Prices of Common Procedures & Services

These prices DO NOT include doctor fees, anesthesia, supplies and medications and are valid through June 30, 2020.

COVID-19 Testing Prices

Service

Billing term

Price

COVID 19 Test - Low Throughput COVID 19 Lab Test - Low Throughput $56
COVID 19 Test - High Throughput COVID 19 Lab Test - High Throughput $100
COVID 19 Test - Antibody (Serology) COVID 19 Test - Antibody (Serology) $43

 

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 $2,079
Adult room and care in the Transitional Care Hospital TCH BASIC ROOM AND CARE $2,079
Adult room and care on the Labor & Delivery unit OB CARE BED $2,426
Pediatric room and care PEDIATRIC ACUTE CARE ROOM AND CARE $2,079
Psychiatric room and care 5 EAST ROOM & CARE $2,570
Normal newborn nursery room and care (includes babies staying in mother's room) NURSERY BED $2,079
Sick newborn nursery room and care NURSERY INTERMEDIATE ROOM AND BED $4,113
Neonatal Step Down Intensive Care Unit (NICU) room and care NICU STEPDOWN ROOM AND BED $6,586
Neonatal Intensive Care Unit (NICU) room and care NICU MAXIMUM ROOM AND BED $8,411
Adult Intensive Care Unit (ICU) room and care ICU ROOM & BED $8,411
Pediatric Intensive Care Unit (PICU) room and care PICU ROOM & BED $8,411
Adult/Pediatric Step Down Intensive Care Unit (ICU) room and care in the Main Hospital INTERMEDIATE ROOM AND CARE $6,586
Adult Step Down Intensive Care Unit (ICU) room and care in the Transitional Care Hospital TCH INTERMEDIATE ROOM AND CARE $4,170


Emergency Department Prices

Service

Billing term

Price

Emergency department visit, limited or minor problem ED LEVEL 1 $374
Emergency department visit, low to moderately severe problem ED LEVEL 2 $616
Emergency department visit, moderately severe problem ED LEVEL 3 $987
Emergency department visit, problem of high severity ED LEVEL 4 $1,612
Emergency department visit, problem with significant threat to life or function ED LEVEL 5 $2,948
Critical care for a critically ill or injured patient, first 30-74 minutes CRITICAL CARE 30-74 MIN $4,334

 

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 $120
Operating room time per minute, heart/lung bypass only Heart and lung bypass procedures only $217


Physical Therapy Prices

Service

Billing term

Price

Evaluation of physical therapy, typically 20 minutes PT EVAL LOW COMPLEX 20 MIN $318
Evaluation of physical therapy, typically 30 minutes PT EVAL MOD COMPLEX 30 MIN $376
Evaluation of physical therapy, typically 45 minutes PT EVAL HIGH COMPLEX 45 MIN $463
Walking training to 1 or more areas, each 15 minutes GAIT TRAINING 15 MIN $147
Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes THERAPEUTIC ACTIVITY 15 MIN $147
Therapeutic procedures in a group setting THERAPEUTIC GROUP $147

 

Occupational Therapy Prices

Service

Billing term

Price

Evaluation of occupational therapy, typically 20 minutes OT EVAL LOW COMPLEX 30 MIN $318
Evaluation of occupational therapy, typically 45 minutes OT EVAL MOD COMPLEX 45 MIN $376
Evaluation of occupational therapy, typically 60 minutes OT EVAL HIGH COMPLEX 60 MIN $463
Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes THERAPEUTIC ACTIVITY 15 MIN $147
Therapeutic procedures in a group setting THERAPEUTIC GROUP $147

 

Pulmonary Therapy Prices

Service

Billing term

Price

Measurement of largest amount of air exhaled from lungs VITAL CAPACITY TOTAL $180
Test for exercise-induced lung stress PULMONARY STRESS TESTING $260
Measurement and graphic recording of total and timed exhaled air capacity SPIROMETRY/PFT SMP

$468

Diagnostic testing in a pulmonary function lab FLOW VOLUME LOOP $434

 

Radiological Prices

Service

Billing term

Price

CT scan of head or brain without contrast CT HEAD/BRAIN W/O CONTRAST $2,261
MRI scan of brain before and after contrast MRI BRAIN W & W/O CONTR $6,024
X-ray of chest, 1 view X-RAY EXAM CHEST 1 VIEW $361
X-ray of chest, 2 views X-RAY EXAM CHEST 2 VIEWS $423
CT scan of chest without contrast CT THORAX W/O CONTRAST $2,805
CT scan of chest with contrast CT CHEST W/CONTRAST $3,442
X-ray of lower and sacral spine, 2 or 3 views XR L-SPINE 2-3V $575
X-ray of shoulder, minimum of 2 views XR SHOULDER CMPL 2+V $679
X-ray of wrist, minimum of 3 views XR WRIST CMPL 3+V $679
X-ray of hand, minimum of 3 views XR HAND CMPL 3+V $637
X-ray of hip with pelvis, 2-3 views X-RAY EXAM HIP UNI 2-3 VIEWS $944
X-ray of knee, 1 or 2 views  XR KNEE 1-2V $656
X-ray of knee, 4 or more views XR KNEE CMPL 4+V $903
X-ray of ankle, minimum of 3 views  XR ANKLE 3+V $725
X-ray of foot, minimum of 3 views XR FOOT CMPL 3+V $725
X-ray of abdomen, 1 view X-RAY EXAM ABDOMEN 1 VIEW $375
CT scan of abdomen and pelvis without contrast CT ABD & PELVIS W/O CONTRAST $5,825
CT scan of abdomen and pelvis with contrast CT ABDOMEN & PELVIS W/CONTRAST $6,505
Ultrasound of head and neck US SOFT TISSUE HEAD/NECK $995
Ultrasound of one breast ULTRASOUND BREAST LIMITED $699
Ultrasound of abdomen US ABDOMEN LTD $841
Ultrasound behind abdominal cavity US RETROPERITIONEAL $951
Ultrasound re-evaluation of pregnant uterus, per fetus US PREGNANCY FOLLOWUP $559
Ultrasound of pelvis through vagina US TRANSVAGINAL $935
Ultrasound guidance for accessing into blood vessel US GUIDED VASCULAR ACCESS $685
Ultrasonic guidance imaging supervision and interpretation for insertion of needle ECHO GUIDE FOR BIOPSY $851
Diagnostic mammography of one breast DIGITAL DIAG MAMMOGRAM $503
Screening mammography of both breasts  SCREENING MAMMOGRAPHY, DIGITAL $500
Bone density measurement using dedicated X-ray machine XR BONE DENSITY AXIAL $784

 

Laboratory Prices

Service

Billing term

Price

Blood test, basic group of blood chemicals BASIC METABOLIC PANEL $232
Blood test, comprehensive group of blood chemicals COMPREHEN METABOLIC PANEL $406
Blood test, lipids (cholesterol and triglycerides)  LIPID PANEL $239
Manual urinalysis test with examination using microscope URINALYSIS, AUTO W/SCOPE $101
Analysis of urine URINALYSIS $50
Vitamin D-3 level ASSAY OF VITAMIN D $351
Calcium level  ASSAY OF CALCIUM $86
Blood gases measurement BLOOD GASES: PH, PO2 & PCO2 $389
Blood glucose (sugar) level ASSAY, GLUCOSE, BLOOD QUANT $68
Blood glucose (sugar) test performed by hand-held instrument GLUCOSE BLOOD TEST $50
Methemoglobin (hemoglobin) analysis HC BLOOD METHEMOGLOBIN ASSAY $150
Lactic acid level ASSAY OF LACTIC ACID $171
Magnesium level ASSAY OF MAGNESIUM $102
Phosphate level ASSAY OF PHOSPHORUS $78
Blood potassium level ASSAY OF SERUM POTASSIUM $78
Blood sodium level ASSAY OF SERUM SODIUM $83
Blood test, thyroid stimulating hormone (TSH)  ASSAY THYROID STIM HORMONE $235
Troponin (protein) analysis ASSAY OF TROPONIN, QUANT $239
Complete blood cell count (red cells, white blood cell, platelets), automated test COMPLETE CBC W/AUTO DIFF WBC $146
Complete blood cell count (red cells, white blood cell, platelets), automated test COMPLETE CBC, AUTOMATED $112
Blood test, clotting time PROTHROMBIN TIME $74
Coagulation assessment blood test THROMBOPLASTIN TIME, PARTIAL $96
Blood group typing (ABO) BLOOD TYPING, ABO $111
Blood typing for Rh (D) antigen BLOOD TYPING, RH (D) $111
Bacterial colony count, urine URINE CULTURE/COLONY COUNT $217
Pathology examination of tissue using a microscope TISSUE EXAM BY PATHOLOGIST $397