HCA Houston Healthcare Tomball

605 Holderrieth, Tomball, TX 77375 · Acute care hospital · Emergency room

These are HCA Houston Healthcare Tomball's own posted figures from its standard-charges file dated September 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

227 of the services we track have a posted price here; 133 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	$7,347.12	$7,347.12	$955.13 – $6,245.05
Emergency room visit, level 1 (minor) CPT 99281	$710.92	$710.92	$119.43 – $604.28
Emergency room visit, level 2 CPT 99282	$1,397.90	$1,397.90	$234.85 – $1,188.22
Emergency room visit, level 3 (moderate) CPT 99283	$2,372.21	$2,372.21	$398.53 – $2,016.38
Emergency room visit, level 4 CPT 99284	$3,690.77	$3,690.77	$516.71 – $3,137.15
Emergency room visit, level 5 (most severe) CPT 99285	$5,031.78	$5,031.78	$704.45 – $4,277.01
Simple wound repair (stitches), 2.5 cm or less CPT 12001	not posted		$304.03 – $5,841.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	not posted		$120.60 – $172.66
New patient office visit, about 30 minutes CPT 99203	$2,591.89	$2,591.89	$181.30 – $259.56
New patient office visit, about 45 minutes CPT 99204	$3,698.35	$3,698.35	$306.96 – $439.45
New patient office visit, about 60 minutes CPT 99205	$3,698.35	$3,698.35	$400.58 – $573.49
Office consultation, about 40 minutes CPT 99243	not posted		$227.71 – $325.99
Office consultation, about 60 minutes CPT 99244	not posted		$366.00 – $523.97
Office visit, established patient, about 10 to 19 minutes CPT 99212	$2,394.84	$2,394.84	$60.72 – $86.93
Office visit, established patient, about 20 to 29 minutes CPT 99213	$2,591.89	$2,591.89	$121.45 – $173.87
Office visit, established patient, about 30 to 39 minutes CPT 99214	$3,698.35	$3,698.35	$221.90 – $3,143.60
Office visit, established patient, about 40 to 54 minutes CPT 99215	$3,698.35	$3,698.35	$263.95 – $377.88
Office visit, established patient, brief (often a nurse) CPT 99211	$2,394.84	$2,394.84	$21.93 – $31.39
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted		$71.48 – $333.22
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted		$86.92 – $405.65

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$1,250.02	$1,250.02	$22.76 – $104.45
Abdominal X-ray, 1 view CPT 74018	$1,401.00	$1,401.00	$84.06 – $1,190.85
Ankle X-ray, 3 or more views CPT 73610	$2,239.53	$2,239.53	$134.37 – $1,903.60
Bone density scan (DEXA), hips and spine CPT 77080	$2,390.67	$2,390.67	$226.62 – $306.53
Breast ultrasound, one breast, complete CPT 76641	$7,000.33	$7,000.33	$420.02 – $5,950.28
Breast ultrasound, one breast, limited CPT 76642	$6,869.85	$6,869.85	$412.19 – $5,839.37
Chest X-ray, 1 view CPT 71045	$1,678.00	$1,678.00	$100.68 – $1,426.30
Chest X-ray, 2 views CPT 71046	$2,018.00	$2,018.00	$121.08 – $1,715.30
CT angiogram of the chest (checks for lung clots) CPT 71275	$20,698.57	$20,698.57	$1,241.91 – $17,593.78
CT angiogram of the head CPT 70496	$20,698.57	$20,698.57	$1,241.91 – $17,593.78
CT scan of the abdomen and pelvis, with contrast CPT 74177	$33,493.96	$33,493.96	$2,009.64 – $28,469.87
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$35,211.98	$35,211.98	$2,112.72 – $29,930.18
CT scan of the abdomen and pelvis, without contrast CPT 74176	$28,541.92	$28,541.92	$1,712.52 – $24,260.63
CT scan of the abdomen, without contrast CPT 74150	$16,182.04	$16,182.04	$970.92 – $13,754.73
CT scan of the chest, with contrast CPT 71260	$13,771.12	$13,771.12	$826.27 – $11,705.45
CT scan of the chest, without contrast CPT 71250	$13,084.22	$13,084.22	$785.05 – $11,121.59
CT scan of the head, without contrast CPT 70450	$10,092.64	$10,092.64	$605.56 – $8,578.74
CT scan of the neck (cervical spine), without contrast CPT 72125	$15,522.06	$15,522.06	$931.32 – $13,193.75
CT scan of the pelvis, with contrast CPT 72193	$16,195.51	$16,195.51	$971.73 – $13,766.18
CT scan of the sinuses or face, without contrast CPT 70486	$12,105.48	$12,105.48	$726.33 – $10,289.66
Diagnostic mammogram, both breasts CPT 77066	$1,791.22	$1,791.22	$107.84 – $498.33
Diagnostic mammogram, one breast CPT 77065	$1,046.86	$1,046.86	$62.81 – $889.83
Foot X-ray, 3 or more views CPT 73630	$2,306.70	$2,306.70	$138.40 – $1,960.69
Hand X-ray, 3 or more views CPT 73130	$1,998.32	$1,998.32	$119.90 – $1,698.57
Knee X-ray, 3 views CPT 73562	$2,175.42	$2,175.42	$130.53 – $1,849.11
Leg or arm vein ultrasound, both sides CPT 93970	$6,446.13	$6,446.13	$386.77 – $5,479.21
Leg or arm vein ultrasound, one side CPT 93971	$5,756.16	$5,756.16	$345.37 – $4,892.74
Lower back X-ray, 2 or 3 views CPT 72100	$2,149.45	$2,149.45	$128.97 – $1,827.03
MRI of both breasts, without and with contrast CPT 77049	not posted		$2,127.00 – $2,739.00
MRI of the abdomen, without and with contrast CPT 74183	$29,819.30	$29,819.30	$348.50 – $2,268.00
MRI of the brain, without and with contrast CPT 70553	$33,674.16	$33,674.16	$328.11 – $2,268.00
MRI of the brain, without contrast CPT 70551	$18,251.80	$18,251.80	$202.15 – $2,268.00
MRI of the knee or other leg joint, without contrast CPT 73721	$19,225.80	$19,225.80	$1,153.55 – $16,341.93
MRI of the lower back (lumbar spine), without contrast CPT 72148	$19,070.09	$19,070.09	$203.12 – $2,739.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$19,284.56	$19,284.56	$202.45 – $2,739.00
MRI of the neck (cervical spine), without contrast CPT 72141	$19,842.82	$19,842.82	$202.45 – $2,739.00
MRI of the pelvis, without and with contrast CPT 72197	$22,396.06	$22,396.06	$360.24 – $2,739.00
MRI of the shoulder or other arm joint, without contrast CPT 73221	$20,020.58	$20,020.58	$1,201.23 – $17,017.49
Neck X-ray, 2 or 3 views CPT 72040	$2,102.13	$2,102.13	$126.13 – $1,786.81
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$5,444.87	$5,444.87	$326.69 – $4,628.14
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$4,899.19	$4,899.19	$293.95 – $4,164.31
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$4,500.00	$4,500.00	$270.00 – $3,825.00
Screening mammogram, both breasts CPT 77067	$901.54	$901.54	$763.68 – $1,032.99
Shoulder X-ray, 2 or more views CPT 73030	$2,326.55	$2,326.55	$139.59 – $1,977.57
Transvaginal pregnancy ultrasound CPT 76817	$3,400.06	$3,400.06	$204.00 – $2,890.05
Transvaginal ultrasound CPT 76830	$2,916.68	$2,916.68	$175.00 – $2,479.18
Ultrasound of the abdomen, complete CPT 76700	$6,235.20	$6,235.20	$374.11 – $5,299.92
Ultrasound of the neck or thyroid CPT 76536	$4,074.75	$4,074.75	$244.49 – $3,463.54
Wrist X-ray, 3 or more views CPT 73110	$1,853.30	$1,853.30	$111.20 – $1,575.31
X-ray of the lower back, 4 or more views CPT 72110	$4,004.28	$4,004.28	$240.26 – $3,403.64

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$1,839.00	$1,839.00	$8.29 – $58.19
Blood culture CPT 87040	$1,285.63	$1,285.63	$8.67 – $70.95
Blood draw (venipuncture) CPT 36415	$79.00	$79.00	$24.12 – $31.08
BNP test (heart failure) CPT 83880	$1,598.00	$1,598.00	$95.88 – $1,358.30
C-reactive protein (CRP) test CPT 86140	$171.95	$171.95	$4.35 – $35.66
Chlamydia test (DNA/NAAT) CPT 87491	$420.56	$420.56	$30.07 – $186.82
Complete blood count (CBC) with differential CPT 85025	not posted		$32.04 – $41.29
Complete blood count (CBC), automated CPT 85027	$732.00	$732.00	$43.92 – $622.20
Comprehensive metabolic panel (blood test) CPT 80053	$3,326.00	$3,326.00	$199.56 – $2,827.10
COVID-19 PCR test CPT 87635	$56.41	$56.41	$52.34 – $52.34
D-dimer test (blood clots) CPT 85379	$986.00	$986.00	$59.16 – $838.10
Drug screen, instrument chemistry CPT 80307	$2,430.57	$2,430.57	$145.83 – $2,065.98
Ferritin (iron stores) test CPT 82728	$1,141.96	$1,141.96	$11.68 – $71.87
Free T4 (thyroid) test CPT 84439	$639.07	$639.07	$7.58 – $62.08
General health panel (blood tests) CPT 80050	not posted		$167.27 – $215.56
Glucose (blood sugar) test CPT 82947	$230.49	$230.49	$3.30 – $27.06
Gonorrhea test (DNA/NAAT) CPT 87591	$420.56	$420.56	$29.48 – $241.36
Hemoglobin A1c test CPT 83036	$487.91	$487.91	$8.32 – $52.12
Hepatitis C antibody test CPT 86803	$1,321.55	$1,321.55	$11.99 – $98.19
HIV-1/HIV-2 antigen and antibody test CPT 87389	$975.81	$975.81	$20.23 – $165.62
Iron test CPT 83540	$683.96	$683.96	$5.54 – $34.15
Kidney function panel CPT 80069	$2,313.84	$2,313.84	$6.01 – $59.73
Lipase test (pancreas) CPT 83690	$745.34	$745.34	$44.72 – $633.54
Lipid panel, cholesterol and triglycerides CPT 80061	$1,335.00	$1,335.00	$80.10 – $1,134.75
Liver function panel CPT 80076	$1,879.00	$1,879.00	$6.01 – $56.20
Magnesium test CPT 83735	$797.72	$797.72	$47.86 – $678.06
Obstetric blood test panel CPT 80055	not posted		$196.54 – $253.28
Partial thromboplastin time (PTT), clotting test CPT 85730	$796.22	$796.22	$47.77 – $676.79
Pregnancy blood test (hCG), quantitative CPT 84702	$802.21	$802.21	$48.13 – $681.88
Prothrombin time (PT/INR), clotting test CPT 85610	$686.97	$686.97	$41.22 – $583.92
PSA (prostate specific antigen), free CPT 84154	$686.97	$686.97	$15.45 – $126.52
PSA (prostate specific antigen), total CPT 84153	$1,098.55	$1,098.55	$15.76 – $96.98
Rapid strep test CPT 87880	not posted		$14.17 – $14.17
Sed rate (ESR) test CPT 85652	$239.47	$239.47	$2.32 – $14.40
TB skin test CPT 86580	not posted		$41.52 – $53.51
Thyroid stimulating hormone (TSH) CPT 84443	$1,480.00	$1,480.00	$14.11 – $115.57
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$1,595.44	$1,595.44	$181.10 – $244.62
Troponin test (heart damage) CPT 84484	$1,134.00	$1,134.00	$68.04 – $963.90
Urinalysis, automated, with microscope CPT 81001	$610.63	$610.63	$2.66 – $21.81
Urinalysis, automated, without microscope CPT 81003	$342.74	$342.74	$20.56 – $291.33
Urinalysis, manual, with microscope CPT 81000	not posted		$16.71 – $21.54
Urinalysis, manual, without microscope CPT 81002	not posted		$2.98 – $17.97
Urine culture, colony count CPT 87086	$1,070.12	$1,070.12	$6.92 – $43.13
Urine pregnancy test CPT 81025	$493.89	$493.89	$7.23 – $59.19
Vitamin B12 test CPT 82607	$1,664.29	$1,664.29	$12.92 – $80.85
Vitamin D test CPT 82306	$1,526.60	$1,526.60	$91.60 – $1,297.61

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$6,420.70	$6,420.70	$385.24 – $5,457.60
ECG tracing only (no interpretation) CPT 93005	$1,920.22	$1,920.22	$128.72 – $184.28
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$8,257.80	$8,257.80	$317.09 – $453.96
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$13.25 – $55.19
Holter monitor, up to 48 hours CPT 93224	not posted		$59.98 – $303.04
Left heart catheterization CPT 93452	$19,095.86	$19,095.86	$2,482.46 – $16,231.48
Left heart catheterization with coronary angiogram CPT 93458	$27,225.95	$27,225.95	$3,539.37 – $23,142.06
Nuclear stress test (heart perfusion imaging) CPT 78452	$19,592.35	$19,592.35	$3,089.27 – $4,178.67
Treadmill stress test, complete CPT 93015	not posted		$169.51 – $242.67

Surgery

Service	Cash price	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted	$3,465.05 – $16,995.26
Appendix removal, laparoscopic CPT 44970	not posted	$2,369.00 – $2,369.00
Breast biopsy with ultrasound guidance CPT 19083	not posted	$521.99 – $3,249.00
Carpal tunnel release CPT 64721	not posted	$2,369.00 – $2,369.00
Colonoscopy with biopsy CPT 45380	not posted	$460.61 – $3,249.00
Colonoscopy with polyp removal (snare) CPT 45385	not posted	$450.72 – $3,755.00
Colonoscopy, diagnostic CPT 45378	not posted	$344.93 – $3,755.00
Colposcopy with biopsy CPT 57454	not posted	$68.31 – $5,841.00
Cystoscopy (bladder scope) CPT 52000	not posted	$250.06 – $3,128.00
Ear tubes, under general anesthesia CPT 69436	not posted	$441.67 – $12,562.00
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted	$137.20 – $137.20
Gallbladder removal, laparoscopic CPT 47562	not posted	$2,026.81 – $11,214.21
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted	$9,124.00 – $9,124.00
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted	$3,265.51 – $19,518.42
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted	$3,041.00 – $3,041.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted	$2,369.00 – $2,369.00
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted	$1,209.12 – $8,234.00
Kidney stone shock-wave lithotripsy CPT 50590	not posted	$1,200.05 – $10,342.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted	$1,142.68 – $7,014.00
Lower colon endoscopy with ultrasound CPT 45391	not posted	$450.72 – $3,755.00
Nasal endoscopy, diagnostic CPT 31231	not posted	$71.55 – $5,841.00
Prostate biopsy CPT 55700	not posted	$718.08 – $816.00
Prostate removal, laparoscopic or robotic CPT 55866	not posted	$14,638.81 – $19,518.42
Removal of a breast lump, open surgery CPT 19120	not posted	$2,369.00 – $2,369.00
Rotator cuff repair, arthroscopic CPT 29827	not posted	$2,518.45 – $13,878.12
Screening colonoscopy, average risk HCPCS G0121	not posted	$352.49 – $3,755.00
Screening colonoscopy, high risk HCPCS G0105	not posted	$352.49 – $3,755.00
Septoplasty (nasal septum repair) CPT 30520	not posted	$930.95 – $8,234.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted	$1,672.00 – $12,562.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted	$8,778.00 – $16,425.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted	$2,051.93 – $2,051.93
Total hip replacement CPT 27130	not posted	$12,000.00 – $60,464.00
Total knee replacement CPT 27447	not posted	$948.00 – $46,412.77
Upper endoscopy (EGD) with biopsy CPT 43239	not posted	$368.44 – $915.67
Upper endoscopy (EGD), diagnostic CPT 43235	not posted	$351.70 – $351.70
Vasectomy CPT 55250	not posted	$685.44 – $5,571.00

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		$3,390.00 – $27,623.25
Fetal non-stress test CPT 59025	$1,201.08	$1,201.08	$17.36 – $680.00
IUD insertion CPT 58300	not posted		$508.94 – $5,841.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$948.00 – $26,874.42
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted		$948.00 – $25,611.40

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$931.92 – $1,015.79
C-section, without complications MS-DRG 788	not posted	$1,200.00 – $12,740.00
Chest pain MS-DRG 313	not posted	$5,081.00 – $15,468.48
COPD flare-up, with major complications MS-DRG 190	not posted	$9,510.71 – $12,251.16
COPD flare-up, without complications MS-DRG 192	not posted	$5,512.21 – $7,100.52
Fainting (syncope) MS-DRG 312	not posted	$7,483.56 – $9,639.90
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$8,420.29 – $10,846.54
Heart failure, with major complications MS-DRG 291	not posted	$11,022.71 – $14,198.83
Heart failure, without complications MS-DRG 293	not posted	$4,859.68 – $6,259.96
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$83,995.12 – $108,197.77
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$15,982.98 – $47,377.64
Irregular heartbeat, without complications MS-DRG 310	not posted	$4,860.53 – $6,261.07
Kidney failure, with complications MS-DRG 683	not posted	$7,519.62 – $9,686.35
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$5,879.00 – $17,391.30
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$20,961.00 – $27,000.78
Normal newborn care MS-DRG 795	not posted	$656.00 – $4,398.82
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$6,681.63 – $8,606.89
Pneumonia, with complications MS-DRG 194	not posted	$6,919.46 – $8,913.25
Pneumonia, with major complications MS-DRG 193	not posted	$11,285.44 – $14,537.26
Pneumonia, without complications MS-DRG 195	not posted	$5,396.30 – $6,951.21
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$1,009.54 – $1,100.39
Sepsis, with major complications MS-DRG 871	not posted	$24,318.00 – $30,800.00
Sepsis, without major complications MS-DRG 872	not posted	$3,559.00 – $3,559.00
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$7,477.55 – $9,632.15
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$995.00 – $5,099.00
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$8,674.44 – $11,173.92
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$10,652.65 – $13,722.14
Vaginal delivery, without complications MS-DRG 807	not posted	$6,048.00 – $13,544.00
Weight loss surgery, without complications MS-DRG 621	not posted	$13,250.00 – $23,879.00

Pain and spine

Service	Cash price	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	not posted	$30.00 – $5,841.00
Lower back nerve root injection with imaging guidance CPT 64483	not posted	$365.66 – $3,083.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	not posted	$276.00 – $5,841.00
Lower back spinal injection (epidural), without imaging CPT 62322	not posted	$282.06 – $5,841.00

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$892.44 – $5,571.00
Eye exam, new patient, comprehensive CPT 92004	not posted	$271.28 – $388.37
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$218.75 – $3,755.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$323.74 – $463.47

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$1,323.04	$1,323.04	$290.54 – $391.97
Sleep study with CPAP titration CPT 95811	$17,234.09	$17,234.09	$2,476.00 – $3,534.00
Sleep study, overnight in a sleep lab CPT 95810	$16,722.22	$16,722.22	$2,476.00 – $3,534.00

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$1,897.77	$1,897.77	$323.74 – $463.47

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$439.00	$439.00	$26.34 – $373.15
Physical therapy evaluation, low complexity CPT 97161	$819.00	$819.00	$49.14 – $696.15
Physical therapy evaluation, moderate complexity CPT 97162	$1,043.00	$1,043.00	$62.58 – $886.55
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$403.20	$403.20	$24.19 – $342.72
Therapeutic activities, 15 minutes CPT 97530	$347.88	$347.88	$20.87 – $295.70

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Group psychotherapy CPT 90853	$245.75	$245.75	$14.74 – $208.89

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$501.04	$501.04	$30.06 – $425.88
IV hydration, each additional hour CPT 96361	$198.26	$198.26	$11.90 – $168.52
IV hydration, first hour CPT 96360	$935.47	$935.47	$56.13 – $795.15
IV push injection of a drug, first CPT 96374	$729.73	$729.73	$43.78 – $620.27
IV push injection, each additional drug CPT 96375	$729.73	$729.73	$43.78 – $620.27

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$504.89	$504.89	$30.29 – $429.16
Dexamethasone injection, per 1 mg HCPCS J1100	$106.96	$106.96	$6.42 – $90.92
Fentanyl injection, per 0.1 mg HCPCS J3010	$69.89	$69.89	$4.19 – $59.41
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$61.32	$61.32	$3.68 – $52.12
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$61.32	$61.32	$3.68 – $52.12
Morphine injection, up to 10 mg HCPCS J2270	$47.07	$47.07	$2.82 – $40.01
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$68.46	$68.46	$4.11 – $58.19
Propofol injection, per 10 mg HCPCS J2704	$345.16	$345.16	$20.71 – $293.39
Saline IV solution, 1000 ml HCPCS J7030	$419.31	$419.31	$2.19 – $40.23

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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