HCPCS 94799

HC SURFACTANT ADMINISTRATION W/O INTUBATION (LMA/LISA) CDM - as described in hospitals' own price files.

28hospitals publishing a price

$211median cash price

-median typical insurance price

Hospital	Location	Cash price	Typical insurance	List price	Negotiated range
Covenant Health Hobbs Hospital	Hobbs, NM	$0.42	-	$1.00	-
Providence Holy Family Hospital	Spokane, WA	$78.40	-	$112	-
Providence Saint Joseph Medical Ctr	Burbank, CA	$85.05	-	$243	-
Providence Newberg Medical Center	Newberg, OR	$98.25	-	$131	-
Providence Milwaukie Hospital	Milwaukie, OR	$98.25	-	$131	-
Providence St. Vincent Medical Center	Portland, OR	$98.25	-	$131	-
Providence Portland Medical Center	Portland, OR	$98.25	-	$131	-
Providence Willamette Falls Medical Center	Oregon City, OR	$98.25	-	$131	-
St. Mary Medical Center	Long Beach, CA	$117	-	$244	-
Covenant Hospital Levelland	Levelland, TX	$130	-	$310	-
Covenant Medical Center	Lubbock, TX	$130	-	$310	-
Providence St. Jude Medical Center	Fullerton, CA	$153	-	$318	-
Providence St. Mary Medical Center	Walla Walla, WA	$167	-	$239	-
Providence Cedars Sinai Tarzana Medical Center	Tarzana, CA	$210	-	$599	-
Saint John'S Health Center	Santa Monica, CA	$211	-	$604	-
Kadlec Regional Medical Center	Richland, WA	$251	-	$359	-
Swedish Medical Center / Cherry Hill	Seattle, WA	$257	-	$536	-
Swedish Issaquah	Issaquah, WA	$257	-	$536	-
Providence Santa Rosa Memorial Hospital	Santa Rosa, CA	$277	-	$544	-
Providence Regional Medical Center Everett	Everett, WA	$319	-	$613	-
Providence St. Joseph Hospital	Eureka, CA	$319	-	$665	-
St. Patrick Hospital	Missoula, MT	$319	-	$399	-
Providence Hood River Memorial Hospital	Hood River, OR	$395	-	$527	-
Providence Holy Cross Medical Center	Mission Hills, CA	$461	-	$1,316	-
Providence Kodiak Island Medical Ctr	Kodiak, AK	$583	-	$748	-
Providence Little Co Of Mary Med Ctr San Pedro	San Pedro, CA	$615	-	$1,758	-
Providence Little Company Of Mary Med Ctr Torrance	Torrance, CA	$615	-	$1,758	-
Providence Alaska Medical Center	Anchorage, AK	$1,626	-	$2,084	-

Prices are from each hospital's own machine-readable price file. Cash price is the published discounted cash price; typical insurance price is the median of the per-plan negotiated rates in the file; list price is the gross charge.