Grossmont Hospital
5555 Grossmont Center Drive Box 58, La Mesa, CA 91942 · Acute care hospital · Emergency room
These are Grossmont Hospital's own posted figures from its standard-charges file dated April 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
193 of the services we track have a posted price here. 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 | $22,189.50 | $29,586.00 | $1.15 – $28,994.28 |
| Emergency room visit, level 1 (minor) CPT 99281 | $749.25 | $999.00 | ? – $799.20 |
| Emergency room visit, level 2 CPT 99282 | $1,353.75 | $1,805.00 | ? – $1,768.90 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $2,187.75 | $2,917.00 | ? – $2,246.09 |
| Emergency room visit, level 4 CPT 99284 | $7,800.00 | $10,400.00 | ? – $10,192.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $11,400.00 | $15,200.00 | ? – $14,896.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $1,375.50 | $1,834.00 | $119.86 – $4,670.01 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | $276.00 | $368.00 | ? – $294.40 |
| New patient office visit, about 30 minutes CPT 99203 | $353.25 | $471.00 | $1.15 – $625.89 |
| New patient office visit, about 45 minutes CPT 99204 | $476.25 | $635.00 | ? – $31,170.74 |
| New patient office visit, about 60 minutes CPT 99205 | $612.75 | $817.00 | ? – $653.60 |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $258.00 | $344.00 | ? – $337.12 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $311.25 | $415.00 | ? – $332.00 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $370.50 | $494.00 | $1.15 – $444.60 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $556.50 | $742.00 | ? – $667.80 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $556.50 | $742.00 | ? – $727.16 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $216.75 | $289.00 | $1.30 – $1,043.55 |
| Abdominal X-ray, 1 view CPT 74018 | $345.75 | $461.00 | ? – $625.89 |
| Ankle X-ray, 3 or more views CPT 73610 | $539.25 | $719.00 | ? – $704.62 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $646.50 | $862.00 | ? – $844.76 |
| Breast ultrasound, one breast, complete CPT 76641 | $747.75 | $997.00 | ? – $977.06 |
| Breast ultrasound, one breast, limited CPT 76642 | $528.75 | $705.00 | ? – $690.90 |
| Chest X-ray, 1 view CPT 71045 | $456.75 | $609.00 | $91.35 – $1,185.44 |
| Chest X-ray, 2 views CPT 71046 | $532.50 | $710.00 | ? – $639.00 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $3,747.75 | $4,997.00 | ? – $4,497.30 |
| CT angiogram of the head CPT 70496 | $3,613.50 | $4,818.00 | ? – $4,336.20 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $4,993.50 | $6,658.00 | ? – $5,459.56 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $5,337.00 | $7,116.00 | ? – $6,973.68 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $3,480.00 | $4,640.00 | $1.15 – $4,547.20 |
| CT scan of the abdomen, without contrast CPT 74150 | $1,908.75 | $2,545.00 | ? – $2,122.53 |
| CT scan of the chest, with contrast CPT 71260 | $3,081.00 | $4,108.00 | ? – $3,697.20 |
| CT scan of the chest, without contrast CPT 71250 | $2,138.25 | $2,851.00 | $1.30 – $2,565.90 |
| CT scan of the head, without contrast CPT 70450 | $2,785.50 | $3,714.00 | ? – $3,045.48 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $3,171.00 | $4,228.00 | ? – $3,171.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $2,442.00 | $3,256.00 | $1.15 – $3,190.88 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $2,850.00 | $3,800.00 | ? – $3,420.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $525.75 | $701.00 | ? – $1,973.80 |
| Diagnostic mammogram, one breast CPT 77065 | $420.00 | $560.00 | $190.40 – $6,414.85 |
| Foot X-ray, 3 or more views CPT 73630 | $529.50 | $706.00 | $1.30 – $691.88 |
| Hand X-ray, 3 or more views CPT 73130 | $508.50 | $678.00 | ? – $625.89 |
| Knee X-ray, 3 views CPT 73562 | $513.00 | $684.00 | ? – $560.88 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $2,721.75 | $3,629.00 | ? – $3,556.42 |
| Leg or arm vein ultrasound, one side CPT 93971 | $1,129.50 | $1,506.00 | $447.28 – $1,292.70 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $576.75 | $769.00 | ? – $576.75 |
| MRI of both breasts, without and with contrast CPT 77049 | $3,663.75 | $4,885.00 | $1.10 – $4,396.50 |
| MRI of the abdomen, without and with contrast CPT 74183 | $4,268.25 | $5,691.00 | ? – $4,268.25 |
| MRI of the brain, without and with contrast CPT 70553 | $4,562.25 | $6,083.00 | $1.15 – $5,961.34 |
| MRI of the brain, without contrast CPT 70551 | $3,036.00 | $4,048.00 | $1.10 – $3,643.20 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $3,246.75 | $4,329.00 | $1.15 – $3,463.20 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $3,111.75 | $4,149.00 | ? – $3,319.20 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $3,201.75 | $4,269.00 | $269.80 – $3,415.20 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $4,149.75 | $5,533.00 | ? – $4,426.40 |
| MRI of the pelvis, without and with contrast CPT 72197 | $4,268.25 | $5,691.00 | $331.39 – $4,552.80 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $2,465.25 | $3,287.00 | ? – $2,958.30 |
| Neck X-ray, 2 or 3 views CPT 72040 | $576.00 | $768.00 | ? – $2,602.84 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $1,311.75 | $1,749.00 | ? – $4,039.91 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $1,068.75 | $1,425.00 | ? – $1,396.50 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $1,194.00 | $1,592.00 | ? – $1,560.16 |
| Screening mammogram, both breasts CPT 77067 | $435.00 | $580.00 | ? – $625.89 |
| Shoulder X-ray, 2 or more views CPT 73030 | $564.75 | $753.00 | $1.15 – $617.46 |
| Transvaginal pregnancy ultrasound CPT 76817 | $841.50 | $1,122.00 | ? – $1,009.80 |
| Transvaginal ultrasound CPT 76830 | $883.50 | $1,178.00 | ? – $1,154.44 |
| Ultrasound of the abdomen, complete CPT 76700 | $1,399.50 | $1,866.00 | $1.15 – $1,530.12 |
| Ultrasound of the neck or thyroid CPT 76536 | $1,015.50 | $1,354.00 | $1.15 – $1,110.28 |
| Wrist X-ray, 3 or more views CPT 73110 | $575.25 | $767.00 | $1.10 – $628.94 |
| X-ray of the lower back, 4 or more views CPT 72110 | $863.25 | $1,151.00 | ? – $1,035.90 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $264.00 | $352.00 | ? – $288.64 |
| Blood culture CPT 87040 | $316.50 | $422.00 | ? – $379.80 |
| Blood draw (venipuncture) CPT 36415 | $21.75 | $29.00 | ? – $21,613.99 |
| BNP test (heart failure) CPT 83880 | $213.00 | $284.00 | ? – $575.36 |
| C-reactive protein (CRP) test CPT 86140 | $78.00 | $104.00 | ? – $93.60 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $321.00 | $428.00 | ? – $419.44 |
| Complete blood count (CBC) with differential CPT 85025 | $147.75 | $197.00 | ? – $535.53 |
| Complete blood count (CBC), automated CPT 85027 | $119.25 | $159.00 | ? – $127.20 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $339.00 | $452.00 | ? – $625.89 |
| COVID-19 PCR test CPT 87635 | $227.25 | $303.00 | ? – $233.31 |
| D-dimer test (blood clots) CPT 85379 | $156.75 | $209.00 | ? – $171.38 |
| Drug screen, instrument chemistry CPT 80307 | $396.00 | $528.00 | $1.10 – $432.96 |
| Ferritin (iron stores) test CPT 82728 | $108.75 | $145.00 | ? – $24,721.39 |
| Free T4 (thyroid) test CPT 84439 | $90.75 | $121.00 | $1.15 – $118.58 |
| Glucose (blood sugar) test CPT 82947 | $52.50 | $70.00 | $1.30 – $8,795.69 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $171.00 | $228.00 | $1.30 – $7,998.43 |
| Hemoglobin A1c test CPT 83036 | $65.25 | $87.00 | ? – $78.30 |
| Hepatitis C antibody test CPT 86803 | $96.00 | $128.00 | $1.15 – $104.96 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $146.25 | $195.00 | ? – $150.15 |
| Iron test CPT 83540 | $58.50 | $78.00 | ? – $76.44 |
| Kidney function panel CPT 80069 | $135.00 | $180.00 | ? – $625.89 |
| Lipase test (pancreas) CPT 83690 | $156.75 | $209.00 | ? – $188.10 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $145.50 | $194.00 | ? – $174.60 |
| Liver function panel CPT 80076 | $195.00 | $260.00 | $1.10 – $254.80 |
| Magnesium test CPT 83735 | $139.50 | $186.00 | $1.15 – $535.53 |
| Obstetric blood test panel CPT 80055 | $229.50 | $306.00 | ? – $229.50 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $96.75 | $129.00 | ? – $116.10 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $273.75 | $365.00 | $1.10 – $273.75 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $95.25 | $127.00 | ? – $101.60 |
| PSA (prostate specific antigen), free CPT 84154 | $4.88 | $6.50 | ? – $6.37 |
| PSA (prostate specific antigen), total CPT 84153 | $110.25 | $147.00 | $1.30 – $117.60 |
| Rapid strep test CPT 87880 | $132.00 | $176.00 | $1.15 – $140.80 |
| Sed rate (ESR) test CPT 85652 | $56.25 | $75.00 | $1.15 – $2,034.14 |
| TB skin test CPT 86580 | $43.50 | $58.00 | ? – $90.33 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $155.25 | $207.00 | ? – $165.60 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $258.75 | $345.00 | ? – $625.89 |
| Troponin test (heart damage) CPT 84484 | $179.25 | $239.00 | $1.15 – $234.22 |
| Urinalysis, automated, with microscope CPT 81001 | $83.25 | $111.00 | ? – $99.90 |
| Urinalysis, automated, without microscope CPT 81003 | $64.50 | $86.00 | ? – $64.50 |
| Urinalysis, manual, without microscope CPT 81002 | $21.75 | $29.00 | ? – $161.01 |
| Urine culture, colony count CPT 87086 | $195.00 | $260.00 | $1.30 – $208.00 |
| Urine pregnancy test CPT 81025 | $18.00 | $24.00 | $3.60 – $23.52 |
| Vitamin B12 test CPT 82607 | $92.25 | $123.00 | $18.45 – $98.40 |
| Vitamin D test CPT 82306 | $100.50 | $134.00 | ? – $625.89 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $1,240.50 | $1,654.00 | ? – $12,997.44 |
| ECG tracing only (no interpretation) CPT 93005 | $628.50 | $838.00 | $1.15 – $821.24 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $4,514.25 | $6,019.00 | ? – $4,815.20 |
| Left heart catheterization CPT 93452 | $14,673.75 | $19,565.00 | ? – $15,652.00 |
| Left heart catheterization with coronary angiogram CPT 93458 | $16,572.75 | $22,097.00 | ? – $21,655.06 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $4,029.00 | $5,372.00 | ? – $4,405.04 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Breast biopsy with ultrasound guidance CPT 19083 | $5,093.25 | $6,791.00 | ? – $5,432.80 |
| Carpal tunnel release CPT 64721 | $6,837.00 | $9,116.00 | ? – $7,292.80 |
| Colonoscopy with biopsy CPT 45380 | $2,756.25 | $3,675.00 | ? – $15,436.00 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $3,486.75 | $4,649.00 | ? – $4,556.02 |
| Colonoscopy, diagnostic CPT 45378 | $2,537.25 | $3,383.00 | ? – $3,315.34 |
| Colposcopy with biopsy CPT 57454 | $1,179.75 | $1,573.00 | $467.18 – $1,258.40 |
| Cystoscopy (bladder scope) CPT 52000 | $1,588.50 | $2,118.00 | ? – $1,694.40 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $2,064.75 | $2,753.00 | ? – $2,477.70 |
| Lower colon endoscopy with ultrasound CPT 45391 | $3,533.25 | $4,711.00 | ? – $15,436.00 |
| Prostate biopsy CPT 55700 | $3,221.25 | $4,295.00 | $1.10 – $4,209.10 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $3,014.25 | $4,019.00 | ? – $3,617.10 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $2,668.50 | $3,558.00 | ? – $2,917.56 |
| Vasectomy CPT 55250 | $5,369.25 | $7,159.00 | ? – $7,015.82 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $1,168.50 | $1,558.00 | ? – $1,277.56 |
| IUD insertion CPT 58300 | $1,063.50 | $1,418.00 | ? – $1,276.20 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $41,766.91 | $55,689.22 | $8,353.38 – $41,766.91 |
| C-section, without complications MS-DRG 788 | $54,576.73 | $72,768.98 | $10,187.66 – $65,492.08 |
| Chest pain MS-DRG 313 | $33,357.02 | $44,476.03 | $6,671.40 – $34,246.54 |
| COPD flare-up, with major complications MS-DRG 190 | $66,194.55 | $88,259.40 | $13,238.91 – $70,607.52 |
| COPD flare-up, without complications MS-DRG 192 | $38,115.54 | $50,820.72 | $7,623.11 – $45,738.65 |
| Fainting (syncope) MS-DRG 312 | $45,577.02 | $60,769.36 | $18,534.65 – $59,553.97 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $54,179.58 | $72,239.44 | $10,113.52 – $57,791.55 |
| Heart failure, with major complications MS-DRG 291 | $66,935.24 | $89,246.99 | $12,494.58 – $66,935.24 |
| Heart failure, without complications MS-DRG 293 | $31,592.25 | $42,123.00 | $14,321.82 – $33,698.40 |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | $572,704.59 | $763,606.13 | $114,540.92 – $687,245.51 |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | $108,334.18 | $144,445.58 | $424.57 – $141,556.67 |
| Irregular heartbeat, without complications MS-DRG 310 | $33,223.63 | $44,298.18 | $18,605.24 – $43,412.22 |
| Kidney failure, with complications MS-DRG 683 | $46,220.32 | $61,627.09 | $9,244.06 – $60,394.55 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $39,163.64 | $52,218.19 | $15,508.80 – $42,818.92 |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | $128,175.93 | $170,901.23 | $29,907.72 – $167,483.21 |
| Normal newborn care MS-DRG 795 | $5,878.03 | $7,837.38 | $2,327.70 – $23,240.00 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $40,992.50 | $54,656.66 | $3,454.30 – $43,725.33 |
| Pneumonia, with complications MS-DRG 194 | $46,172.54 | $61,563.39 | $17,237.75 – $49,250.71 |
| Pneumonia, with major complications MS-DRG 193 | $74,919.19 | $99,892.25 | $14,983.84 – $97,894.40 |
| Pneumonia, without complications MS-DRG 195 | $34,246.82 | $45,662.42 | $2,885.87 – $41,096.18 |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | $71,786.24 | $95,714.99 | $14,357.25 – $78,486.29 |
| Sepsis, with major complications MS-DRG 871 | $105,639.97 | $140,853.30 | $21,127.99 – $112,682.64 |
| Sepsis, without major complications MS-DRG 872 | $51,754.12 | $69,005.49 | $23,461.87 – $55,204.39 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $39,589.20 | $52,785.60 | $14,779.97 – $43,284.19 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $37,641.71 | $50,188.95 | $8,783.07 – $37,641.71 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $74,220.53 | $98,960.71 | $29,391.33 – $89,064.64 |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | $83,589.09 | $111,452.12 | $7,043.77 – $100,306.91 |
| Vaginal delivery, without complications MS-DRG 807 | $24,902.79 | $33,203.72 | $9,297.04 – $32,539.64 |
| Weight loss surgery, without complications MS-DRG 621 | $78,160.01 | $104,213.35 | $15,632.00 – $93,792.02 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $1,499.25 | $1,999.00 | ? – $1,959.02 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $2,793.75 | $3,725.00 | $1.30 – $2,868.25 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $2,718.00 | $3,624.00 | ? – $3,551.52 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | $834.75 | $1,113.00 | ? – $1,001.70 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $768.00 | $1,024.00 | ? – $1,003.52 |
| Sleep study with CPAP titration CPT 95811 | $5,976.75 | $7,969.00 | ? – $7,172.10 |
| Sleep study, overnight in a sleep lab CPT 95810 | $5,535.00 | $7,380.00 | ? – $5,535.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $539.25 | $719.00 | ? – $9,979.00 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $166.50 | $222.00 | ? – $1,251.78 |
| Physical therapy evaluation, low complexity CPT 97161 | $246.75 | $329.00 | ? – $625.89 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $360.00 | $480.00 | $134.40 – $432.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $163.50 | $218.00 | $61.04 – $213.64 |
| Therapeutic activities, 15 minutes CPT 97530 | $171.75 | $229.00 | ? – $2,058.68 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Group psychotherapy CPT 90853 | $344.25 | $459.00 | $1.10 – $625.89 |
| Psychiatric diagnostic evaluation CPT 90791 | $750.00 | $1,000.00 | $1.30 – $900.00 |
| Psychotherapy, 30 minutes CPT 90832 | $270.00 | $360.00 | $50.40 – $6,868.48 |
| Psychotherapy, 45 minutes CPT 90834 | $353.25 | $471.00 | $1.15 – $329.70 |
| Psychotherapy, 60 minutes CPT 90837 | $829.50 | $1,106.00 | ? – $3,999.21 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $297.00 | $396.00 | $1.10 – $356.40 |
| IV hydration, each additional hour CPT 96361 | $299.25 | $399.00 | $1.13 – $391.02 |
| IV hydration, first hour CPT 96360 | $825.00 | $1,100.00 | ? – $990.00 |
| IV push injection of a drug, first CPT 96374 | $657.00 | $876.00 | ? – $657.00 |
| IV push injection, each additional drug CPT 96375 | $666.00 | $888.00 | ? – $870.24 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $27.09 | $36.12 | $10.11 – $28.90 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $47.49 | $63.32 | $1.10 – $1,251.78 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $6.89 | $9.19 | ? – $9.00 |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | $19.14 | $25.52 | ? – $25.01 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $43.22 | $57.62 | ? – $625.89 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $1.91 | $2.54 | ? – $1.91 |
| Morphine injection, up to 10 mg HCPCS J2270 | $9.93 | $13.24 | $1.99 – $10.59 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $5.79 | $7.72 | ? – $6.33 |
| Propofol injection, per 10 mg HCPCS J2704 | $2.52 | $3.36 | ? – $3.02 |
| Saline IV solution, 1000 ml HCPCS J7030 | $1.04 | $1.39 | ? – $118.05 |
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.