Citizens Memorial Hospital

1500 N Oakland, Bolivar, MO 65613 · (417) 326-6000

Acute Care HospitalsGovernment - Hospital District or AuthorityCMS rating 3/5Springfield, MO metro Website ↗

Price file

Prices published

File dated 2026-03-25

2,236 price rows for 66 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 2 lines · metro median $56

$160

cash

$8 to $93

45 negotiated rates

$200

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · metro median $1,435

$5,013

cash

$372 to $2,003

15 negotiated rates

$6,267

list

CT scan of the head, no contrast

CPT 70450 · lowest of 2 lines · metro median $636

$2,095

cash

$112 to $667

30 negotiated rates

$2,619

list

CT scan of the pelvis, with contrast

CPT 72193 · lowest of 2 lines · metro median $746

$2,580

cash

$187 to $610

30 negotiated rates

$3,226

list

Cataract surgery with lens implant

CPT 66984 · lowest of 2 lines · metro median $883

$883

cash

$2,464 to $5,182

32 negotiated rates

$1,104

list

Cesarean delivery with prenatal and postpartum care

CPT 59510 · metro median $3,252

$3,252

cash

$2,370 to $3,235

10 negotiated rates

$4,065

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$1,516 to $12,803

18 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 2 lines · metro median $75

$89

cash

$35 to $180

30 negotiated rates

$111

list

Colonoscopy (diagnostic)

CPT 45378 · lowest of 2 lines · metro median $746

$746

cash

$993 to $5,182

32 negotiated rates

$932

list

Colonoscopy with biopsy

CPT 45380 · lowest of 2 lines · metro median $823

$823

cash

$1,277 to $5,182

31 negotiated rates

$1,029

list

Colonoscopy with polyp removal

CPT 45385 · lowest of 2 lines · metro median $933

$933

cash

$1,277 to $5,182

31 negotiated rates

$1,166

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 2 lines · metro median $30

$38

cash

$8 to $85

60 negotiated rates

$48

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 2 lines · metro median $99

$187

cash

$11 to $116

45 negotiated rates

$234

list

Diagnostic mammogram (both breasts)

CPT 77066 · metro median $472

$690

cash

$45 to $309

15 negotiated rates

$863

list

Electrocardiogram (ECG) with interpretation

CPT 93000 · metro median $84

$84

cash

—

$105

list

Established patient office visit (about 40 minutes)

CPT 99215 · metro median $113

$391

cash

$122 to $166

50 negotiated rates

$489

list

Family psychotherapy with the patient

CPT 90847 · metro median $109

$246

cash

$189 to $259

10 negotiated rates

$308

list

Family psychotherapy without the patient

CPT 90846 · metro median $98

$234

cash

$189 to $259

10 negotiated rates

$293

list

Gallbladder removal (laparoscopic)

CPT 47562 · lowest of 2 lines · metro median $2,210

$2,210

cash

$5,182 to $8,809

23 negotiated rates

$2,762

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 2 lines · metro median $66

$93

cash

$35 to $180

45 negotiated rates

$116

list

Group psychotherapy

CPT 90853 · metro median $65

$65

cash

$108 to $148

10 negotiated rates

$81

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

$1,516 to $22,462

18 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$1,516 to $11,019

18 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$1,516 to $15,610

18 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · lowest of 2 lines · metro median $868

$868

cash

$3,822 to $5,217

21 negotiated rates

$1,085

list

Knee arthroscopy with meniscus repair

CPT 29881 · metro median $959

$959

cash

$3,493 to $4,768

10 negotiated rates

$1,199

list

Laser treatment after cataract surgery (YAG)

CPT 66821 · metro median $163

$453

cash

$587 to $5,182

41 negotiated rates

$566

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 2 lines · metro median $51

$104

cash

$13 to $147

45 negotiated rates

$130

list

Liver function panel

CPT 80076 · lowest of 2 lines · metro median $56

$194

cash

$8 to $90

45 negotiated rates

$243

list

MRI of the brain, with and without contrast

CPT 70553 · metro median $1,159

$3,900

cash

$372 to $2,392

15 negotiated rates

$4,875

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · metro median $847

$2,955

cash

$255 to $1,343

15 negotiated rates

$3,693

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 2 lines · metro median $879

$2,959

cash

$255 to $1,356

30 negotiated rates

$3,698

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473

—

cash

$1,516 to $27,596

18 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · lowest of 2 lines · metro median $1,198

$1,198

cash

$944 to $1,289

40 negotiated rates

$1,498

list

New patient office visit (about 30 minutes)

CPT 99203 · metro median $70

$246

cash

$70 to $95

50 negotiated rates

$308

list

New patient office visit (about 45 minutes)

CPT 99204 · metro median $105

$243

cash

$114 to $155

50 negotiated rates

$304

list

New patient office visit (about 60 minutes)

CPT 99205 · metro median $152

$458

cash

$156 to $213

50 negotiated rates

$572

list

PSA test (prostate)

CPT 84153 · lowest of 2 lines · metro median $70

$150

cash

$18 to $94

45 negotiated rates

$188

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 2 lines · metro median $36

$36

cash

$6 to $31

45 negotiated rates

$45

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 2 lines · metro median $106

$123

cash

$27 to $166

38 negotiated rates

$154

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 2 lines · metro median $178

$178

cash

$112 to $337

60 negotiated rates

$223

list

Preventive visit, new patient age 18 to 39

CPT 99385 · metro median $46

$46

cash

—

$57

list

Preventive visit, new patient age 40 to 64

CPT 99386 · metro median $40

$40

cash

—

$50

list

Prostate biopsy

CPT 55700 · lowest of 2 lines · metro median $658

$658

cash

$5,182 to $5,182

1 negotiated rates

$822

list

Prostate removal (laparoscopic)

CPT 55866 · lowest of 2 lines · metro median $2,425

$2,425

cash

$5,182 to $15,489

21 negotiated rates

$3,031

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 2 lines · metro median $17

$22

cash

$4 to $43

45 negotiated rates

$28

list

Psychotherapy, 30 minutes

CPT 90832 · metro median $186

$186

cash

$189 to $259

10 negotiated rates

$232

list

Psychotherapy, 45 minutes

CPT 90834 · metro median $244

$244

cash

$189 to $259

10 negotiated rates

$305

list

Psychotherapy, 60 minutes

CPT 90837 · metro median $356

$359

cash

$189 to $259

10 negotiated rates

$449

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · lowest of 2 lines · metro median $741

$741

cash

$4,180 to $5,705

52 negotiated rates

$926

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 2 lines · metro median $114

$258

cash

$34 to $219

30 negotiated rates

$322

list

Shoulder arthroscopy with decompression

CPT 29826 · metro median $3,248

$3,248

cash

$143 to $195

10 negotiated rates

$4,060

list

Sleep study (overnight, attended)

CPT 95810 · lowest of 2 lines · metro median $2,035

$4,183

cash

$917 to $2,319

30 negotiated rates

$5,229

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · metro median $1,848

$488

cash

$944 to $1,289

30 negotiated rates

$610

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · lowest of 2 lines · metro median $733

$175

cash

$754 to $1,029

40 negotiated rates

$219

list

TSH test (thyroid)

CPT 84443 · lowest of 2 lines · metro median $48

$83

cash

$17 to $185

45 negotiated rates

$104

list

Tonsils and adenoids removal (under age 12)

CPT 42820 · lowest of 2 lines · metro median $1,055

$1,055

cash

$5,182 to $8,626

22 negotiated rates

$1,319

list

Transvaginal ultrasound

CPT 76830 · lowest of 2 lines · metro median $104

$104

cash

$112 to $322

45 negotiated rates

$130

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 2 lines · metro median $338

$1,376

cash

$112 to $682

30 negotiated rates

$1,720

list

Upper endoscopy (EGD)

CPT 43235 · lowest of 2 lines · metro median $522

$522

cash

$968 to $5,182

31 negotiated rates

$653

list

Upper endoscopy with biopsy

CPT 43239 · lowest of 2 lines · metro median $595

$595

cash

$968 to $5,182

31 negotiated rates

$744

list

Urinalysis with microscope

CPT 81001 · lowest of 2 lines · metro median $29

$38

cash

$3 to $16

45 negotiated rates

$47

list

Vaginal delivery after a previous cesarean

CPT 59610 · metro median $3,490

$3,490

cash

$2,234 to $3,049

10 negotiated rates

$4,362

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$1,516 to $9,970

18 negotiated rates

—

list

Vaginal delivery with prenatal and postpartum care

CPT 59400 · metro median $2,866

$2,866

cash

$2,119 to $2,892

10 negotiated rates

$3,583

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 2 lines · metro median $184

$137

cash

$112 to $152

30 negotiated rates

$171

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://apim.services.craneware.com/api-pricing-transparency/api/public/70a2f3e86bcb0aa7bc3459a5555265ca/charges/mrf
Citizens Memorial Hospital · parsed · wide v3.0.0 · file dated 2026-03-25 · 59.5 MB · 2236 price rows read · read Nov 2026