ASCENSION ST JOHN NOWATA
Critical Access Hospitals
16
Procedure Prices at ASCENSION ST JOHN NOWATA
COLLECTION VENOUS BLOOD VENIPUNCTURE
CPT 36415
$3
EKG Tracing
CPT 93005
$10.37
BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC
CPT 85025
$10.61
EKG Interpretation
CPT 93010
$12.03
Mechanical Traction
CPT 97012
$12.85
COMPREHENSIVE METABOLIC PANEL
CPT 80053
$14.41
Chest X-Ray (1 view)
CPT 71045
$17.71
EKG
CPT 93000
$22.4
Therapeutic Exercises
CPT 97110
$25.52
Therapeutic Activities
CPT 97530
$27.58
Chest X-Ray (2 views)
CPT 71046
$32.14
Thoracic Spine X-Ray
CPT 72072
$49.92
OFFICE OUTPATIENT VISIT 15 MINUTES
CPT 99213
$71.81
ER Visit — Low-Moderate Complexity
CPT 99283
$87.46
Abdominal Ultrasound — Limited
CPT 76705
$143
ER Visit — Moderate Complexity
CPT 99284
$163.46
Echocardiogram
CPT 93307
$173.85
Retroperitoneal Ultrasound
CPT 76770
$175.25
Diagnostic Mammogram (unilateral)
CPT 77065
$175.71
Screening Mammogram (bilateral)
CPT 77067
$179.47
PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES
CPT 90837
$182.52
Abdominal Ultrasound
CPT 76700
$186.16
OB Ultrasound
CPT 76805
$193.81
NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL
CPT 64483
$200.63
Diagnostic Mammogram (bilateral)
CPT 77066
$222.73
ER Visit — High Complexity
CPT 99285
$244.24
CT Chest
CPT 71250
$250.99
Echocardiogram w/ Doppler
CPT 93306
$298.73
Upper GI Endoscopy w/ Biopsy
CPT 43239
$301.57
MRI Brain w/o Contrast
CPT 70551
$322.93
MRI Joint of Lower Extremity
CPT 73721
$334.6
Colonoscopy
CPT 45378
$381.57
CT Abdomen & Pelvis
CPT 74177
$426.21
Colonoscopy w/ Biopsy
CPT 45380
$455.22
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$511.73
MRI Brain w/ Contrast
CPT 70553
$517.69
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$531.41
Laparoscopic Hernia Repair
CPT 49650
$740.29
Inguinal Hernia Repair
CPT 49505
$899.65
Knee Arthroscopy
CPT 29881
$934.57
Recurrent Inguinal Hernia Repair
CPT 49520
$1,092.03
Appendectomy
CPT 44950
$1,111.08
Cataract Surgery
CPT 66984
$1,134.56
Laparoscopic Cholecystectomy
CPT 47562
$1,137.74
Cataract Surgery — Complex
CPT 66982
$1,411.38
ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR
CPT 29827
$1,853.91
TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW
CPT 27245
$2,123.1
Hip Replacement
CPT 27130
$2,489.44
Knee Replacement
CPT 27447
$2,657.69
Vaginal Delivery
CPT 59400
$2,954.87
VBAC Delivery
CPT 59610
$3,098.12
C-Section
CPT 59510
$3,267.16
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Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.