Kenmore Mercy Hospital
2950 Elmwood Avenue, Kenmore, NY 14217 · Acute care hospital · Emergency room
These are Kenmore Mercy 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.
224 of the services we track have a posted price here; 195 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 | $3,100.00 | $3,100.00 | $84.68 – $3,100.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $405.00 | $405.00 | $7.98 – $405.00 |
| Emergency room visit, level 2 CPT 99282 | $759.00 | $759.00 | $14.96 – $759.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $1,206.00 | $1,206.00 | $24.41 – $1,206.00 |
| Emergency room visit, level 4 CPT 99284 | $1,878.00 | $1,878.00 | $40.54 – $1,878.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $2,300.00 | $2,300.00 | $67.19 – $2,300.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $430.00 | $430.00 | $8.08 – $430.00 |
Office visits
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $328.00 | $328.00 | $6.13 – $328.00 |
| Abdominal X-ray, 1 view CPT 74018 | $230.00 | $230.00 | $5.93 – $230.00 |
| Ankle X-ray, 3 or more views CPT 73610 | $199.00 | $199.00 | $5.69 – $343.50 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $60.00 | $373.00 | $6.40 – $373.00 |
| Breast ultrasound, one breast, complete CPT 76641 | $394.00 | $394.00 | $19.68 – $591.00 |
| Breast ultrasound, one breast, limited CPT 76642 | $389.00 | $389.00 | $16.16 – $583.50 |
| Chest X-ray, 1 view CPT 71045 | $229.00 | $229.00 | $5.71 – $229.00 |
| Chest X-ray, 2 views CPT 71046 | $233.00 | $233.00 | $6.85 – $233.00 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $84.00 | $1,030.00 | $56.97 – $1,030.00 |
| CT angiogram of the head CPT 70496 | $996.00 | $996.00 | $54.79 – $996.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $64.76 | $1,071.00 | $57.18 – $1,071.00 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $82.04 | $1,231.00 | $63.35 – $1,231.00 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $41.21 | $949.00 | $20.82 – $949.00 |
| CT scan of the abdomen, without contrast CPT 74150 | $84.00 | $767.00 | $37.38 – $767.00 |
| CT scan of the chest, with contrast CPT 71260 | $102.00 | $886.00 | $36.68 – $886.00 |
| CT scan of the chest, without contrast CPT 71250 | $84.00 | $753.00 | $33.75 – $753.00 |
| CT scan of the head, without contrast CPT 70450 | $72.00 | $852.00 | $26.89 – $852.00 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $84.00 | $745.00 | $31.68 – $745.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $102.00 | $886.00 | $36.46 – $886.00 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $72.00 | $729.00 | $27.11 – $729.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $58.20 | $383.00 | $31.36 – $383.00 |
| Diagnostic mammogram, one breast CPT 77065 | $361.00 | $361.00 | $25.21 – $361.00 |
| Foot X-ray, 3 or more views CPT 73630 | $228.00 | $228.00 | $5.47 – $342.00 |
| Hand X-ray, 3 or more views CPT 73130 | $7.50 | $229.00 | $5.92 – $343.50 |
| Knee X-ray, 3 views CPT 73562 | $260.94 | $260.94 | $6.37 – $345.00 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $1,434.00 | $1,434.00 | $21.77 – $1,434.00 |
| Leg or arm vein ultrasound, one side CPT 93971 | $404.00 | $404.00 | $13.89 – $404.00 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $310.21 | $310.21 | $7.29 – $291.00 |
| MRI of both breasts, without and with contrast CPT 77049 | $1,600.00 | $1,600.00 | $217.91 – $1,600.00 |
| MRI of the abdomen, without and with contrast CPT 74183 | $300.00 | $2,885.00 | $69.29 – $2,885.00 |
| MRI of the brain, without and with contrast CPT 70553 | $300.00 | $2,916.00 | $71.82 – $2,916.00 |
| MRI of the brain, without contrast CPT 70551 | $300.00 | $1,313.00 | $46.31 – $1,313.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $300.00 | $1,296.00 | $42.90 – $1,944.00 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $300.00 | $1,457.00 | $46.75 – $1,457.00 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $300.00 | $1,457.00 | $46.54 – $1,457.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $300.00 | $1,313.00 | $46.54 – $1,313.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $300.00 | $2,885.00 | $69.29 – $2,885.00 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $1,296.00 | $1,296.00 | $43.12 – $1,296.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $278.38 | $278.38 | $7.07 – $234.00 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $33.00 | $1,442.00 | $22.10 – $1,442.00 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $503.89 | $503.89 | $32.17 – $399.00 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $503.89 | $503.89 | $31.72 – $399.00 |
| Screening mammogram, both breasts CPT 77067 | $58.20 | $376.00 | $23.89 – $376.00 |
| Shoulder X-ray, 2 or more views CPT 73030 | $230.00 | $230.00 | $6.15 – $345.00 |
| Transvaginal pregnancy ultrasound CPT 76817 | $533.56 | $533.56 | $24.16 – $368.00 |
| Transvaginal ultrasound CPT 76830 | $518.45 | $518.45 | $22.10 – $391.00 |
| Ultrasound of the abdomen, complete CPT 76700 | $36.00 | $1,454.00 | $25.57 – $1,454.00 |
| Ultrasound of the neck or thyroid CPT 76536 | $18.00 | $378.00 | $18.02 – $378.00 |
| Wrist X-ray, 3 or more views CPT 73110 | $229.00 | $229.00 | $5.92 – $343.50 |
| X-ray of the lower back, 4 or more views CPT 72110 | $347.53 | $347.53 | $8.62 – $301.00 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $7.25 | $19.00 | $6.35 – $19.00 |
| Blood culture CPT 87040 | $8.15 | $47.00 | $7.74 – $47.00 |
| Blood draw (venipuncture) CPT 36415 | $25.11 | $25.11 | $1.26 – $16.00 |
| BNP test (heart failure) CPT 83880 | $34.07 | $77.00 | $10.00 – $77.42 |
| C-reactive protein (CRP) test CPT 86140 | $4.10 | $9.00 | $3.89 – $12.41 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $21.43 | $96.00 | $10.00 – $96.00 |
| Complete blood count (CBC) with differential CPT 85025 | $36.10 | $36.10 | $3.20 – $22.00 |
| Complete blood count (CBC), automated CPT 85027 | $17.00 | $17.00 | $2.72 – $16.00 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $10.00 | $26.00 | $7.92 – $26.00 |
| COVID-19 PCR test CPT 87635 | $90.00 | $90.00 | $30.79 – $90.00 |
| D-dimer test (blood clots) CPT 85379 | $25.00 | $25.00 | $7.64 – $25.00 |
| Drug screen, instrument chemistry CPT 80307 | $109.00 | $109.00 | $7.58 – $109.00 |
| Ferritin (iron stores) test CPT 82728 | $13.63 | $33.00 | $10.00 – $33.00 |
| Free T4 (thyroid) test CPT 84439 | $9.00 | $22.00 | $6.77 – $22.00 |
| Glucose (blood sugar) test CPT 82947 | $26.92 | $26.92 | $1.77 – $15.34 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $21.43 | $96.00 | $10.00 – $96.00 |
| Hemoglobin A1c test CPT 83036 | $38.11 | $38.11 | $4.08 – $24.00 |
| Hepatitis C antibody test CPT 86803 | $10.00 | $35.00 | $10.00 – $35.00 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $18.49 | $51.00 | $10.00 – $51.00 |
| Iron test CPT 83540 | $5.03 | $16.00 | $4.85 – $16.00 |
| Kidney function panel CPT 80069 | $8.68 | $21.00 | $6.51 – $21.00 |
| Lipase test (pancreas) CPT 83690 | $5.75 | $16.00 | $5.17 – $16.00 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $6.04 | $54.00 | $6.10 – $54.00 |
| Liver function panel CPT 80076 | $7.25 | $19.00 | $6.13 – $19.00 |
| Magnesium test CPT 83735 | $5.03 | $16.00 | $5.03 – $16.00 |
| Obstetric blood test panel CPT 80055 | $81.00 | $81.00 | $10.00 – $81.00 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $15.00 | $15.00 | $4.51 – $15.00 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $12.37 | $37.00 | $10.00 – $37.00 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $3.91 | $10.00 | $1.93 – $10.00 |
| PSA (prostate specific antigen), free CPT 84154 | $18.39 | $45.00 | $10.00 – $45.00 |
| PSA (prostate specific antigen), total CPT 84153 | $18.39 | $45.00 | $10.00 – $45.00 |
| Rapid strep test CPT 87880 | $74.20 | $74.20 | $3.79 – $42.29 |
| Sed rate (ESR) test CPT 85652 | $2.00 | $7.00 | $2.02 – $10.00 |
| TB skin test CPT 86580 | $70.00 | $70.00 | $4.11 – $70.00 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $9.00 | $68.00 | $9.09 – $68.00 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $202.00 | $202.00 | $8.98 – $202.00 |
| Troponin test (heart damage) CPT 84484 | $40.00 | $40.00 | $8.13 – $40.00 |
| Urinalysis, automated, with microscope CPT 81001 | $3.07 | $8.00 | $1.43 – $10.00 |
| Urinalysis, automated, without microscope CPT 81003 | $13.92 | $13.92 | $1.01 – $10.00 |
| Urinalysis, manual, with microscope CPT 81000 | $6.00 | $6.00 | $1.81 – $6.00 |
| Urinalysis, manual, without microscope CPT 81002 | $6.00 | $6.00 | $1.57 – $10.00 |
| Urine culture, colony count CPT 87086 | $8.07 | $22.00 | $3.39 – $22.00 |
| Urine pregnancy test CPT 81025 | $17.00 | $17.00 | $2.02 – $15.00 |
| Vitamin B12 test CPT 82607 | $12.50 | $36.00 | $6.33 – $36.00 |
| Vitamin D test CPT 82306 | $29.60 | $117.00 | $10.00 – $117.00 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $64.80 | $1,445.00 | $25.38 – $1,445.00 |
| ECG tracing only (no interpretation) CPT 93005 | $143.00 | $143.00 | $4.61 – $143.00 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $1,424.00 | $1,424.00 | $46.24 – $1,692.30 |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 | $154.25 | $154.25 | $10.30 – $87.92 |
| Holter monitor, up to 48 hours CPT 93224 | $393.96 | $393.96 | $47.14 – $375.20 |
| Left heart catheterization CPT 93452 | $6,959.00 | $6,959.00 | $76.97 – $6,959.00 |
| Left heart catheterization with coronary angiogram CPT 93458 | $1,592.24 | $6,959.00 | $95.58 – $6,959.00 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $143.24 | $3,458.00 | $50.96 – $3,458.00 |
| Treadmill stress test, complete CPT 93015 | $355.98 | $355.98 | $49.49 – $339.03 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $3,781.03 | $3,781.03 | $174.65 – $1,800.49 |
| Appendix removal, laparoscopic CPT 44970 | $1,193.00 | $1,193.00 | $12.72 – $716.80 |
| Breast biopsy with ultrasound guidance CPT 19083 | $3,506.00 | $3,506.00 | $35.37 – $3,506.00 |
| Carpal tunnel release CPT 64721 | $888.90 | $888.90 | $73.01 – $514.13 |
| Colonoscopy with biopsy CPT 45380 | $922.38 | $922.38 | $59.90 – $389.87 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $1,054.78 | $1,054.78 | $73.44 – $502.28 |
| Colonoscopy, diagnostic CPT 45378 | $762.00 | $762.00 | $19.16 – $354.43 |
| Colposcopy with biopsy CPT 57454 | $668.29 | $668.29 | $36.87 – $659.00 |
| Cystoscopy (bladder scope) CPT 52000 | $1,444.00 | $1,444.00 | $23.95 – $1,444.00 |
| Ear tubes, under general anesthesia CPT 69436 | $397.67 | $397.67 | $42.00 – $191.73 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $310.00 | $310.00 | $14.85 – $102.88 |
| Gallbladder removal, laparoscopic CPT 47562 | $1,862.87 | $1,862.87 | $15.85 – $887.08 |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | $4,172.32 | $4,172.32 | $284.82 – $2,051.11 |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | $1,673.61 | $1,673.61 | $174.55 – $1,042.26 |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $1,878.00 | $1,878.00 | $10.93 – $606.65 |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $1,193.00 | $1,193.00 | $9.19 – $852.15 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $1,193.00 | $1,193.00 | $11.69 – $935.15 |
| Kidney stone shock-wave lithotripsy CPT 50590 | $7,462.00 | $7,462.00 | $503.27 – $7,462.00 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $1,869.25 | $1,869.25 | $112.09 – $890.12 |
| Nasal endoscopy, diagnostic CPT 31231 | $756.62 | $756.62 | $18.38 – $473.92 |
| Prostate biopsy CPT 55700 | $372.74 | $372.74 | $34.65 – $172.28 |
| Prostate removal, laparoscopic or robotic CPT 55866 | $2,664.74 | $2,664.74 | $320.71 – $1,859.21 |
| Removal of a breast lump, open surgery CPT 19120 | $864.00 | $864.00 | $66.89 – $464.44 |
| Rotator cuff repair, arthroscopic CPT 29827 | $2,916.69 | $2,916.69 | $154.80 – $1,279.22 |
| Screening colonoscopy, average risk HCPCS G0121 | $614.00 | $614.00 | $14.50 – $196.26 |
| Screening colonoscopy, high risk HCPCS G0105 | $623.00 | $623.00 | $14.46 – $195.98 |
| Septoplasty (nasal septum repair) CPT 30520 | $1,492.85 | $1,492.85 | $101.43 – $816.89 |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $3,086.99 | $3,086.99 | $15.72 – $1,759.58 |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | $2,483.83 | $2,483.83 | $247.29 – $1,300.56 |
| Tonsil and adenoid removal, under age 12 CPT 42820 | $720.91 | $720.91 | $51.32 – $352.91 |
| Total hip replacement CPT 27130 | $5,463.15 | $5,463.15 | $202.97 – $2,601.50 |
| Total knee replacement CPT 27447 | $4,138.30 | $4,138.30 | $218.05 – $1,970.62 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $772.60 | $2,029.00 | $41.68 – $2,029.00 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $772.60 | $2,029.00 | $37.26 – $2,029.00 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| C-section delivery, routine care including prenatal and postpartum CPT 59510 | $4,869.62 | $4,869.62 | $868.98 – $2,887.15 |
| Fetal non-stress test CPT 59025 | $522.00 | $522.00 | $13.94 – $522.00 |
| IUD insertion CPT 58300 | $446.48 | $446.48 | $29.61 – $391.00 |
| Vaginal birth after a prior C-section (VBAC), routine care CPT 59610 | $4,457.00 | $4,457.00 | $868.98 – $2,721.10 |
| Vaginal delivery, routine care including prenatal and postpartum CPT 59400 | $4,665.94 | $4,665.94 | $853.67 – $2,605.17 |
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 | $18,646.04 | $8,672.08 – $18,294.26 |
| C-section, without complications MS-DRG 788 | not posted | $32,007.66 | $9,083.33 – $19,869.21 |
| Chest pain MS-DRG 313 | not posted | $19,198.21 | $5,992.16 – $14,920.56 |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $20,102.48 | $8,255.91 – $22,954.87 |
| COPD flare-up, without complications MS-DRG 192 | not posted | $15,154.96 | $4,577.78 – $13,304.17 |
| Fainting (syncope) MS-DRG 312 | not posted | $19,313.28 | $6,568.16 – $18,062.17 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $19,864.99 | $7,996.26 – $20,323.05 |
| Heart failure, with major complications MS-DRG 291 | not posted | $35,826.97 | $9,865.04 – $26,604.19 |
| Heart failure, without complications MS-DRG 293 | not posted | $12,529.98 | $4,786.23 – $11,729.22 |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $287,930.38 | $84,093.02 – $202,728.96 |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $59,113.34 | $16,817.14 – $39,972.59 |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $20,486.07 | $4,123.38 – $11,731.29 |
| Kidney failure, with complications MS-DRG 683 | not posted | $20,437.57 | $6,021.42 – $18,149.20 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $15,336.81 | $5,748.97 – $16,775.27 |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $60,616.86 | $21,188.44 – $50,591.06 |
| Normal newborn care MS-DRG 795 | not posted | $5,442.24 | $1,180.33 – $4,140.46 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $16,440.88 | $5,727.94 – $16,126.64 |
| Pneumonia, with complications MS-DRG 194 | not posted | $14,187.75 | $6,418.22 – $16,700.67 |
| Pneumonia, with major complications MS-DRG 193 | not posted | $20,876.16 | $9,001.05 – $27,238.31 |
| Pneumonia, without complications MS-DRG 195 | not posted | $15,443.15 | $5,112.63 – $13,024.41 |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $29,310.19 | $4,863.95 – $28,945.89 |
| Sepsis, with major complications MS-DRG 871 | not posted | $45,322.30 | $14,971.27 – $40,254.43 |
| Sepsis, without major complications MS-DRG 872 | not posted | $21,706.12 | $6,879.01 – $21,205.85 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $12,812.20 | $5,222.34 – $18,047.66 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $16,294.67 | $5,896.17 – $16,155.65 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $26,819.67 | $8,980.52 – $20,936.45 |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $43,637.02 | $12,065.70 – $25,711.03 |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $15,134.45 | $3,839.96 – $13,971.45 |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $40,027.81 | $14,576.91 – $31,258.57 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $639.00 | $639.00 | $12.12 – $958.50 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $565.42 | $1,926.00 | $25.51 – $2,889.00 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $1,499.00 | $1,499.00 | $27.71 – $1,541.99 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $1,926.00 | $1,926.00 | $48.57 – $1,926.00 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $1,032.00 | $1,032.00 | $30.60 – $1,032.00 |
| Sleep study with CPAP titration CPT 95811 | $2,682.00 | $2,682.00 | $84.74 – $2,682.00 |
| Sleep study, overnight in a sleep lab CPT 95810 | $2,673.00 | $2,673.00 | $81.73 – $2,673.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $380.00 | $380.00 | $5.69 – $667.01 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $101.00 | $101.00 | $14.60 – $125.66 |
| Physical therapy evaluation, low complexity CPT 97161 | $181.00 | $181.00 | $34.34 – $232.20 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $181.00 | $181.00 | $34.34 – $180.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $101.00 | $101.00 | $15.49 – $125.66 |
| Therapeutic activities, 15 minutes CPT 97530 | $120.00 | $120.00 | $2.37 – $125.66 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $373.93 | $373.93 | $52.03 – $348.00 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $417.46 | $417.46 | $43.35 – $348.00 |
| Group psychotherapy CPT 90853 | $50.71 | $50.71 | $14.69 – $50.71 |
| Psychiatric diagnostic evaluation CPT 90791 | $355.30 | $355.30 | $60.38 – $348.00 |
| Psychotherapy, 30 minutes CPT 90832 | $122.54 | $348.00 | $22.88 – $348.00 |
| Psychotherapy, 45 minutes CPT 90834 | $348.00 | $348.00 | $36.35 – $348.00 |
| Psychotherapy, 60 minutes CPT 90837 | $348.00 | $348.00 | $53.17 – $348.00 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $154.00 | $154.00 | $10.36 – $1,088.00 |
| IV hydration, each additional hour CPT 96361 | $114.99 | $114.99 | $5.05 – $100.00 |
| IV hydration, first hour CPT 96360 | $534.41 | $534.41 | $22.35 – $547.73 |
| IV push injection of a drug, first CPT 96374 | $512.78 | $512.78 | $24.84 – $547.73 |
| IV push injection, each additional drug CPT 96375 | $124.07 | $124.07 | $10.50 – $100.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $77.63 | $77.63 | ? – $79.18 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $5.63 | $5.63 | ? – $5.74 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $50.93 | $50.93 | ? – $50.93 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $5.41 | $5.41 | ? – $5.41 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $72.80 | $72.80 | ? – $72.80 |
| Morphine injection, up to 10 mg HCPCS J2270 | $7.08 | $7.08 | $3.04 – $7.08 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $2.95 | $2.95 | ? – $1.68 |
| Propofol injection, per 10 mg HCPCS J2704 | $29.40 | $29.40 | $9.00 – $29.40 |
| Saline IV solution, 1000 ml HCPCS J7030 | $2.50 | $2.50 | ? – $2.55 |
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.