PROVIDENCE ST JOSEPH MEDICAL CENTER
Critical Access Hospitals
16
Procedure Prices at PROVIDENCE ST JOSEPH MEDICAL CENTER
EKG Interpretation
CPT 93010
$16.8
HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD
CPT 36415
$18.4
HC COMPLETE CBC W/AUTO DIFF WBC
CPT 85025
$28
Therapeutic Activities
CPT 97530
$62.4
HC COMPREHEN METABOLIC PANEL
CPT 80053
$84.8
Mechanical Traction
CPT 97012
$85.6
Therapeutic Exercises
CPT 97110
$87.2
ER Visit — Low-Moderate Complexity
CPT 99283
$103.2
EKG Tracing
CPT 93005
$110.4
HC PR 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES
CPT 90837
$112
HC PR 99213 OFFICE OUTPATIENT VISIT RHC
CPT 99213
$117.6
Chest X-Ray (1 view)
CPT 71045
$122.4
Chest X-Ray (2 views)
CPT 71046
$155.2
Diagnostic Mammogram (unilateral)
CPT 77065
$165.6
Thoracic Spine X-Ray
CPT 72072
$208.8
Diagnostic Mammogram (bilateral)
CPT 77066
$211.2
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$270.4
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$279.2
Abdominal Ultrasound — Limited
CPT 76705
$279.2
Upper GI Endoscopy w/ Biopsy
CPT 43239
$282.4
ER Visit — High Complexity
CPT 99285
$284
Screening Mammogram (bilateral)
CPT 77067
$320
Abdominal Ultrasound
CPT 76700
$338.4
Colonoscopy
CPT 45378
$356
Colonoscopy w/ Biopsy
CPT 45380
$426.4
Retroperitoneal Ultrasound
CPT 76770
$492
OB Ultrasound
CPT 76805
$557.6
ER Visit — Moderate Complexity
CPT 99284
$563.2
Echocardiogram
CPT 93307
$723.2
Inguinal Hernia Repair
CPT 49505
$805.6
HC INJ FORAMEN EPIDURAL L/S
CPT 64483
$882.4
Recurrent Inguinal Hernia Repair
CPT 49520
$984
Knee Arthroscopy
CPT 29881
$1,005.6
Appendectomy
CPT 44950
$1,009.6
CT Chest
CPT 71250
$1,156
Laparoscopic Cholecystectomy
CPT 47562
$1,162.4
HC PR 27245 TX FEMORAL FRACTURE W/INTRAMEDULARY TYPE IMPLANT
CPT 27245
$1,164
MRI Joint of Lower Extremity
CPT 73721
$1,401.6
Hip Replacement
CPT 27130
$1,409.6
Echocardiogram w/ Doppler
CPT 93306
$1,512.8
MRI Brain w/o Contrast
CPT 70551
$1,544.8
HC PR 29827 SHLDR ARTHROSCOP,SURG,W/ROTAT CUFF REPR
CPT 29827
$1,707.2
CT Abdomen & Pelvis
CPT 74177
$2,416
Knee Replacement
CPT 27447
$2,449.6
MRI Brain w/ Contrast
CPT 70553
$2,468
Vaginal Delivery
CPT 59400
$2,908.8
VBAC Delivery
CPT 59610
$3,066.4
C-Section
CPT 59510
$3,296.8
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.