Jefferson Community Health & Life

Fairbury, NE · Critical Access Hospital

Posts prices for 25 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-20.

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ProcedureCash priceGross charge× Medicare
Upper GI endoscopy (EGD), diagnostic (43235) $470.92 $627.90 0.5×
CT abdomen and pelvis with contrast (74177) $3,721.50 $4,962 10.3×
Basic metabolic panel (80048) $124.50 $166 14.7×
Comprehensive metabolic panel (80053) $147 $196 13.9×
Lipid panel (80061) $112.50 $150 8.4×
Renal function panel (80069) $135 $180 15.6×
Hepatic function panel (80076) $121.50 $162 14.9×
PSA, total (84153) $118.50 $158 6.4×
Thyroid stimulating hormone (TSH) (84443) $107.25 $143 6.4×
CBC with automated differential (85025) $93 $124 12.0×
CBC, automated (85027) $70.50 $94 10.9×
Prothrombin time (PT) (85610) $57 $76 13.3×
Partial thromboplastin time (PTT) (85730) $86.25 $115 14.4×
Psychotherapy, 30 minutes (90832) $80.25 $107 0.4×
Psychotherapy, 45 minutes (90834) $158.25 $211 0.9×
Psychotherapy, 60 minutes (90837) $151.50 $202 0.8×
Family psychotherapy, without patient (50 min) (90846) $152.25 $203 0.8×
Family psychotherapy, with patient (50 min) (90847) $159 $212 0.9×
Group psychotherapy (90853) $42.75 $57 0.4×
Electrocardiogram (ECG), complete (93000) $243.75 $325 4.0×
Physical therapy, therapeutic exercise (per 15 min) (97110) $87.75 $117 3.0×
Office visit, new patient (low complexity, ~30 min) (99203) $182.25 $243 1.3×
Office visit, new patient (moderate complexity, ~45 min) (99204) $273.75 $365 2.0×
Office visit, new patient (high complexity, ~60 min) (99205) $360.75 $481 2.6×
Preventive visit, new patient (age 18–39) (99385) $209.25 $279

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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