Ranken Jordan Pediatric Bridge Hospital

11365 Dorsett Road, Maryland Heights, MO 63043 · Children's hospital

These are Ranken Jordan Pediatric Bridge Hospital's own posted figures from its standard-charges file dated April 24, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

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Emergency room

Service	Cash price	Gross charge	Insurer rates (min – max)
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$220.00	$275.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$298.10	$298.10	$32.21 – $32.21
New patient office visit, about 30 minutes CPT 99203	$409.20	$409.20	$55.95 – $55.95
New patient office visit, about 45 minutes CPT 99204	$601.70	$601.70	$90.81 – $90.81
New patient office visit, about 60 minutes CPT 99205	$743.00	$743.00	$123.49 – $123.49
Office visit, established patient, about 10 to 19 minutes CPT 99212	$136.40	$136.40	$24.25 – $24.25
Office visit, established patient, about 20 to 29 minutes CPT 99213	$200.20	$200.20	$44.67 – $44.67
Office visit, established patient, about 30 to 39 minutes CPT 99214	$301.40	$301.40	$65.79 – $65.79
Office visit, established patient, about 40 to 54 minutes CPT 99215	$427.00	$427.00	$97.69 – $97.69
Office visit, established patient, brief (often a nurse) CPT 99211	$75.90	$75.90	$8.44 – $8.44

Imaging

Service	Cash price	Gross charge
Abdominal X-ray, 1 view CPT 74018	$248.78	$310.97
Chest X-ray, 1 view CPT 71045	$262.24	$327.80
Chest X-ray, 2 views CPT 71046	$310.64	$388.30
CT scan of the abdomen, without contrast CPT 74150	$848.94	$1,061.17
CT scan of the chest, with contrast CPT 71260	$1,488.08	$1,860.10
CT scan of the chest, without contrast CPT 71250	$1,312.08	$1,640.10
CT scan of the head, without contrast CPT 70450	$1,596.32	$1,995.40
CT scan of the neck (cervical spine), without contrast CPT 72125	$1,845.98	$2,307.47
CT scan of the pelvis, with contrast CPT 72193	$1,889.36	$2,361.70
CT scan of the sinuses or face, without contrast CPT 70486	$1,760.80	$2,200.99
Foot X-ray, 3 or more views CPT 73630	$452.64	$565.79
Hand X-ray, 3 or more views CPT 73130	$339.77	$424.71
Knee X-ray, 3 views CPT 73562	$348.80	$436.00
Leg or arm vein ultrasound, both sides CPT 93970	$660.00	$825.00
Lower back X-ray, 2 or 3 views CPT 72100	$412.72	$515.90
MRI of the brain, without and with contrast CPT 70553	$2,476.32	$3,095.40
MRI of the brain, without contrast CPT 70551	$3,092.32	$3,865.40
MRI of the knee or other leg joint, without contrast CPT 73721	$826.04	$1,032.55
MRI of the lower back (lumbar spine), without contrast CPT 72148	$1,974.72	$2,468.40
MRI of the mid back (thoracic spine), without contrast CPT 72146	$2,285.36	$2,856.70
MRI of the neck (cervical spine), without contrast CPT 72141	$2,285.36	$2,856.70
MRI of the shoulder or other arm joint, without contrast CPT 73221	$2,730.03	$3,412.53
Neck X-ray, 2 or 3 views CPT 72040	$634.53	$793.16
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$836.00	$1,045.00
Shoulder X-ray, 2 or more views CPT 73030	$428.56	$535.70
Ultrasound of the abdomen, complete CPT 76700	$786.72	$983.40
Ultrasound of the neck or thyroid CPT 76536	$550.00	$687.50

Lab tests

Service	Cash price	Gross charge
Basic metabolic panel (blood test) CPT 80048	$7.24	$9.05
Blood culture CPT 87040	$62.04	$77.55
C-reactive protein (CRP) test CPT 86140	$22.00	$27.50
Complete blood count (CBC) with differential CPT 85025	$4.40	$5.50
Comprehensive metabolic panel (blood test) CPT 80053	$9.05	$11.31
COVID-19 PCR test CPT 87635	$22.00	$27.50
Drug screen, instrument chemistry CPT 80307	$52.80	$66.00
Ferritin (iron stores) test CPT 82728	$20.68	$25.85
Free T4 (thyroid) test CPT 84439	$40.10	$50.12
Glucose (blood sugar) test CPT 82947	$15.40	$19.25
Hemoglobin A1c test CPT 83036	$13.84	$17.30
Hepatitis C antibody test CPT 86803	$21.29	$26.61
Iron test CPT 83540	$40.94	$51.17
Kidney function panel CPT 80069	$7.85	$9.81
Lipase test (pancreas) CPT 83690	$19.60	$24.50
Lipid panel, cholesterol and triglycerides CPT 80061	$17.16	$21.45
Liver function panel CPT 80076	$6.94	$8.67
Magnesium test CPT 83735	$20.15	$25.18
Partial thromboplastin time (PTT), clotting test CPT 85730	$31.84	$39.79
Prothrombin time (PT/INR), clotting test CPT 85610	$6.16	$7.70
Rapid strep test CPT 87880	$129.96	$162.45
Sed rate (ESR) test CPT 85652	$5.86	$7.32
Thyroid stimulating hormone (TSH) CPT 84443	$15.84	$19.80
Urinalysis, automated, with microscope CPT 81001	$4.60	$5.75
Urinalysis, manual, without microscope CPT 81002	$22.44	$28.04
Urine culture, colony count CPT 87086	$18.12	$22.65
Vitamin B12 test CPT 82607	$63.79	$79.73
Vitamin D test CPT 82306	$26.40	$33.00

Heart

Service	Cash price	Gross charge
ECG tracing only (no interpretation) CPT 93005	$176.00	$220.00
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$3,190.00	$3,987.50
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	$330.00	$412.50

Surgery

Service	Cash price	Gross charge
Colonoscopy with biopsy CPT 45380	$1,245.20	$1,556.50
Colonoscopy, diagnostic CPT 45378	$897.60	$1,122.00
Upper endoscopy (EGD) with biopsy CPT 43239	$1,122.00	$1,402.50
Upper endoscopy (EGD), diagnostic CPT 43235	$809.60	$1,012.00

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$169.84	$212.30

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$120.56	$150.70

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$58.40	$73.00	$24.28 – $87.00
Physical therapy evaluation, low complexity CPT 97161	$286.40	$358.00	$32.60 – $274.07
Physical therapy evaluation, moderate complexity CPT 97162	$286.40	$358.00	$32.60 – $274.07
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$233.60	$292.00	$26.36 – $87.00
Therapeutic activities, 15 minutes CPT 97530	$58.40	$73.00	$32.60 – $100.99

Mental health

Service	Cash price	Gross charge
Family psychotherapy, with the patient, 50 minutes CPT 90847	$186.80	$233.49
Family psychotherapy, without the patient, 50 minutes CPT 90846	$179.88	$224.84
Group psychotherapy CPT 90853	$44.62	$55.77
Psychiatric diagnostic evaluation CPT 90791	$366.08	$457.60
Psychotherapy, 30 minutes CPT 90832	$111.32	$139.15
Psychotherapy, 45 minutes CPT 90834	$148.46	$185.57
Psychotherapy, 60 minutes CPT 90837	$223.32	$279.14

Drugs

Service	Cash price	Gross charge
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$40.87	$51.08
Dexamethasone injection, per 1 mg HCPCS J1100	$4.22	$5.27
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$3.31	$4.13
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$12.26	$15.32
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$2.31	$2.88

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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