Holy Redeemer Hospital and Medical Center

1648 Huntingdon Pike, Meadowbrook, PA 19046 · Acute care hospital · Emergency room

These are Holy Redeemer Hospital and Medical Center's own posted figures from its standard-charges file dated September 21, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

235 of the services we track have a posted price here; 158 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	$1,396.68	$2,327.79	$236.00 – $1,792.40
Emergency room visit, level 1 (minor) CPT 99281	$1,062.60	$1,771.00	$85.39 – $1,363.67
Emergency room visit, level 2 CPT 99282	$1,021.50	$1,702.50	$146.00 – $1,310.93
Emergency room visit, level 3 (moderate) CPT 99283	$1,021.50	$1,702.50	$236.00 – $1,310.93
Emergency room visit, level 4 CPT 99284	$1,021.50	$1,702.50	$236.00 – $1,310.93
Emergency room visit, level 5 (most severe) CPT 99285	$1,021.50	$1,702.50	$236.00 – $1,310.93
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$1,399.99	$2,333.31	$203.18 – $2,906.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$85.88	$143.13	$37.21 – $124.52
New patient office visit, about 30 minutes CPT 99203	$121.95	$203.24	$52.84 – $182.96
New patient office visit, about 45 minutes CPT 99204	$184.56	$307.59	$79.97 – $275.78
New patient office visit, about 60 minutes CPT 99205	$231.84	$386.39	$100.46 – $368.49
Office consultation, about 40 minutes CPT 99243	not posted		$98.47 – $174.53
Office consultation, about 60 minutes CPT 99244	not posted		$154.32 – $249.58
Office visit, established patient, about 10 to 19 minutes CPT 99212	$165.00	$275.00	$32.00 – $239.25
Office visit, established patient, about 20 to 29 minutes CPT 99213	$83.28	$138.80	$32.00 – $147.83
Office visit, established patient, about 30 to 39 minutes CPT 99214	$121.74	$202.89	$52.75 – $210.61
Office visit, established patient, about 40 to 54 minutes CPT 99215	$163.10	$271.82	$70.67 – $298.79
Office visit, established patient, brief (often a nurse) CPT 99211	$68.39	$113.97
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted		$139.26 – $208.89
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted		$161.00 – $241.50

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$373.92	$623.20	$25.66 – $542.18
Abdominal X-ray, 1 view CPT 74018	$158.49	$264.15	$46.37 – $203.40
Ankle X-ray, 3 or more views CPT 73610	$158.49	$264.15
Bone density scan (DEXA), hips and spine CPT 77080	$194.44	$324.06	$58.82 – $249.53
Breast ultrasound, one breast, complete CPT 76641	$566.28	$943.79
Breast ultrasound, one breast, limited CPT 76642	$169.76	$282.92	$68.84 – $217.85
Chest X-ray, 1 view CPT 71045	$158.49	$264.15	$46.37 – $203.40
Chest X-ray, 2 views CPT 71046	$158.49	$264.15
CT angiogram of the chest (checks for lung clots) CPT 71275	$985.67	$1,642.77	$177.63 – $1,429.21
CT angiogram of the head CPT 70496	$886.20	$1,477.00	$177.63 – $1,284.99
CT scan of the abdomen and pelvis, with contrast CPT 74177	$842.40	$1,404.00	$230.26 – $1,221.48
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$972.00	$1,620.00	$232.00 – $1,409.40
CT scan of the abdomen and pelvis, without contrast CPT 74176	$758.16	$1,263.60	$148.88 – $1,099.33
CT scan of the abdomen, without contrast CPT 74150	$671.52	$1,119.19	$99.20 – $973.70
CT scan of the chest, with contrast CPT 71260	$808.82	$1,348.02	$112.00 – $1,172.78
CT scan of the chest, without contrast CPT 71250	$691.49	$1,152.47	$102.40 – $1,002.65
CT scan of the head, without contrast CPT 70450	$550.08	$916.80	$99.20 – $797.62
CT scan of the neck (cervical spine), without contrast CPT 72125	$689.47	$1,149.11	$102.40 – $999.73
CT scan of the pelvis, with contrast CPT 72193	$776.36	$1,293.93	$110.72 – $1,125.72
CT scan of the sinuses or face, without contrast CPT 70486	$581.65	$969.41	$99.20 – $843.39
Diagnostic mammogram, both breasts CPT 77066	$373.92	$623.20	$71.00 – $479.86
Diagnostic mammogram, one breast CPT 77065	$258.18	$430.29
Foot X-ray, 3 or more views CPT 73630	$158.49	$264.15
Hand X-ray, 3 or more views CPT 73130	$158.49	$264.15
Knee X-ray, 3 views CPT 73562	$158.49	$264.15
Leg or arm vein ultrasound, both sides CPT 93970	$1,178.21	$1,963.67
Leg or arm vein ultrasound, one side CPT 93971	$1,159.17	$1,931.94
Lower back X-ray, 2 or 3 views CPT 72100	$194.44	$324.06	$28.80 – $249.53
MRI of both breasts, without and with contrast CPT 77049	$2,848.62	$4,747.70	$356.23 – $3,655.73
MRI of the abdomen, without and with contrast CPT 74183	$1,922.18	$3,203.62	$353.30 – $2,466.79
MRI of the brain, without and with contrast CPT 70553	$1,916.57	$3,194.27	$344.32 – $2,459.59
MRI of the brain, without contrast CPT 70551	$1,228.98	$2,048.29	$241.63 – $1,577.18
MRI of the knee or other leg joint, without contrast CPT 73721	$1,278.58	$2,130.96	$241.63 – $1,640.84
MRI of the lower back (lumbar spine), without contrast CPT 72148	$1,228.98	$2,048.29	$239.62 – $1,577.18
MRI of the mid back (thoracic spine), without contrast CPT 72146	$1,228.98	$2,048.29	$239.62 – $1,577.18
MRI of the neck (cervical spine), without contrast CPT 72141	$1,228.98	$2,048.29	$241.63 – $1,577.18
MRI of the pelvis, without and with contrast CPT 72197	$1,922.18	$3,203.62	$353.30 – $2,466.79
MRI of the shoulder or other arm joint, without contrast CPT 73221	$1,278.58	$2,130.96	$241.63 – $1,640.84
Neck X-ray, 2 or 3 views CPT 72040	$158.49	$264.15	$21.12 – $203.40
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$511.21	$852.01	$59.52 – $741.25
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$506.38	$843.96	$59.52 – $649.85
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$529.78	$882.96	$75.62 – $679.88
Screening mammogram, both breasts CPT 77067	$248.30	$413.83	$71.00 – $318.65
Shoulder X-ray, 2 or more views CPT 73030	$158.49	$264.15
Transvaginal pregnancy ultrasound CPT 76817	$507.32	$845.52	$75.62 – $651.05
Transvaginal ultrasound CPT 76830	$419.55	$699.25	$59.52 – $608.35
Ultrasound of the abdomen, complete CPT 76700	$918.24	$1,530.40	$73.60 – $1,331.45
Ultrasound of the neck or thyroid CPT 76536	$471.72	$786.19	$73.60 – $683.99
Wrist X-ray, 3 or more views CPT 73110	$158.49	$264.15
X-ray of the lower back, 4 or more views CPT 72110	$194.44	$324.06	$28.80 – $249.53

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$42.26	$70.42	$8.46 – $33.59
Blood culture CPT 87040	$74.07	$123.45	$10.32 – $46.22
Blood draw (venipuncture) CPT 36415	$15.43	$25.71
BNP test (heart failure) CPT 83880	$132.60	$221.00	$39.26 – $136.16
C-reactive protein (CRP) test CPT 86140	$20.16	$33.60	$5.18 – $23.25
Chlamydia test (DNA/NAAT) CPT 87491	$135.81	$226.35	$35.09 – $139.23
Complete blood count (CBC) with differential CPT 85025	$30.20	$50.33	$7.77 – $31.58
Complete blood count (CBC), automated CPT 85027	$24.89	$41.48	$6.47 – $28.71
Comprehensive metabolic panel (blood test) CPT 80053	$69.47	$115.78	$10.56 – $41.91
COVID-19 PCR test CPT 87635	$103.91	$173.17	$51.31 – $76.97
D-dimer test (blood clots) CPT 85379	$26.39	$43.97	$10.18 – $30.43
Drug screen, instrument chemistry CPT 80307	$171.84	$286.39
Ferritin (iron stores) test CPT 82728	$53.02	$88.36	$13.63 – $61.15
Free T4 (thyroid) test CPT 84439	$71.80	$119.66	$9.02 – $39.33
General health panel (blood tests) CPT 80050	not posted		$47.21 – $94.74
Glucose (blood sugar) test CPT 82947	$17.50	$29.16	$3.93 – $5.90
Gonorrhea test (DNA/NAAT) CPT 87591	$135.81	$226.35	$35.09 – $139.23
Hemoglobin A1c test CPT 83036	$41.45	$69.07	$9.71 – $42.49
Hepatitis C antibody test CPT 86803	$55.17	$91.94	$14.27 – $56.55
HIV-1/HIV-2 antigen and antibody test CPT 87389	$68.33	$113.87	$24.08 – $70.05
Iron test CPT 83540	$38.63	$64.37	$6.47 – $29.00
Kidney function panel CPT 80069	$33.60	$56.00	$8.68 – $34.45
Lipase test (pancreas) CPT 83690	$32.37	$53.94	$6.89 – $31.00
Lipid panel, cholesterol and triglycerides CPT 80061	$53.21	$88.67	$13.39 – $54.55
Liver function panel CPT 80076	$34.74	$57.89	$8.17 – $32.44
Magnesium test CPT 83735	$29.41	$49.01	$6.70 – $30.14
Obstetric blood test panel CPT 80055	not posted		$47.81 – $76.65
Partial thromboplastin time (PTT), clotting test CPT 85730	$26.83	$44.71	$6.01 – $26.99
Pregnancy blood test (hCG), quantitative CPT 84702	$53.21	$88.67	$15.05 – $54.55
Prothrombin time (PT/INR), clotting test CPT 85610	$16.07	$26.78	$4.29 – $16.08
PSA (prostate specific antigen), free CPT 84154	$81.65	$136.08	$18.39 – $72.92
PSA (prostate specific antigen), total CPT 84153	$73.08	$121.80	$18.39 – $74.93
Rapid strep test CPT 87880	$40.63	$67.71	$16.53 – $43.64
Sed rate (ESR) test CPT 85652	$18.08	$30.13	$2.70 – $10.62
TB skin test CPT 86580	not posted		$4.22 – $43.50
Thyroid stimulating hormone (TSH) CPT 84443	$73.37	$122.28	$16.80 – $75.21
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$197.34	$328.89	$50.98 – $253.25
Troponin test (heart damage) CPT 84484	$47.18	$78.62	$12.47 – $34.45
Urinalysis, automated, with microscope CPT 81001	$17.11	$28.51	$3.17 – $12.63
Urinalysis, automated, without microscope CPT 81003	$9.52	$15.86	$2.25 – $9.76
Urinalysis, manual, with microscope CPT 81000	not posted		$4.02 – $14.35
Urinalysis, manual, without microscope CPT 81002	$12.48	$20.80	$3.48 – $14.35
Urine culture, colony count CPT 87086	$36.03	$60.05	$8.07 – $37.32
Urine pregnancy test CPT 81025	$26.32	$43.86	$8.61 – $26.99
Vitamin B12 test CPT 82607	$58.50	$97.49	$15.08 – $67.46
Vitamin D test CPT 82306	$125.73	$209.54	$29.60 – $128.90

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$1,178.21	$1,963.67	$218.98 – $1,512.03
ECG tracing only (no interpretation) CPT 93005	$191.06	$318.43
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$1,687.80	$2,813.00	$208.00 – $2,166.01
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$15.97 – $219.72
Holter monitor, up to 48 hours CPT 93224	not posted		$73.23 – $878.88
Left heart catheterization CPT 93452	$7,719.20	$12,865.32	$2,499.00 – $9,906.30
Left heart catheterization with coronary angiogram CPT 93458	$7,570.47	$12,617.45	$2,499.00 – $9,715.44
Nuclear stress test (heart perfusion imaging) CPT 78452	$2,414.63	$4,024.38	$595.26 – $3,098.77
Treadmill stress test, complete CPT 93015	not posted		$59.52 – $1,098.60

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted		$56.32 – $10,913.24
Appendix removal, laparoscopic CPT 44970	not posted		$56.32 – $9,092.38
Breast biopsy with ultrasound guidance CPT 19083	$3,327.66	$5,546.09	$139.00 – $4,270.49
Carpal tunnel release CPT 64721	not posted		$56.32 – $6,252.00
Colonoscopy with biopsy CPT 45380	$2,815.71	$4,692.85	$1,211.82 – $3,613.49
Colonoscopy with polyp removal (snare) CPT 45385	$2,815.71	$4,692.85	$1,211.82 – $3,613.49
Colonoscopy, diagnostic CPT 45378	$2,815.71	$4,692.85	$941.75 – $3,613.49
Colposcopy with biopsy CPT 57454	not posted		$56.32 – $2,565.56
Cystoscopy (bladder scope) CPT 52000	not posted		$56.32 – $2,182.22
Ear tubes, under general anesthesia CPT 69436	not posted		$56.32 – $3,634.18
Flexible sigmoidoscopy, diagnostic CPT 45330	$4,814.10	$8,023.50	$941.75 – $6,178.10
Gallbladder removal, laparoscopic CPT 47562	not posted		$56.32 – $9,092.38
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted		$1,701.39 – $6,546.96
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted		$3,933.44 – $15,987.11
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted		$56.32 – $4,868.59
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted		$56.32 – $9,092.38
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted		$56.32 – $11,464.00
Kidney stone shock-wave lithotripsy CPT 50590	not posted		$56.32 – $8,617.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted		$56.32 – $5,728.59
Lower colon endoscopy with ultrasound CPT 45391	not posted		$1,199.82 – $3,000.69
Nasal endoscopy, diagnostic CPT 31231	$2,815.71	$4,692.85	$202.14 – $3,613.49
Prostate biopsy CPT 55700	not posted		$56.32 – $2,695.75
Prostate removal, laparoscopic or robotic CPT 55866	not posted		$3,992.24 – $15,987.11
Removal of a breast lump, open surgery CPT 19120	not posted		$281.60 – $5,888.75
Rotator cuff repair, arthroscopic CPT 29827	not posted		$5,239.82 – $10,913.24
Screening colonoscopy, average risk HCPCS G0121	$2,815.71	$4,692.85	$941.75 – $3,000.69
Screening colonoscopy, high risk HCPCS G0105	$2,815.71	$4,692.85	$941.75 – $3,000.69
Septoplasty (nasal septum repair) CPT 30520	not posted		$56.32 – $5,024.03
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted		$56.32 – $5,728.59
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted		$1,052.46 – $6,419.58
Tonsil and adenoid removal, under age 12 CPT 42820	not posted		$56.32 – $8,903.33
Total hip replacement CPT 27130	not posted		$281.60 – $20,768.00
Total knee replacement CPT 27447	not posted		$281.60 – $20,768.00
Upper endoscopy (EGD) with biopsy CPT 43239	$2,815.71	$4,692.85	$918.49 – $3,613.49
Upper endoscopy (EGD), diagnostic CPT 43235	$2,429.10	$4,048.50	$918.49 – $3,117.35
Vasectomy CPT 55250	not posted		$56.32 – $3,464.50

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
C-section delivery, routine care including prenatal and postpartum CPT 59510	not posted		$56.32 – $3,913.81
Fetal non-stress test CPT 59025	$467.60	$779.32	$56.32 – $1,285.35
IUD insertion CPT 58300	not posted		$22.08 – $1,602.93
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$56.32 – $3,689.54
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted		$56.32 – $3,495.54

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$6,976.45 – $16,361.82
C-section, without complications MS-DRG 788	not posted	$7,552.82 – $17,999.00
Chest pain MS-DRG 313	not posted	$4,804.00 – $13,344.48
COPD flare-up, with major complications MS-DRG 190	not posted	$8,682.06 – $20,530.11
COPD flare-up, without complications MS-DRG 192	not posted	$5,150.25 – $11,898.83
Fainting (syncope) MS-DRG 312	not posted	$6,891.50 – $16,154.23
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$7,718.89 – $18,176.29
Heart failure, with major complications MS-DRG 291	not posted	$10,017.58 – $23,793.95
Heart failure, without complications MS-DRG 293	not posted	$4,573.88 – $10,490.24
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$74,473.02 – $181,314.42
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$14,909.95 – $35,750.23
Irregular heartbeat, without complications MS-DRG 310	not posted	$4,574.63 – $10,492.10
Kidney failure, with complications MS-DRG 683	not posted	$6,923.38 – $16,232.08
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$6,420.56 – $15,003.27
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$18,795.93 – $45,247.05
Normal newborn care MS-DRG 795	not posted	$1,300.00 – $5,835.98
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$6,183.18 – $14,423.16
Pneumonia, with complications MS-DRG 194	not posted	$6,393.24 – $14,936.55
Pneumonia, with major complications MS-DRG 193	not posted	$10,249.65 – $24,361.09
Pneumonia, without complications MS-DRG 195	not posted	$5,047.87 – $11,648.62
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$10,874.58 – $25,888.29
Sepsis, with major complications MS-DRG 871	not posted	$15,013.08 – $36,002.30
Sepsis, without major complications MS-DRG 872	not posted	$8,041.97 – $18,965.84
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$6,886.20 – $16,141.26
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$44,783.00 – $47,304.00
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$6,193.78 – $14,449.11
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$7,943.40 – $18,724.90
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$9,690.72 – $22,995.13
Vaginal delivery, without complications MS-DRG 807	not posted	$5,394.46 – $11,621.86
Weight loss surgery, without complications MS-DRG 621	not posted	$11,720.93 – $27,956.69

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$1,399.99	$2,333.31	$236.00 – $1,796.65
Lower back nerve root injection with imaging guidance CPT 64483	not posted		$281.60 – $2,182.22
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$2,063.43	$3,439.05	$714.83 – $2,906.00
Lower back spinal injection (epidural), without imaging CPT 62322	$2,063.43	$3,439.05	$895.69 – $2,906.00

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$56.32 – $7,638.12
Eye exam, new patient, comprehensive CPT 92004	not posted	$75.23 – $200.24
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$56.32 – $3,000.69

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$40.46 – $193.52

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$1,152.22	$1,920.36	$213.12 – $1,478.68
Sleep study with CPAP titration CPT 95811	$3,007.37	$5,012.28	$515.98 – $3,859.46
Sleep study, overnight in a sleep lab CPT 95810	$3,126.24	$5,210.40	$443.60 – $4,012.01

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$295.32	$492.19	$20.93 – $428.21

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$92.40	$154.00	$18.18 – $144.00
Physical therapy evaluation, low complexity CPT 97161	$186.83	$311.37	$48.48 – $151.12
Physical therapy evaluation, moderate complexity CPT 97162	$186.83	$311.37	$60.60 – $156.00
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$131.40	$219.00	$11.69 – $144.00
Therapeutic activities, 15 minutes CPT 97530	$131.40	$219.00	$18.14 – $144.00

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$244.92	$408.20	$106.13 – $355.13
Family psychotherapy, without the patient, 50 minutes CPT 90846	$244.92	$408.20	$106.13 – $355.13
Group psychotherapy CPT 90853	$127.51	$212.51	$55.25 – $184.88
Psychiatric diagnostic evaluation CPT 90791	$244.92	$408.20	$80.52 – $355.13
Psychotherapy, 30 minutes CPT 90832	$244.92	$408.20	$106.13 – $355.13
Psychotherapy, 45 minutes CPT 90834	$244.92	$408.20	$106.13 – $355.13
Psychotherapy, 60 minutes CPT 90837	$244.92	$408.20	$106.13 – $355.13

Infusions and injections

Service	Cash price	Gross charge
Injection under the skin or into a muscle CPT 96372	$165.66	$276.10
IV hydration, each additional hour CPT 96361	$77.09	$128.48
IV hydration, first hour CPT 96360	$375.80	$626.33
IV push injection of a drug, first CPT 96374	$375.80	$626.33
IV push injection, each additional drug CPT 96375	$165.66	$276.10

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$97.44	$162.40	? – $125.05
Dexamethasone injection, per 1 mg HCPCS J1100	$20.40	$34.00	? – $26.18
Fentanyl injection, per 0.1 mg HCPCS J3010	$144.00	$240.00	$1.07 – $184.80
Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170	not posted		$5.16 – $5.16
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$43.20	$72.00	? – $55.44
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$53.76	$89.60	? – $68.99
Morphine injection, up to 10 mg HCPCS J2270	$101.28	$168.80
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$15.00	$25.00	? – $19.25
Propofol injection, per 10 mg HCPCS J2704	$101.40	$169.00	? – $130.13
Saline IV solution, 1000 ml HCPCS J7030	$108.00	$180.00	$2.83 – $156.60

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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