Northwest Community Hospital Menu
| Items | |||||
|---|---|---|---|---|---|
| Lab - Campylobacter Antibody Analysis (30000556) | $99.00 |
N/A
|
|
||
| Lab - Calfornia Encephalitis Antibody Analysis (30000691) | $87.00 |
N/A
|
|
||
| Lab - Calfornia Encephalitis Antibody Analysis (30003155) | $87.00 |
N/A
|
|
||
| Lab - Calcium Level In Urine (Quantitative, Timed) (30000365) | $102.00 |
N/A
|
|
||
| Lab - Cadmium Level (30001067) | $204.00 |
N/A
|
|
||
| Lab - Cadmium Level (30000363) | $95.00 |
N/A
|
|
||
| Lab - Ca125 Tumor Antigen Measurement (30003295) | $290.00 |
N/A
|
|
||
| Lab - Brucella Antibody Analysis (30001087) | $201.00 |
N/A
|
|
||
| Lab - Brucella Antibody Analysis (30000551) | $76.00 |
N/A
|
|
||
| Lab - Brucella Antibody Analysis (30001325) | $76.00 |
N/A
|
|
||
| Lab - Breath Alcohol Level (30001057) | $42.00 |
N/A
|
|
||
| Lab - Breath Alcohol Level (30000362) | $25.00 |
N/A
|
|
||
| Lab - Bone Health Measurement Using Urine Or Blood (Collagen Cross Links) (30000609) | $269.00 |
N/A
|
|
||
| Lab - Bone Health Measurement Using Urine Or Blood (Collagen Cross Links) (30001289) | $116.00 |
N/A
|
|
||
| Lab - Blood Ph Level (30000539) | $65.00 |
N/A
|
|
||
| Lab - Blood Flow Resistance Measurement (30000547) | $134.00 |
N/A
|
|
||
| Lab - Blood Clotting Screening Study (30003306) | $89.00 |
N/A
|
|
||
| Lab - Blood Clotting And Dissolving Evaluation Of Whole Blood With Written Report (30500001) | $322.00 |
N/A
|
|
||
| Lab - Blood Cell Function Test And Detection Of Genetic Marker (30000565) | $212.00 |
N/A
|
|
||
| Lab - Blending Of Blood Products From Multiple Sources (30000918) | $81.00 |
N/A
|
|
||
| Lab - Blastomyces Antibody Analysis (30000532) | $75.00 |
N/A
|
|
||
| Lab - Bilirubin Measurement (30003336) | $98.00 |
N/A
|
|
||
| Lab - Basic Group Of Blood Chemicals (With Ionized Calcium) (30003341) | $164.00 |
N/A
|
|
||
| Lab - Bartonella Antibody Analysis (30000513) | $31.00 |
N/A
|
|
||
| Lab - Bacterial Stool Culture For Additional Pathogens (Aerobic) (30000976) | $103.00 |
N/A
|
|
||
| Lab - Bacterial Culture Using Source Other Than Urine, Blood, Or Stool (Aerobic) (30001288) | $13.00 |
N/A
|
|
||
| Lab - B-Hexosaminidase Enzyme Level (30000353) | $150.00 |
N/A
|
|
||
| Lab - Ascorbic Acid Level In Blood (30000352) | $184.00 |
N/A
|
|
||
| Lab - Arsenic Level (30001063) | $237.00 |
N/A
|
|
||
| Lab - Arsenic Level (30000351) | $184.00 |
N/A
|
|
||
| Lab - Apolipoprotein Level (30000350) | $122.00 |
N/A
|
|
||
| Lab - Antinuclear Antibodies Analysis (Ana Screen) (30001061) | $239.00 |
N/A
|
|
||
| Lab - Antinuclear Antibodies Analysis (Ana Screen) (30000318) | $150.00 |
N/A
|
|
||
| Lab - Antinuclear Antibodies Analysis (Ana Screen) (30003015) | $80.00 |
N/A
|
|
||
| Lab - Antihuman Globulin Antibody Analysis (Indirect Each Titer) (30000624) | $163.00 |
N/A
|
|
||
| Lab - Antiduretic Hormone Level (30000491) | $122.00 |
N/A
|
|
||
| Lab - Anti-Phosphatidylserine Antibody Analysis (30000320) | $116.00 |
N/A
|
|
||
| Lab - Analysis Of Urine, Non-Automated Without Miscroscope (30001151) | $41.00 |
N/A
|
|
||
| Lab - Analysis Of Genetic Material With Initial Single Probe Stain (30000828) | $169.00 |
N/A
|
|
||
| Lab - Amniotic Fluid Scan (30000308) | $83.00 |
N/A
|
|
||
| Lab - Amniotic Fluid Or Placenta Cell Culture To Identify Non-Cancerous Disorders (30003189) | $2,070.00 |
N/A
|
|
||
| Lab - Amino Acids Level, 6 Or More Per Specimen (30003259) | $328.00 |
N/A
|
|
||
| Lab - Amino Acids Level, 6 Or More Per Specimen (30003263) | $328.00 |
N/A
|
|
||
| Lab - Amino Acids Level, 2 To 5 Per Specimen (30000307) | $240.00 |
N/A
|
|
||
| Lab - Amino Acids Analysis With Multiple Identifications (Each Specimen) (30001060) | $196.00 |
N/A
|
|
||
| Lab - Amikacin Level (30000344) | $238.00 |
N/A
|
|
||
| Lab - Alpha-Fetoprotein Level In Blood (30000305) | $436.00 |
N/A
|
|
||
| Lab - Alpha-Fetoprotein Level In Amniotic Fluid (30000304) | $130.00 |
N/A
|
|
||
| Lab - Alpha-1-Antitrypsin Protein Level (Total) (30001302) | $89.00 |
N/A
|
|
||
| Lab - Alpha-1-Antitrypsin Protein Level (Phenotype) (30000301) | $90.00 |
N/A
|
|
||
| Lab - Allergy Antibody Levels (Immunoglobulin G), Each Substance (30003039) | $42.00 |
N/A
|
|
||
| Lab - Allergy Antibody Levels (Immunoglobulin E), Each Crude Substance (30001295) | $33.00 |
N/A
|
|
||
| Lab - Albumin Protein Level In Urine (Quantitative) (30003019) | $105.00 |
N/A
|
|
||
| Lab - Albumin Protein Level In Urine (Quantitative) (30001132) | $80.00 |
N/A
|
|
||
| Lab - Albumin Protein Level In Spinal Or Amniotic Fluid (30000478) | $80.00 |
N/A
|
|
||
| Lab - Adrenal Hormone Level (Cortisol Free) (30000630) | $317.00 |
N/A
|
|
||
| Lab - Adenovirus Antibody Analysis (30000011) | $128.00 |
N/A
|
|
||
| Lab - Activated Protein C Resistance Evaluation (30000325) | $106.00 |
N/A
|
|
||
| Lab - Acetylcholinesterease Enzyme Level (30000007) | $186.00 |
N/A
|
|
||
| Lab (30000830) | $1,497.00 |
N/A
|
|
||
| Lab (30000682) | $61.00 |
N/A
|
|
||
| Lab (30000629) | $3.00 |
N/A
|
|
||
| Lab (30000627) | $3.00 |
N/A
|
|
||
| Lab (30000628) | $3.00 |
N/A
|
|
||
| Heart Monitoring - Signal-Averaged Electrocardiography (Saecg), Computer Analysis Of Ecg Segments To Detect Abnormalities (73000002) | $398.00 |
N/A
|
|
||
| Heart Monitoring - Remote Monitoring Of Wireless Pressure Sensor In Lung Artery With Qualified Professional Analysis, Review, And Report (73000007) | $74.00 |
N/A
|
|
||
| Heart Monitoring - Heart Rhythm Symptom-Related Tracing Of 24-Hour Ekg Monitoring Up To 30 Days, Transmission And Analysis (73000001) | $552.00 |
N/A
|
|
||
| Heart Monitoring - External Ekg Recording For More Than 48 Hours Up To 21 Days (73100004) | $185.00 |
N/A
|
|
||
| Heart Monitoring - Continuous Heart Rhythm Recording Up To 48 Hours, Analysis With Report (73100003) | $1,076.00 |
N/A
|
|
||
| Gi Services - Study Of Anorectal Pressure Generated By Muscles Surrounding Anus (75000035) | $850.00 |
N/A
|
|
||
| Gi Services - Stomach Procedure (75000051) | $4,390.00 |
N/A
|
|
||
| Gi Services - Placement Of Guiding Device For Radiation Therapy Or Surgery (75000030) | $277.00 |
N/A
|
|
||
| Gi Services - Gastroesophageal Reflux Test Via Mucosal Electrode Placement (75000019) | $2,710.00 |
N/A
|
|
||
| Gi Services - Biofeedback Training On Rectal Or Bladder Muscles (75000036) | $345.00 |
N/A
|
|
||
| Gi Services (75000053) | $10,035.00 |
N/A
|
|
||
| Gi Services (75000044) | $8,473.00 |
N/A
|
|
||
| Gi Services (75000014) | $5,521.00 |
N/A
|
|
||
| Gi Services (75000022) | $5,387.00 |
N/A
|
|
||
| Gi Services (75000046) | $5,287.00 |
N/A
|
|
||
| Gi Services (75000011) | $4,626.00 |
N/A
|
|
||
| Gi Services (75000024) | $4,421.00 |
N/A
|
|
||
| Gi Services (75000009) | $4,292.00 |
N/A
|
|
||
| Gi Services (75000001) | $4,053.00 |
N/A
|
|
||
| Gi Services (75000031) | $3,887.00 |
N/A
|
|
||
| Gi Services (75000020) | $3,092.00 |
N/A
|
|
||
| Gi Services (75000017) | $3,027.00 |
N/A
|
|
||
| Gi Services (75000038) | $3,024.00 |
N/A
|
|
||
| Gi Services (75000042) | $2,530.00 |
N/A
|
|
||
| Gi Services (75000007) | $2,512.00 |
N/A
|
|
||
| Gi Services (75000004) | $2,500.00 |
N/A
|
|
||
| Gi Services (75000037) | $2,378.00 |
N/A
|
|
||
| Gi Services (75000041) | $2,378.00 |
N/A
|
|
||
| Gi Services (75000039) | $2,199.00 |
N/A
|
|
||
| Gi Services (75000002) | $2,183.00 |
N/A
|
|
||
| Gi Services (75000048) | $1,765.00 |
N/A
|
|
||
| Gi Services (75000045) | $1,725.00 |
N/A
|
|
||
| Gi Services (75000047) | $1,725.00 |
N/A
|
|
||
| Gi Services (75000040) | $1,719.00 |
N/A
|
|
||
| Gi Services (75000023) | $1,089.00 |
N/A
|
|
||
| Gi Services (75000026) | $945.00 |
N/A
|
|
||
| Gi Services (75000043) | $850.00 |
N/A
|
|
||
| Gi Services (75000032) | $268.00 |
N/A
|
|
||
| Gi Services (75000033) | $267.00 |
N/A
|
|
||
| Emergency Room - Wedging Of Cast (45000313) | $147.00 |
N/A
|
|
||
| Emergency Room - Vaginal Delivery Of Placenta (45000119) | $2,031.00 |
N/A
|
|
||
| Emergency Room - Vaginal Delivery (45000211) | $2,031.00 |
N/A
|
|
||
| Emergency Room - Tying Of Major Neck Artery (45000339) | $6,577.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Upper Arm Fracture Without Incision (45000057) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Hip Dislocation (45000052) | $283.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Dislocated Jaw Without Incision (45000257) | $242.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Dislocated Elbow Without Incision Using Anesthesia (45000299) | $1,174.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Dislocated Elbow Of Child (45000076) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Collarbone And Chest Bone Dislocation Without Incision (45000083) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Upper Arm Without Incision (45000071) | $235.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Upper Arm Bone At Shoulder Joint Without Incision (45000050) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Upper Arm At Shoulder Joint (45000054) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Spine Bones With Casting Or Bracing (45000346) | $462.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Shoulder Blade Without Incision (45000293) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Nose Without Incision (45000100) | $2,183.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Nose Without Incision (45000099) | $85.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Mid Forearm Without Incision (45000097) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Mid Forearm Bones Without Incision (45000073) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Lower Forearm Bones Without Incision (45000040) | $180.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Jaw Or Cheek Bone Without Incision (45000320) | $4,476.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Forearm Without Incision (45000079) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Forearm Bone At Elbow Without Incision (45000075) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Forearm At Elbow Without Incision (45000297) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Forearm And Dislocated Wrist Without Incision (45000077) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Foot Bone (45000305) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Foot Bone (45000306) | $259.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Collarbone Without Incision (45000034) | $239.00 |
N/A
|
|
||
| Emergency Room - Treatment Of Broken Chest Bone Without Incision (45000294) | $259.00 |
N/A
|
|
||
| Emergency Room - Suture Of Non-Obstetrical Vaginal Injury (45000250) | $2,436.00 |
N/A
|
|
||
| Emergency Room - Suture Of Mouth Laceration (45000103) | $759.00 |
N/A
|
|
||
| Emergency Room - Suture Of Mouth Laceration (45000102) | $210.00 |
N/A
|
|
||
| Emergency Room - Suction Removal Of Secretions From The Nose And Throat (45000023) | $333.00 |
N/A
|
|
||
| Emergency Room - Subsequent Control Of Nose Bleed And Insertion Of Packing (45000112) | $197.00 |
N/A
|
|
||
| Emergency Room - Strapping Of Shoulder (45000276) | $185.00 |
N/A
|
|
||
| Emergency Room - Strapping Of Knee (45000275) | $233.00 |
N/A
|
|
||
| Emergency Room - Stomach Procedure (45000274) | $351.00 |
N/A
|
|
||
| Emergency Room - Small Intestine Procedure (45000308) | $3,160.00 |
N/A
|
|
||
| Emergency Room - Simple Wound Repair Of The Scalp, Neck, Underarms, Trunk, Arms, Or Legs (45000269) | $1,030.00 |
N/A
|
|
||
| Emergency Room - Simple Wound Repair Of The Scalp, Neck, Underarms, Trunk, Arms, Or Legs (45000267) | $936.00 |
N/A
|
|
||
| Emergency Room - Simple Wound Repair Of The Scalp, Neck, Underarms, Trunk, Arms, Or Legs (45000266) | $852.00 |
N/A
|
|
||
| Emergency Room - Simple Wound Repair Of The Scalp, Neck, Underarms, Trunk, Arms, Or Legs (45000268) | $774.00 |
N/A
|
|
||
| Emergency Room - Simple Wound Repair Of The Scalp, Neck, Underarms, Trunk, Arms, Or Legs (45000271) | $704.00 |
N/A
|
|
||
| Emergency Room - Simple Wound Repair Of The Face, Ears, Eyelids, Nose, Lips, Or Mucous Membranes (45000259) | $1,153.00 |
N/A
|
|
||
| Emergency Room - Simple Wound Repair Of The Face, Ears, Eyelids, Nose, Lips, Or Mucous Membranes (45000265) | $1,049.00 |
N/A
|
|
||
| Emergency Room - Simple Wound Repair Of The Face, Ears, Eyelids, Nose, Lips, Or Mucous Membranes (45000264) | $953.00 |
N/A
|
|
||
| Emergency Room - Simple Wound Repair Of The Face, Ears, Eyelids, Nose, Lips, Or Mucous Membranes (45000263) | $866.00 |
N/A
|
|
||
| Emergency Room - Separation Of Nail Plate From Nail Bed (45000235) | $160.00 |
N/A
|
|
||
| Emergency Room - Separation Of Nail Plate From Nail Bed (45000240) | $105.00 |
N/A
|
|
||
| Emergency Room - Repositioning Of Stomach Feeding Tube (45000256) | $523.00 |
N/A
|
|
||
| Emergency Room - Repositioning Of Foreskin Including Scar Tissue Removal (45000221) | $289.00 |
N/A
|
|
||
| Emergency Room - Repair Of Wound At Roof Of Mouth (45000255) | $393.00 |
N/A
|
|
||
| Emergency Room - Repair Of Vertical Lip Wound Extending To Over Half Of Lip (45000243) | $645.00 |
N/A
|
|
||
| Emergency Room - Repair Of Vertical Lip Wound Extending To Half Of Lip (45000244) | $645.00 |
N/A
|
|
||
| Emergency Room - Repair Of Traumatic Tear In Lung And/or Control Of Bleeding (45000341) | $2,087.00 |
N/A
|
|
||
| Emergency Room - Repair Of Laceration To Floor Of Mouth Or Tongue (45000248) | $645.00 |
N/A
|
|
||
| Emergency Room - Repair Of Laceration To Floor Of Mouth Or Tongue (45000247) | $178.00 |
N/A
|
|
||
| Emergency Room - Repair Of Finger Or Toe Nail Bed (45000249) | $1,222.00 |
N/A
|
|
||
| Emergency Room - Repair Of Blood Vessel Of Neck (45000327) | $3,821.00 |
N/A
|
|
||
| Emergency Room - Repair Of Blood Vessel Of Leg (45000329) | $817.00 |
N/A
|
|
||
| Emergency Room - Repair Of Blood Vessel Of Hand Or Finger (45000328) | $3,821.00 |
N/A
|
|
||
| Emergency Room - Repair Of Blood Vessel Of Arm (45000325) | $3,816.00 |
N/A
|
|
||
| Emergency Room - Removal Or Cutting Of Gauntlet, Boot, Or Body Cast (45000238) | $147.00 |
N/A
|
|
||
| Emergency Room - Removal Or Cutting Of Full Arm Or Leg Cast (45000237) | $155.00 |
N/A
|
|
||
| Emergency Room - Removal Of Skin Of Finger Or Toe Nail (45000150) | $2,360.00 |
N/A
|
|
||
| Emergency Room - Removal Of Muscle Or Muscle Tissue, Initial Amount (45000117) | $380.00 |
N/A
|
|
||
| Emergency Room - Removal Of Intra-Uterine Pregnancy Prevention Device (45000239) | $143.00 |
N/A
|
|
||
| Emergency Room - Removal Of Inflamed Or Infected Skin, Up To 10 Percent Of Body Surface (45000118) | $1,105.00 |
N/A
|
|
||
| Emergency Room - Removal Of Impacted Ear Wax From One Ear (45000321) | $350.00 |
N/A
|
|
||
| Emergency Room - Removal Of Growth Of The Face, Ears, Eyelids, Nose, Lips, Or Mouth (45000148) | $399.00 |
N/A
|
|
||
| Emergency Room - Removal Of Growth Of The Face, Ears, Eyelids, Nose, Lips, Or Mouth (45000149) | $399.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin (45000228) | $610.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body In Nose Without Anesthesia (45000241) | $85.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body In Anus Using Endoscope (45000003) | $900.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body From Voice Box Using Endoscope (45000194) | $2,754.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body From Voice Box Using Endoscope (45000196) | $468.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body From Voice Box Using Endoscope (45000198) | $237.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body From Tissue Beneath The Skin, Simple (45000164) | $1,258.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body From Throat (45000242) | $74.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body From Eye Surface (45000230) | $290.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body From Eye Membrane Or White Outer Layer (45000229) | $748.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body From Eye Cornea With Slit Lamp Exam (45000231) | $707.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body From Eye Cornea (45000232) | $820.00 |
N/A
|
|
||
| Emergency Room - Removal Of Foreign Body From External Ear Canal (45000022) | $179.00 |
N/A
|
|
||
| Emergency Room - Removal Of Fluid From Chest Cavity (45000012) | $1,152.00 |
N/A
|
|
||
| Emergency Room - Removal Of Fluid From Abdominal Cavity (45000001) | $1,143.00 |
N/A
|
|
||
| Emergency Room - Removal Of Engorged Hemorrhoid (45000233) | $205.00 |
N/A
|
|
||
| Emergency Room - Removal Of Embedded Foreign Body Of Mouth (45000226) | $645.00 |
N/A
|
|
||
| Emergency Room - Removal Of Embedded Foreign Body Of Mouth (45000227) | $63.00 |
N/A
|
|
||
| Emergency Room - Permanent Removal Of Nail (45000234) | $1,545.00 |
N/A
|
|
||
| Emergency Room - Open Treatment Of Dislocated Finger Joint (45000214) | $435.00 |
N/A
|
|
||
| Emergency Room - Open Treatment Of Broken Finger Or Thumb (45000213) | $352.00 |
N/A
|
|
||
| Emergency Room - Needle Aspiration Of Bladder (45000124) | $1,986.00 |
N/A
|
|
||
| Emergency Room - Monitoring Of Muscle Compartment Fluid Pressure (45000155) | $354.00 |
N/A
|
|
||
| Emergency Room - Moderate Sedation Services By Physician Not Performing A Procedure, Patient 5 Years Of Age Or Older, First 15 Minutes (45000337) | $969.00 |
N/A
|
|
||
| Emergency Room - Moderate Sedation Services By Physician Not Performing A Procedure, Patient 5 Years Of Age Or Older, First 15 Minutes (45000336) | $354.00 |
N/A
|
|
||
| Emergency Room - Moderate Sedation Services By Physician Not Performing A Procedure, Each Additional 15 Minutes (45000338) | $340.00 |
N/A
|
|
||
