Top 40 services provided by COULEE MEDICAL CENTER
Services CPT Price Est. Cash Price
Removal of one or more growth from the breast; a surgical procedure on a female or male also called a mastectomy 19120 $1,173.00 $938.40
Repair of the shoulder generally called a shoulder arthroscopy 29826 $501.00 $400.80
Knee cartilage replacement surgery with an endoscope 29881 $1,544.00 $1,235.20
Removal of tonsils for children under 12 42820 $818.00 $654.40
Upper endoscopy; diagnostic exam to diagnose or treat conditions in the upper part of your digestive tract. 43235 $359.00 $287.20
Upper endoscopy; diagnostic exam to diagnose or treat conditions in the upper part of your digestive tract. 43235 $1,209.00 $302.25
Upper endoscopy; diagnostic exam to diagnose or treat conditions in the upper part of your digestive tract. 43235 $532.00 $133.00
Biopsy (or surgical procedure to remove tissue) for the upper digestive tract 43239 $403.00 $322.40
Biopsy (or surgical procedure to remove tissue) for the upper digestive tract 43239 $1,183.00 $295.75
Biopsy (or surgical procedure to remove tissue) for the upper digestive tract 43239 $1,196.00 $299.00
Biopsy (or surgical procedure to remove tissue) for the upper digestive tract 43239 $1,416.00 $354.00
Diagnostic colonoscopy; used to diagnose abnormalities in the large intestines and rectum 45378 $551.00 $440.80
Diagnostic colonoscopy; used to diagnose abnormalities in the large intestines and rectum 45378 $1,225.00 $306.25
Diagnostic colonoscopy; used to diagnose abnormalities in the large intestines and rectum 45378 $492.00 $123.00
Colonoscopy, flexible; with biopsy, single or multiple 45380 $1,581.00 $395.25
Colonoscopy, flexible; with biopsy, single or multiple 45380 $1,687.00 $421.75
Colonoscopy, flexible; with biopsy, single or multiple 45380 $585.00 $468.00
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique 45385 $1,225.00 $306.25
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique 45385 $740.00 $592.00
Surgical removal of the gallbladder called a laparoscopic cholecystectomy 47562 $1,874.00 $1,499.20
Surgical removal of the gallbladder called a laparoscopic cholecystectomy 47562 $532.00 $133.00
Repair of groin hernia patient age 5 years or older without mesh 49505 $1,481.00 $1,184.80
Injection of substance into the lower back or lumbar spine 62322 $248.00 $198.40
Injection of substance into the lower back or lumbar spine 62322 $1,269.00 $1,015.20
Injection into the lower back with help of imaging of some type 62323 $283.00 $226.40
Injection into the lower back with help of imaging of some type 62323 $380.00 $304.00
Epidural steroid injections for lower back pain 64483 $900.00 $720.00
Epidural steroid injections for lower back pain 64483 $490.00 $122.50
Epidural steroid injections for lower back pain 64483 $483.00 $386.40
Release and/or relocation of median nerve of hand 64721 $1,215.00 $972.00
Laser removal of cataracts in eyes 66821 $532.00 $133.00
X-ray of the lower spine with 4 or more views 72110 $292.00 $73.00
CT scan of the pelvis with contrast or dye 72193 $882.00 $220.50
Ultrasound of the abdomen 76700 $548.00 $137.00
Ultrasound of the abdomen 76700 $531.00 $132.75
Ultrasound of the abdomen 76700 $799.00 $199.75
Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples 76805 $764.00 $191.00
Mammogram of both breasts 77067 $62.00 $49.60
Basic Metabolic Panel 80048 $172.00 $137.60
Comprehensive Metabolic Panel 80053 $168.00 $42.00
Comprehensive Metabolic Panel 80053 $220.00 $176.00
Lipid Panel 80061 $35.00 $8.75
Lipid Panel 80061 $143.00 $114.40
Lipid Panel 80061 $629.00 $157.25
Lipid Panel 80061 $64.00 $16.00
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $258.00 $64.50
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $98.00 $24.50
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $144.00 $115.20
Urinalysis, by dipstick or tablet reagent automated with microscopy 81000 $75.00 $60.00
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $56.00 $44.80
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $50.00 $40.00
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $63.00 $15.75
Urinalysis, by dipstick or tablet reagent non-automated with microscopy 81002 $40.00 $32.00
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $58.00 $14.50
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $84.00 $21.00
Blood test for creatine kinase level; test for heart attack, stroke and for skeletal muscular damage 82550 $37.00 $9.25
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 $60.00 $15.00
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 $214.00 $53.50
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 $64.00 $16.00
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. 84443 $113.00 $28.25
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. 84443 $110.00 $88.00
Blood test that measures the amount of thyroid stimulating hormone (TSH). It helps determine how well your thyroid is functioning. 84443 $432.00 $108.00
Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks 84484 $108.00 $27.00
Blood test used to test Troponin levels in the blood; generally used to diagnose heart attacks 84484 $189.00 $151.20
Complete blood cell count (red cells, white blood cell, platelets), automated test 85025 $75.00 $18.75
Complete blood cell count (red cells, white blood cell, platelets), automated test 85025 $100.00 $25.00
Complete blood cell count (red cells, white blood cell, platelets), automated test 85025 $116.00 $92.80
Complete blood cell count (red cells, white blood cell, platelets), automated test 85025 $157.00 $39.25
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $83.00 $66.40
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $286.00 $71.50
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $61.00 $48.80
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $73.00 $58.40
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $103.00 $25.75
Insertion of catheter into left heart for diagnosis 93452 $5,061.00 $1,265.25
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $126.00 $100.80
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $9.00 $2.25
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $86.00 $21.50
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $131.00 $32.75
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $163.00 $130.40
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $80.00 $20.00
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $165.00 $41.25
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $79.00 $63.20
Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110 $144.00 $115.20
Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110 $85.00 $21.25
Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110 $77.00 $19.25
Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110 $88.00 $70.40
Training for walking to 1 or more areas for 15 minutes 97116 $68.00 $17.00
Physical therapy evaluation session for 20 minutes 97161 $227.00 $56.75
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $276.00 $220.80
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $144.00 $115.20
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $206.00 $164.80
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $307.00 $245.60
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $360.00 $288.00
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $29.00 $23.20
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $0.00 $0.00
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $297.00 $237.60
Emergency department visit facility fees for a visit of moderate severity 99283 $363.00 $90.75
Emergency department visit facility fees for a visit of moderate severity 99283 $174.00 $139.20
Emergency department visit facility fees for a visit of moderate severity 99283 $858.00 $214.50
Emergency department visit facility fees for a visit of moderate severity 99283 $914.00 $731.20
Emergency department visit facility fees for a visit of high to moderate severity 99284 $909.00 $227.25
Emergency department visit facility fees for a visit of high to moderate severity 99284 $1,824.00 $1,459.20
Emergency department visit facility fees for a visit of high to moderate severity 99284 $329.00 $263.20
Emergency department visit facility fees for a visit of high to moderate severity 99284 $796.00 $199.00