OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC
Hospital
Procedure Prices at OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC
COLLECTION VENOUS BLOOD VENIPUNCTURE
CPT 36415
$10.93
EKG Interpretation
CPT 93010
$22.33
Mechanical Traction
CPT 97012
$33.05
OFFICE OUTPATIENT VISIT 15 MINUTES
CPT 99213
$42.44
Echocardiogram w/ Doppler
CPT 93306
$44
Chest X-Ray (1 view)
CPT 71045
$47.5
Chest X-Ray (2 views)
CPT 71046
$47.5
Therapeutic Exercises
CPT 97110
$47.7
Therapeutic Activities
CPT 97530
$47.7
BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC
CPT 85025
$51.18
EKG
CPT 93000
$68.78
EKG Tracing
CPT 93005
$77.05
Appendectomy
CPT 44950
$133.85
Laparoscopic Hernia Repair
CPT 49650
$172.5
COMPREHENSIVE METABOLIC PANEL
CPT 80053
$192.96
Thoracic Spine X-Ray
CPT 72072
$205.43
NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL
CPT 64483
$242.9
Diagnostic Mammogram (unilateral)
CPT 77065
$274.53
Laparoscopic Cholecystectomy
CPT 47562
$284.38
ER Visit — Low-Moderate Complexity
CPT 99283
$342.17
Diagnostic Mammogram (bilateral)
CPT 77066
$376.37
Screening Mammogram (bilateral)
CPT 77067
$376.37
OB Ultrasound
CPT 76805
$450
ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR
CPT 29827
$469.05
Knee Arthroscopy
CPT 29881
$544.33
ER Visit — Moderate Complexity
CPT 99284
$547.34
Hip Replacement
CPT 27130
$601.55
CT Chest
CPT 71250
$677.93
Retroperitoneal Ultrasound
CPT 76770
$816.85
ER Visit — High Complexity
CPT 99285
$820.06
C-Section
CPT 59510
$952.5
Abdominal Ultrasound — Limited
CPT 76705
$1,223.83
TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW
CPT 27245
$1,223.98
MRI Brain w/o Contrast
CPT 70551
$1,233.65
Abdominal Ultrasound
CPT 76700
$1,470.62
Knee Replacement
CPT 27447
$1,590
MRI Brain w/ Contrast
CPT 70553
$1,931.05
CT Abdomen & Pelvis
CPT 74177
$3,285.09
MRI Joint of Lower Extremity
CPT 73721
$4,385.15
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
Upper GI Endoscopy w/ Biopsy
CPT 43239
Colonoscopy
CPT 45378
Colonoscopy w/ Biopsy
CPT 45380
Inguinal Hernia Repair
CPT 49505
Recurrent Inguinal Hernia Repair
CPT 49520
Vaginal Delivery
CPT 59400
VBAC Delivery
CPT 59610
Cataract Surgery — Complex
CPT 66982
Cataract Surgery
CPT 66984
Echocardiogram
CPT 93307
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.