JOHNSON MEMORIAL HOSPITAL
Acute Care Hospitals
Procedure Prices at JOHNSON MEMORIAL HOSPITAL
EKG Interpretation
CPT 93010
$25.03
ICC VENIPUNCTURE ROUTINE
CPT 36415
$28.16
.CBC Downtime, IU
CPT 85025
$61.88
Diagnostic Mammogram (unilateral)
CPT 77065
$68.12
Therapeutic Activities
CPT 97530
$86.28
.CMP Downtime, IU
CPT 80053
$92.82
Therapeutic Exercises
CPT 97110
$94.16
Mechanical Traction
CPT 97012
$101.88
Office or other outpatient visit for the evaluation and management of an established patient, lvl 3
CPT 99213
$102.7
EKG Tracing
CPT 93005
$161.5
Diagnostic Mammogram (bilateral)
CPT 77066
$174
Screening Mammogram (bilateral)
CPT 77067
$174
Chest X-Ray (1 view)
CPT 71045
$189.42
OB Ultrasound
CPT 76805
$190.67
Chest X-Ray (2 views)
CPT 71046
$205.01
90837 - Psychotherapy, 60 minutes w/patient
CPT 90837
$245.05
Thoracic Spine X-Ray
CPT 72072
$258.59
ER Visit — High Complexity
CPT 99285
$333.45
Abdominal Ultrasound — Limited
CPT 76705
$479.96
Retroperitoneal Ultrasound
CPT 76770
$504.61
Upper GI Endoscopy w/ Biopsy
CPT 43239
$553.48
ER Visit — Low-Moderate Complexity
CPT 99283
$554.42
Colonoscopy w/ Biopsy
CPT 45380
$692.01
Colonoscopy
CPT 45378
$724.1
Echocardiogram
CPT 93307
$732.77
Abdominal Ultrasound
CPT 76700
$777.54
ER Visit — Moderate Complexity
CPT 99284
$811
Knee Arthroscopy
CPT 29881
$949.33
Inguinal Hernia Repair
CPT 49505
$1,004.58
Recurrent Inguinal Hernia Repair
CPT 49520
$1,106.3
Appendectomy
CPT 44950
$1,127.43
Laparoscopic Cholecystectomy
CPT 47562
$1,152.13
CT Chest
CPT 71250
$1,235
CT Abdomen & Pelvis
CPT 74177
$1,235
Echocardiogram w/ Doppler
CPT 93306
$1,381.01
Laparoscopic Hernia Repair
CPT 49650
$1,430
64483 Transforaminal ESI (Selective nerve root) lumbar / sacral w/ guidance, 1st injection
CPT 64483
$1,457.69
29827 Arthroscop rotator cuff repr
CPT 29827
$1,825.85
MRI Joint of Lower Extremity
CPT 73721
$2,200.22
MRI Brain w/o Contrast
CPT 70551
$2,213
MRI Brain w/ Contrast
CPT 70553
$2,213
Hip Replacement
CPT 27130
$2,373.8
Knee Replacement
CPT 27447
$2,617.23
Vaginal Delivery
CPT 59400
$3,204.83
VBAC Delivery
CPT 59610
$3,361.48
C-Section
CPT 59510
$3,549.65
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.