Franciscan Health Rensselaer, Inc
1104 E Grace St., Rensselaer, IN 47978 · Critical access hospital · Emergency room
These are Franciscan Health Rensselaer, Inc's own posted figures from its standard-charges file dated January 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
185 of the services we track have a posted price here. Tap a service to compare it with nearby hospitals. How to read these numbers.
Emergency room
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Critical care, first 30 to 74 minutes CPT 99291 | $643.33 | $1,797.00 | $295.62 – $1,437.60 |
| Emergency room visit, level 1 (minor) CPT 99281 | $98.45 | $275.00 | $68.75 – $354.74 |
| Emergency room visit, level 2 CPT 99282 | $108.83 | $304.00 | $76.00 – $392.83 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $192.25 | $537.00 | $134.25 – $698.39 |
| Emergency room visit, level 4 CPT 99284 | $262.77 | $734.00 | $183.50 – $1,067.55 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $419.93 | $1,173.00 | $293.25 – $1,523.62 |
Office visits
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $35.80 | $100.00 | $21.67 – $100.04 |
| Abdominal X-ray, 1 view CPT 74018 | $55.85 | $156.00 | $39.00 – $390.96 |
| Ankle X-ray, 3 or more views CPT 73610 | $87.71 | $245.00 | $61.25 – $781.92 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $180.79 | $505.00 | $104.99 – $480.96 |
| Breast ultrasound, one breast, complete CPT 76641 | $132.46 | $370.00 | $92.50 – $961.92 |
| Breast ultrasound, one breast, limited CPT 76642 | $132.46 | $370.00 | $92.50 – $781.92 |
| Chest X-ray, 1 view CPT 71045 | $55.85 | $156.00 | $39.00 – $390.96 |
| Chest X-ray, 2 views CPT 71046 | $106.68 | $298.00 | $74.50 – $390.96 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $501.56 | $1,401.00 | $350.25 – $1,120.80 |
| CT angiogram of the head CPT 70496 | $501.56 | $1,401.00 | $350.25 – $1,170.51 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $1,252.64 | $3,499.00 | $632.46 – $2,799.20 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $1,435.58 | $4,010.00 | $751.30 – $3,208.00 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $1,038.92 | $2,902.00 | $350.38 – $2,321.60 |
| CT scan of the abdomen, without contrast CPT 74150 | $552.39 | $1,543.00 | $227.13 – $1,234.40 |
| CT scan of the chest, with contrast CPT 71260 | $630.80 | $1,762.00 | $381.07 – $1,409.60 |
| CT scan of the chest, without contrast CPT 71250 | $552.39 | $1,543.00 | $227.13 – $1,234.40 |
| CT scan of the head, without contrast CPT 70450 | $552.39 | $1,543.00 | $220.90 – $1,234.40 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $591.77 | $1,653.00 | $227.13 – $1,322.40 |
| CT scan of the pelvis, with contrast CPT 72193 | $630.80 | $1,762.00 | $381.07 – $1,409.60 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $552.39 | $1,543.00 | $227.13 – $1,234.40 |
| Diagnostic mammogram, both breasts CPT 77066 | $147.85 | $413.00 | $102.19 – $463.32 |
| Diagnostic mammogram, one breast CPT 77065 | $111.34 | $311.00 | $77.75 – $363.29 |
| Foot X-ray, 3 or more views CPT 73630 | $85.56 | $239.00 | $59.75 – $781.92 |
| Hand X-ray, 3 or more views CPT 73130 | $90.22 | $252.00 | $63.00 – $781.92 |
| Knee X-ray, 3 views CPT 73562 | $97.38 | $272.00 | $68.00 – $781.92 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $357.64 | $999.00 | $249.75 – $887.42 |
| Leg or arm vein ultrasound, one side CPT 93971 | $272.80 | $762.00 | $190.50 – $631.10 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $106.68 | $298.00 | $66.34 – $480.96 |
| MRI of both breasts, without and with contrast CPT 77049 | $197.97 | $553.00 | $138.25 – $1,079.02 |
| MRI of the abdomen, without and with contrast CPT 74183 | $887.12 | $2,478.00 | $619.50 – $1,982.40 |
| MRI of the brain, without and with contrast CPT 70553 | $887.12 | $2,478.00 | $619.50 – $1,982.40 |
| MRI of the brain, without contrast CPT 70551 | $703.11 | $1,964.00 | $464.37 – $1,571.20 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $703.11 | $1,964.00 | $491.00 – $1,571.20 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $703.11 | $1,964.00 | $457.59 – $1,571.20 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $703.11 | $1,964.00 | $457.59 – $1,571.20 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $703.11 | $1,964.00 | $457.59 – $1,571.20 |
| MRI of the pelvis, without and with contrast CPT 72197 | $887.12 | $2,478.00 | $619.50 – $1,982.40 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $703.11 | $1,964.00 | $491.00 – $1,571.20 |
| Neck X-ray, 2 or 3 views CPT 72040 | $103.82 | $290.00 | $66.34 – $390.96 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $187.95 | $525.00 | $131.25 – $480.96 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $209.43 | $585.00 | $146.25 – $480.96 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $209.43 | $585.00 | $146.25 – $480.96 |
| Screening mammogram, both breasts CPT 77067 | $127.45 | $356.00 | $84.38 – $384.17 |
| Shoulder X-ray, 2 or more views CPT 73030 | $108.47 | $303.00 | $57.64 – $781.92 |
| Transvaginal pregnancy ultrasound CPT 76817 | $60.86 | $170.00 | $42.50 – $480.96 |
| Transvaginal ultrasound CPT 76830 | $163.25 | $456.00 | $114.00 – $480.96 |
| Ultrasound of the abdomen, complete CPT 76700 | $312.18 | $872.00 | $218.00 – $697.60 |
| Ultrasound of the neck or thyroid CPT 76536 | $209.43 | $585.00 | $146.25 – $480.96 |
| Wrist X-ray, 3 or more views CPT 73110 | $81.98 | $229.00 | $57.25 – $781.92 |
| X-ray of the lower back, 4 or more views CPT 72110 | $154.30 | $431.00 | $91.46 – $480.96 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $78.04 | $218.00 | $7.57 – $174.40 |
| Blood culture CPT 87040 | $16.11 | $45.00 | $9.24 – $46.44 |
| Blood draw (venipuncture) CPT 36415 | $12.89 | $36.00 | $8.36 – $38.57 |
| BNP test (heart failure) CPT 83880 | $46.90 | $131.00 | $32.75 – $176.67 |
| C-reactive protein (CRP) test CPT 86140 | $38.31 | $107.00 | $4.64 – $85.60 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $103.82 | $290.00 | $31.41 – $232.00 |
| Complete blood count (CBC) with differential CPT 85025 | $35.08 | $98.00 | $6.95 – $78.40 |
| Complete blood count (CBC), automated CPT 85027 | $28.28 | $79.00 | $5.79 – $63.20 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $88.43 | $247.00 | $9.45 – $197.60 |
| COVID-19 PCR test CPT 87635 | $128.52 | $359.00 | $45.92 – $287.20 |
| D-dimer test (blood clots) CPT 85379 | $63.01 | $176.00 | $9.11 – $140.80 |
| Drug screen, instrument chemistry CPT 80307 | $95.59 | $267.00 | $55.62 – $279.63 |
| Ferritin (iron stores) test CPT 82728 | $22.55 | $63.00 | $12.20 – $61.34 |
| Free T4 (thyroid) test CPT 84439 | $74.46 | $208.00 | $8.07 – $166.40 |
| General health panel (blood tests) CPT 80050 | $153.22 | $428.00 | $107.00 – $342.40 |
| Glucose (blood sugar) test CPT 82947 | $21.84 | $61.00 | $3.52 – $48.80 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $124.94 | $349.00 | $31.41 – $279.20 |
| Hemoglobin A1c test CPT 83036 | $116.35 | $325.00 | $8.69 – $260.00 |
| Hepatitis C antibody test CPT 86803 | $170.41 | $476.00 | $12.77 – $380.80 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $63.37 | $177.00 | $21.55 – $141.60 |
| Iron test CPT 83540 | $27.57 | $77.00 | $5.79 – $61.60 |
| Kidney function panel CPT 80069 | $78.40 | $219.00 | $7.77 – $175.20 |
| Lipase test (pancreas) CPT 83690 | $33.65 | $94.00 | $6.17 – $75.20 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $55.49 | $155.00 | $11.98 – $124.00 |
| Liver function panel CPT 80076 | $63.37 | $177.00 | $7.31 – $141.60 |
| Magnesium test CPT 83735 | $43.32 | $121.00 | $6.00 – $96.80 |
| Obstetric blood test panel CPT 80055 | $156.09 | $436.00 | $42.79 – $348.80 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $29.36 | $82.00 | $5.38 – $65.60 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $55.85 | $156.00 | $13.47 – $124.80 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $21.12 | $59.00 | $3.84 – $47.20 |
| PSA (prostate specific antigen), free CPT 84154 | $78.40 | $219.00 | $16.46 – $175.20 |
| PSA (prostate specific antigen), total CPT 84153 | $75.90 | $212.00 | $16.46 – $169.60 |
| Rapid strep test CPT 87880 | $29.00 | $81.00 | $14.79 – $74.39 |
| Sed rate (ESR) test CPT 85652 | $76.25 | $213.00 | $2.42 – $170.40 |
| TB skin test CPT 86580 | $20.05 | $56.00 | $14.00 – $73.99 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $66.95 | $187.00 | $15.04 – $149.60 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $205.49 | $574.00 | $113.22 – $459.20 |
| Troponin test (heart damage) CPT 84484 | $108.83 | $304.00 | $11.16 – $243.20 |
| Urinalysis, automated, with microscope CPT 81001 | $29.36 | $82.00 | $2.84 – $65.60 |
| Urinalysis, automated, without microscope CPT 81003 | $12.17 | $34.00 | $2.01 – $27.20 |
| Urinalysis, manual, with microscope CPT 81000 | $47.61 | $133.00 | $3.60 – $106.40 |
| Urinalysis, manual, without microscope CPT 81002 | $15.75 | $44.00 | $3.11 – $35.20 |
| Urine culture, colony count CPT 87086 | $21.12 | $59.00 | $7.22 – $47.20 |
| Urine pregnancy test CPT 81025 | $29.36 | $82.00 | $7.71 – $65.60 |
| Vitamin B12 test CPT 82607 | $25.06 | $70.00 | $13.50 – $67.86 |
| Vitamin D test CPT 82306 | $64.44 | $180.00 | $26.49 – $144.00 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $271.36 | $758.00 | $189.50 – $610.44 |
| ECG tracing only (no interpretation) CPT 93005 | $109.91 | $307.00 | $76.75 – $245.60 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $531.99 | $1,486.00 | $371.50 – $1,397.97 |
| Left heart catheterization with coronary angiogram CPT 93458 | $8,889.86 | $24,832.00 | $6,208.00 – $19,865.60 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $965.53 | $2,697.00 | $674.25 – $5,972.72 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Appendix removal, laparoscopic CPT 44970 | $14,284.58 | $39,901.07 | $1,905.42 – $26,225.00 |
| Breast biopsy with ultrasound guidance CPT 19083 | $1,334.27 | $3,727.00 | $931.75 – $4,225.50 |
| Carpal tunnel release CPT 64721 | $3,587.88 | $10,022.02 | $1,728.79 – $10,106.00 |
| Colonoscopy with biopsy CPT 45380 | $3,631.65 | $10,144.26 | $153.27 – $4,106.00 |
| Colonoscopy with polyp removal (snare) CPT 45385 | $3,628.06 | $10,134.25 | $153.27 – $4,106.00 |
| Colonoscopy, diagnostic CPT 45378 | $2,640.51 | $7,375.74 | $153.27 – $4,106.00 |
| Cystoscopy (bladder scope) CPT 52000 | $1,270.64 | $3,549.28 | $1,242.31 – $3,057.00 |
| Flexible sigmoidoscopy, diagnostic CPT 45330 | $2,629.05 | $7,343.72 | $1,242.31 – $4,106.00 |
| Gallbladder removal, laparoscopic CPT 47562 | $15,216.07 | $42,503.00 | $4,211.34 – $26,225.00 |
| Inguinal (groin) hernia repair, open, age 5 or older CPT 49505 | $8,679.22 | $24,243.62 | $2,273.62 – $26,225.00 |
| Kidney stone shock-wave lithotripsy CPT 50590 | $10,338.44 | $28,878.33 | $7,658.23 – $26,225.00 |
| Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881 | $8,410.39 | $23,492.72 | $2,273.62 – $13,183.00 |
| Prostate biopsy CPT 55700 | $3,257.85 | $9,100.15 | $113.22 – $4,106.00 |
| Removal of a breast lump, open surgery CPT 19120 | $5,431.69 | $15,172.33 | $1,905.42 – $10,106.00 |
| Rotator cuff repair, arthroscopic CPT 29827 | $15,039.83 | $42,010.71 | $1,905.42 – $26,225.00 |
| Screening colonoscopy, average risk HCPCS G0121 | $2,317.62 | $6,473.79 | $153.27 – $4,106.00 |
| Screening colonoscopy, high risk HCPCS G0105 | $2,818.21 | $7,872.10 | $153.27 – $3,057.00 |
| Shoulder arthroscopy, bone shaving (decompression) CPT 29826 | $13,008.32 | $36,336.09 | $4,315.74 – $26,225.00 |
| Total hip replacement CPT 27130 | $36,638.06 | $102,340.96 | $26,103.48 – $49,765.00 |
| Total knee replacement CPT 27447 | $37,911.88 | $105,899.10 | $26,103.48 – $49,765.00 |
| Upper endoscopy (EGD) with biopsy CPT 43239 | $3,610.08 | $10,084.02 | $401.86 – $4,106.00 |
| Upper endoscopy (EGD), diagnostic CPT 43235 | $2,044.34 | $5,710.46 | $153.27 – $4,106.00 |
Hospital stays
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| COPD flare-up, with major complications MS-DRG 190 | $6,727.95 | $18,793.15 | $2,923.00 – $27,692.50 |
| Fainting (syncope) MS-DRG 312 | $1,720.24 | $4,805.15 | $2,923.00 – $21,790.00 |
| Heart failure, with major complications MS-DRG 291 | $4,760.69 | $13,298.01 | $2,923.00 – $32,095.00 |
| Heart failure, without complications MS-DRG 293 | $7,985.42 | $22,305.65 | $186.46 – $14,150.00 |
| Irregular heartbeat, without complications MS-DRG 310 | $2,385.94 | $6,664.65 | $2,923.00 – $14,152.50 |
| Kidney failure, with complications MS-DRG 683 | $3,890.21 | $10,866.50 | $2,923.00 – $21,895.00 |
| Kidney or urinary tract infection, without major complications MS-DRG 690 | $3,854.68 | $10,767.25 | $2,923.00 – $20,237.50 |
| Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641 | $3,110.48 | $8,688.50 | $2,923.00 – $19,455.00 |
| Pneumonia, with complications MS-DRG 194 | $3,896.36 | $10,883.70 | $2,923.00 – $20,147.50 |
| Pneumonia, with major complications MS-DRG 193 | $6,995.25 | $19,539.80 | $2,923.00 – $32,860.00 |
| Sepsis, with major complications MS-DRG 871 | $6,172.89 | $17,242.70 | $2,923.00 – $48,562.50 |
| Sepsis, without major complications MS-DRG 872 | $4,031.96 | $11,262.45 | $2,923.00 – $25,582.50 |
| Skin infection (cellulitis), without major complications MS-DRG 603 | $5,731.42 | $16,009.55 | $2,923.00 – $21,772.50 |
| Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392 | $2,379.73 | $6,647.30 | $2,923.00 – $19,490.00 |
| Stroke, with complications or clot-busting drug MS-DRG 65 | $4,792.08 | $13,385.70 | $2,923.00 – $25,257.50 |
Pain and spine
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Large joint injection or drainage (knee, shoulder, hip) CPT 20610 | $473.81 | $1,323.50 | $285.87 – $785.31 |
| Lower back spinal injection (epidural), with imaging guidance CPT 62323 | $2,511.46 | $7,015.24 | $1,533.57 – $3,057.00 |
Eye and ear
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Hearing test, comprehensive CPT 92557 | $192.96 | $539.00 | $134.75 – $431.20 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $147.85 | $413.00 | $103.25 – $780.39 |
| Sleep study with CPAP titration CPT 95811 | $1,839.76 | $5,139.00 | $780.39 – $4,271.86 |
| Sleep study, overnight in a sleep lab CPT 95810 | $1,583.08 | $4,422.00 | $780.39 – $4,271.86 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $73.03 | $204.00 | $51.00 – $552.43 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $56.56 | $158.00 | $39.50 – $223.75 |
| Physical therapy evaluation, low complexity CPT 97161 | $57.64 | $161.00 | $40.25 – $223.75 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $86.99 | $243.00 | $60.75 – $223.75 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $51.91 | $145.00 | $36.25 – $223.75 |
| Therapeutic activities, 15 minutes CPT 97530 | $40.81 | $114.00 | $28.50 – $223.75 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $251.67 | $703.00 | $79.56 – $562.40 |
| Group psychotherapy CPT 90853 | $405.61 | $1,133.00 | $79.56 – $906.40 |
| Psychiatric diagnostic evaluation CPT 90791 | $153.22 | $428.00 | $107.00 – $342.40 |
| Psychotherapy, 60 minutes CPT 90837 | $212.65 | $594.00 | $148.50 – $475.20 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $55.49 | $155.00 | $38.75 – $184.21 |
| IV hydration, each additional hour CPT 96361 | $55.49 | $155.00 | $38.75 – $124.00 |
| IV hydration, first hour CPT 96360 | $176.49 | $493.00 | $73.71 – $544.19 |
| IV push injection of a drug, first CPT 96374 | $55.49 | $155.00 | $38.75 – $544.19 |
| IV push injection, each additional drug CPT 96375 | $55.49 | $155.00 | $38.75 – $124.00 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $54.45 | $152.10 | $2.12 – $121.68 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $47.47 | $132.60 | ? – $106.08 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $55.40 | $154.75 | $3.83 – $123.80 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $63.65 | $177.80 | $1.32 – $142.24 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $53.45 | $149.30 | ? – $119.44 |
| Morphine injection, up to 10 mg HCPCS J2270 | $74.70 | $208.65 | $19.42 – $166.92 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $45.39 | $126.80 | ? – $101.44 |
| Propofol injection, per 10 mg HCPCS J2704 | $53.70 | $150.00 | ? – $120.00 |
| Saline IV solution, 1000 ml HCPCS J7030 | $41.19 | $115.05 | $2.90 – $92.04 |
Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.