Pricing Transparency - Towanda Memorial Hospital

Charge Code Description CPT Code Our Charge
11000004 HC SNU PRIVATE ROOM AND BOARD $664.00
12000000 HC ROOM AND BOARD - SEMI PRIV $1074.25
12000001 HC ROOM AND BOARD - DAILY NO CHARGE $0.00
12000002 HC SNU ROOM AND BOARD $332.00
12000003 HC SWING BED ROOM AND BOARD $392.00
13300000 HC PEDIATRICS ROOM AND BOARD $1372.00
18200000 HC LOA/NURSE HOME MEDICARE AND OTHERS $332.00
18500000 HC LOA/NURSE HOME $77.75
25000000 Acarbose Tab 50 MG $3.70
25000000 Acetaminophen Disintegrating Tab 80 MG $0.43
25000000 Acetaminophen Soln 160 MG/5ML $48.40
25000000 Acetaminophen Suppos 120 MG $2.25
25000000 Acetaminophen Suppos 650 MG $2.81
25000000 Acetaminophen Tab 325 MG $0.19
25000000 Acetaminophen Tab 500 MG $0.24
25000000 Acetaminophen w/ Codeine Soln 120-12 MG/5ML $7.66
25000000 Acetaminophen w/ Codeine Tab 300-30 MG $5.37
25000000 Acetazolamide Tab 250 MG $21.57
25000000 Acetic Acid Irrigation Soln 0.25% $21.63
25000000 Acetic Acid Otic Soln 2% $143.92
25000000 Acetylcysteine Inhal Soln 10% $95.70
25000000 Acetylcysteine Inhal Soln 20% $87.21
25000000 Acyclovir Tab 400 MG $1.01
25000000 Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) $188.53
25000000 Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) $1.14
25000000 Albuterol Sulfate Soln Nebu 0.5% (5 MG/ML) $8.94
25000000 Allopurinol Tab 100 MG $2.24
25000000 Allopurinol Tab 300 MG $5.86
25000000 Alprazolam Tab 0.25 MG $0.39
25000000 Alum & Mag Hydroxide-Simethicone Susp 400-400-40 MG/5ML $21.37
25000000 Aluminum & Magnesium Hydroxides Susp 200-200 MG/5ML $10.71
25000000 Aluminum Hydroxide-Magnesium Trisilicate Chew Tab 80-14.2 MG $0.68
25000000 Amantadine HCl Cap 100 MG $10.13
25000000 Amiloride & Hydrochlorothiazide Tab 5-50 MG $2.93
25000000 Amiloride HCl Tab 5 MG $7.28
25000000 Amino Acid Infusion 2.75% in D5W $194.64
25000000 Amino Acid Infusion 4.25% in D5W $194.64
25000000 Aminocaproic Acid Inj 250 MG/ML $36.42
25000000 Amiodarone HCl Tab 200 MG $2.08
25000000 Amitriptyline HCl Tab 10 MG $1.07
25000000 Amitriptyline HCl Tab 25 MG $2.45
25000000 Amitriptyline HCl Tab 50 MG $4.30
25000000 Amlodipine Besylate Tab 10 MG (Base Equivalent) $0.71
25000000 Amlodipine Besylate Tab 5 MG (Base Equivalent) $0.79
25000000 Amoxicillin & K Clavulanate For Susp 200-28.5 MG/5ML $5.41
25000000 Amoxicillin & K Clavulanate For Susp 400-57 MG/5ML $2.78
25000000 Amoxicillin & K Clavulanate For Susp 600-42.9 MG/5ML $5.35
25000000 Amoxicillin & K Clavulanate Tab 250-125 MG $36.31
25000000 Amoxicillin & K Clavulanate Tab 500-125 MG $4.46
25000000 Amoxicillin & K Clavulanate Tab 875-125 MG $6.23