St Josephs Hospital Health Center
St Josephs Hospital Health Center in Syracuse, NY publishes cash prices for 66 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.
301 Prospect Ave, Syracuse, NY 13203 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $2,134.60 | $3,284.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $2,134.60 | $3,284.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain W/O Contrast | $908.05 | $1,397.00 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head/Brain W/O Contrast | $908.05 | $1,397.00 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/Contrast | $1,209.65 | $1,861.00 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/Contrast | $1,209.65 | $1,861.00 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Mammography Diagnostic Bilateral | $505.05 | $777.00 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mammography Diagnostic Bilateral | $505.05 | $777.00 | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Rt | $469.95 | $723.00 | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Lt | $469.95 | $723.00 | 35% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Lt | $469.95 | $723.00 | 35% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Rt | $469.95 | $723.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Bl | $2,079.35 | $3,199.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Lt | $1,385.80 | $2,132.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Rt | $1,385.80 | $2,132.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Bl | $2,079.35 | $3,199.00 | 35% |
| 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 | $1,385.80 | $2,132.00 | 35% |
| 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 | $1,385.80 | $2,132.00 | 35% |
| 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 | $2,711.80 | $4,172.00 | 35% |
| 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 | $1,807.65 | $2,781.00 | 35% |
| 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 | $1,807.65 | $2,781.00 | 35% |
| 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 | $2,711.80 | $4,172.00 | 35% |
| 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 | $1,807.65 | $2,781.00 | 35% |
| 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 | $1,807.65 | $2,781.00 | 35% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain W/O Contrast | $1,543.10 | $2,374.00 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain W/O Contrast | $1,543.10 | $2,374.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain W/O & W/Contrast | $1,777.10 | $2,734.00 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain W/O & W/Contrast | $1,777.10 | $2,734.00 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine W/O Contrast | $1,543.10 | $2,374.00 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Lumbar Spine W/O Contrast | $1,543.10 | $2,374.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation | $390.00 | $600.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US Pregnant Uterus >= 14 Weeks Single/1st Gestation | $390.00 | $600.00 | 35% |
| Screening mammogram, both breasts both sides CPT 77067 HC Mammography Screen Bilateral | $312.65 | $481.00 | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC Mammography Screen Bilateral | $312.65 | $481.00 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $2,543.00 | — | — |
| Sleep study in a lab (polysomnography) CPT 95810 HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $2,780.05 | $4,277.00 | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PR Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $1,206.00 | $1,206.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $2,780.05 | $4,277.00 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal Non Obstetric | $331.50 | $510.00 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Transvaginal Non Obstetric | $331.50 | $510.00 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete | $525.20 | $808.00 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdomen Complete | $525.20 | $808.00 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Xr Lumbosacral Spine >= 4 Views | $368.55 | $567.00 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Xr Lumbosacral Spine >= 4 Views | $368.55 | $567.00 | 35% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $53.30 | $82.00 | 35% |
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $640.90 | — | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $53.30 | $82.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel | $67.60 | $104.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel | $67.60 | $104.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc Automated/Differential Wbc Automated | $61.75 | $95.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc Automated/Differential Wbc Automated | $532.35 | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc Automated/Differential Wbc Automated | $61.75 | $95.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 HC Cbc Automated | $55.90 | $86.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 HC Cbc Automated | $737.10 | — | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Cbc Automated | $55.90 | $86.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $60.45 | $93.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $659.75 | — | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel | $60.45 | $93.00 | 35% |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel | $54.60 | $84.00 | 35% |
| Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel | $54.60 | $84.00 | 35% |
| Liver function blood test panel CPT 80076 HC Hepatic Function Panel | $48.75 | $75.00 | 35% |
| Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel | $48.75 | $75.00 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Quest 31348 Prostate Specific Antigen Free | $21.45 | $33.00 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Quest 31348 Prostate Specific Antigen Free | $21.45 | $33.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Quest 31348 Prostate Specific Antigen Total | $21.45 | $33.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Quest Prostate Specific Antigen Total | $21.45 | $33.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Warde 1012090 Prostate Specific Antigen Total | $59.80 | $92.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen Total | $81.90 | $126.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Quest Prostate Specific Antigen Total | $21.45 | $33.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Quest 31348 Prostate Specific Antigen Total | $21.45 | $33.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Warde 1012090 Prostate Specific Antigen Total | $59.80 | $92.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen Total | $81.90 | $126.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC External Hppn Thromboplastin Time Partial (Ptt) | $22.75 | $35.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Quest 7079 Thromboplastin Time Partial (Ptt) | $22.75 | $35.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial (Ptt) | $22.75 | $35.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Quest 7079 Thromboplastin Time Partial (Ptt) | $22.75 | $35.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromboplastin Time Partial (Ptt) | $22.75 | $35.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC External Hppn Thromboplastin Time Partial (Ptt) | $22.75 | $35.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC POCT Prothrombin Time | $14.30 | $22.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $15.60 | $24.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POCT Prothrombin Time | $14.30 | $22.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time | $15.60 | $24.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Quest Thyroid Stimulating Hormone | $57.85 | $89.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Quest Thyroid Stimulating Hormone (Tsh) | $63.70 | $98.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone | $90.35 | $139.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Quest Thyroid Stimulating Hormone | $57.85 | $89.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Quest Thyroid Stimulating Hormone (Tsh) | $63.70 | $98.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Thyroid Stimulating Hormone | $90.35 | $139.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis With Microscopy Automated | $24.70 | $38.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis With Microscopy Automated | $589.55 | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis With Microscopy Automated | $24.70 | $38.00 | 35% |
| Urinalysis with microscope exam, manual CPT 81000 HC Urinalysis With Microscopy Nonautomated | $24.70 | $38.00 | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC Urinalysis With Microscopy Nonautomated | $24.70 | $38.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 PR Urinalysis Without Microscopy Automated | $5.00 | $5.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Without Microscopy Automated | $24.70 | $38.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Without Microscopy Automated | $1,485.90 | — | — |
| 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 | $24.70 | $38.00 | 35% |
| Urinalysis without microscope exam, manual CPT 81002 HC Urinalysis Without Microscopy Nonautomated | $27.95 | $43.00 | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC Urinalysis Without Microscopy Nonautomated | $27.95 | $43.00 | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care CPT 59510 PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care | $5,860.00 | $5,860.00 | — |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 PR Routine Obstetric Care Incl Antepartum Care/C-Section & Postpartum Care | $5,141.00 | $5,141.00 | — |
| Colonoscopy with endoscopic ultrasound CPT 45391 PR Colonoscopy Flexible W Endo US Exam Ltd to Rectum/Sigmoid/Colon/Cecum | $2,937.90 | — | — |
| 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) | $5,549.83 | — | — |
| Colonoscopy with polyp removal inpatient CPT 45385 PR Colonoscopy Flexible With Removal Tumor/Polyp/Other Lesion by Snare Tech | $511.00 | $511.00 | — |
| Colonoscopy with tissue sample CPT 45380 PR Colonoscopy Flexible With Biopsy Single/Multiple | $403.00 | — | — |
| Colonoscopy with tissue sample CPT 45380 HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH) | $5,608.07 | — | — |
| Colonoscopy with tissue sample inpatient CPT 45380 PR Colonoscopy Flexible With Biopsy Single/Multiple | $403.00 | $403.00 | — |
| Colonoscopy, diagnostic CPT 45378 PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing | $370.00 | — | — |
| Colonoscopy, diagnostic CPT 45378 HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH) | $3,117.59 | — | — |
| Colonoscopy, diagnostic inpatient CPT 45378 PR Colonoscopy Flexible Diagnostic W Collection Specimen Brushing/Washing | $370.00 | $370.00 | — |
| 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) | $20,992.73 | — | — |
| Gallbladder removal, laparoscopic inpatient CPT 47562 PR Laparoscopy Surgical Cholecystectomy | $1,305.00 | $1,305.00 | — |
| 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) | $8,577.60 | — | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR Repr Init Ing Hernia 5y or Older Reducible | $1,032.00 | $1,032.00 | — |
| 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 one side CPT 29881 HC Arthro Knee W/Mnsc Med or Lat Incl/Chndrplsty Same/Sep Compart Lt (Rest Method II CAH) | $11,410.50 | — | — |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 PR Arthroscopy Knee Surg W/ Meniscectomy Incl Debr/Shvi Artc Cartilage | $1,071.00 | $1,071.00 | — |
| Left heart catheterization, diagnostic one side CPT 93452 HC Cath Lt Heart/Lv Gram | $6,747.00 | $10,380.00 | 35% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC Cath Lt Heart/Lv Gram | $6,747.00 | $10,380.00 | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance | $928.20 | $1,428.00 | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance | $928.20 | $1,428.00 | 35% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 PR Lap Surg Prostatectomy Retropubic Radical Incl Nrv Sparing/Robotic Asst | $32,589.52 | $2,557.00 | -1175% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 PR Lap Surg Prostatectomy Retropubic Radical Incl Nrv Sparing/Robotic Asst | $3,254.00 | $3,254.00 | — |
| Removal of a breast lump, open surgery CPT 19120 PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion | $930.00 | $930.00 | — |
| Removal of a breast lump, open surgery one side CPT 19120 HC Excision Cyst/Fibroadenoma/Other Benign/Malignant Tumor Open Male/Female >= 1 Lesion Lt | $7,618.12 | — | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 PR Exc Cyst/Aberrant Breast Tissue Open Male/Female 1/> Lesion | $818.00 | $818.00 | — |
| 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) one side CPT 29826 HC Arth Shld Srg Decompr Subacrml Sp W/Prt Acrmplsty W/Crccrml Sep Proc Lt(Rest Method II CAH) | $18,892.93 | — | — |
| 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 | $317.00 | $317.00 | — |
| Tonsil and adenoid removal, child under 12 CPT 42820 PR Tonsillectomy & Adenoidectomy Younger Than Age 12 | $7,451.18 | — | — |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 PR Tonsillectomy & Adenoidectomy Younger Than Age 12 | $571.00 | $571.00 | — |
| Total hip replacement CPT 27130 PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement | $2,825.00 | $2,825.00 | — |
| Total hip replacement one side CPT 27130 HC Arthoplasty Acetabular & Proximal Femoral Prosthetic Repl Rt (Restricted Method II CAH) | $26,635.95 | — | — |
| Total hip replacement inpatient CPT 27130 PR Arthroplasty Acetabular and Proximal Femoral Prosthetic Replacement | $2,684.00 | $2,684.00 | — |
| 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 one side CPT 27447 HC Arthro Knee/Condyle/Plateau Med/Lat W/or W/O Patella Resurf (Tka) Lt(Rest Method II CAH) | $26,235.10 | — | — |
| Total knee replacement inpatient CPT 27447 PR Arthroplasty Knee Condyle&Plateau Med/Lat Cpts W/WO Patella Resurfacing | $2,681.00 | $2,681.00 | — |
| 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) | $5,385.41 | — | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR Egd Flexible Transoral W/ Biopsy Single/Multiple | $278.00 | $278.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing | $3,968.22 | $267.00 | -1386% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR Egd Flexible Transoral Dx Incl Coll Spec by Brushing/Washing | $246.00 | $246.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S | $5,000.00 | — | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 PR Routine OB Care Incl Antepartum Care Vag Del & Pp Care After Prev C/S | $5,000.00 | $5,000.00 | — |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care | $5,277.00 | $5,277.00 | — |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 PR Routine Obstetric Care Incl Antepartum Care Vaginal Delivery and Pp Care | $4,666.00 | $4,666.00 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR Ecg 12 Lead Interpretation & Report | $34.00 | $34.00 | — |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC Ecg 12 Lead Interpretation & Report | $228.15 | $351.00 | 35% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR Ecg 12 Lead Interpretation & Report | $29.00 | — | — |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 HC Ecg 12 Lead Interpretation & Report | $228.15 | $351.00 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 PR Psychotherapy Family W/Patient 50 Minutes | $211.00 | $211.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 PR Psychotherapy Family W/Patient 50 Minutes | $211.00 | $211.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 HC Psychotherapy Family W/Patient 50 Minutes | $217.75 | $335.00 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 PR Psychotherapy Family W/Patient 50 Minutes | $211.00 | $211.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 PR Psychotherapy Family W/Patient 50 Minutes | $211.00 | $211.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC Psychotherapy Family W/Patient 50 Minutes | $217.75 | $335.00 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 PR Psychotherapy Family W/O Patient 50 Minutes | $205.00 | $205.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 HC Psychotherapy Family W/O Patient 50 Minutes | $230.75 | $355.00 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 PR Psychotherapy Family W/O Patient 50 Minutes | $216.79 | — | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC Psychotherapy Family W/O Patient 50 Minutes | $230.75 | $355.00 | 35% |
| Group psychotherapy session CPT 90853 PR Psychotherapy Group | $50.00 | $50.00 | — |
| Group psychotherapy session CPT 90853 HC Psychotherapy Group Therapy | $122.20 | $188.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 PR Psychotherapy Group | $50.00 | $50.00 | — |
| Group psychotherapy session inpatient CPT 90853 HC Psychotherapy Group Therapy | $122.20 | $188.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 PR Visit Office Outpatient New Low Level | $220.00 | $220.00 | — |
| New patient office visit, about 30 minutes CPT 99203 PR Visit Office Outpatient New Low Level | $220.00 | $220.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR Visit Office Outpatient New Low Level | $220.00 | $220.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR Visit Office Outpatient New Low Level | $220.00 | $220.00 | — |
| New patient office visit, about 45 minutes CPT 99204 PR Visit Office Outpatient New Moderate Level | $256.00 | $256.00 | — |
| New patient office visit, about 45 minutes CPT 99204 HC Visit New Mod Pro 45-59 Mins (Restricted Method II CAH) | $718.25 | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR Visit Office Outpatient New Moderate Level | $256.00 | $256.00 | — |
| New patient office visit, about 60 minutes CPT 99205 PR Visit Office Outpatient New High Level | $334.00 | $334.00 | — |
| New patient office visit, about 60 minutes CPT 99205 PR Visit Office Outpatient New High Level | $334.00 | $334.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR Visit Office Outpatient New High Level | $334.00 | $334.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR Visit Office Outpatient New High Level | $334.00 | $334.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $115.05 | $177.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $121.55 | $187.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $1,090.70 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $115.05 | $177.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $121.55 | $187.00 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $197.00 | $197.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $252.20 | $388.00 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $1,233.05 | — | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $197.00 | $197.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC E&M Preventive Medicine Initial Comprehensive New Patient 18-39 Years | $252.20 | $388.00 | 35% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years | $239.00 | $239.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years | $284.05 | $437.00 | 35% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years | $239.00 | $239.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC E&M Preventive Medicine Initial Comprehensive New Patient 40-64 Years | $284.05 | $437.00 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 PR Psychotherapy Patient 30 Minutes | $126.00 | $126.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 HC Psychotherapy Patient Individual Therapy 30 Minutes | $148.85 | $229.00 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PR Psychotherapy Patient 30 Minutes | $126.00 | $126.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC Psychotherapy Patient Individual Therapy 30 Minutes | $148.85 | $229.00 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 PR Psychotherapy Patient 45 Minutes | $168.00 | $168.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 HC Psychotherapy Patient Individual Therapy 45 Minutes | $217.10 | $334.00 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PR Psychotherapy Patient 45 Minutes | $168.00 | $168.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC Psychotherapy Patient Individual Therapy 45 Minutes | $217.10 | $334.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HC Psychotherapy Patient Individual Therapy 60 Minutes | $248.95 | $383.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 PR Psychotherapy Patient 60 Minutes | $251.00 | $251.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 PR Psychotherapy Patient 60 Minutes | $251.00 | $251.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC Psychotherapy Patient Individual Therapy 60 Minutes | $248.95 | $383.00 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PR Psychotherapy Patient 60 Minutes | $251.00 | $251.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PR Psychotherapy Patient 60 Minutes | $251.00 | $251.00 | — |
Dental
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Porcelain crown CDT D2740 HC Crown Porcelain/Ceramic Substrate (Restricted Jnpl) | $783.25 | $1,205.00 | 35% |
| Porcelain crown inpatient CDT D2740 HC Crown Porcelain/Ceramic Substrate (Restricted Jnpl) | $783.25 | $1,205.00 | 35% |
Source file: https://hpt.trinity-health.org/150532254_st-josephs-hospital-health-center_standardcharges.zip