Mercy Medical Center

1000 North Village Avenue, Rockville Centre, NY 11571 · Acute care hospital · Emergency room

These are Mercy Medical Center's own posted figures from its standard-charges file dated February 19, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

234 of the services we track have a posted price here; 0 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.

This hospital's file does not post discounted cash prices for these services, so only its gross charges and insurer rate ranges are shown.

Emergency room

Service	Cash price	Gross charge	Insurer rates (min – max)
Critical care, first 30 to 74 minutes CPT 99291	not posted	$3,383.00	$366.40 – $6,427.00
Emergency room visit, level 1 (minor) CPT 99281	not posted	$1,709.00	$37.44 – $2,186.00
Emergency room visit, level 2 CPT 99282	not posted	$1,922.00	$72.77 – $2,186.00
Emergency room visit, level 3 (moderate) CPT 99283	not posted	$2,332.00	$121.76 – $2,332.00
Emergency room visit, level 4 CPT 99284	not posted	$2,619.00	$144.32 – $2,619.00
Emergency room visit, level 5 (most severe) CPT 99285	not posted	$3,019.00	$144.32 – $3,019.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	not posted	$612.00	$97.44 – $5,066.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	not posted	$265.00	$30.80 – $298.00
New patient office visit, about 30 minutes CPT 99203	not posted	$310.00	$43.29 – $310.00
New patient office visit, about 45 minutes CPT 99204	not posted	$375.00	$66.04 – $375.00
New patient office visit, about 60 minutes CPT 99205	not posted	$450.00	$76.97 – $450.00
Office consultation, about 40 minutes CPT 99243	not posted		$57.85 – $298.00
Office consultation, about 60 minutes CPT 99244	not posted		$58.38 – $298.00
Office visit, established patient, about 10 to 19 minutes CPT 99212	not posted	$265.00	$23.09 – $298.00
Office visit, established patient, about 20 to 29 minutes CPT 99213	not posted	$310.00	$43.33 – $310.00
Office visit, established patient, about 30 to 39 minutes CPT 99214	not posted	$375.00	$63.78 – $375.00
Office visit, established patient, about 40 to 54 minutes CPT 99215	not posted	$450.00	$64.50 – $450.00
Office visit, established patient, brief (often a nurse) CPT 99211	not posted	$235.00	$14.00 – $298.00
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted		$61.59 – $536.00
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted		$74.56 – $628.00

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	not posted	$459.00	$10.21 – $765.00
Abdominal X-ray, 1 view CPT 74018	not posted	$494.00	$10.10 – $494.00
Ankle X-ray, 3 or more views CPT 73610	not posted	$716.00	$12.63 – $716.00
Bone density scan (DEXA), hips and spine CPT 77080	not posted	$873.00	$64.69 – $873.00
Breast ultrasound, one breast, complete CPT 76641	not posted	$863.00	$32.79 – $1,096.00
Breast ultrasound, one breast, limited CPT 76642	not posted	$622.00	$26.93 – $1,096.00
Chest X-ray, 1 view CPT 71045	not posted	$668.00	$10.10 – $668.00
Chest X-ray, 2 views CPT 71046	not posted	$623.00	$15.15 – $623.00
CT angiogram of the chest (checks for lung clots) CPT 71275	not posted	$4,551.00	$141.40 – $4,551.00
CT angiogram of the head CPT 70496	not posted	$4,128.00	$206.45 – $4,128.00
CT scan of the abdomen and pelvis, with contrast CPT 74177	not posted	$3,825.00	$109.01 – $3,825.00
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	not posted	$4,112.00	$138.11 – $4,112.00
CT scan of the abdomen and pelvis, without contrast CPT 74176	not posted	$3,451.00	$69.38 – $3,451.00
CT scan of the abdomen, without contrast CPT 74150	not posted	$2,767.00	$123.32 – $2,767.00
CT scan of the chest, with contrast CPT 71260	not posted	$3,669.00	$171.70 – $3,669.00
CT scan of the chest, without contrast CPT 71250	not posted	$2,486.00	$123.32 – $2,486.00
CT scan of the head, without contrast CPT 70450	not posted	$2,400.00	$121.20 – $2,400.00
CT scan of the neck (cervical spine), without contrast CPT 72125	not posted	$1,829.00	$123.32 – $2,331.00
CT scan of the pelvis, with contrast CPT 72193	not posted	$2,767.00	$171.70 – $2,767.00
CT scan of the sinuses or face, without contrast CPT 70486	not posted	$2,767.00	$121.20 – $2,767.00
Diagnostic mammogram, both breasts CPT 77066	not posted	$846.00	$97.97 – $846.00
Diagnostic mammogram, one breast CPT 77065	not posted	$793.00	$97.97 – $793.00
Foot X-ray, 3 or more views CPT 73630	not posted	$716.00	$12.63 – $716.00
Hand X-ray, 3 or more views CPT 73130	not posted	$716.00	$12.63 – $716.00
Knee X-ray, 3 views CPT 73562	not posted	$509.00	$15.15 – $509.00
Leg or arm vein ultrasound, both sides CPT 93970	not posted	$2,714.00	$109.08 – $2,714.00
Leg or arm vein ultrasound, one side CPT 93971	not posted	$1,873.00	$93.93 – $1,873.00
Lower back X-ray, 2 or 3 views CPT 72100	not posted	$686.00	$15.15 – $686.00
MRI of both breasts, without and with contrast CPT 77049	not posted	$7,250.00	$505.00 – $7,250.00
MRI of the abdomen, without and with contrast CPT 74183	not posted	$4,232.00	$414.16 – $6,288.00
MRI of the brain, without and with contrast CPT 70553	not posted	$9,000.00	$414.16 – $9,000.00
MRI of the brain, without contrast CPT 70551	not posted	$4,500.00	$280.32 – $6,288.00
MRI of the knee or other leg joint, without contrast CPT 73721	not posted	$4,232.00	$280.32 – $6,288.00
MRI of the lower back (lumbar spine), without contrast CPT 72148	not posted	$4,232.00	$280.32 – $6,288.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	not posted	$4,232.00	$280.32 – $6,288.00
MRI of the neck (cervical spine), without contrast CPT 72141	not posted	$4,232.00	$280.32 – $6,288.00
MRI of the pelvis, without and with contrast CPT 72197	not posted	$5,628.00	$414.16 – $6,288.00
MRI of the shoulder or other arm joint, without contrast CPT 73221	not posted	$4,232.00	$280.32 – $6,288.00
Neck X-ray, 2 or 3 views CPT 72040	not posted	$561.00	$15.15 – $561.00
Pelvic ultrasound, complete (not pregnancy) CPT 76856	not posted	$1,693.00	$55.55 – $1,693.00
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	not posted	$881.00	$55.55 – $1,096.00
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	not posted	$881.00	$55.55 – $1,096.00
Screening mammogram, both breasts CPT 77067	not posted	$802.00	$97.97 – $802.00
Shoulder X-ray, 2 or more views CPT 73030	not posted	$584.00	$15.15 – $584.00
Transvaginal pregnancy ultrasound CPT 76817	not posted	$1,121.00	$60.60 – $1,121.00
Transvaginal ultrasound CPT 76830	not posted	$1,176.00	$60.60 – $1,176.00
Ultrasound of the abdomen, complete CPT 76700	not posted	$1,286.00	$60.60 – $1,286.00
Ultrasound of the neck or thyroid CPT 76536	not posted	$917.00	$30.30 – $1,096.00
Wrist X-ray, 3 or more views CPT 73110	not posted	$716.00	$12.63 – $716.00
X-ray of the lower back, 4 or more views CPT 72110	not posted	$713.00	$30.30 – $713.00

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	not posted	$215.00	$7.32 – $215.00
Blood culture CPT 87040	not posted	$205.00	$8.23 – $205.00
Blood draw (venipuncture) CPT 36415	not posted	$120.00	$3.00 – $120.00
BNP test (heart failure) CPT 83880	not posted	$602.00	$34.41 – $602.00
C-reactive protein (CRP) test CPT 86140	not posted	$162.00	$4.14 – $162.00
Chlamydia test (DNA/NAAT) CPT 87491	not posted	$351.00	$21.64 – $351.00
Complete blood count (CBC) with differential CPT 85025	not posted	$253.00	$3.20 – $253.00
Complete blood count (CBC), automated CPT 85027	not posted	$140.00	$3.20 – $140.00
Comprehensive metabolic panel (blood test) CPT 80053	not posted	$584.00	$10.10 – $584.00
COVID-19 PCR test CPT 87635	not posted	$405.00	$30.79 – $405.00
D-dimer test (blood clots) CPT 85379	not posted	$244.00	$9.57 – $244.00
Drug screen, instrument chemistry CPT 80307	not posted	$464.00	$7.58 – $464.00
Ferritin (iron stores) test CPT 82728	not posted	$275.00	$13.36 – $275.00
Free T4 (thyroid) test CPT 84439	not posted	$653.00	$8.84 – $653.00
General health panel (blood tests) CPT 80050	not posted		$33.96 – $128.00
Glucose (blood sugar) test CPT 82947	not posted	$156.00	$3.85 – $156.00
Gonorrhea test (DNA/NAAT) CPT 87591	not posted	$392.00	$21.64 – $392.00
Hemoglobin A1c test CPT 83036	not posted	$416.00	$9.52 – $416.00
Hepatitis C antibody test CPT 86803	not posted	$369.00	$10.10 – $369.00
HIV-1/HIV-2 antigen and antibody test CPT 87389	not posted	$74.00	$18.67 – $120.28
Iron test CPT 83540	not posted	$171.00	$5.08 – $171.00
Kidney function panel CPT 80069	not posted	$397.00	$8.51 – $397.00
Lipase test (pancreas) CPT 83690	not posted	$152.00	$5.81 – $152.00
Lipid panel, cholesterol and triglycerides CPT 80061	not posted	$272.00	$6.10 – $272.00
Liver function panel CPT 80076	not posted	$246.00	$7.32 – $246.00
Magnesium test CPT 83735	not posted	$110.00	$5.08 – $110.00
Obstetric blood test panel CPT 80055	not posted		$33.96 – $176.47
Partial thromboplastin time (PTT), clotting test CPT 85730	not posted	$197.00	$5.89 – $197.00
Pregnancy blood test (hCG), quantitative CPT 84702	not posted	$389.00	$12.49 – $389.00
Prothrombin time (PT/INR), clotting test CPT 85610	not posted	$123.00	$3.95 – $123.00
PSA (prostate specific antigen), free CPT 84154	not posted	$231.00	$18.02 – $304.00
PSA (prostate specific antigen), total CPT 84153	not posted	$337.00	$18.02 – $337.00
Rapid strep test CPT 87880	not posted	$165.00	$3.79 – $165.00
Sed rate (ESR) test CPT 85652	not posted		$2.02 – $16.00
TB skin test CPT 86580	not posted	$68.00	$5.05 – $68.00
Thyroid stimulating hormone (TSH) CPT 84443	not posted	$393.00	$9.09 – $393.00
Tissue exam by a pathologist (biopsy specimen) CPT 88305	not posted	$544.00	$34.98 – $544.00
Troponin test (heart damage) CPT 84484	not posted	$285.00	$7.27 – $285.00
Urinalysis, automated, with microscope CPT 81001	not posted	$194.00	$3.11 – $194.00
Urinalysis, automated, without microscope CPT 81003	not posted	$67.00	$2.02 – $67.00
Urinalysis, manual, with microscope CPT 81000	not posted		$3.74 – $20.00
Urinalysis, manual, without microscope CPT 81002	not posted	$42.00	$2.02 – $42.00
Urine culture, colony count CPT 87086	not posted		$7.91 – $48.00
Urine pregnancy test CPT 81025	not posted	$140.00	$3.22 – $140.00
Vitamin B12 test CPT 82607	not posted	$193.00	$12.63 – $193.00
Vitamin D test CPT 82306	not posted	$982.00	$29.01 – $982.00

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	not posted	$2,714.00	$109.08 – $2,714.00
ECG tracing only (no interpretation) CPT 93005	not posted	$510.00	$7.58 – $510.00
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	not posted	$3,963.00	$208.57 – $3,963.00
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$15.15 – $128.00
Holter monitor, up to 48 hours CPT 93224	not posted		$60.60 – $804.00
Left heart catheterization CPT 93452	not posted	$17,609.00	$1,691.46 – $17,609.00
Left heart catheterization with coronary angiogram CPT 93458	not posted	$23,221.00	$1,961.39 – $23,221.00
Nuclear stress test (heart perfusion imaging) CPT 78452	not posted	$7,801.00	$241.13 – $10,339.00
Treadmill stress test, complete CPT 93015	not posted		$60.60 – $508.00

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$2,152.22 – $19,020.60
Appendix removal, laparoscopic CPT 44970	not posted		$1,373.01 – $15,534.34
Breast biopsy with ultrasound guidance CPT 19083	not posted	$5,138.00	$320.90 – $5,138.00
Carpal tunnel release CPT 64721	not posted	$6,820.00	$950.99 – $6,820.00
Colonoscopy with biopsy CPT 45380	not posted		$418.66 – $4,264.00
Colonoscopy with polyp removal (snare) CPT 45385	not posted		$526.34 – $4,264.00
Colonoscopy, diagnostic CPT 45378	not posted		$388.66 – $4,264.00
Colposcopy with biopsy CPT 57454	not posted	$1,214.00	$289.51 – $5,066.00
Cystoscopy (bladder scope) CPT 52000	not posted	$2,195.00	$165.82 – $4,448.67
Ear tubes, under general anesthesia CPT 69436	not posted		$332.88 – $5,066.00
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted	$2,666.00	$116.90 – $4,264.00
Gallbladder removal, laparoscopic CPT 47562	not posted		$1,510.81 – $15,534.34
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$3,014.45 – $40,447.68
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$1,954.99 – $27,720.50
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted		$498.91 – $8,465.69
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$982.23 – $15,534.34
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted	$11,433.00	$1,193.06 – $11,433.00
Kidney stone shock-wave lithotripsy CPT 50590	not posted	$18,120.00	$1,189.10 – $18,120.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$1,196.90 – $8,638.97
Lower colon endoscopy with ultrasound CPT 45391	not posted		$529.46 – $4,264.00
Nasal endoscopy, diagnostic CPT 31231	not posted	$584.00	$134.87 – $5,066.00
Prostate biopsy CPT 55700	not posted		$269.20 – $5,454.27
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$2,249.52 – $46,247.00
Removal of a breast lump, open surgery CPT 19120	not posted		$942.15 – $10,195.70
Rotator cuff repair, arthroscopic CPT 29827	not posted		$2,174.64 – $19,020.60
Screening colonoscopy, average risk HCPCS G0121	not posted		$339.36 – $5,066.00
Screening colonoscopy, high risk HCPCS G0105	not posted		$337.98 – $5,066.00
Septoplasty (nasal septum repair) CPT 30520	not posted		$1,428.71 – $8,634.87
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$386.17 – $5,066.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$2,172.49 – $40,447.68
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$612.14 – $15,750.81
Total hip replacement CPT 27130	not posted		$2,249.52 – $34,258.68
Total knee replacement CPT 27447	not posted		$2,249.52 – $46,247.00
Upper endoscopy (EGD) with biopsy CPT 43239	not posted	$3,435.00	$285.80 – $4,264.00
Upper endoscopy (EGD), diagnostic CPT 43235	not posted	$3,740.00	$255.80 – $4,264.00
Vasectomy CPT 55250	not posted		$476.07 – $5,454.27

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		$1,779.23 – $12,000.00
Fetal non-stress test CPT 59025	not posted	$1,999.00	$15.15 – $5,148.00
IUD insertion CPT 58300	not posted	$1,839.00	$104.09 – $5,066.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$2,410.87 – $12,000.00
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted		$2,410.87 – $12,000.00

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$1,639.00 – $21,461.28
C-section, without complications MS-DRG 788	not posted	$2,712.00 – $26,230.00
Chest pain MS-DRG 313	not posted	$5,336.37 – $17,354.88
COPD flare-up, with major complications MS-DRG 190	not posted	$6,454.00 – $27,319.22
COPD flare-up, without complications MS-DRG 192	not posted	$4,076.77 – $18,030.00
Fainting (syncope) MS-DRG 312	not posted	$5,849.32 – $21,196.12
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$6,454.00 – $23,983.99
Heart failure, with major complications MS-DRG 291	not posted	$6,454.00 – $31,741.87
Heart failure, without complications MS-DRG 293	not posted	$4,262.42 – $13,348.22
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$6,454.00 – $332,940.30
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$6,454.00 – $45,868.56
Irregular heartbeat, without complications MS-DRG 310	not posted	$3,672.11 – $18,030.00
Kidney failure, with complications MS-DRG 683	not posted	$5,362.42 – $21,624.27
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$5,119.78 – $19,524.85
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$6,454.00 – $57,591.74
Normal newborn care MS-DRG 795	not posted	$1,051.15 – $5,157.54
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$5,101.06 – $19,009.12
Pneumonia, with complications MS-DRG 194	not posted	$5,715.79 – $19,948.14
Pneumonia, with major complications MS-DRG 193	not posted	$6,454.00 – $32,055.69
Pneumonia, without complications MS-DRG 195	not posted	$4,553.09 – $18,030.00
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$750.00 – $32,667.48
Sepsis, with major complications MS-DRG 871	not posted	$6,454.00 – $47,732.01
Sepsis, without major complications MS-DRG 872	not posted	$6,126.15 – $25,081.14
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$4,650.80 – $21,427.22
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$5,250.87 – $18,982.36
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$6,454.00 – $24,738.13
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$6,454.00 – $29,160.77
Vaginal delivery, without complications MS-DRG 807	not posted	$2,712.00 – $16,974.00
Weight loss surgery, without complications MS-DRG 621	not posted	$13,238.78 – $49,750.00

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	not posted	$1,761.00	$99.09 – $5,066.00
Lower back nerve root injection with imaging guidance CPT 64483	not posted	$2,552.00	$227.91 – $5,066.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	not posted	$2,860.00	$203.15 – $5,066.00
Lower back spinal injection (epidural), without imaging CPT 62322	not posted		$168.48 – $5,066.00

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$1,095.41 – $6,072.57
Eye exam, new patient, comprehensive CPT 92004	not posted	$30.30 – $572.00
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$633.25 – $5,066.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted	$416.00	$26.91 – $416.59

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	not posted	$5,750.00	$170.78 – $7,090.00
Sleep study with CPAP titration CPT 95811	not posted	$14,180.00	$1,100.10 – $14,180.00
Sleep study, overnight in a sleep lab CPT 95810	not posted	$14,180.00	$1,063.62 – $14,180.00

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	not posted	$585.00	$15.15 – $585.00

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	not posted	$261.00	$45.21 – $356.00
Physical therapy evaluation, low complexity CPT 97161	not posted	$625.00	$125.00 – $625.00
Physical therapy evaluation, moderate complexity CPT 97162	not posted	$650.00	$130.00 – $650.00
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	not posted	$172.00	$34.40 – $356.00
Therapeutic activities, 15 minutes CPT 97530	not posted	$197.00	$2.37 – $356.00

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	not posted	$559.00	$65.00 – $572.52
Family psychotherapy, without the patient, 50 minutes CPT 90846	not posted	$963.00	$65.00 – $963.00
Group psychotherapy CPT 90853	not posted	$280.00	$37.31 – $572.52
Psychiatric diagnostic evaluation CPT 90791	not posted	$525.00	$80.00 – $749.99
Psychotherapy, 30 minutes CPT 90832	not posted	$488.00	$40.00 – $572.52
Psychotherapy, 45 minutes CPT 90834	not posted	$432.00	$80.00 – $652.06
Psychotherapy, 60 minutes CPT 90837	not posted	$425.00	$89.25 – $652.06

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	not posted	$657.00	$13.36 – $2,332.00
IV hydration, each additional hour CPT 96361	not posted	$247.00	$5.05 – $2,332.00
IV hydration, first hour CPT 96360	not posted	$688.00	$35.35 – $2,332.00
IV push injection of a drug, first CPT 96374	not posted	$516.00	$43.42 – $2,332.00
IV push injection, each additional drug CPT 96375	not posted	$360.00	$28.94 – $2,332.00

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	not posted	$526.00	? – $526.00
Dexamethasone injection, per 1 mg HCPCS J1100	not posted	$1,452.00	? – $1,452.00
Fentanyl injection, per 0.1 mg HCPCS J3010	not posted	$378.00	? – $378.00
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted		$3.49 – $3.49
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	not posted	$62.00	? – $62.00
Midazolam (Versed) injection, per 1 mg HCPCS J2250	not posted	$518.00	? – $518.00
Morphine injection, up to 10 mg HCPCS J2270	not posted	$1,566.00	$3.09 – $1,566.00
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	not posted	$76.00	? – $76.00
Propofol injection, per 10 mg HCPCS J2704	not posted	$227.00	? – $227.00
Saline IV solution, 1000 ml HCPCS J7030	not posted	$45.00	$2.87 – $45.00

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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