Hospital Grand Rapids-Wyoming-Kentwood, MI

Mary Free Bed Rehabilitation Hospital

Mary Free Bed Rehabilitation Hospital in Grand Rapids, MI publishes cash prices for 39 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.

235 Wealthy St SE, Grand Rapids, MI 49503 Collected Sep 22, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HCHG CT ABD/PELVIS W/CONTRAST $2,968.00 $2,968.00
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HCHG CT HEAD W/O CONTRAST $1,148.00 $1,148.00
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HCHG CT PELVIS W/ CONTRAST $1,575.00 $1,575.00
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HCHG MG BREAST DIAGNOSTIC BILATERAL $433.00 $433.00
Diagnostic mammogram, one breast inpatient one side CPT 77065 HCHG MG BREAST DIAGNOSTIC UNILAT LT $328.00 $328.00
Diagnostic mammogram, one breast inpatient one side CPT 77065 HCHG MG BREAST DIAGNOSTIC UNILAT RT $328.00 $328.00
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HCHG MRI EXTRE LOW JNT ONLY W/O CONT BIL $3,314.00 $3,314.00
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HCHG MRI EXTRE LOW JNT ONLY W/O CONT RT $2,209.00 $2,209.00
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HCHG MRI EXTRE LOW JNT ONLY W/O CONT LT $2,209.00 $2,209.00
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HCHG O/S MRI LOWER EXT JOINT W/WO CONT $4,416.00 $4,416.00
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HCHG MRI EXTRE LOW JT ONLY W/O W/CONT LT $2,944.00 $2,944.00
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HCHG MRI EXTRE LOW JT ONLY W/O W/CONT RT $2,944.00 $2,944.00
MRI of the brain, no contrast dye inpatient CPT 70551 HCHG MRI BRAIN W/O CONTR $2,008.00 $2,008.00
MRI of the brain, with and without contrast dye inpatient CPT 70553 HCHG MRI BRAIN W/O W/ CONTRAST $3,022.00 $3,022.00
MRI of the lower back, no contrast dye inpatient CPT 72148 HCHG MRI SPINE LUMBAR/SACRUM WO CONT $2,279.00 $2,279.00
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HCHG US OB PREG >14 WEEKS SINGLE GEST $677.00 $677.00
Screening mammogram, both breasts inpatient both sides CPT 77067 HCHG MG BREAST SCREEN BILATERAL $352.00 $352.00
Sleep study in a lab (polysomnography) inpatient CPT 95810 HCHG SLEEP LAB CONSULTATI0N $3,929.00 $3,929.00
Transvaginal pelvic ultrasound inpatient CPT 76830 HCHG HC US TRANSVAGINAL NON OBSTETRIC $500.00 $500.00
Transvaginal pelvic ultrasound inpatient CPT 76830 HCHG US ENDO/TRANS VAGINAL $500.00 $500.00
Ultrasound of the abdomen, complete inpatient CPT 76700 HCHG US ABDOMEN COMPLETE $738.00 $738.00
X-ray of the lower back, 4 or more views CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS $95.00 $95.00
X-ray of the lower back, 4 or more views inpatient CPT 72110 HCHG HC XR LUMBOSACRAL SPINE >= 4 VIEWS $440.00 $440.00

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) inpatient CPT 80048 HCHG BASIC METABOLIC PANEL $55.00 $55.00
Basic metabolic panel (blood test) inpatient CPT 80048 HCHG HC BASIC METABOLIC PANEL (CALCIUM TOTAL) $67.00 $67.00
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HCHG LIPID PANEL $83.00 $83.00
Complete blood count (CBC) with differential inpatient CPT 85025 HCHG CBC W/AUTO DIFF $56.00 $56.00
Complete blood count (CBC) with differential inpatient CPT 85025 HCHG CBC WITH AUTO DIFFERENTIAL $56.00 $56.00
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC AUTOMATED/DIFFERENTIAL WBC AUTOMATED $63.00 $63.00
Complete blood count (CBC), no differential inpatient CPT 85027 HCHG COMPLETE BLOOD COUNT NO DIFF $37.00 $37.00
Complete blood count (CBC), no differential inpatient CPT 85027 HCHG CBC COUNTS $39.00 $39.00
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HCHG COMPREHENSIVE METABOLIC PANEL $76.00 $76.00
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HCHG HC COMPREHENSIVE METABOLIC PANEL $96.00 $96.00
Kidney function blood test panel inpatient CPT 80069 HCHG RENAL FUNCTION PANEL $76.00 $76.00
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL $91.00 $91.00
Liver function blood test panel inpatient CPT 80076 HCHG HEPATIC FUNCTION PANEL $82.00 $82.00
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL $104.00 $104.00
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HCHG THROMBOPLASTIN TIME PART $56.00 $56.00
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC WARDE 2500780 THROMBOPLASTIN TIME PARTIAL (PTT) $56.00 $56.00
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HCHG PROTHROMBIN TIME 1 $33.00 $33.00
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HCHG PROTHROMBIN TIME $38.00 $38.00
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME $38.00 $38.00
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POCT PROTHROMBIN TIME $38.00 $38.00
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HCHG THYROID STIMULATING HORMONE $103.00 $103.00
Urinalysis with microscope exam, automated inpatient CPT 81001 HCHG BILL UA AUTO WITH MICRO $42.00 $42.00
Urinalysis without microscope exam, automated inpatient CPT 81003 HCHG UA W/O MICRO AUTOMATED $24.00 $24.00

Surgery and procedures

ProcedureCash price List priceOff list
Lower-back epidural injection, with imaging guidance CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $460.00 $460.00
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN $837.00 $837.00
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HCHG IR CISTERNOGRAM-FLUORO/INJ $862.00 $862.00
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HCHG XR CISTERNOGRAM-FLUORO/INJ $862.00 $862.00
Lower-back epidural injection, without imaging guidance CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN $240.00 $240.00
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN $531.00 $531.00
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $1,490.00 $1,490.00
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL $532.00 $532.00
Prostate biopsy inpatient CPT 55700 HCHG SC>BIOPSY PROSTATE $2,350.00 $2,350.00

Doctor visits and therapy

ProcedureCash price List priceOff list
New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES $400.00 $400.00
New patient office visit, about 30 minutes inpatient CPT 99203 HCHG NEW PT CLINIC LEVEL 3 $350.00 $350.00
New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES $475.00 $475.00
New patient office visit, about 45 minutes inpatient CPT 99204 HCHG NEW PT CLINIC LEVEL 4 $533.00 $533.00
New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES $575.00 $575.00
New patient office visit, about 60 minutes inpatient CPT 99205 HCHG NEW PT CLINIC LEVEL 5 $662.00 $662.00
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES $117.00 $117.00
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HCHG OT THERAPEUTIC EXERCISE $123.00 $123.00
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HCHG PT THERAPEUTIC EXERCISE $123.00 $123.00
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HCHG MT THERAPEUTIC EXERCISE $123.00 $123.00
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG PT THERAPEUTIC EXERCISE $123.00 $123.00
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG OT THERAPEUTIC EXERCISE $123.00 $123.00
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG MT THERAPEUTIC EXERCISE $123.00 $123.00
Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES $185.00 $185.00
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES $255.00 $255.00

Source file: https://www.maryfreebed.com/wp-content/uploads/2025/03/381359265_mary-free-bed-rehabilitation-hospital_standardcharges.csv