MAD RIVER COMMUNITY HOSPITAL
Acute Care Hospitals
Procedure Prices at MAD RIVER COMMUNITY HOSPITAL
Blood Draw From Vein Using Needle
CPT 36415
$3
Lab Test - Complete Blood Cell Count With White Blood Cell Percentage
CPT 85025
$6.75
Lab Test - Comprehensive Metabolic Panel
CPT 80053
$9.28
Therapeutic Exercises
CPT 97110
$26.15
Thoracic Spine X-Ray
CPT 72072
$41.73
EKG Tracing
CPT 93005
$64.85
Chest X-Ray (2 views)
CPT 71046
$65.87
Chest X-Ray (1 view)
CPT 71045
$94.26
Therapeutic Activities
CPT 97530
$99.1
Screening Mammogram (bilateral)
CPT 77067
$101.96
Diagnostic Mammogram (bilateral)
CPT 77066
$122.94
Retroperitoneal Ultrasound
CPT 76770
$126.97
Abdominal Ultrasound
CPT 76700
$129.12
Mechanical Traction
CPT 97012
$167.61
ER Visit — Low-Moderate Complexity
CPT 99283
$225.04
Outpatient Clinic Visit Established Patient Level III
CPT 99213
$271.01
CT Abdomen & Pelvis
CPT 74177
$379.44
MRI Brain w/ Contrast
CPT 70553
$434.1
ER Visit — Moderate Complexity
CPT 99284
$556.18
Echocardiogram w/ Doppler
CPT 93306
$567.85
OB Ultrasound
CPT 76805
$615.1
ER Visit — High Complexity
CPT 99285
$619.24
Abdominal Ultrasound — Limited
CPT 76705
$633.82
Diagnostic Mammogram (unilateral)
CPT 77065
$640.8
Upper GI Endoscopy w/ Biopsy
CPT 43239
$722.11
Colonoscopy
CPT 45378
$788.94
MRI Joint of Lower Extremity
CPT 73721
$1,015.76
Colonoscopy w/ Biopsy
CPT 45380
$1,230.51
MRI Brain w/o Contrast
CPT 70551
$2,688.28
CT Chest
CPT 71250
$2,742.04
Inguinal Hernia Repair
CPT 49505
$3,020.08
Injection of Drug Into Lower Spinal Nerve Root With Imaging Guidance
CPT 64483
$4,457.65
Knee Arthroscopy
CPT 29881
$9,753.93
Recurrent Inguinal Hernia Repair
CPT 49520
$12,819.37
Laparoscopic Cholecystectomy
CPT 47562
$15,919.44
Repair of Shoulder Rotator Cuff Using Arthroscope
CPT 29827
$38,480.48
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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.