AVERA ST MARY'S HOSPITAL
Acute Care Hospitals
Procedure Prices at AVERA ST MARY'S HOSPITAL
Venipuncture
CPT 36415
$8.91
EKG Tracing
CPT 93005
$18.15
OB CBC W/Auto Diff
CPT 85025
$22.42
EKG Interpretation
CPT 93010
$49.83
Therapeutic Exercises
CPT 97110
$49.83
Therapeutic Activities
CPT 97530
$49.83
Mechanical Traction
CPT 97012
$50.82
Est Patient Level 3 Wound Care
CPT 99213
$52.8
Inj Foramen Epidural L/S RT
CPT 64483
$68.44
Comprehensive Metabolic Panel
CPT 80053
$129.69
ER Visit — Low-Moderate Complexity
CPT 99283
$163.35
ER Visit — Moderate Complexity
CPT 99284
$198.66
Chest X-Ray (1 view)
CPT 71045
$202.29
ER Visit — High Complexity
CPT 99285
$218.13
Diagnostic Mammogram (unilateral)
CPT 77065
$220.44
Screening Mammogram (bilateral)
CPT 77067
$220.44
Chest X-Ray (2 views)
CPT 71046
$266.31
Diagnostic Mammogram (bilateral)
CPT 77066
$271.92
Thoracic Spine X-Ray
CPT 72072
$299.31
Abdominal Ultrasound — Limited
CPT 76705
$553.74
OB Ultrasound
CPT 76805
$564.96
Retroperitoneal Ultrasound
CPT 76770
$657.03
Abdominal Ultrasound
CPT 76700
$687.39
CT Chest
CPT 71250
$1,119.69
Echocardiogram w/ Doppler
CPT 93306
$1,400.52
MRI Brain w/o Contrast
CPT 70551
$1,744.71
MRI Joint of Lower Extremity
CPT 73721
$1,791.9
MRI Brain w/ Contrast
CPT 70553
$2,018.94
CT Abdomen & Pelvis
CPT 74177
$2,337.06
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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.