Sullivan County Community Hospital
Sullivan County Community Hospital in Sullivan, IN publishes cash prices for 51 common procedures listed here, from its own machine-readable price file updated Jun 10, 2026. Click a procedure to compare it with other hospitals nearby.
2200 N Section St Sullivan IN 47882 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $4,081.45 | $5,441.93 | 25% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan head or brain without contrast | $1,644.24 | $2,192.32 | 25% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $2,257.50 | $3,010.00 | 25% |
| Diagnostic mammogram, both breasts CPT 77066 Diagnostic mammography of both breasts | $798.75 | $1,065.00 | 25% |
| Diagnostic mammogram, one breast CPT 77065 Diagnostic mammography of 1 breast | $393.90 | $525.20 | 25% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint without contrast | $2,579.24 | $3,438.98 | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI scan of leg joint before and after contrast | $3,639.00 | $4,852.00 | 25% |
| MRI of the brain, no contrast dye CPT 70551 MRI scan of brain without contrast | $2,581.04 | $3,441.39 | 25% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI scan of brain before and after contrast | $3,592.31 | $4,789.75 | 25% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal without contrast | $2,574.88 | $3,433.17 | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus | $916.31 | $1,221.75 | 25% |
| Screening mammogram, both breasts CPT 77067 Screening mammography | $420.43 | $560.57 | 25% |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep study in sleep lab (6 years or older) | $3,210.75 | $4,281.00 | 25% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | $1,040.00 | $1,386.66 | 25% |
| Ultrasound of the abdomen, complete CPT 76700 Complete ultrasound scan of abdomen | $1,082.75 | $1,443.66 | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 X-ray of lower and sacral spine, minimum of 4 views | $394.79 | $526.38 | 25% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Blood test, basic group of blood chemicals (Calcium, total) | $176.45 | $235.27 | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids (cholesterol and triglycerides) | $60.75 | $81.00 | 25% |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $80.27 | $107.03 | 25% |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (red cells, white blood cell, platelets), automated test | $73.61 | $98.15 | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $200.31 | $267.08 | 25% |
| Kidney function blood test panel CPT 80069 Kidney function blood test panel | $190.97 | $254.62 | 25% |
| Liver function blood test panel CPT 80076 Liver function blood test panel | $177.40 | $236.53 | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (prostate specific antigen) measurement, free | $78.99 | $105.32 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (prostate specific antigen) measurement, total | $78.79 | $105.05 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test, plasma or whole blood | $91.50 | $122.00 | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $55.14 | $73.52 | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $130.13 | $173.50 | 25% |
| Urinalysis with microscope exam, automated CPT 81001 Manual urinalysis test with examination using microscope, automated | $70.83 | $94.44 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 Automated urinalysis test | $41.15 | $54.87 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis, manual test | $27.00 | $36.00 | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care CPT 59510 Cesarean delivery with care before and after delivery | $4,427.25 | $5,903.00 | 25% |
| Knee arthroscopy with meniscus trim CPT 29881 Removal of knee cartilage using an endoscope | $958.50 | $1,278.00 | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection of substance into lower spine canal using imaging guidance | $212.54 | $283.39 | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Injection of substance into lower spine canal | $1,140.75 | $1,521.00 | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | $257.34 | $343.12 | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Shaving of part of shoulder bone and repair of ligament using an endoscope | $292.50 | $390.00 | 25% |
| Total hip replacement CPT 27130 Replacement of thigh bone and hip joint with prosthesis | $2,238.00 | $2,984.00 | 25% |
| Total knee replacement CPT 27447 Replacement of knee joint, both sides of knee | $2,205.75 | $2,941.00 | 25% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 Vaginal delivery with care before and after delivery | $3,989.25 | $5,319.00 | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Routine electrocardiogram (ECG) using at least 12 leads with interpretation and report | $126.00 | $168.00 | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy with patient, 50 minutes | $187.50 | $250.00 | 25% |
| Group psychotherapy session CPT 90853 Group psychotherapy | $302.63 | $403.50 | 25% |
| New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $160.64 | $214.18 | 25% |
| New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $290.95 | $387.93 | 25% |
| New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more | $356.25 | $475.00 | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventive medicine evaluation (18-39 years) | $204.00 | $272.00 | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventive medicine evaluation (40-64 years) | $220.50 | $294.00 | 25% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 minutes | $129.75 | $173.00 | 25% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 minutes | $329.00 | $438.67 | 25% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 1 hour | $353.34 | $471.12 | 25% |
Source file: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSCCHSullivanIN&type=CDMWithoutLabel&fileType=CSV