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 |
|---|---|---|---|---|
| Western blot test CPT 84181 | $174.00 | $290.00 | not published | 0 |
| Whfo electric custom fitted HCPCS L3904 | $12,829.43 | $21,382.39 | not published | 0 |
| Whfo nontorsion joint prefab HCPCS L3931 | $792.49 | $1,320.81 | not published | 0 |
| Whfo w/joint(s) custom fab HCPCS L3806 | $1,726.49 | $2,877.48 | not published | 0 |
| Who nontorsion jnts pre cst HCPCS L3915 | $2,020.43 | $3,367.39 | not published | 0 |
| Who nontorsion jnts pre ots HCPCS L3916 | $2,020.43 | $3,367.39 | not published | 0 |
| Woman's shoe oxford brace HCPCS L3224 | $282.18 | $470.30 | not published | 0 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $775.20 | $1,292.00 | not published | 0 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $513.00 | $855.00 | not published | 0 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $1,095.60 | $1,826.00 | not published | 0 |
| Wrist endoscopy/surgery CPT 29848 | $8,808.59 | $14,680.98 | $1,568.89 – $1,600.27 | 3 |
| Wrist X-ray CPT 73110 | $447.60 | $746.00 | not published | 0 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | $14,002.18 | $23,336.97 | $2,251.71 – $2,296.74 | 3 |
| Xcellistem, 1 mg HCPCS A2004 | $9,328.85 | $15,548.08 | not published | 0 |
| Xe133 xenon 10mci HCPCS A9558 | $69.60 | $116.00 | not published | 0 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | $61,286.45 | $102,144.08 | $2,013.11 – $7,079.78 | 3 |
| Xm archive tissue molec anal CPT 88363 | $60.60 | $101.00 | not published | 0 |
| X-ray abdomen 1 view CPT 74018 | $388.20 | $647.00 | not published | 0 |
| X-ray abdomen 2 views CPT 74019 | $327.60 | $546.00 | not published | 0 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $708.60 | $1,181.00 | not published | 0 |
| X-ray ankle 2 views (both sides) CPT 73600 | $422.40 | $704.00 | not published | 0 |
| X-ray bone age studies CPT 77072 | $394.80 | $658.00 | not published | 0 |
| X-ray bone survey complete CPT 77075 | $1,675.20 | $2,792.00 | not published | 0 |
| X-ray bone survey infant CPT 77076 | $405.60 | $676.00 | not published | 0 |
| X-ray cervical spine 2-3 views CPT 72040 | $803.40 | $1,339.00 | not published | 0 |
| X-ray cervical spine 4-5 views CPT 72050 | $1,170.00 | $1,950.00 | not published | 0 |
| X-ray cervical spine >= 6 views CPT 72052 | $1,330.20 | $2,217.00 | not published | 0 |
| X-ray clavicle complete (both sides) CPT 73000 | $558.00 | $930.00 | not published | 0 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $871.20 | $1,452.00 | not published | 0 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $1,045.80 | $1,743.00 | not published | 0 |
| X-ray elbow 2 views (both sides) CPT 73070 | $411.00 | $685.00 | not published | 0 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $422.40 | $704.00 | not published | 0 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $820.20 | $1,367.00 | not published | 0 |
| X-ray exam of arm infant CPT 73092 | $246.00 | $410.00 | not published | 0 |
| X-ray exam of eye sockets CPT 70200 | $517.80 | $863.00 | not published | 0 |
| X-ray exam of femur 1 CPT 73551 | $343.20 | $572.00 | not published | 0 |
| X-ray exam thorac spine4/>vw CPT 72074 | $511.20 | $852.00 | not published | 0 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $454.80 | $758.00 | not published | 0 |
| X-ray facial bones complete > 3 views CPT 70150 | $527.40 | $879.00 | not published | 0 |
| X-ray femur >=2 views (both sides) CPT 73552 | $519.00 | $865.00 | not published | 0 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $287.40 | $479.00 | not published | 0 |
| X-ray foot 2 views (both sides) CPT 73620 | $384.60 | $641.00 | not published | 0 |
| X-ray forearm 2 views (both sides) CPT 73090 | $355.80 | $593.00 | not published | 0 |
| X-ray hand 2 views (both sides) CPT 73120 | $414.60 | $691.00 | not published | 0 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $480.00 | $800.00 | not published | 0 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $615.60 | $1,026.00 | not published | 0 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $615.60 | $1,026.00 | not published | 0 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $343.80 | $573.00 | not published | 0 |
| X-ray humerus >= 2 views left CPT 73060 | $348.60 | $581.00 | not published | 0 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $461.40 | $769.00 | not published | 0 |
| X-ray knee 3 views (both sides) CPT 73562 | $467.40 | $779.00 | not published | 0 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $1,325.40 | $2,209.00 | not published | 0 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $1,333.80 | $2,223.00 | not published | 0 |
| X-ray mandible complete > 4 views CPT 70110 | $553.20 | $922.00 | not published | 0 |
| X-ray nasal bones complete > 3 views CPT 70160 | $369.60 | $616.00 | not published | 0 |
| X-ray neck soft tissue CPT 70360 | $440.40 | $734.00 | not published | 0 |
| X-ray pelvis 1-2 views CPT 72170 | $462.60 | $771.00 | not published | 0 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $743.40 | $1,239.00 | not published | 0 |
| X-ray ribs 2 views left CPT 71100 | $329.40 | $549.00 | not published | 0 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $523.80 | $873.00 | not published | 0 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $577.20 | $962.00 | not published | 0 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $412.20 | $687.00 | not published | 0 |
| X-ray scapula complete (both sides) CPT 73010 | $519.60 | $866.00 | not published | 0 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $388.20 | $647.00 | not published | 0 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $815.40 | $1,359.00 | not published | 0 |
| X-ray skull < 4 views CPT 70250 | $405.60 | $676.00 | not published | 0 |
| X-ray skull > 4 views complete CPT 70260 | $793.80 | $1,323.00 | not published | 0 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $944.40 | $1,574.00 | not published | 0 |
| X-ray small intestine follow-through study CPT 74248 | $609.60 | $1,016.00 | not published | 0 |
| X-ray spine single view CPT 72020 | $408.00 | $680.00 | not published | 0 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $420.60 | $701.00 | not published | 0 |
| X-ray thoracic spine 2 views CPT 72070 | $625.20 | $1,042.00 | not published | 0 |
| X-ray thoracic spine 3 views CPT 72072 | $768.00 | $1,280.00 | not published | 0 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $441.00 | $735.00 | not published | 0 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $389.40 | $649.00 | not published | 0 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $1,009.80 | $1,683.00 | not published | 0 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $918.00 | $1,530.00 | not published | 0 |
| X-ray wrist 2 views (both sides) CPT 73100 | $407.40 | $679.00 | not published | 0 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $2,194.80 | $3,658.00 | not published | 0 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $209.36 | $348.94 | not published | 0 |
| Zika virus dna/rna amp probe CPT 87662 | $286.80 | $478.00 | not published | 0 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $152.52 | $254.20 | 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.