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 |
|---|---|---|---|---|
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $78.87 | $131.45 | not published | 0 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $21.00 | $35.00 | not published | 0 |
| Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 | $41.92 | $69.86 | not published | 0 |
| #celiac hla-dq2 CPT 81377 | $503.40 | $839.00 | not published | 0 |
| Cell count body fluid CPT 89050 | $73.80 | $123.00 | not published | 0 |
| Cell count w differential body fluid CPT 89051 | $96.60 | $161.00 | not published | 0 |
| Cellesta or duo per sq cm HCPCS Q4184 | $31,127.04 | $51,878.40 | not published | 0 |
| Cell function assay w/stim CPT 86352 | $752.40 | $1,254.00 | not published | 0 |
| Cell marker study CPT 88182 | $259.80 | $433.00 | not published | 0 |
| Cer post col occ/man sup adj HCPCS L0180 | $1,386.36 | $2,310.60 | not published | 0 |
| Cerv collar supp adj cerv ba HCPCS L0190 | $3,511.06 | $5,851.76 | not published | 0 |
| #cf-97variants CPT 81220 | $1,500.00 | $2,500.00 | not published | 0 |
| Cftr gene dup/delet variants CPT 81222 | $346.80 | $578.00 | not published | 0 |
| Change cystostomy tube simple CPT 51705 | $523.80 | $873.00 | not published | 0 |
| Change g-tube to g-j perc CPT 49446 | $2,095.20 | $3,492.00 | not published | 0 |
| Change of windpipe airway 31502 CPT 31502 | $183.60 | $306.00 | not published | 0 |
| Chemodenervation anal musc CPT 46505 | $11,883.58 | $19,805.97 | $1,167.54 – $1,190.90 | 3 |
| Chest apical lordotic proj CPT 71047 | $279.60 | $466.00 | not published | 0 |
| Chest CT scan (with and without contrast) CPT 71270 | $3,013.80 | $5,023.00 | not published | 0 |
| Chest CT scan (with contrast) CPT 71260 | $1,746.00 | $2,910.00 | not published | 0 |
| Chest CT scan (without contrast) CPT 71250 | $1,256.40 | $2,094.00 | not published | 0 |
| Chest X-ray CPT 71046 | $252.00 | $420.00 | not published | 0 |
| Chest X-ray (single view) CPT 71045 | $179.40 | $299.00 | not published | 0 |
| Chimerism anal w/cell select CPT 81268 | $821.40 | $1,369.00 | not published | 0 |
| Chlamydia culture CPT 87110 | $110.40 | $184.00 | not published | 0 |
| Chloride 24 hour urine CPT 82436 | $55.80 | $93.00 | not published | 0 |
| Chloroprocaine hcl injection HCPCS J2401 | $261.35 | $435.58 | not published | 0 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $245.53 | $409.22 | not published | 0 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $82.85 | $138.09 | not published | 0 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $961.80 | $1,603.00 | not published | 0 |
| Cholesterol CPT 82465 | $70.80 | $118.00 | not published | 0 |
| Cholesterol body fluid CPT 84999 | $98.40 | $164.00 | not published | 0 |
| Cholesterol (Lipid) Test CPT 80061 | $226.20 | $377.00 | not published | 0 |
| Cholinesterase CPT 82480 | $24.60 | $41.00 | not published | 0 |
| Chromatography CPT 83021 | $90.60 | $151.00 | not published | 0 |
| Chromo high res and frag x - sendout CPT 81243 | $843.00 | $1,405.00 | not published | 0 |
| Chromosome analys amniotic CPT 88269 | $805.20 | $1,342.00 | not published | 0 |
| Chromosome analysis 15-20 cell count CPT 88262 | $1,307.40 | $2,179.00 | not published | 0 |
| Chromosome analysis 5 CPT 88261 | $867.00 | $1,445.00 | not published | 0 |
| Chromosome analys placenta CPT 88267 | $975.00 | $1,625.00 | not published | 0 |
| Chromosome count additional CPT 88285 | $51.60 | $86.00 | not published | 0 |
| Chromosome karyotype study CPT 88280 | $145.20 | $242.00 | not published | 0 |
| Chromosome study additional CPT 88289 | $410.40 | $684.00 | not published | 0 |
| Chronic urticaria - sendout CPT 86343 | $61.80 | $103.00 | not published | 0 |
| Chylomicron screen, bf - sendout CPT 82664 | $181.20 | $302.00 | not published | 0 |
| Cilastatin sodium injection HCPCS J0743 | $234.11 | $390.18 | not published | 0 |
| Circum 28 days or older CPT 54161 | $12,054.10 | $20,090.17 | $2,039.56 – $2,080.35 | 3 |
| Circumcision (newborn) CPT 54150 | $301.20 | $502.00 | not published | 0 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $341.14 | $568.56 | not published | 0 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $1,262.40 | $2,104.00 | not published | 0 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $50,952.00 | $84,920.00 | not published | 0 |
| Clean out mastoid cavity CPT 69222 | $7,168.20 | $11,947.00 | $526.21 – $536.74 | 3 |
| Clearance of airways CPT 31720 | $264.00 | $440.00 | not published | 0 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $76.72 | $127.87 | not published | 0 |
| Clip ligating vesolock lg HCPCS C1760 | $8,939.76 | $14,899.60 | not published | 0 |
| Cllr miami j sm HCPCS L0174 | $1,585.25 | $2,642.09 | not published | 0 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $45.17 | $75.29 | not published | 0 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $445.80 | $743.00 | not published | 0 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | $1,507.80 | $2,513.00 | not published | 0 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $1,507.80 | $2,513.00 | not published | 0 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $1,507.80 | $2,513.00 | not published | 0 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $445.80 | $743.00 | not published | 0 |
| Closed tx orbit without manipulj CPT 21400 | $634.80 | $1,058.00 | not published | 0 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $2,989.20 | $4,982.00 | not published | 0 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $289.20 | $482.00 | not published | 0 |
| Clos txnose fx without stablz 21315 CPT 21315 | $1,929.00 | $3,215.00 | not published | 0 |
| Clot factor xii hageman CPT 85280 | $211.80 | $353.00 | not published | 0 |
| Clot factor xiii fibrin scrn CPT 85291 | $97.20 | $162.00 | not published | 0 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $445.80 | $743.00 | not published | 0 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $445.80 | $743.00 | not published | 0 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $445.80 | $743.00 | not published | 0 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | $445.80 | $743.00 | not published | 0 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $1,507.80 | $2,513.00 | not published | 0 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $445.80 | $743.00 | not published | 0 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $445.80 | $743.00 | not published | 0 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $445.80 | $743.00 | not published | 0 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $1,507.80 | $2,513.00 | not published | 0 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $445.80 | $743.00 | not published | 0 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $445.80 | $743.00 | not published | 0 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $1,507.80 | $2,513.00 | not published | 0 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $445.80 | $743.00 | not published | 0 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $1,507.80 | $2,513.00 | not published | 0 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $445.80 | $743.00 | not published | 0 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $445.80 | $743.00 | not published | 0 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $453.60 | $756.00 | not published | 0 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $445.80 | $743.00 | not published | 0 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $445.80 | $743.00 | not published | 0 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $445.80 | $743.00 | not published | 0 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $9,433.30 | $15,722.17 | $3,234.84 – $3,234.84 | 2 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $1,507.80 | $2,513.00 | not published | 0 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $445.80 | $743.00 | not published | 0 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $1,507.80 | $2,513.00 | not published | 0 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $445.80 | $743.00 | not published | 0 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $1,507.80 | $2,513.00 | not published | 0 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $1,507.80 | $2,513.00 | not published | 0 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $1,507.80 | $2,513.00 | not published | 0 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $1,507.80 | $2,513.00 | not published | 0 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $445.80 | $743.00 | not published | 0 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $445.80 | $743.00 | not published | 0 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,507.80 | $2,513.00 | 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.