ASCENSION ST JOHN MEDICAL CENTER
Acute Care Hospitals
29
Procedure Prices at ASCENSION ST JOHN MEDICAL CENTER
COLLECTION VENOUS BLOOD VENIPUNCTURE
CPT 36415
$3.6
BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC
CPT 85025
$6.54
EKG Interpretation
CPT 93010
$11.05
COMPREHENSIVE METABOLIC PANEL
CPT 80053
$11.12
EKG Tracing
CPT 93005
$12.94
Mechanical Traction
CPT 97012
$16.89
Chest X-Ray (1 view)
CPT 71045
$17.06
Chest X-Ray (2 views)
CPT 71046
$23.34
EKG
CPT 93000
$24
Therapeutic Exercises
CPT 97110
$27.78
Therapeutic Activities
CPT 97530
$28.83
Thoracic Spine X-Ray
CPT 72072
$35.46
ER Visit — Low-Moderate Complexity
CPT 99283
$51.14
OFFICE OUTPATIENT VISIT 15 MINUTES
CPT 99213
$51.38
Diagnostic Mammogram (unilateral)
CPT 77065
$78.07
Screening Mammogram (bilateral)
CPT 77067
$78.32
ER Visit — Moderate Complexity
CPT 99284
$93.83
Abdominal Ultrasound — Limited
CPT 76705
$95.46
Diagnostic Mammogram (bilateral)
CPT 77066
$98.55
Retroperitoneal Ultrasound
CPT 76770
$117.29
Abdominal Ultrasound
CPT 76700
$126.56
PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES
CPT 90837
$128.32
Echocardiogram
CPT 93307
$130.39
ER Visit — High Complexity
CPT 99285
$138.46
OB Ultrasound
CPT 76805
$140.75
CT Chest
CPT 71250
$143.05
NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL
CPT 64483
$192.27
CT Abdomen & Pelvis
CPT 74177
$197.33
MRI Brain w/o Contrast
CPT 70551
$236.78
Echocardiogram w/ Doppler
CPT 93306
$251.49
Upper GI Endoscopy w/ Biopsy
CPT 43239
$253.4
MRI Joint of Lower Extremity
CPT 73721
$254.24
Colonoscopy
CPT 45378
$366.35
MRI Brain w/ Contrast
CPT 70553
$399.35
Colonoscopy w/ Biopsy
CPT 45380
$436.05
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$491.07
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$503.7
Inguinal Hernia Repair
CPT 49505
$569.12
Laparoscopic Hernia Repair
CPT 49650
$569.12
Knee Arthroscopy
CPT 29881
$588.74
Recurrent Inguinal Hernia Repair
CPT 49520
$608.37
Laparoscopic Cholecystectomy
CPT 47562
$653.46
Appendectomy
CPT 44950
$654.16
Cataract Surgery
CPT 66984
$850.41
Cataract Surgery — Complex
CPT 66982
$864.89
ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR
CPT 29827
$1,085.18
Hip Replacement
CPT 27130
$1,284.36
Knee Replacement
CPT 27447
$1,378.54
TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW
CPT 27245
$1,382.5
Vaginal Delivery
CPT 59400
$1,669.23
VBAC Delivery
CPT 59610
$1,736
C-Section
CPT 59510
$1,882.26
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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.