Palos Community Hospital
12251 South 80th Avenue, Palos Heights, IL 60463 · Acute care hospital · Emergency room
These are Palos Community 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.
210 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 | $2,433.20 | $3,476.00 | $650.01 – $3,476.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $979.30 | $1,399.00 | |
| Emergency room visit, level 2 CPT 99282 | $757.40 | $1,082.00 | $173.12 – $1,082.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $1,890.00 | $2,700.00 | |
| Emergency room visit, level 4 CPT 99284 | $4,054.05 | $5,791.50 | $2,274.00 – $2,527.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $8,222.20 | $11,746.00 | |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $9,687.47 | $13,839.24 | $346.00 – $385.00 |
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 | $49.28 – $308.00 |
| New patient office visit, about 30 minutes CPT 99203 | $380.10 | $543.00 | $86.88 – $543.00 |
| New patient office visit, about 45 minutes CPT 99204 | $438.20 | $626.00 | $100.16 – $626.00 |
| New patient office visit, about 60 minutes CPT 99205 | $640.50 | $915.00 | $146.40 – $915.00 |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $196.00 | $280.00 | $44.80 – $280.00 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $291.20 | $416.00 | $66.56 – $416.00 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $398.30 | $569.00 | $91.04 – $569.00 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $609.00 | $870.00 | $139.20 – $870.00 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $158.90 | $227.00 | $36.32 – $227.00 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $125.30 | $179.00 | $28.64 – $179.00 |
| Abdominal X-ray, 1 view CPT 74018 | $396.90 | $567.00 | $90.72 – $567.00 |
| Ankle X-ray, 3 or more views CPT 73610 | $541.80 | $774.00 | $123.84 – $774.00 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $637.00 | $910.00 | $145.60 – $910.00 |
| Breast ultrasound, one breast, complete CPT 76641 | $532.00 | $760.00 | $121.60 – $760.00 |
| Breast ultrasound, one breast, limited CPT 76642 | $438.90 | $627.00 | $100.32 – $627.00 |
| Chest X-ray, 1 view CPT 71045 | $537.60 | $768.00 | $122.88 – $768.00 |
| Chest X-ray, 2 views CPT 71046 | $674.10 | $963.00 | $154.08 – $963.00 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $3,502.80 | $5,004.00 | $800.64 – $5,004.00 |
| CT angiogram of the head CPT 70496 | $3,656.10 | $5,223.00 | $835.68 – $5,223.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $6,049.40 | $8,642.00 | $1,382.72 – $8,642.00 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $7,105.70 | $10,151.00 | $1,624.16 – $10,151.00 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $4,802.00 | $6,860.00 | $1,097.60 – $6,860.00 |
| CT scan of the abdomen, without contrast CPT 74150 | $2,576.00 | $3,680.00 | $588.80 – $3,680.00 |
| CT scan of the chest, with contrast CPT 71260 | $3,173.80 | $4,534.00 | $725.44 – $4,534.00 |
| CT scan of the chest, without contrast CPT 71250 | $2,611.00 | $3,730.00 | $596.80 – $3,730.00 |
| CT scan of the head, without contrast CPT 70450 | $2,474.50 | $3,535.00 | $565.60 – $3,535.00 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $3,168.20 | $4,526.00 | $724.16 – $4,526.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $2,907.80 | $4,154.00 | $664.64 – $4,154.00 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $2,606.10 | $3,723.00 | $595.68 – $3,723.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $513.80 | $734.00 | $117.44 – $734.00 |
| Diagnostic mammogram, one breast CPT 77065 | $464.80 | $664.00 | $106.24 – $664.00 |
| Foot X-ray, 3 or more views CPT 73630 | $594.30 | $849.00 | $135.84 – $849.00 |
| Hand X-ray, 3 or more views CPT 73130 | $547.40 | $782.00 | $125.12 – $782.00 |
| Knee X-ray, 3 views CPT 73562 | $598.50 | $855.00 | $136.80 – $855.00 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $2,626.40 | $3,752.00 | $600.32 – $3,752.00 |
| Leg or arm vein ultrasound, one side CPT 93971 | $1,673.00 | $2,390.00 | $382.40 – $2,390.00 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $651.70 | $931.00 | $148.96 – $931.00 |
| MRI of both breasts, without and with contrast CPT 77049 | $4,099.20 | $5,856.00 | $936.96 – $5,856.00 |
| MRI of the abdomen, without and with contrast CPT 74183 | $4,385.50 | $6,265.00 | $1,002.40 – $6,265.00 |
| MRI of the brain, without and with contrast CPT 70553 | $5,385.10 | $7,693.00 | $1,230.88 – $7,693.00 |
| MRI of the brain, without contrast CPT 70551 | $3,887.10 | $5,553.00 | $888.48 – $5,553.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $3,835.30 | $5,479.00 | $876.64 – $5,479.00 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $3,837.40 | $5,482.00 | $877.12 – $5,482.00 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $3,809.40 | $5,442.00 | $870.72 – $5,442.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $4,171.30 | $5,959.00 | $953.44 – $5,959.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $4,765.60 | $6,808.00 | $1,089.28 – $6,808.00 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $3,591.70 | $5,131.00 | $820.96 – $5,131.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $665.70 | $951.00 | $152.16 – $951.00 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $1,509.90 | $2,157.00 | $345.12 – $2,157.00 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $1,206.10 | $1,723.00 | $275.68 – $1,723.00 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $940.80 | $1,344.00 | $215.04 – $1,344.00 |
| Screening mammogram, both breasts CPT 77067 | $523.60 | $748.00 | $119.68 – $748.00 |
| Shoulder X-ray, 2 or more views CPT 73030 | $623.00 | $890.00 | $142.40 – $890.00 |
| Transvaginal pregnancy ultrasound CPT 76817 | $749.00 | $1,070.00 | $171.20 – $1,070.00 |
| Transvaginal ultrasound CPT 76830 | $1,079.40 | $1,542.00 | $246.72 – $1,542.00 |
| Ultrasound of the abdomen, complete CPT 76700 | $1,772.40 | $2,532.00 | $405.12 – $2,532.00 |
| Ultrasound of the neck or thyroid CPT 76536 | $1,343.30 | $1,919.00 | $307.04 – $1,919.00 |
| Wrist X-ray, 3 or more views CPT 73110 | $492.80 | $704.00 | $112.64 – $704.00 |
| X-ray of the lower back, 4 or more views CPT 72110 | $909.30 | $1,299.00 | $207.84 – $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 | $50.24 – $314.00 |
| Blood culture CPT 87040 | $739.90 | $1,057.00 | $169.12 – $1,057.00 |
| Blood draw (venipuncture) CPT 36415 | $653.80 | $934.00 | $3.00 – $31.50 |
| BNP test (heart failure) CPT 83880 | $249.90 | $357.00 | $57.12 – $357.00 |
| C-reactive protein (CRP) test CPT 86140 | $107.80 | $154.00 | $24.64 – $154.00 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $151.90 | $217.00 | $34.72 – $217.00 |
| Complete blood count (CBC) with differential CPT 85025 | $90.30 | $129.00 | $20.64 – $129.00 |
| Complete blood count (CBC), automated CPT 85027 | $82.60 | $118.00 | $18.88 – $118.00 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $306.60 | $438.00 | $70.08 – $438.00 |
| COVID-19 PCR test CPT 87635 | $125.30 | $179.00 | $28.64 – $179.00 |
| D-dimer test (blood clots) CPT 85379 | $140.70 | $201.00 | $32.16 – $201.00 |
| Drug screen, instrument chemistry CPT 80307 | $288.40 | $412.00 | $65.92 – $412.00 |
| Ferritin (iron stores) test CPT 82728 | $144.20 | $206.00 | $32.96 – $206.00 |
| Free T4 (thyroid) test CPT 84439 | $121.10 | $173.00 | $27.68 – $173.00 |
| Glucose (blood sugar) test CPT 82947 | $65.80 | $94.00 | $15.04 – $94.00 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $151.20 | $216.00 | $34.56 – $216.00 |
| Hemoglobin A1c test CPT 83036 | $116.90 | $167.00 | $26.72 – $167.00 |
| Hepatitis C antibody test CPT 86803 | $179.20 | $256.00 | $40.96 – $256.00 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $116.90 | $167.00 | $26.72 – $167.00 |
| Iron test CPT 83540 | $79.10 | $113.00 | $18.08 – $113.00 |
| Kidney function panel CPT 80069 | $177.10 | $253.00 | $40.48 – $253.00 |
| Lipase test (pancreas) CPT 83690 | $121.80 | $174.00 | $27.84 – $174.00 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $184.10 | $263.00 | $42.08 – $263.00 |
| Liver function panel CPT 80076 | $189.70 | $271.00 | $43.36 – $271.00 |
| Magnesium test CPT 83735 | $81.20 | $116.00 | $18.56 – $116.00 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $83.30 | $119.00 | $19.04 – $119.00 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $200.20 | $286.00 | $45.76 – $286.00 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $58.10 | $83.00 | $13.28 – $83.00 |
| PSA (prostate specific antigen), free CPT 84154 | $112.70 | $161.00 | $25.76 – $161.00 |
| PSA (prostate specific antigen), total CPT 84153 | $151.90 | $217.00 | $34.72 – $217.00 |
| Rapid strep test CPT 87880 | $133.00 | $190.00 | $30.40 – $190.00 |
| Sed rate (ESR) test CPT 85652 | $60.90 | $87.00 | $13.92 – $87.00 |
| TB skin test CPT 86580 | $32.20 | $46.00 | $7.36 – $46.00 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $162.40 | $232.00 | $37.12 – $232.00 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $6,357.35 | $9,081.93 | $2,741.00 – $3,045.00 |
| Troponin test (heart damage) CPT 84484 | $170.80 | $244.00 | $39.04 – $244.00 |
| Urinalysis, automated, with microscope CPT 81001 | $84.70 | $121.00 | $19.36 – $121.00 |
| Urinalysis, automated, without microscope CPT 81003 | $53.20 | $76.00 | $12.16 – $76.00 |
| Urinalysis, manual, without microscope CPT 81002 | $34.30 | $49.00 | $7.84 – $49.00 |
| Urine culture, colony count CPT 87086 | $129.50 | $185.00 | $29.60 – $185.00 |
| Urine pregnancy test CPT 81025 | $128.80 | $184.00 | $29.44 – $184.00 |
| Vitamin B12 test CPT 82607 | $135.10 | $193.00 | $30.88 – $193.00 |
| Vitamin D test CPT 82306 | $191.10 | $273.00 | $43.68 – $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 | $534.08 – $3,338.00 |
| ECG tracing only (no interpretation) CPT 93005 | $199.50 | $285.00 | $45.60 – $285.00 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $1,694.00 | $2,420.00 | $520.30 – $1,815.00 |
| Left heart catheterization CPT 93452 | $9,258.90 | $13,227.00 | $2,288.27 – $13,227.00 |
| Left heart catheterization with coronary angiogram CPT 93458 | $13,297.20 | $18,996.00 | $3,286.31 – $18,996.00 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $4,929.40 | $7,042.00 | $1,126.72 – $7,042.00 |
| Treadmill stress test, complete CPT 93015 | $431.20 | $616.00 | $98.56 – $616.00 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $67,084.02 | $95,834.31 | $7,055.00 – $7,839.00 |
| Appendix removal, laparoscopic CPT 44970 | $31,985.58 | $45,693.69 | $7,055.00 – $7,839.00 |
| Breast biopsy with ultrasound guidance CPT 19083 | $2,826.60 | $4,038.00 | $4,038.00 – $4,038.00 |
| Carpal tunnel release CPT 64721 | $16,447.11 | $23,495.87 | $3,577.00 – $3,975.00 |
| Colonoscopy with biopsy CPT 45380 | $10,494.22 | $14,991.74 | $2,741.00 – $3,045.00 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $10,302.96 | $14,718.51 | $1,370.50 – $1,522.50 |
| Colonoscopy, diagnostic CPT 45378 | $4,111.88 | $5,874.11 | $2,741.00 – $3,045.00 |
| Colposcopy with biopsy CPT 57454 | $20,964.38 | $29,949.11 | $346.00 – $385.00 |
| Cystoscopy (bladder scope) CPT 52000 | $11,545.57 | $16,493.67 | $1,334.00 – $1,481.00 |
| Ear tubes, under general anesthesia CPT 69436 | $10,431.38 | $14,901.97 | |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $4,624.78 | $6,606.83 | $1,334.00 – $1,481.00 |
| Gallbladder removal, laparoscopic CPT 47562 | $30,679.12 | $43,827.31 | $7,055.00 – $7,839.00 |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | $53,804.69 | $76,863.84 | $3,527.50 – $3,919.50 |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $17,592.47 | $25,132.10 | $3,577.00 – $3,975.00 |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $34,684.01 | $49,548.59 | $7,055.00 – $7,839.00 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $24,380.94 | $34,829.91 | $5,282.00 – $5,868.00 |
| Kidney stone shock-wave lithotripsy CPT 50590 | $19,560.27 | $27,943.24 | $7,055.00 – $7,839.00 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $22,318.87 | $31,884.10 | $5,282.00 – $5,868.00 |
| Lower colon endoscopy with ultrasound CPT 45391 | $6,267.60 | $8,953.71 | $2,137.00 – $2,374.00 |
| Nasal endoscopy, diagnostic CPT 31231 | $25,134.11 | $35,905.87 | $346.00 – $385.00 |
| Prostate biopsy CPT 55700 | $24,176.49 | $34,537.84 | $1,068.50 – $1,187.00 |
| Prostate removal, laparoscopic or robotic CPT 55866 | $116,192.56 | $165,989.38 | $10,343.00 – $11,492.00 |
| Rotator cuff repair, arthroscopic CPT 29827 | $48,088.52 | $68,697.89 | $7,055.00 – $7,839.00 |
| Screening colonoscopy, average risk HCPCS G0121 | $3,198.30 | $4,569.00 | $731.04 – $4,569.00 |
| Screening colonoscopy, high risk HCPCS G0105 | $3,220.00 | $4,600.00 | $736.00 – $4,600.00 |
| Septoplasty (nasal septum repair) CPT 30520 | $31,992.98 | $45,704.26 | $1,788.50 – $1,987.50 |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $47,008.67 | $67,155.24 | $346.00 – $385.00 |
| Tonsil and adenoid removal, under age 12 CPT 42820 | $15,524.16 | $22,177.37 | $3,577.00 – $3,975.00 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $9,470.38 | $13,529.11 | $2,137.00 – $2,374.00 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $4,160.04 | $5,942.91 | $2,137.00 – $2,374.00 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $1,657.60 | $2,368.00 | |
| IUD insertion CPT 58300 | $21,245.10 | $30,350.14 | $346.00 – $385.00 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $11,554.37 | $16,506.24 | $866.00 – $6,281.86 |
| C-section, without complications MS-DRG 788 | $28,151.21 | $40,216.01 | $6,822.66 – $6,822.66 |
| Chest pain MS-DRG 313 | $19,465.60 | $27,808.00 | $5,123.40 – $10,486.80 |
| COPD flare-up, with major complications MS-DRG 190 | $24,980.72 | $35,686.74 | $7,882.21 – $16,133.65 |
| COPD flare-up, without complications MS-DRG 192 | $15,231.82 | $21,759.74 | $4,568.36 – $9,350.73 |
| Fainting (syncope) MS-DRG 312 | $23,429.87 | $33,471.24 | $6,202.16 – $12,694.85 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $24,435.47 | $34,907.81 | $6,978.50 – $14,283.90 |
| Heart failure, with major complications MS-DRG 291 | $23,769.72 | $33,956.74 | $9,135.31 – $18,698.55 |
| Heart failure, without complications MS-DRG 293 | $15,898.05 | $22,711.50 | $4,027.56 – $8,243.79 |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | $383,201.72 | $547,431.00 | $69,612.77 – $142,486.48 |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | $67,406.47 | $96,294.96 | $13,725.73 – $28,094.43 |
| Irregular heartbeat, without complications MS-DRG 310 | $15,866.90 | $22,667.00 | $4,028.27 – $8,245.25 |
| Kidney failure, with complications MS-DRG 683 | $19,924.10 | $28,463.00 | $6,232.05 – $12,756.03 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $19,317.90 | $27,597.00 | $5,760.27 – $11,790.37 |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | $73,213.29 | $104,590.41 | $17,371.88 – $35,557.53 |
| Normal newborn care MS-DRG 795 | $4,434.15 | $6,334.50 | $1,421.74 – $2,910.09 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $20,186.95 | $28,838.50 | $5,537.54 – $11,334.48 |
| Pneumonia, with complications MS-DRG 194 | $19,367.07 | $27,667.24 | $749.00 – $11,737.93 |
| Pneumonia, with major complications MS-DRG 193 | $25,455.15 | $36,364.50 | $9,353.05 – $19,144.24 |
| Pneumonia, without complications MS-DRG 195 | $18,175.32 | $25,964.74 | $4,472.30 – $9,154.10 |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | $12,825.57 | $18,322.24 | $900.00 – $12,634.06 |
| Sepsis, with major complications MS-DRG 871 | $36,665.47 | $52,379.24 | $13,822.50 – $28,292.51 |
| Sepsis, without major complications MS-DRG 872 | $23,361.27 | $33,373.24 | $7,281.63 – $10,526.69 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $16,484.65 | $23,549.50 | $6,197.18 – $12,684.66 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $21,063.52 | $30,090.74 | $5,547.50 – $11,354.87 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $34,895.35 | $49,850.50 | $749.00 – $14,715.02 |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | $46,281.39 | $66,116.27 | $8,828.61 – $18,070.80 |
| Vaginal delivery, without complications MS-DRG 807 | $9,223.72 | $13,176.74 | $4,797.49 – $4,797.49 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $747.60 | $1,068.00 | $1,068.00 – $1,068.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $3,017.70 | $4,311.00 | $4,311.00 – $4,311.00 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $1,940.40 | $2,772.00 | $443.52 – $2,772.00 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $3,347.40 | $4,782.00 | $4,782.00 – $4,782.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | $11,188.68 | $15,983.83 | $3,577.00 – $3,975.00 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | $256.90 | $367.00 | $68.63 – $367.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $405.30 | $579.00 | $92.64 – $579.00 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $214.20 | $306.00 | $48.96 – $306.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $293.30 | $419.00 | $67.04 – $419.00 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $352.10 | $503.00 | $80.48 – $503.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $165.20 | $236.00 | $37.76 – $236.00 |
| Therapeutic activities, 15 minutes CPT 97530 | $168.70 | $241.00 | $38.56 – $241.00 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $303.80 | $434.00 | $69.44 – $434.00 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $303.80 | $434.00 | $69.44 – $434.00 |
| Group psychotherapy CPT 90853 | $268.10 | $383.00 | $61.28 – $383.00 |
| Psychiatric diagnostic evaluation CPT 90791 | $469.00 | $670.00 | $107.20 – $670.00 |
| Psychotherapy, 30 minutes CPT 90832 | $219.80 | $314.00 | $50.24 – $314.00 |
| Psychotherapy, 45 minutes CPT 90834 | $333.90 | $477.00 | $76.32 – $477.00 |
| Psychotherapy, 60 minutes CPT 90837 | $371.70 | $531.00 | $84.96 – $531.00 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $163.10 | $233.00 | $37.28 – $233.00 |
| IV hydration, each additional hour CPT 96361 | $91.00 | $130.00 | $20.80 – $130.00 |
| IV hydration, first hour CPT 96360 | $501.20 | $716.00 | $114.56 – $716.00 |
| IV push injection of a drug, first CPT 96374 | $157.50 | $225.00 | $36.00 – $225.00 |
| IV push injection, each additional drug CPT 96375 | $157.50 | $225.00 | $36.00 – $225.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $15.05 | $21.50 | $3.44 – $21.50 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $13.30 | $19.00 | $3.04 – $19.00 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $73.32 | $104.75 | $16.76 – $104.75 |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | $125.82 | $179.75 | $28.76 – $179.75 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $3.50 | $5.00 | ? – $5.00 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $22.75 | $32.50 | $5.20 – $32.50 |
| Morphine injection, up to 10 mg HCPCS J2270 | $1,229.72 | $1,756.75 | $281.08 – $1,756.75 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $7.17 | $10.25 | $1.64 – $10.25 |
| Propofol injection, per 10 mg HCPCS J2704 | $53.55 | $76.50 | $12.24 – $76.50 |
| Saline IV solution, 1000 ml HCPCS J7030 | $33.42 | $47.75 | $7.64 – $47.75 |
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.