FOSTORIA COMMUNITY HOSPITAL
Critical Access Hospitals
Procedure Prices at FOSTORIA COMMUNITY HOSPITAL
Blood Draw From Vein Using Needle
CPT 36415
$2.74
Lab Test - Complete Blood Cell Count With White Blood Cell Percentage
CPT 85025
$16.31
Lab Test - Comprehensive Metabolic Panel
CPT 80053
$24.52
Mechanical Traction
CPT 97012
$40.85
Diagnostic Mammogram (unilateral)
CPT 77065
$44
EKG Tracing
CPT 93005
$45.96
Outpatient Clinic Visit Established Patient Level III
CPT 99213
$53.39
Chest X-Ray (1 view)
CPT 71045
$56.56
Chest X-Ray (2 views)
CPT 71046
$80.27
Thoracic Spine X-Ray
CPT 72072
$83.54
Screening Mammogram (bilateral)
CPT 77067
$95.56
Therapeutic Exercises
CPT 97110
$107.89
Therapeutic Activities
CPT 97530
$124.05
ER Visit — Low-Moderate Complexity
CPT 99283
$144.4
Abdominal Ultrasound — Limited
CPT 76705
$163.24
Individual Psychotherapy Session 60 Minutes
CPT 90837
$175.78
OB Ultrasound
CPT 76805
$176.45
CT Chest
CPT 71250
$198.31
Diagnostic Mammogram (bilateral)
CPT 77066
$218.95
Retroperitoneal Ultrasound
CPT 76770
$231.3
ER Visit — Moderate Complexity
CPT 99284
$256.98
ER Visit — High Complexity
CPT 99285
$272.59
Abdominal Ultrasound
CPT 76700
$283.52
MRI Joint of Lower Extremity
CPT 73721
$283.89
MRI Brain w/o Contrast
CPT 70551
$297.05
MRI Brain w/ Contrast
CPT 70553
$349.58
CT Abdomen & Pelvis
CPT 74177
$393.54
Echocardiogram w/ Doppler
CPT 93306
$404.28
Repair of Shoulder Rotator Cuff Using Arthroscope
CPT 29827
$496.18
Colonoscopy
CPT 45378
$529.82
Injection of Drug Into Lower Spinal Nerve Root With Imaging Guidance
CPT 64483
$962.6
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$1,000.09
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$1,077.8
Upper GI Endoscopy w/ Biopsy
CPT 43239
$1,226.34
Knee Arthroscopy
CPT 29881
$1,311.81
Inguinal Hernia Repair
CPT 49505
$2,281.28
Laparoscopic Cholecystectomy
CPT 47562
$2,549.33
Colonoscopy w/ Biopsy
CPT 45380
$4,556.28
Cataract Surgery
CPT 66984
$9,141.86
Recurrent Inguinal Hernia Repair
CPT 49520
$13,073.39
Knee Replacement
CPT 27447
$38,666.26
Hip Replacement
CPT 27130
$41,623.93
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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.