NICHOLAS H NOYES MEMORIAL HOSPITAL
Acute Care Hospitals
Procedure Prices at NICHOLAS H NOYES MEMORIAL HOSPITAL
HB Collection Venous Blood Venipuncture
CPT 36415
$6.5
EKG Interpretation
CPT 93010
$7.58
HB Blood Count Complete Auto&Auto Difrntl Wbc
CPT 85025
$8.66
PR SHLDR ARTHROSCOP,SURG,W/ROTAT CUFF REPR
CPT 29827
$20
Knee Arthroscopy
CPT 29881
$20
Upper GI Endoscopy w/ Biopsy
CPT 43239
$20
Appendectomy
CPT 44950
$20
Laparoscopic Hernia Repair
CPT 49650
$20
Recurrent Inguinal Hernia Repair
CPT 49520
$20.6
PR WMLC F/U PT VISIT
CPT 99213
$21.76
Therapeutic Activities
CPT 97530
$23.58
ER Visit — Low-Moderate Complexity
CPT 99283
$24.41
HB Comprehensive Metabolic Panel
CPT 80053
$25.29
Mechanical Traction
CPT 97012
$26.37
Therapeutic Exercises
CPT 97110
$26.89
ER Visit — Moderate Complexity
CPT 99284
$45.02
Chest X-Ray (1 view)
CPT 71045
$47.35
PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL
CPT 64483
$51.02
EKG Tracing
CPT 93005
$57.32
PR OPEN FIX INTER/SUBTROCH FX,IMPLNT
CPT 27245
$57.5
Knee Replacement
CPT 27447
$57.5
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$57.5
Laparoscopic Cholecystectomy
CPT 47562
$57.5
Inguinal Hernia Repair
CPT 49505
$57.5
Cataract Surgery — Complex
CPT 66982
$57.5
Cataract Surgery
CPT 66984
$59
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$60
HB Psychotherapy Patient 60 Minutes
CPT 90837
$63.21
ER Visit — High Complexity
CPT 99285
$67.19
Chest X-Ray (2 views)
CPT 71046
$86.91
Colonoscopy
CPT 45378
$88.58
Screening Mammogram (bilateral)
CPT 77067
$106.86
Thoracic Spine X-Ray
CPT 72072
$108.65
Abdominal Ultrasound — Limited
CPT 76705
$137.81
Diagnostic Mammogram (unilateral)
CPT 77065
$154.68
Colonoscopy w/ Biopsy
CPT 45380
$161.6
Diagnostic Mammogram (bilateral)
CPT 77066
$182.78
Abdominal Ultrasound
CPT 76700
$230.51
OB Ultrasound
CPT 76805
$264.86
CT Abdomen & Pelvis
CPT 74177
$290.42
CT Chest
CPT 71250
$301.83
Retroperitoneal Ultrasound
CPT 76770
$320.02
MRI Brain w/o Contrast
CPT 70551
$332.54
MRI Joint of Lower Extremity
CPT 73721
$332.54
MRI Brain w/ Contrast
CPT 70553
$535.29
Echocardiogram w/ Doppler
CPT 93306
$601.63
Hip Replacement
CPT 27130
$697.27
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.