Humboldt Park Health

1044 N Francisco Ave, Chicago, IL 60622 · Acute care hospital · Emergency room

These are Humboldt Park Health's own posted figures from its standard-charges file dated September 29, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

216 of the services we track have a posted price here. 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	$847.60	$3,027.15	$800.00 – $3,178.51
Emergency room visit, level 1 (minor) CPT 99281	$114.95	$410.55	$185.57 – $800.00
Emergency room visit, level 2 CPT 99282	$214.91	$767.55	$346.93 – $805.93
Emergency room visit, level 3 (moderate) CPT 99283	$267.25	$954.45	$431.41 – $1,002.17
Emergency room visit, level 4 CPT 99284	$353.09	$1,261.05	$569.99 – $1,324.10
Emergency room visit, level 5 (most severe) CPT 99285	$665.03	$2,375.10	$800.00 – $2,493.86
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$197.03	$703.69	$232.22 – $738.87

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$108.78	$388.50	$128.21 – $407.93
New patient office visit, about 30 minutes CPT 99203	$109.96	$392.70	$129.59 – $412.34
New patient office visit, about 45 minutes CPT 99204	$158.47	$565.95	$186.76 – $594.25
New patient office visit, about 60 minutes CPT 99205	$225.20	$804.30	$265.42 – $844.52
Office consultation, about 40 minutes CPT 99243	$96.14	$343.35	$113.31 – $360.52
Office consultation, about 60 minutes CPT 99244	$140.83	$502.95	$165.97 – $528.10
Office visit, established patient, about 10 to 19 minutes CPT 99212	$108.78	$388.50	$128.21 – $407.93
Office visit, established patient, about 20 to 29 minutes CPT 99213	$108.78	$388.50	$128.21 – $407.93
Office visit, established patient, about 30 to 39 minutes CPT 99214	$119.56	$427.00	$140.91 – $448.35
Office visit, established patient, about 40 to 54 minutes CPT 99215	$170.24	$608.00	$200.64 – $638.40
Office visit, established patient, brief (often a nurse) CPT 99211	$108.78	$388.50	$128.21 – $407.93
Preventive checkup, new patient, age 18 to 39 CPT 99385	$102.90	$367.50	$121.28 – $385.88
Preventive checkup, new patient, age 40 to 64 CPT 99386	$119.07	$425.25	$140.33 – $446.51

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$63.21	$225.75	$74.50 – $237.04
Abdominal X-ray, 1 view CPT 74018	$105.13	$375.48	$123.91 – $394.25
Ankle X-ray, 3 or more views CPT 73610	$155.40	$555.00	$183.15 – $582.75
Bone density scan (DEXA), hips and spine CPT 77080	$133.56	$477.00	$157.41 – $500.85
Breast ultrasound, one breast, complete CPT 76641	$96.43	$344.40	$113.65 – $361.62
Breast ultrasound, one breast, limited CPT 76642	$144.72	$516.84	$170.56 – $542.68
Chest X-ray, 1 view CPT 71045	$115.36	$412.00	$135.96 – $432.60
Chest X-ray, 2 views CPT 71046	$78.50	$280.35	$92.52 – $294.37
CT angiogram of the chest (checks for lung clots) CPT 71275	$1,138.27	$4,065.25	$500.00 – $4,268.51
CT angiogram of the head CPT 70496	$631.22	$2,254.35	$500.00 – $2,367.07
CT scan of the abdomen and pelvis, with contrast CPT 74177	$581.53	$2,076.90	$500.00 – $2,180.75
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$1,211.74	$4,327.65	$500.00 – $4,544.03
CT scan of the abdomen and pelvis, without contrast CPT 74176	$253.72	$906.15	$409.58 – $951.46
CT scan of the abdomen, without contrast CPT 74150	$640.26	$2,286.65	$500.00 – $2,400.98
CT scan of the chest, with contrast CPT 71260	$699.72	$2,499.00	$500.00 – $2,623.95
CT scan of the chest, without contrast CPT 71250	$710.58	$2,537.77	$500.00 – $2,664.66
CT scan of the head, without contrast CPT 70450	$446.00	$1,592.85	$500.00 – $1,672.49
CT scan of the neck (cervical spine), without contrast CPT 72125	$412.07	$1,471.69	$500.00 – $1,545.27
CT scan of the pelvis, with contrast CPT 72193	$817.10	$2,918.21	$500.00 – $3,064.12
CT scan of the sinuses or face, without contrast CPT 70486	$409.58	$1,462.78	$500.00 – $1,535.92
Diagnostic mammogram, both breasts CPT 77066	$105.25	$375.90	$124.05 – $394.70
Diagnostic mammogram, one breast CPT 77065	$105.25	$375.90	$124.05 – $394.70
Foot X-ray, 3 or more views CPT 73630	$117.89	$421.05	$138.95 – $442.10
Hand X-ray, 3 or more views CPT 73130	$99.67	$355.95	$117.46 – $373.75
Knee X-ray, 3 views CPT 73562	$155.20	$554.28	$182.91 – $581.99
Leg or arm vein ultrasound, both sides CPT 93970	$281.06	$1,003.80	$331.25 – $1,053.99
Leg or arm vein ultrasound, one side CPT 93971	$167.58	$598.50	$197.51 – $628.43
Lower back X-ray, 2 or 3 views CPT 72100	$82.32	$294.00	$97.02 – $308.70
MRI of both breasts, without and with contrast CPT 77049	$97.90	$349.65	$115.38 – $367.13
MRI of the abdomen, without and with contrast CPT 74183	$1,202.50	$4,294.64	$600.00 – $4,509.37
MRI of the brain, without and with contrast CPT 70553	$845.60	$3,020.00	$600.00 – $3,171.00
MRI of the brain, without contrast CPT 70551	$731.73	$2,613.31	$600.00 – $2,743.98
MRI of the knee or other leg joint, without contrast CPT 73721	$550.66	$1,966.65	$600.00 – $2,064.98
MRI of the lower back (lumbar spine), without contrast CPT 72148	$550.66	$1,966.65	$600.00 – $2,064.98
MRI of the mid back (thoracic spine), without contrast CPT 72146	$817.08	$2,918.16	$600.00 – $3,064.07
MRI of the neck (cervical spine), without contrast CPT 72141	$727.71	$2,598.95	$600.00 – $2,728.90
MRI of the pelvis, without and with contrast CPT 72197	$1,201.93	$4,292.59	$600.00 – $4,507.22
MRI of the shoulder or other arm joint, without contrast CPT 73221	$475.40	$1,697.85	$600.00 – $1,782.74
Neck X-ray, 2 or 3 views CPT 72040	$124.43	$444.39	$146.65 – $466.61
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$307.48	$1,098.15	$362.39 – $1,153.06
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$229.88	$821.00	$270.93 – $862.05
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$437.36	$1,562.00	$515.46 – $1,640.10
Screening mammogram, both breasts CPT 77067	$110.25	$393.75	$129.94 – $413.44
Shoulder X-ray, 2 or more views CPT 73030	$112.99	$403.54	$133.17 – $423.72
Transvaginal pregnancy ultrasound CPT 76817	$189.28	$676.00	$223.08 – $709.80
Transvaginal ultrasound CPT 76830	$304.86	$1,088.78	$359.30 – $1,143.22
Ultrasound of the abdomen, complete CPT 76700	$351.62	$1,255.80	$414.41 – $1,318.59
Ultrasound of the neck or thyroid CPT 76536	$297.73	$1,063.32	$350.90 – $1,116.49
Wrist X-ray, 3 or more views CPT 73110	$135.53	$484.05	$159.74 – $508.25
X-ray of the lower back, 4 or more views CPT 72110	$170.81	$610.05	$201.32 – $640.55

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$61.15	$218.40	$72.07 – $229.32
Blood culture CPT 87040	$76.44	$273.00	$90.09 – $286.65
Blood draw (venipuncture) CPT 36415	$10.88	$38.85	$12.82 – $40.79
BNP test (heart failure) CPT 83880	$43.22	$154.35	$50.94 – $162.07
C-reactive protein (CRP) test CPT 86140	$31.16	$111.30	$36.73 – $116.87
Chlamydia test (DNA/NAAT) CPT 87491	$55.86	$199.50	$65.84 – $209.48
Complete blood count (CBC) with differential CPT 85025	$45.28	$161.70	$53.36 – $169.79
Complete blood count (CBC), automated CPT 85027	$29.40	$105.00	$34.65 – $110.25
Comprehensive metabolic panel (blood test) CPT 80053	$66.15	$236.25	$77.96 – $248.06
D-dimer test (blood clots) CPT 85379	$13.52	$48.30	$15.94 – $50.72
Drug screen, instrument chemistry CPT 80307	$264.01	$942.90	$311.16 – $990.05
Ferritin (iron stores) test CPT 82728	$62.33	$222.60	$73.46 – $233.73
Free T4 (thyroid) test CPT 84439	$74.97	$267.75	$88.36 – $281.14
Glucose (blood sugar) test CPT 82947	$31.46	$112.35	$37.08 – $117.97
Gonorrhea test (DNA/NAAT) CPT 87591	$55.86	$199.50	$65.84 – $209.48
Hemoglobin A1c test CPT 83036	$42.92	$153.30	$50.59 – $160.97
Hepatitis C antibody test CPT 86803	$148.47	$530.25	$174.98 – $556.76
HIV-1/HIV-2 antigen and antibody test CPT 87389	$392.49	$1,401.75	$462.58 – $1,471.84
Iron test CPT 83540	$37.34	$133.35	$44.01 – $140.02
Kidney function panel CPT 80069	$52.04	$185.85	$61.33 – $195.14
Lipase test (pancreas) CPT 83690	$45.86	$163.80	$54.05 – $171.99
Lipid panel, cholesterol and triglycerides CPT 80061	$91.43	$326.55	$107.76 – $342.88
Liver function panel CPT 80076	$95.84	$342.30	$112.96 – $359.42
Magnesium test CPT 83735	$39.10	$139.65	$46.08 – $146.63
Obstetric blood test panel CPT 80055	$165.23	$590.10	$194.73 – $619.61
Partial thromboplastin time (PTT), clotting test CPT 85730	$94.67	$338.10	$111.57 – $355.01
Pregnancy blood test (hCG), quantitative CPT 84702	$64.09	$228.90	$75.54 – $240.35
Prothrombin time (PT/INR), clotting test CPT 85610	$94.67	$338.10	$111.57 – $355.01
PSA (prostate specific antigen), free CPT 84154	$61.15	$218.40	$72.07 – $229.32
PSA (prostate specific antigen), total CPT 84153	$61.15	$218.40	$72.07 – $229.32
Rapid strep test CPT 87880	$22.93	$81.90	$27.03 – $86.00
Sed rate (ESR) test CPT 85652	$2.06	$7.35	$2.43 – $7.72
TB skin test CPT 86580	$27.05	$96.60	$31.88 – $101.43
Thyroid stimulating hormone (TSH) CPT 84443	$82.61	$295.05	$97.37 – $309.80
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$193.75	$691.95	$228.34 – $726.55
Troponin test (heart damage) CPT 84484	$58.21	$207.90	$68.61 – $218.30
Urinalysis, automated, with microscope CPT 81001	$14.70	$52.50	$17.33 – $55.13
Urinalysis, automated, without microscope CPT 81003	$14.70	$52.50	$17.33 – $55.13
Urinalysis, manual, with microscope CPT 81000	$20.58	$73.50	$24.26 – $77.18
Urinalysis, manual, without microscope CPT 81002	$14.70	$52.50	$17.33 – $55.13
Urine culture, colony count CPT 87086	$42.92	$153.30	$50.59 – $160.97
Urine pregnancy test CPT 81025	$13.23	$47.25	$15.59 – $49.61
Vitamin B12 test CPT 82607	$54.39	$194.25	$64.10 – $203.96
Vitamin D test CPT 82306	$94.37	$337.05	$111.23 – $353.90

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$267.68	$956.00	$315.48 – $1,003.80
ECG tracing only (no interpretation) CPT 93005	$87.32	$311.85	$102.91 – $327.44
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$323.69	$1,156.05	$381.50 – $1,213.85
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	$22.05	$78.75	$25.99 – $82.69
Left heart catheterization CPT 93452	$2,867.68	$10,241.70	$3,379.76 – $10,753.79
Left heart catheterization with coronary angiogram CPT 93458	$2,867.68	$10,241.70	$3,379.76 – $10,753.79
Nuclear stress test (heart perfusion imaging) CPT 78452	$1,090.85	$3,895.90	$1,285.65 – $4,090.70

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$1,004.60	$3,587.85	$1,183.99 – $3,767.24
Appendix removal, laparoscopic CPT 44970	$616.81	$2,202.90	$726.96 – $2,313.05
Breast biopsy with ultrasound guidance CPT 19083	$1,464.40	$5,230.00	$1,725.90 – $5,491.50
Carpal tunnel release CPT 64721	$431.59	$1,541.40	$508.66 – $1,618.47
Colonoscopy with biopsy CPT 45380	$471.58	$1,684.20	$555.79 – $1,768.41
Colonoscopy with polyp removal (snare) CPT 45385	$531.85	$1,899.45	$626.82 – $1,994.42
Colonoscopy, diagnostic CPT 45378	$396.61	$1,416.45	$467.43 – $1,487.27
Colposcopy with biopsy CPT 57454	$155.23	$554.40	$182.95 – $582.12
Cystoscopy (bladder scope) CPT 52000	$102.90	$367.50	$121.28 – $385.88
Ear tubes, under general anesthesia CPT 69436	$160.52	$573.30	$189.19 – $601.97
Flexible sigmoidoscopy, diagnostic CPT 45330	$138.47	$494.55	$163.20 – $519.28
Gallbladder removal, laparoscopic CPT 47562	$676.20	$2,415.00	$796.95 – $2,535.75
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$896.70	$3,202.50	$1,056.83 – $3,362.63
Hysteroscopy with biopsy or polyp removal CPT 58558	$398.08	$1,421.70	$469.16 – $1,492.79
Inguinal (groin) hernia repair, laparoscopic CPT 49650	$284.59	$1,016.40	$335.41 – $1,067.22
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$533.61	$1,905.75	$628.90 – $2,001.04
Kidney stone shock-wave lithotripsy CPT 50590	$705.60	$2,520.00	$831.60 – $2,646.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$549.19	$1,961.40	$647.26 – $2,059.47
Nasal endoscopy, diagnostic CPT 31231	$205.80	$735.00	$242.55 – $771.75
Removal of a breast lump, open surgery CPT 19120	$499.80	$1,785.00	$589.05 – $1,874.25
Rotator cuff repair, arthroscopic CPT 29827	$1,060.46	$3,787.35	$1,249.83 – $3,976.72
Screening colonoscopy, average risk HCPCS G0121	$157.29	$561.75	$185.38 – $1,499.35
Screening colonoscopy, high risk HCPCS G0105	$157.29	$561.75	$185.38 – $1,499.35
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	$171.40	$612.15	$202.01 – $642.76
Tonsil and adenoid removal, under age 12 CPT 42820	$290.77	$1,038.45	$342.69 – $1,090.37
Total hip replacement CPT 27130	$1,466.77	$5,238.45	$1,728.69 – $5,500.37
Total knee replacement CPT 27447	$1,565.55	$5,591.25	$1,845.11 – $5,870.81
Upper endoscopy (EGD) with biopsy CPT 43239	$183.75	$656.25	$216.56 – $689.06
Upper endoscopy (EGD), diagnostic CPT 43235	$299.00	$1,067.85	$352.39 – $1,121.24
Vasectomy CPT 55250	$365.74	$1,306.20	$431.05 – $1,371.51

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	$2,493.71	$8,906.10	$2,939.01 – $9,351.41
Fetal non-stress test CPT 59025	$179.05	$639.45	$211.02 – $671.42
IUD insertion CPT 58300	$44.10	$157.50	$51.98 – $165.38
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	$2,678.05	$9,564.45	$3,156.27 – $10,042.67
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	$2,249.39	$8,033.55	$2,651.07 – $8,435.23

Hospital stays

Service	Cash price	Gross charge	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$3,602.13	$12,864.76	$1,438.42 – $27,267.76
C-section, without complications MS-DRG 788	$8,730.15	$31,179.10	$3,872.00 – $23,384.32
Chest pain MS-DRG 313	$5,381.82	$19,220.78	$2,916.00 – $14,415.59
COPD flare-up, with major complications MS-DRG 190	$10,867.86	$38,813.80	$7,940.62 – $29,110.35
COPD flare-up, without complications MS-DRG 192	$8,763.08	$31,296.71	$5,358.97 – $23,472.53
Fainting (syncope) MS-DRG 312	$8,707.02	$31,096.51	$6,872.16 – $23,322.38
Gastrointestinal bleeding, with complications MS-DRG 378	$10,039.91	$35,856.84	$8,186.20 – $26,892.63
Heart failure, with major complications MS-DRG 291	$12,112.28	$43,258.12	$10,598.00 – $32,443.59
Heart failure, without complications MS-DRG 293	$4,311.84	$15,399.43	$2,916.00 – $11,549.58
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	$26,600.13	$95,000.45	$9,669.42 – $71,250.34
Irregular heartbeat, without complications MS-DRG 310	$10,950.99	$39,110.67	$4,725.41 – $29,333.00
Kidney failure, with complications MS-DRG 683	$8,018.76	$28,638.42	$7,310.57 – $21,478.81
Kidney or urinary tract infection, without major complications MS-DRG 690	$6,198.71	$22,138.25	$6,757.14 – $16,603.69
Neck (cervical) spinal fusion, without complications MS-DRG 473	$28,140.60	$100,502.13	$9,583.20 – $75,376.60
Normal newborn care MS-DRG 795	$1,659.65	$5,927.31	$1,667.79 – $12,287.31
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$8,696.63	$31,059.38	$719.21 – $23,294.53
Pneumonia, with complications MS-DRG 194	$8,065.68	$28,806.00	$6,727.09 – $21,604.50
Pneumonia, with major complications MS-DRG 193	$12,413.42	$44,333.65	$9,316.65 – $33,250.23
Pneumonia, without complications MS-DRG 195	$4,082.99	$14,582.12	$2,916.00 – $10,936.59
Psychoses (inpatient psychiatric stay) MS-DRG 885	$6,245.36	$22,304.87	$5,753.68 – $21,103.95
Sepsis, with major complications MS-DRG 871	$16,837.12	$60,132.58	$12,083.00 – $45,099.44
Sepsis, without major complications MS-DRG 872	$8,542.20	$30,507.85	$6,545.61 – $22,880.89
Skin infection (cellulitis), without major complications MS-DRG 603	$6,802.97	$24,296.34	$7,031.52 – $18,222.25
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$6,906.91	$24,667.53	$5,404.14 – $18,500.65
Stroke, with complications or clot-busting drug MS-DRG 65	$8,755.44	$31,269.43	$7,682.00 – $23,452.07
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	$9,639.91	$34,428.25	$3,220.37 – $25,821.19
Vaginal delivery, without complications MS-DRG 807	$3,201.28	$11,433.16	$3,600.00 – $8,574.87

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$263.48	$941.00	$310.53 – $988.05
Lower back nerve root injection with imaging guidance CPT 64483	$191.10	$682.50	$225.23 – $716.63
Lower back spinal injection (epidural), without imaging CPT 62322	$117.60	$420.00	$138.60 – $441.00

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	$655.03	$2,339.40	$772.00 – $2,456.37
Eye exam, new patient, comprehensive CPT 92004	$143.18	$511.35	$168.75 – $536.92
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$698.84	$2,495.85	$1,051.00 – $2,620.64

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$35.28	$126.00	$41.58 – $132.30

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$149.35	$533.40	$176.02 – $560.07

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$42.34	$151.20	$68.34 – $158.76
Physical therapy evaluation, low complexity CPT 97161	$106.13	$379.05	$171.33 – $398.00
Physical therapy evaluation, moderate complexity CPT 97162	$113.78	$406.35	$183.67 – $426.67
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$24.70	$88.20	$39.87 – $92.61
Therapeutic activities, 15 minutes CPT 97530	$38.81	$138.60	$62.65 – $145.53

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$120.25	$429.45	$141.72 – $450.92
Family psychotherapy, without the patient, 50 minutes CPT 90846	$120.25	$429.45	$141.72 – $450.92
Group psychotherapy CPT 90853	$79.38	$283.50	$93.56 – $297.68
Psychiatric diagnostic evaluation CPT 90791	$152.32	$544.00	$179.52 – $571.20
Psychotherapy, 30 minutes CPT 90832	$135.53	$484.05	$159.74 – $508.25
Psychotherapy, 45 minutes CPT 90834	$152.32	$544.00	$179.52 – $571.20
Psychotherapy, 60 minutes CPT 90837	$152.32	$544.00	$179.52 – $571.20

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$119.84	$428.00	$141.24 – $449.40
IV hydration, each additional hour CPT 96361	$202.84	$724.42	$239.06 – $760.64
IV hydration, first hour CPT 96360	$202.84	$724.42	$239.06 – $760.64
IV push injection of a drug, first CPT 96374	$206.64	$738.00	$243.54 – $774.90
IV push injection, each additional drug CPT 96375	$61.45	$219.45	$72.42 – $230.42

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$12.94	$46.20	$15.25 – $48.51
Dexamethasone injection, per 1 mg HCPCS J1100	$29.40	$105.00	$34.65 – $110.25
Fentanyl injection, per 0.1 mg HCPCS J3010	$24.64	$88.00	$29.04 – $92.40
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$9.11	$32.53	$10.73 – $34.16
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$46.20	$165.00	$54.45 – $173.25
Morphine injection, up to 10 mg HCPCS J2270	$21.00	$75.00	$24.75 – $78.75
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$2.45	$8.75	$2.89 – $9.19
Propofol injection, per 10 mg HCPCS J2704	$8.40	$30.00	$9.90 – $31.50

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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