White Rock Medical Center
9440 Poppy Drive, Dallas, TX 75218 · Acute care hospital · Emergency room
These are White Rock Medical Center's own posted figures from its standard-charges file dated September 15, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
202 of the services we track have a posted price here; 171 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 | $2,451.40 | $3,605.00 | $324.45 – $4,117.38 |
| Emergency room visit, level 1 (minor) CPT 99281 | $255.00 | $375.00 | $84.71 – $550.00 |
| Emergency room visit, level 2 CPT 99282 | $518.16 | $762.00 | $154.24 – $900.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $1,056.72 | $1,554.00 | $274.22 – $1,302.00 |
| Emergency room visit, level 4 CPT 99284 | $1,439.56 | $2,117.00 | $280.00 – $2,500.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $2,067.20 | $3,040.00 | $280.00 – $3,520.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $675.58 | $993.50 | $89.42 – $715.32 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| New patient office visit, about 15 to 29 minutes CPT 99202 | $184.96 | $272.00 | $24.48 – $195.84 |
| New patient office visit, about 30 minutes CPT 99203 | $279.48 | $411.00 | $36.99 – $295.92 |
| New patient office visit, about 45 minutes CPT 99204 | $331.84 | $488.00 | $43.92 – $351.36 |
| New patient office visit, about 60 minutes CPT 99205 | $405.28 | $596.00 | $53.64 – $429.12 |
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $118.32 | $174.00 | $15.66 – $125.28 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $143.48 | $211.00 | $18.99 – $151.92 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $265.20 | $390.00 | $35.10 – $280.80 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $289.68 | $426.00 | $38.34 – $306.72 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $76.84 | $113.00 | $10.17 – $81.36 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $44.88 | $66.00 | $8.98 – $55.76 |
| Abdominal X-ray, 1 view CPT 74018 | $502.52 | $739.00 | $30.40 – $532.08 |
| Ankle X-ray, 3 or more views CPT 73610 | $413.44 | $608.00 | $36.75 – $437.76 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $346.80 | $510.00 | $39.09 – $367.20 |
| Breast ultrasound, one breast, complete CPT 76641 | $400.52 | $589.00 | $80.10 – $424.08 |
| Breast ultrasound, one breast, limited CPT 76642 | $352.92 | $519.00 | $70.58 – $373.68 |
| Chest X-ray, 1 view CPT 71045 | $451.52 | $664.00 | $25.73 – $478.08 |
| Chest X-ray, 2 views CPT 71046 | $472.60 | $695.00 | $33.75 – $500.40 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $4,998.68 | $7,351.00 | $175.06 – $5,292.72 |
| CT angiogram of the head CPT 70496 | $4,727.36 | $6,952.00 | $175.06 – $5,005.44 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $5,385.60 | $7,920.00 | $312.08 – $5,702.40 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $6,404.92 | $9,419.00 | $350.18 – $6,781.68 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $5,303.32 | $7,799.00 | $188.11 – $5,615.28 |
| CT scan of the abdomen, without contrast CPT 74150 | $2,822.00 | $4,150.00 | $104.75 – $2,988.00 |
| CT scan of the chest, with contrast CPT 71260 | $3,493.84 | $5,138.00 | $171.74 – $3,699.36 |
| CT scan of the chest, without contrast CPT 71250 | $2,771.00 | $4,075.00 | $104.75 – $2,934.00 |
| CT scan of the head, without contrast CPT 70450 | $3,056.60 | $4,495.00 | $104.75 – $3,236.40 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $4,022.88 | $5,916.00 | $104.75 – $4,259.52 |
| CT scan of the pelvis, with contrast CPT 72193 | $3,085.84 | $4,538.00 | $175.06 – $3,267.36 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $2,438.48 | $3,586.00 | $104.75 – $2,581.92 |
| Diagnostic mammogram, both breasts CPT 77066 | $456.96 | $672.00 | $60.48 – $483.84 |
| Diagnostic mammogram, one breast CPT 77065 | $328.44 | $483.00 | $43.47 – $347.76 |
| Foot X-ray, 3 or more views CPT 73630 | $413.44 | $608.00 | $34.41 – $437.76 |
| Hand X-ray, 3 or more views CPT 73130 | $552.84 | $813.00 | $37.43 – $585.36 |
| Knee X-ray, 3 views CPT 73562 | $497.76 | $732.00 | $41.10 – $527.04 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $1,938.00 | $2,850.00 | $239.69 – $2,052.00 |
| Leg or arm vein ultrasound, one side CPT 93971 | not posted | $105.02 – $10,000.00 | |
| Lower back X-ray, 2 or 3 views CPT 72100 | $605.20 | $890.00 | $40.10 – $640.80 |
| MRI of the abdomen, without and with contrast CPT 74183 | $4,862.68 | $7,151.00 | $348.50 – $5,148.72 |
| MRI of the brain, without and with contrast CPT 70553 | $6,093.48 | $8,961.00 | $328.11 – $6,451.92 |
| MRI of the brain, without contrast CPT 70551 | $3,417.68 | $5,026.00 | $202.15 – $3,618.72 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $2,656.76 | $3,907.00 | $208.84 – $2,813.04 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $4,242.52 | $6,239.00 | $197.14 – $4,492.08 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $4,242.52 | $6,239.00 | $196.14 – $4,492.08 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $4,451.28 | $6,546.00 | $196.48 – $4,713.12 |
| MRI of the pelvis, without and with contrast CPT 72197 | $4,914.36 | $7,227.00 | $347.16 – $5,203.44 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $2,278.00 | $3,350.00 | $209.16 – $2,412.00 |
| Neck X-ray, 2 or 3 views CPT 72040 | $387.60 | $570.00 | $39.76 – $410.40 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $1,008.44 | $1,483.00 | $96.28 – $1,067.76 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $1,124.72 | $1,654.00 | $104.75 – $1,190.88 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $1,092.08 | $1,606.00 | $104.75 – $1,156.32 |
| Screening mammogram, both breasts CPT 77067 | $348.16 | $512.00 | $46.08 – $368.64 |
| Shoulder X-ray, 2 or more views CPT 73030 | $424.32 | $624.00 | $35.09 – $449.28 |
| Transvaginal pregnancy ultrasound CPT 76817 | $206.04 | $303.00 | $92.89 – $247.70 |
| Transvaginal ultrasound CPT 76830 | $665.04 | $978.00 | $104.75 – $704.16 |
| Ultrasound of the abdomen, complete CPT 76700 | $1,086.64 | $1,598.00 | $104.75 – $1,150.56 |
| Ultrasound of the neck or thyroid CPT 76536 | $768.40 | $1,130.00 | $104.75 – $813.60 |
| Wrist X-ray, 3 or more views CPT 73110 | $363.80 | $535.00 | $41.44 – $385.20 |
| X-ray of the lower back, 4 or more views CPT 72110 | $732.36 | $1,077.00 | $52.13 – $775.44 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $337.28 | $496.00 | $3.30 – $357.12 |
| Blood culture CPT 87040 | $265.88 | $391.00 | $4.02 – $281.52 |
| Blood draw (venipuncture) CPT 36415 | $31.96 | $47.00 | $1.17 – $33.84 |
| BNP test (heart failure) CPT 83880 | $339.32 | $499.00 | $15.31 – $359.28 |
| C-reactive protein (CRP) test CPT 86140 | $191.76 | $282.00 | $2.02 – $203.04 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $202.64 | $298.00 | $13.69 – $214.56 |
| Complete blood count (CBC) with differential CPT 85025 | $263.16 | $387.00 | $3.03 – $278.64 |
| Complete blood count (CBC), automated CPT 85027 | $165.24 | $243.00 | $2.52 – $174.96 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $449.48 | $661.00 | $4.12 – $475.92 |
| COVID-19 PCR test CPT 87635 | $174.45 | $256.55 | $51.31 – $184.72 |
| D-dimer test (blood clots) CPT 85379 | $305.32 | $449.00 | $3.97 – $323.28 |
| Drug screen, instrument chemistry CPT 80307 | $215.56 | $317.00 | $24.23 – $228.24 |
| Ferritin (iron stores) test CPT 82728 | $184.28 | $271.00 | $5.32 – $195.12 |
| Free T4 (thyroid) test CPT 84439 | $214.88 | $316.00 | $3.52 – $227.52 |
| General health panel (blood tests) CPT 80050 | $371.28 | $546.00 | $13.70 – $393.12 |
| Glucose (blood sugar) test CPT 82947 | $106.08 | $156.00 | $1.53 – $112.32 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $166.60 | $245.00 | $13.69 – $176.40 |
| Hemoglobin A1c test CPT 83036 | $189.72 | $279.00 | $3.79 – $200.88 |
| Hepatitis C antibody test CPT 86803 | $255.68 | $376.00 | $5.57 – $270.72 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $129.20 | $190.00 | $9.39 – $136.80 |
| Iron test CPT 83540 | $195.84 | $288.00 | $2.52 – $207.36 |
| Kidney function panel CPT 80069 | $329.12 | $484.00 | $3.39 – $348.48 |
| Lipase test (pancreas) CPT 83690 | $186.32 | $274.00 | $2.69 – $197.28 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $297.84 | $438.00 | $5.22 – $315.36 |
| Liver function panel CPT 80076 | $572.72 | $842.23 | $3.19 – $606.41 |
| Magnesium test CPT 83735 | $159.12 | $234.00 | $2.61 – $168.48 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $149.60 | $220.00 | $2.34 – $158.40 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $293.08 | $431.00 | $5.87 – $310.32 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $125.12 | $184.00 | $1.67 – $132.48 |
| PSA (prostate specific antigen), total CPT 84153 | $154.36 | $227.00 | $7.17 – $163.44 |
| Rapid strep test CPT 87880 | $261.12 | $384.00 | $6.45 – $276.48 |
| Sed rate (ESR) test CPT 85652 | $129.88 | $191.00 | $1.05 – $137.52 |
| TB skin test CPT 86580 | $66.61 | $97.96 | $3.66 – $70.53 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $341.36 | $502.00 | $6.55 – $361.44 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $367.20 | $540.00 | $27.87 – $388.80 |
| Troponin test (heart damage) CPT 84484 | $300.56 | $442.00 | $4.86 – $318.24 |
| Urinalysis, automated, with microscope CPT 81001 | $127.84 | $188.00 | $1.24 – $135.36 |
| Urinalysis, automated, without microscope CPT 81003 | $82.96 | $122.00 | ? – $87.84 |
| Urine culture, colony count CPT 87086 | $203.32 | $299.00 | $3.15 – $215.28 |
| Urine pregnancy test CPT 81025 | $293.08 | $431.00 | $3.36 – $310.32 |
| Vitamin B12 test CPT 82607 | $218.96 | $322.00 | $5.88 – $231.84 |
| Vitamin D test CPT 82306 | $354.28 | $521.00 | $11.54 – $375.12 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $2,255.56 | $3,317.00 | $239.69 – $2,388.24 |
| ECG tracing only (no interpretation) CPT 93005 | $476.00 | $700.00 | $59.26 – $504.00 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $3,214.36 | $4,727.00 | $425.43 – $3,403.44 |
| Left heart catheterization with coronary angiogram CPT 93458 | $14,698.20 | $21,615.00 | $1,945.35 – $15,562.80 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $5,013.64 | $7,373.00 | $422.34 – $5,308.56 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| ACL reconstruction, arthroscopic CPT 29888 | $12,780.50 | $18,794.85 | $3,300.05 – $15,408.22 |
| Appendix removal, laparoscopic CPT 44970 | $14,953.44 | $21,990.36 | $1,979.13 – $15,833.06 |
| Breast biopsy with ultrasound guidance CPT 19083 | $3,521.04 | $5,178.00 | $486.45 – $10,000.00 |
| Carpal tunnel release CPT 64721 | $7,157.91 | $10,526.34 | $659.94 – $10,000.00 |
| Colonoscopy with biopsy CPT 45380 | $5,641.06 | $8,295.68 | $429.26 – $10,000.00 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $3,058.26 | $4,497.44 | $429.26 – $10,000.00 |
| Colonoscopy, diagnostic CPT 45378 | $3,238.09 | $4,761.90 | $328.50 – $10,000.00 |
| Ear tubes, under general anesthesia CPT 69436 | $3,679.59 | $5,411.16 | $420.64 – $10,000.00 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $2,479.85 | $3,646.84 | $130.67 – $10,000.00 |
| Gallbladder removal, laparoscopic CPT 47562 | $10,323.30 | $15,181.32 | $1,888.85 – $12,837.39 |
| Gastric bypass (weight loss surgery), laparoscopic CPT 43644 | $6,119.33 | $8,999.01 | $809.91 – $16,500.00 |
| Inguinal (groin) hernia repair, laparoscopic CPT 49650 | $20,646.60 | $30,362.64 | $1,888.85 – $21,861.10 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $25,309.89 | $37,220.43 | $1,151.54 – $26,798.71 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $15,397.38 | $22,643.20 | $1,088.27 – $16,303.10 |
| Prostate biopsy CPT 55700 | $1,246.44 | $1,833.00 | $164.97 – $10,000.00 |
| Removal of a breast lump, open surgery CPT 19120 | $9,878.47 | $14,527.16 | $963.66 – $10,459.56 |
| Rotator cuff repair, arthroscopic CPT 29827 | $34,081.33 | $50,119.60 | $2,398.52 – $36,086.11 |
| Screening colonoscopy, average risk HCPCS G0121 | $465.80 | $685.00 | $328.50 – $10,000.00 |
| Screening colonoscopy, high risk HCPCS G0105 | $1,695.32 | $2,493.12 | $328.50 – $10,000.00 |
| Septoplasty (nasal septum repair) CPT 30520 | $13,025.22 | $19,154.73 | $886.62 – $13,791.41 |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $18,653.25 | $27,431.25 | $2,468.81 – $19,750.50 |
| Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775 | $9,281.67 | $13,649.51 | $1,228.46 – $10,000.00 |
| Tonsil and adenoid removal, under age 12 CPT 42820 | $27,668.11 | $40,688.40 | $1,954.22 – $29,295.65 |
| Total hip replacement CPT 27130 | $53,236.17 | $78,288.48 | $7,045.96 – $56,367.71 |
| Total knee replacement CPT 27447 | $37,683.17 | $55,416.42 | $4,987.48 – $39,899.82 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $1,651.58 | $2,428.80 | $334.95 – $10,000.00 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $1,651.58 | $2,428.80 | $334.95 – $10,000.00 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $682.72 | $1,004.00 | $90.36 – $722.88 |
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 | $7,058.88 – $16,773.20 | |
| C-section, without complications MS-DRG 788 | not posted | $6,879.00 – $18,217.20 | |
| Chest pain MS-DRG 313 | not posted | $6,082.78 – $13,680.00 | |
| COPD flare-up, with major complications MS-DRG 190 | not posted | $9,692.38 – $21,046.30 | |
| COPD flare-up, without complications MS-DRG 192 | not posted | $5,617.50 – $12,198.00 | |
| Fainting (syncope) MS-DRG 312 | not posted | $6,892.90 – $16,560.40 | |
| Gastrointestinal bleeding, with complications MS-DRG 378 | not posted | $8,516.58 – $18,633.30 | |
| Heart failure, with major complications MS-DRG 291 | not posted | $11,233.25 – $24,392.20 | |
| Heart failure, without complications MS-DRG 293 | not posted | $4,952.50 – $10,754.00 | |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | not posted | $76,458.48 – $185,873.20 | |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | not posted | $16,877.88 – $36,649.10 | |
| Irregular heartbeat, without complications MS-DRG 310 | not posted | $4,835.78 – $10,755.90 | |
| Kidney failure, with complications MS-DRG 683 | not posted | $7,663.25 – $16,640.20 | |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | not posted | $6,829.26 – $15,380.50 | |
| Neck (cervical) spinal fusion, without complications MS-DRG 473 | not posted | $20,406.94 – $46,384.70 | |
| Normal newborn care MS-DRG 795 | not posted | $1,585.84 – $6,224.42 | |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | not posted | $6,466.34 – $14,785.80 | |
| Pneumonia, with complications MS-DRG 194 | not posted | $7,051.62 – $15,312.10 | |
| Pneumonia, with major complications MS-DRG 193 | not posted | $11,323.62 – $24,973.60 | |
| Pneumonia, without complications MS-DRG 195 | not posted | $5,499.38 – $11,941.50 | |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | not posted | $10,286.46 – $26,539.20 | |
| Sepsis, with major complications MS-DRG 871 | not posted | $15,965.04 – $36,907.50 | |
| Sepsis, without major complications MS-DRG 872 | not posted | $8,953.88 – $19,442.70 | |
| Skin infection (cellulitis), without major complications MS-DRG 603 | not posted | $7,290.22 – $16,547.10 | |
| Spinal fusion except neck, without major complications MS-DRG 460 | not posted | $34,722.50 – $46,293.97 | |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | not posted | $6,496.44 – $14,812.40 | |
| Stroke, with complications or clot-busting drug MS-DRG 65 | not posted | $8,840.12 – $19,195.70 | |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | not posted | $9,594.16 – $23,573.30 | |
| Vaginal delivery, without complications MS-DRG 807 | not posted | $4,586.00 – $12,809.80 | |
| Weight loss surgery, without complications MS-DRG 621 | not posted | $10,000.00 – $28,659.60 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $1,139.68 | $1,676.00 | $27.96 – $10,000.00 |
| Lower back nerve root injection with imaging guidance CPT 64483 | $1,677.82 | $2,467.38 | $340.77 – $10,000.00 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $1,294.56 | $1,903.77 | $262.86 – $10,000.00 |
| Lower back spinal injection (epidural), without imaging CPT 62322 | $2,125.17 | $3,125.25 | $262.86 – $10,000.00 |
Eye
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Cataract removal with lens implant CPT 66984 | $8,482.97 | $12,474.96 | $849.94 – $10,000.00 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Sleep study with CPAP titration CPT 95811 | $4,392.12 | $6,459.00 | $581.31 – $4,650.48 |
| Sleep study, overnight in a sleep lab CPT 95810 | $4,112.64 | $6,048.00 | $544.32 – $4,354.56 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $200.60 | $295.00 | $26.55 – $458.51 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $126.49 | $186.01 | $16.74 – $200.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $86.36 | $127.00 | $17.27 – $200.00 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $129.88 | $191.00 | $25.98 – $200.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $103.36 | $152.00 | $13.68 – $200.00 |
| Therapeutic activities, 15 minutes CPT 97530 | $128.12 | $188.41 | $16.96 – $200.00 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Group psychotherapy CPT 90853 | $310.08 | $456.00 | $41.04 – $328.32 |
| Psychiatric diagnostic evaluation CPT 90791 | $326.40 | $480.00 | $43.20 – $376.90 |
| Psychotherapy, 30 minutes CPT 90832 | $191.08 | $281.00 | $25.29 – $376.90 |
| Psychotherapy, 45 minutes CPT 90834 | $247.52 | $364.00 | $32.76 – $376.90 |
| Psychotherapy, 60 minutes CPT 90837 | $282.88 | $416.00 | $37.44 – $376.90 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $190.40 | $280.00 | $25.20 – $201.60 |
| IV hydration, each additional hour CPT 96361 | $170.68 | $251.00 | $22.59 – $180.72 |
| IV hydration, first hour CPT 96360 | $575.96 | $847.00 | $76.23 – $609.84 |
| IV push injection of a drug, first CPT 96374 | $244.80 | $360.00 | $32.40 – $451.67 |
| IV push injection, each additional drug CPT 96375 | $224.40 | $330.00 | $29.70 – $237.60 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $87.16 | $128.17 | $3.67 – $92.28 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $87.16 | $128.17 | ? – $92.28 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $87.17 | $128.19 | ? – $92.30 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $87.16 | $128.17 | ? – $92.28 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $87.04 | $128.00 | ? – $92.16 |
| Morphine injection, up to 10 mg HCPCS J2270 | $87.04 | $128.00 | ? – $92.16 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $87.04 | $128.00 | ? – $92.16 |
| Propofol injection, per 10 mg HCPCS J2704 | $87.16 | $128.17 | ? – $92.28 |
| Saline IV solution, 1000 ml HCPCS J7030 | $87.16 | $128.17 | $11.54 – $92.28 |
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.