Community Hospital of Bremen INC
Community Hospital of Bremen INC in Bremen, IN publishes cash prices for 25 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Click a procedure to compare it with other hospitals nearby.
1020 HIGH RD, BREMEN, IN 46506 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 Abdomen and Pelvis W-Contrast | $2,586.72 | $3,979.57 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis W-Contrast | $2,586.72 | $3,979.57 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain W-O Contrast AIS | $892.45 | $1,373.00 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain W-O Contrast AIS | $892.45 | $1,373.00 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W-Contrast | $992.55 | $1,527.00 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W-Contrast | $992.55 | $1,527.00 | 35% |
| Diagnostic mammogram, both breasts CPT 77066 MA Digital Diagnostic Mammo | $317.20 | $488.00 | 35% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MA Digital Diagnostic Mammo | $317.20 | $488.00 | 35% |
| MRI of the brain, no contrast dye CPT 70551 MR Brain W-O Contrast | $1,320.80 | $2,032.00 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR Brain W-O Contrast | $1,320.80 | $2,032.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Brain W W-O Contrast | $1,651.65 | $2,541.00 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Brain W W-O Contrast | $1,651.65 | $2,541.00 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 MR Lumbar Spine W-O Contrast | $1,320.80 | $2,032.00 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR Lumbar Spine W-O Contrast | $1,320.80 | $2,032.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Wks | $401.05 | $617.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Wks | $401.05 | $617.00 | 35% |
| Screening mammogram, both breasts CPT 77067 MA Digital Screening Mammo | $188.50 | $290.00 | 35% |
| Screening mammogram, both breasts inpatient CPT 77067 MA Digital Screening Mammo | $188.50 | $290.00 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 DIAGNOSTIC SLEEP STUDY | $2,954.25 | $4,545.00 | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 DIAGNOSTIC SLEEP STUDY | $2,954.25 | $4,545.00 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 US--Transvaginal Non OB | $406.90 | $626.00 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US--Transvaginal Non OB | $406.90 | $626.00 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $666.90 | $1,026.00 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $666.90 | $1,026.00 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 DX Spine Lumbar 4 Views | $337.35 | $519.00 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 DX Spine Lumbar 4 Views | $337.35 | $519.00 | 35% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel with LDL Cholesterol Direct Measurement, if Indicated | $12.35 | $19.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel with LDL Cholesterol Direct Measurement, if Indicated | $12.35 | $19.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 CBC wDiff | $7.15 | $11.00 | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC wDiff | $7.15 | $11.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 CBC | $5.85 | $9.00 | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC | $5.85 | $9.00 | 35% |
| Kidney function blood test panel CPT 80069 Renal | $10.40 | $16.00 | 35% |
| Kidney function blood test panel inpatient CPT 80069 Renal | $10.40 | $16.00 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 ASSAY OF PSA FREE | $8.45 | $13.00 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 ASSAY OF PSA FREE | $8.45 | $13.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate-specific Antigen (PSA), Free:Total Ratio Reflex | $8.45 | $13.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Prostate Specific Antigen Total Diagnostic | $16.90 | $26.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate-specific Antigen (PSA), Free:Total Ratio Reflex | $8.45 | $13.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Prostate Specific Antigen Total Diagnostic | $16.90 | $26.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 THROMBOPLASTIN TIME PARTIAL | $7.80 | $12.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Factor VIII Inhibitor Profile Comprehensive | $9.10 | $14.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 THROMBOPLASTIN TIME PARTIAL | $7.80 | $12.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Factor VIII Inhibitor Profile Comprehensive | $9.10 | $14.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT Prothrombin Time w/ INR | $3.90 | $6.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT Prothrombin Time with Mixing Studies if Indicated | $9.10 | $14.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT Prothrombin Time w/ INR | $3.90 | $6.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT Prothrombin Time with Mixing Studies if Indicated | $9.10 | $14.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (Thyroid Stimulating Hormone) Sensitive w/Rflx to Free T4 | $15.60 | $24.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Cascade Profile | $37.70 | $58.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (Thyroid Stimulating Hormone) Sensitive w/Rflx to Free T4 | $15.60 | $24.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Cascade Profile | $37.70 | $58.00 | 35% |
| Urinalysis with microscope exam, manual CPT 81000 Done | $7.15 | $11.00 | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Done | $7.15 | $11.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 UA Macro | $2.60 | $4.00 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA Macro | $2.60 | $4.00 | 35% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIB STICK | $118.95 | $183.00 | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIB STICK | $118.95 | $183.00 | 35% |