Southern Ocean Medical Center

1140 Rt 72 W, Manahawkin, NJ 08050 · Acute care hospital · Emergency room

These are Southern Ocean 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.

233 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	$920.87	$5,390.00	$970.20 – $4,894.12
Emergency room visit, level 1 (minor) CPT 99281	$96.23	$649.00	$96.23 – $1,599.00
Emergency room visit, level 2 CPT 99282	$173.07	$1,348.00	$173.07 – $1,599.00
Emergency room visit, level 3 (moderate) CPT 99283	$302.61	$2,090.00	$268.00 – $3,841.00
Emergency room visit, level 4 CPT 99284	$465.37	$3,025.00	$358.00 – $4,374.00
Emergency room visit, level 5 (most severe) CPT 99285	$670.04	$4,125.00	$742.50 – $3,745.50
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$217.16	$825.00

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 – $432.78
New patient office visit, about 30 minutes CPT 99203	not posted	$1,870.00	$336.60 – $1,839.33
New patient office visit, about 45 minutes CPT 99204	not posted	$2,057.00	$370.26 – $2,023.27
New patient office visit, about 60 minutes CPT 99205	not posted	$770.00	$111.00 – $297.38
Office consultation, about 40 minutes CPT 99243	not posted	$550.00	$99.00 – $540.98
Office consultation, about 60 minutes CPT 99244	not posted	$825.00	$148.50 – $811.47
Office visit, established patient, about 10 to 19 minutes CPT 99212	not posted	$314.00	$56.52 – $308.85
Office visit, established patient, about 20 to 29 minutes CPT 99213	not posted	$374.00	$67.32 – $367.87
Office visit, established patient, about 30 to 39 minutes CPT 99214	not posted	$495.00	$89.10 – $486.88
Office visit, established patient, about 40 to 54 minutes CPT 99215	not posted	$605.00	$108.90 – $595.08
Office visit, established patient, brief (often a nurse) CPT 99211	not posted	$275.00	$49.50 – $270.49
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted	$173.00	$31.14 – $170.16
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted	$132.00	$23.76 – $129.84

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	$96.23	$473.00	$85.14 – $432.42
Ankle X-ray, 3 or more views CPT 73610	$96.23	$633.00	$39.24 – $219.04
Bone density scan (DEXA), hips and spine CPT 77080	$116.22	$935.00	$71.80 – $295.04
Breast ultrasound, one breast, complete CPT 76641	$116.22		$133.39 – $295.04
Breast ultrasound, one breast, limited CPT 76642	$96.23		$102.19 – $219.04
Chest X-ray, 1 view CPT 71045	$96.23	$429.00	$19.89 – $219.04
Chest X-ray, 2 views CPT 71046	$96.23	$497.00	$89.46 – $454.36
CT angiogram of the chest (checks for lung clots) CPT 71275	$194.55	$3,587.00	$434.32 – $801.30
CT angiogram of the head CPT 70496	$194.55	$3,443.00	$194.55 – $233.47
CT scan of the abdomen and pelvis, with contrast CPT 74177	$390.30	$4,650.00	$837.00 – $4,251.03
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$390.30	$6,430.00	$1,157.40 – $5,878.31
CT scan of the abdomen and pelvis, without contrast CPT 74176	$264.17	$3,740.00	$673.20 – $3,419.11
CT scan of the abdomen, without contrast CPT 74150	$116.22	$1,980.00	$356.40 – $1,810.12
CT scan of the chest, with contrast CPT 71260	$194.55	$3,354.00	$314.45 – $714.00
CT scan of the chest, without contrast CPT 71250	$116.22	$2,692.00	$249.64 – $714.00
CT scan of the head, without contrast CPT 70450	$116.22	$2,504.00	$450.72 – $2,289.16
CT scan of the neck (cervical spine), without contrast CPT 72125	$116.22	$2,970.00	$534.60 – $2,715.17
CT scan of the pelvis, with contrast CPT 72193	$194.55	$3,245.00	$584.10 – $2,966.58
CT scan of the sinuses or face, without contrast CPT 70486	$116.22	$2,420.00	$435.60 – $2,212.36
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	$96.23	$649.00	$39.24 – $219.04
Hand X-ray, 3 or more views CPT 73130	$96.23	$550.00	$99.00 – $502.81
Knee X-ray, 3 views CPT 73562	$96.23	$688.00	$123.84 – $628.97
Leg or arm vein ultrasound, both sides CPT 93970	$264.17	$2,682.00	$482.76 – $2,638.02
Leg or arm vein ultrasound, one side CPT 93971	$116.22	$1,708.00	$307.44 – $1,679.99
Lower back X-ray, 2 or 3 views CPT 72100	$116.22	$743.00	$133.74 – $679.25
MRI of both breasts, without and with contrast CPT 77049	not posted	$5,583.00	$1,004.94 – $5,103.98
MRI of the abdomen, without and with contrast CPT 74183	$390.30	$5,225.00	$940.50 – $4,776.70
MRI of the brain, without and with contrast CPT 70553	$390.30	$5,631.00	$600.50 – $4,332.00
MRI of the brain, without contrast CPT 70551	$264.17	$4,073.00	$369.70 – $4,332.00
MRI of the knee or other leg joint, without contrast CPT 73721	$264.17	$4,290.00	$772.20 – $3,921.92
MRI of the lower back (lumbar spine), without contrast CPT 72148	$264.17	$4,439.00	$799.02 – $4,058.13
MRI of the mid back (thoracic spine), without contrast CPT 72146	$264.17	$4,329.00	$779.22 – $3,957.57
MRI of the neck (cervical spine), without contrast CPT 72141	$264.17	$4,263.00	$767.34 – $3,897.23
MRI of the pelvis, without and with contrast CPT 72197	$390.30	$5,473.00	$985.14 – $5,003.42
MRI of the shoulder or other arm joint, without contrast CPT 73221	$264.17	$4,113.00	$740.34 – $3,760.10
Neck X-ray, 2 or 3 views CPT 72040	$96.23	$600.00	$45.43 – $219.04
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$116.22	$1,293.00	$232.74 – $1,182.06
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$116.22	$825.00	$148.50 – $754.22
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$116.22	$1,180.00	$212.40 – $1,078.76
Screening mammogram, both breasts CPT 77067	$169.06	$748.00	$169.06 – $202.87
Shoulder X-ray, 2 or more views CPT 73030	$96.23	$688.00	$123.84 – $628.97
Transvaginal pregnancy ultrasound CPT 76817	$116.22	$990.00	$178.20 – $905.06
Transvaginal ultrasound CPT 76830	$116.22	$1,255.00	$115.03 – $328.28
Ultrasound of the abdomen, complete CPT 76700	$116.22	$1,362.00	$147.94 – $299.87
Ultrasound of the neck or thyroid CPT 76536	$116.22	$1,210.00	$106.67 – $322.11
Wrist X-ray, 3 or more views CPT 73110	$96.23	$600.00	$108.00 – $548.52
X-ray of the lower back, 4 or more views CPT 72110	$116.22	$1,019.00	$183.42 – $931.57

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$8.46	$187.00	$34.60 – $183.93
Blood culture CPT 87040	$10.32	$229.00	$42.37 – $225.24
Blood draw (venipuncture) CPT 36415	$9.09	$47.00	$8.70 – $46.23
BNP test (heart failure) CPT 83880	$39.26	$288.00	$53.28 – $283.28
C-reactive protein (CRP) test CPT 86140	$5.18	$108.00	$19.98 – $106.23
Chlamydia test (DNA/NAAT) CPT 87491	$35.09	$298.00	$35.09 – $42.11
Complete blood count (CBC) with differential CPT 85025	$7.77	$165.00	$30.53 – $162.29
Complete blood count (CBC), automated CPT 85027	$6.47	$106.00	$19.61 – $104.26
Comprehensive metabolic panel (blood test) CPT 80053	$10.56	$341.00	$63.09 – $335.41
COVID-19 PCR test CPT 87635	$51.31	$314.00	$58.09 – $308.85
D-dimer test (blood clots) CPT 85379	$10.18	$127.00	$23.50 – $124.92
Drug screen, instrument chemistry CPT 80307	$62.14	$248.00	$45.88 – $243.93
Ferritin (iron stores) test CPT 82728	$13.63	$210.00	$38.85 – $206.56
Free T4 (thyroid) test CPT 84439	$9.02	$162.00	$29.97 – $159.34
General health panel (blood tests) CPT 80050	not posted	$1,232.00	$227.92 – $1,211.80
Glucose (blood sugar) test CPT 82947	$3.93	$48.00	$8.88 – $47.21
Gonorrhea test (DNA/NAAT) CPT 87591	$35.09	$286.00	$52.91 – $281.31
Hemoglobin A1c test CPT 83036	$9.71	$55.00	$10.18 – $54.10
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	$45.33 – $240.98
Iron test CPT 83540	$6.47	$105.00	$19.43 – $103.28
Kidney function panel CPT 80069	$8.68	$197.00	$36.45 – $193.77
Lipase test (pancreas) CPT 83690	$6.89	$132.00	$24.42 – $129.84
Lipid panel, cholesterol and triglycerides CPT 80061	$13.39	$260.00	$48.10 – $255.74
Liver function panel CPT 80076	$8.17	$167.00	$30.90 – $164.26
Magnesium test CPT 83735	$6.70	$138.00	$25.53 – $135.74
Obstetric blood test panel CPT 80055	$47.81	$326.00	$60.31 – $320.65
Partial thromboplastin time (PTT), clotting test CPT 85730	$6.01	$132.00	$24.42 – $129.84
Pregnancy blood test (hCG), quantitative CPT 84702	$15.05	$220.00	$40.70 – $216.39
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	$31.64 – $168.20
PSA (prostate specific antigen), total CPT 84153	$18.39	$328.00	$60.68 – $322.62
Rapid strep test CPT 87880	$16.53	$83.00	$16.53 – $19.84
Sed rate (ESR) test CPT 85652	$2.70	$81.00	$14.99 – $79.67
TB skin test CPT 86580	$26.76	$52.86	$26.76 – $32.12
Thyroid stimulating hormone (TSH) CPT 84443	$16.80	$266.00	$49.21 – $261.64
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$58.39	$1,519.00	$281.02 – $1,494.09
Troponin test (heart damage) CPT 84484	$12.47	$173.00	$32.01 – $170.16
Urinalysis, automated, with microscope CPT 81001	$3.17	$107.00	$3.17 – $3.80
Urinalysis, automated, without microscope CPT 81003	$2.25	$80.00	$14.80 – $78.69
Urinalysis, manual, with microscope CPT 81000	$4.02		$4.02 – $4.82
Urinalysis, manual, without microscope CPT 81002	$3.48	$45.00	$8.33 – $44.26
Urine culture, colony count CPT 87086	$8.07	$154.00	$28.49 – $151.47
Urine pregnancy test CPT 81025	$8.61	$138.00	$25.53 – $135.74
Vitamin B12 test CPT 82607	$15.08	$160.00	$29.60 – $157.38
Vitamin D test CPT 82306	$29.60	$450.00	$83.25 – $442.62

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$264.17	$2,090.00	$264.17 – $317.01
ECG tracing only (no interpretation) CPT 93005	$64.92	$359.00	$64.62 – $353.11
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$599.23	$4,021.00	$723.78 – $3,955.06
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$24.05 – $49.09
Holter monitor, up to 48 hours CPT 93224	not posted		$122.50 – $306.08
Left heart catheterization CPT 93452	$3,515.15	$15,597.00	$2,379.00 – $22,114.00
Left heart catheterization with coronary angiogram CPT 93458	$3,515.15	$18,028.00	$2,379.00 – $22,114.00
Nuclear stress test (heart perfusion imaging) CPT 78452	$1,426.73	$6,381.00	$696.53 – $3,535.83
Treadmill stress test, complete CPT 93015	not posted	$201.00	$36.18 – $197.70

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$7,807.24	$13,167.00	$2,255.00 – $23,291.00
Appendix removal, laparoscopic CPT 44970	$6,376.26	$11,880.00	$2,138.40 – $11,685.17
Breast biopsy with ultrasound guidance CPT 19083	$1,770.73		$1,770.73 – $2,124.87
Carpal tunnel release CPT 64721	$2,134.14	$5,972.00	$1,188.00 – $10,216.00
Colonoscopy with biopsy CPT 45380	$1,288.59	$4,294.00	$772.92 – $4,223.58
Colonoscopy with polyp removal (snare) CPT 45385	$1,288.59	$4,235.00	$762.30 – $4,165.55
Colonoscopy, diagnostic CPT 45378	$996.39	$4,235.00	$762.30 – $4,165.55
Colposcopy with biopsy CPT 57454	$332.44	$703.00	$332.44 – $9,933.00
Cystoscopy (bladder scope) CPT 52000	$729.46	$5,170.00	$729.46 – $9,383.00
Ear tubes, under general anesthesia CPT 69436	$1,618.86		$1,618.86 – $1,942.63
Flexible sigmoidoscopy, diagnostic CPT 45330	$996.39	$2,610.00	$903.00 – $9,933.00
Gallbladder removal, laparoscopic CPT 47562	$6,376.26	$10,973.00	$2,379.00 – $24,016.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted	$5,266.00	$947.88 – $5,179.64
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$11,378.21	$15,125.00	$1,679.00 – $23,291.00
Hysteroscopy with biopsy or polyp removal CPT 58558	$3,474.84	$7,159.00	$1,189.00 – $10,216.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	$6,376.26		$6,376.26 – $7,651.51
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$3,856.84		$3,856.84 – $4,628.21
Kidney stone shock-wave lithotripsy CPT 50590	$3,769.31	$12,375.00	$1,679.00 – $25,006.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$3,545.97		$3,545.97 – $4,255.16
Lower colon endoscopy with ultrasound CPT 45391	$1,288.59	$4,490.00	$808.20 – $4,416.36
Nasal endoscopy, diagnostic CPT 31231	$212.17	$430.00	$212.17 – $9,933.00
Prostate biopsy CPT 55700	$2,238.78	$6,930.00	$1,188.00 – $9,933.00
Prostate removal, laparoscopic or robotic CPT 55866	$11,378.21	$14,441.00	$2,599.38 – $14,204.17
Removal of a breast lump, open surgery CPT 19120	$4,184.94		$4,184.94 – $5,021.93
Rotator cuff repair, arthroscopic CPT 29827	$7,807.24	$9,870.00	$1,776.60 – $9,708.13
Screening colonoscopy, average risk HCPCS G0121	$996.39	$4,023.00	$724.14 – $3,957.02
Screening colonoscopy, high risk HCPCS G0105	$996.39	$4,455.00	$996.39 – $9,933.00
Septoplasty (nasal septum repair) CPT 30520	$3,544.29	$5,580.00	$1,189.00 – $10,216.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$349.95 – $349.95
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted	$4,384.00	$1,525.00 – $45,337.00
Tonsil and adenoid removal, under age 12 CPT 42820	$6,465.11	$9,176.00	$1,189.00 – $10,216.00
Total hip replacement CPT 27130	$14,061.89		$14,061.89 – $16,874.27
Total knee replacement CPT 27447	$14,061.89		$14,061.89 – $16,874.27
Upper endoscopy (EGD) with biopsy CPT 43239	$1,024.64	$4,106.00	$1,024.64 – $9,933.00
Upper endoscopy (EGD), diagnostic CPT 43235	$1,024.64	$4,476.00	$903.00 – $9,933.00
Vasectomy CPT 55250	$2,238.78	$5,816.00	$1,046.88 – $5,720.62

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		$5,589.58 – $5,589.58
Fetal non-stress test CPT 59025	$219.85	$1,419.00	$255.42 – $1,395.73
IUD insertion CPT 58300	not posted	$464.00	$1,189.00 – $9,933.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$5,269.74 – $5,269.74
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted	$5,834.00	$1,050.12 – $5,297.27

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$6,397.07	$5,778.00 – $33,614.47
C-section, without complications MS-DRG 788	$6,560.22
Chest pain MS-DRG 313	$5,173.06	$5,098.00 – $27,182.68
COPD flare-up, with major complications MS-DRG 190	$8,143.18	$5,778.00 – $42,789.67
COPD flare-up, without complications MS-DRG 192	$4,693.02	$4,693.02 – $24,660.26
Fainting (syncope) MS-DRG 312	$6,318.03	$5,778.00 – $33,199.14
Gastrointestinal bleeding, with complications MS-DRG 378	$7,149.03	$5,778.00 – $37,565.75
Heart failure, with major complications MS-DRG 291	$9,461.46	$5,778.00 – $49,716.79
Heart failure, without complications MS-DRG 293	$3,978.77	$3,978.77 – $22,632.40
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	$69,982.73	$6,542.00 – $367,735.86
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	$13,672.27	$6,542.00 – $71,843.21
Irregular heartbeat, without complications MS-DRG 310	$4,057.09	$3,986.00 – $21,318.63
Kidney failure, with complications MS-DRG 683	$6,445.65	$5,778.00 – $33,869.76
Kidney or urinary tract infection, without major complications MS-DRG 690	$5,819.87	$5,636.00 – $30,581.47
Neck (cervical) spinal fusion, without complications MS-DRG 473	$17,166.66	$6,542.00 – $90,205.04
Normal newborn care MS-DRG 795	$1,448.80	$1,335.00 – $7,708.00
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$5,666.14	$5,392.00 – $29,773.68
Pneumonia, with complications MS-DRG 194	$5,946.04	$5,778.00 – $31,244.46
Pneumonia, with major complications MS-DRG 193	$9,555.00	$5,778.00 – $50,208.32
Pneumonia, without complications MS-DRG 195	$4,515.37	$4,515.37 – $23,726.74
Psychoses (inpatient psychiatric stay) MS-DRG 885	$10,221.39	$5,778.00 – $53,709.99
Sepsis, with major complications MS-DRG 871	$14,227.72	$5,778.00 – $74,761.90
Sepsis, without major complications MS-DRG 872	$7,476.06
Skin infection (cellulitis), without major complications MS-DRG 603	$6,386.92	$5,778.00 – $33,561.12
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$29,076.81 – $29,076.81
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$5,658.17	$5,427.00 – $29,731.77
Stroke, with complications or clot-busting drug MS-DRG 65	$7,373.82	$5,778.00 – $38,746.94
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	$8,692.10	$6,542.00 – $45,674.07
Vaginal delivery, without complications MS-DRG 807	$4,621.23	$4,467.00 – $22,187.00
Weight loss surgery, without complications MS-DRG 621	$10,599.91	$6,542.00 – $53,666.93

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$322.61		$322.61 – $387.13
Lower back nerve root injection with imaging guidance CPT 64483	$972.98		$972.98 – $1,167.58
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$756.84	$4,620.00	$756.84 – $9,933.00
Lower back spinal injection (epidural), without imaging CPT 62322	$972.98	$2,396.00	$972.98 – $9,933.00

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	$2,492.56	$7,351.00	$1,189.00 – $10,216.00
Eye exam, new patient, comprehensive CPT 92004	$140.84		$140.84 – $169.01
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$599.55	$2,869.00	$516.42 – $2,821.95

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$170.99	$567.00	$102.06 – $542.22

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$170.99	$1,925.00	$170.99 – $1,580.00
Sleep study with CPAP titration CPT 95811	$1,111.89	$9,782.00	$1,760.76 – $9,354.53
Sleep study, overnight in a sleep lab CPT 95810	$1,111.89	$9,011.00	$1,111.89 – $1,580.00

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$170.99	$1,375.00	$247.50 – $1,352.45

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$35.04	$202.00	$36.36 – $198.69
Physical therapy evaluation, low complexity CPT 97161	$126.19	$396.00	$71.28 – $389.51
Physical therapy evaluation, moderate complexity CPT 97162	$126.19	$453.00	$81.54 – $445.57
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$37.06	$231.00	$41.58 – $227.21
Therapeutic activities, 15 minutes CPT 97530	$44.62	$188.00	$33.84 – $184.92

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$175.59	$497.00	$89.46 – $488.85
Family psychotherapy, without the patient, 50 minutes CPT 90846	$175.59	$385.00	$69.30 – $378.69
Group psychotherapy CPT 90853	$101.09	$413.00	$74.34 – $406.23
Psychiatric diagnostic evaluation CPT 90791	$175.59	$790.00	$142.20 – $777.04
Psychotherapy, 30 minutes CPT 90832	$175.59	$452.00	$81.36 – $444.59
Psychotherapy, 45 minutes CPT 90834	$175.59	$539.00	$97.02 – $530.16
Psychotherapy, 60 minutes CPT 90837	$175.59	$605.00	$108.90 – $595.08

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$77.78	$1,987.00	$357.66 – $1,954.41
IV hydration, each additional hour CPT 96361	$50.43	$440.00	$79.20 – $432.78
IV hydration, first hour CPT 96360	$230.26	$1,430.00	$257.40 – $1,406.55
IV push injection of a drug, first CPT 96374	$230.26	$715.00	$128.70 – $703.27
IV push injection, each additional drug CPT 96375	$50.43	$461.00	$82.98 – $453.44

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	not posted	$1.82	? – $1.66
Fentanyl injection, per 0.1 mg HCPCS J3010	not posted	$2.88	? – $2.63
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted	$8.47	$1.52 – $7.74
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	not posted	$4.37	? – $4.00
Midazolam (Versed) injection, per 1 mg HCPCS J2250	not posted	$1.47	? – $1.34
Morphine injection, up to 10 mg HCPCS J2270	not posted	$20.13	$3.62 – $18.40
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	not posted	$1.60	? – $1.46
Saline IV solution, 1000 ml HCPCS J7030	not posted	$16.00	$2.88 – $14.63

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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