CENTER FOR REHABILITATIVE MEDICINE AT ST. MARY'S

Legal name: ST. MARY'S HOSPITAL, INC.

ATHENS, GA 306063712 (706) 389-3555 207RC0000X

Published Procedure Prices

Procedure	CPT	Cash Price	Insurance Range
insulin regular per 5 units	00202	$27	N/A
baricitinib 2 mg tablet 30 each Bottle	00241	$55	N/A
Injection olanzapine 0.5 mg	00275	$54	N/A
insulin regular per 5 units	00282	$8	N/A
insulin nph (isophane) per 5 units	00283	$27	N/A
insulin nph-insulin regular per 5 units	00287	$27	N/A
triamcinolone acetonide per 10 mg	00302	$39	N/A
belatacept per 1 mg	00303	$3,772	N/A
triamcinolone acetonide per 10 mg	00304	$3	N/A
apixaban 5 mg tablet 60 each Bottle	00308	$3	N/A
Injection abatacept 10 mg	00321	$11,954	N/A
aztreonam 2 gram recon soln 1 each Vial	00325	$257	N/A
peginterferon alfa-2a 180 mcg/mL solution 1 mL Vial	00403	$4,275	N/A
Pneumococcal conjugate vaccine 20 valent (PCV20) for intramuscular use	00520	$1,129	N/A
SITagliptin phosphate 25 mg tablet 1 each BLIST PACK	00602	$11	N/A

Prices shown are published rates from hospital chargemaster files and insurer rate data. Your actual cost depends on your insurance plan, deductible status, and services rendered.