Procedures & surgery prices at Three Rivers Hospital

Brewster, WA · every code in this section with a posted price and a Medicare benchmark.

63 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Application cast elbow finger short arm (29075) $97.50 $130 0.3×
Application cast shoulder hand long arm (29065) $328.50 $438 1.1×
Application Hip Spica Cast 1 Leg (29305) $649.50 $866 2.1×
Application long arm splint shoulder hand (29105) $134.25 $179 0.7×
Application of long leg cast (29345) $360.75 $481 1.2×
Application short arm splint forearm-hand static (29125) $129.75 $173 0.9×
Apply short leg cast (29405) $298.50 $398 1.0×
Apply short leg splint (29515) $110.25 $147 0.6×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $165.38 $220.50 0.5×
Blood transfusion service (36430) $595.50 $794 1.2×
Closed Rx Mandible Fx+Manipulatn (21451) $3,400.50 $4,534 2.0×
Closed Rx Radial Shaft Fx (25500) $792.75 $1,057 2.9×
Closed treatment of trimalleolar ankle fracture with manipulation (27818) $1,881.38 $2,508.50 1.0×
Closed tx nasal fracture w/o stabilization (21315) $603 $804 0.3×
Closed tx radial head/neck fx w/o manipulation (24650) $652.13 $869.50 2.4×
Closed tx radial shaft fracture w/manipulation (25505) $1,095.75 $1,461 0.6×
Closed tx radial&ulnar shaft fractures w/manj (25565) $780.75 $1,041 0.4×
Closed tx temporomandibular dislocation 1st/sbsq (21480) $516 $688 1.9×
Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) $616.13 $821.50 2.2×
Closed tx ulnar shaft fracture w/o manipulation (25530) $543.75 $725 2.0×
Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) $664.88 $886.50 2.4×
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $423 $564 1.5×
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $242.25 $323 0.9×
Cltx iphal jt dislc w/manj w/o anes (26770) $429.75 $573 1.6×
Cltx metacarpal fx w/o manipulation each bone (26600) $731.63 $975.50 2.7×
Cltx prox fibula/shft fx w/o manj (27780) $681.38 $908.50 2.5×
Colpoperineorrhaphy non ob (57210) $1,505.25 $2,007 0.4×
Control Nasal Hemorrhage Anterior Simple (30901) $144 $192 1.0×
Debride tissue/muscle (11043) $569.63 $759.50 0.7×
Drainage of skene's gland abscess or cyst (53060) $355.13 $473.50 0.2×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $478.13 $637.50 1.1×
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $262.50 $350 1.2×
I&d pilonidal cyst simple (10080) $295.88 $394.50 0.4×
I&d vulva/perineal abscess (56405) $345 $460 1.0×
Incision & removal foreign body subq tiss simple (10120) $232.50 $310 0.5×
Incision and drainage of bartholin's gland abscess (56420) $370.50 $494 1.6×
Incisional biopsy skin single lesion (11106) $157.50 $210 0.2×
Initial tx 1st degree burn local tx (16000) $120.38 $160.50 0.5×
Removal foreign body intranasal (30300) $271.50 $362 1.8×
Removal of foreign body, external eye; corneal, without slit lamp (65220) $210.38 $280.50 0.4×
Removal of nail bed (11750) $239.25 $319 0.5×
Removal skn tags mlt fibrq tags any area upw/15 (11200) $194.25 $259 0.9×
Removal/bivalving full arm/full leg cast (29705) $108.75 $145 0.3×
Remv Ext Canal Foreign Body (69200) $126 $168 0.8×
Remv F.B.,Eye,Superf Conjunc (65205) $135.38 $180.50 0.9×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $1,189.88 $1,586.50 2.6×
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $1,020 $1,360 2.3×
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $600 $800 1.3×
Repair intermediate s/a/t/e 2.5 cm/< (12031) $372 $496 0.8×
Repair intermediate s/a/t/e 20.1-30.0 cm (12036) $999.75 $1,333 1.2×
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $472.50 $630 1.0×
Repair of nail bed (11760) $484.13 $645.50 0.6×
Repair Tendon Extensor Foot 1/2 Each Tendon (28208) $824.25 $1,099 0.2×
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $201.38 $268.50 1.4×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $442.50 $590 2.0×
Skin pinch graft (15050) $1,128.75 $1,505 1.4×
Spinal puncture lumbar diagnostic (62270) $241.50 $322 0.3×
Tracheotomy tube change (31502) $329.25 $439 1.2×
Treat clavicle fracture (23505) $810 $1,080 0.5×
Treat Thumb Dislocation (26641) $897 $1,196 3.3×
Treatment closed elbow dislocation req anes (24605) $1,163.25 $1,551 0.6×
Treatment closed elbow dislocation w/o anes (24600) $662.25 $883 2.4×
Tx Superficial Wound Dehiscence Simple Closure (12020) $508.88 $678.50 0.6×