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 |
|---|---|---|---|---|
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $29,843.66 | $49,739.43 | not published | 0 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | $18,251.26 | $30,418.76 | not published | 0 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $19,413.75 | $32,356.25 | not published | 0 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | $19,996.16 | $33,326.94 | not published | 0 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $9,706.88 | $16,178.13 | not published | 0 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | $11,625.01 | $19,375.01 | not published | 0 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | $92,228.97 | $153,714.95 | not published | 0 |
| Pelv band/spread bar thigh c HCPCS L1640 | $1,977.03 | $3,295.05 | not published | 0 |
| Pelvic control band & belt b HCPCS L2640 | $1,312.34 | $2,187.23 | not published | 0 |
| Pelvic control band & belt u HCPCS L2630 | $966.98 | $1,611.63 | not published | 0 |
| Pelvic control hip heavy dut HCPCS L2620 | $1,044.10 | $1,740.17 | not published | 0 |
| Pelvic control pelvic sling HCPCS L2580 | $1,812.41 | $3,020.68 | not published | 0 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,748.40 | $2,914.00 | not published | 0 |
| Pelvic CT scan (without contrast) CPT 72192 | $2,218.80 | $3,698.00 | not published | 0 |
| Pelvic & hip control thigh c HCPCS L1680 | $4,434.40 | $7,390.66 | not published | 0 |
| Pelvic MRI (with and without contrast) CPT 72197 | $4,208.40 | $7,014.00 | not published | 0 |
| Pelvic MRI (without contrast) CPT 72195 | $3,367.20 | $5,612.00 | not published | 0 |
| Pelvic Ultrasound (complete) CPT 76856 | $934.20 | $1,557.00 | not published | 0 |
| Pelvic Ultrasound (limited) CPT 76857 | $334.80 | $558.00 | not published | 0 |
| Pelv & thor control gluteal HCPCS L2650 | $577.93 | $963.22 | not published | 0 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $24,904.92 | $41,508.20 | not published | 0 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $16,738.02 | $27,896.70 | not published | 0 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $1,716.04 | $2,860.06 | not published | 0 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $215.10 | $358.50 | not published | 0 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $54,936.82 | $91,561.36 | not published | 0 |
| Pentamidine 300 mg solution for injection HCPCS J2516 | $1,196.60 | $1,994.34 | not published | 0 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $22,216.80 | $37,028.00 | not published | 0 |
| Perc drug-el cor stent sing HCPCS C9600 | $21,630.00 | $36,050.00 | not published | 0 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $2,105.99 | $3,509.99 | not published | 0 |
| Pericardiocentesis wwo imaging CPT 33016 | $1,623.60 | $2,706.00 | not published | 0 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | $1,677.60 | $2,796.00 | not published | 0 |
| Perit-vens shunt pat tst CPT 78291 | $496.80 | $828.00 | not published | 0 |
| Permanent tear duct plug HCPCS A4263 | $532.68 | $887.80 | not published | 0 |
| Peroneal straps pair pre ots HCPCS L0980 | $71.38 | $118.97 | not published | 0 |
| Perq clsr tcat l atr apndge CPT 33340 | $8,227.80 | $13,713.00 | not published | 0 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | $32,611.30 | $54,352.17 | $9,236.28 – $9,421.01 | 3 |
| Perq skel fix ulnar styld fx CPT 25651 | $11,731.63 | $19,552.72 | $3,192.44 – $3,256.29 | 3 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $28,236.84 | $47,061.40 | not published | 0 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | $57,614.46 | $96,024.10 | not published | 0 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | $444.91 | $741.51 | not published | 0 |
| Pet CT skull-mid thgh initial CPT 78815 | $7,663.20 | $12,772.00 | not published | 0 |
| Pet CT whole body initial CPT 78816 | $9,579.00 | $15,965.00 | not published | 0 |
| Pet fdg brain metoblic eval sb CPT 78608 | $2,641.20 | $4,402.00 | not published | 0 |
| Pet image w/ct lmtd CPT 78814 | $9,122.40 | $15,204.00 | not published | 0 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $145,386.90 | $242,311.50 | not published | 0 |
| Ph body fluid CPT 83986 | $42.00 | $70.00 | not published | 0 |
| Phencyclidine (pcp) CPT 83992 | $138.00 | $230.00 | not published | 0 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $245.21 | $408.69 | not published | 0 |
| Phenobarbital therapeutic drug level CPT 80184 | $68.40 | $114.00 | not published | 0 |
| Phentolaine mesylate inj HCPCS J2760 | $3,513.02 | $5,855.03 | not published | 0 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $143.40 | $239.00 | not published | 0 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $21.00 | $35.00 | not published | 0 |
| Phenytoin total therapeutic drug level CPT 80185 | $121.80 | $203.00 | not published | 0 |
| Phlebotomy therapeutic CPT 99195 | $323.40 | $539.00 | not published | 0 |
| Phosphorus CPT 84100 | $54.00 | $90.00 | not published | 0 |
| Phosphorus 24 hour urine CPT 84105 | $48.00 | $80.00 | not published | 0 |
| Phys blood bank serv reactj CPT 86078 | $255.60 | $426.00 | not published | 0 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $70.22 | $117.04 | not published | 0 |
| Pillow shldr abduc inflat univ HCPCS L3960 | $3,031.51 | $5,052.51 | not published | 0 |
| Pin caspar distraction 12mm HCPCS C1821 | $42,614.40 | $71,024.00 | not published | 0 |
| Pinworm exam CPT 87172 | $48.00 | $80.00 | not published | 0 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $28.68 | $47.80 | not published | 0 |
| Place gastrostomy tube perc CPT 49440 | $2,989.80 | $4,983.00 | not published | 0 |
| Placement nephrostomy catheter (both sides) CPT 50432 | $3,630.60 | $6,051.00 | not published | 0 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $775.80 | $1,293.00 | not published | 0 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $27,872.40 | $46,454.00 | not published | 0 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | $8,859.00 | $14,765.00 | not published | 0 |
| Place slctv cath carotid/inom art intcrn uni CPT 36223 | $11,427.00 | $19,045.00 | not published | 0 |
| Place slctv cath subclavian art CPT 36225 | $9,778.80 | $16,298.00 | not published | 0 |
| Plas shoe insert w ank joint HCPCS L2180 | $436.61 | $727.69 | not published | 0 |
| Plastic mod low ext pad/line HCPCS L2275 | $620.69 | $1,034.48 | not published | 0 |
| Plastic mold recipro hip & c HCPCS L2627 | $8,925.95 | $14,876.59 | not published | 0 |
| Platelet aggregation each agent teg CPT 85576 | $113.40 | $189.00 | not published | 0 |
| Platelet automated CPT 85049 | $54.60 | $91.00 | not published | 0 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $1,285.20 | $2,142.00 | not published | 0 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,288.20 | $2,147.00 | not published | 0 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $2,514.00 | $4,190.00 | not published | 0 |
| Plating chrome/nickel pr bar HCPCS L2750 | $326.42 | $544.03 | not published | 0 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | $5,515.20 | $9,192.00 | not published | 0 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | $7,261.20 | $12,102.00 | not published | 0 |
| Plcmnt ureteral stent pq w/img new w/cath CPT 50695 | $13,354.80 | $22,258.00 | not published | 0 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $241.80 | $403.00 | not published | 0 |
| Plmt biliary drainage cath CPT 47534 | $4,083.60 | $6,806.00 | not published | 0 |
| Plmt nephroureteral catheter CPT 50433 | $7,261.20 | $12,102.00 | not published | 0 |
| Pneum full leg splnt pre ots HCPCS L4370 | $546.30 | $910.50 | not published | 0 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $213.00 | $355.00 | not published | 0 |
| Post non-seg/spine instrumentation 22840 CPT 22840 | $93,145.85 | $155,243.08 | $26,474.25 – $27,003.74 | 2 |
| Postop app non-wgt bear dsg HCPCS L5450 | $1,055.72 | $1,759.54 | not published | 0 |
| Postop app non-wgt bear dsg HCPCS L5460 | $2,452.97 | $4,088.28 | not published | 0 |
| Postop dsg & 1 cast chg ak/d HCPCS L5420 | $5,893.66 | $9,822.77 | not published | 0 |
| Post-operative body jacket HCPCS L1310 | $7,497.17 | $12,495.28 | not published | 0 |
| Post-op hip abduct custom fa HCPCS L1685 | $3,238.80 | $5,398.00 | not published | 0 |
| Post seg spine instrument/3-6 seg 22842 CPT 22842 | $121,564.35 | $202,607.25 | $17,107.48 – $26,474.25 | 2 |
| Potassium 24 hour urine CPT 84133 | $58.20 | $97.00 | not published | 0 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $28.18 | $46.97 | not published | 0 |
| Potassium serum/plasma/whole blood CPT 84132 | $58.80 | $98.00 | not published | 0 |
| Pq thr inj ext pse CPT 36002 | $1,168.80 | $1,948.00 | not published | 0 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $621.64 | $1,036.07 | not published | 0 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $4,135.80 | $6,893.00 | not published | 0 |
| Pr application of long arm splint CPT 29105 | $334.20 | $557.00 | 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.