Procedures & surgery prices at Cottage Hospital

Woodsville, NH · every code in this section with a posted price and a Medicare benchmark.

305 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Abd paracentesis w/imaging (49083)
range across 2 matching MRF lines		 $225–$321.50 $450–$643 varies
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082)
range across 2 matching MRF lines		 $236.50–$612.50 $473–$1,225 varies
Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) $1,750 $3,500 0.5×
Anoscopy diagnostic (46600)
range across 2 matching MRF lines		 $191–$206 $382–$412 varies
Anoscopy; with dilation (eg, balloon, guide wire, bougie) (46604) $116 $232 0.1×
Anrct Xm Surg Req Anes General Spi/Edrl Dx (45990) $1,637.50 $3,275 0.6×
Application cast elbow finger short arm (29075) $125.50 $251 0.4×
Application Cast Finger (29086) $100 $200 0.6×
Application finger splint static (29130) $90.50 $181 0.6×
Application long arm splint shoulder hand (29105) $109.50 $219 0.6×
Application Long Leg Cast Walker/Ambulatory Type (29355) $210 $420 0.7×
Application Long Leg Splint (29505) $109.50 $219 0.6×
Application of long leg cast (29345) $135.50 $271 0.5×
Application Short Arm Splint Dynamic (29126) $90 $180 0.6×
Application short arm splint forearm-hand static (29125) $99 $198 0.7×
Application short leg splint calf foot (29515) $109.50 $219 0.6×
Apply hand/wrist cast (29085) $100 $200 0.6×
Apply long arm cast (29065) $117 $234 0.4×
Apply Short Leg Cast (29405) $135.50 $271 0.5×
Apply short leg cast (29425) $135.50 $271 0.5×
Arterial puncture (36600) $39 $78 0.3×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $287.50 $575 0.9×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $153.50 $307 0.5×
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $117.50 $235 0.4×
Aspirate Pleura W/O Imaging (32554)
range across 2 matching MRF lines		 $254–$525.50 $508–$1,051 varies
Avulsion nail plate partial/complete simple 1 (11730) $129.50 $259 0.6×
Biopsy of liver, needle; percutaneous (47000) $473 $946 0.3×
Bladder Irrigation (51700) $157.50 $315 0.6×
Bladder Scan (51798) $80.50 $161 1.3×
Blepharotomy drainage abscess eyelid (67700) $546 $1,092 1.6×
Blood Transfusion Service (36430)
range across 5 matching MRF lines		 $850–$875 $1,700–$1,750 varies
Bone Marrow Biopsy (38221) $394 $788 0.2×
Bone Marrow; Aspiration Only (38220) $315 $630 0.2×
Bx breast 1st lesion us imag (19083) $255.50 $511 0.1×
Change Cystostomy Tube Simple (51705) $271 $542 1.0×
Chemical Cautery Tissue (17250) $227 $454 1.1×
Chemical Pleurodesis (32560) $600 $1,200 0.9×
Chest tube placement (32551) $274 $548 0.2×
Cl Tx Tib Shft Fx W Manip (27752) $550 $1,100 0.3×
Clear outer ear canal (69200) $89.50 $179 0.6×
Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) $141 $282 0.5×
Closed treatment of ulnar shaft fracture; with manipulation (25535) $130.50 $261 0.5×
Closed tx ankle dislocation w/o anesthesia (27840) $141 $282 0.5×
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $1,000 $2,000 0.6×
Closed Tx Femoral Shaft Fx W/O Manipulation (27500) $968 $1,936 3.7×
Closed tx knee dislocation w/o anesthesia (27550) $141 $282 0.5×
Closed Tx Monteggia Fx Dislocation Elbow W/Manj (24620) $568 $1,136 0.3×
Closed Tx Nasal Bone Fx W/Mnpj W/O Stabilization (21315) $269.50 $539 0.2×
Closed tx patellar dislocation w/o anesthesia (27560) $100 $200 0.4×
Closed tx radial head/neck fx w/o manipulation (24650) $127 $254 0.5×
Closed tx radial shaft fracture w/manipulation (25505) $232.50 $465 0.1×
Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) $130.50 $261 0.1×
Closed tx radial&ulnar shaft fractures w/o man (25560) $680 $1,360 2.6×
Closed Tx Sternoclavicular Dislc W/Manipulation (23525) $127 $254 0.5×
Closed Tx Talus Fracture W/Manipulation (28435) $600 $1,200 0.3×
Closed tx temporomandibular dislocation 1st/sbsq (21480) $95.50 $191 0.4×
Closed Tx Ulnar Fracture Prox End W Manipulation (24675) $1,128 $2,256 0.7×
Clsd tx acromioclavicular dislc w/manipulation (23545) $127 $254 0.5×
Clsd tx clavicular fracture w/o manipulation (23500) $466 $932 1.8×
Clsd tx shoulder dislc w/manipulation req anes (23655) $562.50 $1,125 0.3×
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $141 $282 0.5×
Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) $141 $282 0.1×
Cltx dstl fibular fx lat malls w/manj (27788) $127 $254 0.5×
Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) $238.50 $477 0.9×
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $396.50 $793 1.5×
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $130.50 $261 0.5×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $239.50 $479 0.1×
Cltx Fem Fx Dstl End Medial/Lat Condyle W/Manj (27510) $1,609 $3,218 0.9×
Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) $550 $1,100 0.3×
Cltx fx grt toe phlx/phlg w/manj (28495) $252 $504 1.0×
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $252 $504 1.0×
Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) $925 $1,850 0.5×
Cltx hip dislocation traumatic req anesthesia (27252) $1,480 $2,960 0.9×
Cltx hip dislocation traumatic w/o anesthesia (27250) $141 $282 0.5×
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $238.50 $477 0.9×
Cltx Iphal Jt Dislc W/Manj Req Anes (26775) $732 $1,464 2.5×
Cltx iphal jt dislc w/manj w/o anes (26770) $113 $226 0.4×
Cltx Med Ankle Fx W/Mnpj (27762) $925 $1,850 0.5×
Cltx Medial Ankle Fx (27760) $130.50 $261 0.5×
Cltx metacarpal fx w/manipulation each bone (26605) $127 $254 0.5×
Cltx metacarpal fx w/o manipulation each bone (26600) $105 $210 0.4×
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $127 $254 0.5×
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) $105 $210 0.4×
Cltx post hip arthrp dislc req anes (27266) $500 $1,000 0.3×
Cltx post hip arthrp dislc w/o anes (27265) $252 $504 1.0×
Cltx prox fibula/shft fx w/o manj (27780) $130.50 $261 0.5×
Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) $550 $1,100 0.3×
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $127 $254 0.5×
Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) $896 $1,792 0.5×
Cltx tibial fx proximal w/o manipulation (27530) $130.50 $261 0.5×
Cltx trimalleolar ankle fx w/manipulation (27818) $232.50 $465 0.1×
Collect Blood From Catheter Venous Nos (36592)
range across 4 matching MRF lines		 $70.50–$111.50 $141–$223 varies
Collection of venous blood by venipuncture (36415)
range across 3 matching MRF lines		 $14.50–$15.50 $29–$31 varies
Colonoscopy Flexible With Decompression (45393) $463.50 $927 0.4×
Colonoscopy through stoma; with biopsy, single or multiple (44389) $1,431.50 $2,863 1.1×
Colonoscopy thru stoma (44388) $1,431.50 $2,863 1.4×
Colonoscopy w/ablation (45388) $1,431.50 $2,863 1.1×
Colonoscopy W/Band Ligation (45398) $1,416.50 $2,833 1.1×
Colonoscopy w/fb removal (45379) $1,431.50 $2,863 1.1×
Colonoscopy W/Resection (45390) $1,236 $2,472 0.4×
Colonoscopy w/submucosal inj (45381) $1,431.50 $2,863 1.1×
Colsc Flexible W/Control Bleeding Any Method (45382) $1,431.50 $2,863 1.1×
Colsc Flexible W/Transendoscopic Balloon Dilat (45386) $772.50 $1,545 0.6×
Colsc flx w/removal lesion by hot bx forceps (45384) $1,431.50 $2,863 1.1×
Control Nasal Hemorrhage Anterior Complex (30903) $102.50 $205 0.7×
Control Nasal Hemorrhage Anterior Simple (30901) $102.50 $205 0.7×
Ctrl Nasopharyngeal Hemrrg Smpl W/Pst Nsl Packs (42970) $824 $1,648 3.3×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $185 $370 1.3×
Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) $292.50 $585 1.2×
Curette/treat cornea (65435) $136 $272 0.1×
Cystourethroscopy (52000) $341.50 $683 0.5×
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $171 $342 0.4×
Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) $1,293 $2,586 0.4×
Dbrdmt w/rmvl fm fx&/dislc skin&subq tissus (11010) $750.50 $1,501 1.0×
Debride nail 1-5 (11720) $47.50 $95 0.8×
Debride nail 6 or more (11721) $83 $166 1.3×
Debridement subcutaneous tissue 20 sq cm/< (11042) $171 $342 0.4×
Destruction Internal Hemorrhoid Thermal Energy (46930) $269 $538 0.2×
Destruction premalignant lesion 1st (17000) $109.50 $219 0.5×
Destruction Vaginal Lesions Simple (57061) $228.50 $457 0.1×
Diagnostic sigmoidoscopy (45330)
range across 2 matching MRF lines		 $264–$953 $528–$1,906 varies
Drainage external auditory canal abscess (69020) $286 $572 0.4×
Drainage external ear abscess/hematoma cmplx (69005) $345 $690 0.2×
Drainage External Ear Abscess/Hematoma Simple (69000) $125 $250 0.2×
Drainage Mouth Roof Lesion (42000) $217.50 $435 0.9×
Drainage of gum lesion (41800) $135 $270 1.0×
Drainage of hematoma/fluid (10140) $373.50 $747 0.2×
Drainage of nose lesion (30000) $92.50 $185 0.4×
Drainage of scrotum (54700) $422 $844 0.2×
Draw Blood Off Venous Device (36591) $58.50 $117 0.4×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $113.50 $227 0.3×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $218 $436 1.0×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $129.50 $259 0.6×
Dx Bronchoscope/Wash (31622) $1,931.50 $3,863 1.0×
Dx gastr intub w/asp spec (43754) $108 $216 0.5×
Egd Balloon Dilation Esophagus <30 Mm Diam (43249) $1,936.50 $3,873 0.9×
Egd control bleeding any (43255) $1,936.50 $3,873 0.9×
Egd dilation gastric/duodenal stricture (43245) $1,936.50 $3,873 0.9×
Egd Flexible Foreign Body Removal (43247) $1,287.50 $2,575 1.3×
Egd guide wire insertion (43248) $1,287.50 $2,575 1.3×
Egd place gastrostomy tube (43246) $1,936.50 $3,873 0.9×
Egd remove lesion snare (43251) $1,936.50 $3,873 0.9×
Egd Tube/Cath Insertion (43241) $360.50 $721 0.2×
Endoscopy upper small intestine w/biopsy (44361) $566.50 $1,133 0.3×
Esoph Scope W/Submucous Inj (43201) $1,936.50 $3,873 0.9×
Esophagogastroduodenoscopy Submucosal Injection (43236) $1,287.50 $2,575 1.3×
Esophagoscopy Flex Balloon Dilat <30 Mm Diam (43220) $1,936.50 $3,873 0.9×
Esophagoscopy Flexib Lesion Removal Tumor Snare (43217) $1,936.50 $3,873 0.9×
Esophagoscopy Flexible Transoral Diagnostic (43200) $1,287.50 $2,575 1.3×
Esophagoscopy, flexible, transoral; with biopsy, single or multiple (43202) $1,287.50 $2,575 0.6×
Esophagoscopy, flexible, transoral; with removal of foreign body(s) (43215) $1,936.50 $3,873 0.9×
Evacuation of subungual hematoma (11740) $93 $186 0.7×
Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) $104 $208 0.1×
Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) $316 $632 0.2×
Exc Thrombosed Hemorrhoid Xtrnl (46320) $605 $1,210 0.5×
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $196 $392 0.5×
Exploration penetrating wound spx extremity (20103) $676 $1,352 0.4×
Explore/Treat Hand Joint (26070) $658 $1,316 0.4×
Fine needle aspiration without imaging guidance (10021) $125 $250 0.3×
Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group (46255) $3,862.50 $7,725 1.3×
Hemorrhoidectomy, internal and external, single column/group; with fissurectomy (46257) $1,133 $2,266 0.4×
I&d abscess peritonsillar (42700) $272 $544 1.1×
I&d abscess simple (10060) $135 $270 0.6×
I&d perianal abscess superficial (46050) $234.50 $469 0.2×
I&d pilonidal cyst complicated (10081) $425 $850 0.6×
I&d pilonidal cyst simple (10080) $135 $270 0.2×
Ileoscopy Thru Stoma Dx W/Collj Spec When Prfmd (44380) $1,596.50 $3,193 1.6×
Incise external hemorrhoid (46083) $157.50 $315 0.6×
Incision & drainage abscess complicated/multiple (10061) $135 $270 0.3×
Incision & drainage leg/ankle abscess/hematoma (27603) $750 $1,500 0.2×
Incision & removal foreign body subq tiss compl (10121) $465 $930 0.3×
Incision & removal foreign body subq tiss simple (10120) $170 $340 0.4×
Incision and drainage of bartholin's gland abscess (56420) $213.50 $427 1.0×
Incision and drainage of vulva or perineal abscess (56405) $303.50 $607 0.9×
Incision of rectal abscess (46040) $852 $1,704 0.7×
Initial Tx 1st Degree Burn Local Tx (16000) $93 $186 0.4×
Injection 1 tendon sheath/ligament aponeurosis (20550) $114 $228 0.3×
Injection aa&/strd intercostal nrv ea addl lvl (64421) $152.50 $305 0.2×
Injection single/mlt trigger point 1/2 muscles (20552) $153.50 $307 0.5×
Injection, anesthetic agent; other peripheral nerve or branch (64450) $218 $436 0.3×
Insert Bladder Cath Complex (51703) $147.50 $295 1.1×
Insert cath pleura w/o image (32556) $1,421 $2,842 0.7×
Insert non-tunnel cv cath (36556)
range across 2 matching MRF lines		 $512.50–$1,133 $1,025–$2,266 varies
Insert Temp Bladder Cath (51702)
range across 2 matching MRF lines		 $108–$184 $216–$368 varies
Insert,Non-Indwelling Bladder Catheter (51701)
range across 2 matching MRF lines		 $85.50–$108 $171–$216 varies
Insertion Picc W/Rs&I 5 Yr/> (36573) $744 $1,488 0.4×
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569)
range across 2 matching MRF lines		 $429–$721 $858–$1,442 varies
Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) $887.50 $1,775 0.3×
Insj/rplcmt temp transvns 1chmbr eltrd/pm cath (33210)
likely a partial charge, not the full procedure		 $485.50 $971 0.1×
Intmd Rpr Face/Mm 12.6-20 Cm (12055) $795 $1,590 1.8×
Intmd Rpr Face/Mm 20.1-30.0 (12056) $795 $1,590 1.8×
Intubation endotracheal emergency procedure (31500) $135 $270 0.5×
Laryngoscopy Indirect W/Removal Foreign Body (31511) $262.50 $525 1.2×
Manipulation hip joint general anesthesia (27275) $1,000 $2,000 0.6×
Nasal/Orogastric W/Tube Plmt (43752) $132.50 $265 0.3×
Njx Anes Trigeminal Nrv Any Div/Branch (64400) $153.50 $307 0.5×
Open Tx Radial Head/Neck Fracture (24665)
likely a partial charge, not the full procedure		 $828 $1,656 0.1×
Peritoneal Lavage (49084) $287.50 $575 0.3×
Perq dev breast 1st us imag (19285) $953 $1,906 1.3×
Perq device breast 1st imag (19281) $477.50 $955 0.3×
Placement of needle for intraosseous infusion (36680) $295.50 $591 0.6×
Proctosgmdsc rgd dx w/wo collj spec br/wa spx (45300)
range across 2 matching MRF lines		 $264–$953 $528–$1,906 varies
Proctosigmoidoscopy, rigid; with biopsy, single or multiple (45305) $206 $412 0.2×
Puncture aspiration abscess hematoma bulla/cyst (10160) $135 $270 0.3×
Puncture Aspiration Cyst Breast (19000) $192 $384 0.3×
Removal Foreign Body Foot Complicated (28193) $726 $1,452 0.4×
Removal foreign body foot deep (28192) $622.50 $1,245 0.4×
Removal Foreign Body Foot Subcutaneous (28190) $469 $938 0.6×
Removal Foreign Body Muscle/Tendon Sheath Simple (20520) $500 $1,000 0.3×
Removal impacted cerumen irrigation/lvg unilat (69209) $129 $258 2.0×
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $89.50 $179 1.4×
Removal impacted vag fb spx w/anes oth/thn local (57415) $345 $690 0.1×
Removal Implant Deep (20680) $491 $982 0.2×
Removal Implant Superficial Separate Procedure (20670) $694 $1,388 0.4×
Removal of foreign body from pharynx (42809) $109 $218 0.2×
Removal of nail bed (11750) $202 $404 0.5×
Removal skn tags mlt fibrq tags any area upw/15 (11200) $112.50 $225 0.5×
Removal/bivalving gauntlet boot/body cast (29700) $100 $200 0.3×
Remove Forearm Foreign Body (25248) $842 $1,684 0.5×
Remove foreign body from eye (65205) $100 $200 0.7×
Remove Intrauterine Device (58301) $287.50 $575 0.9×
Remove Nasal Foreign Body (30300) $108 $216 0.8×
Repair Blood Vessel Direct Upper Extremity (35206) $1,175 $2,350 0.3×
Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) $544 $1,088 0.7×
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $211.50 $423 0.3×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $152.50 $305 0.4×
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $260.50 $521 0.6×
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $640 $1,280 1.5×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $260.50 $521 0.6×
Repair extensor tendon finger w/o graft each (26418) $1,700 $3,400 1.0×
Repair Hand Tendon (26410) $1,700 $3,400 1.0×
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $136 $272 0.3×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $152.50 $305 0.4×
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $464.50 $929 1.1×
Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) $324.50 $649 0.7×
Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) $1,120 $2,240 2.6×
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $136 $272 0.2×
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $152.50 $305 0.4×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $140.50 $281 0.3×
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $136 $272 0.2×
Repair intermediate s/a/t/e 12.6-20.0cm (12035)
range across 2 matching MRF lines		 $644–$750 $1,288–$1,500 varies
Repair intermediate s/a/t/e 2.5 cm/< (12031) $140.50 $281 0.3×
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $152.50 $305 0.4×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $152.50 $305 0.4×
Repair intermediate s/a/t/e >30.0 cm (12037) $875.50 $1,751 0.4×
Repair of nail bed (11760) $424 $848 0.5×
Repair tongue laceration (41250) $165 $330 0.3×
Replace g/c tube perc (49450) $1,130 $2,260 1.2×
Revj/rmvl peripheral neurostimulator electrode (64585) $386.50 $773 0.1×
Rmvl Embedded Fb Vestibule Mouth Smpl (40804) $236 $472 0.2×
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $100 $200 0.2×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $100 $200 0.7×
Rmvl fb xtrnl eye embed scjncl/scleral nonperfor (65210) $100 $200 0.2×
Rmvl Foreign Body Muscle/Tendon Sheath Deep/Comp (20525) $920 $1,840 0.3×
Rmvl Foreign Body Upper Arm/Elbow Subcutaneous (24200) $340.50 $681 0.2×
Rplc Gtube No Revj Trc (43762) $129 $258 0.5×
Rplcmt compl non-tun cvc w/o subq port/pmp (36580) $167.50 $335 0.1×
Rpr blood vessel direct lower extremity (35226) $456.50 $913 0.6×
Rpr ctr vad w/subq port/pmp ctr/prph insj sit (36576) $216.50 $433 0.1×
Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) $92.50 $185 0.4×
Rpr Intermediate N/H/F/Xtrnl Gent 20.1-30.0 Cm (12046) $856 $1,712 1.1×
Rpr Lip Full Thickness Vermilion Only (40650) $636 $1,272 1.1×
Rpr tun/non-tun ctr vad cath w/o subq port/pmp (36575) $175 $350 0.3×
Sgmdsc flx dired sbmcsl njx any sbst (45335) $953 $1,906 1.0×
Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) $953 $1,906 0.7×
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) $80 $160 0.4×
Sigmoidoscopy & decompress (45337) $953 $1,906 1.0×
Sigmoidoscopy flx tndsc balo dilat (45340) $283.50 $567 0.2×
Sigmoidoscopy, flexible; with biopsy, single or multiple (45331) $953 $1,906 1.0×
Sigmoidoscopy,Flex,W/Control,Bleeding (45334) $1,699.50 $3,399 1.3×
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $572 $1,144 1.3×
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $102.50 $205 0.5×
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $102.50 $205 0.5×
Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm (12017) $572 $1,144 1.3×
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $102.50 $205 0.5×
Simple Repair F/E/E/N/L/M >30.0 Cm (12018) $624 $1,248 2.9×
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $102.50 $205 0.5×
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $102.50 $205 0.5×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $102.50 $205 0.5×
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $102.50 $205 0.5×
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $102.50 $205 0.2×
Spinal puncture lumbar diagnostic (62270) $218 $436 0.3×
Strapping ankle (29540) $90.50 $181 0.5×
Strapping elbow or wrist (29260) $90.50 $181 1.4×
Strapping hand/finger (29280) $90.50 $181 1.4×
Strapping knee (29530) $90.50 $181 0.6×
Strapping shoulder (29240) $100 $200 0.7×
Strapping thorax (29200) $207.50 $415 1.2×
Strapping toes (29550) $90.50 $181 1.4×
Strapping Unna Boot (29580) $125.50 $251 0.7×
Treat humerus fracture (23600) $127 $254 0.5×
Treat Knuckle Dislocation (26700) $119 $238 0.5×
Treat Thumb Dislocation (26641) $788 $1,576 3.0×
Treatment Closed Elbow Dislocation Req Anes (24605) $1,000 $2,000 0.6×
Treatment closed elbow dislocation w/o anes (24600) $130.50 $261 0.5×
Trim skin lesion (11055) $95.50 $191 0.4×
Trimming Nondystrophic Nails Any Number (11719) $28.50 $57 0.5×
Tx Gastro Intub W/Asp (43753) $108 $216 0.5×
Tx Missed Abortion First Trimester Surgical (59820) $1,530 $3,060 0.4×
Tx Spon Hip Dislc Abdct Splnt/Trcj W/Manj Anes (27257) $258.50 $517 0.2×
Tx Superficial Wound Dehiscence Simple Closure (12020) $502 $1,004 0.6×
Tx superficial wound dehiscence w/packing (12021) $136 $272 0.3×
Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450)
range across 2 matching MRF lines		 $100–$360 $200–$720 varies
Unlisted Procedure Rectum (45999) $249 $498 0.3×
Wedge excision skin nail fold (11765) $95.50 $191 0.2×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.