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MITCHELL COUNTY HOSPITAL HEALTH SYSTEMS

Hospital

400 W 8TH STREET, P O BOX 399

BELOIT, KS, 67420

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Procedure Prices at MITCHELL COUNTY HOSPITAL HEALTH SYSTEMS

CBC w/Diff Standard

CPT 85025

$7.77

82803 Venous Blood Gas RT Standard

CPT 36415

$8.57

.CMP Add On

CPT 80053

$10.56

Mechanical Traction

CPT 97012

$36.36

Established patient office or other outpatient visit, 20-29 minutes

CPT 99213

$38.38

Therapeutic Activities

CPT 97530

$40.81

Therapeutic Exercises

CPT 97110

$49.49

EKG Tracing

CPT 93005

$57.48

ER Visit — Low-Moderate Complexity

CPT 99283

$68.02

Chest X-Ray (1 view)

CPT 71045

$86.88

Thoracic Spine X-Ray

CPT 72072

$106.88

Retroperitoneal Ultrasound

CPT 76770

$106.88

Abdominal Ultrasound — Limited

CPT 76705

$117.16

Diagnostic Mammogram (unilateral)

CPT 77065

$117.43

Diagnostic Mammogram (bilateral)

CPT 77066

$123.22

Screening Mammogram (bilateral)

CPT 77067

$123.22

SLE Psychotherapy 60 Min Charge

CPT 90837

$145.7

Chest X-Ray (2 views)

CPT 71046

$148.93

Abdominal Ultrasound

CPT 76700

$151.5

Colonoscopy

CPT 45378

$171.05

Colonoscopy w/ Biopsy

CPT 45380

$186.17

ER Visit — Moderate Complexity

CPT 99284

$194.58

MRI Brain w/o Contrast

CPT 70551

$233.52

MRI Joint of Lower Extremity

CPT 73721

$233.52

CT Abdomen & Pelvis

CPT 74177

$368.43

Upper GI Endoscopy w/ Biopsy

CPT 43239

$387.47

CT Chest

CPT 71250

$457.53

Inguinal Hernia Repair

CPT 49505

$480.71

Echocardiogram w/ Doppler

CPT 93306

$503.13

MRI Brain w/ Contrast

CPT 70553

$526.21

Laparoscopic Hernia Repair

CPT 49650

$528.66

ER Visit — High Complexity

CPT 99285

$548.11

Recurrent Inguinal Hernia Repair

CPT 49520

$581.45

Appendectomy

CPT 44950

$588.58

Laparoscopic Cholecystectomy

CPT 47562

$604.94

64483 LUMBAR TRANSFORAMINAL EPIDURAL WITH FLUOROSCOPY

CPT 64483

$766.29

Cataract Surgery

CPT 66984

$2,139.55

Cataract Surgery — Complex

CPT 66982

$2,639.52

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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.