Holy Cross Hospital

2701 W 68th Street, Chicago, IL 60629 · Acute care hospital · Emergency room

These are Holy Cross Hospital's own posted figures from its standard-charges file dated September 22, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

225 of the services we track have a posted price here; 224 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	$3,147.63	$4,496.62	$619.00 – $12,590.54
Emergency room visit, level 1 (minor) CPT 99281	$381.86	$545.51	$163.65 – $1,527.43
Emergency room visit, level 2 CPT 99282	$516.10	$737.28	$221.18 – $2,064.38
Emergency room visit, level 3 (moderate) CPT 99283	$891.17	$1,273.10	$381.93 – $3,564.68
Emergency room visit, level 4 CPT 99284	$1,430.56	$2,043.65	$613.10 – $5,722.22
Emergency room visit, level 5 (most severe) CPT 99285	$2,524.27	$3,606.10	$619.00 – $10,097.08
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$871.69	$1,245.27	$278.24 – $3,615.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$225.04	$321.49	$144.67 – $900.17
New patient office visit, about 30 minutes CPT 99203	$297.84	$425.48	$191.47 – $1,191.34
New patient office visit, about 45 minutes CPT 99204	$408.08	$582.97	$262.34 – $1,632.32
New patient office visit, about 60 minutes CPT 99205	$550.61	$786.59	$353.97 – $2,202.45
Office consultation, about 40 minutes CPT 99243	$200.53	$286.47	$128.91 – $802.12
Office consultation, about 60 minutes CPT 99244	$291.10	$415.85	$187.13 – $1,164.38
Office visit, established patient, about 10 to 19 minutes CPT 99212	$225.04	$321.49	$144.67 – $900.17
Office visit, established patient, about 20 to 29 minutes CPT 99213	$233.30	$333.28	$149.98 – $933.18
Office visit, established patient, about 30 to 39 minutes CPT 99214	$297.84	$425.48	$191.47 – $1,191.34
Office visit, established patient, about 40 to 54 minutes CPT 99215	$408.08	$582.97	$262.34 – $1,632.32
Office visit, established patient, brief (often a nurse) CPT 99211	$168.79	$241.13	$108.51 – $675.16
Preventive checkup, new patient, age 18 to 39 CPT 99385	$179.38	$256.25	$115.31 – $717.50
Preventive checkup, new patient, age 40 to 64 CPT 99386	$205.11	$293.01	$131.85 – $820.43

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$98.24	$140.34	$63.15 – $392.95
Abdominal X-ray, 1 view CPT 74018	$235.56	$336.51	$83.73 – $942.23
Ankle X-ray, 3 or more views CPT 73610	$17.94	$25.63	$11.53 – $238.00
Bone density scan (DEXA), hips and spine CPT 77080	$495.87	$708.38	$118.43 – $1,983.46
Breast ultrasound, one breast, complete CPT 76641	$100.63	$143.76	$64.69 – $402.53
Breast ultrasound, one breast, limited CPT 76642	$100.63	$143.76	$64.69 – $402.53
Chest X-ray, 1 view CPT 71045	$326.32	$466.17	$83.73 – $1,305.28
Chest X-ray, 2 views CPT 71046	$348.85	$498.36	$83.73 – $1,395.41
CT angiogram of the chest (checks for lung clots) CPT 71275	$4,017.78	$5,739.69	$589.91 – $16,071.13
CT angiogram of the head CPT 70496	$3,531.72	$5,045.31	$589.91 – $14,126.87
CT scan of the abdomen and pelvis, with contrast CPT 74177	$4,395.87	$6,279.82	$477.34 – $17,583.50
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$5,219.53	$7,456.47	$477.34 – $20,878.12
CT scan of the abdomen and pelvis, without contrast CPT 74176	$3,960.78	$5,658.26	$477.34 – $15,843.13
CT scan of the abdomen, without contrast CPT 74150	$2,080.18	$2,971.68	$173.77 – $8,320.70
CT scan of the chest, with contrast CPT 71260	$2,309.71	$3,299.58	$477.34 – $9,238.82
CT scan of the chest, without contrast CPT 71250	$1,249.02	$1,784.32	$173.77 – $4,996.10
CT scan of the head, without contrast CPT 70450	$1,605.34	$2,293.34	$477.34 – $6,421.35
CT scan of the neck (cervical spine), without contrast CPT 72125	$2,073.44	$2,962.05	$173.77 – $8,293.74
CT scan of the pelvis, with contrast CPT 72193	$2,309.71	$3,299.58	$477.34 – $9,238.82
CT scan of the sinuses or face, without contrast CPT 70486	$2,020.16	$2,885.94	$173.77 – $8,080.63
Diagnostic mammogram, both breasts CPT 77066	$531.13	$758.76	$73.28 – $2,124.53
Diagnostic mammogram, one breast CPT 77065	$440.36	$629.09	$73.28 – $1,761.45
Foot X-ray, 3 or more views CPT 73630	$14.35	$20.50	$9.23 – $238.00
Hand X-ray, 3 or more views CPT 73130	$17.94	$25.63	$11.53 – $238.00
Knee X-ray, 3 views CPT 73562	$18.30	$26.14	$11.76 – $85.41
Leg or arm vein ultrasound, both sides CPT 93970	$402.13	$574.47	$249.94 – $1,608.52
Leg or arm vein ultrasound, one side CPT 93971	$773.43	$1,104.90	$161.07 – $3,093.72
Lower back X-ray, 2 or 3 views CPT 72100	$432.83	$618.33	$83.73 – $1,731.32
MRI of both breasts, without and with contrast CPT 77049	$4,008.78	$5,726.83	$642.10 – $16,035.12
MRI of the abdomen, without and with contrast CPT 74183	$4,960.73	$7,086.75	$642.10 – $19,842.90
MRI of the brain, without and with contrast CPT 70553	$4,099.58	$5,856.54	$642.10 – $16,398.31
MRI of the brain, without contrast CPT 70551	$2,760.55	$3,943.64	$374.86 – $11,042.19
MRI of the knee or other leg joint, without contrast CPT 73721	$170.52	$243.60	$109.62 – $682.08
MRI of the lower back (lumbar spine), without contrast CPT 72148	$3,098.13	$4,425.90	$374.86 – $12,392.52
MRI of the mid back (thoracic spine), without contrast CPT 72146	$1,508.54	$2,155.06	$374.86 – $6,034.17
MRI of the neck (cervical spine), without contrast CPT 72141	$2,951.08	$4,215.83	$374.86 – $11,804.32
MRI of the pelvis, without and with contrast CPT 72197	$4,284.08	$6,120.12	$642.10 – $17,136.34
MRI of the shoulder or other arm joint, without contrast CPT 73221	$170.52	$243.60	$109.62 – $682.08
Neck X-ray, 2 or 3 views CPT 72040	$369.08	$527.26	$83.73 – $1,476.33
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$730.67	$1,043.81	$249.94 – $2,922.67
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$675.89	$965.55	$151.06 – $2,703.54
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$644.39	$920.55	$151.06 – $2,577.54
Screening mammogram, both breasts CPT 77067	$461.36	$659.08	$73.28 – $1,845.42
Shoulder X-ray, 2 or more views CPT 73030	$18.30	$26.14	$11.76 – $238.00
Transvaginal pregnancy ultrasound CPT 76817	$613.64	$876.63	$151.06 – $2,454.56
Transvaginal ultrasound CPT 76830	$662.40	$946.28	$161.07 – $2,649.58
Ultrasound of the abdomen, complete CPT 76700	$1,460.54	$2,086.49	$249.94 – $5,842.17
Ultrasound of the neck or thyroid CPT 76536	$696.16	$994.51	$161.07 – $2,784.63
Wrist X-ray, 3 or more views CPT 73110	$16.51	$23.58	$10.61 – $238.00
X-ray of the lower back, 4 or more views CPT 72110	$476.35	$680.50	$83.73 – $1,905.40

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$207.79	$296.84	$12.08 – $831.15
Blood culture CPT 87040	$198.82	$284.03	$10.64 – $795.28
Blood draw (venipuncture) CPT 36415	$32.29	$46.13	$3.43 – $129.16
BNP test (heart failure) CPT 83880	$227.30	$324.72	$39.66 – $909.22
C-reactive protein (CRP) test CPT 86140	$67.52	$96.45	$14.78 – $270.06
Chlamydia test (DNA/NAAT) CPT 87491	$176.29	$251.84	$38.94 – $705.15
Complete blood count (CBC) with differential CPT 85025	$96.79	$138.27	$8.20 – $387.16
Complete blood count (CBC), automated CPT 85027	$96.79	$138.27	$8.20 – $387.16
Comprehensive metabolic panel (blood test) CPT 80053	$269.31	$384.73	$12.08 – $1,077.24
COVID-19 PCR test CPT 87635	$120.04	$171.48	$34.30 – $480.14
D-dimer test (blood clots) CPT 85379	$108.77	$155.39	$5.41 – $435.09
Drug screen, instrument chemistry CPT 80307	$249.80	$356.85	$71.37 – $999.18
Ferritin (iron stores) test CPT 82728	$183.04	$261.48	$15.77 – $732.14
Free T4 (thyroid) test CPT 84439	$133.53	$190.75	$17.94 – $534.10
General health panel (blood tests) CPT 80050	$351.58	$502.25	$12.08 – $1,406.30
Glucose (blood sugar) test CPT 82947	$76.52	$109.32	$7.30 – $306.10
Gonorrhea test (DNA/NAAT) CPT 87591	$115.27	$164.67	$38.94 – $461.08
Hemoglobin A1c test CPT 83036	$94.53	$135.04	$7.30 – $378.11
Hepatitis C antibody test CPT 86803	$177.04	$252.92	$14.78 – $708.18
HIV-1/HIV-2 antigen and antibody test CPT 87389	$69.16	$98.80	$10.64 – $276.64
Iron test CPT 83540	$153.04	$218.63	$7.30 – $612.16
Kidney function panel CPT 80069	$250.55	$357.93	$12.08 – $1,002.20
Lipase test (pancreas) CPT 83690	$95.28	$136.12	$7.30 – $381.14
Lipid panel, cholesterol and triglycerides CPT 80061	$197.32	$281.88	$12.08 – $789.26
Liver function panel CPT 80076	$336.08	$480.11	$12.08 – $1,344.31
Magnesium test CPT 83735	$99.05	$141.50	$7.30 – $396.20
Obstetric blood test panel CPT 80055	$456.11	$651.59	$12.08 – $1,824.45
Partial thromboplastin time (PTT), clotting test CPT 85730	$133.53	$190.75	$5.41 – $534.10
Pregnancy blood test (hCG), quantitative CPT 84702	$221.31	$316.16	$17.94 – $885.25
Prothrombin time (PT/INR), clotting test CPT 85610	$91.52	$130.74	$5.41 – $366.07
PSA (prostate specific antigen), free CPT 84154	$96.06	$137.23	$15.77 – $384.24
PSA (prostate specific antigen), total CPT 84153	$271.57	$387.96	$15.77 – $1,086.29
Rapid strep test CPT 87880	$28.52	$40.74	$8.15 – $114.07
Sed rate (ESR) test CPT 85652	$50.26	$71.80	$8.20 – $201.04
TB skin test CPT 86580	$25.25	$36.07	$14.78 – $101.00
Thyroid stimulating hormone (TSH) CPT 84443	$246.82	$352.60	$17.94 – $987.28
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$605.39	$864.84	$54.35 – $2,421.55
Troponin test (heart damage) CPT 84484	$48.03	$68.62	$13.72 – $192.14
Urinalysis, automated, with microscope CPT 81001	$70.53	$100.76	$4.06 – $282.13
Urinalysis, automated, without microscope CPT 81003	$45.70	$65.29	$4.06 – $182.81
Urinalysis, manual, with microscope CPT 81000	$18.76	$26.80	$4.06 – $75.04
Urinalysis, manual, without microscope CPT 81002	$15.03	$21.47	$4.06 – $60.12
Urine culture, colony count CPT 87086	$42.27	$60.38	$10.64 – $169.06
Urine pregnancy test CPT 81025	$84.02	$120.03	$4.06 – $336.08
Vitamin B12 test CPT 82607	$222.07	$317.24	$17.94 – $888.27
Vitamin D test CPT 82306	$157.54	$225.05	$39.66 – $630.14

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$773.43	$1,104.90	$249.94 – $3,093.72
ECG tracing only (no interpretation) CPT 93005	$221.31	$316.16	$39.39 – $885.25
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$2,350.96	$3,358.52	$536.00 – $9,403.86
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	$73.74	$105.34	$39.39 – $294.95
Holter monitor, up to 48 hours CPT 93224	$262.00	$374.29	$98.78 – $1,048.01
Left heart catheterization CPT 93452	$8,462.41	$12,089.16	$2,790.00 – $33,849.65
Left heart catheterization with coronary angiogram CPT 93458	$8,462.41	$12,089.16	$2,790.00 – $33,849.65
Nuclear stress test (heart perfusion imaging) CPT 78452	$2,468.74	$3,526.77	$955.00 – $9,874.96
Treadmill stress test, complete CPT 93015	$175.83	$251.19	$113.04 – $703.33

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$1,633.67	$2,333.82	$1,050.22 – $8,513.79
Appendix removal, laparoscopic CPT 44970	$2,119.26	$3,027.51	$1,362.38 – $8,477.03
Breast biopsy with ultrasound guidance CPT 19083	$1,051.30	$1,501.86	$675.84 – $4,205.21
Carpal tunnel release CPT 64721	$674.58	$963.69	$433.66 – $2,698.33
Colonoscopy with biopsy CPT 45380	$1,051.86	$1,502.65	$676.19 – $4,207.42
Colonoscopy with polyp removal (snare) CPT 45385	$1,340.02	$1,914.31	$861.44 – $5,360.07
Colonoscopy, diagnostic CPT 45378	$977.45	$1,396.35	$628.36 – $3,909.78
Colposcopy with biopsy CPT 57454	$516.67	$738.10	$294.50 – $3,615.00
Cystoscopy (bladder scope) CPT 52000	$1,076.84	$1,538.34	$613.80 – $4,307.35
Ear tubes, under general anesthesia CPT 69436	$583.11	$833.01	$374.85 – $2,332.43
Flexible sigmoidoscopy, diagnostic CPT 45330	$1,431.05	$2,044.36	$613.31 – $5,724.21
Gallbladder removal, laparoscopic CPT 47562	$3,357.19	$4,795.98	$2,158.19 – $13,428.74
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	$4,095.80	$5,851.14	$1,957.47 – $16,383.19
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$2,466.70	$3,523.86	$1,585.74 – $11,391.10
Hysteroscopy with biopsy or polyp removal CPT 58558	$536.27	$766.10	$344.75 – $3,487.26
Inguinal (groin) hernia repair, laparoscopic CPT 49650	$1,440.83	$2,058.33	$926.25 – $6,478.50
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$1,292.45	$1,846.35	$830.86 – $5,404.38
Kidney stone shock-wave lithotripsy CPT 50590	$1,229.51	$1,756.44	$790.40 – $4,918.03
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$1,055.69	$1,508.13	$678.66 – $4,222.76
Lower colon endoscopy with ultrasound CPT 45391	$714.65	$1,020.93	$459.42 – $2,858.60
Nasal endoscopy, diagnostic CPT 31231	$561.12	$801.60	$243.36 – $3,615.00
Prostate biopsy CPT 55700	$3,014.87	$4,306.95	$1,718.47 – $12,059.46
Prostate removal, laparoscopic or robotic CPT 55866	$4,347.85	$6,211.21	$2,790.00 – $17,391.39
Removal of a breast lump, open surgery CPT 19120	$1,147.17	$1,638.82	$737.47 – $4,588.70
Rotator cuff repair, arthroscopic CPT 29827	$1,784.25	$2,548.93	$1,147.02 – $8,513.79
Screening colonoscopy, average risk HCPCS G0121	$667.63	$953.76	$429.19 – $2,670.53
Screening colonoscopy, high risk HCPCS G0105	$650.07	$928.67	$417.90 – $2,600.28
Septoplasty (nasal septum repair) CPT 30520	$967.32	$1,381.89	$621.85 – $4,119.04
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	$1,095.03	$1,564.33	$173.56 – $4,380.12
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	$2,612.71	$3,732.44	$1,232.99 – $10,450.83
Tonsil and adenoid removal, under age 12 CPT 42820	$981.23	$1,401.76	$630.79 – $6,343.80
Total hip replacement CPT 27130	$2,396.63	$3,423.76	$1,540.69 – $14,095.79
Total knee replacement CPT 27447	$2,560.38	$3,657.68	$1,645.96 – $14,095.79
Upper endoscopy (EGD) with biopsy CPT 43239	$1,804.12	$2,577.31	$619.00 – $7,216.47
Upper endoscopy (EGD), diagnostic CPT 43235	$948.70	$1,355.28	$540.76 – $3,794.78
Vasectomy CPT 55250	$809.80	$1,156.85	$230.38 – $1,598.42

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	$962.02	$1,374.31	$618.44 – $4,011.11
Fetal non-stress test CPT 59025	$732.89	$1,046.99	$216.65 – $2,931.57
IUD insertion CPT 58300	$482.35	$689.07	$285.54 – $1,929.40
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	$2,838.48	$4,054.97	$1,824.74 – $11,353.92
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	$2,669.42	$3,813.46	$1,716.06 – $10,677.69

Hospital stays

Service	Cash price	Gross charge	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$8,071.22	$11,530.32	$1,386.00 – $58,701.84
Chest pain MS-DRG 313	$16,420.17	$23,457.38	$5,292.00 – $54,905.06
COPD flare-up, with major complications MS-DRG 190	$30,737.64	$43,910.91	$8,141.60 – $98,944.35
COPD flare-up, without complications MS-DRG 192	$13,741.14	$19,630.20	$3,357.00 – $31,059.18
Fainting (syncope) MS-DRG 312	$24,276.47	$34,680.68	$6,406.26 – $58,197.07
Gastrointestinal bleeding, with complications MS-DRG 378	$22,938.41	$32,769.16	$7,208.15 – $72,078.76
Heart failure, with major complications MS-DRG 291	$29,676.37	$42,394.81	$9,435.93 – $89,566.33
Heart failure, without complications MS-DRG 293	$13,969.98	$19,957.11	$3,704.54 – $30,447.51
Irregular heartbeat, without complications MS-DRG 310	$14,387.57	$20,553.67	$4,160.84 – $44,139.43
Kidney failure, with complications MS-DRG 683	$16,654.17	$23,791.67	$6,437.13 – $47,969.33
Kidney or urinary tract infection, without major complications MS-DRG 690	$18,556.40	$26,509.14	$1,386.00 – $50,426.61
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$17,881.29	$25,544.71	$693.00 – $72,716.23
Pneumonia, with complications MS-DRG 194	$22,353.59	$31,933.70	$5,923.37 – $79,105.22
Pneumonia, with major complications MS-DRG 193	$31,578.05	$45,111.50	$9,660.84 – $92,283.02
Pneumonia, without complications MS-DRG 195	$13,462.56	$19,232.23	$4,619.48 – $42,817.99
Psychoses (inpatient psychiatric stay) MS-DRG 885	$12,749.29	$18,213.27	$4,158.00 – $57,679.27
Sepsis, with major complications MS-DRG 871	$47,266.28	$67,523.25	$11,053.63 – $93,411.30
Sepsis, without major complications MS-DRG 872	$20,875.74	$29,822.49	$7,521.26 – $69,132.09
Skin infection (cellulitis), without major complications MS-DRG 603	$16,685.27	$23,836.10	$6,401.12 – $55,283.78
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$18,076.33	$25,823.32	$5,730.06 – $57,271.00
Stroke, with complications or clot-busting drug MS-DRG 65	$36,492.20	$52,131.71	$7,425.71 – $122,888.99

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$585.12	$835.89	$333.52 – $3,615.00
Lower back nerve root injection with imaging guidance CPT 64483	$2,855.83	$4,079.76	$1,304.39 – $11,423.33
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$1,109.56	$1,585.08	$632.45 – $4,438.22
Lower back spinal injection (epidural), without imaging CPT 62322	$2,618.77	$3,741.10	$1,304.39 – $10,475.08

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	$2,694.13	$3,848.75	$1,731.94 – $10,776.50
Eye exam, new patient, comprehensive CPT 92004	$225.04	$321.49	$144.67 – $900.17
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$1,184.86	$1,692.66	$589.39 – $4,739.45

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$532.64	$760.91	$121.32 – $2,130.55

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$489.87	$699.82	$217.13 – $1,959.50
Sleep study with CPAP titration CPT 95811	$3,161.88	$4,516.97	$969.00 – $12,647.52
Sleep study, overnight in a sleep lab CPT 95810	$3,161.88	$4,516.97	$969.00 – $12,647.52

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$241.55	$345.07	$82.02 – $966.20

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$40.62	$58.03	$26.11 – $235.66
Physical therapy evaluation, low complexity CPT 97161	$133.75	$191.07	$85.98 – $535.00
Physical therapy evaluation, moderate complexity CPT 97162	$133.75	$191.07	$85.98 – $535.00
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$51.42	$73.45	$33.05 – $235.66
Therapeutic activities, 15 minutes CPT 97530	$113.30	$161.85	$72.83 – $453.18

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$250.89	$358.42	$161.29 – $1,003.58
Family psychotherapy, without the patient, 50 minutes CPT 90846	$250.89	$358.42	$161.29 – $1,003.58
Group psychotherapy CPT 90853	$130.61	$186.59	$83.97 – $522.45
Psychiatric diagnostic evaluation CPT 90791	$343.57	$490.82	$220.87 – $1,374.30
Psychotherapy, 30 minutes CPT 90832	$250.89	$358.42	$161.29 – $1,003.58
Psychotherapy, 45 minutes CPT 90834	$250.89	$358.42	$161.29 – $1,003.58
Psychotherapy, 60 minutes CPT 90837	$250.89	$358.42	$161.29 – $1,003.58

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$125.28	$178.97	$68.95 – $501.12
IV hydration, each additional hour CPT 96361	$414.11	$591.58	$245.00 – $1,656.42
IV hydration, first hour CPT 96360	$414.11	$591.58	$245.00 – $1,656.42
IV push injection of a drug, first CPT 96374	$414.11	$591.58	$68.95 – $1,656.42
IV push injection, each additional drug CPT 96375	$414.11	$591.58	$68.95 – $1,656.42

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$51.23	$73.19	$32.93 – $204.92
Dexamethasone injection, per 1 mg HCPCS J1100	$4.58	$6.54	$1.72 – $18.31
Fentanyl injection, per 0.1 mg HCPCS J3010	$9.37	$13.39	$5.14 – $37.49
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$16.14	$23.06	$10.38 – $64.57
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$2.30	$3.29	$1.38 – $9.20
Morphine injection, up to 10 mg HCPCS J2270	$9.49	$13.56	$6.05 – $37.97
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$5.68	$8.11	$2.13 – $22.71
Propofol injection, per 10 mg HCPCS J2704	not posted	$1.39	? – $3.89
Saline IV solution, 1000 ml HCPCS J7030	$9.88	$14.11	$6.35 – $39.51

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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