Johnson Memorial Hospital
Johnson Memorial Hospital in Stafford Springs, CT publishes cash prices for 45 common procedures listed here, from its own machine-readable price file updated Mar 31, 2026. Click a procedure to compare it with other hospitals nearby.
201 Chestnut Hill Rd, Stafford Springs, CT 06105 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/Contrast | $896.50 | $1,630.00 | 45% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $896.50 | $1,630.00 | 45% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain W/O Contrast | $754.60 | $1,372.00 | 45% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain W/O Contrast | $754.60 | — | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head/Brain W/O Contrast | $754.60 | $1,372.00 | 45% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/Contrast | $870.10 | $1,582.00 | 45% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/Contrast | $870.10 | $1,582.00 | 45% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Mammography Diagnostic Bilateral | $637.45 | $1,159.00 | 45% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mammography Diagnostic Bilateral | $637.45 | $1,159.00 | 45% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Rt | $499.40 | $908.00 | 45% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammography Diagnostic Unilateral Lt | $499.40 | $908.00 | 45% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Lt | $499.40 | $908.00 | 45% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammography Diagnostic Unilateral Rt | $499.40 | $908.00 | 45% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Bl | $1,841.40 | $3,348.00 | 45% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Lt | $1,227.05 | $2,231.00 | 45% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Rt | $1,227.05 | $2,231.00 | 45% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Bl | $1,841.40 | $3,348.00 | 45% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Rt | $1,227.05 | $2,231.00 | 45% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Lower Extremity Joint W/O Contrast Lt | $1,227.05 | $2,231.00 | 45% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Bl | $3,527.70 | $6,414.00 | 45% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Rt | $2,351.25 | $4,275.00 | 45% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Lt | $2,351.25 | $4,275.00 | 45% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Bl | $3,527.70 | $6,414.00 | 45% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Lt | $2,351.25 | $4,275.00 | 45% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Lower Extremity Joint W/O & W/Contrast Rt | $2,351.25 | $4,275.00 | 45% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain W/O Contrast | $1,134.65 | $2,063.00 | 45% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain W/O Contrast | $1,134.65 | $2,063.00 | 45% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain W/O & W/Contrast | $1,965.15 | $3,573.00 | 45% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain W/O & W/Contrast | $1,965.15 | $3,573.00 | 45% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine W/O Contrast | $1,157.20 | $2,104.00 | 45% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Lumbar Spine W/O Contrast | $1,157.20 | $2,104.00 | 45% |
| Screening mammogram, both breasts both sides CPT 77067 HC Mammography Screen Bilateral | $355.30 | $646.00 | 45% |
| Screening mammogram, both breasts one side CPT 77067 HC Mammography Screen Bl Reduced Service Unilateral Only Completed | $258.50 | $470.00 | 45% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC Mammography Screen Bilateral | $355.30 | $646.00 | 45% |
| Screening mammogram, both breasts inpatient one side CPT 77067 HC Mammography Screen Bl Reduced Service Unilateral Only Completed | $258.50 | $470.00 | 45% |
| Sleep study in a lab (polysomnography) CPT 95810 HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $2,886.95 | $5,249.00 | 45% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Polysomnography Sleep Staging >=4 Parameters Age >=6 Years | $2,886.95 | $5,249.00 | 45% |
| Transvaginal pelvic ultrasound CPT 76830 PR US Transvaginal Non Obstetric | $275.82 | — | — |
| Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal Non Obstetric | $574.75 | $1,045.00 | 45% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 PR US Transvaginal Non Obstetric | $310.00 | $310.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Transvaginal Non Obstetric | $574.75 | $1,045.00 | 45% |
| Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete | $503.80 | $916.00 | 45% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdomen Complete | $503.80 | $916.00 | 45% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Xr Lumbosacral Spine >= 4 Views | $308.55 | $561.00 | 45% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Xr Lumbosacral Spine >= 4 Views | $308.55 | $561.00 | 45% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $33.55 | $61.00 | 45% |
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $670.45 | — | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel (Calcium Total) | $33.55 | $61.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel | $51.70 | $94.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel | $51.70 | $94.00 | 45% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc Automated/Differential Wbc Automated | $22.00 | $40.00 | 45% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc Automated/Differential Wbc Automated | $198.00 | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc Automated/Differential Wbc Automated | $22.00 | $40.00 | 45% |
| Complete blood count (CBC), no differential CPT 85027 HC Cbc Automated | $22.00 | $40.00 | 45% |
| Complete blood count (CBC), no differential CPT 85027 HC Cbc Automated | $215.05 | — | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Cbc Automated | $22.00 | $40.00 | 45% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $41.25 | $75.00 | 45% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $193.05 | — | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel | $41.25 | $75.00 | 45% |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel | $37.95 | $69.00 | 45% |
| Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel | $37.95 | $69.00 | 45% |
| Liver function blood test panel CPT 80076 HC Hepatic Function Panel | $26.40 | $48.00 | 45% |
| Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel | $26.40 | $48.00 | 45% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Warde 1012090 Prostate Specific Antigen Free | $72.05 | $131.00 | 45% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Warde 1012090 Prostate Specific Antigen Free | $72.05 | $131.00 | 45% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Warde 1012090 Prostate Specific Antigen Total | $69.30 | $126.00 | 45% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen Total | $69.30 | $126.00 | 45% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Warde Prostate Specific Antigen Total Ultrasensitive | $69.30 | $126.00 | 45% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Warde Prostate Specific Antigen Total Ultrasensitive | $69.30 | $126.00 | 45% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Warde 1012090 Prostate Specific Antigen Total | $69.30 | $126.00 | 45% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen Total | $69.30 | $126.00 | 45% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time Partial (Ptt) | $27.50 | $50.00 | 45% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Warde 2500780 Thromboplastin Time Partial (Ptt) | $27.50 | $50.00 | 45% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Warde 2500780 Thromboplastin Time Partial (Ptt) | $27.50 | $50.00 | 45% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromboplastin Time Partial (Ptt) | $27.50 | $50.00 | 45% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $14.85 | $27.00 | 45% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC POCT Prothrombin Time | $14.85 | $27.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time | $14.85 | $27.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POCT Prothrombin Time | $14.85 | $27.00 | 45% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone | $79.20 | $144.00 | 45% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Thyroid Stimulating Hormone | $79.20 | $144.00 | 45% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis With Microscopy Automated | $7.70 | $14.00 | 45% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis With Microscopy Automated | $205.70 | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis With Microscopy Automated | $7.70 | $14.00 | 45% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Without Microscopy Automated | $11.00 | $20.00 | 45% |
| Urinalysis without microscope exam, automated CPT 81003 HC POCT Urinalysis Without Microscopy Automated | $11.00 | $20.00 | 45% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Without Microscopy Automated | $304.15 | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis Without Microscopy Automated | $11.00 | $20.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC POCT Urinalysis Without Microscopy Automated | $11.00 | $20.00 | 45% |
| Urinalysis without microscope exam, manual CPT 81002 HC Urinalysis Without Microscopy Nonautomated | $18.70 | $34.00 | 45% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC Urinalysis Without Microscopy Nonautomated | $18.70 | $34.00 | 45% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 PR Rem Cataract Extracapsular Insert Intraocular Lens Prosth Man/Mech Tech | $3,668.71 | — | — |
| Colonoscopy with polyp removal CPT 45385 HC Colon Flex W/Rem Tumor(S)/Polyp(S)/Other Lesion(S) by Snare Tech (Restricted Method II CAH) | $3,644.83 | — | — |
| Colonoscopy with tissue sample CPT 45380 HC Colonoscopy Flexible With Biopsy Single/Multiple (Restricted Method II CAH) | $2,927.57 | — | — |
| Colonoscopy, diagnostic CPT 45378 HC Colon Flexible Dx W/Collection of Specimen(S) by Brushing/Washing (Restricted Method II CAH) | $2,616.07 | — | — |
| Gallbladder removal, laparoscopic CPT 47562 PR Laparoscopy Surgical Cholecystectomy | $1,305.00 | — | — |
| Gallbladder removal, laparoscopic CPT 47562 HC Cholecystectomy W/Laparoscopy (Restricted Method II CAH) | $11,294.54 | — | — |
| Gallbladder removal, laparoscopic inpatient CPT 47562 PR Laparoscopy Surgical Cholecystectomy | $3,112.00 | $3,112.00 | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PR Repr Init Ing Hernia 5y or Older Reducible | $1,032.00 | — | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC Repr Hernia Ing Init >=5yr Bl (Restricted Method II CAH) | $9,160.06 | — | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PR Repr Init Ing Hernia 5y or Older Reducible | $2,293.00 | $2,293.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 PR Injection(S) Epidural Lumbar Needle Placement W/Guidance | $369.00 | — | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance | $2,242.35 | $4,077.00 | 45% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance | $2,605.81 | — | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PR Injection(S) Epidural Lumbar Needle Placement W/Guidance | $305.00 | $305.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Injection(S) Epidural/Subarachnoid Lumbar/Sacral Needle Placement W/Guidance | $2,242.35 | $4,077.00 | 45% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC Injection(S) Epidural Lumbar Needle Placement W/O Guidance | $1,861.75 | $3,385.00 | 45% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC Injection(S) Epidural Lumbar Needle Placement W/O Guidance | $1,861.75 | $3,385.00 | 45% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $413.00 | — | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl | $2,774.38 | — | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl | $3,618.45 | $6,579.00 | 45% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Lt | $2,412.30 | $4,386.00 | 45% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt | $2,412.30 | $4,386.00 | 45% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $435.00 | $435.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Bl | $3,618.45 | $6,579.00 | 45% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Lt | $2,412.30 | $4,386.00 | 45% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 HC Injection(S) Anesthetic Agent(S)/Steroid Lumb/S Transforaminal Epidural W/Img Single Rt | $2,412.30 | $4,386.00 | 45% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd Flexible Transoral W/Bx Single/Mult (Restricted Method II CAH) | $4,272.56 | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 PR Visit Office Outpatient New Low Level | $161.68 | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR Visit Office Outpatient New Low Level | $292.00 | $292.00 | — |
| New patient office visit, about 45 minutes CPT 99204 PR Visit Office Outpatient New Moderate Level | $315.24 | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR Visit Office Outpatient New Moderate Level | $436.00 | $436.00 | — |
| New patient office visit, about 60 minutes CPT 99205 PR Visit Office Outpatient New High Level | $449.00 | $449.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR Visit Office Outpatient New High Level | $575.00 | $575.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $89.65 | $163.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $96.25 | $175.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $89.65 | $163.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Procedure >=1 Area Therapeutic Exercise Each 15 Minutes | $96.25 | $175.00 | 45% |
| Psychotherapy session, 30 minutes CPT 90832 PR Psychotherapy Patient 30 Minutes | $169.18 | — | — |
| Psychotherapy session, 30 minutes CPT 90832 HC Psychotherapy Patient Individual Therapy 30 Minutes | $316.80 | $576.00 | 45% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PR Psychotherapy Patient 30 Minutes | $200.00 | $200.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC Psychotherapy Patient Individual Therapy 30 Minutes | $316.80 | $576.00 | 45% |
Source file: https://hpt.trinity-health.org/475676956_johnson-memorial-hospital_standardcharges.zip