Foothill Regional Medical Center

14662 Newport Ave, Tustin, CA 92780 · Acute care hospital

These are Foothill Regional Medical Center's own posted figures from its standard-charges file dated March 18, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

235 of the services we track have a posted price here; 111 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	$9,679.31	$9,679.31	$11.78 – $8,324.21
Emergency room visit, level 1 (minor) CPT 99281	$1,260.57	$1,260.57	$1.27 – $2,538.00
Emergency room visit, level 2 CPT 99282	$2,044.53	$2,044.53	$2.19 – $2,538.00
Emergency room visit, level 3 (moderate) CPT 99283	$3,149.69	$3,149.69	$3.44 – $2,708.73
Emergency room visit, level 4 CPT 99284	$5,304.74	$5,304.74	$5.53 – $4,562.08
Emergency room visit, level 5 (most severe) CPT 99285	$7,568.01	$7,568.01	$8.17 – $6,508.49
Simple wound repair (stitches), 2.5 cm or less CPT 12001	not posted		$2.11 – $640.49

Office visits

Service	Cash price	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	not posted	$34.30 – $109.17
New patient office visit, about 30 minutes CPT 99203	not posted	$57.20 – $168.45
New patient office visit, about 45 minutes CPT 99204	not posted	$68.90 – $279.65
New patient office visit, about 60 minutes CPT 99205	not posted	$82.70 – $359.63
Office consultation, about 40 minutes CPT 99243	not posted	$59.50 – $207.04
Office consultation, about 60 minutes CPT 99244	not posted	$81.40 – $329.03
Office visit, established patient, about 10 to 19 minutes CPT 99212	not posted	$18.10 – $86.18
Office visit, established patient, about 20 to 29 minutes CPT 99213	not posted	$24.00 – $138.27
Office visit, established patient, about 30 to 39 minutes CPT 99214	not posted	$37.50 – $194.00
Office visit, established patient, about 40 to 54 minutes CPT 99215	not posted	$57.20 – $271.80
Office visit, established patient, brief (often a nurse) CPT 99211	not posted	$12.00 – $36.17
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted	$114.10 – $273.84
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted	$132.20 – $317.28

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	not posted		$1.56 – $114.05
Abdominal X-ray, 1 view CPT 74018	$286.65	$286.65	$1.57 – $297.60
Ankle X-ray, 3 or more views CPT 73610	$1,277.83	$1,277.83	$1.13 – $1,098.93
Bone density scan (DEXA), hips and spine CPT 77080	not posted		$1.81 – $359.42
Breast ultrasound, one breast, complete CPT 76641	$1,296.25	$1,296.25	$2.32 – $1,114.78
Breast ultrasound, one breast, limited CPT 76642	$1,296.25	$1,296.25	$2.32 – $1,114.78
Chest X-ray, 1 view CPT 71045	$330.39	$330.39	$1.57 – $297.60
Chest X-ray, 2 views CPT 71046	$468.54	$468.54	$1.57 – $402.94
CT angiogram of the chest (checks for lung clots) CPT 71275	$3,877.25	$3,877.25	$8.56 – $3,334.44
CT angiogram of the head CPT 70496	$4,462.06	$4,462.06	$8.56 – $3,837.37
CT scan of the abdomen and pelvis, with contrast CPT 74177	$8,979.38	$8,979.38	$14.68 – $7,722.27
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$10,385.00	$10,385.00	$14.68 – $8,931.10
CT scan of the abdomen and pelvis, without contrast CPT 74176	$7,167.38	$7,167.38	$10.25 – $6,163.95
CT scan of the abdomen, without contrast CPT 74150	$3,838.11	$3,838.11	$4.85 – $3,300.77
CT scan of the chest, with contrast CPT 71260	$4,234.12	$4,234.12	$7.60 – $3,641.34
CT scan of the chest, without contrast CPT 71250	$3,393.74	$3,393.74	$4.85 – $2,918.62
CT scan of the head, without contrast CPT 70450	$4,353.85	$4,353.85	$4.85 – $3,744.31
CT scan of the neck (cervical spine), without contrast CPT 72125	$4,353.85	$4,353.85	$4.85 – $3,744.31
CT scan of the pelvis, with contrast CPT 72193	$4,475.87	$4,475.87	$7.60 – $3,849.25
CT scan of the sinuses or face, without contrast CPT 70486	$4,353.85	$4,353.85	$4.85 – $3,744.31
Diagnostic mammogram, both breasts CPT 77066	not posted		$105.18 – $355.27
Diagnostic mammogram, one breast CPT 77065	not posted		$82.51 – $280.99
Foot X-ray, 3 or more views CPT 73630	$1,277.83	$1,277.83	$1.13 – $1,098.93
Hand X-ray, 3 or more views CPT 73130	$1,277.83	$1,277.83	$1.13 – $1,098.93
Knee X-ray, 3 views CPT 73562	$782.82	$782.82	$1.13 – $673.23
Leg or arm vein ultrasound, both sides CPT 93970	$3,162.35	$3,162.35	$3.85 – $2,719.62
Leg or arm vein ultrasound, one side CPT 93971	$1,943.23	$1,943.23	$2.44 – $1,671.18
Lower back X-ray, 2 or 3 views CPT 72100	$1,916.76	$1,916.76	$1.13 – $1,648.41
MRI of both breasts, without and with contrast CPT 77049	not posted		$239.65 – $833.85
MRI of the abdomen, without and with contrast CPT 74183	$6,825.48	$6,825.48	$13.50 – $5,869.91
MRI of the brain, without and with contrast CPT 70553	$7,207.68	$7,207.68	$13.50 – $6,198.60
MRI of the brain, without contrast CPT 70551	$5,627.08	$5,627.08	$8.56 – $4,839.29
MRI of the knee or other leg joint, without contrast CPT 73721	$5,328.92	$5,328.92	$8.56 – $4,582.87
MRI of the lower back (lumbar spine), without contrast CPT 72148	$5,328.92	$5,328.92	$8.56 – $4,582.87
MRI of the mid back (thoracic spine), without contrast CPT 72146	$5,149.33	$5,149.33	$8.56 – $4,428.42
MRI of the neck (cervical spine), without contrast CPT 72141	$5,438.28	$5,438.28	$8.56 – $4,676.92
MRI of the pelvis, without and with contrast CPT 72197	$6,594.09	$6,594.09	$13.50 – $5,670.92
MRI of the shoulder or other arm joint, without contrast CPT 73221	$5,445.19	$5,445.19	$8.56 – $4,682.86
Neck X-ray, 2 or 3 views CPT 72040	$1,916.76	$1,916.76	$1.13 – $1,648.41
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$1,961.65	$1,961.65	$2.44 – $1,687.02
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$1,296.25	$1,296.25	$2.44 – $1,114.78
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$1,296.25	$1,296.25	$2.44 – $1,114.78
Screening mammogram, both breasts CPT 77067	not posted		$86.91 – $286.68
Shoulder X-ray, 2 or more views CPT 73030	$1,277.83	$1,277.83	$1.13 – $1,098.93
Transvaginal pregnancy ultrasound CPT 76817	not posted		$1.59 – $359.42
Transvaginal ultrasound CPT 76830	$1,961.65	$1,961.65	$2.44 – $1,687.02
Ultrasound of the abdomen, complete CPT 76700	$1,961.65	$1,961.65	$2.44 – $1,687.02
Ultrasound of the neck or thyroid CPT 76536	$1,296.25	$1,296.25	$2.44 – $1,114.78
Wrist X-ray, 3 or more views CPT 73110	$731.02	$731.02	$1.13 – $628.68
X-ray of the lower back, 4 or more views CPT 72110	$1,916.76	$1,916.76	$1.91 – $1,648.41

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$633.16	$633.16	? – $544.52
Blood culture CPT 87040	$353.42	$353.42	? – $303.94
Blood draw (venipuncture) CPT 36415	$57.56	$57.56	? – $49.50
BNP test (heart failure) CPT 83880	$229.09	$229.09	$1.09 – $197.02
C-reactive protein (CRP) test CPT 86140	$191.10	$191.10	? – $164.35
Chlamydia test (DNA/NAAT) CPT 87491	$121.19	$121.19	$1.12 – $115.53
Complete blood count (CBC) with differential CPT 85025	$284.34	$284.34	? – $244.53
Complete blood count (CBC), automated CPT 85027	$194.55	$194.55	? – $167.31
Comprehensive metabolic panel (blood test) CPT 80053	$758.64	$758.64	? – $652.43
COVID-19 PCR test CPT 87635	$177.21	$177.21	$34.38 – $168.93
D-dimer test (blood clots) CPT 85379	$39.08	$39.08	? – $33.61
Drug screen, instrument chemistry CPT 80307	$267.08	$267.08	$1.80 – $229.69
Ferritin (iron stores) test CPT 82728	$248.66	$248.66	? – $213.85
Free T4 (thyroid) test CPT 84439	$282.05	$282.05	? – $242.56
General health panel (blood tests) CPT 80050	not posted		$41.18 – $104.37
Glucose (blood sugar) test CPT 82947	$164.63	$164.63	? – $141.58
Gonorrhea test (DNA/NAAT) CPT 87591	$121.19	$121.19	$1.12 – $115.53
Hemoglobin A1c test CPT 83036	$288.95	$288.95	? – $248.50
Hepatitis C antibody test CPT 86803	$54.74	$54.74	? – $47.08
HIV-1/HIV-2 antigen and antibody test CPT 87389	not posted		? – $72.18
Iron test CPT 83540	$229.09	$229.09	? – $197.02
Kidney function panel CPT 80069	$633.16	$633.16	? – $544.52
Lipase test (pancreas) CPT 83690	$196.86	$196.86	? – $169.30
Lipid panel, cholesterol and triglycerides CPT 80061	$240.60	$240.60	? – $206.92
Liver function panel CPT 80076	$594.02	$594.02	? – $510.86
Magnesium test CPT 83735	$196.86	$196.86	? – $169.30
Obstetric blood test panel CPT 80055	not posted		$35.83 – $152.61
Partial thromboplastin time (PTT), clotting test CPT 85730	$225.63	$225.63	? – $194.04
Pregnancy blood test (hCG), quantitative CPT 84702	$248.66	$248.66	? – $213.85
Prothrombin time (PT/INR), clotting test CPT 85610	$162.32	$162.32	? – $139.60
PSA (prostate specific antigen), free CPT 84154	not posted		? – $54.79
PSA (prostate specific antigen), total CPT 84153	$248.66	$248.66	? – $213.85
Rapid strep test CPT 87880	$57.09	$57.09	? – $54.42
Sed rate (ESR) test CPT 85652	$9.32	$9.32	? – $8.89
TB skin test CPT 86580	not posted		? – $78.95
Thyroid stimulating hormone (TSH) CPT 84443	$346.51	$346.51	? – $298.00
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$627.41	$627.41	? – $539.57
Troponin test (heart damage) CPT 84484	$310.82	$310.82	? – $267.31
Urinalysis, automated, with microscope CPT 81001	$177.29	$177.29	? – $152.47
Urinalysis, automated, without microscope CPT 81003	$133.54	$133.54	? – $114.84
Urinalysis, manual, with microscope CPT 81000	$124.33	$124.33	? – $106.92
Urinalysis, manual, without microscope CPT 81002	not posted		? – $7.62
Urine culture, colony count CPT 87086	not posted		? – $24.04
Urine pregnancy test CPT 81025	$246.36	$246.36	? – $211.87
Vitamin B12 test CPT 82607	$81.74	$81.74	? – $70.30
Vitamin D test CPT 82306	$49.10	$49.10	? – $97.45

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$1,868.40	$1,868.40	$3.85 – $1,606.82
ECG tracing only (no interpretation) CPT 93005	$428.25	$428.25	? – $368.30
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$2,424.43	$2,424.43	$9.93 – $2,085.01
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$14.42 – $68.88
Holter monitor, up to 48 hours CPT 93224	not posted		$73.08 – $268.45
Left heart catheterization CPT 93452	not posted		$68.74 – $11,671.00
Left heart catheterization with coronary angiogram CPT 93458	not posted		$68.74 – $11,671.00
Nuclear stress test (heart perfusion imaging) CPT 78452	$8,686.97	$8,686.97	$17.00 – $7,470.79
Treadmill stress test, complete CPT 93015	not posted		$74.82 – $233.08

Surgery

Service	Cash price	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted	$156.96 – $23,026.51
Appendix removal, laparoscopic CPT 44970	not posted	$84.92 – $18,806.01
Breast biopsy with ultrasound guidance CPT 19083	not posted	$26.62 – $5,222.54
Carpal tunnel release CPT 64721	not posted	$33.40 – $6,294.41
Colonoscopy with biopsy CPT 45380	not posted	$16.57 – $3,800.55
Colonoscopy with polyp removal (snare) CPT 45385	not posted	$16.57 – $3,800.55
Colonoscopy, diagnostic CPT 45378	not posted	$16.57 – $2,938.73
Colposcopy with biopsy CPT 57454	not posted	$6.16 – $1,912.00
Cystoscopy (bladder scope) CPT 52000	not posted	$11.98 – $2,151.45
Ear tubes, under general anesthesia CPT 69436	not posted	$29.85 – $4,774.65
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted	$11.02 – $2,938.73
Gallbladder removal, laparoscopic CPT 47562	not posted	$84.92 – $18,806.01
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted	$948.37 – $6,341.00
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted	$84.92 – $33,558.67
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted	$40.69 – $10,248.62
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted	$84.92 – $18,806.01
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted	$58.25 – $11,375.28
Kidney stone shock-wave lithotripsy CPT 50590	not posted	$92.13 – $11,117.12
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted	$52.46 – $10,458.41
Lower colon endoscopy with ultrasound CPT 45391	not posted	$16.57 – $3,800.55
Nasal endoscopy, diagnostic CPT 31231	not posted	$3.30 – $625.77
Prostate biopsy CPT 55700	not posted	$24.48 – $6,602.99
Prostate removal, laparoscopic or robotic CPT 55866	not posted	$953.26 – $33,558.67
Removal of a breast lump, open surgery CPT 19120	not posted	$45.12 – $12,342.99
Rotator cuff repair, arthroscopic CPT 29827	not posted	$100.85 – $23,026.51
Screening colonoscopy, average risk HCPCS G0121	not posted	$14.70 – $2,938.73
Screening colonoscopy, high risk HCPCS G0105	not posted	$14.70 – $2,938.73
Septoplasty (nasal septum repair) CPT 30520	not posted	$44.06 – $10,453.44
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted	$52.46 – $3,552.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted	$1,031.85 – $8,799.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted	$44.06 – $19,068.05
Total hip replacement CPT 27130	not posted	$1,489.20 – $41,473.84
Total knee replacement CPT 27447	not posted	$1,489.20 – $41,473.84
Upper endoscopy (EGD) with biopsy CPT 43239	not posted	$14.95 – $3,022.05
Upper endoscopy (EGD), diagnostic CPT 43235	not posted	$14.95 – $3,022.05
Vasectomy CPT 55250	not posted	$41.74 – $6,602.99

Pregnancy and birth

Service	Cash price	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	not posted	$1,390.97 – $5,227.11
Fetal non-stress test CPT 59025	not posted	$2.80 – $648.45
IUD insertion CPT 58300	not posted	$99.00 – $587.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted	$1,390.14 – $5,227.11
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted	$1,390.14 – $5,227.11

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$9,113.20 – $17,542.91
C-section, without complications MS-DRG 788	not posted	$8,484.00 – $19,019.42
Chest pain MS-DRG 313	not posted	$7,470.19 – $14,380.12
COPD flare-up, with major complications MS-DRG 190	not posted	$10,786.00 – $21,912.18
COPD flare-up, without complications MS-DRG 192	not posted	$6,682.99 – $12,864.76
Fainting (syncope) MS-DRG 312	not posted	$9,000.19 – $17,325.37
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$10,101.24 – $19,444.89
Heart failure, with major complications MS-DRG 291	not posted	$10,786.00 – $25,333.35
Heart failure, without complications MS-DRG 293	not posted	$5,915.99 – $11,388.28
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$10,786.00 – $190,448.01
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$10,786.00 – $37,866.06
Irregular heartbeat, without complications MS-DRG 310	not posted	$5,917.01 – $11,390.24
Kidney failure, with complications MS-DRG 683	not posted	$9,042.55 – $17,406.91
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$8,373.44 – $16,118.87
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$10,786.00 – $47,820.75
Normal newborn care MS-DRG 795	not posted	$2,220.21 – $10,786.00
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$8,057.57 – $15,510.82
Pneumonia, with complications MS-DRG 194	not posted	$8,337.12 – $16,048.96
Pneumonia, with major complications MS-DRG 193	not posted	$10,786.00 – $25,927.84
Pneumonia, without complications MS-DRG 195	not posted	$6,546.76 – $12,602.51
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$14,300.62 – $27,528.69
Sepsis, with major complications MS-DRG 871	not posted	$10,786.00 – $38,130.30
Sepsis, without major complications MS-DRG 872	not posted	$10,531.16 – $20,272.48
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$8,993.11 – $17,311.74
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$14,543.00 – $14,543.00
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$8,071.68 – $15,537.98
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$10,399.96 – $20,019.92
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$10,786.00 – $24,496.03
Vaginal delivery, without complications MS-DRG 807	not posted	$6,060.00 – $13,490.34
Weight loss surgery, without complications MS-DRG 621	not posted	$10,786.00 – $29,696.78

Pain and spine

Service	Cash price	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	not posted	$4.62 – $1,912.00
Lower back nerve root injection with imaging guidance CPT 64483	not posted	$13.22 – $2,869.69
Lower back spinal injection (epidural), with imaging guidance CPT 62323	not posted	$12.82 – $2,232.22
Lower back spinal injection (epidural), without imaging CPT 62322	not posted	$12.82 – $2,869.69

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$42.24 – $8,059.00
Eye exam, new patient, comprehensive CPT 92004	not posted	$2.41 – $415.38
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$9.57 – $2,432.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$2.15 – $504.31

Sleep

Service	Cash price	Insurer rates (min – max)
Home sleep apnea test CPT 95806	not posted	$4.30 – $504.31
Sleep study with CPAP titration CPT 95811	not posted	$20.09 – $3,279.38
Sleep study, overnight in a sleep lab CPT 95810	not posted	$20.09 – $3,279.38

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$600.93	$600.93	$1.31 – $705.00

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$230.24	$230.24	? – $329.00
Physical therapy evaluation, low complexity CPT 97161	$427.10	$427.10	$2.17 – $367.31
Physical therapy evaluation, moderate complexity CPT 97162	$450.12	$450.12	$2.17 – $387.10
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$343.06	$343.06	? – $329.00
Therapeutic activities, 15 minutes CPT 97530	$359.18	$359.18	? – $329.00

Mental health

Service	Cash price	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	not posted	$3.22 – $517.90
Family psychotherapy, without the patient, 50 minutes CPT 90846	not posted	$3.22 – $517.90
Group psychotherapy CPT 90853	not posted	$1.43 – $298.17
Psychiatric diagnostic evaluation CPT 90791	not posted	$2.92 – $517.90
Psychotherapy, 30 minutes CPT 90832	not posted	$2.26 – $517.90
Psychotherapy, 45 minutes CPT 90834	not posted	$2.92 – $517.90
Psychotherapy, 60 minutes CPT 90837	not posted	$2.92 – $517.90

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$209.52	$209.52	? – $229.42
IV hydration, each additional hour CPT 96361	$460.48	$460.48	? – $396.01
IV hydration, first hour CPT 96360	$918.66	$918.66	$1.84 – $790.05
IV push injection of a drug, first CPT 96374	$724.11	$724.11	? – $679.12
IV push injection, each additional drug CPT 96375	$460.48	$460.48	? – $396.01

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	not posted		$1.07 – $1.07
Dexamethasone injection, per 1 mg HCPCS J1100	$185.34	$185.34	? – $159.39
Fentanyl injection, per 0.1 mg HCPCS J3010	$147.35	$147.35	$2.43 – $126.72
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted		$3.89 – $8.81
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$267.08	$267.08	? – $229.69
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$157.71	$157.71	? – $135.63
Morphine injection, up to 10 mg HCPCS J2270	$77.13	$77.13	$4.44 – $66.33
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$14.97	$14.97	? – $12.87
Propofol injection, per 10 mg HCPCS J2704	$394.87	$394.87	? – $339.59
Saline IV solution, 1000 ml HCPCS J7030	$382.20	$382.20	$5.61 – $328.69

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.

Check a bill from this hospital