Gordon Memorial Hospital District

Gordon, NE · Critical Access Hospital

Posts prices for 49 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-20.

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ProcedureCash priceGross charge× Medicare
Breast lesion removal (open) (19120) $308 $308 0.1×
Shoulder arthroscopy with decompression (29826) $2,929 $2,929
Knee arthroscopy with meniscectomy (29881) $6,192.50 $6,192.50 1.8×
Upper GI endoscopy (EGD), diagnostic (43235) $285 $285 0.3×
Upper GI endoscopy (EGD) with biopsy (43239) $1,634 $1,634 1.7×
Diagnostic colonoscopy (45378) $1,892.50 $1,892.50 2.0×
Colonoscopy with biopsy (45380) $2,157.50 $2,157.50 1.7×
Colonoscopy with lesion removal (45385) $2,676.50 $2,676.50 2.2×
Laparoscopic gallbladder removal (47562) $5,937.50 $5,937.50 0.9×
Inguinal hernia repair (age 5+) (49505) $2,414 $2,414 0.6×
Obstetric care, vaginal delivery (global) (59400) $234 $234
Epidural injection, lumbar/sacral (with imaging) (62322) $158 $158 0.2×
Transforaminal epidural injection, lumbar/sacral (64483) $285 $285 0.3×
Cataract removal with lens insertion (66984) $4,183.50 $4,183.50 1.7×
CT head/brain without contrast (70450) $263 $263 2.4×
MRI brain without contrast (70551) $324 $324 1.3×
MRI brain with contrast (70552) $328 $328 0.9×
MRI brain without and with contrast (70553) $344.50 $344.50 1.0×
X-ray lower spine, 4+ views (72110) $206 $206 1.9×
MRI lumbar spine without contrast (72148) $319.50 $319.50 1.3×
CT pelvis with contrast (72193) $282 $282 1.5×
MRI lower-extremity joint without contrast (73721) $302 $302 1.2×
CT abdomen and pelvis with contrast (74177) $359 $359 1.0×
Ultrasound, abdomen complete (76700) $218 $218 2.0×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $215 $215 2.0×
Ultrasound, transvaginal (76830) $222 $222 2.0×
Mammography, one breast (diagnostic) (77065) $510 $510 5.9×
Mammography, both breasts (diagnostic) (77066) $191 $191 1.7×
Mammography, screening (bilateral) (77067) $312.50 $312.50 3.4×
Basic metabolic panel (80048) $41.50 $41.50 4.9×
Comprehensive metabolic panel (80053) $69 $69 6.5×
Lipid panel (80061) $48 $48 3.6×
Renal function panel (80069) $48 $48 5.5×
Hepatic function panel (80076) $51 $51 6.2×
Urinalysis, non-automated, without microscopy (81002) $130 $130 37.4×
PSA, total (84153) $21 $21 1.1×
Thyroid stimulating hormone (TSH) (84443) $48 $48 2.9×
CBC with automated differential (85025) $1,846.50 $1,846.50 237.6×
CBC, automated (85027) $1,243 $1,243 192.1×
Prothrombin time (PT) (85610) $225 $225 52.4×
Partial thromboplastin time (PTT) (85730) $899.50 $899.50 149.7×
Electrocardiogram (ECG), complete (93000) $197 $197 3.2×
Sleep study (attended polysomnography) (95810) $20 $20 0.0×
Physical therapy, therapeutic exercise (per 15 min) (97110) $183 $183 6.3×
Office visit, new patient (low complexity, ~30 min) (99203) $568 $568 4.1×
Office visit, new patient (moderate complexity, ~45 min) (99204) $146 $146 1.1×
Office visit, new patient (high complexity, ~60 min) (99205) $194 $194 1.4×
Preventive visit, new patient (age 18–39) (99385) $111 $111
Preventive visit, new patient (age 40–64) (99386) $138 $138

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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Download the machine-readable file (JSON, 5.4 MB) ↓ — captured 2026-07-20

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