Prices of Common Procedures & Services

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

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