Home › Hospitals › Pawnee County Memorial Hospital Posts prices for 41 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) $874
$1,093
0.2×
Upper GI endoscopy (EGD), diagnostic (43235) $1,730
$2,163
1.8×
Upper GI endoscopy (EGD) with biopsy (43239) $1,558
$1,947
1.7×
Diagnostic colonoscopy (45378) $1,860
$2,325
1.9×
Colonoscopy with biopsy (45380) $1,730
$2,163
1.4×
Colonoscopy with lesion removal (45385) $1,904
$2,380
1.5×
Epidural injection, lumbar/sacral (with imaging) (62322) $627
$784
0.7×
CT head/brain without contrast (70450) $1,644
$2,055
15.1×
MRI brain without contrast (70551) $2,950
$3,688
11.9×
MRI brain with contrast (70552) $3,120
$3,900
8.6×
MRI brain without and with contrast (70553) $3,374
$4,218
9.3×
X-ray lower spine, 4+ views (72110) $433
$541
4.0×
MRI lumbar spine without contrast (72148) $2,655
$3,319
10.7×
CT pelvis with contrast (72193) $2,120
$2,650
11.6×
MRI lower-extremity joint without contrast (73721) $2,206
$2,758
8.9×
CT abdomen and pelvis with contrast (74177) $3,807
$4,759
10.5×
Ultrasound, abdomen complete (76700) $710
$887
6.5×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $606
$758
5.6×
Ultrasound, transvaginal (76830) $519
$649
4.8×
Mammography, one breast (diagnostic) (77065) $346
$433
4.0×
Mammography, both breasts (diagnostic) (77066) $437
$546
4.0×
Mammography, screening (bilateral) (77067) $362
$453
4.0×
Basic metabolic panel (80048) $120
$150
14.2×
Comprehensive metabolic panel (80053) $142
$177
13.4×
Obstetric panel (80055) $196
$245
4.1×
Lipid panel (80061) $92
$115
6.9×
Renal function panel (80069) $132
$165
15.2×
Hepatic function panel (80076) $112
$140
13.7×
PSA, total (84153) $104
$130
5.7×
Thyroid stimulating hormone (TSH) (84443) $95
$119
5.7×
CBC with automated differential (85025) $86
$108
11.1×
CBC, automated (85027) $69
$86
10.7×
Prothrombin time (PT) (85610) $51
$64
11.9×
Partial thromboplastin time (PTT) (85730) $79
$99
13.1×
Sleep study (attended polysomnography) (95810) $2,639
$3,299
3.0×
Physical therapy, therapeutic exercise (per 15 min) (97110) $82
$103
2.8×
Office visit, new patient (low complexity, ~30 min) (99203) $177
$221.50
1.3×
Office visit, new patient (moderate complexity, ~45 min) (99204) $268.50
$335.50
1.9×
Office visit, new patient (high complexity, ~60 min) (99205) $348
$435
2.5×
Preventive visit, new patient (age 18–39) (99385) $210
$262
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Preventive visit, new patient (age 40–64) (99386) $242
$302
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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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