Parkland Medical Center

1 Parkland Drive, Derry, NH 03038 · Acute care hospital · Emergency room

These are Parkland Medical Center's own posted figures from its standard-charges file dated September 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

228 of the services we track have a posted price here; 139 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	$16,022.25	$16,022.25	$495.09 – $15,221.14
Emergency room visit, level 1 (minor) CPT 99281	$1,232.25	$1,232.25	$38.08 – $1,170.64
Emergency room visit, level 2 CPT 99282	$2,162.00	$2,162.00	$66.81 – $2,053.90
Emergency room visit, level 3 (moderate) CPT 99283	$5,252.75	$5,252.75	$162.31 – $4,990.11
Emergency room visit, level 4 CPT 99284	$7,540.25	$7,540.25	$232.99 – $7,163.24
Emergency room visit, level 5 (most severe) CPT 99285	$10,475.50	$10,475.50	$323.69 – $9,951.73
Simple wound repair (stitches), 2.5 cm or less CPT 12001	not posted		$690.90 – $2,702.16

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$697.75	$697.75	$21.56 – $697.75
New patient office visit, about 30 minutes CPT 99203	$826.00	$826.00	$25.52 – $826.00
New patient office visit, about 45 minutes CPT 99204	$955.25	$955.25	$29.52 – $955.25
New patient office visit, about 60 minutes CPT 99205	$1,088.25	$1,088.25	$33.63 – $1,088.25
Office visit, established patient, about 10 to 19 minutes CPT 99212	$598.50	$598.50	$18.49 – $598.50
Office visit, established patient, about 20 to 29 minutes CPT 99213	$795.75	$795.75	$24.59 – $795.75
Office visit, established patient, about 30 to 39 minutes CPT 99214	$929.25	$929.25	$28.71 – $929.25
Office visit, established patient, about 40 to 54 minutes CPT 99215	$1,057.25	$1,057.25	$32.67 – $1,057.25
Office visit, established patient, brief (often a nurse) CPT 99211	$402.50	$402.50	$12.44 – $402.50
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted		$67.81 – $68.51
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted		$82.40 – $83.25

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$11.25	$11.25	? – $10.69
Abdominal X-ray, 1 view CPT 74018	$612.25	$612.25	$18.92 – $581.64
Ankle X-ray, 3 or more views CPT 73610	$1,951.25	$1,951.25	$60.29 – $1,853.69
Bone density scan (DEXA), hips and spine CPT 77080	$1,824.75	$1,824.75	$56.38 – $1,733.51
Breast ultrasound, one breast, complete CPT 76641	$1,409.00	$1,409.00	$43.54 – $1,338.55
Breast ultrasound, one breast, limited CPT 76642	$1,679.75	$1,679.75	$51.90 – $1,595.76
Chest X-ray, 1 view CPT 71045	$549.00	$549.00	$16.96 – $521.55
Chest X-ray, 2 views CPT 71046	$881.50	$881.50	$27.24 – $837.42
CT angiogram of the chest (checks for lung clots) CPT 71275	$6,985.00	$6,985.00	$215.84 – $6,635.75
CT angiogram of the head CPT 70496	$7,589.25	$7,589.25	$234.51 – $7,209.79
CT scan of the abdomen and pelvis, with contrast CPT 74177	$7,011.00	$7,011.00	$216.64 – $6,660.45
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$6,802.00	$6,802.00	$210.18 – $6,461.90
CT scan of the abdomen and pelvis, without contrast CPT 74176	$6,813.50	$6,813.50	$210.54 – $6,472.82
CT scan of the abdomen, without contrast CPT 74150	$6,750.00	$6,750.00	$208.57 – $6,412.50
CT scan of the chest, with contrast CPT 71260	$6,791.25	$6,791.25	$209.85 – $6,451.69
CT scan of the chest, without contrast CPT 71250	$7,222.50	$7,222.50	$223.18 – $6,861.38
CT scan of the head, without contrast CPT 70450	$6,703.25	$6,703.25	$207.13 – $6,368.09
CT scan of the neck (cervical spine), without contrast CPT 72125	$7,015.25	$7,015.25	$216.77 – $6,664.49
CT scan of the pelvis, with contrast CPT 72193	$6,749.00	$6,749.00	$208.54 – $6,411.55
CT scan of the sinuses or face, without contrast CPT 70486	$6,739.25	$6,739.25	$208.24 – $6,402.29
Diagnostic mammogram, both breasts CPT 77066	$1,339.75	$1,339.75	$41.40 – $1,272.76
Diagnostic mammogram, one breast CPT 77065	$1,303.75	$1,303.75	$40.29 – $1,238.56
Foot X-ray, 3 or more views CPT 73630	$1,951.25	$1,951.25	$60.29 – $1,853.69
Hand X-ray, 3 or more views CPT 73130	$1,951.25	$1,951.25	$60.29 – $1,853.69
Knee X-ray, 3 views CPT 73562	$1,951.25	$1,951.25	$60.29 – $1,853.69
Leg or arm vein ultrasound, both sides CPT 93970	$4,826.25	$4,826.25	$149.13 – $4,584.94
Leg or arm vein ultrasound, one side CPT 93971	$3,219.75	$3,219.75	$99.49 – $3,058.76
Lower back X-ray, 2 or 3 views CPT 72100	$1,033.75	$1,033.75	$31.94 – $982.06
MRI of both breasts, without and with contrast CPT 77049	not posted		$1,277.24 – $1,479.19
MRI of the abdomen, without and with contrast CPT 74183	$10,416.00	$10,416.00	$321.85 – $9,895.20
MRI of the brain, without and with contrast CPT 70553	$12,631.75	$12,631.75	$390.32 – $12,000.16
MRI of the brain, without contrast CPT 70551	$8,431.75	$8,431.75	$260.54 – $8,010.16
MRI of the knee or other leg joint, without contrast CPT 73721	$11,120.00	$11,120.00	$343.61 – $10,564.00
MRI of the lower back (lumbar spine), without contrast CPT 72148	$8,431.75	$8,431.75	$260.54 – $8,010.16
MRI of the mid back (thoracic spine), without contrast CPT 72146	$8,431.75	$8,431.75	$260.54 – $8,010.16
MRI of the neck (cervical spine), without contrast CPT 72141	$8,431.75	$8,431.75	$260.54 – $8,010.16
MRI of the pelvis, without and with contrast CPT 72197	$10,416.00	$10,416.00	$321.85 – $9,895.20
MRI of the shoulder or other arm joint, without contrast CPT 73221	$9,705.50	$9,705.50	$299.90 – $9,220.23
Neck X-ray, 2 or 3 views CPT 72040	$993.50	$993.50	$30.70 – $943.83
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$1,975.75	$1,975.75	$61.05 – $1,876.96
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$2,747.75	$2,747.75	$84.91 – $2,610.36
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$2,078.50	$2,078.50	$64.23 – $1,974.58
Screening mammogram, both breasts CPT 77067	$1,434.25	$1,434.25	$44.32 – $1,362.54
Shoulder X-ray, 2 or more views CPT 73030	$1,502.25	$1,502.25	$46.42 – $1,427.14
Transvaginal pregnancy ultrasound CPT 76817	$1,391.00	$1,391.00	$42.98 – $1,321.45
Transvaginal ultrasound CPT 76830	$1,391.00	$1,391.00	$42.98 – $1,321.45
Ultrasound of the abdomen, complete CPT 76700	$2,472.00	$2,472.00	$76.38 – $2,348.40
Ultrasound of the neck or thyroid CPT 76536	$1,905.50	$1,905.50	$58.88 – $1,810.22
Wrist X-ray, 3 or more views CPT 73110	$1,951.25	$1,951.25	$60.29 – $1,853.69
X-ray of the lower back, 4 or more views CPT 72110	$1,624.00	$1,624.00	$50.18 – $1,542.80

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$339.75	$339.75	$13.92 – $34.40
Blood culture CPT 87040	$339.75	$339.75	$71.35 – $322.76
Blood draw (venipuncture) CPT 36415	$76.75	$76.75	$2.37 – $72.91
BNP test (heart failure) CPT 83880	$958.50	$958.50	$201.28 – $910.58
C-reactive protein (CRP) test CPT 86140	$352.00	$352.00	$8.52 – $21.06
Chlamydia test (DNA/NAAT) CPT 87491	$634.75	$634.75	$133.30 – $603.01
Complete blood count (CBC) with differential CPT 85025	not posted		$12.78 – $31.59
Complete blood count (CBC), automated CPT 85027	$221.25	$221.25	$46.46 – $210.19
Comprehensive metabolic panel (blood test) CPT 80053	$358.25	$358.25	$17.37 – $42.93
COVID-19 PCR test CPT 87635	$269.50	$269.50	$41.05 – $176.61
D-dimer test (blood clots) CPT 85379	$341.25	$341.25	$16.75 – $41.39
Drug screen, instrument chemistry CPT 80307	$663.00	$663.00	$49.71 – $1,839.98
Ferritin (iron stores) test CPT 82728	$453.00	$453.00	$22.42 – $55.42
Free T4 (thyroid) test CPT 84439	$357.25	$357.25	$14.84 – $36.67
General health panel (blood tests) CPT 80050	not posted		$74.62 – $184.42
Glucose (blood sugar) test CPT 82947	$156.25	$156.25	$3.14 – $116.17
Gonorrhea test (DNA/NAAT) CPT 87591	$634.75	$634.75	$133.30 – $603.01
Hemoglobin A1c test CPT 83036	$257.50	$257.50	$54.08 – $244.63
Hepatitis C antibody test CPT 86803	$331.50	$331.50	$11.42 – $422.75
HIV-1/HIV-2 antigen and antibody test CPT 87389	$387.00	$387.00	$39.61 – $97.90
Iron test CPT 83540	$223.50	$223.50	$5.18 – $191.77
Kidney function panel CPT 80069	$621.25	$621.25	$6.94 – $256.91
Lipase test (pancreas) CPT 83690	$249.25	$249.25	$5.51 – $204.12
Lipid panel, cholesterol and triglycerides CPT 80061	$371.75	$371.75	$22.03 – $54.44
Liver function panel CPT 80076	$241.00	$241.00	$6.54 – $241.92
Magnesium test CPT 83735	$365.25	$365.25	$76.70 – $346.99
Obstetric blood test panel CPT 80055	not posted		$78.65 – $194.39
Partial thromboplastin time (PTT), clotting test CPT 85730	$347.75	$347.75	$9.89 – $24.44
Pregnancy blood test (hCG), quantitative CPT 84702	$633.50	$633.50	$24.76 – $61.19
Prothrombin time (PT/INR), clotting test CPT 85610	$156.25	$156.25	$7.06 – $17.44
PSA (prostate specific antigen), free CPT 84154	$748.25	$748.25	$14.71 – $544.39
PSA (prostate specific antigen), total CPT 84153	$401.50	$401.50	$84.31 – $381.43
Rapid strep test CPT 87880	$292.50	$292.50	$61.42 – $277.88
Sed rate (ESR) test CPT 85652	$144.25	$144.25	$2.16 – $80.19
TB skin test CPT 86580	not posted		$40.58 – $100.30
Thyroid stimulating hormone (TSH) CPT 84443	$371.75	$371.75	$13.44 – $497.48
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$4,286.50	$4,286.50	$900.16 – $4,072.18
Troponin test (heart damage) CPT 84484	$543.25	$543.25	$9.98 – $369.43
Urinalysis, automated, with microscope CPT 81001	$218.50	$218.50	$2.54 – $93.83
Urinalysis, automated, without microscope CPT 81003	$144.25	$144.25	$3.70 – $9.15
Urinalysis, manual, with microscope CPT 81000	not posted		$6.61 – $16.34
Urinalysis, manual, without microscope CPT 81002	$141.75	$141.75	$29.77 – $134.66
Urine culture, colony count CPT 87086	$239.00	$239.00	$13.28 – $32.81
Urine pregnancy test CPT 81025	$91.75	$91.75	$19.27 – $87.16
Vitamin B12 test CPT 82607	$412.50	$412.50	$24.81 – $61.31
Vitamin D test CPT 82306	$1,625.75	$1,625.75	$48.69 – $120.35

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$3,759.50	$3,759.50	$116.17 – $3,571.53
ECG tracing only (no interpretation) CPT 93005	$828.25	$828.25	$25.59 – $786.84
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$8,922.50	$8,922.50	$275.71 – $8,476.38
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$12.90 – $13.03
Holter monitor, up to 48 hours CPT 93224	not posted		$59.93 – $60.54
Left heart catheterization CPT 93452	not posted		$5,383.60 – $15,260.10
Left heart catheterization with coronary angiogram CPT 93458	not posted		$5,383.60 – $15,260.10
Nuclear stress test (heart perfusion imaging) CPT 78452	$16,609.00	$16,609.00	$1,929.25 – $2,234.29

Surgery

Service	Cash price	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted	$8,425.41 – $17,473.30
Appendix removal, laparoscopic CPT 44970	not posted	$8,425.41 – $17,473.30
Breast biopsy with ultrasound guidance CPT 19083	not posted	$19,032.00 – $22,942.00
Carpal tunnel release CPT 64721	not posted	$6,009.00 – $7,243.00
Colonoscopy with biopsy CPT 45380	not posted	$1,540.00 – $7,243.00
Colonoscopy with polyp removal (snare) CPT 45385	not posted	$1,540.00 – $7,243.00
Colonoscopy, diagnostic CPT 45378	not posted	$1,284.00 – $7,243.00
Colposcopy with biopsy CPT 57454	not posted	$1,284.00 – $6,212.00
Cystoscopy (bladder scope) CPT 52000	not posted	$1,284.00 – $6,212.00
Ear tubes, under general anesthesia CPT 69436	not posted	$1,540.00 – $22,942.00
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted	$1,284.00 – $6,212.00
Gallbladder removal, laparoscopic CPT 47562	not posted	$8,425.41 – $17,473.30
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted	$8,512.00 – $37,298.00
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted	$8,993.00 – $19,850.20
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted	$1,540.00 – $22,942.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted	$8,425.41 – $17,473.30
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted	$3,302.00 – $23,617.00
Kidney stone shock-wave lithotripsy CPT 50590	not posted	$3,302.00 – $11,152.90
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted	$3,302.00 – $6,103.84
Lower colon endoscopy with ultrasound CPT 45391	not posted	$1,540.00 – $7,243.00
Nasal endoscopy, diagnostic CPT 31231	not posted	$690.90 – $2,702.16
Prostate biopsy CPT 55700	not posted	$1,540.00 – $2,989.89
Prostate removal, laparoscopic or robotic CPT 55866	not posted	$8,993.00 – $19,850.20
Removal of a breast lump, open surgery CPT 19120	not posted	$3,302.00 – $22,942.00
Rotator cuff repair, arthroscopic CPT 29827	not posted	$8,512.00 – $32,253.00
Screening colonoscopy, average risk HCPCS G0121	not posted	$1,284.00 – $7,243.00
Screening colonoscopy, high risk HCPCS G0105	not posted	$1,284.00 – $2,702.16
Septoplasty (nasal septum repair) CPT 30520	not posted	$1,540.00 – $23,617.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted	$19,032.00 – $22,942.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted	$8,512.00 – $37,298.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted	$4,769.00 – $22,942.00
Total hip replacement CPT 27130	not posted	$24,133.40 – $52,661.90
Total knee replacement CPT 27447	not posted	$24,133.40 – $52,661.90
Upper endoscopy (EGD) with biopsy CPT 43239	not posted	$1,284.00 – $7,243.00
Upper endoscopy (EGD), diagnostic CPT 43235	not posted	$1,284.00 – $6,212.00
Vasectomy CPT 55250	not posted	$1,540.00 – $7,243.00

Pregnancy and birth

Service	Cash price	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	not posted	$3,302.00 – $8,425.41
Fetal non-stress test CPT 59025	not posted	$21.20 – $21.42
IUD insertion CPT 58300	not posted	$690.90 – $2,702.16
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted	$3,302.00 – $8,425.41
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted	$3,302.00 – $6,103.84

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$944.62 – $944.62
C-section, without complications MS-DRG 788	not posted	$1,685.00 – $23,420.00
Chest pain MS-DRG 313	not posted	$3,965.00 – $4,956.00
COPD flare-up, with major complications MS-DRG 190	not posted	$3,965.00 – $4,956.00
COPD flare-up, without complications MS-DRG 192	not posted	$3,965.00 – $4,956.00
Fainting (syncope) MS-DRG 312	not posted	$3,965.00 – $4,956.00
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$3,965.00 – $4,956.00
Heart failure, with major complications MS-DRG 291	not posted	$3,965.00 – $4,956.00
Heart failure, without complications MS-DRG 293	not posted	$3,965.00 – $4,956.00
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$1,685.00 – $162,123.00
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$1,685.00 – $70,201.90
Irregular heartbeat, without complications MS-DRG 310	not posted	$3,965.00 – $4,956.00
Kidney failure, with complications MS-DRG 683	not posted	$3,965.00 – $4,956.00
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$3,965.00 – $4,956.00
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$3,965.00 – $4,956.00
Normal newborn care MS-DRG 795	not posted	$913.00 – $4,679.00
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$3,965.00 – $4,956.00
Pneumonia, with complications MS-DRG 194	not posted	$3,965.00 – $4,956.00
Pneumonia, with major complications MS-DRG 193	not posted	$3,965.00 – $4,956.00
Pneumonia, without complications MS-DRG 195	not posted	$3,965.00 – $4,956.00
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$1,113.66 – $1,113.66
Sepsis, with major complications MS-DRG 871	not posted	$3,965.00 – $4,956.00
Sepsis, without major complications MS-DRG 872	not posted	$3,965.00 – $4,956.00
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$3,965.00 – $4,956.00
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$3,965.00 – $4,956.00
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$3,965.00 – $4,956.00
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$3,965.00 – $4,956.00
Vaginal delivery, without complications MS-DRG 807	not posted	$2,075.00 – $3,336.00
Weight loss surgery, without complications MS-DRG 621	not posted	$1,685.00 – $42,269.00

Pain and spine

Service	Cash price	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	not posted	$690.90 – $6,212.00
Lower back nerve root injection with imaging guidance CPT 64483	not posted	$1,284.00 – $6,212.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	not posted	$1,284.00 – $6,212.00
Lower back spinal injection (epidural), without imaging CPT 62322	not posted	$1,284.00 – $6,212.00

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted		$1,540.00 – $43,770.00
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted		$6,009.00 – $7,243.00

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$1,916.00	$1,916.00	$59.20 – $1,820.20
Sleep study with CPAP titration CPT 95811	$12,463.50	$12,463.50	$1,651.00 – $3,646.67
Sleep study, overnight in a sleep lab CPT 95810	$11,843.00	$11,843.00	$488.00 – $1,075.86

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$672.75	$672.75	$20.79 – $639.11

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$284.75	$284.75	$8.80 – $270.51
Physical therapy evaluation, low complexity CPT 97161	$798.50	$798.50	$70.20 – $156.43
Physical therapy evaluation, moderate complexity CPT 97162	$798.50	$798.50	$70.20 – $156.43
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$358.50	$358.50	$11.08 – $340.57
Therapeutic activities, 15 minutes CPT 97530	$358.50	$358.50	$11.08 – $340.57

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$1,095.25	$1,095.25	$33.84 – $1,040.49
Family psychotherapy, without the patient, 50 minutes CPT 90846	$1,095.25	$1,095.25	$33.84 – $1,040.49
Group psychotherapy CPT 90853	$960.00	$960.00	$29.66 – $912.00
Psychiatric diagnostic evaluation CPT 90791	$770.50	$770.50	$23.81 – $731.98
Psychotherapy, 30 minutes CPT 90832	$689.00	$689.00	$21.29 – $654.55
Psychotherapy, 45 minutes CPT 90834	$1,332.75	$1,332.75	$41.18 – $1,266.11
Psychotherapy, 60 minutes CPT 90837	$1,332.75	$1,332.75	$41.18 – $1,266.11

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$363.00	$363.00	$11.22 – $344.85
IV hydration, each additional hour CPT 96361	$575.25	$575.25	$17.78 – $546.49
IV hydration, first hour CPT 96360	$575.25	$575.25	$17.78 – $546.49
IV push injection of a drug, first CPT 96374	$1,028.75	$1,028.75	$31.79 – $977.31
IV push injection, each additional drug CPT 96375	$765.00	$765.00	$23.64 – $726.75

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$1,137.50	$1,137.50	$35.15 – $1,137.50
Dexamethasone injection, per 1 mg HCPCS J1100	$154.25	$154.25	$4.77 – $154.25
Fentanyl injection, per 0.1 mg HCPCS J3010	$416.50	$416.50	$12.87 – $416.50
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$97.00	$97.00	$3.00 – $92.15
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$252.00	$252.00	$7.79 – $252.00
Morphine injection, up to 10 mg HCPCS J2270	$118.68	$118.68	$3.67 – $118.68
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$30.00	$30.00	? – $30.00
Propofol injection, per 10 mg HCPCS J2704	$273.25	$273.25	$8.44 – $273.25
Saline IV solution, 1000 ml HCPCS J7030	$140.25	$140.25	$2.12 – $5.50

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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