MERCYONE CENTERVILLE MEDICAL CENTER
Critical Access Hospitals
16
Procedure Prices at MERCYONE CENTERVILLE MEDICAL CENTER
COMPREHEN METABOLIC PANEL
CPT 80053
$5.7
COMPLETE CBC W/AUTO DIFF WBC
CPT 85025
$11.1
BLOOD COLLECTION FEE- VP
CPT 36415
$11.7
Chest X-Ray (1 view)
CPT 71045
$18
Chest X-Ray (2 views)
CPT 71046
$18.6
Thoracic Spine X-Ray
CPT 72072
$26.06
SC EST PAT EXP PROBLEM FC
CPT 99213
$32.4
EKG Tracing
CPT 93005
$53.7
Abdominal Ultrasound
CPT 76700
$82.2
Diagnostic Mammogram (unilateral)
CPT 77065
$109.2
ER Visit — Low-Moderate Complexity
CPT 99283
$114.9
Diagnostic Mammogram (bilateral)
CPT 77066
$119.7
Screening Mammogram (bilateral)
CPT 77067
$125.4
IND PSYCHOTHERAPY 56-67 MIN
CPT 90837
$133.5
OB Ultrasound
CPT 76805
$141.3
ER Visit — Moderate Complexity
CPT 99284
$150.9
Abdominal Ultrasound — Limited
CPT 76705
$188.4
Retroperitoneal Ultrasound
CPT 76770
$213.9
ER Visit — High Complexity
CPT 99285
$225.9
TRANS EPIDURAL SING LEVEL
CPT 64483
$268.5
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$327.6
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$327.6
CT Chest
CPT 71250
$385.07
Echocardiogram w/ Doppler
CPT 93306
$593.02
SCOPE SHOULDER ROTATOR CUFF
CPT 29827
$691.8
Colonoscopy w/ Biopsy
CPT 45380
$696.3
Upper GI Endoscopy w/ Biopsy
CPT 43239
$731.4
Colonoscopy
CPT 45378
$766.2
MRI Brain w/o Contrast
CPT 70551
$809.5
MRI Joint of Lower Extremity
CPT 73721
$809.5
TX INT/PR/SUBTRCHTRC FEM FX IMED
CPT 27245
$831
Knee Replacement
CPT 27447
$850.5
Hip Replacement
CPT 27130
$867
Knee Arthroscopy
CPT 29881
$879.3
CT Abdomen & Pelvis
CPT 74177
$913.81
MRI Brain w/ Contrast
CPT 70553
$1,119.14
Cataract Surgery
CPT 66984
$1,358.7
Cataract Surgery — Complex
CPT 66982
$1,398.6
Laparoscopic Hernia Repair
CPT 49650
$2,079
Recurrent Inguinal Hernia Repair
CPT 49520
$2,445.3
Inguinal Hernia Repair
CPT 49505
$2,473.5
Appendectomy
CPT 44950
$2,604.6
Laparoscopic Cholecystectomy
CPT 47562
$2,992.5
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.