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Sheridan Memorial Hosptial
Plentywood, MT · CMS ID: 271322
This hospital has pricing data for 30 procedures ranging from $59 to $4,906.
Procedures (30)
Chest X-Ray 1 View
71045Cash Price
(No Insurance)
$385
Gross Charge
$428
Medicare Rate
$24
Insurance Negotiated Rates
Pacific Source - All Plans$15
Chest X-Ray 2 Views
71046Cash Price
(No Insurance)
$67
Gross Charge
$74
Medicare Rate
$31
Insurance Negotiated Rates
Pacific Source - All Plans$18
Cash Price
(No Insurance)
$59
Gross Charge
$65
Insurance Negotiated Rates
First Choice Health Network - All Plans$53
Cash Price
(No Insurance)
$170
Gross Charge
$189
Insurance Negotiated Rates
First Choice Health Network - All Plans$156
Cash Price
(No Insurance)
$4,906
Gross Charge
$5,451
Medicare Rate
$280
Insurance Negotiated Rates
Pacific Source - All Plans$148
Cash Price
(No Insurance)
$3,362
Gross Charge
$3,735
Medicare Rate
$172
Insurance Negotiated Rates
Pacific Source - All Plans$141
CT Chest Low Dose
71271Cash Price
(No Insurance)
$455
Gross Charge
$506
Medicare Rate
$128
Insurance Negotiated Rates
Pacific Source - All Plans$49
Cash Price
(No Insurance)
$2,918
Gross Charge
$3,242
Medicare Rate
$156
Insurance Negotiated Rates
Pacific Source - All Plans$101
ER Visit Level 3
99283Cash Price
(No Insurance)
$724
Gross Charge
$804
Medicare Rate
$69
Insurance Negotiated Rates
Pacific Source - All Plans$105
ER Visit Level 4
99284Cash Price
(No Insurance)
$1,244
Gross Charge
$1,382
Medicare Rate
$117
Insurance Negotiated Rates
Pacific Source - All Plans$193
ER Visit Level 5
99285Cash Price
(No Insurance)
$1,950
Gross Charge
$2,167
Medicare Rate
$170
Insurance Negotiated Rates
Pacific Source - All Plans$280
Hemoglobin A1C
83036Cash Price
(No Insurance)
$171
Gross Charge
$190
Insurance Negotiated Rates
First Choice Health Network - All Plans$157
Knee X-Ray
73560Cash Price
(No Insurance)
$152
Gross Charge
$169
Medicare Rate
$32
Insurance Negotiated Rates
Pacific Source - All Plans$14
Lipid Panel
80061Cash Price
(No Insurance)
$149
Gross Charge
$165
Insurance Negotiated Rates
First Choice Health Network - All Plans$136
Mammogram Diagnostic
77066Cash Price
(No Insurance)
$458
Gross Charge
$509
Medicare Rate
$146
Insurance Negotiated Rates
Pacific Source - All Plans$81
Mammogram Screening
77067Cash Price
(No Insurance)
$325
Gross Charge
$361
Medicare Rate
$118
Insurance Negotiated Rates
Pacific Source - All Plans$62
MRI Brain
70551Cash Price
(No Insurance)
$4,189
Gross Charge
$4,654
Medicare Rate
$183
Insurance Negotiated Rates
Pacific Source - All Plans$120
Cash Price
(No Insurance)
$3,397
Gross Charge
$3,774
Medicare Rate
$296
Insurance Negotiated Rates
Pacific Source - All Plans$185
MRI Cervical Spine
72141Cash Price
(No Insurance)
$4,007
Gross Charge
$4,452
Medicare Rate
$179
Insurance Negotiated Rates
Pacific Source - All Plans$120
MRI Knee
73721Cash Price
(No Insurance)
$3,189
Gross Charge
$3,543
Medicare Rate
$191
Insurance Negotiated Rates
Pacific Source - All Plans$109
MRI Lumbar Spine
72148Cash Price
(No Insurance)
$4,172
Gross Charge
$4,636
Medicare Rate
$180
Insurance Negotiated Rates
Pacific Source - All Plans$120
MRI Shoulder
73221Cash Price
(No Insurance)
$3,247
Gross Charge
$3,608
Medicare Rate
$191
Insurance Negotiated Rates
Pacific Source - All Plans$111
Office Visit Level 3
99213Cash Price
(No Insurance)
$304
Gross Charge
$338
Medicare Rate
$91
Insurance Negotiated Rates
Pacific Source - All Plans$83
Office Visit Level 4
99214Cash Price
(No Insurance)
$320
Gross Charge
$355
Medicare Rate
$130
Insurance Negotiated Rates
Pacific Source - All Plans$127
Shoulder X-Ray
73030Cash Price
(No Insurance)
$411
Gross Charge
$457
Medicare Rate
$33
Insurance Negotiated Rates
Pacific Source - All Plans$15
TSH (Thyroid)
84443Cash Price
(No Insurance)
$159
Gross Charge
$177
Insurance Negotiated Rates
First Choice Health Network - All Plans$110
Ultrasound Abdomen
76700Cash Price
(No Insurance)
$963
Gross Charge
$1,070
Medicare Rate
$107
Insurance Negotiated Rates
Pacific Source - All Plans$66
Ultrasound Pelvis
76856Cash Price
(No Insurance)
$804
Gross Charge
$893
Medicare Rate
$98
Insurance Negotiated Rates
Pacific Source - All Plans$55
Cash Price
(No Insurance)
$687
Gross Charge
$763
Medicare Rate
$109
Insurance Negotiated Rates
Pacific Source - All Plans$56
Urinalysis
81001Cash Price
(No Insurance)
$70
Gross Charge
$78
Insurance Negotiated Rates
First Choice Health Network - All Plans$64