Providence Health And Services - Washington
Providence Health And Services - Washington in Chewelah, WA publishes cash prices for 43 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
500 E Webster, Chewelah, WA 99109 Collected Sep 23, 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 | $3,390.80 | $4,844.00 | 30% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST | $3,390.80 | $4,844.00 | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST | $1,033.20 | $1,476.00 | 30% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN WO CONTRAST | $1,033.20 | $1,476.00 | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST | $1,229.90 | $1,757.00 | 30% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST | $1,229.90 | $1,757.00 | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST | $2,089.50 | $2,985.00 | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST | $2,089.50 | $2,985.00 | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST | $3,332.00 | $4,760.00 | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST | $3,332.00 | $4,760.00 | 30% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O DYE | $2,132.20 | $3,046.00 | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O DYE | $2,132.20 | $3,046.00 | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/O & W/DYE | $3,643.50 | $5,205.00 | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/O & W/DYE | $3,643.50 | $5,205.00 | 30% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE LIMITED | $2,201.50 | $3,145.00 | 30% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE | $2,480.80 | $3,544.00 | 30% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE LIMITED | $2,201.50 | $3,145.00 | 30% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE | $2,480.80 | $3,544.00 | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS | $832.30 | $1,189.00 | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS | $832.30 | $1,189.00 | 30% |
| Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN BIL W CAD | $280.00 | $400.00 | 30% |
| Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD | $280.00 | $400.00 | 30% |
| Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN BIL W CAD | $280.00 | $400.00 | 30% |
| Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD | $280.00 | $400.00 | 30% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB | $744.10 | $1,063.00 | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON-OB | $744.10 | $1,063.00 | 30% |
| Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE | $770.70 | $1,101.00 | 30% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE | $770.70 | $1,101.00 | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS | $746.90 | $1,067.00 | 30% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS | $746.90 | $1,067.00 | 30% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $74.90 | $107.00 | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $74.90 | $107.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE | $59.50 | $85.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $59.50 | $85.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL LAB | $59.50 | $85.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL OF NMR | $65.80 | $94.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE | $59.50 | $85.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $59.50 | $85.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL LAB | $59.50 | $85.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL OF NMR | $65.80 | $94.00 | 30% |
| Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $95.90 | $137.00 | 30% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC WITH DIFF AUTO | $95.90 | $137.00 | 30% |
| Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB | $95.90 | $137.00 | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH DIFF AUTO | $95.90 | $137.00 | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB | $95.90 | $137.00 | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $95.90 | $137.00 | 30% |
| Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB | $61.60 | $88.00 | 30% |
| Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED | $61.60 | $88.00 | 30% |
| Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC AUTOMATED | $61.60 | $88.00 | 30% |
| Complete blood count (CBC), no differential CPT 85027 HC CBC WITH NO DIFFERENTIAL | $65.10 | $93.00 | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC AUTOMATED | $61.60 | $88.00 | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB | $61.60 | $88.00 | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED | $61.60 | $88.00 | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC WITH NO DIFFERENTIAL | $65.10 | $93.00 | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL | $91.70 | $131.00 | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL | $91.70 | $131.00 | 30% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL CDM | $76.30 | $109.00 | 30% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL CDM | $76.30 | $109.00 | 30% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL CDM | $61.60 | $88.00 | 30% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL CDM | $61.60 | $88.00 | 30% |
| Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL LAB | $186.90 | $267.00 | 30% |
| Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL LAB | $186.90 | $267.00 | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE LAB | $140.70 | $201.00 | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE | $140.70 | $201.00 | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE | $140.70 | $201.00 | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE | $140.70 | $201.00 | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE LAB | $140.70 | $201.00 | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE | $140.70 | $201.00 | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB | $96.60 | $138.00 | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM | $105.70 | $151.00 | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATIC SPECIFIC AG | $106.40 | $152.00 | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB | $96.60 | $138.00 | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM | $105.70 | $151.00 | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATIC SPECIFIC AG | $106.40 | $152.00 | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT POST 60 MIN INCUBATION | $15.40 | $22.00 | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB | $81.90 | $117.00 | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL | $81.90 | $117.00 | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT POST 60 MIN INCUBATION | $15.40 | $22.00 | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL | $81.90 | $117.00 | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB | $81.90 | $117.00 | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME WHOLE BLOOD | $10.50 | $15.00 | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME LAB | $49.00 | $70.00 | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $52.50 | $75.00 | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTIME | $52.50 | $75.00 | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME WHOLE BLOOD | $10.50 | $15.00 | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME LAB | $49.00 | $70.00 | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTIME | $52.50 | $75.00 | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $52.50 | $75.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH | $112.70 | $161.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH(THYROID STIMULATING HORMONE) | $112.70 | $161.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH REFLEX TO FT4 | $112.70 | $161.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC REFLEXIVE TSH | $112.70 | $161.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB | $112.70 | $161.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB | $112.70 | $161.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH | $112.70 | $161.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH REFLEX TO FT4 | $112.70 | $161.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH(THYROID STIMULATING HORMONE) | $112.70 | $161.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC REFLEXIVE TSH | $112.70 | $161.00 | 30% |
| Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM | $46.90 | $67.00 | 30% |
| Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB | $51.80 | $74.00 | 30% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM | $46.90 | $67.00 | 30% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB | $51.80 | $74.00 | 30% |
| Urinalysis without microscope exam, automated CPT 81003 HC GLUCOSE QUALITATIVE URINE | $29.40 | $42.00 | 30% |
| Urinalysis without microscope exam, automated CPT 81003 HC PH URINE QUALITATIVE | $29.40 | $42.00 | 30% |
| Urinalysis without microscope exam, automated CPT 81003 HC SPECIFIC GRAVITY URINE | $29.40 | $42.00 | 30% |
| Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB | $29.40 | $42.00 | 30% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $35.70 | $51.00 | 30% |
| Urinalysis without microscope exam, automated CPT 81003 HC KETONE URINE QUALITATIVE | $36.40 | $52.00 | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC GLUCOSE QUALITATIVE URINE | $29.40 | $42.00 | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB | $29.40 | $42.00 | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC PH URINE QUALITATIVE | $29.40 | $42.00 | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC SPECIFIC GRAVITY URINE | $29.40 | $42.00 | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $35.70 | $51.00 | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC KETONE URINE QUALITATIVE | $36.40 | $52.00 | 30% |
| Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM | $29.40 | $42.00 | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM | $29.40 | $42.00 | 30% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with polyp removal CPT 45385 HC PR 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ CDM | $628.60 | $898.00 | 30% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC PR 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ CDM | $628.60 | $898.00 | 30% |
| Colonoscopy with tissue sample CPT 45380 HC PR 45380 COLONOSCOPY FLEXIBLE W/BIOPSY SINGLE/MULTIPLE CDM | $529.90 | $757.00 | 30% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC PR 45380 COLONOSCOPY FLEXIBLE W/BIOPSY SINGLE/MULTIPLE CDM | $529.90 | $757.00 | 30% |
| Colonoscopy, diagnostic CPT 45378 HC PR 45378 DX COLONOSCOPY FLEXIBLE W/COLLTN SPEC WHEN PFRMD CDM | $443.10 | $633.00 | 30% |
| Colonoscopy, diagnostic CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM | $1,451.10 | $2,073.00 | 30% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC PR 45378 DX COLONOSCOPY FLEXIBLE W/COLLTN SPEC WHEN PFRMD CDM | $443.10 | $633.00 | 30% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM | $1,451.10 | $2,073.00 | 30% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM | $5,299.70 | $7,571.00 | 30% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM | $5,299.70 | $7,571.00 | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM | $963.90 | $1,377.00 | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG | $963.90 | $1,377.00 | 30% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM | $963.90 | $1,377.00 | 30% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG | $963.90 | $1,377.00 | 30% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC PR 62322 INJ INTERLAMINAR LMBR/SAC W/O IMG | $176.40 | $252.00 | 30% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,275.40 | $1,822.00 | 30% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM | $1,275.40 | $1,822.00 | 30% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC PR 62322 INJ INTERLAMINAR LMBR/SAC W/O IMG | $176.40 | $252.00 | 30% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $1,275.40 | $1,822.00 | 30% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM | $1,275.40 | $1,822.00 | 30% |
| Prostate biopsy CPT 55700 HC BIOPSY OF PROSTATE | $1,144.50 | $1,635.00 | 30% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY OF PROSTATE | $1,144.50 | $1,635.00 | 30% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC PR 43239 EGD BIOPSY SINGLE/MULTIPLE | $350.70 | $501.00 | 30% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM | $3,040.10 | $4,343.00 | 30% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC PR 43239 EGD BIOPSY SINGLE/MULTIPLE | $350.70 | $501.00 | 30% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM | $3,040.10 | $4,343.00 | 30% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC PR 43235 EGD DIAGNOSTIC BRUSH WASH | $297.50 | $425.00 | 30% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM | $1,441.30 | $2,059.00 | 30% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC PR 43235 EGD DIAGNOSTIC BRUSH WASH | $297.50 | $425.00 | 30% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM | $1,441.30 | $2,059.00 | 30% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT 45 MIN | $171.50 | $245.00 | 30% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT 90 MIN | $317.80 | $454.00 | 30% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT 45 MIN | $171.50 | $245.00 | 30% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT 90 MIN | $317.80 | $454.00 | 30% |
| New patient office visit, about 30 minutes CPT 99203 HC PR 99203 NEW PT VISIT - LEVEL 3 | $184.80 | $264.00 | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC PR 99203 NEW PT VISIT - LEVEL 3 | $184.80 | $264.00 | 30% |
| New patient office visit, about 45 minutes CPT 99204 HC PR 99204 NEW PT VISIT - LEVEL 4 | $282.10 | $403.00 | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC PR 99204 NEW PT VISIT - LEVEL 4 | $282.10 | $403.00 | 30% |
| New patient office visit, about 60 minutes CPT 99205 HC PR 99205 NEW PT VISIT - LEVEL 5 | $348.60 | $498.00 | 30% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC PR 99205 NEW PT VISIT - LEVEL 5 | $348.60 | $498.00 | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN | $55.30 | $79.00 | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC CRISIS TELEH 97110 THERAPEUTIC EXERCISES EA 15 MIN CDM | $55.30 | $79.00 | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN | $55.30 | $79.00 | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC CRISIS TELEH 97110 THERAPEUTIC EXERCISES EA 15 MIN CDM | $55.30 | $79.00 | 30% |
Source file: https://pricetransparency.providence.org/wamt/live/611570502_providence-st-joseph-hospital_standardcharges.json