PRESENCE ST MARYS HOSPITAL
Acute Care Hospitals
29
Procedure Prices at PRESENCE ST MARYS HOSPITAL
COLLECTION VENOUS BLOOD VENIPUNCTURE
CPT 36415
$24.5
Therapeutic Activities
CPT 97530
$74.55
BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC
CPT 85025
$106.4
Therapeutic Exercises
CPT 97110
$111.3
Chest X-Ray (1 view)
CPT 71045
$185.85
Chest X-Ray (2 views)
CPT 71046
$204.4
Diagnostic Mammogram (unilateral)
CPT 77065
$204.75
EKG Tracing
CPT 93005
$209.3
Screening Mammogram (bilateral)
CPT 77067
$217.7
COMPREHENSIVE METABOLIC PANEL
CPT 80053
$220.15
Diagnostic Mammogram (bilateral)
CPT 77066
$266.35
OFFICE OUTPATIENT VISIT 15 MINUTES
CPT 99213
$275.1
ER Visit — Low-Moderate Complexity
CPT 99283
$324.45
Thoracic Spine X-Ray
CPT 72072
$352.1
Retroperitoneal Ultrasound
CPT 76770
$442.4
Abdominal Ultrasound — Limited
CPT 76705
$582.05
OB Ultrasound
CPT 76805
$652.75
Abdominal Ultrasound
CPT 76700
$771.4
CT Chest
CPT 71250
$902.3
MRI Joint of Lower Extremity
CPT 73721
$963.55
ER Visit — Moderate Complexity
CPT 99284
$1,192.45
ER Visit — High Complexity
CPT 99285
$1,542.45
MRI Brain w/ Contrast
CPT 70553
$2,115.4
Echocardiogram w/ Doppler
CPT 93306
$2,164.05
MRI Brain w/o Contrast
CPT 70551
$2,295.65
CT Abdomen & Pelvis
CPT 74177
$3,118.5
Hip Replacement
CPT 27130
TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW
CPT 27245
Knee Replacement
CPT 27447
ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR
CPT 29827
Knee Arthroscopy
CPT 29881
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
Upper GI Endoscopy w/ Biopsy
CPT 43239
Appendectomy
CPT 44950
Colonoscopy
CPT 45378
Colonoscopy w/ Biopsy
CPT 45380
Laparoscopic Cholecystectomy
CPT 47562
Inguinal Hernia Repair
CPT 49505
Recurrent Inguinal Hernia Repair
CPT 49520
Laparoscopic Hernia Repair
CPT 49650
Vaginal Delivery
CPT 59400
C-Section
CPT 59510
VBAC Delivery
CPT 59610
NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL
CPT 64483
Cataract Surgery — Complex
CPT 66982
Cataract Surgery
CPT 66984
PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES
CPT 90837
EKG
CPT 93000
EKG Interpretation
CPT 93010
Echocardiogram
CPT 93307
Mechanical Traction
CPT 97012
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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.