SABETHA COMMUNITY HOSPITAL
Critical Access Hospitals
16
Procedure Prices at SABETHA COMMUNITY HOSPITAL
No - Manual Differential?
CPT 85025
$5
36415 Routine Venipuncture
CPT 36415
$6.2
EKG Interpretation
CPT 93010
$7.93
Mechanical Traction
CPT 97012
$11.06
Chest X-Ray (1 view)
CPT 71045
$12.03
Blood test, comprehensive group of blood chemicals
CPT 80053
$12.48
EKG Tracing
CPT 93005
$14.59
Chest X-Ray (2 views)
CPT 71046
$18.48
Therapeutic Exercises
CPT 97110
$22.08
Therapeutic Activities
CPT 97530
$22.92
EKG
CPT 93000
$24.16
Thoracic Spine X-Ray
CPT 72072
$28.93
ER Visit — Low-Moderate Complexity
CPT 99283
$37.14
WC 99213 OFFICE VISIT EST PT DETAILED OR 20-29 MIN
CPT 99213
$40.84
ER Visit — High Complexity
CPT 99285
$45.45
Diagnostic Mammogram (unilateral)
CPT 77065
$62.06
Screening Mammogram (bilateral)
CPT 77067
$62.26
Abdominal Ultrasound — Limited
CPT 76705
$73.78
Diagnostic Mammogram (bilateral)
CPT 77066
$78.34
ER Visit — Moderate Complexity
CPT 99284
$90.35
Retroperitoneal Ultrasound
CPT 76770
$94.92
Abdominal Ultrasound
CPT 76700
$98.69
OB Ultrasound
CPT 76805
$116.17
Upper GI Endoscopy w/ Biopsy
CPT 43239
$131.65
CT Abdomen & Pelvis
CPT 74177
$156.86
Colonoscopy
CPT 45378
$173.83
Echocardiogram w/ Doppler
CPT 93306
$173.95
CT Chest
CPT 71250
$182.5
Colonoscopy w/ Biopsy
CPT 45380
$189.08
Laparoscopic Hernia Repair
CPT 49650
$191.6
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$220.98
Inguinal Hernia Repair
CPT 49505
$228.68
Tonsillectomy & Adenoidectomy (12+)
CPT 42821
$239.65
OR 64483 INJ TRANSFORAMINAL EPI LS SNGL W/ IMAGING Charge
CPT 64483
$280.88
Appendectomy
CPT 44950
$289.71
MRI Joint of Lower Extremity
CPT 73721
$300.35
Laparoscopic Cholecystectomy
CPT 47562
$324.65
MRI Brain w/o Contrast
CPT 70551
$385.43
Recurrent Inguinal Hernia Repair
CPT 49520
$454.52
Knee Arthroscopy
CPT 29881
$467.22
MRI Brain w/ Contrast
CPT 70553
$467.71
Cataract Surgery
CPT 66984
$489.09
Knee Replacement
CPT 27447
$684.88
Cataract Surgery — Complex
CPT 66982
$687.51
OR 29827 ARTHROSCOPY ROTATOR CUFF REPR
CPT 29827
$862.62
Vaginal Delivery
CPT 59400
$1,428.54
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.