ROCHELLE COMMUNITY HOSPITAL
Critical Access Hospitals
16
Procedure Prices at ROCHELLE COMMUNITY HOSPITAL
ROUTINE VENIPUNCTURE
CPT 36415
$3.9
COMP METABOLIC PANEL REF LAB
CPT 80053
$5.04
EKG Tracing
CPT 93005
$7.5
CBC REF LAB
CPT 85025
$10.2
EKG
CPT 93000
$13.96
Mechanical Traction
CPT 97012
$47.46
Therapeutic Activities
CPT 97530
$52.08
Therapeutic Exercises
CPT 97110
$59.64
URG PROF FEE EST LV3
CPT 99213
$76.41
ER Visit — Low-Moderate Complexity
CPT 99283
$78.4
Screening Mammogram (bilateral)
CPT 77067
$107.52
Upper GI Endoscopy w/ Biopsy
CPT 43239
$137.31
Diagnostic Mammogram (unilateral)
CPT 77065
$139.02
ER Visit — Moderate Complexity
CPT 99284
$141.82
Chest X-Ray (1 view)
CPT 71045
$163.8
Chest X-Ray (2 views)
CPT 71046
$163.8
ER Visit — High Complexity
CPT 99285
$179.28
Diagnostic Mammogram (bilateral)
CPT 77066
$198.66
Thoracic Spine X-Ray
CPT 72072
$204.54
Colonoscopy
CPT 45378
$239.32
Abdominal Ultrasound — Limited
CPT 76705
$526.68
OB Ultrasound
CPT 76805
$533.82
Abdominal Ultrasound
CPT 76700
$536.34
Retroperitoneal Ultrasound
CPT 76770
$536.34
Knee Arthroscopy
CPT 29881
$543.34
CT Chest
CPT 71250
$895.02
Echocardiogram w/ Doppler
CPT 93306
$1,157.94
OPEN INTERTROCHANTERIC
CPT 27245
$1,237.27
MRI Joint of Lower Extremity
CPT 73721
$1,396.5
Hip Replacement
CPT 27130
$1,491.67
MRI Brain w/o Contrast
CPT 70551
$1,532.16
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level
CPT 64483
$1,616.95
Knee Replacement
CPT 27447
$1,684.46
MRI Brain w/ Contrast
CPT 70553
$2,061.78
CT Abdomen & Pelvis
CPT 74177
$2,360.4
Colonoscopy w/ Biopsy
CPT 45380
$2,660.81
Cataract Surgery
CPT 66984
$3,487.01
Inguinal Hernia Repair
CPT 49505
$4,543.99
Laparoscopic Hernia Repair
CPT 49650
$9,415.62
Laparoscopic Cholecystectomy
CPT 47562
$13,716.09
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.