Piedmont Newnan Hospital, Inc
745 Poplar Road, Newnan, GA 30265 · Acute care hospital · Emergency room
These are Piedmont Newnan Hospital, Inc's own posted figures from its standard-charges file dated July 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
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Emergency room
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Critical care, first 30 to 74 minutes CPT 99291 | $1,827.90 | $6,093.00 | $694.48 – $5,666.49 |
| Emergency room visit, level 1 (minor) CPT 99281 | $299.97 | $999.90 | $67.13 – $999.90 |
| Emergency room visit, level 2 CPT 99282 | $464.97 | $1,549.90 | $694.48 – $1,549.90 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $629.97 | $2,099.90 | $694.48 – $2,099.90 |
| Emergency room visit, level 4 CPT 99284 | $828.63 | $2,762.10 | $694.48 – $2,736.80 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $1,160.61 | $3,868.70 | $694.48 – $3,597.89 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $287.70 | $959.00 | $90.34 – $959.00 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | $136.50 | $455.00 | ? – $455.00 |
| New patient office visit, about 30 minutes CPT 99203 | $156.90 | $523.00 | $51.72 – $51.72 |
| New patient office visit, about 45 minutes CPT 99204 | $199.50 | $665.00 | ? – $665.00 |
| New patient office visit, about 60 minutes CPT 99205 | $967.50 | $3,225.00 | $3.23 – $2,999.25 |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $125.70 | $419.00 | ? – $419.00 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $150.90 | $503.00 | ? – $503.00 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $172.80 | $576.00 | ? – $576.00 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $941.40 | $3,138.00 | $3.14 – $2,918.34 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $100.50 | $335.00 | ? – $335.00 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $37.62 | $125.40 | $11.81 – $125.40 |
| Abdominal X-ray, 1 view CPT 74018 | $215.16 | $717.20 | $34.01 – $667.00 |
| Ankle X-ray, 3 or more views CPT 73610 | $270.90 | $903.00 | $44.44 – $839.79 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $385.44 | $1,284.80 | $46.53 – $1,194.86 |
| Breast ultrasound, one breast, complete CPT 76641 | $464.31 | $1,547.70 | $107.09 – $1,439.36 |
| Breast ultrasound, one breast, limited CPT 76642 | $332.32 | $1,107.75 | $83.07 – $1,030.21 |
| Chest X-ray, 1 view CPT 71045 | $123.84 | $412.80 | $27.21 – $383.90 |
| Chest X-ray, 2 views CPT 71046 | $154.80 | $516.00 | $36.60 – $479.88 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $1,481.70 | $4,939.00 | $405.00 – $4,593.27 |
| CT angiogram of the head CPT 70496 | $1,579.05 | $5,263.50 | $405.00 – $4,895.06 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $2,266.42 | $7,554.75 | $405.00 – $7,025.92 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $2,594.02 | $8,646.75 | |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $1,840.86 | $6,136.20 | $405.00 – $5,706.67 |
| CT scan of the abdomen, without contrast CPT 74150 | $1,165.50 | $3,885.00 | $261.88 – $3,613.05 |
| CT scan of the chest, with contrast CPT 71260 | $1,278.91 | $4,263.05 | $401.58 – $3,964.64 |
| CT scan of the chest, without contrast CPT 71250 | $1,004.64 | $3,348.80 | $261.88 – $3,114.38 |
| CT scan of the head, without contrast CPT 70450 | $1,082.77 | $3,609.24 | $261.88 – $3,356.59 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $1,188.99 | $3,963.30 | |
| CT scan of the pelvis, with contrast CPT 72193 | $1,331.82 | $4,439.40 | $405.00 – $4,128.64 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $862.62 | $2,875.40 | $261.88 – $2,674.12 |
| Diagnostic mammogram, both breasts CPT 77066 | $318.46 | $1,061.55 | $100.00 – $987.24 |
| Diagnostic mammogram, one breast CPT 77065 | $232.62 | $775.40 | $73.04 – $721.12 |
| Foot X-ray, 3 or more views CPT 73630 | $227.04 | $756.80 | $41.31 – $703.82 |
| Hand X-ray, 3 or more views CPT 73130 | $199.71 | $665.70 | $45.49 – $619.10 |
| Knee X-ray, 3 views CPT 73562 | $235.62 | $785.40 | $50.18 – $730.42 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $690.92 | $2,303.08 | $216.95 – $2,141.86 |
| Leg or arm vein ultrasound, one side CPT 93971 | $553.01 | $1,843.38 | $173.65 – $1,714.34 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $356.07 | $1,186.90 | $46.01 – $1,103.82 |
| MRI of both breasts, without and with contrast CPT 77049 | $2,154.57 | $7,181.90 | $676.53 – $6,679.17 |
| MRI of the abdomen, without and with contrast CPT 74183 | $2,091.21 | $6,970.70 | $656.64 – $6,482.75 |
| MRI of the brain, without and with contrast CPT 70553 | $2,202.42 | $7,341.40 | $683.00 – $6,827.50 |
| MRI of the brain, without contrast CPT 70551 | $1,343.10 | $4,477.00 | $421.73 – $4,163.61 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $1,515.69 | $5,052.30 | $475.93 – $4,698.64 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $1,710.72 | $5,702.40 | $537.17 – $5,303.23 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $1,605.78 | $5,352.60 | $504.21 – $4,977.92 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $1,521.63 | $5,072.10 | $477.79 – $4,717.05 |
| MRI of the pelvis, without and with contrast CPT 72197 | $1,934.46 | $6,448.20 | $607.42 – $5,996.83 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $1,411.41 | $4,704.70 | $443.18 – $4,375.37 |
| Neck X-ray, 2 or 3 views CPT 72040 | $285.78 | $952.60 | $45.49 – $885.92 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $481.80 | $1,606.00 | $114.92 – $1,493.58 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $542.52 | $1,808.40 | |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $430.65 | $1,435.50 | $111.26 – $1,335.02 |
| Screening mammogram, both breasts CPT 77067 | $280.98 | $936.60 | $88.23 – $871.04 |
| Shoulder X-ray, 2 or more views CPT 73030 | $217.35 | $724.50 | $40.79 – $673.79 |
| Transvaginal pregnancy ultrasound CPT 76817 | $385.77 | $1,285.90 | $89.87 – $1,195.89 |
| Transvaginal ultrasound CPT 76830 | $487.74 | $1,625.80 | $136.39 – $1,511.99 |
| Ultrasound of the abdomen, complete CPT 76700 | $581.13 | $1,937.10 | $123.34 – $1,801.50 |
| Ultrasound of the neck or thyroid CPT 76536 | $614.46 | $2,048.20 | |
| Wrist X-ray, 3 or more views CPT 73110 | $206.25 | $687.50 | $51.75 – $639.38 |
| X-ray of the lower back, 4 or more views CPT 72110 | $444.51 | $1,481.70 | $62.20 – $1,377.98 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $131.38 | $437.95 | ? – $407.29 |
| Blood culture CPT 87040 | $150.76 | $502.55 | ? – $467.37 |
| Blood draw (venipuncture) CPT 36415 | $13.39 | $44.65 | ? – $41.52 |
| BNP test (heart failure) CPT 83880 | $121.05 | $403.50 | ? – $375.26 |
| C-reactive protein (CRP) test CPT 86140 | $87.78 | $292.60 | ? – $272.12 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $87.77 | $292.56 | ? – $272.08 |
| Complete blood count (CBC) with differential CPT 85025 | $61.81 | $206.03 | $4.92 – $191.61 |
| Complete blood count (CBC), automated CPT 85027 | $56.43 | $188.10 | $4.10 – $174.93 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $146.77 | $489.25 | ? – $455.00 |
| COVID-19 PCR test CPT 87635 | $75.70 | $252.33 | ? – $234.67 |
| D-dimer test (blood clots) CPT 85379 | $96.61 | $322.05 | ? – $299.51 |
| Drug screen, instrument chemistry CPT 80307 | $142.45 | $474.83 | ? – $441.59 |
| Ferritin (iron stores) test CPT 82728 | $67.35 | $224.50 | ? – $208.79 |
| Free T4 (thyroid) test CPT 84439 | $60.06 | $200.20 | ? – $186.19 |
| General health panel (blood tests) CPT 80050 | $236.83 | $789.45 | ? – $734.19 |
| Glucose (blood sugar) test CPT 82947 | $39.04 | $130.15 | $2.48 – $121.04 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $82.29 | $274.30 | ? – $255.10 |
| Hemoglobin A1c test CPT 83036 | $53.85 | $179.50 | ? – $166.94 |
| Hepatitis C antibody test CPT 86803 | $120.55 | $401.85 | ? – $373.72 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $118.84 | $396.15 | ? – $368.42 |
| Iron test CPT 83540 | $50.70 | $169.00 | ? – $157.17 |
| Kidney function panel CPT 80069 | $86.92 | $289.75 | ? – $269.47 |
| Lipase test (pancreas) CPT 83690 | $76.83 | $256.11 | ? – $238.18 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $98.32 | $327.75 | ? – $304.81 |
| Liver function panel CPT 80076 | $106.30 | $354.35 | ? – $329.55 |
| Magnesium test CPT 83735 | $45.00 | $150.00 | ? – $139.50 |
| Obstetric blood test panel CPT 80055 | $124.20 | $414.00 | ? – $385.02 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $54.72 | $182.40 | $3.80 – $169.63 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $106.19 | $353.98 | ? – $329.20 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $39.06 | $130.20 | $2.49 – $121.09 |
| PSA (prostate specific antigen), free CPT 84154 | $61.56 | $205.20 | ? – $190.84 |
| PSA (prostate specific antigen), total CPT 84153 | $100.89 | $336.30 | ? – $312.76 |
| Rapid strep test CPT 87880 | $72.10 | $240.35 | $7.59 – $223.53 |
| Sed rate (ESR) test CPT 85652 | $33.06 | $110.20 | $1.71 – $102.49 |
| TB skin test CPT 86580 | $49.20 | $164.00 | $4.09 – $152.52 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $73.03 | $243.43 | ? – $226.39 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $2,436.18 | $8,120.60 | $8.12 – $7,552.16 |
| Troponin test (heart damage) CPT 84484 | $125.67 | $418.89 | ? – $389.57 |
| Urinalysis, automated, with microscope CPT 81001 | $63.27 | $210.90 | $2.01 – $196.14 |
| Urinalysis, automated, without microscope CPT 81003 | $36.19 | $120.65 | ? – $112.20 |
| Urinalysis, manual, with microscope CPT 81000 | $38.70 | $129.00 | $2.01 – $119.97 |
| Urinalysis, manual, without microscope CPT 81002 | $36.76 | $122.55 | ? – $113.97 |
| Urine culture, colony count CPT 87086 | $85.78 | $285.95 | ? – $265.93 |
| Urine pregnancy test CPT 81025 | $115.14 | $383.80 | $4.01 – $356.93 |
| Vitamin B12 test CPT 82607 | $81.12 | $270.40 | ? – $251.47 |
| Vitamin D test CPT 82306 | $78.75 | $262.50 | ? – $244.13 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $884.07 | $2,946.90 | $277.60 – $2,740.62 |
| ECG tracing only (no interpretation) CPT 93005 | $190.08 | $633.60 | $59.69 – $589.25 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $1,552.98 | $5,176.60 | $487.64 – $4,814.24 |
| Left heart catheterization CPT 93452 | $5,253.60 | $17,512.00 | $1,649.63 – $16,286.16 |
| Left heart catheterization with coronary angiogram CPT 93458 | $7,356.03 | $24,520.10 | $2,309.79 – $22,803.69 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $2,440.68 | $8,135.60 | $562.27 – $7,566.11 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Breast biopsy with ultrasound guidance CPT 19083 | $2,189.40 | $7,298.00 | $687.47 – $7,298.00 |
| Colonoscopy with biopsy CPT 45380 | $1,391.58 | $4,638.60 | $436.96 – $4,638.60 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $1,529.20 | $5,097.33 | $480.17 – $5,097.33 |
| Colposcopy with biopsy CPT 57454 | $567.90 | $1,893.00 | $178.32 – $1,893.00 |
| Cystoscopy (bladder scope) CPT 52000 | $1,667.70 | $5,559.00 | $523.66 – $5,559.00 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $1,203.93 | $4,013.10 | $378.03 – $4,013.10 |
| Kidney stone shock-wave lithotripsy CPT 50590 | $12,206.97 | $40,689.90 | $3,832.99 – $37,841.61 |
| Lower colon endoscopy with ultrasound CPT 45391 | $1,270.35 | $4,234.50 | $398.89 – $4,234.50 |
| Screening colonoscopy, average risk HCPCS G0121 | $1,525.29 | $5,084.30 | $478.94 – $5,084.30 |
| Screening colonoscopy, high risk HCPCS G0105 | $1,525.29 | $5,084.30 | $478.94 – $5,084.30 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $1,389.27 | $4,630.91 | $436.23 – $4,630.91 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $1,542.28 | $5,140.94 | $484.28 – $4,937.00 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $585.00 | $1,950.00 | $183.69 – $1,813.50 |
| IUD insertion CPT 58300 | $466.05 | $1,553.50 | $146.34 – $1,553.50 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $9,125.62 | $30,418.73 | $1,958.00 – $20,971.80 |
| C-section, without complications MS-DRG 788 | $13,940.22 | $46,467.40 | $7,561.00 – $8,771.77 |
| Chest pain MS-DRG 313 | $10,422.47 | $34,741.57 | $7,038.71 – $20,061.59 |
| COPD flare-up, with major complications MS-DRG 190 | $13,871.41 | $46,238.03 | $7,561.00 – $30,864.20 |
| COPD flare-up, without complications MS-DRG 192 | $8,727.31 | $29,091.05 | $6,472.63 – $17,888.25 |
| Fainting (syncope) MS-DRG 312 | $12,467.06 | $41,556.86 | $7,561.00 – $24,285.67 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $14,117.55 | $47,058.51 | $7,561.00 – $27,325.56 |
| Heart failure, with major complications MS-DRG 291 | $13,784.50 | $45,948.33 | $7,561.00 – $35,770.93 |
| Heart failure, without complications MS-DRG 293 | $6,875.60 | $22,918.67 | $5,921.08 – $15,770.64 |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | $149,162.41 | $497,208.04 | $72,810.88 – $272,581.29 |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | $39,732.93 | $132,443.09 | $7,561.00 – $53,745.56 |
| Irregular heartbeat, without complications MS-DRG 310 | $8,367.38 | $27,891.28 | $5,921.79 – $15,773.43 |
| Kidney failure, with complications MS-DRG 683 | $9,403.25 | $31,344.18 | $7,561.00 – $24,402.70 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $9,534.61 | $31,782.03 | $7,561.00 – $22,555.36 |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | $53,355.93 | $177,853.11 | $7,561.00 – $68,022.72 |
| Normal newborn care MS-DRG 795 | $1,639.59 | $5,465.29 | $3,263.42 – $3,263.42 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $9,903.04 | $33,010.13 | $7,461.10 – $21,683.24 |
| Pneumonia, with complications MS-DRG 194 | $11,715.45 | $39,051.50 | $7,561.00 – $22,455.05 |
| Pneumonia, with major complications MS-DRG 193 | $12,830.83 | $42,769.43 | |
| Pneumonia, without complications MS-DRG 195 | $8,248.08 | $27,493.61 | $6,374.65 – $17,512.10 |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | $15,085.48 | $50,284.95 | $1,958.00 – $33,182.38 |
| Sepsis, with major complications MS-DRG 871 | $19,793.99 | $65,979.96 | $7,561.00 – $54,124.50 |
| Sepsis, without major complications MS-DRG 872 | $12,289.26 | $40,964.20 | $7,561.00 – $28,512.54 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $10,175.43 | $33,918.11 | $7,561.00 – $24,266.17 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $11,415.71 | $38,052.38 | $7,471.25 – $21,722.24 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $15,955.72 | $53,185.73 | $8,593.00 – $28,150.31 |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | $27,302.58 | $91,008.59 | $7,561.00 – $34,570.02 |
| Vaginal delivery, without complications MS-DRG 807 | $10,827.07 | $36,090.23 | |
| Weight loss surgery, without complications MS-DRG 621 | $30,859.17 | $102,863.90 | $7,561.00 – $43,279.00 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $1,145.70 | $3,819.00 | $359.75 – $3,819.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $1,754.40 | $5,848.00 | $550.88 – $5,438.64 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $1,343.25 | $4,477.50 | $1,534.00 – $2,360.00 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $1,660.80 | $5,536.00 | $521.49 – $5,148.48 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Eye exam, new patient, comprehensive CPT 92004 | $268.50 | $895.00 | |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | $424.20 | $1,414.00 | $133.20 – $1,414.00 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $552.75 | $1,842.50 | $173.56 – $1,842.50 |
| Sleep study with CPAP titration CPT 95811 | $2,921.25 | $9,737.50 | $917.27 – $9,055.88 |
| Sleep study, overnight in a sleep lab CPT 95810 | $2,531.08 | $8,436.95 | $794.76 – $7,846.36 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $245.43 | $818.10 | $77.07 – $760.83 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $107.70 | $359.00 | $33.82 – $359.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $175.03 | $583.45 | $54.96 – $542.61 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $176.83 | $589.43 | $55.52 – $548.17 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $75.81 | $252.70 | $23.80 – $252.70 |
| Therapeutic activities, 15 minutes CPT 97530 | $71.53 | $238.45 | $22.46 – $238.45 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $129.06 | $430.20 | $40.52 – $430.20 |
| IV hydration, each additional hour CPT 96361 | $114.46 | $381.55 | $35.94 – $381.55 |
| IV hydration, first hour CPT 96360 | $237.90 | $793.00 | $74.70 – $737.49 |
| IV push injection of a drug, first CPT 96374 | $175.95 | $586.50 | $55.25 – $571.00 |
| IV push injection, each additional drug CPT 96375 | $157.22 | $524.06 | $49.37 – $524.06 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $11.26 | $37.52 | $2.00 – $34.89 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $14.24 | $47.48 | $1.01 – $44.16 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $134.40 | $447.99 | $42.20 – $416.63 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $22.29 | $74.29 | $1.21 – $69.09 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $34.04 | $113.47 | $3.29 – $105.53 |
| Morphine injection, up to 10 mg HCPCS J2270 | $196.59 | $655.31 | $7.62 – $609.44 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $5.68 | $18.92 | ? – $17.60 |
| Propofol injection, per 10 mg HCPCS J2704 | $50.70 | $169.01 | $10.49 – $157.18 |
| Saline IV solution, 1000 ml HCPCS J7030 | $30.19 | $100.65 |
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.