CHEYENNE COUNTY HOSPITAL
Critical Access Hospitals
16
Procedure Prices at CHEYENNE COUNTY HOSPITAL
COLLECTION: Venous Draw
CPT 36415
$10.44
Complete Blood Count with Automated Differential
CPT 85025
$11.9
Comprehensive Metabolic Panel
CPT 80053
$22.46
Mechanical Traction
CPT 97012
$36
Therapeutic Exercises
CPT 97110
$48.6
Therapeutic Activities
CPT 97530
$48.6
TR 99213 WOUND CARE 26-50 SQ CM
CPT 99213
$53.07
EKG Tracing
CPT 93005
$86.22
Abdominal Ultrasound — Limited
CPT 76705
$116
Diagnostic Mammogram (unilateral)
CPT 77065
$122
Chest X-Ray (1 view)
CPT 71045
$122.36
Chest X-Ray (2 views)
CPT 71046
$130.32
OB Ultrasound
CPT 76805
$131
Abdominal Ultrasound
CPT 76700
$131.4
Upper GI Endoscopy w/ Biopsy
CPT 43239
$142.8
Diagnostic Mammogram (bilateral)
CPT 77066
$148.4
CL 90837 PSYCH PT 60 MIN SEP ENCOUNTER
CPT 90837
$149.69
Retroperitoneal Ultrasound
CPT 76770
$150
CT Chest
CPT 71250
$160.32
Colonoscopy
CPT 45378
$191.1
Screening Mammogram (bilateral)
CPT 77067
$203.76
Colonoscopy w/ Biopsy
CPT 45380
$318.68
Laparoscopic Cholecystectomy
CPT 47562
$318.68
Inguinal Hernia Repair
CPT 49505
$318.68
MRI Brain w/o Contrast
CPT 70551
$350.28
MRI Joint of Lower Extremity
CPT 73721
$350.28
Echocardiogram
CPT 93307
$350.28
ER Visit — Low-Moderate Complexity
CPT 99283
$367.5
CT Abdomen & Pelvis
CPT 74177
$453
MRI Brain w/ Contrast
CPT 70553
$472.64
TR 64483 INJ TRANSFORAMINAL EPI L/S SNGL
CPT 64483
$482.16
ER Visit — Moderate Complexity
CPT 99284
$572.42
Echocardiogram w/ Doppler
CPT 93306
$754.7
ER Visit — High Complexity
CPT 99285
$822.17
Cataract Surgery — Complex
CPT 66982
$2,188.2
Cataract Surgery
CPT 66984
$2,679
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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.