Santiam Memorial Hospital
Santiam Memorial Hospital in Stayton, OR publishes cash prices for 55 common procedures listed here, from its own machine-readable price file updated Aug 6, 2026. Click a procedure to compare it with other hospitals nearby.
1401 N 10th Ave Stayton OR 97383 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 | $3,082.35 | $3,082.35 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan head or brain without contrast | $1,251.14 | $1,251.14 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $1,674.56 | $1,674.56 | — |
| Diagnostic mammogram, both breasts CPT 77066 Diagnostic mammography of both breasts | $525.27 | $525.27 | — |
| Diagnostic mammogram, one breast CPT 77065 Diagnostic mammography of 1 breast | $354.21 | $354.21 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint without contrast | $319.00 | $319.00 | — |
| MRI of the brain, no contrast dye CPT 70551 MRI scan of brain without contrast | $1,933.06 | $1,933.06 | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI scan of brain before and after contrast | $4,112.22 | $4,112.22 | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal without contrast | $2,112.98 | $2,112.98 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus | $512.35 | $512.35 | — |
| Screening mammogram, both breasts CPT 77067 Screening mammography | $846.85 | $846.85 | — |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep study in sleep lab (6 years or older) | $4,979.74 | $4,979.74 | — |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | $479.01 | $479.01 | — |
| Ultrasound of the abdomen, complete CPT 76700 Complete ultrasound scan of abdomen | $566.12 | $566.12 | — |
| X-ray of the lower back, 4 or more views CPT 72110 X-ray of lower and sacral spine, minimum of 4 views | $479.01 | $479.01 | — |
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) | $76.00 | $76.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids (cholesterol and triglycerides) | $117.88 | $117.88 | — |
| 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 | $83.24 | $83.24 | — |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (red cells, white blood cell, platelets), automated test | $26.76 | $26.76 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $88.92 | $88.92 | — |
| Kidney function blood test panel CPT 80069 Kidney function blood test panel | $76.00 | $76.00 | — |
| Liver function blood test panel CPT 80076 Liver function blood test panel | $76.00 | $76.00 | — |
| Obstetric blood test panel CPT 80055 Obstetric blood test panel | $216.62 | $216.62 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (prostate specific antigen) measurement, total | $76.06 | $76.06 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test, plasma or whole blood | $24.86 | $24.86 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $17.74 | $17.74 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $136.49 | $136.49 | — |
| Urinalysis with microscope exam, automated CPT 81001 Manual urinalysis test with examination using microscope, automated | $13.11 | $13.11 | — |
| Urinalysis with microscope exam, manual CPT 81000 Manual urinalysis test with examination using microscope, non-automated | $54.29 | $54.29 | — |
| Urinalysis without microscope exam, automated CPT 81003 Automated urinalysis test | $9.31 | $9.31 | — |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis, manual test | $38.78 | $38.78 | — |
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 | $6,243.00 | $6,243.00 | — |
| Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare | $1,054.00 | $1,054.00 | — |
| Colonoscopy with tissue sample CPT 45380 Biopsy of large bowel using a flexible endoscope | $1,002.00 | $1,002.00 | — |
| Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using a flexible endoscope | $855.00 | $855.00 | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Repair of groin hernia (5 years or older) | $15,328.35 | $15,328.35 | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Repair of groin hernia (5 years or older) | $15,328.35 | $15,328.35 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 Injection of substance into lower spine canal | $315.00 | $315.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope | $866.00 | $866.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope | $647.00 | $647.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope | $3,699.75 | $3,699.75 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope | $3,699.75 | $3,699.75 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 Vaginal delivery and care before and after delivery after previous cesarean delivery | $5,907.00 | $5,907.00 | — |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 Vaginal delivery with care before and after delivery | $5,674.00 | $5,674.00 | — |
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 | $54.00 | $54.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy with patient, 50 minutes | $330.00 | $330.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy without patient, 50 minutes | $318.00 | $318.00 | — |
| Group psychotherapy session CPT 90853 Group psychotherapy | $90.00 | $90.00 | — |
| 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 | $321.41 | $321.41 | — |
| 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 | $523.91 | $523.91 | — |
| 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 | $712.38 | $712.38 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $158.20 | $158.20 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventive medicine evaluation (18-39 years) | $338.00 | $338.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventive medicine evaluation (40-64 years) | $387.00 | $387.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 minutes | $256.00 | $256.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 minutes | $340.00 | $340.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 1 hour | $500.00 | $500.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office or other outpatient consultation with moderate level of medical decision making, if using time, 40 minutes or more | $406.00 | $406.00 | — |
Source file: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSMHSTAYTONOR&type=CDMWithoutLabel&fileType=CSV