Our Lady of the Lake Ascension
,
Our Lady of the Lake Ascension. This page also lists hospital-published cash prices for services and billing-code line items.
Overview
- CCN190242
Procedures & prices
Hospital-published price lines. These are billing-code items from the hospital transparency file, not a personalized estimate. Cash is the self-pay price; gross is the pre-discount list price.
Price definitions
- Cash
- — self-pay price (no insurance)
- Gross
- — chargemaster list price; the pre-discount sticker rate, rarely what anyone pays
- Negotiated range
- — min–max of rates the hospital negotiated with insurers
- Payers
- — number of insurers with a published rate (“0” / “—” = none)
Available here:CashGross listInsurer-negotiated rates were not published for these rows.
- Thiamine Hcl 100 MgDrugHCPCS J3411Hospital-published line item$10cashGross $21
- Granisetron Hydrochloride, 1 Mg, Oral, Fda Approved Prescription Anti-Emetic, For Use As A Complete Therapeutic Substitute For An IV Anti-Emetic At The Time Of Chemotherapy Treatment, Not To Exceed A 24 Hour Dosage RegimenDrugHCPCS Q0166Hospital-published line item$10cashGross $21
- Spun MicrohematocritLab testCPT 85013Hospital-published line item$11cashGross $21
- Injection, Promethazine Hcl, Up To 50 MgDrugHCPCS J2550Hospital-published line item$11cashGross $22
- Oasis Ultra Tri-Layer Wound Matrix, Per Square Centimeter (add-On, List Separately In Addition To Primary Procedure)DrugHCPCS Q4124Hospital-published line item$11cashGross $22
- Blood Typing Serologic Rh(d)Lab testCPT 86901Hospital-published line item$12cashGross $24
- Blood Typing Serologic AboLab testCPT 86900Hospital-published line item$12cashGross $24
- Urinalysis Volume MeasureLab testCPT 81050Hospital-published line item$13cashGross $26
- Methotrexate Oral 2.5 MgDrugHCPCS J8610Hospital-published line item$13cashGross $27
- Injection, Meperidine Hydrochloride, Per 100 MgDrugHCPCS J2175Hospital-published line item$14cashGross $28
| Service / code | Self-pay cash↑ | Gross list |
|---|---|---|
Thiamine Hcl 100 Mg DrugHCPCS J3411Hospital-published line item | $10 | $21 |
Granisetron Hydrochloride, 1 Mg, Oral, Fda Approved Prescription Anti-Emetic, For Use As A Complete Therapeutic Substitute For An IV Anti-Emetic At The Time Of Chemotherapy Treatment, Not To Exceed A 24 Hour Dosage Regimen DrugHCPCS Q0166Hospital-published line item | $10 | $21 |
Spun Microhematocrit Lab testCPT 85013Hospital-published line item | $11 | $21 |
Injection, Promethazine Hcl, Up To 50 Mg DrugHCPCS J2550Hospital-published line item | $11 | $22 |
Oasis Ultra Tri-Layer Wound Matrix, Per Square Centimeter (add-On, List Separately In Addition To Primary Procedure) DrugHCPCS Q4124Hospital-published line item | $11 | $22 |
Blood Typing Serologic Rh(d) Lab testCPT 86901Hospital-published line item | $12 | $24 |
Blood Typing Serologic Abo Lab testCPT 86900Hospital-published line item | $12 | $24 |
Urinalysis Volume Measure Lab testCPT 81050Hospital-published line item | $13 | $26 |
Methotrexate Oral 2.5 Mg DrugHCPCS J8610Hospital-published line item | $13 | $27 |
Injection, Meperidine Hydrochloride, Per 100 Mg DrugHCPCS J2175Hospital-published line item | $14 | $28 |
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