St. Michael Medical Center
1800 NW Myhre Rd, Silverdale, WA · Vmfh · · NPI 1518912609
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 |
|---|---|---|---|---|
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,213.64 | $5,015.62 | $705.13 – $4,514.06 | 6 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,029.17 | $4,597.65 | $1,440.56 – $4,137.89 | 6 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,844.70 | $4,179.68 | $417.90 – $3,761.72 | 6 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,653.62 | $10,544.09 | $1,440.56 – $9,489.69 | 6 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,068.87 | $6,953.40 | $1,440.56 – $6,258.06 | 6 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,018.56 | $6,839.41 | $913.06 – $6,155.47 | 6 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $393.59 | $891.78 | $498.80 – $802.61 | 6 |
| Lower jaw bone graft CPT 21215 | not published | not published | $25,165.86 – $25,165.86 | 1 |
| Low frequency non-thermal Ultrasound CPT 97610 | $189.24 | $428.76 | $270.12 – $851.07 | 6 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $24,564.86 – $24,564.86 | 1 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $42,828.44 – $42,828.44 | 1 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $42,828.44 – $42,828.44 | 1 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $42,828.44 – $42,828.44 | 1 |
| Lumbar diskogram s&i CPT 72295 | $2,934.15 | $6,648.14 | $4,188.33 – $8,471.71 | 6 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $103,203.53 – $103,203.53 | 1 |
| Lung Function Test (Spirometry) CPT 94010 | $256.66 | $581.52 | $366.36 – $685.41 | 6 |
| Lung perfusion imaging CPT 78580 | $1,016.47 | $2,303.10 | $1,450.96 – $2,072.79 | 6 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $63,141.94 | $143,066.10 | $78.41 – $73,576.80 | 6 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $33.38 – $117.64 | 6 |
| Lymphatics/lymph node imaging CPT 78195 | $1,732.78 | $3,926.10 | $1,974.45 – $3,533.49 | 6 |
| Lymphocyte transformation mitogen CPT 86353 | $182.89 | $414.37 | $49.03 – $372.94 | 16 |
| Lymph vessel x-ray arms/legs CPT 75803 | $1,124.55 | $2,547.98 | $1,605.23 – $7,012.24 | 6 |
| Lymph vessel x-ray trunk CPT 75807 | $2,755.78 | $6,244.00 | $3,933.72 – $14,039.89 | 6 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $2,152.99 – $2,152.99 | 1 |
| Lysis of labial adhesions CPT 56441 | $2,059.53 | $4,666.45 | $2,939.87 – $13,325.72 | 6 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $8,742.05 – $8,742.05 | 1 |
| Macroscopic exam arthropod CPT 87168 | $61.56 | $139.47 | $4.27 – $125.53 | 16 |
| Macroscopic exam parasite CPT 87169 | $65.89 | $149.27 | $4.31 – $134.35 | 16 |
| Magnesium CPT 83735 | $61.45 | $139.23 | $6.70 – $125.31 | 16 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $125.13 | $283.50 | $1.01 – $40.23 | 5 |
| Magnetic image bone marrow CPT 77084 | $1,921.44 | $4,353.55 | $913.06 – $3,918.20 | 6 |
| Male sling procedure CPT 53440 | not published | not published | $56,688.29 – $56,688.29 | 1 |
| Mammosite ced HCPCS C1728 | $1,087.09 | $2,463.11 | $1,551.76 – $2,216.80 | 5 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $6,760.89 – $6,760.89 | 1 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $6,760.89 – $6,760.89 | 1 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $81.16 | $183.88 | $23.50 – $547.23 | 10 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $147.71 | $334.66 | $14.92 – $547.23 | 10 |
| Manipulation of hip joint CPT 27275 | not published | not published | $6,760.89 – $6,760.89 | 1 |
| Manipulation of spine CPT 22505 | not published | not published | $6,760.89 – $6,760.89 | 1 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $975.64 – $975.64 | 1 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $272.87 | $618.25 | $4.58 – $173.88 | 5 |
| Map tachycard site(s) CPT 93609 | $2,951.33 | $6,687.07 | $4,212.86 – $6,018.37 | 5 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $32,664.35 | $74,010.40 | $8,162.91 – $11,661.30 | 5 |
| Marker biop eviva buckle ss HCPCS A4648 | $3,054.59 | $6,921.04 | $81.39 – $116.28 | 5 |
| Mastectomy partial CPT 19301 | not published | not published | $16,202.35 – $16,202.35 | 1 |
| Mast mod rad CPT 19307 | not published | not published | $28,010.07 – $28,010.07 | 1 |
| Mastoidectomy CPT 69501 | not published | not published | $25,165.86 – $25,165.86 | 1 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $25,165.86 – $25,165.86 | 1 |
| Mastoids complete CPT 70130 | $376.40 | $852.84 | $498.80 – $767.56 | 6 |
| Mastoid surgery revision CPT 69603 | not published | not published | $25,165.86 – $25,165.86 | 1 |
| Mastopexy CPT 19316 | not published | not published | $28,010.07 – $28,010.07 | 1 |
| Mast simple complete CPT 19303 | not published | not published | $28,010.07 – $28,010.07 | 1 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $13,358.73 | $30,268.00 | $38.54 – $378.54 | 5 |
| Maxillofacial fixation CPT 21100 | not published | not published | $25,165.86 – $25,165.86 | 1 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $63.92 | $144.82 | $14.46 – $130.34 | 16 |
| Mayo aathr protein s free CPT 85306 | $155.72 | $352.82 | $15.32 – $317.54 | 16 |
| Mayo activated protein c resistance assay CPT 85307 | $162.26 | $367.64 | $15.32 – $330.88 | 16 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $135.04 | $305.95 | $38.57 – $275.36 | 16 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $81.42 | $184.46 | $14.78 – $166.02 | 16 |
| Mayo alpha 1 antitrypsin CPT 82103 | $94.27 | $213.59 | $13.44 – $192.24 | 16 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $62.76 | $142.19 | $15.08 – $127.98 | 16 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $305.59 | $692.40 | $121.63 – $454.86 | 16 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $454.67 | $1,030.18 | $91.66 – $321.93 | 16 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $177.03 | $401.10 | $137.00 – $360.99 | 16 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,537.43 | $3,483.48 | $803.88 – $2,714.40 | 16 |
| Mayo androstenedione CPT 82157 | $193.55 | $438.53 | $29.28 – $394.68 | 16 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $145.01 | $328.55 | $14.60 – $295.70 | 16 |
| Mayo antithrombin iii antigen CPT 85301 | $169.96 | $385.09 | $10.81 – $346.59 | 16 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $38.40 | $87.00 | $15.05 – $78.30 | 16 |
| Mayo avwpr vw factor activity CPT 85397 | $266.64 | $604.13 | $30.86 – $543.72 | 16 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $40.85 | $92.55 | $10.18 – $83.30 | 16 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $351.70 | $796.86 | $144.84 – $605.78 | 16 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $314.14 | $711.76 | $214.62 – $640.59 | 16 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $37.32 | $84.55 | $12.90 – $76.10 | 16 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $247.35 | $560.43 | $13.19 – $140.84 | 16 |
| Mayo brcmg brucella antibody igm CPT 86622 | $33.58 | $76.07 | $8.93 – $68.47 | 16 |
| Mayo c1 esterase inhibitor CPT 83883 | $91.65 | $207.64 | $13.60 – $110.26 | 16 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $91.36 | $207.00 | $16.87 – $186.30 | 16 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $83.87 | $190.03 | $26.78 – $171.03 | 16 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $105.65 | $239.38 | $122.22 – $285.99 | 16 |
| Mayo ceruloplasmin CPT 82390 | $75.41 | $170.86 | $10.74 – $153.78 | 16 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $287.27 | $650.89 | $14.12 – $157.05 | 16 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $324.18 | $734.52 | $12.88 – $137.33 | 16 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $73.97 | $167.58 | $11.82 – $150.83 | 16 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $47.94 | $108.62 | $12.68 – $97.76 | 16 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $514.07 | $1,164.77 | $116.49 – $1,048.30 | 16 |
| Mayo chromium CPT 82495 | $100.03 | $226.63 | $20.28 – $203.97 | 16 |
| Mayo coccidioides antibody CPT 86635 | $67.11 | $152.04 | $11.47 – $136.84 | 16 |
| Mayo cocou cortisone urine CPT 82542 | $307.19 | $696.02 | $24.09 – $236.39 | 16 |
| Mayo cortisol free CPT 82530 | $129.25 | $292.84 | $16.71 – $263.56 | 16 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $18.60 | $42.13 | $26.55 – $98.58 | 16 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $48.19 | $109.18 | $12.12 – $75.67 | 16 |
| Mayo cyanide CPT 82600 | $133.62 | $302.75 | $19.40 – $272.48 | 16 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $60.91 | $137.99 | $13.25 – $124.20 | 16 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $93.58 | $212.01 | $25.27 – $190.81 | 16 |
| Mayo dihydrotestosterone CPT 82642 | $57.01 | $129.15 | $29.28 – $116.24 | 16 |
| Mayo efpo chloride stool CPT 82438 | $23.85 | $54.03 | $5.00 – $48.63 | 16 |
| Mayo estriol CPT 82677 | $60.24 | $136.48 | $24.18 – $122.84 | 16 |
| Mayo estrone CPT 82679 | $121.72 | $275.78 | $24.95 – $248.21 | 16 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $101.92 | $230.92 | $16.34 – $207.83 | 16 |
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.