Dickenson Community Hospital
Dickenson Community Hospital in Clintwood, VA publishes cash prices for 44 common procedures listed here, from its own machine-readable price file updated Mar 23, 2026. Click a procedure to compare it with other hospitals nearby.
312 HOSPITAL DR., CLINTWOOD, VA 24228 Collected Sep 23, 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 HC CT ABDOMEN/PELVIS W CON | $549.24 | $2,388.00 | 77% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN/PELVIS W CON | $549.24 | $2,388.00 | 77% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST | $521.87 | $2,269.00 | 77% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN WO CONTRAST | $521.87 | $2,269.00 | 77% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CON | $605.36 | $2,632.00 | 77% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CON | $605.36 | $2,632.00 | 77% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BILAT | $83.95 | $365.00 | 77% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BILAT | $83.95 | $365.00 | 77% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNILAT | $72.68 | $316.00 | 77% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNILAT | $72.68 | $316.00 | 77% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MR JOINT LOW EXT WO CON | $593.63 | $2,581.00 | 77% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MR JOINT LOW EXT WO CON | $593.63 | $2,581.00 | 77% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MR JOINT LOW EXT WOW CON | $656.19 | $2,853.00 | 77% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MR JOINT LOW EXT WOW CON | $656.19 | $2,853.00 | 77% |
| MRI of the brain, no contrast dye CPT 70551 HC MR BRAIN WO CON | $593.63 | $2,581.00 | 77% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MR BRAIN WO CON | $593.63 | $2,581.00 | 77% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MR BRAIN WOW CON | $656.19 | $2,853.00 | 77% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MR BRAIN WOW CON | $656.19 | $2,853.00 | 77% |
| MRI of the lower back, no contrast dye CPT 72148 HC MR SPINE LUMBAR WO CON | $593.63 | $2,581.00 | 77% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MR SPINE LUMBAR WO CON | $593.63 | $2,581.00 | 77% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREG COMP >14 WKS SNGL GEST | $99.82 | $434.00 | 77% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREG COMP >14 WKS SNGL GEST | $99.82 | $434.00 | 77% |
| Screening mammogram, both breasts CPT 77067 HC SCREEN MAMMO INCL CAD | $72.68 | $316.00 | 77% |
| Screening mammogram, both breasts inpatient CPT 77067 HC SCREEN MAMMO INCL CAD | $72.68 | $316.00 | 77% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB | $99.82 | $434.00 | 77% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB | $99.82 | $434.00 | 77% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE | $99.82 | $434.00 | 77% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN COMPLETE | $99.82 | $434.00 | 77% |
| X-ray of the lower back, 4 or more views CPT 72110 HC DX SPINE LUMBAR MIN 4 VIEWS | $67.85 | $295.00 | 77% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC DX SPINE LUMBAR MIN 4 VIEWS | $67.85 | $295.00 | 77% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL (CA TOTAL) | $14.26 | $62.00 | 77% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL (CA TOTAL) | $14.26 | $62.00 | 77% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $23.23 | $101.00 | 77% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $23.23 | $101.00 | 77% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC WITH AUTO DIFF | $13.34 | $58.00 | 77% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH AUTO DIFF | $13.34 | $58.00 | 77% |
| Complete blood count (CBC), no differential CPT 85027 HC BLOOD CT COMPLETE AUTOMATED | $11.04 | $48.00 | 77% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD CT COMPLETE AUTOMATED | $11.04 | $48.00 | 77% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $17.25 | $75.00 | 77% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL | $17.25 | $75.00 | 77% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $14.49 | $63.00 | 77% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $14.49 | $63.00 | 77% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL | $13.57 | $59.00 | 77% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL | $13.57 | $59.00 | 77% |
| Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL | $70.61 | $307.00 | 77% |
| Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL | $70.61 | $307.00 | 77% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE | $31.74 | $138.00 | 77% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE | $31.74 | $138.00 | 77% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPEC ANTIGEN TOTAL REF | $31.74 | $138.00 | 77% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPEC ANTIGEN TOTAL REF | $31.74 | $138.00 | 77% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT THROMBOPLASTIN TIME PARTIAL | $10.35 | $45.00 | 77% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT THROMBOPLASTIN TIME PARTIAL | $10.35 | $45.00 | 77% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PT PROTHROMBIN TIME | $6.67 | $29.00 | 77% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PT PROTHROMBIN TIME | $6.67 | $29.00 | 77% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE TSH | $28.98 | $126.00 | 77% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE TSH | $28.98 | $126.00 | 77% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTO W MICROSCOPY | $5.52 | $24.00 | 77% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTO W MICROSCOPY | $5.52 | $24.00 | 77% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO WO MICROSCOPY | $3.91 | $17.00 | 77% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO WO MICROSCOPY | $3.91 | $17.00 | 77% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINE DIP WO MICROSCOPY | $4.37 | $19.00 | 77% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINE DIP WO MICROSCOPY | $4.37 | $19.00 | 77% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $474.95 | $2,065.00 | 77% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $474.95 | $2,065.00 | 77% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD W BIOPSY SINGLE OR MULTIPLE | $377.43 | $1,641.00 | 77% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD W BIOPSY SINGLE OR MULTIPLE | $377.43 | $1,641.00 | 77% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD TRANSORAL DX INCL BRUSH/WASH | $418.83 | $1,821.00 | 77% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD TRANSORAL DX INCL BRUSH/WASH | $418.83 | $1,821.00 | 77% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY THERAPY W PT PRESENT 50 MIN | $124.89 | $543.00 | 77% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY THERAPY W PT PRESENT 50 MIN | $124.89 | $543.00 | 77% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY THERAPY W/O PT PRESENT 50 MIN | $75.67 | $329.00 | 77% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY THERAPY W/O PT PRESENT 50 MIN | $75.67 | $329.00 | 77% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY | $76.13 | $331.00 | 77% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY | $76.13 | $331.00 | 77% |
| New patient office visit, about 30 minutes CPT 99203 HC NEW VISIT LEVEL 3 | $38.64 | $168.00 | 77% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC NEW VISIT LEVEL 3 | $38.64 | $168.00 | 77% |
| New patient office visit, about 45 minutes CPT 99204 HC NEW VISIT LEVEL 4 | $50.14 | $218.00 | 77% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC NEW VISIT LEVEL 4 | $50.14 | $218.00 | 77% |
| New patient office visit, about 60 minutes CPT 99205 HC NEW VISIT LEVEL 5 | $64.17 | $279.00 | 77% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC NEW VISIT LEVEL 5 | $64.17 | $279.00 | 77% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC PROC EA 15MIN | $30.36 | $132.00 | 77% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC PROC EA 15MIN | $30.36 | $132.00 | 77% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W PT 30 MIN | $43.47 | $189.00 | 77% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W PT 30 MIN | $43.47 | $189.00 | 77% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W PT 45 MIN | $43.93 | $191.00 | 77% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W PT 45 MIN | $43.93 | $191.00 | 77% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W PT 60 MIN | $76.13 | $331.00 | 77% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W PT 60 MIN | $76.13 | $331.00 | 77% |
Source file: https://www.balladhealth.org/sites/default/files/2026-03/770599553_dickenson-community-hospital_standardcharges.zip