MONUMENT HEALTH CUSTER HOSPITAL
Critical Access Hospitals
16
Procedure Prices at MONUMENT HEALTH CUSTER HOSPITAL
Therapeutic Exercises
CPT 97110
$5.65
Therapeutic Activities
CPT 97530
$8.91
HC COLLECTION VENOUS BLOOD VENIPUNCTURE
CPT 36415
$13.5
Mechanical Traction
CPT 97012
$21.6
HC COMPLETE BL COUNT W DIFF AUTO
CPT 85025
$34.83
HC CMP COMPREHENSIVE METABOLIC
CPT 80053
$51.84
EKG Tracing
CPT 93005
$75.87
Chest X-Ray (1 view)
CPT 71045
$102.6
Chest X-Ray (2 views)
CPT 71046
$108
Thoracic Spine X-Ray
CPT 72072
$138.24
Screening Mammogram (bilateral)
CPT 77067
$142.29
OB Ultrasound
CPT 76805
$143.64
ER Visit — Low-Moderate Complexity
CPT 99283
$200.61
Abdominal Ultrasound — Limited
CPT 76705
$258.66
Retroperitoneal Ultrasound
CPT 76770
$258.66
ER Visit — Moderate Complexity
CPT 99284
$325.62
Abdominal Ultrasound
CPT 76700
$339.12
HC NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL
CPT 64483
$554.04
ER Visit — High Complexity
CPT 99285
$564.16
Colonoscopy
CPT 45378
$656.37
CT Chest
CPT 71250
$695.79
Echocardiogram w/ Doppler
CPT 93306
$754.92
MRI Joint of Lower Extremity
CPT 73721
$958.5
MRI Brain w/o Contrast
CPT 70551
$970.92
MRI Brain w/ Contrast
CPT 70553
$1,307.07
CT Abdomen & Pelvis
CPT 74177
$1,434.24
Compare Prices Nearby
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.