Schuyler Hospital
220 Steuben Street, Montour Falls, NY 14865 · Critical access hospital · Emergency room
These are Schuyler Hospital's own posted figures from its standard-charges file dated March 27, 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; 142 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 | $963.85 | $1,752.45 | $876.23 – $3,943.01 |
| Emergency room visit, level 1 (minor) CPT 99281 | $123.01 | $223.65 | $175.00 – $490.00 |
| Emergency room visit, level 2 CPT 99282 | $232.16 | $422.10 | $225.00 – $571.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $364.98 | $663.60 | $435.00 – $803.00 |
| Emergency room visit, level 4 CPT 99284 | $487.41 | $886.20 | $625.00 – $1,201.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $716.68 | $1,303.05 | $985.00 – $1,393.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $223.49 | $406.35 | $203.18 – $390.10 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $198.08 | $360.15 | $180.08 – $810.34 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $279.51 | $508.20 | $254.10 – $1,143.45 |
| Preventive checkup, new patient, age 18 to 39 CPT 99385 | $71.03 | $129.15 | $63.41 – $290.59 |
| Preventive checkup, new patient, age 40 to 64 CPT 99386 | $72.19 | $131.25 | $64.44 – $295.31 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $63.53 | $115.50 | $57.75 – $110.88 |
| Abdominal X-ray, 1 view CPT 74018 | $195.77 | $355.95 | $177.98 – $341.71 |
| Ankle X-ray, 3 or more views CPT 73610 | $162.28 | $295.05 | $147.53 – $283.25 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $324.56 | $590.10 | $295.05 – $566.50 |
| Breast ultrasound, one breast, complete CPT 76641 | $345.92 | $628.95 | $314.48 – $603.79 |
| Breast ultrasound, one breast, limited CPT 76642 | $267.96 | $487.20 | $243.60 – $467.71 |
| Chest X-ray, 1 view CPT 71045 | $183.65 | $333.90 | $166.95 – $320.54 |
| Chest X-ray, 2 views CPT 71046 | $196.93 | $358.05 | $179.03 – $343.73 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $1,313.24 | $2,387.70 | $141.40 – $550.00 |
| CT angiogram of the head CPT 70496 | $1,387.16 | $2,522.10 | $219.17 – $550.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $1,950.80 | $3,546.90 | $109.01 – $550.00 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $2,328.48 | $4,233.60 | $138.11 – $550.00 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $1,533.84 | $2,788.80 | $69.38 – $550.00 |
| CT scan of the abdomen, without contrast CPT 74150 | $997.92 | $1,814.40 | $141.40 – $550.00 |
| CT scan of the chest, with contrast CPT 71260 | $1,187.34 | $2,158.80 | $171.70 – $550.00 |
| CT scan of the chest, without contrast CPT 71250 | $954.61 | $1,735.65 | $141.40 – $550.00 |
| CT scan of the head, without contrast CPT 70450 | $929.78 | $1,690.50 | $121.20 – $550.00 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $613.88 | $1,116.15 | $141.40 – $550.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $1,152.11 | $2,094.75 | $171.70 – $550.00 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $993.88 | $1,807.05 | $121.20 – $550.00 |
| Diagnostic mammogram, both breasts CPT 77066 | $304.34 | $553.35 | $276.68 – $531.22 |
| Diagnostic mammogram, one breast CPT 77065 | $215.41 | $391.65 | $195.83 – $375.98 |
| Foot X-ray, 3 or more views CPT 73630 | $191.15 | $347.55 | $173.78 – $333.65 |
| Hand X-ray, 3 or more views CPT 73130 | $177.87 | $323.40 | $161.70 – $310.46 |
| Knee X-ray, 3 views CPT 73562 | $225.80 | $410.55 | $205.28 – $394.13 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $506.47 | $920.85 | $460.43 – $884.02 |
| Leg or arm vein ultrasound, one side CPT 93971 | $449.30 | $816.90 | $408.45 – $784.22 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $202.13 | $367.50 | $183.75 – $352.80 |
| MRI of both breasts, without and with contrast CPT 77049 | not posted | $395.55 – $505.00 | |
| MRI of the abdomen, without and with contrast CPT 74183 | $2,131.55 | $3,875.55 | $505.00 – $728.00 |
| MRI of the brain, without and with contrast CPT 70553 | $2,382.77 | $4,332.30 | $505.00 – $728.00 |
| MRI of the brain, without contrast CPT 70551 | $1,696.70 | $3,084.90 | $397.95 – $728.00 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $712.64 | $1,295.70 | $397.95 – $728.00 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $1,746.94 | $3,176.25 | $397.95 – $728.00 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $1,746.94 | $3,176.25 | $397.95 – $728.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $1,746.94 | $3,176.25 | $397.95 – $728.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $1,832.41 | $3,331.65 | $505.00 – $728.00 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $712.64 | $1,295.70 | $397.95 – $728.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $186.53 | $339.15 | $169.58 – $325.58 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $373.64 | $679.35 | $339.68 – $652.18 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $403.67 | $733.95 | $366.98 – $704.59 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $381.15 | $693.00 | $346.50 – $665.28 |
| Screening mammogram, both breasts CPT 77067 | $269.69 | $490.35 | $245.18 – $470.74 |
| Shoulder X-ray, 2 or more views CPT 73030 | $227.54 | $413.70 | $206.85 – $397.15 |
| Transvaginal pregnancy ultrasound CPT 76817 | $291.06 | $529.20 | $264.60 – $508.03 |
| Transvaginal ultrasound CPT 76830 | $381.73 | $694.05 | $347.03 – $666.29 |
| Ultrasound of the abdomen, complete CPT 76700 | $570.57 | $1,037.40 | $518.70 – $995.90 |
| Ultrasound of the neck or thyroid CPT 76536 | $340.73 | $619.50 | $309.75 – $594.72 |
| Wrist X-ray, 3 or more views CPT 73110 | $170.36 | $309.75 | $154.88 – $297.36 |
| X-ray of the lower back, 4 or more views CPT 72110 | $338.99 | $616.35 | $308.18 – $591.70 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $94.71 | $172.20 | $13.85 – $19.86 |
| Blood culture CPT 87040 | $95.87 | $174.30 | $16.91 – $25.57 |
| Blood draw (venipuncture) CPT 36415 | $15.02 | $27.30 | $13.65 – $26.21 |
| BNP test (heart failure) CPT 83880 | $101.64 | $184.80 | $55.57 – $77.66 |
| C-reactive protein (CRP) test CPT 86140 | $53.71 | $97.65 | $8.47 – $9.43 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $128.78 | $234.15 | $57.44 – $86.92 |
| Complete blood count (CBC) with differential CPT 85025 | $86.23 | $156.78 | $12.73 – $19.15 |
| Complete blood count (CBC), automated CPT 85027 | $49.09 | $89.25 | $10.60 – $16.03 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $128.78 | $234.15 | $17.29 – $26.15 |
| COVID-19 PCR test CPT 87635 | $130.52 | $237.30 | $118.65 – $227.81 |
| D-dimer test (blood clots) CPT 85379 | $103.95 | $189.00 | $16.67 – $25.21 |
| Drug screen, instrument chemistry CPT 80307 | $206.75 | $375.90 | $187.95 – $845.78 |
| Ferritin (iron stores) test CPT 82728 | $106.26 | $193.20 | $22.31 – $33.74 |
| Free T4 (thyroid) test CPT 84439 | $134.56 | $244.65 | $14.76 – $22.33 |
| General health panel (blood tests) CPT 80050 | $343.61 | $624.75 | $312.38 – $599.76 |
| Glucose (blood sugar) test CPT 82947 | $17.90 | $32.55 | $6.43 – $9.72 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $128.78 | $234.15 | $57.44 – $86.92 |
| Hemoglobin A1c test CPT 83036 | $42.16 | $76.65 | $15.89 – $24.04 |
| Hepatitis C antibody test CPT 86803 | $161.12 | $292.95 | $23.36 – $35.34 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $63.53 | $115.50 | $39.43 – $52.60 |
| Iron test CPT 83540 | $51.40 | $93.45 | $10.60 – $16.03 |
| Kidney function panel CPT 80069 | $112.04 | $203.70 | $14.22 – $21.51 |
| Lipase test (pancreas) CPT 83690 | $68.72 | $124.95 | $11.28 – $15.89 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $97.60 | $177.45 | $21.92 – $33.16 |
| Liver function panel CPT 80076 | $154.77 | $281.40 | $13.37 – $19.86 |
| Magnesium test CPT 83735 | $57.75 | $105.00 | $10.97 – $16.58 |
| Obstetric blood test panel CPT 80055 | not posted | $32.20 – $72.45 | |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $46.20 | $84.00 | $9.83 – $14.87 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $174.98 | $318.15 | $24.65 – $37.29 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $22.52 | $40.95 | $6.44 – $9.74 |
| PSA (prostate specific antigen), free CPT 84154 | $131.67 | $239.40 | $30.11 – $45.55 |
| PSA (prostate specific antigen), total CPT 84153 | $131.67 | $239.40 | $30.11 – $45.55 |
| Rapid strep test CPT 87880 | $27.72 | $50.40 | $19.63 – $28.36 |
| Sed rate (ESR) test CPT 85652 | $19.64 | $35.70 | $4.43 – $6.70 |
| TB skin test CPT 86580 | $23.10 | $42.00 | $21.00 – $40.32 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $161.12 | $292.95 | $27.52 – $41.62 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $184.22 | $334.95 | $167.48 – $321.55 |
| Troponin test (heart damage) CPT 84484 | $97.02 | $176.40 | $16.10 – $24.37 |
| Urinalysis, automated, with microscope CPT 81001 | $60.64 | $110.25 | $5.18 – $7.84 |
| Urinalysis, automated, without microscope CPT 81003 | $34.65 | $63.00 | $3.67 – $5.57 |
| Urinalysis, manual, with microscope CPT 81000 | not posted | $5.18 – $7.84 | |
| Urinalysis, manual, without microscope CPT 81002 | $34.65 | $63.00 | $4.19 – $6.33 |
| Urine culture, colony count CPT 87086 | $103.95 | $189.00 | $13.21 – $20.00 |
| Urine pregnancy test CPT 81025 | $47.36 | $86.10 | $10.36 – $15.67 |
| Vitamin B12 test CPT 82607 | $113.19 | $205.80 | $24.67 – $36.38 |
| Vitamin D test CPT 82306 | $153.04 | $278.25 | $48.48 – $71.91 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $456.80 | $830.55 | $415.28 – $797.33 |
| ECG tracing only (no interpretation) CPT 93005 | $107.42 | $195.30 | $97.65 – $187.49 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $975.40 | $1,773.45 | $886.73 – $1,702.51 |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 | not posted | $15.15 – $15.15 | |
| Holter monitor, up to 48 hours CPT 93224 | not posted | $60.60 – $60.60 | |
| Left heart catheterization CPT 93452 | not posted | $1,959.46 – $6,080.00 | |
| Left heart catheterization with coronary angiogram CPT 93458 | not posted | $1,959.46 – $6,080.00 | |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | not posted | $241.13 – $1,557.39 | |
| Treadmill stress test, complete CPT 93015 | not posted | $60.60 – $60.60 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | not posted | $3,773.23 – $8,489.77 | |
| Appendix removal, laparoscopic CPT 44970 | not posted | $2,746.35 – $6,967.00 | |
| Breast biopsy with ultrasound guidance CPT 19083 | $1,455.88 | $2,647.05 | $1,323.53 – $2,541.17 |
| Carpal tunnel release CPT 64721 | not posted | $1,444.92 – $3,251.07 | |
| Colonoscopy with biopsy CPT 45380 | $2,417.42 | $4,395.30 | $2,197.65 – $4,219.49 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $2,408.75 | $4,379.55 | $2,189.78 – $4,204.37 |
| Colonoscopy, diagnostic CPT 45378 | $2,258.60 | $4,106.55 | $2,053.28 – $3,942.29 |
| Colposcopy with biopsy CPT 57454 | not posted | $613.89 – $1,649.00 | |
| Cystoscopy (bladder scope) CPT 52000 | not posted | $1,765.40 – $3,972.15 | |
| Ear tubes, under general anesthesia CPT 69436 | not posted | $1,356.05 – $3,051.11 | |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $2,076.69 | $3,775.80 | $1,887.90 – $3,624.77 |
| Gallbladder removal, laparoscopic CPT 47562 | not posted | $2,935.10 – $6,967.00 | |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | not posted | $2,749.12 – $6,967.00 | |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | not posted | $2,236.59 – $6,967.00 | |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | not posted | $1,520.73 – $3,421.64 | |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | not posted | $2,268.77 – $6,967.00 | |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | not posted | $2,268.77 – $5,104.73 | |
| Kidney stone shock-wave lithotripsy CPT 50590 | not posted | $1,573.67 – $6,967.00 | |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | not posted | $1,985.49 – $4,467.35 | |
| Lower colon endoscopy with ultrasound CPT 45391 | not posted | $842.50 – $2,198.00 | |
| Nasal endoscopy, diagnostic CPT 31231 | $325.71 | $592.20 | $296.10 – $568.51 |
| Prostate biopsy CPT 55700 | not posted | $2,168.21 – $4,878.47 | |
| Prostate removal, laparoscopic or robotic CPT 55866 | not posted | $2,932.91 – $6,967.00 | |
| Removal of a breast lump, open surgery CPT 19120 | not posted | $1,710.39 – $3,848.38 | |
| Rotator cuff repair, arthroscopic CPT 29827 | not posted | $3,773.23 – $8,489.77 | |
| Screening colonoscopy, average risk HCPCS G0121 | $2,335.99 | $4,247.25 | $2,123.63 – $4,077.36 |
| Screening colonoscopy, high risk HCPCS G0105 | not posted | $842.50 – $1,900.00 | |
| Septoplasty (nasal septum repair) CPT 30520 | not posted | $2,769.69 – $6,231.80 | |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | not posted | $1,649.00 – $4,467.35 | |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | not posted | $1,950.62 – $6,967.00 | |
| Tonsil and adenoid removal, under age 12 CPT 42820 | not posted | $1,570.60 – $3,533.85 | |
| Total hip replacement CPT 27130 | not posted | $3,804.04 – $8,559.09 | |
| Total knee replacement CPT 27447 | not posted | $3,804.04 – $8,559.09 | |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $2,251.67 | $4,093.95 | $2,046.98 – $3,930.19 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $2,290.37 | $4,164.30 | $2,082.15 – $3,997.73 |
| Vasectomy CPT 55250 | not posted | $1,415.83 – $3,185.62 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | not posted | $15.15 – $15.15 | |
| IUD insertion CPT 58300 | $419.27 | $762.30 | $381.15 – $731.81 |
| Vaginal birth after a prior C-section (VBAC), routine care CPT 59610 | not posted | $2,176.69 – $4,897.55 | |
| Vaginal delivery, routine care including prenatal and postpartum CPT 59400 | not posted | $2,176.69 – $4,897.55 |
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 | $6,322.61 – $10,595.37 | |
| C-section, without complications MS-DRG 788 | not posted | $6,866.93 – $11,507.52 | |
| Chest pain MS-DRG 313 | not posted | $5,156.64 – $8,641.44 | |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $7,933.35 – $13,294.62 | |
| COPD flare-up, without complications MS-DRG 192 | not posted | $4,598.00 – $7,705.28 | |
| Fainting (syncope) MS-DRG 312 | not posted | $6,242.40 – $10,460.94 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $7,023.77 – $11,770.36 | |
| Heart failure, with major complications MS-DRG 291 | not posted | $9,194.58 – $15,408.17 | |
| Heart failure, without complications MS-DRG 293 | not posted | $4,053.69 – $6,793.13 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $70,064.41 – $117,413.17 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $13,814.78 – $23,150.66 | |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $4,054.41 – $6,794.33 | |
| Kidney failure, with complications MS-DRG 683 | not posted | $6,272.48 – $10,511.35 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $5,797.64 – $9,715.62 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $17,484.59 – $29,300.48 | |
| Normal newborn care MS-DRG 795 | not posted | $1,430.97 – $2,398.00 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $5,573.47 – $9,339.96 | |
| Pneumonia, with complications MS-DRG 194 | not posted | $5,771.86 – $9,672.41 | |
| Pneumonia, with major complications MS-DRG 193 | not posted | $9,413.73 – $15,775.43 | |
| Pneumonia, without complications MS-DRG 195 | not posted | $4,501.32 – $7,543.26 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $10,003.88 – $16,764.39 | |
| Sepsis, with major complications MS-DRG 871 | not posted | $13,912.19 – $23,313.89 | |
| Sepsis, without major complications MS-DRG 872 | not posted | $7,328.87 – $12,281.65 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $6,237.39 – $10,452.54 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $5,583.50 – $9,356.76 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $7,235.77 – $12,125.62 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $8,885.89 – $14,890.88 | |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $4,828.62 – $8,091.75 | |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $10,803.16 – $18,103.82 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $650.27 | $1,182.30 | $591.15 – $1,135.01 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $1,278.59 | $2,324.70 | $1,162.35 – $2,231.71 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $1,213.33 | $2,206.05 | $1,103.03 – $2,117.81 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | not posted | $603.43 – $1,900.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | not posted | $2,219.10 – $4,992.98 | |
| Eye exam, new patient, comprehensive CPT 92004 | not posted | $30.30 – $30.30 | |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | not posted | $1,754.04 – $3,946.59 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | not posted | $25.25 – $25.25 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $263.92 | $479.85 | $239.93 – $460.66 |
| Sleep study with CPAP titration CPT 95811 | $2,132.13 | $3,876.60 | $1,938.30 – $3,721.54 |
| Sleep study, overnight in a sleep lab CPT 95810 | $2,101.52 | $3,820.95 | $1,910.48 – $3,668.11 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $209.06 | $380.10 | $190.05 – $364.90 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $74.50 | $135.45 | $67.73 – $130.03 |
| Physical therapy evaluation, low complexity CPT 97161 | $157.66 | $286.65 | $143.33 – $275.18 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $187.11 | $340.20 | $170.10 – $326.59 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $66.99 | $121.80 | $60.90 – $116.93 |
| Therapeutic activities, 15 minutes CPT 97530 | not posted | $2.37 – $2.37 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | not posted | $123.83 – $278.62 | |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | not posted | $123.83 – $278.62 | |
| Group psychotherapy CPT 90853 | not posted | $63.98 – $143.96 | |
| Psychiatric diagnostic evaluation CPT 90791 | not posted | $206.39 – $464.38 | |
| Psychotherapy, 30 minutes CPT 90832 | not posted | $123.83 – $278.62 | |
| Psychotherapy, 45 minutes CPT 90834 | not posted | $165.11 – $371.50 | |
| Psychotherapy, 60 minutes CPT 90837 | not posted | $165.11 – $371.50 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $59.48 | $108.15 | $54.08 – $103.82 |
| IV hydration, each additional hour CPT 96361 | $63.53 | $115.50 | $57.75 – $110.88 |
| IV hydration, first hour CPT 96360 | $277.20 | $504.00 | $252.00 – $483.84 |
| IV push injection of a drug, first CPT 96374 | $169.21 | $307.65 | $153.83 – $295.34 |
| IV push injection, each additional drug CPT 96375 | $91.82 | $166.95 | $83.48 – $160.27 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $37.22 | $67.68 | $33.84 – $152.28 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $4.13 | $7.50 | $3.75 – $16.88 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $36.34 | $66.08 | $33.04 – $148.68 |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | $353.65 | $643.00 | $321.50 – $1,446.75 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $3.08 | $5.60 | $2.80 – $12.60 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $3.30 | $6.00 | $3.00 – $13.50 |
| Morphine injection, up to 10 mg HCPCS J2270 | $199.38 | $362.50 | $181.25 – $815.63 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $2.21 | $4.02 | $2.01 – $9.05 |
| Propofol injection, per 10 mg HCPCS J2704 | $41.72 | $75.86 | $37.93 – $170.69 |
| Saline IV solution, 1000 ml HCPCS J7030 | not posted | $3.47 – $3.47 |
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.