Procedure Pricing

The information provided on this website is an estimate and not a guarantee of what your charge will be. Based on your medical condition and medical needs from your physician, the charges may be lower or higher than the estimate on this website. The actual charges will depend upon several factors such as: length of time spent in surgery or recovery, additional tests required by your physician, and/or any special care or unexpected conditions or complications. During the care you received at our facility, you may incur charges from other providers such as Radiologist, Physicians, or Anesthesiologists. If you have insurance, your benefits will determine the amount you owe based on your specific plan.

The following information reflects charges solely from Atlantic General Hospital

BLOOD TESTS

PROCEDURE

CHARGE

CPT CODE

BASIC METABOLIC PANEL

$ 24.15

80048

CBC WITH DIFFERENTIAL

$ 22.37

85025

LIPID PROFILE

$ 41.61

80061

PROTHROMBIN TIME

$ 17.51

85610

CBC

$ 17.51

85027

HEPATIC FUNCTION

$ 24.15

80076

COMPREHENSIVE METABOLIC PANEL

$ 32.88

80053

TSH

$ 32.88

84443

MAGNESIUM

$ 13.15

83735

PTT

$ 17.51

85730

URINALYSIS
(additional charge for reflex as required)

$ 19.72

81001

URINE CULTURE
(additional charge for reflex as required)

$ 21.93

87088

GLYCOHEMOGLOBIN (HgbA1c)

$ 43.86

83036

GLUCOSE

$ 8.78

82947

SCREENING PSA

$ 43.76

G0103

CREATININE

$ 4.42

82565

VITAMIN B12

$ 32.88

82607

PSA TOTAL

$ 43.76

84153

BUN

$ 4.42

84520


RADIOLOGY PROCEDURES

PROCEDURE

CHARGE

CPT CODE

CHEST X-RAY PA AND LAT

$ 87.83

71020

DIGITAL SCREENING MAMMOGRAM WITH
COMPUTER AIDED DIAGNOSIS

$376.85

G0202
77052

CT HEAD WITHOUT IV CONTRAST INJECTION

$113.26

70450

ELECTROCARDIOGRAM (ECG OR EKG)

$ 37.29

93005

CT SCAN PELVIS WITH ORAL CONTRAST

$188.80

72193

CT SCAN ABDOMEN WITH ORAL CONTRAST

$188.80

74160

X-RAY OF THE FOOT 3 VIEWS

$ 87.83

73630

COMPLETE ULTRASOUND OF ABDOMEN

$351.25

76700

X-RAY OF THE KNEE 4 VIEWS

$175.65

73564

X-RAY OF THE ANKLE 3 VIEWS

$ 87.83

73610

LUMBAR SPINE X-RAY WITH OBLIQUE VIEWS

$175.65

72110

TRANSTHORACIC ECHOCARDIOGRAM

$186.30

93306

SHOULDER X-RAY AT LEAST 2 VIEWS

$ 87.83

73030

X-RAY OF THE HAND 3 VIEWS

$ 87.83

73130

CT SCAN OF THE CHEST WITH IV CONTRAST

$188.80

71260

HIP X-RAY 2 VIEWS

$117.09

73510

MRI OF THE KNEE

$803.76

73721

MRI OF THE BRAIN
WITHOUT CONTRAST

$535.81

70551

MRI OF THE LS SPINE WITHOUT CONTRAST

$535.81

72148

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SURGICAL PROCEDURES

PROCEDURE

CHARGE

CPT CODE

UPPER GI ENDOSCOPY BIOPSY: Examines
the interior liningof your esophagus, your
stomach and the first part of your small intestine
(duodenum) through a thin, flexible viewing
instrument called an endoscope.

$1,708.99

43239

DIAGNOSTIC COLONOSCOPY:Performed
when other symptoms or tests indicate the
presence of dangerous colon changes.

$ 1,493.61

45378

COLONOSCOPY & BIOPSY:During colonoscopy,
tissue samples are collected (biopsy) and abnormal
growths can be taken out.

$ 2,048.65

45380

COLONOSCOPY: Allows your doctor to look at the
interior lining of your large intestine (rectum and colon)

$ 1,940.06

45384

LESION REMOVAL COLONOSCOPY:Colonoscopy,
flexible, proximal to splenic flexure; with removal of
tumor(s), polyp(s), or other lesion(s) by hot biopsy
forceps or bipolar cautery.

$ 1,981.21

45385

CATARACT REMOVAL WITH INTRAOCULAR LENS:
Surgery to remove a clouded lens (cataract) from the
eye with insertion of intraocular lens.

$ 1,964.94

66984

REPAIR OF WOUND OR LESION: Repair, complex,
scalp, arms, and/or legs; 2.6 cm to 7.5 cm.

$ 1,989.55

13121

EXCISION, MALIGNANT LESION: including
margins, face, ears, eyelids, nose, lips; excised
diameter 1.1 to 2.0 cm.

$ 1,812.22

11642

LAPAROSCOPY, CHOLECYSTECTOMY:
Surgical removal of the gallbladder.

$ 7,865.23

47562

REPAIR, INTERMEDIATE, WOUNDS OF SCALP,
AXILLAE, TRUNK AND/OR EXTREMITIES
(excluding hands and feet); 2.6 cm to 7.5 cm.

$ 2,484.28

12032

REPAIR OF WOUND OR LESION: Repair, complex,
trunk; 2.6 cm. to 7.5 cm.

$ 2,106.40

13101

LAPAROSCOPY, APPENDECTOMY:Minimally
invasive surgical technique to remove the appendix.

$8,785.65

44970

BIOPSY SKIN LESION:Biopsy of skin, subcutaneous
tissue and/or mucous membrane
(including simple closure), unless otherwise
listed; single lesion.

$ 2,011.20

11100

HYSTEROSCOPY, BIOPSY:Inspection of the
uterine cavity by endoscopy with access through the cervix.

$ 4,953.02

58558

BLOOD TRANSFUSION:Process of receiving
blood products into one’s circulation intravenously.

$14,208.18

36430

SHOULDER ARTHROSCOPY/SURGERY:Surgery
that uses a tiny camera called an arthroscope to
examine or repair the tissues inside or around
your shoulder joint.

$ 8,568.02

29826

ARTHROSCOPY ROTATOR CUFF REPAIR:
Arthroscopy, shoulder, surgical; with rotator
cuff repair.

$ 8,589.70

29827

KNEE ARTHROSCOPY/SURGERY:Procedure
performed through small incisions in the skin
to repair injuries to tissues such as ligaments,
cartilage, or bone within the knee joint area.

$ 4,246.56

29881

Last Update 8/31/16