Regional Medical Center — price list

← Hospital overviewVerified from Deaconess Regional 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.

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.

341 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
Acetaminophen 10 mg/ml solution 100 ml flex cont Outpatient	J0137 CPT	$101	$80.80	$0.05 – $0.05	—
Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal) Outpatient	L5655 CPT	—	—	—	—
Addition to upper extremity orthosis, sock, fracture or equal, each Outpatient	L3995 CPT	—	—	—	—
Addition to upper extremity prosthesis, external powered, additional switch, any type Outpatient	L6611 CPT	—	—	—	—
Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control Outpatient	L5780 CPT	—	—	—	—
Allo dbf putty grafton 6cc n t50106 ea1 Outpatient	C1762 CPT	$4,680	$3,744	—	—
Amiodarone 450 mg/9ml solution 9 ml vial Outpatient	J0283 CPT	$33.74	$26.99	—	—
Amphotericin b liposome per 10 mg Outpatient	J0289 CPT	$1,176	$941	$25.33 – $28.55	—
Ampicillin per 500 mg Outpatient	J0290 CPT	$33.50	$26.80	$0.96 – $0.96	—
Analysis for antibody to eastern equine virus (viral encephalitis) Outpatient	86652 CPT	—	—	$10.92 – $14.13	—
Anchr icnx 1.4mm #2 frce fbr n 3910500412 pk5 Outpatient	C1776 CPT	$6,478	$5,182	—	—
Anesthesia for closed diagnostic examination of chest using an endoscope with 1 lung ventilation Outpatient	00529 CPT	—	—	—	—
Anesthesia for procedure on male genitalia glands Outpatient	00922 CPT	—	—	—	—
Anesthesia for procedure on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand Outpatient	01810 CPT	—	—	—	—
Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated Outpatient	L1990 CPT	—	—	—	—
Arm pad repl, each; prosthetics, orthotics, and supplies Outpatient	K0019 CPT	—	—	$19.88 – $19.88	—
Azithromycin dihydrate, oral, capsules/powder, 1 gram Outpatient	Q0144 CPT	—	—	—	—
Back pain was not measured by the visual analog scale (vas) within three months preoperatively and at three months ( 6 - 20 weeks) postoperatively Outpatient	G9943 CPT	—	—	—	—
Balloon dilation of esophagus using a flexible endoscope, 3.0 cm or more Outpatient	43214 CPT	—	—	$184 – $1,942	—
Benztropine per 1 mg Outpatient	J0515 CPT	$321	$257	$15.62 – $15.62	—
Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors Outpatient	K1007 CPT	—	—	—	—
Bit drill qc synt 5x200mm n 310.632 ea1 Inpatient & outpatient	0272 RC	$1,900	$1,520	—	—
Bit drill qcpl 12x270mm n 03.010.439 ea1 Inpatient & outpatient	0272 RC	$2,214	$1,771	—	—
Bit drill twist cann as3 6.5m n 702601 ea1 Inpatient & outpatient	0272 RC	$2,708	$2,167	—	—
Blade hel fix nail ti 11x90mm n 456.303 ea1 Inpatient & outpatient	0272 RC	$2,978	$2,383	—	—
Blade osteotome w10mm n 47-9986-021-21 ea1 Inpatient & outpatient	0272 RC	$672	$538	—	—
Bln inpact admrl 6x80mm l130cm n adm06008013p ea1 Outpatient	C1725 CPT	$5,364	$4,291	—	—
Bln trek rx 2.50x20mm n 1012272-20 ea1 Outpatient	C1725 CPT	$1,170	$936	—	—
Bmi documented outside normal parameters, no follow-up plan documented, no reason given Outpatient	G8419 CPT	—	—	—	—
Bolt fixation l125mm dia6.5mm midfoot stainless steel lockin n 02.111.225s ea1 Outpatient	C1713 CPT	$2,899	$2,319	—	—