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Hospital

St. Joseph's Mercy Hospital, Centerville

St. Joseph's Mercy Hospital, Centerville in Centerville, IA publishes cash prices for 56 common procedures listed here, from its own machine-readable price file updated Mar 31, 2026. Click a procedure to compare it with other hospitals nearby.

1 Saint Joseph Dr, Centerville, IA 52544 Collected Sep 23, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen & Pelvis W/Contrast $5,637.00 $5,637.00 —
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abdomen & Pelvis W/Contrast $5,637.00 $5,637.00 —
CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain W/O Contrast $2,105.00 $2,105.00 —
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head/Brain W/O Contrast $2,105.00 $2,105.00 —
CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/Contrast $2,677.00 $2,677.00 —
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/Contrast $2,677.00 $2,677.00 —
Diagnostic mammogram, both breasts both sides CPT 77066 HC Mammography Diagnostic Bilateral $686.00 $686.00 —
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mammography Diagnostic Bilateral $686.00 $686.00 —
Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Lt $457.00 $457.00 —
Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Rt $457.00 $457.00 —
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Lt $457.00 $457.00 —
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Rt $457.00 $457.00 —
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Bl $6,005.00 $6,005.00 —
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Lt $4,003.00 $4,003.00 —
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Rt $4,003.00 $4,003.00 —
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Bl $6,005.00 $6,005.00 —
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Rt $4,003.00 $4,003.00 —
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Lt $4,003.00 $4,003.00 —
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Bl $7,598.00 $7,598.00 —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Lt $5,065.00 $5,065.00 —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Rt $5,065.00 $5,065.00 —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Bl $7,598.00 $7,598.00 —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Rt $5,065.00 $5,065.00 —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Lt $5,065.00 $5,065.00 —
MRI of the brain, no contrast dye CPT 70551 HC MRI Brain W/O Contrast $3,534.00 $3,534.00 —
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain W/O Contrast $3,534.00 $3,534.00 —
MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain W/O & W/Contrast $5,549.00 $5,549.00 —
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain W/O & W/Contrast $5,549.00 $5,549.00 —
MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine W/O Contrast $3,998.00 $3,998.00 —
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Lumbar Spine W/O Contrast $3,998.00 $3,998.00 —
Screening mammogram, both breasts both sides CPT 77067 HC Mammography Screen Bilateral $710.00 $710.00 —
Screening mammogram, both breasts one side CPT 77067 HC Mammography Screen Bl Reduced Service Unilateral Only Completed $473.00 $473.00 —
Screening mammogram, both breasts inpatient both sides CPT 77067 HC Mammography Screen Bilateral $710.00 $710.00 —
Screening mammogram, both breasts inpatient one side CPT 77067 HC Mammography Screen Bl Reduced Service Unilateral Only Completed $473.00 $473.00 —
Sleep study in a lab (polysomnography) CPT 95810 HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years $6,002.00 $6,002.00 —
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years $6,002.00 $6,002.00 —
Transvaginal pelvic ultrasound CPT 76830 PR US Transvaginal Non Obstetric $341.00 $341.00 —
Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal Non Obstetric $859.00 $859.00 —
Transvaginal pelvic ultrasound inpatient CPT 76830 PR US Transvaginal Non Obstetric $275.82 — —
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Transvaginal Non Obstetric $859.00 $859.00 —
Ultrasound of the abdomen, complete CPT 76700 PR US Abdomen Complete $332.00 $332.00 —
Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete $1,066.00 $1,066.00 —
Ultrasound of the abdomen, complete inpatient CPT 76700 PR US Abdomen Complete $329.89 — —
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdomen Complete $1,066.00 $1,066.00 —
X-ray of the lower back, 4 or more views CPT 72110 PR Xr Lumbosacral Spine >= 4 Views $143.00 $143.00 —
X-ray of the lower back, 4 or more views CPT 72110 HC Xr Lumbosacral Spine >= 4 Views $568.00 $568.00 —
X-ray of the lower back, 4 or more views inpatient CPT 72110 PR Xr Lumbosacral Spine >= 4 Views $157.16 — —
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Xr Lumbosacral Spine >= 4 Views $568.00 $568.00 —

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total) $159.00 $159.00 —
Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total) $439.00 — —
Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel (Calcium Total) $159.00 $159.00 —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Mayo Lmpp Lipid Panel $170.00 $170.00 —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel $170.00 $170.00 —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Mayo Lmpp Lipid Panel $170.00 $170.00 —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel $170.00 $170.00 —
Complete blood count (CBC) with differential CPT 85025 HC Cbc Automated/Differential Wbc Automated $112.00 $112.00 —
Complete blood count (CBC) with differential CPT 85025 HC Cbc Automated/Differential Wbc Automated $713.00 — —
Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc Automated/Differential Wbc Automated $112.00 $112.00 —
Complete blood count (CBC), no differential CPT 85027 HC Cbc Automated $87.00 $87.00 —
Complete blood count (CBC), no differential CPT 85027 HC Cbc Automated $643.00 — —
Complete blood count (CBC), no differential inpatient CPT 85027 HC Cbc Automated $87.00 $87.00 —
Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel $194.00 $194.00 —
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel $194.00 $194.00 —
Kidney function blood test panel CPT 80069 HC Renal Function Panel $145.00 $145.00 —
Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel $145.00 $145.00 —
Liver function blood test panel CPT 80076 HC Hepatic Function Panel $170.00 $170.00 —
Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel $170.00 $170.00 —
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Warde 1012090 Prostate Specific Antigen Free $216.00 $216.00 —
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Mayo Psaft Prostate Specific Antigen Free $216.00 $216.00 —
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Warde 1012090 Prostate Specific Antigen Free $216.00 $216.00 —
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Mayo Psaft Prostate Specific Antigen Free $216.00 $216.00 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen Total $188.00 $188.00 —
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Mayo Psaft Prostate Specific Antigen Total $188.00 $188.00 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen Total $188.00 $188.00 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Mayo Psaft Prostate Specific Antigen Total $188.00 $188.00 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial (Ptt) $99.00 $99.00 —
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial (Ptt) $1,078.00 — —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromboplastin Time Partial (Ptt) $99.00 $99.00 —
Prothrombin time (PT/INR) clotting test CPT 85610 PR Prothrombin Time $10.00 $10.00 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time $66.00 $66.00 —
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time $198.00 — —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PR Prothrombin Time $23.88 — —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time $66.00 $66.00 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone $192.00 $192.00 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Mayo Thyroid Stimulating Hormone $192.00 $192.00 —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone $898.00 — —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Mayo Thyroid Stimulating Hormone $192.00 $192.00 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Thyroid Stimulating Hormone $192.00 $192.00 —
Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis With Microscopy Automated $68.00 $68.00 —
Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis With Microscopy Automated $503.00 — —
Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis With Microscopy Automated $68.00 $68.00 —
Urinalysis without microscope exam, automated CPT 81003 PR Urinalysis Without Microscopy Automated $10.00 $10.00 —
Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Without Microscopy Automated $61.00 $61.00 —
Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Without Microscopy Automated $616.00 — —
Urinalysis without microscope exam, automated inpatient CPT 81003 PR Urinalysis Without Microscopy Automated $7.49 — —
Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis Without Microscopy Automated $61.00 $61.00 —

Surgery and procedures

ProcedureCash price List priceOff list
Colonoscopy with polyp removal CPT 45385 PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech $551.00 $551.00 —
Colonoscopy with polyp removal CPT 45385 HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH) $1,672.00 $1,672.00 —
Colonoscopy with polyp removal CPT 45385 HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH) $8,228.10 — —
Colonoscopy with polyp removal inpatient CPT 45385 PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech $924.00 $924.00 —
Colonoscopy with polyp removal inpatient CPT 45385 HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH) $1,672.00 $1,672.00 —
Colonoscopy with tissue sample CPT 45380 PR Colonoscopy Flexible With Biopsy Single/Multiple $730.00 — —
Colonoscopy with tissue sample CPT 45380 HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH) $1,597.00 $1,597.00 —
Colonoscopy with tissue sample CPT 45380 HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH) $9,749.40 — —
Colonoscopy with tissue sample inpatient CPT 45380 PR Colonoscopy Flexible With Biopsy Single/Multiple $730.00 $730.00 —
Colonoscopy with tissue sample inpatient CPT 45380 HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH) $1,597.00 $1,597.00 —
Colonoscopy, diagnostic CPT 45378 PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing $671.00 — —
Colonoscopy, diagnostic CPT 45378 HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH) $1,249.00 $1,249.00 —
Colonoscopy, diagnostic CPT 45378 HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH) $8,007.35 — —
Colonoscopy, diagnostic inpatient CPT 45378 PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing $671.00 $671.00 —
Colonoscopy, diagnostic inpatient CPT 45378 HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH) $1,249.00 $1,249.00 —
Gallbladder removal, laparoscopic CPT 47562 PR Laparoscopy Surgical Cholecystectomy $1,451.00 $1,451.00 —
Gallbladder removal, laparoscopic CPT 47562 HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH) $2,363.00 $2,363.00 —
Gallbladder removal, laparoscopic CPT 47562 HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH) $20,239.50 — —
Gallbladder removal, laparoscopic inpatient CPT 47562 PR Laparoscopy Surgical Cholecystectomy $2,363.00 $2,363.00 —
Gallbladder removal, laparoscopic inpatient CPT 47562 HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH) $2,363.00 $2,363.00 —
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR Repr Init Ing Hernia 5y or Older Reducible $1,157.00 $1,157.00 —
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH) $11,931.00 $11,931.00 —
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH) $17,880.16 — —
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 HC Repr Hernia Ing Init >=5yr Rt (Restricted Method II CAH) $7,954.00 $7,954.00 —
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 HC Repr Hernia Ing Init >=5yr Lt (Restricted Method II CAH) $7,954.00 $7,954.00 —
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR Repr Init Ing Hernia 5y or Older Reducible $1,878.00 $1,878.00 —
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH) $11,931.00 $11,931.00 —
Inguinal (groin) hernia repair, age 5 or older inpatient one side CPT 49505 HC Repr Hernia Ing Init >=5yr Lt (Restricted Method II CAH) $7,954.00 $7,954.00 —
Inguinal (groin) hernia repair, age 5 or older inpatient one side CPT 49505 HC Repr Hernia Ing Init >=5yr Rt (Restricted Method II CAH) $7,954.00 $7,954.00 —
Knee arthroscopy with meniscus trim CPT 29881 PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage $1,220.00 $1,220.00 —
Knee arthroscopy with meniscus trim CPT 29881 HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Bl (Rest Method II CAH) $4,397.00 $4,397.00 —
Knee arthroscopy with meniscus trim one side CPT 29881 HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Lt (Rest Method II CAH) $2,931.00 $2,931.00 —
Knee arthroscopy with meniscus trim one side CPT 29881 HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Rt (Rest Method II CAH) $2,931.00 $2,931.00 —
Knee arthroscopy with meniscus trim one side CPT 29881 HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Lt (Rest Method II CAH) $18,009.36 — —
Knee arthroscopy with meniscus trim inpatient CPT 29881 PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage $1,870.00 $1,870.00 —
Knee arthroscopy with meniscus trim inpatient CPT 29881 HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Bl (Rest Method II CAH) $4,397.00 $4,397.00 —
Knee arthroscopy with meniscus trim inpatient one side CPT 29881 HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Rt (Rest Method II CAH) $2,931.00 $2,931.00 —
Knee arthroscopy with meniscus trim inpatient one side CPT 29881 HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Lt (Rest Method II CAH) $2,931.00 $2,931.00 —
Lower-back epidural injection, with imaging guidance CPT 62323 PR Injection(S) Epidural Lumbar Needle Placement W/Guidance $213.00 $213.00 —
Lower-back epidural injection, with imaging guidance CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance(Rest Method II CAH) $736.00 $736.00 —
Lower-back epidural injection, with imaging guidance CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance $1,549.00 $1,549.00 —
Lower-back epidural injection, with imaging guidance CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance $1,656.75 — —
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR Injection(S) Epidural Lumbar Needle Placement W/Guidance $310.00 $310.00 —
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance(Rest Method II CAH) $736.00 $736.00 —
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance $1,549.00 $1,549.00 —
Lower-back epidural injection, without imaging guidance CPT 62322 HC Injection(S) Epidural Lumbar Needle Placement W/O Guidance $2,671.00 $2,671.00 —
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC Injection(S) Epidural Lumbar Needle Placement W/O Guidance $2,671.00 $2,671.00 —
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level $321.12 — —
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inj Anes Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl (Rest Method II CAH) $1,343.00 $1,343.00 —
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl $9,846.00 $9,846.00 —
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HC Inj Anes Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Lt (Rest Method II CAH) $895.00 $895.00 —
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HC Inj Anes Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt (Rest Method II CAH) $895.00 $895.00 —
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt $6,564.00 $6,564.00 —
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Lt $6,564.00 $6,564.00 —
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level $347.00 $347.00 —
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Inj Anes Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl (Rest Method II CAH) $1,343.00 $1,343.00 —
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl $9,846.00 $9,846.00 —
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 HC Inj Anes Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Lt (Rest Method II CAH) $895.00 $895.00 —
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 HC Inj Anes Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt (Rest Method II CAH) $895.00 $895.00 —
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt $6,564.00 $6,564.00 —
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Lt $6,564.00 $6,564.00 —
Prostate biopsy CPT 55700 HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach $4,280.00 $4,280.00 —
Prostate biopsy CPT 55700 HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach $15,599.17 — —
Prostate biopsy inpatient CPT 55700 HC Biopsy Prostate Needle/Punch Single/Multiple Any Approach $4,280.00 $4,280.00 —
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PR Arthroscopy Shoulder Decompr Subacromial Space W/Part Acromioplasty $370.00 $370.00 —
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Bl(Rest Method II CAH) $570.00 $570.00 —
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Lt(Rest Method II CAH) $380.00 $380.00 —
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Rt(Rest Method II CAH) $380.00 $380.00 —
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Bl(Rest Method II CAH) $570.00 $570.00 —
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 PR Arthroscopy Shoulder Decompr Subacromial Space W/Part Acromioplasty $2,280.00 $2,280.00 —
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient one side CPT 29826 HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Lt(Rest Method II CAH) $380.00 $380.00 —
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient one side CPT 29826 HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Rt(Rest Method II CAH) $380.00 $380.00 —
Tonsil and adenoid removal, child under 12 CPT 42820 HC Tonsillectomy & Adenoidectomy < Age 12 (Restricted Method II CAH) $1,092.00 $1,092.00 —
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 HC Tonsillectomy & Adenoidectomy < Age 12 (Restricted Method II CAH) $1,092.00 $1,092.00 —
Total hip replacement CPT 27130 PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement $2,825.00 $2,825.00 —
Total hip replacement CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Bl (Restricted Method II CAH) $4,335.00 $4,335.00 —
Total hip replacement CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Replacement Bl $21,359.00 $21,359.00 —
Total hip replacement one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH) $2,890.00 $2,890.00 —
Total hip replacement one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Lt (Restricted Method II CAH) $2,890.00 $2,890.00 —
Total hip replacement one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Replacement Rt $14,239.00 $14,239.00 —
Total hip replacement one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Replacement Lt $14,239.00 $14,239.00 —
Total hip replacement inpatient CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Bl (Restricted Method II CAH) $4,335.00 $4,335.00 —
Total hip replacement inpatient CPT 27130 PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement $4,387.00 $4,387.00 —
Total hip replacement inpatient CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Replacement Bl $21,359.00 $21,359.00 —
Total hip replacement inpatient one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH) $2,890.00 $2,890.00 —
Total hip replacement inpatient one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Lt (Restricted Method II CAH) $2,890.00 $2,890.00 —
Total hip replacement inpatient one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Replacement Rt $14,239.00 $14,239.00 —
Total hip replacement inpatient one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Replacement Lt $14,239.00 $14,239.00 —
Total knee replacement CPT 27447 PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing $2,821.00 $2,821.00 —
Total knee replacement CPT 27447 HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Bl(Rest Method II CAH) $4,253.00 $4,253.00 —
Total knee replacement one side CPT 27447 HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Lt(Rest Method II CAH) $2,835.00 $2,835.00 —
Total knee replacement one side CPT 27447 HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Rt(Rest Method II CAH) $2,835.00 $2,835.00 —
Total knee replacement one side CPT 27447 HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Lt(Rest Method II CAH) $50,618.79 — —
Total knee replacement inpatient CPT 27447 HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Bl(Rest Method II CAH) $4,253.00 $4,253.00 —
Total knee replacement inpatient CPT 27447 PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing $4,383.00 $4,383.00 —
Total knee replacement inpatient one side CPT 27447 HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Rt(Rest Method II CAH) $2,835.00 $2,835.00 —
Total knee replacement inpatient one side CPT 27447 HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Lt(Rest Method II CAH) $2,835.00 $2,835.00 —
Upper endoscopy (EGD) with biopsy CPT 43239 PR Egd Flexible Transoral W/ Biopsy Single/Multiple $301.00 $301.00 —
Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH) $1,386.00 $1,386.00 —
Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH) $7,298.50 — —
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR Egd Flexible Transoral W/ Biopsy Single/Multiple $503.00 $503.00 —
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH) $1,386.00 $1,386.00 —
Upper endoscopy (EGD), diagnostic CPT 43235 PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing $267.00 $267.00 —
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing $446.00 $446.00 —

Doctor visits and therapy

ProcedureCash price List priceOff list
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR Ecg 12 Lead Interpretation & Report $49.00 $49.00 —
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC Ecg 12 Lead Interpretation & Report $125.00 $125.00 —
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR Ecg 12 Lead Interpretation & Report $49.00 — —
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 HC Ecg 12 Lead Interpretation & Report $125.00 $125.00 —
Group psychotherapy session CPT 90853 HC Psychotherapy Group Therapy $772.00 $772.00 —
Group psychotherapy session CPT 90853 HC Psychotherapy Group Therapy Msw $772.00 $772.00 —
Group psychotherapy session inpatient CPT 90853 HC Psychotherapy Group Therapy $772.00 $772.00 —
Group psychotherapy session inpatient CPT 90853 HC Psychotherapy Group Therapy Msw $772.00 $772.00 —
New patient office visit, about 30 minutes CPT 99203 PR Visit Office Outpatient New Low Level $252.00 $252.00 —
New patient office visit, about 30 minutes CPT 99203 HC Visit New Low Pro 30-44 Mins (Restricted Method II CAH) $252.00 $252.00 —
New patient office visit, about 30 minutes inpatient CPT 99203 PR Visit Office Outpatient New Low Level $175.00 $175.00 —
New patient office visit, about 30 minutes inpatient CPT 99203 HC Visit New Low Pro 30-44 Mins (Restricted Method II CAH) $252.00 $252.00 —
New patient office visit, about 45 minutes CPT 99204 HC Visit New Mod Pro 45-59 Mins (Restricted Method II CAH) $386.00 $386.00 —
New patient office visit, about 45 minutes CPT 99204 PR Visit Office Outpatient New Moderate Level $386.00 $386.00 —
New patient office visit, about 45 minutes CPT 99204 HC Visit New Mod Pro 45-59 Mins (Restricted Method II CAH) $906.00 — —
New patient office visit, about 45 minutes inpatient CPT 99204 PR Visit Office Outpatient New Moderate Level $285.00 $285.00 —
New patient office visit, about 45 minutes inpatient CPT 99204 HC Visit New Mod Pro 45-59 Mins (Restricted Method II CAH) $386.00 $386.00 —
New patient office visit, about 60 minutes CPT 99205 PR Visit Office Outpatient New High Level $488.00 $488.00 —
New patient office visit, about 60 minutes CPT 99205 HC Visit New High Pro 60-74 Mins (Restricted Method II CAH) $488.00 $488.00 —
New patient office visit, about 60 minutes inpatient CPT 99205 PR Visit Office Outpatient New High Level $388.00 $388.00 —
New patient office visit, about 60 minutes inpatient CPT 99205 HC Visit New High Pro 60-74 Mins (Restricted Method II CAH) $488.00 $488.00 —
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes $199.00 $199.00 —
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes $199.00 $199.00 —
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes $199.00 $199.00 —
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes $199.00 $199.00 —
Preventive checkup, new patient aged 18–39 CPT 99385 PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years $313.00 $313.00 —
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years $199.00 $199.00 —
Preventive checkup, new patient aged 40–64 CPT 99386 PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years $363.00 $363.00 —
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years $241.00 $241.00 —
Psychotherapy session, 30 minutes CPT 90832 HC Psychotherapy Patient Individual Therapy 30 Minutes $610.00 $610.00 —
Psychotherapy session, 30 minutes inpatient CPT 90832 HC Psychotherapy Patient Individual Therapy 30 Minutes $610.00 $610.00 —
Psychotherapy session, 45 minutes CPT 90834 HC Psychotherapy Patient Individual Therapy 45 Minutes $755.00 $755.00 —
Psychotherapy session, 45 minutes inpatient CPT 90834 HC Psychotherapy Patient Individual Therapy 45 Minutes $755.00 $755.00 —
Psychotherapy session, 60 minutes CPT 90837 HC Psychotherapy Patient Individual Therapy 60 Minutes $770.00 $770.00 —
Psychotherapy session, 60 minutes inpatient CPT 90837 HC Psychotherapy Patient Individual Therapy 60 Minutes $770.00 $770.00 —

Source file: https://hpt.trinity-health.org/420680308_st-josephs-mercy-hospital-centerville_standardcharges.zip