SelfPayRates
Hospital Seattle-Tacoma-Bellevue, WA

Franciscan Specialty Care

Franciscan Specialty Care in Tacoma, WA publishes cash prices for 201 common procedures listed here, from its own machine-readable price file updated Mar 16, 2026. Click a procedure to compare it with other hospitals nearby.

815 South Vassault Street Tacoma WA 98465 Collected Sep 27, 2026 Source price file

The price file shows no self-pay discount

For 273 of the 273 prices listed here, the cash price in Franciscan Specialty Care's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.

Scans and imaging

ProcedureCash price List priceInsurers payOff list
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XRAY ANKLE, COMPLETE $97.52 $97.52 $97.52 —
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 TCPO2 SINGLE LEVEL $421.75 $421.75 $421.75 —
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US EXT ARTERY SINGLE LEVEL BIL $574.17 $574.17 $574.17 —
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS $700.52 $700.52 $700.52 —
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE/JOINT WHOLE BODY $2,694.79 $2,694.79 $2,694.79 —
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST UNIL COMPLT $420.24 $420.24 $420.24 —
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST UNIL LIMITED $380.11 $380.11 $380.11 —
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST (NONCORONARY) WO/W $2,230.17 $2,230.17 $2,230.17 —
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS WO CONTRAST $11,433.00 $11,433.00 $11,433.00 —
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/CONTRAST $5,475.49 $5,475.49 $5,475.49 —
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS W/WO CONTRAST $5,902.53 $5,902.53 $5,902.53 —
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST $2,234.96 $2,234.96 $2,234.96 —
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST $5,459.00 $5,459.00 $5,459.00 —
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST $4,075.71 $4,075.71 $4,075.71 —
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN/HEAD WO CONTRAST $4,242.57 $4,242.57 $4,242.57 —
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN/HEAD W/CONTRAST $3,525.04 $3,525.04 $3,525.04 —
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN/HEAD W/WO CONTRAST $2,633.16 $2,633.16 $2,633.16 —
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST $6,538.44 $6,538.44 $6,538.44 —
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST $7,694.10 $7,694.10 $7,694.10 —
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST $3,610.51 $3,610.51 $3,610.51 —
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID BILATERAL $1,035.01 $1,035.01 $1,035.01 —
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS $99.68 $99.68 $99.68 —
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS FRONTAL & LAT $327.82 $327.82 $327.82 —
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW FRONTAL $315.55 $315.55 $315.55 —
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW $327.82 $327.82 $327.82 —
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE $386.25 $386.25 $386.25 —
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA BONE DENSITY HIP/PELV/SP $675.54 $675.54 $675.54 —
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA BONE DENSITY WRIST/HEEL $419.19 $419.19 $419.19 —
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX W/O CONTRAST $6,306.69 $6,306.69 $6,306.69 —
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W/CONTRAST $1,806.62 $1,806.62 $1,806.62 —
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US LOW EXT ART DUPLEX COMP BIL $932.57 $932.57 $932.57 —
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US EXT VEIN DUPLEX COMPLETE BI $386.25 $386.25 $386.25 —
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US 2D ECHO DOPPLER/COLOR FLOW $969.23 $969.23 $969.23 —
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO 2-D&M-MODE W/DOPPLER $2,157.26 $2,157.26 $2,157.26 —
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY $1,984.44 $1,984.44 $1,984.44 —
Knee X-ray, 3 views inpatient CPT 73562 KNEE EXAM MIN 3 VIEWS $327.82 $327.82 $327.82 —
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED $309.00 $309.00 $309.00 —
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONT $3,290.19 $3,290.19 $3,290.19 —
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO CONTRAST $5,385.09 $5,385.09 $5,385.09 —
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST $2,499.81 $2,499.81 $2,499.81 —
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONTRAST $3,806.88 $3,806.88 $3,806.88 —
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO CONTRAST $2,612.08 $2,612.08 $2,612.08 —
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/WO CONTRAST $3,512.30 $3,512.30 $3,512.30 —
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC WO CONTRAST $2,539.98 $2,539.98 $2,539.98 —
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL W/WO CONTRAST $4,728.59 $4,728.59 $4,728.59 —
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL WO CONTRAST $2,564.70 $2,564.70 $2,564.70 —
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONTRAST $3,227.05 $3,227.05 $3,227.05 —
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST $5,522.15 $5,522.15 $5,522.15 —
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARD PERF MULTI SPECT $7,356.30 $7,356.30 $7,356.30 —
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET TUMOR W/CT SKULL-MIDTHIGH $4,896.85 $4,896.85 $4,896.85 —
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED OR FOLLOWUP $598.08 $598.08 $598.08 —
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE $858.52 $858.52 $858.52 —
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS >14 WEEKS $886.71 $886.71 $886.71 —
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTERUS <14 WEEKS 1ST G $771.14 $771.14 $771.14 —
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREG UTERUS LIMITED $1,043.25 $1,043.25 $1,043.25 —
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMOGRAM SCREEN BILATERAL $206.97 $206.97 $206.97 —
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Shoulder Cmplt 2 Vws $74.99 $74.99 $74.99 —
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOW FUNCTION W/VIDEORAD $1,236.00 $1,236.00 $1,236.00 —
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL $945.03 $945.03 $945.03 —
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANT UTERUS TRANSVAGINA $1,199.79 $1,199.79 $1,199.79 —
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE $424.72 $424.72 $424.72 —
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM $624.90 $624.90 $624.90 —
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE $1,075.92 $1,075.92 $1,075.92 —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI STOMACH W/O KUB $462.31 $462.31 $462.31 —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 RAD US DUPLEX UP EX $633.01 $633.01 $633.01 —
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XRAY WRIST 3+ VIEWS $100.89 $100.89 $100.89 —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 Hip Unilate cmplt 2 Vws $97.49 $97.49 $97.49 —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP RGHT $309.00 $309.00 $309.00 —
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN SINGLE AP VIEW $309.00 $309.00 $309.00 —
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN, 1 VIEW $327.82 $327.82 $327.82 —
X-ray of the ankle, 2 views inpatient CPT 73600 73600 ANKLE AP&LAT 2V $93.01 $93.01 $93.01 —
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-RAY FINGERS 2 VIEW $105.37 $105.37 $105.37 —
X-ray of the foot, 2 views inpatient CPT 73620 73620 FOOT AP&LAT 2V $105.37 $105.37 $105.37 —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMPLETE RT $85.13 $85.13 $85.13 —
X-ray of the hand, 3 or more views inpatient CPT 73130 Hand Min 3 Views $91.90 $91.90 $91.90 —
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 KNEE 1-2 VIEWS BILATERAL $28.92 $28.92 $28.92 —
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBOSACRAL SP 2-3 VIEWS $396.60 $396.60 $396.60 —
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBOSACRAL SP 4+ VIEWS $557.72 $557.72 $557.72 —
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SP 2 VIEWS $396.60 $396.60 $396.60 —
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES 3+ VIEWS $108.77 $108.77 $108.77 —
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SP 2 OR 3 VIEWS $327.82 $327.82 $327.82 —
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 VIEWS $35.63 $35.63 $35.63 —
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX MIN 2+ VIEWS $327.82 $327.82 $327.82 —

Lab tests

ProcedureCash price List priceInsurers payOff list
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT $18.26 $18.26 $18.26 —
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT) $129.32 $129.32 $129.32 —
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST $17.86 $17.86 $17.86 —
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST) $118.56 $118.56 $118.56 —
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL (ACUTE) $432.68 $432.68 $432.68 —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, IGE $17.98 $17.98 $17.98 —
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATD PEPTIDE AB $159.23 $159.23 $159.23 —
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN $142.84 $142.84 $142.84 —
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTID $135.25 $135.25 $135.25 —
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PRO BNP $149.70 $149.70 $149.70 —
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP (B NATRIURETIC PEPTIDE) $215.69 $215.69 $215.69 —
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL $29.14 $29.14 $29.14 —
Basic metabolic panel (blood test) inpatient CPT 80048 METABOLIC PANEL TOTAL CA $245.73 $245.73 $245.73 —
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH LEVEL IV $387.28 $387.28 $387.28 —
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK, INTERP COMPLETE $967.70 $967.70 $967.70 —
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE $35.57 $35.57 $35.57 —
Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIA $120.61 $120.61 $120.61 —
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD $192.53 $192.53 $192.53 —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE $20.25 $20.25 $20.25 —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE FOR COLLECT $30.44 $30.44 $30.44 —
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE,EXCEPT URINE $50.93 $50.93 $50.93 —
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, QUANTITATIVE $74.36 $74.36 $74.36 —
Blood lead test inpatient CPT 83655 LEAD LEVEL $321.20 $321.20 $321.20 —
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL URINE $108.15 $108.15 $108.15 —
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM, QUALITATIVE $220.45 $220.45 $220.45 —
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO & RH TYPE $82.40 $82.40 $82.40 —
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE AND SCREEN $82.40 $82.40 $82.40 —
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 PRENATAL PANEL $82.40 $82.40 $82.40 —
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE & CROSSMATCH $84.18 $84.18 $84.18 —
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD TYPING $126.03 $126.03 $126.03 —
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO $217.74 $217.74 $217.74 —
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO ONLY $471.13 $471.13 $471.13 —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN $17.86 $17.86 $17.86 —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN $101.60 $101.60 $101.60 —
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFF TOXIN AM $128.42 $128.42 $128.42 —
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE AMP PROBE $242.93 $242.93 $242.93 —
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA-19-9 $376.72 $376.72 $376.72 —
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 ANTIBODY $380.72 $380.72 $380.72 —
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 NAA UNIT PERFORMED $176.78 $176.78 $176.78 —
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 CORONAVIRUS $491.40 $491.40 $491.40 —
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS(AMP) $120.31 $120.31 $120.31 —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE $46.13 $46.13 $46.13 —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL $160.83 $160.83 $160.83 —
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF $26.76 $26.76 $26.76 —
Complete blood count (CBC) with differential inpatient CPT 85025 CBC, W/ AUTO DIFF $62.52 $62.52 $62.52 —
Complete blood count (CBC), no differential inpatient CPT 85027 AUTOMATED CBC $22.28 $22.28 $22.28 —
Complete blood count (CBC), no differential inpatient CPT 85027 CBC, AUTO W/O DIFF $57.32 $57.32 $57.32 —
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL $36.37 $36.37 $36.37 —
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL $374.25 $374.25 $374.25 —
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER ELISA $33.50 $33.50 $33.50 —
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN-D-DIMER QUANT $220.80 $220.80 $220.80 —
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S $356.70 $356.70 $356.70 —
Estradiol blood test inpatient CPT 82670 ESTRADIOL $186.77 $186.77 $186.77 —
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE $397.43 $397.43 $397.43 —
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN $117.97 $117.97 $117.97 —
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM $50.65 $50.65 $50.65 —
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID $123.58 $123.58 $123.58 —
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE $136.98 $136.98 $136.98 —
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE (FREE T4) $31.09 $31.09 $31.09 —
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE (THYROXINE) $139.49 $139.49 $139.49 —
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROID FUNCTION PANEL $173.04 $173.04 $173.04 —
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE $129.90 $129.90 $129.90 —
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 POST GLUCOSE DOSE (GTT) $272.13 $272.13 $272.13 —
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL - 3 SPECIMENS $161.72 $161.72 $161.72 —
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE $164.29 $164.29 $164.29 —
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI AB $79.46 $79.46 $79.46 —
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI, STOOL $161.01 $161.01 $161.01 —
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV VIRAL LOAD, QUANT (DNA) $374.27 $374.27 $374.27 —
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1&2 AB SCREEN $18.41 $18.41 $18.41 —
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV1 & HIV2, SINGLE ASSSAY $106.90 $106.90 $106.90 —
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB $121.55 $121.55 $121.55 —
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCO HGB $33.46 $33.46 $33.46 —
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOHEMOGLOBIN (HGB A1) $104.51 $104.51 $104.51 —
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB $113.29 $113.29 $113.29 —
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG $84.36 $84.36 $84.36 —
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG (HBSAG) $132.12 $132.12 $132.12 —
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB $150.73 $150.73 $150.73 —
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS AB RNA $356.72 $356.72 $356.72 —
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 ABY $58.16 $58.16 $58.16 —
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 ABY $68.73 $68.73 $68.73 —
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY RISK $54.88 $54.88 $54.88 —
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP (HIGH SENSITIVITY) $105.66 $105.66 $105.66 —
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE $153.72 $153.72 $153.72 —
Insulin blood test inpatient CPT 83525 INSULIN $63.27 $63.27 $63.27 —
Iron blood test (serum iron) inpatient CPT 83540 IRON SERUM $22.28 $22.28 $22.28 —
Iron blood test (serum iron) inpatient CPT 83540 IRON PANEL $33.54 $33.54 $33.54 —
Iron blood test (serum iron) inpatient CPT 83540 IRON,SERUM,CHEMICAL $81.73 $81.73 $81.73 —
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY $113.85 $113.85 $113.85 —
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL $29.91 $29.91 $29.91 —
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL $206.00 $206.00 $206.00 —
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE $367.60 $367.60 $367.60 —
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE $122.15 $122.15 $122.15 —
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE, MISC FLUID $136.99 $136.99 $136.99 —
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL $153.97 $153.97 $153.97 —
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TITER $273.97 $273.97 $273.97 —
Magnesium blood test inpatient CPT 83735 MAGNESIUM $77.05 $77.05 $77.05 —
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY $95.60 $95.60 $95.60 —
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODY SCREEN $128.22 $128.22 $128.22 —
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL $61.80 $61.80 $61.80 —
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTATE SPECIFIC ATG (FREE) $123.64 $123.64 $123.64 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN $63.35 $63.35 $63.35 —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ATG (TOTAL) $142.51 $142.51 $142.51 —
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR THIN PREP $163.89 $163.89 $163.89 —
Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTACT PARATHYROID HORMON $174.96 $174.96 $174.96 —
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE $200.14 $200.14 $200.14 —
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARA THYROID INTACT C TERMINAL $290.01 $290.01 $290.01 —
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONES INTACT $307.48 $307.48 $307.48 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT $20.70 $20.70 $20.70 —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT $87.10 $87.10 $87.10 —
Progesterone blood test inpatient CPT 84144 PROGESTERONE $429.47 $429.47 $429.47 —
Prolactin blood test inpatient CPT 84146 PROLACTIN $249.44 $249.44 $249.44 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME $40.63 $40.63 $40.63 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 DIC SCREEN $58.71 $58.71 $58.71 —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/PTT $76.22 $76.22 $76.22 —
Rapid flu test (influenza antigen) inpatient CPT 87804 INF AG DET BY IA INFLUENZA $57.01 $57.01 $57.01 —
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP $17.50 $17.50 $17.50 —
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A SCREEN (EIA) $52.21 $52.21 $52.21 —
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR, QUANT $143.81 $143.81 $143.81 —
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY $317.28 $317.28 $317.28 —
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE $9.30 $9.30 $9.30 —
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE (AUTO) $68.14 $68.14 $68.14 —
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SPERM COUNT - COMPLETE $14.42 $14.42 $14.42 —
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES $91.52 $91.52 $91.52 —
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD, FECAL $41.10 $41.10 $41.10 —
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 RESPIRATORY THERAPY 82270 $103.46 $103.46 $103.46 —
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD 1-3 DETERMIN $54.85 $54.85 $54.85 —
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL HGB IMMUNOASSAY $79.35 $79.35 $79.35 —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR $80.00 $80.00 $80.00 —
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD $260.02 $260.02 $260.02 —
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL $98.82 $98.82 $98.82 —
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES $245.55 $245.55 $245.55 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH $132.43 $132.43 $132.43 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID CASCADE $140.27 $140.27 $140.27 —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH ULTRA SENSITIVE $207.03 $207.03 $207.03 —
Uric acid blood test inpatient CPT 84550 URIC ACID SERUM $15.57 $15.57 $15.57 —
Uric acid blood test inpatient CPT 84550 URIC ACID, BLOOD $77.92 $77.92 $77.92 —
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AND MICROSCOPI $10.91 $10.91 $10.91 —
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/MICROSCOPIC $46.90 $46.90 $46.90 —
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS NONAUTO W/MICROSCOP $46.05 $46.05 $46.05 —
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS MACRO ONLY $7.76 $7.76 $7.76 —
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O MICRO $34.60 $34.60 $34.60 —
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O MICROSC $90.35 $90.35 $90.35 —
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE $27.81 $27.81 $27.81 —
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE W/COLONY COUNT $112.40 $112.40 $112.40 —
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST,VISUAL COLOR $8.87 $8.87 $8.87 —
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 $96.93 $96.93 $96.93 —
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 & FOLATE $125.06 $125.06 $125.06 —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25-HYDROXY $101.97 $101.97 $101.97 —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25 HYDROXY $268.77 $268.77 $268.77 —
Zinc blood test inpatient CPT 84630 ZINC $166.13 $166.13 $166.13 —
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG SERUM, QUANTITATIVE $505.05 $505.05 $505.05 —

Surgery and procedures

ProcedureCash price List priceInsurers payOff list
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC $489.84 $489.84 $489.84 —
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMG GD $2,066.28 $2,066.28 $2,066.28 —
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SUBQ TIS FIRST 20CM $919.60 $919.60 $919.60 —

Doctor visits and therapy

ProcedureCash price List priceInsurers payOff list
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD/COMPONENT $1,566.01 $1,566.01 $1,566.01 —
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RESPIRATORY THERAPY 94640 $97.66 $97.66 $97.66 —
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT $113.28 $113.28 $113.28 —
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI $117.06 $117.06 $117.06 —
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL/VAPOR INHALE INITIAL $128.10 $128.10 $128.10 —
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB-INITIAL/EZPAP $226.61 $226.61 $226.61 —
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO VIA IV UP TO 1 HOUR $729.15 $729.15 $729.15 —
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG, AWAKE AND DROWSY $1,236.00 $1,236.00 $1,236.00 —
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG $504.49 $504.49 $504.49 —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING ONLY $133.90 $133.90 $133.90 —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING ONLY (RAD) $286.86 $286.86 $286.86 —
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NCB EA NERVE MOTOR W FW 7-8 $6,102.71 $6,102.71 $6,102.71 —
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 15 MIN $244.14 $244.14 $244.14 —
New patient office visit, about 45 minutes inpatient CPT 99204 OP VISIT NEW PT LEVEL IV $1,904.52 $1,904.52 $1,904.52 —
New patient office visit, about 60 minutes inpatient CPT 99205 OP VISIT NEW PT LEVEL V $1,868.43 $1,868.43 $1,868.43 —
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITIONAL CONS PER 15 MIN $61.59 $61.59 $61.59 —
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY 60 MIN $230.04 $230.04 $230.04 —
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY 45 MIN $657.28 $657.28 $657.28 —
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW COMPLEXITY $657.28 $657.28 $657.28 —
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MOD COMPLEXITY $657.28 $657.28 $657.28 —
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES $121.85 $121.85 $121.85 —
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TRANSTRACHIAL FOLLOW UP $468.90 $468.90 $468.90 —
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP VISIT EST PT LEVEL III $118.45 $118.45 $118.45 —
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP VISIT EST PT LEVEL IV $752.58 $752.58 $752.58 —
Speech therapy session, individual inpatient CPT 92507 SPEECH/LANG THERAPY 30 MIN $167.79 $167.79 $167.79 —
Speech therapy session, individual inpatient CPT 92507 PASSY MUIR VALVE ASSIST $296.70 $296.70 $296.70 —
Speech therapy session, individual inpatient CPT 92507 SPEECH/LANGUAGE THER 60 MIN $316.51 $316.51 $316.51 —
Speech therapy session, individual inpatient CPT 92507 SPEECH/LANGUAGE THER 45 MIN $337.46 $337.46 $337.46 —
Spirometry (breathing test) inpatient CPT 94010 INCENTIVE SPIRO TX $198.40 $198.40 $198.40 —
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY/PFT SIMPLE $239.66 $239.66 $239.66 —
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM EVALUATION $95.15 $95.15 $95.15 —
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODIL RESPONSE-PRE & POST $95.15 $95.15 $95.15 —

Vaccines

ProcedureCash price List priceInsurers payOff list
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE LIVE SOL $2,628.50 $2,628.50 $2,628.50 —
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 CONJ VACC SOL $924.00 $924.00 $924.00 —
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DPT TOX-PED SUS $182.00 $182.00 $182.00 —
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE SUS $162.45 $162.45 $162.45 —

Source file: https://www.vmfhrehabhospital.com/docs/zirfvirginiamasonfranciscanhealthrehabilitationhospitallibraries/mar2026/813725123_franciscan-specialty-care-llc_standardcharges.csv.zip