PROVIDENCE ST PETER HOSPITAL
Acute Care Hospitals
Procedure Prices at PROVIDENCE ST PETER HOSPITAL
HC BLOOD DRAW VENIPUNCTURE
CPT 36415
$16.8
EKG Interpretation
CPT 93010
$18.2
Mechanical Traction
CPT 97012
$58.8
HC CBC WITH DIFF AUTO
CPT 85025
$59.5
Therapeutic Exercises
CPT 97110
$105
Therapeutic Activities
CPT 97530
$111.3
HC COMPREHEN METABOLIC PANEL
CPT 80053
$122.5
HC ESTAB PT VISIT - LEVEL 3
CPT 99213
$196.7
EKG Tracing
CPT 93005
$199.5
Chest X-Ray (1 view)
CPT 71045
$209.3
Chest X-Ray (2 views)
CPT 71046
$209.3
CT Chest
CPT 71250
$311.5
Thoracic Spine X-Ray
CPT 72072
$312.9
HC 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES
CPT 90837
$396.2
Abdominal Ultrasound
CPT 76700
$502.6
Abdominal Ultrasound — Limited
CPT 76705
$502.6
Retroperitoneal Ultrasound
CPT 76770
$502.6
OB Ultrasound
CPT 76805
$502.6
MRI Brain w/o Contrast
CPT 70551
$632.83
ER Visit — Low-Moderate Complexity
CPT 99283
$869.4
MRI Joint of Lower Extremity
CPT 73721
$1,161.3
ER Visit — Moderate Complexity
CPT 99284
$1,523.9
MRI Brain w/ Contrast
CPT 70553
$1,620.5
CT Abdomen & Pelvis
CPT 74177
$1,629.6
Echocardiogram w/ Doppler
CPT 93306
$1,729.7
HC INJ FORAMEN EPIDURAL L/S
CPT 64483
$2,097.2
ER Visit — High Complexity
CPT 99285
$3,227.7
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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.