Patient Pricing

Patient Price Information List

In compliance with state law, Gov. Juan F. Luis Hospital is providing this price list containing our charges for room and board, emergency department, operating room, delivery, physical therapy and other procedures. The hospital’s charges are the same for all patients, but a patient’s responsibility may vary, depending on payment plans negotiated with individual health insurers. These prices are correct as of January 1, 2021.

Room and Board – Per Day Charge

Department Price Department Price
OBSTETRICS SEMI-PVT $1,478.00 Semi Private $1,478.00
MED/SUR/GYN $1,478.00 PCU-TELEMETRY $1,996.0
Semi Private Pediatric $1,478.00 ER HOLDING $1,146.00
Nursery Normal $451.00 Neonatal ICU $3,908.00
Intensive Care Unit  $3,908.00

Emergency Department Charge

Emergency Department charges are based on the level of emergency care provided to our patients. The levels, with level 1 representing basic emergency care, reflect the type of accommodations needed, the personnel resources, the intensity of care and the amount of time needed to provide treatment. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular emergency treatment. They also do not include fees for Emergency Department physicians, who will bill separately for their services.

Department Price Department Price
Level I ED $177.00 Level I ED Physician $71.00
Level II ED $249.00 Level II ED Physician $139.00
Level III ED $505.00 Level III ED Physician $198.00
Level IV ED $794.00 Level IV ED Physician $410.00
Level V ED $798.00 Level V ED Physician $450.00

Labor and Delivery Charges

The following list does not include charges for anesthesia, drugs, or supplies required for a particular delivery room procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.

Department Price
Vaginal Delivery Normal $5,401.00
Vaginal Delivery Twins $2,850.00
Vaginal Delivery Only Include/PP $5,401.00
Vaginal Delivery after C-Section  $4,723.00
Vaginal Delivery after C-Section Include/PP $3,920.55
C/Section Delivery after Vaginal Attempt $4,448.60
C/S Include OB Ante & PP Care $4,930.27
C/Section Delivery Twins $3,455.00

Operating Room Charge

Department Price
OR Service 15min Interval $425.00
Anesthesia 15min Interval $225.00
Recovery 15min Interval $210.00

Physical Therapy Charges

Department Price
Physical Therapy Evaluation $263.00
Physical Therapy Re-Evaluation $282.00
Gait Training Therapy per 15min $114.00

Pulmonary Therapy Charges

Department Price
O2 Uptake Direct Simple $541.00
Airway Inhalation Treatment $575.00
Spirometry $305.00
Oxygen Uptake O2 % $205.00

ESRD Dialysis CHARGES

Department Price
ESRD SERVICE 2-3 VISIT $1974.00
ESRD SERVICE 1 VISIT $1974.00
ESRD SERVICE 4 VISITS $1974.00
OP DIAYLIS URR<60MIN $315.00
RENAL DIALYSIS I/P $375.00

Laboratory Charges

Department Price Department Price
Antibody ID, EA, RBC $152.00 Bacterial Culture $63.00
Basic Metabolic Panel $119.00 Blood Typing Antigen Screen $30.00
Complete Blood Count $89.00 Comprehensive Metabolic Panel $237.00
Glucose; Blood $18.00 Hemoglobin; A1C $163.00
Hemoglobin $75.00 Lipid Panel $193.00
Magnesium Level $52.00 Surgical Path Level 4 $177.00
Troponin Qual $106.00 THS Highly Sensitive $163.00
Urinalysis $36.00 Urinalysis $83.00

Popular Surgery Charges

The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular surgery treatment. They also do not include fees for physicians.

Department Price Department Price
TOT Knee Arthro $24,301.42 TOT Abdominal Hysterectomy $3,696.00
TOT Hip Arthro $24,301.42 CYSTO w Lithotripsy $9,864.00
Colonoscopy w/Lesion Removal $2,875.00 Diagnostic Colonoscopy $2,027.00
Laparoscopic Cholecystectomy $2,875.00 Partial Mastectomy $6,560.00

XRAY and Radiological Charges

Department Price Department Price
CT Abdomen & Pelvis w Contrast $1,166.00 X-RAY of Ankle 2V $319.00
CT Head Brain wo Contrast $1,029.00 Shoulder LT 1V $174.00
CT Thorax w Contrast $1,175.00 Ultrasound Breast $308.00
Screening Mammo Bi Incl CAD 2V $578.00 Ultrasound Liver $452.00
Mammo Bilateral Diagnostic $578.00 OB US >= 14 WKS SNGL Fetus $257.00
Ultrasound Chest $452.00 X-RAY of Hip 1V UNILA $160.00
MDX Mammo Incl CAD UNI $316.00 X-RAY Chest 4+Views $295.00
X-RAY of Foot; 2V $199.00

Patient Price Information List

In compliance with state law, Gov. Juan F. Luis Hospital is providing this price list containing our charges for room and board, emergency department, operating room, delivery, physical therapy and other procedures. The hospital’s charges are the same for all patients, but a patient’s responsibility may vary, depending on payment plans negotiated with individual health insurers. These prices are correct as of January 1, 2021.

Room and Board – Per Day Charge

OBSTETRICS SEMI-PVT – $1,478.00

MED/SUR/GYN – $1,478.00

Semi Private Pediatric – $1,478.00

Nursery Normal – $451.00

Intensive Care Unit – $3,908.00

Semi Private – $1,478.00

PCU-TELEMETRY – $1,996.0

ER HOLDING – $1,146.00

Neonatal ICU – $3,908.00

Emergency Department Charge

Emergency Department charges are based on the level of emergency care provided to our patients. The levels, with level 1 representing basic emergency care, reflect the type of accommodations needed, the personnel resources, the intensity of care and the amount of time needed to provide treatment. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular emergency treatment. They also do not include fees for Emergency Department physicians, who will bill separately for their services.

Level I ED – $177.00

Level II ED – $249.00

Level III ED – $505.00

Level IV ED – $794.00

Level V ED – $798.00

Level I ED Physician – $71.00

Level II ED Physician – $139.00

Level III ED Physician – $198.00

Level IV ED Physician – $410.00

Level V ED Physician – $450.00

Labor and Delivery Charges

The following list does not include charges for anesthesia, drugs, or supplies required for a particular delivery room procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.

Vaginal Delivery Normal – $5,401.00

Vaginal Delivery Twins – $2,850.00

Vaginal Delivery Only Include/PP – $5,401.00

Vaginal Delivery after C-Section – $4,723.00

Vaginal Delivery after C-Section Include/PP – $3,920.55

C/Section Delivery after Vaginal Attempt – $4,448.60

C/S Include OB Ante & PP Care – $4,930.27

C/Section Delivery Twins – $3,455.00

Operating Room Charge

OR Service 15min Interval – $425.00

Anesthesia 15min Interval – $225.00

Recovery 15min Interval – $210.00

Physical Therapy Charges

Physical Therapy Evaluation – $263.00

Physical Therapy Re-Evaluation – $282.00

Gait Training Therapy per 15min – $114.00

Pulmonary Therapy Charges

O2 Uptake Direct Simple – $541.00

Airway Inhalation Treatment – $575.00

Spirometry – $305.00

Oxygen Uptake O2 % – $205.00

ESRD Dialysis CHARGES

ESRD SERVICE 1 VISIT – $1974.00

ESRD SERVICE 2-3 VISIT – $1974.00

ESRD SERVICE 4 VISITS – $1974.00

OP DIAYLIS URR<60MIN – $315.00

RENAL DIALYSIS I/P – $375.00

Laboratory Charges

Antibody ID, EA, RBC – $152.00

Basic Metabolic Panel – $119.00

Complete Blood Count – $89.00

Glucose; Blood – $18.00

Hemoglobin – $75.00

Magnesium Level – $52.00

Troponin Qual – $106.00

Urinalysis – $36.00

Bacterial Culture – $63.00

Blood Typing Antigen Screen – $30.00

Comprehensive Metabolic Panel – $237.00

Hemoglobin; A1C – $163.00

Lipid Panel – $193.00

Surgical Path Level 4 – $177.00

THS Highly Sensitive – $163.00

Urinalysis – $83.00

Popular Surgery Charges

The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular surgery treatment. They also do not include fees for physicians.

TOT Knee Arthro – $24,301.42

TOT Hip Arthro – $24,301.42

Colonoscopy w/Lesion Removal – $2,875.00

Laparoscopic Cholecystectomy – $2,875.00

TOT Abdominal Hysterectomy – $3,696.00

CYSTO w Lithotripsy – $9,864.00

Diagnostic Colonoscopy – $2,027.00

Partial Mastectomy – $6,560.00

XRAY and Radiological Charges

CT Abdomen & Pelvis w Contrast – $1,166.00

CT Head Brain wo Contrast – $1,029.00

CT Thorax w Contrast – $1,175.00

Screening Mammo Bi Incl CAD 2V – $578.00

Mammo Bilateral Diagnostic – $578.00

Ultrasound Chest – $452.00

MDX Mammo Incl CAD UNI – $316.00

X-RAY of Foot; 2V – $199.00

X-RAY of Ankle 2V – $319.00

Shoulder LT 1V – $174.00

Ultrasound Breast – $308.00

Ultrasound Liver – $452.00

OB US >= 14 WKS SNGL Fetus – $257.00

X-RAY of Hip 1V UNILA – $160.00

X-RAY Chest 4+Views – $295.00

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