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Stephens Memorial Hospital

200 South Geneva Street, Breckenridge, TX 76424 · (254) 559-2241

Critical Access HospitalsGovernment - Hospital District or Authority

Price file

Prices published

File dated 2025-09-09 (older than a year)

2,151 price rows for 62 procedures

Published prices

cash · negotiated range · list
Basic metabolic panel (blood test)

CPT 80048 · lowest of 2 lines

$192
cash
$1,838
cash
CT scan of the head, no contrast

CPT 70450 · lowest of 2 lines

$1,141
cash
CT scan of the pelvis, with contrast

CPT 72193 · lowest of 2 lines

$1,014
cash
—
cash
—
cash
Chlamydia test (DNA)

CPT 87491 · lowest of 2 lines

$151
cash
—
cash
—
cash
—
cash
Complete blood count (CBC) with differential

CPT 85025 · lowest of 2 lines

$130
cash
Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 2 lines

$236
cash
Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 2 lines

$398
cash
—
cash
$464
cash
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cash
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cash
—
cash
Gonorrhea test (DNA)

CPT 87591 · lowest of 2 lines

$202
cash
—
cash
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cash
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cash
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cash
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cash
Lipid panel (cholesterol test)

CPT 80061 · lowest of 2 lines

$140
cash
Liver function panel

CPT 80076 · lowest of 2 lines

$165
cash
MRI of the brain, with and without contrast

CPT 70553 · lowest of 2 lines

$3,302
cash
$2,140
cash
$1,442
cash
MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 2 lines

$1,442
cash
—
cash
New patient office visit (about 30 minutes)

CPT 99203 · lowest of 3 lines

$272
cash
New patient office visit (about 45 minutes)

CPT 99204 · lowest of 3 lines

$404
cash
New patient office visit (about 60 minutes)

CPT 99205 · lowest of 3 lines

$287
cash
PSA test (prostate)

CPT 84153 · lowest of 4 lines

$186
cash
$117
cash
$193
cash
Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 2 lines

$1,407
cash
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cash
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cash
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cash
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cash
Prothrombin time (blood clotting test)

CPT 85610 · lowest of 2 lines

$101
cash
—
cash
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cash
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cash
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Screening mammogram (both breasts)

CPT 77067 · lowest of 2 lines

$260
cash
—
cash
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cash
$856
cash
$856
cash
TSH test (thyroid)

CPT 84443 · lowest of 2 lines

$277
cash
—
cash
Transvaginal ultrasound

CPT 76830 · lowest of 2 lines

$757
cash
Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 2 lines

$1,373
cash
—
cash
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cash
Urinalysis with microscope

CPT 81001 · lowest of 2 lines

$129
cash
—
cash
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cash
X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 2 lines

$952
cash

Source files

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