St. Luke's Jerome Standard Charges — price list
← Hospital overviewVerified from St. Luke's Jerome Standard Charges’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.
89 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| ACUTE MAJOR EYE INFECTIONS WITH CC/MCC Inpatient | 121 MS-DRG | $19,017 | $19,017 | $10,660 – $29,092 | — | |
| ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC Inpatient | 122 MS-DRG | $12,381 | $12,381 | $7,739 – $18,293 | — | |
| AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC Inpatient | 016 MS-DRG | $334,576 | $334,576 | $47,539 – $247,166 | — | |
| BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC Inpatient | 095 MS-DRG | $52,650 | $52,650 | $21,615 – $71,838 | — | |
| BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC Inpatient | 094 MS-DRG | $107,455 | $107,455 | $28,890 – $96,908 | — | |
| BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC Inpatient | 096 MS-DRG | $74,219 | $74,219 | $21,615 – $59,954 | — | |
| CAROTID ARTERY STENT PROCEDURES WITH CC Inpatient | 035 MS-DRG | $112,884 | $112,884 | $20,155 – $77,457 | — | |
| CAROTID ARTERY STENT PROCEDURES WITH MCC Inpatient | 034 MS-DRG | $132,109 | $132,109 | $31,608 – $112,375 | — | |
| CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC Inpatient | 036 MS-DRG | $94,881 | $94,881 | $16,691 – $52,814 | — | |
| CONCUSSION WITH CC Inpatient | 089 MS-DRG | $36,010 | $36,010 | $10,159 – $26,813 | — | |
| CONCUSSION WITH MCC Inpatient | 088 MS-DRG | $24,213 | $24,213 | $12,118 – $35,282 | — | |
| CONCUSSION WITHOUT CC/MCC Inpatient | 090 MS-DRG | $26,011 | $26,011 | $8,028 – $21,441 | — | |
| CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC Inpatient | 073 MS-DRG | $63,957 | $63,957 | $14,072 – $38,655 | — | |
| CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC Inpatient | 074 MS-DRG | $27,242 | $27,242 | $12,352 – $26,277 | — | |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC Inpatient | 026 MS-DRG | $173,592 | $173,592 | $25,716 – $84,423 | — | |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC Inpatient | 025 MS-DRG | $216,760 | $216,760 | $36,838 – $111,852 | — | |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC Inpatient | 027 MS-DRG | $139,870 | $139,870 | $21,179 – $63,881 | — | |
| CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR Inpatient | 023 MS-DRG | $191,923 | $191,923 | $45,996 – $150,706 | — | |
| CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC Inpatient | 024 MS-DRG | $150,721 | $150,721 | $31,927 – $107,053 | — | |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC Inpatient | 056 MS-DRG | $70,042 | $70,042 | $3,630 – $62,628 | — | |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC Inpatient | 057 MS-DRG | $57,642 | $57,642 | $3,630 – $33,373 | — | |
| ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES Inpatient | 003 MS-DRG | $967,671 | $967,671 | $165,885 – $461,161 | — | |
| EXTRACRANIAL PROCEDURES WITH CC Inpatient | 038 MS-DRG | $94,086 | $94,086 | $14,214 – $41,200 | — | |
| EXTRACRANIAL PROCEDURES WITH MCC Inpatient | 037 MS-DRG | $162,890 | $162,890 | $27,131 – $83,056 | — | |
| EXTRACRANIAL PROCEDURES WITHOUT CC/MCC Inpatient | 039 MS-DRG | $99,903 | $99,903 | $10,754 – $11,830 | — | |
| EXTRAOCULAR PROCEDURES EXCEPT ORBIT Inpatient | 115 MS-DRG | $64,992 | $64,992 | $13,535 – $38,290 | — | |
| HEADACHES WITH MCC Inpatient | 102 MS-DRG | $61,109 | $61,109 | $10,332 – $28,999 | — | |
| HEADACHES WITHOUT MCC Inpatient | 103 MS-DRG | $37,515 | $37,515 | $8,130 – $22,152 | — | |
| HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC Inpatient | 001 MS-DRG | $453,030 | $453,030 | $218,489 – $844,977 | — | |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS Inpatient | 065 MS-DRG | $42,998 | $42,998 | $9,476 – $26,736 | — |