Haskell Rural Health Clinic

Cash prices

1. Manual therapy, each 15 min

   CPT 97140

   Facility fee only
   $48.83
   US typical $89.25

   Doctor fees are billed separately.
2. Nebulizer or inhaler breathing treatment

   CPT 94640

   Facility fee only
   $30.09
   US typical $140

   Doctor fees are billed separately.
3. Blood draw (venipuncture)

   CPT 36415

   Facility fee only
   $10.78
   US typical $15.75

   Doctor fees are billed separately.
4. Injection under the skin or into muscle

   CPT 96372

   Facility fee only
   $24.41
   US typical $89.43

   Doctor fees are billed separately.
5. Wound debridement, first 20 sq cm or less

   CPT 97597

   Facility fee only
   $166
   US typical $220

   Doctor fees are billed separately.
6. Vaccine administration (first shot)

   CPT 90471

   Facility fee only
   $24.41
   US typical $52

   Doctor fees are billed separately.
7. Joint injection (large joint, e.g. knee)

   CPT 20610

   Facility fee only
   $107
   US typical $392

   Doctor fees are billed separately.
8. Spirometry before and after bronchodilator

   CPT 94060

   Facility fee only
   $101
   US typical $407

   Doctor fees are billed separately.
9. Ceftriaxone injection, per 250 mg

   HCPCS J0696

   Facility fee only
   $19.85
   US typical $6.70

   Doctor fees are billed separately. As listed: J0696 INJECTION, CEFTRIAXONE SODIUM, PER 250 MG
10. Drainage of skin abscess or boil, simple or single

    CPT 10060

    Facility fee only
    $208
    US typical $286

    Doctor fees are billed separately.
11. Insertion of temporary urinary catheter (Foley)

    CPT 51702

    Facility fee only
    $105
    US typical $175

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

    CPT 10140

    Facility fee only
    $292
    US typical $1,467

    Doctor fees are billed separately.
13. Tdap vaccine (tetanus, diphtheria, whooping cough), age 7+

    CPT 90715

    Facility fee only
    $56.21
    US typical $98.55

    Doctor fees are billed separately.
14. Enoxaparin (Lovenox) injection, per 10 mg

    HCPCS J1650

    Facility fee only
    $8.61
    US typical $18.21

    Doctor fees are billed separately. As listed: J1650 INJECTION, ENOXAPARIN SODIUM, 10 MG
15. Triamcinolone acetonide (Kenalog) injection, per 10 mg

    HCPCS J3301

    Facility fee only
    $5.75
    US typical $15.74

    Doctor fees are billed separately. As listed: J3301 INJECTION, TRIAMCINOLONE ACETONIDE, NOT OTHERWISE SPEC
16. Vitamin B12 (cyanocobalamin) injection, up to 1000 mcg

    HCPCS J3420

    Facility fee only
    $5.15
    US typical $12.18

    Doctor fees are billed separately. As listed: J3420 INJECTION, VITAMIN B-12, UP TO 1000MCG
17. Medium joint aspiration or injection, without ultrasound

    CPT 20605

    Scan only
    $200
    US typical $327

    The radiologist read is billed separately.
18. Vaccine administration, each additional vaccine

    CPT 90472

    Facility fee only
    $22.14
    US typical $35.40

    Doctor fees are billed separately.
19. Simple removal of foreign object under the skin

    CPT 10120

    Facility fee only
    $261
    US typical $416

    Doctor fees are billed separately.
20. Rapid strep test

    CPT 87880

    Facility fee only
    $123
    US typical $50.37

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

    CPT 10061

    Facility fee only
    $361
    US typical $459

    Doctor fees are billed separately.
22. Short arm splint (forearm to hand), static

    CPT 29125

    Facility fee only
    $110
    US typical $181

    Doctor fees are billed separately.
23. Simple removal of nail plate, single nail

    CPT 11730

    Facility fee only
    $190
    US typical $234

    Doctor fees are billed separately.
24. Prochlorperazine (Compazine) injection, up to 10 mg

    HCPCS J0780

    Facility fee only
    $30.78
    US typical $20

    Doctor fees are billed separately. As listed: J0780 INJECTION, PROCHLORPERAZINE, UP TO 10 MG
25. Diazepam injection, up to 5 mg

    HCPCS J3360

    Facility fee only
    $4.21
    US typical $46.14

    Doctor fees are billed separately. As listed: J3360 INJECTION, DIAZEPAM, UP TO 5 MG
26. Trigger point injection, 1 or 2 muscles

    CPT 20552

    Facility fee only
    $95.96
    US typical $335

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

    CPT 29105

    Facility fee only
    $139
    US typical $216

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

    CPT 29515

    Facility fee only
    $121
    US typical $198

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

    CPT 69210

    Facility fee only
    $82.33
    US typical $105

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

    CPT 20600

    Scan only
    $191
    US typical $323

    The radiologist read is billed separately.
31. Finger splint application, static

    CPT 29130

    Facility fee only
    $70.97
    US typical $146

    Doctor fees are billed separately.
32. Meperidine injection, per 100 mg

    HCPCS J2175

    Facility fee only
    $1.10
    US typical $13

    Doctor fees are billed separately. As listed: J2175 INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG
33. Simple wound repair (stitches), body/limbs/scalp, 2.5 cm or less

    CPT 12001

    Facility fee only
    $155
    US typical $261

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

    CPT 11750

    Facility fee only
    $270
    US typical $480

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

    CPT 12002

    Facility fee only
    $538
    US typical $297

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

    CPT 11104

    Facility fee only
    $215
    US typical $341

    Doctor fees are billed separately.
37. Tetanus-diphtheria (Td) vaccine, preservative-free, age 7+

    CPT 90714

    Facility fee only
    $40.88
    US typical $74.75

    Doctor fees are billed separately.
38. Simple wound repair of face, ears, eyelids, nose or lips, 2.5 cm or less

    CPT 12011

    Facility fee only
    $479
    US typical $295

    Doctor fees are billed separately.
39. Established patient office visit (straightforward, ~10-19 min)

    CPT 99212

    Facility fee only
    $77.78
    US typical $88.23

    Doctor fees are billed separately.
40. Injection into one tendon sheath or ligament

    CPT 20550

    Facility fee only
    $94.83
    US typical $322

    Doctor fees are billed separately.
41. Sumatriptan injection, 6 mg

    HCPCS J3030

    Facility fee only
    $32.22
    US typical $44.50

    Doctor fees are billed separately. As listed: J3030 INJECTION, SUMATRIPTAN SUCCINATE, 6 MG
42. Established patient office visit (low complexity, ~20-29 min)

    CPT 99213

    Facility fee only
    $88.01
    US typical $116

    Doctor fees are billed separately.
43. Established patient office visit (moderate complexity, ~30-39 min)

    CPT 99214

    Facility fee only
    $88.01
    US typical $155

    Doctor fees are billed separately.
44. Tuberculosis (TB) skin test

    CPT 86580

    Facility fee only
    $15.33
    US typical $29.40

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

    CPT 69209

    Facility fee only
    $23.85
    US typical $80.40

    Doctor fees are billed separately.
46. Removal of object from ear canal, without general anesthesia

    CPT 69200

    Facility fee only
    $139
    US typical $177

    Doctor fees are billed separately.
47. Established patient office visit (high complexity, 40+ min)

    CPT 99215

    Facility fee only
    $88.01
    US typical $203

    Doctor fees are billed separately.
48. Flu shot administration

    HCPCS G0008

    Facility fee only
    $28.39
    US typical $46.40

    Doctor fees are billed separately.
49. Trimming of corn or callus, 1 lesion

    CPT 11055

    Facility fee only
    $107
    US typical $188

    Doctor fees are billed separately.
50. Promethazine injection, up to 50 mg

    HCPCS J2550

    Facility fee only
    $2.52
    US typical $9.60

    Doctor fees are billed separately. As listed: J2550 INJECTION, PROMETHAZINE HCL, UP TO 50 MG

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.