Guadalupe County Hospital

Santa Rosa, NM · CMS ID: 320067

This hospital has pricing data for 25 procedures.

Procedures (25)

Chest X-Ray 1 View

71045

Cash Price

(No Insurance)

—

Gross Charge

$125

No payer-negotiated rates available

Chest X-Ray 2 Views

71046

Cash Price

(No Insurance)

—

Gross Charge

$174

No payer-negotiated rates available

Complete Blood Count (CBC)

85025

Cash Price

(No Insurance)

—

Gross Charge

$65

No payer-negotiated rates available

Comprehensive Metabolic Panel

80053

Cash Price

(No Insurance)

—

Gross Charge

$121

No payer-negotiated rates available

CT Abdomen/Pelvis with Contrast

74177

Cash Price

(No Insurance)

—

Gross Charge

$2,527

No payer-negotiated rates available

CT Abdomen/Pelvis without Contrast

74176

Cash Price

(No Insurance)

—

Gross Charge

$1,703

No payer-negotiated rates available

CT Chest with Contrast

71260

Cash Price

(No Insurance)

—

Gross Charge

$1,702

No payer-negotiated rates available

ER Visit Level 3

99283

Cash Price

(No Insurance)

—

Gross Charge

$719

No payer-negotiated rates available

ER Visit Level 4

99284

Cash Price

(No Insurance)

—

Gross Charge

$1,224

No payer-negotiated rates available

ER Visit Level 5

99285

Cash Price

(No Insurance)

—

Gross Charge

$1,953

No payer-negotiated rates available

Hemoglobin A1C

83036

Cash Price

(No Insurance)

—

Gross Charge

$120

No payer-negotiated rates available

Knee X-Ray

73560

Cash Price

(No Insurance)

—

Gross Charge

$164

No payer-negotiated rates available

Lipid Panel

80061

Cash Price

(No Insurance)

—

Gross Charge

$361

No payer-negotiated rates available

MRI Brain

70551

Cash Price

(No Insurance)

—

Gross Charge

$2,549

No payer-negotiated rates available

MRI Brain with Contrast

70553

Cash Price

(No Insurance)

—

Gross Charge

$4,102

No payer-negotiated rates available

MRI Cervical Spine

72141

Cash Price

(No Insurance)

—

Gross Charge

$2,684

No payer-negotiated rates available

MRI Knee

73721

Cash Price

(No Insurance)

—

Gross Charge

$2,562

No payer-negotiated rates available

MRI Lumbar Spine

72148

Cash Price

(No Insurance)

—

Gross Charge

$2,686

No payer-negotiated rates available

MRI Shoulder

73221

Cash Price

(No Insurance)

—

Gross Charge

$2,684

No payer-negotiated rates available

Shoulder X-Ray

73030

Cash Price

(No Insurance)

—

Gross Charge

$187

No payer-negotiated rates available

TSH (Thyroid)

84443

Cash Price

(No Insurance)

—

Gross Charge

$185

No payer-negotiated rates available

Ultrasound Abdomen

76700

Cash Price

(No Insurance)

—

Gross Charge

$627

No payer-negotiated rates available

Ultrasound Pelvis

76856

Cash Price

(No Insurance)

—

Gross Charge

$689

No payer-negotiated rates available

Ultrasound Transvaginal

76830

Cash Price

(No Insurance)

—

Gross Charge

$670

No payer-negotiated rates available

Urinalysis

81001

Cash Price

(No Insurance)

—

Gross Charge

$55

No payer-negotiated rates available