CHRISTUS Trinity Mother Frances Hospital - Jacksonville — price list

← Hospital overviewVerified from CHRISTUS Trinity Mother Frances Hospital - Jacksonville’s published price file

Includes 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.

233 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	—	—	—	—
1 ADMN RSV MONOC ANTB IM NJX Outpatient	96381 CPT	—	—	$24.00 – $184	—
1 BOD TEMP >=35.5 Outpatient	G9773 HCPCS	—	—	—	—
1 BODYTEMP >=35.5CW/IN 30MIN Outpatient	4559F CPT	—	—	$2,050 – $8,200	—
1 CC STERILE SYRINGE&NEEDLE Outpatient	A4206 HCPCS	—	—	—	—
1 EM CORE SESSION Outpatient	G9873 HCPCS	—	—	$324 – $478	—
1 MED VISIT IN 24MO Outpatient	G9247 HCPCS	—	—	—	—
1 OR NO CT SINUS W/IN 90D DX Outpatient	G9354 HCPCS	—	—	—	—
100 INSULIN SYRINGES Outpatient	S8490 HCPCS	—	—	—	—
12-LEAD ECG PERFORMED Outpatient	3120F CPT	—	—	$2,050 – $8,200	—
1DOSE MENIG VAC BTWN 11 & 13 Outpatient	G9414 HCPCS	—	—	—	—
1ST PLMT DRUG ELUT OC INS Outpatient	444T CPT	—	—	$224 – $252	—
1ST PSYC COLLAB CARE MGMT Outpatient	99492 CPT	—	—	$2,407 – $2,407	—
1ST/SBSQ PSYC COLLAB CARE Outpatient	99494 CPT	—	—	—	—
2 CC STERILE SYRINGE&NEEDLE Outpatient	A4207 HCPCS	—	—	—	—
2 EM CORE MS MO 10-12 NO WL Outpatient	G9877 HCPCS	—	—	$324 – $478	—
2 EM CORE MS MO 10-12 WL Outpatient	G9879 HCPCS	—	—	$324 – $478	—
2 EM CORE MS MO 7-9 NO WL Outpatient	G9876 HCPCS	—	—	$324 – $478	—
2 EM CORE MS MO 7-9 WL Outpatient	G9878 HCPCS	—	—	$324 – $478	—
2 EM ONGOING MS MO 13-15 WL Outpatient	G9882 HCPCS	—	—	$324 – $478	—
2 EM ONGOING MS MO 16-18 WL Outpatient	G9883 HCPCS	—	—	$324 – $478	—