Pricing Transparency - Towanda Memorial Hospital Charge Code CPT Code Description 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 Showing 1-50 of 6081 Results Pagination Current page 1 Page 2 Page 3 Page 4 Page 5 … 122 122 Next page ›