Medical City Alliance

3101 North Tarrant Parkway, Fort Worth, TX 76177 · Acute care hospital · Emergency room

These are Medical City Alliance'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; 124 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	$11,816.71	$11,816.71	$1,595.26 – $11,816.71
Emergency room visit, level 1 (minor) CPT 99281	$1,478.97	$1,478.97	$199.66 – $1,478.97
Emergency room visit, level 2 CPT 99282	$1,782.77	$1,782.77	$240.67 – $1,782.77
Emergency room visit, level 3 (moderate) CPT 99283	$2,857.78	$2,857.78	$385.80 – $2,857.78
Emergency room visit, level 4 CPT 99284	$3,669.03	$3,669.03	$495.32 – $3,669.03
Emergency room visit, level 5 (most severe) CPT 99285	$7,974.05	$7,974.05	$1,076.50 – $7,974.05
Simple wound repair (stitches), 2.5 cm or less CPT 12001	not posted		$2,152.00 – $4,850.00

Office visits

Service	Cash price	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	not posted	$141.73 – $275.74
New patient office visit, about 30 minutes CPT 99203	not posted	$213.07 – $414.52
New patient office visit, about 45 minutes CPT 99204	not posted	$360.75 – $701.81
New patient office visit, about 60 minutes CPT 99205	not posted	$470.77 – $915.87
Office consultation, about 40 minutes CPT 99243	not posted	$267.60 – $520.61
Office consultation, about 60 minutes CPT 99244	not posted	$430.13 – $836.79
Office visit, established patient, about 10 to 19 minutes CPT 99212	not posted	$71.36 – $138.83
Office visit, established patient, about 20 to 29 minutes CPT 99213	not posted	$142.72 – $277.66
Office visit, established patient, about 30 to 39 minutes CPT 99214	not posted	$220.03 – $428.05
Office visit, established patient, about 40 to 54 minutes CPT 99215	not posted	$310.20 – $603.48
Office visit, established patient, brief (often a nurse) CPT 99211	not posted	$25.77 – $50.13
Preventive checkup, new patient, age 18 to 39 CPT 99385	not posted	$67.64 – $532.16
Preventive checkup, new patient, age 40 to 64 CPT 99386	not posted	$82.19 – $647.83

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$251.97	$251.97	$22.36 – $131.43
Abdominal X-ray, 1 view CPT 74018	$867.56	$867.56	$60.73 – $867.56
Ankle X-ray, 3 or more views CPT 73610	$1,569.37	$1,569.37	$109.86 – $1,569.37
Bone density scan (DEXA), hips and spine CPT 77080	$765.96	$765.96	$53.62 – $765.96
Breast ultrasound, one breast, complete CPT 76641	$1,709.31	$1,709.31	$119.65 – $1,709.31
Breast ultrasound, one breast, limited CPT 76642	$1,065.07	$1,065.07	$74.55 – $1,065.07
Chest X-ray, 1 view CPT 71045	$872.91	$872.91	$61.10 – $872.91
Chest X-ray, 2 views CPT 71046	$1,150.95	$1,150.95	$80.57 – $1,150.95
CT angiogram of the chest (checks for lung clots) CPT 71275	$7,508.61	$7,508.61	$525.60 – $7,508.61
CT angiogram of the head CPT 70496	$7,410.23	$7,410.23	$518.72 – $7,410.23
CT scan of the abdomen and pelvis, with contrast CPT 74177	$15,882.82	$15,882.82	$1,111.80 – $15,882.82
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$18,798.41	$18,798.41	$1,315.89 – $18,798.41
CT scan of the abdomen and pelvis, without contrast CPT 74176	$13,203.33	$13,203.33	$924.23 – $13,203.33
CT scan of the abdomen, without contrast CPT 74150	$7,470.56	$7,470.56	$522.94 – $7,470.56
CT scan of the chest, with contrast CPT 71260	$6,454.12	$6,454.12	$451.79 – $6,454.12
CT scan of the chest, without contrast CPT 71250	$5,640.96	$5,640.96	$394.87 – $5,640.96
CT scan of the head, without contrast CPT 70450	$5,880.98	$5,880.98	$411.67 – $5,880.98
CT scan of the neck (cervical spine), without contrast CPT 72125	$5,950.49	$5,950.49	$416.53 – $5,950.49
CT scan of the pelvis, with contrast CPT 72193	$7,023.34	$7,023.34	$491.63 – $7,023.34
CT scan of the sinuses or face, without contrast CPT 70486	$3,112.30	$3,112.30	$217.86 – $3,112.30
Diagnostic mammogram, both breasts CPT 77066	$1,548.59	$1,548.59	$165.73 – $263.00
Diagnostic mammogram, one breast CPT 77065	$1,332.02	$1,332.02	$93.24 – $1,332.02
Foot X-ray, 3 or more views CPT 73630	$1,640.21	$1,640.21	$114.81 – $1,640.21
Hand X-ray, 3 or more views CPT 73130	$1,640.21	$1,640.21	$114.81 – $1,640.21
Knee X-ray, 3 views CPT 73562	$2,363.39	$2,363.39	$165.44 – $2,363.39
Leg or arm vein ultrasound, both sides CPT 93970	$2,096.36	$2,096.36	$146.75 – $2,096.36
Leg or arm vein ultrasound, one side CPT 93971	$1,397.58	$1,397.58	$97.83 – $1,397.58
Lower back X-ray, 2 or 3 views CPT 72100	$1,306.03	$1,306.03	$91.42 – $1,306.03
MRI of both breasts, without and with contrast CPT 77049	not posted		$395.55 – $635.92
MRI of the abdomen, without and with contrast CPT 74183	$14,129.29	$14,129.29	$616.10 – $828.27
MRI of the brain, without and with contrast CPT 70553	$12,380.49	$12,380.49	$367.48 – $367.48
MRI of the brain, without contrast CPT 70551	$9,307.85	$9,307.85	$651.55 – $9,307.85
MRI of the knee or other leg joint, without contrast CPT 73721	$16,727.97	$16,727.97	$1,170.96 – $16,727.97
MRI of the lower back (lumbar spine), without contrast CPT 72148	$9,795.44	$9,795.44	$197.14 – $1,321.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$9,762.75	$9,762.75	$215.75 – $215.75
MRI of the neck (cervical spine), without contrast CPT 72141	$10,022.90	$10,022.90	$701.60 – $10,022.90
MRI of the pelvis, without and with contrast CPT 72197	$11,414.84	$11,414.84	$799.04 – $11,414.84
MRI of the shoulder or other arm joint, without contrast CPT 73221	$16,727.97	$16,727.97	$1,170.96 – $16,727.97
Neck X-ray, 2 or 3 views CPT 72040	$1,098.83	$1,098.83	$76.92 – $1,098.83
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$2,828.86	$2,828.86	$198.02 – $2,828.86
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$2,884.69	$2,884.69	$201.93 – $2,884.69
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$2,928.28	$2,928.28	$204.98 – $2,928.28
Screening mammogram, both breasts CPT 77067	$789.09	$789.09	$87.18 – $445.63
Shoulder X-ray, 2 or more views CPT 73030	$1,987.77	$1,987.77	$139.14 – $1,987.77
Transvaginal pregnancy ultrasound CPT 76817	$2,399.82	$2,399.82	$167.99 – $2,399.82
Transvaginal ultrasound CPT 76830	$2,828.86	$2,828.86	$198.02 – $2,828.86
Ultrasound of the abdomen, complete CPT 76700	$2,886.06	$2,886.06	$202.02 – $2,886.06
Ultrasound of the neck or thyroid CPT 76536	$2,845.20	$2,845.20	$199.16 – $2,845.20
Wrist X-ray, 3 or more views CPT 73110	$2,021.20	$2,021.20	$141.48 – $2,021.20
X-ray of the lower back, 4 or more views CPT 72110	$1,939.66	$1,939.66	$135.78 – $1,939.66

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$1,532.98	$1,532.98	$107.31 – $1,532.98
Blood culture CPT 87040	$679.03	$679.03	$47.53 – $679.03
Blood draw (venipuncture) CPT 36415	$72.01	$72.01	$5.04 – $72.01
BNP test (heart failure) CPT 83880	$1,809.05	$1,809.05	$126.63 – $1,809.05
C-reactive protein (CRP) test CPT 86140	$378.95	$378.95	$26.53 – $378.95
Chlamydia test (DNA/NAAT) CPT 87491	$689.31	$689.31	$48.25 – $689.31
Complete blood count (CBC) with differential CPT 85025	not posted		$8.47 – $8.47
Complete blood count (CBC), automated CPT 85027	$877.95	$877.95	$61.46 – $877.95
Comprehensive metabolic panel (blood test) CPT 80053	$1,920.49	$1,920.49	$134.43 – $1,920.49
COVID-19 PCR test CPT 87635	$75.32	$75.32	$5.27 – $75.32
D-dimer test (blood clots) CPT 85379	$1,814.19	$1,814.19	$126.99 – $1,814.19
Drug screen, instrument chemistry CPT 80307	$2,460.64	$2,460.64	$172.24 – $2,460.64
Ferritin (iron stores) test CPT 82728	$586.43	$586.43	$41.05 – $586.43
Free T4 (thyroid) test CPT 84439	$615.58	$615.58	$8.34 – $8.34
General health panel (blood tests) CPT 80050	$3,366.01	$3,366.01	$2,524.51 – $2,524.51
Glucose (blood sugar) test CPT 82947	$514.42	$514.42	$36.01 – $514.42
Gonorrhea test (DNA/NAAT) CPT 87591	$689.31	$689.31	$48.25 – $689.31
Hemoglobin A1c test CPT 83036	$797.36	$797.36	$55.82 – $797.36
Hepatitis C antibody test CPT 86803	$953.39	$953.39	$66.74 – $953.39
HIV-1/HIV-2 antigen and antibody test CPT 87389	$1,290.66	$1,290.66	$24.08 – $24.08
Iron test CPT 83540	$574.44	$574.44	$40.21 – $574.44
Kidney function panel CPT 80069	$1,692.45	$1,692.45	$118.47 – $1,692.45
Lipase test (pancreas) CPT 83690	$768.20	$768.20	$53.77 – $768.20
Lipid panel, cholesterol and triglycerides CPT 80061	$1,428.37	$1,428.37	$99.99 – $1,428.37
Liver function panel CPT 80076	$1,851.93	$1,851.93	$129.64 – $1,851.93
Magnesium test CPT 83735	$392.67	$392.67	$27.49 – $392.67
Obstetric blood test panel CPT 80055	not posted		$47.81 – $47.81
Partial thromboplastin time (PTT), clotting test CPT 85730	$768.20	$768.20	$53.77 – $768.20
Pregnancy blood test (hCG), quantitative CPT 84702	$1,649.57	$1,649.57	$115.47 – $1,649.57
Prothrombin time (PT/INR), clotting test CPT 85610	$768.20	$768.20	$53.77 – $768.20
PSA (prostate specific antigen), free CPT 84154	$1,328.92	$1,328.92	$18.39 – $18.39
PSA (prostate specific antigen), total CPT 84153	$1,207.17	$1,207.17	$84.50 – $1,207.17
Rapid strep test CPT 87880	$608.73	$608.73	$16.53 – $16.53
Sed rate (ESR) test CPT 85652	$608.73	$608.73	$42.61 – $608.73
TB skin test CPT 86580	$159.06	$159.06	$24.67 – $24.67
Thyroid stimulating hormone (TSH) CPT 84443	$713.35	$713.35	$49.93 – $713.35
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$1,404.37	$1,404.37	$39.86 – $50.46
Troponin test (heart damage) CPT 84484	$1,472.95	$1,472.95	$103.11 – $1,472.95
Urinalysis, automated, with microscope CPT 81001	$644.75	$644.75	$45.13 – $644.75
Urinalysis, automated, without microscope CPT 81003	$334.37	$334.37	$23.41 – $334.37
Urinalysis, manual, with microscope CPT 81000	not posted		$4.02 – $4.02
Urinalysis, manual, without microscope CPT 81002	$411.55	$411.55	$2.09 – $18.26
Urine culture, colony count CPT 87086	$631.02	$631.02	$44.17 – $631.02
Urine pregnancy test CPT 81025	$888.22	$888.22	$62.18 – $888.22
Vitamin B12 test CPT 82607	$538.43	$538.43	$14.19 – $14.19
Vitamin D test CPT 82306	$1,589.55	$1,589.55	$111.27 – $1,589.55

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$3,170.30	$3,170.30	$221.92 – $3,170.30
ECG tracing only (no interpretation) CPT 93005	$1,318.27	$1,318.27	$92.28 – $1,318.27
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$9,013.53	$9,013.53	$372.65 – $1,514.00
Electrocardiogram (ECG/EKG) with interpretation CPT 93000	not posted		$12.53 – $1,514.00
Holter monitor, up to 48 hours CPT 93224	not posted		$57.44 – $1,514.00
Left heart catheterization CPT 93452	$54,106.47	$54,106.47	$7,304.37 – $54,106.47
Left heart catheterization with coronary angiogram CPT 93458	$54,106.47	$54,106.47	$7,304.37 – $54,106.47
Nuclear stress test (heart perfusion imaging) CPT 78452	$19,831.94	$19,831.94	$862.65 – $1,090.56
Treadmill stress test, complete CPT 93015	not posted		$199.21 – $1,514.00

Surgery

Service	Cash price	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	not posted	$8,024.00 – $19,055.00
Appendix removal, laparoscopic CPT 44970	not posted	$2,369.00 – $15,648.00
Breast biopsy with ultrasound guidance CPT 19083	not posted	$544.82 – $544.82
Carpal tunnel release CPT 64721	not posted	$692.94 – $5,773.00
Colonoscopy with biopsy CPT 45380	not posted	$450.72 – $5,773.00
Colonoscopy with polyp removal (snare) CPT 45385	not posted	$450.72 – $5,773.00
Colonoscopy, diagnostic CPT 45378	not posted	$328.50 – $940.41
Colposcopy with biopsy CPT 57454	not posted	$2,095.00 – $2,960.00
Cystoscopy (bladder scope) CPT 52000	not posted	$2,095.00 – $2,960.00
Ear tubes, under general anesthesia CPT 69436	not posted	$441.67 – $8,910.00
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted	$146.35 – $146.35
Gallbladder removal, laparoscopic CPT 47562	not posted	$8,858.00 – $9,198.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted	$8,858.00 – $37,859.65
Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571	not posted	$3,265.51 – $24,902.81
Hysteroscopy with biopsy or polyp removal CPT 58558	not posted	$1,063.52 – $9,831.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted	$8,843.00 – $12,499.00
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted	$1,289.72 – $1,289.72
Kidney stone shock-wave lithotripsy CPT 50590	not posted	$7,184.13 – $19,055.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted	$1,088.27 – $30,876.00
Lower colon endoscopy with ultrasound CPT 45391	not posted	$480.77 – $480.77
Nasal endoscopy, diagnostic CPT 31231	not posted	$74.95 – $74.95
Prostate biopsy CPT 55700	not posted	$2,214.00 – $4,723.00
Prostate removal, laparoscopic or robotic CPT 55866	not posted	$10,122.00 – $25,750.00
Removal of a breast lump, open surgery CPT 19120	not posted	$1,011.84 – $8,967.47
Rotator cuff repair, arthroscopic CPT 29827	not posted	$9,541.00 – $13,485.00
Screening colonoscopy, average risk HCPCS G0121	not posted	$1,346.00 – $5,773.00
Screening colonoscopy, high risk HCPCS G0105	not posted	$1,266.00 – $5,773.00
Septoplasty (nasal septum repair) CPT 30520	not posted	$930.95 – $12,499.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted	$2,636.00 – $2,636.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted	$8,024.00 – $8,024.00
Tonsil and adenoid removal, under age 12 CPT 42820	not posted	$3,796.00 – $14,357.57
Total hip replacement CPT 27130	not posted	$12,000.00 – $63,906.81
Total knee replacement CPT 27447	not posted	$10,122.00 – $63,906.81
Upper endoscopy (EGD) with biopsy CPT 43239	not posted	$368.44 – $368.44
Upper endoscopy (EGD), diagnostic CPT 43235	not posted	$2,214.00 – $4,850.00
Vasectomy CPT 55250	not posted	$685.44 – $5,773.00

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		$6,587.00 – $6,587.00
Fetal non-stress test CPT 59025	$860.23	$860.23	$60.22 – $860.23
IUD insertion CPT 58300	not posted		$1,056.16 – $4,850.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$2,152.00 – $47,784.37
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted		$6,587.00 – $6,587.00

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$1,023.00 – $1,023.00
C-section, without complications MS-DRG 788	not posted	$649.00 – $649.00
Chest pain MS-DRG 313	not posted	$1,023.00 – $1,023.00
COPD flare-up, with major complications MS-DRG 190	not posted	$2,555.00 – $26,554.26
COPD flare-up, without complications MS-DRG 192	not posted	$1,023.00 – $1,023.00
Fainting (syncope) MS-DRG 312	not posted	$1,023.00 – $1,023.00
Gastrointestinal bleeding, with complications MS-DRG 378	not posted	$1,023.00 – $1,023.00
Heart failure, with major complications MS-DRG 291	not posted	$1,023.00 – $1,023.00
Heart failure, without complications MS-DRG 293	not posted	$1,023.00 – $1,023.00
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$74,774.61 – $335,921.79
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$1,196.00 – $1,196.00
Irregular heartbeat, without complications MS-DRG 310	not posted	$1,023.00 – $1,023.00
Kidney failure, with complications MS-DRG 683	not posted	$1,023.00 – $1,023.00
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$1,023.00 – $1,023.00
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$1,196.00 – $1,196.00
Normal newborn care MS-DRG 795	not posted	$995.00 – $1,275.00
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$1,023.00 – $1,023.00
Pneumonia, with complications MS-DRG 194	not posted	$1,023.00 – $1,023.00
Pneumonia, with major complications MS-DRG 193	not posted	$1,023.00 – $1,023.00
Pneumonia, without complications MS-DRG 195	not posted	$1,023.00 – $1,023.00
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$1,023.00 – $1,023.00
Sepsis, with major complications MS-DRG 871	not posted	$1,023.00 – $1,023.00
Sepsis, without major complications MS-DRG 872	not posted	$1,023.00 – $1,023.00
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$1,023.00 – $1,023.00
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$1,023.00 – $1,023.00
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$1,023.00 – $1,023.00
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$1,196.00 – $1,196.00
Vaginal delivery, without complications MS-DRG 807	not posted	$649.00 – $649.00
Weight loss surgery, without complications MS-DRG 621	not posted	$19,500.00 – $26,000.00

Pain and spine

Service	Cash price	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	not posted	$189.96 – $4,850.00
Lower back nerve root injection with imaging guidance CPT 64483	not posted	$1,266.00 – $4,850.00
Lower back spinal injection (epidural), with imaging guidance CPT 62323	not posted	$276.00 – $4,850.00
Lower back spinal injection (epidural), without imaging CPT 62322	not posted	$276.00 – $4,850.00

Eye

Service	Cash price	Insurer rates (min – max)
Cataract removal with lens implant CPT 66984	not posted	$892.44 – $18,490.00
Eye exam, new patient, comprehensive CPT 92004	not posted	$318.81 – $620.23
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	not posted	$218.75 – $5,773.00

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	not posted		$380.46 – $740.17

Sleep

Service	Cash price	Insurer rates (min – max)
Home sleep apnea test CPT 95806	not posted	$1,927.00 – $3,130.00
Sleep study with CPAP titration CPT 95811	not posted	$1,927.00 – $3,130.00
Sleep study, overnight in a sleep lab CPT 95810	not posted	$1,927.00 – $3,130.00

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	not posted		$380.46 – $740.17

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$316.88	$316.88	$22.18 – $316.88
Physical therapy evaluation, low complexity CPT 97161	$345.81	$345.81	$94.70 – $462.72
Physical therapy evaluation, moderate complexity CPT 97162	$681.98	$681.98	$90.22 – $90.22
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$361.89	$361.89	$25.33 – $361.89
Therapeutic activities, 15 minutes CPT 97530	$231.62	$231.62	$16.21 – $231.62

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$173.81	$173.81	$12.17 – $173.81
IV hydration, each additional hour CPT 96361	$313.36	$313.36	$21.94 – $313.36
IV hydration, first hour CPT 96360	$1,104.26	$1,104.26	$77.30 – $1,104.26
IV push injection of a drug, first CPT 96374	$1,176.94	$1,176.94	$82.39 – $1,176.94
IV push injection, each additional drug CPT 96375	$381.68	$381.68	$26.72 – $381.68

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$116.33	$116.33	$8.14 – $116.33
Dexamethasone injection, per 1 mg HCPCS J1100	$79.05	$79.05	$59.29 – $59.29
Fentanyl injection, per 0.1 mg HCPCS J3010	$105.62	$105.62	$79.22 – $79.22
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$63.59	$63.59	$4.45 – $63.59
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$101.22	$101.22	$7.09 – $101.22
Morphine injection, up to 10 mg HCPCS J2270	$46.45	$46.45	$3.25 – $46.45
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$21.73	$21.73	$16.30 – $16.30
Propofol injection, per 10 mg HCPCS J2704	$685.76	$685.76	$48.00 – $685.76
Saline IV solution, 1000 ml HCPCS J7030	$344.47	$344.47	$3.61 – $3.61

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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