Prices of Common Procedures & Services

These prices DO NOT include doctor fees, anesthesia, supplies, and medications. Effective July 1, 2020.

COVID-19 Testing Prices

Service Price
COVID 19 Test - Low Throughput $59
COVID 19 Test - High Throughput $105
COVID 19 Test - Antibody (Serology) $45

 

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 $2,183
Adult room and care in the Transitional Care Hospital TCH BASIC ROOM AND CARE $2,183
Adult room and care on the Labor & Delivery unit OB CARE BED $2,547
Pediatric room and care PEDIATRIC ACUTE CARE ROOM AND CARE $2,183
Psychiatric room and care 5 EAST ROOM & CARE $2,699
Normal newborn nursery room and care (includes babies staying in mother's room) NURSERY BED $2,183
Sick newborn nursery room and care NURSERY INTERMEDIATE ROOM AND BED $4,319
Neonatal Step Down Intensive Care Unit (NICU) room and care NICU STEPDOWN ROOM AND BED $6,915
Neonatal Intensive Care Unit (NICU) room and care NICU MAXIMUM ROOM AND BED $8,832
Adult Intensive Care Unit (ICU) room and care ICU ROOM & BED $8,832
Pediatric Intensive Care Unit (PICU) room and care PICU ROOM & BED $8,832
Adult/Pediatric Step Down Intensive Care Unit (ICU) room and care in the Main Hospital INTERMEDIATE ROOM AND CARE $6,915
Adult Step Down Intensive Care Unit (ICU) room and care in the Transitional Care Hospital TCH INTERMEDIATE ROOM AND CARE $4,379


Emergency Department Prices

Service

Billing term

Price

Emergency department visit, limited or minor problem ED LEVEL 1 $393
Emergency department visit, low to moderately severe problem ED LEVEL 2 $647
Emergency department visit, moderately severe problem ED LEVEL 3 $1,036
Emergency department visit, problem of high severity ED LEVEL 4 $1,693
Emergency department visit, problem with significant threat to life or function ED LEVEL 5 $3,095
Critical care for a critically ill or injured patient, first 30-74 minutes CRITICAL CARE 30-74 MIN $4,551

 

Operating Room Prices Per Minute

Service

Billing term

Price

Operating room time per minute HC OR TIME PER MINUTE $126
Operating room time per minute, complex HC OR TIME COMPLEX PER MINUTE $228

 

Physical Therapy Prices

Service

Billing term

Price

Evaluation of physical therapy, typically 20 minutes PT EVAL LOW COMPLEX 20 MIN $334
Evaluation of physical therapy, typically 30 minutes PT EVAL MOD COMPLEX 30 MIN $395
Evaluation of physical therapy, typically 45 minutes PT EVAL HIGH COMPLEX 45 MIN $486
Walking training to 1 or more areas, each 15 minutes GAIT TRAINING 15 MIN $154
Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes THERAPEUTIC ACTIVITY 15 MIN $154
Therapeutic procedures in a group setting THERAPEUTIC GROUP $154

 

Occupational Therapy Prices

Service

Billing term

Price

Evaluation of occupational therapy, typically 20 minutes OT EVAL LOW COMPLEX 30 MIN $334
Evaluation of occupational therapy, typically 45 minutes OT EVAL MOD COMPLEX 45 MIN $395
Evaluation of occupational therapy, typically 60 minutes OT EVAL HIGH COMPLEX 60 MIN $486
Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes THERAPEUTIC ACTIVITY 15 MIN $154
Therapeutic procedures in a group setting THERAPEUTIC GROUP $154

 

Pulmonary Therapy Prices

Service

Billing term

Price

Measurement of largest amount of air exhaled from lungs VITAL CAPACITY TOTAL $189
Test for exercise-induced lung stress PULMONARY STRESS TESTING $273
Measurement and graphic recording of total and timed exhaled air capacity SPIROMETRY/PFT SMP $491
Diagnostic testing in a pulmonary function lab FLOW VOLUME LOOP $456

 

Radiological Prices

Service

Billing term

Price

CT scan of head or brain without contrast CT HEAD/BRAIN W/O CONTRAST $2,374
MRI scan of brain before and after contrast MRI BRAIN W & W/O CONTR $6,325
X-ray of chest, 1 view X-RAY EXAM CHEST 1 VIEW $379
X-ray of chest, 2 views X-RAY EXAM CHEST 2 VIEWS $444
CT scan of chest without contrast CT THORAX W/O CONTRAST $2,945
CT scan of chest with contrast CT CHEST W/CONTRAST $3,614
X-ray of lower and sacral spine, 2 or 3 views XR L-SPINE 2-3V $604
X-ray of shoulder, minimum of 2 views XR SHOULDER CMPL 2+V $713
X-ray of wrist, minimum of 3 views XR WRIST CMPL 3+V $713
X-ray of hand, minimum of 3 views XR HAND CMPL 3+V $669
X-ray of hip with pelvis, 2-3 views X-RAY EXAM HIP UNI 2-3 VIEWS $991
X-ray of knee, 1 or 2 views  XR KNEE 1-2V $689
X-ray of knee, 4 or more views XR KNEE CMPL 4+V $948
X-ray of ankle, minimum of 3 views  XR ANKLE 3+V $761
X-ray of foot, minimum of 3 views XR FOOT CMPL 3+V $761
X-ray of abdomen, 1 view X-RAY EXAM ABDOMEN 1 VIEW $394
CT scan of abdomen and pelvis without contrast CT ABD & PELVIS W/O CONTRAST $6,116
CT scan of abdomen and pelvis with contrast CT ABDOMEN & PELVIS W/CONTRAST $6,830
Ultrasound of head and neck US SOFT TISSUE HEAD/NECK $1,045
Ultrasound of one breast ULTRASOUND BREAST LIMITED $734
Ultrasound of abdomen US ABDOMEN LTD $883
Ultrasound behind abdominal cavity US RETROPERITIONEAL $999
Ultrasound re-evaluation of pregnant uterus, per fetus US PREGNANCY FOLLOWUP $587
Ultrasound of pelvis through vagina US TRANSVAGINAL $982
Ultrasound guidance for accessing into blood vessel US GUIDED VASCULAR ACCESS $719
Ultrasonic guidance imaging supervision and interpretation for insertion of needle ECHO GUIDE FOR BIOPSY $894
Diagnostic mammography of one breast DIGITAL DIAG MAMMOGRAM $528
Screening mammography of both breasts  SCREENING MAMMOGRAPHY, DIGITAL $525
Bone density measurement using dedicated X-ray machine XR BONE DENSITY AXIAL $823

 

Laboratory Prices

Service

Billing term

Price

Blood test, basic group of blood chemicals BASIC METABOLIC PANEL $244
Blood test, comprehensive group of blood chemicals COMPREHEN METABOLIC PANEL $426
Blood test, lipids (cholesterol and triglycerides)  LIPID PANEL $251
Manual urinalysis test with examination using microscope URINALYSIS, AUTO W/SCOPE $106
Analysis of urine URINALYSIS $53
Vitamin D-3 level ASSAY OF VITAMIN D $369
Calcium level  ASSAY OF CALCIUM $90
Blood gases measurement BLOOD GASES: PH, PO2 & PCO2 $408
Blood glucose (sugar) level ASSAY, GLUCOSE, BLOOD QUANT $71
Blood glucose (sugar) test performed by hand-held instrument GLUCOSE BLOOD TEST $53
Methemoglobin (hemoglobin) analysis HC BLOOD METHEMOGLOBIN ASSAY $158
Lactic acid level ASSAY OF LACTIC ACID $180
Magnesium level ASSAY OF MAGNESIUM $107
Phosphate level ASSAY OF PHOSPHORUS $82
Blood potassium level ASSAY OF SERUM POTASSIUM $82
Blood sodium level ASSAY OF SERUM SODIUM $87
Blood test, thyroid stimulating hormone (TSH)  ASSAY THYROID STIM HORMONE $247
Troponin (protein) analysis ASSAY OF TROPONIN, QUANT $251
Complete blood cell count (red cells, white blood cell, platelets), automated test COMPLETE CBC W/AUTO DIFF WBC $153
Complete blood cell count (red cells, white blood cell, platelets), automated test COMPLETE CBC, AUTOMATED $118
Blood test, clotting time PROTHROMBIN TIME $78
Coagulation assessment blood test THROMBOPLASTIN TIME, PARTIAL $101
Blood group typing (ABO) BLOOD TYPING, ABO $117
Blood typing for Rh (D) antigen BLOOD TYPING, RH (D) $117
Bacterial colony count, urine URINE CULTURE/COLONY COUNT $228
Pathology examination of tissue using a microscope TISSUE EXAM BY PATHOLOGIST $417