Hospital

Ascension Seton

Ascension Seton in Burnet, TX publishes cash prices for 35 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.

3201 S Water St Burnet TX 78611 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 ELECTROCARIOGRAM 12 LEAD	$2,784.96	$7,736.00	64%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 ELECTROCARIOGRAM 12 LEAD	$2,784.96	$7,736.00	64%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL W CONT	$4,349.16	$12,081.00	64%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL W CONT	$4,349.16	$12,081.00	64%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ELECTROCARIOGRAM 12 LEAD	$2,784.96	$7,736.00	64%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PEL W CONT	$4,349.16	$12,081.00	64%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONT	$1,267.56	$3,521.00	64%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONT	$1,267.56	$3,521.00	64%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONT	$1,267.56	$3,521.00	64%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS LTD W	$1,998.18	$5,550.50	64%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONT	$1,998.18	$5,550.50	64%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONT	$1,998.18	$5,550.50	64%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS LTD W	$1,998.18	$5,550.50	64%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS LTD W	$1,998.18	$5,550.50	64%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONT	$1,998.18	$5,550.50	64%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG BILAT	$240.75	$668.75	64%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG BILAT	$240.75	$668.75	64%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIAG BILAT	$240.75	$668.75	64%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CON LT	$166.77	$463.25	64%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI RT	$166.77	$463.25	64%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI LT	$166.77	$463.25	64%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI LT	$166.77	$463.25	64%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CON RT	$166.77	$463.25	64%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CON RT	$166.77	$463.25	64%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CON LT	$166.77	$463.25	64%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI RT	$166.77	$463.25	64%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG UNI LT	$166.77	$463.25	64%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG CON LT	$166.77	$463.25	64%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG CON RT	$166.77	$463.25	64%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG UNI RT	$166.77	$463.25	64%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J R LTD	$711.81	$1,977.25	64%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J R LTD	$711.81	$1,977.25	64%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J L LTD	$711.81	$1,977.25	64%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J L LTD	$711.81	$1,977.25	64%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J L	$860.49	$2,390.25	64%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J R	$860.49	$2,390.25	64%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J L	$860.49	$2,390.25	64%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J R	$860.49	$2,390.25	64%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LW EXT WO J R LTD	$711.81	$1,977.25	64%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LW EXT WO J L LTD	$711.81	$1,977.25	64%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LW EXT WO J L	$860.49	$2,390.25	64%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LW EXT WO J R	$860.49	$2,390.25	64%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J L	$1,406.88	$3,908.00	64%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J R	$1,406.88	$3,908.00	64%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J L	$1,406.88	$3,908.00	64%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J R	$1,406.88	$3,908.00	64%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LW EXT WOW J R	$1,406.88	$3,908.00	64%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LW EXT WOW J L	$1,406.88	$3,908.00	64%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO LTD	$565.83	$1,571.75	64%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO LTD	$565.83	$1,571.75	64%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO	$1,322.91	$3,674.75	64%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO	$1,322.91	$3,674.75	64%
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO LTD	$565.83	$1,571.75	64%
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO	$1,322.91	$3,674.75	64%
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WOW	$1,972.44	$5,479.00	64%
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WOW	$1,972.44	$5,479.00	64%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN WOW	$1,972.44	$5,479.00	64%
MRI of the lower back, no contrast dye CPT 72148 MR L SPN CANL WO	$917.91	$2,549.75	64%
MRI of the lower back, no contrast dye CPT 72148 MR L SPN CANL WO	$917.91	$2,549.75	64%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR L SPN CANL WO	$917.91	$2,549.75	64%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG 2/3 TRIMST	$467.91	$1,299.75	64%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG 2/3 TRIMST	$467.91	$1,299.75	64%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS	$1,037.79	$2,882.75	64%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS	$1,037.79	$2,882.75	64%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG 2/3 TRIMST	$467.91	$1,299.75	64%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SNGL FETUS	$1,037.79	$2,882.75	64%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREENING BILAT	$145.26	$403.50	64%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREENING BILAT	$145.26	$403.50	64%
Screening mammogram, both breasts one side CPT 77067 SCRN MAM DIR DIGITAL-UNILAT	$145.26	$403.50	64%
Screening mammogram, both breasts one side CPT 77067 SCRN MAM DIR DIGITAL-UNILAT	$145.26	$403.50	64%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREENING BILAT	$145.26	$403.50	64%
Screening mammogram, both breasts inpatient one side CPT 77067 SCRN MAM DIR DIGITAL-UNILAT	$145.26	$403.50	64%
Transvaginal pelvic ultrasound CPT 76830 EDUS NON-OB TRANSVAG	$288.45	$801.25	64%
Transvaginal pelvic ultrasound CPT 76830 EDUS NON-OB TRANSVAG	$288.45	$801.25	64%
Transvaginal pelvic ultrasound CPT 76830 US TRSVAG NONPREG	$405.72	$1,127.00	64%
Transvaginal pelvic ultrasound CPT 76830 US TRSVAG NONPREG	$405.72	$1,127.00	64%
Transvaginal pelvic ultrasound inpatient CPT 76830 EDUS NON-OB TRANSVAG	$288.45	$801.25	64%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRSVAG NONPREG	$405.72	$1,127.00	64%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN CMPLT	$235.89	$655.25	64%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN CMPLT	$235.89	$655.25	64%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN CMPLT	$235.89	$655.25	64%
X-ray of the lower back, 4 or more views CPT 72110 XR SP COMP LUMB MIN 4 VWS	$181.35	$503.75	64%
X-ray of the lower back, 4 or more views CPT 72110 XR SP COMP LUMB MIN 4 VWS	$181.35	$503.75	64%
X-ray of the lower back, 4 or more views CPT 72110 XR SP COMP LUMB 4+V	$248.22	$689.50	64%
X-ray of the lower back, 4 or more views CPT 72110 XR SP COMP LUMB 4+V	$248.22	$689.50	64%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SP COMP LUMB MIN 4 VWS	$181.35	$503.75	64%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SP COMP LUMB 4+V	$248.22	$689.50	64%

Lab tests

Procedure	Cash price	List price	Off list
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$284.13	$789.25	64%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$284.13	$789.25	64%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$284.13	$789.25	64%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$144.72	$402.00	64%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$144.72	$402.00	64%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$144.72	$402.00	64%
Complete blood count (CBC) with differential CPT 85025 EOSINOPHIL COUNT	$39.96	$111.00	64%
Complete blood count (CBC) with differential CPT 85025 CBC (COMPLETE BLOOD COUNT)	$39.96	$111.00	64%
Complete blood count (CBC) with differential CPT 85025 EOSINOPHIL COUNT	$39.96	$111.00	64%
Complete blood count (CBC) with differential CPT 85025 CBC (COMPLETE BLOOD COUNT)	$39.96	$111.00	64%
Complete blood count (CBC) with differential inpatient CPT 85025 EOSINOPHIL COUNT	$39.96	$111.00	64%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC (COMPLETE BLOOD COUNT)	$39.96	$111.00	64%
Complete blood count (CBC), no differential CPT 85027 FETAL HEMOGRAM	$37.71	$104.75	64%
Complete blood count (CBC), no differential CPT 85027 FETAL HEMOGRAM	$37.71	$104.75	64%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$94.05	$261.25	64%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$94.05	$261.25	64%
Complete blood count (CBC), no differential inpatient CPT 85027 FETAL HEMOGRAM	$37.71	$104.75	64%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM	$94.05	$261.25	64%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$91.62	$254.50	64%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$91.62	$254.50	64%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$91.62	$254.50	64%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$309.69	$860.25	64%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$309.69	$860.25	64%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$309.69	$860.25	64%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$196.29	$545.25	64%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$196.29	$545.25	64%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$196.29	$545.25	64%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$205.83	$571.75	64%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$205.83	$571.75	64%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$205.83	$571.75	64%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$52.47	$145.75	64%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA,TOTAL	$52.47	$145.75	64%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$52.47	$145.75	64%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA,TOTAL	$52.47	$145.75	64%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA,TOTAL	$52.47	$145.75	64%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$52.47	$145.75	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-D HEPARIN REFLEX	$14.22	$39.50	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-D HEPARIN REFLEX	$14.22	$39.50	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 F-VIII INH COMPREHENSIVE-85730	$32.04	$89.00	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 F-VIII INH COMPREHENSIVE-85730	$32.04	$89.00	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 FACTOR IX INHIBITOR PNL-85730	$40.05	$111.25	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 FACTOR IX INHIBITOR PNL-85730	$40.05	$111.25	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBO TIME (PTT)	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 REFLEX PTT HEP NEUTRAL(LUPSC)	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT 1:1 MIX STUDY	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT 1:1 MIX STUDY	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBO TIME (PTT)	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 REFLEX PTT HEP NEUTRAL(LUPSC)	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-D HEPARIN REFLEX	$14.22	$39.50	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 F-VIII INH COMPREHENSIVE-85730	$32.04	$89.00	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 FACTOR IX INHIBITOR PNL-85730	$40.05	$111.25	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 REFLEX PTT HEP NEUTRAL(LUPSC)	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT 1:1 MIX STUDY	$115.65	$321.25	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBO TIME (PTT)	$115.65	$321.25	64%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT)	$105.21	$292.25	64%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT)	$105.21	$292.25	64%
Prothrombin time (PT/INR) clotting test CPT 85610 PT 1:1 MIX STUDY	$105.21	$292.25	64%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$105.21	$292.25	64%
Prothrombin time (PT/INR) clotting test CPT 85610 PT 1:1 MIX STUDY	$105.21	$292.25	64%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$105.21	$292.25	64%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$105.21	$292.25	64%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT 1:1 MIX STUDY	$105.21	$292.25	64%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT)	$105.21	$292.25	64%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$62.10	$172.50	64%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$62.10	$172.50	64%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$62.10	$172.50	64%
Urinalysis with microscope exam, automated CPT 81001 UA W/MICRO	$134.01	$372.25	64%
Urinalysis with microscope exam, automated CPT 81001 UA W/MICRO	$134.01	$372.25	64%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA W/MICRO	$134.01	$372.25	64%
Urinalysis without microscope exam, automated CPT 81003 GTT,EA ADDL URINE	$24.12	$67.00	64%
Urinalysis without microscope exam, automated CPT 81003 GTT,EA ADDL URINE	$24.12	$67.00	64%
Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/2HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/2HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/3HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/4HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/5HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/4HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 ACETONE UR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 SPEC GRAV UR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 UA CHEM ONLY	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/1HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/3HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/1HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/2HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/3HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/1HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/2HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/3HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/4HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/5HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/4HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 ACETONE UR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 SPEC GRAV UR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 UA CHEM ONLY	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/1HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/2HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/3HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/1HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/2HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/3HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/1HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT,EA ADDL URINE	$24.12	$67.00	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT3HR/GLU/U/1HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT4HR/GLU/U/4HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT3HR/GLU/U/2HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT5HR/GLU/U/1HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT3HR/GLU/U/3HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT5HR/GLU/U/5HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT4HR/GLU/U/3HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT5HR/GLU/U/3HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT4HR/GLU/U/2HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT5HR/GLU/U/2HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT5HR/GLU/U/4HR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA CHEM ONLY	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 ACETONE UR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPEC GRAV UR	$76.14	$211.50	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 GTT4HR/GLU/U/1HR	$76.14	$211.50	64%
Urinalysis without microscope exam, manual CPT 81002 KETONE GLUCOSE SCRN	$21.96	$61.00	64%
Urinalysis without microscope exam, manual CPT 81002 CLINITEST	$21.96	$61.00	64%
Urinalysis without microscope exam, manual CPT 81002 CLINITEST	$21.96	$61.00	64%
Urinalysis without microscope exam, manual CPT 81002 KETONE GLUCOSE SCRN	$21.96	$61.00	64%
Urinalysis without microscope exam, manual CPT 81002 URINE DIP/NON-AUTO	$23.04	$64.00	64%
Urinalysis without microscope exam, manual CPT 81002 URINE DIP/NON-AUTO	$23.04	$64.00	64%
Urinalysis without microscope exam, manual inpatient CPT 81002 KETONE GLUCOSE SCRN	$21.96	$61.00	64%
Urinalysis without microscope exam, manual inpatient CPT 81002 CLINITEST	$21.96	$61.00	64%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIP/NON-AUTO	$23.04	$64.00	64%

Surgery and procedures

Procedure	Cash price	List price	Off list
Lower-back epidural injection, with imaging guidance CPT 62323 PAIN EPIDRL INJ L/S W IMG	$1,647.00	$4,575.00	64%

Doctor visits and therapy

Procedure	Cash price	List price	Off list
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY	$155.97	$433.25	64%
Group psychotherapy session CPT 90853 PROCESS GROUP THERAPY	$159.93	$444.25	64%
Group psychotherapy session CPT 90853 FOCUS GROUP THERAPY	$159.93	$444.25	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PHY TH/SCHOOL/ 30MIN	$27.27	$75.75	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PHY TH/SCHOOL/ 30MIN	$27.27	$75.75	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PHY TH/SCHOOL/ 30MIN -MFALLS C	$32.22	$89.50	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PHY TH/SCHOOL/ 30MIN -MFALLS C	$32.22	$89.50	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT-THERAPEUTIC EX/15MIN	$39.78	$110.50	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT-THERAPEUTIC EX/15MIN	$39.78	$110.50	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT-EXERCISE/15MIN	$50.13	$139.25	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT-EXERCISE/15MIN	$50.13	$139.25	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 EXERCISE PER 15	$59.04	$164.00	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 EXERCISE PER 15	$59.04	$164.00	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA PROC EX. - 15MIN MFALLS	$63.45	$176.25	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA PROC EX. - 15MIN MFALLS	$63.45	$176.25	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPUTIC PROCEDURE EX - 15MI	$63.45	$176.25	64%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPUTIC PROCEDURE EX - 15MI	$63.45	$176.25	64%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PHY TH/SCHOOL/ 30MIN	$27.27	$75.75	64%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PHY TH/SCHOOL/ 30MIN -MFALLS C	$32.22	$89.50	64%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT-THERAPEUTIC EX/15MIN	$39.78	$110.50	64%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT-EXERCISE/15MIN	$50.13	$139.25	64%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 EXERCISE PER 15	$59.04	$164.00	64%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA PROC EX. - 15MIN MFALLS	$63.45	$176.25	64%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPUTIC PROCEDURE EX - 15MI	$63.45	$176.25	64%
Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL THERAPY(45-50MIN)	$159.93	$444.25	64%

Source file: https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/tx-csv/741109643-1003833013_ascension-seton_standardcharges.csv