PHILLIPS COUNTY HEALTH SYSTEMS
Critical Access Hospitals
16
Procedure Prices at PHILLIPS COUNTY HEALTH SYSTEMS
Venipuncture
CPT 36415
$11.93
Complete Blood Count with Automated Differential
CPT 85025
$13.23
Comprehensive Metabolic Panel
CPT 80053
$22.46
EKG Interpretation
CPT 93010
$35.7
Mechanical Traction
CPT 97012
$36
Therapeutic Exercises
CPT 97110
$49
Therapeutic Activities
CPT 97530
$49
TR 99213 EVAL LEVEL 3 or 20-29 min
CPT 99213
$67
EKG Tracing
CPT 93005
$78.4
EKG
CPT 93000
$81.6
Abdominal Ultrasound — Limited
CPT 76705
$116
Diagnostic Mammogram (unilateral)
CPT 77065
$122
Diagnostic Mammogram (bilateral)
CPT 77066
$122
Screening Mammogram (bilateral)
CPT 77067
$122
Chest X-Ray (1 view)
CPT 71045
$122.36
OB Ultrasound
CPT 76805
$131
Chest X-Ray (2 views)
CPT 71046
$149.28
PSYCHOTHERAPY PT &/OR FAMILY 60 MIN Charge
CPT 90837
$149.69
Abdominal Ultrasound
CPT 76700
$150
Retroperitoneal Ultrasound
CPT 76770
$150
Thoracic Spine X-Ray
CPT 72072
$199.64
ER Visit — Low-Moderate Complexity
CPT 99283
$403.75
CT Chest
CPT 71250
$453
CT Abdomen & Pelvis
CPT 74177
$453
MRI Brain w/o Contrast
CPT 70551
$521
MRI Brain w/ Contrast
CPT 70553
$521
MRI Joint of Lower Extremity
CPT 73721
$521
Colonoscopy
CPT 45378
$531.25
Echocardiogram
CPT 93307
$570
OR 64483 INJ TRANSFORAMINAL EPI LS SNGL W/ IMAGING Charge
CPT 64483
$574
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$637.5
Colonoscopy w/ Biopsy
CPT 45380
$675.75
ER Visit — Moderate Complexity
CPT 99284
$688.36
Inguinal Hernia Repair
CPT 49505
$765
Upper GI Endoscopy w/ Biopsy
CPT 43239
$860
ER Visit — High Complexity
CPT 99285
$1,069.84
Echocardiogram w/ Doppler
CPT 93306
$1,517
Cataract Surgery
CPT 66984
$2,679
Knee Arthroscopy
CPT 29881
$3,801
Laparoscopic Cholecystectomy
CPT 47562
$3,860.8
OR 29827 ARTHROSCOPY ROTATOR CUFF REPR
CPT 29827
$4,345.6
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.