Wynn Hospital
1656 Champlin Avenue, Utica, NY 13503 · Acute care hospital · Emergency room
These are Wynn Hospital's own posted figures from its standard-charges file dated August 7, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
219 of the services we track have a posted price here. 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 | $3,759.00 | $6,265.00 | $242.13 – $4,698.75 |
| Emergency room visit, level 1 (minor) CPT 99281 | $568.20 | $947.00 | $22.00 – $2,267.00 |
| Emergency room visit, level 2 CPT 99282 | $772.80 | $1,288.00 | $34.00 – $2,267.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $1,204.20 | $2,007.00 | $62.00 – $2,267.00 |
| Emergency room visit, level 4 CPT 99284 | $1,593.00 | $2,655.00 | $94.00 – $2,267.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $6,411.79 | $10,686.32 | $12.00 – $2,267.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $2,086.00 | $3,476.67 | $28.34 – $2,267.00 |
Office visits
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $63.00 | $105.00 | $10.21 – $382.00 |
| Abdominal X-ray, 1 view CPT 74018 | $356.40 | $594.00 | $10.10 – $445.50 |
| Ankle X-ray, 3 or more views CPT 73610 | $370.80 | $618.00 | $12.63 – $463.50 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $966.00 | $1,610.00 | $39.40 – $1,207.50 |
| Breast ultrasound, one breast, complete CPT 76641 | $744.00 | $1,240.00 | $32.79 – $930.00 |
| Breast ultrasound, one breast, limited CPT 76642 | $688.20 | $1,147.00 | $26.93 – $860.25 |
| Chest X-ray, 1 view CPT 71045 | $267.60 | $446.00 | $6.06 – $334.50 |
| Chest X-ray, 2 views CPT 71046 | $386.40 | $644.00 | $15.15 – $483.00 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $2,866.20 | $4,777.00 | $141.40 – $3,582.75 |
| CT angiogram of the head CPT 70496 | $1,837.20 | $3,062.00 | $200.13 – $2,296.50 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $3,646.20 | $6,077.00 | $65.41 – $4,557.75 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $3,701.40 | $6,169.00 | $138.11 – $4,626.75 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $3,400.80 | $5,668.00 | $69.38 – $1,595.00 |
| CT scan of the abdomen, without contrast CPT 74150 | $2,040.00 | $3,400.00 | $119.55 – $2,550.00 |
| CT scan of the chest, with contrast CPT 71260 | $2,325.60 | $3,876.00 | $171.70 – $2,907.00 |
| CT scan of the chest, without contrast CPT 71250 | $2,053.80 | $3,423.00 | $119.55 – $2,567.25 |
| CT scan of the head, without contrast CPT 70450 | $1,782.60 | $2,971.00 | $72.72 – $2,228.25 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $1,969.20 | $3,282.00 | $84.84 – $2,461.50 |
| CT scan of the pelvis, with contrast CPT 72193 | $2,273.40 | $3,789.00 | $171.70 – $2,841.75 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $1,890.00 | $3,150.00 | $119.55 – $2,362.50 |
| Diagnostic mammogram, both breasts CPT 77066 | $664.20 | $1,107.00 | $97.97 – $830.25 |
| Diagnostic mammogram, one breast CPT 77065 | $541.80 | $903.00 | $81.78 – $677.25 |
| Foot X-ray, 3 or more views CPT 73630 | $400.20 | $667.00 | $7.58 – $500.25 |
| Hand X-ray, 3 or more views CPT 73130 | $383.40 | $639.00 | $12.63 – $479.25 |
| Knee X-ray, 3 views CPT 73562 | $277.80 | $463.00 | $15.15 – $347.25 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $1,732.80 | $2,888.00 | $109.08 – $2,166.00 |
| Leg or arm vein ultrasound, one side CPT 93971 | $1,390.20 | $2,317.00 | $93.93 – $1,737.75 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $491.40 | $819.00 | $15.15 – $614.25 |
| MRI of both breasts, without and with contrast CPT 77049 | $390.60 | $651.00 | $155.40 – $590.57 |
| MRI of the abdomen, without and with contrast CPT 74183 | $2,032.80 | $3,388.00 | $401.48 – $2,541.00 |
| MRI of the brain, without and with contrast CPT 70553 | $1,854.00 | $3,090.00 | $401.48 – $2,317.50 |
| MRI of the brain, without contrast CPT 70551 | $1,527.60 | $2,546.00 | $271.74 – $1,909.50 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $1,527.60 | $2,546.00 | $271.74 – $1,909.50 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $1,527.60 | $2,546.00 | $271.74 – $1,909.50 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $1,527.60 | $2,546.00 | $271.74 – $1,909.50 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $1,527.60 | $2,546.00 | $271.74 – $1,909.50 |
| MRI of the pelvis, without and with contrast CPT 72197 | $1,854.00 | $3,090.00 | $401.48 – $2,317.50 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $2,160.60 | $3,601.00 | $271.74 – $2,700.75 |
| Neck X-ray, 2 or 3 views CPT 72040 | $296.40 | $494.00 | $15.15 – $370.50 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $1,120.20 | $1,867.00 | $55.55 – $1,400.25 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $865.20 | $1,442.00 | $55.55 – $1,081.50 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $655.20 | $1,092.00 | $55.55 – $819.00 |
| Screening mammogram, both breasts CPT 77067 | $717.60 | $1,196.00 | $86.54 – $382.00 |
| Shoulder X-ray, 2 or more views CPT 73030 | $400.20 | $667.00 | $15.15 – $500.25 |
| Transvaginal pregnancy ultrasound CPT 76817 | $670.20 | $1,117.00 | $60.60 – $837.75 |
| Transvaginal ultrasound CPT 76830 | $888.60 | $1,481.00 | $60.60 – $1,110.75 |
| Ultrasound of the abdomen, complete CPT 76700 | $1,332.00 | $2,220.00 | $60.60 – $1,665.00 |
| Ultrasound of the neck or thyroid CPT 76536 | $790.20 | $1,317.00 | $30.30 – $987.75 |
| Wrist X-ray, 3 or more views CPT 73110 | $366.00 | $610.00 | $12.63 – $457.50 |
| X-ray of the lower back, 4 or more views CPT 72110 | $690.60 | $1,151.00 | $30.30 – $863.25 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $63.00 | $105.00 | $7.32 – $78.75 |
| Blood culture CPT 87040 | $197.40 | $329.00 | $8.23 – $246.75 |
| Blood draw (venipuncture) CPT 36415 | $6.60 | $11.00 | $2.91 – $12.61 |
| BNP test (heart failure) CPT 83880 | $274.20 | $457.00 | $34.41 – $342.75 |
| C-reactive protein (CRP) test CPT 86140 | $30.00 | $50.00 | $4.14 – $37.50 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $121.80 | $203.00 | $21.64 – $152.25 |
| Complete blood count (CBC) with differential CPT 85025 | $34.20 | $57.00 | $3.20 – $42.75 |
| Complete blood count (CBC), automated CPT 85027 | $30.00 | $50.00 | $3.20 – $37.50 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $98.40 | $164.00 | $10.03 – $123.00 |
| COVID-19 PCR test CPT 87635 | $340.80 | $568.00 | $30.79 – $426.00 |
| D-dimer test (blood clots) CPT 85379 | $157.20 | $262.00 | $10.18 – $196.50 |
| Drug screen, instrument chemistry CPT 80307 | $183.00 | $305.00 | $7.58 – $228.75 |
| Ferritin (iron stores) test CPT 82728 | $357.60 | $596.00 | $12.95 – $447.00 |
| Free T4 (thyroid) test CPT 84439 | $59.40 | $99.00 | $8.57 – $74.25 |
| Glucose (blood sugar) test CPT 82947 | $18.00 | $30.00 | $3.73 – $22.50 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $121.80 | $203.00 | $21.64 – $152.25 |
| Hemoglobin A1c test CPT 83036 | $183.60 | $306.00 | $9.22 – $229.50 |
| Hepatitis C antibody test CPT 86803 | $34.80 | $58.00 | $10.10 – $46.35 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $49.20 | $82.00 | $18.67 – $69.18 |
| Iron test CPT 83540 | $167.40 | $279.00 | $5.08 – $209.25 |
| Kidney function panel CPT 80069 | $40.80 | $68.00 | $8.25 – $51.00 |
| Lipase test (pancreas) CPT 83690 | $33.60 | $56.00 | $5.81 – $42.00 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $98.40 | $164.00 | $6.10 – $123.00 |
| Liver function panel CPT 80076 | $43.20 | $72.00 | $7.32 – $54.00 |
| Magnesium test CPT 83735 | $62.40 | $104.00 | $5.08 – $78.00 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $38.40 | $64.00 | $5.71 – $48.00 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $77.40 | $129.00 | $12.49 – $96.75 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $28.80 | $48.00 | $3.95 – $36.00 |
| PSA (prostate specific antigen), free CPT 84154 | $72.60 | $121.00 | $18.39 – $90.75 |
| PSA (prostate specific antigen), total CPT 84153 | $79.80 | $133.00 | $17.47 – $99.75 |
| Rapid strep test CPT 87880 | $18.00 | $30.00 | $15.70 – $47.49 |
| Sed rate (ESR) test CPT 85652 | $23.40 | $39.00 | $2.02 – $29.25 |
| TB skin test CPT 86580 | $491.41 | $819.02 | $216.47 – $614.27 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $98.40 | $164.00 | $9.09 – $123.00 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $4,908.79 | $8,181.31 | $1.80 – $5,993.00 |
| Troponin test (heart damage) CPT 84484 | $272.40 | $454.00 | $8.13 – $340.50 |
| Urinalysis, automated, with microscope CPT 81001 | $19.20 | $32.00 | $3.01 – $24.00 |
| Urinalysis, automated, without microscope CPT 81003 | $16.20 | $27.00 | $2.02 – $20.25 |
| Urinalysis, manual, without microscope CPT 81002 | $15.60 | $26.00 | $2.02 – $19.50 |
| Urine culture, colony count CPT 87086 | $147.60 | $246.00 | $7.67 – $184.50 |
| Urine pregnancy test CPT 81025 | $115.20 | $192.00 | $2.02 – $144.00 |
| Vitamin B12 test CPT 82607 | $66.00 | $110.00 | $12.63 – $82.50 |
| Vitamin D test CPT 82306 | $763.80 | $1,273.00 | $28.12 – $954.75 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $762.00 | $1,270.00 | $109.08 – $952.50 |
| ECG tracing only (no interpretation) CPT 93005 | $4,602.79 | $7,671.31 | $6.58 – $2,267.00 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $1,080.60 | $1,801.00 | $208.57 – $1,959.69 |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 | $17.40 | $29.00 | $10.15 – $23.95 |
| Left heart catheterization CPT 93452 | $6,400.20 | $10,667.00 | $1,208.29 – $11,627.01 |
| Left heart catheterization with coronary angiogram CPT 93458 | $23,203.79 | $38,672.99 | $2.20 – $11,627.01 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $3,469.20 | $5,782.00 | $241.13 – $4,643.19 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $45,432.82 | $75,721.37 | $55.80 – $46,045.22 |
| Appendix removal, laparoscopic CPT 44970 | $23,778.38 | $39,630.64 | $81.48 – $21,681.95 |
| Breast biopsy with ultrasound guidance CPT 19083 | $4,839.61 | $8,066.02 | $60.90 – $5,993.00 |
| Carpal tunnel release CPT 64721 | $8,760.11 | $14,600.19 | $3.60 – $7,003.34 |
| Colonoscopy with biopsy CPT 45380 | $4,370.57 | $7,284.29 | $6.00 – $5,993.00 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $5,402.02 | $9,003.37 | $4.50 – $5,993.00 |
| Colonoscopy, diagnostic CPT 45378 | $3,683.15 | $6,138.59 | $4.50 – $5,993.00 |
| Colposcopy with biopsy CPT 57454 | $989.40 | $1,649.00 | $61.11 – $1,092.90 |
| Cystoscopy (bladder scope) CPT 52000 | $347.04 | $578.40 | $9.71 – $2,500.82 |
| Ear tubes, under general anesthesia CPT 69436 | $6,422.93 | $10,704.89 | $3.60 – $7,234.50 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $3,657.25 | $6,095.42 | $1.35 – $4,217.00 |
| Gallbladder removal, laparoscopic CPT 47562 | $19,207.60 | $32,012.67 | $4.64 – $21,681.95 |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | $31,374.78 | $52,291.30 | $8.10 – $9,751.00 |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | $28,168.67 | $46,947.79 | $4.64 – $38,123.31 |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | $13,134.22 | $21,890.37 | $1.80 – $11,609.77 |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $25,892.72 | $43,154.53 | $18.81 – $21,681.95 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $12,449.92 | $20,749.86 | $4.64 – $12,840.91 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $14,881.01 | $24,801.69 | $3.48 – $11,734.85 |
| Lower colon endoscopy with ultrasound CPT 45391 | $10,056.51 | $16,760.85 | $9.00 – $9,954.75 |
| Nasal endoscopy, diagnostic CPT 31231 | $5,658.49 | $9,430.82 | $52.51 – $11,890.71 |
| Prostate removal, laparoscopic or robotic CPT 55866 | $40,013.40 | $66,689.00 | $122.22 – $38,123.31 |
| Removal of a breast lump, open surgery CPT 19120 | $13,307.15 | $22,178.58 | $3.40 – $14,042.49 |
| Rotator cuff repair, arthroscopic CPT 29827 | $20,720.20 | $34,533.67 | $10.00 – $26,024.01 |
| Screening colonoscopy, average risk HCPCS G0121 | $3,147.88 | $5,246.47 | $2.61 – $4,217.00 |
| Screening colonoscopy, high risk HCPCS G0105 | $3,659.78 | $6,099.64 | $2.70 – $4,217.00 |
| Septoplasty (nasal septum repair) CPT 30520 | $8,145.02 | $13,575.03 | $37.62 – $11,890.71 |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $20,414.50 | $34,024.17 | $5.00 – $26,024.01 |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | $37,713.71 | $62,856.18 | $6.51 – $9,751.00 |
| Tonsil and adenoid removal, under age 12 CPT 42820 | $9,165.73 | $15,276.21 | $1.16 – $21,231.14 |
| Total hip replacement CPT 27130 | $40,235.78 | $67,059.64 | $4.64 – $46,045.22 |
| Total knee replacement CPT 27447 | $36,057.85 | $60,096.41 | $8.10 – $46,045.22 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $4,983.92 | $8,306.53 | $6.00 – $6,882.06 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $3,665.60 | $6,109.33 | $1.80 – $5,993.00 |
| Vasectomy CPT 55250 | $9,270.51 | $15,450.85 | $8.10 – $7,497.04 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| C-section delivery, routine care including prenatal and postpartum CPT 59510 | $1,922.40 | $3,204.00 | $560.70 – $1,880.90 |
| Fetal non-stress test CPT 59025 | $273.60 | $456.00 | $9.09 – $725.08 |
| IUD insertion CPT 58300 | $16,069.64 | $26,782.74 | $4.64 – $17,941.01 |
| Vaginal birth after a prior C-section (VBAC), routine care CPT 59610 | $1,812.00 | $3,020.00 | $528.50 – $1,771.21 |
| Vaginal delivery, routine care including prenatal and postpartum CPT 59400 | $1,736.40 | $2,894.00 | $506.45 – $1,691.77 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $14,209.43 | $23,682.38 | $7,172.39 – $15,887.75 |
| C-section, without complications MS-DRG 788 | $17,648.72 | $29,414.54 | $7,789.86 – $17,255.52 |
| Chest pain MS-DRG 313 | $15,314.69 | $25,524.49 | $2,267.00 – $122,874.00 |
| COPD flare-up, with major complications MS-DRG 190 | $21,321.00 | $35,535.00 | $4,442.83 – $27,547.11 |
| COPD flare-up, without complications MS-DRG 192 | $15,793.24 | $26,322.07 | $4,336.55 – $78,177.36 |
| Fainting (syncope) MS-DRG 312 | $22,321.39 | $37,202.32 | $7,081.40 – $23,143.90 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $28,853.68 | $48,089.47 | $7,967.78 – $17,649.66 |
| Heart failure, with major complications MS-DRG 291 | $24,574.53 | $40,957.55 | $10,430.34 – $23,104.55 |
| Heart failure, without complications MS-DRG 293 | $4,836.93 | $8,061.55 | $4,598.52 – $10,186.30 |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | $281,232.18 | $468,720.30 | $79,481.24 – $176,061.05 |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | $44,380.82 | $73,968.03 | $4,126.39 – $50,434.68 |
| Irregular heartbeat, without complications MS-DRG 310 | $13,717.63 | $22,862.71 | $4,599.33 – $48,323.26 |
| Kidney failure, with complications MS-DRG 683 | $23,203.40 | $38,672.34 | $7,115.52 – $15,761.77 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $19,087.10 | $31,811.84 | $6,576.86 – $115,119.50 |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | $50,034.51 | $83,390.85 | $19,834.57 – $43,936.08 |
| Normal newborn care MS-DRG 795 | $2,864.86 | $4,774.76 | $1,623.29 – $3,595.80 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $20,275.88 | $33,793.13 | $6,322.55 – $14,005.27 |
| Pneumonia, with complications MS-DRG 194 | $20,256.17 | $33,760.29 | $3,440.98 – $54,843.58 |
| Pneumonia, with major complications MS-DRG 193 | $24,405.62 | $40,676.03 | $8,322.24 – $84,764.13 |
| Pneumonia, without complications MS-DRG 195 | $16,096.88 | $26,828.13 | $5,106.31 – $11,311.11 |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | $16,589.21 | $27,648.68 | $775.00 – $21,486.88 |
| Sepsis, with major complications MS-DRG 871 | $42,726.94 | $71,211.56 | $15,782.02 – $34,959.17 |
| Sepsis, without major complications MS-DRG 872 | $27,575.54 | $45,959.24 | $8,313.90 – $18,416.33 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $20,357.24 | $33,928.73 | $7,075.70 – $15,673.59 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $18,469.78 | $30,782.97 | $6,333.94 – $14,030.46 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $28,060.02 | $46,766.70 | $8,208.28 – $18,182.37 |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | $33,724.61 | $56,207.69 | $10,080.17 – $22,328.88 |
| Vaginal delivery, without complications MS-DRG 807 | $10,788.01 | $17,980.02 | $5,477.60 – $12,133.58 |
| Weight loss surgery, without complications MS-DRG 621 | $37,626.57 | $62,710.95 | $5,481.53 – $27,146.67 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $4,837.80 | $8,063.00 | $12.67 – $2,267.00 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $9,073.01 | $15,121.69 | $7.20 – $4,217.00 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | $99.60 | $166.00 | $25.25 – $461.48 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $334.20 | $557.00 | $86.00 – $774.40 |
| Sleep study with CPAP titration CPT 95811 | $4,990.20 | $8,317.00 | $561.38 – $6,237.75 |
| Sleep study, overnight in a sleep lab CPT 95810 | $4,658.40 | $7,764.00 | $306.43 – $5,823.00 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $243.60 | $406.00 | $15.15 – $774.40 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $83.40 | $139.00 | $16.00 – $150.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $156.00 | $260.00 | $68.72 – $274.27 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $178.80 | $298.00 | $78.76 – $274.27 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $73.80 | $123.00 | $16.00 – $150.00 |
| Therapeutic activities, 15 minutes CPT 97530 | $121.20 | $202.00 | $2.37 – $151.50 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $310.80 | $518.00 | $95.28 – $388.50 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $292.20 | $487.00 | $91.20 – $365.25 |
| Group psychotherapy CPT 90853 | $54.00 | $90.00 | $23.79 – $86.00 |
| Psychiatric diagnostic evaluation CPT 90791 | $210.00 | $350.00 | $92.51 – $262.50 |
| Psychotherapy, 30 minutes CPT 90832 | $101.40 | $169.00 | $25.21 – $137.88 |
| Psychotherapy, 45 minutes CPT 90834 | $135.00 | $225.00 | $37.79 – $182.82 |
| Psychotherapy, 60 minutes CPT 90837 | $198.00 | $330.00 | $57.05 – $268.26 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $72.60 | $121.00 | $13.36 – $2,267.00 |
| IV hydration, each additional hour CPT 96361 | $111.00 | $185.00 | $5.05 – $2,267.00 |
| IV hydration, first hour CPT 96360 | $842.40 | $1,404.00 | $35.35 – $2,267.00 |
| IV push injection of a drug, first CPT 96374 | $285.00 | $475.00 | $66.00 – $762.85 |
| IV push injection, each additional drug CPT 96375 | $285.00 | $475.00 | $23.38 – $2,267.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $568.05 | $946.75 | $184.80 – $1,344.00 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $180.74 | $301.23 | ? – $301.23 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $181.94 | $303.23 | $1.16 – $227.42 |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | $95.17 | $158.62 | $63.45 – $118.97 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $25.43 | $42.39 | ? – $31.79 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $51.29 | $85.48 | $17.00 – $64.11 |
| Morphine injection, up to 10 mg HCPCS J2270 | $54.53 | $90.89 | $13.35 – $68.17 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $34.09 | $56.81 | $3.72 – $56.81 |
| Propofol injection, per 10 mg HCPCS J2704 | $116.86 | $194.76 | $1.80 – $146.07 |
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.