Virtua Mount Holly Hospital
175 Madison Ave, Mount Holly, NJ 08060 · Acute care hospital · Emergency room
These are Virtua Mount Holly Hospital's own posted figures from its standard-charges file dated April 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
193 of the services we track have a posted price here; 164 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 | $403.50 | $4,035.00 | $884.04 – $4,500.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $328.30 | $3,283.00 | $92.38 – $4,500.00 |
| Emergency room visit, level 2 CPT 99282 | $330.50 | $3,305.00 | $166.15 – $4,500.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $331.20 | $3,312.00 | $290.50 – $4,500.00 |
| Emergency room visit, level 4 CPT 99284 | $393.10 | $3,931.00 | $446.76 – $4,500.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $403.50 | $4,035.00 | $643.24 – $4,500.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $61.60 | $616.00 | $217.16 – $16,391.00 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | $56.60 | $566.00 | |
| New patient office visit, about 30 minutes CPT 99203 | $85.90 | $859.00 | |
| New patient office visit, about 45 minutes CPT 99204 | $115.20 | $1,152.00 | |
| New patient office visit, about 60 minutes CPT 99205 | $144.40 | $1,444.00 | |
| Office consultation, about 40 minutes CPT 99243 | $39.00 | $390.00 | |
| Office consultation, about 60 minutes CPT 99244 | $47.30 | $473.00 | |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $56.60 | $566.00 | |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $56.60 | $566.00 | |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $85.90 | $859.00 | |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $115.20 | $1,152.00 | |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $56.60 | $566.00 | |
| Preventive checkup, new patient, age 18 to 39 CPT 99385 | $39.00 | $390.00 | |
| Preventive checkup, new patient, age 40 to 64 CPT 99386 | $44.40 | $444.00 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $45.00 | $450.00 | $54.50 – $1,307.48 |
| Abdominal X-ray, 1 view CPT 74018 | $111.30 | $1,113.00 | $59.60 – $288.68 |
| Ankle X-ray, 3 or more views CPT 73610 | $140.20 | $1,402.00 | $92.38 – $425.54 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $116.40 | $1,164.00 | $55.79 – $508.52 |
| Breast ultrasound, one breast, complete CPT 76641 | $142.90 | $1,429.00 | $111.57 – $449.08 |
| Breast ultrasound, one breast, limited CPT 76642 | $139.80 | $1,398.00 | $92.38 – $449.08 |
| Chest X-ray, 1 view CPT 71045 | $98.80 | $988.00 | $49.17 – $288.68 |
| Chest X-ray, 2 views CPT 71046 | $157.60 | $1,576.00 | $32.78 – $288.68 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $893.90 | $8,939.00 | $186.77 – $2,615.25 |
| CT angiogram of the head CPT 70496 | $725.70 | $7,257.00 | $186.77 – $2,344.48 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $836.60 | $8,366.00 | $350.00 – $2,093.52 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $932.50 | $9,325.00 | $350.00 – $2,536.00 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $789.90 | $7,899.00 | $253.60 – $1,776.52 |
| CT scan of the abdomen, without contrast CPT 74150 | $504.10 | $5,041.00 | $111.57 – $1,776.52 |
| CT scan of the chest, with contrast CPT 71260 | $611.70 | $6,117.00 | $186.77 – $2,139.75 |
| CT scan of the chest, without contrast CPT 71250 | $551.00 | $5,510.00 | $111.57 – $1,829.36 |
| CT scan of the head, without contrast CPT 70450 | $381.00 | $3,810.00 | $111.57 – $2,520.23 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $551.20 | $5,512.00 | $111.57 – $1,829.36 |
| CT scan of the pelvis, with contrast CPT 72193 | $660.90 | $6,609.00 | $186.77 – $2,053.90 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $505.30 | $5,053.00 | $111.57 – $1,538.77 |
| Diagnostic mammogram, both breasts CPT 77066 | $214.10 | $2,141.00 | $64.93 – $10,605.00 |
| Diagnostic mammogram, one breast CPT 77065 | $142.80 | $1,428.00 | $51.18 – $430.49 |
| Foot X-ray, 3 or more views CPT 73630 | $123.10 | $1,231.00 | $59.60 – $288.68 |
| Hand X-ray, 3 or more views CPT 73130 | $125.70 | $1,257.00 | $62.58 – $533.89 |
| Knee X-ray, 3 views CPT 73562 | $170.50 | $1,705.00 | $92.38 – $542.36 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $430.30 | $4,303.00 | ? – $1,044.00 |
| Leg or arm vein ultrasound, one side CPT 93971 | $239.70 | $2,397.00 | ? – $875.00 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $182.60 | $1,826.00 | $81.95 – $348.65 |
| MRI of both breasts, without and with contrast CPT 77049 | $988.60 | $9,886.00 | $417.20 – $6,174.91 |
| MRI of the abdomen, without and with contrast CPT 74183 | $1,236.80 | $12,368.00 | $374.69 – $5,085.22 |
| MRI of the brain, without and with contrast CPT 70553 | $1,236.80 | $12,368.00 | $374.69 – $5,085.22 |
| MRI of the brain, without contrast CPT 70551 | $943.70 | $9,437.00 | $253.60 – $4,545.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $1,011.00 | $10,110.00 | $253.60 – $4,545.00 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $860.10 | $8,601.00 | $253.60 – $4,545.00 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $889.50 | $8,895.00 | $253.60 – $4,545.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $876.60 | $8,766.00 | $253.60 – $4,545.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $1,302.60 | $13,026.00 | $374.69 – $5,085.22 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $774.70 | $7,747.00 | $253.60 – $4,545.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $160.80 | $1,608.00 | $49.17 – $288.68 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $280.60 | $2,806.00 | $111.57 – $614.19 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $355.50 | $3,555.00 | $111.57 – $660.42 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $117.30 | $1,173.00 | $111.57 – $660.42 |
| Screening mammogram, both breasts CPT 77067 | $168.70 | $1,687.00 | $98.04 – $1,603.15 |
| Shoulder X-ray, 2 or more views CPT 73030 | $134.10 | $1,341.00 | $92.38 – $750.96 |
| Transvaginal pregnancy ultrasound CPT 76817 | $139.80 | $1,398.00 | $111.57 – $660.42 |
| Transvaginal ultrasound CPT 76830 | $254.70 | $2,547.00 | $111.57 – $614.19 |
| Ultrasound of the abdomen, complete CPT 76700 | $460.60 | $4,606.00 | $96.23 – $752.88 |
| Ultrasound of the neck or thyroid CPT 76536 | $247.40 | $2,474.00 | $111.57 – $541.54 |
| Wrist X-ray, 3 or more views CPT 73110 | $145.50 | $1,455.00 | $89.06 – $288.68 |
| X-ray of the lower back, 4 or more views CPT 72110 | $241.80 | $2,418.00 | $111.57 – $379.46 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $19.70 | $197.00 | $8.12 – $543.91 |
| Blood culture CPT 87040 | $19.50 | $195.00 | $6.47 – $131.12 |
| Blood draw (venipuncture) CPT 36415 | $3.30 | $33.00 | |
| BNP test (heart failure) CPT 83880 | $114.20 | $1,142.00 | $3.10 – $386.28 |
| C-reactive protein (CRP) test CPT 86140 | $11.00 | $110.00 | $4.97 – $65.97 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $58.40 | $584.00 | $1.59 – $395.00 |
| Complete blood count (CBC) with differential CPT 85025 | $22.80 | $228.00 | $3.66 – $89.59 |
| Complete blood count (CBC), automated CPT 85027 | $18.60 | $186.00 | $2.86 – $81.44 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $29.40 | $294.00 | $10.14 – $228.47 |
| COVID-19 PCR test CPT 87635 | $25.50 | $255.00 | $49.26 – $4,108.83 |
| D-dimer test (blood clots) CPT 85379 | $31.80 | $318.00 | $9.77 – $133.37 |
| Drug screen, instrument chemistry CPT 80307 | $83.20 | $832.00 | $5.95 – $275.68 |
| Ferritin (iron stores) test CPT 82728 | $29.50 | $295.00 | $13.08 – $173.47 |
| Free T4 (thyroid) test CPT 84439 | $18.30 | $183.00 | $8.66 – $111.58 |
| Glucose (blood sugar) test CPT 82947 | $14.20 | $142.00 | $3.57 – $24.35 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $60.00 | $600.00 | $33.69 – $432.56 |
| Hemoglobin A1c test CPT 83036 | $25.30 | $253.00 | $7.86 – $120.54 |
| Hepatitis C antibody test CPT 86803 | $29.90 | $299.00 | $7.15 – $160.44 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $3.80 | $38.00 | $23.12 – $198.72 |
| Iron test CPT 83540 | $21.50 | $215.00 | $3.10 – $82.26 |
| Kidney function panel CPT 80069 | $45.60 | $456.00 | $6.59 – $97.73 |
| Lipase test (pancreas) CPT 83690 | $16.30 | $163.00 | $2.07 – $87.96 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $31.30 | $313.00 | $12.85 – $154.74 |
| Liver function panel CPT 80076 | $24.10 | $241.00 | $7.84 – $92.03 |
| Magnesium test CPT 83735 | $12.50 | $125.00 | $6.43 – $85.52 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $33.60 | $336.00 | $5.77 – $76.56 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $28.50 | $285.00 | $3.83 – $154.74 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $33.60 | $336.00 | $3.57 – $45.61 |
| PSA (prostate specific antigen), free CPT 84154 | $34.80 | $348.00 | $17.65 – $206.87 |
| PSA (prostate specific antigen), total CPT 84153 | $56.70 | $567.00 | $15.90 – $212.57 |
| Rapid strep test CPT 87880 | $10.50 | $105.00 | $15.87 – $167.01 |
| Sed rate (ESR) test CPT 85652 | $3.90 | $39.00 | $1.19 – $30.13 |
| TB skin test CPT 86580 | $12.90 | $129.00 | $4.95 – $59.16 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $36.90 | $369.00 | $16.13 – $213.38 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $140.20 | $1,402.00 | $21.12 – $488.66 |
| Troponin test (heart damage) CPT 84484 | $20.40 | $204.00 | $6.08 – $97.73 |
| Urinalysis, automated, with microscope CPT 81001 | $13.00 | $130.00 | $3.04 – $66.12 |
| Urinalysis, automated, without microscope CPT 81003 | $11.40 | $114.00 | $2.16 – $60.29 |
| Urinalysis, manual, with microscope CPT 81000 | $3.80 | $38.00 | $3.86 – $96.26 |
| Urinalysis, manual, without microscope CPT 81002 | $3.90 | $39.00 | $3.34 – $44.07 |
| Urine culture, colony count CPT 87086 | $28.60 | $286.00 | $7.75 – $124.08 |
| Urine pregnancy test CPT 81025 | $15.40 | $154.00 | $8.27 – $76.56 |
| Vitamin B12 test CPT 82607 | $21.80 | $218.00 | $2.28 – $191.39 |
| Vitamin D test CPT 82306 | $61.50 | $615.00 | $10.33 – $365.68 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $235.10 | $2,351.00 | ? – $1,236.00 |
| ECG tracing only (no interpretation) CPT 93005 | $69.80 | $698.00 | $37.07 – $276.14 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $545.50 | $5,455.00 | $575.26 – $2,549.18 |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 | $6.50 | $65.00 | $36.09 – $278.00 |
| Left heart catheterization CPT 93452 | $1,444.70 | $14,447.00 | $3,374.54 – $18,315.00 |
| Left heart catheterization with coronary angiogram CPT 93458 | $1,694.40 | $16,944.00 | $3,374.54 – $18,315.00 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $960.40 | $9,604.00 | $95.96 – $4,280.20 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Breast biopsy with ultrasound guidance CPT 19083 | $365.30 | $3,653.00 | $1,770.73 – $16,391.00 |
| Colposcopy with biopsy CPT 57454 | $108.00 | $1,080.00 | $17.41 – $3,961.00 |
| Cystoscopy (bladder scope) CPT 52000 | $386.70 | $3,867.00 | $729.46 – $16,391.00 |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $356.70 | $3,567.00 | $24.37 – $10,424.53 |
| Kidney stone shock-wave lithotripsy CPT 50590 | $2,639.60 | $26,396.00 | $407.51 – $12,933.00 |
| Nasal endoscopy, diagnostic CPT 31231 | $115.50 | $1,155.00 | $212.17 – $16,391.00 |
| Prostate biopsy CPT 55700 | $308.30 | $3,083.00 | $983.65 – $16,391.00 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $206.20 | $2,062.00 | $313.34 – $313.34 |
| IUD insertion CPT 58300 | $151.90 | $1,519.00 | $25.64 – $3,961.00 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | not posted | $6,724.08 – $20,280.92 | |
| C-section, without complications MS-DRG 788 | not posted | $7,225.84 – $23,753.26 | |
| Chest pain MS-DRG 313 | not posted | $5,794.78 – $18,652.92 | |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $8,848.46 – $31,401.14 | |
| COPD flare-up, without complications MS-DRG 192 | not posted | $5,180.43 – $19,095.97 | |
| Fainting (syncope) MS-DRG 312 | not posted | $6,819.38 – $21,137.16 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $7,848.16 – $26,116.19 | |
| Heart failure, with major complications MS-DRG 291 | not posted | $10,235.48 – $35,480.89 | |
| Heart failure, without complications MS-DRG 293 | not posted | $4,581.82 – $17,553.20 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $77,176.83 – $258,996.77 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $15,316.54 – $52,475.01 | |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $4,548.42 – $14,828.98 | |
| Kidney failure, with complications MS-DRG 683 | not posted | $7,021.92 – $24,235.87 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $6,452.84 – $20,942.01 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $19,352.40 – $62,578.12 | |
| Normal newborn care MS-DRG 795 | not posted | $1,551.71 – $5,047.87 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $6,133.54 – $19,829.11 | |
| Pneumonia, with complications MS-DRG 194 | not posted | $6,471.36 – $23,740.07 | |
| Pneumonia, with major complications MS-DRG 193 | not posted | $10,476.50 – $34,724.01 | |
| Pneumonia, without complications MS-DRG 195 | not posted | $5,074.09 – $18,112.29 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $10,076.75 – $32,089.25 | |
| Sepsis, with major complications MS-DRG 871 | not posted | $15,217.36 – $48,956.98 | |
| Sepsis, without major complications MS-DRG 872 | not posted | $8,183.69 – $27,767.08 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $6,881.29 – $22,355.54 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $6,226.39 – $19,921.41 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $8,081.30 – $27,202.72 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $9,223.11 – $29,420.60 | |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $5,222.06 – $16,192.41 | |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $12,004.51 – $41,622.93 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $170.90 | $1,709.00 | $322.61 – $16,391.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $466.60 | $4,666.00 | $972.98 – $16,391.00 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $414.40 | $4,144.00 | $700.29 – $16,391.00 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $227.70 | $2,277.00 | $255.17 – $16,391.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | $403.60 | $4,036.00 | $599.55 – $16,391.00 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $372.10 | $3,721.00 | $164.15 – $3,324.00 |
| Sleep study with CPAP titration CPT 95811 | $761.50 | $7,615.00 | $393.28 – $8,935.00 |
| Sleep study, overnight in a sleep lab CPT 95810 | $1,062.40 | $10,624.00 | $190.00 – $8,935.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $67.00 | $670.00 | $164.15 – $778.00 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $35.20 | $352.00 | $20.00 – $176.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $49.50 | $495.00 | $60.00 – $176.00 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $49.50 | $495.00 | $60.00 – $176.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $23.20 | $232.00 | $18.50 – $176.00 |
| Therapeutic activities, 15 minutes CPT 97530 | $24.40 | $244.00 | $20.00 – $176.00 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $74.90 | $749.00 | $77.16 – $532.00 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $90.10 | $901.00 | $77.16 – $532.00 |
| Group psychotherapy CPT 90853 | $46.10 | $461.00 | $72.96 – $532.00 |
| Psychiatric diagnostic evaluation CPT 90791 | $115.20 | $1,152.00 | $77.16 – $532.00 |
| Psychotherapy, 30 minutes CPT 90832 | $39.00 | $390.00 | $77.16 – $532.00 |
| Psychotherapy, 45 minutes CPT 90834 | $48.90 | $489.00 | $77.16 – $532.00 |
| Psychotherapy, 60 minutes CPT 90837 | $57.60 | $576.00 | $77.16 – $532.00 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $48.10 | $481.00 | $12.76 – $1,216.00 |
| IV hydration, each additional hour CPT 96361 | $83.80 | $838.00 | $48.41 – $1,216.00 |
| IV hydration, first hour CPT 96360 | $133.60 | $1,336.00 | $153.41 – $1,216.00 |
| IV push injection of a drug, first CPT 96374 | $49.20 | $492.00 | $34.54 – $1,216.00 |
| IV push injection, each additional drug CPT 96375 | $46.60 | $466.00 | $48.41 – $1,216.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $37.56 | $375.62 | $3.02 – $26.98 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $15.29 | $152.93 | |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $16.90 | $169.03 | ? – $299.90 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $6.71 | $67.08 | ? – $2.24 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $37.19 | $371.86 | |
| Morphine injection, up to 10 mg HCPCS J2270 | $33.00 | $330.01 | $2.71 – $8.48 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $12.69 | $126.91 | |
| Propofol injection, per 10 mg HCPCS J2704 | $50.31 | $503.06 | $1.01 – $1,372.60 |
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.