UNIVERSITY HOSPITALS SAMARITAN MEDICAL CENTER
Acute Care Hospitals
Procedure Prices at UNIVERSITY HOSPITALS SAMARITAN MEDICAL CENTER
Blood Draw From Vein Using Needle
CPT 36415
$3
Lab Test - Complete Blood Cell Count
CPT 85025
$8.51
Lab Test - Comprehensive Metabolic Panel
CPT 80053
$11.14
Screening Mammogram (bilateral)
CPT 77067
$51.85
Chest X-Ray (1 view)
CPT 71045
$58.92
Chest X-Ray (2 views)
CPT 71046
$58.92
Thoracic Spine X-Ray
CPT 72072
$59.57
Therapeutic Exercises
CPT 97110
$78.12
Therapeutic Activities
CPT 97530
$78.12
OB Ultrasound
CPT 76805
$78.96
Outpatient Clinic Visit
CPT 99213
$79.16
Diagnostic Mammogram (unilateral)
CPT 77065
$91.93
Diagnostic Mammogram (bilateral)
CPT 77066
$91.93
Abdominal Ultrasound
CPT 76700
$100.15
Abdominal Ultrasound — Limited
CPT 76705
$100.15
CT Chest
CPT 71250
$110.91
EKG
CPT 93000
$137.25
EKG Tracing
CPT 93005
$137.25
ER Visit — Low-Moderate Complexity
CPT 99283
$156.04
ER Visit — Moderate Complexity
CPT 99284
$156.04
ER Visit — High Complexity
CPT 99285
$156.04
MRI Joint of Lower Extremity
CPT 73721
$186.66
MRI Brain w/o Contrast
CPT 70551
$204.53
CT Abdomen & Pelvis
CPT 74177
$261.85
Echocardiogram w/ Doppler
CPT 93306
$287.02
Echocardiogram
CPT 93307
$287.02
MRI Brain w/ Contrast
CPT 70553
$296.04
Colonoscopy
CPT 45378
$397.48
Colonoscopy w/ Biopsy
CPT 45380
$459.92
Retroperitoneal Ultrasound
CPT 76770
$587.39
Injection Of Drug Into Spinal Nerve Root With Imaging Guidance
CPT 64483
$639.65
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$1,123.34
Cataract Surgery — Complex
CPT 66982
$1,215.54
Cataract Surgery
CPT 66984
$1,215.54
Knee Arthroscopy
CPT 29881
$1,408.11
Upper GI Endoscopy w/ Biopsy
CPT 43239
$2,234.93
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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.