ASCENSION PROVIDENCE HOSPITAL
Acute Care Hospitals
29
Procedure Prices at ASCENSION PROVIDENCE HOSPITAL
BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC
CPT 85025
$19.08
COMPREHENSIVE METABOLIC PANEL
CPT 80053
$22.26
Mechanical Traction
CPT 97012
$35.48
Therapeutic Exercises
CPT 97110
$35.48
Therapeutic Activities
CPT 97530
$51.41
EKG Tracing
CPT 93005
$65.72
Chest X-Ray (1 view)
CPT 71045
$97.52
Chest X-Ray (2 views)
CPT 71046
$100.17
Thoracic Spine X-Ray
CPT 72072
$111.3
Screening Mammogram (bilateral)
CPT 77067
$144.69
Diagnostic Mammogram (unilateral)
CPT 77065
$169.6
Abdominal Ultrasound — Limited
CPT 76705
$209.35
Retroperitoneal Ultrasound
CPT 76770
$222.07
Diagnostic Mammogram (bilateral)
CPT 77066
$231.61
OB Ultrasound
CPT 76805
$251.22
Abdominal Ultrasound
CPT 76700
$334.43
ER Visit — Low-Moderate Complexity
CPT 99283
$556.5
CT Chest
CPT 71250
$675.22
ER Visit — Moderate Complexity
CPT 99284
$966.72
MRI Brain w/o Contrast
CPT 70551
$1,036.68
ER Visit — High Complexity
CPT 99285
$1,430.47
Echocardiogram w/ Doppler
CPT 93306
$1,562.44
CT Abdomen & Pelvis
CPT 74177
$1,650.42
MRI Brain w/ Contrast
CPT 70553
$1,843.87
NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL
CPT 64483
$1,851.82
MRI Joint of Lower Extremity
CPT 73721
$2,036.26
Hip Replacement
CPT 27130
TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW
CPT 27245
Knee Replacement
CPT 27447
ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR
CPT 29827
Knee Arthroscopy
CPT 29881
COLLECTION VENOUS BLOOD VENIPUNCTURE
CPT 36415
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
Upper GI Endoscopy w/ Biopsy
CPT 43239
Appendectomy
CPT 44950
Colonoscopy
CPT 45378
Colonoscopy w/ Biopsy
CPT 45380
Laparoscopic Cholecystectomy
CPT 47562
Inguinal Hernia Repair
CPT 49505
Recurrent Inguinal Hernia Repair
CPT 49520
Laparoscopic Hernia Repair
CPT 49650
Vaginal Delivery
CPT 59400
C-Section
CPT 59510
VBAC Delivery
CPT 59610
Cataract Surgery — Complex
CPT 66982
Cataract Surgery
CPT 66984
EKG
CPT 93000
Echocardiogram
CPT 93307
OFFICE OUTPATIENT VISIT 15 MINUTES
CPT 99213
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Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.