St. David's South Austin Medical Center
901 West Ben White Blvd, Austin, TX 78704 · Acute care hospital · Emergency room
These are St. David's South Austin Medical Center'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.
230 of the services we track have a posted price here; 137 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 | $8,346.00 | $8,346.00 | $5,257.98 – $5,257.98 |
| Emergency room visit, level 1 (minor) CPT 99281 | $529.00 | $529.00 | $333.27 – $333.27 |
| Emergency room visit, level 2 CPT 99282 | $961.00 | $961.00 | $163.37 – $961.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $1,825.00 | $1,825.00 | $310.25 – $1,825.00 |
| Emergency room visit, level 4 CPT 99284 | $3,745.00 | $3,745.00 | $1,835.05 – $1,835.05 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $5,318.00 | $5,318.00 | $2,605.82 – $2,605.82 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $1,330.00 | $1,330.00 | $64.15 – $5,722.00 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | $2,241.00 | $2,241.00 | $1,510.43 – $1,510.43 |
| New patient office visit, about 30 minutes CPT 99203 | $3,132.00 | $3,132.00 | $532.44 – $3,132.00 |
| New patient office visit, about 45 minutes CPT 99204 | $4,026.00 | $4,026.00 | $2,536.38 – $2,536.38 |
| New patient office visit, about 60 minutes CPT 99205 | $4,928.00 | $4,928.00 | $3,321.47 – $3,321.47 |
| Office consultation, about 40 minutes CPT 99243 | not posted | $69.77 – $559.53 | |
| Office consultation, about 60 minutes CPT 99244 | not posted | $97.83 – $899.36 | |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $1,351.00 | $1,351.00 | $661.99 – $661.99 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $2,241.00 | $2,241.00 | $380.97 – $2,241.00 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $3,132.00 | $3,132.00 | $1,973.16 – $1,973.16 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $4,026.00 | $4,026.00 | $2,536.38 – $2,536.38 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $892.00 | $892.00 | $601.21 – $601.21 |
| Preventive checkup, new patient, age 18 to 39 CPT 99385 | not posted | $70.26 – $571.95 | |
| Preventive checkup, new patient, age 40 to 64 CPT 99386 | not posted | $85.38 – $696.27 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $91.00 | $91.00 | $143.74 – $234.31 |
| Abdominal X-ray, 1 view CPT 74018 | $928.00 | $928.00 | $625.47 – $625.47 |
| Ankle X-ray, 3 or more views CPT 73610 | $1,435.00 | $1,435.00 | $904.05 – $904.05 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $784.00 | $784.00 | $38.85 – $245.18 |
| Breast ultrasound, one breast, complete CPT 76641 | $1,238.00 | $1,238.00 | $61.90 – $1,238.00 |
| Breast ultrasound, one breast, limited CPT 76642 | $927.00 | $927.00 | $584.01 – $584.01 |
| Chest X-ray, 1 view CPT 71045 | $833.00 | $833.00 | $582.27 – $582.27 |
| Chest X-ray, 2 views CPT 71046 | $1,045.00 | $1,045.00 | $658.35 – $658.35 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $9,627.00 | $9,627.00 | $6,065.01 – $6,065.01 |
| CT angiogram of the head CPT 70496 | $9,089.00 | $9,089.00 | $454.45 – $9,089.00 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $15,623.00 | $15,623.00 | $10,529.90 – $10,529.90 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $21,656.00 | $21,656.00 | $13,643.28 – $13,643.28 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $14,182.00 | $14,182.00 | $9,558.67 – $9,558.67 |
| CT scan of the abdomen, without contrast CPT 74150 | $6,942.00 | $6,942.00 | $347.10 – $6,942.00 |
| CT scan of the chest, with contrast CPT 71260 | $8,548.00 | $8,548.00 | $427.40 – $8,548.00 |
| CT scan of the chest, without contrast CPT 71250 | $6,647.00 | $6,647.00 | $4,187.61 – $4,187.61 |
| CT scan of the head, without contrast CPT 70450 | $5,889.00 | $5,889.00 | $3,710.07 – $3,710.07 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $7,647.00 | $7,647.00 | $382.35 – $7,647.00 |
| CT scan of the pelvis, with contrast CPT 72193 | $7,110.00 | $7,110.00 | $4,969.89 – $4,969.89 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $6,113.00 | $6,113.00 | $4,272.99 – $4,272.99 |
| Diagnostic mammogram, both breasts CPT 77066 | $729.00 | $729.00 | $113.34 – $368.33 |
| Diagnostic mammogram, one breast CPT 77065 | $451.00 | $451.00 | $303.97 – $303.97 |
| Foot X-ray, 3 or more views CPT 73630 | $1,379.00 | $1,379.00 | $929.45 – $929.45 |
| Hand X-ray, 3 or more views CPT 73130 | $1,323.00 | $1,323.00 | $66.15 – $1,323.00 |
| Knee X-ray, 3 views CPT 73562 | $1,577.00 | $1,577.00 | $1,062.90 – $1,062.90 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $3,848.00 | $3,848.00 | $2,593.55 – $2,593.55 |
| Leg or arm vein ultrasound, one side CPT 93971 | $2,412.00 | $2,412.00 | $120.60 – $2,412.00 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $1,357.00 | $1,357.00 | $914.62 – $914.62 |
| MRI of both breasts, without and with contrast CPT 77049 | not posted | $432.42 – $635.92 | |
| MRI of the abdomen, without and with contrast CPT 74183 | $8,331.00 | $8,331.00 | $361.60 – $828.27 |
| MRI of the brain, without and with contrast CPT 70553 | $8,116.00 | $8,116.00 | $339.46 – $828.27 |
| MRI of the brain, without contrast CPT 70551 | $7,204.00 | $7,204.00 | $202.15 – $1,088.30 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $7,151.00 | $7,151.00 | $4,819.77 – $4,819.77 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $7,458.00 | $7,458.00 | $1,911.00 – $3,118.00 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $7,573.00 | $7,573.00 | $1,911.00 – $3,118.00 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $6,794.00 | $6,794.00 | $1,911.00 – $3,118.00 |
| MRI of the pelvis, without and with contrast CPT 72197 | $7,316.00 | $7,316.00 | $347.16 – $1,783.24 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $11,621.00 | $11,621.00 | $581.05 – $11,621.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $1,671.00 | $1,671.00 | $1,052.73 – $1,052.73 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $3,508.00 | $3,508.00 | $2,364.39 – $2,364.39 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $2,655.00 | $2,655.00 | $1,789.47 – $1,789.47 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $2,053.00 | $2,053.00 | $102.65 – $2,053.00 |
| Screening mammogram, both breasts CPT 77067 | $520.00 | $520.00 | $566.55 – $923.56 |
| Shoulder X-ray, 2 or more views CPT 73030 | $1,375.00 | $1,375.00 | $673.75 – $673.75 |
| Transvaginal pregnancy ultrasound CPT 76817 | $912.00 | $912.00 | $45.60 – $912.00 |
| Transvaginal ultrasound CPT 76830 | $1,057.00 | $1,057.00 | $52.85 – $1,057.00 |
| Ultrasound of the abdomen, complete CPT 76700 | $2,417.00 | $2,417.00 | $1,522.71 – $1,522.71 |
| Ultrasound of the neck or thyroid CPT 76536 | $1,698.00 | $1,698.00 | $832.02 – $832.02 |
| Wrist X-ray, 3 or more views CPT 73110 | $935.00 | $935.00 | $630.19 – $630.19 |
| X-ray of the lower back, 4 or more views CPT 72110 | $1,783.00 | $1,783.00 | $873.67 – $873.67 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $1,160.00 | $1,160.00 | $810.84 – $810.84 |
| Blood culture CPT 87040 | $964.00 | $964.00 | $649.74 – $649.74 |
| Blood draw (venipuncture) CPT 36415 | $46.00 | $46.00 | $31.00 – $31.00 |
| BNP test (heart failure) CPT 83880 | $423.00 | $423.00 | $266.49 – $266.49 |
| C-reactive protein (CRP) test CPT 86140 | $131.00 | $131.00 | $82.53 – $82.53 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $667.00 | $667.00 | $30.07 – $35.09 |
| Complete blood count (CBC) with differential CPT 85025 | not posted | $6.66 – $6.66 | |
| Complete blood count (CBC), automated CPT 85027 | $472.00 | $472.00 | $329.93 – $329.93 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $1,602.00 | $1,602.00 | $80.10 – $1,602.00 |
| COVID-19 PCR test CPT 87635 | $54.00 | $54.00 | $36.40 – $36.40 |
| D-dimer test (blood clots) CPT 85379 | $944.00 | $944.00 | $462.56 – $462.56 |
| Drug screen, instrument chemistry CPT 80307 | $616.00 | $616.00 | $430.58 – $430.58 |
| Ferritin (iron stores) test CPT 82728 | $640.00 | $640.00 | $431.36 – $431.36 |
| Free T4 (thyroid) test CPT 84439 | $927.00 | $927.00 | $46.35 – $927.00 |
| General health panel (blood tests) CPT 80050 | $2,129.00 | $2,129.00 | $106.45 – $2,129.00 |
| Glucose (blood sugar) test CPT 82947 | $532.00 | $532.00 | $358.57 – $358.57 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $747.00 | $747.00 | $29.48 – $172.99 |
| Hemoglobin A1c test CPT 83036 | $538.00 | $538.00 | $8.16 – $47.87 |
| Hepatitis C antibody test CPT 86803 | $742.00 | $742.00 | $11.99 – $70.35 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | not posted | $20.63 – $24.08 | |
| Iron test CPT 83540 | $894.00 | $894.00 | $563.22 – $563.22 |
| Kidney function panel CPT 80069 | $1,160.00 | $1,160.00 | $58.00 – $1,160.00 |
| Lipase test (pancreas) CPT 83690 | $695.00 | $695.00 | $34.75 – $695.00 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $1,160.00 | $1,160.00 | $7.66 – $66.01 |
| Liver function panel CPT 80076 | $1,511.00 | $1,511.00 | $1,018.41 – $1,018.41 |
| Magnesium test CPT 83735 | $629.00 | $629.00 | $31.45 – $629.00 |
| Obstetric blood test panel CPT 80055 | not posted | $47.81 – $47.81 | |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $651.00 | $651.00 | $438.77 – $438.77 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $1,130.00 | $1,130.00 | $711.90 – $711.90 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $477.00 | $477.00 | $23.85 – $477.00 |
| PSA (prostate specific antigen), free CPT 84154 | $614.00 | $614.00 | $15.45 – $90.66 |
| PSA (prostate specific antigen), total CPT 84153 | $614.00 | $614.00 | $15.45 – $90.66 |
| Rapid strep test CPT 87880 | not posted | $14.17 – $16.53 | |
| Sed rate (ESR) test CPT 85652 | $438.00 | $438.00 | $214.62 – $214.62 |
| TB skin test CPT 86580 | $76.00 | $76.00 | $7.07 – $113.34 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $1,561.00 | $1,561.00 | $78.05 – $1,561.00 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $1,131.00 | $1,131.00 | $762.29 – $762.29 |
| Troponin test (heart damage) CPT 84484 | $1,200.00 | $1,200.00 | $60.00 – $1,200.00 |
| Urinalysis, automated, with microscope CPT 81001 | $444.00 | $444.00 | $279.72 – $279.72 |
| Urinalysis, automated, without microscope CPT 81003 | $248.00 | $248.00 | $156.24 – $156.24 |
| Urinalysis, manual, with microscope CPT 81000 | not posted | $3.45 – $4.02 | |
| Urinalysis, manual, without microscope CPT 81002 | $241.00 | $241.00 | $118.09 – $118.09 |
| Urine culture, colony count CPT 87086 | $1,057.00 | $1,057.00 | $6.78 – $72.95 |
| Urine pregnancy test CPT 81025 | $336.00 | $336.00 | $16.80 – $336.00 |
| Vitamin B12 test CPT 82607 | $288.00 | $288.00 | $12.92 – $15.08 |
| Vitamin D test CPT 82306 | $223.00 | $223.00 | $25.36 – $29.60 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $4,396.00 | $4,396.00 | $219.80 – $4,396.00 |
| ECG tracing only (no interpretation) CPT 93005 | $735.00 | $735.00 | $463.05 – $463.05 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $7,991.00 | $7,991.00 | $399.55 – $7,991.00 |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 | not posted | $13.45 – $85.29 | |
| Holter monitor, up to 48 hours CPT 93224 | not posted | $62.63 – $520.14 | |
| Left heart catheterization CPT 93452 | $21,847.00 | $21,847.00 | $10,705.03 – $10,705.03 |
| Left heart catheterization with coronary angiogram CPT 93458 | $27,119.00 | $27,119.00 | $17,084.97 – $17,084.97 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $12,282.00 | $12,282.00 | $8,278.07 – $8,278.07 |
| Treadmill stress test, complete CPT 93015 | not posted | $84.20 – $416.53 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | not posted | $2,323.00 – $16,517.00 | |
| Appendix removal, laparoscopic CPT 44970 | not posted | $5,681.00 – $10,470.00 | |
| Breast biopsy with ultrasound guidance CPT 19083 | not posted | $521.99 – $5,947.00 | |
| Carpal tunnel release CPT 64721 | not posted | $708.15 – $10,285.00 | |
| Colonoscopy with biopsy CPT 45380 | not posted | $460.61 – $5,947.00 | |
| Colonoscopy with polyp removal (snare) CPT 45385 | not posted | $460.61 – $5,947.00 | |
| Colonoscopy, diagnostic CPT 45378 | not posted | $352.49 – $5,947.00 | |
| Colposcopy with biopsy CPT 57454 | not posted | $69.81 – $17,365.00 | |
| Cystoscopy (bladder scope) CPT 52000 | not posted | $255.54 – $4,496.00 | |
| Ear tubes, under general anesthesia CPT 69436 | not posted | $451.36 – $5,947.00 | |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | not posted | $140.21 – $4,496.00 | |
| Gallbladder removal, laparoscopic CPT 47562 | not posted | $508.41 – $13,329.00 | |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | not posted | $929.00 – $16,517.00 | |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | not posted | $3,337.16 – $22,967.79 | |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | not posted | $4,836.00 – $6,046.00 | |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | not posted | $294.30 – $13,329.00 | |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | not posted | $1,235.65 – $11,764.00 | |
| Kidney stone shock-wave lithotripsy CPT 50590 | not posted | $1,226.38 – $16,517.00 | |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | not posted | $1,167.76 – $11,764.00 | |
| Lower colon endoscopy with ultrasound CPT 45391 | not posted | $460.61 – $5,947.00 | |
| Nasal endoscopy, diagnostic CPT 31231 | not posted | $73.11 – $17,365.00 | |
| Prostate biopsy CPT 55700 | not posted | $700.49 – $4,304.00 | |
| Prostate removal, laparoscopic or robotic CPT 55866 | not posted | $8,681.00 – $10,177.00 | |
| Removal of a breast lump, open surgery CPT 19120 | not posted | $1,034.05 – $10,285.00 | |
| Rotator cuff repair, arthroscopic CPT 29827 | not posted | $2,573.70 – $16,517.00 | |
| Screening colonoscopy, average risk HCPCS G0121 | not posted | $352.49 – $4,496.00 | |
| Screening colonoscopy, high risk HCPCS G0105 | not posted | $1,877.00 – $4,496.00 | |
| Septoplasty (nasal septum repair) CPT 30520 | not posted | $951.37 – $10,285.00 | |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | not posted | $1,444.00 – $17,365.00 | |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | not posted | $8,593.00 – $11,856.00 | |
| Tonsil and adenoid removal, under age 12 CPT 42820 | not posted | $198.61 – $5,722.00 | |
| Total hip replacement CPT 27130 | not posted | $1,462.96 – $26,482.00 | |
| Total knee replacement CPT 27447 | not posted | $929.00 – $51,768.09 | |
| Upper endoscopy (EGD) with biopsy CPT 43239 | not posted | $359.42 – $5,947.00 | |
| Upper endoscopy (EGD), diagnostic CPT 43235 | not posted | $359.42 – $5,947.00 | |
| Vasectomy CPT 55250 | not posted | $700.49 – $10,285.00 |
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 | $3,346.00 – $20,934.76 | |
| Fetal non-stress test CPT 59025 | $3,189.00 | $3,189.00 | $159.45 – $3,189.00 |
| IUD insertion CPT 58300 | not posted | $326.34 – $17,365.00 | |
| Vaginal birth after a prior C-section (VBAC), routine care CPT 59610 | not posted | $929.00 – $19,813.03 | |
| Vaginal delivery, routine care including prenatal and postpartum CPT 59400 | not posted | $929.00 – $18,881.87 |
Hospital stays
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | not posted | $30.00 – $17,365.00 | |
| Lower back nerve root injection with imaging guidance CPT 64483 | $19,157.00 | $19,157.00 | $9,386.93 – $9,386.93 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | not posted | $282.06 – $14,612.00 | |
| Lower back spinal injection (epidural), without imaging CPT 62322 | not posted | $2,078.00 – $14,612.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | not posted | $912.02 – $10,285.00 | |
| Eye exam, new patient, comprehensive CPT 92004 | not posted | $62.28 – $666.60 | |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | not posted | $223.54 – $4,496.00 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | not posted | $35.02 – $795.51 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $3,030.00 | $3,030.00 | $2,042.22 – $2,042.22 |
| Sleep study with CPAP titration CPT 95811 | $9,556.00 | $9,556.00 | $6,440.74 – $6,440.74 |
| Sleep study, overnight in a sleep lab CPT 95810 | $9,556.00 | $9,556.00 | $6,020.28 – $6,020.28 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $1,137.00 | $1,137.00 | $24.86 – $795.51 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $167.00 | $167.00 | $81.83 – $81.83 |
| Physical therapy evaluation, low complexity CPT 97161 | $258.00 | $258.00 | $12.90 – $258.00 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $320.00 | $320.00 | $201.60 – $201.60 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $167.00 | $167.00 | $112.56 – $112.56 |
| Therapeutic activities, 15 minutes CPT 97530 | $194.00 | $194.00 | $122.22 – $122.22 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | not posted | $75.38 – $75.38 | |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | not posted | $71.60 – $71.60 | |
| Group psychotherapy CPT 90853 | not posted | $19.25 – $19.25 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $282.00 | $282.00 | $138.18 – $138.18 |
| IV hydration, each additional hour CPT 96361 | $370.00 | $370.00 | $233.10 – $233.10 |
| IV hydration, first hour CPT 96360 | $520.00 | $520.00 | $327.60 – $327.60 |
| IV push injection of a drug, first CPT 96374 | $654.00 | $654.00 | $412.02 – $412.02 |
| IV push injection, each additional drug CPT 96375 | $287.00 | $287.00 | $200.61 – $200.61 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $64.00 | $64.00 | $31.36 – $31.36 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $55.00 | $55.00 | $37.07 – $37.07 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $108.00 | $108.00 | $5.40 – $108.00 |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | not posted | $1.07 – $1.07 | |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $171.00 | $171.00 | $119.53 – $119.53 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $50.00 | $50.00 | $33.70 – $33.70 |
| Morphine injection, up to 10 mg HCPCS J2270 | $71.00 | $71.00 | $47.85 – $47.85 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $28.00 | $28.00 | $19.57 – $19.57 |
| Propofol injection, per 10 mg HCPCS J2704 | $389.00 | $389.00 | $262.19 – $262.19 |
| Saline IV solution, 1000 ml HCPCS J7030 | $448.00 | $448.00 | $219.52 – $219.52 |
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.