Home › Hospitals › Banner Churchill Community Hospital Posts prices for 33 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-01.
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Procedure Cash price Gross charge × Medicare
Epidural injection, lumbar/sacral (with imaging) (62322) $336.24
$1,041
0.4×
CT head/brain without contrast (70450) $467.04
$1,112
4.2×
MRI brain without contrast (70551) $1,506.45
$2,837
6.0×
MRI brain with contrast (70552) $1,883.46
$3,547
5.1×
MRI brain without and with contrast (70553) $2,259.94
$4,256
6.1×
X-ray lower spine, 4+ views (72110) $448.63
$837
4.1×
MRI lumbar spine without contrast (72148) $1,950.95
$3,688
7.7×
CT pelvis with contrast (72193) $1,635.62
$3,338
8.8×
MRI lower-extremity joint without contrast (73721) $1,543.15
$3,074
6.1×
CT abdomen and pelvis with contrast (74177) $2,127.58
$4,342
5.8×
Ultrasound, abdomen complete (76700) $739.88
$1,060
6.7×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $748.95
$1,073
6.8×
Ultrasound, transvaginal (76830) $580.74
$832
5.3×
Mammography, one breast (diagnostic) (77065) $161.77
$258
1.9×
Mammography, both breasts (diagnostic) (77066) $244.53
$390
2.2×
Mammography, screening (bilateral) (77067) $188.02
$287.50
2.1×
Basic metabolic panel (80048) $53.50
$111
6.3×
Comprehensive metabolic panel (80053) $66.03
$137
6.3×
Lipid panel (80061) $36.39
$75.50
2.7×
Renal function panel (80069) $75.19
$156
8.7×
Hepatic function panel (80076) $52.06
$108
6.4×
Urinalysis, non-automated, without microscopy (81002) $5.29
$11
1.5×
PSA, total (84153) $26.99
$56
1.5×
Thyroid stimulating hormone (TSH) (84443) $40
$83
2.4×
CBC with automated differential (85025) $21.45
$44.50
2.8×
CBC, automated (85027) $26.03
$54
4.0×
Prothrombin time (PT) (85610) $24.58
$51
5.7×
Partial thromboplastin time (PTT) (85730) $17.60
$36.50
2.9×
Sleep study (attended polysomnography) (95810) $3,416.71
$4,895
3.8×
Physical therapy, therapeutic exercise (per 15 min) (97110) $70.53
$116
2.4×
Office visit, new patient (low complexity, ~30 min) (99203) $1,189.18
$1,340
8.5×
Office visit, new patient (moderate complexity, ~45 min) (99204) $1,443.96
$1,637.50
10.3×
Office visit, new patient (high complexity, ~60 min) (99205) $1,906.58
$2,145
13.6×
As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs. The × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.
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