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 |
|---|---|---|---|---|
| Cystouretero w/biopsy CPT 52354 | $22,479.74 | $37,466.23 | $5,231.42 – $5,336.05 | 3 |
| Cysto/uretero w/lithotripsy CPT 52356 | $26,272.37 | $43,787.28 | $5,231.42 – $5,336.05 | 3 |
| Cystouretero w/lithotripsy CPT 52353 | $38,328.77 | $63,881.28 | $5,231.42 – $5,336.05 | 3 |
| Cystouretero w/stone remove CPT 52352 | $21,749.16 | $36,248.60 | $3,439.27 – $3,508.06 | 3 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $10,787.24 | $17,978.73 | $2,039.56 – $2,080.35 | 3 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | $27,055.70 | $45,092.83 | $2,039.56 – $2,080.35 | 3 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $90.00 | $150.00 | not published | 0 |
| Cytogenetics 25-99 CPT 88274 | $316.20 | $527.00 | not published | 0 |
| Cytogenomic neo microra alys CPT 81277 | $1,837.80 | $3,063.00 | not published | 0 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $84.60 | $141.00 | not published | 0 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $118.20 | $197.00 | not published | 0 |
| Cytopath c/v index add-on CPT 88155 | $44.40 | $74.00 | not published | 0 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $594.00 | $990.00 | not published | 0 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $280.20 | $467.00 | not published | 0 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $134.40 | $224.00 | not published | 0 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $161.40 | $269.00 | not published | 0 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $145.20 | $242.00 | not published | 0 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $111.60 | $186.00 | not published | 0 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $200.40 | $334.00 | not published | 0 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $365.40 | $609.00 | not published | 0 |
| Cytopath smear other source CPT 88160 | $83.40 | $139.00 | not published | 0 |
| Cytopath smear other source CPT 88162 | $85.20 | $142.00 | not published | 0 |
| Cytopath smear oth prep screen & interp CPT 88161 | $99.60 | $166.00 | not published | 0 |
| Cytopath tbs c/v manual CPT 88164 | $76.80 | $128.00 | not published | 0 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $322.20 | $537.00 | not published | 0 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $90.00 | $150.00 | not published | 0 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $104.63 | $174.38 | not published | 0 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $10,797.30 | $17,995.50 | not published | 0 |
| Deamidated gliadin antibody iga CPT 86258 | $40.20 | $67.00 | not published | 0 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $807.00 | $1,345.00 | not published | 0 |
| Debridement (>20 cm) charge pt CPT 97598 | $332.40 | $554.00 | not published | 0 |
| Debridement bone <= 20 sq cm CPT 11044 | $2,704.80 | $4,508.00 | not published | 0 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $927.00 | $1,545.00 | not published | 0 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $1,412.40 | $2,354.00 | not published | 0 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $8,682.24 | $14,470.40 | $396.63 – $404.56 | 3 |
| Debride skin bone at fx site CPT 11012 | $3,588.60 | $5,981.00 | not published | 0 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $860.40 | $1,434.00 | not published | 0 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $12,892.85 | $21,488.08 | $721.10 – $735.52 | 3 |
| Decalcification CPT 88311 | $84.60 | $141.00 | not published | 0 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $756.00 | $1,260.00 | not published | 0 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $3,155.06 | $5,258.43 | not published | 0 |
| Delayed breast prosthesis 19342 CPT 19342 | $56,711.92 | $94,519.87 | $7,974.65 – $8,134.14 | 3 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $107.40 | $179.00 | not published | 0 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $16,041.29 | $26,735.49 | not published | 0 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $162.00 | $270.00 | not published | 0 |
| Dermapure 1 square cm HCPCS Q4152 | $9,240.84 | $15,401.40 | not published | 0 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $68.12 | $113.53 | not published | 0 |
| Destruction benign lesions < 14 lesions CPT 17110 | $251.40 | $419.00 | not published | 0 |
| Device ablt adv novasure HCPCS C1886 | $22,465.20 | $37,442.00 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $11,580.00 | $19,300.00 | not published | 0 |
| Device sut capio slim opn HCPCS C2631 | $5,299.01 | $8,831.68 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $4,290.39 | $7,150.65 | not published | 0 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $10.20 | $17.00 | not published | 0 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $26.89 | $44.82 | not published | 0 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $84.00 | $140.00 | not published | 0 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $142.20 | $237.00 | not published | 0 |
| Diabetes (HbA1c) Test CPT 83036 | $120.00 | $200.00 | not published | 0 |
| Diag laparo separate proc 49320 CPT 49320 | $20,056.82 | $33,428.03 | $5,898.53 – $6,016.50 | 3 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $162.00 | $270.00 | not published | 0 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $249.00 | $415.00 | not published | 0 |
| Dialysis one evaluation CPT 90945 | $487.80 | $813.00 | not published | 0 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $256.50 | $427.50 | not published | 0 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $31.07 | $51.78 | not published | 0 |
| Diffusing capacity CPT 94729 | $366.60 | $611.00 | not published | 0 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $21.00 | $35.00 | not published | 0 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $23,129.10 | $38,548.50 | not published | 0 |
| Digoxin total therapeutic drug level CPT 80162 | $97.20 | $162.00 | not published | 0 |
| Dilate esophagus 1/mult pass CPT 43450 | $4,195.12 | $6,991.87 | $884.93 – $902.63 | 3 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $869.40 | $1,449.00 | not published | 0 |
| Dilator fascial 10fx20cm HCPCS C2627 | $1,470.20 | $2,450.33 | not published | 0 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $81.82 | $136.37 | not published | 0 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $21.00 | $35.00 | not published | 0 |
| Disaccharidases CPT 82657 | $98.40 | $164.00 | not published | 0 |
| Dise eval slp do brth flx dx CPT 42975 | $7,695.05 | $12,825.08 | $1,736.62 – $1,771.35 | 3 |
| Dmpk gene detc abnor allele CPT 81234 | $431.40 | $719.00 | not published | 0 |
| Dna antibody native/double stranded CPT 86225 | $127.20 | $212.00 | not published | 0 |
| Dna gardnerella CPT 87510 | $112.80 | $188.00 | not published | 0 |
| Dna trichomonas CPT 87660 | $112.80 | $188.00 | not published | 0 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $279.63 | $466.05 | not published | 0 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $1,043.55 | $1,739.25 | not published | 0 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $112.93 | $188.22 | not published | 0 |
| Doppler echo complete CPT 93320 | $663.00 | $1,105.00 | not published | 0 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $3,467.40 | $5,779.00 | not published | 0 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $571.20 | $952.00 | not published | 0 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $415.80 | $693.00 | not published | 0 |
| Dornase alfa non-comp unit HCPCS J7639 | $959.14 | $1,598.56 | not published | 0 |
| Dornhoffer fixed part w/window HCPCS L8614 | $119,274.00 | $198,790.00 | not published | 0 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $1,653.00 | $2,755.00 | not published | 0 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $105.22 | $175.36 | not published | 0 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $901.80 | $1,503.00 | not published | 0 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $901.80 | $1,503.00 | not published | 0 |
| Drainage external ear complex 69005 CPT 69005 | $1,452.60 | $2,421.00 | not published | 0 |
| Drainage external ear simple 69000 CPT 69000 | $901.80 | $1,503.00 | not published | 0 |
| Drainage mouth roof lesion CPT 42000 | $289.20 | $482.00 | not published | 0 |
| Drainage of arm bursa 23931 CPT 23931 | $2,083.80 | $3,473.00 | not published | 0 |
| Drainage of mouth lesion CPT 41009 | $962.40 | $1,604.00 | not published | 0 |
| Drainage of rectal abscess CPT 45005 | $4,205.40 | $7,009.00 | not published | 0 |
| Drain blood from under nail 11740 CPT 11740 | $112.80 | $188.00 | not published | 0 |
| Drain finger abscess;simple 26010 CPT 26010 | $428.40 | $714.00 | not published | 0 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $441.60 | $736.00 | 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.