Pricing Transparency - Robert Packer Hospital Charge Code CPT Code Description Charge Code Description CPT Code Our Charge 11000000 HC ROOM AND BOARD - PRIVATE $2150.50 11400000 HC ROOM AND BOARD - PSYCH PRIV $1814.75 12000000 HC ROOM AND BOARD - SEMI PRIV $2025.50 12000001 HC ROOM AND BOARD - DAILY NO CHARGE $0.00 12200000 HC ROOM AND BOARD - LDRP SEMI $2028.00 12400000 HC ROOM AND BOARD - PSYCH SEMI $1748.50 17000000 HC ROOM AND BOARD - LDRP NUR $1528.75 17200000 HC LEVEL II NEWBORN $2823.00 20000000 HC ROOM AND BOARD - ICU $3545.75 20000001 HC ROOM AND BOARD - ICU SEMI PRIV $1644.00 20400000 HC ROOM AND BOARD - ICU PSYCH $1449.75 20600000 HC ROOM AND BOARD - ICU INTERMED $2512.25 21000000 HC ROOM AND BOARD - CCU $1726.25 25000000 Acarbose Tab 50 MG $3.31 25000000 Acetaminophen Soln 160 MG/5ML $26.05 25000000 Acetaminophen Suppos 120 MG $2.46 25000000 Acetaminophen Suppos 650 MG $3.71 25000000 Acetaminophen Susp 160 MG/5ML $4.44 25000000 Acetaminophen Tab 325 MG $0.12 25000000 Acetaminophen Tab 500 MG $0.10 25000000 Acetaminophen w/ Codeine Soln 120-12 MG/5ML $10.32 25000000 Acetaminophen w/ Codeine Tab 300-30 MG $1.62 25000000 Acetazolamide Cap ER 12HR 500 MG $11.59 25000000 Acetazolamide Tab 125 MG $9.13 25000000 Acetazolamide Tab 250 MG $21.57 25000000 Acetic Acid Otic Soln 2% $143.92 25000000 Acetic Acid Soln $122.22 25000000 Acetylcholine Chloride Intraocular For Soln 20 MG (1:100) $503.30 25000000 Acetylcysteine Inhal Soln 20% $70.09 25000000 Acyclovir Cap 200 MG $1.59 25000000 Acyclovir Susp 200 MG/5ML $20.60 25000000 Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) $32.51 25000000 Albuterol Sulfate Soln Nebu 0.083% (2.5 MG/3ML) $0.94 25000000 Albuterol Sulfate Soln Nebu 0.5% (5 MG/ML) $5.34 25000000 Alcohol Absolute Inj 98% $583.25 25000000 Allopurinol Tab 100 MG $1.55 25000000 Allopurinol Tab 300 MG $2.98 25000000 Alprazolam Tab 0.25 MG $0.25 25000000 Alprazolam Tab 0.5 MG $0.39 25000000 Alprazolam Tab 1 MG $0.76 25000000 Alteplase For Inj 100 MG J2997 $49696.44 25000000 Alum & Mag Hydroxide-Simethicone Susp 400-400-40 MG/5ML $21.37 25000000 Alum (Ammonium) Powder $54.64 25000000 Aluminum Sulfate & Calcium Acetate Powd Pack $4.64 25000000 Amantadine HCl Cap 100 MG $6.23 25000000 AMIKACIN SULFATE 250 MG/mL IJ SOLN $122.27 25000000 Amikacin Sulfate Inj 250 MG/mL $26.36 25000000 Amiloride HCl Tab 5 MG $6.48 25000000 Amino Acid Electrolyte w/Cal Infusion 4.25% in D5W $249.85 25000000 Amino Acid Electrolyte w/Cal Infusion 5% in D15W $290.73 Showing 1-50 of 7063 Results Pagination Current page 1 Page 2 Page 3 Page 4 Page 5 … 142 142 Next page ›