Niagara Falls Memorial Medical Center
621 Tenth Street, Niagara Falls, NY 14302 · Acute care hospital · Emergency room
These are Niagara Falls Memorial Medical Center's own posted figures from its standard-charges file dated June 17, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
214 of the services we track have a posted price here; 183 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 | $1,536.79 | $2,195.42 | $189.83 – $2,136.47 |
| Emergency room visit, level 1 (minor) CPT 99281 | $342.19 | $488.84 | $99.50 – $668.00 |
| Emergency room visit, level 2 CPT 99282 | $342.19 | $488.84 | $181.19 – $668.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $467.54 | $667.92 | $322.13 – $898.12 |
| Emergency room visit, level 4 CPT 99284 | $682.68 | $975.26 | $340.75 – $1,314.50 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $1,307.77 | $1,868.24 | $340.75 – $2,136.47 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $198.09 | $282.98 | $47.72 – $1,515.00 |
Office visits
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $24.63 | $35.19 | $25.58 – $31.65 |
| Abdominal X-ray, 1 view CPT 74018 | $124.94 | $178.49 | $17.58 – $111.34 |
| Ankle X-ray, 3 or more views CPT 73610 | $104.73 | $149.61 | $24.99 – $111.34 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $164.63 | $235.19 | $31.45 – $133.76 |
| Breast ultrasound, one breast, complete CPT 76641 | $185.20 | $264.57 | $71.57 – $133.76 |
| Breast ultrasound, one breast, limited CPT 76642 | $92.60 | $132.29 | $54.81 – $111.34 |
| Chest X-ray, 1 view CPT 71045 | $104.73 | $149.61 | $10.28 – $111.34 |
| Chest X-ray, 2 views CPT 71046 | $104.73 | $149.61 | $18.97 – $111.34 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $85.38 | $121.97 | $121.97 – $224.42 |
| CT angiogram of the head CPT 70496 | $1,386.00 | $1,980.00 | $194.76 – $352.90 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $712.38 | $1,017.69 | $254.22 – $446.36 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $712.38 | $1,017.69 | $286.84 – $446.36 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $441.51 | $630.73 | $117.51 – $305.27 |
| CT scan of the abdomen, without contrast CPT 74150 | $230.93 | $329.90 | $93.75 – $196.38 |
| CT scan of the chest, with contrast CPT 71260 | $553.99 | $791.41 | $129.22 – $260.48 |
| CT scan of the chest, without contrast CPT 71250 | $230.93 | $329.90 | $95.22 – $202.05 |
| CT scan of the head, without contrast CPT 70450 | $230.93 | $329.90 | $76.53 – $161.68 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $230.93 | $329.90 | $95.95 – $202.05 |
| CT scan of the pelvis, with contrast CPT 72193 | $454.68 | $649.54 | $194.83 – $247.37 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $230.93 | $329.90 | $101.46 – $202.05 |
| Diagnostic mammogram, both breasts CPT 77066 | $117.41 | $167.73 | $42.99 – $185.02 |
| Diagnostic mammogram, one breast CPT 77065 | $92.09 | $131.55 | $34.92 – $146.71 |
| Foot X-ray, 3 or more views CPT 73630 | $104.73 | $149.61 | $24.29 – $111.34 |
| Hand X-ray, 3 or more views CPT 73130 | $104.73 | $149.61 | $24.64 – $111.34 |
| Knee X-ray, 3 views CPT 73562 | $104.73 | $149.61 | $27.83 – $111.34 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $296.72 | $423.89 | $167.34 – $305.27 |
| Leg or arm vein ultrasound, one side CPT 93971 | $197.27 | $281.82 | $123.37 – $247.00 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $104.73 | $149.61 | $30.31 – $133.76 |
| MRI of the abdomen, without and with contrast CPT 74183 | $900.07 | $1,285.82 | $274.95 – $446.36 |
| MRI of the brain, without and with contrast CPT 70553 | $900.07 | $1,285.82 | $245.99 – $446.36 |
| MRI of the brain, without contrast CPT 70551 | $538.27 | $768.96 | $146.82 – $335.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $538.27 | $768.96 | $160.76 – $335.00 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $538.27 | $768.96 | $141.32 – $335.00 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $538.27 | $768.96 | $140.60 – $335.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $538.27 | $768.96 | $140.60 – $335.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $900.07 | $1,285.82 | $273.49 – $446.36 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $538.27 | $768.96 | $160.76 – $335.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $104.73 | $149.61 | $28.54 – $111.34 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $136.23 | $194.62 | $94.75 – $140.84 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $223.38 | $319.12 | $100.07 – $180.96 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $223.38 | $319.12 | $85.19 – $157.32 |
| Screening mammogram, both breasts CPT 77067 | $198.26 | $283.23 | $32.51 – $121.67 |
| Shoulder X-ray, 2 or more views CPT 73030 | $104.73 | $149.61 | $21.81 – $111.34 |
| Transvaginal pregnancy ultrasound CPT 76817 | $136.23 | $194.62 | $64.65 – $133.76 |
| Transvaginal ultrasound CPT 76830 | $136.23 | $194.62 | $95.11 – $159.73 |
| Ultrasound of the abdomen, complete CPT 76700 | $145.47 | $207.81 | $86.80 – $133.76 |
| Ultrasound of the neck or thyroid CPT 76536 | $245.72 | $351.03 | $93.02 – $133.76 |
| Wrist X-ray, 3 or more views CPT 73110 | $104.73 | $149.61 | $28.89 – $111.34 |
| X-ray of the lower back, 4 or more views CPT 72110 | $165.96 | $237.09 | $41.64 – $133.76 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $33.65 | $48.07 | $8.04 – $11.53 |
| Blood culture CPT 87040 | $59.44 | $84.92 | $9.80 – $14.06 |
| Blood draw (venipuncture) CPT 36415 | $12.47 | $17.82 | $2.58 – $12.65 |
| BNP test (heart failure) CPT 83880 | $424.70 | $606.72 | $35.33 – $53.49 |
| C-reactive protein (CRP) test CPT 86140 | $13.24 | $18.92 | $4.92 – $7.06 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $100.87 | $144.10 | $33.34 – $47.82 |
| Complete blood count (CBC) with differential CPT 85025 | $107.72 | $153.89 | $7.38 – $10.58 |
| Complete blood count (CBC), automated CPT 85027 | $24.02 | $34.32 | $6.15 – $8.81 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $40.04 | $57.20 | $10.03 – $14.39 |
| COVID-19 PCR test CPT 87635 | $279.87 | $399.82 | $46.20 – $69.91 |
| D-dimer test (blood clots) CPT 85379 | $13.14 | $18.77 | $9.67 – $13.88 |
| Drug screen, instrument chemistry CPT 80307 | $58.21 | $83.16 | $58.18 – $83.16 |
| Ferritin (iron stores) test CPT 82728 | $39.27 | $56.10 | $12.95 – $18.58 |
| Free T4 (thyroid) test CPT 84439 | $184.80 | $264.00 | $8.57 – $12.29 |
| General health panel (blood tests) CPT 80050 | $57.44 | $82.06 | $42.49 – $52.76 |
| Glucose (blood sugar) test CPT 82947 | $37.65 | $53.79 | $3.73 – $5.36 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $104.72 | $149.60 | $33.34 – $47.82 |
| Hemoglobin A1c test CPT 83036 | $28.03 | $40.04 | $9.22 – $13.23 |
| Hepatitis C antibody test CPT 86803 | $41.12 | $58.74 | $13.56 – $19.44 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $26.41 | $37.73 | $22.88 – $32.82 |
| Iron test CPT 83540 | $36.12 | $51.60 | $6.15 – $8.81 |
| Kidney function panel CPT 80069 | $48.34 | $69.06 | $8.25 – $11.83 |
| Lipase test (pancreas) CPT 83690 | $18.48 | $26.40 | $6.55 – $9.39 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $59.29 | $84.70 | $12.72 – $18.25 |
| Liver function panel CPT 80076 | $34.42 | $49.17 | $7.76 – $11.13 |
| Magnesium test CPT 83735 | $19.33 | $27.61 | $6.37 – $9.13 |
| Obstetric blood test panel CPT 80055 | $33.65 | $48.07 | $45.42 – $57.37 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $145.38 | $207.68 | $5.71 – $8.19 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $43.35 | $61.93 | $14.30 – $20.51 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $16.65 | $23.79 | $3.93 – $5.85 |
| PSA (prostate specific antigen), free CPT 84154 | $52.82 | $75.46 | $17.47 – $25.06 |
| PSA (prostate specific antigen), total CPT 84153 | $52.90 | $75.57 | $17.47 – $25.06 |
| Rapid strep test CPT 87880 | $10.21 | $14.59 | $11.11 – $19.84 |
| TB skin test CPT 86580 | $14.55 | $20.79 | $7.92 – $37.00 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $48.28 | $68.97 | $15.96 – $22.89 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $179.51 | $256.44 | $45.88 – $89.16 |
| Troponin test (heart damage) CPT 84484 | $445.09 | $635.84 | $11.22 – $16.99 |
| Urinalysis, automated, with microscope CPT 81001 | $12.01 | $17.16 | $3.01 – $4.31 |
| Urinalysis, automated, without microscope CPT 81003 | $8.78 | $12.54 | $2.14 – $3.07 |
| Urinalysis, manual, with microscope CPT 81000 | $12.94 | $18.48 | $3.62 – $5.47 |
| Urinalysis, manual, without microscope CPT 81002 | $9.16 | $13.09 | $3.06 – $4.75 |
| Urine culture, colony count CPT 87086 | $28.80 | $41.14 | $7.67 – $10.99 |
| Urine pregnancy test CPT 81025 | $15.29 | $21.84 | $2.81 – $11.73 |
| Vitamin B12 test CPT 82607 | $42.27 | $60.39 | $14.33 – $20.55 |
| Vitamin D test CPT 82306 | $83.31 | $119.02 | $28.12 – $40.33 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $215.71 | $308.15 | $167.34 – $305.27 |
| ECG tracing only (no interpretation) CPT 93005 | $90.43 | $129.18 | $7.54 – $75.48 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $920.07 | $1,314.38 | $180.34 – $699.10 |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 | $62.25 | $88.93 | $17.43 – $23.06 |
| Holter monitor, up to 48 hours CPT 93224 | $243.17 | $347.39 | $87.64 – $115.96 |
| Left heart catheterization with coronary angiogram CPT 93458 | $6,699.00 | $9,570.00 | $1,252.40 – $4,500.36 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $2,106.52 | $3,009.31 | $397.87 – $1,656.42 |
| Treadmill stress test, complete CPT 93015 | $412.01 | $588.59 | $85.48 – $113.08 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $1,946.70 | $2,781.00 | $1,672.00 – $9,283.84 |
| Appendix removal, laparoscopic CPT 44970 | $2,129.40 | $3,042.00 | $376.00 – $7,734.84 |
| Breast biopsy with ultrasound guidance CPT 19083 | $647.48 | $924.97 | $186.07 – $2,113.11 |
| Carpal tunnel release CPT 64721 | $1,134.00 | $1,620.00 | $1,436.00 – $2,498.39 |
| Colonoscopy with biopsy CPT 45380 | $917.07 | $1,310.10 | $298.65 – $2,021.88 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $873.10 | $1,247.29 | $377.99 – $2,021.88 |
| Colonoscopy, diagnostic CPT 45378 | $1,050.00 | $1,500.00 | $311.82 – $2,021.88 |
| Colposcopy with biopsy CPT 57454 | $116.21 | $166.01 | $150.66 – $2,021.88 |
| Cystoscopy (bladder scope) CPT 52000 | $694.68 | $992.40 | $118.46 – $1,515.00 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $383.42 | $547.74 | $83.80 – $1,515.00 |
| Gallbladder removal, laparoscopic CPT 47562 | $2,717.40 | $3,882.00 | $722.95 – $7,734.84 |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | $2,717.40 | $3,882.00 | $1,002.46 – $13,600.15 |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $476.70 | $681.00 | $297.47 – $4,141.68 |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $2,423.40 | $3,462.00 | $475.65 – $7,734.84 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $3,305.40 | $4,722.00 | $1,470.00 – $4,580.88 |
| Kidney stone shock-wave lithotripsy CPT 50590 | not posted | $1.10 | $1.10 – $6,860.98 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $1,835.40 | $2,622.00 | $1,470.00 – $4,186.31 |
| Prostate biopsy CPT 55700 | $554.86 | $792.65 | $198.46 – $2,021.88 |
| Removal of a breast lump, open surgery CPT 19120 | $788.76 | $1,126.80 | $1,441.00 – $5,009.53 |
| Rotator cuff repair, arthroscopic CPT 29827 | $1,046.85 | $1,495.50 | $1,672.00 – $9,283.84 |
| Screening colonoscopy, average risk HCPCS G0121 | $917.07 | $1,310.10 | $196.93 – $2,021.88 |
| Screening colonoscopy, high risk HCPCS G0105 | $917.07 | $1,310.10 | $196.65 – $2,021.88 |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $1,101.80 | $1,574.00 | $133.34 – $2,609.54 |
| Total hip replacement CPT 27130 | $3,599.40 | $5,142.00 | $376.00 – $16,426.22 |
| Total knee replacement CPT 27447 | $3,599.40 | $5,142.00 | $376.00 – $16,426.22 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $3,416.70 | $4,881.00 | $188.49 – $2,021.88 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $1,054.63 | $1,506.62 | $147.11 – $1,515.00 |
| Vasectomy CPT 55250 | not posted | ? – $2,674.50 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $240.86 | $344.08 | $19.88 – $258.66 |
| IUD insertion CPT 58300 | $329.70 | $471.00 | $65.45 – $1,515.00 |
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 | $9,009.47 – $12,223.32 | |
| C-section, without complications MS-DRG 788 | not posted | $9,003.15 – $12,214.74 | |
| Chest pain MS-DRG 313 | not posted | $7,619.51 – $10,337.53 | |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $11,346.90 – $15,743.45 | |
| COPD flare-up, without complications MS-DRG 192 | not posted | $6,758.15 – $9,168.92 | |
| Fainting (syncope) MS-DRG 312 | not posted | $9,092.66 – $12,336.18 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $10,142.99 – $14,054.81 | |
| Heart failure, with major complications MS-DRG 291 | not posted | $13,016.24 – $18,342.12 | |
| Heart failure, without complications MS-DRG 293 | not posted | $5,912.60 – $8,021.73 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $93,582.42 – $138,652.34 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $19,131.45 – $26,882.44 | |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $5,823.09 – $7,900.30 | |
| Kidney failure, with complications MS-DRG 683 | not posted | $9,148.61 – $12,869.05 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $8,496.66 – $11,527.58 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $23,988.74 – $35,152.75 | |
| Normal newborn care MS-DRG 795 | not posted | $2,123.90 – $2,971.24 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $8,223.39 – $11,163.28 | |
| Pneumonia, with complications MS-DRG 194 | not posted | $8,485.98 – $11,746.15 | |
| Pneumonia, with major complications MS-DRG 193 | not posted | $13,306.31 – $18,952.14 | |
| Pneumonia, without complications MS-DRG 195 | not posted | $6,587.57 – $8,937.48 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $14,087.42 – $19,520.73 | |
| Sepsis, with major complications MS-DRG 871 | not posted | $19,260.38 – $28,323.92 | |
| Sepsis, without major complications MS-DRG 872 | not posted | $10,546.83 – $14,713.41 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $9,102.16 – $12,639.05 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $8,236.66 – $11,223.28 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $10,423.61 – $14,520.54 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $12,235.86 – $16,600.62 | |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $6,889.78 – $9,347.49 | |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $15,145.34 – $21,676.53 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $257.47 | $367.82 | $54.58 – $1,515.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $529.45 | $756.36 | $146.21 – $1,515.00 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $471.21 | $673.15 | $115.02 – $1,515.00 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $471.21 | $673.15 | $93.62 – $1,515.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Eye exam, new patient, comprehensive CPT 92004 | $137.47 | $196.39 | $91.65 – $170.34 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $120.02 | $171.45 | $29.18 – $276.26 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $116.91 | $167.02 | $25.62 – $100.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $92.76 | $132.51 | $57.12 – $125.63 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $92.76 | $132.51 | $90.69 – $100.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $189.42 | $270.60 | $26.86 – $100.00 |
| Therapeutic activities, 15 minutes CPT 97530 | $67.99 | $97.13 | $32.27 – $100.00 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $155.86 | $222.66 | $114.16 – $227.08 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $133.16 | $190.23 | $109.49 – $227.08 |
| Group psychotherapy CPT 90853 | $117.01 | $167.16 | $28.85 – $129.98 |
| Psychiatric diagnostic evaluation CPT 90791 | $150.97 | $215.67 | $165.00 – $227.08 |
| Psychotherapy, 30 minutes CPT 90832 | $141.23 | $201.76 | $75.65 – $227.08 |
| Psychotherapy, 45 minutes CPT 90834 | $150.63 | $215.18 | $108.87 – $227.08 |
| Psychotherapy, 60 minutes CPT 90837 | $127.17 | $181.67 | $150.61 – $227.08 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $170.17 | $243.10 | $16.37 – $92.12 |
| IV hydration, each additional hour CPT 96361 | $605.68 | $865.26 | $14.68 – $167.00 |
| IV hydration, first hour CPT 96360 | $315.08 | $450.12 | $37.49 – $277.42 |
| IV push injection of a drug, first CPT 96374 | $257.51 | $367.87 | $42.81 – $277.42 |
| IV push injection, each additional drug CPT 96375 | $201.89 | $288.42 | $17.77 – $167.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $127.83 | $182.62 | |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $43.93 | $62.76 | |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $131.11 | $187.30 | |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | $14.22 | $20.31 | $3.96 – $4.64 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $36.96 | $52.80 | |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $69.16 | $98.80 | |
| Morphine injection, up to 10 mg HCPCS J2270 | $13.78 | $19.68 | $4.25 – $4.71 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $13.40 | $19.14 | |
| Propofol injection, per 10 mg HCPCS J2704 | $10.08 | $14.40 | |
| Saline IV solution, 1000 ml HCPCS J7030 | $337.16 | $481.66 | $2.72 – $2.72 |
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.