COVENANT MEDICAL CENTER
Acute Care Hospitals
Procedure Prices at COVENANT MEDICAL CENTER
HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD
CPT 36415
$14.54
Mechanical Traction
CPT 97012
$35.63
HC CBC WITH DIFF AUTO
CPT 85025
$41.94
HC COMPREHEN METABOLIC PANEL
CPT 80053
$61.54
Therapeutic Exercises
CPT 97110
$64.87
Therapeutic Activities
CPT 97530
$84.35
Chest X-Ray (1 view)
CPT 71045
$169.25
Chest X-Ray (2 views)
CPT 71046
$169.25
EKG Tracing
CPT 93005
$251.45
Diagnostic Mammogram (unilateral)
CPT 77065
$272.5
Diagnostic Mammogram (bilateral)
CPT 77066
$273.9
Thoracic Spine X-Ray
CPT 72072
$365.1
CT Chest
CPT 71250
$437.35
Abdominal Ultrasound
CPT 76700
$437.35
Abdominal Ultrasound — Limited
CPT 76705
$437.35
Retroperitoneal Ultrasound
CPT 76770
$437.35
MRI Joint of Lower Extremity
CPT 73721
$713.71
Echocardiogram w/ Doppler
CPT 93306
$893.8
MRI Brain w/ Contrast
CPT 70553
$1,141.67
CT Abdomen & Pelvis
CPT 74177
$1,477.45
MRI Brain w/o Contrast
CPT 70551
List: $6,809.82
OB Ultrasound
CPT 76805
List: $1,835.46
Screening Mammogram (bilateral)
CPT 77067
List: $652.17
HC PSYCHOTH IND 60 MIN IOP CD/SA
CPT 90837
List: $398.13
HC ESTAB PT VISIT - LEVEL 3
CPT 99213
List: $652.03
ER Visit — Low-Moderate Complexity
CPT 99283
List: $1,677.65
ER Visit — Moderate Complexity
CPT 99284
List: $3,052.08
ER Visit — High Complexity
CPT 99285
List: $5,779.67
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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.