GRACE SURGICAL HOSPITAL
Acute Care Hospitals
16
Procedure Prices at GRACE SURGICAL HOSPITAL
HC BLOOD DRAW VENIPUNCTURE
CPT 36415
$14.44
HC CBC WITH DIFF AUTO
CPT 85025
$46.74
HC COMPREHEN METABOLIC PANEL
CPT 80053
$66.12
Therapeutic Exercises
CPT 97110
$66.88
Therapeutic Activities
CPT 97530
$75.62
EKG Tracing
CPT 93005
$114
Chest X-Ray (1 view)
CPT 71045
$134.14
Chest X-Ray (2 views)
CPT 71046
$182.78
Thoracic Spine X-Ray
CPT 72072
$266
Screening Mammogram (bilateral)
CPT 77067
$348.84
Abdominal Ultrasound — Limited
CPT 76705
$459.04
Diagnostic Mammogram (unilateral)
CPT 77065
$460.18
Abdominal Ultrasound
CPT 76700
$564.68
Retroperitoneal Ultrasound
CPT 76770
$564.68
OB Ultrasound
CPT 76805
$564.68
ER Visit — Low-Moderate Complexity
CPT 99283
$585.96
Diagnostic Mammogram (bilateral)
CPT 77066
$587.48
ER Visit — Moderate Complexity
CPT 99284
$807.12
Echocardiogram
CPT 93307
$872.1
CT Chest
CPT 71250
$1,098.58
Echocardiogram w/ Doppler
CPT 93306
$1,287.82
ER Visit — High Complexity
CPT 99285
$1,407.14
CT Abdomen & Pelvis
CPT 74177
$1,423.86
MRI Brain w/o Contrast
CPT 70551
$1,526.08
MRI Joint of Lower Extremity
CPT 73721
$1,562.94
MRI Brain w/ Contrast
CPT 70553
$2,373.48
Compare Prices Nearby
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.