BLANCHARD VALLEY HOSPITAL
Legal name: BLANCHARD VALLEY REGIONAL HEALTH CENTER
Published Procedure Prices
| Procedure | CPT | Cash Price | Insurance Range |
|---|---|---|---|
| CT Sinus w/ Contrast | 11682 | $561 - $1,013 | N/A |
| MRI Ankle w/o Contrast Left | 11687 | $641 - $897 | N/A |
| MRI Elbow w/o Contrast Right | 11688 | $641 | N/A |
| MRI Hip w/o Contrast Right | 11689 | $641 - $897 | N/A |
| MRI Spine Cervical w/ + w/o Contrast | 11690 | $1,007 - $1,039 | N/A |
| XR Abdomen AP | 11699 | $30 - $406 | N/A |
| XR Chest Decubitus Right | 11700 | $19 - $250 | N/A |
| XR Finger 4th Digit Left | 11701 | $50 - $404 | N/A |
| XR Pelvis 1 or 2 Views | 11703 | $37 - $268 | N/A |
| XR Toes 3rd Digit Right | 11705 | $43 - $404 | N/A |
| Folate Level | 38338 | $110 | N/A |
| Apcr Activated Protein C | 38340 | $169 | N/A |
| 131 I NaI Total Body Scan (A9528) | 38380 | $303 | N/A |
| CELERO BIOPSY MARKER | 38381 | $287 | N/A |
| GUIDEWIRE 50 CM | 38382 | $32 | N/A |
| PET FDG | 38383 | $1,056 | N/A |
| CT Chest Abdomen w/o IV Con | 38408 | $336 - $734 | N/A |
| CT Drainage/Injection Major Joint Bursa | 38409 | $856 | N/A |
| MG Mammogram Digital Screening Bilateral | 38412 | $93 - $236 | N/A |
| US Abd Pelvis and Transvaginal | 38413 | $270 - $891 | N/A |
| US Fetal Biophysical Profile | 38415 | $264 - $837 | N/A |
| US OB > 14 OB TV w/ Cord Duplex | 38416 | $720 | N/A |
| US Urinary Bladder | 38417 | $48 - $803 | N/A |
| XR Foot 3 Views Left | 38418 | $42 - $450 | N/A |
| XR Spine Cervical (ER) | 38419 | $826 | N/A |
| ONC 96367 | 38428 | $177 | N/A |
| CT Chest w/ Abdomen Pelvis w/ + w/o Cont | 38451 | $748 - $3,332 | N/A |
| Brace Leg PO Lite Short 00116 | 38454 | $312 | N/A |
| Stapler With DST Series EEA31 | 38455 | $3,310 | N/A |
| Suture Vicryl Plus 4-0 Tie, 18" (45cm) VCP103G | 38457 | $53 | N/A |
Prices shown are published rates from hospital chargemaster files and insurer rate data. Your actual cost depends on your insurance plan, deductible status, and services rendered.