North Canyon Medical Center
Critical Access Hospitals
16
Procedure Prices at North Canyon Medical Center
Thoracic Spine X-Ray
CPT 72072
$11.2
MRI Brain w/o Contrast
CPT 70551
$14
MRI Brain w/ Contrast
CPT 70553
$16
Abdominal Ultrasound — Limited
CPT 76705
$24
Retroperitoneal Ultrasound
CPT 76770
$24
Mechanical Traction
CPT 97012
$24
Therapeutic Activities
CPT 97530
$26
CT Chest
CPT 71250
$35
Diagnostic Mammogram (unilateral)
CPT 77065
$39.79
Abdominal Ultrasound
CPT 76700
$39.8
Screening Mammogram (bilateral)
CPT 77067
$40.59
Diagnostic Mammogram (bilateral)
CPT 77066
$49.05
Chest X-Ray (1 view)
CPT 71045
$54.82
EKG Tracing
CPT 93005
$59.4
MRI Joint of Lower Extremity
CPT 73721
$66.78
Therapeutic Exercises
CPT 97110
$72
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$87
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$87
Appendectomy
CPT 44950
$87
Vaginal Delivery
CPT 59400
$87
C-Section
CPT 59510
$87
VBAC Delivery
CPT 59610
$87
Cataract Surgery — Complex
CPT 66982
$87
Cataract Surgery
CPT 66984
$87
Chest X-Ray (2 views)
CPT 71046
$87
CT Abdomen & Pelvis
CPT 74177
$87
OB Ultrasound
CPT 76805
$87
EKG
CPT 93000
$87
EKG Interpretation
CPT 93010
$87
Echocardiogram
CPT 93307
$87
Colonoscopy
CPT 45378
$205
Colonoscopy w/ Biopsy
CPT 45380
$205
ER Visit — Low-Moderate Complexity
CPT 99283
$276.89
Upper GI Endoscopy w/ Biopsy
CPT 43239
$337.02
Echocardiogram w/ Doppler
CPT 93306
$373.1
ER Visit — Moderate Complexity
CPT 99284
$425.82
Laparoscopic Hernia Repair
CPT 49650
$497.33
ER Visit — High Complexity
CPT 99285
$613.1
Inguinal Hernia Repair
CPT 49505
$615
Recurrent Inguinal Hernia Repair
CPT 49520
$716.68
Laparoscopic Cholecystectomy
CPT 47562
$864.28
Knee Arthroscopy
CPT 29881
$1,215.65
Knee Replacement
CPT 27447
$2,702.31
Hip Replacement
CPT 27130
$4,454.24
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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.