SANFORD VERMILLION HOSPITAL
Critical Access Hospitals
16
Procedure Prices at SANFORD VERMILLION HOSPITAL
Blood Draw From Vein Using Needle
CPT 36415
$5.92
Lab Test - Complete Blood Cell Count With White Blood Cell Percentage
CPT 85025
$6.72
Lab Test - Comprehensive Metabolic Panel
CPT 80053
$9.13
EKG Tracing
CPT 93005
$18.02
Chest X-Ray (1 view)
CPT 71045
$42.65
Outpatient Clinic Visit Established Patient Level III
CPT 99213
$44.66
Therapeutic Activities
CPT 97530
$46.72
Mechanical Traction
CPT 97012
$47.56
Therapeutic Exercises
CPT 97110
$54.52
Chest X-Ray (2 views)
CPT 71046
$56.89
Individual Psychotherapy Session for 60 Minutes
CPT 90837
$88.03
Screening Mammogram (bilateral)
CPT 77067
$95.28
ER Visit — Low-Moderate Complexity
CPT 99283
$102.09
Thoracic Spine X-Ray
CPT 72072
$116.49
ER Visit — Moderate Complexity
CPT 99284
$126.91
Diagnostic Mammogram (unilateral)
CPT 77065
$163.06
Diagnostic Mammogram (bilateral)
CPT 77066
$212.5
Abdominal Ultrasound — Limited
CPT 76705
$296.45
Abdominal Ultrasound
CPT 76700
$308.33
Retroperitoneal Ultrasound
CPT 76770
$314.47
OB Ultrasound
CPT 76805
$421.47
Echocardiogram w/ Doppler
CPT 93306
$421.57
CT Abdomen & Pelvis
CPT 74177
$454.5
CT Chest
CPT 71250
$710.33
ER Visit — High Complexity
CPT 99285
$861.89
Upper GI Endoscopy w/ Biopsy
CPT 43239
$960.61
MRI Brain w/o Contrast
CPT 70551
$1,220.77
MRI Joint of Lower Extremity
CPT 73721
$1,448.93
Colonoscopy w/ Biopsy
CPT 45380
$1,610.92
Colonoscopy
CPT 45378
$1,656.55
MRI Brain w/ Contrast
CPT 70553
$2,006.79
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$5,197.97
Inguinal Hernia Repair
CPT 49505
$6,563.14
Laparoscopic Cholecystectomy
CPT 47562
$10,599.84
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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.