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MEMORIAL HOSPITAL LOS BANOS

Hospital

520 WEST I ST

LOS BANOS, CA, 93635

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Procedure Prices at MEMORIAL HOSPITAL LOS BANOS

HCHG CBC AUTOMATED W/ AUTOMATED DIFFERENTIAL

CPT 85025

$13.21

Chest X-Ray (1 view)

CPT 71045

$16.52

HCHG CORE COMPR MET PNL

CPT 80053

$17.95

HCHG VENIPUNCTURE

CPT 36415

$25.2

Therapeutic Exercises

CPT 97110

$26.73

Therapeutic Activities

CPT 97530

$27.16

EKG Interpretation

CPT 93010

$29.99

Chest X-Ray (2 views)

CPT 71046

$30.83

EKG Tracing

CPT 93005

$39.99

Thoracic Spine X-Ray

CPT 72072

$58.75

Abdominal Ultrasound — Limited

CPT 76705

$102.2

CT Chest

CPT 71250

$129.12

Abdominal Ultrasound

CPT 76700

$129.12

Retroperitoneal Ultrasound

CPT 76770

$129.12

OB Ultrasound

CPT 76805

$129.12

Diagnostic Mammogram (unilateral)

CPT 77065

$143.31

Screening Mammogram (bilateral)

CPT 77067

$150.27

Diagnostic Mammogram (bilateral)

CPT 77066

$183.71

HCHG RHC LEVEL 3 ESTABLISHED PATIENT

CPT 99213

$184.26

Echocardiogram

CPT 93307

$219.61

MRI Brain w/o Contrast

CPT 70551

$272.89

MRI Joint of Lower Extremity

CPT 73721

$272.89

Echocardiogram w/ Doppler

CPT 93306

$301.62

CT Abdomen & Pelvis

CPT 74177

$344.92

MRI Brain w/ Contrast

CPT 70553

$436.72

Colonoscopy

CPT 45378

$941.15

Upper GI Endoscopy w/ Biopsy

CPT 43239

$959.62

All Services for Outpatient Surgery for Njx aa&/strd tfrm epi l/s 1

CPT 64483

$976.27

Colonoscopy w/ Biopsy

CPT 45380

$1,229.8

Cataract Surgery — Complex

CPT 66982

$2,462.79

Cataract Surgery

CPT 66984

$2,462.79

Tonsillectomy & Adenoidectomy (12+)

CPT 42821

$3,244.43

Knee Arthroscopy

CPT 29881

$3,358.57

Appendectomy

CPT 44950

$3,773.21

Inguinal Hernia Repair

CPT 49505

$3,773.21

Recurrent Inguinal Hernia Repair

CPT 49520

$3,773.21

Tonsillectomy & Adenoidectomy (under 12)

CPT 42820

$4,115.88

Laparoscopic Cholecystectomy

CPT 47562

$6,000.83

Laparoscopic Hernia Repair

CPT 49650

$6,000.83

All Services for Outpatient Surgery for Arthroscop rotator cuff repr

CPT 29827

$7,428.38

Hip Replacement

CPT 27130

$14,623.58

Knee Replacement

CPT 27447

$14,623.58

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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.