CHRISTUS St. Francis Cabrini Hospital — price list

← Hospital overviewVerified from CHRISTUS St. Francis Cabrini Hospital’s published price file

Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.

How to read these columns

List: The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
Cash: The discounted self-pay price for paying directly, without insurance.
Negotiated: Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.

These are the hospital’s published reference prices, not a personalized estimate of your bill.

156 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
""Y SET"" TUBING Outpatient	A4719 HCPCS	—	—	—	—
<50% TOTAL PT OUTPT RA ENCTS Outpatient	M1008 HCPCS	—	—	—	—
<6YR NEW ONSET HD ACHE Outpatient	G2193 HCPCS	—	—	—	—
>= 2 SAME HI-RSK MED NOT ORD Outpatient	G9368 HCPCS	—	—	—	—
>= 2 SAME HI-RSK MED ORD Outpatient	G9367 HCPCS	—	—	—	—
>=2 SAME HI-RSK MED W/O DIAG Outpatient	M1209 HCPCS	—	—	—	—
>=2 SAME MEDS TBL4 NOT ORD Outpatient	M1210 HCPCS	—	—	—	—
>=50% TOTAL PT OUTPT RA ENCT Outpatient	M1007 HCPCS	—	—	—	—
>=86Y NO HX COLO CA/RSN SCOP Outpatient	G9659 HCPCS	—	—	—	—
>55 YRS TEMP HD ACHE Outpatient	G2192 HCPCS	—	—	—	—
0.45% NaCl + KCl 20 mEq/L infusion Outpatient	J3480 HCPCS	$15.75	$4.10	$0.12 – $159	—
0.45% NaCl + KCl 20 mEq/L infusion Inpatient	J3480 HCPCS	$159	$41.46	—	—
0.9% NaCl + KCl 20 mEq/L infusion Outpatient	J3480 HCPCS	$14.00	$3.64	$0.12 – $142	—
0.9% NaCl + KCl 20 mEq/L infusion Inpatient	J3480 HCPCS	$142	$36.86	—	—
0.9% NaCl + KCl 40 mEq/L infusion Outpatient	J3480 HCPCS	$24.50	$6.37	$0.12 – $248	—
0.9% NaCl + KCl 40 mEq/L infusion Inpatient	J3480 HCPCS	$248	$64.50	—	—
1 ADMN RSV MONOC ANTB IM NJX Outpatient	96381 CPT	—	—	$82.00 – $82.00	—
1 BOD TEMP >=35.5 Outpatient	G9773 HCPCS	—	—	—	—
1 BODYTEMP >=35.5CW/IN 30MIN Outpatient	4559F CPT	—	—	—	—
1 CC STERILE SYRINGE&NEEDLE Outpatient	A4206 HCPCS	—	—	$0.82 – $0.82	—
1 EM CORE SESSION Outpatient	G9873 HCPCS	—	—	—	—
1 MED VISIT IN 24MO Outpatient	G9247 HCPCS	—	—	—	—
1 OR NO CT SINUS W/IN 90D DX Outpatient	G9354 HCPCS	—	—	—	—
10% dextran 40 in dextrose 5% (Lmd) IVPB 500 mL Outpatient	J7100 HCPCS	$140	$36.40	$28.80 – $885	—
10% dextran 40 in dextrose 5% (Lmd) IVPB 500 mL Inpatient	J7100 HCPCS	$885	$230	—	—
10% dextran 40 in NaCl (Dextran 40 In Normal Saline) 10-0.9 % infusion Outpatient	J7100 HCPCS	$146	$37.99	$28.80 – $924	—
10% dextran 40 in NaCl (Dextran 40 In Normal Saline) 10-0.9 % infusion Inpatient	J7100 HCPCS	$924	$240	—	—
100 INSULIN SYRINGES Outpatient	S8490 HCPCS	—	—	—	—
12-LEAD ECG PERFORMED Outpatient	3120F CPT	—	—	—	—
1DOSE MENIG VAC BTWN 11 & 13 Outpatient	G9414 HCPCS	—	—	—	—