St. Mary Medical Center Inc
1500 S Lake Park Ave, Hobart, IN 46342 · Acute care hospital · Emergency room
These are St. Mary Medical Center Inc's own posted figures from its standard-charges file dated April 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
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Emergency room
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Critical care, first 30 to 74 minutes CPT 99291 | $2,923.80 | $4,873.00 | $267.31 – $5,617.00 |
| Emergency room visit, level 1 (minor) CPT 99281 | $446.40 | $744.00 | $27.53 – $1,739.00 |
| Emergency room visit, level 2 CPT 99282 | $625.20 | $1,042.00 | $52.69 – $1,739.00 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $1,120.20 | $1,867.00 | $78.64 – $1,949.00 |
| Emergency room visit, level 4 CPT 99284 | $1,480.20 | $2,467.00 | $145.53 – $4,158.00 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $2,146.20 | $3,577.00 | $211.64 – $4,158.00 |
| Simple wound repair (stitches), 2.5 cm or less CPT 12001 | $518.40 | $864.00 | $57.74 – $1,739.00 |
Office visits
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Office visit, established patient, about 10 to 19 minutes CPT 99212 | $788.40 | $1,314.00 | $59.24 – $1,158.95 |
| Office visit, established patient, about 20 to 29 minutes CPT 99213 | $1,021.20 | $1,702.00 | $110.20 – $1,501.16 |
| Office visit, established patient, about 30 to 39 minutes CPT 99214 | $1,024.80 | $1,708.00 | $140.86 – $1,506.46 |
| Office visit, established patient, about 40 to 54 minutes CPT 99215 | $1,206.00 | $2,010.00 | $140.86 – $1,772.82 |
| Office visit, established patient, brief (often a nurse) CPT 99211 | $710.40 | $1,184.00 | $14.82 – $1,044.29 |
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $45.00 | $75.00 | $21.67 – $319.00 |
| Abdominal X-ray, 1 view CPT 74018 | $276.60 | $461.00 | $23.44 – $439.00 |
| Ankle X-ray, 3 or more views CPT 73610 | $305.40 | $509.00 | $30.32 – $447.92 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $648.60 | $1,081.00 | $34.57 – $951.28 |
| Breast ultrasound, one breast, complete CPT 76641 | $662.40 | $1,104.00 | $82.42 – $1,457.28 |
| Breast ultrasound, one breast, limited CPT 76642 | $356.40 | $594.00 | $62.62 – $785.86 |
| Chest X-ray, 1 view CPT 71045 | $153.60 | $256.00 | $19.32 – $439.00 |
| Chest X-ray, 2 views CPT 71046 | $289.80 | $483.00 | $25.50 – $439.00 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $1,733.40 | $2,889.00 | $185.58 – $2,542.32 |
| CT angiogram of the head CPT 70496 | $1,733.40 | $2,889.00 | $185.58 – $2,542.32 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $2,806.20 | $4,677.00 | $273.74 – $4,115.76 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $3,539.40 | $5,899.00 | $310.44 – $5,191.12 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $2,292.00 | $3,820.00 | $130.68 – $3,361.60 |
| CT scan of the abdomen, without contrast CPT 74150 | $1,153.20 | $1,922.00 | $103.87 – $1,691.36 |
| CT scan of the chest, with contrast CPT 71260 | $1,505.40 | $2,509.00 | $155.01 – $2,207.92 |
| CT scan of the chest, without contrast CPT 71250 | $1,153.20 | $1,922.00 | $110.61 – $1,691.36 |
| CT scan of the head, without contrast CPT 70450 | $1,029.60 | $1,716.00 | $84.48 – $1,510.08 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $1,192.80 | $1,988.00 | $110.61 – $1,749.44 |
| CT scan of the pelvis, with contrast CPT 72193 | $1,300.80 | $2,168.00 | $185.58 – $1,907.84 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $1,029.60 | $1,716.00 | $110.61 – $1,510.08 |
| Diagnostic mammogram, both breasts CPT 77066 | $307.20 | $512.00 | $102.19 – $530.90 |
| Diagnostic mammogram, one breast CPT 77065 | $226.20 | $377.00 | $79.74 – $415.98 |
| Foot X-ray, 3 or more views CPT 73630 | $305.40 | $509.00 | $28.39 – $447.92 |
| Hand X-ray, 3 or more views CPT 73130 | $305.40 | $509.00 | $29.78 – $447.92 |
| Knee X-ray, 3 views CPT 73562 | $344.40 | $574.00 | $33.00 – $505.12 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $1,677.00 | $2,795.00 | $187.53 – $2,465.19 |
| Leg or arm vein ultrasound, one side CPT 93971 | $1,132.20 | $1,887.00 | $110.61 – $1,664.33 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $305.40 | $509.00 | $31.27 – $467.61 |
| MRI of both breasts, without and with contrast CPT 77049 | $3,806.40 | $6,344.00 | $327.77 – $5,595.41 |
| MRI of the abdomen, without and with contrast CPT 74183 | $3,963.00 | $6,605.00 | $326.94 – $5,812.40 |
| MRI of the brain, without and with contrast CPT 70553 | $3,710.40 | $6,184.00 | $290.24 – $5,441.92 |
| MRI of the brain, without contrast CPT 70551 | $2,341.20 | $3,902.00 | $172.68 – $3,433.76 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $2,363.40 | $3,939.00 | $187.12 – $3,466.32 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $2,368.80 | $3,948.00 | $165.74 – $3,474.24 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $2,368.80 | $3,948.00 | $165.33 – $3,474.24 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $2,368.80 | $3,948.00 | $165.33 – $3,474.24 |
| MRI of the pelvis, without and with contrast CPT 72197 | $3,710.40 | $6,184.00 | $326.12 – $5,441.92 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $2,363.40 | $3,939.00 | $187.12 – $3,466.32 |
| Neck X-ray, 2 or 3 views CPT 72040 | $305.40 | $509.00 | $31.27 – $447.92 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $559.80 | $933.00 | $87.78 – $821.04 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $595.80 | $993.00 | $105.11 – $873.84 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $595.80 | $993.00 | $84.48 – $873.84 |
| Screening mammogram, both breasts CPT 77067 | $256.80 | $428.00 | $84.38 – $439.28 |
| Shoulder X-ray, 2 or more views CPT 73030 | $305.40 | $509.00 | $27.57 – $447.92 |
| Transvaginal pregnancy ultrasound CPT 76817 | $559.80 | $933.00 | $67.99 – $821.04 |
| Transvaginal ultrasound CPT 76830 | $559.80 | $933.00 | $103.05 – $821.04 |
| Ultrasound of the abdomen, complete CPT 76700 | $624.00 | $1,040.00 | $95.62 – $915.20 |
| Ultrasound of the neck or thyroid CPT 76536 | $557.40 | $929.00 | $89.46 – $817.52 |
| Wrist X-ray, 3 or more views CPT 73110 | $305.40 | $509.00 | $31.41 – $447.92 |
| X-ray of the lower back, 4 or more views CPT 72110 | $459.00 | $765.00 | $41.17 – $673.20 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $146.40 | $244.00 | $8.46 – $214.72 |
| Blood culture CPT 87040 | $94.20 | $157.00 | $10.32 – $138.16 |
| Blood draw (venipuncture) CPT 36415 | $11.40 | $19.00 | $3.00 – $23.35 |
| BNP test (heart failure) CPT 83880 | $221.40 | $369.00 | $39.26 – $324.72 |
| C-reactive protein (CRP) test CPT 86140 | $103.20 | $172.00 | $5.18 – $151.36 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $189.60 | $316.00 | $35.09 – $278.08 |
| Complete blood count (CBC) with differential CPT 85025 | $73.20 | $122.00 | $7.77 – $107.36 |
| Complete blood count (CBC), automated CPT 85027 | $65.40 | $109.00 | $6.47 – $95.92 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $246.00 | $410.00 | $10.56 – $360.80 |
| COVID-19 PCR test CPT 87635 | $187.20 | $312.00 | $51.31 – $275.18 |
| D-dimer test (blood clots) CPT 85379 | $161.40 | $269.00 | $10.18 – $236.72 |
| Drug screen, instrument chemistry CPT 80307 | $545.40 | $909.00 | $62.14 – $801.74 |
| Ferritin (iron stores) test CPT 82728 | $114.60 | $191.00 | $13.63 – $168.08 |
| Free T4 (thyroid) test CPT 84439 | $135.00 | $225.00 | $9.02 – $198.00 |
| General health panel (blood tests) CPT 80050 | $475.80 | $793.00 | $3.50 – $697.84 |
| Glucose (blood sugar) test CPT 82947 | $49.80 | $83.00 | $3.93 – $73.04 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $147.60 | $246.00 | $35.09 – $216.48 |
| Hemoglobin A1c test CPT 83036 | $116.40 | $194.00 | $9.71 – $170.72 |
| Hepatitis C antibody test CPT 86803 | $147.60 | $246.00 | $14.27 – $216.48 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $109.80 | $183.00 | $24.08 – $161.04 |
| Iron test CPT 83540 | $355.20 | $592.00 | $6.47 – $520.96 |
| Kidney function panel CPT 80069 | $209.40 | $349.00 | $8.68 – $307.12 |
| Lipase test (pancreas) CPT 83690 | $93.60 | $156.00 | $6.89 – $137.28 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $324.60 | $541.00 | $13.39 – $476.08 |
| Liver function panel CPT 80076 | $246.00 | $410.00 | $8.17 – $360.80 |
| Magnesium test CPT 83735 | $205.80 | $343.00 | $6.70 – $301.84 |
| Obstetric blood test panel CPT 80055 | $250.80 | $418.00 | $47.81 – $368.68 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $92.40 | $154.00 | $6.01 – $135.52 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $238.80 | $398.00 | $15.05 – $350.24 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $48.60 | $81.00 | $4.29 – $71.28 |
| PSA (prostate specific antigen), free CPT 84154 | $88.80 | $148.00 | $18.39 – $130.24 |
| PSA (prostate specific antigen), total CPT 84153 | $201.60 | $336.00 | $18.39 – $295.68 |
| Rapid strep test CPT 87880 | $96.00 | $160.00 | $16.53 – $140.80 |
| Sed rate (ESR) test CPT 85652 | $52.20 | $87.00 | $2.70 – $76.56 |
| TB skin test CPT 86580 | $28.80 | $48.00 | $11.07 – $42.24 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $157.20 | $262.00 | $16.80 – $230.56 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $390.00 | $650.00 | $37.05 – $572.00 |
| Troponin test (heart damage) CPT 84484 | $177.60 | $296.00 | $12.47 – $260.48 |
| Urinalysis, automated, with microscope CPT 81001 | $48.60 | $81.00 | $3.17 – $71.28 |
| Urinalysis, automated, without microscope CPT 81003 | $31.20 | $52.00 | $2.25 – $45.76 |
| Urinalysis, manual, with microscope CPT 81000 | $5.40 | $9.00 | $4.02 – $11.04 |
| Urinalysis, manual, without microscope CPT 81002 | $39.00 | $65.00 | $3.48 – $57.20 |
| Urine culture, colony count CPT 87086 | $90.60 | $151.00 | $8.07 – $132.88 |
| Urine pregnancy test CPT 81025 | $78.60 | $131.00 | $8.61 – $115.28 |
| Vitamin B12 test CPT 82607 | $150.00 | $250.00 | $15.08 – $220.00 |
| Vitamin D test CPT 82306 | $127.80 | $213.00 | $29.60 – $187.44 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $1,282.80 | $2,138.00 | $186.70 – $1,885.72 |
| ECG tracing only (no interpretation) CPT 93005 | $275.40 | $459.00 | $10.24 – $404.84 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $3,114.60 | $5,191.00 | $156.60 – $4,578.46 |
| Left heart catheterization CPT 93452 | $15,136.20 | $25,227.00 | $787.86 – $22,199.76 |
| Left heart catheterization with coronary angiogram CPT 93458 | $16,749.60 | $27,916.00 | $902.95 – $24,566.08 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $4,356.60 | $7,261.00 | $464.28 – $6,404.20 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Breast biopsy with ultrasound guidance CPT 19083 | $2,932.20 | $4,887.00 | $195.31 – $8,100.00 |
| Cystoscopy (bladder scope) CPT 52000 | $1,332.00 | $2,220.00 | $100.42 – $1,953.60 |
| Kidney stone shock-wave lithotripsy CPT 50590 | $18,673.80 | $31,123.00 | $704.18 – $41,082.36 |
| Nasal endoscopy, diagnostic CPT 31231 | $771.00 | $1,285.00 | $78.19 – $8,100.00 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $1,939.20 | $3,232.00 | $171.28 – $2,844.16 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $1,939.20 | $3,232.00 | $152.39 – $2,844.16 |
Pregnancy and birth
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Fetal non-stress test CPT 59025 | $456.00 | $760.00 | $22.20 – $670.32 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897 | $21,432.96 | $35,721.60 | $6,983.98 – $18,657.10 |
| C-section, without complications MS-DRG 788 | $14,996.69 | $24,994.49 | $6,232.20 – $20,263.28 |
| Chest pain MS-DRG 313 | $22,361.85 | $37,269.75 | $5,747.61 – $15,216.48 |
| COPD flare-up, with major complications MS-DRG 190 | $19,381.37 | $32,302.29 | $8,691.70 – $28,082.46 |
| COPD flare-up, without complications MS-DRG 192 | $12,441.01 | $20,735.01 | $4,173.00 – $19,910.50 |
| Fainting (syncope) MS-DRG 312 | $17,698.79 | $29,497.99 | $6,898.93 – $18,420.39 |
| Gastrointestinal bleeding, with complications MS-DRG 378 | $24,855.07 | $41,425.12 | $7,727.36 – $20,726.11 |
| Heart failure, with major complications MS-DRG 291 | $22,702.52 | $37,837.53 | $10,028.85 – $27,131.83 |
| Heart failure, without complications MS-DRG 293 | $14,404.45 | $24,007.42 | $4,574.68 – $11,961.84 |
| Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216 | $177,682.91 | $296,138.18 | $74,563.60 – $188,631.95 |
| Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 | $33,527.21 | $55,878.69 | $14,927.25 – $47,134.00 |
| Irregular heartbeat, without complications MS-DRG 310 | $7,567.12 | $12,611.86 | $3,679.65 – $34,371.43 |
| Kidney failure, with complications MS-DRG 683 | $17,511.79 | $29,186.32 | $6,930.83 – $18,509.16 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $14,031.77 | $23,386.29 | $5,261.75 – $17,107.97 |
| Normal newborn care MS-DRG 795 | $3,648.32 | $6,080.54 | $541.00 – $4,222.57 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $15,539.06 | $25,898.44 | $5,058.30 – $16,446.48 |
| Pneumonia, with complications MS-DRG 194 | $17,272.63 | $28,787.71 | $6,400.06 – $48,980.29 |
| Pneumonia, with major complications MS-DRG 193 | $23,687.41 | $39,479.01 | $10,261.20 – $31,954.57 |
| Pneumonia, without complications MS-DRG 195 | $10,254.45 | $17,090.75 | $4,085.25 – $13,282.72 |
| Psychoses (inpatient psychiatric stay) MS-DRG 885 | $9,787.58 | $16,312.64 | $9,079.20 – $29,519.97 |
| Sepsis, with major complications MS-DRG 871 | $35,502.20 | $59,170.34 | $15,030.52 – $41,052.80 |
| Sepsis, without major complications MS-DRG 872 | $21,081.56 | $35,135.94 | $8,050.82 – $21,626.42 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $16,305.97 | $27,176.61 | $6,893.62 – $18,405.60 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $17,483.93 | $29,139.88 | $6,200.36 – $16,476.07 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $28,035.23 | $46,725.38 | $7,952.12 – $21,351.68 |
| Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743 | $20,838.80 | $34,731.34 | $9,701.60 – $26,220.95 |
| Vaginal delivery, without complications MS-DRG 807 | $7,642.60 | $12,737.67 | $4,187.00 – $14,248.54 |
| Weight loss surgery, without complications MS-DRG 621 | $26,521.66 | $44,202.76 | $11,734.29 – $31,878.53 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $895.80 | $1,493.00 | $57.60 – $8,100.00 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $1,522.20 | $2,537.00 | $121.96 – $8,100.00 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | $307.80 | $513.00 | $38.67 – $803.00 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Sleep study with CPAP titration CPT 95811 | $4,581.00 | $7,635.00 | $597.71 – $6,734.07 |
| Sleep study, overnight in a sleep lab CPT 95810 | $3,820.80 | $6,368.00 | $571.31 – $5,616.58 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $257.40 | $429.00 | $31.69 – $807.00 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $91.80 | $153.00 | $26.60 – $287.00 |
| Physical therapy evaluation, low complexity CPT 97161 | $133.20 | $222.00 | $94.33 – $287.00 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $181.80 | $303.00 | $94.33 – $287.00 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $79.80 | $133.00 | $27.89 – $287.00 |
| Therapeutic activities, 15 minutes CPT 97530 | $79.80 | $133.00 | $33.44 – $287.00 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Group psychotherapy CPT 90853 | $102.60 | $171.00 | $28.85 – $150.82 |
| Psychotherapy, 30 minutes CPT 90832 | $182.40 | $304.00 | $73.27 – $268.13 |
| Psychotherapy, 45 minutes CPT 90834 | $228.00 | $380.00 | $97.69 – $335.16 |
| Psychotherapy, 60 minutes CPT 90837 | $283.80 | $473.00 | $145.78 – $417.19 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $118.20 | $197.00 | $16.63 – $355.00 |
| IV hydration, each additional hour CPT 96361 | $104.40 | $174.00 | $15.91 – $355.00 |
| IV hydration, first hour CPT 96360 | $467.40 | $779.00 | $40.07 – $685.52 |
| IV push injection of a drug, first CPT 96374 | $191.40 | $319.00 | $46.26 – $355.00 |
| IV push injection, each additional drug CPT 96375 | $181.80 | $303.00 | $19.20 – $355.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $77.23 | $128.71 | $1.84 – $113.52 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $23.80 | $39.66 | $2.20 – $34.98 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $13.87 | $23.12 | ? – $20.39 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $13.87 | $23.12 | ? – $20.39 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $248.72 | $414.54 | $13.89 – $365.62 |
| Morphine injection, up to 10 mg HCPCS J2270 | $197.40 | $329.00 | $30.40 – $290.18 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $32.45 | $54.09 | $3.60 – $47.71 |
| Propofol injection, per 10 mg HCPCS J2704 | $89.66 | $149.44 | $8.80 – $131.81 |
Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.