PROVIDENCE SEWARD MEDICAL CENTER
Critical Access Hospitals
16
Procedure Prices at PROVIDENCE SEWARD MEDICAL CENTER
HC BLOOD DRAW VENIPUNCTURE
CPT 36415
$52
HC CBC WITH DIFF AUTO
CPT 85025
$128.8
Mechanical Traction
CPT 97012
$144.8
Therapeutic Activities
CPT 97530
$144.8
Therapeutic Exercises
CPT 97110
$149.6
HC COMPREHEN METABOLIC PANEL
CPT 80053
$184
HC ESTAB PT VISIT - LEVEL 3
CPT 99213
$260
Chest X-Ray (1 view)
CPT 71045
$285.6
HC PR 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES
CPT 90837
$305.6
Chest X-Ray (2 views)
CPT 71046
$332
EKG Tracing
CPT 93005
$493.6
Thoracic Spine X-Ray
CPT 72072
$558.4
Abdominal Ultrasound — Limited
CPT 76705
$562.4
ER Visit — Low-Moderate Complexity
CPT 99283
$577.6
EKG
CPT 93000
$819.2
ER Visit — Moderate Complexity
CPT 99284
$862.4
OB Ultrasound
CPT 76805
$896.8
Retroperitoneal Ultrasound
CPT 76770
$908.8
Abdominal Ultrasound
CPT 76700
$982.4
ER Visit — High Complexity
CPT 99285
$2,607.2
CT Chest
CPT 71250
$2,683.2
CT Abdomen & Pelvis
CPT 74177
$4,332.8
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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.