DAVIESS COMMUNITY HOSPITAL
Acute Care Hospitals
Procedure Prices at DAVIESS COMMUNITY HOSPITAL
OCC MED VENIPUNCTURE
CPT 36415
$4.66
EKG Interpretation
CPT 93010
$8.26
CBC WITH AUTO WBC DIFF
CPT 85025
$9.52
HSP-CHEM 16
CPT 80053
$14.26
Mechanical Traction
CPT 97012
$18.74
EKG Tracing
CPT 93005
$21
Therapeutic Exercises
CPT 97110
$38.31
Abdominal Ultrasound — Limited
CPT 76705
$38.68
Diagnostic Mammogram (unilateral)
CPT 77065
$39.85
Therapeutic Activities
CPT 97530
$47.86
Diagnostic Mammogram (bilateral)
CPT 77066
$49
LEVEL 3 EST PT INTERMEDIATE PR
CPT 99213
$49.36
Screening Mammogram (bilateral)
CPT 77067
$70
ER Visit — Low-Moderate Complexity
CPT 99283
$95.9
Chest X-Ray (1 view)
CPT 71045
$105.95
Chest X-Ray (2 views)
CPT 71046
$105.95
ER Visit — Moderate Complexity
CPT 99284
$114.69
PSYTX W PT 60 MINS TELE MED
CPT 90837
$123.74
CT Chest
CPT 71250
$130.34
Thoracic Spine X-Ray
CPT 72072
$130.34
Abdominal Ultrasound
CPT 76700
$130.34
Retroperitoneal Ultrasound
CPT 76770
$130.34
OB Ultrasound
CPT 76805
$130.34
Upper GI Endoscopy w/ Biopsy
CPT 43239
$133.87
ER Visit — High Complexity
CPT 99285
$166.55
Colonoscopy
CPT 45378
$179.07
Colonoscopy w/ Biopsy
CPT 45380
$194.49
MRI Brain w/o Contrast
CPT 70551
$284.78
MRI Joint of Lower Extremity
CPT 73721
$284.78
Echocardiogram
CPT 93307
$284.78
Laparoscopic Hernia Repair
CPT 49650
$404.58
MRI Brain w/ Contrast
CPT 70553
$449.3
CT Abdomen & Pelvis
CPT 74177
$449.3
Inguinal Hernia Repair
CPT 49505
$490.77
Knee Arthroscopy
CPT 29881
$511.21
Recurrent Inguinal Hernia Repair
CPT 49520
$594.99
Appendectomy
CPT 44950
$605.87
Echocardiogram w/ Doppler
CPT 93306
$613.57
Laparoscopic Cholecystectomy
CPT 47562
$620.21
PRO FEE SHO ARTHRS SRG RT8TR C
CPT 29827
$871.15
TFESI Lumbar or Sacral single
CPT 64483
$1,039.24
Hip Replacement
CPT 27130
$1,042.65
PRO FEE TREAT THIGH FRACTURE
CPT 27245
$1,162.4
Knee Replacement
CPT 27447
$1,281.34
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.