UCHealth Memorial Hospital North — price list

← Hospital overviewVerified from UCHealth Memorial Hospital North’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.

638 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
ABIRATERONE 250 MG TABLET Inpatient	J3490 HCPCS	$4.55	$2.05	$1.46 – $3.23	—
ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY Inpatient	0250 RC	$1.00	$0.45	$0.32 – $0.71	—
ADJUVANT AS01B (PF), COMPONENT VIAL 1 OF 2 INTRAMUSCULAR SUSPENSION Inpatient	0272 RC	$0.05	$0.03	$0.02 – $0.04	—
ALBENDAZOLE 200 MG TABLET Inpatient	0250 RC	$30.45	$13.71	$9.77 – $21.62	—
ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION Inpatient	P9045 HCPCS	$640	$288	$205 – $454	—
ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG (+/-)/20 ML IV SOLUTION Inpatient	J0256 HCPCS	$41.25	$18.57	$13.24 – $29.29	—
AMITRIPTYLINE 25 MG TABLET Inpatient	0250 RC	$1.00	$0.45	$0.32 – $0.71	—
AMLODIPINE 2.5 MG TABLET Inpatient	0250 RC	$1.00	$0.45	$0.32 – $0.71	—
AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION Inpatient	J0295 HCPCS	$87.05	$39.18	$27.94 – $61.81	—
ANTIHEMOPHILIC FACTOR-VWF (FOR HEMOPHILIA A) INTRAVENOUS SOLUTION Inpatient	J7187 HCPCS	$73.70	$33.17	$23.66 – $52.33	—
ANTIHEMOPHILIC FVIII,HEK CELL,B-DOMAIN DELETED 1,500 UNIT IV SOLN Inpatient	J7209 HCPCS	$84.30	$37.94	$27.06 – $59.85	—
ARIPIPRAZOLE 10 MG TABLET Inpatient	0250 RC	$1.00	$0.45	$0.32 – $0.71	—
ASPIRIN 25 MG-DIPYRIDAMOLE 200 MG CAPSULE,EXT.RELEASE 12 HR MULTIPHASE Inpatient	0250 RC	$5.15	$2.32	$1.65 – $3.66	—
AZATHIOPRINE 75 MG TABLET Inpatient	J7500 HCPCS	$21.00	$9.45	$6.74 – $14.91	—
AZELASTINE 137 MCG (0.1 %) NASAL SPRAY Inpatient	0250 RC	$22.05	$9.93	$7.08 – $15.66	—
BACLOFEN (BULK) 100 % POWDER Inpatient	J3490 HCPCS	$1,008	$454	$324 – $716	—
BELLADONNA ALKALOIDS-OPIUM 16.2 MG-60 MG RECTAL SUPPOSITORY Inpatient	0250 RC	$27.15	$12.22	$8.72 – $19.28	—
BENZOIN TOPICAL TINCTURE Inpatient	0250 RC	$14.45	$6.51	$4.64 – $10.26	—
BENZTROPINE 1 MG TABLET Inpatient	0250 RC	$1.00	$0.45	$0.32 – $0.71	—
BENZTROPINE 1 MG/ML INJECTION SOLUTION Inpatient	J0515 HCPCS	$442	$199	$142 – $314	—
BETAMETHASONE, AUGMENTED 0.05 % TOPICAL OINTMENT Inpatient	0250 RC	$67.00	$30.15	$21.51 – $47.57	—
BEVACIZUMAB-ADCD 25 MG/ML INTRAVENOUS SOLUTION Inpatient	Q5129 HCPCS	$9,351	$4,208	$3,002 – $6,639	—
BIMATOPROST 0.01 % EYE DROPS Inpatient	0250 RC	$535	$241	$172 – $380	—
BRINZOLAMIDE 1 % EYE DROPS,SUSPENSION Inpatient	0250 RC	$297	$134	$95.26 – $211	—
BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION Inpatient	0250 RC	$282	$127	$90.63 – $200	—
BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET Inpatient	J0571 HCPCS	$1.00	$0.45	$0.32 – $0.71	—
BUPRENORPHINE HCL 300 MCG BUCCAL FILM Inpatient	J3490 HCPCS	$12.00	$5.40	$3.85 – $8.52	—
BUPRENORPHINE HCL 600 MCG BUCCAL FILM Inpatient	0250 RC	$17.40	$7.83	$5.59 – $12.35	—
BUPROPION HCL 75 MG TABLET Inpatient	J3490 HCPCS	$1.05	$0.48	$0.34 – $0.75	—
BUSPIRONE 10 MG TABLET Inpatient	0250 RC	$1.00	$0.45	$0.32 – $0.71	—