Mercy Hospital Washington
901 East 5th Street, Washington, MO 63090 · Acute care hospital · Emergency room
These are Mercy Hospital Washington's own posted figures from its standard-charges file dated June 10, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
207 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 | $2,564.90 | $3,946.00 | $776.00 – $1,798.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $193.05 | $297.00 | $451.00 – $1,823.00 |
| Emergency room visit, level 2 CPT 99282 | $767.00 | $1,180.00 | $134.99 – $222.73 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $1,583.76 | $2,436.55 | $268.22 – $341.77 |
| Emergency room visit, level 4 CPT 99284 | $2,705.30 | $4,162.00 | $776.00 – $1,798.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $4,848.09 | $7,458.60 | $585.16 – $745.62 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $322.40 | $496.00 | $197.14 – $251.20 |
Office visits
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $98.15 | $151.00 | $292.00 – $336.00 |
| Abdominal X-ray, 1 view CPT 74018 | $289.90 | $446.00 | $176.00 – $201.00 |
| Ankle X-ray, 3 or more views CPT 73610 | $490.10 | $754.00 | $85.51 – $108.96 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $224.90 | $346.00 | $43.54 – $217.04 |
| Breast ultrasound, one breast, complete CPT 76641 | $543.40 | $836.00 | $54.34 – $752.40 |
| Breast ultrasound, one breast, limited CPT 76642 | $522.60 | $804.00 | $85.51 – $108.96 |
| Chest X-ray, 1 view CPT 71045 | $224.25 | $345.00 | $176.00 – $201.00 |
| Chest X-ray, 2 views CPT 71046 | $282.10 | $434.00 | $176.00 – $201.00 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $1,613.30 | $2,482.00 | $261.00 – $464.00 |
| CT angiogram of the head CPT 70496 | $1,366.30 | $2,102.00 | $525.00 – $525.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $2,717.65 | $4,181.00 | $342.80 – $436.80 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $3,914.95 | $6,023.00 | $525.00 – $525.00 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $2,327.65 | $3,581.00 | $261.00 – $464.00 |
| CT scan of the abdomen, without contrast CPT 74150 | $853.45 | $1,313.00 | $261.00 – $464.00 |
| CT scan of the chest, with contrast CPT 71260 | $1,364.35 | $2,099.00 | $172.35 – $219.61 |
| CT scan of the chest, without contrast CPT 71250 | $1,036.10 | $1,594.00 | $102.72 – $130.89 |
| CT scan of the head, without contrast CPT 70450 | $1,132.30 | $1,742.00 | $261.00 – $464.00 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $1,725.75 | $2,655.00 | $102.72 – $130.89 |
| CT scan of the pelvis, with contrast CPT 72193 | $1,548.30 | $2,382.00 | $172.35 – $219.61 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $971.10 | $1,494.00 | $261.00 – $464.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $386.10 | $594.00 | $94.03 – $506.22 |
| Diagnostic mammogram, one breast CPT 77065 | $257.40 | $396.00 | $25.74 – $356.40 |
| Foot X-ray, 3 or more views CPT 73630 | $483.60 | $744.00 | $85.51 – $108.96 |
| Hand X-ray, 3 or more views CPT 73130 | $484.90 | $746.00 | $43.54 – $130.34 |
| Knee X-ray, 3 views CPT 73562 | $569.40 | $876.00 | $85.51 – $108.96 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $2,256.80 | $3,472.00 | $234.45 – $298.73 |
| Leg or arm vein ultrasound, one side CPT 93971 | $1,230.45 | $1,893.00 | $102.72 – $130.89 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $223.60 | $344.00 | $44.55 – $149.59 |
| MRI of the abdomen, without and with contrast CPT 74183 | $2,055.30 | $3,162.00 | $560.00 – $560.00 |
| MRI of the brain, without and with contrast CPT 70553 | $1,785.55 | $2,747.00 | $304.45 – $907.22 |
| MRI of the brain, without contrast CPT 70551 | $1,677.00 | $2,580.00 | $560.00 – $560.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $2,354.30 | $3,622.00 | $351.00 – $797.00 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $1,882.40 | $2,896.00 | $560.00 – $560.00 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $1,274.00 | $1,960.00 | $127.40 – $1,764.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $1,820.00 | $2,800.00 | $351.00 – $797.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $1,899.95 | $2,923.00 | $351.00 – $797.00 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $4,209.40 | $6,476.00 | $351.00 – $797.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $325.00 | $500.00 | $176.00 – $201.00 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $762.45 | $1,173.00 | $90.66 – $333.43 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $876.20 | $1,348.00 | $87.62 – $1,213.20 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $856.05 | $1,317.00 | $102.72 – $130.89 |
| Screening mammogram, both breasts CPT 77067 | $279.50 | $430.00 | $27.95 – $387.00 |
| Shoulder X-ray, 2 or more views CPT 73030 | $421.85 | $649.00 | $176.00 – $201.00 |
| Transvaginal pregnancy ultrasound CPT 76817 | $499.20 | $768.00 | $87.08 – $260.68 |
| Transvaginal ultrasound CPT 76830 | $648.05 | $997.00 | $102.72 – $130.89 |
| Ultrasound of the abdomen, complete CPT 76700 | $526.50 | $810.00 | $90.66 – $359.18 |
| Ultrasound of the neck or thyroid CPT 76536 | $636.35 | $979.00 | $90.66 – $384.98 |
| Wrist X-ray, 3 or more views CPT 73110 | $415.35 | $639.00 | $85.51 – $108.96 |
| X-ray of the lower back, 4 or more views CPT 72110 | $444.60 | $684.00 | $102.72 – $130.89 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $118.30 | $182.00 | $11.83 – $163.80 |
| Blood culture CPT 87040 | $125.45 | $193.00 | $12.55 – $173.70 |
| Blood draw (venipuncture) CPT 36415 | $546.65 | $841.00 | $2.82 – $123.85 |
| BNP test (heart failure) CPT 83880 | $124.15 | $191.00 | $12.42 – $171.90 |
| C-reactive protein (CRP) test CPT 86140 | $24.70 | $38.00 | $2.47 – $34.20 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $159.90 | $246.00 | $15.99 – $221.40 |
| Complete blood count (CBC) with differential CPT 85025 | $17.55 | $27.00 | $1.76 – $24.30 |
| Complete blood count (CBC), automated CPT 85027 | $14.30 | $22.00 | $5.82 – $10.95 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $23.40 | $36.00 | $9.50 – $17.88 |
| COVID-19 PCR test CPT 87635 | $148.20 | $228.00 | $14.82 – $205.20 |
| D-dimer test (blood clots) CPT 85379 | $134.55 | $207.00 | $13.46 – $186.30 |
| Drug screen, instrument chemistry CPT 80307 | $231.40 | $356.00 | $55.93 – $92.28 |
| Ferritin (iron stores) test CPT 82728 | $110.50 | $170.00 | $11.05 – $153.00 |
| Free T4 (thyroid) test CPT 84439 | $125.45 | $193.00 | $8.12 – $15.25 |
| Glucose (blood sugar) test CPT 82947 | $45.50 | $70.00 | $3.54 – $6.64 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $110.50 | $170.00 | $31.58 – $59.36 |
| Hemoglobin A1c test CPT 83036 | $61.75 | $95.00 | $8.74 – $16.42 |
| Hepatitis C antibody test CPT 86803 | $50.70 | $78.00 | $5.07 – $70.20 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $48.75 | $75.00 | $21.67 – $40.75 |
| Iron test CPT 83540 | $49.40 | $76.00 | $5.82 – $10.96 |
| Kidney function panel CPT 80069 | $145.60 | $224.00 | $7.81 – $14.69 |
| Lipase test (pancreas) CPT 83690 | $22.10 | $34.00 | $6.20 – $11.65 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $128.05 | $197.00 | $12.05 – $22.65 |
| Liver function panel CPT 80076 | $172.90 | $266.00 | $17.29 – $239.40 |
| Magnesium test CPT 83735 | $83.85 | $129.00 | $6.03 – $11.33 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $70.85 | $109.00 | $7.09 – $98.10 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $144.30 | $222.00 | $14.43 – $199.80 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $38.35 | $59.00 | $3.84 – $53.10 |
| PSA (prostate specific antigen), free CPT 84154 | $68.90 | $106.00 | $6.89 – $95.40 |
| PSA (prostate specific antigen), total CPT 84153 | $75.40 | $116.00 | $7.54 – $104.40 |
| Rapid strep test CPT 87880 | $69.55 | $107.00 | $6.96 – $96.30 |
| Sed rate (ESR) test CPT 85652 | $12.35 | $19.00 | $2.43 – $4.57 |
| TB skin test CPT 86580 | $44.85 | $69.00 | $7.05 – $34.45 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $71.50 | $110.00 | $7.15 – $99.00 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $4,617.88 | $7,104.43 | $29.84 – $1,140.00 |
| Troponin test (heart damage) CPT 84484 | $55.25 | $85.00 | $5.53 – $76.50 |
| Urinalysis, automated, with microscope CPT 81001 | $11.05 | $17.00 | $1.11 – $15.30 |
| Urinalysis, automated, without microscope CPT 81003 | $28.60 | $44.00 | $2.03 – $3.53 |
| Urinalysis, manual, with microscope CPT 81000 | $52.65 | $81.00 | $5.27 – $72.90 |
| Urinalysis, manual, without microscope CPT 81002 | $55.90 | $86.00 | $5.59 – $77.40 |
| Urine culture, colony count CPT 87086 | $28.60 | $44.00 | $7.26 – $11.98 |
| Urine pregnancy test CPT 81025 | $90.35 | $139.00 | $9.04 – $125.10 |
| Vitamin B12 test CPT 82607 | $124.80 | $192.00 | $12.48 – $172.80 |
| Vitamin D test CPT 82306 | $105.95 | $163.00 | $10.60 – $146.70 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $2,483.65 | $3,821.00 | $128.98 – $1,069.71 |
| ECG tracing only (no interpretation) CPT 93005 | $218.40 | $336.00 | $57.96 – $73.86 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $4,692.35 | $7,219.00 | $469.24 – $6,497.10 |
| Left heart catheterization CPT 93452 | $5,682.30 | $8,742.00 | $4,901.00 – $10,011.00 |
| Left heart catheterization with coronary angiogram CPT 93458 | $9,004.45 | $13,853.00 | |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $5,278.65 | $8,121.00 | $691.00 – $795.00 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $21,188.62 | $32,597.88 | $829.36 – $7,734.17 |
| Appendix removal, laparoscopic CPT 44970 | $9,526.55 | $14,656.23 | $541.98 – $6,316.59 |
| Breast biopsy with ultrasound guidance CPT 19083 | $4,319.90 | $6,646.00 | $3,199.00 – $7,801.00 |
| Carpal tunnel release CPT 64721 | $5,736.65 | $8,825.61 | |
| Colonoscopy with biopsy CPT 45380 | $4,412.40 | $6,788.31 | |
| Colonoscopy with polyp removal (snare) CPT 45385 | $4,412.40 | $6,788.31 | |
| Colonoscopy, diagnostic CPT 45378 | $2,801.36 | $4,309.79 | $913.76 – $1,164.32 |
| Colposcopy with biopsy CPT 57454 | $5,973.01 | $9,189.25 | $112.84 – $1,106.00 |
| Cystoscopy (bladder scope) CPT 52000 | $3,987.31 | $6,134.33 | |
| Ear tubes, under general anesthesia CPT 69436 | $3,656.84 | $5,625.91 | |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $2,284.07 | $3,513.96 | |
| Gallbladder removal, laparoscopic CPT 47562 | $9,301.51 | $14,310.02 | $5,940.24 – $7,569.11 |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | $25,495.50 | $39,223.84 | |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $4,706.37 | $7,240.57 | |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $9,118.34 | $14,028.22 | $3,713.00 – $12,455.00 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $6,378.35 | $9,812.84 | $3,518.04 – $4,482.73 |
| Kidney stone shock-wave lithotripsy CPT 50590 | $9,708.10 | $14,935.54 | $3,463.59 – $4,413.34 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $7,628.45 | $11,736.07 | |
| Prostate biopsy CPT 55700 | $6,545.67 | $10,070.26 | $358.10 – $2,217.81 |
| Removal of a breast lump, open surgery CPT 19120 | $1,267.50 | $1,950.00 | $926.25 – $1,755.00 |
| Rotator cuff repair, arthroscopic CPT 29827 | $16,853.85 | $25,929.00 | $910.02 – $7,734.17 |
| Septoplasty (nasal septum repair) CPT 30520 | $8,276.31 | $12,732.78 | $3,199.00 – $7,801.00 |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $13,867.94 | $21,335.30 | $3,713.00 – $10,471.00 |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | $17,102.92 | $26,312.19 | |
| Tonsil and adenoid removal, under age 12 CPT 42820 | $5,909.03 | $9,090.82 | |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $3,559.59 | $5,476.30 | $116.61 – $1,576.00 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $2,454.07 | $3,775.50 | $1,047.00 – $2,125.00 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $642.20 | $988.00 | $198.65 – $253.12 |
| IUD insertion CPT 58300 | $4,760.77 | $7,324.26 | $1,286.00 – $3,185.00 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $18,319.39 | $28,183.68 | $685.68 – $3,078.00 |
| C-section, without complications MS-DRG 788 | $9,733.63 | $14,974.81 | $685.68 – $685.68 |
| Chest pain MS-DRG 313 | $17,269.88 | $26,569.04 | $685.68 – $3,209.00 |
| COPD flare-up, with major complications MS-DRG 190 | $19,118.37 | $29,412.88 | $685.68 – $4,197.00 |
| COPD flare-up, without complications MS-DRG 192 | $13,883.11 | $21,358.63 | $685.68 – $3,209.00 |
| Fainting (syncope) MS-DRG 312 | $18,838.62 | $28,982.50 | $685.68 – $3,209.00 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $21,645.44 | $33,300.68 | $685.68 – $3,209.00 |
| Heart failure, with major complications MS-DRG 291 | $19,669.62 | $30,260.96 | $685.68 – $3,209.00 |
| Heart failure, without complications MS-DRG 293 | $19,808.74 | $30,474.99 | $685.68 – $3,209.00 |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | $25,953.67 | $39,928.72 | $685.68 – $3,478.00 |
| Irregular heartbeat, without complications MS-DRG 310 | $13,337.64 | $20,519.45 | $685.68 – $3,209.00 |
| Kidney failure, with complications MS-DRG 683 | $18,224.49 | $28,037.67 | $685.68 – $3,209.00 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $17,029.23 | $26,198.81 | $685.68 – $4,197.00 |
| Normal newborn care MS-DRG 795 | $2,723.91 | $4,190.63 | $650.00 – $2,350.00 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $14,172.94 | $21,804.52 | $685.68 – $3,209.00 |
| Pneumonia, with complications MS-DRG 194 | $14,655.59 | $22,547.06 | $685.68 – $3,209.00 |
| Pneumonia, with major complications MS-DRG 193 | $17,884.55 | $27,514.70 | $685.68 – $3,209.00 |
| Pneumonia, without complications MS-DRG 195 | $10,909.74 | $16,784.21 | $685.68 – $3,209.00 |
| Sepsis, with major complications MS-DRG 871 | $27,344.98 | $42,069.20 | $685.68 – $4,197.00 |
| Sepsis, without major complications MS-DRG 872 | $16,655.89 | $25,624.45 | $685.68 – $3,209.00 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $14,884.92 | $22,899.87 | $685.68 – $3,209.00 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $13,958.29 | $21,474.29 | $685.68 – $3,209.00 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $20,676.63 | $31,810.20 | $685.68 – $3,209.00 |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | $13,701.88 | $21,079.82 | $685.68 – $3,478.00 |
| Vaginal delivery, without complications MS-DRG 807 | $7,403.11 | $11,389.40 | $685.68 – $685.68 |
| Weight loss surgery, without complications MS-DRG 621 | $19,191.77 | $29,525.80 | $685.68 – $685.68 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $623.35 | $959.00 | $3,199.00 – $7,801.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $2,198.55 | $3,382.38 | $93.63 – $1,445.82 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $3,508.98 | $5,398.43 | $693.59 – $883.78 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $3,348.80 | $5,152.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | $5,615.21 | $8,638.78 | $3,199.00 – $7,801.00 |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | $756.60 | $1,164.00 | $3,199.00 – $7,801.00 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $1,428.70 | $2,198.00 | $212.16 – $270.34 |
| Sleep study with CPAP titration CPT 95811 | $5,328.70 | $8,198.00 | $867.31 – $2,158.11 |
| Sleep study, overnight in a sleep lab CPT 95810 | $4,602.00 | $7,080.00 | $843.78 – $1,075.16 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $367.25 | $565.00 | $93.78 – $250.39 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $123.50 | $190.00 | $12.35 – $171.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $479.05 | $737.00 | $86.18 – $142.20 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $564.85 | $869.00 | $56.49 – $782.10 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $133.90 | $206.00 | $25.31 – $41.76 |
| Therapeutic activities, 15 minutes CPT 97530 | $94.25 | $145.00 | $9.43 – $130.50 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $234.00 | $360.00 | $137.00 – $137.00 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $258.05 | $397.00 | $137.00 – $137.00 |
| Group psychotherapy CPT 90853 | $487.50 | $750.00 | $78.86 – $130.12 |
| Psychiatric diagnostic evaluation CPT 90791 | $395.20 | $608.00 | $39.52 – $547.20 |
| Psychotherapy, 30 minutes CPT 90832 | $263.90 | $406.00 | $67.90 – $324.40 |
| Psychotherapy, 45 minutes CPT 90834 | $278.85 | $429.00 | $89.77 – $430.21 |
| Psychotherapy, 60 minutes CPT 90837 | $278.85 | $429.00 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $182.65 | $281.00 | $70.75 – $90.15 |
| IV hydration, each additional hour CPT 96361 | $160.55 | $247.00 | $16.06 – $222.30 |
| IV hydration, first hour CPT 96360 | $133.90 | $206.00 | $29.19 – $296.36 |
| IV push injection of a drug, first CPT 96374 | $371.15 | $571.00 | $37.12 – $513.90 |
| IV push injection, each additional drug CPT 96375 | $285.35 | $439.00 | $46.01 – $58.63 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $25.92 | $39.87 | $2.59 – $35.88 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $7.15 | $11.00 | |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $136.63 | $210.20 | $13.66 – $189.18 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $21.22 | $32.65 | ? – $1.46 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $158.20 | $243.38 | $15.82 – $219.04 |
| Morphine injection, up to 10 mg HCPCS J2270 | $136.63 | $210.20 | $6.10 – $100.80 |
| Propofol injection, per 10 mg HCPCS J2704 | $97.50 | $150.00 | ? – $19.00 |
| Saline IV solution, 1000 ml HCPCS J7030 | $40.30 | $62.00 | $4.03 – $55.80 |
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.