Hospital Williston, ND

Mercy Medical Center

Mercy Medical Center in Williston, ND publishes cash prices for 60 common procedures listed here, from its own machine-readable price file updated Feb 28, 2026. Click a procedure to compare it with other hospitals nearby.

1301 15th Avenue West, Williston, ND 58801 Collected Sep 23, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
CT scan of abdomen and pelvis, with contrast dye CPT 74177 ABDOMEN PELVIS W CONT $2,481.24 $4,278.00 42%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ABDOMEN PELVIS W CONT $2,481.24 $4,278.00 42%
CT scan of the head or brain, no contrast dye CPT 70450 HEAD WO CONT $888.56 $1,532.00 42%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HEAD WO CONT $888.56 $1,532.00 42%
CT scan of the pelvis, with contrast dye CPT 72193 PELVIS W CONT $1,219.74 $2,103.00 42%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 PELVIS W CONT $1,219.74 $2,103.00 42%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC DIGITAL BI PF $102.66 $177.00 42%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC DIGITAL BI $470.38 $811.00 42%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC DIGITAL BI PF $102.66 $177.00 42%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC DIGITAL BI $470.38 $811.00 42%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC DIGITAL LT PF $82.36 $142.00 42%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC DIGITAL LT $385.70 $665.00 42%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAGNOSTIC DIGITAL LT PF $82.36 $142.00 42%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAGNOSTIC DIGITAL LT $385.70 $665.00 42%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 ANKLE WO CONT BI PF $259.84 $448.00 42%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 ANKLE WO CONT BI $2,326.38 $4,011.00 42%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 ACHILLES WO CONT LT $1,615.30 $2,785.00 42%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 ANKLE WO CONT BI PF $259.84 $448.00 42%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 ANKLE WO CONT BI $2,326.38 $4,011.00 42%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 ACHILLES WO CONT LT $1,615.30 $2,785.00 42%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 ANKLE W WO CONT BI PF $407.74 $703.00 42%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 ANKLE W WO CONT BI $4,975.24 $8,578.00 42%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 ACHILLES W WO CONT LT $3,295.56 $5,682.00 42%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 ANKLE W WO CONT BI PF $407.74 $703.00 42%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 ANKLE W WO CONT BI $4,975.24 $8,578.00 42%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 ACHILLES W WO CONT LT $3,295.56 $5,682.00 42%
MRI of the brain, no contrast dye CPT 70551 BRAIN WO CONT PF $171.68 $296.00 42%
MRI of the brain, no contrast dye CPT 70551 BRAIN WO CONT $1,675.04 $2,888.00 42%
MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN WO CONT PF $171.68 $296.00 42%
MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN WO CONT $1,675.04 $2,888.00 42%
MRI of the brain, with and without contrast dye CPT 70553 BRAIN W WO CONT PF $272.60 $470.00 42%
MRI of the brain, with and without contrast dye CPT 70553 BRAIN W WO CONT $3,284.54 $5,663.00 42%
MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN W WO CONT PF $272.60 $470.00 42%
MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN W WO CONT $3,284.54 $5,663.00 42%
MRI of the lower back, no contrast dye CPT 72148 LUMBAR SPINE COMP WO CONT PF $171.68 $296.00 42%
MRI of the lower back, no contrast dye CPT 72148 LUMBAR SPINE COMP WO CONT $1,643.72 $2,834.00 42%
MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR SPINE COMP WO CONT PF $171.68 $296.00 42%
MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR SPINE COMP WO CONT $1,643.72 $2,834.00 42%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB 2 OR 3 TRI SGL 1ST GEST PF $115.42 $199.00 42%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB 2 OR 3 TRI SGL 1ST GEST $389.18 $671.00 42%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB 2 OR 3 TRI SGL 1ST GEST PF $115.42 $199.00 42%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB 2 OR 3 TRI SGL 1ST GEST $389.18 $671.00 42%
Screening mammogram, both breasts both sides CPT 77067 SCREENING DIGITAL BI PF $82.36 $142.00 42%
Screening mammogram, both breasts both sides CPT 77067 SCREENING DIGITAL BI $339.88 $586.00 42%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING DIGITAL BI PF $82.36 $142.00 42%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING DIGITAL BI $339.88 $586.00 42%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY $2,029.42 $3,499.00 42%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY $2,029.42 $3,499.00 42%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL NON OB PF $81.78 $141.00 42%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL NON OB $389.18 $671.00 42%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL NON OB PF $81.78 $141.00 42%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL NON OB $389.18 $671.00 42%
Ultrasound of the abdomen, complete CPT 76700 ABDOMEN COMP PF $95.12 $164.00 42%
Ultrasound of the abdomen, complete CPT 76700 ABDOMEN COMP $509.82 $879.00 42%
Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMEN COMP PF $95.12 $164.00 42%
Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMEN COMP $509.82 $879.00 42%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE MIN 4V $262.74 $453.00 42%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE MIN 4V $262.74 $453.00 42%

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) CPT 80048 TEST - FAC SPECIFIC CODE $73.66 $127.00 42%
Basic metabolic panel (blood test) CPT 80048 BMP $75.40 $130.00 42%
Basic metabolic panel (blood test) inpatient CPT 80048 TEST - FAC SPECIFIC CODE $73.66 $127.00 42%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP $75.40 $130.00 42%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PNL $35.38 $61.00 42%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID $87.00 $150.00 42%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE $89.32 $154.00 42%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PNL $35.38 $61.00 42%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID $87.00 $150.00 42%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE $89.32 $154.00 42%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF $61.48 $106.00 42%
Complete blood count (CBC) with differential CPT 85025 CBC W/MANUAL DIFF $190.24 $328.00 42%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF $61.48 $106.00 42%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/MANUAL DIFF $190.24 $328.00 42%
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF $59.74 $103.00 42%
Complete blood count (CBC), no differential CPT 85027 CBC WITH MAN DIFF $90.48 $156.00 42%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFF $59.74 $103.00 42%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITH MAN DIFF $90.48 $156.00 42%
Comprehensive metabolic panel (blood test) CPT 80053 CMP $87.58 $151.00 42%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP $87.58 $151.00 42%
Kidney function blood test panel CPT 80069 RENAL PROFILE $61.48 $106.00 42%
Kidney function blood test panel inpatient CPT 80069 RENAL PROFILE $61.48 $106.00 42%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL $47.56 $82.00 42%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION $78.30 $135.00 42%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL $47.56 $82.00 42%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION $78.30 $135.00 42%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE $32.00 $55.17 42%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA $77.72 $134.00 42%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE $32.00 $55.17 42%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA $77.72 $134.00 42%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN $32.00 $55.17 42%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC $104.40 $180.00 42%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSITC $110.20 $190.00 42%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN SCRE $117.74 $203.00 42%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN $32.00 $55.17 42%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC $104.40 $180.00 42%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSITC $110.20 $190.00 42%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN SCRE $117.74 $203.00 42%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA SCREEN (PTT-D) $10.46 $18.03 42%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT $54.52 $94.00 42%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA SCREEN (PTT-D) $10.46 $18.03 42%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT $54.52 $94.00 42%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME $7.47 $12.87 42%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME/INR IMC $7.54 $13.00 42%
Prothrombin time (PT/INR) clotting test CPT 85610 APS - PT $33.64 $58.00 42%
Prothrombin time (PT/INR) clotting test CPT 85610 PT $35.38 $61.00 42%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME/INR $38.86 $67.00 42%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME $7.47 $12.87 42%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME/INR IMC $7.54 $13.00 42%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 APS - PT $33.64 $58.00 42%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT $35.38 $61.00 42%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME/INR $38.86 $67.00 42%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE $29.24 $50.40 42%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CONG HYPOTHYROIDISM $87.00 $150.00 42%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID FUNCTION CASCADE S $110.20 $190.00 42%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH $116.00 $200.00 42%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE $29.24 $50.40 42%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CONG HYPOTHYROIDISM $87.00 $150.00 42%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID FUNCTION CASCADE S $110.20 $190.00 42%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH $116.00 $200.00 42%
Urinalysis with microscope exam, automated CPT 81001 UA MICROSCOPIC $25.52 $44.00 42%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICROSCOPIC $33.06 $57.00 42%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA MICROSCOPIC $25.52 $44.00 42%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICROSCOPIC $33.06 $57.00 42%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS BY DIP STICK $17.40 $30.00 42%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS BY DIP STICK $17.40 $30.00 42%
Urinalysis without microscope exam, automated CPT 81003 UA W/O MICROSCOPIC $22.62 $39.00 42%
Urinalysis without microscope exam, automated CPT 81003 PROTEIN URINE $39.44 $68.00 42%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA W/O MICROSCOPIC $22.62 $39.00 42%
Urinalysis without microscope exam, automated inpatient CPT 81003 PROTEIN URINE $39.44 $68.00 42%

Surgery and procedures

ProcedureCash price List priceOff list
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W LESION REM SC PF $737.18 $1,271.00 42%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W LESION REM SC PF $737.18 $1,271.00 42%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY SC PF $704.70 $1,215.00 42%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY AND BIOPSY SC PF $704.70 $1,215.00 42%
Colonoscopy, diagnostic CPT 45378 SCREEN COLON-HI RISK SC PF $554.48 $956.00 42%
Colonoscopy, diagnostic CPT 45378 SCREEN COLON-NON HI RISK SC PF $555.06 $957.00 42%
Colonoscopy, diagnostic inpatient CPT 45378 SCREEN COLON-HI RISK SC PF $554.48 $956.00 42%
Colonoscopy, diagnostic inpatient CPT 45378 SCREEN COLON-NON HI RISK SC PF $555.06 $957.00 42%
Gallbladder removal, laparoscopic CPT 47562 LAP CHOLE ASSIST SC OR PF $1,045.16 $1,802.00 42%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAP CHOLE ASSIST SC OR PF $1,045.16 $1,802.00 42%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR HERNIA INITIAL 5+YR ER PF $822.44 $1,418.00 42%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR HERNIA INITIAL 5+YR SC OR $833.46 $1,437.00 42%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR HERNIA INITIAL 5+YR ER PF $822.44 $1,418.00 42%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR HERNIA INITIAL 5+YR SC OR $833.46 $1,437.00 42%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY SURG ORT OR $890.30 $1,535.00 42%
Knee arthroscopy with meniscus trim inpatient CPT 29881 KNEE ARTHROSCOPY SURG ORT OR $890.30 $1,535.00 42%
Lower-back epidural injection, with imaging guidance CPT 62323 EPIDURAL STEROID INJ W GUID PF $143.84 $248.00 42%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTRLM LMBR/SAC WIMG PM OR $589.86 $1,017.00 42%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ LUMBAR EPIDURAL WO GUIDE $1,172.76 $2,022.00 42%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 EPIDURAL STEROID INJ W GUID PF $143.84 $248.00 42%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTRLM LMBR/SAC WIMG PM OR $589.86 $1,017.00 42%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ LUMBAR EPIDURAL WO GUIDE $1,172.76 $2,022.00 42%
Lower-back epidural injection, without imaging guidance CPT 62322 EPIDURAL STEROID INJ WO GUI PF $143.84 $248.00 42%
Lower-back epidural injection, without imaging guidance CPT 62322 CRNA EPIDURAL/SINGLE $194.88 $336.00 42%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ LUMBAR EPIDU WO GUIDE CRNA $200.68 $346.00 42%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ LUMBAR EPIDURL WO GUIDE PF $200.68 $346.00 42%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ LUMB EPIDURAL WO GUIDE PF $304.50 $525.00 42%
Lower-back epidural injection, without imaging guidance CPT 62322 EPIDURAL STEROID INJ WO GUIDE $1,172.76 $2,022.00 42%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 EPIDURAL STEROID INJ WO GUI PF $143.84 $248.00 42%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 CRNA EPIDURAL/SINGLE $194.88 $336.00 42%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ LUMBAR EPIDU WO GUIDE CRNA $200.68 $346.00 42%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ LUMBAR EPIDURL WO GUIDE PF $200.68 $346.00 42%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ LUMB EPIDURAL WO GUIDE PF $304.50 $525.00 42%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 EPIDURAL STEROID INJ WO GUIDE $1,172.76 $2,022.00 42%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 INJ FORAM EPI LUM SAC BI PM PF $1,187.84 $2,048.00 42%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPI LUM SAC PM PF $593.92 $1,024.00 42%
Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 INJ FORAM EPI LUM SAC BI PM PF $1,187.84 $2,048.00 42%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMEN EPI LUM SAC PM PF $593.92 $1,024.00 42%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE URC PF $248.82 $429.00 42%
Prostate biopsy inpatient CPT 55700 BIOPSY OF PROSTATE URC PF $248.82 $429.00 42%
Removal of a breast lump, open surgery CPT 19120 REMOVAL BREAST LESION SC OR $841.58 $1,451.00 42%
Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL BREAST LESION SC OR $841.58 $1,451.00 42%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHO ARTHRS SRG DECOMP ORT OR $270.28 $466.00 42%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SHO ARTHRS SRG DECOMP ORT OR $270.28 $466.00 42%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY ORT PF $2,059.58 $3,551.00 42%
Total hip replacement inpatient CPT 27130 TOTAL HIP ARTHROPLASTY ORT PF $2,059.58 $3,551.00 42%
Total knee replacement CPT 27447 TOTAL KNEE ARTHOPLAS ORT OR PF $2,056.68 $3,546.00 42%
Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHOPLAS ORT OR PF $2,056.68 $3,546.00 42%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD FLEX W BIOPSY SUR PF $610.74 $1,053.00 42%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD FLEX W BIOPSY SUR PF $610.74 $1,053.00 42%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY DIAG SC OR $450.66 $777.00 42%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPR GI ENDOSCOPY DIAG SC OR $450.66 $777.00 42%

Doctor visits and therapy

ProcedureCash price List priceOff list
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG ROUT 12+ LEADS I&R IM (P) $23.20 $40.00 42%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG ROUT 12+ LEADS I&R IM (P) $23.20 $40.00 42%
Family therapy with the patient, 50 minutes CPT 90847 FAM PSYTX W PT 50 MIN SLS $490.10 $845.00 42%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAM PSYTX W PT 50 MIN SLS $490.10 $845.00 42%
Family therapy without the patient, 50 minutes CPT 90846 FAM PSYTX W/O PT 50 MIN SLS $466.90 $805.00 42%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAM PSYTX W/O PT 50 MIN SLS $466.90 $805.00 42%
Group psychotherapy session CPT 90853 GROUP PSYTX SLS $426.30 $735.00 42%
Group psychotherapy session inpatient CPT 90853 GROUP PSYTX SLS $426.30 $735.00 42%
New patient office visit, about 30 minutes CPT 99203 OFF/OP VISIT NEW LVL 3 URC FAC $45.82 $79.00 42%
New patient office visit, about 30 minutes CPT 99203 OFF/OP VISIT NEW LVL 3 ONC $59.74 $103.00 42%
New patient office visit, about 30 minutes CPT 99203 MD OP VISIT LIMITED/NEW PATIEN $102.08 $176.00 42%
New patient office visit, about 30 minutes CPT 99203 OFF/OP VISIT NEW LVL 3 URC PF $137.46 $237.00 42%
New patient office visit, about 30 minutes CPT 99203 OFF/OP VISIT NEW LVL 3 BH PF $137.46 $237.00 42%
New patient office visit, about 30 minutes CPT 99203 OFF/OP VIS NEW LVL 3 MEDONC PF $183.28 $316.00 42%
New patient office visit, about 30 minutes CPT 99203 OFF/OP NEW LVL3 TELEMED URC PF $183.28 $316.00 42%
New patient office visit, about 30 minutes CPT 99203 OFF/OP VISIT NEW LVL 3 BH (P) $183.28 $316.00 42%
New patient office visit, about 30 minutes inpatient CPT 99203 OFF/OP VISIT NEW LVL 3 URC FAC $45.82 $79.00 42%
New patient office visit, about 30 minutes inpatient CPT 99203 OFF/OP VISIT NEW LVL 3 ONC $59.74 $103.00 42%
New patient office visit, about 30 minutes inpatient CPT 99203 MD OP VISIT LIMITED/NEW PATIEN $102.08 $176.00 42%
New patient office visit, about 30 minutes inpatient CPT 99203 OFF/OP VISIT NEW LVL 3 BH PF $137.46 $237.00 42%
New patient office visit, about 30 minutes inpatient CPT 99203 OFF/OP VISIT NEW LVL 3 URC PF $137.46 $237.00 42%
New patient office visit, about 30 minutes inpatient CPT 99203 OFF/OP VISIT NEW LVL 3 BH (P) $183.28 $316.00 42%
New patient office visit, about 30 minutes inpatient CPT 99203 OFF/OP VIS NEW LVL 3 MEDONC PF $183.28 $316.00 42%
New patient office visit, about 30 minutes inpatient CPT 99203 OFF/OP NEW LVL3 TELEMED URC PF $183.28 $316.00 42%
New patient office visit, about 45 minutes CPT 99204 OFF/OP VISIT NEW LVL 4 URC FAC $68.44 $118.00 42%
New patient office visit, about 45 minutes CPT 99204 OFF/OP VISIT NEW LVL 4 ONC $89.90 $155.00 42%
New patient office visit, about 45 minutes CPT 99204 MD OUTPT/NEW PATIENT INTERM/EX $149.64 $258.00 42%
New patient office visit, about 45 minutes CPT 99204 OFF/OP VISIT NEW LVL 4 URC PF $205.90 $355.00 42%
New patient office visit, about 45 minutes CPT 99204 OFF/OP VISIT NEW LVL 4 BH PF $205.90 $355.00 42%
New patient office visit, about 45 minutes CPT 99204 OFF/OP VISIT NEW LVL 4 BH (P) $274.34 $473.00 42%
New patient office visit, about 45 minutes CPT 99204 OFF/OP VIS NEW LVL 4 MEDONC PF $274.34 $473.00 42%
New patient office visit, about 45 minutes CPT 99204 OFF/OP NEW LVL4 TELEMED URC PF $274.34 $473.00 42%
New patient office visit, about 45 minutes inpatient CPT 99204 OFF/OP VISIT NEW LVL 4 URC FAC $68.44 $118.00 42%
New patient office visit, about 45 minutes inpatient CPT 99204 OFF/OP VISIT NEW LVL 4 ONC $89.90 $155.00 42%
New patient office visit, about 45 minutes inpatient CPT 99204 MD OUTPT/NEW PATIENT INTERM/EX $149.64 $258.00 42%
New patient office visit, about 45 minutes inpatient CPT 99204 OFF/OP VISIT NEW LVL 4 URC PF $205.90 $355.00 42%
New patient office visit, about 45 minutes inpatient CPT 99204 OFF/OP VISIT NEW LVL 4 BH PF $205.90 $355.00 42%
New patient office visit, about 45 minutes inpatient CPT 99204 OFF/OP VISIT NEW LVL 4 BH (P) $274.34 $473.00 42%
New patient office visit, about 45 minutes inpatient CPT 99204 OFF/OP VIS NEW LVL 4 MEDONC PF $274.34 $473.00 42%
New patient office visit, about 45 minutes inpatient CPT 99204 OFF/OP NEW LVL4 TELEMED URC PF $274.34 $473.00 42%
New patient office visit, about 60 minutes CPT 99205 OFF/OP VISIT NEW LVL 5 URC FAC $90.48 $156.00 42%
New patient office visit, about 60 minutes CPT 99205 OFF/OP VISIT NEW LVL 5 ONC $112.52 $194.00 42%
New patient office visit, about 60 minutes CPT 99205 MD OP NEW PATIENT/COMPREHEN $197.78 $341.00 42%
New patient office visit, about 60 minutes CPT 99205 OFF/OP VISIT NEW LVL 5 BH PF $271.44 $468.00 42%
New patient office visit, about 60 minutes CPT 99205 OFF/OP VISIT NEW LVL 5 URC PF $271.44 $468.00 42%
New patient office visit, about 60 minutes CPT 99205 OFF/OP NEW LVL5 TELEMED URC PF $361.92 $624.00 42%
New patient office visit, about 60 minutes CPT 99205 OFF/OP VIS NEW LVL 5 MEDONC PF $361.92 $624.00 42%
New patient office visit, about 60 minutes CPT 99205 OFF/OP VISIT NEW LVL 5 BH (P) $361.92 $624.00 42%
New patient office visit, about 60 minutes inpatient CPT 99205 OFF/OP VISIT NEW LVL 5 URC FAC $90.48 $156.00 42%
New patient office visit, about 60 minutes inpatient CPT 99205 OFF/OP VISIT NEW LVL 5 ONC $112.52 $194.00 42%
New patient office visit, about 60 minutes inpatient CPT 99205 MD OP NEW PATIENT/COMPREHEN $197.78 $341.00 42%
New patient office visit, about 60 minutes inpatient CPT 99205 OFF/OP VISIT NEW LVL 5 BH PF $271.44 $468.00 42%
New patient office visit, about 60 minutes inpatient CPT 99205 OFF/OP VISIT NEW LVL 5 URC PF $271.44 $468.00 42%
New patient office visit, about 60 minutes inpatient CPT 99205 OFF/OP VIS NEW LVL 5 MEDONC PF $361.92 $624.00 42%
New patient office visit, about 60 minutes inpatient CPT 99205 OFF/OP NEW LVL5 TELEMED URC PF $361.92 $624.00 42%
New patient office visit, about 60 minutes inpatient CPT 99205 OFF/OP VISIT NEW LVL 5 BH (P) $361.92 $624.00 42%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE PROCEDURE/15 MIN. $94.54 $163.00 42%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT EXERCISE EA 15 MIN $94.54 $163.00 42%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT EXERCISE PROCEDURE/15 MIN. $94.54 $163.00 42%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT EXERCISE EA 15 MIN $94.54 $163.00 42%
Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW 18-39 WHCFAC $54.52 $94.00 42%
Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW 18-39 WHCPF $164.72 $284.00 42%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREV VISIT NEW 18-39 WHCFAC $54.52 $94.00 42%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREV VISIT NEW 18-39 WHCPF $164.72 $284.00 42%
Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW 40-64 OB FAC $63.22 $109.00 42%
Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW 40-64 OB PF $189.66 $327.00 42%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV VISIT NEW 40-64 OB FAC $63.22 $109.00 42%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV VISIT NEW 40-64 OB PF $189.66 $327.00 42%
Psychotherapy session, 30 minutes CPT 90832 BH THERAPY 30 MIN SLS $353.80 $610.00 42%
Psychotherapy session, 30 minutes inpatient CPT 90832 BH THERAPY 30 MIN SLS $353.80 $610.00 42%
Psychotherapy session, 45 minutes CPT 90834 BH THERAPY 45 MIN SLS $437.90 $755.00 42%
Psychotherapy session, 45 minutes inpatient CPT 90834 BH THERAPY 45 MIN SLS $437.90 $755.00 42%
Psychotherapy session, 60 minutes CPT 90837 BH THERAPY 60 MIN SLS $446.60 $770.00 42%
Psychotherapy session, 60 minutes inpatient CPT 90837 BH THERAPY 60 MIN SLS $446.60 $770.00 42%

Source file: https://www.chistalexiushealth.org/content/dam/stalexiushealthorg/documents/financial/price-transparency-standard-charges/450231183-1902824576_mercy-medical-center_standardcharges.json