▸ Hospital · · CCN 010171

CHOCTAW GENERAL HOSPITAL

25 beds22

Compliance grade

89/100

Rates published

1,746

last crawl 2026-05-22

Procedures tracked

153

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals JSON

Source MRF: https://ochsner-craft.s3.amazonaws.com/core/640655993_rush-hospitalbutler-inc._standardcharges.csv_2026-03-26-185915_vatb.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychiatric diagnostic evaluation	CPT	90791	0	$615	$467.4	—	—	—
Psychiatric eval with medical services	CPT	90792	0	$615	$467.4	—	—	—
Psychotherapy 30 minutes	CPT	90832	0	$376	$285.76	—	—	—
Psychotherapy 45 minutes	CPT	90834	0	$376	$285.76	—	—	—
Psychotherapy 60 minutes	CPT	90837	0	$250	$190	—	—	—
emergency
ED visit level 1	CPT	99281	0	$275	$209	—	—	—
ED visit level 2	CPT	99282	0	$550	$418	—	—	—
ED visit level 3	CPT	99283	0	$850	$646	—	—	—
ED visit level 4	CPT	99284	0	$1,200	$912	—	—	—
ED visit level 5	CPT	99285	0	$1,500	$1,140	—	—	—
Critical care, first hour	CPT	99291	0	$1,648	$1,252.48	—	—	—
imaging
CT head without contrast	CPT	70450	0	$1,390	$1,056.4	—	—	—
CT head with contrast	CPT	70460	0	$1,860	$1,413.6	—	—	—
CT head with and without contrast	CPT	70470	0	$2,280	$1,732.8	—	—	—
CT neck with contrast	CPT	70491	0	$1,941	$1,475.16	—	—	—
MRI brain without contrast	CPT	70551	0	$2,363	$1,795.88	—	—	—
MRI brain with contrast	CPT	70552	0	$2,718	$2,065.68	—	—	—
MRI brain with and without contrast	CPT	70553	0	$3,264	$2,480.64	—	—	—
Chest X-ray single view	CPT	71045	0	$250	$190	—	—	—
Chest X-ray 2 views	CPT	71046	0	$250	$190	—	—	—
Chest X-ray 3 views	CPT	71047	0	$394	$299.44	—	—	—
CT chest without contrast	CPT	71250	0	$1,142	$867.92	—	—	—
CT chest with contrast	CPT	71260	0	$2,212	$1,681.12	—	—	—
CT chest with and without contrast	CPT	71270	0	$2,427	$1,844.52	—	—	—
MRI chest without contrast	CPT	71550	0	$2,697	$2,049.72	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$262	$199.12	—	—	—
CT cervical spine without contrast	CPT	72125	0	$1,430	$1,086.8	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$1,430	$1,086.8	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$1,430	$1,086.8	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$2,029	$1,542.04	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$2,212	$1,681.12	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$2,101	$1,596.76	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$2,417	$1,836.92	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$2,798	$2,126.48	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$2,901	$2,204.76	—	—	—
CT pelvis without contrast	CPT	72192	0	$1,142	$867.92	—	—	—
CT pelvis with contrast	CPT	72193	0	$1,941	$1,475.16	—	—	—
Shoulder X-ray	CPT	73030	0	$525	$399	—	—	—
Humerus X-ray	CPT	73060	0	$240	$182.4	—	—	—
Hand X-ray 3 views	CPT	73130	0	$479	$364.04	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$1,723	$1,309.48	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$4,760	$3,617.6	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$384	$291.84	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$524	$398.24	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$1,606	$1,220.56	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$4,768	$3,623.68	—	—	—
CT abdomen without contrast	CPT	74150	0	$1,142	$867.92	—	—	—
CT abdomen with contrast	CPT	74160	0	$1,860	$1,413.6	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$2,218	$1,685.68	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$1,540	$1,170.4	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$2,355	$1,789.8	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$2,657	$2,019.32	—	—	—
MRI abdomen without contrast	CPT	74181	0	$2,496	$1,896.96	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$3,446	$2,618.96	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$631	$479.56	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$524	$398.24	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$524	$398.24	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$524	$398.24	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$524	$398.24	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$480	$364.8	—	—	—
Transvaginal ultrasound	CPT	76830	0	$444	$337.44	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$560	$425.6	—	—	—
Scrotal ultrasound	CPT	76870	0	$444	$337.44	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$346	$262.96	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$384	$291.84	—	—	—
Screening mammography bilateral	CPT	77067	0	$355	$269.8	—	—	—
EKG complete	CPT	93000	0	$93	$70.68	—	—	—
EKG tracing only	CPT	93005	0	$250	$190	—	—	—
EKG interpretation only	CPT	93010	0	$30	$22.8	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$1,470	$1,117.2	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$108	$82.08	—	—	—
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	0	—	—	—	—	—
COPD w CC	MS-DRG	191	0	$10,981	$8,345.74	—	—	—
COPD w/o CC/MCC	MS-DRG	192	0	$12,763	$9,699.66	—	—	—
Simple pneumonia & pleurisy w CC	MS-DRG	194	0	$17,135	$13,023	—	—	—
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	0	$22,630	$17,199	—	—	—
Heart failure & shock w MCC	MS-DRG	291	0	—	—	—	—	—
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	0	$12,083	$9,182.81	—	—	—
Kidney/UTI w MCC	MS-DRG	689	0	$5,348.12	$4,064.57	—	—	—
Kidney/UTI w/o MCC	MS-DRG	690	0	$12,633	$9,601.16	—	—	—
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	0	$17,206	$13,076	—	—	—
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	0	$23,972	$18,218	—	—	—
Initial hospital care, moderate complexity	CPT	99222	0	$185	$140.6	—	—	—
Initial hospital care, high complexity	CPT	99223	0	$275	$209	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$46	$34.96	—	—	—
General health panel	CPT	80050	0	$106	$80.56	—	—	—
Electrolyte panel	CPT	80051	0	$87	$66.12	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$33	$25.08	—	—	—
Lipid panel	CPT	80061	0	$84	$63.84	—	—	—
Renal function panel	CPT	80069	0	$268	$203.68	—	—	—
Hepatic function panel	CPT	80076	0	$44	$33.44	—	—	—
Urinalysis non-automated	CPT	81002	0	$46	$34.96	—	—	—
Urinalysis automated	CPT	81003	0	$46	$34.96	—	—	—
Glucose quantitative	CPT	82947	0	$95	$72.2	—	—	—
Hemoglobin A1c	CPT	83036	0	$109.15	$82.95	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$63	$47.88	—	—	—
Complete blood count with automated differential	CPT	85025	0	$68	$51.68	—	—	—
Complete blood count without differential	CPT	85027	0	$95	$72.2	—	—	—
Urine culture bacterial	CPT	87086	0	$53	$40.28	—	—	—
Urine culture identification	CPT	87088	0	$27.5	$20.9	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$207	$157.32	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$451.36	$343.03	—	—	—
Vaginal delivery only	CPT	59409	0	$2,080	$1,580.8	—	—	—
office
Office visit, new patient, 15-29 min	CPT	99202	0	$259	$196.84	—	—	—
Office visit, new patient, 30-44 minutes	CPT	99203	0	$276	$209.76	—	—	—
Office visit, new patient, 45-59 min	CPT	99204	0	$414	$314.64	—	—	—
Office visit, new patient, 60-74 min	CPT	99205	0	$454	$345.04	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$310.82	$236.22	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$201	$152.76	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$256	$194.56	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$445.82	$338.82	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$431	$327.56	—	—	—
preventive
Upper GI endoscopy diagnostic	CPT	43235	0	$2,189.1	$1,663.72	—	—	—
Upper GI endoscopy with biopsy	CPT	43239	0	$2,278.5	$1,731.66	—	—	—
Sigmoidoscopy diagnostic	CPT	45330	0	$1,117.34	$849.18	—	—	—
Sigmoidoscopy with biopsy	CPT	45331	0	$1,511	$1,148.36	—	—	—
Colonoscopy diagnostic	CPT	45378	0	$1,864.5	$1,417.02	—	—	—
Colonoscopy with biopsy	CPT	45380	0	$1,938.2	$1,473.03	—	—	—
Colonoscopy with polyp removal	CPT	45385	0	$2,614.3	$1,986.87	—	—	—
surgery
Total shoulder arthroplasty	CPT	23472	0	—	—	—	—	—
Hip hemiarthroplasty	CPT	27125	0	—	—	—	—	—
Total hip replacement	CPT	27130	0	—	—	—	—	—
Total knee replacement	CPT	27447	0	—	—	—	—	—
Knee revision arthroplasty single component	CPT	27486	0	—	—	—	—	—
Knee revision arthroplasty all components	CPT	27487	0	—	—	—	—	—
Shoulder arthroscopy with decompression	CPT	29826	0	—	—	—	—	—
Shoulder arthroscopy with rotator cuff repair	CPT	29827	0	—	—	—	—	—
Knee arthroscopy with meniscectomy	CPT	29881	0	—	—	—	—	—
ACL reconstruction	CPT	29888	0	—	—	—	—	—
CABG single arterial graft	CPT	33533	0	—	—	—	—	—
CABG 2 arterial grafts	CPT	33534	0	—	—	—	—	—
CABG 3 arterial grafts	CPT	33535	0	—	—	—	—	—
CABG 4+ arterial grafts	CPT	33536	0	—	—	—	—	—
Open appendectomy	CPT	44950	0	—	—	—	—	—
Laparoscopic appendectomy	CPT	44970	0	—	—	—	—	—
Laparoscopic cholecystectomy	CPT	47562	0	$2,635	$2,002.6	—	—	—
Lap cholecystectomy with cholangiography	CPT	47563	0	—	—	—	—	—
Lap inguinal hernia repair	CPT	49650	0	—	—	—	—	—
Total abdominal hysterectomy	CPT	58150	0	$2,917	$2,216.92	—	—	—
Vaginal hysterectomy	CPT	58260	0	—	—	—	—	—
Lap-assisted vaginal hysterectomy	CPT	58550	0	—	—	—	—	—
Lap-assisted vaginal hysterectomy >250g	CPT	58552	0	—	—	—	—	—
Lap salpingo-oophorectomy	CPT	58661	0	—	—	—	—	—
Complex cataract surgery	CPT	66982	0	—	—	—	—	—
Cataract surgery with lens implant	CPT	66984	0	—	—	—	—	—
Intravitreal injection	CPT	67028	0	$1,100	$836	—	—	—
Vitrectomy mechanical	CPT	67042	0	—	—	—	—	—
PCI single major coronary artery	CPT	92920	0	—	—	—	—	—
PCI with drug-eluting stent	CPT	92928	0	—	—	—	—	—
PCI bypass graft	CPT	92937	0	—	—	—	—	—
Left heart catheterization	CPT	93452	0	—	—	—	—	—
Coronary angiography with cath	CPT	93455	0	—	—	—	—	—
Coronary angiography with bypass cath	CPT	93458	0	—	—	—	—	—

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