Polk Medical Center Inc
Polk Medical Center Inc in Cedartown, GA publishes cash prices for 30 common procedures listed here, from its own machine-readable price file updated Nov 19, 2025. Click a procedure to compare it with other hospitals nearby.
2360 Rockmart Hwy, Cedartown, GA 30125 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 SCAN ABDOMEN AND PELVIS W CONTRAST | $4,875.00 | $9,750.00 | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT SCAN ABDOMEN AND PELVIS W CONTRAST | $4,875.00 | $9,750.00 | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $2,178.50 | $4,357.00 | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST | $2,178.50 | $4,357.00 | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST | $1,644.00 | $3,288.00 | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT SCAN OF PELVIS CONTRAST | $1,644.00 | $3,288.00 | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $278.50 | $557.00 | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $278.50 | $557.00 | 50% |
| Diagnostic mammogram, one breast CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $211.50 | $423.00 | 50% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $211.50 | $423.00 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREM JT W/O CONTRAST | $1,508.00 | $3,016.00 | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREM JT W/O CONTRAST | $1,508.00 | $3,016.00 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI JOINT OF LEG COMBO | $4,384.00 | $8,768.00 | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI JOINT OF LEG COMBO | $4,384.00 | $8,768.00 | 50% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST | $1,104.00 | $2,208.00 | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST | $1,104.00 | $2,208.00 | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W & W/O CONTRAST | $3,010.50 | $6,021.00 | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W & W/O CONTRAST | $3,010.50 | $6,021.00 | 50% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $1,782.50 | $3,565.00 | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $1,782.50 | $3,565.00 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB >/= 14 WKS SNGL FETUS | $797.50 | $1,595.00 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB >/= 14 WKS SNGL FETUS | $797.50 | $1,595.00 | 50% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $232.00 | $464.00 | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $232.00 | $464.00 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 HC TRANSVAGINAL ULTRASOUND | $773.00 | $1,546.00 | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC TRANSVAGINAL ULTRASOUND | $773.00 | $1,546.00 | 50% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE | $887.00 | $1,774.00 | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOM B-SCAN &/OR REAL TIME COMPLETE | $887.00 | $1,774.00 | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 HC DX SPINE LUMBAR MIN 4 VIEWS | $720.50 | $1,441.00 | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC DX SPINE LUMBAR MIN 4 VIEWS | $720.50 | $1,441.00 | 50% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE | $292.50 | $585.00 | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL BUNDLED CHARGE | $292.50 | $585.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL BUNDLED CHARGE | $275.50 | $551.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL BUNDLED CHARGE | $275.50 | $551.00 | 50% |
| Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC AUTO DIFF WBC | $244.00 | $488.00 | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC AUTO DIFF WBC | $244.00 | $488.00 | 50% |
| Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC | $155.50 | $311.00 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC | $155.50 | $311.00 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE | $438.50 | $877.00 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC METABOLIC PANEL COMPREHENSIVE BUNDLED CHARGE | $438.50 | $877.00 | 50% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL BUNDLED CHARGE | $236.00 | $472.00 | 50% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL BUNDLED CHARGE | $236.00 | $472.00 | 50% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL BUNDLED CHARGE | $274.00 | $548.00 | 50% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL BUNDLED CHARGE | $274.00 | $548.00 | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC AG PSA FREE | $58.50 | $117.00 | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC AG PSA FREE | $58.50 | $117.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL | $230.00 | $460.00 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL | $230.00 | $460.00 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL | $70.00 | $140.00 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL | $70.00 | $140.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $55.00 | $110.00 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $55.00 | $110.00 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIMULATING HORMONE | $200.50 | $401.00 | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIMULATING HORMONE | $200.50 | $401.00 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTO W/SCOPE MICRO | $137.50 | $275.00 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTO W/SCOPE MICRO | $137.50 | $275.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $61.50 | $123.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $61.50 | $123.00 | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISES | $47.50 | $95.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES | $47.50 | $95.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISES | $47.50 | $95.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISES | $47.50 | $95.00 | 50% |