Jennie M Melham Memorial Medical Center
Broken Bow, NE · Critical Access Hospital
Posts prices for 48 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-20.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Breast lesion removal (open) (19120) | $5,522.55 | $5,522.55 | 1.4× |
| Knee arthroscopy with meniscectomy (29881) | $8,010.72 | $8,010.72 | 2.4× |
| Upper GI endoscopy (EGD), diagnostic (43235) | $3,677.34 | $3,677.34 | 3.9× |
| Upper GI endoscopy (EGD) with biopsy (43239) | $3,595.14 | $3,595.15 | 3.8× |
| Diagnostic colonoscopy (45378) | $3,958.08 | $3,958.08 | 4.1× |
| Colonoscopy with biopsy (45380) | $4,024.76 | $4,024.76 | 3.2× |
| Colonoscopy with lesion removal (45385) | $4,031.92 | $4,031.92 | 3.2× |
| Laparoscopic gallbladder removal (47562) | $12,085.99 | $12,085.99 | 1.9× |
| Inguinal hernia repair (age 5+) (49505) | $7,843.33 | $7,843.33 | 2.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) | $1,614.74 | $1,614.74 | 1.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) | $1,800 | $1,800 | 2.0× |
| Cataract removal with lens insertion (66984) | $5,210.21 | $5,210.21 | 2.2× |
| CT head/brain without contrast (70450) | $2,166.62 | $2,166.62 | 20.0× |
| MRI brain without contrast (70551) | $3,699.10 | $3,699.10 | 14.9× |
| MRI brain with contrast (70552) | $3,646 | $3,646 | 10.1× |
| MRI brain without and with contrast (70553) | $4,266.89 | $4,266.89 | 11.8× |
| X-ray lower spine, 4+ views (72110) | $549.07 | $549.07 | 5.1× |
| MRI lumbar spine without contrast (72148) | $3,442.45 | $3,442.45 | 13.9× |
| CT pelvis with contrast (72193) | $2,348.85 | $2,348.85 | 12.9× |
| MRI lower-extremity joint without contrast (73721) | $2,716.56 | $2,716.56 | 11.0× |
| CT abdomen and pelvis with contrast (74177) | $4,793.50 | $4,793.50 | 13.2× |
| Ultrasound, abdomen complete (76700) | $938.47 | $938.47 | 8.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $799.62 | $799.62 | 7.4× |
| Ultrasound, transvaginal (76830) | $710.32 | $710.32 | 6.5× |
| Mammography, one breast (diagnostic) (77065) | $364.85 | $364.85 | 4.2× |
| Mammography, both breasts (diagnostic) (77066) | $442.17 | $442.17 | 4.0× |
| Mammography, screening (bilateral) (77067) | $378.21 | $378.21 | 4.1× |
| Basic metabolic panel (80048) | $147.30 | $147.30 | 17.4× |
| Comprehensive metabolic panel (80053) | $150.30 | $150.30 | 14.2× |
| Obstetric panel (80055) | $390.73 | $390.73 | 8.2× |
| Lipid panel (80061) | $85 | $85 | 6.3× |
| Renal function panel (80069) | $93.85 | $93.85 | 10.8× |
| Hepatic function panel (80076) | $128.05 | $128.05 | 15.7× |
| Urinalysis, non-automated, with microscopy (81000) | $45.57 | $45.57 | 11.3× |
| Urinalysis, non-automated, without microscopy (81002) | $32.61 | $32.61 | 9.4× |
| PSA, total (84153) | $101.41 | $101.41 | 5.5× |
| Thyroid stimulating hormone (TSH) (84443) | $107.75 | $107.75 | 6.4× |
| CBC with automated differential (85025) | $102.40 | $102.40 | 13.2× |
| CBC, automated (85027) | $74.88 | $74.88 | 11.6× |
| Prothrombin time (PT) (85610) | $65.60 | $65.60 | 15.3× |
| Partial thromboplastin time (PTT) (85730) | $112.62 | $112.62 | 18.7× |
| Psychotherapy, 30 minutes (90832) | $175 | $175 | 0.9× |
| Psychotherapy, 45 minutes (90834) | $200 | $200 | 1.1× |
| Psychotherapy, 60 minutes (90837) | $225 | $225 | 1.2× |
| Family psychotherapy, with patient (50 min) (90847) | $300 | $300 | 1.6× |
| Group psychotherapy (90853) | $175 | $175 | 1.7× |
| Sleep study (attended polysomnography) (95810) | $4,442.32 | $4,442.32 | 5.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) | $231.96 | $231.96 | 8.0× |
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.
More prices at this hospital
- Imaging: 209 codes with posted prices and Medicare benchmarks
- Lab & pathology: 520 codes with posted prices and Medicare benchmarks
- Visits & medical services: 118 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 80 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 13 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (CSV, 18.9 MB) ↓ — captured 2026-07-20
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