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Evanston Regional Hospital

ID 5000026

Part of Evanston Regional Hospital

Evanston, WY

Cash prices at Evanston Regional Hospital

Showing 50 of 769 procedures

Procedure	Code	Estimated cash price
XR NASOJEJUNAL FEEDING TUBE REPOSITION	CPT 76000	$57
HC CATH BALLN ANGIOSCLPT RX SCORING 137MM	HCPCS C1725	$59
MRI JNT OF LWR EXTRE W/O DYE	CPT 73721	$445
PLUG OBTURATOR TIBIAL 12MM	HCPCS C1776	$827
PREDNISOLN ACET 1.5 PERC 5ML 5ML SPOP	HCPCS J3490	$1,255
SET SCREW	HCPCS C1713	$7,400
Xr fluoro exam	CPT 64450	$18
Prp i/hern init reduc >5 yr	CPT 49505	$19
IMP PROSTH SPHINCTR URIN LVL 07	HCPCS C1815	$24
HEPARIN (PORCINE) 10,000 UNIT/ML INJECTION SOLUTION	HCPCS J1644	$25
XR TOE MINIMUM 2 VIEWS LT	CPT 73660	$27
CULT STL E COLI PLAT	CPT 87046	$30
EXCISE BENIGN LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM	CPT 11442	$32
INSULIN REG 5U 1U 1ML SNIJ	HCPCS J1815	$32
FACTOR VII ACTIVITY ASSAY (MAYO F_7)	CPT 85230	$35
CATH OCCLUSION LVL 01	HCPCS C2628	$38
HB NEUROMYELITIS OPTICA AB (NMO) IFA SENDOUT	CPT 86052	$40
PF EXCISION LESION MENISCUS/CAPSULE KNEE	CPT 27347	$44
IV THROMBOLYSIS CORONARY	CPT 92977	$45
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION	HCPCS J9370	$47
HEMOGLOBIN A1C LEVEL	CPT 83036	$49
STABILIZATION DEVICE STATLOCK SMALL 6 TO 8.5 FR UNIVERSAL	HCPCS A5200	$50
CAREGIVER TRAINING IN STRATEGIES AND TECHNIQUES TO FACILITATE THE PATIENTS FUNCTIONAL PERFORMANCE IN THE HOME OR COMMUNITY (EG, ACTIVITIES OF DAILY LIVING [ADLS], INSTRUMENTAL ADLS [IADLS], TRANSFERS, MOBILITY, COMMUNICATION, SWALLOWING, FEEDING, PROBLEM SOLVING, SAFETY PRACTICES) (WITHOUT THE PATIENT PRESENT), FACE TO FACE; EACH ADDITIONAL 15 MINUTES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY SERVICE)	CPT 97551	$51
REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	CPT 29827	$56
HC CATH OPTICROSS 35 PERIPH IMAG	HCPCS C1753	$59
EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; LESS THAN 3 CM	CPT 27047	$64
NM Parathyroid planar imaging	CPT 78070	$64
CRYSTAL IDENTIFICATION BY LIGHT MICROSCOPY WITH OR WITHOUT POLARIZING LENS ANALYSIS, TISSUE OR ANY BODY FLUID (EXCEPT URINE)	CPT 89060	$65
Radex Nasal Bones Complete Minimum 3 Views	CPT 70160	$69
PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	CPT 90732	$70
PT SELF-CARE DC G8989-CJ	HCPCS G8989	$75
CULT SCREEN (MRSA ETC)	CPT 87081	$84
US BICEP INJECTION R	CPT 76942	$91
Diabetic Management Program,	HCPCS S9460	$97
MAGNESIUM RBC	CPT 83735	$103
CT TEMPORAL BONES W/WO CONTRAST - REPORT	CPT 70482	$119
INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE	HCPCS J1602	$119
PR ROM RAD THERAPY PANCREAS, PC	HCPCS M1099	$121
SMALL BOWEL ENDOSCOPY BR/WA	CPT 44381	$121
US RIGHT UPPER QUADRANT	CPT 76705	$122
PR INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS	CPT 22841	$126
PF XR FEMUR 1 VW BI	CPT 73551	$130
GTT (EACH PAST 3)	CPT 82952	$133
INSJ WCS LV BOTH COMPNT PG	HCPCS 0517T	$138
XR ISOVUE M 200-20ML	HCPCS Q9966	$144
HC CATH THROM 12 LIGHTNING INDIGO	HCPCS C1757	$165
HC Strep a Pcr	CPT 87880	$172
PF DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MLT PASS	CPT 43450	$176
OT ELBOW OR WRIST STRAPPING	CPT 29260	$187
HC LEAD ICD SPRINT QUATTRO SECURE S	HCPCS C1777	$197