Charles A. Dean Memorial Hospital
Charles A. Dean Memorial Hospital in Greenville, ME publishes cash prices for 30 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
364 Pritham Ave Greenville, ME 04441 Collected Sep 23, 2026 Source price file
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL-Q | $91.00 | $182.00 | 50% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PAN | $95.50 | $191.00 | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL-Q | $91.00 | $182.00 | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PAN | $95.50 | $191.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HDL PROFILE | $67.50 | $135.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HDL PROFILE | $67.50 | $135.00 | 50% |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFF-Q | $58.00 | $116.00 | 50% |
| Complete blood count (CBC) with differential CPT 85025 CBC/AUTO DIFF | $61.00 | $122.00 | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFF-Q | $58.00 | $116.00 | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC/AUTO DIFF | $61.00 | $122.00 | 50% |
| Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFFERENTIAL-Q | $33.50 | $67.00 | 50% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $35.00 | $70.00 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFFERENTIAL-Q | $33.50 | $67.00 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM | $35.00 | $70.00 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANL-Q | $135.00 | $270.00 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PAN | $142.00 | $284.00 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANL-Q | $135.00 | $270.00 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PAN | $142.00 | $284.00 | 50% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $51.00 | $102.00 | 50% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL-Q | $51.00 | $102.00 | 50% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL-Q | $51.00 | $102.00 | 50% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $51.00 | $102.00 | 50% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL-Q | $69.50 | $139.00 | 50% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PAN | $73.00 | $146.00 | 50% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL-Q | $69.50 | $139.00 | 50% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PAN | $73.00 | $146.00 | 50% |
| Obstetric blood test panel CPT 80055 PRENATAL PROFILE | $243.50 | $487.00 | 50% |
| Obstetric blood test panel inpatient CPT 80055 PRENATAL PROFILE | $243.50 | $487.00 | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE | $81.50 | $163.00 | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE | $81.50 | $163.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL(PART OF PSA FREE) | $73.50 | $147.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPE-AG/LAB | $73.50 | $147.00 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPE-AG/LAB | $73.50 | $147.00 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL(PART OF PSA FREE) | $73.50 | $147.00 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT/LAB | $42.00 | $84.00 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $42.00 | $84.00 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT/LAB | $42.00 | $84.00 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL | $42.00 | $84.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROMTHROMBIN TIME/LAB | $30.50 | $61.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME/LAB | $30.50 | $61.00 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME/LAB | $30.50 | $61.00 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROMTHROMBIN TIME/LAB | $30.50 | $61.00 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH/LAB | $80.00 | $160.00 | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH/LAB | $80.00 | $160.00 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 MICRO SEDIMNT & DIPSTIK (AUTO) | $23.50 | $47.00 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS REFLEX TO CULTURE-Q | $23.50 | $47.00 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS REFLEX TO CULTURE-Q | $23.50 | $47.00 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 MICRO SEDIMNT & DIPSTIK (AUTO) | $23.50 | $47.00 | 50% |
| Urinalysis with microscope exam, manual CPT 81000 MICRO SEDIMNT & DIPSTICK(MAN) | $13.50 | $27.00 | 50% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 MICRO SEDIMNT & DIPSTICK(MAN) | $13.50 | $27.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 DISTICK- URINE LAB/SCREEN | $18.50 | $37.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINE SCREEN/LAB | $18.50 | $37.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O MICRO | $18.50 | $37.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 DIPSTICK-URINE LAB/SCREEN | $18.50 | $37.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE-Q | $24.00 | $48.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS MACROSCOPIC-Q | $24.00 | $48.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/MICROSCOPIC-Q | $24.00 | $48.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINE PH/LAB | $24.00 | $48.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 PH URINE-Q | $24.00 | $48.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 DIPSTICK-URINE LAB/SCREEN | $18.50 | $37.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SCREEN/LAB | $18.50 | $37.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O MICRO | $18.50 | $37.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 DISTICK- URINE LAB/SCREEN | $18.50 | $37.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS MACROSCOPIC-Q | $24.00 | $48.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/MICROSCOPIC-Q | $24.00 | $48.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE-Q | $24.00 | $48.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 PH URINE-Q | $24.00 | $48.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PH/LAB | $24.00 | $48.00 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 URINE SUGAR | $13.50 | $27.00 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 DIPSTICK U/A | $13.50 | $27.00 | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 DIPSTICK U/A | $13.50 | $27.00 | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE SUGAR | $13.50 | $27.00 | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $740.50 | $1,481.00 | 50% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $740.50 | $1,481.00 | 50% |
| Prostate biopsy CPT 55700 PF PROSTATE NEEDLE BIOPSY | $242.00 | $484.00 | 50% |
| Prostate biopsy CPT 55700 HC PROSTATE NEEDLE BIOPSY | $276.00 | $552.00 | 50% |
| Prostate biopsy inpatient CPT 55700 PF PROSTATE NEEDLE BIOPSY | $242.00 | $484.00 | 50% |
| Removal of a breast lump, open surgery CPT 19120 REMOVAL BREAST LESION PF | $609.00 | $1,218.00 | 50% |
| Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION | $609.00 | $1,218.00 | 50% |
| Removal of a breast lump, open surgery CPT 19120 EXC. CYST/ABRNT BREAST TISSUE | $609.00 | $1,218.00 | 50% |
| Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL BREAST LESION PF | $609.00 | $1,218.00 | 50% |
| Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL OF BREAST LESION | $609.00 | $1,218.00 | 50% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC. CYST/ABRNT BREAST TISSUE | $609.00 | $1,218.00 | 50% |
| Total knee replacement CPT 27447 ARTHROPLASTY KNEE MEDICAL & | $1,455.50 | $2,911.00 | 50% |
| Total knee replacement inpatient CPT 27447 ARTHROPLASTY KNEE MEDICAL & | $1,455.50 | $2,911.00 | 50% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 DELIVERY-ANTE/POST PARTUM | $5,484.00 | $10,968.00 | 50% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 DELIVERY-ANTE/POST PARTUM | $5,484.00 | $10,968.00 | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 HC OUTPT CLINIC VST NEW LVL 3 | $81.50 | $163.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 HC NEW PATIENT E/M LEVEL 3 | $93.50 | $187.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 PAIN MGMT-NEW PT LVL 3 | $93.50 | $187.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 SUB NEW PT VISIT LVL 3 F | $93.50 | $187.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE O/P NEW PT 30-44 MIN | $93.50 | $187.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT E/M LEVEL 3 | $93.50 | $187.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT E/M LEVEL 3 F | $93.50 | $187.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 HC OP CLINIC VST NEW LV 3 SNGV | $93.50 | $187.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT E/M LEVEL 3 F | $93.50 | $187.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 PF OUTPT CLINIC VST NEW LVL 3 | $114.50 | $229.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 PC NEW PATIENT E/M LEVEL 3 | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 SUB NEW PT VISIT LVL 3 PF | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 PF NEW PATIENT E/M LEVEL 3 | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 PF OFFICE O/P NEW PT 30-44 MIN | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT E/M LEVEL 3 PF | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT E/M LEVEL 3 PF | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 RH NEW PT E/M LEVEL 3 | $219.50 | $439.00 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PF OUTPT CLINIC VST NEW LVL 3 | $114.50 | $229.00 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PF NEW PATIENT E/M LEVEL 3 | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT E/M LEVEL 3 PF | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT E/M LEVEL 3 | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT E/M LEVEL 3 PF | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 SUB NEW PT VISIT LVL 3 PF | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PF OFFICE O/P NEW PT 30-44 MIN | $126.00 | $252.00 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PC NEW PATIENT E/M LEVEL 3 | $126.00 | $252.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 HC OUTPT CLINIC VST NEW LVL 4 | $111.00 | $222.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE O/P NEW PT 45-59 MIN | $127.50 | $255.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 SUB NEW PT VISIT LVL 4 F | $127.50 | $255.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 HC NEW PATIENT E/M LEVEL 4 | $127.50 | $255.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT E/M LEVEL 4 | $127.50 | $255.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 PAIN MGMT-NEW PT LVL 4 | $127.50 | $255.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT E/M LEVEL 4 F | $127.50 | $255.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 HC OP CLINIC VST NEW LV 4 SNGV | $127.50 | $255.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT E/M LEVEL 4 F | $127.50 | $255.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 PF OUTPT CLINIC VST NEW LVL 4 | $172.00 | $344.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 PC NEW PATIENT E/M LEVEL 4 | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT E/M LEVEL 4 PF | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT E/M LEVEL 4 PF | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 PF NEW PATIENT E/M LEVEL 4 | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 SUB NEW PT VISIT LVL 4 PF | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 PF OFFICE O/P NEW PT 45-59 MIN | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 RH NEW PT E/M LEVEL 4 | $317.00 | $634.00 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PF OUTPT CLINIC VST NEW LVL 4 | $172.00 | $344.00 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT E/M LEVEL 4 PF | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PF OFFICE O/P NEW PT 45-59 MIN | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 SUB NEW PT VISIT LVL 4 PF | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PF NEW PATIENT E/M LEVEL 4 | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PC NEW PATIENT E/M LEVEL 4 | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT E/M LEVEL 4 | $189.50 | $379.00 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT E/M LEVEL 4 PF | $189.50 | $379.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 PF OUTPT CLINIC VST NEW LVL 5 | $195.50 | $391.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE O/P NEW PT 60-74 MIN | $224.50 | $449.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 HC OP CLINIC VST NEW LV 5 SNGV | $224.50 | $449.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT E/M LEVEL 5 F | $224.50 | $449.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 PAIN MGMT-NEW PT LVL 5 | $224.50 | $449.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT E/M LEVEL 5 F | $224.50 | $449.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT E/M LEVEL 5 | $224.50 | $449.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 HC NEW PATIENT E/M LEVEL 5 | $224.50 | $449.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 SUB NEW PT VISIT LVL 5 F | $224.50 | $449.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 HC OUTPT CLINIC VST NEW LVL 5 | $226.50 | $453.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT E/M LEVEL 5 PF | $249.00 | $498.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT E/M LEVEL 5 PF | $249.00 | $498.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 PF NEW PATIENT E/M LEVEL 5 | $249.00 | $498.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 SUB NEW PT VISIT LVL 5 PF | $249.00 | $498.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 PF OFFICE O/P NEW PT 60-74 MIN | $249.00 | $498.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 RH NEW PT E/M LEVEL 5 | $473.50 | $947.00 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 PF OUTPT CLINIC VST NEW LVL 5 | $195.50 | $391.00 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT E/M LEVEL 5 | $249.00 | $498.00 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT E/M LEVEL 5 PF | $249.00 | $498.00 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT E/M LEVEL 5 PF | $249.00 | $498.00 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 PF OFFICE O/P NEW PT 60-74 MIN | $249.00 | $498.00 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 PF NEW PATIENT E/M LEVEL 5 | $249.00 | $498.00 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 SUB NEW PT VISIT LVL 5 PF | $249.00 | $498.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC SP THERAPEUTIC EXER 15 MINS | $66.00 | $132.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OTA THERAPEUTIC PROCED | $66.00 | $132.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PTA THERAPEUTC EXERCISE 15 MIN | $66.00 | $132.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROCED | $66.00 | $132.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE 15 MIN | $66.00 | $132.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PTA THERAPEUTC EXERCISE 15 MIN | $66.00 | $132.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE 15 MIN | $66.00 | $132.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC SP THERAPEUTIC EXER 15 MINS | $66.00 | $132.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OTA THERAPEUTIC PROCED | $66.00 | $132.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROCED | $66.00 | $132.00 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREVENTIVE NEW PT 18-39 YRS F | $43.00 | $86.00 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREVENTIVE NEW PT 18-39 YRS PF | $140.00 | $280.00 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 RH PREVENTIVE NEW PT 18-39 YRS | $183.00 | $366.00 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREVENTIVE NEW PT 18-39 YRS PF | $140.00 | $280.00 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE NEW PT 40-64 F | $52.50 | $105.00 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE NEW PT 40-64 YRS F | $52.50 | $105.00 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE NEW PT 40-64 YRS PF | $190.50 | $381.00 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE NEW PT 40-64 PF | $190.50 | $381.00 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 RH PREVENTIVE NEW PT 40-64 YRS | $243.00 | $486.00 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREVENTIVE NEW PT 40-64 YRS PF | $190.50 | $381.00 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREVENTIVE NEW PT 40-64 PF | $190.50 | $381.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OV CONSULT NEW/EST PT 40MIN | $47.50 | $95.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT LEVEL 3 F | $54.50 | $109.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OV CNSLT NEW/EST PT 40MN SV | $54.50 | $109.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION LEVEL 3 F | $54.50 | $109.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULT LEVEL 3 | $54.50 | $109.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PF OV CONSULT NEW/EST PT 40MIN | $143.50 | $287.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION NEW LVL 3 PF | $157.50 | $315.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PF OFFICE CONSULT LEVEL 3 | $157.50 | $315.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 ER CONSULT LEVEL 3 | $157.50 | $315.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT NEW LEVEL 3 PF | $157.50 | $315.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PF OV CONSULT NEW/EST PT 40MIN | $143.50 | $287.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULT NEW LEVEL 3 PF | $157.50 | $315.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULTATION NEW LVL 3 PF | $157.50 | $315.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PF OFFICE CONSULT LEVEL 3 | $157.50 | $315.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 ER CONSULT LEVEL 3 | $157.50 | $315.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OV CONSULT NEW/EST PT 60MIN | $69.50 | $139.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC PAIN MGMT-CONSULT EST 30MIN | $80.00 | $160.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULT LEVEL 4 | $80.00 | $160.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OV CNSLT NEW/EST PT 60MN SV | $80.00 | $160.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULTATION LEVEL 4 F | $80.00 | $160.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT LEVEL 4 F | $80.00 | $160.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PF OV CONSULT NEW/EST PT 60MIN | $219.00 | $438.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULTATION NEW LVL 4 PF | $241.00 | $482.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT LEVEL 5 PF | $241.00 | $482.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PF OFFICE CONSULT LEVEL 4 | $241.00 | $482.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT NEW LEVEL 4 PF | $241.00 | $482.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 ER CONSULT LEVEL 4 | $241.00 | $482.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PF OV CONSULT NEW/EST PT 60MIN | $219.00 | $438.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULTATION NEW LVL 4 PF | $241.00 | $482.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 ER CONSULT LEVEL 4 | $241.00 | $482.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULT NEW LEVEL 4 PF | $241.00 | $482.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PF OFFICE CONSULT LEVEL 4 | $241.00 | $482.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULT LEVEL 5 PF | $241.00 | $482.00 | 50% |
Source file: https://northernlighthealth.org/NLH/media/Price-Transparency/043341666_CA-Dean-hospital_standardcharges.csv