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Sheridan Memorial Hosptial
Plentywood, MT · CMS ID: 271322
This hospital has pricing data for 30 procedures ranging from $34 to $4,493.
Procedures (30)
Chest X-Ray 1 View
71045Cash Price
(No Insurance)
$352
Gross Charge
$392
Insurance Negotiated Rates
Pacific Source - All Plans$15
Chest X-Ray 2 Views
71046Cash Price
(No Insurance)
$34
Gross Charge
$38
Insurance Negotiated Rates
Pacific Source - All Plans$18
Cash Price
(No Insurance)
$53
Gross Charge
$59
Insurance Negotiated Rates
First Choice Health Network - All Plans$53
Cash Price
(No Insurance)
$156
Gross Charge
$173
Insurance Negotiated Rates
First Choice Health Network - All Plans$156
Cash Price
(No Insurance)
$4,493
Gross Charge
$4,992
Insurance Negotiated Rates
Pacific Source - All Plans$148
Cash Price
(No Insurance)
$3,078
Gross Charge
$3,420
Insurance Negotiated Rates
Pacific Source - All Plans$141
CT Chest Low Dose
71271Cash Price
(No Insurance)
$123
Gross Charge
$137
Insurance Negotiated Rates
Pacific Source - All Plans$49
Cash Price
(No Insurance)
$150
Gross Charge
$167
Insurance Negotiated Rates
Pacific Source - All Plans$101
ER Visit Level 3
99283Cash Price
(No Insurance)
$665
Gross Charge
$739
Insurance Negotiated Rates
Pacific Source - All Plans$105
ER Visit Level 4
99284Cash Price
(No Insurance)
$770
Gross Charge
$856
Insurance Negotiated Rates
Pacific Source - All Plans$193
ER Visit Level 5
99285Cash Price
(No Insurance)
$1,005
Gross Charge
$1,117
Insurance Negotiated Rates
Pacific Source - All Plans$280
Hemoglobin A1C
83036Cash Price
(No Insurance)
$157
Gross Charge
$174
Insurance Negotiated Rates
First Choice Health Network - All Plans$157
Knee X-Ray
73560Cash Price
(No Insurance)
$167
Gross Charge
$185
Insurance Negotiated Rates
Pacific Source - All Plans$14
Lipid Panel
80061Cash Price
(No Insurance)
$136
Gross Charge
$151
Insurance Negotiated Rates
First Choice Health Network - All Plans$136
Mammogram Diagnostic
77066Cash Price
(No Insurance)
$117
Gross Charge
$130
Insurance Negotiated Rates
Pacific Source - All Plans$81
Mammogram Screening
77067Cash Price
(No Insurance)
$103
Gross Charge
$114
Insurance Negotiated Rates
Pacific Source - All Plans$62
MRI Brain
70551Cash Price
(No Insurance)
$175
Gross Charge
$194
Insurance Negotiated Rates
Pacific Source - All Plans$120
Cash Price
(No Insurance)
$1,397
Gross Charge
$1,553
Insurance Negotiated Rates
Pacific Source - All Plans$185
MRI Cervical Spine
72141Cash Price
(No Insurance)
$187
Gross Charge
$207
Insurance Negotiated Rates
Pacific Source - All Plans$120
MRI Knee
73721Cash Price
(No Insurance)
$167
Gross Charge
$185
Insurance Negotiated Rates
Pacific Source - All Plans$109
MRI Lumbar Spine
72148Cash Price
(No Insurance)
$177
Gross Charge
$197
Insurance Negotiated Rates
Pacific Source - All Plans$120
MRI Shoulder
73221Cash Price
(No Insurance)
$167
Gross Charge
$185
Insurance Negotiated Rates
Pacific Source - All Plans$111
Office Visit Level 3
99213Cash Price
(No Insurance)
$304
Gross Charge
$338
Insurance Negotiated Rates
Pacific Source - All Plans$83
Office Visit Level 4
99214Cash Price
(No Insurance)
$320
Gross Charge
$355
Insurance Negotiated Rates
Pacific Source - All Plans$127
Shoulder X-Ray
73030Cash Price
(No Insurance)
$62
Gross Charge
$69
Insurance Negotiated Rates
Pacific Source - All Plans$15
TSH (Thyroid)
84443Cash Price
(No Insurance)
$146
Gross Charge
$162
Insurance Negotiated Rates
First Choice Health Network - All Plans$110
Ultrasound Abdomen
76700Cash Price
(No Insurance)
$150
Gross Charge
$167
Insurance Negotiated Rates
Pacific Source - All Plans$66
Ultrasound Pelvis
76856Cash Price
(No Insurance)
$103
Gross Charge
$115
Insurance Negotiated Rates
Pacific Source - All Plans$55
Cash Price
(No Insurance)
$629
Gross Charge
$699
Insurance Negotiated Rates
Pacific Source - All Plans$56
Urinalysis
81001Cash Price
(No Insurance)
$64
Gross Charge
$71
Insurance Negotiated Rates
First Choice Health Network - All Plans$64