Prices Posted and Effective on 12-30-2020

Union County General Hospital's Price List for Shoppable Services

Prices Posted and Effective as of 12-30-2020

Disclaimer: The Hospital determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary. Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise.

Filtering
Service DescriptionService CodeCash PriceRates
Service DescriptionService CodeCash PriceRates
CT Scan
CT scanCPT 70450$927
CT scan of abdomen and pelvis with contrastCPT 74177$2,372
CT scan of pelvis with contrast (Not Offered)CPT 72193--
Ct abd & pelv 1/> regnsCPT 74178$3,035
Ct abdomen w/dyeCPT 74160$1,575
Ct angiography chestCPT 71275$1,973
Ct angiography headCPT 70496$1,042
Ct bone density axialCPT 77078$499
Ct chest spine w/o dyeCPT 72128$1,330
Ct head/brain w/o & w/dyeCPT 70470$1,697
Ct lower extremity w/o dyeCPT 73700$826
Ct lumbar spine w/o dyeCPT 72131$1,250
Ct maxillofacial w/dyeCPT 70487$1,130
Ct maxillofacial w/o dyeCPT 70486$897
Ct neck spine w/o dyeCPT 72125$1,253
Ct pelvis w/o dyeCPT 72192$924
Ct soft tissue neck w/dyeCPT 70491$966
Ct soft tissue neck w/o dyeCPT 70490$755
Ct thorax w/o dyeCPT 71250$980
Ct upper extremity w/o dyeCPT 73200$941
Cardiology
Tte w/doppler completeCPT 93306$1,272
Clinic
Initial new patient preventative medicine evaluation (18-3...CPT 99385$674
Initial new patient preventative medicine evaluation (40-6... (Not Offered)CPT 99386--
New patient office or other outpatient visit, 30 minCPT 99203$674
New patient office or other outpatient visit, 45 minCPT 99204$674
New patient office or other outpatient visit, 60 min (Not Offered)CPT 99205--
Patient office consultation, 40 min (Not Offered)CPT 99243--
Patient office consultation, 60 min (Not Offered)CPT 99244--
EEG
Sleep studyCPT 95810$2,050
EKG
Electrocardiogram tracingCPT 93005$145
Electrocardiogram, routine, with interpretation and reportCPT 93000$78
Emergency Room
Catheterize for urine specHCPCS P9612$39
Emergency dept visitCPT 99284$532
Emergency dept visitCPT 99283$351
Emergency dept visitCPT 99282$208
Emergency dept visitCPT 99285$1,467
Emergency dept visitCPT 99281$132
Inj trigger point 1/2 musclCPT 20552$258
Insert temp bladder cathCPT 51702$161
Place needle in veinCPT 36000$122
Rmvl devital tis addl 20cm/<CPT 97598$139
Ther/proph/diag inj sc/imCPT 96372$55
Tx/pro/dx inj new drug addonCPT 96375$128
Tx/pro/dx inj same drug adonCPT 96376$83
IV Therapy
Hydration iv infusion initCPT 96360$77
Ther/diag concurrent infCPT 96368$186
Ther/proph/diag inj iv pushCPT 96374$200
Ther/proph/diag iv inf addonCPT 96366$36
Ther/proph/diag iv inf initCPT 96365$121
Tx/proph/dg addl seq iv infCPT 96367$194
Imaging
Abdomial ultrasound of pregnant uterus (Not Offered)CPT 76805--
Echo exam of abdomenCPT 76705$259
Mammography of both breasts (Not Offered)CPT 77066--
Mammography of one breast (Not Offered)CPT 77065--
Mammography, screening, bilateral (Not Offered)CPT 77067--
Ob us < 14 wks single fetusCPT 76801$376
Ultrasound of abdomenCPT 76700$394
Ultrasound pelvis through vagina (Not Offered)CPT 76830--
Us exam abdo back wall compCPT 76770$343
Us exam of head and neckCPT 76536$292
Us exam pelvic completeCPT 76856$317
Us exam scrotumCPT 76870$314
Inpatient Procedures
Cardiac valve or cardiothoracic procedure with cardiac cat... (Not Offered)DRG 216--
Cervical spinal fusion without CC or MCC (Not Offered)DRG 473--
Major joint replacement or reattachment of lower extremity... (Not Offered)DRG 470--
Spinal fusion except cervical without MCC (Not Offered)DRG 460--
Uterine and adnexa procedures for non-malignancy without C... (Not Offered)DRG 743--
Laboratory
Ag detect nos ia multCPT 87449$46
Alanine amino (alt) (sgpt)CPT 84460$29
Alpha-fetoprotein serumCPT 82105$105
Analgesics non-opioid 1 or 2CPT 80329$83
Antinuclear antibodiesCPT 86038$69
Antistreptolysin o titerCPT 86060$41
Assay dipropylacetic acd totCPT 80164$85
Assay glucose blood quantCPT 82947$34
Assay of ammoniaCPT 82140$86
Assay of amylaseCPT 82150$53
Assay of blood pkuCPT 84030$116
Assay of blood/uric acidCPT 84550$37
Assay of c-peptideCPT 84681$156
Assay of ck (cpk)CPT 82550$44
Assay of creatinineCPT 82565$38
Assay of digoxin totalCPT 80162$67
Assay of estradiolCPT 82670$67
Assay of ferritinCPT 82728$74
Assay of folic acid serumCPT 82746$72
Assay of free testosteroneCPT 84402$62
Assay of ggtCPT 82977$48
Assay of gonadotropin (fsh)CPT 83001$45
Assay of lactic acidCPT 83605$62
Assay of lipaseCPT 83690$71
Assay of magnesiumCPT 83735$44
Assay of natriuretic peptideCPT 83880$170
Assay of parathormoneCPT 83970$115
Assay of phenytoin totalCPT 80185$70
Assay of phosphorusCPT 84100$34
Assay of progesteroneCPT 84144$103
Assay of prolactinCPT 84146$105
Assay of serum potassiumCPT 84132$29
Assay of thyroid (t3 or t4)CPT 84479$15
Assay of total testosteroneCPT 84403$62
Assay of total thyroxineCPT 84436$53
Assay of triglyceridesCPT 84478$40
Assay of troponin quantCPT 84484$76
Assay of urea nitrogenCPT 84520$43
Assay of urine creatinineCPT 82570$45
Assay of vancomycinCPT 80202$83
Assay triiodothyronine (t3)CPT 84480$89
Basic metabolic panelCPT 80048$81
Bilirubin directCPT 82248$49
Blood culture for bacteriaCPT 87040$78
Blood smear interpretationCPT 85060$59
Blood test, clotting timeCPT 85610$41
Blood test, comprehensive group of blood chemicalsCPT 80053$103
Blood test, lipidsCPT 80061$90
Blood test, thyroid stimulating hormone (TSH)CPT 84443$41
Blood typing serologic aboCPT 86900$41
Blood typing serologic rh(d)CPT 86901$38
Body fluid cell countCPT 89051$40
C-reactive proteinCPT 86140$59
Capillary blood drawCPT 36416$0
Carcinoembryonic antigenCPT 82378$97
Ccp antibodyCPT 86200$81
Chorionic gonadotropin assayCPT 84703$46
Chorionic gonadotropin testCPT 84702$78
Chylmd trach dna amp probeCPT 87491$101
Coagulation assessment blood testCPT 85730$41
Complement antigenCPT 86160$69
Complete blood cell count (CBC), automated (Not Offered)CPT 85027--
Complete blood cell count (CBC), with differential white b...CPT 85025$51
Creatine mb fractionCPT 82553$81
Culture aerobic identifyCPT 87077$54
Culture othr specimn aerobicCPT 87070$57
Culture screen onlyCPT 87081$49
DehydroepiandrosteroneCPT 82626$142
Dna antibody nativeCPT 86225$109
Drug assay cyclosporineCPT 80158$85
Drug test def 1-7 classesHCPCS G0480$59
Exam synovial fluid crystalsCPT 89060$53
Feces culture aerobic bactCPT 87045$55
Fibrin degradation productsCPT 85362$76
Free assay (ft-3)CPT 84481$41
Glucose tolerance test (gtt)CPT 82951$82
Glycosylated hemoglobin testCPT 83036$72
Helicobacter pylori antibodyCPT 86677$85
HematocritCPT 85014$27
HemoglobinCPT 85018$27
Hepatitis b surface ag iaCPT 87340$71
Hepatitis c ab testCPT 86803$83
Hepatitis c probe&rvrs trnscCPT 87521$212
Hepatitis c revrs trnscrpjCPT 87522$212
Heterophile antibody screenCPT 86308$62
Hiv-1antibodyCPT 86701$81
Hpylori stool iaCPT 87338$92
Iadna-dna/rna probe tq 12-25CPT 87507$420
Immunoassay infectious agentCPT 86317$61
Immunoassay tumor ca 125CPT 86304$130
Influenza virus antibodyCPT 86710$47
Iron binding testCPT 83550$59
Kidney function panel testCPT 80069$71
Lactoferrin fecal (qual)CPT 83630$57
Liver function blood testCPT 80076$80
Manual cell count eachCPT 85032$130
Manual reticulocyte countCPT 85044$49
Microbe susceptible micCPT 87186$59
Microsomal antibody eachCPT 86376$59
Mycoplasma antibodyCPT 86738$112
Obstetric blood test panel (Not Offered)CPT 80055--
Ova and parasites smearsCPT 87177$75
Protein e-phoresis serumCPT 84165$81
Rbc antibody screenCPT 86850$91
Rbc sed rate automatedCPT 85652$65
Reagent strip/blood glucoseCPT 82948$16
Respiratory virus antibodyCPT 86756$70
Rheumatoid factor quantCPT 86431$53
Rotavirus antibodyCPT 86759$76
Rubella antibodyCPT 86762$49
Smear gram stainCPT 87205$57
Stool cultr aerobic bact eaCPT 87046$42
Strep a ag iaCPT 87430$43
Syphilis test non-trep qualCPT 86592$52
Tissue exam by pathologistCPT 88305$159
Tissue exam by pathologistCPT 88304$83
Total cortisolCPT 82533$91
Total prostate-specific antigen (PSA) testCPT 84153$44
Total prostate-specific antigen (PSA) test (Not Offered)CPT 84154--
Transferase (ast) (sgot)CPT 84450$29
Trichomonas vaginalis amplifCPT 87661$57
Ur albumin quantitativeCPT 82043$63
Urinalysis testCPT 81002$12
Urinalysis testCPT 81003$215
Urinalysis test using microscopeCPT 81000$15
Urinalysis test using microscope (Not Offered)CPT 81001--
Urine culture/colony countCPT 87086$50
Vitamin d 25 hydroxyCPT 82306$112
Withdrawal of arterial bloodCPT 36600$46
MRI
MRI ScanCPT 70553$3,065
MRI scan of leg jointCPT 73721$2,535
MRI scan of lower spinal canalCPT 72148$2,525
Mri abdomen w/o & w/dyeCPT 74183$3,007
Mri chest spine w/o dyeCPT 72146$2,535
Mri neck spine w/o dyeCPT 72141$2,535
Medical and Surgical Supplies
Bedside drainage bagHCPCS A4357$6
Cath insertion tray w/bagHCPCS A4354$13
Disposable canister for pumpHCPCS A7000$37
Dme supply or accessory, nosHCPCS A9999$10
Drug screen quantalcoholsCPT 80320$31
Foam drg <=16 sq in w/borderHCPCS A6212$39
Foam drsg <=16 sq in w/o bdrHCPCS A6209$22
Nasal/orogastric w/tube plmtCPT 43752$6
Neg pres wound ther drsg setHCPCS A6550$40
Non-covered item or serviceHCPCS A9270$6
Non-waterproof tapeHCPCS A4450$16
Sterile water/saline, 500 mlHCPCS A4217$10
Zinc paste band w >=3"<5"/ydHCPCS A6456$27
Nuclear Medicine
Bone imaging whole bodyCPT 78306$1,106
Hepatobil syst image w/drugCPT 78227$812
Ht muscle image spect multCPT 78452$3,041
Iodine i-123 sod iodide micHCPCS A9516$152
Tc99m mebrofeninHCPCS A9537$155
Tc99m medronateHCPCS A9503$106
Tc99m sestamibiHCPCS A9500$97
Other Diagnostic
Extracranial bilat studyCPT 93880$800
Extremity studyCPT 93971$407
Extremity studyCPT 93970$363
Fetal non-stress testCPT 59025$386
Polysom 6/>yrs cpap 4/> parmCPT 95811$2,036
Other Procedures and Observation
Removal of nail bedCPT 11750$204
Other Therapeutic
Blood transfusion serviceCPT 36430$431
PhlebotomyCPT 99195$267
Plasma 1 donor frz w/in 8 hrHCPCS P9017$124
Pharmacy
5% dextrose/normal salineHCPCS J7042$13
Adrenalin epinephrine injectHCPCS J0171$42
Albuterol ipratrop non-compHCPCS J7620$8
Amiodarone hclHCPCS J0282$11
AzithromycinHCPCS J0456$28
Bumetanide 0.5 mgHCPCS S0171$25
Cefazolin sodium injectionHCPCS J0690$15
Cefepime hcl for injectionHCPCS J0692$28
Ceftriaxone sodium injectionHCPCS J0696$11
Ciprofloxacin ivHCPCS J0744$21
D5w infusionHCPCS J7070$14
Dexamethasone sodium phosHCPCS J1100$14
Diazepam injectionHCPCS J3360$92
Dicyclomine injectionHCPCS J0500$172
Diphenhydramine hcl injectioHCPCS J1200$13
Drugs unclassified injectionHCPCS J3490$20
Ertapenem injectionHCPCS J1335$398
Fentanyl citrate injectionHCPCS J3010$11
Fluphenazine decanoate 25 mgHCPCS J2680$95
Furosemide injectionHCPCS J1940$16
Haloperidol decanoate injHCPCS J1631$28
Hydromorphone injectionHCPCS J1170$14
Hydroxyzine hcl injectionHCPCS J3410$71
Iiv4 vaccine splt 0.5 ml imCPT 90688$14
Inj enoxaparin sodiumHCPCS J1650$147
Inj heparin sodium per 10 uHCPCS J1642$8
Inj iron dextranHCPCS J1750$95
Inj midazolam hydrochlorideHCPCS J2250$13
Inj naloxone hydrochlorideHCPCS J2310$53
Inj, afstyla, 1 i.u.HCPCS J7210$20
Inj, propofol, 10 mgHCPCS J2704$15
Injection, clindamycin phospHCPCS S0077$17
Injection, metronidazoleHCPCS S0030$12
Ketorolac tromethamine injHCPCS J1885$11
Levalbuterol non-comp unitHCPCS J7614$26
Levofloxacin injectionHCPCS J1956$50
Lidocaine injectionHCPCS J2001$16
Lorazepam injectionHCPCS J2060$13
MeropenemHCPCS J2185$173
Methylprednisolone injectionHCPCS J2930$38
Metoclopramide hcl injectionHCPCS J2765$12
Morphine sulfate injectionHCPCS J2270$12
Normal saline solution infusHCPCS J7030$35
Normal saline solution infusHCPCS J7050$13
Ondansetron hcl injectionHCPCS J2405$14
Oral prescrip drug non chemoHCPCS J8499$3
Oxytocin injectionHCPCS J2590$11
PROTONIX (PANTOPRAZOLEHCPCS C9113$25
Penicillin g benzathine injHCPCS J0561$306
Phenytoin sodium injectionHCPCS J1165$11
Piperacillin/tazobactamHCPCS J2543$44
Ppsv23 vacc 2 yrs+ subq/imCPT 90732$179
Prednisone ir or dr oral 1mgHCPCS J7512$9
Prochlorperazine injectionHCPCS J0780$69
Promethazine hcl 12.5mg oralHCPCS Q0169$4
Promethazine hcl injectionHCPCS J2550$14
Ranitidine hydrochloride injHCPCS J2780$49
Regadenoson injectionHCPCS J2785$380
Sincalide injectionHCPCS J2805$451
Thiamine hcl 100 mgHCPCS J3411$38
Triamcinolone acet inj nosHCPCS J3301$33
Vancomycin hcl injectionHCPCS J3370$41
Psychiatric
Family psychotherapy, including patient, 50 min (Not Offered)CPT 90847--
Family psychotherapy, not including patient, 50 min (Not Offered)CPT 90846--
Group psychotherapy (Not Offered)CPT 90853--
Psychotherapy, 30 min (Not Offered)CPT 90832--
Psychotherapy, 45 min (Not Offered)CPT 90834--
Psychotherapy, 60 min (Not Offered)CPT 90837--
Pulmonary Function
Evaluation of wheezingCPT 94060$329
Measure blood oxygen levelCPT 94760$65
Respiratory flow volume loopCPT 94375$309
Radiology
X-Ray of lower back (Not Offered)CPT 72110--
X-ray exam abdomen 1 viewCPT 74018$120
X-ray exam abdomen 2 viewsCPT 74019$159
X-ray exam chest 1 viewCPT 71045$132
X-ray exam chest 2 viewsCPT 71046$152
X-ray exam complete abdomenCPT 74022$247
X-ray exam l-s spine 2/3 vwsCPT 72100$169
X-ray exam neck spine 2-3 vwCPT 72040$161
X-ray exam of pelvisCPT 72170$136
X-ray exam thorac spine 2vwsCPT 72070$166
X-ray exam thorac spine 3vwsCPT 72072$206
Respiratory
Airway inhalation treatmentCPT 94640$209
Chest wall manipulationCPT 94667$83
Insert emergency airwayCPT 31500$447
Surgical Procedures
Biopsy exam of esophagus, stomach or small bowel using an ...CPT 43239$305
Biopsy exam of large bowel using an endoscope (Not Offered)CPT 45380--
Biopsy of prostate gland (Not Offered)CPT 55700--
Diagnostic exam of esophagus, stomach or small bowel using...CPT 43235$550
Diagnostic exam of large bowel using an endoscopeCPT 45378$659
Injection(s) of anesthetic into lower spine using imaging ... (Not Offered)CPT 64483--
Injection(s) of therapeutic substanceCPT 62322$263
Injection(s) of therapeutic substance (Not Offered)CPT 62323--
Insert non-tunnel cv cathCPT 36556$927
Insertion of catheter into left heart for diagnosis (Not Offered)CPT 93452--
Lap inc hernia repairCPT 49654$1,862
Obstetric care, planned cesarean delivery (Not Offered)CPT 59510--
Obstetric care, planned vaginal delivery (Not Offered)CPT 59400--
Obstetric care, planned vaginal delivery (post delivery by... (Not Offered)CPT 59610--
Removal of cataract with insertion of lens (Not Offered)CPT 66984--
Removal of gallbladder using an endoscopeCPT 47562$1,449
Removal of one knee cartilage using an endoscope (Not Offered)CPT 29881--
Removal of one or more breast growth, open procedure (Not Offered)CPT 19120--
Removal of polyps or growths of large bowel using an endos... (Not Offered)CPT 45385--
Removal of recurring cataract in lens capsule using laser (Not Offered)CPT 66821--
Removal of tonsils and adenoid glands, patient younger tha... (Not Offered)CPT 42820--
Repair of groin hernia patient age 5 years or older (Not Offered)CPT 49505--
Rmvl devital tis 20 cm/<CPT 97597$133
Shaving of shoulder bone using endoscope (Not Offered)CPT 29826--
Surgical removal of prostate and surrounding lymph nodes u... (Not Offered)CPT 55866--
Ultrasound examination of lower large bowel using an endos... (Not Offered)CPT 45391--
Therapy
Physical therapy, therapeutic exerciseCPT 97110$76
Uncategorized
Immunization adminCPT 90471$40
SlingsHCPCS A4565$11
Loading