Northwestern Memorial Hospital

251 E Huron St., Chicago, IL 60611 · Acute care hospital · Emergency room

These are Northwestern Memorial 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.

221 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	$1,598.10	$2,283.00	$534.22 – $5,045.00
Emergency room visit, level 1 (minor) CPT 99281	$399.70	$571.00	$110.77 – $571.00
Emergency room visit, level 2 CPT 99282	$757.40	$1,082.00
Emergency room visit, level 3 (moderate) CPT 99283	$1,751.05	$2,501.50	$796.00 – $796.00
Emergency room visit, level 4 CPT 99284	$4,049.15	$5,784.50	$796.00 – $3,026.00
Emergency room visit, level 5 (most severe) CPT 99285	$10,081.05	$14,401.50	$796.00 – $3,026.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$23,086.46	$32,980.66	$796.00 – $20,796.00

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	$59.75 – $308.00
New patient office visit, about 30 minutes CPT 99203	$380.10	$543.00	$105.34 – $543.00
New patient office visit, about 45 minutes CPT 99204	$438.20	$626.00	$121.44 – $626.00
New patient office visit, about 60 minutes CPT 99205	$640.50	$915.00	$177.51 – $915.00
Office visit, established patient, about 10 to 19 minutes CPT 99212	$196.00	$280.00	$54.32 – $280.00
Office visit, established patient, about 20 to 29 minutes CPT 99213	$291.20	$416.00	$80.70 – $416.00
Office visit, established patient, about 30 to 39 minutes CPT 99214	$398.30	$569.00	$110.39 – $569.00
Office visit, established patient, about 40 to 54 minutes CPT 99215	$609.00	$870.00	$168.78 – $870.00
Office visit, established patient, brief (often a nurse) CPT 99211	$158.90	$227.00	$44.04 – $227.00

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$125.30	$179.00	$34.73 – $179.00
Abdominal X-ray, 1 view CPT 74018	$396.90	$567.00	$78.16 – $567.00
Ankle X-ray, 3 or more views CPT 73610	$541.80	$774.00	$110.68 – $774.00
Bone density scan (DEXA), hips and spine CPT 77080	$637.00	$910.00	$176.54 – $910.00
Breast ultrasound, one breast, complete CPT 76641	$532.00	$760.00	$147.44 – $760.00
Breast ultrasound, one breast, limited CPT 76642	$438.90	$627.00	$121.64 – $627.00
Chest X-ray, 1 view CPT 71045	$537.60	$768.00	$80.26 – $768.00
Chest X-ray, 2 views CPT 71046	$674.10	$963.00	$108.81 – $963.00
CT angiogram of the chest (checks for lung clots) CPT 71275	$3,502.80	$5,004.00	$970.78 – $5,004.00
CT angiogram of the head CPT 70496	$3,656.10	$5,223.00	$1,013.26 – $5,223.00
CT scan of the abdomen and pelvis, with contrast CPT 74177	$6,049.40	$8,642.00	$1,676.55 – $8,642.00
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$7,105.70	$10,151.00	$1,969.29 – $10,151.00
CT scan of the abdomen and pelvis, without contrast CPT 74176	$4,802.00	$6,860.00	$1,330.84 – $6,860.00
CT scan of the abdomen, without contrast CPT 74150	$2,576.00	$3,680.00	$713.92 – $3,680.00
CT scan of the chest, with contrast CPT 71260	$3,173.80	$4,534.00	$879.60 – $4,534.00
CT scan of the chest, without contrast CPT 71250	$2,611.00	$3,730.00	$723.62 – $3,730.00
CT scan of the head, without contrast CPT 70450	$2,474.50	$3,535.00	$685.79 – $3,535.00
CT scan of the neck (cervical spine), without contrast CPT 72125	$3,168.20	$4,526.00	$878.04 – $4,526.00
CT scan of the pelvis, with contrast CPT 72193	$2,907.80	$4,154.00	$805.88 – $4,154.00
CT scan of the sinuses or face, without contrast CPT 70486	$2,606.10	$3,723.00	$722.26 – $3,723.00
Diagnostic mammogram, both breasts CPT 77066	$513.80	$734.00	$142.40 – $734.00
Diagnostic mammogram, one breast CPT 77065	$464.80	$664.00	$128.82 – $664.00
Foot X-ray, 3 or more views CPT 73630	$594.30	$849.00	$103.43 – $849.00
Hand X-ray, 3 or more views CPT 73130	$547.40	$782.00	$91.49 – $782.00
Knee X-ray, 3 views CPT 73562	$598.50	$855.00	$165.87 – $855.00
Leg or arm vein ultrasound, both sides CPT 93970	$2,626.40	$3,752.00	$310.52 – $3,752.00
Leg or arm vein ultrasound, one side CPT 93971	$1,673.00	$2,390.00	$212.94 – $2,390.00
Lower back X-ray, 2 or 3 views CPT 72100	$651.70	$931.00	$157.95 – $931.00
MRI of both breasts, without and with contrast CPT 77049	$4,099.20	$5,856.00	$1,136.06 – $5,856.00
MRI of the abdomen, without and with contrast CPT 74183	$4,385.50	$6,265.00	$1,215.41 – $6,265.00
MRI of the brain, without and with contrast CPT 70553	$5,385.10	$7,693.00	$1,492.44 – $7,693.00
MRI of the brain, without contrast CPT 70551	$3,887.10	$5,553.00	$1,077.28 – $5,553.00
MRI of the knee or other leg joint, without contrast CPT 73721	$3,835.30	$5,479.00	$1,062.93 – $5,479.00
MRI of the lower back (lumbar spine), without contrast CPT 72148	$3,837.40	$5,482.00	$1,063.51 – $5,482.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$3,809.40	$5,442.00	$1,055.75 – $5,442.00
MRI of the neck (cervical spine), without contrast CPT 72141	$4,171.30	$5,959.00	$1,156.05 – $5,959.00
MRI of the pelvis, without and with contrast CPT 72197	$4,765.60	$6,808.00	$1,320.75 – $6,808.00
MRI of the shoulder or other arm joint, without contrast CPT 73221	$3,591.70	$5,131.00	$995.41 – $5,131.00
Neck X-ray, 2 or 3 views CPT 72040	$665.70	$951.00	$142.27 – $951.00
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$1,509.90	$2,157.00	$418.46 – $2,157.00
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$1,206.10	$1,723.00	$334.26 – $1,723.00
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$940.80	$1,344.00	$260.74 – $1,344.00
Screening mammogram, both breasts CPT 77067	$523.60	$748.00	$145.11 – $748.00
Shoulder X-ray, 2 or more views CPT 73030	$623.00	$890.00	$76.28 – $890.00
Transvaginal pregnancy ultrasound CPT 76817	$749.00	$1,070.00	$207.58 – $1,070.00
Transvaginal ultrasound CPT 76830	$1,079.40	$1,542.00	$299.15 – $1,542.00
Ultrasound of the abdomen, complete CPT 76700	$1,772.40	$2,532.00	$491.21 – $2,532.00
Ultrasound of the neck or thyroid CPT 76536	$1,343.30	$1,919.00	$372.29 – $1,919.00
Wrist X-ray, 3 or more views CPT 73110	$492.80	$704.00	$91.49 – $704.00
X-ray of the lower back, 4 or more views CPT 72110	$909.30	$1,299.00	$194.69 – $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	$60.92 – $314.00
Blood culture CPT 87040	$739.90	$1,057.00	$205.06 – $1,057.00
Blood draw (venipuncture) CPT 36415	$952.70	$1,361.00	? – $303.71
BNP test (heart failure) CPT 83880	$374.50	$535.00	$94.23 – $535.00
C-reactive protein (CRP) test CPT 86140	$177.10	$253.00	$12.64 – $274.00
Chlamydia test (DNA/NAAT) CPT 87491	$353.50	$505.00	$75.35 – $505.00
Complete blood count (CBC) with differential CPT 85025	$153.30	$219.00	$51.25 – $219.00
Complete blood count (CBC), automated CPT 85027	$86.10	$123.00	$20.12 – $175.00
Comprehensive metabolic panel (blood test) CPT 80053	$306.60	$438.00	$84.97 – $438.00
COVID-19 PCR test CPT 87635	$125.30	$179.00	$34.73 – $179.00
D-dimer test (blood clots) CPT 85379	$181.30	$259.00	$15.91 – $259.00
Drug screen, instrument chemistry CPT 80307	$693.70	$991.00	$167.23 – $991.00
Ferritin (iron stores) test CPT 82728	$144.20	$206.00	$39.96 – $206.00
Free T4 (thyroid) test CPT 84439	$121.10	$173.00	$33.56 – $173.00
Glucose (blood sugar) test CPT 82947	$99.40	$142.00	$15.91 – $142.00
Gonorrhea test (DNA/NAAT) CPT 87591	$159.60	$228.00	$23.17 – $393.00
Hemoglobin A1c test CPT 83036	$116.90	$167.00	$32.40 – $167.00
Hepatitis C antibody test CPT 86803	$322.70	$461.00	$55.69 – $461.00
HIV-1/HIV-2 antigen and antibody test CPT 87389	$210.00	$300.00	$70.20 – $300.00
Iron test CPT 83540	$79.10	$113.00	$21.92 – $113.00
Kidney function panel CPT 80069	$277.90	$397.00	$43.26 – $397.00
Lipase test (pancreas) CPT 83690	$114.10	$163.00	$38.14 – $163.00
Lipid panel, cholesterol and triglycerides CPT 80061	$184.10	$263.00	$51.02 – $263.00
Liver function panel CPT 80076	$271.60	$388.00	$18.72 – $395.00
Magnesium test CPT 83735	$81.20	$116.00	$22.50 – $116.00
Partial thromboplastin time (PTT), clotting test CPT 85730	$125.30	$179.00	$23.17 – $190.00
Pregnancy blood test (hCG), quantitative CPT 84702	$341.60	$488.00	$31.36 – $488.00
Prothrombin time (PT/INR), clotting test CPT 85610	$86.80	$124.00	$17.55 – $124.00
PSA (prostate specific antigen), free CPT 84154	$178.50	$255.00	$55.69 – $255.00
PSA (prostate specific antigen), total CPT 84153	$254.10	$363.00	$50.78 – $363.00
Rapid strep test CPT 87880	$133.70	$191.00	$28.31 – $191.00
Sed rate (ESR) test CPT 85652	$44.80	$64.00	$12.42 – $64.00
TB skin test CPT 86580	$32.20	$46.00	$8.92 – $46.00
Thyroid stimulating hormone (TSH) CPT 84443	$162.40	$232.00	$45.01 – $232.00
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$8,605.29	$12,293.27	$2,432.00 – $2,702.00
Troponin test (heart damage) CPT 84484	$170.80	$244.00	$47.34 – $244.00
Urinalysis, automated, with microscope CPT 81001	$140.00	$200.00	$24.80 – $200.00
Urinalysis, automated, without microscope CPT 81003	$50.40	$72.00	$13.97 – $146.00
Urinalysis, manual, without microscope CPT 81002	$85.40	$122.00	$28.55 – $171.00
Urine culture, colony count CPT 87086	$192.50	$275.00	$19.42 – $275.00
Urine pregnancy test CPT 81025	$142.10	$203.00	$28.08 – $203.00
Vitamin B12 test CPT 82607	$135.10	$193.00	$37.44 – $193.00
Vitamin D test CPT 82306	$191.10	$273.00	$52.96 – $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	$647.57 – $3,338.00
ECG tracing only (no interpretation) CPT 93005	$238.00	$340.00	$26.21 – $435.00
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$3,278.10	$4,683.00	$653.40 – $1,653.10
Left heart catheterization CPT 93452	$10,777.90	$15,397.00	$2,675.45 – $15,397.00
Left heart catheterization with coronary angiogram CPT 93458	$24,326.40	$34,752.00	$1,592.60 – $34,752.00
Nuclear stress test (heart perfusion imaging) CPT 78452	$5,432.70	$7,761.00	$1,083.89 – $8,381.00
Treadmill stress test, complete CPT 93015	$431.20	$616.00	$119.50 – $616.00

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$106,675.84	$152,394.06	$7,941.00 – $8,823.00
Appendix removal, laparoscopic CPT 44970	$30,072.48	$42,960.69	$425.00 – $8,823.00
Breast biopsy with ultrasound guidance CPT 19083	$2,353.40	$3,362.00	$3,362.00 – $8,563.00
Carpal tunnel release CPT 64721	$8,775.65	$12,536.64	$6,039.00 – $6,711.00
Colonoscopy with biopsy CPT 45380	$11,528.19	$16,468.84	$2,432.00 – $7,500.00
Colonoscopy with polyp removal (snare) CPT 45385	$12,858.85	$18,369.79	$2,432.00 – $2,702.00
Colonoscopy, diagnostic CPT 45378	$4,336.60	$6,195.14	$2,432.00 – $2,702.00
Colposcopy with biopsy CPT 57454	$14,458.58	$20,655.11	$973.00 – $1,081.00
Cystoscopy (bladder scope) CPT 52000	$9,786.06	$13,980.09	$2,188.00 – $2,431.00
Ear tubes, under general anesthesia CPT 69436	$10,652.35	$15,217.64	$1,566.00 – $3,750.00
Flexible sigmoidoscopy, diagnostic CPT 45330	$8,821.94	$12,602.77
Gallbladder removal, laparoscopic CPT 47562	$30,640.64	$43,772.34	$7,941.00 – $8,823.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	$103,066.49	$147,237.84	$425.00 – $8,823.00
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$52,934.16	$75,620.23	$425.00 – $8,823.00
Hysteroscopy with biopsy or polyp removal CPT 58558	$18,795.57	$26,850.81	$4,026.00 – $4,474.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	$62,291.03	$88,987.19	$7,941.00 – $8,823.00
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$19,604.89	$28,006.99	$5,944.00 – $6,604.00
Kidney stone shock-wave lithotripsy CPT 50590	$12,705.35	$18,150.50	$7,941.00 – $8,823.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$25,663.99	$36,662.84	$5,944.00 – $6,604.00
Lower colon endoscopy with ultrasound CPT 45391	$12,241.49	$17,487.84	$3,132.00 – $3,480.00
Nasal endoscopy, diagnostic CPT 31231	$25,117.60	$35,882.29	$486.50 – $540.50
Prostate biopsy CPT 55700	$17,132.54	$24,475.06	$3,132.00 – $3,480.00
Prostate removal, laparoscopic or robotic CPT 55866	$84,657.59	$120,939.41	$425.00 – $12,933.00
Removal of a breast lump, open surgery CPT 19120	$4,458.30	$6,369.00	$1,490.35 – $3,502.95
Rotator cuff repair, arthroscopic CPT 29827	$66,414.12	$94,877.31	$7,500.00 – $8,823.00
Screening colonoscopy, average risk HCPCS G0121	$3,198.30	$4,569.00	$468.00 – $4,112.00
Screening colonoscopy, high risk HCPCS G0105	$2,389.80	$3,414.00	$468.00 – $4,747.00
Septoplasty (nasal septum repair) CPT 30520	$32,729.44	$46,756.34	$3,750.00 – $6,711.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	$54,262.96	$77,518.51	$486.50 – $540.50
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	$74,263.22	$106,090.31	$425.00 – $8,823.00
Tonsil and adenoid removal, under age 12 CPT 42820	$12,729.41	$18,184.87
Total hip replacement CPT 27130	$34,605.90	$49,437.00	$11,568.26 – $27,190.35
Total knee replacement CPT 27447	$34,605.90	$49,437.00	$11,568.26 – $29,975.00
Upper endoscopy (EGD) with biopsy CPT 43239	$10,335.13	$14,764.47	$3,132.00 – $7,500.00
Upper endoscopy (EGD), diagnostic CPT 43235	$4,437.85	$6,339.79	$3,132.00 – $3,480.00
Vasectomy CPT 55250	$15,443.07	$22,061.53	$2,013.00 – $3,750.00

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
Fetal non-stress test CPT 59025	$1,267.00	$1,810.00
IUD insertion CPT 58300	$27,174.10	$38,820.14	$486.50 – $540.50

Hospital stays

Service	Cash price	Gross charge	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$22,790.95	$32,558.50	$15,927.48 – $15,927.48
C-section, without complications MS-DRG 788	$41,614.65	$59,449.50
Chest pain MS-DRG 313	$27,560.05	$39,371.50
COPD flare-up, with major complications MS-DRG 190	$28,483.52	$40,690.74
COPD flare-up, without complications MS-DRG 192	$11,348.57	$16,212.24	$796.00 – $9,357.15
Fainting (syncope) MS-DRG 312	$30,154.07	$43,077.24
Gastrointestinal bleeding, with complications MS-DRG 378	$29,918.71	$42,741.01
Heart failure, with major complications MS-DRG 291	$38,987.37	$55,696.24
Heart failure, without complications MS-DRG 293	$25,724.47	$36,749.24
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	$384,392.53	$549,132.20
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	$81,629.92	$116,614.17
Irregular heartbeat, without complications MS-DRG 310	$19,162.84	$27,375.49
Kidney failure, with complications MS-DRG 683	$26,902.22	$38,431.74
Kidney or urinary tract infection, without major complications MS-DRG 690	$22,343.30	$31,919.00	$14,605.00 – $14,605.00
Neck (cervical) spinal fusion, without complications MS-DRG 473	$118,646.31	$169,494.73
Normal newborn care MS-DRG 795	$5,822.42	$8,317.74
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$24,138.62	$34,483.74	$7,886.28 – $14,040.28
Pneumonia, with complications MS-DRG 194	$17,421.42	$24,887.74	$8,166.99 – $11,745.99
Pneumonia, with major complications MS-DRG 193	$26,657.92	$38,082.74
Pneumonia, without complications MS-DRG 195	$15,520.92	$22,172.74
Psychoses (inpatient psychiatric stay) MS-DRG 885	$29,479.80	$42,114.00
Sepsis, with major complications MS-DRG 871	$58,548.00	$83,640.00
Sepsis, without major complications MS-DRG 872	$29,216.95	$41,738.50
Skin infection (cellulitis), without major complications MS-DRG 603	$20,324.32	$29,034.74
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$23,644.07	$33,777.24
Stroke, with complications or clot-busting drug MS-DRG 65	$44,046.45	$62,923.50
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	$73,210.25	$104,586.07
Vaginal delivery, without complications MS-DRG 807	$12,970.65	$18,529.50
Weight loss surgery, without complications MS-DRG 621	$91,447.17	$130,638.81

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$1,018.50	$1,455.00	$297.00 – $1,455.00
Lower back nerve root injection with imaging guidance CPT 64483	$3,376.80	$4,824.00	$391.25 – $4,824.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$2,781.62	$3,973.74	$16.00 – $16.00
Lower back spinal injection (epidural), without imaging CPT 62322	$23,212.63	$33,160.90	$425.00 – $1,215.50

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	$10,852.99	$15,504.27	$4,026.00 – $4,474.00
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$893.90	$1,277.00	$298.82 – $702.35

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$256.90	$367.00	$71.20 – $367.00

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$847.00	$1,210.00	$234.74 – $1,642.00
Sleep study with CPAP titration CPT 95811	$4,979.10	$7,113.00	$1,379.92 – $8,168.00
Sleep study, overnight in a sleep lab CPT 95810	$3,990.00	$5,700.00	$1,105.80 – $6,546.00

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$405.30	$579.00	$112.33 – $579.00

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$214.20	$306.00	$43.99 – $306.00
Physical therapy evaluation, low complexity CPT 97161	$293.30	$419.00	$81.29 – $486.50
Physical therapy evaluation, moderate complexity CPT 97162	$352.10	$503.00	$97.58 – $611.10
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$165.20	$236.00	$42.35 – $236.00
Therapeutic activities, 15 minutes CPT 97530	$168.70	$241.00	$42.12 – $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	$53.59 – $456.00
Family psychotherapy, without the patient, 50 minutes CPT 90846	$141.40	$202.00	$47.27 – $202.00
Group psychotherapy CPT 90853	$845.60	$1,208.00	$282.67 – $1,208.00
Psychiatric diagnostic evaluation CPT 90791	$1,337.70	$1,911.00	$354.28 – $1,911.00
Psychotherapy, 30 minutes CPT 90832	$219.80	$314.00	$37.21 – $281.00
Psychotherapy, 45 minutes CPT 90834	$143.50	$205.00	$47.97 – $205.00
Psychotherapy, 60 minutes CPT 90837	$555.80	$794.00	$53.59 – $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	$10.02 – $212.00
IV hydration, each additional hour CPT 96361	$289.80	$414.00	$30.42 – $439.00
IV hydration, first hour CPT 96360	$301.00	$430.00	$83.42 – $691.00
IV push injection of a drug, first CPT 96374	$165.90	$237.00	$45.98 – $431.00
IV push injection, each additional drug CPT 96375	$275.10	$393.00	$40.35 – $431.00

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$144.55	$206.50	$5.03 – $263.00
Dexamethasone injection, per 1 mg HCPCS J1100	$458.85	$655.50	$16.47 – $655.50
Fentanyl injection, per 0.1 mg HCPCS J3010	$236.07	$337.25	$78.92 – $337.25
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	$347.20	$496.00	$42.06 – $551.50
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$59.32	$84.75	$19.83 – $84.75
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$45.85	$65.50	$1.07 – $65.50
Morphine injection, up to 10 mg HCPCS J2270	$1,653.22	$2,361.75	$346.10 – $3,645.50
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$66.67	$95.25	$22.29 – $95.25
Propofol injection, per 10 mg HCPCS J2704	$473.90	$677.00	$10.82 – $677.00
Saline IV solution, 1000 ml HCPCS J7030	$279.65	$399.50	$5.62 – $399.50

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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