COREWELL HEALTH WILLIAM BEAUMONT UNIVERSITY HOSPITAL REHAB UNIT

Legal name: WILLIAM BEAUMONT HOSPITAL

ROYAL OAK, MI 480736712 (248) 898-5000 273Y00000X

Published Procedure Prices

Procedure	CPT	Cash Price	Insurance Range
LEUCOVORIN CALCIUM 100 MG IJ SOLR [4392]	00574	N/A	N/A
ETOMIDATE 2 MG/ML IV SOLN [20472]	10006	N/A	N/A
KETOROLAC TROMETHAMINE 15 MG/ML IJ SOLN [22472]	10019	N/A	N/A
ADALIMUMAB 40 MG/0.4ML SUBCUT PSKT [150535]	10702	N/A	N/A
ZINC OXIDE 20 % EXT OINT [8874]	11701	N/A	N/A
LURASIDONE HCL 40 MG PO TABS [101636]	12547	N/A	N/A
MAGNESIUM SULFATE 4 GM/50ML IV SOLN [125078]	13107	N/A	N/A
ERYTHROMYCIN 5 MG/GM OPTH OINT [2888]	13668	N/A	N/A
LEUPROLIDE ACETATE (6 MONTH) 45 MG IM KIT [104596]	13925	N/A	N/A
MECLIZINE HCL 25 MG PO TABS [12025]	14428	N/A	N/A
CLINDAMYCIN PHOSPHATE IN NACL 600-0.9 MG/50ML-% IV SOLN [145429]	16571	N/A	N/A
MORPHINE SULFATE (PF) 0.5 MG/ML IJ SOLN [29464]	16729	N/A	N/A
FLUCONAZOLE 150 MG PO TABS [13577]	16784	N/A	N/A
HEPARIN SODIUM (PORCINE) 1000 UNIT/ML IJ SOLN [10176]	16864	N/A	N/A
ACYCLOVIR 400 MG PO TABS [8971]	17271	N/A	N/A
INSULIN LISPRO PROT & LISPRO (75-25) 100 UNIT/ML SUBCUT SUSP [70693]	17478	N/A	N/A
LINEZOLID 100 MG/5ML PO SUSR [28225]	19903	N/A	N/A
IMMUNE GLOBULIN (HUMAN) 30 GM/300ML IJ SOLN [105573]	20555	N/A	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.