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Common Medical Costs: The Cost of Care
Below are estimated costs for Providence Health Plan members only.
- Members do not necessarily pay the average costs listed on this page.
- Members are responsible for deductible amounts, copayments, and coinsurances.
- Members pay up to the amount of their maximum out-of pocket limit on covered charges.
- See your specific plan benefit summary for details, or contact Customer Service.
| Procedure Name | Average Cost |
|---|---|
| Abdominal ultrasound | $200.00 |
| Breast biopsy | $2,356.00 |
| C-section delivery ( includes prenatal care) | $11,948.00 |
| Chest X-ray ( front and back views) | $60.00 |
| Cholesterol Screening ( lipid panel) | $26.00 |
| Colonoscopy | $1,779.00 |
| Complete Blood Count ( CBC) | $15.00 |
| Coronary artery bypass graft ( one vessel) | $50,878.00 |
| Coronary artery stent ( one vessel) | $27,061.00 |
| CT of brain | $574.00 |
| CT of pelvis | $549.00 |
| Hysterectomy | $10,892.00 |
| Juvenile ear tubes ( typanostomy with tubes) | $2,135.00 |
| Knee surgery ( arthroscopy with meniscectomy) | $3,538.00 |
| Laparoscopic gallbladder removal | $6,693.00 |
| Lumbar disk surgery ( laminectomy) | $8,098.00 |
| Mammography ( bilateral) | $141.00 |
| MRI of brain | $1,840.00 |
| MRI of lumbar spine | $945.00 |
| Sigmoidoscopy office procedure | $208.00 |
| Tonsils, adenoids ( juvenile) | $3,434.00 |
| Urinalysis | $6.00 |
| Vaginal delivery ( includes prenatal care) | $7,069.00 |
| Medical/surgical inpatient day | $4,199.00 |
| Emergency Room | $840.00 |
| Personal physician/provider office visit | $87.00 |
| Specialist office visit | $87.00 |
| Specialist office visit ( complex) | $136.00 |
| Specialist office visit ( highly complex) | $198.00 |
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Additional Information
Costs include physician fees associated with routine performance of the procedure described. Costs provided are not intended to represent fees charged by any specific facility or provider.