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Southwell Medical, A Campus Of Trmc
Adel, GA · CMS ID: 110101
This hospital has pricing data for 35 procedures ranging from $1 to $15,511.
Procedures (35)
Chest X-Ray 1 View
71045Cash Price
(No Insurance)
$518
Gross Charge
$596
Medicare Rate
$24
Insurance Negotiated Rates
$548.19$548
Chest X-Ray 2 Views
71046Cash Price
(No Insurance)
$271
Gross Charge
$311
Medicare Rate
$31
Insurance Negotiated Rates
$286.52$287
Cash Price
(No Insurance)
$54
Gross Charge
$61
Insurance Negotiated Rates
$56.57$57
Cash Price
(No Insurance)
$42
Gross Charge
$49
Insurance Negotiated Rates
$9.03$9
Cash Price
(No Insurance)
$4,642
Gross Charge
$5,336
Medicare Rate
$280
Insurance Negotiated Rates
$4,908.94$4,909
Cash Price
(No Insurance)
$2,967
Gross Charge
$3,411
Medicare Rate
$172
Insurance Negotiated Rates
$3,137.75$3,138
CT Chest Low Dose
71271Cash Price
(No Insurance)
$5,274
Gross Charge
$6,062
Medicare Rate
$128
Insurance Negotiated Rates
$5,577.04$5,577
Cash Price
(No Insurance)
$2,060
Gross Charge
$2,368
Medicare Rate
$156
Insurance Negotiated Rates
$2,178.10$2,178
ER Visit Level 3
99283Cash Price
(No Insurance)
$380
Gross Charge
$437
Medicare Rate
$69
Insurance Negotiated Rates
$401.66$402
ER Visit Level 4
99284Cash Price
(No Insurance)
$658
Gross Charge
$757
Medicare Rate
$117
Insurance Negotiated Rates
$696.22$696
ER Visit Level 5
99285Cash Price
(No Insurance)
$875
Gross Charge
$1,006
Medicare Rate
$170
Insurance Negotiated Rates
$925.21$925
Cash Price
(No Insurance)
$430
Gross Charge
$494
Medicare Rate
$48
Insurance Negotiated Rates
$454.52$455
Hip Replacement
27130Cash Price
(No Insurance)
$118
Gross Charge
$136
Medicare Rate
$1,129
Insurance Negotiated Rates
$124.89$125
Knee Arthroscopy
29881Cash Price
(No Insurance)
$939
Gross Charge
$1,079
Medicare Rate
$495
Insurance Negotiated Rates
$992.91$993
Knee Replacement
27447Cash Price
(No Insurance)
$3,476
Gross Charge
$3,996
Medicare Rate
$1,127
Insurance Negotiated Rates
$3,676.06$3,676
Knee X-Ray
73560Cash Price
(No Insurance)
$4,191
Gross Charge
$4,817
Medicare Rate
$32
Insurance Negotiated Rates
$86.80$87
Mammogram Diagnostic
77066Cash Price
(No Insurance)
$2,774
Gross Charge
$3,189
Medicare Rate
$146
Insurance Negotiated Rates
$4.09$4
Mammogram Screening
77067Cash Price
(No Insurance)
$3,762
Gross Charge
$4,324
Medicare Rate
$118
Insurance Negotiated Rates
$10.81$11
MRI Brain
70551Cash Price
(No Insurance)
$20
Gross Charge
$24
Medicare Rate
$183
Insurance Negotiated Rates
$0.30$0
Cash Price
(No Insurance)
$1
Gross Charge
$1
Medicare Rate
$296
Insurance Negotiated Rates
$0.87$1
MRI Cervical Spine
72141Cash Price
(No Insurance)
$2,456
Gross Charge
$2,823
Medicare Rate
$179
Insurance Negotiated Rates
$2,596.89$2,597
MRI Knee
73721Cash Price
(No Insurance)
$2,456
Gross Charge
$2,823
Medicare Rate
$191
Insurance Negotiated Rates
$2,596.89$2,597
MRI Lumbar Spine
72148Cash Price
(No Insurance)
$2,456
Gross Charge
$2,823
Medicare Rate
$180
Insurance Negotiated Rates
$2,596.89$2,597
MRI Shoulder
73221Cash Price
(No Insurance)
$919
Gross Charge
$1,056
Medicare Rate
$191
Insurance Negotiated Rates
$69.22$69
Office Visit Level 3
99213Cash Price
(No Insurance)
$309
Gross Charge
$355
Medicare Rate
$91
Insurance Negotiated Rates
$326.31$326
Office Visit Level 4
99214Cash Price
(No Insurance)
$549
Gross Charge
$630
Medicare Rate
$130
Insurance Negotiated Rates
$580.03$580
Shoulder X-Ray
73030Cash Price
(No Insurance)
$15,511
Gross Charge
$17,829
Medicare Rate
$33
Insurance Negotiated Rates
$97.38$97
Ultrasound Abdomen
76700Cash Price
(No Insurance)
$6,455
Gross Charge
$7,419
Medicare Rate
$107
Insurance Negotiated Rates
$1,292.11$1,292
Ultrasound Pelvis
76856Cash Price
(No Insurance)
$703
Gross Charge
$808
Medicare Rate
$98
Insurance Negotiated Rates
$743.33$743
Cash Price
(No Insurance)
$757
Gross Charge
$870
Medicare Rate
$109
Insurance Negotiated Rates
$800.16$800
Cash Price
(No Insurance)
$1,013
Gross Charge
$1,164
Medicare Rate
$301
Insurance Negotiated Rates
$1,070.94$1,071