Goshen Health Surgery Center LLC

Cash prices

1. Joint injection (large joint, e.g. knee)

   CPT 20610

   Facility fee only
   $505
   US typical $392

   Doctor fees are billed separately.
2. Ultrasound guidance for needle placement

   CPT 76942

   Scan only
   $875
   US typical $500

   The radiologist read is billed separately.
3. Drainage of skin abscess or boil, simple or single

   CPT 10060

   Facility fee only
   $272
   US typical $286

   Doctor fees are billed separately.
4. Spinal tap (lumbar puncture), diagnostic

   CPT 62270

   Facility fee only
   $1,349
   US typical $758

   Doctor fees are billed separately.
5. Needle drainage of abscess, hematoma, blister, or cyst

   CPT 10160

   Facility fee only
   $338
   US typical $383

   Doctor fees are billed separately.
6. Incision and drainage of hematoma, seroma, or fluid collection

   CPT 10140

   Facility fee only
   $421
   US typical $1,466

   Doctor fees are billed separately.
7. Medium joint aspiration or injection, without ultrasound

   CPT 20605

   Scan only
   $251
   US typical $327

   The radiologist read is billed separately.
8. Wound debridement under the skin, first 20 sq cm or less

   CPT 11042

   Facility fee only
   $520
   US typical $515

   Doctor fees are billed separately.
9. X-ray (fluoroscopy) guidance for needle placement

   CPT 77002

   Scan only
   $1,534
   US typical $434

   The radiologist read is billed separately.
10. Simple removal of foreign object under the skin

    CPT 10120

    Facility fee only
    $436
    US typical $416

    Doctor fees are billed separately.
11. Drainage of skin abscess, complicated or multiple

    CPT 10061

    Facility fee only
    $458
    US typical $459

    Doctor fees are billed separately.
12. Nerve block injection, other peripheral nerve

    CPT 64450

    Facility fee only
    $955
    US typical $639

    Doctor fees are billed separately.
13. Trigger point injection, 1 or 2 muscles

    CPT 20552

    Facility fee only
    $505
    US typical $335

    Doctor fees are billed separately.
14. Unna boot application

    CPT 29580

    Facility fee only
    $130
    US typical $196

    Doctor fees are billed separately.
15. Long arm splint application (shoulder to hand)

    CPT 29105

    Facility fee only
    $225
    US typical $216

    Doctor fees are billed separately.
16. Short leg splint application (calf to foot)

    CPT 29515

    Facility fee only
    $182
    US typical $198

    Doctor fees are billed separately.
17. Impacted earwax removal with instruments, one ear

    CPT 69210

    Facility fee only
    $837
    US typical $105

    Doctor fees are billed separately.
18. Small joint drain or injection (e.g. finger, toe), without ultrasound

    CPT 20600

    Scan only
    $251
    US typical $323

    The radiologist read is billed separately.
19. Simple wound repair (stitches), body/limbs/scalp, 2.5 cm or less

    CPT 12001

    Facility fee only
    $272
    US typical $262

    Doctor fees are billed separately.
20. Permanent fingernail or toenail removal (including nail root)

    CPT 11750

    Facility fee only
    $505
    US typical $480

    Doctor fees are billed separately.
21. Simple wound repair (stitches), body/limbs/scalp, 2.6-7.5 cm

    CPT 12002

    Facility fee only
    $272
    US typical $297

    Doctor fees are billed separately.
22. Long leg splint application (thigh to ankle or toes)

    CPT 29505

    Facility fee only
    $235
    US typical $221

    Doctor fees are billed separately.
23. Punch skin biopsy, single lesion

    CPT 11104

    Facility fee only
    $69.95
    US typical $341

    Doctor fees are billed separately.
24. Wound debridement down to muscle or fascia, first 20 sq cm or less

    CPT 11043

    Facility fee only
    $988
    US typical $800

    Doctor fees are billed separately.
25. Large joint/bursa drain or injection, with ultrasound guidance

    CPT 20611

    Scan only
    $251
    US typical $572

    The radiologist read is billed separately.
26. Layered stitches for wound on scalp, armpit, trunk or limbs, 2.6-7.5 cm

    CPT 12032

    Facility fee only
    $520
    US typical $520

    Doctor fees are billed separately.
27. Change of bladder (cystostomy) tube, simple

    CPT 51705

    Facility fee only
    $234
    US typical $330

    Doctor fees are billed separately.
28. Ropivacaine (Naropin) injection, per 1 mg

    HCPCS J2795

    Facility fee only
    $407
    US typical $19.20

    Doctor fees are billed separately. As listed: Ropivacaine hcl injection
29. Injection into one tendon sheath or ligament

    CPT 20550

    Facility fee only
    $251
    US typical $322

    Doctor fees are billed separately.
30. Fluoroscopy guidance for spine injection (add-on)

    CPT 77003

    Scan only
    $1,534
    US typical $430

    The radiologist read is billed separately.
31. Feeding tube placement through nose or mouth, with X-ray guidance

    CPT 43752

    Scan only
    $442
    US typical $452

    The radiologist read is billed separately.
32. Wound debridement down to bone, first 20 sq cm or less

    CPT 11044

    Facility fee only
    $2,171
    US typical $1,790

    Doctor fees are billed separately.
33. Layered wound repair of scalp, armpit, trunk, arms or legs, 2.5 cm or less

    CPT 12031

    Facility fee only
    $520
    US typical $449

    Doctor fees are billed separately.
34. Earwax removal by irrigation, one ear

    CPT 69209

    Facility fee only
    $326
    US typical $80

    Doctor fees are billed separately.
35. Bladder irrigation or instillation, simple

    CPT 51700

    Facility fee only
    $204
    US typical $298

    Doctor fees are billed separately.
36. Drainage of pilonidal cyst, simple

    CPT 10080

    Facility fee only
    $526
    US typical $488

    Doctor fees are billed separately.
37. Partial-thickness burn dressing or debridement, medium area

    CPT 16025

    Facility fee only
    $520
    US typical $313

    Doctor fees are billed separately.
38. Layered stitches, scalp/trunk/arms/legs, 7.6-12.5 cm

    CPT 12034

    Facility fee only
    $520
    US typical $547

    Doctor fees are billed separately.
39. Breast cyst needle aspiration

    CPT 19000

    Facility fee only
    $334
    US typical $704

    Doctor fees are billed separately.
40. Removal of skin tags, up to 15

    CPT 11200

    Facility fee only
    $578
    US typical $217

    Doctor fees are billed separately.
41. Surgical mesh implant

    HCPCS C1781

    Facility fee only
    $1,369
    US typical $149

    Doctor fees are billed separately.
42. Layered stitches, face/ears/eyelids/nose/lips, 2.5 cm or less

    CPT 12051

    Facility fee only
    $520
    US typical $471

    Doctor fees are billed separately.
43. Epidural injection (lumbar, with imaging)

    CPT 62323

    Scan only
    $879
    US typical $1,267

    The radiologist read is billed separately.
44. Trigeminal nerve block injection, each branch

    CPT 64400

    Facility fee only
    $342
    US typical $397

    Doctor fees are billed separately.
45. Removal of object under skin of foot

    CPT 28190

    Facility fee only
    $772
    US typical $730

    Doctor fees are billed separately.
46. Layered wound repair of face, ears, eyelids, nose or lips, 2.6–5 cm

    CPT 12052

    Facility fee only
    $520
    US typical $513

    Doctor fees are billed separately.
47. Needle biopsy or removal of superficial lymph node

    CPT 38505

    Facility fee only
    $2,171
    US typical $1,584

    Doctor fees are billed separately.
48. Trigger point injections, 3 or more muscles

    CPT 20553

    Facility fee only
    $251
    US typical $376

    Doctor fees are billed separately.
49. Simple wound repair of scalp, neck, trunk or limbs, 12.6–20 cm

    CPT 12005

    Facility fee only
    $272
    US typical $449

    Doctor fees are billed separately.
50. Broken wrist (distal radius) set without surgery

    CPT 25605

    Facility fee only
    $2,526
    US typical $1,220

    Doctor fees are billed separately.

Prices are published cash prices with their source and the date we last checked. Confirm with the provider before you book. Hospital prices for a billing code are often the facility charge only.