Kaiser Foundation Hospital - South San Francisco
1200 El Camino Real, South San Francisco, CA 94080 · Acute care hospital · Emergency room
These are Kaiser Foundation Hospital - South San Francisco'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.
213 of the services we track have a posted price here; 184 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 | $5,909.68 | $10,553.00 | $6,260.00 – $6,260.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $472.08 | $843.00 | $655.00 – $655.00 |
| Emergency room visit, level 2 CPT 99282 | $872.48 | $1,558.00 | $1,175.00 – $1,175.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $1,621.76 | $2,896.00 | $2,055.00 – $2,055.00 |
| Emergency room visit, level 4 CPT 99284 | $2,712.64 | $4,844.00 | $3,165.00 – $3,165.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $4,220.16 | $7,536.00 | $4,555.00 – $4,555.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $795.20 | $1,420.00 | $240.00 – $752.00 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $115.36 | $206.00 | $35.00 – $110.00 |
| Abdominal X-ray, 1 view CPT 74018 | $442.40 | $790.00 | $118.00 – $370.00 |
| Ankle X-ray, 3 or more views CPT 73610 | $604.80 | $1,080.00 | $118.00 – $370.00 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $504.00 | $900.00 | $142.00 – $445.00 |
| Breast ultrasound, one breast, complete CPT 76641 | $1,164.80 | $2,080.00 | $142.00 – $445.00 |
| Breast ultrasound, one breast, limited CPT 76642 | $560.00 | $1,000.00 | $118.00 – $370.00 |
| Chest X-ray, 1 view CPT 71045 | $476.00 | $850.00 | $118.00 – $370.00 |
| Chest X-ray, 2 views CPT 71046 | $504.00 | $900.00 | $118.00 – $370.00 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $4,872.00 | $8,700.00 | $394.00 – $1,235.00 |
| CT angiogram of the head CPT 70496 | $4,989.60 | $8,910.00 | $393.00 – $1,230.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $4,754.40 | $8,490.00 | $476.00 – $1,490.00 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $6,602.40 | $11,790.00 | $533.00 – $1,670.00 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $4,351.20 | $7,770.00 | $323.00 – $1,010.00 |
| CT scan of the abdomen, without contrast CPT 74150 | $2,206.40 | $3,940.00 | $177.00 – $555.00 |
| CT scan of the chest, with contrast CPT 71260 | $3,763.20 | $6,720.00 | $244.00 – $765.00 |
| CT scan of the chest, without contrast CPT 71250 | $2,844.80 | $5,080.00 | $180.00 – $565.00 |
| CT scan of the head, without contrast CPT 70450 | $2,682.40 | $4,790.00 | $145.00 – $455.00 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $3,231.20 | $5,770.00 | $184.00 – $575.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $4,760.00 | $8,500.00 | $377.00 – $1,180.00 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $2,934.40 | $5,240.00 | $193.00 – $605.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $504.00 | $900.00 | $160.00 – $500.00 |
| Diagnostic mammogram, one breast CPT 77065 | $375.20 | $670.00 | $125.00 – $390.00 |
| Foot X-ray, 3 or more views CPT 73630 | $565.60 | $1,010.00 | $118.00 – $370.00 |
| Hand X-ray, 3 or more views CPT 73130 | $565.60 | $1,010.00 | $118.00 – $370.00 |
| Knee X-ray, 3 views CPT 73562 | $459.20 | $820.00 | $118.00 – $370.00 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $1,803.20 | $3,220.00 | |
| Leg or arm vein ultrasound, one side CPT 93971 | $1,153.60 | $2,060.00 | |
| Lower back X-ray, 2 or 3 views CPT 72100 | $554.40 | $990.00 | $142.00 – $445.00 |
| MRI of both breasts, without and with contrast CPT 77049 | $6,238.40 | $11,140.00 | $511.00 – $1,600.00 |
| MRI of the abdomen, without and with contrast CPT 74183 | $5,969.60 | $10,660.00 | $513.00 – $1,605.00 |
| MRI of the brain, without and with contrast CPT 70553 | $5,499.20 | $9,820.00 | $476.00 – $1,490.00 |
| MRI of the brain, without contrast CPT 70551 | $3,628.80 | $6,480.00 | $323.00 – $1,010.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $3,438.40 | $6,140.00 | $323.00 – $1,010.00 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $3,281.60 | $5,860.00 | $323.00 – $1,010.00 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $3,645.60 | $6,510.00 | $323.00 – $1,010.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $3,735.20 | $6,670.00 | $323.00 – $1,010.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $6,714.40 | $11,990.00 | $509.00 – $1,595.00 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $3,304.00 | $5,900.00 | $323.00 – $1,010.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $537.60 | $960.00 | $118.00 – $370.00 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $940.80 | $1,680.00 | $142.00 – $445.00 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $946.40 | $1,690.00 | $142.00 – $445.00 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $1,299.20 | $2,320.00 | $142.00 – $445.00 |
| Screening mammogram, both breasts CPT 77067 | $375.20 | $670.00 | $133.00 – $415.00 |
| Shoulder X-ray, 2 or more views CPT 73030 | $655.20 | $1,170.00 | $118.00 – $370.00 |
| Transvaginal pregnancy ultrasound CPT 76817 | $806.40 | $1,440.00 | $142.00 – $445.00 |
| Transvaginal ultrasound CPT 76830 | $716.80 | $1,280.00 | $142.00 – $445.00 |
| Ultrasound of the abdomen, complete CPT 76700 | $991.20 | $1,770.00 | $142.00 – $445.00 |
| Ultrasound of the neck or thyroid CPT 76536 | $907.20 | $1,620.00 | $142.00 – $445.00 |
| Wrist X-ray, 3 or more views CPT 73110 | $632.80 | $1,130.00 | $118.00 – $370.00 |
| X-ray of the lower back, 4 or more views CPT 72110 | $588.00 | $1,050.00 | $142.00 – $445.00 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $193.20 | $345.00 | $8.00 – $25.00 |
| Blood culture CPT 87040 | $272.16 | $486.00 | $10.00 – $30.00 |
| Blood draw (venipuncture) CPT 36415 | $39.76 | $71.00 | |
| BNP test (heart failure) CPT 83880 | $302.40 | $540.00 | $37.00 – $115.00 |
| C-reactive protein (CRP) test CPT 86140 | $116.48 | $208.00 | $5.00 – $15.00 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $128.80 | $230.00 | $32.00 – $100.00 |
| Complete blood count (CBC) with differential CPT 85025 | $123.20 | $220.00 | $8.00 – $25.00 |
| Complete blood count (CBC), automated CPT 85027 | $89.60 | $160.00 | $6.00 – $20.00 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $255.36 | $456.00 | $10.00 – $30.00 |
| COVID-19 PCR test CPT 87635 | $113.12 | $202.00 | $48.00 – $150.00 |
| D-dimer test (blood clots) CPT 85379 | $199.92 | $357.00 | $10.00 – $30.00 |
| Drug screen, instrument chemistry CPT 80307 | $515.20 | $920.00 | $57.00 – $180.00 |
| Ferritin (iron stores) test CPT 82728 | $127.68 | $228.00 | $13.00 – $40.00 |
| Free T4 (thyroid) test CPT 84439 | $102.48 | $183.00 | $8.00 – $25.00 |
| General health panel (blood tests) CPT 80050 | $277.76 | $496.00 | $48.00 – $150.00 |
| Glucose (blood sugar) test CPT 82947 | $37.52 | $67.00 | $3.00 – $10.00 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $154.56 | $276.00 | $32.00 – $100.00 |
| Hemoglobin A1c test CPT 83036 | $79.52 | $142.00 | $10.00 – $30.00 |
| Hepatitis C antibody test CPT 86803 | $111.44 | $199.00 | $13.00 – $40.00 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $169.68 | $303.00 | $22.00 – $70.00 |
| Iron test CPT 83540 | $80.08 | $143.00 | $6.00 – $20.00 |
| Kidney function panel CPT 80069 | $142.24 | $254.00 | $8.00 – $25.00 |
| Lipase test (pancreas) CPT 83690 | $185.36 | $331.00 | $6.00 – $20.00 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $156.24 | $279.00 | $13.00 – $40.00 |
| Liver function panel CPT 80076 | $133.84 | $239.00 | $8.00 – $25.00 |
| Magnesium test CPT 83735 | $120.40 | $215.00 | $6.00 – $20.00 |
| Obstetric blood test panel CPT 80055 | $431.20 | $770.00 | $45.00 – $140.00 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $141.68 | $253.00 | $5.00 – $15.00 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $291.20 | $520.00 | $14.00 – $45.00 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $89.60 | $160.00 | $3.00 – $10.00 |
| PSA (prostate specific antigen), free CPT 84154 | $127.68 | $228.00 | $18.00 – $55.00 |
| PSA (prostate specific antigen), total CPT 84153 | $130.48 | $233.00 | $18.00 – $55.00 |
| Rapid strep test CPT 87880 | $171.36 | $306.00 | $16.00 – $50.00 |
| Sed rate (ESR) test CPT 85652 | $56.00 | $100.00 | $3.00 – $8.00 |
| TB skin test CPT 86580 | $61.60 | $110.00 | $26.00 – $80.00 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $155.12 | $277.00 | $16.00 – $50.00 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $229.60 | $410.00 | $57.00 – $180.00 |
| Troponin test (heart damage) CPT 84484 | $285.60 | $510.00 | $11.00 – $35.00 |
| Urinalysis, automated, with microscope CPT 81001 | $82.88 | $148.00 | $3.00 – $10.00 |
| Urinalysis, automated, without microscope CPT 81003 | $56.00 | $100.00 | $2.00 – $7.00 |
| Urinalysis, manual, with microscope CPT 81000 | $165.76 | $296.00 | $3.00 – $10.00 |
| Urinalysis, manual, without microscope CPT 81002 | $36.40 | $65.00 | $3.00 – $10.00 |
| Urine culture, colony count CPT 87086 | $157.92 | $282.00 | $8.00 – $25.00 |
| Urine pregnancy test CPT 81025 | $87.92 | $157.00 | $8.00 – $25.00 |
| Vitamin B12 test CPT 82607 | $120.96 | $216.00 | $14.00 – $45.00 |
| Vitamin D test CPT 82306 | $114.80 | $205.00 | $27.00 – $85.00 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $1,775.20 | $3,170.00 | |
| ECG tracing only (no interpretation) CPT 93005 | $380.80 | $680.00 | |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $3,824.80 | $6,830.00 | |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 | $89.60 | $160.00 | |
| Left heart catheterization CPT 93452 | $15,612.80 | $27,880.00 | |
| Left heart catheterization with coronary angiogram CPT 93458 | $19,488.00 | $34,800.00 | $3,887.00 – $12,171.00 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $5,146.40 | $9,190.00 | $1,742.00 – $5,455.00 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $18,200.00 | $32,500.00 | $8,633.00 – $27,033.00 |
| Appendix removal, laparoscopic CPT 44970 | $22,680.00 | $40,500.00 | $7,050.00 – $22,078.00 |
| Breast biopsy with ultrasound guidance CPT 19083 | $4,093.60 | $7,310.00 | $1,958.00 – $6,131.00 |
| Carpal tunnel release CPT 64721 | $5,308.80 | $9,480.00 | $2,360.00 – $7,390.00 |
| Colonoscopy with biopsy CPT 45380 | $3,550.40 | $6,340.00 | $1,425.00 – $4,462.00 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $3,466.40 | $6,190.00 | $1,425.00 – $4,462.00 |
| Colonoscopy, diagnostic CPT 45378 | $3,679.20 | $6,570.00 | $1,102.00 – $3,450.00 |
| Colposcopy with biopsy CPT 57454 | $1,685.60 | $3,010.00 | $368.00 – $1,151.00 |
| Cystoscopy (bladder scope) CPT 52000 | $2,884.00 | $5,150.00 | $806.00 – $2,525.00 |
| Ear tubes, under general anesthesia CPT 69436 | $6,356.00 | $11,350.00 | $1,790.00 – $5,606.00 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $2,251.20 | $4,020.00 | $1,102.00 – $3,450.00 |
| Gallbladder removal, laparoscopic CPT 47562 | $19,219.20 | $34,320.00 | $7,050.00 – $22,078.00 |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | $23,128.00 | $41,300.00 | $12,581.00 – $39,398.00 |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $12,252.80 | $21,880.00 | $3,842.00 – $12,031.00 |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $26,068.00 | $46,550.00 | $7,050.00 – $22,078.00 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $18,726.40 | $33,440.00 | $4,265.00 – $13,355.00 |
| Kidney stone shock-wave lithotripsy CPT 50590 | $14,425.60 | $25,760.00 | $4,168.00 – $13,052.00 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $7,324.80 | $13,080.00 | $3,921.00 – $12,278.00 |
| Lower colon endoscopy with ultrasound CPT 45391 | $2,906.40 | $5,190.00 | $1,425.00 – $4,462.00 |
| Nasal endoscopy, diagnostic CPT 31231 | $582.40 | $1,040.00 | $235.00 – $735.00 |
| Prostate removal, laparoscopic or robotic CPT 55866 | $38,337.60 | $68,460.00 | $12,581.00 – $39,398.00 |
| Removal of a breast lump, open surgery CPT 19120 | $8,041.60 | $14,360.00 | $4,627.00 – $14,491.00 |
| Rotator cuff repair, arthroscopic CPT 29827 | $6,300.00 | $11,250.00 | $8,633.00 – $27,033.00 |
| Screening colonoscopy, average risk HCPCS G0121 | $3,214.40 | $5,740.00 | $1,102.00 – $3,450.00 |
| Screening colonoscopy, high risk HCPCS G0105 | $3,225.60 | $5,760.00 | $1,102.00 – $3,450.00 |
| Septoplasty (nasal septum repair) CPT 30520 | $9,990.40 | $17,840.00 | $3,919.00 – $12,272.00 |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $5,241.60 | $9,360.00 | |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | $6,423.20 | $11,470.00 | |
| Tonsil and adenoid removal, under age 12 CPT 42820 | $10,634.40 | $18,990.00 | $7,148.00 – $22,386.00 |
| Total hip replacement CPT 27130 | $9,161.60 | $16,360.00 | $15,548.00 – $48,690.00 |
| Total knee replacement CPT 27447 | $25,760.00 | $46,000.00 | $15,548.00 – $48,690.00 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $3,354.40 | $5,990.00 | $1,133.00 – $3,547.00 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $3,707.20 | $6,620.00 | $1,133.00 – $3,547.00 |
| Vasectomy CPT 55250 | $8,377.60 | $14,960.00 | $2,475.00 – $7,752.00 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $498.40 | $890.00 | $243.00 – $761.00 |
| IUD insertion CPT 58300 | $1,814.40 | $3,240.00 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | not posted | $2,037.00 – $8,176.00 | |
| C-section, without complications MS-DRG 788 | not posted | $7,093.00 – $35,051.00 | |
| Chest pain MS-DRG 313 | not posted | $5,763.00 – $23,133.00 | |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $5,286.00 – $21,218.00 | |
| COPD flare-up, without complications MS-DRG 192 | not posted | $4,552.00 – $18,271.00 | |
| Fainting (syncope) MS-DRG 312 | not posted | $5,275.00 – $21,174.00 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $5,406.00 – $21,699.00 | |
| Heart failure, with major complications MS-DRG 291 | not posted | $5,309.00 – $21,312.00 | |
| Heart failure, without complications MS-DRG 293 | not posted | $4,013.00 – $16,107.00 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $29,246.00 – $117,396.00 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $18,397.00 – $73,848.00 | |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $4,531.00 – $18,189.00 | |
| Kidney failure, with complications MS-DRG 683 | not posted | $4,624.00 – $18,559.00 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $4,464.00 – $17,917.00 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $24,216.00 – $97,204.00 | |
| Normal newborn care MS-DRG 795 | not posted | $1,099.00 – $4,410.00 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $4,492.00 – $18,031.00 | |
| Pneumonia, with complications MS-DRG 194 | not posted | $4,545.00 – $18,244.00 | |
| Pneumonia, with major complications MS-DRG 193 | not posted | $5,528.00 – $22,191.00 | |
| Pneumonia, without complications MS-DRG 195 | not posted | $4,215.00 – $16,920.00 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $1,609.00 – $6,461.00 | |
| Sepsis, with major complications MS-DRG 871 | not posted | $6,513.00 – $26,145.00 | |
| Sepsis, without major complications MS-DRG 872 | not posted | $4,883.00 – $19,600.00 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $4,502.00 – $18,070.00 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $4,604.00 – $18,481.00 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $5,446.00 – $21,862.00 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $13,090.00 – $52,546.00 | |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $3,381.00 – $16,706.00 | |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $17,414.00 – $69,901.00 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $1,271.20 | $2,270.00 | $357.00 – $1,117.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $3,365.60 | $6,010.00 | $1,076.00 – $3,369.00 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $3,662.40 | $6,540.00 | $837.00 – $2,620.00 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $2,402.40 | $4,290.00 | $1,076.00 – $3,369.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | $8,624.00 | $15,400.00 | $2,756.00 – $8,631.00 |
| Eye exam, new patient, comprehensive CPT 92004 | $245.28 | $438.00 | |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | $2,704.80 | $4,830.00 | $663.00 – $2,076.00 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | $548.80 | $980.00 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $823.20 | $1,470.00 | |
| Sleep study with CPAP titration CPT 95811 | $3,651.20 | $6,520.00 | |
| Sleep study, overnight in a sleep lab CPT 95810 | $4,888.80 | $8,730.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $487.20 | $870.00 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $155.68 | $278.00 | |
| Physical therapy evaluation, low complexity CPT 97161 | $336.00 | $600.00 | |
| Physical therapy evaluation, moderate complexity CPT 97162 | $380.80 | $680.00 | |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $145.04 | $259.00 | |
| Therapeutic activities, 15 minutes CPT 97530 | $191.52 | $342.00 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $593.60 | $1,060.00 | |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $476.00 | $850.00 | |
| Group psychotherapy CPT 90853 | $532.00 | $950.00 | |
| Psychiatric diagnostic evaluation CPT 90791 | $659.12 | $1,177.00 | |
| Psychotherapy, 30 minutes CPT 90832 | $442.96 | $791.00 | |
| Psychotherapy, 45 minutes CPT 90834 | $582.40 | $1,040.00 | |
| Psychotherapy, 60 minutes CPT 90837 | $403.20 | $720.00 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $236.88 | $423.00 | $86.00 – $269.00 |
| IV hydration, each additional hour CPT 96361 | $369.60 | $660.00 | |
| IV hydration, first hour CPT 96360 | $739.20 | $1,320.00 | |
| IV push injection of a drug, first CPT 96374 | $520.80 | $930.00 | |
| IV push injection, each additional drug CPT 96375 | $302.40 | $540.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $655.72 | $1,170.92 | |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $17.91 | $31.99 | |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $106.09 | $189.45 | ? – $1.62 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $10.68 | $19.08 | |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $18.56 | $33.15 | |
| Morphine injection, up to 10 mg HCPCS J2270 | $78.29 | $139.81 | $4.55 – $7.64 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $7.03 | $12.55 | |
| Propofol injection, per 10 mg HCPCS J2704 | $71.34 | $127.40 | |
| Saline IV solution, 1000 ml HCPCS J7030 | $39.34 | $70.25 | $2.28 – $3.83 |
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.