Advocate Trinity Hospital

2320 E 93rd St., Chicago, IL 60617 · Acute care hospital · Emergency room

These are Advocate Trinity Hospital's own posted figures from its standard-charges file dated November 4, 2025. They are not a quote. Source: the hospital's file · its price transparency page.

231 of the services we track have a posted price here; 144 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	$2,290.00	$4,580.00	$1,273.61 – $11,010.00
Emergency room visit, level 1 (minor) CPT 99281	$195.00	$390.00	$133.09 – $796.00
Emergency room visit, level 2 CPT 99282	$417.50	$835.00	$239.36 – $1,214.00
Emergency room visit, level 3 (moderate) CPT 99283	$715.00	$1,430.00	$418.52 – $2,071.00
Emergency room visit, level 4 CPT 99284	$1,265.00	$2,530.00	$643.63 – $3,426.00
Emergency room visit, level 5 (most severe) CPT 99285	$1,820.00	$3,640.00	$926.71 – $4,020.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$410.00	$820.00	$300.34 – $656.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$115.00	$230.00	$80.27 – $184.00
New patient office visit, about 30 minutes CPT 99203	$147.50	$295.00	$102.96 – $236.00
New patient office visit, about 45 minutes CPT 99204	$177.50	$355.00	$105.00 – $284.00
New patient office visit, about 60 minutes CPT 99205	$207.50	$415.00	$105.00 – $332.00
Office consultation, about 40 minutes CPT 99243	not posted		$636.07 – $723.94
Office consultation, about 60 minutes CPT 99244	not posted		$929.32 – $1,057.71
Office visit, established patient, about 10 to 19 minutes CPT 99212	$120.00	$240.00	$83.76 – $192.00
Office visit, established patient, about 20 to 29 minutes CPT 99213	$147.50	$295.00	$102.96 – $236.00
Office visit, established patient, about 30 to 39 minutes CPT 99214	$177.50	$355.00	$105.00 – $284.00
Office visit, established patient, about 40 to 54 minutes CPT 99215	$207.50	$415.00	$105.00 – $332.00
Office visit, established patient, brief (often a nurse) CPT 99211	$90.00	$180.00	$62.82 – $144.00
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted		$660.85 – $752.15
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted		$772.37 – $879.08

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$152.50	$305.00	$34.55 – $524.00
Abdominal X-ray, 1 view CPT 74018	$195.00	$390.00	$98.18 – $634.00
Ankle X-ray, 3 or more views CPT 73610	$360.00	$720.00	$101.97 – $634.00
Bone density scan (DEXA), hips and spine CPT 77080	$395.00	$790.00	$133.89 – $662.83
Breast ultrasound, one breast, complete CPT 76641	$555.00	$1,110.00	$160.73 – $888.00
Breast ultrasound, one breast, limited CPT 76642	$440.00	$880.00	$133.09 – $704.00
Chest X-ray, 1 view CPT 71045	$225.00	$450.00	$78.83 – $634.00
Chest X-ray, 2 views CPT 71046	$270.00	$540.00	$105.62 – $634.00
CT angiogram of the chest (checks for lung clots) CPT 71275	$1,720.00	$3,440.00	$269.08 – $2,752.00
CT angiogram of the head CPT 70496	$1,720.00	$3,440.00	$269.08 – $2,752.00
CT scan of the abdomen and pelvis, with contrast CPT 74177	$2,455.00	$4,910.00	$539.81 – $3,928.00
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$3,580.00	$7,160.00	$539.81 – $5,728.00
CT scan of the abdomen and pelvis, without contrast CPT 74176	$2,245.00	$4,490.00	$365.36 – $3,592.00
CT scan of the abdomen, without contrast CPT 74150	$1,125.00	$2,250.00	$160.73 – $1,800.00
CT scan of the chest, with contrast CPT 71260	$1,225.00	$2,450.00	$269.08 – $1,960.00
CT scan of the chest, without contrast CPT 71250	$1,125.00	$2,250.00	$160.73 – $1,800.00
CT scan of the head, without contrast CPT 70450	$1,125.00	$2,250.00	$160.73 – $1,800.00
CT scan of the neck (cervical spine), without contrast CPT 72125	$1,125.00	$2,250.00	$160.73 – $1,800.00
CT scan of the pelvis, with contrast CPT 72193	$1,225.00	$2,450.00	$269.08 – $1,960.00
CT scan of the sinuses or face, without contrast CPT 70486	$1,125.00	$2,250.00	$160.73 – $1,800.00
Diagnostic mammogram, both breasts CPT 77066	$282.50	$565.00	$161.67 – $524.00
Diagnostic mammogram, one breast CPT 77065	$282.50	$565.00	$127.12 – $524.00
Foot X-ray, 3 or more views CPT 73630	$360.00	$720.00	$100.21 – $634.00
Hand X-ray, 3 or more views CPT 73130	$385.00	$770.00	$100.21 – $634.00
Knee X-ray, 3 views CPT 73562	$380.00	$760.00	$114.69 – $634.00
Leg or arm vein ultrasound, both sides CPT 93970	$845.00	$1,690.00	$365.36 – $1,570.11
Leg or arm vein ultrasound, one side CPT 93971	$565.00	$1,130.00	$160.73 – $1,038.90
Lower back X-ray, 2 or 3 views CPT 72100	$385.00	$770.00	$130.42 – $634.00
MRI of both breasts, without and with contrast CPT 77049	$2,920.00	$5,840.00	$1,096.00 – $4,672.00
MRI of the abdomen, without and with contrast CPT 74183	$2,575.00	$5,150.00	$539.81 – $4,120.00
MRI of the brain, without and with contrast CPT 70553	$2,575.00	$5,150.00	$539.81 – $4,120.00
MRI of the brain, without contrast CPT 70551	$1,650.00	$3,300.00	$365.36 – $2,640.00
MRI of the knee or other leg joint, without contrast CPT 73721	$2,060.00	$4,120.00	$365.36 – $3,296.00
MRI of the lower back (lumbar spine), without contrast CPT 72148	$1,650.00	$3,300.00	$365.36 – $2,640.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$1,650.00	$3,300.00	$365.36 – $2,640.00
MRI of the neck (cervical spine), without contrast CPT 72141	$1,650.00	$3,300.00	$365.36 – $2,640.00
MRI of the pelvis, without and with contrast CPT 72197	$2,575.00	$5,150.00	$539.81 – $4,120.00
MRI of the shoulder or other arm joint, without contrast CPT 73221	$2,060.00	$4,120.00	$365.36 – $3,296.00
Neck X-ray, 2 or 3 views CPT 72040	$277.50	$555.00	$119.90 – $634.00
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$435.00	$870.00	$160.73 – $808.55
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$540.00	$1,080.00	$160.73 – $973.09
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$465.00	$930.00	$160.73 – $879.08
Screening mammogram, both breasts CPT 77067	$237.50	$475.00	$133.37 – $524.00
Shoulder X-ray, 2 or more views CPT 73030	$395.00	$790.00	$107.66 – $634.00
Transvaginal pregnancy ultrasound CPT 76817	$350.00	$700.00	$160.73 – $691.03
Transvaginal ultrasound CPT 76830	$405.00	$810.00	$160.73 – $803.85
Ultrasound of the abdomen, complete CPT 76700	$810.00	$1,620.00	$160.73 – $1,296.00
Ultrasound of the neck or thyroid CPT 76536	$515.00	$1,030.00	$160.73 – $824.00
Wrist X-ray, 3 or more views CPT 73110	$370.00	$740.00	$105.47 – $634.00
X-ray of the lower back, 4 or more views CPT 72110	$575.00	$1,150.00	$160.73 – $920.00

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$62.50	$125.00	$8.46 – $162.98
Blood culture CPT 87040	$57.50	$115.00	$10.32 – $92.00
Blood draw (venipuncture) CPT 36415	$22.50	$45.00	$3.00 – $36.00
BNP test (heart failure) CPT 83880	$155.00	$310.00	$39.26 – $303.29
C-reactive protein (CRP) test CPT 86140	$37.50	$75.00	$5.18 – $60.00
Chlamydia test (DNA/NAAT) CPT 87491	$180.00	$360.00	$35.09 – $288.00
Complete blood count (CBC) with differential CPT 85025	$42.50	$85.00	$7.77 – $83.40
Complete blood count (CBC), automated CPT 85027	$30.00	$60.00	$6.47 – $48.00
Comprehensive metabolic panel (blood test) CPT 80053	$107.50	$215.00	$10.56 – $212.58
COVID-19 PCR test CPT 87635	$87.50	$175.00	$51.31 – $233.63
D-dimer test (blood clots) CPT 85379	$85.00	$170.00	$10.18 – $166.80
Drug screen, instrument chemistry CPT 80307	$380.00	$760.00	$62.14 – $608.00
Ferritin (iron stores) test CPT 82728	$80.00	$160.00	$13.63 – $128.00
Free T4 (thyroid) test CPT 84439	$65.00	$130.00	$9.02 – $104.00
General health panel (blood tests) CPT 80050	not posted		$47.28 – $329.06
Glucose (blood sugar) test CPT 82947	$40.00	$80.00	$3.93 – $64.00
Gonorrhea test (DNA/NAAT) CPT 87591	$180.00	$360.00	$35.09 – $288.00
Hemoglobin A1c test CPT 83036	$70.00	$140.00	$9.71 – $112.00
Hepatitis C antibody test CPT 86803	$90.00	$180.00	$14.27 – $144.00
HIV-1/HIV-2 antigen and antibody test CPT 87389	$112.50	$225.00	$24.08 – $180.00
Iron test CPT 83540	$67.50	$135.00	$6.47 – $108.00
Kidney function panel CPT 80069	$82.50	$165.00	$8.68 – $132.00
Lipase test (pancreas) CPT 83690	$67.50	$135.00	$6.89 – $108.00
Lipid panel, cholesterol and triglycerides CPT 80061	$82.50	$165.00	$13.39 – $132.00
Liver function panel CPT 80076	$80.00	$160.00	$8.17 – $155.89
Magnesium test CPT 83735	$50.00	$100.00	$6.70 – $80.00
Obstetric blood test panel CPT 80055	$187.50	$375.00	$47.81 – $371.37
Partial thromboplastin time (PTT), clotting test CPT 85730	$47.50	$95.00	$6.01 – $76.00
Pregnancy blood test (hCG), quantitative CPT 84702	$105.00	$210.00	$15.05 – $168.00
Prothrombin time (PT/INR), clotting test CPT 85610	$37.50	$75.00	$4.29 – $60.00
PSA (prostate specific antigen), free CPT 84154	$92.50	$185.00	$18.39 – $148.00
PSA (prostate specific antigen), total CPT 84153	$107.50	$215.00	$18.39 – $172.00
Rapid strep test CPT 87880	$47.50	$95.00	$16.53 – $76.00
Sed rate (ESR) test CPT 85652	$25.00	$50.00	$2.70 – $40.00
TB skin test CPT 86580	$25.00	$50.00	$19.70 – $49.02
Thyroid stimulating hormone (TSH) CPT 84443	$110.00	$220.00	$16.80 – $176.00
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$237.50	$475.00	$49.47 – $446.59
Troponin test (heart damage) CPT 84484	$72.50	$145.00	$12.47 – $116.00
Urinalysis, automated, with microscope CPT 81001	$35.00	$70.00	$3.17 – $56.00
Urinalysis, automated, without microscope CPT 81003	$32.50	$65.00	$2.25 – $52.00
Urinalysis, manual, with microscope CPT 81000	not posted		$4.02 – $18.81
Urinalysis, manual, without microscope CPT 81002	$25.00	$50.00	$3.48 – $40.00
Urine culture, colony count CPT 87086	$57.50	$115.00	$8.07 – $92.00
Urine pregnancy test CPT 81025	$57.50	$115.00	$8.61 – $92.00
Vitamin B12 test CPT 82607	$92.50	$185.00	$15.08 – $148.00
Vitamin D test CPT 82306	$222.50	$445.00	$29.60 – $439.77

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$905.00	$1,810.00	$365.36 – $1,527.80
ECG tracing only (no interpretation) CPT 93005	$262.50	$525.00	$78.47 – $420.00
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$1,160.00	$2,320.00	$809.68 – $1,964.99
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$136.30 – $155.13
Holter monitor, up to 48 hours CPT 93224	not posted		$805.41 – $916.68
Left heart catheterization CPT 93452	$5,325.00	$10,650.00	$4,196.10 – $18,102.00
Left heart catheterization with coronary angiogram CPT 93458	$4,525.00	$9,050.00	$3,565.70 – $18,102.00
Nuclear stress test (heart perfusion imaging) CPT 78452	$2,745.00	$5,490.00	$1,973.24 – $4,392.00
Treadmill stress test, complete CPT 93015	not posted		$644.32 – $733.34

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$10,797.81 – $25,111.00
Appendix removal, laparoscopic CPT 44970	not posted		$8,818.69 – $25,111.00
Breast biopsy with ultrasound guidance CPT 19083	$1,805.00	$3,610.00	$1,422.34 – $6,181.00
Carpal tunnel release CPT 64721	not posted		$2,951.63 – $12,362.00
Colonoscopy with biopsy CPT 45380	not posted		$1,782.19 – $6,181.00
Colonoscopy with polyp removal (snare) CPT 45385	not posted		$1,782.19 – $6,181.00
Colonoscopy, diagnostic CPT 45378	not posted		$1,378.06 – $6,181.00
Colposcopy with biopsy CPT 57454	not posted		$459.79 – $6,291.00
Cystoscopy (bladder scope) CPT 52000	not posted		$1,008.89 – $6,071.00
Ear tubes, under general anesthesia CPT 69436	not posted		$2,238.97 – $6,181.00
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted		$1,378.06 – $6,071.00
Gallbladder removal, laparoscopic CPT 47562	not posted		$8,818.69 – $25,111.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$12,700.00 – $25,111.00
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$12,700.00 – $25,111.00
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted		$4,805.89 – $12,362.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$8,818.69 – $25,111.00
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted		$5,334.21 – $17,439.00
Kidney stone shock-wave lithotripsy CPT 50590	not posted		$5,213.15 – $25,111.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$4,904.26 – $17,439.00
Lower colon endoscopy with ultrasound CPT 45391	not posted		$1,782.19 – $6,181.00
Nasal endoscopy, diagnostic CPT 31231	not posted		$293.44 – $6,291.00
Prostate biopsy CPT 55700	$735.00	$1,470.00	$579.18 – $6,181.00
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$15,736.65 – $47,462.00
Removal of a breast lump, open surgery CPT 19120	not posted		$5,787.99 – $12,362.00
Rotator cuff repair, arthroscopic CPT 29827	not posted		$10,797.81 – $25,111.00
Screening colonoscopy, average risk HCPCS G0121	not posted		$1,378.06 – $6,071.00
Screening colonoscopy, high risk HCPCS G0105	not posted		$1,378.06 – $6,071.00
Septoplasty (nasal septum repair) CPT 30520	not posted		$4,901.93 – $12,362.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$3,181.00 – $6,291.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$12,700.00 – $25,111.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$6,296.00 – $12,362.00
Total hip replacement CPT 27130	not posted		$19,448.31 – $47,462.00
Total knee replacement CPT 27447	not posted		$19,448.31 – $47,462.00
Upper endoscopy (EGD) with biopsy CPT 43239	not posted		$1,417.13 – $6,181.00
Upper endoscopy (EGD), diagnostic CPT 43235	not posted		$1,417.13 – $6,181.00
Vasectomy CPT 55250	not posted		$3,096.34 – $12,362.00

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
Fetal non-stress test CPT 59025	$450.00	$900.00	$304.07 – $720.00
IUD insertion CPT 58300	not posted		$3,181.00 – $6,291.00

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$9,688.32 – $18,875.55
C-section, without complications MS-DRG 788	not posted	$5,609.00 – $19,356.96
Chest pain MS-DRG 313	not posted	$7,834.56 – $15,509.07
COPD flare-up, with major complications MS-DRG 190	not posted	$12,332.79 – $24,027.71
COPD flare-up, without complications MS-DRG 192	not posted	$7,107.55 – $14,375.35
Fainting (syncope) MS-DRG 312	not posted	$9,568.62 – $18,642.33
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$10,827.15 – $21,094.32
Heart failure, with major complications MS-DRG 291	not posted	$14,329.31 – $27,917.50
Heart failure, without complications MS-DRG 293	not posted	$6,025.82 – $12,688.49
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$105,988.38 – $206,494.94
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$20,706.56 – $40,342.16
Irregular heartbeat, without complications MS-DRG 310	not posted	$6,144.43 – $12,873.47
Kidney failure, with complications MS-DRG 683	not posted	$9,761.90 – $19,018.90
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$8,814.15 – $17,172.43
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$25,998.79 – $50,652.89
Normal newborn care MS-DRG 795	not posted	$2,194.20 – $6,713.45
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$8,581.33 – $16,718.83
Pneumonia, with complications MS-DRG 194	not posted	$9,005.24 – $17,544.72
Pneumonia, with major complications MS-DRG 193	not posted	$14,470.98 – $28,193.51
Pneumonia, without complications MS-DRG 195	not posted	$6,838.49 – $13,955.77
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$15,480.23 – $30,159.80
Sepsis, with major complications MS-DRG 871	not posted	$21,547.78 – $41,981.09
Sepsis, without major complications MS-DRG 872	not posted	$11,322.44 – $22,059.28
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$9,672.95 – $18,845.60
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$8,569.25 – $16,695.30
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$11,167.60 – $21,757.59
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$13,164.12 – $25,647.39
Vaginal delivery, without complications MS-DRG 807	not posted	$5,609.00 – $14,205.83
Weight loss surgery, without complications MS-DRG 621	not posted	$13,685.00 – $31,276.67

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$450.00	$900.00	$354.60 – $6,291.00
Lower back nerve root injection with imaging guidance CPT 64483	$1,510.00	$3,020.00	$84.00 – $2,416.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$1,145.00	$2,290.00	$84.00 – $1,832.00
Lower back spinal injection (epidural), without imaging CPT 62322	$895.00	$1,790.00	$84.00 – $1,781.87

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$3,447.34 – $12,362.00
Eye exam, new patient, comprehensive CPT 92004	not posted	$194.79 – $817.96
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$829.21 – $6,071.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$236.49 – $343.16

Sleep

Service	Cash price	Insurer rates (min – max)
Home sleep apnea test CPT 95806	not posted	$236.49 – $637.75
Sleep study with CPAP titration CPT 95811	not posted	$1,283.00 – $3,398.22
Sleep study, overnight in a sleep lab CPT 95810	not posted	$1,283.00 – $3,088.29

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$307.50	$615.00	$227.17 – $1,287.00

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$85.00	$170.00	$40.45 – $469.00
Physical therapy evaluation, low complexity CPT 97161	$207.50	$415.00	$146.09 – $469.00
Physical therapy evaluation, moderate complexity CPT 97162	$210.00	$420.00	$146.09 – $469.00
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$85.00	$170.00	$42.83 – $469.00
Therapeutic activities, 15 minutes CPT 97530	$85.00	$170.00	$51.48 – $469.00

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	not posted		$242.85 – $719.24
Family psychotherapy, without the patient, 50 minutes CPT 90846	not posted		$242.85 – $554.71
Group psychotherapy CPT 90853	not posted		$139.81 – $454.92
Psychiatric diagnostic evaluation CPT 90791	not posted		$242.85 – $973.09
Psychotherapy, 30 minutes CPT 90832	$152.50	$305.00	$106.45 – $408.99
Psychotherapy, 45 minutes CPT 90834	not posted		$242.85 – $592.31
Psychotherapy, 60 minutes CPT 90837	not posted		$242.85 – $869.68

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$107.50	$215.00	$84.71 – $1,270.00
IV hydration, each additional hour CPT 96361	$95.00	$190.00	$69.74 – $1,270.00
IV hydration, first hour CPT 96360	$285.00	$570.00	$224.58 – $1,270.00
IV push injection of a drug, first CPT 96374	$215.00	$430.00	$169.42 – $1,270.00
IV push injection, each additional drug CPT 96375	$162.50	$325.00	$69.74 – $1,270.00

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$17.75	$35.50	? – $28.40
Dexamethasone injection, per 1 mg HCPCS J1100	$15.40	$30.79	? – $24.63
Fentanyl injection, per 0.1 mg HCPCS J3010	$61.29	$122.58	$1.39 – $98.06
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted		$4.46 – $9.13
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$59.96	$119.91	? – $95.93
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$37.35	$74.69	? – $59.75
Morphine injection, up to 10 mg HCPCS J2270	$64.20	$128.40	$5.35 – $102.72
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$15.10	$30.19	? – $24.15
Propofol injection, per 10 mg HCPCS J2704	$6.12	$12.24	? – $9.79
Saline IV solution, 1000 ml HCPCS J7030	$86.34	$172.67	$4.44 – $138.14

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.

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