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 |
|---|---|---|---|---|
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $63,098.59 | $105,164.31 | not published | 0 |
| Alt/sgpt CPT 84460 | $70.80 | $118.00 | not published | 0 |
| Aluminum - quest CPT 82108 | $130.80 | $218.00 | not published | 0 |
| Amino acids quant 2-5 CPT 82136 | $97.20 | $162.00 | not published | 0 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $52.20 | $87.00 | not published | 0 |
| Aminolevulinic acid delta CPT 82135 | $127.20 | $212.00 | not published | 0 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $28.67 | $47.78 | not published | 0 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $31.56 | $52.60 | not published | 0 |
| Ammonia CPT 82140 | $130.20 | $217.00 | not published | 0 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $4,135.80 | $6,893.00 | not published | 0 |
| Amphetamine confirm urine -sendout CPT 80324 | $152.40 | $254.00 | not published | 0 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $344.16 | $573.60 | not published | 0 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $1,170.23 | $1,950.39 | not published | 0 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $199.32 | $332.20 | not published | 0 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $66.25 | $110.42 | not published | 0 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $65,718.08 | $109,530.13 | $3,192.44 – $3,256.29 | 3 |
| Amylase CPT 82150 | $103.20 | $172.00 | not published | 0 |
| Analysis gene f2 20210g>a variant CPT 81240 | $287.40 | $479.00 | not published | 0 |
| Analysis gene f5 leiden variant CPT 81241 | $637.20 | $1,062.00 | not published | 0 |
| Anca screen with reflex to titer -quest CPT 86021 | $135.60 | $226.00 | not published | 0 |
| An fluoro guide for cvp CPT 77001 | $750.00 | $1,250.00 | not published | 0 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | $9,420.60 | $15,701.00 | not published | 0 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $2,181.87 | $3,636.45 | not published | 0 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $6,430.20 | $10,717.00 | not published | 0 |
| Angio trnslmnl balloon same vein ini CPT 37248 | $9,420.60 | $15,701.00 | not published | 0 |
| Anidulafungin injection HCPCS J0348 | $1,368.68 | $2,281.14 | not published | 0 |
| Ankle arthroscopy/surgery CPT 29891 | $11,907.15 | $19,845.25 | $3,192.44 – $3,256.29 | 3 |
| Ankle arthroscopy/surgery CPT 29892 | $28,221.82 | $47,036.37 | $7,079.78 – $7,221.37 | 3 |
| Ankle arthroscopy/surgery CPT 29894 | $53,733.97 | $89,556.62 | $7,079.78 – $7,221.37 | 3 |
| Ankle arthroscopy/surgery CPT 29897 | $30,986.48 | $51,644.13 | $7,079.78 – $7,221.37 | 3 |
| Ankle arthroscopy/surgery CPT 29898 | $58,152.97 | $96,921.62 | $7,079.78 – $7,221.37 | 3 |
| Ankle X-ray CPT 73610 | $520.80 | $868.00 | not published | 0 |
| Anterior asis pad HCPCS L1250 | $330.31 | $550.51 | not published | 0 |
| Anterior swing band HCPCS L2335 | $1,174.03 | $1,956.71 | not published | 0 |
| Anterior thoracic derotation HCPCS L1260 | $393.91 | $656.51 | not published | 0 |
| Anterior thoracic extension HCPCS L1220 | $909.68 | $1,516.13 | not published | 0 |
| Antibody elution rbc reference CPT 86860 | $150.60 | $251.00 | not published | 0 |
| Antibody htlv-i CPT 86687 | $102.00 | $170.00 | not published | 0 |
| Antibody htlv-ii CPT 86688 | $83.40 | $139.00 | not published | 0 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $168.00 | $280.00 | not published | 0 |
| Antibody id rbc panel CPT 86870 | $675.60 | $1,126.00 | not published | 0 |
| Antibody influenza virus CPT 86710 | $79.80 | $133.00 | not published | 0 |
| Antibody screen rbc CPT 86850 | $101.40 | $169.00 | not published | 0 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | $18,414.00 | $30,690.00 | not published | 0 |
| Anti mog serum - sendout CPT 86362 | $519.60 | $866.00 | not published | 0 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $42.00 | $70.00 | not published | 0 |
| Ant instr 2-3 vert segm 22845 CPT 22845 | $46,078.24 | $76,797.07 | $12,526.51 – $12,777.04 | 3 |
| Ant instrumentation/4-7 vert seg 22846 CPT 22846 | $61,242.40 | $102,070.67 | $12,526.51 – $12,777.04 | 3 |
| Antinuclear antibodies CPT 86038 | $126.00 | $210.00 | not published | 0 |
| Antinuclear antibodies titer CPT 86039 | $82.80 | $138.00 | not published | 0 |
| Antiphosphatidylserine antibody CPT 86148 | $96.00 | $160.00 | not published | 0 |
| Antistreptolysin o titer CPT 86060 | $80.40 | $134.00 | not published | 0 |
| Antithrombin iii activity CPT 85300 | $122.40 | $204.00 | not published | 0 |
| Apl(pml-rara) quant - sendout CPT 81315 | $454.80 | $758.00 | not published | 0 |
| Appendix Removal (Laparoscopic) CPT 44970 | $19,465.42 | $32,442.37 | $5,898.53 – $6,016.50 | 3 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | $1,036.80 | $1,728.00 | not published | 0 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $478.20 | $797.00 | not published | 0 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | $2,290.20 | $3,817.00 | not published | 0 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | $183.00 | $305.00 | not published | 0 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $185.40 | $309.00 | not published | 0 |
| Application finger splntstatic 29130 CPT 29130 | $334.20 | $557.00 | not published | 0 |
| Application long leg splint 29505 CPT 29505 | $334.20 | $557.00 | not published | 0 |
| Application lower leg splint 29515 CPT 29515 | $334.20 | $557.00 | not published | 0 |
| Application multi layer compression below knee (both sides) CPT 29581 | $441.00 | $735.00 | not published | 0 |
| Application of forearm cast 29075 CPT 29075 | $761.40 | $1,269.00 | not published | 0 |
| Application of long arm cast 29065 CPT 29065 | $573.60 | $956.00 | not published | 0 |
| Application of long leg cast 29345 CPT 29345 | $761.40 | $1,269.00 | not published | 0 |
| Application of paste boot 29580 CPT 29580 | $367.20 | $612.00 | not published | 0 |
| Application short leg cast 29405 CPT 29405 | $761.40 | $1,269.00 | not published | 0 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $66,381.86 | $110,636.43 | $721.10 – $735.52 | 3 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $7,229.95 | $12,049.92 | $721.10 – $735.52 | 3 |
| Applicator tag rfid localizer 12gx7cm HCPCS C1819 | $11,556.84 | $19,261.40 | not published | 0 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $109.20 | $182.00 | not published | 0 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $109.20 | $182.00 | not published | 0 |
| Appl modality 1+lllt po pain CPT 97037 | $76.20 | $127.00 | not published | 0 |
| Apply forearm splintdynamic 29126 CPT 29126 | $334.20 | $557.00 | not published | 0 |
| Apply of finger splint 29131 CPT 29131 | $334.20 | $557.00 | not published | 0 |
| Apply rigid leg cast 29445 CPT 29445 | $783.00 | $1,305.00 | not published | 0 |
| Apply short leg castambul type 29425 CPT 29425 | $761.40 | $1,269.00 | not published | 0 |
| #aptt mix-1:1 incubated CPT 87532 | $235.80 | $393.00 | not published | 0 |
| Aquaporin-4 antibody cba each CPT 86052 | $719.40 | $1,199.00 | not published | 0 |
| Aquaporin-4 antibody elisa CPT 86051 | $379.20 | $632.00 | not published | 0 |
| Arch supp att to shoe long/m HCPCS L3090 | $169.99 | $283.32 | not published | 0 |
| Arch supp att to shoe metata HCPCS L3080 | $132.80 | $221.33 | not published | 0 |
| Arch suprt att to sho longit HCPCS L3070 | $132.80 | $221.33 | not published | 0 |
| Arformoterol non-comp unit HCPCS J7605 | $21.00 | $35.00 | not published | 0 |
| Argatroban esrd dialysis 1mg HCPCS J0884 | $1,419.66 | $2,366.10 | not published | 0 |
| Argatroban nonesrd (accord) HCPCS J0891 | $1,419.66 | $2,366.10 | not published | 0 |
| Arterial blood draw/perc 36620 CPT 36620 | $490.20 | $817.00 | not published | 0 |
| Artery xray each vessel 7577426 CPT 75774 | $2,044.20 | $3,407.00 | not published | 0 |
| Artery xray of abdomen 75726-26 CPT 75726 | $3,180.60 | $5,301.00 | not published | 0 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | $3,016.20 | $5,027.00 | not published | 0 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | $2,265.60 | $3,776.00 | not published | 0 |
| Artery x-rays lungs CPT 75743 | $2,028.60 | $3,381.00 | not published | 0 |
| Artery xrays of pelvis 75736 26 CPT 75736 | $3,601.80 | $6,003.00 | not published | 0 |
| Arthrd ant ntrbdy cervical CPT 22551 | $42,346.10 | $70,576.83 | $12,526.51 – $12,526.51 | 1 |
| Arthrd cmbn 1ntrspc lumbar CPT 22633 | $103,933.77 | $173,222.95 | not published | 0 |
| Arthrd pst tq 1ntrspc lum CPT 22630 | $93,863.18 | $156,438.63 | $26,474.25 – $27,003.74 | 3 |
| Arthrd si jt perq/min nvas CPT 27279 | $53,688.52 | $89,480.87 | $17,107.48 – $17,449.63 | 3 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $9,738.80 | $16,231.33 | $1,905.24 – $1,943.35 | 2 |
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.