Stephens Memorial Hospital — price list
← Hospital overviewVerified from Stephens Memorial 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.
1,500 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ACETAMINOPHEN 10 MG/ML IV SOLN Outpatient | J0131 HCPCS | $93.06 | $93.06 | $36.29 – $90.27 | — | |
| ACETYLCYSTEINE 20 % IN SOLN (FOR ORAL USE) Outpatient | 0250 RC | $30.29 | $30.29 | $11.81 – $29.38 | — | |
| AMINOPHYLLINE 25 MG/ML IV SOLN Outpatient | J0280 HCPCS | $74.58 | $74.58 | $29.09 – $72.34 | — | |
| AMIODARONE HCL IN DEXTROSE 360-4.14 MG/200ML-% IV SOLN Outpatient | J0283 HCPCS | $268 | $268 | $104 – $260 | — | |
| AMOXICILLIN 250 MG/5ML PO SUSR Outpatient | 0637 RC | $0.16 | $0.16 | $0.06 – $0.16 | — | |
| AMPHOTERICIN B 50 MG IV SOLR Outpatient | J0285 HCPCS | $278 | $278 | $108 – $270 | — | |
| AMPICILLIN SODIUM 1 GM/8 ML (WET SOLR VIAL (COMBINED)) Outpatient | J0290 HCPCS | $48.63 | $48.63 | $18.97 – $47.17 | — | |
| APIXABAN 5 MG PO TABS Outpatient | 0637 RC | $10.33 | $10.33 | $4.03 – $10.02 | — | |
| AZITHROMYCIN 200 MG/5ML PO SUSR Outpatient | 0637 RC | $20.45 | $20.45 | $7.98 – $19.84 | — | |
| AZTREONAM 2 G IJ SOLR Outpatient | J0457 HCPCS | $425 | $425 | $6.46 – $412 | — | |
| BELIMUMAB 120 MG IV SOLR Outpatient | J0490 HCPCS | $778 | $778 | $164 – $755 | — | |
| BELIMUMAB 400 MG/5ML IV (WET SOLR VIAL) Outpatient | J0490 HCPCS | $2,594 | $2,594 | $164 – $2,517 | — | |
| BUDESONIDE-FORMOTEROL FUMARATE 80-4.5 MCG/ACT IN AERO Outpatient | 0637 RC | $141 | $141 | $55.16 – $137 | — | |
| BUPIVACAINE LIPOSOME 1.3 % IJ SUSP Outpatient | J0666 HCPCS | $1,087 | $1,087 | $3.06 – $1,055 | — | |
| BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL FILM Outpatient | 0637 RC | $2.28 | $2.28 | $0.89 – $2.21 | — | |
| BUPRENORPHINE HCL-NALOXONE HCL 8-2 MG SL FILM Outpatient | 0637 RC | $2.88 | $2.88 | $1.12 – $2.79 | — | |
| CALCIUM GLUCONATE PEDI PARTIAL BAG IVPB Outpatient | J0613 HCPCS | $126 | $126 | $0.27 – $122 | — | |
| CAPTOPRIL 3.125 MG PO PARTIAL TABS Outpatient | 0637 RC | $1.47 | $1.47 | $0.57 – $1.43 | — | |
| CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN Outpatient | 0250 RC | $1,438 | $1,438 | $561 – $1,394 | — | |
| CARFILZOMIB 30 MG IV SOLR Outpatient | J9047 HCPCS | $2,169 | $2,169 | $151 – $2,104 | — | |
| CARFILZOMIB 60 MG IV SOLR Outpatient | J9047 HCPCS | $4,338 | $4,338 | $151 – $4,208 | — | |
| CARFILZOMIB 60 MG/30ML IV (WET SOLR VIAL) Outpatient | J9047 HCPCS | $4,338 | $4,338 | $151 – $4,208 | — | |
| CARQUANTITATIVE POC Outpatient | 82375 CPT | $197 | $197 | $40.76 – $191 | — | |
| CEFADROXIL 500 MG/5ML PO SUSR Outpatient | 0637 RC | $3.44 | $3.44 | $1.34 – $3.34 | — | |
| CEFEPIME HCL 2 GM/12.5 ML IJ/IV (WET SOLR VIAL) Outpatient | J0692 HCPCS | $37.00 | $37.00 | $14.43 – $35.89 | — | |
| CEFOTETAN DISODIUM 1 GM/10ML IJ (WET SOLR VIAL) Outpatient | 0250 RC | $161 | $161 | $62.91 – $156 | — | |
| CEFTRIAXONE SODIUM 1 G IJ SOLR Outpatient | J0696 HCPCS | $10.73 | $10.73 | $4.18 – $10.41 | $39.28 | |
| CEFTRIAXONE SODIUM 2 GM IN 50 ML DEXTROSE IV (COMBINED) Outpatient | J0696 HCPCS | $195 | $195 | $75.93 – $189 | $39.28 | |
| CHG OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC Outpatient | 82272 CPT | $99.85 | $99.85 | $13.99 – $96.85 | $92.02 | |
| CHG US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG Outpatient | 76882 CPT | $162 | $162 | $63.22 – $489 | $292 |