Jacobson Memorial Hospital Care Center
Critical Access Hospitals
16
Procedure Prices at Jacobson Memorial Hospital Care Center
Mechanical Traction
CPT 97012
$53.25
List: $71
EKG Tracing
CPT 93005
$55.69
List: $74.25
Chest X-Ray (1 view)
CPT 71045
$78.49
List: $104.65
Therapeutic Exercises
CPT 97110
$106.5
List: $142
Chest X-Ray (2 views)
CPT 71046
$108.67
List: $144.9
Thoracic Spine X-Ray
CPT 72072
$114
List: $152
Therapeutic Activities
CPT 97530
$132
List: $176
Abdominal Ultrasound — Limited
CPT 76705
$284.25
List: $379
Retroperitoneal Ultrasound
CPT 76770
$362.25
List: $483
Abdominal Ultrasound
CPT 76700
$369.75
List: $493
Diagnostic Mammogram (unilateral)
CPT 77065
$374.25
List: $499
OB Ultrasound
CPT 76805
$378.75
List: $505
Screening Mammogram (bilateral)
CPT 77067
$395.25
List: $527
Diagnostic Mammogram (bilateral)
CPT 77066
$478.5
List: $638
Echocardiogram w/ Doppler
CPT 93306
$621.86
List: $829.15
ER Visit — Low-Moderate Complexity
CPT 99283
$623
List: $830.67
ER Visit — Moderate Complexity
CPT 99284
$958.1
List: $1,277.46
CT Chest
CPT 71250
$1,019.47
List: $1,359.3
MRI Brain w/o Contrast
CPT 70551
$1,119
List: $1,492
ER Visit — High Complexity
CPT 99285
$1,379.48
List: $1,839.3
MRI Joint of Lower Extremity
CPT 73721
$1,892.32
List: $2,523.1
CT Abdomen & Pelvis
CPT 74177
$2,164.01
List: $2,885.35
MRI Brain w/ Contrast
CPT 70553
$2,881.61
List: $3,842.15
Compare Prices Nearby
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.