East Los Angeles Doctors Hospital

4060 Whittier Blvd, Los Angeles, CA 90023 · Acute care hospital · Emergency room

These are East Los Angeles Doctors Hospital's own posted figures from its standard-charges file dated February 4, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

234 of the services we track have a posted price here; 139 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.

Emergency room

Service	Cash price	Gross charge	Insurer rates (min – max)
Critical care, first 30 to 74 minutes CPT 99291	$5,045.25	$5,045.25	$124.03 – $4,036.20
Emergency room visit, level 1 (minor) CPT 99281	$420.00	$420.00	$15.48 – $1,266.00
Emergency room visit, level 2 CPT 99282	$1,230.00	$1,230.00	$24.87 – $1,266.00
Emergency room visit, level 3 (moderate) CPT 99283	$1,780.00	$1,780.00	$45.49 – $1,424.00
Emergency room visit, level 4 CPT 99284	$2,930.00	$2,930.00	$69.72 – $2,344.00
Emergency room visit, level 5 (most severe) CPT 99285	$4,420.00	$4,420.00	$110.24 – $3,536.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$451.50	$451.50	$88.31 – $1,266.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$341.00	$341.00	$68.20 – $272.80
New patient office visit, about 30 minutes CPT 99203	$374.00	$374.00	$74.80 – $299.20
New patient office visit, about 45 minutes CPT 99204	$675.00	$675.00	$135.00 – $540.00
New patient office visit, about 60 minutes CPT 99205	$735.00	$735.00	$147.00 – $588.00
Office consultation, about 40 minutes CPT 99243	$271.00	$271.00	$54.20 – $216.80
Office consultation, about 60 minutes CPT 99244	$388.00	$388.00	$77.60 – $310.40
Office visit, established patient, about 10 to 19 minutes CPT 99212	$329.00	$329.00	$52.69 – $263.20
Office visit, established patient, about 20 to 29 minutes CPT 99213	$388.00	$388.00	$77.60 – $310.40
Office visit, established patient, about 30 to 39 minutes CPT 99214	$464.00	$464.00	$92.80 – $371.20
Office visit, established patient, about 40 to 54 minutes CPT 99215	$601.00	$601.00	$120.20 – $480.80
Office visit, established patient, brief (often a nurse) CPT 99211	$243.00	$243.00	$22.44 – $194.40
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted		$146.98 – $146.98
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted		$137.71 – $137.71

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	not posted		$22.89 – $57.23
Abdominal X-ray, 1 view CPT 74018	$394.80	$394.80	$25.12 – $315.84
Ankle X-ray, 3 or more views CPT 73610	$989.10	$989.10	$25.64 – $791.28
Bone density scan (DEXA), hips and spine CPT 77080	not posted		$34.96 – $274.73
Breast ultrasound, one breast, complete CPT 76641	$2,585.10	$2,585.10	$98.15 – $2,068.08
Breast ultrasound, one breast, limited CPT 76642	$1,241.10	$1,241.10	$80.03 – $992.88
Chest X-ray, 1 view CPT 71045	$394.80	$394.80	$18.02 – $315.84
Chest X-ray, 2 views CPT 71046	$592.20	$592.20	$28.03 – $473.76
CT angiogram of the chest (checks for lung clots) CPT 71275	$6,222.30	$6,222.30	$222.68 – $4,977.84
CT angiogram of the head CPT 70496	$5,801.25	$5,801.25	$222.68 – $4,641.00
CT scan of the abdomen and pelvis, with contrast CPT 74177	$7,366.80	$7,366.80	$287.44 – $5,893.44
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$8,859.90	$8,859.90	$325.62 – $7,087.92
CT scan of the abdomen and pelvis, without contrast CPT 74176	$3,246.60	$3,246.60	$177.80 – $2,597.28
CT scan of the abdomen, without contrast CPT 74150	$2,296.35	$2,296.35	$133.24 – $1,837.08
CT scan of the chest, with contrast CPT 71260	$5,387.55	$5,387.55	$164.16 – $4,310.04
CT scan of the chest, without contrast CPT 71250	$4,435.20	$4,435.20	$129.87 – $3,548.16
CT scan of the head, without contrast CPT 70450	$4,674.60	$4,674.60	$103.30 – $3,739.68
CT scan of the neck (cervical spine), without contrast CPT 72125	$4,710.30	$4,710.30	$127.49 – $3,768.24
CT scan of the pelvis, with contrast CPT 72193	$3,378.90	$3,378.90	$208.54 – $2,703.12
CT scan of the sinuses or face, without contrast CPT 70486	$4,127.55	$4,127.55	$125.82 – $3,302.04
Diagnostic mammogram, both breasts CPT 77066	not posted		$106.57 – $266.42
Diagnostic mammogram, one breast CPT 77065	not posted		$83.17 – $207.93
Foot X-ray, 3 or more views CPT 73630	$771.75	$771.75	$24.70 – $617.40
Hand X-ray, 3 or more views CPT 73130	$1,025.85	$1,025.85	$25.64 – $820.68
Knee X-ray, 3 views CPT 73562	$811.65	$811.65	$23.85 – $649.32
Leg or arm vein ultrasound, both sides CPT 93970	$2,849.70	$2,849.70	$171.60 – $2,279.76
Leg or arm vein ultrasound, one side CPT 93971	$1,047.90	$1,047.90	$86.25 – $838.32
Lower back X-ray, 2 or 3 views CPT 72100	$878.85	$878.85	$30.90 – $703.08
MRI of both breasts, without and with contrast CPT 77049	not posted		$344.60 – $344.60
MRI of the abdomen, without and with contrast CPT 74183	$6,109.95	$6,109.95	$340.19 – $4,887.96
MRI of the brain, without and with contrast CPT 70553	$8,163.75	$8,163.75	$317.28 – $6,531.00
MRI of the brain, without contrast CPT 70551	$7,585.20	$7,585.20	$193.96 – $6,068.16
MRI of the knee or other leg joint, without contrast CPT 73721	$9,836.40	$9,836.40	$296.97 – $7,869.12
MRI of the lower back (lumbar spine), without contrast CPT 72148	$3,370.50	$3,370.50	$189.72 – $2,696.40
MRI of the mid back (thoracic spine), without contrast CPT 72146	$3,743.25	$3,743.25	$189.06 – $2,994.60
MRI of the neck (cervical spine), without contrast CPT 72141	$3,341.10	$3,341.10	$189.36 – $2,672.88
MRI of the pelvis, without and with contrast CPT 72197	$3,659.25	$3,659.25	$339.57 – $2,927.40
MRI of the shoulder or other arm joint, without contrast CPT 73221	$4,353.30	$4,353.30	$201.21 – $3,482.64
Neck X-ray, 2 or 3 views CPT 72040	$720.30	$720.30	$26.50 – $576.24
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$1,206.45	$1,206.45	$69.00 – $965.16
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$1,333.50	$1,333.50	$130.50 – $1,066.80
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$1,019.55	$1,019.55	$113.03 – $815.64
Screening mammogram, both breasts CPT 77067	not posted		$87.94 – $219.85
Shoulder X-ray, 2 or more views CPT 73030	$1,099.35	$1,099.35	$26.38 – $879.48
Transvaginal pregnancy ultrasound CPT 76817	$591.15	$591.15	$88.97 – $472.92
Transvaginal ultrasound CPT 76830	$846.30	$846.30	$69.00 – $677.04
Ultrasound of the abdomen, complete CPT 76700	$1,482.60	$1,482.60	$84.86 – $1,186.08
Ultrasound of the neck or thyroid CPT 76536	$1,971.90	$1,971.90	$60.93 – $1,577.52
Wrist X-ray, 3 or more views CPT 73110	$754.95	$754.95	$25.64 – $603.96
X-ray of the lower back, 4 or more views CPT 72110	$1,342.95	$1,342.95	$44.73 – $1,074.36

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$796.95	$796.95	$3.55 – $637.56
Blood culture CPT 87040	$507.15	$507.15	$4.33 – $405.72
Blood draw (venipuncture) CPT 36415	$40.95	$40.95	$7.51 – $1,266.00
BNP test (heart failure) CPT 83880	$281.40	$281.40	$16.49 – $225.12
C-reactive protein (CRP) test CPT 86140	$142.80	$142.80	$2.18 – $114.24
Chlamydia test (DNA/NAAT) CPT 87491	$46.01	$46.01	$14.74 – $70.18
Complete blood count (CBC) with differential CPT 85025	$300.30	$300.30	$3.26 – $240.24
Complete blood count (CBC), automated CPT 85027	$189.00	$189.00	$2.72 – $151.20
Comprehensive metabolic panel (blood test) CPT 80053	$998.55	$998.55	$4.44 – $798.84
COVID-19 PCR test CPT 87635	$150.00	$150.00	$21.55 – $120.00
D-dimer test (blood clots) CPT 85379	$166.95	$166.95	$4.28 – $133.56
Drug screen, instrument chemistry CPT 80307	$559.65	$559.65	$26.10 – $447.72
Ferritin (iron stores) test CPT 82728	$227.85	$227.85	$5.72 – $182.28
Free T4 (thyroid) test CPT 84439	$165.90	$165.90	$3.79 – $132.72
General health panel (blood tests) CPT 80050	$1,000.45	$1,000.45	$200.09 – $800.36
Glucose (blood sugar) test CPT 82947	$112.35	$112.35	$1.65 – $89.88
Gonorrhea test (DNA/NAAT) CPT 87591	$65.10	$65.10	$14.74 – $70.18
Hemoglobin A1c test CPT 83036	$199.50	$199.50	$4.08 – $159.60
Hepatitis C antibody test CPT 86803	$84.00	$84.00	$5.99 – $67.20
HIV-1/HIV-2 antigen and antibody test CPT 87389	$26.70	$26.70	$10.11 – $48.16
Iron test CPT 83540	$95.55	$95.55	$2.72 – $76.44
Kidney function panel CPT 80069	$845.30	$845.30	$3.65 – $676.24
Lipase test (pancreas) CPT 83690	$213.15	$213.15	$2.89 – $170.52
Lipid panel, cholesterol and triglycerides CPT 80061	$542.49	$542.49	$5.62 – $433.99
Liver function panel CPT 80076	$636.30	$636.30	$3.43 – $509.04
Magnesium test CPT 83735	$274.05	$274.05	$2.81 – $219.24
Obstetric blood test panel CPT 80055	$1,001.70	$1,001.70	$20.08 – $801.36
Partial thromboplastin time (PTT), clotting test CPT 85730	$95.00	$95.00	$2.52 – $76.00
Pregnancy blood test (hCG), quantitative CPT 84702	$350.70	$350.70	$6.32 – $280.56
Prothrombin time (PT/INR), clotting test CPT 85610	$233.10	$233.10	$1.80 – $186.48
PSA (prostate specific antigen), free CPT 84154	$22.89	$22.89	$7.72 – $36.78
PSA (prostate specific antigen), total CPT 84153	$307.65	$307.65	$7.72 – $246.12
Rapid strep test CPT 87880	$12.49	$12.49	$5.86 – $33.06
Sed rate (ESR) test CPT 85652	$180.60	$180.60	$1.13 – $144.48
TB skin test CPT 86580	$161.57	$161.57	$3.43 – $129.26
Thyroid stimulating hormone (TSH) CPT 84443	$367.50	$367.50	$7.06 – $294.00
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$379.00	$379.00	$28.44 – $303.20
Troponin test (heart damage) CPT 84484	$331.80	$331.80	$5.24 – $265.44
Urinalysis, automated, with microscope CPT 81001	$181.65	$181.65	$1.33 – $145.32
Urinalysis, automated, without microscope CPT 81003	$120.00	$120.00	? – $96.00
Urinalysis, manual, with microscope CPT 81000	$82.95	$82.95	$1.69 – $66.36
Urinalysis, manual, without microscope CPT 81002	$100.80	$100.80	$1.46 – $80.64
Urine culture, colony count CPT 87086	$306.60	$306.60	$3.39 – $245.28
Urine pregnancy test CPT 81025	$176.40	$176.40	$2.86 – $141.12
Vitamin B12 test CPT 82607	$113.40	$113.40	$6.33 – $90.72
Vitamin D test CPT 82306	$74.55	$74.55	$12.43 – $59.64

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$2,704.80	$2,704.80	$159.77 – $2,163.84
ECG tracing only (no interpretation) CPT 93005	$460.95	$460.95	$16.73 – $368.76
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$4,700.85	$4,700.85	$244.56 – $3,760.68
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$29.27 – $29.27
Holter monitor, up to 48 hours CPT 93224	not posted		$113.06 – $113.06
Left heart catheterization CPT 93452	not posted		$778.12 – $8,142.71
Left heart catheterization with coronary angiogram CPT 93458	not posted		$969.01 – $8,142.71
Nuclear stress test (heart perfusion imaging) CPT 78452	$4,271.40	$4,271.40	$355.08 – $3,548.30
Treadmill stress test, complete CPT 93015	not posted		$97.83 – $97.83

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$688.10 – $17,877.05
Appendix removal, laparoscopic CPT 44970	not posted		$278.74 – $14,418.42
Breast biopsy with ultrasound guidance CPT 19083	$2,734.20	$2,734.20	$626.20 – $4,051.39
Carpal tunnel release CPT 64721	not posted		$323.17 – $4,824.76
Colonoscopy with biopsy CPT 45380	not posted		$336.83 – $2,948.84
Colonoscopy with polyp removal (snare) CPT 45385	not posted		$408.22 – $2,948.84
Colonoscopy, diagnostic CPT 45378	not posted		$301.13 – $2,283.86
Colposcopy with biopsy CPT 57454	not posted		$156.10 – $2,428.00
Cystoscopy (bladder scope) CPT 52000	not posted		$88.49 – $2,428.00
Ear tubes, under general anesthesia CPT 69436	not posted		$123.04 – $3,810.89
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted		$55.82 – $2,283.86
Gallbladder removal, laparoscopic CPT 47562	not posted		$475.44 – $14,418.42
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$967.34 – $967.34
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$823.97 – $25,722.62
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted		$1,303.92 – $7,812.36
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$270.00 – $14,418.42
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted		$350.89 – $8,645.25
Kidney stone shock-wave lithotripsy CPT 50590	not posted		$683.54 – $8,711.44
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$562.02 – $8,088.42
Lower colon endoscopy with ultrasound CPT 45391	not posted		$173.04 – $2,948.84
Nasal endoscopy, diagnostic CPT 31231	not posted		$50.12 – $1,850.00
Prostate biopsy CPT 55700	$6,059.55	$6,059.55	$89.24 – $5,089.73
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$972.33 – $25,722.62
Removal of a breast lump, open surgery CPT 19120	not posted		$214.93 – $9,525.02
Rotator cuff repair, arthroscopic CPT 29827	not posted		$503.84 – $17,877.05
Screening colonoscopy, average risk HCPCS G0121	$2,623.95	$2,623.95	$1,107.67 – $2,428.00
Screening colonoscopy, high risk HCPCS G0105	$2,623.95	$2,623.95	$1,107.67 – $2,428.00
Septoplasty (nasal septum repair) CPT 30520	not posted		$379.75 – $8,045.39
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$430.26 – $4,387.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$1,094.81 – $5,552.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$172.02 – $14,633.79
Total hip replacement CPT 27130	not posted		$1,518.98 – $32,887.94
Total knee replacement CPT 27447	not posted		$1,518.98 – $32,887.94
Upper endoscopy (EGD) with biopsy CPT 43239	not posted		$238.86 – $2,428.00
Upper endoscopy (EGD), diagnostic CPT 43235	not posted		$228.60 – $2,428.00
Vasectomy CPT 55250	not posted		$265.82 – $5,089.73

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	not posted		$2,343.49 – $4,935.00
Fetal non-stress test CPT 59025	$502.95	$502.95	$44.75 – $497.94
IUD insertion CPT 58300	not posted		$171.58 – $174.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$2,217.12 – $4,387.00
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted		$2,133.03 – $4,935.00

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$10,128.89 – $20,884.30
C-section, without complications MS-DRG 788	not posted	$5,279.00 – $21,360.88
Chest pain MS-DRG 313	not posted	$8,394.94 – $17,309.16
COPD flare-up, with major complications MS-DRG 190	not posted	$12,602.46 – $25,984.46
COPD flare-up, without complications MS-DRG 192	not posted	$7,714.92 – $15,907.06
Fainting (syncope) MS-DRG 312	not posted	$10,016.93 – $20,653.46
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$11,194.12 – $23,080.66
Heart failure, with major complications MS-DRG 291	not posted	$14,469.94 – $29,834.92
Heart failure, without complications MS-DRG 293	not posted	$6,703.11 – $13,820.84
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$100,204.97 – $206,608.18
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$20,435.01 – $42,134.04
Irregular heartbeat, without complications MS-DRG 310	not posted	$6,814.05 – $14,049.58
Kidney failure, with complications MS-DRG 683	not posted	$10,197.73 – $21,026.24
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$9,311.21 – $19,198.38
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$25,385.19 – $52,340.60
Normal newborn care MS-DRG 795	not posted	$774.00 – $6,431.20
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$9,093.45 – $18,749.38
Pneumonia, with complications MS-DRG 194	not posted	$9,489.97 – $19,566.94
Pneumonia, with major complications MS-DRG 193	not posted	$14,602.44 – $30,108.12
Pneumonia, without complications MS-DRG 195	not posted	$7,463.24 – $15,388.12
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$15,546.47 – $32,054.58
Sepsis, with major complications MS-DRG 871	not posted	$21,221.86 – $43,756.42
Sepsis, without major complications MS-DRG 872	not posted	$11,657.41 – $24,035.90
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$10,114.50 – $20,854.64
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$9,082.15 – $18,726.08
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$11,512.55 – $23,737.22
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$13,380.04 – $27,587.72
Vaginal delivery, without complications MS-DRG 807	not posted	$4,329.00 – $15,697.38
Weight loss surgery, without complications MS-DRG 621	not posted	$16,082.68 – $33,160.16

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$1,339.80	$1,339.80	$59.78 – $1,071.84
Lower back nerve root injection with imaging guidance CPT 64483	not posted		$146.21 – $2,277.67
Lower back spinal injection (epidural), with imaging guidance CPT 62323	not posted		$224.43 – $1,850.00
Lower back spinal injection (epidural), without imaging CPT 62322	not posted		$141.27 – $2,277.67

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$1,025.31 – $5,823.27
Eye exam, new patient, comprehensive CPT 92004	not posted	$50.78 – $330.33
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$189.87 – $2,428.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$185.12 – $390.33

Sleep

Service	Cash price	Insurer rates (min – max)
Home sleep apnea test CPT 95806	not posted	$84.37 – $390.33
Sleep study with CPAP titration CPT 95811	not posted	$364.87 – $2,612.66
Sleep study, overnight in a sleep lab CPT 95810	not posted	$355.03 – $2,612.66

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$430.50	$430.50	$25.51 – $390.33

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$150.15	$150.15	$22.65 – $218.00
Physical therapy evaluation, low complexity CPT 97161	$495.60	$495.60	$88.94 – $396.48
Physical therapy evaluation, moderate complexity CPT 97162	$668.85	$668.85	$88.94 – $535.08
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$270.41	$270.41	$11.18 – $218.00
Therapeutic activities, 15 minutes CPT 97530	$292.95	$292.95	$11.36 – $234.36

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	not posted		$91.44 – $398.41
Family psychotherapy, without the patient, 50 minutes CPT 90846	not posted		$88.37 – $398.41
Group psychotherapy CPT 90853	not posted		$24.44 – $222.74
Psychiatric diagnostic evaluation CPT 90791	$473.55	$473.55	$166.34 – $1,266.00
Psychotherapy, 30 minutes CPT 90832	not posted		$69.19 – $398.41
Psychotherapy, 45 minutes CPT 90834	not posted		$91.43 – $398.41
Psychotherapy, 60 minutes CPT 90837	not posted		$134.61 – $398.41

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$238.35	$238.35	$19.13 – $1,266.00
IV hydration, each additional hour CPT 96361	$152.25	$152.25	$14.89 – $1,266.00
IV hydration, first hour CPT 96360	$973.35	$973.35	$52.33 – $1,266.00
IV push injection of a drug, first CPT 96374	$924.00	$924.00	$50.82 – $1,266.00
IV push injection, each additional drug CPT 96375	$278.25	$278.25	$21.72 – $399.00

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$71.97	$71.97	$5.05 – $57.57
Dexamethasone injection, per 1 mg HCPCS J1100	$96.92	$96.92	$4.67 – $77.53
Fentanyl injection, per 0.1 mg HCPCS J3010	$1,306.00	$1,306.00	$5.54 – $1,044.80
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted		$9.23 – $9.23
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$124.51	$124.51	$5.05 – $99.61
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$128.17	$128.17	$4.69 – $102.54
Morphine injection, up to 10 mg HCPCS J2270	$128.38	$128.38	$9.31 – $102.70
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$98.06	$98.05	$4.65 – $78.44
Propofol injection, per 10 mg HCPCS J2704	$128.17	$128.17	$4.68 – $102.54
Saline IV solution, 1000 ml HCPCS J7030	$85.91	$85.91	$7.29 – $68.73

Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.

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