PAGE HOSPITAL
Critical Access Hospitals
16
Procedure Prices at PAGE HOSPITAL
EKG Interpretation
CPT 93010
$22
Abdominal Ultrasound — Limited
CPT 76705
$75
LAB HEMO PLT AUTO W AUTO SCAN
CPT 85025
$86
Retroperitoneal Ultrasound
CPT 76770
$94
Screening Mammogram (bilateral)
CPT 77067
$99
Therapeutic Activities
CPT 97530
$99
Mechanical Traction
CPT 97012
$112
Therapeutic Exercises
CPT 97110
$121
CT Chest
CPT 71250
$148
ER Visit — Low-Moderate Complexity
CPT 99283
$167
MRI Joint of Lower Extremity
CPT 73721
$174
LAB PANEL METAB COMP
CPT 80053
$182
Echocardiogram w/ Doppler
CPT 93306
$188
Diagnostic Mammogram (unilateral)
CPT 77065
$250
Chest X-Ray (1 view)
CPT 71045
$285
ER Visit — Moderate Complexity
CPT 99284
$305
EKG Tracing
CPT 93005
$341
Inguinal Hernia Repair
CPT 49505
$343
Upper GI Endoscopy w/ Biopsy
CPT 43239
$360
Chest X-Ray (2 views)
CPT 71046
$361
Diagnostic Mammogram (bilateral)
CPT 77066
$378
Laparoscopic Cholecystectomy
CPT 47562
$433
ER Visit — High Complexity
CPT 99285
$443
Thoracic Spine X-Ray
CPT 72072
$473
Colonoscopy
CPT 45378
$483
VISIT OB TRIAGE ESTABLISHED LEVEL 3
CPT 99213
$506
Colonoscopy w/ Biopsy
CPT 45380
$523
OB Ultrasound
CPT 76805
$807
Abdominal Ultrasound
CPT 76700
$916
Laparoscopic Hernia Repair
CPT 49650
$1,128
Echocardiogram
CPT 93307
$1,159
Appendectomy
CPT 44950
$1,690
MRI Brain w/o Contrast
CPT 70551
$2,428
Recurrent Inguinal Hernia Repair
CPT 49520
$2,491
CT Abdomen & Pelvis
CPT 74177
$3,656
MRI Brain w/ Contrast
CPT 70553
$3,981
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.