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Niobrara Community Hospital

ID 5000023

Part of Niobrara Community Hospital

Lusk, WY 82225

921 S Ballancee Ave

Cash prices at Niobrara Community Hospital

Showing 50 of 4903 procedures

Procedure	Code	Estimated cash price
XR NASOJEJUNAL FEEDING TUBE REPOSITION	CPT 76000	$261
ZIMMER TSA TAPER ADAPTER	HCPCS C1776	$2,180
PF MRI ANKLE W/O CONTRAST RIGHT	CPT 73721	$2,495
WIRE SMOOTH GUIDE 3.0MM	HCPCS C1713	$2,561
diphenhydramine per 50 mg	HCPCS J3490	$2,907
HC CATH BLLN CUTTING FLEXTME	HCPCS C1725	$3,545
EXCISE BENIGN LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM	CPT 11442	$21
STABILIZATION DEVICE STATLOCK SMALL 6 TO 8.5 FR UNIVERSAL	HCPCS A5200	$22
SMALL BOWEL ENDOSCOPY BR/WA	CPT 44381	$23
EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; LESS THAN 3 CM	CPT 27047	$25
vinCRIStine 2 mg/2 mL Soln 2 mL Vial	HCPCS J9370	$29
IMP PROSTH SPHINCTR URIN LVL 07	HCPCS C1815	$46
Diabetic Management Program,	HCPCS S9460	$49
INJECTION, GOLIMUMAB, 1 MG, FOR INTRAVENOUS USE	HCPCS J1602	$62
PF EXCISION LESION MENISCUS/CAPSULE KNEE	CPT 27347	$62
REPAIR OF SHOULDER ROTATOR CUFF USING AN ENDOSCOPE	CPT 29827	$65
HC CUSTOM WRIST-HAND-FINGER ORTHOTIC RIGID W/O JOINTS	HCPCS L3808	$67
HEMOGLOBIN A1C LEVEL	CPT 83036	$67
HC CATH OPTICROSS 35 PERIPH IMAG	HCPCS C1753	$70
CATH OCCLUSION LVL 02	HCPCS C2628	$72
XR ISOVUE M 200-20ML	HCPCS Q9966	$93
PF DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MLT PASS	CPT 43450	$104
PR INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS	CPT 22841	$110
INSJ WCS LV BOTH COMPNT PG	HCPCS 0517T	$116
PR ROM RAD THERAPY PANCREAS, PC	HCPCS M1099	$117
PR STRAPPING ELBOW/WRIST	CPT 29260	$127
THROMBOLYSIS, CORONARY; BY INTRAVENOUS INFUSION	CPT 92977	$156
UA W O MICRO AUTO	CPT 81003	$187
Stool cultr aerobic bact ea	CPT 87046	$295
FACTOR VII ACTIVITY ASSAY (MAYO F_7)	CPT 85230	$369
US lmtd jt/nonvasc xtr strux	CPT 76882	$390
CRYSTALS BODY FL	CPT 89060	$466
HC CATH THROMB XMI ULTRA	HCPCS C1757	$506
LAB SCR AQUAPORIN 4 AB IGG CSF	CPT 86052	$599
AMBULANCE SERVICE, ADVANCED LIFE SUPPORT, EMERGENCY TRANSPORT, LEVEL 1 (ALS1- EMERGENCY)	HCPCS A0427	$616
HC CT SCAN SKULL COMBO - CT ORBITS/SELLA W AND WO IV CONTRAST	CPT 70482	$692
MAGNESIUM RBC	CPT 83735	$711
MRI joint upr extrem w/o dye	CPT 73221	$711
TREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANESTHESIA	CPT 24600	$935
HC GTT-ADDED SAMPLES - GTT 4 HOUR	CPT 82952	$1,004
CULTURE GROUP B STREP	CPT 87081	$1,128
IMP LD ICD COIL SGL LVL 05	HCPCS C1777	$1,156
PT OTHER PT/OT DC G8992-CN	HCPCS G8992	$1,192
Islet cell ab(gad65) (mayo gd65s)	CPT 86341	$1,458
SCALP/NECK/AX/GENIT/TRUNK/EXT 2.6-7.5CM	CPT 12032	$1,480
PF CT TIBIA/FIBULA W/ + W/O CONTRAST LEFT	CPT 73701	$1,498
PARATHYROID PLANAR IMAGING (INCLUDING SUBTRACTION, WHEN PERFORMED)	CPT 78070	$1,532
LAB STREPTOCOCCUS GRP A	CPT 87880	$1,806
Hepatic function panel	CPT 80076	$1,809
Xr fluoro exam	CPT 64450	$1,862