St. Mary's General Hospital
350 Boulevard, Passaic, NJ 07055 · Acute care hospital · Emergency room
These are St. Mary's General Hospital'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.
208 of the services we track have a posted price here; 189 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 | $976.00 | $3,700.10 | $337.00 – $3,363.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $99.00 | $650.00 | $79.74 – $650.00 |
| Emergency room visit, level 2 CPT 99282 | $181.00 | $1,041.62 | $140.00 – $1,041.62 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $322.00 | $1,634.95 | $140.00 – $1,331.00 |
| Emergency room visit, level 4 CPT 99284 | $493.00 | $2,098.64 | $138.00 – $1,678.91 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $704.00 | $2,636.87 | $140.00 – $2,109.50 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $237.00 | $821.86 | $156.89 – $821.86 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | not posted | $462.00 | $48.86 – $392.70 |
| New patient office visit, about 30 minutes CPT 99203 | not posted | $831.00 | $84.64 – $706.35 |
| New patient office visit, about 45 minutes CPT 99204 | not posted | $1,081.00 | $137.64 – $918.85 |
| New patient office visit, about 60 minutes CPT 99205 | not posted | $1,331.00 | $187.26 – $1,131.35 |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | not posted | $542.65 | $36.38 – $461.25 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | not posted | $542.65 | $67.86 – $461.25 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | not posted | $554.00 | $100.02 – $470.90 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | not posted | $694.66 | $132.61 – $590.46 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | not posted | $542.65 | $8.98 – $461.25 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $27.00 | $155.00 | $16.12 – $131.75 |
| Abdominal X-ray, 1 view CPT 74018 | $102.00 | $373.03 | $53.20 – $317.08 |
| Ankle X-ray, 3 or more views CPT 73610 | $102.00 | $537.32 | $46.75 – $456.72 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $123.00 | $578.70 | $98.87 – $491.89 |
| Breast ultrasound, one breast, complete CPT 76641 | $123.00 | $980.00 | $98.87 – $833.00 |
| Breast ultrasound, one breast, limited CPT 76642 | $102.00 | $800.00 | $80.90 – $680.00 |
| Chest X-ray, 1 view CPT 71045 | $102.00 | $373.03 | $54.81 – $317.08 |
| Chest X-ray, 2 views CPT 71046 | $102.00 | $440.71 | $54.81 – $374.60 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $207.00 | $1,100.00 | $165.89 – $935.00 |
| CT angiogram of the head CPT 70496 | $207.00 | $1,100.00 | $165.89 – $935.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $412.00 | $5,307.25 | $329.95 – $4,511.16 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $412.00 | $6,210.83 | $329.95 – $5,279.21 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $282.00 | $4,802.13 | $225.66 – $4,081.81 |
| CT scan of the abdomen, without contrast CPT 74150 | $123.00 | $1,541.00 | $98.87 – $1,309.85 |
| CT scan of the chest, with contrast CPT 71260 | $207.00 | $2,540.00 | $165.89 – $2,159.00 |
| CT scan of the chest, without contrast CPT 71250 | $123.00 | $2,120.00 | $98.87 – $1,802.00 |
| CT scan of the head, without contrast CPT 70450 | $123.00 | $2,219.00 | $98.87 – $1,886.15 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $123.00 | $2,756.89 | $98.87 – $2,343.36 |
| CT scan of the pelvis, with contrast CPT 72193 | $207.00 | $1,541.00 | $165.89 – $1,309.85 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $123.00 | $2,090.00 | $98.87 – $1,776.50 |
| Diagnostic mammogram, both breasts CPT 77066 | $128.00 | $3,325.00 | $102.54 – $2,826.25 |
| Diagnostic mammogram, one breast CPT 77065 | $99.00 | $1,469.90 | $79.94 – $1,249.41 |
| Foot X-ray, 3 or more views CPT 73630 | $102.00 | $756.50 | $46.75 – $643.02 |
| Hand X-ray, 3 or more views CPT 73130 | $102.00 | $794.29 | $46.75 – $675.15 |
| Knee X-ray, 3 views CPT 73562 | $102.00 | $1,049.75 | $49.97 – $892.29 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $282.00 | $1,410.41 | $225.66 – $1,337.00 |
| Leg or arm vein ultrasound, one side CPT 93971 | $123.00 | $850.00 | $98.87 – $850.00 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $123.00 | $572.00 | $59.64 – $486.20 |
| MRI of the abdomen, without and with contrast CPT 74183 | $412.00 | $6,120.00 | $329.95 – $5,202.00 |
| MRI of the brain, without and with contrast CPT 70553 | $412.00 | $5,116.57 | $329.95 – $4,349.08 |
| MRI of the brain, without contrast CPT 70551 | $282.00 | $3,241.69 | $225.66 – $2,755.44 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $282.00 | $5,166.38 | $225.66 – $4,391.42 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $282.00 | $3,572.26 | $225.66 – $3,036.42 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $282.00 | $3,544.35 | $225.66 – $3,012.70 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $282.00 | $3,604.07 | $225.66 – $3,063.46 |
| MRI of the pelvis, without and with contrast CPT 72197 | $412.00 | $6,100.00 | $329.95 – $5,185.00 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $282.00 | $5,730.00 | $225.66 – $4,870.50 |
| Neck X-ray, 2 or 3 views CPT 72040 | $102.00 | $686.20 | $54.81 – $583.27 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $123.00 | $1,025.00 | $98.87 – $871.25 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $123.00 | $940.00 | $98.87 – $799.00 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $123.00 | $919.00 | $98.87 – $781.15 |
| Screening mammogram, both breasts CPT 77067 | $105.00 | $1,270.00 | $84.59 – $1,079.50 |
| Shoulder X-ray, 2 or more views CPT 73030 | $102.00 | $987.16 | $49.97 – $839.09 |
| Transvaginal pregnancy ultrasound CPT 76817 | $123.00 | $820.00 | $98.87 – $697.00 |
| Transvaginal ultrasound CPT 76830 | $123.00 | $1,012.00 | $98.87 – $860.20 |
| Ultrasound of the abdomen, complete CPT 76700 | $123.00 | $830.00 | $98.87 – $705.50 |
| Ultrasound of the neck or thyroid CPT 76536 | $123.00 | $886.98 | $98.87 – $753.93 |
| Wrist X-ray, 3 or more views CPT 73110 | $102.00 | $817.11 | $46.75 – $694.54 |
| X-ray of the lower back, 4 or more views CPT 72110 | $123.00 | $814.00 | $80.60 – $691.90 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $8.00 | $70.00 | $5.08 – $59.50 |
| Blood culture CPT 87040 | $10.00 | $98.00 | $6.19 – $83.30 |
| Blood draw (venipuncture) CPT 36415 | $9.00 | $33.00 | $1.80 – $28.05 |
| BNP test (heart failure) CPT 83880 | $39.00 | $296.00 | $23.56 – $251.60 |
| C-reactive protein (CRP) test CPT 86140 | $5.00 | $103.00 | $3.11 – $87.55 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $35.00 | $144.00 | $21.05 – $122.40 |
| Complete blood count (CBC) with differential CPT 85025 | $7.00 | $27.58 | $4.66 – $23.44 |
| Complete blood count (CBC), automated CPT 85027 | $6.00 | $32.35 | $3.88 – $27.50 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $10.00 | $185.00 | $6.34 – $157.25 |
| COVID-19 PCR test CPT 87635 | $51.00 | $182.15 | $30.79 – $154.83 |
| D-dimer test (blood clots) CPT 85379 | $10.00 | $56.55 | $6.11 – $48.07 |
| Drug screen, instrument chemistry CPT 80307 | $62.00 | $424.00 | $37.28 – $360.40 |
| Ferritin (iron stores) test CPT 82728 | $13.00 | $120.00 | $8.18 – $102.00 |
| Free T4 (thyroid) test CPT 84439 | $9.00 | $172.00 | $5.41 – $146.20 |
| Glucose (blood sugar) test CPT 82947 | $3.00 | $100.00 | $2.36 – $85.00 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $35.00 | $124.57 | $21.05 – $105.88 |
| Hemoglobin A1c test CPT 83036 | $9.00 | $90.00 | $5.83 – $76.50 |
| Hepatitis C antibody test CPT 86803 | $14.00 | $130.00 | $8.56 – $110.50 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $24.00 | $120.40 | $14.45 – $102.34 |
| Iron test CPT 83540 | $6.00 | $64.00 | $3.88 – $54.40 |
| Kidney function panel CPT 80069 | $8.00 | $125.00 | $5.21 – $106.25 |
| Lipase test (pancreas) CPT 83690 | $6.00 | $162.00 | $4.13 – $137.70 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $13.00 | $263.00 | $8.03 – $223.55 |
| Liver function panel CPT 80076 | $8.00 | $87.00 | $4.90 – $73.95 |
| Magnesium test CPT 83735 | $6.00 | $45.00 | $4.02 – $38.25 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $6.00 | $40.00 | $3.61 – $34.00 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $15.00 | $245.29 | $9.03 – $208.50 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $4.00 | $74.00 | $2.57 – $62.90 |
| PSA (prostate specific antigen), free CPT 84154 | $18.00 | $67.00 | $11.03 – $56.95 |
| PSA (prostate specific antigen), total CPT 84153 | $18.00 | $170.00 | $11.03 – $144.50 |
| Rapid strep test CPT 87880 | $16.00 | $58.68 | $9.92 – $49.88 |
| Sed rate (ESR) test CPT 85652 | $2.00 | $85.60 | $1.62 – $72.76 |
| TB skin test CPT 86580 | $34.00 | $53.00 | $8.52 – $53.00 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $16.00 | $229.00 | $10.08 – $194.65 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $61.00 | $592.50 | $29.68 – $503.62 |
| Troponin test (heart damage) CPT 84484 | $12.00 | $92.00 | $7.48 – $78.20 |
| Urinalysis, automated, with microscope CPT 81001 | $3.00 | $59.00 | $1.90 – $50.15 |
| Urinalysis, automated, without microscope CPT 81003 | $2.00 | $52.55 | $1.35 – $44.67 |
| Urinalysis, manual, with microscope CPT 81000 | $4.00 | $23.00 | $2.41 – $19.55 |
| Urinalysis, manual, without microscope CPT 81002 | $3.00 | $13.00 | $2.09 – $11.05 |
| Urine culture, colony count CPT 87086 | $8.00 | $58.00 | $4.84 – $49.30 |
| Urine pregnancy test CPT 81025 | $8.00 | $162.40 | $5.17 – $138.04 |
| Vitamin B12 test CPT 82607 | $15.00 | $140.00 | $9.05 – $119.00 |
| Vitamin D test CPT 82306 | $29.00 | $343.00 | $17.76 – $291.55 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $282.00 | $1,357.00 | $225.66 – $1,337.00 |
| ECG tracing only (no interpretation) CPT 93005 | $69.00 | $293.00 | $55.79 – $293.00 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $645.00 | $3,703.75 | $474.85 – $3,148.19 |
| Holter monitor, up to 48 hours CPT 93224 | not posted | $1,230.00 | $234.81 – $1,230.00 |
| Left heart catheterization CPT 93452 | $3,832.00 | $14,052.00 | $2,472.00 – $11,241.60 |
| Left heart catheterization with coronary angiogram CPT 93458 | $3,832.00 | $15,952.00 | $2,472.00 – $12,761.60 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $1,530.00 | $6,529.70 | $822.12 – $5,550.24 |
| Treadmill stress test, complete CPT 93015 | not posted | $1,156.75 | $220.82 – $1,156.75 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $8,578.00 | $12,344.04 | $1,715.00 – $12,344.04 |
| Appendix removal, laparoscopic CPT 44970 | $7,147.00 | $19,145.50 | $1,715.00 – $15,316.40 |
| Breast biopsy with ultrasound guidance CPT 19083 | $1,952.00 | $6,655.86 | $1,270.60 – $5,324.69 |
| Carpal tunnel release CPT 64721 | $2,308.00 | $15,390.00 | $1,715.00 – $12,312.00 |
| Colonoscopy with biopsy CPT 45380 | $1,414.00 | $4,898.95 | $935.21 – $4,164.11 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $1,414.00 | $4,898.95 | $935.21 – $4,164.11 |
| Colonoscopy, diagnostic CPT 45378 | $1,099.00 | $3,752.03 | $716.26 – $3,752.03 |
| Cystoscopy (bladder scope) CPT 52000 | $824.00 | $16,350.00 | $659.47 – $13,080.00 |
| Ear tubes, under general anesthesia CPT 69436 | $1,834.00 | $15,390.00 | $1,467.43 – $12,312.00 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $1,099.00 | $3,819.40 | $716.26 – $3,341.00 |
| Gallbladder removal, laparoscopic CPT 47562 | $7,147.00 | $29,447.80 | $1,715.00 – $23,558.24 |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | not posted | $63,297.00 | $1,513.40 – $50,637.60 |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | $12,566.00 | $15,459.19 | $1,715.00 – $15,459.19 |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $3,826.00 | $15,402.20 | $1,715.00 – $12,321.76 |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $7,147.00 | $34,713.25 | $1,715.00 – $27,770.60 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $4,232.00 | $28,702.20 | $1,715.00 – $22,961.76 |
| Kidney stone shock-wave lithotripsy CPT 50590 | $4,167.00 | $8,558.00 | $1,633.72 – $8,558.00 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $3,868.00 | $28,240.20 | $1,715.00 – $22,592.16 |
| Nasal endoscopy, diagnostic CPT 31231 | $235.00 | $753.00 | $143.75 – $753.00 |
| Prostate biopsy CPT 55700 | $2,370.00 | $15,664.30 | $1,715.00 – $12,531.44 |
| Removal of a breast lump, open surgery CPT 19120 | $4,628.00 | $22,975.70 | $1,715.00 – $18,380.56 |
| Rotator cuff repair, arthroscopic CPT 29827 | $8,578.00 | $53,559.00 | $1,715.00 – $42,847.20 |
| Screening colonoscopy, average risk HCPCS G0121 | $1,099.00 | $3,752.03 | $716.26 – $3,341.00 |
| Screening colonoscopy, high risk HCPCS G0105 | $1,099.00 | $3,752.03 | $716.26 – $3,341.00 |
| Septoplasty (nasal septum repair) CPT 30520 | $3,919.00 | $12,953.06 | $1,715.00 – $10,362.45 |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | not posted | $9,563.75 | $1,715.00 – $7,651.00 |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | not posted | $30,292.50 | $1,268.08 – $24,234.00 |
| Tonsil and adenoid removal, under age 12 CPT 42820 | $6,998.00 | $5,950.31 | $1,135.91 – $5,950.31 |
| Total hip replacement CPT 27130 | $15,177.00 | $63,739.50 | $1,715.00 – $50,991.60 |
| Total knee replacement CPT 27447 | $15,177.00 | $63,297.00 | $1,715.00 – $50,637.60 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $1,072.00 | $15,390.00 | $726.90 – $12,312.00 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $1,072.00 | $3,807.75 | $726.90 – $3,807.75 |
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 | $4,863.00 | $928.35 – $3,890.40 |
| Fetal non-stress test CPT 59025 | not posted | $818.03 | $156.16 – $818.03 |
| IUD insertion CPT 58300 | not posted | $10,260.00 | $1,715.00 – $8,208.00 |
| Vaginal delivery, routine care including prenatal and postpartum CPT 59400 | not posted | $3,641.00 | $695.07 – $2,912.80 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $11,758.00 | $1,350.00 – $21,283.37 | |
| C-section, without complications MS-DRG 788 | $12,637.00 | $4,406.63 – $22,873.08 | |
| Chest pain MS-DRG 313 | $9,877.00 | $4,416.62 – $17,878.06 | |
| COPD flare-up, with major complications MS-DRG 190 | $14,357.00 | $7,435.13 – $25,987.65 | |
| COPD flare-up, without complications MS-DRG 192 | $8,975.00 | $4,521.52 – $16,246.51 | |
| Fainting (syncope) MS-DRG 312 | $11,629.00 | $5,004.83 – $21,049.11 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $12,890.00 | $6,183.76 – $23,331.17 | |
| Heart failure, with major complications MS-DRG 291 | $16,392.00 | $8,401.13 – $29,671.19 | |
| Heart failure, without complications MS-DRG 293 | $8,097.00 | $4,156.23 – $14,656.80 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | $114,611.00 | $61,324.98 – $207,446.54 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | $23,847.00 | $12,424.98 – $43,164.86 | |
| Irregular heartbeat, without complications MS-DRG 310 | $8,098.00 | $3,511.19 – $14,658.90 | |
| Kidney failure, with complications MS-DRG 683 | $11,677.00 | $5,738.54 – $21,136.96 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $10,911.00 | $4,958.63 – $19,750.14 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | $29,769.00 | $14,817.18 – $53,882.85 | |
| Normal newborn care MS-DRG 795 | $3,865.00 | $1,151.46 – $6,996.92 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $10,549.00 | $4,695.11 – $19,095.43 | |
| Pneumonia, with complications MS-DRG 194 | $10,870.00 | $5,621.15 – $19,674.84 | |
| Pneumonia, with major complications MS-DRG 193 | $16,746.00 | $8,221.91 – $30,311.24 | |
| Pneumonia, without complications MS-DRG 195 | $8,819.00 | $4,288.61 – $15,964.13 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | $17,698.00 | $1,350.00 – $32,034.83 | |
| Sepsis, with major complications MS-DRG 871 | $24,005.00 | $11,591.98 – $43,449.34 | |
| Sepsis, without major complications MS-DRG 872 | $13,382.00 | $6,574.66 – $24,222.25 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $11,621.00 | $5,293.32 – $21,034.46 | |
| Spinal fusion except neck, without major complications MS-DRG 460 | not posted | $25,211.50 – $78,379.99 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $10,566.00 | $4,716.97 – $19,124.71 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $13,232.00 | $6,441.03 – $23,950.32 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | $15,894.00 | $6,966.18 – $28,769.64 | |
| Vaginal delivery, without complications MS-DRG 807 | $9,348.00 | $4,406.63 – $16,920.04 | |
| Weight loss surgery, without complications MS-DRG 621 | $18,988.00 | $9,855.43 – $34,369.18 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $362.00 | $15,390.00 | $232.12 – $12,312.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $1,045.00 | $15,144.90 | $730.04 – $12,115.92 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $834.00 | $15,363.90 | $605.72 – $12,291.12 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $1,045.00 | $3,741.88 | $714.32 – $3,341.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | $2,728.00 | $16,673.20 | $1,715.00 – $13,338.56 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Sleep study with CPAP titration CPT 95811 | $1,015.00 | $5,286.26 | $812.16 – $5,286.26 |
| Sleep study, overnight in a sleep lab CPT 95810 | $1,015.00 | $4,778.00 | $812.16 – $4,778.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $255.00 | $641.24 | $122.41 – $641.24 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $30.00 | $220.00 | $24.58 – $220.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $108.00 | $510.00 | $86.80 – $433.50 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $108.00 | $475.18 | $86.81 – $432.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $32.00 | $150.97 | $25.78 – $150.97 |
| Therapeutic activities, 15 minutes CPT 97530 | $39.00 | $182.00 | $31.38 – $182.00 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $209.00 | $704.00 | $113.94 – $598.40 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $209.00 | $704.00 | $113.94 – $598.40 |
| Group psychotherapy CPT 90853 | $120.00 | $504.32 | $27.50 – $428.67 |
| Psychiatric diagnostic evaluation CPT 90791 | $209.00 | $654.51 | $124.95 – $654.51 |
| Psychotherapy, 30 minutes CPT 90832 | $209.00 | $654.51 | $70.34 – $556.33 |
| Psychotherapy, 45 minutes CPT 90834 | $209.00 | $654.51 | $79.31 – $556.33 |
| Psychotherapy, 60 minutes CPT 90837 | $209.00 | $670.00 | $79.31 – $569.50 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $85.00 | $298.75 | $14.95 – $298.75 |
| IV hydration, each additional hour CPT 96361 | $55.00 | $204.97 | $39.13 – $202.00 |
| IV hydration, first hour CPT 96360 | $251.00 | $879.90 | $167.00 – $703.92 |
| IV push injection of a drug, first CPT 96374 | $251.00 | $935.90 | $178.66 – $935.90 |
| IV push injection, each additional drug CPT 96375 | $55.00 | $230.25 | $43.95 – $230.25 |
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.