PROVIDENCE MISSION HOSPITAL
Acute Care Hospitals
Procedure Prices at PROVIDENCE MISSION HOSPITAL
HC CBC WITH DIFF AUTO
CPT 85025
$1.55
HC COMPREHEN METABOLIC PANEL
CPT 80053
$2.11
HC ROUTINE VENIPUNCTURE - REFERRAL DRAW FEE
CPT 36415
$10.35
Mechanical Traction
CPT 97012
$57.81
Therapeutic Activities
CPT 97530
$67.24
Therapeutic Exercises
CPT 97110
$69.29
Chest X-Ray (1 view)
CPT 71045
$108
Thoracic Spine X-Ray
CPT 72072
$174.25
HC ESTAB PT VISIT - LEVEL 3
CPT 99213
$175.48
EKG Tracing
CPT 93005
$188.6
Diagnostic Mammogram (unilateral)
CPT 77065
$197.21
Screening Mammogram (bilateral)
CPT 77067
$217.71
HC PSYCHOTHERAPY,INDIVID 1 HOUR
CPT 90837
$239.85
Diagnostic Mammogram (bilateral)
CPT 77066
$245.18
Chest X-Ray (2 views)
CPT 71046
$375.97
OB Ultrasound
CPT 76805
$423.45
Abdominal Ultrasound — Limited
CPT 76705
$452.7
Abdominal Ultrasound
CPT 76700
$657.45
Retroperitoneal Ultrasound
CPT 76770
$657.45
Echocardiogram
CPT 93307
$665.02
ER Visit — Low-Moderate Complexity
CPT 99283
$724.88
HC INJ FORAMEN EPIDURAL L/S
CPT 64483
$849.52
Echocardiogram w/ Doppler
CPT 93306
$1,107.41
ER Visit — Moderate Complexity
CPT 99284
$1,176.7
MRI Brain w/o Contrast
CPT 70551
$1,493.55
CT Chest
CPT 71250
$1,535.85
ER Visit — High Complexity
CPT 99285
$1,594.49
MRI Joint of Lower Extremity
CPT 73721
$1,678.5
CT Abdomen & Pelvis
CPT 74177
$1,881
MRI Brain w/ Contrast
CPT 70553
$2,940.75
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.