DELAWARE VALEY HOSPITAL PRICING EFECTIVE JANUARY 1, 2019 SERVICE DESCRIPTION PRICE A & D OINT. U.D. $1 A ENDO-STITCH INST $1,218 ABDOMEN, 1 VIEW $295 ABDOMEN, 3 VIEWS $332 ABDOMEN, COMPLETE $386 ABDOMINAL BINDER $118 ABDOMINAL BINDER $191 ABDUCTION THUMB SPLI $147 ABG DRAW $206 ABG KIT $5 ABILIFY 10MG $81 ABILIFY 15MG TAB $81 ABILIFY 20 MG $113 ABILIFY 2MG $81 ABILIFY 5 MG $81 ABO GROUP $95 ABREVA $59 ACCOLATE 10MG TAB $4 ACCUPRIL 20 MG 10MG $3 ACCUPRIL 40MG $4 ACCUPRIL 5MG $3 ACE BANDAGE 3" $7 ACETADOTE 100 MG $360 ACETADOTE 200MGLML $720 ACETAMIN 160 MG -SUS $3 ACETAMINOPHEN LEVEL $235 ACETAMINOPHEN TAB500 $1 ACETAZOLAMIDE 250MG $9 ACETIC ACID DR 2% 15 $137 ACETONE, SERUM $72 ACETYLCHOLINE RECEPT $208 ACETYLCHOLINESTERASE $160 ACID FAST STAIN $106 ACID PHOSPHATASE, TO $227 ACID PHOSPHATASE, TO $343 ACROMIOCLAVICULAR (A $383 ACROMIOCLAVICULAR SP $607 ACTICOAT FLEX 3 4X4 $24 ACTIVATED CHARCOAL L $40 ACTIVATED PROT C RES $294 ACTIVATED PROTEIN C $308 ACTOS 15MG TAB $1 ACTOS 30 MG $1 ACTOS 45MG $1 ACUTE ABD SERIES $567 ACYCLOUIR 800 MG $5 ACYCLOVIR 200MG CAP $1 ACYCLOVIR 5% OINTMEN $2,367 ACYCLOVIR 500MG INJ $19 ADACELL(TDAP)0.5 MG $145 ADAPT PASTE 2.0OZ $14 ADDERALL XR 15 MG $24 ADD'L SEQ IV PUSH NE $92 ADD'L SEQ IV PUSH SA $92 ADENOSINE 1MG $13 ADENOSINE 6MG. $71 ADENOVIRUS ANTIBODY $42 ADJUSTABLE CRUTCHES $82 ADMIN HEP B VACC ER $36 ADMIN PNEMOCOCCAL ER $36 ADMINISTRATION $36 ADMISSION KITS $22 ADRENAL AB $145 ADRENALIN 1:1000 30 $39 ADRENALIN AMP. $903 ADRENOCORTICOTROPIC $481 ADULT DIAPER $7 ADULT DIAPERS $5 ADVAIR 100/50 $361 ADVAIR 250/50 $361 ADVAIR 500/50 $590 ADVIL 200 MG TAB - G $1 A-ENDOCLOSE $269 AEROSOL POCKET CHAMB $18 AFB CULTURE - UHS $351 AFB/TB CULTURE,SMEAR $461 AFP EXTRA/TRIPLE TES $910 AFP MATERNAL, S (EIA $261 AFP QUAD PROFILE $1,505 AFP TUMOR MARKER $261 AFP TUMOR MARKER $261 AFRIN SPRAY - GENERI $5 AGGRENOX 200/25 MG C $7 AIR STRIP $7 AIRWAY $5 AIRWAY NASAL LATEX F $21 AIRWAY NASO 26FR $21 AIRWAY NASO 30FR $21 AIRWAY NASO 6.00MM $24 AIRWAY NASO 8.0MM $24 ALBUMIN - 25% 50CC $238 ALBUMIN BODY FLUID $48 ALBUMIN, SERUM $69 ALBUTEROL SUL 1.25MG $5 ALBUTEROL SULFATE AM $2 ALCO WIPES $1 ALCO WIPES - BOX $8 ALCOHOL TOX SCREEN $2,127 ALDACTONE 25 MG - GE $1 ALDOLASE, SERUM $160 ALDOSTERONE, 24 HR U $570 ALDOSTERONE, SERUM $570 ALFUZOSIN HCL TB 10M $15 ALK PHOS ISOENZYME B $316 ALK PHOSP, SERUM $89 ALL ABOCATHS $8 ALL ABOCATHS $49 ALLEGRA 180 MG $6 ALLEGRA 30 MG TAB $2 ALLERGEN SPECIFIC IG $69 ALLERGEN SPECIFIC IG $69 ALLERGEN TEST $69 ALLERGENS DAIRY-GRAI $347 ALLERGY PROF RESP NE $1,940 ALLERGY SYRINGE TRAY $24 ALLEVYN $42 ALLEVYN GB LITE 2 1/ $5 ALLEVYN HEEL DRESSIN $27 ALLEVYN HEEL DRSG $46 ALLOPURINAL 300 MG $2 ALLOPURINOL 100MG. $1 ALPHA THALASSEMIA DN $1,215 ALPHA1 ANTITRYPSIN P $90 ALPHA1-ANTITRYPSIN, $161 ALPHA-FETOPROTEIN (A $261 ALPHA-FETOPROTEIN (A $261 ALPHA-FETOPROTEIN (A $261 ALPHA-FETOPROTEIN, A $261 ALPHAGAN P 0.15% 5ML $667 ALPRAZOLAM BLOOD $221 ALPRAZOLAM URINE $59 ALTACE 5 MG $5 ALTEPLASE RECOMBINAN $516 AM/PM CORTISOL $435 AMANTADINE 100 MG CA $2 AMARYL 2MG TAB $1 AMB BLOOD PRESS MON $170 AMBIEN TAB GEN $1 AMBU BAG (DISP) INFA $282 AMBU BAG DISP. (PED) $282 AMBULANCE BAG $32 AMEBIASIS ANTIBODY $195 AMENORRHEA PROFILE $859 AMIDATE 20MG VIAL $28 AMIKACIN PEAK $58 AMIKACIN TROUGH $58 AMINO ACID QUANT $403 AMINOPHYLLINE 250 $2 AMINOPHYLLINE 500 MG $4 AMINOSYN 3.5 1000 ML $34 AMINOSYN 3.5 M 1000 $431 AMINOSYN 3.5% 1000 M $1,080 AMINOSYN 4.25 1000 M $521 AMINOSYN TPN KIT $1,088 AMIODARONE 150 MG AM $8 AMIODARONE 200MG TAB $1 AMIODARONE INJ 30MG $4 AMITRIPTLINE 25MB TA $1 AMITRIPTYLINE (ELAVI $274 AMITRIPTYLINE 100MG $3 AMITRIPTYLINE 50MG T $2 AMMIODORONE LEVEL $731 AMMONIA $189 AMMONIA LEVEL $251 AMMONIUM LACTATE CRE $69 AMNICOT $8 AMNIHOOK $5 AMNIO TEST $2 AMONIA AMPULES/WIPES $7 AMOX. SUSP. 250 MG/5 $1 AMOXICILLIN 250MG $1 AMOXICILLIN 500MG $1 AMPHETAMINES >4 CONF $83 AMPHETAMINES URINE $135 AMPHETAMINES, 1 OR 2 $83 AMPICILLIN 500MG W/S $137 AMPICILLIN INJ 2 ADV $202 AMPICILLIN INJ 2 REG $206 AMPICILLIN INJ. 500M $22 AMPICILLIN INJ.1GM A $158 AMPICILLIN ORAL CAP $1 AMYLASE $130 AMYLASE, FLUID $130 AMYLASE, SERUM $130 ANAEROB/AEROBIC CULT $275 ANAEROBIC CULTURE ON $140 ANALGESICS >5 CONFIR $83 ANALYSIS OF KIDNEY S $191 ANAPLASMA PHAGOCYTOP $191 ANASTROZOLE 1MG TAB $39 ANCA $261 ANCA PROFILE $1,040 ANCA(P-ANCA,C-ANCA) $315 ANCEF 1GM VIAL $38 ANDER NASO TUBE 16FR $27 ANDERSEN GASTRIC TUB $39 ANDROSTANEDIOL GLUCU $427 ANDROSTENEDIONE $364 ANDROSTENEDIONE - SE $364 ANES. EXT SET 3 PORT $58 ANESTHESIA BREATHING $62 ANESTHESIA VENOSET $96 ANGELMAN-PRADER WILL $815 ANGIOTENSIN CONVERTI $195 ANKLE 3 VIEW BILATER $610 ANKLE PARTIAL, BILAT $561 ANKLE, 3 VIEW $306 ANKLE, 3 VIEW, LEFT $306 ANKLE, 3 VIEW, RIGHT $306 ANKLE, PARTIAL, LEFT $278 ANKLE, PARTIAL, RIGH $278 ANKLE-FOOT ORTHOSIS $448 ANORO ELLIPTA 14 DAY $319 ANTI 68 KD (HSP 70) $295 ANTI DNASE B (STREPT $227 ANTI JO ABS $80 ANTI MUSK ABS $75 ANTI N-DNA $227 ANTI THYROID AB'S $428 ANTIADRENAL ANTIB QU $105 ANTIBODY ELUTION, EA $139 ANTIBODY FUNGUS NES $210 ANTIBODY IDENTIFICAT $144 ANTIBODY IDENTIFICAT $182 ANTIBODY IDENTIFICAT $281 ANTIBODY INFLUENZA V $217 ANTIBODY SCREEN $154 ANTIBODY TETANUS $108 ANTIBODY, BARTONELLA $191 ANTIBODY, HELMINTH, $489 ANTIBODY, HISTOPLASM $182 ANTIBODY, HISTOPLASM $363 ANTIBODY, VIRUS $208 ANTIBODY: BACTERIUM, $191 ANTIBODY: DIPTHERIA $64 ANTIBODY:PROTOZOA, N $195 ANTIBODY; ACTINOMYCE $29 ANTIBODY; ASPERGILLU $29 ANTIBODY; ENTEROVIRU $208 ANTIBODY; HERPES SIM $217 ANTIBODY; LEGIONELLA $235 ANTIBODY; PARVOVIRUS $235 ANTICARDIOLIPIN ABS $398 ANTICARDIOLIPIN IGM $398 ANTICARDIOLIPINS,G,M $796 ANTICARDIOLIPINS,GAM $1,194 ANTICENTROMEVE B ABS $80 ANTICHROMATIN ABS $80 ANTICOAGULANT $421 ANTIDEPRESSANTS >5 C $83 ANTIDEPRESSANTS S>5 $83 ANTIDEPRESSANTS UNSP $83 ANTIDIOVETIC HORMONE $364 ANTIDIURETIC HORMONE $364 ANTI-DNA (DS) AB, EI $227 ANTI-DNA (SS) ABS, E $235 ANTI-DNP ABS $191 ANTIEPILEPTICS >6 $83 ANTIEXTRACTABLE NUCL $416 ANTIFLIADIN IGG & IG $382 ANTIGLOMERULAR BASEM $167 ANTIMICROBIAL DRSG $59 ANTI-MICROSOMAL (TPO $217 ANTIMITOCHONDRIAL AB $208 ANTIMUSCLE ABS, QUAN $315 ANTINUCLEAR ABS,ANA $188 ANTINUCLEAR ANTIBODI $188 ANTINUCLEAR ANTIBODI $188 ANTINUCLEAR ANTIBODI $188 ANTIPHOSPHATIDYLSERI $83 ANTIPHOSPHOLIPID SYN $950 ANTIPROTHROMBIN ABS $196 ANTIPYSCHOTICS >6 CO $83 ANTI-RANA $208 ANTIRIBOSOMAL P ABS $58 ANTISCLERODERMA 70 $208 ANTISMOOTH MUSCLE AB $208 ANTISTREPTOLYSIS O ( $139 ANTI-THROMBIN 111 $182 ANTI-THROMBIN 111 $363 ANTITHROMBIN ANTIGEN $182 ANTITHROMBIN,FUNCT $182 ANTI-THYROGLOBULIN A $211 ANTIVERT 25MG $1 ANTIVERT TAB 12.5 $2 ANUSOL H.C. SUPP.- G $2 APLIGRAF SKIN GRAFT $3,954 APNEA MONITOR $174 APOLIPOPROTEIN E GEN $600 APOLIPOPROTEIN EACH $211 APPLICATOR, COTTON 6 $1 APPLICATOR, COTTON 6 $1 APPLICATORS - STER. $103 APTT MIXING STUDY $314 AQUACEL 4X5 SILVER $563 AQUACEL 8X8 SILVER $69 AQUACEL AG EXTRA 2X2 $15 AQUACEL AG EXTRA 6X6 $59 AQUACEL AG EXTRA 8X1 $86 AQUACEL AG FM 10X10 $27 AQUACEL AG FM 17.5X1 $71 AQUACEL AG FM HEEL $72 AQUACEL AG FM NON AD $19 AQUACEL AG FM SAC20X $20 AQUACEL AG FOAM 4X4 $7 AQUACEL AG FOAM 7X7 $68 AQUACEL AG FOAM 8X8C $17 AQUACEL AG RIB.39X18 $36 AQUACEL AG RIB.75X18 $29 AQUACEL AG SACRUM $71 AQUACEL AG SURG3.5X4 $70 AQUACEL EXTRA 2X2 $5 AQUACEL EXTRA 6X6 $24 AQUACEL FOAM 8X5.5 $292 AQUACEL SURG 3.5 INC $86 AQUACEL SURG 6.5INCH $107 AQUA-MEPHYT. NEO $38 AQUA-MEPHYTON 10MG $360 ARICEPT 10 MG TAB GE $1 ARICEPT 5 MG TAB $1 ARM BOARD COVERS 5 X $1 ARM IMMOBILIZER $164 ARM SLING $8 ARM SPLINT, WRIST $145 ARROW 2 LUMEN CV KIT $382 ARROW 3 LUMEN CV KIT $726 ARROW 8.5 PERC INTRO $395 ARROW EMERG. INFUSIO $437 ARROW IV01100 TWIN C $44 ARROW THERM CATH KIT $1,161 ARROW TRAUMA TUBING $353 ARSENIC $91 ARTANE TAB 2MG.- GEN $1 ARTERIAL BLOOD GAS $256 ARTERIAL CATH SET $129 ARTERIAL LINE KIT $333 ARTERIAL PUNCTURE $160 ARTIFICIAL TEARS 1.4 $17 ASACOL 400 MG TAB $5 ASCARIS, IGE $17 ASCORBIC ACID TAB AL $1 A-SEAL ADAPTER $62 ASEPTIZYME PRESOAK $36 ASMANEX TWST IN 110M $563 ASMANEX TWST IN 220 $288 ASPCLEANPRESPRAY32OZ $25 ASPIRATION RENAL CYS $1,622 ASPIRATOR $39 ASPIRIN 325MG TAB $1 ASPIRIN 600 MG SUPP $1 ASPIRIN 81 MG CHEWTA $1 ASPIRIN 81 MG ECTAB $1 ASSAY OF SWEAT SODIU $74 ASSAY OTHER FLUID CH $37 A-SURGISPIKE $345 ATACAND 32MG $7 ATHLETIC SUPPORTER $0 ATHLETIC SUPPORTER $78 ATISPERM, AB $359 ATIVAN 0.5MG TAB $2 ATIVAN 1 MG TAB $2 ATIVAN INJ 2 MG. $2 ATOMIZATION DEVICE M $17 ATRIPLA TAB $271 ATROPINE 1% 5 ML OPH $181 ATROPINE 10MG ABBOJE $2 ATROPINE 1MG/ML INJ $11 ATROPINE ABBOJET 1MG $21 ATROPINE INJ 0.1 MG $1 ATROPINE INJ. 0.4MG/ $4 ATROPINE PED SYR $35 ATROVENT INHALER GEN $172 ATROVENT SOLUTION $6 AUGMENTIN 1000MG $7 AUGMENTIN 125 MG/5 M $6 AUGMENTIN 250 MG. TA $1 AUGMENTIN 250mg SUSP $23 AUGMENTIN 250MG/5ML $23 AUGMENTIN 500 MG TAB $22 AUGMENTIN 875 MG TAB $24 AURALGAN DROPS GENER $56 AUTO PULSE BELTS $506 AUTO SUTURE DISPOSAB $838 AUTO SUTURES TA 30 $1,106 AUTOIMMUNE PANEL $623 AUTOLOGOUS SURCHARGE $176 AVAPRO 150 MG GEN $1 AVAPRO 75 MG GEN $1 A-VERSAPORT 10.5mm $759 AVODART 0.5MG PO $19 AZACTAM 1 GM. INJ. $217 AZACTAM 1 GRAM MBP $107 AZACTAM 1/2 GM INJ $51 AZATHIOPRINE 50MG TA $6 AZELASTINE HCL 30ML $364 AZITHROMYCIN 500MG V $227 AZOPT 1% 10ML $437 AZULFIDINE 500 MG TA $1 B CELL, TOTAL COUNT $170 BABESIA MICROT: ABS $391 BABY LOTION $7 BABY POWDER $7 BABY POWDER $7 BABY WIPES $8 BACITRACIN OINT 1/2 $7 BACITRACIN OINT FOIL $1 BACK BRACE $2,766 BACK TABLE COVER $5 BACLOFEN 10 MG $1 BACLOFEN 20 MG $3 BACT.