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 |
|---|---|---|---|---|
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $493.20 | $822.00 | not published | 0 |
| Scan proc cranial extra CPT 61782 | $35,598.32 | $59,330.53 | $6,885.86 – $7,023.57 | 3 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $2,386.80 | $3,978.00 | not published | 0 |
| Scope plantar fasciotomy CPT 29893 | $42,624.53 | $71,040.88 | $3,192.44 – $3,256.29 | 3 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $27,097.20 | $45,162.00 | not published | 0 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $3,287.40 | $5,479.00 | $907.35 – $925.49 | 3 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $3,687.00 | $6,145.00 | $907.35 – $925.49 | 3 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $93.00 | $155.00 | not published | 0 |
| Screening Mammogram CPT 77067 | $667.80 | $1,113.00 | not published | 0 |
| Screening prostate cancer PSA HCPCS G0103 | $115.20 | $192.00 | not published | 0 |
| Screen pap by tech w md supv HCPCS P3000 | $60.60 | $101.00 | not published | 0 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $499,880.81 | $833,134.68 | not published | 0 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $256.80 | $428.00 | not published | 0 |
| Sedimentation rate erythrocyte automated CPT 85652 | $54.00 | $90.00 | not published | 0 |
| Serpina1 gene CPT 81332 | $213.60 | $356.00 | not published | 0 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $117.81 | $196.35 | not published | 0 |
| Sewho cap design without jnts cf HCPCS L3961 | $6,386.00 | $10,643.33 | not published | 0 |
| Sex chromatin identification CPT 88130 | $58.80 | $98.00 | not published | 0 |
| Sf3b1 gene common variants CPT 81347 | $639.00 | $1,065.00 | not published | 0 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $518.40 | $864.00 | not published | 0 |
| Sheath below knee HCPCS L8400 | $67.35 | $112.25 | not published | 0 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $15,401.40 | $25,669.00 | not published | 0 |
| Sheath laser cavaclear 14f HCPCS C1603 | $23,136.84 | $38,561.40 | not published | 0 |
| Sho arthrs srg bicp tenodsis CPT 29828 | $24,274.00 | $40,456.67 | $7,079.78 – $7,221.37 | 3 |
| Sho arthrs srg capsulorraphy CPT 29806 | $19,898.72 | $33,164.53 | $7,079.78 – $7,221.37 | 3 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | $21,365.92 | $35,609.87 | $3,192.44 – $3,256.29 | 3 |
| Sho arthrs srg rpr slap les CPT 29807 | $22,610.20 | $37,683.67 | $7,079.78 – $7,221.37 | 3 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | $18,165.62 | $30,276.03 | $7,079.78 – $7,221.37 | 3 |
| Shoe clubfoot wedge HCPCS L3380 | $207.14 | $345.24 | not published | 0 |
| Shoe dennis browne splint bo HCPCS L3640 | $180.70 | $301.16 | not published | 0 |
| Shoe heel new leather standa HCPCS L3455 | $169.99 | $283.32 | not published | 0 |
| Shoe heel new rubber standar HCPCS L3460 | $143.50 | $239.17 | not published | 0 |
| Shoe heel pad & depress for HCPCS L3480 | $260.23 | $433.71 | not published | 0 |
| Shoe heel sach cushion type HCPCS L3450 | $440.74 | $734.56 | not published | 0 |
| Shoe heel thomas extend to b HCPCS L3470 | $260.23 | $433.71 | not published | 0 |
| Shoe heel thomas with wedge HCPCS L3465 | $244.48 | $407.46 | not published | 0 |
| Shoe lift elev heel/sole neo HCPCS L3310 | $309.23 | $515.39 | not published | 0 |
| Shoe metatarsal bar between HCPCS L3410 | $387.70 | $646.16 | not published | 0 |
| Shoe metatarsal bar wedge ro HCPCS L3400 | $169.99 | $283.32 | not published | 0 |
| Shoe outflare wedge HCPCS L3390 | $207.14 | $345.24 | not published | 0 |
| Shoe post-op mens m HCPCS L3260 | $509.52 | $849.20 | not published | 0 |
| Shoe sole wedge between sole HCPCS L3370 | $207.14 | $345.24 | not published | 0 |
| Shoe sole wedge outside sole HCPCS L3360 | $148.69 | $247.81 | not published | 0 |
| Shoe wedge sach HCPCS L3340 | $355.97 | $593.28 | not published | 0 |
| Sho heel count plast reinfor HCPCS L3430 | $669.28 | $1,115.46 | not published | 0 |
| Sho insert w arch toe filler HCPCS L5000 | $2,161.15 | $3,601.92 | not published | 0 |
| Sho lift taper to metatarsal HCPCS L3300 | $217.79 | $362.99 | not published | 0 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $24,482.93 | $40,804.88 | $7,079.78 – $7,221.37 | 3 |
| Shoulder MRI (with and without contrast) CPT 73223 | $4,874.40 | $8,124.00 | not published | 0 |
| Shoulder MRI (with contrast) CPT 73222 | $4,015.80 | $6,693.00 | not published | 0 |
| Shoulder MRI (without contrast) CPT 73221 | $5,052.60 | $8,421.00 | not published | 0 |
| Shoulder X-ray CPT 73030 | $380.40 | $634.00 | not published | 0 |
| Shrinker prosth above knee HCPCS L8460 | $352.68 | $587.80 | not published | 0 |
| Shrinker prosth below knee HCPCS L8440 | $248.09 | $413.48 | not published | 0 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $13,432.80 | $22,388.00 | not published | 0 |
| Sialidase enzyme assay CPT 87905 | $142.80 | $238.00 | not published | 0 |
| Sickling rbc CPT 85660 | $57.00 | $95.00 | not published | 0 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $935.42 | $1,559.04 | not published | 0 |
| Sinus CT scan (with contrast) CPT 70487 | $2,024.40 | $3,374.00 | not published | 0 |
| Sinus CT scan (without contrast) CPT 70486 | $1,437.00 | $2,395.00 | not published | 0 |
| Sio flex pelvisacral custom HCPCS L0622 | $1,116.26 | $1,860.44 | not published | 0 |
| Sio rig pnl pelv/sac pre ots HCPCS L0623 | $739.13 | $1,231.88 | not published | 0 |
| Skin Biopsy CPT 11102 | $251.40 | $419.00 | not published | 0 |
| Sleeve fing rolyan med HCPCS L3933 | $811.01 | $1,351.69 | not published | 0 |
| Sling pelv split sam med HCPCS L0621 | $360.09 | $600.15 | not published | 0 |
| Sling suprapubic suburetheral HCPCS C1771 | $31,494.26 | $52,490.44 | not published | 0 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $63.00 | $105.00 | not published | 0 |
| Smear gram stain CPT 87205 | $71.40 | $119.00 | not published | 0 |
| Smear nasal eosinophil CPT 89190 | $40.80 | $68.00 | not published | 0 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $172.20 | $287.00 | not published | 0 |
| Smear wet mount CPT 87210 | $61.20 | $102.00 | not published | 0 |
| Snrpn/ube3a gene CPT 81331 | $286.20 | $477.00 | not published | 0 |
| So airplane w/wo joint cf HCPCS L3674 | $4,492.76 | $7,487.94 | not published | 0 |
| So cap design without jnts cf HCPCS L3671 | $3,424.81 | $5,708.01 | not published | 0 |
| Socket insert without lock mech HCPCS L5679 | $2,270.00 | $3,783.34 | not published | 0 |
| Sock fracture or equal each HCPCS L3995 | $127.01 | $211.68 | not published | 0 |
| Sodium 24 hour urine CPT 84300 | $51.60 | $86.00 | not published | 0 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $84.00 | $140.00 | not published | 0 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $84.00 | $140.00 | not published | 0 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $84.00 | $140.00 | not published | 0 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $84.00 | $140.00 | not published | 0 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $228.01 | $380.01 | not published | 0 |
| Sodium serum/plasma/whole blood CPT 84295 | $52.20 | $87.00 | not published | 0 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $21.00 | $35.00 | not published | 0 |
| Soft interface below knee se HCPCS L2820 | $316.09 | $526.81 | not published | 0 |
| So neo gsap dna/dna&rna CPT 81459 | $8,968.80 | $14,948.00 | not published | 0 |
| So vest canvas/web pre ots HCPCS L3675 | $667.15 | $1,111.91 | not published | 0 |
| Sp bone algrft morsel add-on CPT 20930 | $86,355.42 | $143,925.70 | $26,474.25 – $26,474.25 | 2 |
| Specific gravity body fluid CPT 84315 | $10.20 | $17.00 | not published | 0 |
| Spinal bone allograftstructural 20931 CPT 20931 | $31,962.14 | $53,270.23 | $12,526.51 – $12,526.51 | 2 |
| Spinal bone autograftlocal 20936 CPT 20936 | $96,661.81 | $161,103.02 | $17,107.48 – $17,449.63 | 3 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $3,011.40 | $5,019.00 | not published | 0 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $1,926.17 | $3,210.28 | not published | 0 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $249.67 | $416.11 | not published | 0 |
| Splint finger fold over sm HCPCS L3924 | $367.13 | $611.89 | not published | 0 |
| Splint finger frog med HCPCS L3927 | $373.62 | $622.70 | not published | 0 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $367.13 | $611.89 | not published | 0 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $20,557.02 | $34,261.70 | $2,834.09 – $2,834.09 | 2 |
| Sputum specimen collection CPT 89220 | $152.40 | $254.00 | not published | 0 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $429.00 | $715.00 | 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.