Prices of Common Procedures & Services

These prices DO NOT include doctor fees, anesthesia, supplies and medications and are valid through June 30, 2019.

Room and Board Prices Per Day

Service

Billing term

 Price

Adult semi-private (up to two patients) room and care in the Main Hospital

SEMI-PRIVATE ROOM AND CARE

 $1,980

Adult room and care in the Transitional Care Hospital

TCH BASIC ROOM AND CARE

 $1,980

Adult room and care on the Labor & Delivery unit

OB CARE BED

 $2,310

Pediatric room and care

PEDIATRIC ACUTE CARE ROOM AND CARE

 $1,980

Psychiatric room and care

5 EAST ROOM & CARE

 $2,448

Normal newborn nursery room and care (includes babies staying in mother's room)

NURSERY BED

 $1,980

Sick newborn nursery room and care

NURSERY INTERMEDIATE ROOM AND BED

 $3,917

Neonatal Step Down Intensive Care Unit (NICU) room and care

NICU STEPDOWN ROOM AND BED

 $6,272

Neonatal Intensive Care Unit (NICU) room and care

NICU MAXIMUM ROOM AND BED

 $8,010

Adult Intensive Care Unit (ICU) room and care

ICU ROOM & BED

 $8,010

Pediatric Intensive Care Unit (PICU) room and care

PICU ROOM & BED

 $8,010

Adult/Pediatric Step Down Intensive Care Unit (ICU) room and care in the Main Hospital

INTERMEDIATE ROOM AND CARE

 $6,272

Adult Step Down Intensive Care Unit (ICU) room and care in the Transitional Care Hospital

TCH INTERMEDIATE ROOM AND CARE

 $3,971

Emergency Department Prices

Service

Billing term

 Price

Emergency department visit, limited or minor problem

ED LEVEL 1

 $356

Emergency department visit, low to moderately severe problem

ED LEVEL 2

 $587

Emergency department visit, moderately severe problem

ED LEVEL 3

 $940

Emergency department visit, problem of high severity

ED LEVEL 4

 $1,535

Emergency department visit, problem with significant threat to life or function

ED LEVEL 5

 $2,808

Critical care for a critically ill or injured patient, first 30-74 minutes

CRITICAL CARE 30-74 MIN

 $4,128

Operating Room Prices Per Minute

Service

Billing term

  Price 

Operating room time per minute, all except heart/lung bypass

All procedures except heart/lung bypass

 $114

Operating room time per minute, heart/lung bypass only

Heart and lung bypass procedures only

 $207

Physical Therapy Prices

Service

Billing term

  Price 

Evaluation of physical therapy, typically 20 minutes

PT EVAL LOW COMPLEX 20 MIN

 $303

Evaluation of physical therapy, typically 30 minutes

PT EVAL MOD COMPLEX 30 MIN

 $358

Evaluation of physical therapy, typically 45 minutes

PT EVAL HIGH COMPLEX 45 MIN

 $441

Walking training to 1 or more areas, each 15 minutes

GAIT TRAINING 15 MIN

 $140

Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes

THERAPEUTIC ACTIVITY 15 MIN

 $140

Therapeutic procedures in a group setting

THERAPEUTIC GROUP

 $140

Occupational Therapy Prices

Service

Billing term

  Price 

Evaluation of occupational therapy, typically 20 minutes

OT EVAL LOW COMPLEX 30 MIN

 $303

Evaluation of occupational therapy, typically 45 minutes

OT EVAL MOD COMPLEX 45 MIN

 $358

Evaluation of occupational therapy, typically 60 minutes

OT EVAL HIGH COMPLEX 60 MIN

 $441

Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes

THERAPEUTIC ACTIVITY 15 MIN

 $140

Therapeutic procedures in a group setting

THERAPEUTIC GROUP

 $140

Pulmonary Therapy Prices

Service

Billing term

  Price 

Measurement of largest amount of air exhaled from lungs

VITAL CAPACITY TOTAL

 $171

Test for exercise-induced lung stress

PULMONARY STRESS TESTING

 $248

Measurement and graphic recording of total and timed exhaled air capacity

SPIROMETRY/PFT SMP

 $446

Diagnostic testing in a pulmonary function lab

FLOW VOLUME LOOP

 $413

Radiological Prices

Service

Billing term

  Price 

CT scan of head or brain without contrast

CT HEAD/BRAIN W/O CONTRAST

 $2,153

MRI scan of brain before and after contrast

MRI BRAIN W & W/O CONTR

 $5,737

X-ray of chest, 1 view

X-RAY EXAM CHEST 1 VIEW

 $344

X-ray of chest, 2 views

X-RAY EXAM CHEST 2 VIEWS

 $403

CT scan of chest without contrast

CT THORAX W/O CONTRAST

 $2,671

CT scan of chest with contrast

CT CHEST W/CONTRAST

 $3,278

X-ray of lower and sacral spine, 2 or 3 views

XR L-SPINE 2-3V

 $548

X-ray of shoulder, minimum of 2 views

XR SHOULDER CMPL 2+V

 $647

X-ray of wrist, minimum of 3 views

XR WRIST CMPL 3+V

 $647

X-ray of hand, minimum of 3 views

XR HAND CMPL 3+V

 $607

X-ray of hip with pelvis, 2-3 views

X-RAY EXAM HIP UNI 2-3 VIEWS

 $899

X-ray of knee, 1 or 2 views 

XR KNEE 1-2V

 $625

X-ray of knee, 4 or more views

XR KNEE CMPL 4+V

 $860

X-ray of ankle, minimum of 3 views 

XR ANKLE 3+V

 $690

X-ray of foot, minimum of 3 views

XR FOOT CMPL 3+V

 $690

X-ray of abdomen, 1 view

X-RAY EXAM ABDOMEN 1 VIEW

 $357

CT scan of abdomen and pelvis without contrast

CT ABD & PELVIS W/O CONTRAST

 $5,548

CT scan of abdomen and pelvis with contrast

CT ABDOMEN & PELVIS W/CONTRAST

 $6,195

Ultrasound of head and neck

US SOFT TISSUE HEAD/NECK

 $948

Ultrasound of one breast

ULTRASOUND BREAST LIMITED

 $666

Ultrasound of abdomen

US ABDOMEN LTD

 $801

Ultrasound behind abdominal cavity

US RETROPERITIONEAL

 $906

Ultrasound re-evaluation of pregnant uterus, per fetus

US PREGNANCY FOLLOWUP

 $532

Ultrasound of pelvis through vagina

US TRANSVAGINAL

 $890

Ultrasound guidance for accessing into blood vessel

US GUIDED VASCULAR ACCESS

 $652

Ultrasonic guidance imaging supervision and interpretation for insertion of needle

ECHO GUIDE FOR BIOPSY

 $810

Diagnostic mammography of one breast

DIGITAL DIAG MAMMOGRAM

 $479

Screening mammography of both breasts 

SCREENING MAMMOGRAPHY, DIGITAL

 $476

Bone density measurement using dedicated X-ray machine

XR BONE DENSITY AXIAL

 $747

Laboratory Prices

Service

Billing term

  Price 

Blood test, basic group of blood chemicals

BASIC METABOLIC PANEL

 $221

Blood test, comprehensive group of blood chemicals

COMPREHEN METABOLIC PANEL

 $387

Blood test, lipids (cholesterol and triglycerides) 

LIPID PANEL

 $228

Manual urinalysis test with examination using microscope

URINALYSIS, AUTO W/SCOPE

 $96

Analysis of urine

URINALYSIS

 $48

Vitamin D-3 level

ASSAY OF VITAMIN D

 $334

Calcium level 

ASSAY OF CALCIUM

 $82

Blood gases measurement

BLOOD GASES: PH, PO2 & PCO2

 $370

Blood glucose (sugar) level

ASSAY, GLUCOSE, BLOOD QUANT

 $65

Blood glucose (sugar) test performed by hand-held instrument

GLUCOSE BLOOD TEST

 $48

Methemoglobin (hemoglobin) analysis

HC BLOOD METHEMOGLOBIN ASSAY

 $143

Lactic acid level

ASSAY OF LACTIC ACID

 $163

Magnesium level

ASSAY OF MAGNESIUM

 $97

Phosphate level

ASSAY OF PHOSPHORUS

 $74

Blood potassium level

ASSAY OF SERUM POTASSIUM

 $74

Blood sodium level

ASSAY OF SERUM SODIUM

 $79

Blood test, thyroid stimulating hormone (TSH) 

ASSAY THYROID STIM HORMONE

 $224

Troponin (protein) analysis

ASSAY OF TROPONIN, QUANT

 $228

Complete blood cell count (red cells, white blood cell, platelets), automated test

COMPLETE CBC W/AUTO DIFF WBC

 $139

Complete blood cell count (red cells, white blood cell, platelets), automated test

COMPLETE CBC, AUTOMATED

 $107

Blood test, clotting time

PROTHROMBIN TIME

 $70

Coagulation assessment blood test

THROMBOPLASTIN TIME, PARTIAL

 $91

Blood group typing (ABO)

BLOOD TYPING, ABO

 $106

Blood typing for Rh (D) antigen

BLOOD TYPING, RH (D)

 $106

Bacterial colony count, urine

URINE CULTURE/COLONY COUNT

 $207

Pathology examination of tissue using a microscope

TISSUE EXAM BY PATHOLOGIST

 $378