Providence Medical Center
Wayne, NE · Critical Access Hospital
Posts prices for 47 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-20.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Breast lesion removal (open) (19120) | $1,207.45 | $1,271 | 0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) | $1,620.70 | $1,706 | 1.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) | $2,385.45 | $2,511 | 2.5× |
| Diagnostic colonoscopy (45378) range across 3 matching MRF lines |
$2,277.15–$2,320.85 | $2,397–$2,443 | varies |
| Colonoscopy with biopsy (45380) | $3,654.65 | $3,847 | 2.9× |
| Colonoscopy with lesion removal (45385) | $3,014.35 | $3,173 | 2.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) range across 2 matching MRF lines |
$1,066.85–$1,176.10 | $1,123–$1,238 | varies |
| After-cataract laser surgery (YAG capsulotomy) (66821) range across 4 matching MRF lines |
$1,132.40–$2,264.80 | $1,192–$2,384 | varies |
| Cataract removal with lens insertion (66984) range across 3 matching MRF lines |
$4,047–$4,533.40 | $4,260–$4,772 | varies |
| CT head/brain without contrast (70450) | $1,626.40 | $1,712 | 15.0× |
| MRI brain without contrast (70551) | $2,247.70 | $2,366 | 9.1× |
| MRI brain with contrast (70552) | $3,428.55 | $3,609 | 9.5× |
| MRI brain without and with contrast (70553) | $3,791.45 | $3,991 | 10.5× |
| X-ray lower spine, 4+ views (72110) | $423.70 | $446 | 3.9× |
| MRI lumbar spine without contrast (72148) | $2,210.65 | $2,327 | 8.9× |
| CT pelvis with contrast (72193) | $3,412.40 | $3,592 | 18.7× |
| MRI lower-extremity joint without contrast (73721) | $2,432 | $2,560 | 9.8× |
| CT abdomen and pelvis with contrast (74177) | $4,655.95 | $4,901 | 12.9× |
| Ultrasound, abdomen complete (76700) | $808.45 | $851 | 7.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $898.70 | $946 | 8.3× |
| Ultrasound, transvaginal (76830) | $828.40 | $872 | 7.6× |
| Mammography, one breast (diagnostic) (77065) | $367.65 | $387 | 4.3× |
| Mammography, both breasts (diagnostic) (77066) | $410.40 | $432 | 3.7× |
| Mammography, screening (bilateral) (77067) | $352.45 | $371 | 3.9× |
| Basic metabolic panel (80048) | $133 | $140 | 15.7× |
| Comprehensive metabolic panel (80053) | $156.75 | $165 | 14.8× |
| Lipid panel (80061) | $183.35 | $193 | 13.7× |
| Renal function panel (80069) | $125.40 | $132 | 14.4× |
| Hepatic function panel (80076) | $118.75 | $125 | 14.5× |
| PSA, total (84153) range across 3 matching MRF lines |
$36.10–$155.80 | $38–$164 | varies |
| Thyroid stimulating hormone (TSH) (84443) range across 2 matching MRF lines |
$114–$174.80 | $120–$184 | varies |
| CBC with automated differential (85025) range across 2 matching MRF lines |
$85.50–$89.30 | $90–$94 | varies |
| CBC, automated (85027) | $75.05 | $79 | 11.6× |
| Prothrombin time (PT) (85610) | $61.75 | $65 | 14.4× |
| Partial thromboplastin time (PTT) (85730) range across 3 matching MRF lines |
$18.05–$82.65 | $19–$87 | varies |
| Psychotherapy, 30 minutes (90832) range across 2 matching MRF lines |
$297.35–$363.85 | $313–$383 | varies |
| Psychotherapy, 45 minutes (90834) range across 2 matching MRF lines |
$250.80–$388.55 | $264–$409 | varies |
| Psychotherapy, 60 minutes (90837) range across 2 matching MRF lines |
$416.10–$593.75 | $438–$625 | varies |
| Family psychotherapy, without patient (50 min) (90846) range across 2 matching MRF lines |
$399–$477.85 | $420–$503 | varies |
| Family psychotherapy, with patient (50 min) (90847) | $399 | $420 | 2.2× |
| Group psychotherapy (90853) | $343.90 | $362 | 3.3× |
| Electrocardiogram (ECG), complete (93000) | $220.40 | $232 | 3.6× |
| Sleep study (attended polysomnography) (95810) range across 2 matching MRF lines |
$1,245.45–$3,803.80 | $1,311–$4,004 | varies |
| Physical therapy, therapeutic exercise (per 15 min) (97110) range across 4 matching MRF lines |
$95–$103.55 | $100–$109 | varies |
| Office visit, new patient (low complexity, ~30 min) (99203) range across 5 matching MRF lines |
$191.90–$260.30 | $202–$274 | varies |
| Office visit, new patient (moderate complexity, ~45 min) (99204) range across 5 matching MRF lines |
$327.75–$383.80 | $345–$404 | varies |
| Office visit, new patient (high complexity, ~60 min) (99205) range across 6 matching MRF lines |
$429.40–$513 | $452–$540 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.
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: 205 codes with posted prices and Medicare benchmarks
- Lab & pathology: 379 codes with posted prices and Medicare benchmarks
- Visits & medical services: 179 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 455 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 21 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (CSV, 45.3 MB) ↓ — captured 2026-07-20
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.