Providence Holy Family Hospital — MRI prices
← Hospital overviewVerified from Providence Holy Family Hospital’s published price file
Includes cash prices, list prices. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
20 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC MRI ABDOMEN WO CONTRAST Inpatient & outpatient | 74181 HCPCS | $4,875 | $3,413 | — | — | |
| HC MRI ABDOMEN WO CONTRAST Outpatient | 74181 HCPCS | $1,083 | $758 | — | — | |
| HC MRI BRAIN STEM W/O DYE Inpatient & outpatient | 70551 HCPCS | $3,996 | $2,797 | — | — | |
| HC MRI BRAIN STEM W/O DYE Outpatient | 70551 HCPCS | $1,043 | $730 | — | — | |
| HC MRI BRAIN W/DYE Inpatient & outpatient | 70552 HCPCS | $4,876 | $3,413 | — | — | |
| HC MRI BRAIN W/DYE Outpatient | 70552 HCPCS | $1,507 | $1,055 | — | — | |
| HC MRI BRAIN W/O & W/DYE Inpatient & outpatient | 70553 HCPCS | $5,508 | $3,856 | — | — | |
| HC MRI BRAIN W/O & W/DYE Outpatient | 70553 HCPCS | $1,742 | $1,219 | — | — | |
| HC MRI BRAIN W/O DYE LIMITED Inpatient & outpatient | 70551 HCPCS | $1,648 | $1,154 | — | — | |
| HC MRI CERVICAL SPINE W/O DYE Inpatient & outpatient | 72141 HCPCS | $4,226 | $2,958 | — | — | |
| HC MRI CERVICAL SPINE W/O DYE Outpatient | 72141 HCPCS | $1,043 | $730 | — | — | |
| HC MRI CERVICAL SPINE W/O DYE LIMITED Inpatient & outpatient | 72141 HCPCS | $2,225 | $1,558 | — | — | |
| HC MRI JNT OF LWR EXTRE W/O DYE LIMITED Inpatient & outpatient | 73721 HCPCS | $1,780 | $1,246 | — | — | |
| HC MRI LOWER EXTREMITY JOINT WO CONTRAST Inpatient & outpatient | 73721 HCPCS | $4,012 | $2,808 | — | — | |
| HC MRI LOWER EXTREMITY JOINT WO CONTRAST Outpatient | 73721 HCPCS | $1,083 | $758 | — | — | |
| HC MRI LUMBAR SPINE W/O DYE Inpatient & outpatient | 72148 HCPCS | $5,046 | $3,532 | — | — | |
| HC MRI LUMBAR SPINE W/O DYE Outpatient | 72148 HCPCS | $1,083 | $758 | — | — | |
| HC MRI LUMBAR SPINE W/O DYE LIMITED Inpatient & outpatient | 72148 HCPCS | $2,523 | $1,766 | — | — | |
| HC MRI MRCP ABDOMEN WO CONTRAST Inpatient & outpatient | 74181 HCPCS | $4,875 | $3,413 | — | — | |
| HC MRI MRCP ABDOMEN WO CONTRAST Outpatient | 74181 HCPCS | $1,083 | $758 | — | — |