Coming Soon

Our patient price estimator tool will be activated by January 1, 2021 or sooner.

Patient Price Information List

Disclaimer: Hendry Regional Medical Center determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.

LOCAL MARKET HOSPITALS

In order to present a meaningful comparison, Hendry Regional Medical Center has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/2022. Hendry Regional Medical Center's charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Box Butte General Hospital

Alliance

NE

Cheyenne Regional Medical Center

Cheyenne

WY

Great Plains Health

North Platte

NE

Kimball Health Services

Kimball

NE

Morrill County Community Hospital

Bridgeport

NE

Ogallala Community Hospital

Ogallala

NE

Perkins County Health Services

Grant

NE

Phelps Memorial Health Center

Holdrege

NE

Regional West Garden County Hospital

Oshkosh

NE

Regional West Medical Center

Scottsbluff

NE

Sterling Regional MedCenter

Sterling

CO

UCHealth Medical Center of the Rockies

Loveland

CO

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$1,876
$1,442

30% higher than market

CMS SHOPPABLE SERVICE

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74177]

$4,776
$4,853

2% lower than market

Abdominal ultrasound (complete) [HCPCS 76700]

$944
$925

2% higher than market

Abdominal ultrasound of pregnant uterus after first trimester, greater than or equal to 14 weeks 0 days (single or first fetus) [HCPCS 76805]

$861
$656

31% higher than market

Anesthetic agent and/or steroid injection into lower or sacral spine nerve root with imaging guidance (single level) [HCPCS 64483]

$3,320
$1,705

95% higher than market

Cataract removal involving removal of the front part of the capsule and the central part of the lens with lens prosthesis insertion [HCPCS 66984]

$3,706
$4,485

17% lower than market

Colon (large bowel) examination and biopsy with endoscope [HCPCS 45380]

$5,132
$2,501

105% higher than market

Colon (large bowel) examination and polyps or tumors removal by snare technique with endoscope [HCPCS 45385]

$5,132
$2,778

85% higher than market

Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]

$2,502
$2,442

2% higher than market

Esophagus, stomach, and/or upper small bowel examination and biopsy with endoscope [HCPCS 43239]

$4,891
$2,582

89% higher than market

Esophagus, stomach, and/or upper small bowel examination with endoscope for diagnosis [HCPCS 43235]

$2,261
$1,998

13% higher than market

Groin hernia repair for patient 5 years of age or older (herniated tissue that is not trapped) [HCPCS 49505]

$7,301
$10,296

29% lower than market

Head or brain CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70450]

$2,099
$2,048

2% higher than market

Imaging of brain by MRI without contrast, followed by contrast [HCPCS 70553]

$4,445
$4,254

4% higher than market

Imaging of leg joint by MRI without contrast [HCPCS 73721]

$2,921
$2,695

8% higher than market

Imaging of lower spinal canal by MRI without contrast [HCPCS 72148]

$3,475
$3,276

6% higher than market

Knee cartilage removal with endoscope (one knee) [HCPCS 29881]

$10,901
$6,890

58% higher than market

Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]

$59
$65

9% lower than market

Lab analysis of urine specimen by dipstick without microscope (automated) [HCPCS 81003]

$43
$37

17% higher than market

Lab analysis to evaluate kidney function via a blood test panel [HCPCS 80069]

$142
$143

1% lower than market

Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]

$56
$61

9% lower than market

Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]

$121
$111

9% higher than market

Lab analysis to measure coagulation in plasma or whole blood specimen [HCPCS 85730]

$113
$101

12% higher than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test [HCPCS 85027]

$70
$71

2% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]

$89
$95

7% lower than market

Lab analysis to measure the amount of albumin, total and direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase, and asparate amino transferase in blood specimen to evaluate liver function [HCPCS 800

$133
$122

9% higher than market

Lab analysis to measure the amount of free PSA (prostate specific antigen) in serum specimen [HCPCS 84154]

$149
$102

46% higher than market

Lab analysis to measure the amount of lipids (cholesterol and triglycerides) in blood specimen [HCPCS 80061]

$135
$119

13% higher than market

Lab analysis to measure the amount of total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN) in blood specimen [HCPCS 80048]

$124
$129

4% lower than market

Lab analysis to measure the amount of total PSA (prostate specific antigen) in serum specimen [HCPCS 84153]

$148
$130

14% higher than market

Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]

$156
$157

1% lower than market

Mammography of both breasts (screening exam) [HCPCS 77067]

$476
$394

21% higher than market

Mammography of both breasts for diagnosis [HCPCS 77066]

$451
$446

1% higher than market

Mammography of one breast for diagnosis [HCPCS 77065]

$360
$348

4% higher than market

New patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 30-44 minutes) [HCPCS 99203]

$89
$69

29% higher than market

New patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 45-59 minutes) [HCPCS 99204]

$89
$242

63% lower than market

New patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 60-74 minutes) [HCPCS 99205]

$89
$93

4% lower than market

Pelvis CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 72193]

$2,955
$2,844

4% higher than market

Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]

$55
$71

24% lower than market

Prostate gland biopsy [HCPCS 55700]

$1,877
$2,563

27% lower than market

Psychotherapy treatment by physician face-to-face with patient (30 minutes) [HCPCS 90832]

$207
$200

4% higher than market

Psychotherapy treatment by physician face-to-face with patient (45 minutes) [HCPCS 90834]

$262
$253

4% higher than market

Psychotherapy treatment by physician face-to-face with patient (60 minutes) [HCPCS 90837]

$332
$311

7% higher than market

Psychotherapy treatment for multiple patients in one group session [HCPCS 90853]

$106
$87

22% higher than market

Sleep pattern monitoring of patient in sleep lab, sleep staging with 4 or more parameters of sleep (6 years of age or older) [HCPCS 95810]

$4,072
$4,218

3% lower than market

Spinal canal injection of substance into lower back or sacrum with imaging guidance [HCPCS 62323]

$1,855
$2,155

14% lower than market

Spinal fusion other than the neck without major complications

$101,729
$126,266

19% lower than market

Spinal x-ray of lower and sacral spine (minimum of 4 views) [HCPCS 72110]

$633
$577

10% higher than market

OUTPATIENT CLINIC

Description

Our Charge
Market Charge

Variance

Established patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 10-19 minutes) [HCPCS 99212]

$89
$95

6% lower than market

Established patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 20-29 minutes) [HCPCS 99213]

$89
$107

17% lower than market

Established patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 30-39 minutes) [HCPCS 99214]

$89
$187

52% lower than market

OUTPATIENT EMERGENCY DEPARTMENT

Description

Our Charge
Market Charge

Variance

Emergency department visit for problem of moderate severity [HCPCS 99283]

$762
$687

11% higher than market

Emergency department visit for problem of high severity [HCPCS 99284]

$1,179
$1,068

10% higher than market

Emergency department visit for problem with significant threat to life [HCPCS 99285]

$1,802
$1,724

5% higher than market

OUTPATIENT LABORATORY AND PATHOLOGY

Description

Our Charge
Market Charge

Variance

Cov-19 amp prb hgh thruput [HCPCS U0003]

$166
$193

14% lower than market

Drug screening read by direct visual reading with instrument assistance [HCPCS 80306]

$324
$363

11% lower than market

Lab analysis by immunoassay to identify Strep (streptococcus) [HCPCS 87880]

$72
$55

30% higher than market

Lab analysis by nucleic acid (DNA or RNA) to identify multiple types of respiratory virus (3-5 targets) [HCPCS 87631]

$303
$426

29% lower than market

Lab analysis by nucleic acid (DNA or RNA) to identify multiple types of the influenza virus (first 2 types or sub-types) [HCPCS 87502]

$265
$280

5% lower than market

Lab analysis of any culture (except urine, blood, or stool) to identify bacteria [HCPCS 87070]

$155
$135

15% higher than market

Lab analysis of blood culture to identify bacteria [HCPCS 87040]

$207
$197

5% higher than market

Lab analysis of rheumatoid factor [HCPCS 86430]

$117
$97

21% higher than market

Lab analysis of urine culture to identify bacteria [HCPCS 87088]

$83
$89

7% lower than market

Lab analysis to identify white blood cells (manual) with microscope [HCPCS 85007]

$71
$75

5% lower than market

Lab analysis to measure blood count (hemoglobin) [HCPCS 85018]

$45
$39

14% higher than market

Lab analysis to measure coagulation function measurement of D-dimer (quantitative) [HCPCS 85379]

$198
$200

1% lower than market

Lab analysis to measure red blood cell concentration [HCPCS 85014]

$51
$51

Approximately equal to market

Lab analysis to measure red blood cell sedimentation rate to detect inflammation (automated) [HCPCS 85652]

$41
$45

9% lower than market

Lab analysis to measure the amount of blood gases [HCPCS 82803]

$252
$257

2% lower than market

Lab analysis to measure the amount of protein in serum specimen [HCPCS 84165]

$132
$132

Approximately equal to market

Lab analysis to measure the amount of total digoxin in blood specimen [HCPCS 80162]

$140
$131

7% higher than market

Lab analysis to measure the amount of troponin (protein) in serum specimen [HCPCS 84484]

$234
$243

4% lower than market

Lab analysis to measure the blood potassium level in blood specimen [HCPCS 84132]

$64
$60

6% higher than market

Lab analysis to measure the carcinoembryonic antigen (cea) protein level [HCPCS 82378]

$204
$178

15% higher than market

Lab analysis to measure the direct bilirubin level [HCPCS 82248]

$70
$67

5% higher than market

Lab analysis to measure the ferritin (blood protein) level [HCPCS 82728]

$152
$130

17% higher than market

Lab analysis to measure the folic acid level in serum specimen [HCPCS 82746]

$154
$132

16% higher than market

Lab analysis to measure the hemoglobin A1C level in blood specimen [HCPCS 83036]

$92
$80

15% higher than market

Lab analysis to measure the iron level [HCPCS 83540]

$72
$68

7% higher than market

Lab analysis to measure the lactate dehydrogenase (enzyme) level [HCPCS 83615]

$85
$72

19% higher than market

Lab analysis to measure the lactic acid level in blood, plasma, or cerbrospinal fluid specimen [HCPCS 83605]

$62
$196

68% lower than market

Lab analysis to measure the lipase (fat enzyme) level [HCPCS 83690]

$150
$151

1% lower than market

Lab analysis to measure the magnesium level in body fluids and cells [HCPCS 83735]

$40
$82

51% lower than market

Lab analysis to measure the phosphate level [HCPCS 84100]

$62
$66

7% lower than market

Lab analysis to measure the procalcitonin (hormone) level in serum or plasma specimen [HCPCS 84145]

$217
$230

5% lower than market

Lab analysis to measure the total calcium level in blood specimen [HCPCS 82310]

$77
$52

49% higher than market

Lab analysis to measure the total protein level in blood specimen [HCPCS 84155]

$64
$60

7% higher than market

Lab analysis to screen for autoimmune disorders [HCPCS 86038]

$109
$112

3% lower than market

Lab analysis to screen for pathogenic organisms [HCPCS 87081]

$92
$85

8% higher than market

Lab blood analysis to confirm blood unit compatibility by immediate spin technique [HCPCS 86920]

$128
$212

39% lower than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's blood group type (ABO) [HCPCS 86900]

$105
$97

8% higher than market

Lab blood analysis to screen for antibodies to red blood cell antigens (each serum technique) [HCPCS 86850]

$305
$127

140% higher than market

Pathology lab analysis of special stained specimen slides to examine tissue (initial procedure) [HCPCS 88342]

$257
$279

8% lower than market

Pathology lab analysis of tissue with microscope (moderately low complexity) [HCPCS 88304]

$233
$196

19% higher than market

Platelet pheres leukoreduced [HCPCS P9035]

$1,667
$1,495

12% higher than market

OUTPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Chemotherapy administration beneath the skin or into muscle (hormonal, anti-cancer) [HCPCS 96402]

$214
$233

8% lower than market

Chemotherapy administration beneath the skin or into muscle (non-hormonal, anti-cancer) [HCPCS 96401]

$265
$325

19% lower than market

Chemotherapy administration into vein by infusion (prolonged, more than 8 hours) [HCPCS 96416]

$739
$713

4% higher than market

Chemotherapy administration into vein by infusion of each additional sequential infusion (up to 1 hour, different drug) [HCPCS 96417]

$127
$186

32% lower than market

Drug administration into vein by infusion for therapy, prevention, or diagnosis (each additional hour) [HCPCS 96366]

$157
$131

20% higher than market

Drug administration into vein by infusion for therapy, prevention, or diagnosis (up to 1 hour) [HCPCS 96365]

$421
$419

Approximately equal to market

Drug administration into vein by infusion of additional sequential infusion of new drug for therapy, prevention, or diagnosis (up to 1 hour) [HCPCS 96367]

$183
$168

9% higher than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of same drug) [HCPCS 96376]

$147
$133

11% higher than market

External 24-hour EKG monitoring heart rhythm symptom-related tracing (up to 30 days) [HCPCS 93270]

$338
$330

3% higher than market

Hydration administration into vein by infusion (31 minutes to 1 hour) [HCPCS 96360]

$419
$406

3% higher than market

Hydration administration into vein by infusion (each additional hour) [HCPCS 96361]

$165
$140

18% higher than market

Immunization administration of vaccine into, between, or beneath the skin or into muscle (single vaccine) [HCPCS 90471]

$68
$92

26% lower than market

Medication application by electic current through skin (each 15 minutes) [HCPCS 97033]

$128
$108

19% higher than market

Sleep pattern monitoring of patient in sleep lab with continued pressured respiratory assistance by mask or breathing tube (6 years of age or older) [HCPCS 95811]

$5,496
$4,736

16% higher than market

Whirlpool therapy application to 1 or more areas [HCPCS 97022]

$126
$93

35% higher than market

Wound vac therapy (negative pressure wound therapy) with DME (durable medical equipment) per session (surface area less than or equal to 50 square cm) [HCPCS 97605]

$268
$298

10% lower than market

OUTPATIENT OTHER

Description

Our Charge
Market Charge

Variance

2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc

$166
$105

58% higher than market

Diab manage trn per indiv [HCPCS G0108]

$62
$62

Approximately equal to market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION

Description

Our Charge
Market Charge

Variance

Adrenalin epinephrine inject [HCPCS J0171]

$1
$9

93% lower than market

Ampicillin sulbactam 1.5 gm [HCPCS J0295]

$10
$42

77% lower than market

Azithromycin [HCPCS J0456]

$14
$62

77% lower than market

Bevacizumab injection [HCPCS J9035]

$2
$9

76% lower than market

Cefazolin sodium injection [HCPCS J0690]

$3
$14

82% lower than market

Cefepime hcl for injection [HCPCS J0692]

$5
$20

73% lower than market

Chemotherapy administration into vein by infusion (up to 1 hour, single drug) [HCPCS 96413]

$719
$667

8% higher than market

Cyclophosphamide 100 mg inj [HCPCS J9070]

$10
$38

74% lower than market

Diazepam injection [HCPCS J3360]

$21
$46

55% lower than market

Doxorubicin hcl injection [HCPCS J9000]

$2
$292

99% lower than market

Ertapenem injection [HCPCS J1335]

$74
$139

47% lower than market

Hydralazine hcl injection [HCPCS J0360]

$22
$62

65% lower than market

In gemcitabine hcl nos 200mg [HCPCS J9201]

$2
$77

97% lower than market

Inj dobutamine hcl/250 mg [HCPCS J1250]

$8
$78

90% lower than market

Inj magnesium sulfate [HCPCS J3475]

$3
$15

79% lower than market

Inj trastuzumab excl biosimi [HCPCS J9355]

$8
$13

36% lower than market

Inj., rituximab, 10 mg [HCPCS J9312]

$2
$793

100% lower than market

Injection, carfilzomib, 1 mg [HCPCS J9047]

$1
$3

68% lower than market

Injection, pegfilgrastim 6mg [HCPCS J2505]

$7,756
$13,863

44% lower than market

Leucovorin calcium injection [HCPCS J0640]

$4
$10

58% lower than market

Methylprednisolone 40 mg inj [HCPCS J1030]

$57
$47

21% higher than market

Methylprednisolone 80 mg inj [HCPCS J1040]

$78
$66

18% higher than market

Methylprednisolone injection [HCPCS J2920]

$31
$50

38% lower than market

Methylprednisolone injection [HCPCS J2930]

$50
$59

16% lower than market

Metoclopramide hcl injection [HCPCS J2765]

$3
$34

93% lower than market

Morphine sulfate injection [HCPCS J2270]

$12
$37

68% lower than market

Omalizumab injection [HCPCS J2357]

$4
$168

98% lower than market

Oral prescrip drug non chemo [HCPCS J8499]

$3
$8

69% lower than market

Phenylephrine hcl injection [HCPCS J2370]

$22
$25

12% lower than market

Promethazine hcl injection [HCPCS J2550]

$22
$48

53% lower than market

Regadenoson injection [HCPCS J2785]

$35
$213

84% lower than market

Tetanus, diphtheria toxoids and acellular pertussis (whooping cough) vaccine for injection into muscle (7 years of age or older) [HCPCS 90715]

$197
$190

3% higher than market

Triamcinolone acet inj nos [HCPCS J3301]

$4
$10

64% lower than market

Vancomycin hcl injection [HCPCS J3370]

$12
$37

68% lower than market

Vitamin k phytonadione inj [HCPCS J3430]

$2
$19

91% lower than market

Zoledronic acid 1mg [HCPCS J3489]

$5
$120

96% lower than market

OUTPATIENT PHYSICAL/OCCUPATIONAL/SPEECH THERAPY

Description

Our Charge
Market Charge

Variance

Electrical stimulation application to 1 or more areas (each 15 minutes) [HCPCS 97032]

$100
$96

4% higher than market

Occupational therapy evaluation (typically 30 minutes) [HCPCS 97165]

$187
$186

1% higher than market

Occupational therapy evaluation (typically 45 minutes) [HCPCS 97166]

$216
$217

1% lower than market

Occupational therapy re-evaluation with established plan of care (typically 30 minutes) [HCPCS 97168]

$148
$135

10% higher than market

Physcial therapy exercise of walking training to 1 or more areas (each 15 minutes) [HCPCS 97116]

$98
$100

2% lower than market

Physical therapy evaluation (typically 20 minutes) [HCPCS 97161]

$172
$177

3% lower than market

Physical therapy evaluation (typically 30 minutes) [HCPCS 97162]

$202
$206

2% lower than market

Physical therapy evaluation (typically 45 minutes) [HCPCS 97163]

$278
$261

6% higher than market

Physical therapy re-evaluation (typically 20 minutes) [HCPCS 97164]

$142
$142

Approximately equal to market

Training activities for home and self-care management (each 15 minutes) [HCPCS 97535]

$128
$105

22% higher than market

OUTPATIENT PULMONARY THERAPY

Description

Our Charge
Market Charge

Variance

Amount and speed of breathed air measurement and graphic recording before and after medication administration [HCPCS 94060]

$719
$631

14% higher than market

Heart and blood vessel stress test with EKG tracing and monitoring (exercise or drug-induced) [HCPCS 93017]

$1,203
$1,146

5% higher than market

OUTPATIENT RESPIRATORY THERAPY

Description

Our Charge
Market Charge

Variance

Airway inhalation treatment to relieve airway obstruction or for sputum collection (inhaled pressure or nonpressure treatment) [HCPCS 94640]

$202
$199

1% higher than market

OUTPATIENT SUPPLIES

Description

Our Charge
Market Charge

Variance

Anchor/screw bn/bn,tis/bn [HCPCS C1713]

$317
$1,288

75% lower than market

Joint device (implantable) [HCPCS C1776]

$1,748
$12,299

86% lower than market

OUTPATIENT SURGICAL SERVICES

Description

Our Charge
Market Charge

Variance

Abdominal cavity fluid drainage with imaging guidance [HCPCS 49083]

$1,283
$1,696

24% lower than market

Bladder and urethra (bladder canal) examination with endoscope for diagnosis [HCPCS 52000]

$2,167
$1,808

20% higher than market

Blood or blood products transfusion [HCPCS 36430]

$1,088
$980

11% higher than market

Colorectal scrn; hi risk ind [HCPCS G0105]

$2,502
$2,344

7% higher than market

Destruction of non-cancerous skin lesions/growths other than skin tags (up to 14 lesions/growths) [HCPCS 17110]

$202
$295

32% lower than market

Foreign body, stone, or stent removal from urethra (bladder canal) or bladder with endoscope (simple) [HCPCS 52310]

$3,490
$2,830

23% higher than market

Impacted ear wax removal (one ear) [HCPCS 69210]

$451
$247

83% higher than market

Knee cartilage removal with endoscope (both knees) [HCPCS 29880]

$11,411
$8,909

28% higher than market

Large joint or joint capsule fluid removal and/or injection with needle [HCPCS 20610]

$629
$718

12% lower than market

Lower or sacral spinal facet joint nerves destruction with imaging guidance (single facet joint) [HCPCS 64635]

$7,625
$2,485

207% higher than market

Measurement of bladder capacity after voiding by ultrasound [HCPCS 51798]

$241
$195

24% higher than market

Medium joint or joint capsule fluid removal and/or injection with needle [HCPCS 20605]

$374
$1,065

65% lower than market

Needle insertion into vein for collection of blood sample [HCPCS 36415]

$29
$29

1% higher than market

Prostate laser vaporization including control of bleeding with endoscope [HCPCS 52648]

$13,757
$11,280

22% higher than market

Simple repair of wound of scalp, neck, underarms, genitalia, trunk, arms, and/or legs (2.5 cm or less) [HCPCS 12001]

$429
$480

11% lower than market

Simple repair of wound of scalp, neck, underarms, genitalia, trunk, arms, and/or legs (2.6 to 7.5 cm) [HCPCS 12002]

$459
$493

7% lower than market

Skin and tissue removal (first 20 sq cm or less) [HCPCS 11042]

$1,553
$2,231

30% lower than market

Strapping application of unna boot [HCPCS 29580]

$296
$299

1% lower than market

Tendon sheath, ligament, or muscle membrane injections [HCPCS 20550]

$178
$316

44% lower than market

Upper or middle spine facet joint injections with imaging guidance (first level) [HCPCS 64490]

$3,067
$1,198

156% higher than market

Voice box examination for diagnosis with flexible endoscope [HCPCS 31575]

$360
$428

16% lower than market

OUTPATIENT X-RAY AND RADIOLOGICAL

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 74176]

$4,206
$4,005

5% higher than market

Abdominal and pelvic CT scan without contrast, followed by contrast for injury, foreign bodies, or tumors [HCPCS 74178]

$5,366
$5,405

1% lower than market

Abdominal ultrasound (limited) [HCPCS 76705]

$744
$732

2% higher than market

Abdominal x-ray (2 views) [HCPCS 74019]

$423
$403

5% higher than market

Abdominal x-ray (single view) [HCPCS 74018]

$334
$336

Approximately equal to market

Ankle x-ray (2 views) [HCPCS 73600]

$304
$324

6% lower than market

Ankle x-ray (minimum of 3 views) [HCPCS 73610]

$364
$371

2% lower than market

Arm x-ray of upper arm (minimum of 2 views) [HCPCS 73060]

$344
$356

3% lower than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (limited, one arm or leg) [HCPCS 93971]

$1,046
$1,006

4% higher than market

Breast ultrasound (one breast, limited) [HCPCS 76642]

$467
$473

1% lower than market

Chest CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 71260]

$2,791
$2,667

5% higher than market

Chest x-ray (2 views) [HCPCS 71046]

$367
$368

Approximately equal to market

Chest x-ray (single view) [HCPCS 71045]

$300
$302

1% lower than market

CTA scan of chest blood vessels with contrast to examine injury, foreign bodies, or tumors [HCPCS 71275]

$3,354
$3,252

3% higher than market

Elbow x-ray, complete study (minimum of 3 views) [HCPCS 73080]

$365
$355

3% higher than market

Foot x-ray, complete study (minimum of 3 views) [HCPCS 73630]

$364
$368

1% lower than market

Hand x-ray (minimum of 2 views) [HCPCS 73130]

$360
$346

4% higher than market

Head and neck ultrasound [HCPCS 76536]

$716
$710

1% higher than market

Hip x-ray of hip with pelvis (2 to 3 views) [HCPCS 73502]

$347
$367

5% lower than market

Imaging of brain by MRI without contrast [HCPCS 70551]

$3,465
$3,278

6% higher than market

Imaging of heart vessels with SPECT tomography and drugs or exercise (multiple studies) [HCPCS 78452]

$5,697
$4,920

16% higher than market

Imaging of upper spinal canal by MRI without contrast [HCPCS 72141]

$3,453
$3,181

9% higher than market

Knee x-ray (1 or 2 views) [HCPCS 73560]

$340
$358

5% lower than market

Knee x-ray (3 views) [HCPCS 73562]

$410
$434

6% lower than market

Leg CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 73700]

$2,118
$2,091

1% higher than market

Pelvis ultrasound, not pregrnancy related (complete) [HCPCS 76856]

$855
$843

1% higher than market

Pelvis x-ray (1 or 2 views) [HCPCS 72170]

$364
$352

3% higher than market

Rib cage x-ray of ribs on one side of body (2 views) [HCPCS 71100]

$367
$375

2% lower than market

Shoulder x-ray, complete study (minimum of 2 views) [HCPCS 73030]

$385
$383

1% higher than market

Spinal x-ray of lower and sacral spine (2 or 3 views) [HCPCS 72100]

$441
$477

8% lower than market

Spinal x-ray of middle spine (2 views) [HCPCS 72070]

$389
$405

4% lower than market

Spinal x-ray of upper spine (2 or 3 views) [HCPCS 72040]

$389
$387

Approximately equal to market

Spinal x-ray of upper spine (4 or 5 views) [HCPCS 72050]

$534
$499

7% higher than market

Ultrasound of area behind abdominal cavity (complete) [HCPCS 76770]

$824
$830

1% lower than market

Wrist x-ray, complete study (minimum of 3 views) [HCPCS 73110]

$365
$372

2% lower than market

INPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Blood Infection with major complications

$23,096
$33,208

30% lower than market

INPATIENT PULMONOLOGY

Description

Our Charge
Market Charge

Variance

Respiratory Failure

$15,469
$29,000

47% lower than market

Respiratory infections and inflammations with major complications

$44,363
$34,303

29% higher than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Hendry Regional Medical Center for your healthcare needs. We want to make understanding and paying your bill as easy as possible. Here are some ways you can help us as we work to make the billing process go smoothly.

• Please give us complete health insurance information.

In addition to your health insurance card, we may ask for a photo ID. If you have been seen at Hendry Regional Medical Center, let us know if your personal information or insurance information has changed since your last visit.

• Please understand and follow the requirements of your health plan.

Be sure to know your benefits, obtain proper authorization for services and submit referral claim forms if necessary. Many insurance plans require patients to pay a co-payment or deductible amount. You are responsible for paying co-payments required by your insurance provider and Hendry Regional Medical Center is responsible for collecting co-payments. Please come to your appointment prepared to make your co-payment.

• Please respond promptly to any requests from your insurance provider.

You may receive multiple bills from your hospital visit, including your family doctor, specialists, physicians that read x-rays, providers that give anesthesia, or physicians that interpret blood work. Insurance benefits are the result of your contract with your insurance company. We are a third-party to those benefits and may need your help with your insurance. If your insurance plan does not pay the bill within 90 days after billing, or your claim is denied, you will receive a statement from Hendry Regional Medical Center indicating the bill is now your responsibility. All bills sent to you are due upon receipt.

Questions about Price and Billing Information

Our goal is for each of our patients and their families to have the best healthcare experience possible. Part of our commitment is to provide you with information that helps you make well informed decisions about your own care.

To ask questions or get more information about a bill for services you've received, please contact our Billing Department at 863-902-3000.

If you need more information about the price of a future service, please contact our Customer Service at 863-902-3000. A physician’s order or CPT code is strongly encouraged when you call to assist us in providing you with the most accurate estimate. You can obtain the CPT code from the ordering physician.