St. Mary�s Medical Center
St. Mary�s Medical Center in Huntington, WV publishes cash prices for 40 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
2900 First Avenue, Huntington, WV 25702 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 CT Abdomen Pelvis w IV and Oral Contrast | $4,836.42 | $4,836.42 | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis w IV Contrast Only | $4,836.42 | $4,836.42 | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Dummy Order CT Abdomen Pelvis w IV Contrast Only | $4,836.42 | $4,836.42 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis w IV and Oral Contrast | $4,836.42 | $4,836.42 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Dummy Order CT Abdomen Pelvis w IV Contrast Only | $4,836.42 | $4,836.42 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis w IV Contrast Only | $4,836.42 | $4,836.42 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Contrast | $3,309.79 | $3,309.79 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain w/o Contrast | $3,309.79 | $3,309.79 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w IV Contrast | $2,421.91 | $2,421.91 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w IV Contrast | $2,421.91 | $2,421.91 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilat w/CAD | $522.60 | $522.60 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Combo Diagnostic Bilat w CAD | $522.60 | $522.60 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Combo Diag Implant Bilat w CAD | $522.60 | $522.60 | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Combo Diag Implant Bilat w CAD | $522.60 | $522.60 | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Combo Diagnostic Bilat w CAD | $522.60 | $522.60 | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilat w/CAD | $522.60 | $522.60 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE Joint w/o Contrast Left | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LE Joint w/o Contrast Right | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE Joint w/o Contrast Right | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LE Joint w/o Contrast Left | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right | $4,155.46 | $4,155.46 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w + wo IV Contrast Right | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w+ wo IV Contrast Left | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w + wo IV Contrast Right | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w + wo IV Contrast Left | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w + wo IV Contrast Right | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w + wo IV Contrast Left | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w+ wo IV Contrast Left | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w + wo IV Contrast Left | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w + wo IV Contrast Right | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w + wo IV Contrast Left | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w + wo IV Contrast Right | $5,823.55 | $5,823.55 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w + wo IV Contrast Right | $5,823.55 | $5,823.55 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast Limited | $3,623.36 | $3,623.36 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $3,623.36 | $3,623.36 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain IAC w/o Contrast | $3,623.36 | $3,623.36 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast Limited | $3,623.36 | $3,623.36 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain IAC w/o Contrast | $3,623.36 | $3,623.36 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast | $3,623.36 | $3,623.36 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Pituitary w + wo IV Contrast | $6,164.56 | $6,164.56 | — |
| MRI of the brain, with and without contrast dye CPT 70553 Dummy Order MRI Brain w + wo IV Contrast | $6,164.56 | $6,164.56 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w + wo IV Contrast | $6,164.56 | $6,164.56 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain IAC w + wo IV Contrast | $6,164.56 | $6,164.56 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain IAC w + wo IV Contrast | $6,164.56 | $6,164.56 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w + wo IV Contrast | $6,164.56 | $6,164.56 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Pituitary w + wo IV Contrast | $6,164.56 | $6,164.56 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Dummy Order MRI Brain w + wo IV Contrast | $6,164.56 | $6,164.56 | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $3,421.71 | $3,421.71 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast | $3,421.71 | $3,421.71 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Fetal > 14 Wks Single | $1,163.45 | $1,163.45 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Fetal Twins > 14 Wks | $1,163.45 | $1,163.45 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Fetal > 14 Wks Single | $1,163.45 | $1,163.45 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Fetal Twins > 14 Wks | $1,163.45 | $1,163.45 | — |
| Screening mammogram, both breasts both sides CPT 77067 MG Combo Screen Implant Bilat w CAD | $363.18 | $363.18 | — |
| Screening mammogram, both breasts both sides CPT 77067 MG Combo Screening Bilat w CAD | $363.18 | $363.18 | — |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screen Bilateral (Foundation) | $398.02 | $398.02 | — |
| Screening mammogram, both breasts CPT 77067 MG Mammo Screening w/CAD | $363.18 | $363.18 | — |
| Screening mammogram, both breasts one side CPT 77067 MG Combo Screening Lt w CAD | $181.59 | $181.59 | — |
| Screening mammogram, both breasts one side CPT 77067 MG Combo Screening Rt w CAD | $181.59 | $181.59 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Combo Screening Bilat w CAD | $363.18 | $363.18 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Combo Screen Implant Bilat w CAD | $363.18 | $363.18 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screen Bilateral (Foundation) | $398.02 | $398.02 | — |
| Screening mammogram, both breasts inpatient CPT 77067 MG Mammo Screening w/CAD | $363.18 | $363.18 | — |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Combo Screening Rt w CAD | $181.59 | $181.59 | — |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Combo Screening Lt w CAD | $181.59 | $181.59 | — |
| Sleep study in a lab (polysomnography) CPT 95810 In-Lab Dx Sleep Study | $5,170.04 | $5,170.04 | — |
| Sleep study in a lab (polysomnography) CPT 95810 PED EEG Polysomngraphy greater than 6 years | $5,170.04 | $5,170.04 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 In-Lab Dx Sleep Study | $5,170.04 | $5,170.04 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PED EEG Polysomngraphy greater than 6 years | $5,170.04 | $5,170.04 | — |
| Transvaginal pelvic ultrasound CPT 76830 US Pelvis Transvaginal Non OB | $1,163.45 | $1,163.45 | — |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB w Doppler | $1,163.45 | $1,163.45 | — |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $1,163.45 | $1,163.45 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB w Doppler | $1,163.45 | $1,163.45 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB | $1,163.45 | $1,163.45 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvis Transvaginal Non OB | $1,163.45 | $1,163.45 | — |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $1,163.45 | $1,163.45 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $1,163.45 | $1,163.45 | — |
| X-ray of the lower back, 4 or more views CPT 72110 CR Spine Lumbar w/ Flex/Ext | $616.56 | $616.56 | — |
| X-ray of the lower back, 4 or more views CPT 72110 CR Spine Lumbar w/Obliques | $616.56 | $616.56 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 CR Spine Lumbar w/Obliques | $616.56 | $616.56 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 CR Spine Lumbar w/ Flex/Ext | $616.56 | $616.56 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel-LC | $73.90 | $73.90 | — |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $73.90 | $73.90 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $73.90 | $73.90 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel-LC | $73.90 | $73.90 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $117.19 | $117.19 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LDL-P | $117.19 | $117.19 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Cholesterol | $117.19 | $117.19 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel-LC | $172.62 | $172.62 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LDL-P | $117.19 | $117.19 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Cholesterol | $117.19 | $117.19 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $117.19 | $117.19 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel-LC | $172.62 | $172.62 | — |
| Complete blood count (CBC) with differential CPT 85025 CBC Manual Diff | $67.57 | $67.57 | — |
| Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/ Automated Differential | $67.57 | $67.57 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/ Automated Differential | $67.57 | $67.57 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC Manual Diff | $67.57 | $67.57 | — |
| Complete blood count (CBC), no differential CPT 85027 CBCND | $77.07 | $77.07 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBCND | $77.07 | $77.07 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel-LC | $91.85 | $91.85 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $91.85 | $91.85 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 AddCMP | $91.85 | $91.85 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel-LC | $91.85 | $91.85 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $91.85 | $91.85 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 AddCMP | $91.85 | $91.85 | — |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $74.96 | $74.96 | — |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $74.96 | $74.96 | — |
| Liver function blood test panel CPT 80076 Liver Panel LC | $67.81 | $67.81 | — |
| Liver function blood test panel CPT 80076 Liver | $69.69 | $69.69 | — |
| Liver function blood test panel inpatient CPT 80076 Liver Panel LC | $67.81 | $67.81 | — |
| Liver function blood test panel inpatient CPT 80076 Liver | $69.69 | $69.69 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Free PSA | $157.31 | $157.31 | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Free PSA | $157.31 | $157.31 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen | $157.31 | $157.31 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Medicare | $157.31 | $157.31 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Followup | $157.31 | $157.31 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen | $157.31 | $157.31 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Followup | $157.31 | $157.31 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Medicare | $157.31 | $157.31 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 DRVVT Mix | $53.84 | $53.84 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromblastin Time | $53.84 | $53.84 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $53.84 | $53.84 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT (POC) Meter | $53.84 | $53.84 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT - LC | $91.51 | $91.51 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT (POC) Meter | $53.84 | $53.84 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 DRVVT Mix | $53.84 | $53.84 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromblastin Time | $53.84 | $53.84 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $53.84 | $53.84 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT - LC | $91.51 | $91.51 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 INR POC | $13.73 | $13.73 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 Prothrombin time test | $13.73 | $13.73 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 .PT/INR POC | $32.73 | $32.73 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $42.23 | $42.23 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin and INR POC | $42.23 | $42.23 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 Prothrombin time test | $13.73 | $13.73 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR POC | $13.73 | $13.73 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .PT/INR POC | $32.73 | $32.73 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $42.23 | $42.23 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin and INR POC | $42.23 | $42.23 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH-Third Generation | $143.58 | $143.58 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $143.58 | $143.58 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH-Third Generation | $143.58 | $143.58 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $143.58 | $143.58 | — |
| Urinalysis with microscope exam, automated CPT 81001 UA Trich | $28.48 | $28.48 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA Trich | $28.48 | $28.48 | — |
| Urinalysis with microscope exam, manual CPT 81000 Urine Ketones | $28.50 | $28.50 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urine Ketones | $28.50 | $28.50 | — |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Automated POC | $8.45 | $8.45 | — |
| Urinalysis without microscope exam, automated CPT 81003 UA w/o Microscopic | $21.12 | $21.12 | — |
| Urinalysis without microscope exam, automated CPT 81003 UA w Cult if Ind | $21.12 | $21.12 | — |
| Urinalysis without microscope exam, automated CPT 81003 UA Routine | $21.12 | $21.12 | — |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Automated | $21.12 | $21.12 | — |
| Urinalysis without microscope exam, automated CPT 81003 Glucose Urine qual | $21.12 | $21.12 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Automated POC | $8.45 | $8.45 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA Routine | $21.12 | $21.12 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine Automated | $21.12 | $21.12 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Glucose Urine qual | $21.12 | $21.12 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA w/o Microscopic | $21.12 | $21.12 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA w Cult if Ind | $21.12 | $21.12 | — |
| Urinalysis without microscope exam, manual CPT 81002 Occult Blood Urine | $7.15 | $7.15 | — |
| Urinalysis without microscope exam, manual CPT 81002 Glucose Urine Qual | $7.15 | $7.15 | — |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dipstick POC | $7.39 | $7.39 | — |
| Urinalysis without microscope exam, manual CPT 81002 Dipstick Urine POC | $7.39 | $7.39 | — |
| Urinalysis without microscope exam, manual CPT 81002 Specific Gravity Ur DrgScr 788901-LC | $51.73 | $51.73 | — |
| Urinalysis without microscope exam, manual CPT 81002 Specific Gravity | $51.73 | $51.73 | — |
| Urinalysis without microscope exam, manual CPT 81002 Ketones Urine | $51.73 | $51.73 | — |
| Urinalysis without microscope exam, manual CPT 81002 pH Urine | $51.73 | $51.73 | — |
| Urinalysis without microscope exam, manual CPT 81002 Urine pH | $157.31 | $157.31 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Glucose Urine Qual | $7.15 | $7.15 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Occult Blood Urine | $7.15 | $7.15 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Dipstick Urine POC | $7.39 | $7.39 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dipstick POC | $7.39 | $7.39 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Specific Gravity Ur DrgScr 788901-LC | $51.73 | $51.73 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Specific Gravity | $51.73 | $51.73 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 pH Urine | $51.73 | $51.73 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Ketones Urine | $51.73 | $51.73 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine pH | $157.31 | $157.31 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821 Discission of secondary membran | $1,699.77 | $1,699.77 | — |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821 Discission of secondary membran | $1,699.77 | $1,699.77 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 62323 IT Inj with imaging guidance | $716.86 | $716.86 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323 IT Inj with imaging guidance | $716.86 | $716.86 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 62322 IT Inj without imaging guidance | $937.51 | $937.51 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 62322 IT Inj without imaging guidance | $937.51 | $937.51 | — |
| Prostate biopsy CPT 55700 55700 Biopsy, prostate, needle or pun | $840.38 | $840.38 | — |
| Prostate biopsy inpatient CPT 55700 55700 Biopsy, prostate, needle or pun | $840.38 | $840.38 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 90847 Family psytx w/pt 50 min | $101.35 | $101.35 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 Family psytx w/pt 50 min | $101.35 | $101.35 | — |
| Group psychotherapy session CPT 90853 90853 Group Therapy | $57.01 | $57.01 | — |
| Group psychotherapy session inpatient CPT 90853 90853 Group Therapy | $57.01 | $57.01 | — |
| Psychotherapy session, 30 minutes CPT 90832 90832 Psychotherapy, 30 Mins | $76.27 | $76.27 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 90832 Psychotherapy, 30 Mins | $76.27 | $76.27 | — |
| Psychotherapy session, 45 minutes CPT 90834 90834 Psychotherapy, 45 Mins | $100.53 | $100.53 | — |
| Psychotherapy session, 45 minutes CPT 90834 90834 Video/Audio Telehealth, Psychot | $100.53 | $100.53 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 90834 Video/Audio Telehealth, Psychot | $100.53 | $100.53 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 90834 Psychotherapy, 45 Mins | $100.53 | $100.53 | — |
| Psychotherapy session, 60 minutes CPT 90837 90837 Psychotherapy, 60 Mins | $148.25 | $148.25 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 90837 Psychotherapy, 60 Mins | $148.25 | $148.25 | — |
Source file: https://www.st-marys.org/static/550357050_St-Marys-Medical-Center_standardcharges.csv