Medical City Arlington

3301 Matlock Road, Arlington, TX 76015 · Acute care hospital · Emergency room

These are Medical City Arlington'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; 132 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	$11,148.84	$11,148.84	$1,505.09 – $11,148.84
Emergency room visit, level 1 (minor) CPT 99281	$1,011.00	$1,011.00	$136.49 – $1,011.00
Emergency room visit, level 2 CPT 99282	$1,865.74	$1,865.74	$251.87 – $1,865.74
Emergency room visit, level 3 (moderate) CPT 99283	$2,925.58	$2,925.58	$394.95 – $2,925.58
Emergency room visit, level 4 CPT 99284	$4,392.47	$4,392.47	$592.98 – $4,392.47
Emergency room visit, level 5 (most severe) CPT 99285	$7,716.93	$7,716.93	$1,041.79 – $7,716.93
Simple wound repair (stitches), 2.5 cm or less CPT 12001	not posted		$2,152.00 – $5,442.00

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	$249.88	$249.88	$187.41 – $187.41
New patient office visit, about 30 minutes CPT 99203	$423.07	$423.07	$213.07 – $414.52
New patient office visit, about 45 minutes CPT 99204	$689.97	$689.97	$360.75 – $701.81
New patient office visit, about 60 minutes CPT 99205	$937.07	$937.07	$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	$183.01	$183.01	$71.36 – $138.83
Office visit, established patient, about 20 to 29 minutes CPT 99213	$342.64	$342.64	$142.72 – $277.66
Office visit, established patient, about 30 to 39 minutes CPT 99214	$506.70	$506.70	$220.03 – $428.05
Office visit, established patient, about 40 to 54 minutes CPT 99215	$745.64	$745.64	$310.20 – $603.48
Office visit, established patient, brief (often a nurse) CPT 99211	$45.95	$45.95	$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	$265.34	$265.34	$54.24 – $68.57
Abdominal X-ray, 1 view CPT 74018	$1,130.90	$1,130.90	$79.16 – $1,130.90
Ankle X-ray, 3 or more views CPT 73610	$2,184.49	$2,184.49	$152.91 – $2,184.49
Bone density scan (DEXA), hips and spine CPT 77080	$577.74	$577.74	$40.44 – $577.74
Breast ultrasound, one breast, complete CPT 76641	$1,467.69	$1,467.69	$102.74 – $1,467.69
Breast ultrasound, one breast, limited CPT 76642	$1,120.81	$1,120.81	$78.46 – $1,120.81
Chest X-ray, 1 view CPT 71045	$1,130.90	$1,130.90	$79.16 – $1,130.90
Chest X-ray, 2 views CPT 71046	$1,241.13	$1,241.13	$86.88 – $1,241.13
CT angiogram of the chest (checks for lung clots) CPT 71275	$13,952.68	$13,952.68	$976.69 – $13,952.68
CT angiogram of the head CPT 70496	$12,274.95	$12,274.95	$859.25 – $12,274.95
CT scan of the abdomen and pelvis, with contrast CPT 74177	$17,106.43	$17,106.43	$1,197.45 – $17,106.43
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$19,343.87	$19,343.87	$1,354.07 – $19,343.87
CT scan of the abdomen and pelvis, without contrast CPT 74176	$16,100.33	$16,100.33	$1,127.02 – $16,100.33
CT scan of the abdomen, without contrast CPT 74150	$9,012.02	$9,012.02	$630.84 – $9,012.02
CT scan of the chest, with contrast CPT 71260	$9,104.62	$9,104.62	$637.32 – $9,104.62
CT scan of the chest, without contrast CPT 71250	$6,775.95	$6,775.95	$474.32 – $6,775.95
CT scan of the head, without contrast CPT 70450	$5,963.34	$5,963.34	$417.43 – $5,963.34
CT scan of the neck (cervical spine), without contrast CPT 72125	$6,267.38	$6,267.38	$438.72 – $6,267.38
CT scan of the pelvis, with contrast CPT 72193	$7,092.43	$7,092.43	$496.47 – $7,092.43
CT scan of the sinuses or face, without contrast CPT 70486	$5,948.14	$5,948.14	$416.37 – $5,948.14
Diagnostic mammogram, both breasts CPT 77066	$1,662.56	$1,662.56	$114.38 – $114.38
Diagnostic mammogram, one breast CPT 77065	$1,018.53	$1,018.53	$71.30 – $1,018.53
Foot X-ray, 3 or more views CPT 73630	$2,105.77	$2,105.77	$147.40 – $2,105.77
Hand X-ray, 3 or more views CPT 73130	$2,933.19	$2,933.19	$205.32 – $2,933.19
Knee X-ray, 3 views CPT 73562	$1,473.04	$1,473.04	$103.11 – $1,473.04
Leg or arm vein ultrasound, both sides CPT 93970	$3,826.95	$3,826.95	$267.89 – $3,826.95
Leg or arm vein ultrasound, one side CPT 93971	$3,489.85	$3,489.85	$244.29 – $3,489.85
Lower back X-ray, 2 or 3 views CPT 72100	$1,717.83	$1,717.83	$120.25 – $1,717.83
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	$17,223.98	$17,223.98	$383.35 – $383.35
MRI of the brain, without and with contrast CPT 70553	$17,845.61	$17,845.61	$360.92 – $360.92
MRI of the brain, without contrast CPT 70551	$13,307.48	$13,307.48	$313.62 – $517.79
MRI of the knee or other leg joint, without contrast CPT 73721	$24,264.12	$24,264.12	$1,698.49 – $24,264.12
MRI of the lower back (lumbar spine), without contrast CPT 72148	$13,307.48	$13,307.48	$194.18 – $1,321.00
MRI of the mid back (thoracic spine), without contrast CPT 72146	$12,135.15	$12,135.15	$313.62 – $517.79
MRI of the neck (cervical spine), without contrast CPT 72141	$13,307.48	$13,307.48	$216.13 – $216.13
MRI of the pelvis, without and with contrast CPT 72197	$15,699.94	$15,699.94	$381.88 – $381.88
MRI of the shoulder or other arm joint, without contrast CPT 73221	$12,135.15	$12,135.15	$849.46 – $12,135.15
Neck X-ray, 2 or 3 views CPT 72040	$2,214.57	$2,214.57	$155.02 – $2,214.57
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$2,936.75	$2,936.75	$205.57 – $2,936.75
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$4,079.66	$4,079.66	$285.58 – $4,079.66
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$2,946.43	$2,946.43	$206.25 – $2,946.43
Screening mammogram, both breasts CPT 77067	$1,054.47	$1,054.47	$73.81 – $1,054.47
Shoulder X-ray, 2 or more views CPT 73030	$2,933.19	$2,933.19	$205.32 – $2,933.19
Transvaginal pregnancy ultrasound CPT 76817	$3,260.15	$3,260.15	$228.21 – $3,260.15
Transvaginal ultrasound CPT 76830	$3,260.15	$3,260.15	$228.21 – $3,260.15
Ultrasound of the abdomen, complete CPT 76700	$3,423.21	$3,423.21	$239.62 – $3,423.21
Ultrasound of the neck or thyroid CPT 76536	$2,404.68	$2,404.68	$168.33 – $2,404.68
Wrist X-ray, 3 or more views CPT 73110	$2,742.79	$2,742.79	$192.00 – $2,742.79
X-ray of the lower back, 4 or more views CPT 72110	$2,072.84	$2,072.84	$145.10 – $2,072.84

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$2,343.69	$2,343.69	$164.06 – $2,343.69
Blood culture CPT 87040	$1,195.89	$1,195.89	$83.71 – $1,195.89
Blood draw (venipuncture) CPT 36415	$125.04	$125.04	$8.75 – $125.04
BNP test (heart failure) CPT 83880	$1,571.01	$1,571.01	$109.97 – $1,571.01
C-reactive protein (CRP) test CPT 86140	$373.52	$373.52	$26.15 – $373.52
Chlamydia test (DNA/NAAT) CPT 87491	$410.39	$410.39	$28.73 – $410.39
Complete blood count (CBC) with differential CPT 85025	not posted		$7.77 – $7.77
Complete blood count (CBC), automated CPT 85027	$654.05	$654.05	$45.78 – $654.05
Comprehensive metabolic panel (blood test) CPT 80053	$2,343.69	$2,343.69	$164.06 – $2,343.69
COVID-19 PCR test CPT 87635	$139.59	$139.59	$9.77 – $139.59
D-dimer test (blood clots) CPT 85379	$1,707.27	$1,707.27	$119.51 – $1,707.27
Drug screen, instrument chemistry CPT 80307	$315.80	$315.80	$22.11 – $315.80
Ferritin (iron stores) test CPT 82728	$894.50	$894.50	$62.62 – $894.50
Free T4 (thyroid) test CPT 84439	$859.24	$859.24	$9.47 – $9.47
General health panel (blood tests) CPT 80050	not posted		$45.36 – $45.36
Glucose (blood sugar) test CPT 82947	$453.67	$453.67	$31.76 – $453.67
Gonorrhea test (DNA/NAAT) CPT 87591	$410.39	$410.39	$28.73 – $410.39
Hemoglobin A1c test CPT 83036	$509.78	$509.78	$35.68 – $509.78
Hepatitis C antibody test CPT 86803	$841.62	$841.62	$58.91 – $841.62
HIV-1/HIV-2 antigen and antibody test CPT 87389	$171.52	$171.52	$24.08 – $24.08
Iron test CPT 83540	$684.52	$684.52	$3.88 – $34.70
Kidney function panel CPT 80069	$1,567.80	$1,567.80	$109.75 – $1,567.80
Lipase test (pancreas) CPT 83690	$851.23	$851.23	$59.59 – $851.23
Lipid panel, cholesterol and triglycerides CPT 80061	$1,946.12	$1,946.12	$136.23 – $1,946.12
Liver function panel CPT 80076	$1,724.90	$1,724.90	$120.74 – $1,724.90
Magnesium test CPT 83735	$894.50	$894.50	$62.62 – $894.50
Obstetric blood test panel CPT 80055	not posted		$47.81 – $47.81
Partial thromboplastin time (PTT), clotting test CPT 85730	$756.66	$756.66	$52.97 – $756.66
Pregnancy blood test (hCG), quantitative CPT 84702	$1,562.99	$1,562.99	$109.41 – $1,562.99
Prothrombin time (PT/INR), clotting test CPT 85610	$646.05	$646.05	$45.22 – $646.05
PSA (prostate specific antigen), free CPT 84154	$1,822.68	$1,822.68	$18.39 – $18.39
PSA (prostate specific antigen), total CPT 84153	$1,195.89	$1,195.89	$83.71 – $1,195.89
Rapid strep test CPT 87880	not posted		$16.53 – $16.53
Sed rate (ESR) test CPT 85652	$458.47	$458.47	$32.09 – $458.47
TB skin test CPT 86580	not posted		$24.67 – $24.67
Thyroid stimulating hormone (TSH) CPT 84443	$841.62	$841.62	$58.91 – $841.62
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$1,439.55	$1,439.55	$100.77 – $1,439.55
Troponin test (heart damage) CPT 84484	$1,239.17	$1,239.17	$86.74 – $1,239.17
Urinalysis, automated, with microscope CPT 81001	$492.15	$492.15	$34.45 – $492.15
Urinalysis, automated, without microscope CPT 81003	$1,000.31	$1,000.31	$70.02 – $1,000.31
Urinalysis, manual, with microscope CPT 81000	$545.05	$545.05	$38.15 – $545.05
Urinalysis, manual, without microscope CPT 81002	$343.04	$343.04	$24.01 – $343.04
Urine culture, colony count CPT 87086	$894.50	$894.50	$62.62 – $894.50
Urine pregnancy test CPT 81025	$1,131.76	$1,131.76	$79.22 – $1,131.76
Vitamin B12 test CPT 82607	$1,506.88	$1,506.88	$9.05 – $82.16
Vitamin D test CPT 82306	$2,986.52	$2,986.52	$209.06 – $2,986.52

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$8,396.40	$8,396.40	$587.75 – $8,396.40
ECG tracing only (no interpretation) CPT 93005	$1,278.76	$1,278.76	$89.51 – $1,278.76
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$7,106.78	$7,106.78	$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	$33,343.11	$33,343.11	$2,796.00 – $25,655.00
Left heart catheterization with coronary angiogram CPT 93458	$47,871.50	$47,871.50	$9,661.33 – $22,644.00
Nuclear stress test (heart perfusion imaging) CPT 78452	$15,504.68	$15,504.68	$1,623.62 – $2,938.37
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	$3,465.05 – $8,024.00
Appendix removal, laparoscopic CPT 44970	not posted	$8,024.00 – $19,055.00
Breast biopsy with ultrasound guidance CPT 19083	not posted	$510.77 – $10,853.00
Carpal tunnel release CPT 64721	not posted	$739.13 – $739.13
Colonoscopy with biopsy CPT 45380	not posted	$450.72 – $5,773.00
Colonoscopy with polyp removal (snare) CPT 45385	not posted	$422.82 – $1,210.10
Colonoscopy, diagnostic CPT 45378	not posted	$344.93 – $5,773.00
Colposcopy with biopsy CPT 57454	not posted	$443.94 – $5,773.00
Cystoscopy (bladder scope) CPT 52000	not posted	$2,514.00 – $3,553.00
Ear tubes, under general anesthesia CPT 69436	not posted	$471.12 – $471.12
Flexible sigmoidoscopy, diagnostic CPT 45330	not posted	$143.74 – $143.74
Gallbladder removal, laparoscopic CPT 47562	not posted	$8,858.00 – $9,198.00
Gastric bypass (weight loss surgery), laparoscopic CPT 43644	not posted	$948.00 – $37,859.65
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	$5,381.00 – $5,381.00
Inguinal (groin) hernia repair, laparoscopic CPT 49650	not posted	$8,024.00 – $19,055.00
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	not posted	$1,209.12 – $18,490.00
Kidney stone shock-wave lithotripsy CPT 50590	not posted	$8,858.00 – $9,198.00
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	not posted	$1,071.95 – $30,876.00
Lower colon endoscopy with ultrasound CPT 45391	not posted	$450.72 – $5,773.00
Nasal endoscopy, diagnostic CPT 31231	not posted	$2,152.00 – $5,773.00
Prostate biopsy CPT 55700	not posted	$685.44 – $4,723.00
Prostate removal, laparoscopic or robotic CPT 55866	not posted	$10,122.00 – $23,556.71
Removal of a breast lump, open surgery CPT 19120	not posted	$3,796.00 – $11,209.00
Rotator cuff repair, arthroscopic CPT 29827	not posted	$2,518.45 – $19,055.00
Screening colonoscopy, average risk HCPCS G0121	not posted	$323.57 – $410.63
Screening colonoscopy, high risk HCPCS G0105	not posted	$1,266.00 – $5,773.00
Septoplasty (nasal septum repair) CPT 30520	not posted	$930.95 – $18,490.00
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted	$1,580.00 – $10,853.00
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted	$8,024.00 – $24,385.87
Tonsil and adenoid removal, under age 12 CPT 42820	not posted	$3,796.00 – $13,581.48
Total hip replacement CPT 27130	not posted	$10,122.00 – $10,512.00
Total knee replacement CPT 27447	not posted	$12,000.00 – $63,906.81
Upper endoscopy (EGD) with biopsy CPT 43239	not posted	$329.93 – $917.18
Upper endoscopy (EGD), diagnostic CPT 43235	not posted	$351.70 – $5,442.00
Vasectomy CPT 55250	not posted	$685.44 – $7,828.00

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		$948.00 – $50,489.70
Fetal non-stress test CPT 59025	$754.03	$754.03	$52.78 – $754.03
IUD insertion CPT 58300	not posted		$2,152.00 – $5,442.00
Vaginal birth after a prior C-section (VBAC), routine care CPT 59610	not posted		$2,287.00 – $47,784.37
Vaginal delivery, routine care including prenatal and postpartum CPT 59400	not posted		$948.00 – $45,538.63

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	not posted	$12,448.13 – $12,672.42
C-section, without complications MS-DRG 788	not posted	$3,395.00 – $13,365.95
Chest pain MS-DRG 313	not posted	$10,988.81 – $11,186.81
COPD flare-up, with major complications MS-DRG 190	not posted	$23,559.67 – $33,298.57
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 – $13,565.79
Heart failure, with major complications MS-DRG 291	not posted	$16,042.62 – $16,331.68
Heart failure, without complications MS-DRG 293	not posted	$9,608.39 – $9,781.51
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	not posted	$92,226.16 – $93,887.89
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	not posted	$1,198.00 – $22,218.43
Irregular heartbeat, without complications MS-DRG 310	not posted	$9,609.28 – $9,782.42
Kidney failure, with complications MS-DRG 683	not posted	$12,385.38 – $12,608.54
Kidney or urinary tract infection, without major complications MS-DRG 690	not posted	$1,023.00 – $12,003.53
Neck (cervical) spinal fusion, without complications MS-DRG 473	not posted	$1,198.00 – $26,894.25
Normal newborn care MS-DRG 795	not posted	$6,325.83 – $6,439.81
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	not posted	$1,023.00 – $11,717.91
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	$10,168.62 – $10,351.84
Psychoses (inpatient psychiatric stay) MS-DRG 885	not posted	$1,023.00 – $17,362.83
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 – $13,954.53
Skin infection (cellulitis), without major complications MS-DRG 603	not posted	$12,341.46 – $12,563.83
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	not posted	$1,023.00 – $11,730.68
Stroke, with complications or clot-busting drug MS-DRG 65	not posted	$1,023.00 – $13,835.90
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	not posted	$1,198.00 – $15,938.37
Vaginal delivery, without complications MS-DRG 807	not posted	$649.00 – $649.00
Weight loss surgery, without complications MS-DRG 621	not posted	$5,000.00 – $5,000.00

Pain and spine

Service	Cash price	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	not posted	$29.36 – $5,442.00
Lower back nerve root injection with imaging guidance CPT 64483	not posted	$381.66 – $381.66
Lower back spinal injection (epidural), with imaging guidance CPT 62323	not posted	$276.00 – $5,442.00
Lower back spinal injection (epidural), without imaging CPT 62322	not posted	$2,514.00 – $3,553.00

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	$233.33 – $233.33

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	$3,878.61	$3,878.61	$380.46 – $740.17

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$254.35	$254.35	$17.80 – $254.35
Physical therapy evaluation, low complexity CPT 97161	$387.50	$387.50	$94.70 – $462.72
Physical therapy evaluation, moderate complexity CPT 97162	$580.50	$580.50	$85.49 – $225.12
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$195.99	$195.99	$13.72 – $195.99
Therapeutic activities, 15 minutes CPT 97530	$568.53	$568.53	$39.80 – $568.53

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$1,016.60	$1,016.60	$71.16 – $1,016.60
IV hydration, each additional hour CPT 96361	$291.43	$291.43	$39.34 – $291.43
IV hydration, first hour CPT 96360	$941.02	$941.02	$127.04 – $941.02
IV push injection of a drug, first CPT 96374	$964.39	$964.39	$67.51 – $964.39
IV push injection, each additional drug CPT 96375	$422.01	$422.01	$29.54 – $422.01

Drugs

Service	Cash price	Gross charge	Insurer rates (min – max)
Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696	$120.70	$120.70	$8.45 – $120.70
Dexamethasone injection, per 1 mg HCPCS J1100	$78.06	$78.06	$58.55 – $58.55
Fentanyl injection, per 0.1 mg HCPCS J3010	$209.30	$209.30	$156.97 – $156.97
Ketorolac (Toradol) injection, per 15 mg HCPCS J1885	$63.29	$63.29	$4.43 – $63.29
Midazolam (Versed) injection, per 1 mg HCPCS J2250	$117.94	$117.94	$88.45 – $88.45
Morphine injection, up to 10 mg HCPCS J2270	$86.45	$86.45	$64.84 – $64.84
Ondansetron (Zofran) injection, per 1 mg HCPCS J2405	$550.98	$550.98	$38.57 – $550.98
Propofol injection, per 10 mg HCPCS J2704	$507.68	$507.68	$380.76 – $380.76
Saline IV solution, 1000 ml HCPCS J7030	$676.19	$676.19	$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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