Methodist Fremont Health
Methodist Fremont Health in Fremont, NE publishes cash prices for 61 common procedures listed here, from its own machine-readable price file updated Feb 16, 2026. Click a procedure to compare it with other hospitals nearby.
450 East 23rd Street, Fremont, NE 68025 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 MECT Exam | $2,682.87 | $7,251.00 | 63% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Exam | $2,682.87 | $7,251.00 | 63% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd/Pelvis w/ Contrast | $2,682.87 | $7,251.00 | 63% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Exam | $2,682.87 | $7,251.00 | 63% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 MECT Exam | $2,682.87 | $7,251.00 | 63% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd/Pelvis w/ Contrast | $2,682.87 | $7,251.00 | 63% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Exam | $1,319.42 | $3,566.00 | 63% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Exam | $1,319.42 | $3,566.00 | 63% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Wh Body w/Cont-Pelv | $1,642.80 | $4,440.00 | 63% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Exam | $1,642.80 | $4,440.00 | 63% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/Contrast | $1,642.80 | $4,440.00 | 63% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Wh Body w/Cont-Pelv | $1,642.80 | $4,440.00 | 63% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/Contrast | $1,642.80 | $4,440.00 | 63% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Exam | $1,642.80 | $4,440.00 | 63% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Mammo Digital Bilat-Diag | $262.70 | $710.00 | 63% |
| Diagnostic mammogram, both breasts CPT 77066 MM Exam | $262.70 | $710.00 | 63% |
| Diagnostic mammogram, both breasts CPT 77066 Mammo Diagnostic | $262.70 | $710.00 | 63% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mammo Digital Bilat-Diag | $262.70 | $710.00 | 63% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 Mammo Diagnostic | $262.70 | $710.00 | 63% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MM Exam | $262.70 | $710.00 | 63% |
| Diagnostic mammogram, one breast one side CPT 77065 Mammo Digital Unilat Rt-Diag | $195.36 | $528.00 | 63% |
| Diagnostic mammogram, one breast one side CPT 77065 Mammo Digital Unilat Lt-Diag | $195.36 | $528.00 | 63% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Digital Unilat Lt-Diag | $195.36 | $528.00 | 63% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Digital Unilat Rt-Diag | $195.36 | $528.00 | 63% |
| MRI of the brain, no contrast dye CPT 70551 MRI Exam | $1,841.12 | $4,976.00 | 63% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Exam | $1,841.12 | $4,976.00 | 63% |
| MRI of the brain, with and without contrast dye CPT 70553 MMRI Exam | $2,698.78 | $7,294.00 | 63% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Exam | $2,698.78 | $7,294.00 | 63% |
| MRI of the brain, with and without contrast dye CPT 70553 MRIME Exam | $2,698.78 | $7,294.00 | 63% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MMRI Exam | $2,698.78 | $7,294.00 | 63% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRIME Exam | $2,698.78 | $7,294.00 | 63% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Exam | $2,698.78 | $7,294.00 | 63% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Exam | $2,506.38 | $6,774.00 | 63% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Exam | $2,506.38 | $6,774.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Pregnant Uterus after first trimester t | $131.72 | $356.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Pregnant Uterus after first trimester | $185.37 | $501.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Level 1 Diagnostic/Screening - Labor Pr | $223.48 | $604.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Yes - Ultrasound Level 1 Diag/Screen Charge | $223.48 | $604.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound Level 1 Diagnostic/Screening | $223.48 | $604.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Exam | $486.18 | $1,314.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ultrasound Pregnant Uterus after first trimester t | $131.72 | $356.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Yes - Ultrasound Level 1 Diag/Screen Charge | $223.48 | $604.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ultrasound Level 1 Diagnostic/Screening | $223.48 | $604.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ultrasound Level 1 Diagnostic/Screening - Labor Pr | $223.48 | $604.00 | 63% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Exam | $486.18 | $1,314.00 | 63% |
| Screening mammogram, both breasts CPT 77067 JEMAM Exam | $201.28 | $544.00 | 63% |
| Screening mammogram, both breasts CPT 77067 MM Exam | $201.28 | $544.00 | 63% |
| Screening mammogram, both breasts inpatient CPT 77067 JEMAM Exam | $201.28 | $544.00 | 63% |
| Screening mammogram, both breasts inpatient CPT 77067 MM Exam | $201.28 | $544.00 | 63% |
| Sleep study in a lab (polysomnography) CPT 95810 SL-All Night Polysomnogram | $2,494.91 | $6,743.00 | 63% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 SL-All Night Polysomnogram | $2,494.91 | $6,743.00 | 63% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound Transvaginal ER MD | $166.50 | $450.00 | 63% |
| Transvaginal pelvic ultrasound CPT 76830 MUS Exam | $405.52 | $1,096.00 | 63% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvag | $405.52 | $1,096.00 | 63% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 MUS Exam | $405.52 | $1,096.00 | 63% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvag | $405.52 | $1,096.00 | 63% |
| Ultrasound of the abdomen, complete CPT 76700 US Exam | $563.14 | $1,522.00 | 63% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Exam | $563.14 | $1,522.00 | 63% |
| X-ray of the lower back, 4 or more views CPT 72110 RA Exam | $411.07 | $1,111.00 | 63% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 RA Exam | $411.07 | $1,111.00 | 63% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Basic Panel | $136.16 | $368.00 | 63% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Panel | $136.16 | $368.00 | 63% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $122.47 | $331.00 | 63% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $122.47 | $331.00 | 63% |
| Complete blood count (CBC) with differential CPT 85025 UNMC CBC | $24.42 | $66.00 | 63% |
| Complete blood count (CBC) with differential CPT 85025 Differntial (Auto) | $57.72 | $156.00 | 63% |
| Complete blood count (CBC) with differential inpatient CPT 85025 UNMC CBC | $24.42 | $66.00 | 63% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Differntial (Auto) | $57.72 | $156.00 | 63% |
| Complete blood count (CBC), no differential CPT 85027 Hemogram Charge | $41.44 | $112.00 | 63% |
| Complete blood count (CBC), no differential CPT 85027 Hemogram | $41.44 | $112.00 | 63% |
| Complete blood count (CBC), no differential CPT 85027 Manual Diff - Diff Type | $41.44 | $112.00 | 63% |
| Complete blood count (CBC), no differential CPT 85027 Cellavision Diff - Diff Type | $41.44 | $112.00 | 63% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram | $41.44 | $112.00 | 63% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Cellavision Diff - Diff Type | $41.44 | $112.00 | 63% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Manual Diff - Diff Type | $41.44 | $112.00 | 63% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram Charge | $41.44 | $112.00 | 63% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $141.34 | $382.00 | 63% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $141.34 | $382.00 | 63% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $136.90 | $370.00 | 63% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $136.90 | $370.00 | 63% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $127.65 | $345.00 | 63% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $127.65 | $345.00 | 63% |
| Obstetric blood test panel CPT 80055 Prenatal Panel Charge - MH/WH/FH | $153.55 | $415.00 | 63% |
| Obstetric blood test panel inpatient CPT 80055 Prenatal Panel Charge - MH/WH/FH | $153.55 | $415.00 | 63% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free | $127.65 | $345.00 | 63% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free | $127.65 | $345.00 | 63% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Ultrasensitive - Post Prostatectomy | $31.82 | $86.00 | 63% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total | $65.12 | $176.00 | 63% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen | $89.91 | $243.00 | 63% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Ultrasensitive - Post Prostatectomy | $31.82 | $86.00 | 63% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total | $65.12 | $176.00 | 63% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen | $89.91 | $243.00 | 63% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT Inhib 1 Hr Rflx | $18.87 | $51.00 | 63% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Inhibitor Assay PTT Rflx 11 Mix | $18.87 | $51.00 | 63% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time Panel | $47.36 | $128.00 | 63% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time (PTT) - FH | $47.36 | $128.00 | 63% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time - MH/WH/JE | $47.36 | $128.00 | 63% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Inhibitor Assay PTT Rflx 11 Mix | $18.87 | $51.00 | 63% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT Inhib 1 Hr Rflx | $18.87 | $51.00 | 63% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time (PTT) - FH | $47.36 | $128.00 | 63% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time Panel | $47.36 | $128.00 | 63% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time - MH/WH/JE | $47.36 | $128.00 | 63% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Protime POC - PC | $31.45 | $85.00 | 63% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time - MH/WH/JE | $31.45 | $85.00 | 63% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time Panel | $31.45 | $85.00 | 63% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Protime - MH/WH/JE | $31.45 | $85.00 | 63% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time (PT) - FH | $31.45 | $85.00 | 63% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time (PT) - FH | $31.45 | $85.00 | 63% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time - MH/WH/JE | $31.45 | $85.00 | 63% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time Panel | $31.45 | $85.00 | 63% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Protime POC - PC | $31.45 | $85.00 | 63% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Protime - MH/WH/JE | $31.45 | $85.00 | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $96.20 | $260.00 | 63% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH Reflex | $96.20 | $260.00 | 63% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH Reflex | $96.20 | $260.00 | 63% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $96.20 | $260.00 | 63% |
| Urinalysis with microscope exam, automated CPT 81001 UA with Microscopic Charge | $39.22 | $106.00 | 63% |
| Urinalysis with microscope exam, automated CPT 81001 UA Microscopic | $39.22 | $106.00 | 63% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA Microscopic | $39.22 | $106.00 | 63% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA with Microscopic Charge | $39.22 | $106.00 | 63% |
| Urinalysis without microscope exam, automated CPT 81003 UA (Culture if Positive) | $8.88 | $24.00 | 63% |
| Urinalysis without microscope exam, automated CPT 81003 UA without Microscopic Charge | $8.88 | $24.00 | 63% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis | $8.88 | $24.00 | 63% |
| Urinalysis without microscope exam, automated CPT 81003 Urogram | $8.88 | $24.00 | 63% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA (Culture if Positive) | $8.88 | $24.00 | 63% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA without Microscopic Charge | $8.88 | $24.00 | 63% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis | $8.88 | $24.00 | 63% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urogram | $8.88 | $24.00 | 63% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 XCAPSL CTRC RMVL INSJ IO LENS PROSTH W-O ECP | $1,125.54 | $3,042.00 | 63% |
| Cataract surgery with lens implant one side CPT 66984 Unilateral Extracap Cataract Removal w/IOL | $1,763.05 | $4,765.00 | 63% |
| Cataract surgery with lens implant inpatient CPT 66984 XCAPSL CTRC RMVL INSJ IO LENS PROSTH W-O ECP | $1,125.54 | $3,042.00 | 63% |
| Cataract surgery with lens implant inpatient one side CPT 66984 Unilateral Extracap Cataract Removal w/IOL | $1,763.05 | $4,765.00 | 63% |
| Colonoscopy with endoscopic ultrasound CPT 45391 COLSC FLX W-NDSC US XM RCTM ET AL LMTDANDADJ STRUX | $608.28 | $1,644.00 | 63% |
| Colonoscopy with endoscopic ultrasound CPT 45391 END-Colonoscopy/ultrasound | $1,349.39 | $3,647.00 | 63% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLSC FLX W-NDSC US XM RCTM ET AL LMTDANDADJ STRUX | $608.28 | $1,644.00 | 63% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 END-Colonoscopy/ultrasound | $1,349.39 | $3,647.00 | 63% |
| Colonoscopy with polyp removal CPT 45385 COLSC FLX W-RMVL OF TUMOR POLYP LESION SNARE TQ | $608.28 | $1,644.00 | 63% |
| Colonoscopy with polyp removal CPT 45385 COLON FLEX PROX SPLEN TUM | $881.71 | $2,383.00 | 63% |
| Colonoscopy with polyp removal CPT 45385 END-Colonoscopy w/Poly | $1,140.34 | $3,082.00 | 63% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLSC FLX W-RMVL OF TUMOR POLYP LESION SNARE TQ | $608.28 | $1,644.00 | 63% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLON FLEX PROX SPLEN TUM | $881.71 | $2,383.00 | 63% |
| Colonoscopy with polyp removal inpatient CPT 45385 END-Colonoscopy w/Poly | $1,140.34 | $3,082.00 | 63% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W-BIOPSY SINGLE-MULTIPLE | $608.28 | $1,644.00 | 63% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy Flex w/Biopsy Sngl or Multi | $881.71 | $2,383.00 | 63% |
| Colonoscopy with tissue sample CPT 45380 END-Colonoscopy w/ Biopsy | $1,140.34 | $3,082.00 | 63% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W-BIOPSY SINGLE-MULTIPLE | $608.28 | $1,644.00 | 63% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy Flex w/Biopsy Sngl or Multi | $881.71 | $2,383.00 | 63% |
| Colonoscopy with tissue sample inpatient CPT 45380 END-Colonoscopy w/ Biopsy | $1,140.34 | $3,082.00 | 63% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX W-COLLJ SPEC WHEN PFRMD | $608.28 | $1,644.00 | 63% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Beyond Splenic Flexure | $979.39 | $2,647.00 | 63% |
| Colonoscopy, diagnostic CPT 45378 END-Colonoscopy Spl Flex | $1,140.34 | $3,082.00 | 63% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLX DX W-COLLJ SPEC WHEN PFRMD | $608.28 | $1,644.00 | 63% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Beyond Splenic Flexure | $979.39 | $2,647.00 | 63% |
| Colonoscopy, diagnostic inpatient CPT 45378 END-Colonoscopy Spl Flex | $1,140.34 | $3,082.00 | 63% |
| Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surgical Cholecystectomy | $4,005.62 | $10,826.00 | 63% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY | $4,501.42 | $12,166.00 | 63% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 Laparoscopy Surgical Cholecystectomy | $4,005.62 | $10,826.00 | 63% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY | $4,501.42 | $12,166.00 | 63% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Repair Inguinal Hernia age 5 older | $2,310.28 | $6,244.00 | 63% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS-GREATER THAN REDUCIBL | $4,501.42 | $12,166.00 | 63% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Repair Inguinal Hernia age 5 older | $2,310.28 | $6,244.00 | 63% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS-GREATER THAN REDUCIBL | $4,501.42 | $12,166.00 | 63% |
| Knee arthroscopy with meniscus trim CPT 29881 ARTHRS KNEE SURG W-MENISCECTOMY MED-LAT W-SHVG | $1,350.87 | $3,651.00 | 63% |
| Knee arthroscopy with meniscus trim CPT 29881 Arthroscopy w Menisectomy | $2,163.02 | $5,846.00 | 63% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHRS KNEE SURG W-MENISCECTOMY MED-LAT W-SHVG | $1,350.87 | $3,651.00 | 63% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 Arthroscopy w Menisectomy | $2,163.02 | $5,846.00 | 63% |
| Left heart catheterization, diagnostic CPT 93452 LHC /- LV | $6,296.66 | $17,018.00 | 63% |
| Left heart catheterization, diagnostic inpatient CPT 93452 LHC /- LV | $6,296.66 | $17,018.00 | 63% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Inject diag/therapeutic substance w/needle or cath | $711.88 | $1,924.00 | 63% |
| Lower-back epidural injection, with imaging guidance CPT 62323 MECT Exam | $907.24 | $2,452.00 | 63% |
| Lower-back epidural injection, with imaging guidance CPT 62323 L/S Spinal Inj | $907.24 | $2,452.00 | 63% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection diagnostic or therapeutic substance not | $907.24 | $2,452.00 | 63% |
| Lower-back epidural injection, with imaging guidance CPT 62323 SP Limited Exam | $907.24 | $2,452.00 | 63% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inject diag/therapeutic substance w/needle or cath | $711.88 | $1,924.00 | 63% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 SP Limited Exam | $907.24 | $2,452.00 | 63% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Injection diagnostic or therapeutic substance not | $907.24 | $2,452.00 | 63% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 MECT Exam | $907.24 | $2,452.00 | 63% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 L/S Spinal Inj | $907.24 | $2,452.00 | 63% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Inject diag/therapeutic substancesinterlaminar epi | $608.28 | $1,644.00 | 63% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Intrathecal Injection | $626.78 | $1,694.00 | 63% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Injection diagnostic or therapeutic substance not | $907.24 | $2,452.00 | 63% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Inject diag/therapeutic substancesinterlaminar epi | $608.28 | $1,644.00 | 63% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Intrathecal Injection | $626.78 | $1,694.00 | 63% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Injection diagnostic or therapeutic substance not | $907.24 | $2,452.00 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT Exam | $468.79 | $1,267.00 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Foramen Epidural L/S | $468.79 | $1,267.00 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 MSP Exam | $468.79 | $1,267.00 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Foramen Epidura L/S-CT | $468.79 | $1,267.00 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inject anes agent transforamnal epidural w/image g | $595.33 | $1,609.00 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Foramen Epidura L/S-CT | $468.79 | $1,267.00 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 MSP Exam | $468.79 | $1,267.00 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Foramen Epidural L/S | $468.79 | $1,267.00 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CT Exam | $468.79 | $1,267.00 | 63% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inject anes agent transforamnal epidural w/image g | $595.33 | $1,609.00 | 63% |
| Prostate biopsy CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH | $2,518.96 | $6,808.00 | 63% |
| Prostate biopsy inpatient CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH | $2,518.96 | $6,808.00 | 63% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPS SURG PRST8ECT RPBIC RAD W-NERVE SPARING | $9,368.03 | $25,319.00 | 63% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPS SURG PRST8ECT RPBIC RAD W-NERVE SPARING | $9,368.03 | $25,319.00 | 63% |
| Removal of a breast lump, open surgery CPT 19120 EXC CYST-ABERRANT BREAST TISSUE OPEN 1-GREATER THA | $2,518.96 | $6,808.00 | 63% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST-ABERRANT BREAST TISSUE OPEN 1-GREATER THA | $2,518.96 | $6,808.00 | 63% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SURGICAL ARTHROSCOPY SHO W-CORACOACRM LIGM RLS | $1,125.54 | $3,042.00 | 63% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Arthroscopy Decompress Subacromial | $2,002.81 | $5,413.00 | 63% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SURGICAL ARTHROSCOPY SHO W-CORACOACRM LIGM RLS | $1,125.54 | $3,042.00 | 63% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 Arthroscopy Decompress Subacromial | $2,002.81 | $5,413.00 | 63% |
| Tonsil and adenoid removal, child under 12 CPT 42820 TONSILLECTOMY AND ADENOIDECTOMY LESS THAN AGE 12 | $2,026.12 | $5,476.00 | 63% |
| Tonsil and adenoid removal, child under 12 CPT 42820 Tonsillectomy Adenoidectomy Under Age 12 | $3,700.00 | $10,000.00 | 63% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 TONSILLECTOMY AND ADENOIDECTOMY LESS THAN AGE 12 | $2,026.12 | $5,476.00 | 63% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 Tonsillectomy Adenoidectomy Under Age 12 | $3,700.00 | $10,000.00 | 63% |
| Total hip replacement CPT 27130 ARTHRP ACETBLR-PROX FEM PROSTC AGRFT-ALGRFT | $7,652.34 | $20,682.00 | 63% |
| Total hip replacement inpatient CPT 27130 ARTHRP ACETBLR-PROX FEM PROSTC AGRFT-ALGRFT | $7,652.34 | $20,682.00 | 63% |
| Total knee replacement CPT 27447 ARTHRP KNE CONDYLEANDPLATU MEDIALANDLAT COMPARTMEN | $7,652.34 | $20,682.00 | 63% |
| Total knee replacement inpatient CPT 27447 ARTHRP KNE CONDYLEANDPLATU MEDIALANDLAT COMPARTMEN | $7,652.34 | $20,682.00 | 63% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD TRANSORAL BIOPSY SINGLE-MULTIPLE | $608.28 | $1,644.00 | 63% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UP GAS ENDO ESO STO DUODE | $881.71 | $2,383.00 | 63% |
| Upper endoscopy (EGD) with biopsy CPT 43239 END-Esophogogastroscopy w/Bx | $1,093.72 | $2,956.00 | 63% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD with biopsy | $1,125.54 | $3,042.00 | 63% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD TRANSORAL BIOPSY SINGLE-MULTIPLE | $608.28 | $1,644.00 | 63% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UP GAS ENDO ESO STO DUODE | $881.71 | $2,383.00 | 63% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 END-Esophogogastroscopy w/Bx | $1,093.72 | $2,956.00 | 63% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD with biopsy | $1,125.54 | $3,042.00 | 63% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Upper GI Mode of charge entry | $167.98 | $454.00 | 63% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $608.28 | $1,644.00 | 63% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Upper GI Endoscopy w/w-o Specimen Collection | $980.13 | $2,649.00 | 63% |
| Upper endoscopy (EGD), diagnostic CPT 43235 END-Esophagogastroduoden Diagnostic | $1,093.72 | $2,956.00 | 63% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $608.28 | $1,644.00 | 63% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Upper GI Endoscopy w/w-o Specimen Collection | $980.13 | $2,649.00 | 63% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 END-Esophagogastroduoden Diagnostic | $1,093.72 | $2,956.00 | 63% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 EVM - Fam Thrpy w/ Patient | $281.20 | $760.00 | 63% |
| New patient office visit, about 30 minutes CPT 99203 EVM - OP VISIT NEW PATIENT LOW LEVEL 30 MIN | $90.28 | $244.00 | 63% |
| New patient office visit, about 30 minutes CPT 99203 OP Eval - New Pt Exp Focused | $104.34 | $282.00 | 63% |
| New patient office visit, about 30 minutes CPT 99203 WC-OP visit new patient low level 30-44 min-PF | $142.08 | $384.00 | 63% |
| New patient office visit, about 30 minutes CPT 99203 RAO-OP VISIT NEW PATIENT LOW LEVEL 30-44 MIN | $200.17 | $541.00 | 63% |
| New patient office visit, about 30 minutes CPT 99203 WC-OP visit new patient low level 30-44 min | $264.18 | $714.00 | 63% |
| New patient office visit, about 30 minutes inpatient CPT 99203 EVM - OP VISIT NEW PATIENT LOW LEVEL 30 MIN | $90.28 | $244.00 | 63% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OP Eval - New Pt Exp Focused | $104.34 | $282.00 | 63% |
| New patient office visit, about 30 minutes inpatient CPT 99203 RAO-OP VISIT NEW PATIENT LOW LEVEL 30-44 MIN | $200.17 | $541.00 | 63% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WC-OP visit new patient low level 30-44 min | $264.18 | $714.00 | 63% |
| New patient office visit, about 45 minutes CPT 99204 EVM - OP VISIT NEW PATIENT MODERATE LEVEL 45 MIN | $90.28 | $244.00 | 63% |
| New patient office visit, about 45 minutes CPT 99204 OP Eval - New Pt Detailed | $135.42 | $366.00 | 63% |
| New patient office visit, about 45 minutes CPT 99204 WC-OP visit new patient moderate level 45-59 min - | $201.28 | $544.00 | 63% |
| New patient office visit, about 45 minutes CPT 99204 RAO-OP VISIT NEW PATIENT MODERATE LEVEL 45-59 MIN | $231.62 | $626.00 | 63% |
| New patient office visit, about 45 minutes CPT 99204 WC-OP visit new patient moderate level 45-59 min | $340.03 | $919.00 | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 EVM - OP VISIT NEW PATIENT MODERATE LEVEL 45 MIN | $90.28 | $244.00 | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OP Eval - New Pt Detailed | $135.42 | $366.00 | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 RAO-OP VISIT NEW PATIENT MODERATE LEVEL 45-59 MIN | $231.62 | $626.00 | 63% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WC-OP visit new patient moderate level 45-59 min | $340.03 | $919.00 | 63% |
| New patient office visit, about 60 minutes CPT 99205 EVM - OP VISIT NEW PATIENT HIGH LEVEL 60 MIN | $90.28 | $244.00 | 63% |
| New patient office visit, about 60 minutes CPT 99205 OP Eval - New Pt Comp | $167.61 | $453.00 | 63% |
| New patient office visit, about 60 minutes CPT 99205 HOSP-VISIT NEW PATIENT HIGH LEVEL 60 MIN | $234.95 | $635.00 | 63% |
| New patient office visit, about 60 minutes CPT 99205 WC-OP visit new patient high level 60-74 min- PF | $256.78 | $694.00 | 63% |
| New patient office visit, about 60 minutes CPT 99205 RAO-OP VISIT NEW PATIENT HIGH LEVEL 60-74 MIN | $257.52 | $696.00 | 63% |
| New patient office visit, about 60 minutes CPT 99205 WC-OP visit new patient high level 60-74 min | $446.96 | $1,208.00 | 63% |
| New patient office visit, about 60 minutes inpatient CPT 99205 EVM - OP VISIT NEW PATIENT HIGH LEVEL 60 MIN | $90.28 | $244.00 | 63% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OP Eval - New Pt Comp | $167.61 | $453.00 | 63% |
| New patient office visit, about 60 minutes inpatient CPT 99205 RAO-OP VISIT NEW PATIENT HIGH LEVEL 60-74 MIN | $257.52 | $696.00 | 63% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WC-OP visit new patient high level 60-74 min | $446.96 | $1,208.00 | 63% |
| Preventive checkup, new patient aged 18–39 CPT 99385 EVM - Prev Med New Patient 18-39 yrs | $90.28 | $244.00 | 63% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 EVM - Prev Med New Patient 18-39 yrs | $90.28 | $244.00 | 63% |
| Preventive checkup, new patient aged 40–64 CPT 99386 EVM - Prev Med New Patient 40-64 yrs | $90.28 | $244.00 | 63% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 EVM - Prev Med New Patient 40-64 yrs | $90.28 | $244.00 | 63% |
| Psychotherapy session, 30 minutes CPT 90832 EVM - PF Psychotherapy 30 Min. | $93.24 | $252.00 | 63% |
| Psychotherapy session, 30 minutes CPT 90832 EVM - Psychothrpy 20-30Min w/o Em | $140.23 | $379.00 | 63% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 EVM - Psychothrpy 20-30Min w/o Em | $140.23 | $379.00 | 63% |
| Psychotherapy session, 45 minutes CPT 90834 EVM - Psychothry 45-50 Min w/o EM | $191.66 | $518.00 | 63% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 EVM - Psychothry 45-50 Min w/o EM | $191.66 | $518.00 | 63% |
| Psychotherapy session, 60 minutes CPT 90837 EVM - Psychotherapy 60 min with patient | $218.30 | $590.00 | 63% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 EVM - Psychotherapy 60 min with patient | $218.30 | $590.00 | 63% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 EVM - Office Consult Detailed 40 Min | $179.45 | $485.00 | 63% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 EVM- PF Office Consult Comp 60 min | $254.19 | $687.00 | 63% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 EVM - Office Consult Comprehensive 60 Min | $254.19 | $687.00 | 63% |
Source file: https://bestcare.org/sites/default/files/2026-02/831362276_Methodist-Fremont-Health_standardcharges.zip