Mount Sinai South Nassau — price list

← Hospital overviewVerified from Mount Sinai South Nassau’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)
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	34003074 CDM	$5.29	$4.76	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	J0595 HCPCS	$5.97	$5.38	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	34003079 CDM	$0.59	$0.53	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	34003083 CDM	$0.68	$0.61	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	J1644 HCPCS	$0.68	$0.61	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	34003085 CDM	$4.05	$3.64	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	34003088 CDM	$0.33	$0.30	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	34003089 CDM	$0.33	$0.30	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	34003090 CDM	$4.85	$4.36	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	34003092 CDM	$1.97	$1.77	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	J0640 HCPCS	$1.91	$1.72	—	—
Acetaminophen/Butalbital/Caffeine 325 mg-50 mg-40 mg Tab Inpatient & outpatient	J9280 HCPCS	$2.88	$2.59	—	—
acetaZOLAMIDE 500 mg Injection Inpatient & outpatient	34001488 CDM	$86.76	$78.09	—	—
acetaZOLAMIDE 500 mg Injection Inpatient & outpatient	J0456 HCPCS	$7.08	$6.37	—	—
acetaZOLAMIDE 500 mg Injection Inpatient & outpatient	34001504 CDM	$45.94	$41.34	—	—
acetaZOLAMIDE 500 mg Injection Inpatient & outpatient	J0585 HCPCS	$41.18	$37.07	—	—
Actigraphy testing Outpatient	95803 HCPCS	—	—	$55.96 – $73.64	—
Adenosine 300 mcg/mL Injection Inpatient & outpatient	34000084 CDM	$81.06	$72.96	—	—
Adenosine 6 mg/2 mL Inj Inpatient & outpatient	J7644 HCPCS	$5.69	$5.12	—	—
Adenosine 6 mg/2 mL Inj Inpatient & outpatient	34000090 CDM	$11.07	$9.96	—	—
Adenosine 6 mg/2 mL Inj Inpatient & outpatient	J0457 HCPCS	$10.59	$9.53	—	—
Adenosine 6 mg/2 mL Inj Inpatient & outpatient	34000093 CDM	$10.26	$9.24	—	—
Adenosine 6 mg/2 mL Inj Inpatient & outpatient	34000094 CDM	$10.59	$9.53	—	—
Aerosol inhalation treatment Outpatient	94642 HCPCS	—	—	$3.00 – $273	—
Airway inhalation treatment Outpatient	94640 HCPCS	—	—	$3.00 – $273	—
Albuterol 2 mg/5 mL Syrup Inpatient & outpatient	J9040 HCPCS	$5.63	$5.07	—	—
Albuterol 2 mg/5 mL Syrup Inpatient & outpatient	J3105 HCPCS	$94.33	$84.89	—	—
Albuterol 2 mg/5 mL Syrup Inpatient & outpatient	J0665 HCPCS	$0.25	$0.23	—	—
Albuterol 2 mg/5 mL Syrup Inpatient & outpatient	J3490 HCPCS	$8.00	$7.20	—	—
Albuterol 2.5 mg/3 mL (0.083%) Inhalation Solution Inpatient & outpatient	J3490 HCPCS	$1.06	$0.95	—	—