SUSAN B ALLEN MEMORIAL HOSPITAL
Acute Care Hospitals
16
Procedure Prices at SUSAN B ALLEN MEMORIAL HOSPITAL
CL DIAG CBCD
CPT 85025
$5.4
EUCC-VENIPUNCTURE
CPT 36415
$11.93
Blood test, comprehensive group of blood chemicals
CPT 80053
$16.34
Mechanical Traction
CPT 97012
$17.1
Therapeutic Exercises
CPT 97110
$23.28
Therapeutic Activities
CPT 97530
$23.28
SPC-DRES CHG ESTB III
CPT 99213
$31.83
Abdominal Ultrasound — Limited
CPT 76705
$55.1
Diagnostic Mammogram (unilateral)
CPT 77065
$57.95
Diagnostic Mammogram (bilateral)
CPT 77066
$57.95
Chest X-Ray (1 view)
CPT 71045
$58.12
EKG Tracing
CPT 93005
$70.2
Retroperitoneal Ultrasound
CPT 76770
$71.25
Chest X-Ray (2 views)
CPT 71046
$77.35
Screening Mammogram (bilateral)
CPT 77067
$88.83
Thoracic Spine X-Ray
CPT 72072
$94.83
OB Ultrasound
CPT 76805
$124.45
Abdominal Ultrasound
CPT 76700
$142.5
CT Chest
CPT 71250
$215.18
ER Visit — Low-Moderate Complexity
CPT 99283
$235.03
MRI Brain w/o Contrast
CPT 70551
$247.48
SPC-PAIN CLIN-INJ FORAMEN EPID
CPT 64483
$272.65
ER Visit — Moderate Complexity
CPT 99284
$326.97
CT Abdomen & Pelvis
CPT 74177
$484.5
MRI Joint of Lower Extremity
CPT 73721
$494.95
ER Visit — High Complexity
CPT 99285
$498.95
MRI Brain w/ Contrast
CPT 70553
$521
Echocardiogram w/ Doppler
CPT 93306
$1,085.45
Colonoscopy
CPT 45378
$1,279.82
Colonoscopy w/ Biopsy
CPT 45380
$1,420.81
Upper GI Endoscopy w/ Biopsy
CPT 43239
$1,443.68
Cataract Surgery — Complex
CPT 66982
$1,627.02
Cataract Surgery
CPT 66984
$1,653.98
Knee Arthroscopy
CPT 29881
$3,361.36
Inguinal Hernia Repair
CPT 49505
$3,849.58
Laparoscopic Cholecystectomy
CPT 47562
$15,553.77
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.