PROVIDENCE MOUNT CARMEL HOSPITAL
Critical Access Hospitals
Procedure Prices at PROVIDENCE MOUNT CARMEL HOSPITAL
EKG Interpretation
CPT 93010
$14
EKG
CPT 93000
$28
HC BLOOD DRAW VENIPUNCTURE
CPT 36415
$36.4
HC COMPREHEN METABOLIC PANEL
CPT 80053
$39.9
Therapeutic Activities
CPT 97530
$46.2
Therapeutic Exercises
CPT 97110
$58.8
Mechanical Traction
CPT 97012
$60.2
Echocardiogram
CPT 93307
$92.4
HC COMPLETE CBC W/AUTO DIFF WBC
CPT 85025
$95.9
ESTAB PT VISIT - LEVEL 3
CPT 99213
$100.1
ER Visit — Low-Moderate Complexity
CPT 99283
$119.7
EKG Tracing
CPT 93005
$121.8
Chest X-Ray (1 view)
CPT 71045
$204.4
Screening Mammogram (bilateral)
CPT 77067
$223.3
Chest X-Ray (2 views)
CPT 71046
$229.6
Diagnostic Mammogram (unilateral)
CPT 77065
$257.6
Thoracic Spine X-Ray
CPT 72072
$332.5
Diagnostic Mammogram (bilateral)
CPT 77066
$333.9
Upper GI Endoscopy w/ Biopsy
CPT 43239
$350.7
Colonoscopy
CPT 45378
$443.1
Abdominal Ultrasound — Limited
CPT 76705
$477.4
Colonoscopy w/ Biopsy
CPT 45380
$529.9
ER Visit — Moderate Complexity
CPT 99284
$534.8
OB Ultrasound
CPT 76805
$666.4
Abdominal Ultrasound
CPT 76700
$689.5
Retroperitoneal Ultrasound
CPT 76770
$714
HC INJ FORAMEN EPIDURAL L/S
CPT 64483
$834.4
Echocardiogram w/ Doppler
CPT 93306
$854
MRI Brain w/o Contrast
CPT 70551
$938
ER Visit — High Complexity
CPT 99285
$965.3
CT Chest
CPT 71250
$1,117.9
MRI Joint of Lower Extremity
CPT 73721
$1,810.9
MRI Brain w/ Contrast
CPT 70553
$3,168.2
CT Abdomen & Pelvis
CPT 74177
$3,324.3
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.