PULASKI MEMORIAL HOSPITAL
Critical Access Hospitals
16
Procedure Prices at PULASKI MEMORIAL HOSPITAL
OFFICE VENIPUNCTURE
CPT 36415
$6.51
CBC-DAILY ORDER
CPT 85025
$41.06
Therapeutic Activities
CPT 97530
$42.46
Therapeutic Exercises
CPT 97110
$46.03
Mechanical Traction
CPT 97012
$54.08
TREATMENT ROOM LEVEL 3 EST. PAT.
CPT 99213
$70.11
EKG Tracing
CPT 93005
$74.59
Chest X-Ray (1 view)
CPT 71045
$87.85
EKG Interpretation
CPT 93010
$89.29
COMPREHENSIVE METABOLIC PANEL
CPT 80053
$92.12
Chest X-Ray (2 views)
CPT 71046
$131.53
Diagnostic Mammogram (unilateral)
CPT 77065
$141
Diagnostic Mammogram (bilateral)
CPT 77066
$141
Screening Mammogram (bilateral)
CPT 77067
$141
Thoracic Spine X-Ray
CPT 72072
$143.36
INDIVIDUAL THERAPY - 60 MINS
CPT 90837
$165.48
Abdominal Ultrasound — Limited
CPT 76705
$285.11
ER Visit — Low-Moderate Complexity
CPT 99283
$292.32
Retroperitoneal Ultrasound
CPT 76770
$327.43
ER Visit — Moderate Complexity
CPT 99284
$365.4
OB Ultrasound
CPT 76805
$391.72
ER Visit — High Complexity
CPT 99285
$444.36
Knee Replacement
CPT 27447
$500
Abdominal Ultrasound
CPT 76700
$587.62
Colonoscopy
CPT 45378
$610.54
Colonoscopy w/ Biopsy
CPT 45380
$816.81
CT Chest
CPT 71250
$991.97
Inguinal Hernia Repair
CPT 49505
$992.29
CT Abdomen & Pelvis
CPT 74177
$997
Echocardiogram w/ Doppler
CPT 93306
$1,224.9
Laparoscopic Hernia Repair
CPT 49650
$1,336.48
MRI Brain w/o Contrast
CPT 70551
$1,688
MRI Brain w/ Contrast
CPT 70553
$1,688
MRI Joint of Lower Extremity
CPT 73721
$1,688
Laparoscopic Cholecystectomy
CPT 47562
$1,725.22
Cataract Surgery
CPT 66984
$2,509.93
Upper GI Endoscopy w/ Biopsy
CPT 43239
$2,522.82
Knee Arthroscopy
CPT 29881
$3,267.15
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.