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Diagnostic & Therapeutic Charges for Lebanon County

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CPT Code Service/Procedure WellSpan Good Samaritan Hospital
Cardiac Diagnostics
93017 Treadmill stress test $1,153
93351 Treadmill stress echocardiogram w/ monitoring $2,586
0093306 Echocardiogram w/ Doppler $2,285
Cardiac Rehabilitation
93798 Therapy -- initial visit $294
Physical Therapy
97161 Physical therapy evaluation (low complex) $509
97162 Physical therapy evaluation (moderate complex) $520
97163 Physical therapy evaluation (high complex) $534
97140 Manual therapy (15 min.) $237
Diagnostic Imaging Studies
74150 CT scan of the abdomen (unenhanced) $1,047
72141 MRI scan of the cervical spine (unenhanced) $1,650
77067 Digital screening mammogram with computer aided detection $608
71045 X-ray - Chest 1 View $505
71046 X-ray - Chest 2 View $321
Laboratory Studies
80061 Lipid panel $135
81003 Routine urinalysis $20