Bayshore Medical Center

727 N Beers St., Holmdel, NJ 07733 · Acute care hospital · Emergency room

These are Bayshore Medical Center's own posted figures from its standard-charges file dated December 31, 2025. They are not a quote. Source: the hospital's file · its price transparency page.

231 of the services we track have a posted price here; 199 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	$932.65	$5,390.00	$883.96 – $4,743.20
Emergency room visit, level 1 (minor) CPT 99281	$97.46	$649.00	$97.00 – $1,599.00
Emergency room visit, level 2 CPT 99282	$175.28	$1,348.00	$175.28 – $1,599.00
Emergency room visit, level 3 (moderate) CPT 99283	$306.48	$2,090.00	$342.76 – $1,839.20
Emergency room visit, level 4 CPT 99284	$471.32	$3,025.00	$496.10 – $2,662.00
Emergency room visit, level 5 (most severe) CPT 99285	$678.62	$4,125.00	$676.50 – $3,630.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$219.93	$825.00	$105.10 – $368.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	not posted	$440.00	$79.20 – $428.21
New patient office visit, about 30 minutes CPT 99203	not posted	$1,870.00	$336.60 – $1,819.88
New patient office visit, about 45 minutes CPT 99204	not posted	$2,057.00	$337.35 – $2,001.87
New patient office visit, about 60 minutes CPT 99205	not posted	$770.00	$138.60 – $749.36
Office consultation, about 40 minutes CPT 99243	not posted	$550.00	$90.20 – $535.26
Office consultation, about 60 minutes CPT 99244	not posted	$825.00	$135.30 – $802.89
Office visit, established patient, about 10 to 19 minutes CPT 99212	not posted	$314.00	$56.52 – $305.58
Office visit, established patient, about 20 to 29 minutes CPT 99213	not posted	$374.00	$67.32 – $363.98
Office visit, established patient, about 30 to 39 minutes CPT 99214	not posted	$495.00	$111.00 – $122.61
Office visit, established patient, about 40 to 54 minutes CPT 99215	not posted	$605.00	$111.00 – $164.16
Office visit, established patient, brief (often a nurse) CPT 99211	not posted	$275.00	$49.50 – $267.63
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted	$173.00	$28.37 – $168.36
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted	$132.00	$21.65 – $128.46

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$65.52	$222.00	$65.52 – $78.62
Abdominal X-ray, 1 view CPT 74018	$97.46	$473.00	$33.90 – $219.04
Ankle X-ray, 3 or more views CPT 73610	$97.46	$633.00	$103.81 – $557.04
Bone density scan (DEXA), hips and spine CPT 77080	$117.70	$935.00	$153.34 – $822.80
Breast ultrasound, one breast, complete CPT 76641	$117.70		$133.39 – $295.04
Breast ultrasound, one breast, limited CPT 76642	$97.46		$102.19 – $219.04
Chest X-ray, 1 view CPT 71045	$97.46	$429.00	$97.46 – $116.95
Chest X-ray, 2 views CPT 71046	$97.46	$497.00	$97.46 – $116.95
CT angiogram of the chest (checks for lung clots) CPT 71275	$197.04	$3,587.00	$197.04 – $236.45
CT angiogram of the head CPT 70496	$197.04	$3,443.00	$197.04 – $236.45
CT scan of the abdomen and pelvis, with contrast CPT 74177	$395.29	$4,650.00	$395.29 – $474.35
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$395.29	$6,430.00	$395.29 – $474.35
CT scan of the abdomen and pelvis, without contrast CPT 74176	$267.55	$3,740.00	$267.55 – $321.06
CT scan of the abdomen, without contrast CPT 74150	$117.70	$1,980.00	$251.91 – $2,159.44
CT scan of the chest, with contrast CPT 71260	$197.04	$3,354.00	$197.04 – $236.45
CT scan of the chest, without contrast CPT 71250	$117.70	$2,692.00	$117.70 – $141.24
CT scan of the head, without contrast CPT 70450	$117.70	$2,504.00	$410.66 – $2,161.45
CT scan of the neck (cervical spine), without contrast CPT 72125	$117.70	$2,970.00	$257.66 – $2,159.44
CT scan of the pelvis, with contrast CPT 72193	$197.04	$3,245.00	$197.04 – $236.45
CT scan of the sinuses or face, without contrast CPT 70486	$117.70	$2,420.00	$396.88 – $2,088.94
Diagnostic mammogram, both breasts CPT 77066	$207.95	$1,045.00	$207.95 – $249.54
Diagnostic mammogram, one breast CPT 77065	$164.52	$737.00	$164.52 – $197.42
Foot X-ray, 3 or more views CPT 73630	$97.46	$649.00	$39.24 – $219.04
Hand X-ray, 3 or more views CPT 73130	$97.46	$550.00	$39.24 – $219.04
Knee X-ray, 3 views CPT 73562	$97.46	$688.00	$112.83 – $605.44
Leg or arm vein ultrasound, both sides CPT 93970	$267.55	$2,682.00	$439.85 – $2,610.12
Leg or arm vein ultrasound, one side CPT 93971	$117.70	$1,708.00	$280.11 – $1,662.23
Lower back X-ray, 2 or 3 views CPT 72100	$117.70	$743.00	$50.46 – $295.04
MRI of both breasts, without and with contrast CPT 77049	not posted	$5,583.00	$915.61 – $4,819.25
MRI of the abdomen, without and with contrast CPT 74183	$395.29	$5,225.00	$395.29 – $474.35
MRI of the brain, without and with contrast CPT 70553	$395.29	$5,631.00	$923.48 – $4,860.68
MRI of the brain, without contrast CPT 70551	$267.55	$4,073.00	$667.97 – $3,515.81
MRI of the knee or other leg joint, without contrast CPT 73721	$267.55	$4,290.00	$443.43 – $4,332.00
MRI of the lower back (lumbar spine), without contrast CPT 72148	$267.55	$4,439.00	$267.55 – $321.06
MRI of the mid back (thoracic spine), without contrast CPT 72146	$267.55	$4,329.00	$267.55 – $321.06
MRI of the neck (cervical spine), without contrast CPT 72141	$267.55	$4,263.00	$267.55 – $321.06
MRI of the pelvis, without and with contrast CPT 72197	$395.29	$5,473.00	$395.29 – $474.35
MRI of the shoulder or other arm joint, without contrast CPT 73221	$267.55	$4,113.00	$444.39 – $4,332.00
Neck X-ray, 2 or 3 views CPT 72040	$97.46	$600.00	$45.43 – $219.04
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$117.70	$1,293.00	$212.05 – $1,163.70
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$117.70	$825.00	$157.85 – $333.21
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$117.70	$1,180.00	$157.85 – $295.04
Screening mammogram, both breasts CPT 77067	$169.06	$748.00	$169.06 – $202.87
Shoulder X-ray, 2 or more views CPT 73030	$97.46	$688.00	$112.83 – $605.44
Transvaginal pregnancy ultrasound CPT 76817	$117.70	$990.00	$112.70 – $295.04
Transvaginal ultrasound CPT 76830	$117.70	$1,255.00	$205.82 – $1,129.50
Ultrasound of the abdomen, complete CPT 76700	$117.70	$1,362.00	$147.94 – $299.87
Ultrasound of the neck or thyroid CPT 76536	$117.70	$1,210.00	$117.70 – $141.24
Wrist X-ray, 3 or more views CPT 73110	$97.46	$600.00	$98.40 – $528.00
X-ray of the lower back, 4 or more views CPT 72110	$117.70	$1,019.00	$68.87 – $295.04

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$8.46	$187.00	$92.75 – $181.99
Blood culture CPT 87040	$10.32	$229.00	$10.32 – $12.38
Blood draw (venipuncture) CPT 36415	$9.09	$47.00	$23.31 – $45.74
BNP test (heart failure) CPT 83880	$39.26	$288.00	$142.85 – $280.28
C-reactive protein (CRP) test CPT 86140	$5.18	$108.00	$5.18 – $6.22
Chlamydia test (DNA/NAAT) CPT 87491	$35.09	$298.00	$147.81 – $290.01
Complete blood count (CBC) with differential CPT 85025	$7.77	$165.00	$7.77 – $9.32
Complete blood count (CBC), automated CPT 85027	$6.47	$106.00	$52.58 – $103.16
Comprehensive metabolic panel (blood test) CPT 80053	$10.56	$341.00	$10.56 – $12.67
COVID-19 PCR test CPT 87635	$51.31	$314.00	$51.31 – $61.57
D-dimer test (blood clots) CPT 85379	$10.18	$127.00	$62.99 – $123.60
Drug screen, instrument chemistry CPT 80307	$62.14	$248.00	$123.01 – $241.35
Ferritin (iron stores) test CPT 82728	$13.63	$210.00	$13.63 – $16.36
Free T4 (thyroid) test CPT 84439	$9.02	$162.00	$9.02 – $10.82
General health panel (blood tests) CPT 80050	not posted	$1,232.00	$202.05 – $1,198.98
Glucose (blood sugar) test CPT 82947	$3.93	$48.00	$23.81 – $46.71
Gonorrhea test (DNA/NAAT) CPT 87591	$35.09	$286.00	$141.86 – $278.34
Hemoglobin A1c test CPT 83036	$9.71	$55.00	$27.28 – $53.53
Hepatitis C antibody test CPT 86803	$14.27	$226.00	$14.27 – $17.12
HIV-1/HIV-2 antigen and antibody test CPT 87389	$24.08	$245.00	$121.52 – $238.43
Iron test CPT 83540	$6.47	$105.00	$52.08 – $102.19
Kidney function panel CPT 80069	$8.68	$197.00	$8.68 – $10.42
Lipase test (pancreas) CPT 83690	$6.89	$132.00	$65.47 – $128.46
Lipid panel, cholesterol and triglycerides CPT 80061	$13.39	$260.00	$13.39 – $16.07
Liver function panel CPT 80076	$8.17	$167.00	$8.17 – $9.80
Magnesium test CPT 83735	$6.70	$138.00	$6.70 – $8.04
Obstetric blood test panel CPT 80055	$47.81	$326.00	$161.70 – $317.26
Partial thromboplastin time (PTT), clotting test CPT 85730	$6.01	$132.00	$65.47 – $128.46
Pregnancy blood test (hCG), quantitative CPT 84702	$15.05	$220.00	$15.05 – $18.06
Prothrombin time (PT/INR), clotting test CPT 85610	$4.29	$97.00	$4.29 – $5.15
PSA (prostate specific antigen), free CPT 84154	$18.39	$171.00	$18.39 – $22.07
PSA (prostate specific antigen), total CPT 84153	$18.39	$328.00	$18.39 – $22.07
Rapid strep test CPT 87880	$16.53	$83.00	$41.17 – $80.78
Sed rate (ESR) test CPT 85652	$2.70	$81.00	$40.18 – $78.83
TB skin test CPT 86580	$27.11	$66.71	? – $60.04
Thyroid stimulating hormone (TSH) CPT 84443	$16.80	$266.00	$16.80 – $20.16
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$59.14	$1,519.00	$249.12 – $1,478.29
Troponin test (heart damage) CPT 84484	$12.47	$173.00	$85.81 – $168.36
Urinalysis, automated, with microscope CPT 81001	$3.17	$107.00	$3.17 – $3.80
Urinalysis, automated, without microscope CPT 81003	$2.25	$80.00	$2.25 – $2.70
Urinalysis, manual, with microscope CPT 81000	$4.02		$4.02 – $4.82
Urinalysis, manual, without microscope CPT 81002	$3.48	$45.00	$22.32 – $43.79
Urine culture, colony count CPT 87086	$8.07	$154.00	$8.07 – $9.68
Urine pregnancy test CPT 81025	$8.61	$138.00	$68.45 – $134.30
Vitamin B12 test CPT 82607	$15.08	$160.00	$15.08 – $18.10
Vitamin D test CPT 82306	$29.60	$450.00	$223.20 – $437.94

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$267.55	$2,090.00	$342.76 – $2,033.99
ECG tracing only (no interpretation) CPT 93005	$65.75	$359.00	$58.88 – $349.38
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$606.89	$4,021.00	$659.44 – $3,913.24
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$49.09 – $49.09
Holter monitor, up to 48 hours CPT 93224	not posted		$306.08 – $306.08
Left heart catheterization CPT 93452	$3,560.12	$15,597.00	$2,379.00 – $22,114.00
Left heart catheterization with coronary angiogram CPT 93458	$3,560.12	$18,028.00	$2,379.00 – $22,114.00
Nuclear stress test (heart perfusion imaging) CPT 78452	$1,444.98	$6,381.00	$1,046.48 – $5,742.90
Treadmill stress test, complete CPT 93015	not posted	$201.00	$32.96 – $195.61

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$7,907.11	$13,167.00	$2,159.39 – $12,814.12
Appendix removal, laparoscopic CPT 44970	$6,457.82	$11,880.00	$2,379.00 – $22,999.00
Breast biopsy with ultrasound guidance CPT 19083	$1,793.38		$1,793.38 – $2,152.05
Carpal tunnel release CPT 64721	$2,161.44	$5,972.00	$1,141.00 – $10,105.00
Colonoscopy with biopsy CPT 45380	$1,305.08	$4,294.00	$704.22 – $4,178.92
Colonoscopy with polyp removal (snare) CPT 45385	$1,305.08	$4,235.00	$694.54 – $4,121.50
Colonoscopy, diagnostic CPT 45378	$1,009.14	$4,235.00	$694.54 – $4,121.50
Colposcopy with biopsy CPT 57454	$336.70	$703.00	$336.70 – $9,933.00
Cystoscopy (bladder scope) CPT 52000	$738.80	$5,170.00	$847.88 – $5,031.44
Ear tubes, under general anesthesia CPT 69436	$1,639.57		$1,639.57 – $1,967.48
Flexible sigmoidoscopy, diagnostic CPT 45330	$1,009.14	$2,610.00	$868.00 – $9,933.00
Gallbladder removal, laparoscopic CPT 47562	$6,457.82	$10,973.00	$1,799.57 – $9,863.63
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted	$5,266.00	$863.62 – $5,124.87
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$11,523.76	$15,125.00	$1,613.00 – $22,999.00
Hysteroscopy with biopsy or polyp removal CPT 58558	$3,519.29	$7,159.00	$1,189.00 – $10,105.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	$6,457.82		$6,457.82 – $7,749.38
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$3,906.18		$3,906.18 – $4,687.41
Kidney stone shock-wave lithotripsy CPT 50590	$3,817.53	$12,375.00	$1,613.00 – $25,006.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$3,591.33		$3,591.33 – $4,309.59
Lower colon endoscopy with ultrasound CPT 45391	$1,305.08	$4,490.00	$736.36 – $4,369.67
Nasal endoscopy, diagnostic CPT 31231	$214.89	$430.00	$214.89 – $9,933.00
Prostate biopsy CPT 55700	$2,267.41	$6,930.00	$1,141.00 – $9,933.00
Prostate removal, laparoscopic or robotic CPT 55866	$11,523.76	$14,441.00	$2,368.32 – $14,053.98
Removal of a breast lump, open surgery CPT 19120	$4,238.48		$4,238.48 – $5,086.17
Rotator cuff repair, arthroscopic CPT 29827	$7,907.11	$9,870.00	$2,379.00 – $22,999.00
Screening colonoscopy, average risk HCPCS G0121	$1,009.14	$4,023.00	$1,009.14 – $9,933.00
Screening colonoscopy, high risk HCPCS G0105	$1,009.14	$4,455.00	$1,009.14 – $9,933.00
Septoplasty (nasal septum repair) CPT 30520	$3,589.62	$5,580.00	$1,189.00 – $10,105.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted	$5,304.00	$869.86 – $5,161.85
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted	$4,384.00	$718.98 – $4,266.51
Tonsil and adenoid removal, under age 12 CPT 42820	$6,547.81	$9,176.00	$1,504.86 – $8,930.08
Total hip replacement CPT 27130	$14,241.77		$14,241.77 – $17,090.12
Total knee replacement CPT 27447	$14,241.77		$14,241.77 – $17,090.12
Upper endoscopy (EGD) with biopsy CPT 43239	$1,037.75	$4,106.00	$673.38 – $3,995.96
Upper endoscopy (EGD), diagnostic CPT 43235	$1,037.75	$4,476.00	$734.06 – $4,356.04
Vasectomy CPT 55250	$2,267.41	$5,816.00	$1,141.00 – $10,105.00

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
Fetal non-stress test CPT 59025	$222.67	$1,419.00	$232.72 – $1,380.97
IUD insertion CPT 58300	not posted	$464.00	$1,189.00 – $9,933.00
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted	$5,834.00	$956.78 – $5,133.92

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$7,484.13	$5,778.00 – $33,336.57
C-section, without complications MS-DRG 788	$7,675.00
Chest pain MS-DRG 313	$6,052.11	$5,241.34 – $29,959.00
COPD flare-up, with major complications MS-DRG 190	$9,526.95	$5,778.00 – $50,434.00
COPD flare-up, without complications MS-DRG 192	$5,490.51	$4,754.97 – $30,671.00
Fainting (syncope) MS-DRG 312	$7,391.66	$5,778.00 – $33,949.00
Gastrointestinal bleeding, with complications MS-DRG 378	$8,363.86	$5,778.00 – $41,946.00
Heart failure, with major complications MS-DRG 291	$11,069.24	$5,778.00 – $56,987.00
Heart failure, without complications MS-DRG 293	$4,654.89	$4,031.29 – $28,193.00
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	$81,874.91	$6,542.00 – $415,984.00
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	$15,995.60	$6,542.00 – $84,282.00
Irregular heartbeat, without complications MS-DRG 310	$4,746.51	$4,096.84 – $23,817.00
Kidney failure, with complications MS-DRG 683	$7,540.97	$5,778.00 – $38,926.00
Kidney or urinary tract infection, without major complications MS-DRG 690	$6,808.84	$5,778.00 – $33,636.00
Neck (cervical) spinal fusion, without complications MS-DRG 473	$20,083.79	$6,542.00 – $100,509.00
Normal newborn care MS-DRG 795	$1,695.00	$1,423.00 – $7,811.00
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$6,628.99	$5,524.57 – $31,848.00
Pneumonia, with complications MS-DRG 194	$6,956.45	$5,778.00 – $38,130.00
Pneumonia, with major complications MS-DRG 193	$11,178.68	$5,778.00 – $55,771.00
Pneumonia, without complications MS-DRG 195	$5,282.66	$4,574.97 – $29,091.00
Psychoses (inpatient psychiatric stay) MS-DRG 885	$11,958.31	$5,778.00 – $53,265.96
Sepsis, with major complications MS-DRG 871	$16,645.44	$5,778.00 – $78,632.00
Sepsis, without major complications MS-DRG 872	$8,746.47	$5,778.00 – $44,598.00
Skin infection (cellulitis), without major complications MS-DRG 603	$7,472.25	$5,778.00 – $35,906.00
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$28,853.24 – $28,853.24
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$6,619.66	$5,608.21 – $31,996.00
Stroke, with complications or clot-busting drug MS-DRG 65	$8,626.85	$5,778.00 – $43,691.00
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	$10,169.15	$6,542.00 – $47,253.00
Vaginal delivery, without complications MS-DRG 807	$5,406.52	$4,682.24 – $26,007.00
Weight loss surgery, without complications MS-DRG 621	$12,401.15	$6,542.00 – $66,852.00

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$326.73		$326.73 – $392.08
Lower back nerve root injection with imaging guidance CPT 64483	$985.43		$985.43 – $1,182.51
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$766.52	$4,620.00	$766.52 – $9,933.00
Lower back spinal injection (epidural), without imaging CPT 62322	$985.43	$2,396.00	$985.43 – $9,933.00

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	$2,524.45	$7,351.00	$1,189.00 – $10,105.00
Eye exam, new patient, comprehensive CPT 92004	$142.64		$142.64 – $171.17
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$607.22	$2,869.00	$470.52 – $2,792.11

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$173.18	$567.00	$92.99 – $542.22

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$173.18	$1,925.00	$315.70 – $1,873.41
Sleep study with CPAP titration CPT 95811	$1,126.11	$9,782.00	$1,604.25 – $9,354.53
Sleep study, overnight in a sleep lab CPT 95810	$1,126.11	$9,011.00	$1,477.80 – $8,617.22

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$173.18	$1,375.00	$225.50 – $1,338.15

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$35.04	$202.00	$36.36 – $196.59
Physical therapy evaluation, low complexity CPT 97161	$126.19	$396.00	$60.00 – $151.43
Physical therapy evaluation, moderate complexity CPT 97162	$126.19	$453.00	$60.00 – $151.43
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$37.06	$231.00	$41.58 – $224.81
Therapeutic activities, 15 minutes CPT 97530	$44.62	$188.00	$33.84 – $182.96

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$177.84	$497.00	$81.51 – $483.68
Family psychotherapy, without the patient, 50 minutes CPT 90846	$177.84	$385.00	$63.14 – $374.68
Group psychotherapy CPT 90853	$102.38	$413.00	$102.38 – $122.86
Psychiatric diagnostic evaluation CPT 90791	$177.84	$790.00	$129.56 – $768.83
Psychotherapy, 30 minutes CPT 90832	$177.84	$452.00	$74.13 – $439.89
Psychotherapy, 45 minutes CPT 90834	$177.84	$539.00	$88.40 – $524.55
Psychotherapy, 60 minutes CPT 90837	$177.84	$605.00	$99.22 – $588.79

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$78.78	$1,987.00	$78.78 – $94.53
IV hydration, each additional hour CPT 96361	$51.07	$440.00	$72.16 – $428.21
IV hydration, first hour CPT 96360	$233.20	$1,430.00	$234.52 – $1,391.68
IV push injection of a drug, first CPT 96374	$233.20	$715.00	$117.26 – $695.84
IV push injection, each additional drug CPT 96375	$51.07	$461.00	$75.60 – $448.65

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	not posted	$22.82	? – $20.54
Fentanyl injection, per 0.1 mg HCPCS J3010	not posted	$2.85	? – $2.57
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted	$104.03	? – $93.63
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	not posted	$3.85	? – $3.47
Midazolam (Versed) injection, per 1 mg HCPCS J2250	not posted	$1.59	? – $1.43
Morphine injection, up to 10 mg HCPCS J2270	not posted	$28.27	? – $25.44
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	not posted	$1.60	? – $1.44
Saline IV solution, 1000 ml HCPCS J7030	not posted	$16.00	? – $14.40

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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