Samaritan Medical Center

830 Washington Street, Watertown, NY 13601 · Acute care hospital · Emergency room

These are Samaritan Medical Center's own posted figures from its standard-charges file dated February 2, 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; 177 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	$3,153.50	$3,153.50	$1,031.12 – $4,732.83
Emergency room visit, level 1 (minor) CPT 99281	$344.00	$344.00	$105.26 – $1,122.00
Emergency room visit, level 2 CPT 99282	$566.50	$566.50	$191.67 – $1,122.00
Emergency room visit, level 3 (moderate) CPT 99283	$903.50	$903.50	$67.02 – $722.80
Emergency room visit, level 4 CPT 99284	$1,439.00	$1,439.00	$520.86 – $4,386.00
Emergency room visit, level 5 (most severe) CPT 99285	$2,135.00	$2,135.00	$743.39 – $7,548.00
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$552.00	$552.00	$250.45 – $3,060.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$282.00	$282.00	$72.37 – $762.82
New patient office visit, about 30 minutes CPT 99203	$282.00	$282.00	$113.04 – $762.82
New patient office visit, about 45 minutes CPT 99204	$188.50	$188.50	$123.28 – $784.22
New patient office visit, about 60 minutes CPT 99205	$282.00	$282.00	$166.19 – $1,045.82
Office consultation, about 40 minutes CPT 99243	$418.50	$418.50	$66.75 – $334.80
Office consultation, about 60 minutes CPT 99244	$382.50	$382.50	$66.75 – $306.00
Office visit, established patient, about 10 to 19 minutes CPT 99212	$282.00	$282.00	$57.15 – $762.82
Office visit, established patient, about 20 to 29 minutes CPT 99213	$196.50	$196.50	$91.86 – $421.64
Office visit, established patient, about 30 to 39 minutes CPT 99214	$282.00	$282.00	$130.88 – $762.82
Office visit, established patient, about 40 to 54 minutes CPT 99215	$282.00	$282.00	$166.19 – $852.42
Office visit, established patient, brief (often a nurse) CPT 99211	$196.50	$196.50	$23.38 – $300.00
Preventive checkup, new patient, age 18 to 39 CPT 99385	$255.00	$255.00	$130.09 – $762.82
Preventive checkup, new patient, age 40 to 64 CPT 99386	$251.50	$251.50	$105.00 – $201.20

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$146.00	$146.00	$49.29 – $226.22
Abdominal X-ray, 1 view CPT 74018	$301.50	$301.50	$108.63 – $498.62
Ankle X-ray, 3 or more views CPT 73610	$327.50	$327.50	$108.63 – $498.62
Bone density scan (DEXA), hips and spine CPT 77080	$1,094.50	$1,094.50	$130.50 – $930.33
Breast ultrasound, one breast, complete CPT 76641	$486.00	$486.00	$130.50 – $599.01
Breast ultrasound, one breast, limited CPT 76642	$486.00	$486.00	$108.63 – $498.62
Chest X-ray, 1 view CPT 71045	$282.00	$282.00	$108.63 – $498.62
Chest X-ray, 2 views CPT 71046	$334.00	$334.00	$108.63 – $498.62
CT angiogram of the chest (checks for lung clots) CPT 71275	$4,899.00	$4,899.00	$218.95 – $4,164.15
CT angiogram of the head CPT 70496	$4,502.00	$4,502.00	$218.95 – $3,826.70
CT scan of the abdomen and pelvis, with contrast CPT 74177	$3,547.50	$3,547.50	$435.49 – $3,015.38
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$4,190.00	$4,190.00	$435.49 – $3,561.50
CT scan of the abdomen and pelvis, without contrast CPT 74176	$3,100.00	$3,100.00	$297.84 – $2,635.00
CT scan of the abdomen, without contrast CPT 74150	$3,100.00	$3,100.00	$130.50 – $2,635.00
CT scan of the chest, with contrast CPT 71260	$3,866.00	$3,866.00	$218.95 – $3,286.10
CT scan of the chest, without contrast CPT 71250	$3,524.50	$3,524.50	$130.50 – $2,995.83
CT scan of the head, without contrast CPT 70450	$3,320.00	$3,320.00	$130.50 – $2,822.00
CT scan of the neck (cervical spine), without contrast CPT 72125	$3,501.50	$3,501.50	$130.50 – $2,976.28
CT scan of the pelvis, with contrast CPT 72193	$1,317.00	$1,317.00	$218.95 – $1,119.45
CT scan of the sinuses or face, without contrast CPT 70486	$3,501.50	$3,501.50	$130.50 – $2,976.28
Diagnostic mammogram, both breasts CPT 77066	$753.50	$753.50	$150.11 – $689.01
Diagnostic mammogram, one breast CPT 77065	$597.50	$597.50	$118.55 – $544.13
Foot X-ray, 3 or more views CPT 73630	$327.50	$327.50	$108.63 – $498.62
Hand X-ray, 3 or more views CPT 73130	$297.00	$297.00	$108.63 – $498.62
Knee X-ray, 3 views CPT 73562	not posted		$108.63 – $498.62
Leg or arm vein ultrasound, both sides CPT 93970	$857.00	$857.00	$297.84 – $1,367.10
Leg or arm vein ultrasound, one side CPT 93971	$535.00	$535.00	$130.50 – $599.01
Lower back X-ray, 2 or 3 views CPT 72100	$413.00	$413.00	$130.50 – $599.01
MRI of both breasts, without and with contrast CPT 77049	$1,909.50	$1,909.50	$325.12 – $2,500.00
MRI of the abdomen, without and with contrast CPT 74183	$4,751.00	$4,751.00	$435.49 – $4,038.35
MRI of the brain, without and with contrast CPT 70553	$8,432.00	$8,432.00	$435.49 – $7,167.20
MRI of the brain, without contrast CPT 70551	$6,107.50	$6,107.50	$297.84 – $5,191.38
MRI of the knee or other leg joint, without contrast CPT 73721	$5,131.00	$5,131.00	$297.84 – $4,361.35
MRI of the lower back (lumbar spine), without contrast CPT 72148	$6,078.00	$6,078.00	$297.84 – $5,166.30
MRI of the mid back (thoracic spine), without contrast CPT 72146	$1,705.50	$1,705.50	$297.84 – $2,500.00
MRI of the neck (cervical spine), without contrast CPT 72141	$5,866.50	$5,866.50	$297.84 – $4,986.53
MRI of the pelvis, without and with contrast CPT 72197	$6,897.50	$6,897.50	$435.49 – $5,862.88
MRI of the shoulder or other arm joint, without contrast CPT 73221	$4,751.00	$4,751.00	$297.84 – $4,038.35
Neck X-ray, 2 or 3 views CPT 72040	$427.00	$427.00	$108.63 – $498.62
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$986.50	$986.50	$130.50 – $838.53
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$670.50	$670.50	$130.50 – $599.01
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$496.00	$496.00	$130.50 – $599.01
Screening mammogram, both breasts CPT 77067	$417.50	$417.50	$120.77 – $554.32
Shoulder X-ray, 2 or more views CPT 73030	$322.50	$322.50	$108.63 – $498.62
Transvaginal pregnancy ultrasound CPT 76817	$496.00	$496.00	$130.50 – $599.01
Transvaginal ultrasound CPT 76830	$1,183.00	$1,183.00	$130.50 – $1,005.55
Ultrasound of the abdomen, complete CPT 76700	$1,128.00	$1,128.00	$130.50 – $958.80
Ultrasound of the neck or thyroid CPT 76536	$1,007.50	$1,007.50	$130.50 – $856.38
Wrist X-ray, 3 or more views CPT 73110	$297.00	$297.00	$108.63 – $498.62
X-ray of the lower back, 4 or more views CPT 72110	$672.00	$672.00	$130.50 – $599.01

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$123.50	$123.50	$8.46 – $104.98
Blood culture CPT 87040	$152.00	$152.00	$10.32 – $129.20
Blood draw (venipuncture) CPT 36415	$44.50	$44.50	$9.27 – $42.87
BNP test (heart failure) CPT 83880	$261.50	$261.50	$39.26 – $222.28
C-reactive protein (CRP) test CPT 86140	$101.50	$101.50	$5.18 – $86.28
Chlamydia test (DNA/NAAT) CPT 87491	not posted		$35.09 – $161.06
Complete blood count (CBC) with differential CPT 85025	$134.00	$134.00	$7.77 – $113.90
Complete blood count (CBC), automated CPT 85027	$104.00	$104.00	$6.47 – $88.40
Comprehensive metabolic panel (blood test) CPT 80053	$293.00	$293.00	$10.56 – $249.05
COVID-19 PCR test CPT 87635	not posted		$51.31 – $235.51
D-dimer test (blood clots) CPT 85379	$245.50	$245.50	$10.18 – $208.68
Drug screen, instrument chemistry CPT 80307	$541.00	$541.00	$62.14 – $459.85
Ferritin (iron stores) test CPT 82728	$258.50	$258.50	$13.63 – $219.73
Free T4 (thyroid) test CPT 84439	$349.00	$349.00	$9.02 – $296.65
General health panel (blood tests) CPT 80050	not posted		$36.78 – $36.78
Glucose (blood sugar) test CPT 82947	$65.00	$65.00	$3.93 – $55.25
Gonorrhea test (DNA/NAAT) CPT 87591	$391.00	$391.00	$35.09 – $332.35
Hemoglobin A1c test CPT 83036	$193.50	$193.50	$9.71 – $164.48
Hepatitis C antibody test CPT 86803	$255.50	$255.50	$14.27 – $217.18
HIV-1/HIV-2 antigen and antibody test CPT 87389	$130.00	$130.00	$24.08 – $110.53
Iron test CPT 83540	$201.00	$201.00	$6.47 – $170.85
Kidney function panel CPT 80069	$125.00	$125.00	$8.68 – $106.25
Lipase test (pancreas) CPT 83690	$138.50	$138.50	$6.89 – $117.73
Lipid panel, cholesterol and triglycerides CPT 80061	$258.50	$258.50	$13.39 – $219.73
Liver function panel CPT 80076	$134.50	$134.50	$8.17 – $114.33
Magnesium test CPT 83735	$261.00	$261.00	$6.70 – $221.85
Obstetric blood test panel CPT 80055	$359.50	$359.50	$10.33 – $305.58
Partial thromboplastin time (PTT), clotting test CPT 85730	$98.00	$98.00	$6.01 – $83.30
Pregnancy blood test (hCG), quantitative CPT 84702	$435.00	$435.00	$15.05 – $369.75
Prothrombin time (PT/INR), clotting test CPT 85610	$78.00	$78.00	$4.29 – $66.30
PSA (prostate specific antigen), free CPT 84154	$467.00	$467.00	$18.39 – $396.95
PSA (prostate specific antigen), total CPT 84153	$382.50	$382.50	$18.39 – $325.13
Rapid strep test CPT 87880	$78.00	$78.00	$16.53 – $75.87
Sed rate (ESR) test CPT 85652	$77.50	$77.50	$2.70 – $65.88
TB skin test CPT 86580	$73.00	$73.00	$36.10 – $165.72
Thyroid stimulating hormone (TSH) CPT 84443	$397.50	$397.50	$16.80 – $337.88
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$837.50	$837.50	$65.05 – $711.88
Troponin test (heart damage) CPT 84484	$514.00	$514.00	$12.47 – $436.90
Urinalysis, automated, with microscope CPT 81001	$63.50	$63.50	$3.17 – $53.98
Urinalysis, automated, without microscope CPT 81003	not posted		$2.25 – $10.33
Urinalysis, manual, with microscope CPT 81000	$71.50	$71.50	$4.02 – $60.78
Urinalysis, manual, without microscope CPT 81002	$60.00	$60.00	$3.48 – $51.00
Urine culture, colony count CPT 87086	$128.50	$128.50	$8.07 – $109.23
Urine pregnancy test CPT 81025	$68.00	$68.00	$8.61 – $57.80
Vitamin B12 test CPT 82607	$297.50	$297.50	$15.08 – $252.88
Vitamin D test CPT 82306	$67.50	$67.50	$29.60 – $135.86

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$946.00	$946.00	$297.84 – $1,367.10
ECG tracing only (no interpretation) CPT 93005	$350.00	$350.00	$73.64 – $338.00
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$2,005.50	$2,005.50	$682.08 – $3,130.75
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	$254.50	$254.50	$14.72 – $216.33
Holter monitor, up to 48 hours CPT 93224	not posted		$67.34 – $309.09
Left heart catheterization CPT 93452	not posted		$4,046.85 – $18,575.05
Left heart catheterization with coronary angiogram CPT 93458	not posted		$4,046.85 – $18,575.05
Nuclear stress test (heart perfusion imaging) CPT 78452	$2,927.50	$2,927.50	$1,616.09 – $7,417.85
Treadmill stress test, complete CPT 93015	$1,520.50	$1,520.50	$70.70 – $1,292.43

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$8,670.00 – $41,575.38
Appendix removal, laparoscopic CPT 44970	$1,810.50	$1,810.50	$517.76 – $7,546.53
Breast biopsy with ultrasound guidance CPT 19083	$3,337.00	$3,337.00	$300.00 – $9,463.03
Carpal tunnel release CPT 64721	not posted		$2,437.56 – $11,188.38
Colonoscopy with biopsy CPT 45380	$1,072.00	$1,072.00	$162.58 – $1,493.75
Colonoscopy with polyp removal (snare) CPT 45385	$1,111.50	$1,111.50	$204.74 – $1,493.75
Colonoscopy, diagnostic CPT 45378	$829.00	$829.00	$150.44 – $1,160.85
Colposcopy with biopsy CPT 57454	$721.00	$721.00	$300.00 – $3,978.00
Cystoscopy (bladder scope) CPT 52000	$2,395.00	$2,395.00	$870.42 – $3,995.25
Ear tubes, under general anesthesia CPT 69436	$3,100.00	$3,100.00	$300.00 – $8,889.99
Flexible sigmoidoscopy, diagnostic CPT 45330	$452.00	$452.00	$48.90 – $1,160.85
Gallbladder removal, laparoscopic CPT 47562	$1,160.00	$1,160.00	$565.60 – $7,546.53
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$1,522.21 – $6,986.94
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	$3,608.50	$3,608.50	$747.81 – $13,269.05
Hysteroscopy with biopsy or polyp removal CPT 58558	$6,226.00	$6,226.00	$300.00 – $18,547.51
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$7,546.53 – $34,638.59
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$3,633.50	$3,633.50	$454.74 – $4,469.36
Kidney stone shock-wave lithotripsy CPT 50590	$6,940.00	$6,940.00	$475.73 – $5,552.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$4,084.39 – $18,747.33
Lower colon endoscopy with ultrasound CPT 45391	not posted		$1,493.75 – $6,856.30
Nasal endoscopy, diagnostic CPT 31231	$842.50	$842.50	$249.17 – $3,978.00
Prostate biopsy CPT 55700	$396.50	$396.50	$196.01 – $317.20
Prostate removal, laparoscopic or robotic CPT 55866	$9,456.50	$9,456.50	$988.94 – $13,269.05
Removal of a breast lump, open surgery CPT 19120	$7,488.00	$7,488.00	$300.00 – $22,433.96
Rotator cuff repair, arthroscopic CPT 29827	not posted		$9,057.82 – $41,575.38
Screening colonoscopy, average risk HCPCS G0121	$830.00	$830.00	$158.60 – $1,160.85
Screening colonoscopy, high risk HCPCS G0105	$829.00	$829.00	$158.36 – $1,160.85
Septoplasty (nasal septum repair) CPT 30520	$1,484.00	$1,484.00	$556.37 – $4,138.63
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$140.36 – $8,670.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$939.81 – $4,313.73
Tonsil and adenoid removal, under age 12 CPT 42820	$638.00	$638.00	$237.32 – $7,389.63
Total hip replacement CPT 27130	not posted		$14,280.00 – $73,560.81
Total knee replacement CPT 27447	not posted		$14,280.00 – $73,560.81
Upper endoscopy (EGD) with biopsy CPT 43239	$930.00	$930.00	$113.12 – $1,132.18
Upper endoscopy (EGD), diagnostic CPT 43235	$722.50	$722.50	$101.14 – $1,132.18
Vasectomy CPT 55250	$2,269.50	$2,269.50	$300.00 – $11,977.11

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	$5,911.00	$5,911.00	$2,195.42 – $4,728.80
Fetal non-stress test CPT 59025	$404.00	$404.00	$252.37 – $3,060.00
IUD insertion CPT 58300	$438.50	$438.50	$101.00 – $3,060.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	$5,601.00	$5,601.00	$2,067.39 – $4,480.80
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	$5,350.50	$5,350.50	$1,974.66 – $4,280.40

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$8,153.54 – $12,589.25
C-section, without complications MS-DRG 788	not posted	$7,132.00 – $13,666.58
Chest pain MS-DRG 313	not posted	$6,649.92 – $10,281.51
COPD flare-up, with major complications MS-DRG 190	not posted	$10,230.72 – $15,777.30
COPD flare-up, without complications MS-DRG 192	not posted	$5,929.51 – $9,175.82
Fainting (syncope) MS-DRG 312	not posted	$8,050.10 – $12,430.50
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$9,057.75 – $13,977.00
Heart failure, with major complications MS-DRG 291	not posted	$11,857.18 – $18,273.60
Heart failure, without complications MS-DRG 293	not posted	$5,227.58 – $8,098.48
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$90,353.94 – $138,750.36
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$17,815.32 – $27,418.16
Irregular heartbeat, without complications MS-DRG 310	not posted	$5,228.50 – $8,099.92
Kidney failure, with complications MS-DRG 683	not posted	$8,088.89 – $12,490.04
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$7,476.54 – $11,550.20
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$22,547.85 – $34,681.62
Normal newborn care MS-DRG 795	not posted	$893.00 – $2,907.46
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$7,187.46 – $11,106.50
Pneumonia, with complications MS-DRG 194	not posted	$7,443.29 – $11,499.16
Pneumonia, with major complications MS-DRG 193	not posted	$12,139.80 – $18,707.37
Pneumonia, without complications MS-DRG 195	not posted	$5,804.83 – $8,984.46
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$12,900.84 – $19,875.40
Sepsis, with major complications MS-DRG 871	not posted	$17,940.93 – $27,610.94
Sepsis, without major complications MS-DRG 872	not posted	$9,451.20 – $14,580.91
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$8,043.63 – $12,420.56
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$41,367.19 – $41,367.19
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$7,200.39 – $11,126.35
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$9,331.13 – $14,396.62
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$11,459.11 – $17,662.63
Vaginal delivery, without complications MS-DRG 807	not posted	$4,415.00 – $9,632.25
Weight loss surgery, without complications MS-DRG 621	not posted	$13,931.58 – $21,457.38

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$1,025.00	$1,025.00	$300.00 – $3,060.00
Lower back nerve root injection with imaging guidance CPT 64483	$2,680.50	$2,680.50	$300.00 – $5,067.70
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$1,591.00	$1,591.00	$300.00 – $4,044.43
Lower back spinal injection (epidural), without imaging CPT 62322	$1,127.00	$1,127.00	$300.00 – $5,067.70

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$2,880.82 – $13,260.00
Eye exam, new patient, comprehensive CPT 92004	not posted	$166.19 – $762.82
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$686.55 – $3,978.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$160.62 – $737.25

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	not posted		$269.53 – $1,237.16
Sleep study with CPAP titration CPT 95811	$6,714.50	$6,714.50	$1,071.95 – $5,707.33
Sleep study, overnight in a sleep lab CPT 95810	$4,706.00	$4,706.00	$1,071.95 – $4,920.26

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$392.50	$392.50	$256.70 – $1,237.16

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$187.00	$187.00	$26.97 – $275.00
Physical therapy evaluation, low complexity CPT 97161	$230.00	$230.00	$95.46 – $438.16
Physical therapy evaluation, moderate complexity CPT 97162	$230.00	$230.00	$95.46 – $438.16
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$148.50	$148.50	$28.27 – $275.00
Therapeutic activities, 15 minutes CPT 97530	$160.00	$160.00	$33.97 – $275.00

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$329.00	$329.00	$215.17 – $1,016.98
Family psychotherapy, without the patient, 50 minutes CPT 90846	$329.00	$329.00	$215.17 – $1,016.98
Group psychotherapy CPT 90853	$563.50	$563.50	$126.81 – $582.07
Psychiatric diagnostic evaluation CPT 90791	$356.50	$356.50	$99.25 – $285.20
Psychotherapy, 30 minutes CPT 90832	$329.00	$329.00	$215.17 – $1,016.98
Psychotherapy, 45 minutes CPT 90834	$329.00	$329.00	$215.17 – $1,016.98
Psychotherapy, 60 minutes CPT 90837	$363.00	$363.00	$78.75 – $290.40

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$161.50	$161.50	$89.88 – $412.54
IV hydration, each additional hour CPT 96361	$171.00	$171.00	$58.45 – $268.29
IV hydration, first hour CPT 96360	$776.00	$776.00	$265.51 – $1,218.71
IV push injection of a drug, first CPT 96374	$794.50	$794.50	$265.51 – $1,218.71
IV push injection, each additional drug CPT 96375	$347.00	$347.00	$58.45 – $294.95

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$156.00	$156.00	$124.80 – $124.80
Dexamethasone injection, per 1 mg HCPCS J1100	$16.96	$16.95	$11.02 – $14.41
Fentanyl injection, per 0.1 mg HCPCS J3010	$85.67	$85.67	$55.68 – $72.82
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$25.00	$25.00	? – $21.25
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$34.16	$34.16	$22.20 – $29.04
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$63.00	$63.00	$40.95 – $53.55

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.

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