Home › Hospitals › West Holt 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
Knee arthroscopy with meniscectomy (29881) $7,381
$9,226
2.2×
Upper GI endoscopy (EGD) with biopsy (43239) $8,402
$10,503
8.9×
Diagnostic colonoscopy (45378) $8,013
$10,016
8.3×
Colonoscopy with biopsy (45380) $7,937
$9,921
6.4×
Colonoscopy with lesion removal (45385) $7,975
$9,969
6.4×
Laparoscopic gallbladder removal (47562) $8,585
$10,731
1.4×
Inguinal hernia repair (age 5+) (49505) $5,340
$6,675
1.4×
CT head/brain without contrast (70450) $1,974
$2,468
18.2×
MRI brain without contrast (70551) $3,308
$4,135
13.4×
MRI brain with contrast (70552) $3,422
$4,278
9.4×
MRI brain without and with contrast (70553) $3,886
$4,857
10.7×
X-ray lower spine, 4+ views (72110) $518
$647
4.8×
MRI lumbar spine without contrast (72148) $3,273
$4,091
13.2×
CT pelvis with contrast (72193) $2,566
$3,207
14.1×
MRI lower-extremity joint without contrast (73721) $2,585
$3,231
10.4×
CT abdomen and pelvis with contrast (74177) $4,528
$5,660
12.5×
Ultrasound, abdomen complete (76700) $838
$1,048
7.7×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $738
$922
6.8×
Ultrasound, transvaginal (76830) $626
$782
5.8×
Mammography, one breast (diagnostic) (77065) $298
$373
3.5×
Mammography, both breasts (diagnostic) (77066) $384
$480
3.5×
Mammography, screening (bilateral) (77067) $292.50
$365.50
3.2×
Basic metabolic panel (80048) $167
$209
19.7×
Comprehensive metabolic panel (80053) $195
$244
18.5×
Obstetric panel (80055) $283
$354
5.9×
Lipid panel (80061) $149
$186
11.1×
Renal function panel (80069) $152
$190
17.5×
Hepatic function panel (80076) $143
$179
17.5×
Urinalysis, non-automated, without microscopy (81002) $17.50
$22
5.0×
PSA, total (84153) $104.50
$131
5.7×
Thyroid stimulating hormone (TSH) (84443) $124
$155.50
7.4×
CBC with automated differential (85025) $109.50
$136.50
14.1×
CBC, automated (85027) $98
$123
15.1×
Prothrombin time (PT) (85610) $54
$68
12.6×
Partial thromboplastin time (PTT) (85730) $82
$102
13.6×
Physical therapy, therapeutic exercise (per 15 min) (97110) $105
$131
3.6×
Office visit, new patient (low complexity, ~30 min) (99203) $226.50
$283.50
1.6×
Office visit, new patient (moderate complexity, ~45 min) (99204) $243
$303.50
1.8×
Office visit, new patient (high complexity, ~60 min) (99205) $380
$474.50
2.7×
Preventive visit, new patient (age 18–39) (99385) $247
$309
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Preventive visit, new patient (age 40–64) (99386) $268
$335
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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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