Mary Immaculate Hospital
2 Bernardine Dr., Newport News, VA · Bonsecours · · NPI 1427064310
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Ghs quinidine CPT 80194 | $46.20 | $77.00 | not published | 0 |
| Ghs removal intranasal foreign body CPT 30300 | $192.00 | $320.00 | not published | 0 |
| Ghs removal pharyngeal foreign body CPT 42809 | $1,309.80 | $2,183.00 | not published | 0 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $52.80 | $88.00 | not published | 0 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $44.40 | $74.00 | not published | 0 |
| Ghs sensitivity (per antimicro) CPT 87184 | $76.80 | $128.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $760.80 | $1,268.00 | not published | 0 |
| Ghs sphenopalatine ganglion block CPT 64505 | $378.00 | $630.00 | not published | 0 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $172.20 | $287.00 | not published | 0 |
| Ghs strapping shoulder - 29240 CPT 29240 | $334.20 | $557.00 | not published | 0 |
| Ghs st - re-eval for alt comm CPT 92597 | $111.00 | $185.00 | not published | 0 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $807.00 | $1,345.00 | not published | 0 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,929.00 | $3,215.00 | not published | 0 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $445.80 | $743.00 | not published | 0 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $445.80 | $743.00 | not published | 0 |
| Ghs urine, porphyrins quant CPT 84120 | $118.20 | $197.00 | not published | 0 |
| Ghs vaginal delivery only CPT 59409 | $12,418.97 | $20,698.28 | $3,158.41 – $3,221.58 | 3 |
| Giardia lamblia antibody CPT 86674 | $70.20 | $117.00 | not published | 0 |
| Gi inhouse confirmation CPT 87045 | $29.40 | $49.00 | not published | 0 |
| Gjb2 gene full sequence CPT 81252 | $604.80 | $1,008.00 | not published | 0 |
| Glove finger flexion right lg xl HCPCS L3912 | $400.43 | $667.39 | not published | 0 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $2,007.60 | $3,346.00 | not published | 0 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $2,006.17 | $3,343.61 | not published | 0 |
| Glucagon plasma - sendout CPT 82943 | $82.80 | $138.00 | not published | 0 |
| Glucose 1 hr post dose CPT 82950 | $40.80 | $68.00 | not published | 0 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $35.40 | $59.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $53.40 | $89.00 | not published | 0 |
| Glucose body fluid CPT 82945 | $242.40 | $404.00 | not published | 0 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $109.80 | $183.00 | not published | 0 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $39.60 | $66.00 | not published | 0 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $229.12 | $381.87 | not published | 0 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $9,296.24 | $15,493.74 | not published | 0 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $115.80 | $193.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $115.20 | $192.00 | not published | 0 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $4,653.16 | $7,755.26 | not published | 0 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $7,892.93 | $13,154.88 | not published | 0 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $106,373.88 | $177,289.80 | not published | 0 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $76,673.50 | $127,789.16 | not published | 0 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $6,886.76 | $11,477.94 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $195,887.28 | $326,478.80 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $148,224.00 | $247,040.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $64,848.00 | $108,080.00 | not published | 0 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $23,762.16 | $39,603.60 | not published | 0 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $40,298.40 | $67,164.00 | not published | 0 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $15,652.92 | $26,088.20 | not published | 0 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $6,948.00 | $11,580.00 | not published | 0 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $146,065.49 | $243,442.48 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $12,274.80 | $20,458.00 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $146,324.88 | $243,874.80 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $69,306.30 | $115,510.50 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | $445.80 | $743.00 | not published | 0 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | $39,629.94 | $66,049.90 | $7,974.65 – $8,134.14 | 2 |
| Grfg autol fat lipo ea addl CPT 15772 | $39,629.94 | $66,049.90 | $7,974.65 – $8,134.14 | 3 |
| Guided cath fluid drainage 10030 CPT 10030 | $1,597.80 | $2,663.00 | not published | 0 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $24,012.29 | $40,020.48 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $36,963.36 | $61,605.60 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $3,242.40 | $5,404.00 | not published | 0 |
| Gw stiffened micro access kit HCPCS C1894 | $31,618.03 | $52,696.72 | not published | 0 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | $180.70 | $301.16 | not published | 0 |
| Halo cervical into jckt vest HCPCS L0810 | $31,266.00 | $52,110.00 | not published | 0 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $100.67 | $167.78 | not published | 0 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $21.00 | $35.00 | not published | 0 |
| Halo repl liner/interface HCPCS L0861 | $5,299.01 | $8,831.68 | not published | 0 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $24.60 | $41.00 | not published | 0 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | $401.36 | $668.94 | not published | 0 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $15,054.00 | $25,090.00 | not published | 0 |
| Hand X-ray CPT 73130 | $480.60 | $801.00 | not published | 0 |
| Haptoglobin quantitative CPT 83010 | $91.80 | $153.00 | not published | 0 |
| Hbb full gene sequence CPT 81364 | $1,074.00 | $1,790.00 | not published | 0 |
| Hbot, full body chamber, 30m HCPCS G0277 | $261.00 | $435.00 | not published | 0 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $908.40 | $1,514.00 | not published | 0 |
| Hcg qualitative CPT 84703 | $118.80 | $198.00 | not published | 0 |
| Hcg quantitative CPT 84702 | $179.40 | $299.00 | not published | 0 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $196.80 | $328.00 | not published | 0 |
| Head CT scan (with and without contrast) CPT 70470 | $2,436.00 | $4,060.00 | not published | 0 |
| Head CT scan (with contrast) CPT 70460 | $1,986.60 | $3,311.00 | not published | 0 |
| Head CT scan (without contrast) CPT 70450 | $1,420.20 | $2,367.00 | not published | 0 |
| Heel leather reinforced HCPCS L3440 | $318.68 | $531.14 | not published | 0 |
| Heinz bodies direct CPT 85441 | $24.00 | $40.00 | not published | 0 |
| Heinz bodies induced CPT 85445 | $37.20 | $62.00 | not published | 0 |
| Helicobacter pylori antibody igm CPT 86677 | $84.60 | $141.00 | not published | 0 |
| Hematocrit CPT 85014 | $35.40 | $59.00 | not published | 0 |
| Hemodialysis one evaluation CPT 90935 | $940.20 | $1,567.00 | not published | 0 |
| Hemoglobin CPT 85018 | $34.20 | $57.00 | not published | 0 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $105.60 | $176.00 | not published | 0 |
| Hemoglobin plasma CPT 83051 | $64.80 | $108.00 | not published | 0 |
| Hemophilus influenza antibdy CPT 86684 | $145.20 | $242.00 | not published | 0 |
| Hemorrhoidectomy intern transanal deater 2+ 46948 CPT 46948 | $18,086.33 | $30,143.88 | $2,708.17 – $2,762.33 | 3 |
| Heparin assay CPT 85520 | $112.80 | $188.00 | not published | 0 |
| Heparin bolus from bag HCPCS J1644 | $102.17 | $170.29 | not published | 0 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $21.00 | $35.00 | not published | 0 |
| Hepatitis a antibody igm CPT 86709 | $129.00 | $215.00 | not published | 0 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.