Home › Hospitals › Haxtun Hospital District Posts prices for 35 of the 66 common shoppable procedures we track. Price file retrieved 2026-06-28.
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Procedure Cash price Gross charge × Medicare
Upper GI endoscopy (EGD), diagnostic (43235) $934.05
$958
1.0×
Upper GI endoscopy (EGD) with biopsy (43239) $1,521.98
$1,561
1.6×
Diagnostic colonoscopy (45378) $2,392.16
$2,453.50
2.4×
Colonoscopy with biopsy (45380) $2,773.88
$2,845
2.2×
Colonoscopy with lesion removal (45385) $2,735.85
$2,806
2.2×
Transforaminal epidural injection, lumbar/sacral (64483) $1,610.70
$1,652
1.7×
CT head/brain without contrast (70450) $2,376.08
$2,437
21.5×
MRI brain without contrast (70551) $3,281.85
$3,366
13.0×
MRI brain without and with contrast (70553) $3,824.93
$3,923
10.4×
X-ray lower spine, 4+ views (72110) $687.86
$705.50
6.2×
MRI lumbar spine without contrast (72148) $3,253.58
$3,337
12.9×
CT pelvis with contrast (72193) $2,674.43
$2,743
14.5×
MRI lower-extremity joint without contrast (73721) $3,267.23
$3,351
13.0×
CT abdomen and pelvis with contrast (74177) $3,584.10
$3,676
9.7×
Ultrasound, abdomen complete (76700) $852.15
$874
7.7×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $881.40
$904
8.0×
Ultrasound, transvaginal (76830) $856.05
$878
7.8×
Basic metabolic panel (80048) $169.65
$174
20.1×
Comprehensive metabolic panel (80053) $205.24
$210.50
19.4×
Obstetric panel (80055) $417.30
$428
8.7×
Lipid panel (80061) $145.28
$149
10.8×
Renal function panel (80069) $294.45
$302
33.9×
Hepatic function panel (80076) $161.86
$166
19.8×
Urinalysis, non-automated, without microscopy (81002) $23.40
$24
6.7×
PSA, total (84153) $152.10
$156
8.3×
Thyroid stimulating hormone (TSH) (84443) $146.25
$150
8.7×
CBC with automated differential (85025) $121.88
$125
15.7×
CBC, automated (85027) $94.58
$97
14.6×
Prothrombin time (PT) (85610) $118.95
$122
27.7×
Partial thromboplastin time (PTT) (85730) $127.73
$131
21.3×
Sleep study (attended polysomnography) (95810) $4,329
$4,440
4.8×
Physical therapy, therapeutic exercise (per 15 min) (97110) $120.90
$124
4.2×
Office visit, new patient (low complexity, ~30 min) (99203) $215.48
$221
1.5×
Office visit, new patient (moderate complexity, ~45 min) (99204) $254.48
$261
1.8×
Office visit, new patient (high complexity, ~60 min) (99205) $328.58
$337
2.3×
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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