Hodgeman County Health Center

Jetmore, KS · Critical Access Hospital

Posts prices for 39 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-29.

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ProcedureCash priceGross charge× Medicare
Upper GI endoscopy (EGD), diagnostic (43235) $1,406.40 $1,758 1.7×
Upper GI endoscopy (EGD) with biopsy (43239) $1,832 $2,290 2.2×
Diagnostic colonoscopy (45378) $1,632 $2,040 1.9×
Colonoscopy with biopsy (45380) $1,768.80 $2,211 1.6×
Colonoscopy with lesion removal (45385) $1,836.80 $2,296 1.7×
Laparoscopic gallbladder removal (47562) $8,752 $10,940 1.6×
Inguinal hernia repair (age 5+) (49505) $5,293.60 $6,617 1.6×
Epidural injection, lumbar/sacral (with imaging) (62322) $833.60 $1,042 1.0×
Transforaminal epidural injection, lumbar/sacral (64483) $1,989.60 $2,487 2.4×
CT head/brain without contrast (70450) $1,354.40 $1,693 14.1×
MRI brain without contrast (70551) $1,796 $2,245 8.2×
MRI brain with contrast (70552) $1,876 $2,345 5.8×
MRI brain without and with contrast (70553) $2,052 $2,565 6.4×
X-ray lower spine, 4+ views (72110) $556.80 $696 5.8×
MRI lumbar spine without contrast (72148) $1,796 $2,245 8.2×
CT pelvis with contrast (72193) $1,392 $1,740 8.6×
MRI lower-extremity joint without contrast (73721) $1,796 $2,245 8.2×
CT abdomen and pelvis with contrast (74177) $2,015.20 $2,519 6.3×
Ultrasound, abdomen complete (76700) $408.80 $511 4.3×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $389.60 $487 4.1×
Ultrasound, transvaginal (76830) $389.60 $487 4.1×
Mammography, one breast (diagnostic) (77065) $199.20 $249 2.3×
Mammography, both breasts (diagnostic) (77066) $199.20 $249 1.8×
Mammography, screening (bilateral) (77067) $207.20 $259 2.3×
Basic metabolic panel (80048) $107.20 $134 12.7×
Comprehensive metabolic panel (80053) $152 $190 14.4×
Lipid panel (80061) $132 $165 9.9×
Renal function panel (80069) $92 $115 10.6×
Hepatic function panel (80076) $127.20 $159 15.6×
Urinalysis, non-automated, without microscopy (81002) $45.60 $57 13.1×
PSA, total (84153) $129.60 $162 7.0×
Thyroid stimulating hormone (TSH) (84443) $112.80 $141 6.7×
CBC with automated differential (85025) $89.60 $112 11.5×
CBC, automated (85027) $70.40 $88 10.9×
Prothrombin time (PT) (85610) $59.20 $74 13.8×
Partial thromboplastin time (PTT) (85730) $66.40 $83 11.0×
Physical therapy, therapeutic exercise (per 15 min) (97110) $78.40 $98 2.7×
Office visit, new patient (low complexity, ~30 min) (99203) $220 $275 1.8×
Office visit, new patient (moderate complexity, ~45 min) (99204) $240 $300 2.0×

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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