Community Behavioral Health: disclosed hospital rates

iDirect answer

Based on the published hospital price files, Community Behavioral Health appears in disclosed negotiated rates across 1 hospital and 100 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

100 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
ALTEPLASE (TPA) 1 MG/ML SYRINGE EVD CLEARANCE Inpatient	Pennsylvania Hospital	J2997 HCPCS	$255	$255	$43.09 – $255	—
ALTEPLASE (TPA) 1 MG/ML SYRINGE EVD CLEARANCE Outpatient	Pennsylvania Hospital	J2997 HCPCS	$255	$255	$44.83 – $255	—
ALTEPLASE (TPA) INJECTION 1MG/ML ORD Inpatient	Pennsylvania Hospital	J2997 HCPCS	$308	$308	$52.05 – $308	—
ALTEPLASE (TPA) INJECTION 1MG/ML ORD Outpatient	Pennsylvania Hospital	J2997 HCPCS	$308	$308	$54.15 – $308	—
ALTEPLASE (TPA) INJECTION 5MG/5ML ORD Inpatient	Pennsylvania Hospital	J2997 HCPCS	$1,372	$1,372	$232 – $1,372	—
ALTEPLASE (TPA) INJECTION 5MG/5ML ORD Outpatient	Pennsylvania Hospital	J2997 HCPCS	$1,372	$1,372	$91.48 – $1,372	—
AMPHOTERICIN B 100 MCG/ML NASAL IRRIGATION ORD Inpatient	Pennsylvania Hospital	J0285 HCPCS	$28.00	$28.00	$4.73 – $28.00	—
AMPHOTERICIN B 100 MCG/ML NASAL IRRIGATION ORD Outpatient	Pennsylvania Hospital	J0285 HCPCS	$28.00	$28.00	$3.78 – $96.37	—
AMPICILLIN IVPB 1G/50ML NSS (CNR) Inpatient	Pennsylvania Hospital	J0290 HCPCS	$31.00	$31.00	$5.24 – $31.00	—
AMPICILLIN IVPB 1G/50ML NSS (CNR) Outpatient	Pennsylvania Hospital	J0290 HCPCS	$31.00	$31.00	$0.49 – $31.00	—
AMPICILLIN IVPB 2G/100ML NSS (CNR) Inpatient	Pennsylvania Hospital	J0290 HCPCS	$56.00	$56.00	$9.46 – $56.00	—
AMPICILLIN IVPB 2G/100ML NSS (CNR) Outpatient	Pennsylvania Hospital	J0290 HCPCS	$56.00	$56.00	$0.49 – $56.00	—
ATROPINE SULFATE 0.4 MG/ML INJECTION SOLN (WRAPPER Inpatient	Pennsylvania Hospital	J0461 HCPCS	$32.00	$32.00	$5.41 – $32.00	—
ATROPINE SULFATE 0.4 MG/ML INJECTION SOLN (WRAPPER Outpatient	Pennsylvania Hospital	J0461 HCPCS	$32.00	$32.00	$0.07 – $32.00	—
BETAMETHASONE SOD PHOS ACET 6 (33) MG/ML INJECTI Inpatient	Pennsylvania Hospital	J0702 HCPCS	$48.00	$48.00	$8.11 – $48.00	—
BETAMETHASONE SOD PHOS ACET 6 (33) MG/ML INJECTI Outpatient	Pennsylvania Hospital	J0702 HCPCS	$48.00	$48.00	$6.48 – $48.00	—
CEFAZOLIN 100 MG/ML (ANESTHESIA) Inpatient	Pennsylvania Hospital	J0690 HCPCS	$2.00	$2.00	$0.34 – $2.00	—
CEFAZOLIN 100 MG/ML (ANESTHESIA) Outpatient	Pennsylvania Hospital	J0690 HCPCS	$2.00	$2.00	$0.27 – $2.00	—
CEFAZOLIN FORTE 50 MG/ML OPHTH SOLN ORD Inpatient	Pennsylvania Hospital	J0690 HCPCS	$89.00	$89.00	$15.04 – $89.00	—
CEFAZOLIN FORTE 50 MG/ML OPHTH SOLN ORD Outpatient	Pennsylvania Hospital	J0690 HCPCS	$89.00	$89.00	$0.81 – $89.00	—
CEFAZOLIN SODIUM 1 G INJECTION SOLR Inpatient	Pennsylvania Hospital	J0690 HCPCS	$23.00	$23.00	$3.89 – $23.00	—
CEFAZOLIN SODIUM 1 G INJECTION SOLR Outpatient	Pennsylvania Hospital	J0690 HCPCS	$23.00	$23.00	$0.81 – $23.00	—
CEFTAZIDIME 50 MG/ML OPHTH SOLN ORD Inpatient	Pennsylvania Hospital	J0713 HCPCS	$183	$183	$30.93 – $183	—
CEFTAZIDIME 50 MG/ML OPHTH SOLN ORD Outpatient	Pennsylvania Hospital	J0713 HCPCS	$183	$183	$1.47 – $183	—
CIDOFOVIR 15 MG/ML IV SOLN Inpatient	Pennsylvania Hospital	J0740 HCPCS	$533	$533	$90.08 – $533	—