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BRODSTONE MEMORIAL HOSPITAL

Hospital

P O BOX 187, 520 EAST 10TH ST

SUPERIOR, NE, 68978

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Procedure Prices at BRODSTONE MEMORIAL HOSPITAL

EKG

CPT 93000

$8.16

EKG Interpretation

CPT 93010

$13.16

LEGAL BLOOD ALCOHOL COLL.

CPT 36415

$14.1

BEHAVIORAL HEALTH - LEVEL 3

CPT 99213

$18.44

EKG Tracing

CPT 93005

$23.5

Knee Arthroscopy

CPT 29881

$25.38

ER Visit — Low-Moderate Complexity

CPT 99283

$26.97

Mechanical Traction

CPT 97012

$37.6

ER Visit — Moderate Complexity

CPT 99284

$43.5

Therapeutic Exercises

CPT 97110

$46.53

Appendectomy

CPT 44950

$48.15

Therapeutic Activities

CPT 97530

$48.88

CBC w Auto Diff/RPS

CPT 85025

$55.93

INJ ANES/STER TRANS EPI W GUI LUM/SACR

CPT 64483

$70.52

ER Visit — High Complexity

CPT 99285

$71.77

COMPREHENSIVE METABOLIC PANEL

CPT 80053

$82.25

Hip Replacement

CPT 27130

$101.65

PSYCH TX 60 MIN IND OP (53+ Min)

CPT 90837

$120.32

Upper GI Endoscopy w/ Biopsy

CPT 43239

$123.41

Chest X-Ray (1 view)

CPT 71045

$141

Screening Mammogram (bilateral)

CPT 77067

$168.73

Diagnostic Mammogram (unilateral)

CPT 77065

$171.08

Chest X-Ray (2 views)

CPT 71046

$177.19

Diagnostic Mammogram (bilateral)

CPT 77066

$203.04

Colonoscopy w/ Biopsy

CPT 45380

$239.78

Tonsillectomy & Adenoidectomy (under 12)

CPT 42820

$251.92

Colonoscopy

CPT 45378

$306.45

Tonsillectomy & Adenoidectomy (12+)

CPT 42821

$318.94

Abdominal Ultrasound — Limited

CPT 76705

$348.74

Laparoscopic Cholecystectomy

CPT 47562

$370.25

OB Ultrasound

CPT 76805

$407.02

Retroperitoneal Ultrasound

CPT 76770

$428.17

Abdominal Ultrasound

CPT 76700

$449.79

ARTHROSCOPY DECOMPRESSION W/ROTATOR CUFF

CPT 29827

$905.05

Echocardiogram

CPT 93307

$912.74

Echocardiogram w/ Doppler

CPT 93306

$1,157.61

CT Chest

CPT 71250

$1,206.96

MRI Joint of Lower Extremity

CPT 73721

$1,338.56

Knee Replacement

CPT 27447

$1,468.88

Vaginal Delivery

CPT 59400

$1,794.46

MRI Brain w/o Contrast

CPT 70551

$1,794.46

C-Section

CPT 59510

$2,005.49

MRI Brain w/ Contrast

CPT 70553

$2,024.76

CT Abdomen & Pelvis

CPT 74177

$2,233.44

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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.