West Jefferson Medical Center — price list
← Hospital overviewVerified from West Jefferson 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.
32 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Albuterol sulfate concentrate 2.5 mg/0.5 ml solution for nebulization Outpatient | RX-112670 CDM | $1.00 | $1.00 | $0.19 – $1.00 | $0.01 | |
| Aluminum-mag hydroxide-simethicone 200 mg-200 mg-20 mg/5 ml oral susp Outpatient | RX-38285 CDM | $0.75 | $0.75 | $0.14 – $71.70 | $0.01 | |
| Azathioprine 50 mg tablet Outpatient | RX-9183 CDM | $3.00 | $3.00 | $0.35 – $3.00 | $0.01 | |
| Dexamethasone 0.5 mg tablet Outpatient | RX-2322 CDM | $0.75 | $0.75 | $0.09 – $0.75 | $0.01 | |
| Dexamethasone 0.5 mg/5 ml oral solution Outpatient | RX-2320 CDM | $4.75 | $4.75 | $0.24 – $4.75 | $0.01 | |
| Dexamethasone 0.75 mg tablet Outpatient | RX-2323 CDM | $1.00 | $1.00 | $0.19 – $1.00 | $0.01 | |
| Dexamethasone 1.5 mg tablet Outpatient | RX-2325 CDM | $2.00 | $2.00 | $0.23 – $2.00 | $0.01 | |
| Dexamethasone 4 mg tablet Outpatient | RX-2327 CDM | $4.25 | $4.25 | $0.49 – $4.25 | $0.01 | |
| Diphenhydramine 12.5 mg/5 ml oral elixir Outpatient | RX-2511 CDM | $9.25 | $9.25 | $0.03 – $9.25 | $0.01 | |
| Diphenhydramine 12.5 mg/5 ml oral liquid Outpatient | RX-12556 CDM | $8.75 | $8.75 | $0.03 – $8.75 | $0.01 | |
| Diphenhydramine 50 mg capsule Outpatient | RX-2510 CDM | $0.25 | $0.25 | $0.03 – $0.25 | $0.01 | |
| Dressing wound 3x3in sorbex absorbent nonadherent outer layer thick fluff latex free sterile blue Outpatient | SUP-773288 CDM | $3.19 | $0.51 | $0.37 – $3.19 | $0.01 | |
| Hearing Aid Battery Each Outpatient | PX-27008627 CDM | $2.00 | $0.32 | $0.39 – $2.00 | $0.01 | |
| Hydroxyurea 500 mg capsule Outpatient | RX-10236 CDM | $4.00 | $4.00 | $0.46 – $4.00 | $0.01 | |
| Hydroxyzine pamoate 100 mg capsule Outpatient | RX-3776 CDM | $4.25 | $4.25 | $0.49 – $4.25 | $0.01 | |
| Hydroxyzine pamoate 25 mg capsule Outpatient | RX-3777 CDM | $1.25 | $1.25 | $0.24 – $1.25 | $0.01 | |
| Inv-florbetaben f-18 8.1 mci (300 mbq) intravenous solution Outpatient | RX-6000229 CDM | $0.25 | $0.25 | $0.03 – $0.25 | $0.01 | |
| Inv-mk-6240 1 mci/ml intravenous solution Outpatient | RX-6000230 CDM | $0.25 | $0.25 | $0.03 – $0.25 | $0.01 | |
| Ipratropium 0.5 mg-albuterol 3 mg (2.5 mg base)/3 ml nebulization soln Outpatient | RX-30510 CDM | $2.00 | $2.00 | $0.39 – $2.00 | $0.01 | |
| Ipratropium bromide 0.02 % solution for inhalation Outpatient | RX-12580 CDM | $1.50 | $1.50 | $0.17 – $1.50 | $0.01 | |
| Levalbuterol 0.63 mg/3 ml solution for nebulization Outpatient | RX-24915 CDM | $7.25 | $7.25 | $0.05 – $7.25 | $0.01 | |
| Levalbuterol 1.25 mg/3 ml solution for nebulization Outpatient | RX-24916 CDM | $7.25 | $7.25 | $0.15 – $7.25 | $0.01 | |
| Methotrexate sodium 2.5 mg tablet Outpatient | RX-4973 CDM | $12.50 | $12.50 | $0.26 – $9.56 | $0.01 | |
| Ondansetron hcl 4 mg tablet Outpatient | RX-10778 CDM | $3.25 | $3.25 | $0.04 – $3.25 | $0.01 | |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution Outpatient | RX-29302 CDM | $2.00 | $2.00 | $0.23 – $2.00 | $0.01 | |
| Prednisone 1 mg tablet Outpatient | RX-6493 CDM | $1.00 | $1.00 | $0.02 – $1.00 | $0.01 | |
| Prednisone 10 mg tablet Outpatient | RX-6494 CDM | $1.00 | $1.00 | $0.12 – $1.00 | $0.01 | |
| Prednisone 5 mg tablet Outpatient | RX-6497 CDM | $1.00 | $1.00 | $0.10 – $1.00 | $0.01 | |
| Prednisone 50 mg tablet Outpatient | RX-6498 CDM | $1.50 | $1.50 | $0.17 – $1.50 | $0.01 | |
| Promethazine 6.25 mg/5 ml oral syrup Outpatient | RX-6620 CDM | $3.50 | $3.50 | $0.24 – $3.50 | $0.01 |