PROV SACRED HRT MED CTR & CHILDS HOSP.
Hospital
Procedure Prices at PROV SACRED HRT MED CTR & CHILDS HOSP.
HC BLOOD DRAW VENIPUNCTURE
CPT 36415
$14.7
Mechanical Traction
CPT 97012
$25.9
HC CBC WITH DIFF AUTO
CPT 85025
$35.7
HC COMPREHEN METABOLIC PANEL
CPT 80053
$45.5
Therapeutic Exercises
CPT 97110
$49
Therapeutic Activities
CPT 97530
$53.9
EKG Tracing
CPT 93005
$79.1
Chest X-Ray (1 view)
CPT 71045
$80.5
Chest X-Ray (2 views)
CPT 71046
$80.5
Thoracic Spine X-Ray
CPT 72072
$160.3
Diagnostic Mammogram (bilateral)
CPT 77066
$160.3
HC 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES
CPT 90837
$184.1
Abdominal Ultrasound
CPT 76700
$205.1
Abdominal Ultrasound — Limited
CPT 76705
$205.1
Retroperitoneal Ultrasound
CPT 76770
$205.1
OB Ultrasound
CPT 76805
$205.1
HC CRISIS TELEH 99213 LACTATION EDUCATION ESTAB PT VISIT CDM
CPT 99213
$298.9
Screening Mammogram (bilateral)
CPT 77067
$325.5
CT Chest
CPT 71250
$425.6
Echocardiogram
CPT 93307
$592.9
ER Visit — Low-Moderate Complexity
CPT 99283
$599.2
MRI Brain w/o Contrast
CPT 70551
$991.9
Echocardiogram w/ Doppler
CPT 93306
$1,028.3
ER Visit — Moderate Complexity
CPT 99284
$1,078.7
MRI Joint of Lower Extremity
CPT 73721
$1,157.1
CT Abdomen & Pelvis
CPT 74177
$1,274.7
MRI Brain w/ Contrast
CPT 70553
$1,656.9
ER Visit — High Complexity
CPT 99285
$2,339.4
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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.