Franciscan Health Dyer
24 Joliet St., Dyer, IN 46311 · Acute care hospital · Emergency room
These are Franciscan Health Dyer's own posted figures from its standard-charges file dated January 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
206 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 | $1,490.40 | $5,520.00 | $295.62 – $9,798.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $111.78 | $414.00 | $89.22 – $485.00 |
| Emergency room visit, level 2 CPT 99282 | $223.83 | $829.00 | $162.45 – $948.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $521.64 | $1,932.00 | $288.81 – $1,932.00 |
| Emergency room visit, level 4 CPT 99284 | $745.20 | $2,760.00 | $295.62 – $2,969.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $1,117.53 | $4,139.00 | $295.62 – $4,625.00 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | $97.47 | $361.00 | $140.86 – $285.34 |
| New patient office visit, about 30 minutes CPT 99203 | $126.90 | $470.00 | $135.60 – $352.50 |
| New patient office visit, about 45 minutes CPT 99204 | $145.53 | $539.00 | $140.86 – $404.25 |
| New patient office visit, about 60 minutes CPT 99205 | $197.64 | $732.00 | $140.86 – $549.00 |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $82.62 | $306.00 | $130.97 – $281.72 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $93.15 | $345.00 | $140.86 – $281.72 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $119.88 | $444.00 | $140.86 – $333.00 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $149.31 | $553.00 | $140.86 – $414.75 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $63.72 | $236.00 | $7.41 – $448.59 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $37.53 | $139.00 | $21.67 – $211.00 |
| Abdominal X-ray, 1 view CPT 74018 | $141.75 | $525.00 | $92.07 – $401.00 |
| Ankle X-ray, 3 or more views CPT 73610 | $160.38 | $594.00 | $68.29 – $891.00 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $183.06 | $678.00 | $104.99 – $508.50 |
| Breast ultrasound, one breast, complete CPT 76641 | $308.88 | $1,144.00 | $110.61 – $961.00 |
| Breast ultrasound, one breast, limited CPT 76642 | $227.61 | $843.00 | $89.96 – $961.00 |
| Chest X-ray, 1 view CPT 71045 | $97.47 | $361.00 | $92.07 – $401.00 |
| Chest X-ray, 2 views CPT 71046 | $149.31 | $553.00 | $92.07 – $414.75 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $1,304.10 | $4,830.00 | $185.58 – $3,622.50 |
| CT angiogram of the head CPT 70496 | $1,304.10 | $4,830.00 | $185.58 – $3,622.50 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $1,490.40 | $5,520.00 | $369.11 – $4,140.00 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $1,676.43 | $6,209.00 | $369.11 – $4,656.75 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $1,304.10 | $4,830.00 | $252.44 – $3,622.50 |
| CT scan of the abdomen, without contrast CPT 74150 | $745.20 | $2,760.00 | $110.61 – $2,070.00 |
| CT scan of the chest, with contrast CPT 71260 | $894.24 | $3,312.00 | $185.58 – $2,484.00 |
| CT scan of the chest, without contrast CPT 71250 | $745.20 | $2,760.00 | $110.61 – $2,070.00 |
| CT scan of the head, without contrast CPT 70450 | $745.20 | $2,760.00 | $110.61 – $2,070.00 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $745.20 | $2,760.00 | $110.61 – $2,070.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $894.24 | $3,312.00 | $185.58 – $2,484.00 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $745.20 | $2,760.00 | $110.61 – $2,070.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $186.57 | $691.00 | $102.19 – $518.25 |
| Diagnostic mammogram, one breast CPT 77065 | $119.88 | $444.00 | $79.74 – $333.00 |
| Foot X-ray, 3 or more views CPT 73630 | $171.72 | $636.00 | $63.45 – $954.00 |
| Hand X-ray, 3 or more views CPT 73130 | $160.38 | $594.00 | $27.10 – $891.00 |
| Knee X-ray, 3 views CPT 73562 | $160.38 | $594.00 | $75.04 – $891.00 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $670.41 | $2,483.00 | $252.44 – $1,887.08 |
| Leg or arm vein ultrasound, one side CPT 93971 | $447.12 | $1,656.00 | $110.61 – $1,258.56 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $197.64 | $732.00 | $66.34 – $549.00 |
| MRI of both breasts, without and with contrast CPT 77049 | $420.93 | $1,559.00 | $369.11 – $1,970.00 |
| MRI of the abdomen, without and with contrast CPT 74183 | $1,676.43 | $6,209.00 | $369.11 – $4,656.75 |
| MRI of the brain, without and with contrast CPT 70553 | $1,676.43 | $6,209.00 | $369.11 – $4,656.75 |
| MRI of the brain, without contrast CPT 70551 | $1,304.10 | $4,830.00 | $252.44 – $3,622.50 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $1,304.10 | $4,830.00 | $252.44 – $3,622.50 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $1,304.10 | $4,830.00 | $252.44 – $3,622.50 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $1,304.10 | $4,830.00 | $252.44 – $3,622.50 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $1,304.10 | $4,830.00 | $252.44 – $3,622.50 |
| MRI of the pelvis, without and with contrast CPT 72197 | $1,676.43 | $6,209.00 | $369.11 – $4,656.75 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $1,304.10 | $4,830.00 | $252.44 – $3,622.50 |
| Neck X-ray, 2 or 3 views CPT 72040 | $156.60 | $580.00 | $66.34 – $435.00 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $350.46 | $1,298.00 | $110.61 – $973.50 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $409.86 | $1,518.00 | $110.61 – $1,138.50 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $409.86 | $1,518.00 | $110.61 – $1,138.50 |
| Screening mammogram, both breasts CPT 77067 | $149.31 | $553.00 | $84.38 – $414.75 |
| Shoulder X-ray, 2 or more views CPT 73030 | $175.50 | $650.00 | $57.64 – $975.00 |
| Transvaginal pregnancy ultrasound CPT 76817 | $194.13 | $719.00 | $110.61 – $961.00 |
| Transvaginal ultrasound CPT 76830 | $302.40 | $1,120.00 | $110.61 – $961.00 |
| Ultrasound of the abdomen, complete CPT 76700 | $670.41 | $2,483.00 | $110.61 – $1,862.25 |
| Ultrasound of the neck or thyroid CPT 76536 | $343.17 | $1,271.00 | $110.61 – $961.00 |
| Wrist X-ray, 3 or more views CPT 73110 | $160.38 | $594.00 | $79.87 – $891.00 |
| X-ray of the lower back, 4 or more views CPT 72110 | $316.71 | $1,173.00 | $91.46 – $879.75 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $56.16 | $208.00 | $7.57 – $156.00 |
| Blood culture CPT 87040 | $63.72 | $236.00 | $9.24 – $177.00 |
| Blood draw (venipuncture) CPT 36415 | $9.72 | $36.00 | $8.36 – $109.00 |
| BNP test (heart failure) CPT 83880 | $97.47 | $361.00 | $35.14 – $270.75 |
| C-reactive protein (CRP) test CPT 86140 | $45.36 | $168.00 | $4.64 – $126.00 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $74.79 | $277.00 | $31.41 – $207.75 |
| Complete blood count (CBC) with differential CPT 85025 | $52.11 | $193.00 | $6.95 – $144.75 |
| Complete blood count (CBC), automated CPT 85027 | $45.36 | $168.00 | $5.79 – $126.00 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $130.68 | $484.00 | $9.45 – $363.00 |
| COVID-19 PCR test CPT 87635 | $96.93 | $359.00 | $45.92 – $269.25 |
| D-dimer test (blood clots) CPT 85379 | $78.30 | $290.00 | $9.11 – $217.50 |
| Drug screen, instrument chemistry CPT 80307 | $93.15 | $345.00 | $55.62 – $258.75 |
| Ferritin (iron stores) test CPT 82728 | $59.94 | $222.00 | $12.20 – $166.50 |
| Free T4 (thyroid) test CPT 84439 | $78.30 | $290.00 | $8.07 – $217.50 |
| General health panel (blood tests) CPT 80050 | $338.85 | $1,255.00 | $100.00 – $941.25 |
| Glucose (blood sugar) test CPT 82947 | $29.97 | $111.00 | $3.52 – $109.00 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $74.79 | $277.00 | $31.41 – $207.75 |
| Hemoglobin A1c test CPT 83036 | $63.72 | $236.00 | $8.69 – $177.00 |
| Hepatitis C antibody test CPT 86803 | $97.47 | $361.00 | $12.77 – $270.75 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $63.72 | $236.00 | $21.55 – $177.00 |
| Iron test CPT 83540 | $33.75 | $125.00 | $5.79 – $109.00 |
| Kidney function panel CPT 80069 | $93.15 | $345.00 | $7.77 – $258.75 |
| Lipase test (pancreas) CPT 83690 | $52.11 | $193.00 | $6.17 – $144.75 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $100.98 | $374.00 | $11.98 – $280.50 |
| Liver function panel CPT 80076 | $119.88 | $444.00 | $7.31 – $333.00 |
| Magnesium test CPT 83735 | $33.75 | $125.00 | $6.00 – $109.00 |
| Obstetric blood test panel CPT 80055 | $242.46 | $898.00 | $42.79 – $673.50 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $29.97 | $111.00 | $5.38 – $109.00 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $119.88 | $444.00 | $13.47 – $333.00 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $3.78 | $14.00 | $3.84 – $109.00 |
| PSA (prostate specific antigen), free CPT 84154 | $48.60 | $180.00 | $16.46 – $135.00 |
| PSA (prostate specific antigen), total CPT 84153 | $71.28 | $264.00 | $16.46 – $198.00 |
| Rapid strep test CPT 87880 | $54.54 | $202.00 | $14.79 – $151.50 |
| Sed rate (ESR) test CPT 85652 | $33.75 | $125.00 | $2.42 – $109.00 |
| TB skin test CPT 86580 | $10.26 | $38.00 | $16.57 – $109.00 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $82.62 | $306.00 | $15.04 – $229.50 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $130.68 | $484.00 | $55.13 – $363.00 |
| Troponin test (heart damage) CPT 84484 | $67.23 | $249.00 | $11.16 – $186.75 |
| Urinalysis, automated, with microscope CPT 81001 | $29.97 | $111.00 | $2.84 – $109.00 |
| Urinalysis, automated, without microscope CPT 81003 | $22.14 | $82.00 | $2.01 – $109.00 |
| Urinalysis, manual, with microscope CPT 81000 | $26.73 | $99.00 | $3.60 – $109.00 |
| Urinalysis, manual, without microscope CPT 81002 | $29.97 | $111.00 | $3.11 – $109.00 |
| Urine culture, colony count CPT 87086 | $41.31 | $153.00 | $7.22 – $114.75 |
| Urine pregnancy test CPT 81025 | $45.36 | $168.00 | $7.71 – $126.00 |
| Vitamin B12 test CPT 82607 | $82.62 | $306.00 | $13.50 – $229.50 |
| Vitamin D test CPT 82306 | $52.11 | $193.00 | $26.49 – $144.75 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $595.89 | $2,207.00 | $252.44 – $1,677.32 |
| ECG tracing only (no interpretation) CPT 93005 | $138.24 | $512.00 | $62.41 – $389.12 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $894.24 | $3,312.00 | $578.11 – $2,517.12 |
| Left heart catheterization CPT 93452 | $4,097.52 | $15,176.00 | $3,430.00 – $10,923.59 |
| Left heart catheterization with coronary angiogram CPT 93458 | $6,704.64 | $24,832.00 | $3,430.00 – $16,935.42 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $1,974.51 | $7,313.00 | $1,095.24 – $5,484.75 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $19,857.47 | $73,546.20 | $1,905.42 – $24,449.60 |
| Appendix removal, laparoscopic CPT 44970 | $13,958.06 | $51,696.51 | $1,905.42 – $20,370.23 |
| Breast biopsy with ultrasound guidance CPT 19083 | $1,825.20 | $6,760.00 | $123.42 – $5,565.02 |
| Carpal tunnel release CPT 64721 | $3,812.46 | $14,120.21 | $1,728.79 – $6,579.66 |
| Cystoscopy (bladder scope) CPT 52000 | $4,776.61 | $17,691.15 | $737.75 – $2,349.51 |
| Ear tubes, under general anesthesia CPT 69436 | $5,735.80 | $21,243.72 | $1,641.59 – $19,946.70 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $4,532.32 | $16,786.36 | $983.90 – $3,133.48 |
| Gallbladder removal, laparoscopic CPT 47562 | $16,977.76 | $62,880.58 | $4,211.34 – $20,370.23 |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | $21,960.61 | $81,335.58 | $4,315.74 – $35,816.92 |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $7,157.15 | $26,507.95 | $1,905.42 – $10,907.40 |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $16,969.92 | $62,851.56 | $2,273.62 – $20,370.23 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $8,336.43 | $30,875.68 | $2,273.62 – $12,064.06 |
| Kidney stone shock-wave lithotripsy CPT 50590 | $5,959.04 | $22,070.50 | $3,729.47 – $11,877.32 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $10,005.40 | $37,057.04 | $2,273.62 – $24,449.60 |
| Prostate biopsy CPT 55700 | $6,917.29 | $25,619.59 | $55.13 – $2,074.55 |
| Prostate removal, laparoscopic or robotic CPT 55866 | $30,647.98 | $113,511.03 | $401.86 – $35,816.92 |
| Removal of a breast lump, open surgery CPT 19120 | $19,274.65 | $71,387.61 | $1,905.42 – $20,370.23 |
| Rotator cuff repair, arthroscopic CPT 29827 | $12,561.86 | $46,525.42 | $1,905.42 – $24,449.60 |
| Septoplasty (nasal septum repair) CPT 30520 | $10,067.79 | $37,288.12 | $4,315.74 – $23,779.90 |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $12,561.86 | $46,525.42 | $3,121.64 – $24,449.60 |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | $25,623.35 | $94,901.31 | $401.86 – $20,370.23 |
| Tonsil and adenoid removal, under age 12 CPT 42820 | $5,630.52 | $20,853.77 | $3,121.64 – $19,946.70 |
| Total hip replacement CPT 27130 | $20,678.06 | $76,585.39 | $13,583.45 – $43,259.56 |
| Total knee replacement CPT 27447 | $15,623.03 | $57,863.08 | $13,583.45 – $43,259.56 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $6,115.94 | $22,651.63 | $959.60 – $5,000.00 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $317.79 | $1,177.00 | $213.90 – $681.22 |
| IUD insertion CPT 58300 | $7,187.23 | $26,619.38 | $648.18 – $10,907.40 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $4,606.20 | $17,060.00 | $776.73 – $19,421.60 |
| C-section, without complications MS-DRG 788 | $9,181.07 | $34,003.98 | $8,336.98 – $21,093.60 |
| Chest pain MS-DRG 313 | $9,105.13 | $33,722.70 | $2,709.06 – $15,840.00 |
| COPD flare-up, with major complications MS-DRG 190 | $10,765.49 | $39,872.20 | $2,709.06 – $24,369.40 |
| COPD flare-up, without complications MS-DRG 192 | $4,867.95 | $18,029.45 | $3,146.05 – $14,124.00 |
| Fainting (syncope) MS-DRG 312 | $8,001.32 | $29,634.50 | $2,709.06 – $19,175.20 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $10,760.34 | $39,853.10 | $2,709.06 – $21,575.40 |
| Heart failure, with major complications MS-DRG 291 | $10,219.49 | $37,849.95 | $6,348.65 – $28,243.60 |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | $88,448.72 | $327,587.85 | $5,318.00 – $156,508.56 |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | $24,093.25 | $89,234.25 | $2,709.06 – $42,435.80 |
| Irregular heartbeat, without complications MS-DRG 310 | $5,143.65 | $19,050.55 | $3,146.05 – $12,454.20 |
| Kidney failure, with complications MS-DRG 683 | $8,265.67 | $30,613.60 | $2,709.06 – $19,267.60 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $6,900.75 | $25,558.35 | $2,709.06 – $17,809.00 |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | $30,646.33 | $113,504.92 | $3,146.05 – $53,708.60 |
| Normal newborn care MS-DRG 795 | $1,695.55 | $6,279.80 | $2,041.96 – $4,615.80 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $7,237.88 | $26,806.95 | $2,709.06 – $17,120.40 |
| Pneumonia, with complications MS-DRG 194 | $8,853.93 | $32,792.35 | $3,146.05 – $17,729.80 |
| Pneumonia, with major complications MS-DRG 193 | $11,966.22 | $44,319.35 | $2,709.06 – $28,916.80 |
| Pneumonia, without complications MS-DRG 195 | $4,811.14 | $17,819.05 | $2,709.06 – $13,827.00 |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | $5,140.69 | $19,039.60 | $817.61 – $30,729.60 |
| Sepsis, with major complications MS-DRG 871 | $16,981.02 | $62,892.65 | $2,709.06 – $42,735.00 |
| Sepsis, without major complications MS-DRG 872 | $9,445.28 | $34,982.50 | $2,709.06 – $22,512.60 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $7,554.22 | $27,978.60 | $2,709.06 – $19,159.80 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $7,579.43 | $28,071.95 | $2,709.06 – $17,151.20 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $11,919.72 | $44,147.10 | $2,709.06 – $22,226.60 |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | $16,699.00 | $61,848.15 | $2,709.06 – $27,295.40 |
| Vaginal delivery, without complications MS-DRG 807 | $3,943.08 | $14,604.00 | $6,092.26 – $14,832.40 |
| Weight loss surgery, without complications MS-DRG 621 | $27,729.71 | $102,702.64 | $3,146.05 – $33,184.80 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $670.41 | $2,483.00 | $285.87 – $3,386.81 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $3,251.73 | $12,043.45 | $935.78 – $2,980.20 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $2,250.34 | $8,334.60 | $746.83 – $2,378.45 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $2,347.35 | $8,693.90 | $935.78 – $2,980.20 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | $4,955.76 | $18,354.68 | $2,441.70 – $7,776.15 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | $189.81 | $703.00 | $136.14 – $534.28 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $223.83 | $829.00 | $223.21 – $780.39 |
| Sleep study with CPAP titration CPT 95811 | $2,169.45 | $8,035.00 | $780.39 – $6,106.60 |
| Sleep study, overnight in a sleep lab CPT 95810 | $1,862.19 | $6,897.00 | $780.39 – $5,241.72 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $145.53 | $539.00 | $141.84 – $727.56 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $59.94 | $222.00 | $26.73 – $223.75 |
| Physical therapy evaluation, low complexity CPT 97161 | $97.47 | $361.00 | $94.80 – $270.75 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $138.24 | $512.00 | $94.80 – $384.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $52.38 | $194.00 | $28.03 – $223.75 |
| Therapeutic activities, 15 minutes CPT 97530 | $67.23 | $249.00 | $33.60 – $223.75 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $189.81 | $703.00 | $79.56 – $527.25 |
| Group psychotherapy CPT 90853 | $141.75 | $525.00 | $79.56 – $393.75 |
| Psychiatric diagnostic evaluation CPT 90791 | $115.56 | $428.00 | $159.12 – $325.28 |
| Psychotherapy, 30 minutes CPT 90832 | $98.55 | $365.00 | $159.12 – $273.75 |
| Psychotherapy, 60 minutes CPT 90837 | $160.38 | $594.00 | $159.12 – $445.50 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $74.79 | $277.00 | $73.71 – $242.61 |
| IV hydration, each additional hour CPT 96361 | $93.15 | $345.00 | $49.54 – $262.20 |
| IV hydration, first hour CPT 96360 | $260.82 | $966.00 | $73.71 – $734.16 |
| IV push injection of a drug, first CPT 96374 | $56.16 | $208.00 | $73.71 – $716.70 |
| IV push injection, each additional drug CPT 96375 | $111.78 | $414.00 | $49.54 – $314.64 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $10.08 | $37.35 | $15.32 – $28.01 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $9.18 | $34.00 | $4.86 – $25.50 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $18.68 | $69.20 | $29.62 – $51.90 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $12.54 | $46.45 | ? – $34.84 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $33.57 | $124.35 | $14.74 – $93.26 |
| Morphine injection, up to 10 mg HCPCS J2270 | $10.11 | $37.45 | $16.03 – $28.09 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $9.18 | $34.00 | ? – $25.50 |
| Propofol injection, per 10 mg HCPCS J2704 | $40.50 | $150.00 | ? – $112.50 |
| Saline IV solution, 1000 ml HCPCS J7030 | $13.27 | $49.15 | $2.82 – $37.39 |
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.