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FAXTON-ST LUKE'S HEALTHCARE

Hospital

1656 CHAMPLIN AVENUE

NEW HARTFD, NY, 13413

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Procedure Prices at FAXTON-ST LUKE'S HEALTHCARE

Blood Draw From Vein Using Needle

CPT 36415

$1.82

Lab Test - Complete Blood Cell Count With White Blood Cell Percentage

CPT 85025

$3.17

Mechanical Traction

CPT 97012

$9.46

Lab Test - Comprehensive Metabolic Panel

CPT 80053

$10.56

Chest X-Ray (2 views)

CPT 71046

$15

Thoracic Spine X-Ray

CPT 72072

$18

Therapeutic Exercises

CPT 97110

$24.75

Therapeutic Activities

CPT 97530

$28.97

Retroperitoneal Ultrasound

CPT 76770

$36

EKG Tracing

CPT 93005

$39.74

Abdominal Ultrasound

CPT 76700

$45.66

Abdominal Ultrasound — Limited

CPT 76705

$48.11

Individual Psychotherapy Session 60 Minutes

CPT 90837

$52.33

Diagnostic Mammogram (unilateral)

CPT 77065

$58.2

Diagnostic Mammogram (bilateral)

CPT 77066

$58.2

Screening Mammogram (bilateral)

CPT 77067

$58.2

Chest X-Ray (1 view)

CPT 71045

$65.7

OB Ultrasound

CPT 76805

$71.85

CT Chest

CPT 71250

$84

Outpatient Clinic Visit Established Patient Level III

CPT 99213

$97.52

ER Visit — Moderate Complexity

CPT 99284

$117.81

ER Visit — Low-Moderate Complexity

CPT 99283

$120.45

Echocardiogram w/ Doppler

CPT 93306

$270.03

ER Visit — High Complexity

CPT 99285

$278.52

CT Abdomen & Pelvis

CPT 74177

$294.91

Colonoscopy w/ Biopsy

CPT 45380

$377.8

MRI Brain w/ Contrast

CPT 70553

$391.65

Upper GI Endoscopy w/ Biopsy

CPT 43239

$421.28

Colonoscopy

CPT 45378

$640.65

MRI Joint of Lower Extremity

CPT 73721

$662.53

MRI Brain w/o Contrast

CPT 70551

$1,284.57

Inguinal Hernia Repair

CPT 49505

$1,826.56

Knee Arthroscopy

CPT 29881

$2,288.98

Laparoscopic Cholecystectomy

CPT 47562

$2,331.13

Laparoscopic Hernia Repair

CPT 49650

$2,711.38

Recurrent Inguinal Hernia Repair

CPT 49520

$2,996.61

Appendectomy

CPT 44950

$12,584.71

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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.