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SIERRA VISTA HOSPITAL

Hospital

800 EAST 9TH AVENUE

T OR C, NM, 87901

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Procedure Prices at SIERRA VISTA HOSPITAL

.CBC W AUTO COMPLETE DIFF

CPT 85025

$9.71

Chest X-Ray (1 view)

CPT 71045

$9.94

Chest X-Ray (2 views)

CPT 71046

$10.3

Thoracic Spine X-Ray

CPT 72072

$12.24

VENIPUNCTURE

CPT 36415

$12.3

COMPREHENSIVE METABOLIC PANEL

CPT 80053

$13.2

Abdominal Ultrasound — Limited

CPT 76705

$28

Retroperitoneal Ultrasound

CPT 76770

$34.61

Mechanical Traction

CPT 97012

$34.83

Abdominal Ultrasound

CPT 76700

$37.9

Diagnostic Mammogram (unilateral)

CPT 77065

$43.59

OB Ultrasound

CPT 76805

$46.75

Therapeutic Activities

CPT 97530

$47.8

Therapeutic Exercises

CPT 97110

$48.66

CT Chest

CPT 71250

$50.9

Screening Mammogram (bilateral)

CPT 77067

$50.98

Diagnostic Mammogram (bilateral)

CPT 77066

$55.78

MRI Joint of Lower Extremity

CPT 73721

$63.8

Echocardiogram w/ Doppler

CPT 93306

$66.65

ER Visit — Low-Moderate Complexity

CPT 99283

$82.86

CT Abdomen & Pelvis

CPT 74177

$85.81

MRI Brain w/o Contrast

CPT 70551

$101.25

MRI Brain w/ Contrast

CPT 70553

$107.73

PF - INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL, WITH IMAGING GUIDANCE; LUMBAR OR SACRAL, SINGLE LEVEL

CPT 64483

$107.89

ER Visit — Moderate Complexity

CPT 99284

$120.97

EKG Tracing

CPT 93005

$145.87

Upper GI Endoscopy w/ Biopsy

CPT 43239

$154.86

ER Visit — High Complexity

CPT 99285

$176.33

Colonoscopy w/ Biopsy

CPT 45380

$195.84

Colonoscopy

CPT 45378

$216.36

Appendectomy

CPT 44950

$645.45

Laparoscopic Cholecystectomy

CPT 47562

$661.92

Knee Replacement

CPT 27447

$1,272.86

Hip Replacement

CPT 27130

$1,274.18

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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.