CONEMAUGH MEMORIAL HOSPITAL

1086 Franklin Street Johnstown, PA 15905

8145349000

List price markup
High to Average Markup

Services	CPT	Price	Est. Cash Price
CT scan of the head or brain without contrast or dye	70450	$1,253.00	$400.96
MRI scan of the brain with and without contrast	70553	$2,448.00	$783.36
MRI scan of the brain with and without contrast	70553	$3,016.00	$965.12
X-ray of the lower spine with 4 or more views	72110	$477.00	$152.64
CT scan of the pelvis with contrast or dye	72193	$1,344.00	$430.08
CT scan of the abdomen with contrast or dye	74160	$1,510.00	$483.20
Basic Metabolic Panel	80048	$85.00	$27.20
Comprehensive Metabolic Panel	80053	$90.00	$28.80
Lipid Panel	80061	$57.00	$18.24
Urinalysis, by dipstick or tablet reagent not automated without a microscope	81001	$46.00	$14.72
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage	82550	$51.00	$16.32
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning.	84443	$81.00	$25.92
Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks	84484	$74.00	$23.68
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test.	85610	$44.00	$14.08
Routine electrocardiogram (EKG) with tracing using at least 12 leads	93005	$189.00	$60.48
Routine electrocardiogram (EKG) with tracing using at least 12 leads	93005	$276.00	$88.32
Physical therapy evaluation session for 20 minutes	97161	$297.00	$95.04