MARY BRIDGE CHILDREN'S HOSPITAL
Hospital
Procedure Prices at MARY BRIDGE CHILDREN'S HOSPITAL
Blood Draw From Vein Using Needle
CPT 36415
$3
Lab Test - Complete Blood Cell Count With White Blood Cell Percentage
CPT 85025
$6.84
Lab Test - Comprehensive Metabolic Panel
CPT 80053
$9.49
Therapeutic Exercises
CPT 97110
$10.23
EKG
CPT 93000
$19.09
Therapeutic Activities
CPT 97530
$21.79
EKG Tracing
CPT 93005
$24.62
Outpatient Clinic Visit Established Patient Level III
CPT 99213
$50
Chest X-Ray (2 views)
CPT 71046
$52.5
Chest X-Ray (1 view)
CPT 71045
$58.02
Thoracic Spine X-Ray
CPT 72072
$58.02
OB Ultrasound
CPT 76805
$75.95
CT Chest
CPT 71250
$86.85
Individual Psychotherapy Session 60 Minutes
CPT 90837
$123.19
Retroperitoneal Ultrasound
CPT 76770
$141.68
Screening Mammogram (bilateral)
CPT 77067
$144.8
Abdominal Ultrasound — Limited
CPT 76705
$147.78
Abdominal Ultrasound
CPT 76700
$153.29
ER Visit — Low-Moderate Complexity
CPT 99283
$153.72
Diagnostic Mammogram (unilateral)
CPT 77065
$235.46
ER Visit — Moderate Complexity
CPT 99284
$272.31
MRI Joint of Lower Extremity
CPT 73721
$281.33
Diagnostic Mammogram (bilateral)
CPT 77066
$301.35
ER Visit — High Complexity
CPT 99285
$303.62
CT Abdomen & Pelvis
CPT 74177
$318.54
MRI Brain w/ Contrast
CPT 70553
$405.05
MRI Brain w/o Contrast
CPT 70551
$415.25
Echocardiogram w/ Doppler
CPT 93306
$493.01
Colonoscopy w/ Biopsy
CPT 45380
$636.97
Upper GI Endoscopy w/ Biopsy
CPT 43239
$658.91
Vaginal Delivery
CPT 59400
$956.6
Inguinal Hernia Repair
CPT 49505
$1,140.79
Cataract Surgery
CPT 66984
$1,210.4
Colonoscopy
CPT 45378
$1,377.04
Laparoscopic Cholecystectomy
CPT 47562
$1,600.38
Cataract Surgery — Complex
CPT 66982
$1,644.08
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$1,709.81
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$1,714.49
Knee Arthroscopy
CPT 29881
$2,351.28
Injection of Drug Into Lower Spinal Nerve Root With Imaging Guidance
CPT 64483
$3,334.53
Laparoscopic Hernia Repair
CPT 49650
$3,490.79
Appendectomy
CPT 44950
$4,206.82
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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.