Notice of Charges/ Common Procedures

You have reached the FEDERALLY REQUIRED section of our website that contains the charges (list prices) for the most common services we provide within our facility.  While we provide this information to comply with federal regulations, healthcare billing is complex.  It is extremely important for you, as the consumer, to understand that standard charges may not be a relevant starting point for estimating what costs you may incur during an episode of care, and the amount actually paid by a patient will depend on that patient’s insurance coverage, policy provisions and other factors.  Everyone’s case is different based on that patient’s medical condition.

The charges (list price) displayed only include the hospital charges effective 1/1/2019 and do not account for medical complications or include charges that are billed separately by the physician, surgeon, anesthesiologist, lab, pathologists or other professional fees.  Furthermore, the actual amount paid by a patient will depend on that patient’s insurance coverage, as benefit plans vary greatly.


  • Contact your insurance company to understand all of the factors affecting your financial responsibility.
  • Numerous factors, such as type of plan, co-pay, co-insurance, deductible, out-of-pocket maximums, provider network and other limitations, will affect your financial responsibility to a hospital.
  • The charges reflected on this site do not include any negotiated discounts between your insurance company and the hospital



  • Medicare has many different parts, and not everyone has the same type of Medicare coverage. Medicare will pay for many of your healthcare expenses but not all of them.
  • Special rules apply if you have employer group health insurance coverage through your job or a spouse’s job.
  • If you have a supplemental health insurance policy, it may cover some costs that Medicare does not cover.
  • The best way to be sure of what your Medicare plan covers is to call 1-800-MEDICARE, or visit the website at



  • Contact your local Medicaid office at 1-888-544-7996, or visit the Louisiana Department of Health to determine all the factors affecting your financial responsibility.
  • Generally, Medicaid recipients are not responsible for any portion of the bill.



  • Please contact us at 318-213-3900 and ask for Patient Financial Services (Business Office) and ask about our payment policies.
  • As required by the Affordable Care Act (ACA), hospitals have a written financial assistance policy that includes eligibility criteria, the basis for calculating charges and the method for applying for financial assistance in case of hardship.
  • Contact our Patient Financial Services Department at 318-213-3900 to determine if you meet the criteria for financial assistance.
Specialists Hospital Shreveport Charge Master Charge
  (List Price)
Laboratory Charges  
Arterial Blood Gas Measurement 120.00
Bacterial Culture 54.00
Blood Creatinine 29.00
Blood Glucose Level Test 19.00
Blood Potassium Level 27.00
Blood Sodium Level 26.00
Calcium Level 32.00
Complete Blood Count 23.00
Electrolyte Panel 25.00
EKG-Routine Minimum 12 Leads 253.75
Pathology Examination of Tissue with Microscope 61.13
Pharmacy Charges  
Injection, Famotidine, up to 20mgs 4.20
Injection, Cefazolin Sodium 1gm 4.86
Injection, Dexamethasone Sodium Phosphate, 10mg 10.20
Injection, Fentanyl, up to 100mcg 3.58
Injection, Tranexamic Acid 1000mg 75.56
Injection, Hydromorphone, up to 2mgs 5.94
Injection, Glycopyrrolate 0.4mg 31.92
Injection, Midazolam Hydrochloride, up to 2mgs 2.76
Injection, Morphine Sulfate, up to 10mgs 11.04
Injection, Promethazine HCL, up to 50mgs 6.00
Injection, Vancomycin HCL, 1gm 20.10
Neosporin GU Irrigant 1ml 38.35
Isovue-M 200 10ml 82.74
Sevoflurane Inhalant 250ml 239.80
IV, Cefazolin Sodium 1gm 50ml ivpb 22.59
IV, Propofol 200mg 12.24
Injection, Bupivacaine 0.25% 10ml 9.27
Injection, Lidocaine 2% 5ml 16.42
Injection, Ondansetron 4mg 1.84
Injection, Lidocaine 1% 5ml 9.30
Acetaminophen Caplet 500mg 1.00
Gabapentin capsule 300mg 1.00
Methocarbaml Tablet 750mg 1.00
Bisacodyl tablet 5mg 1.00
Docusate Gelcap 100mg 1.00
Sodium Chloride 0.9% 10ml 1.47
IV, Sodium Chloride 0.9% 250mls 6.45
IV, Lactated Ringers 1000mls 9.21
Physical Therapy Charges  
Physical Therapy Evaluation – 30 minutes 90.00
Physical Therapy Evaluation – Low Complexity 90.00
Physical Therapy Evaluation – Moderate Complexity 90.00
Physical Therapy Evaluation – High Complexity 120.00
Application of Electrical Stimulation – 15 minutes 33.00
Physical Therapy Exercise – 15 minutes 46.00
Gait Training – 15 minutes 40.00
Physical Therapy 1 or More Regions – 15 minutes 50.00
Re-Evaluation of Physical Therapy Established Plan 45.00
Radiological Charges  
CT Spine Cervical with Contrast 1,712.00
CT Knee with Contrast 2,765.00
MRI Shoulder 1,535.00
MRI Knee 1,360.00
MRI Spine Cervical without Contrast 1,674.00
MRI Spine Thoracic without Contrast 1,827.00
MRI Spine Lumbar without Contrast 1,735.00
Ultrasound, Lower Extremity 315.00
Ultrasound, Bladder 68.89
X-Ray Chest 1 View 230.00
X-Ray Chest 2 Views 300.00
X-Ray Knee 260.00
X-Ray Shoulder 260.00
Room and Board Charges  
Private Room 750.00
Observation per Hour 525.00
Surgical Procedure Charges  
ACL Reconstruction 15,905.00
ACL Reconstruction, Arthroscopically aided 16,143.00
Achilles Tendon Repair 13,369.00
Ankle, Collateral Ligament Repair 8,741.00
Anterior Cervical Fusion, 1 Level 29,252.00
Anterior Cervical Fusion, 2 Levels 37,257.00
Anterior Cervical Fusion, 3 Levels 42,645.00
Anterior Cervical Discectomy with Decompression 15,527.00
Arthrodesis, Subtalar 14,805.00
Arthrodesis, Triple 14,805.00
Arthroscopy, Knee 10,250.00
Arthroscopy, Knee, Medial or Lateral Menisectomy 10,250.00
Arthroscopy, Knee, Medial & Lateral Menisectomy 10,250.00
Arthroscopy, Shoulder 16,143.00
Arthroscopy, Shoulder, Mumford 13,369.00
Arthroscopy, Shoulder, Rotator Cuff Repair 16,143.00
Arthroscopy, Shoulder, Subacromial Decompression 26,393.00
Bunionectomy, 1 digit 10,005.00
Carpal Tunnel Repair 6,325.00
Carpal Tunnel Repair, Endoscopic 11,850.00
Clawtoe Correction, 1 digit 7,280.00
Combined Anterior-Posterior Lumbar Fusion, 1 Level 57,150.00
Combined Anterior-Posterior Lumbar Fusion, 2 Levels 98,145.00
Epidural Steroid Injection, Lumbar, 1 Level 3,335.00
Excision, Morton Neuroma, single 7,280.00
Excision, Ganglion Cyst, single 7,445.00
Fasciectomy, partial palmar with release of single digit 9,177.00
Hammertoe Correction, 1 digit 7,280.00
Implant Spine Infusion Pump 60,333.00
Implant Spinal Stim Generator 61,958.00
Posterior Lumbar Fusion, 1 Level 44,387.00
Posterior Lumbar Fusion, 2 Levels 55,790.00
Posterior Lumbar Fusion, 3 Levels 71,316.00
Revision of Total Knee Replacement 39,601.00
Revision of Total Hip Replacement 52,478.00
Robotic Total Hip Replacement 45,986.00
Robotic Total Knee Replacement 27,832.00
Robotic Total Knee Replacement, Bilateral 55,664.00
Selective Nerve Root Block, Cervical, 1 Level 2,196.00
Selective Nerve Root Block, Lumbar, 1 Level 2,196.00
Selective Nerve Root Block, Thoracic, 1 Level 2,196.00
Total Ankle Replacement 20,886.00
Total Hip Replacement 45,986.00
Total Knee Replacement 27,832.00
Total Knee Replacement, Bilateral 55,664.00
Total Shoulder Replacement 21,715.00
Trapezium Replacement 15,486.00
Ulnar Nerve Transposition 6,325.00
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    Notice of Charges/ Common Procedures

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