Grace Surgical Hospital — price list
← Hospital overviewVerified from Grace Surgical 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 FOR IV SOLN 250 MG Inpatient & outpatient | J0129 HCPCS | $22,313 | $9,371 | — | — | |
| ACETAMINOPHEN IV SOLN 10 MG/ML Inpatient & outpatient | J0136 HCPCS | $135 | $56.70 | — | — | |
| ACETAMINOPHEN IV SOLN 10 MG/ML Inpatient & outpatient | J0131 HCPCS | $135 | $56.70 | — | — | |
| ACETAMINOPHEN SUPPOS 325 MG Inpatient & outpatient | RX00713016406 CDM | $5.22 | $2.19 | — | — | |
| ACETAMINOPHEN SUPPOS 650 MG Inpatient & outpatient | RX00713016512 CDM | $5.90 | $2.48 | — | — | |
| ACETAMINOPHEN SUSP 160 MG/5ML Inpatient & outpatient | RX00000007052 CDM | $5.00 | $2.10 | — | — | |
| ACETAMINOPHEN TAB 325 MG Inpatient & outpatient | RX00904671960 CDM | $5.00 | $2.10 | — | — | |
| ACETAMINOPHEN TAB 325 MG Inpatient & outpatient | RX00904671980 CDM | $5.00 | $2.10 | — | — | |
| ACETAMINOPHEN TAB 325 MG Inpatient & outpatient | RX00904677361 CDM | $5.00 | $2.10 | — | — | |
| ACETAMINOPHEN TAB 500 MG Inpatient & outpatient | RX00904672051 CDM | $5.00 | $2.10 | — | — | |
| ACETAMINOPHEN TAB 500 MG Inpatient & outpatient | RX00904672060 CDM | $5.00 | $2.10 | — | — | |
| ACETAMINOPHEN TAB 500 MG Inpatient & outpatient | RX00904673061 CDM | $5.00 | $2.10 | — | — | |
| ACETAMINOPHEN W/ CODEINE SOLN 120-12 MG/5ML Inpatient & outpatient | RX00000003780 CDM | $14.05 | $5.90 | — | — | |
| ACETAMINOPHEN W/ CODEINE SOLN 120-12 MG/5ML Inpatient & outpatient | RX00121050404 CDM | $14.05 | $5.90 | — | — | |
| ACETAMINOPHEN W/ CODEINE TAB 300-30 MG Inpatient & outpatient | RX00406048423 CDM | $14.05 | $5.90 | — | — | |
| ACETAMINOPHEN W/ CODEINE TAB 300-30 MG Inpatient & outpatient | RX00406048462 CDM | $14.05 | $5.90 | — | — | |
| ACETIC ACID IRRIGATION SOLN 0.25% Inpatient & outpatient | RX00338065604 CDM | $118 | $49.37 | — | — | |
| ACETYLCYSTEINE INHAL SOLN 10% Inpatient & outpatient | J7608 HCPCS | $11.00 | $4.62 | — | — | |
| ALBUMIN, HUMAN INJ 25% Inpatient & outpatient | P9047 HCPCS | $589 | $247 | — | — | |
| ALBUMIN, HUMAN INJ 5% Inpatient & outpatient | P9045 HCPCS | $591 | $248 | — | — | |
| ALBUTEROL SULFATE INHAL AERO 108 MCG/ACT (90MCG BASE EQUIV) Inpatient & outpatient | RX00054074287 CDM | $245 | $103 | — | — | |
| ALBUTEROL SULFATE INHAL AERO 108 MCG/ACT (90MCG BASE EQUIV) Inpatient & outpatient | RX00781729685 CDM | $488 | $205 | — | — | |
| ALBUTEROL SULFATE SOLN NEBU 0.083% (2.5 MG/3ML) Inpatient & outpatient | J7613 HCPCS | $11.00 | $4.62 | — | — | |
| ALCOHOL, RUBBING 70% Inpatient & outpatient | RX00395004016 CDM | $22.77 | $9.56 | — | — | |
| ALLOPURINOL TAB 100 MG Inpatient & outpatient | RX00904704161 CDM | $11.00 | $4.62 | — | — | |
| ALTEPLASE CATH DECLOT IN SW INJ 0.5MG/ML Inpatient & outpatient | J2997 HCPCS | $792 | $333 | — | — | |
| ALUM (AMMONIUM) POWDER Inpatient & outpatient | RX00395004912 CDM | $138 | $57.88 | — | — | |
| ALUM & MAG HYDROXIDE-SIMETHICONE SUSP 200-200-20 MG/5ML Inpatient & outpatient | RX00000003150 CDM | $5.00 | $2.10 | — | — | |
| ALUM & MAG HYDROXIDE-SIMETHICONE SUSP 200-200-20 MG/5ML Inpatient & outpatient | RX00000005863 CDM | $5.00 | $2.10 | — | — | |
| ALUM & MAG HYDROXIDE-SIMETHICONE SUSP 200-200-20 MG/5ML Inpatient & outpatient | RX00536129383 CDM | $5.00 | $2.10 | — | — |