HCA Houston Healthcare West
12141 Richmond Ave, Houston, TX 77082 · Acute care hospital · Emergency room
These are HCA Houston Healthcare West'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.
226 of the services we track have a posted price here; 131 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 | $13,527.00 | $13,527.00 | $1,758.51 – $12,174.30 |
| Emergency room visit, level 1 (minor) CPT 99281 | $551.00 | $551.00 | $92.57 – $495.90 |
| Emergency room visit, level 2 CPT 99282 | $1,569.00 | $1,569.00 | $263.59 – $1,412.10 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $3,015.00 | $3,015.00 | $506.52 – $2,713.50 |
| Emergency room visit, level 4 CPT 99284 | $4,896.00 | $4,896.00 | $685.44 – $4,406.40 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $7,151.00 | $7,151.00 | $1,001.14 – $6,435.90 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | not posted | $5,841.00 – $5,841.00 |
Office visits
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $2,060.00 | $2,060.00 | $52.83 – $665.00 |
| Abdominal X-ray, 1 view CPT 74018 | $2,042.00 | $2,042.00 | $122.52 – $1,837.80 |
| Ankle X-ray, 3 or more views CPT 73610 | $2,784.00 | $2,784.00 | $167.04 – $2,505.60 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $2,051.00 | $2,051.00 | $38.09 – $111.80 |
| Breast ultrasound, one breast, complete CPT 76641 | $9,789.00 | $9,789.00 | $300.00 – $8,810.10 |
| Breast ultrasound, one breast, limited CPT 76642 | $6,166.00 | $6,166.00 | $300.00 – $5,549.40 |
| Chest X-ray, 1 view CPT 71045 | $2,216.00 | $2,216.00 | $132.96 – $1,994.40 |
| Chest X-ray, 2 views CPT 71046 | $2,728.00 | $2,728.00 | $163.68 – $2,455.20 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $27,253.00 | $27,253.00 | $1,635.18 – $24,527.70 |
| CT angiogram of the head CPT 70496 | $22,030.00 | $22,030.00 | $1,321.80 – $19,827.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $34,566.00 | $34,566.00 | $2,073.96 – $31,109.40 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $42,904.00 | $42,904.00 | $2,574.24 – $38,613.60 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $31,983.00 | $31,983.00 | $1,918.98 – $28,784.70 |
| CT scan of the abdomen, without contrast CPT 74150 | $17,317.00 | $17,317.00 | $1,039.02 – $15,585.30 |
| CT scan of the chest, with contrast CPT 71260 | $18,583.00 | $18,583.00 | $1,114.98 – $16,724.70 |
| CT scan of the chest, without contrast CPT 71250 | $17,587.00 | $17,587.00 | $1,055.22 – $15,828.30 |
| CT scan of the head, without contrast CPT 70450 | $13,743.00 | $13,743.00 | $824.58 – $12,368.70 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $18,976.00 | $18,976.00 | $1,138.56 – $17,078.40 |
| CT scan of the pelvis, with contrast CPT 72193 | $15,702.00 | $15,702.00 | $942.12 – $14,131.80 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $14,508.00 | $14,508.00 | $870.48 – $13,057.20 |
| Diagnostic mammogram, both breasts CPT 77066 | $3,708.00 | $3,708.00 | $516.00 – $665.00 |
| Diagnostic mammogram, one breast CPT 77065 | $2,519.00 | $2,519.00 | $151.14 – $2,267.10 |
| Foot X-ray, 3 or more views CPT 73630 | $2,542.00 | $2,542.00 | $152.52 – $2,287.80 |
| Hand X-ray, 3 or more views CPT 73130 | $2,674.00 | $2,674.00 | $160.44 – $2,406.60 |
| Knee X-ray, 3 views CPT 73562 | $2,066.00 | $2,066.00 | $123.96 – $1,859.40 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $12,930.00 | $12,930.00 | $300.00 – $11,637.00 |
| Leg or arm vein ultrasound, one side CPT 93971 | $9,163.00 | $9,163.00 | $300.00 – $8,246.70 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $3,296.00 | $3,296.00 | $197.76 – $2,966.40 |
| 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 | $31,330.00 | $31,330.00 | $1,879.80 – $28,197.00 |
| MRI of the brain, without and with contrast CPT 70553 | $25,098.00 | $25,098.00 | $1,505.88 – $22,588.20 |
| MRI of the brain, without contrast CPT 70551 | $15,853.00 | $15,853.00 | $951.18 – $14,267.70 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $20,844.00 | $20,844.00 | $1,250.64 – $18,759.60 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $19,795.00 | $19,795.00 | $1,187.70 – $17,815.50 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $19,795.00 | $19,795.00 | $1,187.70 – $17,815.50 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $19,795.00 | $19,795.00 | $1,187.70 – $17,815.50 |
| MRI of the pelvis, without and with contrast CPT 72197 | $32,208.00 | $32,208.00 | $1,932.48 – $28,987.20 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $20,844.00 | $20,844.00 | $1,250.64 – $18,759.60 |
| Neck X-ray, 2 or 3 views CPT 72040 | $2,917.00 | $2,917.00 | $175.02 – $2,625.30 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $4,198.00 | $4,198.00 | $251.88 – $3,778.20 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $6,605.00 | $6,605.00 | $300.00 – $5,944.50 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $4,554.00 | $4,554.00 | $273.24 – $4,098.60 |
| Screening mammogram, both breasts CPT 77067 | $2,060.00 | $2,060.00 | $516.00 – $665.00 |
| Shoulder X-ray, 2 or more views CPT 73030 | $2,600.00 | $2,600.00 | $156.00 – $2,340.00 |
| Transvaginal pregnancy ultrasound CPT 76817 | $4,207.00 | $4,207.00 | $252.42 – $3,786.30 |
| Transvaginal ultrasound CPT 76830 | $2,993.00 | $2,993.00 | $179.58 – $2,693.70 |
| Ultrasound of the abdomen, complete CPT 76700 | $4,578.00 | $4,578.00 | $274.68 – $4,120.20 |
| Ultrasound of the neck or thyroid CPT 76536 | $4,550.00 | $4,550.00 | $273.00 – $4,095.00 |
| Wrist X-ray, 3 or more views CPT 73110 | $2,496.00 | $2,496.00 | $149.76 – $2,246.40 |
| X-ray of the lower back, 4 or more views CPT 72110 | $4,736.00 | $4,736.00 | $284.16 – $4,262.40 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $1,511.00 | $1,511.00 | $90.66 – $1,359.90 |
| Blood culture CPT 87040 | $1,076.00 | $1,076.00 | $8.84 – $53.90 |
| Blood draw (venipuncture) CPT 36415 | not posted | $24.12 – $31.08 | |
| BNP test (heart failure) CPT 83880 | $1,175.00 | $1,175.00 | $70.50 – $1,057.50 |
| C-reactive protein (CRP) test CPT 86140 | $540.00 | $540.00 | $32.40 – $486.00 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $322.00 | $322.00 | $30.07 – $186.82 |
| Complete blood count (CBC) with differential CPT 85025 | not posted | $6.40 – $53.49 | |
| Complete blood count (CBC), automated CPT 85027 | $694.00 | $694.00 | $41.64 – $624.60 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $2,097.00 | $2,097.00 | $125.82 – $1,887.30 |
| COVID-19 PCR test CPT 87635 | $62.00 | $62.00 | $52.34 – $52.34 |
| D-dimer test (blood clots) CPT 85379 | $663.00 | $663.00 | $39.78 – $596.70 |
| Drug screen, instrument chemistry CPT 80307 | $1,781.00 | $1,781.00 | $106.86 – $1,602.90 |
| Ferritin (iron stores) test CPT 82728 | $997.00 | $997.00 | $59.82 – $897.30 |
| Free T4 (thyroid) test CPT 84439 | $588.00 | $588.00 | $35.28 – $529.20 |
| General health panel (blood tests) CPT 80050 | not posted | $167.27 – $215.56 | |
| Glucose (blood sugar) test CPT 82947 | $357.00 | $357.00 | $21.42 – $321.30 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $374.00 | $374.00 | $28.89 – $241.36 |
| Hemoglobin A1c test CPT 83036 | $575.00 | $575.00 | $34.50 – $517.50 |
| Hepatitis C antibody test CPT 86803 | $1,490.00 | $1,490.00 | $12.23 – $75.44 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $722.00 | $722.00 | $19.83 – $165.62 |
| Iron test CPT 83540 | $571.00 | $571.00 | $5.32 – $44.53 |
| Kidney function panel CPT 80069 | $1,511.00 | $1,511.00 | $5.89 – $59.73 |
| Lipase test (pancreas) CPT 83690 | $657.00 | $657.00 | $39.42 – $591.30 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $1,045.00 | $1,045.00 | $62.70 – $940.50 |
| Liver function panel CPT 80076 | $1,693.00 | $1,693.00 | $101.58 – $1,523.70 |
| Magnesium test CPT 83735 | $731.00 | $731.00 | $43.86 – $657.90 |
| Obstetric blood test panel CPT 80055 | not posted | $196.54 – $253.28 | |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $721.00 | $721.00 | $43.26 – $648.90 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $955.00 | $955.00 | $57.30 – $859.50 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $620.00 | $620.00 | $37.20 – $558.00 |
| PSA (prostate specific antigen), free CPT 84154 | $159.00 | $159.00 | $9.54 – $143.10 |
| PSA (prostate specific antigen), total CPT 84153 | $827.00 | $827.00 | $49.62 – $744.30 |
| Rapid strep test CPT 87880 | not posted | $14.17 – $88.00 | |
| Sed rate (ESR) test CPT 85652 | $414.00 | $414.00 | $24.84 – $372.60 |
| TB skin test CPT 86580 | not posted | $41.52 – $53.51 | |
| Thyroid stimulating hormone (TSH) CPT 84443 | $1,306.00 | $1,306.00 | $78.36 – $1,175.40 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $634.00 | $634.00 | $99.93 – $157.81 |
| Troponin test (heart damage) CPT 84484 | $1,223.00 | $1,223.00 | $73.38 – $1,100.70 |
| Urinalysis, automated, with microscope CPT 81001 | $620.00 | $620.00 | $37.20 – $558.00 |
| Urinalysis, automated, without microscope CPT 81003 | $620.00 | $620.00 | $37.20 – $558.00 |
| Urinalysis, manual, with microscope CPT 81000 | not posted | $3.45 – $21.54 | |
| Urinalysis, manual, without microscope CPT 81002 | not posted | $13.94 – $17.97 | |
| Urine culture, colony count CPT 87086 | $880.00 | $880.00 | $52.80 – $792.00 |
| Urine pregnancy test CPT 81025 | $886.00 | $886.00 | $7.37 – $44.92 |
| Vitamin B12 test CPT 82607 | $779.00 | $779.00 | $46.74 – $701.10 |
| Vitamin D test CPT 82306 | $663.00 | $663.00 | $39.78 – $596.70 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $10,007.00 | $10,007.00 | $300.00 – $9,006.30 |
| ECG tracing only (no interpretation) CPT 93005 | $1,236.00 | $1,236.00 | $74.16 – $1,112.40 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $11,511.00 | $11,511.00 | $300.00 – $10,359.90 |
| 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 – $363.65 | |
| Left heart catheterization CPT 93452 | $31,953.00 | $31,953.00 | $300.00 – $28,757.70 |
| Left heart catheterization with coronary angiogram CPT 93458 | $34,826.00 | $34,826.00 | $300.00 – $31,343.40 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $21,581.00 | $21,581.00 | $300.00 – $19,422.90 |
| Treadmill stress test, complete CPT 93015 | not posted | $169.51 – $291.21 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | not posted | $2,369.00 – $2,369.00 | |
| Appendix removal, laparoscopic CPT 44970 | not posted | $8,410.66 – $11,987.60 | |
| Breast biopsy with ultrasound guidance CPT 19083 | not posted | $521.99 – $12,562.00 | |
| 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 – $344.93 | |
| Colposcopy with biopsy CPT 57454 | not posted | $63.76 – $307.65 | |
| 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 – $3,128.00 | |
| Gallbladder removal, laparoscopic CPT 47562 | not posted | $2,026.81 – $11,987.60 | |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | not posted | $9,124.00 – $20,713.26 | |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | not posted | $3,265.51 – $3,265.51 | |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | not posted | $1,141.20 – $6,195.29 | |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | not posted | $1,983.29 – $11,987.60 | |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | not posted | $1,209.12 – $1,209.12 | |
| Kidney stone shock-wave lithotripsy CPT 50590 | not posted | $1,226.38 – $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 | $460.61 – $3,249.00 | |
| Nasal endoscopy, diagnostic CPT 31231 | not posted | $71.55 – $5,841.00 | |
| Prostate biopsy CPT 55700 | not posted | $685.44 – $3,755.00 | |
| Prostate removal, laparoscopic or robotic CPT 55866 | not posted | $11,558.00 – $20,864.51 | |
| Removal of a breast lump, open surgery CPT 19120 | not posted | $1,011.84 – $12,562.00 | |
| Rotator cuff repair, arthroscopic CPT 29827 | not posted | $9,124.00 – $9,124.00 | |
| Screening colonoscopy, average risk HCPCS G0121 | not posted | $352.49 – $3,249.00 | |
| 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 | $1,915.14 – $5,976.54 | |
| Total hip replacement CPT 27130 | not posted | $3,375.00 – $42,583.00 | |
| Total knee replacement CPT 27447 | not posted | $3,375.00 – $40,700.43 | |
| Upper endoscopy (EGD) with biopsy CPT 43239 | not posted | $328.25 – $915.67 | |
| Upper endoscopy (EGD), diagnostic CPT 43235 | not posted | $351.70 – $3,128.00 | |
| 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 | $5,841.00 – $5,841.00 | |
| Fetal non-stress test CPT 59025 | $1,499.00 | $1,499.00 | $15.46 – $680.00 |
| IUD insertion CPT 58300 | not posted | $5,841.00 – $5,841.00 | |
| Vaginal birth after a prior C-section (VBAC), routine care CPT 59610 | not posted | $3,390.00 – $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 | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | not posted | $13,075.41 – $13,075.41 | |
| C-section, without complications MS-DRG 788 | not posted | $13,743.47 – $13,743.47 | |
| Chest pain MS-DRG 313 | not posted | $11,644.35 – $11,644.35 | |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $15,052.36 – $15,052.36 | |
| COPD flare-up, without complications MS-DRG 192 | not posted | $10,958.71 – $10,958.71 | |
| Fainting (syncope) MS-DRG 312 | not posted | $12,976.96 – $12,976.96 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $13,935.98 – $13,935.98 | |
| Heart failure, with major complications MS-DRG 291 | not posted | $16,600.32 – $16,600.32 | |
| Heart failure, without complications MS-DRG 293 | not posted | $10,290.65 – $10,290.65 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $91,309.02 – $91,309.02 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $22,270.93 – $22,270.93 | |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $4,860.53 – $6,261.07 | |
| Kidney failure, with complications MS-DRG 683 | not posted | $13,013.88 – $13,013.88 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $12,431.08 – $12,431.08 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $26,775.09 – $26,775.09 | |
| Normal newborn care MS-DRG 795 | not posted | $7,071.64 – $7,071.64 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $12,155.95 – $12,155.95 | |
| Pneumonia, with complications MS-DRG 194 | not posted | $6,919.46 – $8,913.25 | |
| Pneumonia, with major complications MS-DRG 193 | not posted | $16,869.30 – $16,869.30 | |
| Pneumonia, without complications MS-DRG 195 | not posted | $10,840.04 – $10,840.04 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $17,593.62 – $17,593.62 | |
| Sepsis, with major complications MS-DRG 871 | not posted | $22,390.49 – $22,390.49 | |
| Sepsis, without major complications MS-DRG 872 | not posted | $14,310.45 – $14,310.45 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $12,970.80 – $12,970.80 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $12,168.26 – $12,168.26 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $14,196.17 – $14,196.17 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $250.00 – $23,067.21 | |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $11,241.76 – $11,241.76 | |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $18,574.62 – $18,574.62 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | not posted | $29.36 – $3,128.00 | |
| Lower back nerve root injection with imaging guidance CPT 64483 | not posted | $357.81 – $3,128.00 | |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | not posted | $5,841.00 – $5,841.00 | |
| Lower back spinal injection (epidural), without imaging CPT 62322 | not posted | $276.00 – $5,841.00 |
Eye
| Service | Cash price | Gross charge | 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 – $466.04 | |
| 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 – $556.17 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | not posted | $290.54 – $391.97 | |
| Sleep study with CPAP titration CPT 95811 | $16,911.00 | $16,911.00 | $1,232.08 – $2,116.65 |
| Sleep study, overnight in a sleep lab CPT 95810 | $16,176.00 | $16,176.00 | $1,172.20 – $2,013.78 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $1,920.00 | $1,920.00 | $323.74 – $556.17 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $683.00 | $683.00 | $40.98 – $614.70 |
| Physical therapy evaluation, low complexity CPT 97161 | $977.00 | $977.00 | $58.62 – $879.30 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $1,079.00 | $1,079.00 | $64.74 – $971.10 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $707.00 | $707.00 | $42.42 – $636.30 |
| Therapeutic activities, 15 minutes CPT 97530 | $727.00 | $727.00 | $43.62 – $654.30 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $107.00 | $107.00 | $6.42 – $600.00 |
| IV hydration, each additional hour CPT 96361 | $100.00 | $100.00 | $6.00 – $600.00 |
| IV hydration, first hour CPT 96360 | $393.00 | $393.00 | $23.58 – $600.00 |
| IV push injection of a drug, first CPT 96374 | $204.00 | $204.00 | $12.24 – $600.00 |
| IV push injection, each additional drug CPT 96375 | $92.00 | $92.00 | $5.52 – $600.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $1,846.00 | $1,846.00 | $110.76 – $1,661.40 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $100.00 | $100.00 | $6.00 – $90.00 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $194.93 | $194.93 | $11.70 – $175.44 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $48.00 | $48.00 | $2.88 – $43.20 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $82.00 | $82.00 | $4.92 – $73.80 |
| Morphine injection, up to 10 mg HCPCS J2270 | $147.50 | $147.50 | $8.85 – $132.75 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $679.00 | $679.00 | $40.74 – $611.10 |
| Propofol injection, per 10 mg HCPCS J2704 | $1,487.00 | $1,487.00 | $89.22 – $1,338.30 |
| Saline IV solution, 1000 ml HCPCS J7030 | $503.00 | $503.00 | $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.