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JEFFERSON COUNTY HEALTH CENTER

Hospital

2000 S MAIN

FAIRFIELD, IA, 52556

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Procedure Prices at JEFFERSON COUNTY HEALTH CENTER

HB Cbc With Automated Differential

CPT 85025

$7.77

HB Jchc Phlebotomy

CPT 36415

$7.84

HB Jchc HRA Chemistry Panel

CPT 80053

$10.56

EKG

CPT 93000

$13.46

Mechanical Traction

CPT 97012

$18.06

Therapeutic Exercises

CPT 97110

$28.14

Therapeutic Activities

CPT 97530

$28.98

Chest X-Ray (2 views)

CPT 71046

$45.92

EKG Tracing

CPT 93005

$46.2

Chest X-Ray (1 view)

CPT 71045

$56.28

HB Jchc Office Outpatient Visit 15 Minutes

CPT 99213

$57.96

Thoracic Spine X-Ray

CPT 72072

$59.45

Diagnostic Mammogram (unilateral)

CPT 77065

$75

ER Visit — Low-Moderate Complexity

CPT 99283

$119.28

Screening Mammogram (bilateral)

CPT 77067

$122.64

Diagnostic Mammogram (bilateral)

CPT 77066

$144.9

OB Ultrasound

CPT 76805

$169.67

ER Visit — Moderate Complexity

CPT 99284

$186.48

Abdominal Ultrasound — Limited

CPT 76705

$191.72

ER Visit — High Complexity

CPT 99285

$261.66

Echocardiogram

CPT 93307

$302.4

Abdominal Ultrasound

CPT 76700

$303.27

Retroperitoneal Ultrasound

CPT 76770

$311.22

CT Chest

CPT 71250

$415.5

Echocardiogram w/ Doppler

CPT 93306

$416.16

HB Inj Transforamen Epidural Lumb/Sacr Incl Imaging, Single Lvl

CPT 64483

$419.16

MRI Joint of Lower Extremity

CPT 73721

$746.76

MRI Brain w/o Contrast

CPT 70551

$795.9

CT Abdomen & Pelvis

CPT 74177

$992.99

MRI Brain w/ Contrast

CPT 70553

$1,113.56

Hip Replacement

CPT 27130

$1,575.42

Upper GI Endoscopy w/ Biopsy

CPT 43239

$2,696.72

Tonsillectomy & Adenoidectomy (under 12)

CPT 42820

$3,452.89

Cataract Surgery — Complex

CPT 66982

$4,064.78

Cataract Surgery

CPT 66984

$4,064.78

Colonoscopy

CPT 45378

$4,385.42

Knee Arthroscopy

CPT 29881

$4,749.48

Colonoscopy w/ Biopsy

CPT 45380

$4,959.9

Inguinal Hernia Repair

CPT 49505

$6,253.82

Laparoscopic Cholecystectomy

CPT 47562

$8,802.9

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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.