AVERA HOLY FAMILY HOSPITAL
Critical Access Hospitals
Procedure Prices at AVERA HOLY FAMILY HOSPITAL
EKG Interpretation
CPT 93010
$7.26
OB CBC W/Auto Diff
CPT 85025
$25.08
Venipuncture
CPT 36415
$27.72
Office Visit Level 3
CPT 99213
$48.45
Mechanical Traction
CPT 97012
$58.74
EKG Tracing
CPT 93005
$66.72
Therapeutic Exercises
CPT 97110
$73.26
Therapeutic Activities
CPT 97530
$73.26
Comprehensive Metabolic Panel
CPT 80053
$91.74
Chest X-Ray (1 view)
CPT 71045
$190.74
Screening Mammogram (bilateral)
CPT 77067
$190.74
Chest X-Ray (2 views)
CPT 71046
$198
Thoracic Spine X-Ray
CPT 72072
$227.7
Diagnostic Mammogram (unilateral)
CPT 77065
$261.36
Diagnostic Mammogram (bilateral)
CPT 77066
$283.8
ER Visit — Low-Moderate Complexity
CPT 99283
$370.92
ER Visit — Moderate Complexity
CPT 99284
$372.24
Abdominal Ultrasound — Limited
CPT 76705
$397.98
Abdominal Ultrasound
CPT 76700
$508.86
Retroperitoneal Ultrasound
CPT 76770
$508.86
OB Ultrasound
CPT 76805
$529.98
ER Visit — High Complexity
CPT 99285
$615.78
Inj Foramen Epidural L/S RT
CPT 64483
$1,432.25
Echocardiogram w/ Doppler
CPT 93306
$1,450.68
CT Chest
CPT 71250
$1,583.34
MRI Brain w/o Contrast
CPT 70551
$2,014.98
MRI Brain w/ Contrast
CPT 70553
$2,014.98
MRI Joint of Lower Extremity
CPT 73721
$2,121.9
CT Abdomen & Pelvis
CPT 74177
$2,813.58
Compare Prices Nearby
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.