Louis A Weiss Memorial Hospital

4646 N Marine Drive, Chicago, IL 60640 · Acute care hospital · Emergency room

These are Louis A Weiss Memorial Hospital's own posted figures from its standard-charges file dated March 17, 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; 145 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	$301.95	$888.10	$147.69 – $4,566.00
Emergency room visit, level 1 (minor) CPT 99281	$167.71	$493.26	$28.32 – $967.00
Emergency room visit, level 2 CPT 99282	$283.61	$834.16	$56.17 – $1,286.00
Emergency room visit, level 3 (moderate) CPT 99283	$519.33	$1,527.43	$85.36 – $1,821.00
Emergency room visit, level 4 CPT 99284	$833.78	$2,452.28	$162.93 – $2,760.00
Emergency room visit, level 5 (most severe) CPT 99285	$1,135.44	$3,339.54	$242.30 – $3,360.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$170.57	$501.67	$83.43 – $326.09

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$119.00	$350.00	$227.50 – $227.50
New patient office visit, about 30 minutes CPT 99203	$132.60	$390.00	$253.50 – $253.50
New patient office visit, about 45 minutes CPT 99204	$169.32	$498.00	$323.70 – $323.70
New patient office visit, about 60 minutes CPT 99205	$215.90	$635.00	$412.75 – $412.75
Office consultation, about 40 minutes CPT 99243	not posted		$85.26 – $85.26
Office consultation, about 60 minutes CPT 99244	not posted		$143.10 – $143.10
Office visit, established patient, about 10 to 19 minutes CPT 99212	$87.72	$258.00	$167.70 – $167.70
Office visit, established patient, about 20 to 29 minutes CPT 99213	$98.26	$289.00	$187.85 – $187.85
Office visit, established patient, about 30 to 39 minutes CPT 99214	$126.14	$371.00	$241.15 – $241.15
Office visit, established patient, about 40 to 54 minutes CPT 99215	$149.60	$440.00	$286.00 – $286.00
Office visit, established patient, brief (often a nurse) CPT 99211	$64.26	$189.00	$122.85 – $122.85
Preventive checkup, new patient, age 18 to 39 CPT 99385	$90.10	$265.00	$44.07 – $818.00
Preventive checkup, new patient, age 40 to 64 CPT 99386	$109.48	$322.00	$53.55 – $209.30

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$47.77	$140.51	$20.74 – $91.33
Abdominal X-ray, 1 view CPT 74018	$105.59	$310.55	$26.46 – $201.86
Ankle X-ray, 3 or more views CPT 73610	$293.67	$863.74	$32.99 – $561.43
Bone density scan (DEXA), hips and spine CPT 77080	$200.84	$590.72	$46.53 – $383.97
Breast ultrasound, one breast, complete CPT 76641	$165.18	$485.81	$80.79 – $315.78
Breast ultrasound, one breast, limited CPT 76642	$150.76	$443.40	$73.74 – $288.21
Chest X-ray, 1 view CPT 71045	$105.59	$310.55	$15.59 – $201.86
Chest X-ray, 2 views CPT 71046	$105.59	$310.55	$28.22 – $201.86
CT angiogram of the chest (checks for lung clots) CPT 71275	$1,936.81	$5,696.49	$180.00 – $3,702.72
CT angiogram of the head CPT 70496	$1,705.51	$5,016.22	$180.00 – $3,260.54
CT scan of the abdomen and pelvis, with contrast CPT 74177	$3,498.11	$10,288.56	$240.00 – $6,687.56
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$3,482.20	$10,241.75	$240.00 – $6,657.14
CT scan of the abdomen and pelvis, without contrast CPT 74176	$2,921.05	$8,591.31	$192.08 – $5,584.35
CT scan of the abdomen, without contrast CPT 74150	$1,449.06	$4,261.94	$107.53 – $2,770.26
CT scan of the chest, with contrast CPT 71260	$1,409.16	$4,144.60	$180.00 – $2,693.99
CT scan of the chest, without contrast CPT 71250	$589.32	$1,733.29	$107.53 – $1,126.64
CT scan of the head, without contrast CPT 70450	$1,133.86	$3,334.88	$104.99 – $2,167.67
CT scan of the neck (cervical spine), without contrast CPT 72125	$1,410.46	$4,148.40	$107.53 – $2,696.46
CT scan of the pelvis, with contrast CPT 72193	$1,559.33	$4,586.26	$180.00 – $2,981.07
CT scan of the sinuses or face, without contrast CPT 70486	$1,122.21	$3,300.61	$107.53 – $2,145.40
Diagnostic mammogram, both breasts CPT 77066	$506.53	$1,489.79	$97.03 – $968.36
Diagnostic mammogram, one breast CPT 77065	$388.55	$1,142.79	$76.30 – $742.81
Foot X-ray, 3 or more views CPT 73630	$255.46	$751.34	$30.45 – $488.37
Hand X-ray, 3 or more views CPT 73130	$263.93	$776.26	$33.27 – $504.57
Knee X-ray, 3 views CPT 73562	$328.53	$966.27	$47.89 – $628.08
Leg or arm vein ultrasound, both sides CPT 93970	$705.92	$2,076.24	$244.41 – $1,349.56
Leg or arm vein ultrasound, one side CPT 93971	$526.93	$1,549.80	$107.53 – $1,007.37
Lower back X-ray, 2 or 3 views CPT 72100	$238.64	$701.89	$34.28 – $456.23
MRI of both breasts, without and with contrast CPT 77049	$1,062.13	$3,123.92	$323.20 – $2,030.55
MRI of the abdomen, without and with contrast CPT 74183	$684.51	$2,013.27	$334.81 – $1,308.63
MRI of the brain, without and with contrast CPT 70553	$2,043.51	$6,010.32	$361.11 – $3,906.71
MRI of the brain, without contrast CPT 70551	$1,399.99	$4,117.62	$239.68 – $2,676.45
MRI of the knee or other leg joint, without contrast CPT 73721	$1,870.05	$5,500.15	$244.41 – $3,575.10
MRI of the lower back (lumbar spine), without contrast CPT 72148	$1,425.49	$4,192.62	$230.76 – $2,725.20
MRI of the mid back (thoracic spine), without contrast CPT 72146	$1,381.76	$4,063.99	$229.57 – $2,641.59
MRI of the neck (cervical spine), without contrast CPT 72141	$1,641.81	$4,828.86	$229.57 – $3,138.76
MRI of the pelvis, without and with contrast CPT 72197	$663.10	$1,950.29	$324.33 – $1,267.69
MRI of the shoulder or other arm joint, without contrast CPT 73221	$1,958.60	$5,760.59	$244.41 – $3,744.38
Neck X-ray, 2 or 3 views CPT 72040	$243.19	$715.27	$31.75 – $464.93
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$542.87	$1,596.67	$107.53 – $1,037.84
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$552.89	$1,626.15	$107.53 – $1,057.00
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$552.89	$1,626.15	$107.53 – $1,057.00
Screening mammogram, both breasts CPT 77067	$408.85	$1,202.51	$80.06 – $781.63
Shoulder X-ray, 2 or more views CPT 73030	$252.15	$741.63	$36.38 – $482.06
Transvaginal pregnancy ultrasound CPT 76817	$358.87	$1,055.49	$92.60 – $686.07
Transvaginal ultrasound CPT 76830	$401.03	$1,179.49	$107.53 – $766.67
Ultrasound of the abdomen, complete CPT 76700	$871.23	$2,562.44	$107.53 – $1,665.59
Ultrasound of the neck or thyroid CPT 76536	$440.40	$1,295.28	$107.53 – $841.93
Wrist X-ray, 3 or more views CPT 73110	$218.60	$642.94	$37.81 – $417.91
X-ray of the lower back, 4 or more views CPT 72110	$370.72	$1,090.35	$60.05 – $708.73

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$128.24	$377.18	$8.21 – $245.17
Blood culture CPT 87040	$96.37	$283.43	$8.28 – $184.23
Blood draw (venipuncture) CPT 36415	$18.31	$53.85	$8.57 – $35.00
BNP test (heart failure) CPT 83880	$73.81	$217.10	$36.10 – $141.12
C-reactive protein (CRP) test CPT 86140	$86.33	$253.90	$4.15 – $165.04
Chlamydia test (DNA/NAAT) CPT 87491	$120.74	$355.13	$28.16 – $230.83
Complete blood count (CBC) with differential CPT 85025	$103.33	$303.91	$7.54 – $197.54
Complete blood count (CBC), automated CPT 85027	$67.90	$199.72	$6.28 – $129.82
Comprehensive metabolic panel (blood test) CPT 80053	$176.34	$518.65	$10.24 – $337.12
COVID-19 PCR test CPT 87635	$69.70	$205.00	$34.09 – $133.25
D-dimer test (blood clots) CPT 85379	$77.15	$226.92	$8.16 – $147.50
Drug screen, instrument chemistry CPT 80307	$184.11	$541.51	$351.98 – $351.98
Ferritin (iron stores) test CPT 82728	$153.69	$452.02	$10.94 – $293.81
Free T4 (thyroid) test CPT 84439	$145.95	$429.27	$7.23 – $279.03
General health panel (blood tests) CPT 80050	$168.30	$495.00	$35.00 – $321.75
Glucose (blood sugar) test CPT 82947	$50.89	$149.68	$3.81 – $97.29
Gonorrhea test (DNA/NAAT) CPT 87591	$120.74	$355.13	$28.16 – $230.83
Hemoglobin A1c test CPT 83036	$93.40	$274.72	$9.42 – $178.57
Hepatitis C antibody test CPT 86803	$258.97	$761.69	$13.84 – $495.10
HIV-1/HIV-2 antigen and antibody test CPT 87389	$67.51	$198.56	$23.36 – $129.06
Iron test CPT 83540	$101.28	$297.87	$5.19 – $193.62
Kidney function panel CPT 80069	$274.94	$808.64	$8.42 – $525.62
Lipase test (pancreas) CPT 83690	$88.31	$259.74	$5.53 – $168.83
Lipid panel, cholesterol and triglycerides CPT 80061	$144.44	$424.81	$12.99 – $276.13
Liver function panel CPT 80076	$286.36	$842.23	$6.56 – $547.45
Magnesium test CPT 83735	$43.42	$127.70	$6.50 – $83.01
Obstetric blood test panel CPT 80055	not posted		$38.36 – $54.88
Partial thromboplastin time (PTT), clotting test CPT 85730	$66.86	$196.64	$5.83 – $127.82
Pregnancy blood test (hCG), quantitative CPT 84702	$183.23	$538.92	$14.60 – $350.30
Prothrombin time (PT/INR), clotting test CPT 85610	$49.48	$145.52	$4.16 – $94.59
PSA (prostate specific antigen), free CPT 84154	$57.38	$168.76	$14.76 – $109.69
PSA (prostate specific antigen), total CPT 84153	$127.98	$376.40	$14.76 – $244.66
Rapid strep test CPT 87880	$82.96	$244.00	$14.55 – $158.60
Sed rate (ESR) test CPT 85652	$6.29	$18.50	$2.62 – $12.03
TB skin test CPT 86580	not posted		$10.93 – $26.04
Thyroid stimulating hormone (TSH) CPT 84443	$145.05	$426.61	$16.30 – $277.30
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$417.34	$1,227.48	$42.15 – $797.86
Troponin test (heart damage) CPT 84484	$130.73	$384.50	$8.11 – $249.93
Urinalysis, automated, with microscope CPT 81001	$64.09	$188.50	$3.07 – $122.53
Urinalysis, automated, without microscope CPT 81003	$44.34	$130.41	$2.18 – $84.77
Urinalysis, manual, with microscope CPT 81000	not posted		$3.54 – $4.62
Urinalysis, manual, without microscope CPT 81002	not posted		$3.06 – $3.99
Urine culture, colony count CPT 87086	$144.70	$425.59	$7.83 – $276.63
Urine pregnancy test CPT 81025	$183.23	$538.92	$7.58 – $350.30
Vitamin B12 test CPT 82607	$154.19	$453.51	$12.10 – $294.78
Vitamin D test CPT 82306	$189.92	$558.59	$23.76 – $363.08

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$749.63	$2,204.80	$244.41 – $1,433.12
ECG tracing only (no interpretation) CPT 93005	$153.36	$451.07	$14.78 – $293.20
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$921.56	$2,710.46	$230.52 – $1,761.80
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$32.77 – $32.77
Holter monitor, up to 48 hours CPT 93224	not posted		$154.67 – $154.67
Left heart catheterization CPT 93452	not posted		$3,252.26 – $8,602.00
Left heart catheterization with coronary angiogram CPT 93458	$10,661.27	$31,356.67	$3,252.26 – $20,381.84
Nuclear stress test (heart perfusion imaging) CPT 78452	$2,278.97	$6,702.85	$595.18 – $4,356.85
Treadmill stress test, complete CPT 93015	not posted		$139.65 – $139.65

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$2,067.00 – $7,595.70
Appendix removal, laparoscopic CPT 44970	not posted		$3,970.00 – $7,566.00
Breast biopsy with ultrasound guidance CPT 19083	$986.57	$2,901.67	$482.55 – $5,099.00
Carpal tunnel release CPT 64721	not posted		$1,100.00 – $3,874.00
Colonoscopy with biopsy CPT 45380	not posted		$1,100.00 – $2,430.00
Colonoscopy with polyp removal (snare) CPT 45385	not posted		$1,100.00 – $2,430.00
Colonoscopy, diagnostic CPT 45378	not posted		$921.87 – $2,430.00
Colposcopy with biopsy CPT 57454	$335.24	$986.00	$163.97 – $818.00
Cystoscopy (bladder scope) CPT 52000	not posted		$674.91 – $1,719.00
Ear tubes, under general anesthesia CPT 69436	not posted		$1,497.79 – $2,880.00
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted		$735.00 – $1,719.00
Gallbladder removal, laparoscopic CPT 47562	not posted		$3,970.00 – $7,566.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$6,904.00 – $13,896.00
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$5,174.00 – $11,069.92
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted		$2,833.00 – $7,344.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$3,970.00 – $7,566.00
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted		$3,239.00 – $7,344.00
Kidney stone shock-wave lithotripsy CPT 50590	$1,808.61	$5,319.44	$884.62 – $7,566.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$2,067.00 – $5,743.00
Lower colon endoscopy with ultrasound CPT 45391	not posted		$1,100.00 – $2,430.00
Nasal endoscopy, diagnostic CPT 31231	$163.94	$482.19	$80.19 – $5,099.00
Prostate biopsy CPT 55700	not posted		$1,100.00 – $2,430.00
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$3,970.00 – $11,069.92
Removal of a breast lump, open surgery CPT 19120	not posted		$2,833.00 – $4,071.55
Rotator cuff repair, arthroscopic CPT 29827	not posted		$2,067.00 – $7,595.70
Screening colonoscopy, average risk HCPCS G0121	not posted		$317.20 – $2,430.00
Screening colonoscopy, high risk HCPCS G0105	not posted		$316.17 – $2,430.00
Septoplasty (nasal septum repair) CPT 30520	not posted		$3,239.00 – $3,874.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$728.00 – $2,833.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$6,904.00 – $13,896.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$2,833.00 – $6,289.93
Total hip replacement CPT 27130	not posted		$5,942.00 – $13,680.88
Total knee replacement CPT 27447	not posted		$5,942.00 – $13,680.88
Upper endoscopy (EGD) with biopsy CPT 43239	not posted		$948.01 – $2,430.00
Upper endoscopy (EGD), diagnostic CPT 43235	not posted		$735.00 – $2,256.00
Vasectomy CPT 55250	not posted		$1,100.00 – $3,874.00

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
Fetal non-stress test CPT 59025	$258.40	$760.00	$126.39 – $494.00
IUD insertion CPT 58300	$134.30	$395.00	$65.69 – $818.00

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$1,122.00 – $11,719.14
C-section, without complications MS-DRG 788	not posted	$8,133.25 – $11,153.30
Chest pain MS-DRG 313	not posted	$6,413.47 – $9,476.81
COPD flare-up, with major complications MS-DRG 190	not posted	$10,095.77 – $14,917.93
COPD flare-up, without complications MS-DRG 192	not posted	$5,818.33 – $8,597.40
Fainting (syncope) MS-DRG 312	not posted	$7,832.99 – $11,574.35
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$8,863.24 – $13,096.70
Heart failure, with major complications MS-DRG 291	not posted	$11,730.15 – $17,332.96
Heart failure, without complications MS-DRG 293	not posted	$4,932.81 – $7,523.84
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$86,763.39 – $128,205.21
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$16,950.65 – $25,046.98
Irregular heartbeat, without complications MS-DRG 310	not posted	$5,029.91 – $7,633.97
Kidney failure, with complications MS-DRG 683	not posted	$7,991.21 – $11,808.15
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$7,215.37 – $10,661.74
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$20,075.00 – $31,448.54
Normal newborn care MS-DRG 795	not posted	$1,796.20 – $3,966.76
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$7,024.79 – $10,380.12
Pneumonia, with complications MS-DRG 194	not posted	$7,371.80 – $10,892.88
Pneumonia, with major complications MS-DRG 193	not posted	$11,846.12 – $17,504.33
Pneumonia, without complications MS-DRG 195	not posted	$5,598.07 – $8,278.26
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$1,122.00 – $18,725.13
Sepsis, with major complications MS-DRG 871	not posted	$17,639.28 – $26,064.54
Sepsis, without major complications MS-DRG 872	not posted	$9,268.69 – $13,695.80
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$7,918.39 – $11,700.55
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$41,256.00 – $41,256.00
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$7,014.90 – $10,365.51
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$9,141.93 – $13,508.50
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$10,776.31 – $15,923.53
Vaginal delivery, without complications MS-DRG 807	not posted	$5,060.00 – $8,427.12
Weight loss surgery, without complications MS-DRG 621	not posted	$13,141.58 – $25,301.00

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$445.79	$1,311.16	$852.25 – $852.25
Lower back nerve root injection with imaging guidance CPT 64483	$1,088.00	$3,200.00	$532.16 – $5,099.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	not posted		$700.24 – $1,719.00
Lower back spinal injection (epidural), without imaging CPT 62322	not posted		$735.00 – $1,719.00

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$2,306.15 – $5,667.00
Eye exam, new patient, comprehensive CPT 92004	not posted	$123.60 – $137.02
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$554.72 – $2,430.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$51.09 – $166.36

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	not posted		$95.05 – $967.00
Sleep study with CPAP titration CPT 95811	$1,132.80	$3,331.76	$554.07 – $2,165.64
Sleep study, overnight in a sleep lab CPT 95810	$1,132.80	$3,331.76	$554.07 – $2,165.64

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$374.73	$1,102.16	$41.99 – $716.40

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$83.34	$245.11	$19.26 – $161.00
Physical therapy evaluation, low complexity CPT 97161	$194.62	$572.41	$67.89 – $372.07
Physical therapy evaluation, moderate complexity CPT 97162	$263.63	$775.39	$75.44 – $504.00
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$97.81	$287.67	$27.06 – $186.99
Therapeutic activities, 15 minutes CPT 97530	$70.69	$207.90	$32.17 – $161.00

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	not posted		$153.96 – $170.84
Family psychotherapy, without the patient, 50 minutes CPT 90846	not posted		$146.10 – $170.84
Group psychotherapy CPT 90853	$187.00	$550.00	$82.60 – $357.50
Psychiatric diagnostic evaluation CPT 90791	$153.29	$450.85	$74.98 – $293.05
Psychotherapy, 30 minutes CPT 90832	$89.19	$262.32	$43.62 – $170.84
Psychotherapy, 45 minutes CPT 90834	not posted		$120.80 – $170.84
Psychotherapy, 60 minutes CPT 90837	not posted		$162.46 – $181.42

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$77.12	$226.81	$33.68 – $393.00
IV hydration, each additional hour CPT 96361	$85.19	$250.57	$21.47 – $393.00
IV hydration, first hour CPT 96360	$219.37	$645.21	$72.21 – $419.39
IV push injection of a drug, first CPT 96374	$131.39	$386.43	$64.26 – $393.00
IV push injection, each additional drug CPT 96375	$123.23	$362.44	$29.75 – $393.00

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$34.53	$101.56	? – $66.01
Dexamethasone injection, per 1 mg HCPCS J1100	$2.14	$6.30	? – $4.10
Fentanyl injection, per 0.1 mg HCPCS J3010	not posted	$1.21	? – $1.35
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	$2.69	$7.92	$5.15 – $5.15
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$2.35	$6.90	$1.02 – $4.49
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$1.25	$3.69	? – $2.40
Morphine injection, up to 10 mg HCPCS J2270	not posted		? – $7.26
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$4.09	$12.03	? – $7.82
Saline IV solution, 1000 ml HCPCS J7030	not posted		$2.34 – $3.86

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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