Mt Sinai Hospital Medical Center

15th Street at California, Chicago, IL 60608 · Acute care hospital · Emergency room

These are Mt Sinai Hospital Medical Center'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.

231 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	$3,147.63	$4,496.62	$480.00 – $10,162.36
Emergency room visit, level 1 (minor) CPT 99281	$381.86	$545.51	$90.36 – $1,232.85
Emergency room visit, level 2 CPT 99282	$516.10	$737.28	$164.54 – $1,666.25
Emergency room visit, level 3 (moderate) CPT 99283	$891.17	$1,273.10	$292.53 – $2,877.21
Emergency room visit, level 4 CPT 99284	$1,430.56	$2,043.65	$447.15 – $4,618.65
Emergency room visit, level 5 (most severe) CPT 99285	$2,524.27	$3,606.10	$480.00 – $8,149.79
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$871.69	$1,245.27	$215.00 – $3,796.00

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	$128.60 – $726.57
New patient office visit, about 30 minutes CPT 99203	$297.84	$425.48	$170.19 – $961.58
New patient office visit, about 45 minutes CPT 99204	$408.08	$582.97	$182.00 – $1,317.51
New patient office visit, about 60 minutes CPT 99205	$550.61	$786.59	$182.00 – $1,777.69
Office consultation, about 40 minutes CPT 99243	$200.53	$286.47	$114.59 – $647.42
Office consultation, about 60 minutes CPT 99244	$291.10	$415.85	$166.34 – $939.82
Office visit, established patient, about 10 to 19 minutes CPT 99212	$225.04	$321.49	$128.60 – $726.57
Office visit, established patient, about 20 to 29 minutes CPT 99213	$233.30	$333.28	$133.31 – $753.21
Office visit, established patient, about 30 to 39 minutes CPT 99214	$297.84	$425.48	$170.19 – $961.58
Office visit, established patient, about 40 to 54 minutes CPT 99215	$408.08	$582.97	$182.00 – $1,317.51
Office visit, established patient, brief (often a nurse) CPT 99211	$168.79	$241.13	$96.45 – $544.95
Preventive checkup, new patient, age 18 to 39 CPT 99385	$179.38	$256.25	$102.50 – $579.13
Preventive checkup, new patient, age 40 to 64 CPT 99386	$205.11	$293.01	$117.20 – $662.20

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$98.24	$140.34	$56.14 – $350.00
Abdominal X-ray, 1 view CPT 74018	$235.56	$336.51	$83.73 – $760.51
Ankle X-ray, 3 or more views CPT 73610	$17.94	$25.63	$10.25 – $337.00
Bone density scan (DEXA), hips and spine CPT 77080	$495.87	$708.38	$118.43 – $1,600.94
Breast ultrasound, one breast, complete CPT 76641	$100.63	$143.76	$57.50 – $324.90
Breast ultrasound, one breast, limited CPT 76642	$100.63	$143.76	$57.50 – $324.90
Chest X-ray, 1 view CPT 71045	$326.32	$466.17	$83.73 – $1,053.54
Chest X-ray, 2 views CPT 71046	$348.85	$498.36	$83.73 – $1,126.29
CT angiogram of the chest (checks for lung clots) CPT 71275	$4,017.78	$5,739.69	$589.91 – $12,971.70
CT angiogram of the head CPT 70496	$3,531.72	$5,045.31	$589.91 – $11,402.40
CT scan of the abdomen and pelvis, with contrast CPT 74177	$4,395.87	$6,279.82	$477.34 – $14,192.39
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$5,219.53	$7,456.47	$477.34 – $16,851.62
CT scan of the abdomen and pelvis, without contrast CPT 74176	$3,960.78	$5,658.26	$477.34 – $12,787.67
CT scan of the abdomen, without contrast CPT 74150	$2,080.18	$2,971.68	$173.77 – $6,716.00
CT scan of the chest, with contrast CPT 71260	$2,309.71	$3,299.58	$477.34 – $7,457.05
CT scan of the chest, without contrast CPT 71250	$1,249.02	$1,784.32	$173.77 – $4,032.56
CT scan of the head, without contrast CPT 70450	$1,605.34	$2,293.34	$477.34 – $5,182.95
CT scan of the neck (cervical spine), without contrast CPT 72125	$2,073.44	$2,962.05	$173.77 – $6,694.23
CT scan of the pelvis, with contrast CPT 72193	$2,309.71	$3,299.58	$477.34 – $7,457.05
CT scan of the sinuses or face, without contrast CPT 70486	$2,020.16	$2,885.94	$173.77 – $6,522.22
Diagnostic mammogram, both breasts CPT 77066	$531.13	$758.76	$73.28 – $1,714.80
Diagnostic mammogram, one breast CPT 77065	$440.36	$629.09	$73.28 – $1,421.74
Foot X-ray, 3 or more views CPT 73630	$14.35	$20.50	$8.20 – $337.00
Hand X-ray, 3 or more views CPT 73130	$17.94	$25.63	$10.25 – $337.00
Knee X-ray, 3 views CPT 73562	$18.30	$26.14	$10.46 – $87.92
Leg or arm vein ultrasound, both sides CPT 93970	$402.13	$574.47	$229.79 – $1,298.30
Leg or arm vein ultrasound, one side CPT 93971	$773.43	$1,104.90	$161.07 – $2,497.07
Lower back X-ray, 2 or 3 views CPT 72100	$432.83	$618.33	$83.73 – $1,397.43
MRI of both breasts, without and with contrast CPT 77049	$4,008.78	$5,726.83	$642.10 – $12,942.64
MRI of the abdomen, without and with contrast CPT 74183	$4,960.73	$7,086.75	$642.10 – $16,016.06
MRI of the brain, without and with contrast CPT 70553	$4,099.58	$5,856.54	$642.10 – $13,235.78
MRI of the brain, without contrast CPT 70551	$2,760.55	$3,943.64	$374.86 – $8,912.63
MRI of the knee or other leg joint, without contrast CPT 73721	$170.52	$243.60	$97.44 – $550.54
MRI of the lower back (lumbar spine), without contrast CPT 72148	$3,098.13	$4,425.90	$374.86 – $10,002.53
MRI of the mid back (thoracic spine), without contrast CPT 72146	$1,508.54	$2,155.06	$374.86 – $4,870.44
MRI of the neck (cervical spine), without contrast CPT 72141	$2,951.08	$4,215.83	$374.86 – $9,527.78
MRI of the pelvis, without and with contrast CPT 72197	$4,284.08	$6,120.12	$642.10 – $13,831.47
MRI of the shoulder or other arm joint, without contrast CPT 73221	$170.52	$243.60	$97.44 – $550.54
Neck X-ray, 2 or 3 views CPT 72040	$369.08	$527.26	$83.73 – $1,191.61
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$730.67	$1,043.81	$249.94 – $2,359.01
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$675.89	$965.55	$151.06 – $2,182.14
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$644.39	$920.55	$151.06 – $2,080.44
Screening mammogram, both breasts CPT 77067	$461.36	$659.08	$73.28 – $1,489.52
Shoulder X-ray, 2 or more views CPT 73030	$18.30	$26.14	$10.46 – $337.00
Transvaginal pregnancy ultrasound CPT 76817	$613.64	$876.63	$151.06 – $1,981.18
Transvaginal ultrasound CPT 76830	$662.40	$946.28	$161.07 – $2,138.59
Ultrasound of the abdomen, complete CPT 76700	$1,460.54	$2,086.49	$249.94 – $4,715.47
Ultrasound of the neck or thyroid CPT 76536	$696.16	$994.51	$161.07 – $2,247.59
Wrist X-ray, 3 or more views CPT 73110	$16.51	$23.58	$9.43 – $337.00
X-ray of the lower back, 4 or more views CPT 72110	$476.35	$680.50	$83.73 – $1,537.93

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$207.79	$296.84	$12.08 – $670.86
Blood culture CPT 87040	$198.82	$284.03	$10.64 – $641.91
Blood draw (venipuncture) CPT 36415	$32.29	$46.13	$3.43 – $104.25
BNP test (heart failure) CPT 83880	$227.30	$324.72	$39.66 – $733.87
C-reactive protein (CRP) test CPT 86140	$67.52	$96.45	$5.00 – $217.98
Chlamydia test (DNA/NAAT) CPT 87491	$176.29	$251.84	$38.94 – $569.16
Complete blood count (CBC) with differential CPT 85025	$96.79	$138.27	$8.20 – $312.49
Complete blood count (CBC), automated CPT 85027	$96.79	$138.27	$8.20 – $312.49
Comprehensive metabolic panel (blood test) CPT 80053	$269.31	$384.73	$12.08 – $869.49
COVID-19 PCR test CPT 87635	$120.04	$171.48	$34.30 – $387.54
D-dimer test (blood clots) CPT 85379	$108.77	$155.39	$5.41 – $351.18
Drug screen, instrument chemistry CPT 80307	$249.80	$356.85	$71.37 – $806.48
Ferritin (iron stores) test CPT 82728	$183.04	$261.48	$15.77 – $590.94
Free T4 (thyroid) test CPT 84439	$133.53	$190.75	$17.21 – $431.10
General health panel (blood tests) CPT 80050	$351.58	$502.25	$12.08 – $1,135.09
Glucose (blood sugar) test CPT 82947	$76.52	$109.32	$4.30 – $247.06
Gonorrhea test (DNA/NAAT) CPT 87591	$115.27	$164.67	$38.94 – $372.15
Hemoglobin A1c test CPT 83036	$94.53	$135.04	$7.30 – $305.19
Hepatitis C antibody test CPT 86803	$177.04	$252.92	$14.78 – $571.60
HIV-1/HIV-2 antigen and antibody test CPT 87389	$69.16	$98.80	$10.64 – $223.29
Iron test CPT 83540	$153.04	$218.63	$7.30 – $494.10
Kidney function panel CPT 80069	$250.55	$357.93	$12.08 – $808.92
Lipase test (pancreas) CPT 83690	$95.28	$136.12	$7.30 – $307.63
Lipid panel, cholesterol and triglycerides CPT 80061	$197.32	$281.88	$12.08 – $637.05
Liver function panel CPT 80076	$336.08	$480.11	$12.08 – $1,085.05
Magnesium test CPT 83735	$99.05	$141.50	$7.30 – $319.79
Obstetric blood test panel CPT 80055	$456.11	$651.59	$12.08 – $1,472.59
Partial thromboplastin time (PTT), clotting test CPT 85730	$133.53	$190.75	$5.41 – $431.10
Pregnancy blood test (hCG), quantitative CPT 84702	$221.31	$316.16	$17.94 – $714.52
Prothrombin time (PT/INR), clotting test CPT 85610	$91.52	$130.74	$5.41 – $295.47
PSA (prostate specific antigen), free CPT 84154	$96.06	$137.23	$15.77 – $310.14
PSA (prostate specific antigen), total CPT 84153	$271.57	$387.96	$15.77 – $876.79
Rapid strep test CPT 87880	$28.52	$40.74	$6.73 – $92.07
Sed rate (ESR) test CPT 85652	$50.26	$71.80	$1.94 – $162.27
TB skin test CPT 86580	$25.25	$36.07	$14.43 – $81.52
Thyroid stimulating hormone (TSH) CPT 84443	$246.82	$352.60	$17.94 – $796.88
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$605.39	$864.84	$54.35 – $1,954.54
Troponin test (heart damage) CPT 84484	$48.03	$68.62	$8.56 – $155.08
Urinalysis, automated, with microscope CPT 81001	$70.53	$100.76	$3.19 – $227.72
Urinalysis, automated, without microscope CPT 81003	$45.70	$65.29	$1.47 – $147.56
Urinalysis, manual, with microscope CPT 81000	$18.76	$26.80	$1.08 – $60.57
Urinalysis, manual, without microscope CPT 81002	$15.03	$21.47	? – $48.52
Urine culture, colony count CPT 87086	$42.27	$60.38	$10.64 – $136.46
Urine pregnancy test CPT 81025	$84.02	$120.03	$4.06 – $271.27
Vitamin B12 test CPT 82607	$222.07	$317.24	$17.94 – $716.96
Vitamin D test CPT 82306	$157.54	$225.05	$39.66 – $508.61

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$773.43	$1,104.90	$249.94 – $2,497.07
ECG tracing only (no interpretation) CPT 93005	$221.31	$316.16	$39.39 – $714.52
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$2,350.96	$3,358.52	$692.75 – $7,590.26
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	$73.74	$105.34	$39.39 – $238.07
Holter monitor, up to 48 hours CPT 93224	$262.00	$374.29	$98.78 – $845.90
Left heart catheterization CPT 93452	$8,462.41	$12,089.16	$2,790.00 – $27,321.50
Left heart catheterization with coronary angiogram CPT 93458	$8,462.41	$12,089.16	$2,790.00 – $27,321.50
Nuclear stress test (heart perfusion imaging) CPT 78452	$2,468.74	$3,526.77	$1,218.00 – $7,970.50
Treadmill stress test, complete CPT 93015	$175.83	$251.19	$100.48 – $567.69

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$1,633.67	$2,333.82	$933.53 – $8,764.20
Appendix removal, laparoscopic CPT 44970	$2,119.26	$3,027.51	$1,211.00 – $7,119.66
Breast biopsy with ultrasound guidance CPT 19083	$1,051.30	$1,501.86	$600.74 – $3,394.20
Carpal tunnel release CPT 64721	$674.58	$963.69	$385.48 – $2,180.95
Colonoscopy with biopsy CPT 45380	$1,051.86	$1,502.65	$525.93 – $3,395.99
Colonoscopy with polyp removal (snare) CPT 45385	$1,340.02	$1,914.31	$670.01 – $4,326.34
Colonoscopy, diagnostic CPT 45378	$977.45	$1,396.35	$177.87 – $1,186.90
Colposcopy with biopsy CPT 57454	$516.67	$738.10	$294.50 – $1,898.00
Cystoscopy (bladder scope) CPT 52000	$1,076.84	$1,538.34	$613.80 – $3,845.85
Ear tubes, under general anesthesia CPT 69436	$583.11	$833.01	$333.20 – $2,328.96
Flexible sigmoidoscopy, diagnostic CPT 45330	$1,431.05	$2,044.36	$480.00 – $4,620.25
Gallbladder removal, laparoscopic CPT 47562	$3,357.19	$4,795.98	$1,918.39 – $10,838.91
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	$4,095.80	$5,851.14	$1,957.47 – $13,223.58
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$2,466.70	$3,523.86	$1,409.54 – $11,391.10
Hysteroscopy with biopsy or polyp removal CPT 58558	$536.27	$766.10	$306.44 – $3,589.83
Inguinal (groin) hernia repair, laparoscopic CPT 49650	$1,440.83	$2,058.33	$823.33 – $6,478.50
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$1,292.45	$1,846.35	$738.54 – $5,563.33
Kidney stone shock-wave lithotripsy CPT 50590	$1,229.51	$1,756.44	$702.58 – $4,650.54
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$1,055.69	$1,508.13	$603.25 – $3,506.34
Lower colon endoscopy with ultrasound CPT 45391	$714.65	$1,020.93	$408.37 – $2,307.30
Nasal endoscopy, diagnostic CPT 31231	$561.12	$801.60	$213.90 – $3,796.00
Prostate biopsy CPT 55700	$3,014.87	$4,306.95	$1,718.47 – $10,767.38
Prostate removal, laparoscopic or robotic CPT 55866	$4,347.85	$6,211.21	$2,484.48 – $14,037.33
Removal of a breast lump, open surgery CPT 19120	$1,147.17	$1,638.82	$655.53 – $4,195.85
Rotator cuff repair, arthroscopic CPT 29827	$1,784.25	$2,548.93	$1,019.57 – $8,764.20
Screening colonoscopy, average risk HCPCS G0121	$667.63	$953.76	$333.82 – $2,155.50
Screening colonoscopy, high risk HCPCS G0105	$650.07	$928.67	$325.03 – $2,098.79
Septoplasty (nasal septum repair) CPT 30520	$967.32	$1,381.89	$552.76 – $4,240.19
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	$1,095.03	$1,564.33	$173.56 – $3,535.39
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	$2,612.71	$3,732.44	$1,232.99 – $8,435.31
Tonsil and adenoid removal, under age 12 CPT 42820	$981.23	$1,401.76	$560.70 – $6,343.80
Total hip replacement CPT 27130	$2,396.63	$3,423.76	$1,369.50 – $14,510.37
Total knee replacement CPT 27447	$2,560.38	$3,657.68	$1,463.07 – $14,510.37
Upper endoscopy (EGD) with biopsy CPT 43239	$1,804.12	$2,577.31	$480.00 – $5,824.72
Upper endoscopy (EGD), diagnostic CPT 43235	$948.70	$1,355.28	$540.76 – $3,388.20
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	$549.72 – $4,129.08
Fetal non-stress test CPT 59025	$732.89	$1,046.99	$182.00 – $2,366.20
IUD insertion CPT 58300	$482.35	$689.07	$182.00 – $1,557.30
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	$2,838.48	$4,054.97	$1,621.99 – $9,164.23
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	$2,669.42	$3,813.46	$1,525.38 – $8,618.42

Hospital stays

Service	Cash price	Gross charge	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$17,209.40	$24,584.86	$800.97 – $65,999.43
C-section, without complications MS-DRG 788	$26,538.95	$37,912.78	$6,279.14 – $61,438.19
Chest pain MS-DRG 313	$15,267.10	$21,810.14	$3,357.00 – $34,387.60
COPD flare-up, with major complications MS-DRG 190	$20,003.46	$28,576.37	$7,587.75 – $79,948.99
COPD flare-up, without complications MS-DRG 192	$12,221.26	$17,458.94	$3,357.00 – $31,892.89
Fainting (syncope) MS-DRG 312	$21,489.43	$30,699.19	$2,249.00 – $51,434.07
Gastrointestinal bleeding, with complications MS-DRG 378	$32,207.30	$46,010.43	$6,717.80 – $81,430.73
Heart failure, with major complications MS-DRG 291	$27,653.87	$39,505.53	$8,794.03 – $85,598.37
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	$342,412.81	$489,161.16	$26,247.44 – $538,695.86
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	$57,640.90	$82,344.14	$13,212.97 – $117,012.59
Irregular heartbeat, without complications MS-DRG 310	$15,439.47	$22,056.38	$3,644.00 – $33,823.42
Kidney failure, with complications MS-DRG 683	$24,819.97	$35,457.09	$5,999.23 – $62,271.21
Kidney or urinary tract infection, without major complications MS-DRG 690	$19,562.55	$27,946.51	$5,545.08 – $68,408.25
Normal newborn care MS-DRG 795	$10,258.59	$14,655.12	$1,368.63 – $76,273.17
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$21,057.51	$30,082.16	$5,330.67 – $70,447.73
Pneumonia, with complications MS-DRG 194	$19,658.03	$28,082.90	$5,520.42 – $58,811.46
Pneumonia, with major complications MS-DRG 193	$30,936.57	$44,195.10	$2,249.00 – $90,287.94
Pneumonia, without complications MS-DRG 195	$8,796.28	$12,566.11	$3,357.00 – $27,906.81
Psychoses (inpatient psychiatric stay) MS-DRG 885	$16,368.68	$23,383.83	$2,249.00 – $73,227.83
Sepsis, with major complications MS-DRG 871	$51,956.81	$74,224.01	$2,249.00 – $108,162.62
Sepsis, without major complications MS-DRG 872	$23,539.89	$33,628.41	$7,009.61 – $61,708.00
Skin infection (cellulitis), without major complications MS-DRG 603	$17,754.48	$25,363.55	$5,965.67 – $65,789.99
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$16,526.66	$23,609.51	$5,340.26 – $57,535.27
Stroke, with complications or clot-busting drug MS-DRG 65	$34,953.44	$49,933.49	$6,920.56 – $75,679.01
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	$41,283.03	$58,975.76	$5,229.70 – $85,176.26
Vaginal delivery, without complications MS-DRG 807	$10,576.08	$15,108.68	$4,382.59 – $50,778.24
Weight loss surgery, without complications MS-DRG 621	$55,905.22	$79,864.60	$3,942.96 – $97,564.30

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	$328.94 – $2,089.73
Lower back nerve root injection with imaging guidance CPT 64483	$2,855.83	$4,079.76	$947.82 – $10,199.40
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$1,109.56	$1,585.08	$632.45 – $3,962.70
Lower back spinal injection (epidural), without imaging CPT 62322	$2,618.77	$3,741.10	$947.82 – $9,352.75

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	$2,694.13	$3,848.75	$1,539.50 – $8,698.18
Eye exam, new patient, comprehensive CPT 92004	$225.04	$321.49	$128.60 – $726.57
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$1,184.86	$1,692.66	$589.39 – $3,825.41

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$532.64	$760.91	$121.32 – $1,719.66

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$489.87	$699.82	$199.00 – $1,581.59
Sleep study with CPAP titration CPT 95811	$3,161.88	$4,516.97	$928.00 – $10,208.35
Sleep study, overnight in a sleep lab CPT 95810	$3,161.88	$4,516.97	$928.00 – $10,208.35

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$241.55	$345.07	$82.02 – $779.86

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$40.62	$58.03	$23.21 – $242.59
Physical therapy evaluation, low complexity CPT 97161	$133.75	$191.07	$76.43 – $431.82
Physical therapy evaluation, moderate complexity CPT 97162	$133.75	$191.07	$76.43 – $431.82
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$51.42	$73.45	$29.38 – $242.59
Therapeutic activities, 15 minutes CPT 97530	$113.30	$161.85	$37.50 – $365.78

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$250.89	$358.42	$143.37 – $810.03
Family psychotherapy, without the patient, 50 minutes CPT 90846	$250.89	$358.42	$143.37 – $810.03
Group psychotherapy CPT 90853	$130.61	$186.59	$74.64 – $421.69
Psychiatric diagnostic evaluation CPT 90791	$343.57	$490.82	$196.33 – $1,109.25
Psychotherapy, 30 minutes CPT 90832	$250.89	$358.42	$143.37 – $810.03
Psychotherapy, 45 minutes CPT 90834	$250.89	$358.42	$143.37 – $810.03
Psychotherapy, 60 minutes CPT 90837	$250.89	$358.42	$143.37 – $810.03

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$139.55	$199.36	$68.95 – $450.55
IV hydration, each additional hour CPT 96361	$414.11	$591.58	$90.10 – $1,336.97
IV hydration, first hour CPT 96360	$414.11	$591.58	$236.63 – $1,336.97
IV push injection of a drug, first CPT 96374	$414.11	$591.58	$68.95 – $1,336.97
IV push injection, each additional drug CPT 96375	$414.11	$591.58	$68.95 – $1,336.97

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$34.98	$49.97	$19.99 – $112.93
Dexamethasone injection, per 1 mg HCPCS J1100	$4.58	$6.54	$1.72 – $14.78
Fentanyl injection, per 0.1 mg HCPCS J3010	$10.13	$14.48	$4.34 – $32.71
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$9.88	$14.11	$3.70 – $31.89
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$2.78	$3.97	$1.59 – $8.98
Morphine injection, up to 10 mg HCPCS J2270	$14.96	$21.37	$8.55 – $48.30
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$5.68	$8.11	$2.13 – $18.33
Propofol injection, per 10 mg HCPCS J2704	$1.03	$1.47	? – $3.32
Saline IV solution, 1000 ml HCPCS J7030	$9.88	$14.11	$5.64 – $31.89

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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