Blue Mountain Hospital
802 South 200 West
Blanding, UT 84511
Critical Access Hospitals
Overview
- CCN461310
Procedures & prices
- DEXAMETHASONE SODIUM PHOSJ1100$12cashGross $120 payers
- FENTANYL CITRATE INJECTIONJ3010$12cashGross $120 payers
- KETOROLAC TROMETHAMINE INJJ1885$19cashGross $190 payers
- LORAZEPAM INJECTIONJ2060$21cashGross $210 payers
- HC ASSAY OF URINE POTASSIUM84133$25cashGross $250 payers
- Lidocaine injectionJ2001$26cashGross $260 payers
- AZITHROMYCINJ0456$27cashGross $270 payers
- LEVETIRACETAM INJECTIONJ1953$29cashGross $290 payers
- HC GTT-ADDED SAMPLES82952$30cashGross $300 payers
- STERILE WATER/SALINE, 10 MLA4216$30cashGross $300 payers
| Procedure | Code | Cash↑ | Gross | Negotiated range | Payers |
|---|---|---|---|---|---|
| DEXAMETHASONE SODIUM PHOS | J1100 | $12 | $12 | — | 0 |
| FENTANYL CITRATE INJECTION | J3010 | $12 | $12 | — | 0 |
| KETOROLAC TROMETHAMINE INJ | J1885 | $19 | $19 | — | 0 |
| LORAZEPAM INJECTION | J2060 | $21 | $21 | — | 0 |
| HC ASSAY OF URINE POTASSIUM | 84133 | $25 | $25 | — | 0 |
| Lidocaine injection | J2001 | $26 | $26 | — | 0 |
| AZITHROMYCIN | J0456 | $27 | $27 | — | 0 |
| LEVETIRACETAM INJECTION | J1953 | $29 | $29 | — | 0 |
| HC GTT-ADDED SAMPLES | 82952 | $30 | $30 | — | 0 |
| STERILE WATER/SALINE, 10 ML | A4216 | $30 | $30 | — | 0 |
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