Modoc Medical Center

Cash prices

1. Comprehensive metabolic panel (CMP) blood test

   CPT 80053

   Facility fee only
   $264
   US typical $100

   Doctor fees are billed separately.
2. Chest X-ray (1 view)

   CPT 71045

   Scan only
   $309
   US typical $191

   The radiologist read is billed separately.
3. TSH (thyroid) test

   CPT 84443

   Facility fee only
   $171
   US typical $71

   Doctor fees are billed separately.
4. Hemoglobin A1c (diabetes) test

   CPT 83036

   Facility fee only
   $102
   US typical $51

   Doctor fees are billed separately.
5. Prothrombin time (PT/INR) clotting test

   CPT 85610

   Facility fee only
   $65.44
   US typical $27.20

   Doctor fees are billed separately.
6. Chest X-ray (2 views)

   CPT 71046

   Scan only
   $481
   US typical $219

   The radiologist read is billed separately.
7. Magnesium test

   CPT 83735

   Facility fee only
   $141
   US typical $34.43

   Doctor fees are billed separately.
8. Potassium blood test

   CPT 84132

   Facility fee only
   $95.23
   US typical $33

   Doctor fees are billed separately.
9. Lipid panel (cholesterol) blood test

   CPT 80061

   Facility fee only
   $170
   US typical $71.50

   Doctor fees are billed separately.
10. Free T4 (thyroid hormone) test

    CPT 84439

    Facility fee only
    $125
    US typical $56.70

    Doctor fees are billed separately.
11. Uric acid blood test

    CPT 84550

    Facility fee only
    $73.49
    US typical $39

    Doctor fees are billed separately.
12. X-ray of abdomen, 1 view

    CPT 74018

    Scan only
    $303
    US typical $209

    The radiologist read is billed separately.
13. Partial thromboplastin time (PTT) clotting test

    CPT 85730

    Facility fee only
    $99.89
    US typical $37.50

    Doctor fees are billed separately.
14. Phosphorus test

    CPT 84100

    Facility fee only
    $79.22
    US typical $35.40

    Doctor fees are billed separately.
15. Liver function (hepatic) panel

    CPT 80076

    Facility fee only
    $195
    US typical $81.60

    Doctor fees are billed separately.
16. Hemoglobin blood test

    CPT 85018

    Facility fee only
    $63.85
    US typical $20

    Doctor fees are billed separately.
17. X-ray of pelvis, 1-2 views

    CPT 72170

    Scan only
    $320
    US typical $223

    The radiologist read is billed separately.
18. Creatine kinase (CK) test, total

    CPT 82550

    Facility fee only
    $103
    US typical $44.20

    Doctor fees are billed separately.
19. Creatinine blood test

    CPT 82565

    Facility fee only
    $105
    US typical $33

    Doctor fees are billed separately.
20. Lactic acid (lactate) test

    CPT 83605

    Facility fee only
    $142
    US typical $67

    Doctor fees are billed separately.
21. Bacterial culture, aerobic (not urine, blood, or stool)

    CPT 87070

    Facility fee only
    $179
    US typical $55.80

    Doctor fees are billed separately.
22. Iron test

    CPT 83540

    Facility fee only
    $97.61
    US typical $42.10

    Doctor fees are billed separately.
23. Vitamin B12 test

    CPT 82607

    Facility fee only
    $206
    US typical $75.60

    Doctor fees are billed separately.
24. Ferritin test

    CPT 82728

    Facility fee only
    $191
    US typical $76.85

    Doctor fees are billed separately.
25. Troponin test, quantitative

    CPT 84484

    Facility fee only
    $185
    US typical $89.50

    Doctor fees are billed separately.
26. BNP heart failure blood test (natriuretic peptide)

    CPT 83880

    Facility fee only
    $253
    US typical $135

    Doctor fees are billed separately.
27. Lipase test

    CPT 83690

    Facility fee only
    $122
    US typical $56.61

    Doctor fees are billed separately.
28. Creatinine test, urine or other non-blood sample

    CPT 82570

    Facility fee only
    $78.07
    US typical $26

    Doctor fees are billed separately.
29. Ultrasound of abdomen (complete)

    CPT 76700

    Scan only
    $958
    US typical $617

    The radiologist read is billed separately.
30. Amylase test

    CPT 82150

    Facility fee only
    $116
    US typical $44.50

    Doctor fees are billed separately.
31. X-ray of neck spine (cervical), 2-3 views

    CPT 72040

    Scan only
    $389
    US typical $255

    The radiologist read is billed separately.
32. Folic acid (folate) blood test

    CPT 82746

    Facility fee only
    $204
    US typical $76.80

    Doctor fees are billed separately.
33. X-ray of lower back spine (lumbosacral), 2-3 views

    CPT 72100

    Scan only
    $334
    US typical $279

    The radiologist read is billed separately.
34. Blood infection test (bacterial culture)

    CPT 87040

    Facility fee only
    $187
    US typical $96.19

    Doctor fees are billed separately.
35. Gram stain smear for bacteria or fungi

    CPT 87205

    Facility fee only
    $72.35
    US typical $35.40

    Doctor fees are billed separately.
36. Direct bilirubin blood test

    CPT 82248

    Facility fee only
    $76.92
    US typical $38.35

    Doctor fees are billed separately.
37. Total calcium blood test

    CPT 82310

    Facility fee only
    $81.52
    US typical $36

    Doctor fees are billed separately.
38. C-reactive protein (CRP) blood test

    CPT 86140

    Facility fee only
    $90.70
    US typical $43.16

    Doctor fees are billed separately.
39. Vitamin D test

    CPT 82306

    Facility fee only
    $351
    US typical $101

    Doctor fees are billed separately.
40. Sodium blood test

    CPT 84295

    Facility fee only
    $96.31
    US typical $33.15

    Doctor fees are billed separately.
41. Total bilirubin blood test

    CPT 82247

    Facility fee only
    $78.07
    US typical $32.90

    Doctor fees are billed separately.
42. CT scan of head/brain (no contrast)

    CPT 70450

    Scan only
    $1,844
    US typical $1,078

    The radiologist read is billed separately.
43. Albumin blood test

    CPT 82040

    Facility fee only
    $75.77
    US typical $25.60

    Doctor fees are billed separately.
44. Ammonia blood test

    CPT 82140

    Facility fee only
    $157
    US typical $78

    Doctor fees are billed separately.
45. Hematocrit blood test

    CPT 85014

    Facility fee only
    $53.03
    US typical $21

    Doctor fees are billed separately.
46. Ultrasound of abdomen (limited)

    CPT 76705

    Scan only
    $727
    US typical $460

    The radiologist read is billed separately.
47. Blood type test (ABO)

    CPT 86900

    Facility fee only
    $80.37
    US typical $58

    Doctor fees are billed separately.
48. ALT liver enzyme test (SGPT)

    CPT 84460

    Facility fee only
    $86.11
    US typical $35

    Doctor fees are billed separately.
49. BUN kidney function blood test (urea nitrogen)

    CPT 84520

    Facility fee only
    $86.58
    US typical $30

    Doctor fees are billed separately.
50. CT scan of abdomen and pelvis (with contrast)

    CPT 74177

    Scan only
    $3,846
    US typical $2,362

    The radiologist read is 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.