Texas Health Center for Diagnostics & Surgery Plan
6020 W Parker Road, Plano, TX 75093 · Acute care hospital · Emergency room
These are Texas Health Center for Diagnostics & Surgery Plan's own posted figures from its standard-charges file dated April 21, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
234 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 | $1,929.60 | $3,216.00 | $462.14 – $45,861.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $184.50 | $307.50 | $44.19 – $1,564.00 |
| Emergency room visit, level 2 CPT 99282 | $298.65 | $497.75 | $71.53 – $5,556.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $579.15 | $965.25 | $138.71 – $9,653.00 |
| Emergency room visit, level 4 CPT 99284 | $845.10 | $1,408.50 | $202.40 – $24,138.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $1,591.20 | $2,652.00 | $381.09 – $45,861.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $312.90 | $521.50 | $74.94 – $490.73 |
Office visits
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $66.15 | $110.25 | $37.46 – $276.00 |
| Abdominal X-ray, 1 view CPT 74018 | $339.15 | $565.25 | $30.40 – $722.00 |
| Ankle X-ray, 3 or more views CPT 73610 | $404.40 | $674.00 | $36.75 – $722.00 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $415.80 | $693.00 | $39.09 – $722.00 |
| Breast ultrasound, one breast, complete CPT 76641 | $383.10 | $638.50 | $102.27 – $884.54 |
| Breast ultrasound, one breast, limited CPT 76642 | $383.10 | $638.50 | $84.68 – $629.86 |
| Chest X-ray, 1 view CPT 71045 | $383.10 | $638.50 | $25.73 – $722.00 |
| Chest X-ray, 2 views CPT 71046 | $457.05 | $761.75 | $33.75 – $722.00 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $3,264.90 | $5,441.50 | $171.21 – $5,120.45 |
| CT angiogram of the head CPT 70496 | $2,830.05 | $4,716.75 | $171.21 – $4,438.46 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $3,920.40 | $6,534.00 | $312.08 – $6,148.49 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $4,407.45 | $7,345.75 | $343.46 – $6,912.35 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $3,356.10 | $5,593.50 | $188.11 – $5,263.48 |
| CT scan of the abdomen, without contrast CPT 74150 | $2,394.15 | $3,990.25 | $102.27 – $3,754.83 |
| CT scan of the chest, with contrast CPT 71260 | $2,656.20 | $4,427.00 | $171.21 – $4,165.81 |
| CT scan of the chest, without contrast CPT 71250 | $2,383.80 | $3,973.00 | $102.27 – $3,738.59 |
| CT scan of the head, without contrast CPT 70450 | $2,057.70 | $3,429.50 | $102.27 – $3,227.16 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $2,394.15 | $3,990.25 | $102.27 – $3,754.83 |
| CT scan of the pelvis, with contrast CPT 72193 | $2,612.85 | $4,354.75 | $171.21 – $4,097.82 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $1,666.95 | $2,778.25 | $102.27 – $2,614.33 |
| Diagnostic mammogram, both breasts CPT 77066 | $366.15 | $610.25 | $87.69 – $949.96 |
| Diagnostic mammogram, one breast CPT 77065 | $366.15 | $610.25 | $87.69 – $742.32 |
| Foot X-ray, 3 or more views CPT 73630 | $371.85 | $619.75 | $34.41 – $722.00 |
| Hand X-ray, 3 or more views CPT 73130 | $404.40 | $674.00 | $37.43 – $722.00 |
| Knee X-ray, 3 views CPT 73562 | $404.40 | $674.00 | $41.10 – $722.00 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $1,212.45 | $2,020.75 | $184.78 – $1,901.53 |
| Leg or arm vein ultrasound, one side CPT 93971 | $652.20 | $1,087.00 | $102.27 – $1,022.87 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $524.40 | $874.00 | $40.10 – $884.54 |
| MRI of both breasts, without and with contrast CPT 77049 | not posted | $322.24 – $364.13 | |
| MRI of the abdomen, without and with contrast CPT 74183 | $3,264.90 | $5,441.50 | $343.46 – $5,120.45 |
| MRI of the brain, without and with contrast CPT 70553 | $2,830.05 | $4,716.75 | $328.11 – $4,438.46 |
| MRI of the brain, without contrast CPT 70551 | $2,504.25 | $4,173.75 | $202.15 – $3,927.50 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $3,264.90 | $5,441.50 | $208.84 – $5,120.45 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $2,394.15 | $3,990.25 | $197.14 – $3,754.83 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $2,394.15 | $3,990.25 | $196.14 – $3,754.83 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $2,394.15 | $3,990.25 | $196.48 – $3,754.83 |
| MRI of the pelvis, without and with contrast CPT 72197 | $3,482.70 | $5,804.50 | $343.46 – $5,462.03 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $3,264.90 | $5,441.50 | $209.16 – $5,120.45 |
| Neck X-ray, 2 or 3 views CPT 72040 | $364.80 | $608.00 | $39.76 – $722.00 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $861.45 | $1,435.75 | $96.28 – $1,351.04 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $381.75 | $636.25 | $102.27 – $722.43 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $393.00 | $655.00 | $102.27 – $616.36 |
| Screening mammogram, both breasts CPT 77067 | $313.35 | $522.25 | $75.05 – $785.02 |
| Shoulder X-ray, 2 or more views CPT 73030 | $282.15 | $470.25 | $35.09 – $722.00 |
| Transvaginal pregnancy ultrasound CPT 76817 | $589.80 | $983.00 | $92.89 – $925.00 |
| Transvaginal ultrasound CPT 76830 | $589.80 | $983.00 | $102.27 – $925.00 |
| Ultrasound of the abdomen, complete CPT 76700 | $785.55 | $1,309.25 | $102.27 – $1,232.00 |
| Ultrasound of the neck or thyroid CPT 76536 | $601.05 | $1,001.75 | $102.27 – $942.65 |
| Wrist X-ray, 3 or more views CPT 73110 | $502.05 | $836.75 | $41.44 – $787.38 |
| X-ray of the lower back, 4 or more views CPT 72110 | $652.50 | $1,087.50 | $52.13 – $1,023.34 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $265.50 | $442.50 | $7.11 – $416.39 |
| Blood culture CPT 87040 | $239.10 | $398.50 | $8.67 – $374.99 |
| Blood draw (venipuncture) CPT 36415 | $23.85 | $39.75 | $3.00 – $37.40 |
| BNP test (heart failure) CPT 83880 | $214.95 | $358.25 | $32.98 – $337.11 |
| C-reactive protein (CRP) test CPT 86140 | $123.90 | $206.50 | $4.35 – $194.32 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $230.40 | $384.00 | $29.48 – $361.34 |
| Complete blood count (CBC) with differential CPT 85025 | $134.70 | $224.50 | $6.53 – $211.25 |
| Complete blood count (CBC), automated CPT 85027 | $120.30 | $200.50 | $5.43 – $188.67 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $391.80 | $653.00 | $8.87 – $614.47 |
| COVID-19 PCR test CPT 87635 | $140.00 | $233.33 | $43.10 – $300.73 |
| D-dimer test (blood clots) CPT 85379 | $407.55 | $679.25 | $8.55 – $639.17 |
| Drug screen, instrument chemistry CPT 80307 | $411.00 | $685.00 | $52.20 – $644.59 |
| Ferritin (iron stores) test CPT 82728 | $76.65 | $127.75 | $11.45 – $120.21 |
| Free T4 (thyroid) test CPT 84439 | $284.70 | $474.50 | $7.58 – $446.50 |
| General health panel (blood tests) CPT 80050 | $638.70 | $1,064.50 | $47.28 – $1,001.69 |
| Glucose (blood sugar) test CPT 82947 | $80.70 | $134.50 | $3.30 – $126.56 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $183.30 | $305.50 | $29.48 – $287.48 |
| Hemoglobin A1c test CPT 83036 | $113.55 | $189.25 | $8.16 – $178.08 |
| Hepatitis C antibody test CPT 86803 | $192.45 | $320.75 | $11.99 – $301.83 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $174.90 | $291.50 | $20.23 – $274.30 |
| Iron test CPT 83540 | $217.80 | $363.00 | $5.43 – $341.58 |
| Kidney function panel CPT 80069 | not posted | $7.29 – $17.04 | |
| Lipase test (pancreas) CPT 83690 | $160.50 | $267.50 | $5.79 – $251.72 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $391.80 | $653.00 | $11.25 – $614.47 |
| Liver function panel CPT 80076 | $370.20 | $617.00 | $6.86 – $580.60 |
| Magnesium test CPT 83735 | $160.50 | $267.50 | $5.63 – $251.72 |
| Obstetric blood test panel CPT 80055 | not posted | $47.81 – $71.84 | |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $130.65 | $217.75 | $5.05 – $204.90 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $325.95 | $543.25 | $12.64 – $511.20 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $119.10 | $198.50 | $3.60 – $186.79 |
| PSA (prostate specific antigen), free CPT 84154 | not posted | $15.45 – $36.10 | |
| PSA (prostate specific antigen), total CPT 84153 | $127.05 | $211.75 | $15.45 – $199.26 |
| Rapid strep test CPT 87880 | not posted | $13.89 – $23.54 | |
| Sed rate (ESR) test CPT 85652 | $84.00 | $140.00 | $2.27 – $131.74 |
| TB skin test CPT 86580 | $20.81 | $34.67 | $4.98 – $134.74 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $324.00 | $540.00 | $14.11 – $508.14 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $576.00 | $960.00 | $35.38 – $903.36 |
| Troponin test (heart damage) CPT 84484 | $339.75 | $566.25 | $10.47 – $532.84 |
| Urinalysis, automated, with microscope CPT 81001 | $107.85 | $179.75 | $2.66 – $169.14 |
| Urinalysis, automated, without microscope CPT 81003 | $107.85 | $179.75 | $1.89 – $169.14 |
| Urinalysis, manual, with microscope CPT 81000 | not posted | $3.38 – $6.23 | |
| Urinalysis, manual, without microscope CPT 81002 | not posted | $2.92 – $5.01 | |
| Urine culture, colony count CPT 87086 | $210.00 | $350.00 | $6.78 – $329.35 |
| Urine pregnancy test CPT 81025 | $187.20 | $312.00 | $7.23 – $293.59 |
| Vitamin B12 test CPT 82607 | $177.60 | $296.00 | $12.67 – $278.54 |
| Vitamin D test CPT 82306 | $267.15 | $445.25 | $24.86 – $418.98 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $1,288.35 | $2,147.25 | $187.79 – $2,020.56 |
| ECG tracing only (no interpretation) CPT 93005 | $205.35 | $342.25 | $49.18 – $438.00 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | not posted | $527.31 – $595.86 | |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 | not posted | $13.44 – $15.19 | |
| Holter monitor, up to 48 hours CPT 93224 | not posted | $65.18 – $73.65 | |
| Left heart catheterization CPT 93452 | not posted | $3,093.29 – $3,495.41 | |
| Left heart catheterization with coronary angiogram CPT 93458 | not posted | $3,093.29 – $3,495.41 | |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | not posted | $438.05 – $1,418.72 | |
| Treadmill stress test, complete CPT 93015 | not posted | $68.26 – $77.14 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | not posted | $3,300.05 – $7,763.40 | |
| Appendix removal, laparoscopic CPT 44970 | not posted | $5,611.02 – $6,340.45 | |
| Breast biopsy with ultrasound guidance CPT 19083 | not posted | $486.45 – $1,760.79 | |
| Carpal tunnel release CPT 64721 | not posted | $659.94 – $2,122.16 | |
| Colonoscopy with biopsy CPT 45380 | $760.95 | $1,268.25 | $429.26 – $8,391.26 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $760.95 | $1,268.25 | $429.26 – $8,391.26 |
| Colonoscopy, diagnostic CPT 45378 | $1,899.00 | $3,165.00 | $328.50 – $6,382.98 |
| Colposcopy with biopsy CPT 57454 | not posted | $65.06 – $330.58 | |
| Cystoscopy (bladder scope) CPT 52000 | $1,594.35 | $2,657.25 | $238.15 – $14,300.00 |
| Ear tubes, under general anesthesia CPT 69436 | not posted | $420.64 – $1,609.77 | |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $1,094.55 | $1,824.25 | $130.67 – $3,076.00 |
| Gallbladder removal, laparoscopic CPT 47562 | not posted | $1,888.85 – $6,340.45 | |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | not posted | $1,649.86 – $20,000.00 | |
| Hysterectomy, laparoscopic, with tubes and/or ovaries CPT 58571 | not posted | $3,110.01 – $11,314.33 | |
| Hysteroscopy with biopsy or polyp removal CPT 58558 | not posted | $1,063.52 – $3,455.33 | |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | not posted | $1,888.85 – $6,340.45 | |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | not posted | $1,151.54 – $3,835.18 | |
| Kidney stone shock-wave lithotripsy CPT 50590 | $18,406.05 | $30,676.75 | $1,142.90 – $28,866.82 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | not posted | $1,088.27 – $3,526.06 | |
| Lower colon endoscopy with ultrasound CPT 45391 | not posted | $429.26 – $1,281.36 | |
| Nasal endoscopy, diagnostic CPT 31231 | not posted | $68.14 – $210.98 | |
| Prostate biopsy CPT 55700 | $3,009.45 | $5,015.75 | $652.80 – $14,803.07 |
| Prostate removal, laparoscopic or robotic CPT 55866 | not posted | $10,012.68 – $11,314.33 | |
| Removal of a breast lump, open surgery CPT 19120 | not posted | $963.66 – $4,161.45 | |
| Rotator cuff repair, arthroscopic CPT 29827 | not posted | $2,398.52 – $7,763.40 | |
| Screening colonoscopy, average risk HCPCS G0121 | not posted | $328.50 – $990.79 | |
| Screening colonoscopy, high risk HCPCS G0105 | not posted | $328.50 – $990.79 | |
| Septoplasty (nasal septum repair) CPT 30520 | not posted | $886.62 – $3,524.39 | |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | not posted | $162.55 – $183.68 | |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | not posted | $1,048.35 – $20,000.00 | |
| Tonsil and adenoid removal, under age 12 CPT 42820 | not posted | $1,954.22 – $6,428.81 | |
| Total hip replacement CPT 27130 | not posted | $12,374.28 – $13,982.93 | |
| Total knee replacement CPT 27447 | not posted | $12,374.28 – $13,982.93 | |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $731.70 | $1,219.50 | $334.95 – $6,567.15 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $1,824.75 | $3,041.25 | $334.95 – $6,567.15 |
| Vasectomy CPT 55250 | not posted | $652.80 – $2,226.21 |
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 | $2,541.25 – $2,871.62 | |
| Fetal non-stress test CPT 59025 | not posted | $15.78 – $218.62 | |
| IUD insertion CPT 58300 | not posted | $101.11 – $114.25 | |
| Vaginal birth after a prior C-section (VBAC), routine care CPT 59610 | not posted | $2,396.37 – $2,707.90 | |
| Vaginal delivery, routine care including prenatal and postpartum CPT 59400 | not posted | $2,288.17 – $2,585.63 |
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 | $778.00 – $19,999.47 | |
| C-section, without complications MS-DRG 788 | not posted | $6,855.32 – $32,198.27 | |
| Chest pain MS-DRG 313 | not posted | $5,147.92 – $51,675.84 | |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $7,919.94 – $81,345.63 | |
| COPD flare-up, without complications MS-DRG 192 | not posted | $4,590.24 – $46,880.58 | |
| Fainting (syncope) MS-DRG 312 | not posted | $6,231.85 – $63,113.49 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $7,011.90 – $71,414.65 | |
| Heart failure, with major complications MS-DRG 291 | not posted | $9,179.03 – $94,514.49 | |
| Heart failure, without complications MS-DRG 293 | not posted | $4,046.83 – $39,745.63 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $69,945.98 – $536,253.72 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $13,791.43 – $156,624.71 | |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $4,047.56 – $40,527.94 | |
| Kidney failure, with complications MS-DRG 683 | not posted | $6,261.88 – $64,388.36 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $5,787.84 – $58,137.13 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $17,455.04 – $124,972.68 | |
| Normal newborn care MS-DRG 795 | not posted | $1,013.00 – $7,110.88 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $5,564.04 – $56,601.49 | |
| Pneumonia, with complications MS-DRG 194 | not posted | $5,762.10 – $59,397.52 | |
| Pneumonia, with major complications MS-DRG 193 | not posted | $9,397.82 – $95,448.92 | |
| Pneumonia, without complications MS-DRG 195 | not posted | $4,493.71 – $45,105.90 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $1,038.00 – $31,955.63 | |
| Sepsis, with major complications MS-DRG 871 | not posted | $13,888.67 – $142,126.68 | |
| Sepsis, without major complications MS-DRG 872 | not posted | $7,316.49 – $74,681.52 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $6,226.84 – $63,801.63 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $5,574.05 – $56,521.81 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $7,223.54 – $73,660.17 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $8,870.87 – $86,829.03 | |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $4,820.46 – $22,681.51 | |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $10,784.90 – $61,873.76 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $441.30 | $735.50 | $27.96 – $1,568.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $1,482.45 | $2,470.75 | $340.77 – $6,785.49 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $1,001.25 | $1,668.75 | $262.86 – $5,222.92 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $1,001.25 | $1,668.75 | $262.86 – $5,222.92 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | not posted | $849.94 – $2,478.57 | |
| Eye exam, new patient, comprehensive CPT 92004 | not posted | $123.94 – $140.05 | |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 | not posted | $208.33 – $596.19 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | not posted | $150.47 – $170.03 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | not posted | $150.47 – $170.03 | |
| Sleep study with CPAP titration CPT 95811 | $7,244.10 | $12,073.50 | $772.42 – $11,361.16 |
| Sleep study, overnight in a sleep lab CPT 95810 | $4,830.30 | $8,050.50 | $734.88 – $7,575.52 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | not posted | $150.47 – $170.03 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $115.20 | $192.00 | $26.44 – $401.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $164.55 | $274.25 | $39.41 – $710.26 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $169.80 | $283.00 | $40.67 – $710.26 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | not posted | $28.00 – $31.64 | |
| Therapeutic activities, 15 minutes CPT 97530 | not posted | $33.49 – $37.84 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | not posted | $154.52 – $174.61 | |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | not posted | $154.52 – $174.61 | |
| Group psychotherapy CPT 90853 | not posted | $88.96 – $100.52 | |
| Psychiatric diagnostic evaluation CPT 90791 | not posted | $154.52 – $174.61 | |
| Psychotherapy, 30 minutes CPT 90832 | not posted | $154.52 – $174.61 | |
| Psychotherapy, 45 minutes CPT 90834 | not posted | $154.52 – $174.61 | |
| Psychotherapy, 60 minutes CPT 90837 | not posted | $154.52 – $174.61 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $146.85 | $244.75 | $35.17 – $1,399.00 |
| IV hydration, each additional hour CPT 96361 | $59.70 | $99.50 | $14.30 – $1,399.00 |
| IV hydration, first hour CPT 96360 | $449.55 | $749.25 | $56.57 – $1,399.00 |
| IV push injection of a drug, first CPT 96374 | $192.15 | $320.25 | $46.02 – $1,399.00 |
| IV push injection, each additional drug CPT 96375 | $192.15 | $320.25 | $24.85 – $1,399.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $49.88 | $83.13 | $5.18 – $78.23 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $20.52 | $34.20 | ? – $32.18 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $101.40 | $169.00 | ? – $159.03 |
| Hydromorphone (Dilaudid) injection, up to 4 mg HCPCS J1170 | $39.40 | $65.66 | $9.44 – $61.79 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $19.68 | $32.79 | ? – $30.86 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $69.30 | $115.50 | ? – $108.69 |
| Morphine injection, up to 10 mg HCPCS J2270 | $118.17 | $196.95 | ? – $185.33 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $9.00 | $15.00 | $1.21 – $14.12 |
| Propofol injection, per 10 mg HCPCS J2704 | $75.60 | $126.00 | ? – $118.57 |
| Saline IV solution, 1000 ml HCPCS J7030 | $30.00 | $50.00 | $7.19 – $138.75 |
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.