Saline Memorial Hospital

1 Medical Park Drive, Benton, AR 72015 · (501) 776-6000

Acute Care HospitalsProprietaryCMS rating 3/5Little Rock, AR metro Website ↗

Price file

Prices published

File dated 2026-07-17

2,112 price rows for 50 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048

—

cash

$10 to $14

20 negotiated rates

$455

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177

—

cash

$354 to $1,146

60 negotiated rates

$6,203

list

CT scan of the head, no contrast

CPT 70450

—

cash

$106 to $1,146

60 negotiated rates

$2,256

list

CT scan of the pelvis, with contrast

CPT 72193

—

cash

$178 to $1,146

60 negotiated rates

$2,831

list

Cesarean delivery with prenatal and postpartum care

CPT 59510

—

cash

$2,169 to $3,535

6 negotiated rates

$27,589

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$4,346 to $14,535

30 negotiated rates

$28,074

list

Chlamydia test (DNA)

CPT 87491

—

cash

$39 to $57

20 negotiated rates

$255

list

Colonoscopy (diagnostic)

CPT 45378

—

cash

$873 to $2,084

60 negotiated rates

$5,506

list

Colonoscopy with biopsy

CPT 45380

—

cash

$1,129 to $2,084

30 negotiated rates

$5,748

list

Colonoscopy with polyp removal

CPT 45385

—

cash

$1,129 to $2,084

30 negotiated rates

$6,169

list

Complete blood count (CBC) with differential

CPT 85025

—

cash

$9 to $13

20 negotiated rates

$126

list

Comprehensive metabolic panel (blood test)

CPT 80053

—

cash

$12 to $17

20 negotiated rates

$513

list

Diagnostic mammogram (both breasts)

CPT 77066

—

cash

$44 to $226

58 negotiated rates

$466

list

Established patient office visit (about 40 minutes)

CPT 99215

—

cash

$119 to $193

20 negotiated rates

$718

list

Gallbladder removal (laparoscopic)

CPT 47562

—

cash

$3,963 to $9,865

60 negotiated rates

$26,293

list

Gonorrhea test (DNA)

CPT 87591

—

cash

$39 to $57

20 negotiated rates

$255

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

$13,289 to $19,956

30 negotiated rates

$94,884

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$5,754 to $8,066

30 negotiated rates

$31,169

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$8,607 to $12,836

30 negotiated rates

$45,848

list

Inguinal hernia repair (age 5 and up)

CPT 49505

—

cash

$2,985 to $5,842

30 negotiated rates

$24,437

list

Knee arthroscopy with meniscus repair

CPT 29881

—

cash

$2,985 to $5,339

60 negotiated rates

$20,782

list

Lipid panel (cholesterol test)

CPT 80061

—

cash

$13 to $22

58 negotiated rates

$295

list

Liver function panel

CPT 80076

—

cash

$9 to $13

20 negotiated rates

$469

list

MRI of the brain, with and without contrast

CPT 70553

—

cash

$354 to $1,412

60 negotiated rates

$7,435

list

MRI of the knee or other lower joint, no contrast

CPT 73721

—

cash

$242 to $1,412

60 negotiated rates

$6,046

list

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

CPT 72148

—

cash

$242 to $1,412

60 negotiated rates

$5,314

list

MRI of the neck (cervical spine), no contrast

CPT 72141

—

cash

$242 to $1,412

60 negotiated rates

$5,106

list

New patient office visit (about 30 minutes)

CPT 99203

—

cash

$67 to $109

20 negotiated rates

$438

list

New patient office visit (about 45 minutes)

CPT 99204

—

cash

$110 to $179

20 negotiated rates

$549

list

New patient office visit (about 60 minutes)

CPT 99205

—

cash

$150 to $245

20 negotiated rates

$705

list

PSA test (prostate)

CPT 84153

—

cash

$21 to $30

20 negotiated rates

$214

list

Partial thromboplastin time (blood clotting test)

CPT 85730

—

cash

$7 to $10

20 negotiated rates

$126

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110

—

cash

$27 to $147

58 negotiated rates

$133

list

Pregnancy ultrasound (after first trimester)

CPT 76805

—

cash

$102 to $171

58 negotiated rates

$801

list

Prothrombin time (blood clotting test)

CPT 85610

—

cash

$5 to $7

10 negotiated rates

$81

list

Removal of a breast lump (biopsy by excision)

CPT 19120

—

cash

$2,461 to $6,389

30 negotiated rates

$16,766

list

Screening mammogram (both breasts)

CPT 77067

—

cash

$78 to $182

58 negotiated rates

$385

list

Shoulder arthroscopy with decompression

CPT 29826

—

cash

$134 to $1,603

7 negotiated rates

$32,290

list

Sleep study (overnight, attended)

CPT 95810

—

cash

$847 to $1,401

58 negotiated rates

$4,227

list

Spinal injection, lower back, with imaging guidance

CPT 62323

—

cash

$663 to $1,603

30 negotiated rates

$2,774

list

TSH test (thyroid)

CPT 84443

—

cash

$19 to $27

20 negotiated rates

$260

list

Transvaginal ultrasound

CPT 76830

—

cash

$102 to $171

58 negotiated rates

$1,151

list

Ultrasound of the abdomen (complete)

CPT 76700

—

cash

$106 to $293

58 negotiated rates

$1,502

list

Upper endoscopy (EGD)

CPT 43235

—

cash

$897 to $1,603

60 negotiated rates

$6,158

list

Upper endoscopy with biopsy

CPT 43239

—

cash

$897 to $2,084

60 negotiated rates

$6,222

list

Urinalysis with microscope

CPT 81001

—

cash

$4 to $5

20 negotiated rates

$73

list

Vaginal delivery after a previous cesarean

CPT 59610

—

cash

$2,041 to $3,328

6 negotiated rates

$15,779

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$3,965 to $7,404

30 negotiated rates

$16,143

list

Vaginal delivery with prenatal and postpartum care

CPT 59400

—

cash

$1,955 to $3,187

6 negotiated rates

$15,779

list

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

CPT 72110

—

cash

$102 to $171

58 negotiated rates

$640

list

Source files

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

https://www.salinememorial.org/docs/ahsalinememorialhospitallibraries/hcl/mrf3q262/812816675_saline-memorial-hospital_standardcharges.csv
Saline Health System · parsed · wide v3.0.0 · file dated 2026-07-17 · 13.7 MB · 2112 price rows read · read Nov 2026