Northwestern Medicine Central Dupage Hospital
25 North Winfield Road, Winfield, IL 60190 · Acute care hospital · Emergency room
These are Northwestern Medicine Central Dupage Hospital's own posted figures from its standard-charges file dated April 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
215 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 | $3,147.90 | $4,497.00 | $643.07 – $4,497.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $399.70 | $571.00 | |
| Emergency room visit, level 2 CPT 99282 | $757.40 | $1,082.00 | |
| Emergency room visit, level 3 (moderate) CPT 99283 | $1,808.97 | $2,584.24 | |
| Emergency room visit, level 4 CPT 99284 | $4,365.20 | $6,236.00 | |
| Emergency room visit, level 5 (most severe) CPT 99285 | $9,731.92 | $13,902.74 | $2,429.00 – $3,238.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $23,086.46 | $32,980.66 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | $215.60 | $308.00 | $21.25 – $308.00 |
| New patient office visit, about 30 minutes CPT 99203 | $380.10 | $543.00 | $37.47 – $543.00 |
| New patient office visit, about 45 minutes CPT 99204 | $438.20 | $626.00 | $43.19 – $626.00 |
| New patient office visit, about 60 minutes CPT 99205 | $640.50 | $915.00 | $63.14 – $915.00 |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $196.00 | $280.00 | $19.32 – $280.00 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $291.20 | $416.00 | $28.70 – $416.00 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $398.30 | $569.00 | $39.26 – $569.00 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $609.00 | $870.00 | $60.03 – $870.00 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $158.90 | $227.00 | $15.66 – $227.00 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $125.30 | $179.00 | $12.35 – $179.00 |
| Abdominal X-ray, 1 view CPT 74018 | $396.90 | $567.00 | $39.12 – $567.00 |
| Ankle X-ray, 3 or more views CPT 73610 | $541.80 | $774.00 | $53.41 – $774.00 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $637.00 | $910.00 | $62.79 – $910.00 |
| Breast ultrasound, one breast, complete CPT 76641 | $532.00 | $760.00 | $52.44 – $760.00 |
| Breast ultrasound, one breast, limited CPT 76642 | $438.90 | $627.00 | $43.26 – $627.00 |
| Chest X-ray, 1 view CPT 71045 | $537.60 | $768.00 | $52.99 – $768.00 |
| Chest X-ray, 2 views CPT 71046 | $674.10 | $963.00 | $66.45 – $963.00 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $3,502.80 | $5,004.00 | $345.28 – $5,004.00 |
| CT angiogram of the head CPT 70496 | $3,656.10 | $5,223.00 | $360.39 – $5,223.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $6,049.40 | $8,642.00 | $596.30 – $8,642.00 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $7,105.70 | $10,151.00 | $700.42 – $10,151.00 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $4,802.00 | $6,860.00 | $473.34 – $6,860.00 |
| CT scan of the abdomen, without contrast CPT 74150 | $2,576.00 | $3,680.00 | $253.92 – $3,680.00 |
| CT scan of the chest, with contrast CPT 71260 | $3,173.80 | $4,534.00 | $312.85 – $4,534.00 |
| CT scan of the chest, without contrast CPT 71250 | $2,611.00 | $3,730.00 | $257.37 – $3,730.00 |
| CT scan of the head, without contrast CPT 70450 | $2,474.50 | $3,535.00 | $243.92 – $3,535.00 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $3,168.20 | $4,526.00 | $312.29 – $4,526.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $2,907.80 | $4,154.00 | $286.63 – $4,154.00 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $2,606.10 | $3,723.00 | $256.89 – $3,723.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $513.80 | $734.00 | $50.65 – $734.00 |
| Diagnostic mammogram, one breast CPT 77065 | $464.80 | $664.00 | $45.82 – $664.00 |
| Foot X-ray, 3 or more views CPT 73630 | $594.30 | $849.00 | $58.58 – $849.00 |
| Hand X-ray, 3 or more views CPT 73130 | $547.40 | $782.00 | $53.96 – $782.00 |
| Knee X-ray, 3 views CPT 73562 | $598.50 | $855.00 | $59.00 – $855.00 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $2,626.40 | $3,752.00 | $258.89 – $3,752.00 |
| Leg or arm vein ultrasound, one side CPT 93971 | $1,673.00 | $2,390.00 | $164.91 – $2,390.00 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $651.70 | $931.00 | $64.24 – $931.00 |
| MRI of both breasts, without and with contrast CPT 77049 | $4,099.20 | $5,856.00 | $404.06 – $5,856.00 |
| MRI of the abdomen, without and with contrast CPT 74183 | $4,385.50 | $6,265.00 | $432.29 – $6,265.00 |
| MRI of the brain, without and with contrast CPT 70553 | $5,385.10 | $7,693.00 | $530.82 – $7,693.00 |
| MRI of the brain, without contrast CPT 70551 | $3,887.10 | $5,553.00 | $383.16 – $5,553.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $3,835.30 | $5,479.00 | $378.05 – $5,479.00 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $3,837.40 | $5,482.00 | $378.26 – $5,482.00 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $3,809.40 | $5,442.00 | $375.50 – $5,442.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $4,171.30 | $5,959.00 | $411.17 – $5,959.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $4,765.60 | $6,808.00 | $469.75 – $6,808.00 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $3,591.70 | $5,131.00 | $354.04 – $5,131.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $665.70 | $951.00 | $65.62 – $951.00 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $1,509.90 | $2,157.00 | $148.83 – $2,157.00 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $1,206.10 | $1,723.00 | $118.89 – $1,723.00 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $940.80 | $1,344.00 | $92.74 – $1,344.00 |
| Screening mammogram, both breasts CPT 77067 | $523.60 | $748.00 | $51.61 – $748.00 |
| Shoulder X-ray, 2 or more views CPT 73030 | $623.00 | $890.00 | $61.41 – $890.00 |
| Transvaginal pregnancy ultrasound CPT 76817 | $749.00 | $1,070.00 | $73.83 – $1,070.00 |
| Transvaginal ultrasound CPT 76830 | $1,079.40 | $1,542.00 | $106.40 – $1,542.00 |
| Ultrasound of the abdomen, complete CPT 76700 | $1,772.40 | $2,532.00 | $174.71 – $2,532.00 |
| Ultrasound of the neck or thyroid CPT 76536 | $1,343.30 | $1,919.00 | $132.41 – $1,919.00 |
| Wrist X-ray, 3 or more views CPT 73110 | $492.80 | $704.00 | $48.58 – $704.00 |
| X-ray of the lower back, 4 or more views CPT 72110 | $909.30 | $1,299.00 | $89.63 – $1,299.00 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $219.80 | $314.00 | $21.67 – $314.00 |
| Blood culture CPT 87040 | $739.90 | $1,057.00 | $72.93 – $1,057.00 |
| Blood draw (venipuncture) CPT 36415 | $935.90 | $1,337.00 | $1.50 – $13.64 |
| BNP test (heart failure) CPT 83880 | $329.00 | $470.00 | $32.43 – $470.00 |
| C-reactive protein (CRP) test CPT 86140 | $191.80 | $274.00 | $18.91 – $274.00 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $225.40 | $322.00 | $22.22 – $322.00 |
| Complete blood count (CBC) with differential CPT 85025 | $153.30 | $219.00 | $15.11 – $219.00 |
| Complete blood count (CBC), automated CPT 85027 | $122.50 | $175.00 | $12.08 – $175.00 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $306.60 | $438.00 | $30.22 – $438.00 |
| COVID-19 PCR test CPT 87635 | $125.30 | $179.00 | $12.35 – $179.00 |
| D-dimer test (blood clots) CPT 85379 | $181.30 | $259.00 | $17.87 – $259.00 |
| Drug screen, instrument chemistry CPT 80307 | $693.70 | $991.00 | $68.38 – $991.00 |
| Ferritin (iron stores) test CPT 82728 | $144.20 | $206.00 | $14.21 – $206.00 |
| Free T4 (thyroid) test CPT 84439 | $121.10 | $173.00 | $11.94 – $173.00 |
| Glucose (blood sugar) test CPT 82947 | $99.40 | $142.00 | $9.80 – $142.00 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $231.00 | $330.00 | $22.77 – $330.00 |
| Hemoglobin A1c test CPT 83036 | $116.90 | $167.00 | $11.52 – $167.00 |
| Hepatitis C antibody test CPT 86803 | $322.70 | $461.00 | $31.81 – $461.00 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $210.00 | $300.00 | $20.70 – $300.00 |
| Iron test CPT 83540 | $79.10 | $113.00 | $7.80 – $113.00 |
| Kidney function panel CPT 80069 | $277.90 | $397.00 | $27.39 – $397.00 |
| Lipase test (pancreas) CPT 83690 | $263.20 | $376.00 | $25.94 – $376.00 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $184.10 | $263.00 | $18.15 – $263.00 |
| Liver function panel CPT 80076 | $271.60 | $388.00 | $26.77 – $388.00 |
| Magnesium test CPT 83735 | $81.20 | $116.00 | $8.00 – $116.00 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $133.00 | $190.00 | $13.11 – $190.00 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $341.60 | $488.00 | $33.67 – $488.00 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $89.60 | $128.00 | $8.83 – $128.00 |
| PSA (prostate specific antigen), free CPT 84154 | $178.50 | $255.00 | $17.60 – $255.00 |
| PSA (prostate specific antigen), total CPT 84153 | $254.10 | $363.00 | $25.05 – $363.00 |
| Rapid strep test CPT 87880 | $133.70 | $191.00 | $13.18 – $191.00 |
| Sed rate (ESR) test CPT 85652 | $99.40 | $142.00 | $9.80 – $142.00 |
| TB skin test CPT 86580 | $32.20 | $46.00 | $3.17 – $46.00 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $162.40 | $232.00 | $16.01 – $232.00 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $12,315.40 | $17,593.43 | $72.29 – $100.00 |
| Troponin test (heart damage) CPT 84484 | $170.80 | $244.00 | $16.84 – $244.00 |
| Urinalysis, automated, with microscope CPT 81001 | $140.00 | $200.00 | $13.80 – $200.00 |
| Urinalysis, automated, without microscope CPT 81003 | $85.40 | $122.00 | $8.42 – $122.00 |
| Urinalysis, manual, without microscope CPT 81002 | $85.40 | $122.00 | $8.42 – $122.00 |
| Urine culture, colony count CPT 87086 | $192.50 | $275.00 | $18.98 – $275.00 |
| Urine pregnancy test CPT 81025 | $142.10 | $203.00 | $14.01 – $203.00 |
| Vitamin B12 test CPT 82607 | $135.10 | $193.00 | $13.32 – $193.00 |
| Vitamin D test CPT 82306 | $191.10 | $273.00 | $18.84 – $273.00 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $2,336.60 | $3,338.00 | $230.32 – $3,338.00 |
| ECG tracing only (no interpretation) CPT 93005 | $304.50 | $435.00 | $30.02 – $435.00 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $2,713.90 | $3,877.00 | $554.41 – $2,981.41 |
| Left heart catheterization CPT 93452 | $10,777.90 | $15,397.00 | $1,062.39 – $15,397.00 |
| Left heart catheterization with coronary angiogram CPT 93458 | $12,549.60 | $17,928.00 | $1,237.03 – $17,928.00 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $5,866.70 | $8,381.00 | $578.29 – $8,381.00 |
| Treadmill stress test, complete CPT 93015 | $431.20 | $616.00 | $42.50 – $616.00 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $98,326.19 | $140,465.98 | |
| Appendix removal, laparoscopic CPT 44970 | $30,573.64 | $43,676.63 | |
| Breast biopsy with ultrasound guidance CPT 19083 | $4,846.80 | $6,924.00 | $3,475.85 – $6,924.00 |
| Carpal tunnel release CPT 64721 | $17,726.43 | $25,323.47 | |
| Colonoscopy with biopsy CPT 45380 | $12,839.87 | $18,342.67 | |
| Colonoscopy with polyp removal (snare) CPT 45385 | $12,858.85 | $18,369.79 | |
| Colonoscopy, diagnostic CPT 45378 | $5,304.60 | $7,578.00 | |
| Colposcopy with biopsy CPT 57454 | $14,458.58 | $20,655.11 | |
| Cystoscopy (bladder scope) CPT 52000 | $13,450.78 | $19,215.40 | |
| Ear tubes, under general anesthesia CPT 69436 | $10,652.35 | $15,217.64 | |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $5,618.90 | $8,027.00 | |
| Gallbladder removal, laparoscopic CPT 47562 | $37,006.57 | $52,866.53 | |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | $103,066.49 | $147,237.84 | $425.00 – $695.00 |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | $68,263.20 | $97,518.86 | |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $24,166.37 | $34,523.39 | |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $41,038.61 | $58,626.59 | |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $19,604.89 | $28,006.99 | |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $25,663.99 | $36,662.84 | |
| Lower colon endoscopy with ultrasound CPT 45391 | $6,971.22 | $9,958.89 | |
| Nasal endoscopy, diagnostic CPT 31231 | $16,095.89 | $22,994.13 | |
| Prostate biopsy CPT 55700 | $5,028.80 | $7,184.00 | $3,606.37 – $7,184.00 |
| Prostate removal, laparoscopic or robotic CPT 55866 | $96,291.40 | $137,559.14 | $425.00 – $695.00 |
| Rotator cuff repair, arthroscopic CPT 29827 | $63,200.32 | $90,286.17 | |
| Screening colonoscopy, average risk HCPCS G0121 | $2,878.40 | $4,112.00 | $283.73 – $4,112.00 |
| Screening colonoscopy, high risk HCPCS G0105 | $2,898.00 | $4,140.00 | $285.66 – $4,140.00 |
| Septoplasty (nasal septum repair) CPT 30520 | $34,831.19 | $49,758.84 | |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $54,262.96 | $77,518.51 | |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | $87,815.83 | $125,451.19 | $425.00 – $695.00 |
| Tonsil and adenoid removal, under age 12 CPT 42820 | $12,729.41 | $18,184.87 | |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $11,894.69 | $16,992.41 | |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $8,412.00 | $12,017.14 | |
| Vasectomy CPT 55250 | $15,443.07 | $22,061.53 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $1,442.70 | $2,061.00 | $23.21 – $23.21 |
| IUD insertion CPT 58300 | $27,174.10 | $38,820.14 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $24,229.45 | $34,613.50 | $1,217.23 – $27,135.51 |
| C-section, without complications MS-DRG 788 | $33,782.08 | $48,260.11 | $6,822.66 – $6,822.66 |
| Chest pain MS-DRG 313 | $31,186.75 | $44,552.50 | $5,123.40 – $11,970.00 |
| COPD flare-up, with major complications MS-DRG 190 | $30,861.60 | $44,088.00 | $7,794.73 – $11,886.96 |
| COPD flare-up, without complications MS-DRG 192 | $22,442.17 | $32,060.24 | $4,568.36 – $10,673.25 |
| Fainting (syncope) MS-DRG 312 | $32,792.72 | $46,846.74 | $6,202.16 – $14,490.35 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $35,606.19 | $50,865.99 | $6,978.50 – $16,304.14 |
| Heart failure, with major complications MS-DRG 291 | $35,207.72 | $50,296.74 | $9,135.31 – $21,343.18 |
| Heart failure, without complications MS-DRG 293 | $14,165.90 | $20,237.00 | $4,027.56 – $9,409.75 |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | $374,534.03 | $535,048.60 | $69,612.77 – $162,639.05 |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | $89,428.80 | $127,755.43 | $13,725.73 – $32,067.96 |
| Irregular heartbeat, without complications MS-DRG 310 | $24,576.65 | $35,109.50 | $4,028.27 – $9,411.41 |
| Kidney failure, with complications MS-DRG 683 | $25,410.17 | $36,300.24 | $6,232.05 – $14,560.18 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $25,290.47 | $36,129.24 | $1,217.23 – $24,882.41 |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | $147,976.78 | $211,395.40 | $17,371.88 – $40,586.61 |
| Normal newborn care MS-DRG 795 | $8,411.02 | $12,015.74 | $1,421.74 – $3,321.68 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $21,750.22 | $31,071.74 | $5,537.54 – $12,937.58 |
| Pneumonia, with complications MS-DRG 194 | $23,802.97 | $34,004.24 | $5,734.65 – $13,398.09 |
| Pneumonia, with major complications MS-DRG 193 | $32,900.87 | $47,001.24 | $9,353.05 – $21,851.90 |
| Pneumonia, without complications MS-DRG 195 | $15,103.37 | $21,576.24 | $4,472.30 – $10,448.81 |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | $37,527.52 | $53,610.74 | $908.95 – $23,221.80 |
| Sepsis, with major complications MS-DRG 871 | $55,441.40 | $79,202.00 | $13,822.50 – $32,294.06 |
| Sepsis, without major complications MS-DRG 872 | $32,898.95 | $46,998.50 | $7,281.63 – $17,012.36 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $22,782.90 | $32,547.00 | $6,197.18 – $14,478.71 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $25,828.25 | $36,897.50 | $5,547.50 – $12,960.85 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $45,400.77 | $64,858.24 | $1,217.23 – $31,054.60 |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | $47,233.49 | $67,476.41 | $8,828.61 – $20,626.64 |
| Vaginal delivery, without complications MS-DRG 807 | $13,277.95 | $18,968.50 | $4,797.49 – $4,797.49 |
| Weight loss surgery, without complications MS-DRG 621 | $92,827.20 | $132,610.30 | $10,733.52 – $25,077.15 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $788.90 | $1,127.00 | $565.75 – $1,127.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $3,376.80 | $4,824.00 | $2,421.65 – $4,824.00 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $3,305.75 | $4,722.50 | $16.00 – $112.37 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $23,212.63 | $33,160.90 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | $18,066.53 | $25,809.33 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | $256.90 | $367.00 | $52.48 – $367.00 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $1,149.40 | $1,642.00 | $113.30 – $1,642.00 |
| Sleep study with CPAP titration CPT 95811 | $5,476.80 | $7,824.00 | $539.86 – $7,824.00 |
| Sleep study, overnight in a sleep lab CPT 95810 | $4,389.00 | $6,270.00 | $432.63 – $6,270.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $443.10 | $633.00 | $43.68 – $633.00 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $214.20 | $306.00 | $21.11 – $306.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $293.30 | $419.00 | $28.91 – $419.00 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $352.10 | $503.00 | $34.71 – $503.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $165.20 | $236.00 | $16.28 – $236.00 |
| Therapeutic activities, 15 minutes CPT 97530 | $168.70 | $241.00 | $16.63 – $241.00 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $319.20 | $456.00 | $31.46 – $456.00 |
| Group psychotherapy CPT 90853 | $845.60 | $1,208.00 | $83.35 – $1,208.00 |
| Psychiatric diagnostic evaluation CPT 90791 | $1,059.80 | $1,514.00 | $104.47 – $1,514.00 |
| Psychotherapy, 30 minutes CPT 90832 | $196.70 | $281.00 | $19.39 – $281.00 |
| Psychotherapy, 45 minutes CPT 90834 | $274.40 | $392.00 | $27.05 – $392.00 |
| Psychotherapy, 60 minutes CPT 90837 | $555.80 | $794.00 | $54.79 – $794.00 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $93.10 | $133.00 | $9.18 – $133.00 |
| IV hydration, each additional hour CPT 96361 | $289.80 | $414.00 | $28.57 – $414.00 |
| IV hydration, first hour CPT 96360 | $483.70 | $691.00 | $47.68 – $691.00 |
| IV push injection of a drug, first CPT 96374 | $275.10 | $393.00 | $43.62 – $393.00 |
| IV push injection, each additional drug CPT 96375 | $275.10 | $393.00 | $27.12 – $393.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $1,289.57 | $1,842.25 | $127.12 – $1,842.25 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $288.22 | $411.75 | $28.41 – $411.75 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $609.70 | $871.00 | $60.10 – $871.00 |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | $521.50 | $745.00 | $51.41 – $745.00 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $59.32 | $84.75 | $5.85 – $84.75 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $169.22 | $241.75 | $16.68 – $241.75 |
| Morphine injection, up to 10 mg HCPCS J2270 | $2,551.85 | $3,645.50 | $251.54 – $3,645.50 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $66.67 | $95.25 | $6.57 – $95.25 |
| Propofol injection, per 10 mg HCPCS J2704 | $297.67 | $425.25 | $29.34 – $425.25 |
| Saline IV solution, 1000 ml HCPCS J7030 | $194.07 | $277.25 | $19.13 – $277.25 |
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.