Sky Ridge Medical Center
10101 Ridgegate Pkwy, Lone Tree, CO 80124 · Acute care hospital · Emergency room
These are Sky Ridge Medical Center's own posted figures from its standard-charges file dated September 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
228 of the services we track have a posted price here; 126 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 | $28,757.85 | $28,757.85 | $4,371.19 – $25,882.06 |
| Emergency room visit, level 1 (minor) CPT 99281 | $1,570.80 | $1,570.80 | $238.76 – $1,413.72 |
| Emergency room visit, level 2 CPT 99282 | $3,816.45 | $3,816.45 | $580.10 – $3,434.80 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $8,663.60 | $8,663.60 | $1,316.87 – $7,797.24 |
| Emergency room visit, level 4 CPT 99284 | $14,520.00 | $14,520.00 | $2,207.04 – $13,068.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $23,598.30 | $23,598.30 | $3,586.94 – $21,238.47 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | not posted | $308.07 – $321.04 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | $1,407.50 | $1,407.50 | $213.94 – $1,266.75 |
| New patient office visit, about 30 minutes CPT 99203 | $1,457.50 | $1,457.50 | $221.54 – $1,311.75 |
| New patient office visit, about 45 minutes CPT 99204 | $1,527.50 | $1,527.50 | $232.18 – $1,374.75 |
| New patient office visit, about 60 minutes CPT 99205 | $1,609.00 | $1,609.00 | $244.57 – $1,448.10 |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $2,091.00 | $2,091.00 | $317.83 – $1,881.90 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $1,072.50 | $1,072.50 | $163.02 – $965.25 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $1,124.50 | $1,124.50 | $170.92 – $1,012.05 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $1,183.50 | $1,183.50 | $179.89 – $1,065.15 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $1,276.50 | $1,276.50 | $194.03 – $1,148.85 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | not posted | $130.55 – $263.23 | |
| Abdominal X-ray, 1 view CPT 74018 | $2,288.00 | $2,288.00 | $347.78 – $2,059.20 |
| Ankle X-ray, 3 or more views CPT 73610 | $6,149.55 | $6,149.55 | $934.73 – $5,534.60 |
| Bone density scan (DEXA), hips and spine CPT 77080 | not posted | $23.39 – $47.17 | |
| Breast ultrasound, one breast, complete CPT 76641 | $2,552.55 | $2,552.55 | $387.99 – $2,297.30 |
| Breast ultrasound, one breast, limited CPT 76642 | $2,552.55 | $2,552.55 | $387.99 – $2,297.30 |
| Chest X-ray, 1 view CPT 71045 | $1,689.05 | $1,689.05 | $256.74 – $1,520.14 |
| Chest X-ray, 2 views CPT 71046 | $2,561.35 | $2,561.35 | $389.33 – $2,305.22 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $17,732.55 | $17,732.55 | $2,695.35 – $15,959.30 |
| CT angiogram of the head CPT 70496 | $17,732.55 | $17,732.55 | $2,695.35 – $15,959.30 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $21,672.20 | $21,672.20 | $3,294.17 – $19,504.98 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $25,613.50 | $25,613.50 | $3,893.25 – $23,052.15 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $18,717.60 | $18,717.60 | $2,845.08 – $16,845.84 |
| CT scan of the abdomen, without contrast CPT 74150 | $18,717.60 | $18,717.60 | $2,845.08 – $16,845.84 |
| CT scan of the chest, with contrast CPT 71260 | $21,672.20 | $21,672.20 | $3,294.17 – $19,504.98 |
| CT scan of the chest, without contrast CPT 71250 | $17,732.55 | $17,732.55 | $2,695.35 – $15,959.30 |
| CT scan of the head, without contrast CPT 70450 | $18,717.60 | $18,717.60 | $2,845.08 – $16,845.84 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $18,717.60 | $18,717.60 | $2,845.08 – $16,845.84 |
| CT scan of the pelvis, with contrast CPT 72193 | $21,672.20 | $21,672.20 | $3,294.17 – $19,504.98 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $18,717.60 | $18,717.60 | $2,845.08 – $16,845.84 |
| Diagnostic mammogram, both breasts CPT 77066 | not posted | $288.90 – $582.50 | |
| Diagnostic mammogram, one breast CPT 77065 | not posted | $94.24 – $190.02 | |
| Foot X-ray, 3 or more views CPT 73630 | $4,769.60 | $4,769.60 | $724.98 – $4,292.64 |
| Hand X-ray, 3 or more views CPT 73130 | $2,223.10 | $2,223.10 | $337.91 – $2,000.79 |
| Knee X-ray, 3 views CPT 73562 | $2,595.45 | $2,595.45 | $394.51 – $2,335.90 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $8,267.60 | $8,267.60 | $1,256.68 – $7,440.84 |
| Leg or arm vein ultrasound, one side CPT 93971 | $5,958.15 | $5,958.15 | $905.64 – $5,362.34 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $4,536.40 | $4,536.40 | $689.53 – $4,082.76 |
| MRI of both breasts, without and with contrast CPT 77049 | not posted | $611.29 – $1,232.51 | |
| MRI of the abdomen, without and with contrast CPT 74183 | $24,396.90 | $24,396.90 | $625.80 – $828.27 |
| MRI of the brain, without and with contrast CPT 70553 | $24,440.90 | $24,440.90 | $625.80 – $828.27 |
| MRI of the brain, without contrast CPT 70551 | $19,540.95 | $19,540.95 | $391.22 – $517.79 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $19,383.10 | $19,383.10 | $2,946.23 – $17,444.79 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $19,472.20 | $19,472.20 | $391.22 – $517.79 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $19,355.60 | $19,355.60 | $391.22 – $517.79 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $19,454.05 | $19,454.05 | $391.22 – $517.79 |
| MRI of the pelvis, without and with contrast CPT 72197 | $24,411.75 | $24,411.75 | $591.76 – $2,447.00 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $19,598.70 | $19,598.70 | $2,979.00 – $17,638.83 |
| Neck X-ray, 2 or 3 views CPT 72040 | $3,022.80 | $3,022.80 | $459.47 – $2,720.52 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $5,948.25 | $5,948.25 | $904.13 – $5,353.43 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $2,915.00 | $2,915.00 | $443.08 – $2,623.50 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $1,861.75 | $1,861.75 | $282.99 – $1,675.58 |
| Screening mammogram, both breasts CPT 77067 | not posted | $87.70 – $176.82 | |
| Shoulder X-ray, 2 or more views CPT 73030 | $5,758.50 | $5,758.50 | $875.29 – $5,182.65 |
| Transvaginal pregnancy ultrasound CPT 76817 | $6,078.05 | $6,078.05 | $923.86 – $5,470.24 |
| Transvaginal ultrasound CPT 76830 | $6,074.20 | $6,074.20 | $923.28 – $5,466.78 |
| Ultrasound of the abdomen, complete CPT 76700 | $5,691.40 | $5,691.40 | $865.09 – $5,122.26 |
| Ultrasound of the neck or thyroid CPT 76536 | $4,563.35 | $4,563.35 | $693.63 – $4,107.02 |
| Wrist X-ray, 3 or more views CPT 73110 | $2,584.45 | $2,584.45 | $392.84 – $2,326.00 |
| X-ray of the lower back, 4 or more views CPT 72110 | $7,765.45 | $7,765.45 | $1,180.35 – $6,988.90 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $1,346.49 | $1,346.49 | $204.67 – $1,211.84 |
| Blood culture CPT 87040 | $1,469.63 | $1,469.63 | $223.38 – $1,322.67 |
| Blood draw (venipuncture) CPT 36415 | $189.33 | $189.33 | $28.78 – $170.40 |
| BNP test (heart failure) CPT 83880 | $2,336.01 | $2,336.01 | $355.07 – $2,102.41 |
| C-reactive protein (CRP) test CPT 86140 | $903.81 | $903.81 | $2.97 – $5.44 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $1,402.36 | $1,402.36 | $213.16 – $1,262.12 |
| Complete blood count (CBC) with differential CPT 85025 | not posted | $4.44 – $8.16 | |
| Complete blood count (CBC), automated CPT 85027 | $701.45 | $701.45 | $106.62 – $631.31 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $1,635.64 | $1,635.64 | $248.62 – $1,472.08 |
| COVID-19 PCR test CPT 87635 | $164.38 | $164.38 | $24.99 – $147.94 |
| D-dimer test (blood clots) CPT 85379 | $1,346.49 | $1,346.49 | $204.67 – $1,211.84 |
| Drug screen, instrument chemistry CPT 80307 | $2,253.55 | $2,253.55 | $342.54 – $2,028.20 |
| Ferritin (iron stores) test CPT 82728 | $813.75 | $813.75 | $13.63 – $64.74 |
| Free T4 (thyroid) test CPT 84439 | $902.72 | $902.72 | $9.02 – $42.84 |
| General health panel (blood tests) CPT 80050 | not posted | $45.36 – $215.46 | |
| Glucose (blood sugar) test CPT 82947 | $296.75 | $296.75 | $45.11 – $267.07 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $858.24 | $858.24 | $130.45 – $772.42 |
| Hemoglobin A1c test CPT 83036 | $977.59 | $977.59 | $5.55 – $10.20 |
| Hepatitis C antibody test CPT 86803 | $746.48 | $746.48 | $14.27 – $67.78 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $1,597.12 | $1,597.12 | $24.08 – $114.38 |
| Iron test CPT 83540 | $2,532.93 | $2,532.93 | $385.01 – $2,279.64 |
| Kidney function panel CPT 80069 | $1,714.30 | $1,714.30 | $8.68 – $41.23 |
| Lipase test (pancreas) CPT 83690 | $1,067.64 | $1,067.64 | $6.89 – $32.73 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $1,792.42 | $1,792.42 | $13.39 – $63.60 |
| Liver function panel CPT 80076 | $1,395.85 | $1,395.85 | $212.17 – $1,256.26 |
| Magnesium test CPT 83735 | $1,067.64 | $1,067.64 | $162.28 – $960.88 |
| Obstetric blood test panel CPT 80055 | not posted | $47.81 – $227.10 | |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $515.92 | $515.92 | $6.01 – $28.55 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $1,854.27 | $1,854.27 | $281.85 – $1,668.84 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $310.85 | $310.85 | $47.25 – $279.77 |
| PSA (prostate specific antigen), free CPT 84154 | not posted | $18.39 – $87.35 | |
| PSA (prostate specific antigen), total CPT 84153 | $1,176.68 | $1,176.68 | $18.39 – $87.35 |
| Rapid strep test CPT 87880 | $150.27 | $150.27 | $9.45 – $17.36 |
| Sed rate (ESR) test CPT 85652 | not posted | $2.70 – $12.83 | |
| TB skin test CPT 86580 | $371.07 | $371.07 | $5.82 – $47.75 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $1,417.01 | $1,417.01 | $16.80 – $79.80 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $3,336.38 | $3,336.38 | $49.76 – $236.36 |
| Troponin test (heart damage) CPT 84484 | $1,395.85 | $1,395.85 | $212.17 – $1,256.26 |
| Urinalysis, automated, with microscope CPT 81001 | $915.74 | $915.74 | $1.81 – $3.33 |
| Urinalysis, automated, without microscope CPT 81003 | $794.22 | $794.22 | $120.72 – $714.80 |
| Urinalysis, manual, with microscope CPT 81000 | not posted | $4.02 – $19.09 | |
| Urinalysis, manual, without microscope CPT 81002 | $305.97 | $305.97 | $46.51 – $275.37 |
| Urine culture, colony count CPT 87086 | $977.59 | $977.59 | $4.62 – $8.47 |
| Urine pregnancy test CPT 81025 | $600.01 | $600.01 | $91.20 – $540.01 |
| Vitamin B12 test CPT 82607 | $757.87 | $757.87 | $15.08 – $71.63 |
| Vitamin D test CPT 82306 | $1,395.85 | $1,395.85 | $29.60 – $140.60 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $7,110.40 | $7,110.40 | $1,080.78 – $6,399.36 |
| ECG tracing only (no interpretation) CPT 93005 | $1,799.05 | $1,799.05 | $273.46 – $1,619.14 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $9,715.75 | $9,715.75 | $848.89 – $884.63 |
| Left heart catheterization CPT 93452 | not posted | $5,014.14 – $21,020.00 | |
| Left heart catheterization with coronary angiogram CPT 93458 | not posted | $4,319.00 – $29,717.00 | |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $30,606.50 | $30,606.50 | $186.81 – $376.66 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | not posted | $1,671.00 – $16,686.00 | |
| Appendix removal, laparoscopic CPT 44970 | not posted | $8,878.60 – $9,252.44 | |
| Breast biopsy with ultrasound guidance CPT 19083 | not posted | $2,494.78 – $2,599.82 | |
| Carpal tunnel release CPT 64721 | not posted | $4,186.00 – $6,405.00 | |
| Colonoscopy with biopsy CPT 45380 | not posted | $1,147.00 – $8,538.00 | |
| Colonoscopy with polyp removal (snare) CPT 45385 | not posted | $1,815.84 – $1,892.30 | |
| Colonoscopy, diagnostic CPT 45378 | not posted | $1,406.36 – $1,465.58 | |
| Colposcopy with biopsy CPT 57454 | not posted | $983.00 – $6,405.00 | |
| Cystoscopy (bladder scope) CPT 52000 | not posted | $983.00 – $5,061.00 | |
| Ear tubes, under general anesthesia CPT 69436 | not posted | $1,671.00 – $8,538.00 | |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | not posted | $983.00 – $5,061.00 | |
| Gallbladder removal, laparoscopic CPT 47562 | not posted | $8,878.60 – $9,252.44 | |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | not posted | $6,868.00 – $13,180.00 | |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | not posted | $8,340.00 – $20,468.00 | |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | not posted | $4,810.71 – $5,013.27 | |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | not posted | $2,555.00 – $13,938.00 | |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | not posted | $2,555.00 – $10,063.00 | |
| Kidney stone shock-wave lithotripsy CPT 50590 | not posted | $3,964.00 – $22,227.00 | |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | not posted | $14,300.00 – $14,300.00 | |
| Lower colon endoscopy with ultrasound CPT 45391 | not posted | $3,802.00 – $8,538.00 | |
| Nasal endoscopy, diagnostic CPT 31231 | not posted | $524.00 – $6,405.00 | |
| Prostate biopsy CPT 55700 | not posted | $3,802.00 – $8,538.00 | |
| Prostate removal, laparoscopic or robotic CPT 55866 | not posted | $15,839.53 – $16,506.46 | |
| Removal of a breast lump, open surgery CPT 19120 | not posted | $5,865.34 – $6,112.30 | |
| Rotator cuff repair, arthroscopic CPT 29827 | not posted | $7,881.00 – $12,057.00 | |
| Screening colonoscopy, average risk HCPCS G0121 | not posted | $1,147.00 – $6,405.00 | |
| Screening colonoscopy, high risk HCPCS G0105 | not posted | $1,147.00 – $6,405.00 | |
| Septoplasty (nasal septum repair) CPT 30520 | not posted | $4,954.20 – $5,162.80 | |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | not posted | $1,547.00 – $8,007.00 | |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | not posted | $6,868.00 – $32,782.00 | |
| Tonsil and adenoid removal, under age 12 CPT 42820 | not posted | $9,011.23 – $9,390.65 | |
| Total hip replacement CPT 27130 | not posted | $20,251.81 – $21,104.51 | |
| Total knee replacement CPT 27447 | not posted | $5,913.00 – $44,089.00 | |
| Upper endoscopy (EGD) with biopsy CPT 43239 | not posted | $1,394.86 – $1,453.59 | |
| Upper endoscopy (EGD), diagnostic CPT 43235 | not posted | $983.00 – $5,268.00 | |
| Vasectomy CPT 55250 | not posted | $3,134.16 – $3,266.13 |
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 | $4,472.00 – $10,063.00 | |
| Fetal non-stress test CPT 59025 | $1,270.50 | $1,270.50 | $306.62 – $319.53 |
| IUD insertion CPT 58300 | not posted | $524.00 – $5,061.00 | |
| Vaginal birth after a prior C-section (VBAC), routine care CPT 59610 | not posted | $4,472.00 – $10,063.00 | |
| Vaginal delivery, routine care including prenatal and postpartum CPT 59400 | not posted | $4,472.00 – $10,063.00 |
Hospital stays
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | not posted | $983.00 – $5,061.00 | |
| Lower back nerve root injection with imaging guidance CPT 64483 | not posted | $983.00 – $5,061.00 | |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | not posted | $1,927.00 – $5,061.00 | |
| Lower back spinal injection (epidural), without imaging CPT 62322 | not posted | $1,402.55 – $1,461.61 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | not posted | $3,585.87 – $3,736.85 | |
| Eye exam, new patient, comprehensive CPT 92004 | not posted | $203.41 – $211.98 | |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | not posted | $894.43 – $932.09 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | not posted | $240.36 – $250.48 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | not posted | $1,353.00 – $5,579.00 | |
| Sleep study with CPAP titration CPT 95811 | $28,263.95 | $28,263.95 | $4,296.12 – $25,437.56 |
| Sleep study, overnight in a sleep lab CPT 95810 | $24,070.20 | $24,070.20 | $1,353.00 – $5,579.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $1,736.35 | $1,736.35 | $263.93 – $1,562.71 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $422.95 | $422.95 | $64.29 – $380.65 |
| Physical therapy evaluation, low complexity CPT 97161 | $386.10 | $386.10 | $58.69 – $347.49 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $578.60 | $578.60 | $87.95 – $520.74 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $422.95 | $422.95 | $64.29 – $380.65 |
| Therapeutic activities, 15 minutes CPT 97530 | $422.95 | $422.95 | $64.29 – $380.65 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | not posted | $245.34 – $255.67 | |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | not posted | $245.34 – $255.67 | |
| Group psychotherapy CPT 90853 | not posted | $300.00 – $300.00 | |
| Psychiatric diagnostic evaluation CPT 90791 | $4,687.00 | $4,687.00 | $712.42 – $4,218.30 |
| Psychotherapy, 30 minutes CPT 90832 | not posted | $245.34 – $255.67 | |
| Psychotherapy, 45 minutes CPT 90834 | not posted | $245.34 – $255.67 | |
| Psychotherapy, 60 minutes CPT 90837 | not posted | $245.34 – $255.67 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $580.25 | $580.25 | $88.20 – $522.23 |
| IV hydration, each additional hour CPT 96361 | $1,601.60 | $1,601.60 | $243.44 – $1,441.44 |
| IV hydration, first hour CPT 96360 | $2,284.70 | $2,284.70 | $347.27 – $2,056.23 |
| IV push injection of a drug, first CPT 96374 | $1,088.50 | $1,088.50 | $165.45 – $979.65 |
| IV push injection, each additional drug CPT 96375 | $603.35 | $603.35 | $91.71 – $543.01 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $3,973.76 | $3,973.76 | $604.01 – $3,576.38 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $505.68 | $505.68 | $76.86 – $455.11 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $700.00 | $700.00 | $106.40 – $630.00 |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | not posted | $6.23 – $6.23 | |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $505.68 | $505.68 | $76.86 – $455.11 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $1,005.76 | $1,005.76 | $152.88 – $905.18 |
| Morphine injection, up to 10 mg HCPCS J2270 | $658.00 | $658.00 | $100.02 – $592.20 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $440.72 | $440.72 | $66.99 – $396.65 |
| Propofol injection, per 10 mg HCPCS J2704 | $594.72 | $594.72 | $90.40 – $535.25 |
| Saline IV solution, 1000 ml HCPCS J7030 | not posted | $3.61 – $6.57 |
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.