Pricing Transparency - Cortland Medical Center

Charge Code

CPT Code

Description

Charge Code	Description	CPT Code	Our Charge
1100002	PRIVATE ROOM 2SOU MJ		$1041.00
1100003	PRIVATE ROOM 2CEN MJ		$1094.00
1100004	PRIVATE ROOM MAT MJ		$1512.00
1100005	PRIVATE ROOM 3SOU MJ		$937.00
1100008	PRIVATE ROOM MISTY GLEN MJ		$468.00
1100009	PRI ROOM TELE UNIT MJ		$1041.00
1110000	PRIVATE ROOM 2SOU		$1041.00
1110001	PATIENT RESPONSIBILITY 2SOUTH		$96.00
1110003	PRIVATE ROOM 2CEN		$1094.00
1110004	PATIENT RESPONSIBILITY 2CEN		$111.00
1110006	PRIVATE ROOM 3SOU		$1041.00
1110007	PATIENT RESPONSIBILITY 3SOU		$96.00
1110011	PRIVATE ROOM TELEMETRY		$1041.00
1110012	PATIENT RESPONSIBILITY TELE		$107.00
1120000	PRIVATE ROOM MAT		$1512.00
1120001	PATIENT RESPONSIBILITY MAT		$96.00
1190000	PRIVATE ROOM CEDAR RUN		$468.00
1190001	PATIENT RESPONSIBILITY C-RUN		$48.00
1190002	PRIVATE ROOM MISTY GLEN		$468.00
1190004	PATIENT RESPONSIBILITY M-GLEN		$48.00
1210000	SEMI-PRIVATE ROOM 2SOU		$850.00
1210001	SEMI-PRIVATE ROOM 2CEN		$974.00
1210002	SEMI-PRIVATE ROOM 3SOU		$850.00
1210004	SEMI-PRIVATE ROOM 3CEN		$850.00
1210005	SEMI-PRIVATE ROOM ICU		$850.00
1210006	SEMI-PRIVATE ROOM ER		$666.00
1210007	SEMI-PRIVATE ROOM TELE		$850.00
1220000	SEMI-PRIVATE ROOM MAT		$1273.00
1220001	LABOR & DELIVERY		$1389.00
1240000	SEMI-PRIVATE ROOM 1E		$1143.00
1290000	SEMI-PRIVATE CEDAR RUN		$423.00
1290001	SEMI-PRIVATE MISTY GLEN		$423.00
1290002	SEMI-PRIVATE SWING BED		$1824.00
1290003	HOLD BED UNIT SEMI-PRIVATE		$424.00
1293012	SEMI-PRIVATE SWING BED 2C		$1824.00
1293013	SEMI-PRIVATE SWING BED 2S		$1824.00
1293014	SEMI-PRIVATE SWING BED 3S		$1824.00
1700000	NURSERY ROOM AND BOARD		$1079.00
1900000	RESPITE ROOM CEDAR RUN		$272.00
1900001	RESPITE ROOM MISTY GLEN		$272.00
2000000	INTENSIVE CARE UNIT		$1470.00
2060000	TELEMETRY ROOM 2SOU		$1119.00
2063022	CLINICAL DECISION UNIT ROOM		$944.00
2090000	INTENSIVE CARE TELEMETRY		$1119.00
2200044	INIT NUTRITION COUNS EA 15MIN	97802	$53.00
2200045	FOLLOWUP NUTRITION COUNS/15MIN	97803	$50.00
2500010	Tylenol #3 1 TAB TAB		$0.24
2500020	Tylenol #4 1 TAB TAB		$0.44
2500040	Tylenol, Feverall 120 MG SUPP		$1.22
2500050	Tylenol 160 MG/5 ML BOT		$0.99