▸ Hospital · SC · CCN 420105

Mcleod Loris Hospital

3655 MITCHELL STREET, LORIS, SC, 420105

Compliance grade

86/100

Rates published

762

last crawl 2026-05-24

Procedures tracked

162

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All SC hospitals JSON

Source MRF: https://www.mcleodhealth.org/wp-content/uploads/price-transparency/45-3576100_mcleod-health-loris_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	0	—	—	—	—	—
Psychotherapy 30 minutes	CPT	90832	0	$218	$154.78	—	—	—
emergency
ED visit level 1	CPT	99281	0	$607	$430.97	—	—	—
ED visit level 2	CPT	99282	0	$667	$473.57	—	—	—
ED visit level 3	CPT	99283	0	$1,431	$1,016.01	—	—	—
ED visit level 4	CPT	99284	0	$2,119	$1,504.49	—	—	—
ED visit level 5	CPT	99285	0	$3,292	$2,337.32	—	—	—
Critical care, first hour	CPT	99291	0	$4,521	$3,209.91	—	—	—
imaging
CT head without contrast	CPT	70450	0	$2,727	$1,936.17	—	—	—
CT head with contrast	CPT	70460	0	$3,189	$2,264.19	—	—	—
CT head with and without contrast	CPT	70470	0	$3,510	$2,492.1	—	—	—
CT neck with contrast	CPT	70491	0	$3,375	$2,396.25	—	—	—
MRI brain without contrast	CPT	70551	0	$4,475	$3,177.25	—	—	—
MRI brain with contrast	CPT	70552	0	$4,905	$3,482.55	—	—	—
MRI brain with and without contrast	CPT	70553	0	$6,115	$4,341.65	—	—	—
Chest X-ray single view	CPT	71045	0	$294	$208.74	—	—	—
Chest X-ray 2 views	CPT	71046	0	$357	$253.47	—	—	—
Chest X-ray 3 views	CPT	71047	0	$404	$286.84	—	—	—
CT chest without contrast	CPT	71250	0	$3,255	$2,311.05	—	—	—
CT chest with contrast	CPT	71260	0	$3,903	$2,771.13	—	—	—
CT chest with and without contrast	CPT	71270	0	$4,482	$3,182.22	—	—	—
MRI chest without contrast	CPT	71550	0	$3,592	$2,550.32	—	—	—
MRI chest with and without contrast	CPT	71552	0	$4,528	$3,214.88	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$711	$504.81	—	—	—
CT cervical spine without contrast	CPT	72125	0	$3,282	$2,330.22	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$2,869	$2,036.99	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$3,186	$2,262.06	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$4,658	$3,307.18	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$3,045	$2,161.95	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$4,737	$3,363.27	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$5,651	$4,012.21	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$6,649	$4,720.79	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$6,567	$4,662.57	—	—	—
CT pelvis without contrast	CPT	72192	0	$2,993	$2,125.03	—	—	—
CT pelvis with contrast	CPT	72193	0	$3,530	$2,506.3	—	—	—
Shoulder X-ray	CPT	73030	0	$642	$455.82	—	—	—
Humerus X-ray	CPT	73060	0	$368	$261.28	—	—	—
Hand X-ray 3 views	CPT	73130	0	$684	$485.64	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$5,113	$3,630.23	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$6,387	$4,534.77	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$460	$326.6	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$615	$436.65	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$5,002	$3,551.42	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$6,486	$4,605.06	—	—	—
CT abdomen without contrast	CPT	74150	0	$3,458	$2,455.18	—	—	—
CT abdomen with contrast	CPT	74160	0	$3,975	$2,822.25	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$4,834	$3,432.14	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$5,767	$4,094.57	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$6,811	$4,835.81	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$8,275	$5,875.25	—	—	—
MRI abdomen without contrast	CPT	74181	0	$4,896	$3,476.16	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$6,546	$4,647.66	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$1,811	$1,285.81	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$1,320	$937.2	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$792	$562.32	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$1,088	$772.48	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$1,500	$1,065	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$1,633	$1,159.43	—	—	—
Transvaginal ultrasound	CPT	76830	0	$1,090	$773.9	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$1,245	$883.95	—	—	—
Scrotal ultrasound	CPT	76870	0	$941	$668.11	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$472	$335.12	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$585	$415.35	—	—	—
Screening mammography bilateral	CPT	77067	0	$414	$293.94	—	—	—
EKG tracing only	CPT	93005	0	$498	$353.58	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$2,368	$1,681.28	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$1,407	$998.97	—	—	—
Stress echocardiogram	CPT	93350	0	$1,834	$1,302.14	—	—	—
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	0	—	—	—	—	—
COPD w MCC	MS-DRG	190	0	—	—	—	—	—
COPD w CC	MS-DRG	191	0	—	—	—	—	—
COPD w/o CC/MCC	MS-DRG	192	0	—	—	—	—	—
Simple pneumonia & pleurisy w CC	MS-DRG	194	0	—	—	—	—	—
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	0	—	—	—	—	—
AMI discharged alive w MCC	MS-DRG	280	0	—	—	—	—	—
AMI discharged alive w CC	MS-DRG	281	0	—	—	—	—	—
AMI discharged alive w/o CC/MCC	MS-DRG	282	0	—	—	—	—	—
Heart failure & shock w MCC	MS-DRG	291	0	—	—	—	—	—
Heart failure & shock w CC	MS-DRG	292	0	—	—	—	—	—
Heart failure & shock w/o CC/MCC	MS-DRG	293	0	—	—	—	—	—
Cardiac arrhythmia w MCC	MS-DRG	308	0	—	—	—	—	—
Cardiac arrhythmia w CC	MS-DRG	309	0	—	—	—	—	—
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	0	—	—	—	—	—
GI hemorrhage w CC	MS-DRG	378	0	—	—	—	—	—
GI hemorrhage w/o CC/MCC	MS-DRG	379	0	—	—	—	—	—
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	0	—	—	—	—	—
Fractures of femur w/o MCC	MS-DRG	533	0	—	—	—	—	—
Kidney/UTI w MCC	MS-DRG	689	0	—	—	—	—	—
Kidney/UTI w/o MCC	MS-DRG	690	0	—	—	—	—	—
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	0	—	—	—	—	—
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	0	—	—	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$313	$222.23	—	—	—
Electrolyte panel	CPT	80051	0	$146	$103.66	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$366	$259.86	—	—	—
Lipid panel	CPT	80061	0	$165	$117.15	—	—	—
Renal function panel	CPT	80069	0	$193	$137.03	—	—	—
Hepatic function panel	CPT	80076	0	$285	$202.35	—	—	—
Urinalysis non-automated	CPT	81002	0	$65	$46.15	—	—	—
Urinalysis automated	CPT	81003	0	$129	$91.59	—	—	—
Glucose quantitative	CPT	82947	0	$67	$47.57	—	—	—
Hemoglobin A1c	CPT	83036	0	$122	$86.62	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$197	$139.87	—	—	—
Complete blood count with automated differential	CPT	85025	0	$171	$121.41	—	—	—
Complete blood count without differential	CPT	85027	0	$123	$87.33	—	—	—
Urine culture bacterial	CPT	87086	0	$144	$102.24	—	—	—
Urine culture identification	CPT	87088	0	$115	$81.65	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$617	$438.07	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$817	$580.07	—	—	—
Vaginal delivery only	CPT	59409	0	$8,311	$5,900.81	—	—	—
office
Office visit, new patient, 15-29 min	CPT	99202	0	$426	$302.46	—	—	—
Office visit, new patient, 30-44 minutes	CPT	99203	0	$552	$391.92	—	—	—
Office visit, new patient, 45-59 min	CPT	99204	0	$697	$494.87	—	—	—
Office visit, new patient, 60-74 min	CPT	99205	0	$999	$709.29	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$344	$244.24	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$364	$258.44	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$426	$302.46	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$552	$391.92	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$697	$494.87	—	—	—
preventive
Upper GI endoscopy diagnostic	CPT	43235	0	—	—	—	—	—
Upper GI endoscopy with biopsy	CPT	43239	0	—	—	—	—	—
Sigmoidoscopy diagnostic	CPT	45330	0	—	—	—	—	—
Sigmoidoscopy with biopsy	CPT	45331	0	—	—	—	—	—
Colonoscopy diagnostic	CPT	45378	0	—	—	—	—	—
Colonoscopy with biopsy	CPT	45380	0	—	—	—	—	—
Colonoscopy with polyp removal	CPT	45385	0	—	—	—	—	—
surgery
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	—	—	—	—	—
Major small/large bowel procedures w MCC	MS-DRG	329	0	—	—	—	—	—
Major small/large bowel procedures w CC	MS-DRG	330	0	—	—	—	—	—
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	0	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	0	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	0	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	0	—	—	—	—	—
Laparoscopic appendectomy	CPT	44970	0	—	—	—	—	—
Major joint replacement w MCC	MS-DRG	469	0	—	—	—	—	—
Major joint replacement w/o MCC	MS-DRG	470	0	—	—	—	—	—
Laparoscopic cholecystectomy	CPT	47562	0	—	—	—	—	—
Lap cholecystectomy with cholangiography	CPT	47563	0	—	—	—	—	—
Hip & femur procedures except major joint w MCC	MS-DRG	480	0	—	—	—	—	—
Hip & femur procedures except major joint w CC	MS-DRG	481	0	—	—	—	—	—
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	0	—	—	—	—	—
Lap inguinal hernia repair	CPT	49650	0	—	—	—	—	—
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	—	—	—	—	—
OR procedure for obesity w MCC	MS-DRG	619	0	—	—	—	—	—
OR procedure for obesity w CC	MS-DRG	620	0	—	—	—	—	—
OR procedure for obesity w/o CC/MCC	MS-DRG	621	0	—	—	—	—	—
Complex cataract surgery	CPT	66982	0	—	—	—	—	—
Cataract surgery with lens implant	CPT	66984	0	—	—	—	—	—
Intravitreal injection	CPT	67028	0	$1,111	$788.81	—	—	—
Vitrectomy mechanical	CPT	67042	0	—	—	—	—	—
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	0	—	—	—	—	—
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	0	—	—	—	—	—
PCI single major coronary artery	CPT	92920	0	$24,276	$17,236	—	—	—
PCI bypass graft	CPT	92937	0	$37,656	$26,736	—	—	—
Left heart catheterization	CPT	93452	0	$14,920	$10,593	—	—	—
Coronary angiography with cath	CPT	93455	0	$18,697	$13,275	—	—	—
Coronary angiography with bypass cath	CPT	93458	0	$19,828	$14,078	—	—	—

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

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