Ascension Providence Rochester Hospital

1101 W University Drive, Rochester, MI 48307 · Acute care hospital · Emergency room

These are Ascension Providence Rochester Hospital'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.

230 of the services we track have a posted price here; 142 of them have a discounted cash price. 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	$919.62	$2,554.50	$1,009.00 – $2,554.50
Emergency room visit, level 1 (minor) CPT 99281	$248.40	$690.00	$21.40 – $621.00
Emergency room visit, level 2 CPT 99282	$299.88	$833.00	$21.40 – $612.00
Emergency room visit, level 3 (moderate) CPT 99283	$396.00	$1,100.00	$21.40 – $1,087.25
Emergency room visit, level 4 CPT 99284	$777.60	$2,160.00	$174.17 – $1,944.00
Emergency room visit, level 5 (most severe) CPT 99285	$1,281.60	$3,560.00	$234.75 – $3,204.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$263.97	$733.25	$513.27 – $513.27

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$151.56	$421.00	$85.55 – $127.30
New patient office visit, about 30 minutes CPT 99203	$195.57	$543.25	$128.61 – $191.38
New patient office visit, about 45 minutes CPT 99204	$229.77	$638.25	$217.75 – $324.01
New patient office visit, about 60 minutes CPT 99205	$273.87	$760.75	$284.17 – $422.84
Office consultation, about 40 minutes CPT 99243	not posted		$161.53 – $240.36
Office consultation, about 60 minutes CPT 99244	not posted		$259.63 – $386.33
Office visit, established patient, about 10 to 19 minutes CPT 99212	$174.60	$485.00	$43.08 – $64.10
Office visit, established patient, about 20 to 29 minutes CPT 99213	$209.97	$583.25	$86.15 – $128.19
Office visit, established patient, about 30 to 39 minutes CPT 99214	$239.94	$666.50	$132.81 – $197.62
Office visit, established patient, about 40 to 54 minutes CPT 99215	$270.09	$750.25	$187.24 – $278.62
Office visit, established patient, brief (often a nurse) CPT 99211	$146.25	$406.25	$15.55 – $23.14
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted		$165.12 – $245.69
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted		$201.00 – $299.09

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$38.79	$107.75	$42.39 – $61.81
Abdominal X-ray, 1 view CPT 74018	$233.55	$648.75	$25.73 – $369.79
Ankle X-ray, 3 or more views CPT 73610	$140.58	$390.50	$29.74 – $222.59
Bone density scan (DEXA), hips and spine CPT 77080	$233.55	$648.75	$38.09 – $617.75
Breast ultrasound, one breast, complete CPT 76641	$203.94	$566.50	$102.25 – $322.90
Breast ultrasound, one breast, limited CPT 76642	$160.29	$445.25	$62.12 – $230.71
Chest X-ray, 1 view CPT 71045	$120.69	$335.25	$20.71 – $195.53
Chest X-ray, 2 views CPT 71046	$148.77	$413.25	$28.74 – $235.55
CT angiogram of the chest (checks for lung clots) CPT 71275	$1,010.34	$2,806.50	$180.34 – $1,523.47
CT angiogram of the head CPT 70496	$1,114.20	$3,095.00	$180.34 – $1,764.15
CT scan of the abdomen and pelvis, with contrast CPT 74177	$1,895.49	$5,265.25	$252.74 – $3,001.19
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$2,021.40	$5,615.00	$252.74 – $3,200.55
CT scan of the abdomen and pelvis, without contrast CPT 74176	$1,466.37	$4,073.25	$189.79 – $2,321.75
CT scan of the abdomen, without contrast CPT 74150	$733.14	$2,036.50	$106.88 – $1,105.52
CT scan of the chest, with contrast CPT 71260	$1,052.73	$2,924.25	$173.08 – $1,587.45
CT scan of the chest, without contrast CPT 71250	$733.14	$2,036.50	$106.88 – $618.68
CT scan of the head, without contrast CPT 70450	$695.25	$1,931.25	$106.88 – $618.68
CT scan of the neck (cervical spine), without contrast CPT 72125	$786.96	$2,186.00	$106.88 – $618.68
CT scan of the pelvis, with contrast CPT 72193	$473.49	$1,315.25	$180.34 – $1,005.85
CT scan of the sinuses or face, without contrast CPT 70486	$524.25	$1,456.25	$106.88 – $790.59
Diagnostic mammogram, both breasts CPT 77066	$198.81	$552.25	$94.30 – $314.78
Diagnostic mammogram, one breast CPT 77065	$130.50	$362.50	$158.03 – $230.45
Foot X-ray, 3 or more views CPT 73630	$140.58	$390.50	$27.74 – $222.59
Hand X-ray, 3 or more views CPT 73130	$115.20	$320.00	$30.08 – $195.53
Knee X-ray, 3 views CPT 73562	$134.37	$373.25	$33.75 – $212.75
Leg or arm vein ultrasound, both sides CPT 93970	$558.09	$1,550.25	$184.44 – $404.14
Leg or arm vein ultrasound, one side CPT 93971	$351.00	$975.00	$106.88 – $247.47
Lower back X-ray, 2 or 3 views CPT 72100	$196.11	$544.75	$33.08 – $310.51
MRI of both breasts, without and with contrast CPT 77049	$1,754.37	$4,873.25	$618.23 – $1,617.36
MRI of the abdomen, without and with contrast CPT 74183	$1,460.43	$4,056.75	$354.51 – $2,107.81
MRI of the brain, without and with contrast CPT 70553	$1,460.43	$4,056.75	$332.80 – $2,107.81
MRI of the brain, without contrast CPT 70551	$490.59	$1,362.75	$204.15 – $1,319.12
MRI of the knee or other leg joint, without contrast CPT 73721	$959.58	$2,665.50	$210.84 – $1,319.12
MRI of the lower back (lumbar spine), without contrast CPT 72148	$959.58	$2,665.50	$199.14 – $1,319.12
MRI of the mid back (thoracic spine), without contrast CPT 72146	$959.58	$2,665.50	$198.48 – $1,319.12
MRI of the neck (cervical spine), without contrast CPT 72141	$959.58	$2,665.50	$198.48 – $1,319.12
MRI of the pelvis, without and with contrast CPT 72197	$1,460.43	$4,056.75	$353.18 – $2,107.81
MRI of the shoulder or other arm joint, without contrast CPT 73221	$959.58	$2,665.50	$211.18 – $1,319.12
Neck X-ray, 2 or 3 views CPT 72040	$190.71	$529.75	$31.41 – $301.96
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$287.37	$798.25	$96.28 – $455.00
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$287.37	$798.25	$106.88 – $455.00
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$205.02	$569.50	$106.88 – $295.12
Screening mammogram, both breasts CPT 77067	$150.30	$417.50	$78.03 – $243.70
Shoulder X-ray, 2 or more views CPT 73030	$131.67	$365.75	$27.74 – $208.48
Transvaginal pregnancy ultrasound CPT 76817	$214.20	$595.00	$92.55 – $308.37
Transvaginal ultrasound CPT 76830	$265.59	$737.75	$106.88 – $382.33
Ultrasound of the abdomen, complete CPT 76700	$396.09	$1,100.25	$106.88 – $570.14
Ultrasound of the neck or thyroid CPT 76536	$206.01	$572.25	$106.88 – $326.18
Wrist X-ray, 3 or more views CPT 73110	$140.58	$390.50	$33.08 – $222.59
X-ray of the lower back, 4 or more views CPT 72110	$236.52	$657.00	$46.11 – $374.49

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$100.80	$280.00	$7.11 – $37.31
Blood culture CPT 87040	$121.32	$337.00	$7.37 – $45.51
Blood draw (venipuncture) CPT 36415	$19.53	$54.25	$5.04 – $5.35
BNP test (heart failure) CPT 83880	$99.36	$276.00	$10.85 – $173.14
C-reactive protein (CRP) test CPT 86140	$29.88	$83.00	$4.35 – $22.84
Chlamydia test (DNA/NAAT) CPT 87491	$57.69	$160.25	$16.84 – $154.75
Complete blood count (CBC) with differential CPT 85025	$44.10	$122.50	$1.99 – $34.27
Complete blood count (CBC), automated CPT 85027	$31.86	$88.50	$1.99 – $28.53
Comprehensive metabolic panel (blood test) CPT 80053	$121.14	$336.50	$8.87 – $46.57
COVID-19 PCR test CPT 87635	$72.63	$201.75	$51.31 – $119.55
D-dimer test (blood clots) CPT 85379	$59.13	$164.25	$8.55 – $44.89
Drug screen, instrument chemistry CPT 80307	$32.04	$89.00	$52.20 – $52.20
Ferritin (iron stores) test CPT 82728	$54.18	$150.50	$11.45 – $60.11
Free T4 (thyroid) test CPT 84439	$50.94	$141.50	$5.77 – $39.78
General health panel (blood tests) CPT 80050	not posted		$66.05 – $155.76
Glucose (blood sugar) test CPT 82947	$37.26	$103.50	$3.30 – $17.33
Gonorrhea test (DNA/NAAT) CPT 87591	$57.69	$160.25	$16.84 – $154.75
Hemoglobin A1c test CPT 83036	$40.32	$112.00	$8.16 – $42.82
Hepatitis C antibody test CPT 86803	$23.31	$64.75	$10.82 – $62.93
HIV-1/HIV-2 antigen and antibody test CPT 87389	$48.69	$135.25	$8.68 – $106.19
Iron test CPT 83540	$50.85	$141.25	$5.43 – $28.53
Kidney function panel CPT 80069	$94.50	$262.50	$7.29 – $38.28
Lipase test (pancreas) CPT 83690	$52.11	$144.75	$5.79 – $30.38
Lipid panel, cholesterol and triglycerides CPT 80061	$95.67	$265.75	$11.25 – $59.05
Liver function panel CPT 80076	$47.16	$131.00	$6.86 – $36.03
Magnesium test CPT 83735	$57.33	$159.25	$5.63 – $29.55
Obstetric blood test panel CPT 80055	not posted		$47.81 – $71.72
Partial thromboplastin time (PTT), clotting test CPT 85730	$51.48	$143.00	$5.05 – $26.50
Pregnancy blood test (hCG), quantitative CPT 84702	$75.15	$208.75	$9.57 – $66.37
Prothrombin time (PT/INR), clotting test CPT 85610	$42.39	$117.75	$3.60 – $18.92
PSA (prostate specific antigen), free CPT 84154	$46.62	$129.50	$15.45 – $81.10
PSA (prostate specific antigen), total CPT 84153	$60.57	$168.25	$15.45 – $81.10
Rapid strep test CPT 87880	$17.73	$49.25	$12.84 – $38.51
Sed rate (ESR) test CPT 85652	$28.17	$78.25	$2.27 – $11.91
TB skin test CPT 86580	not posted		$24.00 – $36.00
Thyroid stimulating hormone (TSH) CPT 84443	$73.44	$204.00	$7.58 – $74.09
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$140.49	$390.25	$79.04 – $218.16
Troponin test (heart damage) CPT 84484	$83.34	$231.50	$10.47 – $54.99
Urinalysis, automated, with microscope CPT 81001	$33.66	$93.50	$2.66 – $13.98
Urinalysis, automated, without microscope CPT 81003	$14.49	$40.25	$1.89 – $9.92
Urinalysis, manual, with microscope CPT 81000	not posted		$4.02 – $6.03
Urinalysis, manual, without microscope CPT 81002	$17.46	$48.50	$2.92 – $15.35
Urine culture, colony count CPT 87086	$60.12	$167.00	$6.78 – $35.59
Urine pregnancy test CPT 81025	$14.49	$40.25	$7.23 – $37.97
Vitamin B12 test CPT 82607	$57.06	$158.50	$12.67 – $66.50
Vitamin D test CPT 82306	$82.44	$229.00	$24.86 – $130.54

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$605.52	$1,682.00	$190.45 – $405.92
ECG tracing only (no interpretation) CPT 93005	$120.15	$333.75	$7.08 – $135.87
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$1,516.41	$4,212.25	$136.74 – $334.71
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$32.35 – $76.29
Holter monitor, up to 48 hours CPT 93224	not posted		$150.16 – $223.44
Left heart catheterization CPT 93452	$3,751.20	$10,420.00	$2,400.00 – $4,177.77
Left heart catheterization with coronary angiogram CPT 93458	$7,824.60	$21,735.00	$2,400.00 – $4,177.77
Nuclear stress test (heart perfusion imaging) CPT 78452	$2,429.82	$6,749.50	$438.05 – $1,007.46
Treadmill stress test, complete CPT 93015	not posted		$120.25 – $178.93

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$859.35 – $11,305.89
Appendix removal, laparoscopic CPT 44970	not posted		$3,867.12 – $9,135.71
Breast biopsy with ultrasound guidance CPT 19083	$818.37	$2,273.25	$486.45 – $1,591.28
Carpal tunnel release CPT 64721	not posted		$659.94 – $3,249.57
Colonoscopy with biopsy CPT 45380	not posted		$429.26 – $1,897.98
Colonoscopy with polyp removal (snare) CPT 45385	not posted		$429.26 – $1,897.98
Colonoscopy, diagnostic CPT 45378	not posted		$893.55 – $1,340.32
Colposcopy with biopsy CPT 57454	not posted		$298.13 – $447.19
Cystoscopy (bladder scope) CPT 52000	$428.67	$1,190.75	$238.15 – $833.52
Ear tubes, under general anesthesia CPT 69436	not posted		$420.64 – $2,550.25
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted		$893.55 – $1,340.32
Gallbladder removal, laparoscopic CPT 47562	not posted		$1,888.85 – $9,836.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$6,074.00 – $7,593.00
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$3,110.01 – $15,900.78
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted		$859.35 – $4,721.41
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$1,061.55 – $9,135.71
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted		$1,061.55 – $5,876.65
Kidney stone shock-wave lithotripsy CPT 50590	not posted		$1,142.90 – $8,404.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$1,061.55 – $5,173.78
Lower colon endoscopy with ultrasound CPT 45391	not posted		$429.26 – $1,897.98
Nasal endoscopy, diagnostic CPT 31231	not posted		$190.27 – $285.41
Prostate biopsy CPT 55700	$544.50	$1,512.50	$652.80 – $1,417.29
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$6,730.74 – $15,900.78
Removal of a breast lump, open surgery CPT 19120	not posted		$859.35 – $5,725.85
Rotator cuff repair, arthroscopic CPT 29827	not posted		$1,213.20 – $11,305.89
Septoplasty (nasal septum repair) CPT 30520	not posted		$886.62 – $4,950.46
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$859.35 – $859.35
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$8,566.00 – $16,874.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$859.35 – $9,167.50
Total hip replacement CPT 27130	not posted		$9,520.93 – $22,492.34
Total knee replacement CPT 27447	not posted		$9,520.93 – $22,492.34
Upper endoscopy (EGD) with biopsy CPT 43239	not posted		$918.88 – $1,378.32
Upper endoscopy (EGD), diagnostic CPT 43235	not posted		$918.88 – $1,378.32
Vasectomy CPT 55250	not posted		$652.80 – $3,348.23

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	not posted		$1,931.77 – $4,563.63
Fetal non-stress test CPT 59025	$561.51	$1,559.75	$15.78 – $1,091.83
IUD insertion CPT 58300	not posted		$44.40 – $104.89
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$1,828.26 – $4,319.10
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted		$1,742.34 – $4,116.12

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$5,529.23 – $8,293.84
C-section, without complications MS-DRG 788	not posted	$6,005.24 – $9,007.86
Chest pain MS-DRG 313	not posted	$4,509.57 – $6,764.35
COPD flare-up, with major complications MS-DRG 190	not posted	$6,937.85 – $10,406.78
COPD flare-up, without complications MS-DRG 192	not posted	$4,021.03 – $6,031.55
Fainting (syncope) MS-DRG 312	not posted	$5,459.08 – $8,188.62
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$6,142.41 – $9,213.61
Heart failure, with major complications MS-DRG 291	not posted	$8,040.81 – $12,061.22
Heart failure, without complications MS-DRG 293	not posted	$3,545.02 – $5,317.53
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$61,272.51 – $91,908.76
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$12,081.26 – $18,121.89
Irregular heartbeat, without complications MS-DRG 310	not posted	$3,545.65 – $5,318.48
Kidney failure, with complications MS-DRG 683	not posted	$5,485.39 – $8,228.09
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$5,070.13 – $7,605.19
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$15,290.57 – $22,935.85
Normal newborn care MS-DRG 795	not posted	$1,251.41 – $1,877.12
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$4,874.09 – $7,311.14
Pneumonia, with complications MS-DRG 194	not posted	$5,047.59 – $7,571.39
Pneumonia, with major complications MS-DRG 193	not posted	$8,232.47 – $12,348.70
Pneumonia, without complications MS-DRG 195	not posted	$3,936.48 – $5,904.72
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$8,748.56 – $13,122.84
Sepsis, with major complications MS-DRG 871	not posted	$12,166.44 – $18,249.66
Sepsis, without major complications MS-DRG 872	not posted	$6,409.22 – $9,613.83
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$5,454.70 – $8,182.05
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$4,882.86 – $7,324.29
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$6,327.80 – $9,491.70
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$7,770.86 – $11,656.29
Vaginal delivery, without complications MS-DRG 807	not posted	$4,222.71 – $6,334.07
Weight loss surgery, without complications MS-DRG 621	not posted	$9,447.55 – $14,171.32

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$636.48	$1,768.00	$24.83 – $1,237.60
Lower back nerve root injection with imaging guidance CPT 64483	$1,605.87	$4,460.75	$340.77 – $3,122.53
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$777.78	$2,160.50	$262.86 – $1,512.35
Lower back spinal injection (epidural), without imaging CPT 62322	not posted		$872.56 – $1,308.84

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$849.94 – $3,821.32
Eye exam, new patient, comprehensive CPT 92004	not posted	$126.30 – $189.45
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$537.67 – $806.50

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$153.34 – $230.01

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$406.71	$1,129.75	$148.96 – $587.00
Sleep study with CPAP titration CPT 95811	$2,952.45	$8,201.25	$874.02 – $2,940.00
Sleep study, overnight in a sleep lab CPT 95810	$2,952.45	$8,201.25	$831.54 – $2,940.00

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$107.28	$298.00	$229.66 – $287.77

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$48.96	$136.00	$47.26 – $70.32
Physical therapy evaluation, low complexity CPT 97161	$133.02	$369.50	$143.57 – $213.63
Physical therapy evaluation, moderate complexity CPT 97162	$154.98	$430.50	$143.57 – $213.63
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$44.37	$123.25	$52.04 – $77.43
Therapeutic activities, 15 minutes CPT 97530	$43.20	$120.00	$67.59 – $100.58

Mental health

Service	Cash price	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	not posted	$157.47 – $236.20
Family psychotherapy, without the patient, 50 minutes CPT 90846	not posted	$157.47 – $236.20
Group psychotherapy CPT 90853	not posted	$90.66 – $135.99
Psychiatric diagnostic evaluation CPT 90791	not posted	$157.47 – $236.20
Psychotherapy, 30 minutes CPT 90832	not posted	$157.47 – $236.20
Psychotherapy, 45 minutes CPT 90834	not posted	$157.47 – $236.20
Psychotherapy, 60 minutes CPT 90837	not posted	$157.47 – $236.20

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$75.87	$210.75	$100.38 – $149.36
IV hydration, each additional hour CPT 96361	$18.00	$50.00	$22.72 – $33.81
IV hydration, first hour CPT 96360	$72.00	$200.00	$64.01 – $95.24
IV push injection of a drug, first CPT 96374	$90.00	$250.00	$65.80 – $97.91
IV push injection, each additional drug CPT 96375	$107.55	$298.75	$28.12 – $41.84

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$35.46	$98.50	? – $8.78
Dexamethasone injection, per 1 mg HCPCS J1100	not posted	$2.50
Fentanyl injection, per 0.1 mg HCPCS J3010	$8.01	$22.25	? – $1.35
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$9.54	$26.50
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$6.93	$19.25
Morphine injection, up to 10 mg HCPCS J2270	$25.92	$72.00	? – $2.03
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$12.51	$34.75	? – $2.05
Saline IV solution, 1000 ml HCPCS J7030	$19.08	$53.00	$1.90 – $51.70

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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