JEFFERSON HEALTHCARE
Critical Access Hospitals
Procedure Prices at JEFFERSON HEALTHCARE
HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD
CPT 36415
$8.51
EKG Interpretation
CPT 93010
$9.35
Chest X-Ray (1 view)
CPT 71045
$10.14
Chest X-Ray (2 views)
CPT 71046
$12.1
Thoracic Spine X-Ray
CPT 72072
$12.49
HC CBC WITH DIFF AUTO
CPT 85025
$16.32
HC COMPREHEN METABOLIC PANEL
CPT 80053
$28.22
Abdominal Ultrasound — Limited
CPT 76705
$32.67
Therapeutic Exercises
CPT 97110
$40.12
Retroperitoneal Ultrasound
CPT 76770
$40.54
Therapeutic Activities
CPT 97530
$42.5
Mechanical Traction
CPT 97012
$43.37
Abdominal Ultrasound
CPT 76700
$44.47
Diagnostic Mammogram (unilateral)
CPT 77065
$44.47
Diagnostic Mammogram (bilateral)
CPT 77066
$54.71
OB Ultrasound
CPT 76805
$55.11
CT Chest
CPT 71250
$59.63
EKG Tracing
CPT 93005
$69.32
Echocardiogram w/ Doppler
CPT 93306
$78.68
MRI Brain w/o Contrast
CPT 70551
$81.87
ER Visit — Low-Moderate Complexity
CPT 99283
$81.97
HC ESTAB PT VISIT - LEVEL 3
CPT 99213
$97.4
CT Abdomen & Pelvis
CPT 74177
$100.57
Screening Mammogram (bilateral)
CPT 77067
$109.3
MRI Brain w/ Contrast
CPT 70553
$126.34
HC PR 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES
CPT 90837
$148.99
Upper GI Endoscopy w/ Biopsy
CPT 43239
$157.39
Echocardiogram
CPT 93307
$176.48
ER Visit — High Complexity
CPT 99285
$200.62
Colonoscopy
CPT 45378
$209.71
Colonoscopy w/ Biopsy
CPT 45380
$228.05
Laparoscopic Hernia Repair
CPT 49650
$498.9
Inguinal Hernia Repair
CPT 49505
$601.81
Knee Arthroscopy
CPT 29881
$633.54
ER Visit — Moderate Complexity
CPT 99284
$653.93
HC INJ FORAMEN EPIDURAL L/S
CPT 64483
$704.87
Recurrent Inguinal Hernia Repair
CPT 49520
$726.73
Appendectomy
CPT 44950
$733.68
MRI Joint of Lower Extremity
CPT 73721
$737.21
Laparoscopic Cholecystectomy
CPT 47562
$755.71
HC PR 29827 SHLDR ARTHROSCOP,SURG,W/ROTAT CUFF REPR
CPT 29827
$1,238.34
HC PR 27245 TX FEMORAL FRACTURE W/INTRAMEDULARY TYPE IMPLANT
CPT 27245
$1,415.79
Knee Replacement
CPT 27447
$1,477.64
Hip Replacement
CPT 27130
$1,479.13
Vaginal Delivery
CPT 59400
$2,745.4
VBAC Delivery
CPT 59610
$2,864.44
C-Section
CPT 59510
$3,026.73
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.