Evanston Regional Hospital

Evanston, WY · Critical Access Hospital

Posts prices for 32 of the 66 common shoppable procedures we track. Price file retrieved 2026-06-27.

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ProcedureCash priceGross charge× Medicare
CT head/brain without contrast (70450) $1,750.96 $2,918.27 16.4×
MRI brain without contrast (70551) $2,962.76 $4,937.93 12.2×
MRI brain with contrast (70552) $3,152.97 $5,254.95 8.8×
MRI brain without and with contrast (70553) $3,343.16 $5,571.93 9.4×
X-ray lower spine, 4+ views (72110) $524.31 $873.85 4.9×
MRI lumbar spine without contrast (72148) $3,124.66 $5,207.76 12.8×
CT pelvis with contrast (72193) $1,639.55 $2,732.59 9.1×
MRI lower-extremity joint without contrast (73721) $3,578.94 $5,964.91 14.7×
CT abdomen and pelvis with contrast (74177) $3,272.66 $5,454.44 9.2×
Ultrasound, abdomen complete (76700) $1,107.43 $1,845.72 10.4×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $829.38 $1,382.30 7.8×
Ultrasound, transvaginal (76830) $385.45 $642.41 3.6×
Mammography, one breast (diagnostic) (77065) $314.75 $524.59 3.7×
Mammography, both breasts (diagnostic) (77066) $393.87 $656.45 3.6×
Mammography, screening (bilateral) (77067) $341.69 $569.48 3.7×
Basic metabolic panel (80048) $144.25 $240.42 17.1×
Comprehensive metabolic panel (80053) $152.42 $254.04 14.4×
Obstetric panel (80055) $131.38 $218.96 2.7×
Lipid panel (80061) $138.11 $230.18 10.3×
Renal function panel (80069) $66.68 $111.14 7.7×
Hepatic function panel (80076) $120.72 $201.20 14.8×
Urinalysis, non-automated, without microscopy (81002) $25.25 $42.08 7.3×
PSA, total (84153) $203.57 $339.29 11.1×
Thyroid stimulating hormone (TSH) (84443) $166.75 $277.91 9.9×
CBC with automated differential (85025) $79.46 $132.43 10.2×
CBC, automated (85027) $40.99 $68.31 6.3×
Prothrombin time (PT) (85610) $47.83 $79.71 11.1×
Partial thromboplastin time (PTT) (85730) $119.18 $198.63 19.8×
Sleep study (attended polysomnography) (95810) $3,531.40 $5,885.67 4.0×
Physical therapy, therapeutic exercise (per 15 min) (97110) $81.88 $136.46 2.8×
Office visit, new patient (low complexity, ~30 min) (99203) $154.50 $257.50 1.1×
Office visit, new patient (moderate complexity, ~45 min) (99204) $154.50 $257.50 1.1×

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.