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BON SECOURS ST MARYS HOSPITAL

Hospital

5801 BREMO RD

RICHMOND, VA, 23226

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Procedure Prices at BON SECOURS ST MARYS HOSPITAL

ROUTINE VENIPUNCTURE

CPT 36415

$3.15

Chest X-Ray (1 view)

CPT 71045

$11.2

EKG Tracing

CPT 93005

$11.2

CBC WITH AUTO DIFF

CPT 85025

$13.03

COMPREHEN METABOLIC PANEL

CPT 80053

$17.72

Chest X-Ray (2 views)

CPT 71046

$20.65

Thoracic Spine X-Ray

CPT 72072

$26.25

Mechanical Traction

CPT 97012

$26.25

Therapeutic Exercises

CPT 97110

$45.5

WC SUBSQ INTERMEDIATE EVAL

CPT 99213

$48.65

Therapeutic Activities

CPT 97530

$52.85

Abdominal Ultrasound — Limited

CPT 76705

$73.85

Screening Mammogram (bilateral)

CPT 77067

$96.6

Echocardiogram

CPT 93307

$102.55

INJ(S) ANES/STER EPI LUMB SNG W IMA-PBB

CPT 64483

$167.65

Diagnostic Mammogram (unilateral)

CPT 77065

$172.2

OP PSYCH TELEHEALTH 60 MIN

CPT 90837

$190.75

Diagnostic Mammogram (bilateral)

CPT 77066

$213.15

Colonoscopy

CPT 45378

$231.35

Echocardiogram w/ Doppler

CPT 93306

$269.4

CT Chest

CPT 71250

$392

ER Visit — Moderate Complexity

CPT 99284

$424

OB Ultrasound

CPT 76805

$530.25

ER Visit — Low-Moderate Complexity

CPT 99283

$540.4

MRI Brain w/ Contrast

CPT 70553

$574.35

Retroperitoneal Ultrasound

CPT 76770

$630.7

MRI Brain w/o Contrast

CPT 70551

$678.65

Abdominal Ultrasound

CPT 76700

$699.65

MRI Joint of Lower Extremity

CPT 73721

$822.15

ER Visit — High Complexity

CPT 99285

$1,368.5

CT Abdomen & Pelvis

CPT 74177

$1,379

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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.