St. Luke's Hospital - Upper Bucks Campus
3000 St. Luke's Drive, Quakertown, PA 18951 · Acute care hospital · Emergency room
These are St. Luke's Hospital - Upper Bucks Campus's own posted figures from its standard-charges file dated February 26, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
203 of the services we track have a posted price here; 145 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 | $10,295.10 | $11,439.00 | $151.63 – $9,473.78 |
| Emergency room visit, level 1 (minor) CPT 99281 | $558.90 | $621.00 | $25.20 – $1,424.00 |
| Emergency room visit, level 2 CPT 99282 | $1,401.30 | $1,557.00 | $38.92 – $1,424.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $2,538.00 | $2,820.00 | $66.85 – $2,335.52 |
| Emergency room visit, level 4 CPT 99284 | $5,967.90 | $6,631.00 | $112.49 – $5,491.79 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $10,490.40 | $11,656.00 | $146.00 – $9,653.50 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $566.10 | $629.00 | $24.50 – $702.96 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | $415.80 | $462.00 | $35.33 – $382.63 |
| New patient office visit, about 30 minutes CPT 99203 | $644.40 | $716.00 | $54.25 – $592.99 |
| New patient office visit, about 45 minutes CPT 99204 | $952.20 | $1,058.00 | $90.37 – $876.24 |
| New patient office visit, about 60 minutes CPT 99205 | $1,163.70 | $1,293.00 | $117.54 – $1,070.86 |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $216.00 | $240.00 | $23.04 – $198.77 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $313.20 | $348.00 | $33.41 – $288.21 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $520.20 | $578.00 | $54.42 – $478.70 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $839.70 | $933.00 | $78.05 – $772.71 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $165.60 | $184.00 | $17.66 – $152.39 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $291.60 | $324.00 | $25.88 – $268.34 |
| Abdominal X-ray, 1 view CPT 74018 | $677.70 | $753.00 | $21.14 – $623.63 |
| Ankle X-ray, 3 or more views CPT 73610 | $845.10 | $939.00 | $75.04 – $777.68 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $738.00 | $820.00 | $60.11 – $679.12 |
| Breast ultrasound, one breast, complete CPT 76641 | $612.00 | $680.00 | $108.87 – $563.18 |
| Breast ultrasound, one breast, limited CPT 76642 | $468.90 | $521.00 | $88.57 – $431.49 |
| Chest X-ray, 1 view CPT 71045 | $538.20 | $598.00 | $15.48 – $495.26 |
| Chest X-ray, 2 views CPT 71046 | $646.20 | $718.00 | $23.64 – $594.65 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $5,309.10 | $5,899.00 | $182.25 – $4,885.55 |
| CT angiogram of the head CPT 70496 | $4,338.00 | $4,820.00 | $182.25 – $3,991.92 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $8,946.00 | $9,940.00 | $263.16 – $8,232.31 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $11,701.80 | $13,002.00 | $332.72 – $10,768.26 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $6,304.50 | $7,005.00 | $168.29 – $5,801.54 |
| CT scan of the abdomen, without contrast CPT 74150 | $3,412.80 | $3,792.00 | $108.87 – $3,140.53 |
| CT scan of the chest, with contrast CPT 71260 | $4,998.60 | $5,554.00 | $145.15 – $4,599.82 |
| CT scan of the chest, without contrast CPT 71250 | $3,592.80 | $3,992.00 | $108.87 – $3,306.17 |
| CT scan of the head, without contrast CPT 70450 | $2,664.00 | $2,960.00 | $108.87 – $2,451.47 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $3,594.60 | $3,994.00 | $108.87 – $3,307.83 |
| CT scan of the pelvis, with contrast CPT 72193 | $4,132.80 | $4,592.00 | $140.09 – $3,803.09 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $3,881.70 | $4,313.00 | $108.87 – $3,572.03 |
| Diagnostic mammogram, both breasts CPT 77066 | $1,290.60 | $1,434.00 | $129.85 – $1,187.64 |
| Diagnostic mammogram, one breast CPT 77065 | $1,058.40 | $1,176.00 | $102.41 – $973.96 |
| Foot X-ray, 3 or more views CPT 73630 | $775.80 | $862.00 | $75.04 – $713.91 |
| Hand X-ray, 3 or more views CPT 73130 | $810.00 | $900.00 | $75.04 – $745.38 |
| Knee X-ray, 3 views CPT 73562 | $817.20 | $908.00 | $80.21 – $752.01 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $5,985.90 | $6,651.00 | $146.66 – $5,508.36 |
| Leg or arm vein ultrasound, one side CPT 93971 | $2,989.80 | $3,322.00 | $99.80 – $2,751.28 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $792.00 | $880.00 | $32.53 – $728.82 |
| MRI of the abdomen, without and with contrast CPT 74183 | $12,750.30 | $14,167.00 | $365.62 – $4,944.28 |
| MRI of the brain, without and with contrast CPT 70553 | $13,007.70 | $14,453.00 | $339.00 – $5,044.10 |
| MRI of the brain, without contrast CPT 70551 | $5,859.90 | $6,511.00 | $247.46 – $2,272.34 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $5,794.20 | $6,438.00 | $247.46 – $2,246.86 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $6,500.70 | $7,223.00 | $247.46 – $2,520.83 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $6,500.70 | $7,223.00 | $247.46 – $2,520.83 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $5,859.90 | $6,511.00 | $247.46 – $2,272.34 |
| MRI of the pelvis, without and with contrast CPT 72197 | $12,750.30 | $14,167.00 | $365.62 – $4,944.28 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $5,794.20 | $6,438.00 | $247.46 – $2,246.86 |
| Neck X-ray, 2 or 3 views CPT 72040 | $792.00 | $880.00 | $26.50 – $728.82 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $1,549.80 | $1,722.00 | $76.50 – $1,426.16 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $1,810.80 | $2,012.00 | $77.50 – $1,666.34 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $924.30 | $1,027.00 | $84.09 – $850.56 |
| Screening mammogram, both breasts CPT 77067 | $699.30 | $777.00 | $74.59 – $643.51 |
| Shoulder X-ray, 2 or more views CPT 73030 | $737.10 | $819.00 | $80.21 – $678.30 |
| Transvaginal pregnancy ultrasound CPT 76817 | $1,277.10 | $1,419.00 | $87.59 – $1,175.22 |
| Transvaginal ultrasound CPT 76830 | $856.80 | $952.00 | $76.50 – $788.45 |
| Ultrasound of the abdomen, complete CPT 76700 | $1,998.90 | $2,221.00 | $95.27 – $1,839.43 |
| Ultrasound of the neck or thyroid CPT 76536 | $1,446.30 | $1,607.00 | $76.35 – $1,330.92 |
| Wrist X-ray, 3 or more views CPT 73110 | $777.60 | $864.00 | $75.04 – $715.56 |
| X-ray of the lower back, 4 or more views CPT 72110 | $1,483.20 | $1,648.00 | $36.62 – $1,364.87 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $243.90 | $271.00 | $8.46 – $224.44 |
| Blood culture CPT 87040 | $450.90 | $501.00 | $10.32 – $414.93 |
| Blood draw (venipuncture) CPT 36415 | $38.70 | $43.00 | $2.59 – $35.61 |
| BNP test (heart failure) CPT 83880 | $742.50 | $825.00 | $37.94 – $683.26 |
| C-reactive protein (CRP) test CPT 86140 | $172.80 | $192.00 | $3.00 – $159.01 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $753.30 | $837.00 | $23.19 – $693.20 |
| Complete blood count (CBC) with differential CPT 85025 | $223.20 | $248.00 | $6.00 – $205.39 |
| Complete blood count (CBC), automated CPT 85027 | $155.70 | $173.00 | $6.47 – $143.28 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $289.80 | $322.00 | $10.56 – $266.68 |
| COVID-19 PCR test CPT 87635 | $263.70 | $293.00 | $35.49 – $242.66 |
| D-dimer test (blood clots) CPT 85379 | $175.50 | $195.00 | $10.18 – $161.50 |
| Drug screen, instrument chemistry CPT 80307 | $848.70 | $943.00 | $62.14 – $780.99 |
| Ferritin (iron stores) test CPT 82728 | $550.80 | $612.00 | $12.00 – $506.86 |
| Free T4 (thyroid) test CPT 84439 | $485.10 | $539.00 | $8.00 – $446.40 |
| Glucose (blood sugar) test CPT 82947 | $122.40 | $136.00 | $3.93 – $112.64 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $753.30 | $837.00 | $23.19 – $693.20 |
| Hemoglobin A1c test CPT 83036 | $384.30 | $427.00 | $7.00 – $353.64 |
| Hepatitis C antibody test CPT 86803 | $296.10 | $329.00 | $14.27 – $272.48 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $513.90 | $571.00 | $24.08 – $472.90 |
| Iron test CPT 83540 | $204.30 | $227.00 | $6.47 – $188.00 |
| Kidney function panel CPT 80069 | $309.60 | $344.00 | $8.68 – $284.90 |
| Lipase test (pancreas) CPT 83690 | $232.20 | $258.00 | $5.00 – $213.68 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $458.10 | $509.00 | $13.39 – $421.55 |
| Liver function panel CPT 80076 | $404.10 | $449.00 | $8.17 – $371.86 |
| Magnesium test CPT 83735 | $216.90 | $241.00 | $6.70 – $199.60 |
| Obstetric blood test panel CPT 80055 | $1,344.60 | $1,494.00 | $12.00 – $1,237.33 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $230.40 | $256.00 | $6.01 – $212.02 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $384.30 | $427.00 | $15.05 – $353.64 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $140.40 | $156.00 | $4.00 – $129.20 |
| PSA (prostate specific antigen), free CPT 84154 | $456.30 | $507.00 | $18.39 – $419.90 |
| PSA (prostate specific antigen), total CPT 84153 | $203.40 | $226.00 | $18.39 – $187.17 |
| Rapid strep test CPT 87880 | $212.40 | $236.00 | $6.30 – $195.46 |
| Sed rate (ESR) test CPT 85652 | $144.90 | $161.00 | $2.70 – $133.34 |
| TB skin test CPT 86580 | $58.50 | $65.00 | $5.50 – $86.63 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $367.20 | $408.00 | $16.80 – $337.91 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $909.90 | $1,011.00 | $34.00 – $837.31 |
| Troponin test (heart damage) CPT 84484 | $306.90 | $341.00 | $9.87 – $282.42 |
| Urinalysis, automated, with microscope CPT 81001 | $135.00 | $150.00 | $3.00 – $124.23 |
| Urinalysis, automated, without microscope CPT 81003 | $48.60 | $54.00 | $2.25 – $44.72 |
| Urinalysis, manual, with microscope CPT 81000 | $135.00 | $150.00 | $4.02 – $124.23 |
| Urinalysis, manual, without microscope CPT 81002 | $37.80 | $42.00 | $3.48 – $34.78 |
| Urine culture, colony count CPT 87086 | $293.40 | $326.00 | $8.00 – $269.99 |
| Urine pregnancy test CPT 81025 | $125.10 | $139.00 | $4.00 – $115.12 |
| Vitamin B12 test CPT 82607 | $325.80 | $362.00 | $13.00 – $299.81 |
| Vitamin D test CPT 82306 | $657.00 | $730.00 | $29.60 – $604.59 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $5,985.90 | $6,651.00 | $147.86 – $5,508.36 |
| ECG tracing only (no interpretation) CPT 93005 | $356.40 | $396.00 | $10.46 – $327.97 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $3,524.40 | $3,916.00 | $141.02 – $3,243.23 |
| Left heart catheterization CPT 93452 | $25,171.20 | $27,968.00 | $3,292.83 – $23,163.10 |
| Left heart catheterization with coronary angiogram CPT 93458 | $31,490.10 | $34,989.00 | $3,292.83 – $28,977.89 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $5,503.50 | $6,115.00 | $340.80 – $5,064.44 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | not posted | $4,764.00 – $25,273.16 | |
| Appendix removal, laparoscopic CPT 44970 | not posted | $5,729.53 – $20,640.83 | |
| Breast biopsy with ultrasound guidance CPT 19083 | $6,696.00 | $7,440.00 | $138.89 – $6,161.81 |
| Carpal tunnel release CPT 64721 | not posted | $345.00 – $6,908.53 | |
| Colonoscopy with biopsy CPT 45380 | not posted | $225.42 – $4,171.34 | |
| Colonoscopy with polyp removal (snare) CPT 45385 | not posted | $268.08 – $4,171.34 | |
| Colonoscopy, diagnostic CPT 45378 | not posted | $180.50 – $3,225.45 | |
| Ear tubes, under general anesthesia CPT 69436 | not posted | $113.28 – $5,240.50 | |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | not posted | $53.15 – $3,225.45 | |
| Gallbladder removal, laparoscopic CPT 47562 | not posted | $5,972.98 – $20,640.83 | |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | not posted | $7,279.74 – $36,832.89 | |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | not posted | $3,255.08 – $11,248.58 | |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | not posted | $3,259.00 – $20,640.83 | |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | not posted | $365.12 – $12,485.13 | |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | not posted | $625.02 – $11,478.80 | |
| Prostate biopsy CPT 55700 | $11,740.50 | $13,045.00 | $89.50 – $7,247.22 |
| Removal of a breast lump, open surgery CPT 19120 | not posted | $198.95 – $13,547.24 | |
| Rotator cuff repair, arthroscopic CPT 29827 | not posted | $5,729.53 – $25,273.16 | |
| Screening colonoscopy, average risk HCPCS G0121 | not posted | $933.37 – $3,225.45 | |
| Screening colonoscopy, high risk HCPCS G0105 | not posted | $933.37 – $3,225.45 | |
| Septoplasty (nasal septum repair) CPT 30520 | not posted | $3,259.00 – $11,473.37 | |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | not posted | $181.42 – $5,825.61 | |
| Tonsil and adenoid removal, under age 12 CPT 42820 | not posted | $2,550.00 – $20,928.48 | |
| Total hip replacement CPT 27130 | not posted | $13,172.54 – $45,520.35 | |
| Total knee replacement CPT 27447 | not posted | $13,172.54 – $45,520.35 | |
| Upper endoscopy (EGD) with biopsy CPT 43239 | not posted | $148.58 – $3,316.92 | |
| Upper endoscopy (EGD), diagnostic CPT 43235 | not posted | $125.22 – $3,316.92 | |
| Vasectomy CPT 55250 | not posted | $170.78 – $7,247.22 |
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 | $2,576.06 – $2,576.06 | |
| Fetal non-stress test CPT 59025 | $936.90 | $1,041.00 | $17.50 – $1,500.00 |
| IUD insertion CPT 58300 | not posted | $19.84 – $693.52 |
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 | $7,318.55 – $14,571.35 | |
| C-section, without complications MS-DRG 788 | not posted | $7,872.28 – $15,825.79 | |
| Chest pain MS-DRG 313 | not posted | $6,046.94 – $14,265.00 | |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $9,075.20 – $18,283.51 | |
| COPD flare-up, without complications MS-DRG 192 | not posted | $5,437.69 – $14,265.00 | |
| Fainting (syncope) MS-DRG 312 | not posted | $7,231.06 – $14,386.48 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $8,083.22 – $16,187.27 | |
| Heart failure, with major complications MS-DRG 291 | not posted | $10,450.70 – $21,190.18 | |
| Heart failure, without complications MS-DRG 293 | not posted | $4,844.08 – $14,265.00 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $14,265.00 – $161,473.23 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $14,265.00 – $31,838.10 | |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $4,844.85 – $14,265.00 | |
| Kidney failure, with complications MS-DRG 683 | not posted | $7,263.87 – $14,455.81 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $6,746.00 – $14,265.00 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $14,265.00 – $40,295.68 | |
| Normal newborn care MS-DRG 795 | not posted | $870.00 – $14,265.00 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $6,501.54 – $14,265.00 | |
| Pneumonia, with complications MS-DRG 194 | not posted | $6,717.90 – $14,265.00 | |
| Pneumonia, with major complications MS-DRG 193 | not posted | $10,689.70 – $21,695.26 | |
| Pneumonia, without complications MS-DRG 195 | not posted | $5,332.25 – $14,265.00 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $10,299.94 – $23,055.34 | |
| Sepsis, with major complications MS-DRG 871 | not posted | $14,265.00 – $32,062.57 | |
| Sepsis, without major complications MS-DRG 872 | not posted | $8,415.96 – $16,890.42 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $7,225.61 – $14,374.93 | |
| Spinal fusion except neck, without major complications MS-DRG 460 | not posted | $14,265.00 – $52,522.95 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $6,512.46 – $14,265.00 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $8,314.43 – $16,917.23 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $10,114.05 – $20,478.78 | |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $5,689.20 – $11,128.23 | |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $12,205.01 – $24,897.39 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $520.20 | $578.00 | $23.50 – $1,044.31 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $1,066.50 | $1,185.00 | $95.04 – $3,149.66 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $3,843.90 | $4,271.00 | $81.32 – $3,537.24 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Sleep study with CPAP titration CPT 95811 | $15,561.90 | $17,291.00 | $647.56 – $14,320.41 |
| Sleep study, overnight in a sleep lab CPT 95810 | $14,117.40 | $15,686.00 | $346.56 – $12,991.15 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $976.50 | $1,085.00 | $15.00 – $898.60 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $308.70 | $343.00 | $18.14 – $284.07 |
| Physical therapy evaluation, low complexity CPT 97161 | $585.00 | $650.00 | $62.40 – $538.33 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $613.80 | $682.00 | $65.47 – $564.83 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $306.90 | $341.00 | $8.38 – $282.42 |
| Therapeutic activities, 15 minutes CPT 97530 | $312.30 | $347.00 | $13.00 – $287.39 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $109.80 | $122.00 | $12.70 – $251.78 |
| IV hydration, each additional hour CPT 96361 | $278.10 | $309.00 | $9.00 – $255.91 |
| IV hydration, first hour CPT 96360 | $912.60 | $1,014.00 | $31.63 – $839.79 |
| IV push injection of a drug, first CPT 96374 | $864.90 | $961.00 | $31.02 – $795.90 |
| IV push injection, each additional drug CPT 96375 | $385.20 | $428.00 | $13.01 – $354.47 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $37.33 | $44.97 | ? – $37.24 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $7.06 | $8.51 | ? – $7.05 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $3.82 | $4.60 | ? – $3.81 |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | $3.69 | $4.44 | ? – $3.68 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $4.72 | $5.69 | ? – $4.71 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $11.61 | $13.99 | ? – $11.59 |
| Morphine injection, up to 10 mg HCPCS J2270 | $40.61 | $48.93 | $4.64 – $40.52 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $1.49 | $1.80 | ? – $1.49 |
| Propofol injection, per 10 mg HCPCS J2704 | $1.04 | $1.25 | ? – $1.04 |
| Saline IV solution, 1000 ml HCPCS J7030 | $1.04 | $1.25 | ? – $4.72 |
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.