Atrium Health Pineville

10628 Park Rd, Charlotte, NC 28210 · Acute care hospital · Emergency room

These are Atrium Health Pineville's own posted figures from its standard-charges file dated December 5, 2025. They are not a quote. Source: the hospital's file · its price transparency page.

233 of the services we track have a posted price here; 155 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	$2,808.93	$5,617.85	$561.79 – $5,168.42
Emergency room visit, level 1 (minor) CPT 99281	$178.33	$356.65	$35.67 – $1,554.00
Emergency room visit, level 2 CPT 99282	$328.58	$657.15	$65.72 – $1,554.00
Emergency room visit, level 3 (moderate) CPT 99283	$1,519.05	$3,038.10	$268.62 – $2,795.05
Emergency room visit, level 4 CPT 99284	$1,590.63	$3,181.25	$318.13 – $2,926.75
Emergency room visit, level 5 (most severe) CPT 99285	$1,682.03	$3,364.05	$336.41 – $3,094.93
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$374.23	$748.45	$74.85 – $688.57

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	not posted		$67.66 – $82.92
New patient office visit, about 30 minutes CPT 99203	not posted		$105.49 – $129.28
New patient office visit, about 45 minutes CPT 99204	not posted		$158.57 – $194.32
New patient office visit, about 60 minutes CPT 99205	not posted		$209.40 – $256.62
Office consultation, about 40 minutes CPT 99243	not posted		$106.63 – $130.67
Office consultation, about 60 minutes CPT 99244	not posted		$152.14 – $186.45
Office visit, established patient, about 10 to 19 minutes CPT 99212	not posted		$53.22 – $65.22
Office visit, established patient, about 20 to 29 minutes CPT 99213	not posted		$86.33 – $105.80
Office visit, established patient, about 30 to 39 minutes CPT 99214	not posted		$121.63 – $149.06
Office visit, established patient, about 40 to 54 minutes CPT 99215	not posted		$170.92 – $209.47
Office visit, established patient, brief (often a nurse) CPT 99211	not posted		$21.74 – $26.64
Preventive checkup, new patient, age 18 to 39 CPT 99385	$143.25	$286.50	$28.65 – $263.58
Preventive checkup, new patient, age 40 to 64 CPT 99386	$188.15	$376.30	$115.45 – $338.67

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$40.18	$80.35	$8.04 – $73.92
Abdominal X-ray, 1 view CPT 74018	$224.43	$448.85	$44.89 – $412.94
Ankle X-ray, 3 or more views CPT 73610	$274.50	$549.00	$54.90 – $505.08
Bone density scan (DEXA), hips and spine CPT 77080	$413.48	$826.95	$82.70 – $760.79
Breast ultrasound, one breast, complete CPT 76641	$519.75	$1,039.50	$103.16 – $956.34
Breast ultrasound, one breast, limited CPT 76642	$346.53	$693.05	$69.31 – $637.61
Chest X-ray, 1 view CPT 71045	$186.83	$373.65	$37.37 – $343.76
Chest X-ray, 2 views CPT 71046	$232.30	$464.60	$46.46 – $427.43
CT angiogram of the chest (checks for lung clots) CPT 71275	$2,094.23	$4,188.45	$172.70 – $3,853.37
CT angiogram of the head CPT 70496	$2,094.23	$4,188.45	$172.70 – $3,853.37
CT scan of the abdomen and pelvis, with contrast CPT 74177	$3,217.18	$6,434.35	$346.46 – $5,919.60
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$3,810.23	$7,620.45	$346.46 – $7,010.81
CT scan of the abdomen and pelvis, without contrast CPT 74176	$2,874.83	$5,749.65	$234.50 – $5,289.68
CT scan of the abdomen, without contrast CPT 74150	$1,363.35	$2,726.70	$103.16 – $2,508.56
CT scan of the chest, with contrast CPT 71260	$1,608.98	$3,217.95	$172.70 – $2,960.51
CT scan of the chest, without contrast CPT 71250	$1,350.03	$2,700.05	$103.16 – $2,484.05
CT scan of the head, without contrast CPT 70450	$1,268.90	$2,537.80	$103.16 – $2,334.78
CT scan of the neck (cervical spine), without contrast CPT 72125	$1,513.95	$3,027.90	$103.16 – $2,785.67
CT scan of the pelvis, with contrast CPT 72193	$1,608.98	$3,217.95	$172.70 – $2,960.51
CT scan of the sinuses or face, without contrast CPT 70486	$1,145.38	$2,290.75	$103.16 – $2,107.49
Diagnostic mammogram, both breasts CPT 77066	$442.60	$885.20	$88.52 – $814.38
Diagnostic mammogram, one breast CPT 77065	$221.33	$442.65	$44.27 – $407.24
Foot X-ray, 3 or more views CPT 73630	$262.03	$524.05	$52.41 – $482.13
Hand X-ray, 3 or more views CPT 73130	$266.50	$533.00	$53.30 – $490.36
Knee X-ray, 3 views CPT 73562	$227.45	$454.90	$45.49 – $418.51
Leg or arm vein ultrasound, both sides CPT 93970	$1,155.88	$2,311.75	$231.18 – $2,126.81
Leg or arm vein ultrasound, one side CPT 93971	$872.75	$1,745.50	$103.16 – $1,605.86
Lower back X-ray, 2 or 3 views CPT 72100	$278.40	$556.80	$55.68 – $512.26
MRI of both breasts, without and with contrast CPT 77049	not posted		$322.28 – $394.95
MRI of the abdomen, without and with contrast CPT 74183	$2,518.40	$5,036.80	$346.46 – $4,633.86
MRI of the brain, without and with contrast CPT 70553	$2,659.03	$5,318.05	$346.46 – $4,892.61
MRI of the brain, without contrast CPT 70551	$1,765.28	$3,530.55	$234.50 – $3,248.11
MRI of the knee or other leg joint, without contrast CPT 73721	$1,922.30	$3,844.60	$234.50 – $3,537.03
MRI of the lower back (lumbar spine), without contrast CPT 72148	$2,013.08	$4,026.15	$234.50 – $3,704.06
MRI of the mid back (thoracic spine), without contrast CPT 72146	$2,013.08	$4,026.15	$234.50 – $3,704.06
MRI of the neck (cervical spine), without contrast CPT 72141	$1,947.58	$3,895.15	$234.50 – $3,583.54
MRI of the pelvis, without and with contrast CPT 72197	$2,648.58	$5,297.15	$346.46 – $4,873.38
MRI of the shoulder or other arm joint, without contrast CPT 73221	$1,938.28	$3,876.55	$234.50 – $3,566.43
Neck X-ray, 2 or 3 views CPT 72040	$299.28	$598.55	$59.86 – $550.67
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$643.80	$1,287.60	$103.16 – $1,184.59
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$479.30	$958.60	$95.86 – $881.91
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$326.73	$653.45	$65.35 – $601.17
Screening mammogram, both breasts CPT 77067	$319.93	$639.85	$63.99 – $588.66
Shoulder X-ray, 2 or more views CPT 73030	$279.28	$558.55	$55.86 – $513.87
Transvaginal pregnancy ultrasound CPT 76817	$385.58	$771.15	$77.12 – $709.46
Transvaginal ultrasound CPT 76830	$491.58	$983.15	$98.32 – $904.50
Ultrasound of the abdomen, complete CPT 76700	$665.35	$1,330.70	$103.16 – $1,224.24
Ultrasound of the neck or thyroid CPT 76536	$544.80	$1,089.60	$103.16 – $1,002.43
Wrist X-ray, 3 or more views CPT 73110	$229.33	$458.65	$45.87 – $421.96
X-ray of the lower back, 4 or more views CPT 72110	$430.23	$860.45	$86.05 – $791.61

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$177.03	$354.05	$8.63 – $325.73
Blood culture CPT 87040	$150.05	$300.10	$10.53 – $276.09
Blood draw (venipuncture) CPT 36415	$4.55	$9.09	? – $11.36
BNP test (heart failure) CPT 83880	$133.30	$266.60	$26.66 – $245.27
C-reactive protein (CRP) test CPT 86140	$131.10	$262.20	$5.28 – $241.22
Chlamydia test (DNA/NAAT) CPT 87491	$119.10	$238.20	$24.42 – $219.14
Complete blood count (CBC) with differential CPT 85025	$135.48	$270.95	$7.93 – $249.27
Complete blood count (CBC), automated CPT 85027	$66.43	$132.85	$6.60 – $122.22
Comprehensive metabolic panel (blood test) CPT 80053	$244.73	$489.45	$10.77 – $450.29
COVID-19 PCR test CPT 87635	$85.03	$170.05	$17.43 – $156.45
D-dimer test (blood clots) CPT 85379	$144.50	$289.00	$10.38 – $265.88
Drug screen, instrument chemistry CPT 80307	$330.53	$661.05	$200.30 – $608.17
Ferritin (iron stores) test CPT 82728	$156.70	$313.40	$13.90 – $288.33
Free T4 (thyroid) test CPT 84439	$150.93	$301.85	$9.20 – $277.70
General health panel (blood tests) CPT 80050	not posted		$11.16 – $88.78
Glucose (blood sugar) test CPT 82947	$38.33	$76.65	$4.01 – $70.52
Gonorrhea test (DNA/NAAT) CPT 87591	$112.83	$225.65	$23.13 – $207.60
Hemoglobin A1c test CPT 83036	$136.70	$273.40	$9.90 – $251.53
Hepatitis C antibody test CPT 86803	$174.58	$349.15	$14.56 – $321.22
HIV-1/HIV-2 antigen and antibody test CPT 87389	$172.08	$344.15	$24.56 – $316.62
Iron test CPT 83540	$85.93	$171.85	$6.60 – $158.10
Kidney function panel CPT 80069	$113.35	$226.70	$8.85 – $208.56
Lipase test (pancreas) CPT 83690	$140.63	$281.25	$7.03 – $258.75
Lipid panel, cholesterol and triglycerides CPT 80061	$187.73	$375.45	$13.66 – $345.41
Liver function panel CPT 80076	$198.50	$397.00	$8.33 – $365.24
Magnesium test CPT 83735	$73.00	$146.00	$6.83 – $134.32
Obstetric blood test panel CPT 80055	not posted		$48.77 – $59.76
Partial thromboplastin time (PTT), clotting test CPT 85730	$69.85	$139.70	$6.13 – $128.52
Pregnancy blood test (hCG), quantitative CPT 84702	$152.65	$305.30	$15.35 – $280.88
Prothrombin time (PT/INR), clotting test CPT 85610	$67.70	$135.40	$4.38 – $124.57
PSA (prostate specific antigen), free CPT 84154	$99.20	$198.40	$18.76 – $182.53
PSA (prostate specific antigen), total CPT 84153	$103.85	$207.70	$18.76 – $191.08
Rapid strep test CPT 87880	$105.48	$210.95	$16.86 – $194.07
Sed rate (ESR) test CPT 85652	$89.38	$178.75	$2.75 – $164.45
TB skin test CPT 86580	$1,003.85	$2,007.70	$23.76 – $1,847.08
Thyroid stimulating hormone (TSH) CPT 84443	$186.98	$373.95	$17.14 – $344.03
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$346.30	$692.60	$51.83 – $637.19
Troponin test (heart damage) CPT 84484	$204.18	$408.35	$12.72 – $375.68
Urinalysis, automated, with microscope CPT 81001	$40.35	$80.70	$3.23 – $74.24
Urinalysis, automated, without microscope CPT 81003	$52.38	$104.75	$2.30 – $96.37
Urinalysis, manual, with microscope CPT 81000	$40.35	$80.70	$4.10 – $74.24
Urinalysis, manual, without microscope CPT 81002	$37.18	$74.35	$3.55 – $68.40
Urine culture, colony count CPT 87086	$119.23	$238.45	$8.23 – $219.37
Urine pregnancy test CPT 81025	$71.60	$143.20	$8.78 – $131.74
Vitamin B12 test CPT 82607	$158.85	$317.70	$15.38 – $292.28
Vitamin D test CPT 82306	$224.53	$449.05	$30.19 – $413.13

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$1,145.63	$2,291.25	$229.13 – $2,107.95
ECG tracing only (no interpretation) CPT 93005	$290.78	$581.55	$57.63 – $535.03
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$1,780.05	$3,560.10	$356.01 – $3,275.29
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$13.38 – $16.40
Holter monitor, up to 48 hours CPT 93224	not posted		$65.16 – $79.85
Left heart catheterization CPT 93452	$11,777.43	$23,554.85	$2,355.49 – $21,670.46
Left heart catheterization with coronary angiogram CPT 93458	$14,653.28	$29,306.55	$2,930.66 – $26,962.03
Nuclear stress test (heart perfusion imaging) CPT 78452	$3,341.83	$6,683.65	$668.37 – $6,148.96
Treadmill stress test, complete CPT 93015	not posted		$68.40 – $83.82

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$6,930.29 – $8,493.00
Appendix removal, laparoscopic CPT 44970	not posted		$5,660.04 – $6,936.32
Breast biopsy with ultrasound guidance CPT 19083	$1,944.10	$3,888.20	$388.82 – $3,577.14
Carpal tunnel release CPT 64721	$3,503.75	$7,007.50	$700.75 – $6,446.90
Colonoscopy with biopsy CPT 45380	not posted		$1,143.85 – $1,401.78
Colonoscopy with polyp removal (snare) CPT 45385	not posted		$1,143.85 – $1,401.78
Colonoscopy, diagnostic CPT 45378	not posted		$884.47 – $1,083.91
Colposcopy with biopsy CPT 57454	$929.78	$1,859.55	$185.96 – $1,710.79
Cystoscopy (bladder scope) CPT 52000	$404.00	$808.00	$80.80 – $793.54
Ear tubes, under general anesthesia CPT 69436	$3,006.50	$6,013.00	$601.30 – $5,531.96
Flexible sigmoidoscopy, diagnostic CPT 45330	$1,284.13	$2,568.25	$256.83 – $2,362.79
Gallbladder removal, laparoscopic CPT 47562	not posted		$5,660.04 – $6,936.32
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$1,607.11 – $1,969.49
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$10,100.15 – $12,377.64
Hysteroscopy with biopsy or polyp removal CPT 58558	$3,044.63	$6,089.25	$608.93 – $5,602.11
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$5,660.04 – $6,936.32
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted		$3,423.62 – $4,195.61
Kidney stone shock-wave lithotripsy CPT 50590	$2,535.35	$5,070.70	$507.07 – $4,665.04
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$3,147.67 – $3,857.44
Lower colon endoscopy with ultrasound CPT 45391	not posted		$1,143.85 – $1,401.78
Nasal endoscopy, diagnostic CPT 31231	$147.55	$295.10	$29.51 – $271.49
Prostate biopsy CPT 55700	$897.95	$1,795.90	$179.59 – $2,435.42
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$10,100.15 – $12,377.64
Removal of a breast lump, open surgery CPT 19120	$4,631.50	$9,263.00	$926.30 – $8,521.96
Rotator cuff repair, arthroscopic CPT 29827	not posted		$6,930.29 – $8,493.00
Screening colonoscopy, average risk HCPCS G0121	not posted		$884.47 – $1,083.91
Screening colonoscopy, high risk HCPCS G0105	not posted		$884.47 – $1,083.91
Septoplasty (nasal septum repair) CPT 30520	not posted		$3,146.17 – $3,855.60
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$159.59 – $195.57
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$1,018.82 – $1,248.55
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$5,738.91 – $7,032.98
Total hip replacement CPT 27130	not posted		$12,482.39 – $15,297.04
Total knee replacement CPT 27447	not posted		$12,482.39 – $15,297.04
Upper endoscopy (EGD) with biopsy CPT 43239	not posted		$909.55 – $1,114.64
Upper endoscopy (EGD), diagnostic CPT 43235	not posted		$909.55 – $1,114.64
Vasectomy CPT 55250	not posted		$1,987.30 – $2,435.42

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		$2,465.65 – $3,021.63
Fetal non-stress test CPT 59025	$507.90	$1,015.80	$101.58 – $934.54
IUD insertion CPT 58300	$366.65	$733.30	$73.33 – $674.64
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$2,323.91 – $2,847.93
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted		$2,228.50 – $2,731.00

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$6,980.33 – $17,731.34
C-section, without complications MS-DRG 788	not posted	$7,138.04 – $12,686.00
Chest pain MS-DRG 313	not posted	$5,797.11 – $14,338.63
COPD flare-up, with major complications MS-DRG 190	not posted	$8,668.23 – $22,571.18
COPD flare-up, without complications MS-DRG 192	not posted	$5,333.07 – $13,008.07
Fainting (syncope) MS-DRG 312	not posted	$6,903.92 – $17,512.26
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$7,707.21 – $19,815.60
Heart failure, with major complications MS-DRG 291	not posted	$9,942.57 – $26,225.18
Heart failure, without complications MS-DRG 293	not posted	$4,642.63 – $11,028.32
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$68,446.58 – $193,977.46
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$14,013.02 – $62,427.02
Irregular heartbeat, without complications MS-DRG 310	not posted	$4,718.32 – $11,245.39
Kidney failure, with complications MS-DRG 683	not posted	$7,027.29 – $17,866.00
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$6,422.35 – $16,131.46
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$17,390.94 – $47,582.37
Normal newborn care MS-DRG 795	not posted	$718.00 – $3,328.31
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$6,273.75 – $15,705.36
Pneumonia, with complications MS-DRG 194	not posted	$6,544.32 – $16,481.18
Pneumonia, with major complications MS-DRG 193	not posted	$10,033.00 – $26,484.45
Pneumonia, without complications MS-DRG 195	not posted	$5,161.34 – $12,515.65
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$10,677.18 – $28,331.55
Sepsis, with major complications MS-DRG 871	not posted	$14,549.96 – $39,436.25
Sepsis, without major complications MS-DRG 872	not posted	$8,023.34 – $20,722.07
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$6,970.52 – $17,703.20
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$6,266.05 – $15,683.25
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$7,924.51 – $20,602.85
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$9,198.85 – $24,092.67
Vaginal delivery, without complications MS-DRG 807	not posted	$5,086.00 – $9,426.03
Weight loss surgery, without complications MS-DRG 621	not posted	$11,043.07 – $23,532.06

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$619.80	$1,239.60	$123.96 – $1,140.43
Lower back nerve root injection with imaging guidance CPT 64483	$2,207.48	$4,414.95	$441.50 – $4,061.75
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$2,207.98	$4,415.95	$441.60 – $4,062.67
Lower back spinal injection (epidural), without imaging CPT 62322	$1,177.23	$2,354.45	$235.45 – $2,166.09

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$2,212.59 – $2,711.50
Eye exam, new patient, comprehensive CPT 92004	not posted	$125.02 – $153.21
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$532.21 – $652.22

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$220.23	$440.45	$44.05 – $405.21

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$359.00	$718.00	$71.80 – $660.56
Sleep study with CPAP titration CPT 95811	$3,751.48	$7,502.95	$750.30 – $6,902.71
Sleep study, overnight in a sleep lab CPT 95810	$3,182.88	$6,365.75	$636.58 – $5,856.49

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$235.25	$470.50	$47.05 – $432.86

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$122.25	$244.50	$24.45 – $224.94
Physical therapy evaluation, low complexity CPT 97161	$202.08	$404.15	$40.42 – $371.82
Physical therapy evaluation, moderate complexity CPT 97162	$303.15	$606.30	$60.63 – $557.80
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$95.65	$191.30	$19.13 – $176.00
Therapeutic activities, 15 minutes CPT 97530	$101.38	$202.75	$20.28 – $186.53

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$27.68	$55.35	$5.54 – $191.02
Family psychotherapy, without the patient, 50 minutes CPT 90846	$56.90	$113.80	$11.38 – $191.02
Group psychotherapy CPT 90853	$100.78	$201.55	$20.16 – $185.43
Psychiatric diagnostic evaluation CPT 90791	$175.28	$350.55	$95.58 – $378.32
Psychotherapy, 30 minutes CPT 90832	$81.48	$162.95	$16.30 – $191.02
Psychotherapy, 45 minutes CPT 90834	$113.13	$226.25	$60.29 – $217.34
Psychotherapy, 60 minutes CPT 90837	$109.70	$219.40	$21.94 – $201.85

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$41.45	$82.90	$8.29 – $84.61
IV hydration, each additional hour CPT 96361	$27.15	$54.30	$5.43 – $54.85
IV hydration, first hour CPT 96360	$140.15	$280.30	$28.03 – $257.88
IV push injection of a drug, first CPT 96374	$140.15	$280.30	$28.03 – $257.88
IV push injection, each additional drug CPT 96375	$27.15	$54.30	$5.43 – $54.85

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$262.00	$524.00	$158.77 – $482.08
Dexamethasone injection, per 1 mg HCPCS J1100	$15.30	$30.60	$9.27 – $28.15
Fentanyl injection, per 0.1 mg HCPCS J3010	$156.88	$313.75	$95.07 – $288.65
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$14.33	$28.65	$8.68 – $26.36
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$78.50	$157.00	$47.57 – $144.44
Morphine injection, up to 10 mg HCPCS J2270	$55.23	$110.45	$33.47 – $101.61
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$40.10	$80.20	$24.30 – $73.78
Propofol injection, per 10 mg HCPCS J2704	$85.50	$171.00	$51.81 – $157.32
Saline IV solution, 1000 ml HCPCS J7030	not posted		$3.29 – $9.45

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.

Check a bill from this hospital