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Top 40 services provided by ADVENTIST LA GRANGE MEMORIAL HOSPITAL
Services CPT Price Est. Cash Price
Biopsy (or surgical procedure to remove tissue) for the upper digestive tract 43239 $99.00 $59.40
Injection of substance into the lower back or lumbar spine 62322 $228.00 $136.80
CT scan of the head or brain without contrast or dye 70450 $2,999.00 $1,799.40
CT scan of the head or brain without contrast or dye 70450 $4,616.00 $2,769.60
MRI scan of the brain with and without contrast 70553 $5,245.00 $3,147.00
MRI scan of the brain with and without contrast 70553 $3,629.00 $2,177.40
X-ray of the chest, 2 views 71046 $747.00 $448.20
CT scan of the pelvis with contrast or dye 72193 $2,862.00 $1,717.20
CT scan of the abdomen with contrast or dye 74160 $4,338.00 $2,602.80
Basic Metabolic Panel 80048 $976.00 $585.60
Basic Metabolic Panel 80048 $300.00 $180.00
Comprehensive Metabolic Panel 80053 $499.00 $299.40
Comprehensive Metabolic Panel 80053 $88.00 $52.80
Lipid Panel 80061 $464.00 $278.40
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $97.00 $58.20
Urinalysis, by dipstick or tablet reagent not automated without a microscope 81001 $116.00 $69.60
Urinalysis, by dipstick or tablet reagent not automated without a microscope 81001 $38.00 $22.80
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $78.00 $46.80
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $97.00 $58.20
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $88.00 $52.80
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $171.00 $102.60
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $348.00 $208.80
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $182.00 $109.20
Blood test that measures gases in the blood including the acidity, or pH, and the levels of oxygen (O2) and carbon dioxide (CO2) from an artery. 82805 $138.00 $82.80
Blood test that measures gases in the blood including the acidity, or pH, and the levels of oxygen (O2) and carbon dioxide (CO2) from an artery. 82805 $361.00 $216.60
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. 84443 $279.00 $167.40
Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks 84484 $118.00 $70.80
Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks 84484 $361.00 $216.60
Complete blood cell count (red cells, white blood cell, platelets), automated test 85025 $199.00 $119.40
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $140.00 $84.00
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $133.00 $79.80
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $434.00 $260.40
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $437.00 $262.20
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $312.00 $187.20
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $314.00 $188.40
Physical therapy evaluation session for 20 minutes 97161 $541.00 $324.60
Physical therapy evaluation session for 20 minutes 97161 $491.00 $294.60
Emergency department visit facility fees for a visit of moderate severity 99283 $1,025.00 $615.00
Emergency department visit facility fees for a visit of moderate severity 99283 $2,783.00 $1,669.80
Emergency department visit facility fees for a visit of high to moderate severity 99284 $1,868.00 $1,120.80