Top 40 services provided by GRUNDY COUNTY MEMORIAL HOSPITAL
Services CPT Price Est. Cash Price
Repair of the shoulder generally called a shoulder arthroscopy 29826 $4,544.00 $0.00
Knee cartilage replacement surgery with an endoscope 29881 $4,028.00 $0.00
Injection of substance into the lower back or lumbar spine 62322 $1,310.00 $0.00
Injection of substance into the lower back or lumbar spine 62322 $1,168.00 $0.00
Injection into the lower back with help of imaging of some type 62323 $1,168.00 $0.00
Injection into the lower back with help of imaging of some type 62323 $1,310.00 $0.00
Epidural steroid injections for lower back pain 64483 $1,435.00 $0.00
Epidural steroid injections for lower back pain 64483 $1,987.00 $0.00
Epidural steroid injections for lower back pain 64483 $1,310.00 $0.00
Release and/or relocation of median nerve of hand 64721 $2,518.00 $0.00
CT scan of the head or brain without contrast or dye 70450 $1,470.00 $0.00
MRI scan of the brain with and without contrast 70553 $3,742.00 $0.00
X-ray of the chest, 2 views 71046 $218.00 $0.00
X-ray of the lower spine with 4 or more views 72110 $463.00 $0.00
CT scan of the pelvis with contrast or dye 72193 $1,743.00 $0.00
CT scan of the abdomen with contrast or dye 74160 $1,743.00 $0.00
Ultrasound of the abdomen 76700 $1,039.00 $0.00
Ultrasound for pregnancy after 1st trimester or after 14 weeks for a single baby or first baby for multiples 76805 $897.00 $0.00
Mammogram of both breasts 77067 $375.00 $0.00
Mammogram of both breasts 77067 $322.00 $0.00
Blood test for the amount of time it takes to form clots; called a Prothrombin Time (PT) test. 85610 $25.00 $0.00
Routine electrocardiogram (EKG) with tracing using at least 12 leads 93005 $272.00 $0.00
Treatment to relieve airway obstruction or for sputum specimen; used to relieve conditions of COPD 94640 $100.00 $0.00
Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110 $99.00 $0.00
Training for walking to 1 or more areas for 15 minutes 97116 $99.00 $0.00
Physical therapy evaluation session for 20 minutes 97161 $217.00 $0.00
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $205.00 $0.00
Office visit for an established patient (moderate severity) typically 15 minutes 99213 $291.00 $0.00
Emergency department visit facility fees for a visit of moderate severity 99283 $466.00 $0.00
Emergency department visit facility fees for a visit of moderate severity 99283 $351.00 $0.00
Emergency department visit facility fees for a visit of moderate severity 99283 $28.00 $0.00
Emergency department visit facility fees for a visit of high to moderate severity 99284 $1,083.00 $0.00
Emergency department visit facility fees for a visit of high to moderate severity 99284 $527.00 $0.00
Emergency department visit facility fees for a visit of high to moderate severity 99284 $28.00 $0.00