Montefiore Medical Center

111 East 210th Street, Bronx, NY 10467 · Acute care hospital · Emergency room

These are Montefiore Medical Center's own posted figures from its standard-charges file dated September 28, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

231 of the services we track have a posted price here; 171 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	not posted	$6,238.00	$174.75 – $43,416.48
Emergency room visit, level 1 (minor) CPT 99281	$228.90	$350.00	$8.04 – $315.84
Emergency room visit, level 2 CPT 99282	$248.52	$380.00	$15.11 – $345.45
Emergency room visit, level 3 (moderate) CPT 99283	$294.30	$450.00	$24.41 – $419.39
Emergency room visit, level 4 CPT 99284	$454.53	$695.00	$45.02 – $700.74
Emergency room visit, level 5 (most severe) CPT 99285	$680.16	$1,040.00	$64.75 – $1,020.28
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$699.78	$1,070.00	$42.14 – $690.90

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$388.32	$597.41	$57.27 – $592.20
New patient office visit, about 30 minutes CPT 99203	$565.50	$870.00	$88.14 – $789.60
New patient office visit, about 45 minutes CPT 99204	$667.30	$1,026.62	$130.69 – $987.00
New patient office visit, about 60 minutes CPT 99205	$929.50	$1,430.00	$172.75 – $1,381.80
Office consultation, about 40 minutes CPT 99243	$591.87	$905.00	$48.30 – $819.21
Office consultation, about 60 minutes CPT 99244	$814.90	$1,253.70	$112.62 – $1,029.39
Office visit, established patient, about 10 to 19 minutes CPT 99212	$320.46	$490.00	$11.47 – $444.15
Office visit, established patient, about 20 to 29 minutes CPT 99213	$360.75	$555.00	$69.61 – $532.98
Office visit, established patient, about 30 to 39 minutes CPT 99214	$464.75	$715.00	$99.31 – $690.90
Office visit, established patient, about 40 to 54 minutes CPT 99215	$650.00	$1,000.00	$140.45 – $987.00
Office visit, established patient, brief (often a nurse) CPT 99211	$241.98	$370.00	$4.36 – $335.58
Preventive checkup, new patient, age 18 to 39 CPT 99385	$664.17	$1,021.80	$62.90 – $740.25
Preventive checkup, new patient, age 40 to 64 CPT 99386	$742.40	$1,142.16	$68.00 – $769.10

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$209.28	$320.00	$25.16 – $298.49
Abdominal X-ray, 1 view CPT 74018	$165.75	$255.00	$22.34 – $248.33
Ankle X-ray, 3 or more views CPT 73610	$150.42	$230.00	$7.43 – $138.00
Bone density scan (DEXA), hips and spine CPT 77080	$614.76	$940.00	$8.28 – $564.00
Breast ultrasound, one breast, complete CPT 76641	$608.22	$930.00	$30.54 – $558.00
Breast ultrasound, one breast, limited CPT 76642	$637.00	$980.00	$60.68 – $888.30
Chest X-ray, 1 view CPT 71045	$143.00	$220.00	$16.21 – $209.84
Chest X-ray, 2 views CPT 71046	$185.25	$285.00	$24.90 – $274.88
CT angiogram of the chest (checks for lung clots) CPT 71275	$5,612.36	$8,634.40	$262.37 – $5,180.64
CT angiogram of the head CPT 70496	$1,907.52	$2,916.70	$72.64 – $1,750.02
CT scan of the abdomen and pelvis, with contrast CPT 74177	$1,504.20	$2,300.00	$76.04 – $1,380.00
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$2,024.13	$3,095.00	$83.28 – $1,857.00
CT scan of the abdomen and pelvis, without contrast CPT 74176	$941.76	$1,440.00	$72.37 – $864.00
CT scan of the abdomen, without contrast CPT 74150	$798.44	$1,220.85	$49.23 – $732.51
CT scan of the chest, with contrast CPT 71260	$1,389.75	$2,125.00	$48.11 – $1,275.00
CT scan of the chest, without contrast CPT 71250	$1,154.31	$1,765.00	$44.90 – $1,059.00
CT scan of the head, without contrast CPT 70450	$1,222.98	$1,870.00	$35.17 – $1,122.00
CT scan of the neck (cervical spine), without contrast CPT 72125	$835.95	$1,278.21	$41.23 – $766.93
CT scan of the pelvis, with contrast CPT 72193	$953.11	$1,457.36	$48.07 – $874.42
CT scan of the sinuses or face, without contrast CPT 70486	$1,062.75	$1,625.00	$35.47 – $975.00
Diagnostic mammogram, both breasts CPT 77066	not posted	$1,178.00	$97.97 – $8,198.88
Diagnostic mammogram, one breast CPT 77065	$510.12	$780.00	$33.72 – $726.44
Foot X-ray, 3 or more views CPT 73630	$140.61	$215.00	$7.13 – $129.00
Hand X-ray, 3 or more views CPT 73130	$150.42	$230.00	$7.43 – $138.00
Knee X-ray, 3 views CPT 73562	$247.00	$380.00	$23.77 – $296.10
Leg or arm vein ultrasound, both sides CPT 93970	$1,667.25	$2,565.00	$152.87 – $1,539.00
Leg or arm vein ultrasound, one side CPT 93971	$1,059.48	$1,620.00	$18.46 – $972.00
Lower back X-ray, 2 or 3 views CPT 72100	$186.39	$285.00	$9.46 – $171.00
MRI of both breasts, without and with contrast CPT 77049	$4,794.30	$7,375.84	$322.15 – $4,425.50
MRI of the abdomen, without and with contrast CPT 74183	$3,348.48	$5,120.00	$90.97 – $3,072.00
MRI of the brain, without and with contrast CPT 70553	$7,780.37	$11,969.80	$300.17 – $7,181.88
MRI of the brain, without contrast CPT 70551	$2,122.23	$3,245.00	$61.46 – $1,947.00
MRI of the knee or other leg joint, without contrast CPT 73721	$1,602.39	$2,450.13	$56.39 – $1,470.08
MRI of the lower back (lumbar spine), without contrast CPT 72148	$1,965.27	$3,005.00	$61.78 – $1,803.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$1,988.16	$3,040.00	$61.78 – $1,824.00
MRI of the neck (cervical spine), without contrast CPT 72141	$1,935.84	$2,960.00	$61.78 – $1,776.00
MRI of the pelvis, without and with contrast CPT 72197	$2,949.54	$4,510.00	$91.27 – $2,706.00
MRI of the shoulder or other arm joint, without contrast CPT 73221	$2,808.93	$4,295.00	$56.39 – $2,577.00
Neck X-ray, 2 or 3 views CPT 72040	$156.96	$240.00	$9.46 – $144.00
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$770.25	$1,185.00	$80.63 – $1,075.83
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$1,010.75	$1,555.00	$124.01 – $1,411.41
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$903.50	$1,390.00	$107.15 – $1,263.36
Screening mammogram, both breasts CPT 77067	$939.25	$1,445.00	$104.42 – $1,312.61
Shoulder X-ray, 2 or more views CPT 73030	$208.00	$320.00	$20.01 – $266.49
Transvaginal pregnancy ultrasound CPT 76817	$1,059.95	$1,630.69	$84.55 – $978.41
Transvaginal ultrasound CPT 76830	$1,299.35	$1,999.00	$80.85 – $1,199.40
Ultrasound of the abdomen, complete CPT 76700	$680.16	$1,040.00	$33.72 – $624.00
Ultrasound of the neck or thyroid CPT 76536	$672.75	$1,035.00	$76.59 – $987.00
Wrist X-ray, 3 or more views CPT 73110	$247.00	$380.00	$23.62 – $296.10
X-ray of the lower back, 4 or more views CPT 72110	$215.82	$330.00	$10.90 – $198.00

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$75.21	$115.00	$4.03 – $108.57
Blood culture CPT 87040	not posted	$368.00	$8.23 – $517.04
Blood draw (venipuncture) CPT 36415	$37.08	$57.05	$1.70 – $41.72
BNP test (heart failure) CPT 83880	not posted	$524.00	$19.50 – $736.22
C-reactive protein (CRP) test CPT 86140	not posted	$208.00	$4.14 – $292.24
Chlamydia test (DNA/NAAT) CPT 87491	not posted	$612.00	$21.64 – $859.86
Complete blood count (CBC) with differential CPT 85025	$65.40	$100.00	$3.17 – $98.70
Complete blood count (CBC), automated CPT 85027	$58.86	$90.00	$3.17 – $88.83
Comprehensive metabolic panel (blood test) CPT 80053	$234.50	$360.77	$6.04 – $216.46
COVID-19 PCR test CPT 87635	not posted	$193.00	$30.79 – $461.79
D-dimer test (blood clots) CPT 85379	not posted		$9.00 – $124.69
Drug screen, instrument chemistry CPT 80307	not posted	$390.00	$7.58 – $559.26
Ferritin (iron stores) test CPT 82728	$78.32	$119.75	$8.60 – $114.49
Free T4 (thyroid) test CPT 84439	$156.31	$239.00	$5.69 – $143.40
General health panel (blood tests) CPT 80050	not posted	$667.00	$24.00 – $937.13
Glucose (blood sugar) test CPT 82947	$51.29	$78.91	$2.48 – $49.35
Gonorrhea test (DNA/NAAT) CPT 87591	$177.40	$271.25	$21.43 – $326.70
Hemoglobin A1c test CPT 83036	$65.52	$100.80	$6.12 – $78.97
Hepatitis C antibody test CPT 86803	$96.66	$148.70	$9.00 – $114.49
HIV-1/HIV-2 antigen and antibody test CPT 87389	$292.50	$450.00	$15.20 – $270.00
Iron test CPT 83540	$55.59	$85.00	$4.09 – $78.96
Kidney function panel CPT 80069	not posted	$104.00	$8.68 – $146.12
Lipase test (pancreas) CPT 83690	not posted	$329.00	$5.81 – $462.24
Lipid panel, cholesterol and triglycerides CPT 80061	$96.05	$146.87	$6.04 – $139.17
Liver function panel CPT 80076	not posted	$136.00	$7.32 – $191.08
Magnesium test CPT 83735	not posted	$258.00	$5.08 – $362.49
Obstetric blood test panel CPT 80055	not posted		$32.25 – $584.32
Partial thromboplastin time (PTT), clotting test CPT 85730	not posted	$132.00	$6.01 – $185.46
Pregnancy blood test (hCG), quantitative CPT 84702	$134.07	$205.00	$9.50 – $183.58
Prothrombin time (PT/INR), clotting test CPT 85610	$26.16	$40.00	$2.48 – $31.17
PSA (prostate specific antigen), free CPT 84154	not posted	$246.00	$18.39 – $345.63
PSA (prostate specific antigen), total CPT 84153	$92.61	$141.60	$11.61 – $149.04
Rapid strep test CPT 87880	$84.50	$130.00	$3.75 – $124.36
Sed rate (ESR) test CPT 85652	not posted	$108.00	$2.02 – $151.74
TB skin test CPT 86580	$42.25	$65.00	$5.05 – $59.22
Thyroid stimulating hormone (TSH) CPT 84443	$157.61	$241.00	$9.00 – $144.60
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$903.63	$1,390.20	$43.62 – $834.12
Troponin test (heart damage) CPT 84484	not posted	$302.00	$6.75 – $424.31
Urinalysis, automated, with microscope CPT 81001	$26.00	$40.00	$2.00 – $34.55
Urinalysis, automated, without microscope CPT 81003	$15.57	$23.96	$1.42 – $18.70
Urinalysis, manual, with microscope CPT 81000	$26.00	$40.00	$2.00 – $34.55
Urinalysis, manual, without microscope CPT 81002	$17.55	$27.00	$1.62 – $20.78
Urine culture, colony count CPT 87086	$152.64	$234.83	$5.10 – $140.90
Urine pregnancy test CPT 81025	$42.81	$65.86	$2.00 – $51.95
Vitamin B12 test CPT 82607	$127.53	$195.00	$9.51 – $188.52
Vitamin D test CPT 82306	not posted	$744.00	$29.60 – $1,045.32

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$1,495.00	$2,300.00	$155.52 – $1,560.45
ECG tracing only (no interpretation) CPT 93005	$133.25	$205.00	$6.16 – $197.40
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$2,232.75	$3,435.00	$178.81 – $3,118.92
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	$198.25	$305.00	$13.29 – $276.36
Holter monitor, up to 48 hours CPT 93224	$1,313.00	$2,020.00	$61.23 – $1,835.82
Left heart catheterization CPT 93452	$3,133.99	$4,792.04	$216.17 – $4,159.40
Left heart catheterization with coronary angiogram CPT 93458	$3,251.53	$4,971.76	$269.33 – $4,784.38
Nuclear stress test (heart perfusion imaging) CPT 78452	$3,383.25	$5,205.00	$308.64 – $4,727.73
Treadmill stress test, complete CPT 93015	$1,764.28	$2,714.28	$66.85 – $1,628.57

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$10,624.23	$16,245.00	$479.98 – $14,765.52
Appendix removal, laparoscopic CPT 44970	$4,362.18	$6,670.00	$267.83 – $6,060.18
Breast biopsy with ultrasound guidance CPT 19083	$6,022.25	$9,265.00	$438.33 – $8,419.11
Carpal tunnel release CPT 64721	$8,521.62	$13,030.00	$200.67 – $11,844.00
Colonoscopy with biopsy CPT 45380	$3,903.25	$6,005.00	$285.15 – $5,458.11
Colonoscopy with polyp removal (snare) CPT 45385	$4,504.50	$6,930.00	$319.93 – $6,297.06
Colonoscopy, diagnostic CPT 45378	$1,690.59	$2,585.00	$103.24 – $2,349.06
Colposcopy with biopsy CPT 57454	$1,644.50	$2,530.00	$92.11 – $2,299.71
Cystoscopy (bladder scope) CPT 52000	$1,660.75	$2,555.00	$135.55 – $2,465.03
Ear tubes, under general anesthesia CPT 69436	$2,279.19	$3,485.00	$101.00 – $3,168.27
Flexible sigmoidoscopy, diagnostic CPT 45330	$996.98	$1,533.82	$81.37 – $1,480.50
Gallbladder removal, laparoscopic CPT 47562	$5,434.74	$8,310.00	$333.58 – $7,550.55
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	$19,342.05	$29,575.00	$782.78 – $26,885.88
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$13,122.51	$20,065.00	$479.71 – $18,239.76
Hysteroscopy with biopsy or polyp removal CPT 58558	$5,695.73	$8,762.66	$182.61 – $7,437.23
Inguinal (groin) hernia repair, laparoscopic CPT 49650	$3,211.14	$4,910.00	$193.57 – $4,461.24
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$3,871.68	$5,920.00	$233.75 – $5,379.15
Kidney stone shock-wave lithotripsy CPT 50590	$6,867.00	$10,500.00	$283.93 – $9,544.29
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$6,536.67	$10,056.42	$369.68 – $8,991.57
Lower colon endoscopy with ultrasound CPT 45391	$2,321.70	$3,550.00	$142.75 – $3,227.49
Nasal endoscopy, diagnostic CPT 31231	$896.75	$1,379.61	$111.49 – $1,135.05
Prostate biopsy CPT 55700	$2,032.67	$3,127.18	$153.81 – $2,220.75
Prostate removal, laparoscopic or robotic CPT 55866	$13,953.09	$21,335.00	$881.41 – $19,394.55
Removal of a breast lump, open surgery CPT 19120	$4,925.02	$7,576.95	$256.42 – $5,181.75
Rotator cuff repair, arthroscopic CPT 29827	$11,595.42	$17,730.00	$531.79 – $16,117.71
Screening colonoscopy, average risk HCPCS G0121	$3,311.75	$5,095.00	$315.48 – $4,629.03
Screening colonoscopy, high risk HCPCS G0105	$1,690.59	$2,585.00	$168.77 – $2,349.06
Septoplasty (nasal septum repair) CPT 30520	$3,871.68	$5,920.00	$278.77 – $5,379.15
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	$7,265.94	$11,110.00	$162.30 – $10,097.01
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	$12,455.43	$19,045.00	$679.63 – $17,311.98
Tonsil and adenoid removal, under age 12 CPT 42820	$2,743.53	$4,195.00	$141.04 – $3,809.82
Total hip replacement CPT 27130	$14,715.00	$22,500.00	$697.27 – $20,450.64
Total knee replacement CPT 27447	$15,843.15	$24,225.00	$749.09 – $22,019.97
Upper endoscopy (EGD) with biopsy CPT 43239	$2,895.75	$4,455.00	$210.62 – $4,046.70
Upper endoscopy (EGD), diagnostic CPT 43235	$2,554.50	$3,930.00	$183.47 – $3,572.94
Vasectomy CPT 55250	$4,023.37	$6,189.80	$310.25 – $3,713.88

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	$25,368.66	$38,790.00	$1,967.57 – $35,263.78
Fetal non-stress test CPT 59025	$301.33	$463.58	$46.38 – $345.45
IUD insertion CPT 58300	$694.63	$1,068.66	$49.00 – $888.30
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	$25,368.66	$38,790.00	$1,829.32 – $35,263.78
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	$25,368.66	$38,790.00	$1,737.96 – $35,263.78

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$2,961.56 – $9,730.84
C-section, without complications MS-DRG 788	not posted	$3,038.10 – $9,982.33
Chest pain MS-DRG 313	not posted	$2,394.56 – $7,867.84
COPD flare-up, with major complications MS-DRG 190	not posted	$3,770.93 – $12,390.21
COPD flare-up, without complications MS-DRG 192	not posted	$2,172.66 – $7,138.74
Fainting (syncope) MS-DRG 312	not posted	$2,924.97 – $9,610.61
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$3,309.68 – $10,874.66
Heart failure, with major complications MS-DRG 291	not posted	$4,380.57 – $14,393.29
Heart failure, without complications MS-DRG 293	not posted	$1,843.00 – $6,055.58
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$32,396.53 – $106,445.73
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$6,329.65 – $20,797.41
Irregular heartbeat, without complications MS-DRG 310	not posted	$1,878.25 – $6,171.39
Kidney failure, with complications MS-DRG 683	not posted	$2,984.05 – $9,804.73
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$2,694.34 – $8,852.82
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$7,946.72 – $26,110.66
Normal newborn care MS-DRG 795	not posted	$670.73 – $2,203.83
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$2,623.50 – $8,620.09
Pneumonia, with complications MS-DRG 194	not posted	$2,752.75 – $9,044.75
Pneumonia, with major complications MS-DRG 193	not posted	$4,423.87 – $14,535.58
Pneumonia, without complications MS-DRG 195	not posted	$2,090.75 – $6,869.60
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$4,731.71 – $15,547.05
Sepsis, with major complications MS-DRG 871	not posted	$6,587.47 – $21,644.54
Sepsis, without major complications MS-DRG 872	not posted	$3,461.08 – $11,372.12
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$2,957.19 – $9,716.50
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$2,619.48 – $8,606.85
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$3,414.08 – $11,217.70
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$4,023.72 – $13,220.79
Vaginal delivery, without complications MS-DRG 807	not posted	$2,139.09 – $7,028.44
Weight loss surgery, without complications MS-DRG 621	not posted	$4,906.95 – $16,122.83

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$650.73	$995.00	$24.23 – $597.00
Lower back nerve root injection with imaging guidance CPT 64483	$1,498.25	$2,305.00	$187.24 – $1,470.91
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$1,446.25	$2,225.00	$160.68 – $2,077.64
Lower back spinal injection (epidural), without imaging CPT 62322	$523.20	$800.00	$48.57 – $744.59

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	$5,800.98	$8,870.00	$444.40 – $8,063.79
Eye exam, new patient, comprehensive CPT 92004	$646.29	$994.29	$75.00 – $755.24
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$2,054.00	$3,160.00	$169.28 – $2,872.17

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$258.18	$397.20	$32.52 – $296.10

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$1,255.68	$1,920.00	$37.83 – $1,152.00
Sleep study with CPAP titration CPT 95811	$4,067.60	$6,257.85	$615.03 – $5,140.43
Sleep study, overnight in a sleep lab CPT 95810	$3,741.47	$5,756.11	$587.03 – $4,661.68

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$258.39	$397.52	$25.56 – $394.80

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	not posted	$493.00	$30.65 – $795.00
Physical therapy evaluation, low complexity CPT 97161	not posted	$511.00	$110.69 – $795.00
Physical therapy evaluation, moderate complexity CPT 97162	$327.00	$500.00	$64.75 – $513.21
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	not posted	$396.00	$32.48 – $795.00
Therapeutic activities, 15 minutes CPT 97530	not posted	$481.00	$2.37 – $795.00

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$514.51	$791.56	$55.50 – $590.93
Family psychotherapy, without the patient, 50 minutes CPT 90846	$640.92	$980.00	$85.96 – $888.30
Group psychotherapy CPT 90853	$195.62	$300.95	$21.47 – $246.75
Psychiatric diagnostic evaluation CPT 90791	$1,023.51	$1,565.00	$107.67 – $1,421.28
Psychotherapy, 30 minutes CPT 90832	$392.40	$600.00	$52.84 – $542.85
Psychotherapy, 45 minutes CPT 90834	$739.02	$1,130.00	$71.09 – $1,026.48
Psychotherapy, 60 minutes CPT 90837	$739.02	$1,130.00	$106.12 – $1,026.48

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$157.98	$243.05	$13.11 – $227.01
IV hydration, each additional hour CPT 96361	$294.45	$453.00	$11.19 – $271.80
IV hydration, first hour CPT 96360	$578.50	$890.00	$28.83 – $809.34
IV push injection of a drug, first CPT 96374	$490.75	$755.00	$32.75 – $730.38
IV push injection, each additional drug CPT 96375	$409.71	$630.33	$13.66 – $378.20

Drugs

Service	Cash price	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	not posted	? – $1.39
Fentanyl injection, per 0.1 mg HCPCS J3010	not posted	? – $3.47
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted	$3.02 – $3.02
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	not posted	? – $2.14
Morphine injection, up to 10 mg HCPCS J2270	not posted	$3.24 – $3.24
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	not posted	? – $3.69
Saline IV solution, 1000 ml HCPCS J7030	not posted	$1.94 – $1.94

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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