Witham Health Services

2605 N Lebanon St, Lebanon, IN 46052 · (765) 485-8000

Acute Care HospitalsGovernment - LocalCMS rating 4/5Indianapolis, IN metro Website ↗

Price file

Prices published

File dated 2026-10-26

2,889 price rows for 50 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · metro median $132

$54

cash

$8 to $194

19 negotiated rates

$78

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · metro median $966

$4,807

cash

$162 to $17,168

19 negotiated rates

$6,867

list

CT scan of the head, no contrast

CPT 70450 · metro median $542

$1,678

cash

$57 to $5,993

19 negotiated rates

$2,397

list

CT scan of the pelvis, with contrast

CPT 72193 · metro median $542

$2,405

cash

$123 to $8,589

19 negotiated rates

$3,436

list

Cesarean delivery with prenatal and postpartum care

CPT 59510 · metro median $2,561

$2,561

cash

$2,201 to $9,146

19 negotiated rates

$3,658

list

Chlamydia test (DNA)

CPT 87491 · metro median $131

$190

cash

$35 to $680

57 negotiated rates

$272

list

Colonoscopy (diagnostic)

CPT 45378 · metro median $891

$341

cash

$302 to $1,869

19 negotiated rates

$487

list

Colonoscopy with biopsy

CPT 45380 · metro median $1,027

$1,027

cash

$909 to $3,667

19 negotiated rates

$1,467

list

Colonoscopy with polyp removal

CPT 45385 · metro median $1,040

$1,040

cash

$921 to $3,715

19 negotiated rates

$1,486

list

Complete blood count (CBC) with differential

CPT 85025 · metro median $42

$51

cash

$8 to $181

19 negotiated rates

$72

list

Comprehensive metabolic panel (blood test)

CPT 80053 · metro median $55

$66

cash

$11 to $236

19 negotiated rates

$95

list

Diagnostic mammogram (both breasts)

CPT 77066 · metro median $378

$680

cash

$84 to $2,428

38 negotiated rates

$971

list

Established patient office visit (about 40 minutes)

CPT 99215 · metro median $74

$420

cash

$103 to $1,811

276 negotiated rates

$601

list

Gallbladder removal (laparoscopic)

CPT 47562 · metro median $1,563

$2,279

cash

$358 to $12,153

38 negotiated rates

$3,255

list

Gonorrhea test (DNA)

CPT 87591 · metro median $131

$190

cash

$35 to $680

57 negotiated rates

$272

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · metro median $1,237

$1,452

cash

$76 to $7,197

114 negotiated rates

$2,075

list

Knee arthroscopy with meniscus repair

CPT 29881 · metro median $1,082

$1,082

cash

$81 to $6,577

114 negotiated rates

$1,546

list

Left heart catheterization

CPT 93452 · metro median $13,433

$11,884

cash

$3,430 to $42,444

19 negotiated rates

$16,977

list

Lipid panel (cholesterol test)

CPT 80061 · metro median $147

$64

cash

$13 to $295

57 negotiated rates

$91

list

Liver function panel

CPT 80076 · metro median $158

$61

cash

$8 to $218

19 negotiated rates

$87

list

MRI of the brain, with and without contrast

CPT 70553 · metro median $932

$3,479

cash

$194 to $12,427

57 negotiated rates

$4,971

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · metro median $583

$2,617

cash

$129 to $13,191

57 negotiated rates

$3,739

list

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

CPT 72148 · metro median $583

$2,496

cash

$117 to $8,915

19 negotiated rates

$3,566

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · metro median $583

$2,617

cash

$117 to $9,348

19 negotiated rates

$3,739

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · metro median $2,216

$115

cash

$102 to $1,778

57 negotiated rates

$164

list

New patient office visit (about 30 minutes)

CPT 99203 · metro median $325

$325

cash

$59 to $1,838

257 negotiated rates

$464

list

New patient office visit (about 45 minutes)

CPT 99204 · metro median $419

$419

cash

$96 to $2,061

226 negotiated rates

$599

list

New patient office visit (about 60 minutes)

CPT 99205 · metro median $550

$550

cash

$130 to $2,239

238 negotiated rates

$785

list

PSA test (prostate)

CPT 84153 · metro median $82

$91

cash

$18 to $753

38 negotiated rates

$130

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · metro median $84

$142

cash

$6 to $507

19 negotiated rates

$203

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · metro median $61

$141

cash

$28 to $554

171 negotiated rates

$202

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · metro median $531

$740

cash

$68 to $2,643

19 negotiated rates

$1,057

list

Preventive visit, new patient age 18 to 39

CPT 99385 · metro median $149

$132

cash

$117 to $473

13 negotiated rates

$189

list

Preventive visit, new patient age 40 to 64

CPT 99386 · metro median $190

$132

cash

$117 to $473

13 negotiated rates

$189

list

Prostate biopsy

CPT 55700 · metro median $3,604

$278

cash

$246 to $993

13 negotiated rates

$397

list

Prothrombin time (blood clotting test)

CPT 85610 · metro median $54

$87

cash

$4 to $312

19 negotiated rates

$125

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · metro median $817

$817

cash

$724 to $7,871

19 negotiated rates

$1,168

list

Screening mammogram (both breasts)

CPT 77067 · metro median $250

$138

cash

$69 to $1,292

76 negotiated rates

$197

list

Shoulder arthroscopy with decompression

CPT 29826 · metro median $634

$362

cash

$135 to $1,292

57 negotiated rates

$517

list

Sleep study (overnight, attended)

CPT 95810 · metro median $2,770

$4,761

cash

$122 to $17,002

57 negotiated rates

$6,801

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · metro median $1,970

$311

cash

$275 to $1,419

19 negotiated rates

$444

list

TSH test (thyroid)

CPT 84443 · metro median $82

$79

cash

$17 to $1,242

57 negotiated rates

$113

list

Tonsils and adenoids removal (under age 12)

CPT 42820 · metro median $300

$662

cash

$587 to $11,900

19 negotiated rates

$946

list

Transvaginal ultrasound

CPT 76830 · metro median $462

$525

cash

$64 to $1,874

57 negotiated rates

$750

list

Ultrasound of the abdomen (complete)

CPT 76700 · metro median $520

$1,114

cash

$70 to $3,980

19 negotiated rates

$1,592

list

Upper endoscopy (EGD)

CPT 43235 · metro median $730

$567

cash

$502 to $2,024

19 negotiated rates

$810

list

Upper endoscopy with biopsy

CPT 43239 · metro median $654

$654

cash

$579 to $2,336

19 negotiated rates

$935

list

Urinalysis with microscope

CPT 81001 · metro median $75

$118

cash

$3 to $420

19 negotiated rates

$168

list

Vaginal delivery with prenatal and postpartum care

CPT 59400 · metro median $2,195

$2,195

cash

$1,945 to $7,841

19 negotiated rates

$3,136

list

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

CPT 72110 · metro median $347

$862

cash

$23 to $3,079

19 negotiated rates

$1,232

list

Source files

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

https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbWithamHospital&type=CDMWithoutLabel&fileType=CSV
Witham Memorial Hospital · parsed · tall v3.0.0 · file dated 2026-10-26 · 55.7 MB · 2889 price rows read · read Nov 2026