▸ Hospital · TX · CCN 450411
Eastland Memorial Hospital
304 S DAUGHTERY, EASTLAND, TX, 76448-
19 beds11
Compliance grade
A
93/100
Procedures tracked
97
of 209 target codes
Payers
3
with negotiated rates
Rates published
1,088
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychiatric diagnostic evaluation | CPT | 90791 | 3 | $217 | $109 | $135 | $155.5 | $195 |
| Psychiatric eval with medical services | CPT | 90792 | 3 | $241 | $121 | $149 | $172.5 | $217 |
| Psychotherapy 30 minutes | CPT | 90832 | 3 | $106 | $53 | $66 | $76 | $95 |
| Psychotherapy 45 minutes | CPT | 90834 | 3 | $141 | $71 | $87 | $101 | $127 |
| Psychotherapy 60 minutes | CPT | 90837 | 3 | $211 | $106 | $131 | $150.5 | $190 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 3 | $221 | $111 | $137 | $158 | $199 |
| emergency | ||||||||
| ED visit level 4 | CPT | 99284 | 3 | $1,081 | $541 | $670 | $773 | $973 |
| ED visit level 5 | CPT | 99285 | 3 | $1,576 | $788 | $977 | $1,127 | $1,418 |
| Critical care, first hour | CPT | 99291 | 3 | $2,220 | $1,110 | $1,376 | $1,587.5 | $1,998 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 3 | $981 | $491 | $608 | $701.5 | $883 |
| CT head with contrast | CPT | 70460 | 3 | $1,247 | $624 | $773 | $891.5 | $1,122 |
| CT head with and without contrast | CPT | 70470 | 3 | $1,403 | $702 | $870 | $1,003 | $1,263 |
| CT neck with contrast | CPT | 70491 | 3 | $1,277 | $639 | $792 | $913 | $1,149 |
| MRI brain without contrast | CPT | 70551 | 3 | $1,794 | $897 | $1,112 | $1,283 | $1,615 |
| MRI brain with contrast | CPT | 70552 | 3 | $1,830 | $915 | $1,135 | $1,308.5 | $1,647 |
| MRI brain with and without contrast | CPT | 70553 | 3 | $3,122 | $1,561 | $1,936 | $2,232.5 | $2,810 |
| Chest X-ray single view | CPT | 71045 | 3 | $215 | $108 | $133 | $153.5 | $194 |
| Chest X-ray 2 views | CPT | 71046 | 3 | $244 | $122 | $151 | $174.5 | $220 |
| Chest X-ray 3 views | CPT | 71047 | 3 | $187 | $94 | $116 | $133.5 | $168 |
| CT chest without contrast | CPT | 71250 | 3 | $1,153 | $577 | $715 | $824.5 | $1,038 |
| CT chest with contrast | CPT | 71260 | 3 | $1,337 | $669 | $829 | $956 | $1,203 |
| CT chest with and without contrast | CPT | 71270 | 3 | $1,488 | $744 | $923 | $1,064 | $1,339 |
| Lumbosacral spine X-ray | CPT | 72100 | 3 | $388 | $194 | $241 | $277.5 | $349 |
| CT cervical spine without contrast | CPT | 72125 | 3 | $1,158 | $579 | $718 | $828 | $1,042 |
| CT thoracic spine without contrast | CPT | 72128 | 3 | $1,007 | $504 | $624 | $720 | $906 |
| CT lumbar spine without contrast | CPT | 72131 | 3 | $1,007 | $504 | $624 | $720 | $906 |
| MRI cervical spine without contrast | CPT | 72141 | 3 | $1,794 | $897 | $1,112 | $1,283 | $1,615 |
| MRI thoracic spine without contrast | CPT | 72146 | 3 | $1,766 | $883 | $1,095 | $1,263 | $1,589 |
| MRI lumbar spine without contrast | CPT | 72148 | 3 | $1,794 | $897 | $1,112 | $1,283 | $1,615 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 3 | $1,855 | $928 | $1,150 | $1,326 | $1,670 |
| MRI cervical spine with and without contrast | CPT | 72156 | 3 | $3,118 | $1,559 | $1,933 | $2,229.5 | $2,806 |
| MRI lumbar spine with contrast | CPT | 72158 | 3 | $3,122 | $1,561 | $1,936 | $2,232.5 | $2,810 |
| CT pelvis without contrast | CPT | 72192 | 3 | $894 | $447 | $554 | $639.5 | $805 |
| CT pelvis with contrast | CPT | 72193 | 3 | $1,266 | $633 | $785 | $905.5 | $1,139 |
| Shoulder X-ray | CPT | 73030 | 3 | $215 | $108 | $133 | $153.5 | $194 |
| Humerus X-ray | CPT | 73060 | 3 | $218 | $109 | $116 | $144 | $196 |
| Hand X-ray 3 views | CPT | 73130 | 3 | $388 | $194 | $241 | $277.5 | $349 |
| MRI upper extremity joint without contrast | CPT | 73221 | 3 | $1,794 | $897 | $1,112 | $1,283 | $1,615 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 3 | $1,863 | $932 | $1,155 | $1,332 | $1,677 |
| Knee X-ray 1-2 views | CPT | 73560 | 3 | $218 | $109 | $116 | $144 | $196 |
| Ankle X-ray 3 views | CPT | 73610 | 3 | $224 | $112 | $116 | $146 | $202 |
| MRI lower extremity joint without contrast | CPT | 73721 | 3 | $1,794 | $897 | $1,112 | $1,283 | $1,615 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 3 | $2,079 | $1,040 | $1,289 | $1,486.5 | $1,871 |
| CT abdomen without contrast | CPT | 74150 | 3 | $1,025 | $513 | $636 | $733 | $923 |
| CT abdomen with contrast | CPT | 74160 | 3 | $1,371 | $686 | $850 | $980 | $1,234 |
| CT abdomen with and without contrast | CPT | 74170 | 3 | $1,547 | $774 | $959 | $1,106 | $1,392 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 3 | $1,597 | $799 | $990 | $1,142 | $1,437 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 3 | $1,712 | $856 | $1,061 | $1,224 | $1,541 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 3 | $1,563 | $782 | $969 | $1,117.5 | $1,407 |
| MRI abdomen without contrast | CPT | 74181 | 3 | $1,794 | $897 | $1,112 | $1,283 | $1,615 |
| MRI abdomen with and without contrast | CPT | 74183 | 3 | $2,079 | $1,040 | $1,289 | $1,486.5 | $1,871 |
| Abdominal ultrasound complete | CPT | 76700 | 3 | $338 | $169 | $210 | $242 | $304 |
| Abdominal ultrasound limited | CPT | 76705 | 3 | $388 | $194 | $241 | $277.5 | $349 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 3 | $338 | $169 | $210 | $242 | $304 |
| Obstetric ultrasound first trimester | CPT | 76801 | 3 | $185 | $93 | $115 | $132.5 | $167 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 3 | $331 | $166 | $131 | $198 | $298 |
| Transvaginal ultrasound | CPT | 76830 | 3 | $338 | $169 | $115 | $188.5 | $304 |
| Pelvic ultrasound complete | CPT | 76856 | 3 | $338 | $169 | $103 | $179.5 | $304 |
| Scrotal ultrasound | CPT | 76870 | 3 | $338 | $169 | $210 | $242 | $304 |
| Diagnostic mammography unilateral | CPT | 77065 | 3 | $134 | $67 | $83 | $96 | $121 |
| Diagnostic mammography bilateral | CPT | 77066 | 3 | $148 | $74 | $83 | $101 | $133 |
| Screening mammography bilateral | CPT | 77067 | 3 | $113 | $57 | $70 | $81 | $102 |
| EKG complete | CPT | 93000 | 3 | $51 | $26 | $32 | $36.5 | $46 |
| EKG tracing only | CPT | 93005 | 3 | $224 | $112 | $82 | $125.5 | $202 |
| Transthoracic echocardiogram complete | CPT | 93306 | 3 | $1,716 | $858 | $1,064 | $1,227 | $1,544 |
| inpatient | ||||||||
| Initial hospital care, low complexity | CPT | 99221 | 3 | $66 | $33 | $41 | $47.5 | $59 |
| Initial hospital care, moderate complexity | CPT | 99222 | 3 | $105 | $53 | $65 | $75 | $95 |
| Initial hospital care, high complexity | CPT | 99223 | 3 | $133 | $67 | $82 | $95 | $120 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 3 | $170 | $85 | $105 | $122 | $153 |
| Electrolyte panel | CPT | 80051 | 3 | $124 | $62 | $77 | $88.5 | $112 |
| Comprehensive metabolic panel | CPT | 80053 | 3 | $276 | $138 | $171 | $197.5 | $248 |
| Lipid panel | CPT | 80061 | 3 | $110 | $55 | $68 | $79 | $99 |
| Renal function panel | CPT | 80069 | 3 | $148 | $74 | $92 | $106 | $133 |
| Hepatic function panel | CPT | 80076 | 3 | $168 | $84 | $104 | $120 | $151 |
| Urinalysis automated | CPT | 81003 | 3 | $60 | $30 | $2 | $6.5 | $54 |
| Glucose quantitative | CPT | 82947 | 3 | $95 | $48 | $9 | $36 | $86 |
| Hemoglobin A1c | CPT | 83036 | 3 | $70 | $35 | $24 | $38.5 | $63 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 3 | $128 | $64 | $79 | $91.5 | $115 |
| Complete blood count with automated differential | CPT | 85025 | 3 | $77 | $39 | $7 | $29.5 | $69 |
| Complete blood count without differential | CPT | 85027 | 3 | $53 | $27 | $33 | $38 | $48 |
| Urine culture bacterial | CPT | 87086 | 3 | $100 | $50 | $62 | $71.5 | $90 |
| Tissue exam by pathologist level IV | CPT | 88305 | 3 | $172 | $86 | $107 | $123 | $155 |
| maternity | ||||||||
| Vaginal delivery only | CPT | 59409 | 3 | $5,575 | $2,788 | $3,457 | $3,986 | $5,018 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 3 | $150 | $75 | $93 | $107.5 | $135 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 3 | $240 | $120 | $149 | $171.5 | $216 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 3 | $363 | $182 | $225 | $259.5 | $327 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 3 | $485 | $243 | $301 | $347 | $437 |
| Office visit, established patient, 5 min | CPT | 99211 | 3 | $273 | $137 | $20 | $66.5 | $246 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 3 | $80 | $40 | $50 | $57 | $72 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 3 | $130 | $65 | $81 | $93 | $117 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 3 | $182 | $91 | $113 | $130.5 | $164 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 3 | $256 | $128 | $159 | $183 | $230 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 3 | $3,800 | $1,900 | $2,356 | $2,717 | $3,420 |
| Colonoscopy diagnostic | CPT | 45378 | 3 | $3,800 | $1,900 | $2,356 | $2,717 | $3,420 |
| surgery | ||||||||
| Laparoscopic cholecystectomy | CPT | 47562 | 3 | $10,550 | $5,275 | $6,541 | $7,543.5 | $9,495 |
| Lap inguinal hernia repair | CPT | 49650 | 3 | $2,387 | $1,194 | $1,480 | $1,706.5 | $2,148 |
| Cataract surgery with lens implant | CPT | 66984 | 3 | $3,987 | $1,994 | $2,472 | $2,850.5 | $3,588 |
Payer mix (top 3)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 97 | $183 |
| scott and whte | 97 | $225 |
| UnitedHealthcare | 97 | $159 |