Melrosewakefield Healthcare
585 Lebanon Street, Melrose, MA 02176 · Acute care hospital · Emergency room
These are Melrosewakefield Healthcare'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.
200 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 | $812.70 | $1,161.00 | $372.00 – $2,361.28 |
| Emergency room visit, level 1 (minor) CPT 99281 | $388.50 | $555.00 | $106.21 – $1,559.00 |
| Emergency room visit, level 2 CPT 99282 | $480.90 | $687.00 | $175.26 – $1,559.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $535.50 | $765.00 | $267.75 – $1,559.00 |
| Emergency room visit, level 4 CPT 99284 | $660.10 | $943.00 | $330.05 – $1,559.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $991.90 | $1,417.00 | $372.00 – $1,559.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $461.30 | $659.00 | $67.19 – $712.58 |
Office visits
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $80.50 | $115.00 | $19.88 – $530.75 |
| Abdominal X-ray, 1 view CPT 74018 | $198.10 | $283.00 | $58.71 – $530.75 |
| Ankle X-ray, 3 or more views CPT 73610 | $200.20 | $286.00 | $77.16 – $530.75 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $331.10 | $473.00 | $82.69 – $530.75 |
| Breast ultrasound, one breast, complete CPT 76641 | $350.70 | $501.00 | $112.51 – $557.00 |
| Breast ultrasound, one breast, limited CPT 76642 | $268.80 | $384.00 | $31.15 – $576.00 |
| Chest X-ray, 1 view CPT 71045 | $177.80 | $254.00 | $44.45 – $530.75 |
| Chest X-ray, 2 views CPT 71046 | $198.10 | $283.00 | $64.24 – $530.75 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $523.60 | $748.00 | $201.74 – $1,948.00 |
| CT angiogram of the head CPT 70496 | $842.10 | $1,203.00 | $201.74 – $1,948.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $1,290.80 | $1,844.00 | $255.65 – $1,948.00 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $1,290.80 | $1,844.00 | $288.41 – $1,948.00 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $1,297.80 | $1,854.00 | $121.29 – $1,948.00 |
| CT scan of the abdomen, without contrast CPT 74150 | $511.00 | $730.00 | $95.88 – $1,948.00 |
| CT scan of the chest, with contrast CPT 71260 | $1,331.40 | $1,902.00 | $132.91 – $1,948.00 |
| CT scan of the chest, without contrast CPT 71250 | $1,339.80 | $1,914.00 | $97.82 – $1,948.00 |
| CT scan of the head, without contrast CPT 70450 | $1,050.00 | $1,500.00 | $79.23 – $1,948.00 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $822.50 | $1,175.00 | $98.98 – $1,948.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $710.50 | $1,015.00 | $201.74 – $1,948.00 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $751.10 | $1,073.00 | $104.01 – $1,948.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $483.00 | $690.00 | $86.59 – $690.00 |
| Diagnostic mammogram, one breast CPT 77065 | $402.50 | $575.00 | $69.55 – $575.00 |
| Foot X-ray, 3 or more views CPT 73630 | $200.20 | $286.00 | $71.63 – $530.75 |
| Hand X-ray, 3 or more views CPT 73130 | $200.20 | $286.00 | $79.92 – $530.75 |
| Knee X-ray, 3 views CPT 73562 | $200.20 | $286.00 | $87.31 – $530.75 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $501.90 | $717.00 | $125.48 – $800.04 |
| Leg or arm vein ultrasound, one side CPT 93971 | $353.50 | $505.00 | $85.69 – $819.08 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $236.60 | $338.00 | $79.92 – $530.75 |
| MRI of both breasts, without and with contrast CPT 77049 | $2,448.60 | $3,498.00 | $192.94 – $3,498.00 |
| MRI of the abdomen, without and with contrast CPT 74183 | $1,445.50 | $2,065.00 | $277.18 – $2,065.00 |
| MRI of the brain, without and with contrast CPT 70553 | $3,135.30 | $4,479.00 | $192.94 – $4,479.00 |
| MRI of the brain, without contrast CPT 70551 | $1,632.40 | $2,332.00 | $115.28 – $2,332.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $1,878.80 | $2,684.00 | $115.28 – $2,684.00 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $1,793.40 | $2,562.00 | $115.28 – $2,562.00 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $1,857.80 | $2,654.00 | $115.28 – $2,654.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $742.00 | $1,060.00 | $115.28 – $1,060.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $2,119.60 | $3,028.00 | $192.94 – $3,028.00 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $715.40 | $1,022.00 | $115.28 – $1,022.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $204.40 | $292.00 | $79.92 – $530.75 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $354.20 | $506.00 | $83.73 – $557.00 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $350.70 | $501.00 | $112.51 – $557.00 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $377.30 | $539.00 | $112.51 – $557.00 |
| Screening mammogram, both breasts CPT 77067 | $515.90 | $737.00 | $81.47 – $737.00 |
| Shoulder X-ray, 2 or more views CPT 73030 | $141.40 | $202.00 | $35.35 – $530.75 |
| Transvaginal pregnancy ultrasound CPT 76817 | $312.20 | $446.00 | $112.51 – $557.00 |
| Transvaginal ultrasound CPT 76830 | $354.20 | $506.00 | $112.51 – $557.00 |
| Ultrasound of the abdomen, complete CPT 76700 | $456.40 | $652.00 | $89.54 – $652.00 |
| Ultrasound of the neck or thyroid CPT 76536 | $350.70 | $501.00 | $56.26 – $557.00 |
| Wrist X-ray, 3 or more views CPT 73110 | $200.20 | $286.00 | $91.00 – $530.75 |
| X-ray of the lower back, 4 or more views CPT 72110 | $294.00 | $420.00 | $108.54 – $530.75 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $21.70 | $31.00 | $10.85 – $530.75 |
| Blood culture CPT 87040 | $25.20 | $36.00 | $12.60 – $530.75 |
| Blood draw (venipuncture) CPT 36415 | $19.60 | $28.00 | $6.55 – $530.75 |
| BNP test (heart failure) CPT 83880 | $109.90 | $157.00 | $54.95 – $530.75 |
| C-reactive protein (CRP) test CPT 86140 | $12.60 | $18.00 | $6.30 – $530.75 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $81.90 | $117.00 | $40.95 – $530.75 |
| Complete blood count (CBC) with differential CPT 85025 | $18.90 | $27.00 | $9.45 – $530.75 |
| Complete blood count (CBC), automated CPT 85027 | $16.10 | $23.00 | $8.05 – $530.75 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $27.30 | $39.00 | $13.65 – $530.75 |
| COVID-19 PCR test CPT 87635 | $84.00 | $120.00 | $42.00 – $530.75 |
| D-dimer test (blood clots) CPT 85379 | $23.80 | $34.00 | $11.90 – $530.75 |
| Drug screen, instrument chemistry CPT 80307 | $165.20 | $236.00 | $76.00 – $530.75 |
| Ferritin (iron stores) test CPT 82728 | $31.50 | $45.00 | $15.75 – $530.75 |
| Free T4 (thyroid) test CPT 84439 | $22.40 | $32.00 | $11.20 – $530.75 |
| General health panel (blood tests) CPT 80050 | $144.90 | $207.00 | $72.45 – $530.75 |
| Glucose (blood sugar) test CPT 82947 | $10.50 | $15.00 | $5.25 – $530.75 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $81.90 | $117.00 | $40.95 – $530.75 |
| Hemoglobin A1c test CPT 83036 | $25.20 | $36.00 | $12.60 – $530.75 |
| Hepatitis C antibody test CPT 86803 | $37.10 | $53.00 | $18.55 – $530.75 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $62.30 | $89.00 | $31.15 – $530.75 |
| Iron test CPT 83540 | $16.10 | $23.00 | $8.05 – $530.75 |
| Kidney function panel CPT 80069 | $22.40 | $32.00 | $11.20 – $530.75 |
| Lipase test (pancreas) CPT 83690 | $16.80 | $24.00 | $8.40 – $530.75 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $35.00 | $50.00 | $17.50 – $530.75 |
| Liver function panel CPT 80076 | $20.30 | $29.00 | $10.15 – $530.75 |
| Magnesium test CPT 83735 | $16.80 | $24.00 | $8.40 – $530.75 |
| Obstetric blood test panel CPT 80055 | $117.60 | $168.00 | $58.80 – $530.75 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $14.70 | $21.00 | $7.35 – $530.75 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $37.10 | $53.00 | $18.55 – $530.75 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $10.50 | $15.00 | $5.25 – $530.75 |
| PSA (prostate specific antigen), free CPT 84154 | $45.50 | $65.00 | $22.75 – $530.75 |
| PSA (prostate specific antigen), total CPT 84153 | $45.50 | $65.00 | $22.75 – $530.75 |
| Rapid strep test CPT 87880 | $46.20 | $66.00 | $23.10 – $530.75 |
| Sed rate (ESR) test CPT 85652 | $6.30 | $9.00 | $3.15 – $530.75 |
| TB skin test CPT 86580 | $63.70 | $91.00 | $12.33 – $530.75 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $43.40 | $62.00 | $21.70 – $530.75 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $134.40 | $192.00 | $67.20 – $530.75 |
| Troponin test (heart damage) CPT 84484 | $35.00 | $50.00 | $17.50 – $530.75 |
| Urinalysis, automated, with microscope CPT 81001 | $7.70 | $11.00 | $3.85 – $530.75 |
| Urinalysis, automated, without microscope CPT 81003 | $5.60 | $8.00 | $2.80 – $530.75 |
| Urinalysis, manual, with microscope CPT 81000 | $9.10 | $13.00 | $4.55 – $530.75 |
| Urinalysis, manual, without microscope CPT 81002 | $8.40 | $12.00 | $4.20 – $530.75 |
| Urine culture, colony count CPT 87086 | $19.60 | $28.00 | $9.80 – $530.75 |
| Urine pregnancy test CPT 81025 | $18.90 | $27.00 | $9.45 – $530.75 |
| Vitamin B12 test CPT 82607 | $42.00 | $60.00 | $21.00 – $530.75 |
| Vitamin D test CPT 82306 | $72.80 | $104.00 | $36.40 – $530.75 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $485.80 | $694.00 | $242.90 – $800.04 |
| ECG tracing only (no interpretation) CPT 93005 | $123.20 | $176.00 | $61.60 – $530.75 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $1,080.10 | $1,543.00 | $530.75 – $1,726.29 |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 | $106.40 | $152.00 | $39.08 – $530.75 |
| Holter monitor, up to 48 hours CPT 93224 | $338.10 | $483.00 | $169.05 – $587.38 |
| Left heart catheterization CPT 93452 | $4,545.80 | $6,494.00 | $530.75 – $8,776.91 |
| Left heart catheterization with coronary angiogram CPT 93458 | $6,596.80 | $9,424.00 | $530.75 – $9,424.00 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $3,140.90 | $4,487.00 | $530.75 – $4,635.04 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Breast biopsy with ultrasound guidance CPT 19083 | $2,149.00 | $3,070.00 | $530.75 – $6,443.53 |
| Carpal tunnel release CPT 64721 | $4,914.70 | $7,021.00 | $530.75 – $11,387.71 |
| Colonoscopy with biopsy CPT 45380 | $2,338.70 | $3,341.00 | $530.75 – $3,399.87 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $2,524.90 | $3,607.00 | $530.75 – $3,607.00 |
| Colonoscopy, diagnostic CPT 45378 | $2,524.90 | $3,607.00 | $283.66 – $3,607.00 |
| Cystoscopy (bladder scope) CPT 52000 | $728.00 | $1,040.00 | $364.00 – $1,951.01 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $1,661.10 | $2,373.00 | $364.71 – $2,584.77 |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $6,255.20 | $8,936.00 | $530.75 – $9,662.50 |
| Nasal endoscopy, diagnostic CPT 31231 | $460.60 | $658.00 | $187.51 – $711.50 |
| Prostate biopsy CPT 55700 | $2,981.30 | $4,259.00 | $530.75 – $4,605.26 |
| Screening colonoscopy, average risk HCPCS G0121 | $1,942.50 | $2,775.00 | $283.66 – $2,775.00 |
| Screening colonoscopy, high risk HCPCS G0105 | $2,034.20 | $2,906.00 | $283.66 – $2,906.00 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $1,962.80 | $2,804.00 | $435.44 – $2,804.00 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $1,962.80 | $2,804.00 | $435.44 – $2,804.00 |
| Vasectomy CPT 55250 | $991.20 | $1,416.00 | $495.60 – $5,433.26 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $380.10 | $543.00 | $190.05 – $587.15 |
| IUD insertion CPT 58300 | $1,521.10 | $2,173.00 | $89.94 – $2,349.66 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $9,516.29 | $13,594.70 | $530.75 – $13,594.70 |
| C-section, without complications MS-DRG 788 | $17,302.55 | $24,717.93 | $530.75 – $14,933.00 |
| Chest pain MS-DRG 313 | $37,966.94 | $54,238.49 | $12,978.09 – $83,279.84 |
| COPD flare-up, with major complications MS-DRG 190 | $19,541.86 | $27,916.94 | $4,883.55 – $27,008.84 |
| COPD flare-up, without complications MS-DRG 192 | $36,486.51 | $52,123.58 | $7,525.94 – $60,264.93 |
| Fainting (syncope) MS-DRG 312 | $32,504.17 | $46,434.53 | $60,274.30 – $84,233.33 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $13,663.13 | $19,518.75 | $530.75 – $14,681.35 |
| Heart failure, with major complications MS-DRG 291 | $10,873.31 | $15,533.30 | $530.75 – $19,066.14 |
| Heart failure, without complications MS-DRG 293 | $7,496.09 | $10,708.70 | ? – $7,456.97 |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | $198,709.95 | $283,871.36 | $530.75 – $121,976.34 |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | $129,225.75 | $184,608.22 | $6,780.11 – $48,920.93 |
| Irregular heartbeat, without complications MS-DRG 310 | $629,760.93 | $899,658.47 | $10,479.70 – $82,857.20 |
| Kidney failure, with complications MS-DRG 683 | $8,878.58 | $12,683.69 | $530.75 – $13,163.82 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $49,774.92 | $71,107.03 | $31,649.56 – $112,794.19 |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | $33,295.87 | $47,565.53 | $530.75 – $33,232.58 |
| Normal newborn care MS-DRG 795 | $2,001.27 | $2,858.96 | $530.75 – $3,384.50 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $34,586.85 | $49,409.78 | $530.75 – $49,409.78 |
| Pneumonia, with complications MS-DRG 194 | $23,856.92 | $34,081.32 | $5,144.47 – $53,735.79 |
| Pneumonia, with major complications MS-DRG 193 | $70,652.16 | $100,931.65 | $11,588.59 – $40,058.13 |
| Pneumonia, without complications MS-DRG 195 | $7,802.87 | $11,146.96 | $530.75 – $9,586.25 |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | $13,160.04 | $18,800.05 | $530.75 – $14,882.90 |
| Sepsis, with major complications MS-DRG 871 | $15,681.67 | $22,402.39 | $530.75 – $28,595.20 |
| Sepsis, without major complications MS-DRG 872 | $10,105.89 | $14,436.99 | $530.75 – $15,297.62 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $19,431.48 | $27,759.25 | $530.75 – $27,759.25 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $8,975.98 | $12,822.83 | $530.75 – $12,822.83 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $13,288.89 | $18,984.13 | $530.75 – $15,109.56 |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | $15,789.48 | $22,556.40 | $530.75 – $18,442.61 |
| Vaginal delivery, without complications MS-DRG 807 | $9,438.04 | $13,482.91 | $530.75 – $12,728.00 |
| Weight loss surgery, without complications MS-DRG 621 | $481,669.44 | $688,099.20 | $8,023.37 – $177,011.00 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $374.50 | $535.00 | $187.25 – $858.76 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $814.80 | $1,164.00 | $407.40 – $2,077.87 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | $312.90 | $447.00 | $138.00 – $530.75 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $455.00 | $650.00 | $207.09 – $702.85 |
| Sleep study with CPAP titration CPT 95811 | $1,942.50 | $2,775.00 | $530.75 – $3,167.38 |
| Sleep study, overnight in a sleep lab CPT 95810 | $2,111.20 | $3,016.00 | $530.75 – $3,261.20 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $303.10 | $433.00 | $97.25 – $530.75 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $108.50 | $155.00 | $54.25 – $530.75 |
| Physical therapy evaluation, low complexity CPT 97161 | $192.50 | $275.00 | $96.25 – $530.75 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $192.50 | $275.00 | $96.25 – $530.75 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $116.20 | $166.00 | $58.10 – $530.75 |
| Therapeutic activities, 15 minutes CPT 97530 | $112.70 | $161.00 | $56.35 – $530.75 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $262.50 | $375.00 | $46.33 – $530.75 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $262.50 | $375.00 | $46.33 – $530.75 |
| Group psychotherapy CPT 90853 | $255.50 | $365.00 | $23.44 – $530.75 |
| Psychiatric diagnostic evaluation CPT 90791 | $268.80 | $384.00 | $41.74 – $530.75 |
| Psychotherapy, 30 minutes CPT 90832 | $171.50 | $245.00 | $32.94 – $530.75 |
| Psychotherapy, 45 minutes CPT 90834 | $233.80 | $334.00 | $41.74 – $530.75 |
| Psychotherapy, 60 minutes CPT 90837 | $319.20 | $456.00 | $41.74 – $530.75 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $104.30 | $149.00 | $23.22 – $530.75 |
| IV hydration, each additional hour CPT 96361 | $91.00 | $130.00 | $45.50 – $530.75 |
| IV hydration, first hour CPT 96360 | $429.10 | $613.00 | $200.49 – $662.84 |
| IV push injection of a drug, first CPT 96374 | $205.80 | $294.00 | $99.18 – $649.51 |
| IV push injection, each additional drug CPT 96375 | $66.50 | $95.00 | $33.25 – $530.75 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $7.60 | $10.85 | $3.31 – $530.75 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $2.10 | $3.00 | ? – $530.75 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $3.07 | $4.39 | $1.14 – $530.75 |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | $12.03 | $17.19 | $2.92 – $530.75 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $4.59 | $6.56 | ? – $530.75 |
| Morphine injection, up to 10 mg HCPCS J2270 | $7.65 | $10.93 | $2.27 – $530.75 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $2.23 | $3.19 | ? – $530.75 |
| Propofol injection, per 10 mg HCPCS J2704 | $4.83 | $6.90 | $2.42 – $530.75 |
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.