PROVIDENCE VALDEZ MEDICAL CENTER
Critical Access Hospitals
16
Procedure Prices at PROVIDENCE VALDEZ MEDICAL CENTER
HC ROUTINE VENIPUNCTURE - REFERRAL PROCESSING
CPT 36415
$68.8
HC CBC WITH DIFF AUTO
CPT 85025
$76.8
EKG Interpretation
CPT 93010
$78.4
HC COMPREHEN METABOLIC PANEL
CPT 80053
$111.2
Mechanical Traction
CPT 97012
$118.4
Therapeutic Exercises
CPT 97110
$150.4
Therapeutic Activities
CPT 97530
$150.4
Chest X-Ray (1 view)
CPT 71045
$228.8
Chest X-Ray (2 views)
CPT 71046
$273.6
Thoracic Spine X-Ray
CPT 72072
$355.2
EKG Tracing
CPT 93005
$359.2
ER Visit — Low-Moderate Complexity
CPT 99283
$444.8
HC ESTAB PT VISIT - LEVEL 3
CPT 99213
$485.6
Abdominal Ultrasound — Limited
CPT 76705
$538.4
EKG
CPT 93000
$627.2
OB Ultrasound
CPT 76805
$652.8
ER Visit — Moderate Complexity
CPT 99284
$684.8
Retroperitoneal Ultrasound
CPT 76770
$687.2
Abdominal Ultrasound
CPT 76700
$718.4
ER Visit — High Complexity
CPT 99285
$1,017.6
HC PR 64483 INJ FORAMEN EPIDURAL L/S
CPT 64483
$1,709.6
CT Chest
CPT 71250
$3,061.6
MRI Joint of Lower Extremity
CPT 73721
$3,098.4
MRI Brain w/o Contrast
CPT 70551
$3,328.8
MRI Brain w/ Contrast
CPT 70553
$4,501.6
CT Abdomen & Pelvis
CPT 74177
$5,970.4
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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.