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Summit Medical Center

ID 5000002

Part of Summit Medical Center

Casper, WY

Cash prices at Summit Medical Center

Showing 50 of 2471 procedures

Procedure	Code	Estimated cash price
HC CATH BALLN ANGIOSCLPT RX SCORING 137MM	HCPCS C1725	$34
XR NASOJEJUNAL FEEDING TUBE REPOSITION	CPT 76000	$96
PF MRI ANKLE W/O CONTRAST RIGHT	CPT 73721	$356
VERSA DIAL STD TAPER	HCPCS C1776	$522
diphenhydramine per 50 mg	HCPCS J3490	$838
WIRE K	HCPCS C1713	$946
IV THROMBOLYSIS CORONARY	CPT 92977	$40
HC CATH OPTICROSS 35 PERIPH IMAG	HCPCS C1753	$48
CULTURE GROUP B STREP	CPT 87081	$56
PT SELF-CARE DC G8989-CJ	HCPCS G8989	$56
IMP LD ICD COIL SGL LVL 03	HCPCS C1777	$58
Diabetic Management Program,	HCPCS S9460	$60
Xr fluoro exam	CPT 64450	$63
PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	CPT 90732	$73
INSJ WCS LV BOTH COMPNT PG	HCPCS 0517T	$76
CATH OCCLUSION LVL 01	HCPCS C2628	$78
INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE	HCPCS J1602	$78
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION	HCPCS J9370	$80
Prp i/hern init reduc >5 yr	CPT 49505	$84
PR ROM RAD THERAPY PANCREAS, PC	HCPCS M1099	$92
NM Parathyroid planar imaging	CPT 78070	$94
STABILIZATION DEVICE STATLOCK SMALL 6 TO 8.5 FR UNIVERSAL	HCPCS A5200	$99
HC PRO CLOSED TX ELBOW DISLOCATION W/O ANES	CPT 24600	$101
EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; LESS THAN 3 CM	CPT 27047	$102
HEMOGLOBIN A1C LEVEL	CPT 83036	$102
CRYSTAL IDENTIFICATION BY LIGHT MICROSCOPY WITH OR WITHOUT POLARIZING LENS ANALYSIS, TISSUE OR ANY BODY FLUID (EXCEPT URINE)	CPT 89060	$107
DEMO/EVAL PATIENT USE OF AEROSOL GENERATOR NEBLIZER MDI OR I	CPT 94664	$108
SMALL BOWEL ENDOSCOPY BR/WA	CPT 44381	$110
EXCISE BENIGN LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM	CPT 11442	$114
IMP PROSTH SPHINCTR URIN LVL 07	HCPCS C1815	$118
XR ISOVUE M 200-20ML	HCPCS Q9966	$123
CT TEMPORAL BONES W/WO CONTRAST - REPORT	CPT 70482	$129
GTT (EACH PAST 3)	CPT 82952	$139
Radex Nasal Bones Complete Minimum 3 Views	CPT 70160	$142
REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	CPT 29827	$147
OT ELBOW OR WRIST STRAPPING	CPT 29260	$150
ST CAREGIVER TRNG, ADDL 15 MIN	CPT 97551	$157
US lmtd jt/nonvasc xtr strux	CPT 76882	$164
HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION [19030]	HCPCS J1644	$168
PF DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MLT PASS	CPT 43450	$170
PF EXCISION LESION MENISCUS/CAPSULE KNEE	CPT 27347	$172
US RIGHT UPPER QUADRANT	CPT 76705	$202
MAGNESIUM RBC	CPT 83735	$209
Ia-2 autoantibodies (barbara davis ia-2)	CPT 86341	$216
RED SORREL IGE (MAYO RPR11)	CPT 86003	$217
CMC CONTROLLER PLUS BRACE SM/ MED LEFT	HCPCS L3808	$219
HC CATH THROM 12 LIGHTNING INDIGO	HCPCS C1757	$239
PR INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS	CPT 22841	$239
HC Strep a Pcr	CPT 87880	$289
Stool cultr aerobic bact ea	CPT 87046	$381