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Garfield County Memorial Hospital

Pomeroy, WA · CMS ID: 501301

This hospital has pricing data for 20 procedures ranging from $22 to $264.

Procedures (20)

Chest X-Ray 1 View

71045
Cash Price
(No Insurance)
$22
Gross Charge
$26
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$22

Chest X-Ray 2 Views

71046
Cash Price
(No Insurance)
$22
Gross Charge
$26
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$22

Complete Blood Count (CBC)

85025
Cash Price
(No Insurance)
$68
Gross Charge
$80
Insurance Negotiated Rates
Cigna$64

Comprehensive Metabolic Panel

80053
Cash Price
(No Insurance)
$106
Gross Charge
$125
Insurance Negotiated Rates
Cigna$100

ER Visit Level 3

99283
Cash Price
(No Insurance)
$106
Gross Charge
$125
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$106

ER Visit Level 4

99284
Cash Price
(No Insurance)
$194
Gross Charge
$228
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$194

ER Visit Level 5

99285
Cash Price
(No Insurance)
$264
Gross Charge
$311
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$264

Hemoglobin A1C

83036
Cash Price
(No Insurance)
$71
Gross Charge
$83
Insurance Negotiated Rates
Cigna$66

Hip Replacement

27130
Cash Price
(No Insurance)
$118
Gross Charge
$139
Insurance Negotiated Rates
Cigna$111

Knee X-Ray

73560
Cash Price
(No Insurance)
$22
Gross Charge
$26
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$22

Lipid Panel

80061
Cash Price
(No Insurance)
$106
Gross Charge
$125
Insurance Negotiated Rates
Cigna$100

MRI Knee

73721
Cash Price
(No Insurance)
$131
Gross Charge
$154
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$131

Office Visit Level 3

99213
Cash Price
(No Insurance)
$153
Gross Charge
$180
Insurance Negotiated Rates
Cigna$144

Office Visit Level 4

99214
Cash Price
(No Insurance)
$216
Gross Charge
$254
Insurance Negotiated Rates
Cigna$203

Shoulder X-Ray

73030
Cash Price
(No Insurance)
$22
Gross Charge
$26
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$22

TSH (Thyroid)

84443
Cash Price
(No Insurance)
$103
Gross Charge
$121
Insurance Negotiated Rates
Cigna$97

Ultrasound Abdomen

76700
Cash Price
(No Insurance)
$150
Gross Charge
$176
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$150

Ultrasound Pelvis

76856
Cash Price
(No Insurance)
$150
Gross Charge
$176
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$150

Ultrasound Transvaginal

76830
Cash Price
(No Insurance)
$150
Gross Charge
$176
Insurance Negotiated Rates
Three Rivers Provider Network - All Plans$150

Urinalysis

81001
Cash Price
(No Insurance)
$60
Gross Charge
$70
Insurance Negotiated Rates
Cigna$56