Hospital pricing can be very complex and frustrating. For the most part, patients have remained in the dark about what they will be asked to pay for healthcare services until after the services have been provided. At NCMC, we aspire to bring this information to you prior to your services and explain how healthcare pricing works. Please visit the links below for detailed information our pricing. If you would like pricing on additional services, please contact us at (208) 934-8764.
Prices show the following;
Facility Fee – The charge for the use of a facility and equipment.
Professional Fee – The charge associated to the physician’s time and expertise.
Current Procedural Terminology (CPT) Code – The standard codes used by medical professionals to document and report medical services to insurance companies.
Service Description – The description tied to each CPT code that explains the service/exam provided.
While we offer hundreds of lab tests, this is a list of our most commonly ordered. If you need additional pricing, please contact us at (208) 934-8764.
Collection Fee – With each visit for blood work, a $19.00 collection fee is added to the visit to account for staff time and supplies needed to draw your blood. The charge is per visit, not per test.
| CPT CODE | SERVICE DESCRIPTION | FACILITY FEE |
| 80048 | Basic Metabolic Panel | $53.00 |
| 80053 | Comprehensive Metabolic Panel 1 | $66.00 |
| 80061 | Lipid Panel 1 | $83.00 |
| 82550 | Creatine Kinase | $47.30 |
| 82553 | Creatine Kinase-MB | $75.00 |
| 83036 | Hemoglobin A1c 1 | $60.00 |
| 83605 | Lactic Acid | $80.00 |
| 83690 | Lipase Level | $45.00 |
| 83880 | N-Terminal pro B-Type Natriuretic Peptide | $200.00 |
| 84153 | Prostate Specific Antigen (PSA) | $114.00 |
| 84403 | Testosterone | $ 108.00 |
| 84439 | Free T4 | $46.20 |
| 84443 | Thyroid Stimulating Hormone | $104.00 |
| 84484 | Troponin | $65.00 |
| 85025 | Complete Blood Count w/ Auto Diff 4 | $48.00 |
| 85027 | Hemogram 2 | $40.00 |
| 85610 | PT/INR | $25.00 |
| 86140 | C-Reactive Protein | $30.00 |
| 87040 | Blood Culture | $74.80 |
EKG Interpretation Fee – With each EKG, an interpretation fee of $54.00 is added to the exam to have a physician read the results.
| CPT CODE | SERVICE DESCRIPTION | FACILITY FEE |
| 93005 | EKG 12-Lead (Lab) | $ 300.00 |
Urinalysis
| CPT CODE | SERVICE DESCRIPTION | FACILITY FEE |
| 81000 | Urinalysis (UA) | $ 20.00 |
| 81015 | Urinalysis Microscopic 1 | $ 20.00 |
Level Visits are determined by the complexity of diagnosis and time spent with the provider.
| CPT CODE | SERVICE DESCRIPTION | VISIT FEE |
| 99201 | New Visit Level 1 | $ 80.00 |
| 99202 | New Visit Level 2 | $ 125.00 |
| 99203 | New Visit Level 3 | $ 176.00 |
| 99204 | New Visit Level 4 | $ 270.00 |
| 99205 | New Visit Level 5 | $ 300.00 |
| 99211 | Established Visit Level 1 | $ 75.00 |
| 99212 | Established Visit Level 2 | $ 90.00 |
| 99213 | Established Visit Level 3 | $ 125.00 |
| 99214 | Established Visit Level 4 | $ 180.00 |
| 99215 | Established Visit Level 5 | $ 240.00 |
With so many imaging procedures, we have captured our most common and provided a break down of the pricing. It is important to know when pricing imaging tests, to verify if the radiologist (professional) fee has been included in the price. In our pricing we have listed the radiologist (professional fee) separate.
| CPT CODE | SERVICE DESCRIPTION | FACILITY FEE | PROFESSIONAL FEE |
| 23350 | MRI Injection for Arthrography | $600.00 | $330.00 |
| 70543 | MRI Face Neck Orbit | $2,641.00 | $695.00 |
| 70546 | MRI Head | $2,525.00 | $250.00 |
| 70551 | MRI Brain | $1,717.00 | $376.00 |
| 70553 | MRI Brain | $2,561.00 | $300.00 |
| 71550 | MRI Chest | $2,145.00 | $581.00 |
| 72141 | MRI Spine Cervical | $1,700.00 | $458.00 |
| 72146 | MRI Spine Thoracic | $1,700.00 | $475.00 |
| 72148 | MRI Spine Lumbar | $1,800.00 | $225.00 |
| 72156 | MRI Spine Cervical | $2,404.00 | $641.00 |
| 72158 | MRI Spine Lumbar | $2,508.00 | $500.00 |
| 72195 | MRI Pelvis | $1,652.00 | $468.00 |
| 72197 | MRI Pelvis | $2,500.00 | $270.00 |
| 73221 | MRI UE Joint | $1,700.00 | $312.00 |
| 73222 | MRI UE Joint | $1,811.00 | $505.00 |
| 73223 | MRI UE Joint | $1,922.00 | $641.00 |
| 73718 | MRI LE Non Joint | $1,500.00 | $565.00 |
| 73720 | MRI LE Non Joint | $2,256.00 | $883.00 |
| 73721 | MRI LE Joint | $1,500.00 | $305.00 |
| 73722 | MRI LE Joint | $1,755.00 | $351.00 |
| 73723 | MRI LE Joint | $2,106.00 | $421.00 |
| 74181 | MRI Abdomen | $1,832.00 | $355.00 |
| 74183 | MRI Abdomen | $2,500.00 | $713.00 |
With so many imaging procedures, we have captured our most common and provided a break down of the pricing. It is important to know when pricing imaging tests, to verify if the radiologist (professional) fee has been included in the price. In our pricing we have listed the radiologist (professional fee) separate.
| CPT CODE | SERVICE DESCRIPTION | FACILITY FEE | PROFESSIONAL FEE |
| 19083 | US Biopsy Breast | $2,752.00 | $485.00 |
| 19084 | US Biopsy Breast Addl Lesion | $1,400.00 | $155.00 |
| 60100 | US Core Needle Biopsy of Thyroid | $800.00 | $80.00 |
| 76536 | US Head/Neck Soft Tissue | $450.00 | $124.00 |
| 76641 | US Breast Complete | $500.00 | $100.00 |
| 76642 | US Breast Limited | $271.00 | $84.00 |
| 76700 | US Abdomen Complete | $450.00 | $163.00 |
| 76705 | US Abdomen Limited | $400.00 | $121.00 |
| 76770 | US Renal | $426.00 | $155.00 |
| 76817 | US Pregnancy Transvaginal | $346.00 | $104.00 |
| 76856 | Ultrasound pelvic/transvag | $731.00 | $244.00 |
| 76870 | US Scrotum (Contents) | $450.00 | $147.00 |
| 76942 | US Guidance Needle Placement Non Rad | $400.00 | $116.00 |
| 76999 | US Soft Tissue Other Than Neck | $395.00 | $104.00 |
| 93880 | US Carotid Duplex Bilateral | $500.00 | $150.00 |
| 93970 | US LE Venous Duplex Bilateral | $500.00 | $193.00 |
With so many imaging procedures, we have captured our most common and provided a break down of the pricing. It is important to know when pricing imaging tests, to verify if the radiologist (professional) fee has been included in the price. In our pricing we have listed the radiologist (professional fee) separate.
| 70450 | CT Head or Brain | $1,200.00 | $234.00 |
| 70460 | CT Head or Brain | $1,233.00 | $291.00 |
| 70470 | CT Head or Brain | $2,000.00 | $342.00 |
| 70480 | CT Orbit Sella etc. | $1,176.00 | $242.00 |
| 70486 | CT maxillofacial | $2,200.00 | $245.00 |
| 70487 | CT Maxillofacial | $1,292.00 | $292.00 |
| 70491 | CT Soft Tissue Neck | $1,546.00 | $341.00 |
| 70496 | CT Angiography Head | $2,200.00 | $356.00 |
| 70498 | CT Angiography Neck | $2,200.00 | $350.00 |
| 71250 | CT Chest | $1,300.00 | $270.00 |
| 71260 | CT Chest | $1,600.00 | $308.00 |
| 71275 | CT PE CHEST | $2,132.00 | $345.00 |
| 72125 | CT Spine Cervical | $1,400.00 | $273.00 |
| 72128 | CT Spine Thoracic | $1,308.00 | $273.00 |
| 72131 | CT Spine Lumbar | $1,308.00 | $273.00 |
| 72132 | CT Spine Lumbar | $1,600.00 | $309.00 |
| 72191 | CT Angio Pelvis | $2,024.00 | $344.00 |
| 72192 | CT Pelvis | $1,200.00 | $231.00 |
| 72193 | CT Pelvis | $1,800.00 | $292.00 |
| 73200 | CT Upper Extremity | $1,140.00 | $234.00 |
| 73201 | CT Upper Extremity | $1,281.00 | $291.00 |
| 73700 | CT Lower Extremity | $1,119.00 | $229.00 |
| 74160 | CT Abdomen | $1,800.00 | $301.00 |
| 74170 | CT Abdomen | $1,900.00 | $355.00 |
| 74175 | CT Angiography Abdomen | $1,996.00 | $340.00 |
| 74176 | CT Urogram/Renal Stones | $2,000.00 | $300.00 |
| 74177 | CT Abdomen/Pelvis | $3,000.00 | $680.00 |
| 74178 | CT Abdomen/Pelvis | $3,100.00 | $565.00 |
| 77078 | CT Bone Density Study | $269.00 | $42.00 |
With so many imaging procedures, we have captured our most common and provided a break down of the pricing. It is important to know when pricing imaging tests, to verify if the radiologist (professional) fee has been included in the price. In our pricing we have listed the radiologist (professional fee) separate.
| CPT CODE | SERVICE DESCRIPTION | FACILITY FEE | PROFESSIONAL FEE |
| 77065 | MA Mammogram Diagnostic | $265.00 | $105.00 |
| 77066 | MA Mammogram Diagnostic Bilateral | $368.00 | $132.00 |
| 77067 | MA Mammo Screening | $301.00 | $99.00 |
With so many imaging procedures, we have captured our most common and provided a break down of the pricing. It is important to know when pricing imaging tests, to verify if the radiologist (professional) fee has been included in the price. In our pricing we have listed the radiologist (professional fee) separate.
| 70110 | XR Mandible Complete Minimum 4 Views | $312.00 | $81.00 |
| 70150 | XR Facial Bones Minimum 3 Views | $287.00 | $64.00 |
| 70160 | XR Nasal Bones Minimum 3 Views | $193.00 | $71.00 |
| 70210 | XR Waters View | $158.00 | $48.00 |
| 70220 | XR Sinuses Paranasal Complete | $287.00 | $64.00 |
| 70250 | XR Skull < 4 Views | $203.00 | $71.00 |
| 70328 | XR TMJ Open and Closed Bilateral | $140.00 | $47.00 |
| 70360 | XR Neck Soft Tissue | $207.00 | $48.00 |
| 71045 | XR Chest 1 View | $188.00 | $50.00 |
| 71046 | XR Chest 2 Views | $209.00 | $57.00 |
| 71100 | XR Ribs 2 Views | $293.00 | $70.00 |
| 71101 | XR Ribs w/ PA Chest | $293.00 | $68.00 |
| 71111 | XR Ribs w/ PA Chest Bilateral Minimum 4 Views | $297.00 | $92.00 |
| 72040 | XR Spine Cervical 3 Views or Less | $209.00 | $48.00 |
| 72050 | XR Spine Cervical Minimum 4 Views | $347.00 | $81.00 |
| 72052 | XR Spine Cervical 6 Views or more | $376.00 | $90.00 |
| 72070 | XR Spine Thoracic 2 Views | $239.00 | $70.00 |
| 72072 | XR Spine Thoracic 3 Views | $275.00 | $70.00 |
| 72080 | XR Spine Thoracolumbar 2 Views | $245.00 | $63.00 |
| 72083 | XR Spine Scoliosis Study Standing | $271.00 | $82.00 |
| 72100 | XR Spine Lumbosacral 2 or 3 Views | $242.00 | $70.00 |
| 72110 | XR Spine Lumbosacral Minimum 4 Views | $397.00 | $97.00 |
| 72114 | XR Spine Lumbosacral Complete w/ Bending | $316.00 | $82.00 |
| 72120 | XR Spine Lumbosacral Bending Only / 4 + Views | $271.00 | $82.00 |
| 72170 | XR Pelvis 1 or 2 Views | $207.00 | $52.00 |
| 72202 | XR Sacrum/Coccyx Minimum 2 Views | $211.00 | $70.00 |
| 72220 | XR Sacroiliac Joints 1 or 2 Views | $247.00 | $56.00 |
| 72255 | XR Myelography Cervical Spine | $800.00 | $90.00 |
| 73000 | XR Clavicle | $209.00 | $50.00 |
| 73010 | XR Scapula | $195.00 | $56.00 |
| 73020 | XR Shoulder 1 View | $184.00 | $48.00 |
| 73030 | XR Shoulder Complete | $233.00 | $61.00 |
| 73040 | XR Arthrogram Shoulder | $306.00 | $76.00 |
| 73060 | XR Humerus | $209.00 | $50.00 |
| 73070 | XR Elbow 2 Views | $113.00 | $31.00 |
| 73080 | XR Elbow Complete | $130.00 | $36.00 |
| 73090 | XR Forearm 2 Views | $209.00 | $50.00 |
| 73100 | XR Wrist 2 Views | $158.00 | $50.00 |
| 73110 | XR Wrist Complete | $209.00 | $59.00 |
| 73115 | XR Arthrogram Wrist | $600.00 | $98.00 |
| 73120 | XR Hand 2 Views | $158.00 | $48.00 |
| 73130 | XR Hand Complete | $209.00 | $48.00 |
| 73140 | XR Finger 4th Digit | $100.00 | $30.00 |
| 73501 | XR Hip 1 View | $109.00 | $36.00 |
| 73521 | XR Hips Bil w/ Pelvis 2 Views | $150.00 | $50.00 |
| 73522 | XR Hips Bil w/ Pelvis 3-4 Views | $160.00 | $50.00 |
| 73525 | XR Arthrogram Hip | $800.00 | $90.00 |
| 73552 | XR Femur | $233.00 | $56.00 |
| 73560 | XR Knee One or Two Views | $178.00 | $51.00 |
| 73562 | XR Knee 3 Views | $213.00 | $58.00 |
| 73564 | XR Knee Complete | $222.00 | $71.00 |
| 73590 | XR Tibia/Fibula | $209.00 | $51.00 |
| 73600 | XR Ankle 2 Views | $165.00 | $50.00 |
| 73610 | XR Ankle Complete | $215.00 | $63.00 |
| 73620 | XR Foot 2 Views | $165.00 | $48.00 |
| 73630 | XR Foot Complete | $209.00 | $50.00 |
| 73650 | XR Calcaneous | $201.00 | $48.00 |
| 73660 | XR Toes Great | $100.00 | $30.00 |
| 74018 | XR Abdomen 1 View | $209.00 | $57.00 |
| 74019 | XR Abdomen 2 Views | $249.00 | $62.00 |
| 74022 | XR Abdomen Complete w/ Decub/Erect | $347.00 | $91.00 |
| 74220 | XR Fluoro Esophagus | $415.00 | $95.00 |
| 74230 | XR Fluoro Modified Esophagram | $415.00 | $115.00 |
| 74241 | XR Upper GI + KUB | $405.00 | $127.00 |
| 74245 | XR Upper GI w/ Small Bowel | $555.00 | $166.00 |
| 76000 | XR Fluoroscopy Up to 1 Hour | $473.00 | $158.00 |
| 76010 | XR Child Nose-Rectum For FB | $208.00 | $48.00 |
| 77001 | XR Fluoro Guidance for Central Venous Access | $550.00 | $100.00 |
| 77002 | XR Fluoro Guidance for Injection | $259.00 | $120.00 |
| 77003 | XR Fluoro Guidance Needle Placement | $300.00 | $145.00 |
| 77073 | XR Bone Length Survey | $225.00 | $81.00 |
| 77074 | XR Bone Survey Complete (Mets) | $447.00 | $60.00 |
As we work to explain how healthcare pricing works, it is helpful to understand terms used on your insurance Explanation of Benefits statement.
Explanation of Benefits (EOB) – a statement you receive from your insurance company that explains how your benefits were applied to the hospital charges. It shows the hospital charges, how much your insurance paid and what the patient responsibility is.
Deductible – the amount a patient will pay before insurance will start paying for services (typical is $5,000)
Copay – a predetermined price that a patient will pay at the time of service based on their insurance carrier (office visits, ER visits, specialists, etc.)
Coinsurance – the amount (%) your insurance will cover for services. Typical is 80/20, the insurance pays 80% and the patient pays 20%.
Out of Pocket Maximum – the most a patient will have to pay out of pocket in a given period.
Standard Charges – Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2019 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Prospective Payment System Final Rule (CMS-1694-F)
Please click the link below to view our standard charges, in machine-readable format. These charges may not reflect what you would pay for services, particularly if you are insured. For additional information, please call (208) 934-4433 ext. 1222.
Standard Charges »
Pharmacy Charges »
Price estimates are for both Gooding and Buhl locations, although the services offered differ by location. Some procedures do not exactly match a particular billing code. We will look at the most similar procedure to determine the actual charge amount.
Cash Discounts
After appropriate paperwork is complete, patients may qualify for a cash discount or a sliding fee scale to help offset the amount owed. Please call (208) 934-8764 for more information.
