STOUGHTON HOSPITAL
Critical Access Hospitals
Procedure Prices at STOUGHTON HOSPITAL
ER Visit — Moderate Complexity
CPT 99284
$3.37
EKG Interpretation
CPT 93010
$7.8
ER Visit — Low-Moderate Complexity
CPT 99283
$9.43
LCHG BLOOD DRAW
CPT 36415
$11.84
HP OFFICE OUTPT VISIT EST LEVL III
CPT 99213
$14.32
LCHG CBC W AUTO DIFFERENTIAL
CPT 85025
$23.31
LCHG COMPREHENSIVE METABOLIC PANEL FAST
CPT 80053
$31.68
Abdominal Ultrasound
CPT 76700
$40.04
Mechanical Traction
CPT 97012
$44.08
Chest X-Ray (1 view)
CPT 71045
$49.58
Therapeutic Activities
CPT 97530
$50.68
Therapeutic Exercises
CPT 97110
$52.42
Chest X-Ray (2 views)
CPT 71046
$76.15
EKG
CPT 93000
$82.72
EKG Tracing
CPT 93005
$82.8
OB Ultrasound
CPT 76805
$98.7
Diagnostic Mammogram (unilateral)
CPT 77065
$124.64
Upper GI Endoscopy w/ Biopsy
CPT 43239
$128.5
Diagnostic Mammogram (bilateral)
CPT 77066
$159.39
Colonoscopy
CPT 45378
$170.96
Abdominal Ultrasound — Limited
CPT 76705
$184.15
HP TRTMT OF FEMORAL FRACTURE W INT I
CPT 27245
$205.21
Screening Mammogram (bilateral)
CPT 77067
$217.94
Recurrent Inguinal Hernia Repair
CPT 49520
$224.03
Echocardiogram w/ Doppler
CPT 93306
$225.29
Retroperitoneal Ultrasound
CPT 76770
$329.64
ER Visit — High Complexity
CPT 99285
$343.7
Appendectomy
CPT 44950
$348.26
Laparoscopic Hernia Repair
CPT 49650
$395.66
Laparoscopic Cholecystectomy
CPT 47562
$416.88
CT Chest
CPT 71250
$427.52
Inguinal Hernia Repair
CPT 49505
$476.78
Knee Arthroscopy
CPT 29881
$508.31
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level
CPT 64483
$723.48
CT Abdomen & Pelvis
CPT 74177
$779.97
MRI Brain w/o Contrast
CPT 70551
$934.08
HP ARTHROSCOPY ROTATOR CUFF REPAIR
CPT 29827
$1,041.83
MRI Joint of Lower Extremity
CPT 73721
$1,079.17
Knee Replacement
CPT 27447
$1,396.35
MRI Brain w/ Contrast
CPT 70553
$1,473.72
Colonoscopy w/ Biopsy
CPT 45380
$1,573.86
Hip Replacement
CPT 27130
$2,583.41
Cataract Surgery
CPT 66984
$3,403.48
Cataract Surgery — Complex
CPT 66982
$3,601.2
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.