| Procedure | Amery Hospital & Clinic | Fairview Lakes Health Services | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $208 | $43 | $51 |
| Abdominal fluid drain (paracentesis) | $277 | $820 | $284 |
| Abdominal ultrasound | $462 | $217 | $100 |
| Abdominal ultrasound (complete) | $462 | $278 | $114 |
| Abdominal ultrasound (limited) | $462 | $217 | $86 |
| Abscess drainage (complex or multiple) | $148 | $412 | $220 |
| Abscess drainage (simple) | $102 | $294 | $129 |
| Abscess incision and drainage | $125 | $370 | $174 |
| Achilles tendon repair | $1,475 | $1,666 | $624 |
| Adenoid removal (adenoidectomy) | $373 | $570 | $204 |
| Albumin blood test | $21 | $18 | $5 |
| Aldosterone test | $89 | $32 | $41 |
| Alkaline phosphatase test | $15 | $16 | $5 |
| Allergy shots | $26 | $47 | $11 |
| Alpha-fetoprotein (AFP) test | $25 | $55 | $17 |
| ALT liver enzyme test | $33 | $19 | $5 |
| Ammonia blood test | $50 | $41 | $15 |
| Amylase test | $34 | $34 | $6 |
| Ankle fracture repair | $1,424 | $1,580 | $608 |
| Anoscopy | $107 | $138 | $129 |
| Antinuclear antibody (ANA) test | $63 | $21 | $12 |
| Arterial blood gas (ABG) | $92 | $57 | $26 |
| AST liver enzyme test | $33 | $20 | $5 |
| Barium swallow study | $334 | $295 | $107 |
| Bartholin cyst removal | $188 | $202 | $182 |
| Basic metabolic panel | $56 | $68 | $8 |
| Bilirubin blood test | $19 | $15 | $5 |
| Bladder scope (cystoscopy) | $202 | $747 | $216 |
| Bladder tumor removal (TURBT) | $381 | $648 | $236 |
| Blood clotting test (PT/INR) | $16 | $31 | $4 |
| Blood crossmatch | $54 | $121 | — |
| Blood glucose test | $21 | $18 | $5 |
| Blood transfusion | $239 | $476 | $47 |
| Blood type and screen | $51 | $52 | $10 |
| Blood type test | $27 | $39 | $3 |
| Blood type test (ABO group) | $20 | $44 | $3 |
| Blood type test (Rh/D antigen) | $51 | $39 | $3 |
| BNP (heart failure) test | $94 | $112 | $39 |
| Bone density scan (DEXA) | $479 | $158 | $39 |
| Bone scan (nuclear) | $1,032 | $638 | $259 |
| Breast biopsy | $940 | $1,735 | $478 |
| Breast ultrasound | $364 | $208 | $92 |
| Breast ultrasound (limited) | $364 | $198 | $84 |
| Breathing tube insertion (intubation) | $248 | $338 | $133 |
| Bronchoscopy | $717 | $1,628 | $303 |
| Bunion surgery (bunionectomy) | $1,242 | $2,207 | $883 |
| Burn dressing and debridement (medium) | $50 | $296 | $166 |
| Burn dressing and debridement (small) | $75 | $209 | $93 |
| Burn treatment | $62 | $221 | $129 |
| C-reactive protein (CRP) | $42 | $20 | $5 |
| CA 19-9 tumor marker test | $50 | $61 | $21 |
| CA-125 ovarian marker test | $34 | $46 | $21 |
| Calcium blood test | $28 | $16 | $5 |
| Cardiac MRI | $1,610 | $638 | $322 |
| Cardiac MRI without contrast | $1,370 | $638 | $280 |
| Cardiac rehabilitation | $228 | $147 | $26 |
| Cardiac stress test | $300 | $425 | $39 |
| Cardioversion | $183 | $723 | $155 |
| Carotid artery ultrasound | $570 | $204 | $156 |
| Carpal tunnel release | $972 | $1,134 | $483 |
| CEA tumor marker test | $23 | $53 | $19 |
| Celiac disease test | $47 | $40 | $12 |
| Central line placement | $2,060 | $2,073 | $238 |
| Chalazion (eyelid cyst) removal | $117 | $331 | $131 |
| Chemotherapy infusion | $324 | $313 | $81 |
| Chemotherapy infusion (each additional) | $120 | $187 | $28 |
| Chemotherapy infusion (first hour) | $527 | $440 | $133 |
| Chest fluid drain (thoracentesis) | $613 | $776 | $311 |
| Chest tube insertion | $140 | $1,503 | $143 |
| Chest X-ray | $142 | $111 | $37 |
| Chest X-ray (1 view) | $104 | $128 | $25 |
| Chest X-ray (2 views) | $142 | $139 | $33 |
| Chickenpox (varicella) vaccine | $142 | $142 | — |
| Circumcision | $281 | $426 | $167 |
| Clotting time test (PTT) | $39 | $59 | $6 |
| Colon resection (colectomy) | $2,132 | $2,982 | $1,238 |
| Colonoscopy | $1,951 | $1,164 | $480 |
| Colposcopy | $64 | $539 | $161 |
| Complete blood count (CBC) | $35 | $43 | $7 |
| Complete blood count (CBC) (complete) | $39 | $43 | $8 |
| Comprehensive metabolic panel | $106 | $89 | $11 |
| Contraceptive implant (Nexplanon) | $83 | $487 | $115 |
| Copper blood test | $27 | $32 | $12 |
| Cortisol test | $45 | $33 | $16 |
| COVID-19 PCR test | $73 | $53 | $51 |
| CPAP titration study | $129 | $316 | $69 |
| Creatine kinase (CK) test | $38 | $21 | $7 |
| CT angiography of the chest | $1,524 | $537 | $281 |
| CT angiography of the head | $1,541 | $511 | $274 |
| CT colonography (virtual colonoscopy) | $1,690 | $1,402 | $835 |
| CT scan of the abdomen | $1,343 | $624 | $230 |
| CT scan of the abdomen and pelvis | $1,731 | $561 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $2,017 | $817 | $338 |
| CT scan of the abdomen and pelvis with contrast | $1,731 | $607 | $300 |
| CT scan of the abdomen and pelvis without contrast | $1,524 | $516 | $183 |
| CT scan of the abdomen with and without contrast | $1,560 | $719 | $259 |
| CT scan of the abdomen with contrast | $1,343 | $624 | $230 |
| CT scan of the abdomen without contrast | $1,104 | $471 | $136 |
| CT scan of the arm | $951 | $643 | $199 |
| CT scan of the arm with contrast | $913 | $689 | $199 |
| CT scan of the arm without contrast | $951 | $735 | $161 |
| CT scan of the chest | $1,313 | $468 | $167 |
| CT scan of the chest with and without contrast | $1,598 | $392 | $196 |
| CT scan of the chest with contrast | $1,313 | $574 | $167 |
| CT scan of the chest without contrast | $1,027 | $469 | $133 |
| CT scan of the head | $1,160 | $480 | $148 |
| CT scan of the head with and without contrast | $1,445 | $480 | $173 |
| CT scan of the head with contrast | $1,160 | $480 | $148 |
| CT scan of the head without contrast | $875 | $361 | $107 |
| CT scan of the leg | $1,065 | $608 | $166 |
| CT scan of the leg with contrast | $1,065 | $689 | $166 |
| CT scan of the leg without contrast | $951 | $664 | $130 |
| CT scan of the lower back (lumbar spine) | $1,388 | $420 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $1,674 | $370 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,388 | $627 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,104 | $407 | $130 |
| CT scan of the neck | $1,236 | $564 | $183 |
| CT scan of the neck (cervical spine) | $1,388 | $472 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $1,674 | $349 | $196 |
| CT scan of the neck (cervical spine) with contrast | $1,388 | $551 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,104 | $472 | $131 |
| CT scan of the neck with and without contrast | $1,524 | $573 | $220 |
| CT scan of the neck with contrast | $1,236 | $562 | $183 |
| CT scan of the neck without contrast | $951 | $569 | $150 |
| CT scan of the pelvis | $1,236 | $491 | $226 |
| CT scan of the pelvis with and without contrast | $1,524 | $407 | $251 |
| CT scan of the pelvis with contrast | $1,236 | $650 | $226 |
| CT scan of the pelvis without contrast | $951 | $491 | $133 |
| CT scan of the sinuses | $1,217 | $573 | $152 |
| CT scan of the sinuses with and without contrast | $1,503 | $573 | $184 |
| CT scan of the sinuses with contrast | $1,217 | $573 | $152 |
| CT scan of the sinuses without contrast | $933 | $561 | $128 |
| D-dimer test | $108 | $41 | $10 |
| Developmental screening (child) | $16 | $74 | — |
| DHEA-sulfate test | $28 | $58 | $22 |
| Diagnostic mammogram | $242 | $179 | $140 |
| Drug screen (urine) | $84 | $39 | $17 |
| Ear tubes (myringotomy) | $191 | $1,842 | $174 |
| Echocardiogram | $560 | $446 | $138 |
| Echocardiogram with and without contrast | $230 | $446 | $101 |
| EEG (awake and asleep) | $84 | $342 | $482 |
| EKG / ECG (tracing only) | $26 | $82 | $7 |
| Electrocardiogram (EKG) | $26 | $37 | $8 |
| Electroencephalogram (EEG) | $79 | $337 | $448 |
| Electrolyte panel | $60 | $32 | $7 |
| Electromyography (EMG) | $33 | $191 | $141 |
| Emergency department visit | $286 | $288 | $69 |
| Emergency department visit (level 1) | $91 | $206 | $11 |
| Emergency department visit (level 2) | $186 | $239 | $40 |
| Emergency department visit (level 3) | $286 | $288 | $69 |
| Emergency department visit (level 4) | $590 | $498 | $118 |
| Emergency department visit (level 5) | $379 | $708 | $171 |
| Endometrial biopsy | $44 | $217 | $98 |
| Epidural steroid injection | $399 | $711 | $275 |
| Estradiol (estrogen) test | $119 | $62 | $28 |
| Eye refraction (glasses prescription) | $16 | $42 | — |
| Facet joint injection (spine) | $731 | $928 | $99 |
| Fallopian tube X-ray (HSG) | $331 | $446 | $164 |
| Family therapy session | $166 | $232 | $110 |
| Feeding tube (PEG) placement | $440 | $1,781 | $178 |
| Femoral hernia repair | $1,288 | $1,534 | $584 |
| Ferritin (iron) test | $69 | $47 | $14 |
| Fibrinogen test | $50 | $32 | $10 |
| Flexible sigmoidoscopy | $1,494 | $870 | $323 |
| Flu test | $62 | $34 | $17 |
| Folate (folic acid) test | $18 | $38 | $15 |
| Foreign body removal (skin) | $72 | $598 | $157 |
| Free T4 thyroid test | $115 | $31 | $9 |
| FSH hormone test | $19 | $46 | $19 |
| Gallbladder removal (laparoscopic) | $1,365 | $1,660 | $658 |
| Gallbladder scan (HIDA) | $1,151 | $648 | $334 |
| Ganglion cyst removal | $543 | $838 | $321 |
| GGT liver test | $42 | $20 | $7 |
| Glucose tolerance test | $30 | $24 | $8 |
| Group therapy session | $193 | $138 | $30 |
| H. pylori test | $166 | $131 | $67 |
| Hammertoe repair | $808 | $1,386 | $548 |
| HDL cholesterol test | $10 | $27 | $8 |
| Hematocrit test | $32 | $17 | $2 |
| Hemoglobin A1c (diabetes test) | $18 | $26 | $10 |
| Hemorrhoid removal | $414 | $815 | $338 |
| Hepatitis A vaccine | $66 | $59 | — |
| Hepatitis B test | $74 | $37 | $10 |
| Hepatitis B vaccine | $66 | $53 | — |
| Hepatitis C test | $36 | $51 | $14 |
| HIV test | $58 | $45 | $19 |
| HIV test (antigen/antibody combo) | $58 | $44 | $24 |
| Holter heart monitor | $161 | $153 | $26 |
| HPV vaccine | $166 | $122 | — |
| Hydrocele repair | $756 | $846 | $315 |
| Hysterectomy | $1,708 | $1,723 | $933 |
| Hysteroscopy | $1,241 | $3,566 | $1,270 |
| Inguinal hernia repair | $978 | $973 | $538 |
| Iron blood test | $26 | $30 | $6 |
| IUD insertion | $39 | $238 | — |
| IUD removal | $45 | $377 | $112 |
| IV infusion therapy | $92 | $160 | $44 |
| IV infusion therapy (each additional) | $84 | $113 | $21 |
| IV infusion therapy (initial) | $100 | $228 | $67 |
| Kidney biopsy | $1,239 | $1,735 | $492 |
| Kidney scan (nuclear) | $834 | $651 | $172 |
| Kidney stone shock-wave (lithotripsy) | $1,543 | $1,880 | $760 |
| Kidney ultrasound | $436 | $229 | $84 |
| Kidney ultrasound (limited) | $386 | $228 | $61 |
| Lactate test | $85 | $31 | $12 |
| Laryngoscopy | $312 | $527 | $189 |
| LDH test | $36 | $20 | $6 |
| LDL cholesterol test | $49 | $30 | $11 |
| Leg vein ultrasound (Doppler) | $728 | $222 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $527 | $193 | $116 |
| LH hormone test | $19 | $41 | $19 |
| Lipase test | $47 | $29 | $7 |
| Lipid (cholesterol) panel | $38 | $39 | $13 |
| Liver biopsy | $1,037 | $1,310 | $288 |
| Liver function panel | $58 | $48 | $8 |
| Lumpectomy (breast) | $1,439 | $400 | $750 |
| Lung function test (PFT) | $154 | $178 | $37 |
| Lung scan (V/Q) | $1,280 | $589 | $291 |
| Magnesium blood test | $36 | $26 | $7 |
| Mastectomy | $1,792 | $3,471 | $1,021 |
| MMR vaccine | $74 | $82 | — |
| MRA of the brain | $2,285 | $766 | $226 |
| MRA of the brain with contrast | $2,285 | $767 | $226 |
| MRA of the brain without contrast | $2,514 | $658 | $328 |
| MRA of the neck | $2,295 | $611 | $245 |
| MRA of the neck with contrast | $2,295 | $611 | $245 |
| MRA of the neck without contrast | $2,849 | $588 | $343 |
| MRI of the abdomen | $2,285 | $721 | $300 |
| MRI of the abdomen with contrast | $2,285 | $609 | $300 |
| MRI of the abdomen without contrast | $1,979 | $832 | $194 |
| MRI of the ankle | $1,860 | $699 | $261 |
| MRI of the ankle with contrast | $1,860 | $699 | $261 |
| MRI of the ankle without contrast | $1,623 | $873 | $222 |
| MRI of the brain | $2,462 | $900 | $269 |
| MRI of the brain with contrast | $2,462 | $900 | $269 |
| MRI of the brain without contrast | $2,118 | $643 | $195 |
| MRI of the chest | $2,491 | $622 | $371 |
| MRI of the chest without contrast | $2,925 | $622 | $466 |
| MRI of the knee | $1,860 | $806 | $315 |
| MRI of the knee with contrast | $1,860 | $681 | $315 |
| MRI of the knee without contrast | $1,623 | $806 | $204 |
| MRI of the lower back (lumbar spine) | $2,295 | $760 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $2,295 | $561 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $2,057 | $760 | $192 |
| MRI of the mid-back (thoracic spine) | $2,295 | $722 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $2,849 | $1,159 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $2,295 | $551 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $2,057 | $722 | $190 |
| MRI of the neck (cervical spine) | $2,057 | $753 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $2,057 | $1,162 | $318 |
| MRI of the neck (cervical spine) with contrast | $2,295 | $579 | $274 |
| MRI of the neck (cervical spine) without contrast | $2,057 | $753 | $191 |
| MRI of the pelvis | $2,295 | $746 | $268 |
| MRI of the pelvis with contrast | $2,295 | $687 | $268 |
| MRI of the pelvis without contrast | $2,057 | $805 | $227 |
| MRI of the shoulder | $1,860 | $964 | $313 |
| MRI of the shoulder with contrast | $1,860 | $964 | $313 |
| MRI of the shoulder without contrast | $1,623 | $823 | $205 |
| MRI of the wrist | $1,851 | $873 | $330 |
| MRI of the wrist with contrast | $1,851 | $873 | $330 |
| MRI of the wrist without contrast | $1,623 | $873 | $303 |
| Nebulizer breathing treatment | $163 | $260 | $9 |
| Newborn hospital care | $78 | $169 | $58 |
| Nuclear cardiac stress test | $1,901 | $1,402 | $428 |
| Occupational therapy evaluation | $124 | $160 | $101 |
| Occupational therapy evaluation (high complexity) | $142 | $180 | $101 |
| Occupational therapy evaluation (low complexity) | $107 | $141 | $101 |
| Occupational therapy evaluation (moderate complexity) | $124 | $160 | $101 |
| Office visit (established patient) | $26 | $220 | $115 |
| Office visit (new patient) | $39 | $421 | $177 |
| Office visit, established patient (level 3) | $23 | $152 | $95 |
| Office visit, established patient (level 4) | $30 | $220 | $136 |
| Office visit, new patient (level 3) | $37 | $285 | $118 |
| Office visit, new patient (level 4) | $39 | $421 | $177 |
| Office visit, new patient (level 5) | $42 | $558 | $237 |
| Orthopedic hardware removal | $1,052 | $1,468 | $632 |
| Pap smear (cervical screening) | $68 | $53 | $20 |
| Parathyroid hormone (PTH) test | $39 | $113 | $41 |
| Pelvic ultrasound | $307 | $227 | $78 |
| Pelvic ultrasound (complete) | $432 | $229 | $105 |
| Pelvic ultrasound (limited) | $182 | $227 | $51 |
| PET scan | $3,500 | $1,992 | — |
| Phosphorus blood test | $23 | $24 | $5 |
| Physical therapy evaluation | $107 | $133 | $98 |
| Physical therapy evaluation (high complexity) | $124 | $160 | $98 |
| Physical therapy evaluation (moderate complexity) | $107 | $133 | $98 |
| Pilonidal cyst removal | $853 | $2,988 | $541 |
| Platelet count | $20 | $14 | $4 |
| Pneumonia vaccine | $125 | $98 | — |
| Pregnancy blood test (hCG) | $23 | $38 | $8 |
| Pregnancy ultrasound | $484 | $266 | $126 |
| Pregnancy ultrasound (first trimester) | $452 | $266 | $117 |
| Pregnancy ultrasound (second or third trimester) | $516 | $274 | $136 |
| Procalcitonin test | $51 | $101 | $27 |
| Prolactin test | $18 | $81 | $19 |
| Prostate test (PSA) | $25 | $48 | $18 |
| Psychiatric evaluation | $114 | $367 | $188 |
| Psychotherapy session | $162 | $227 | $140 |
| Pulmonary rehabilitation | $165 | $70 | $87 |
| Radiofrequency nerve ablation | $1,507 | $2,611 | $462 |
| Retina scan (OCT) | $35 | $119 | $33 |
| Rotator cuff repair | $1,910 | $2,655 | $792 |
| RSV vaccine | $257 | $118 | — |
| Sacroiliac joint injection | $185 | $752 | $176 |
| Scoliosis spine X-ray | $129 | $131 | $58 |
| Scoliosis spine X-ray (1 view) | $147 | $109 | $44 |
| Scoliosis spine X-ray (3 views) | $111 | $154 | $72 |
| Screening colonoscopy | $1,862 | $850 | $378 |
| Screening mammogram | $244 | $188 | $126 |
| Scrotal ultrasound | $430 | $248 | $99 |
| Sedimentation rate (ESR) test | $23 | $31 | $3 |
| Semen analysis | $50 | $112 | $12 |
| Septoplasty (deviated septum) | $1,090 | $1,756 | $613 |
| Sex hormone binding globulin test | $27 | $78 | $22 |
| Shingles vaccine | $154 | $142 | — |
| Shoulder replacement | $3,190 | $3,562 | $1,300 |
| Simple laceration repair (small, up to 2.5 cm) | $102 | $219 | $114 |
| Simple wound stitches | $113 | $243 | $127 |
| Skin biopsy | $94 | $341 | $121 |
| Skin biopsy (punch) | $94 | $352 | $121 |
| Skin cancer lesion removal | $132 | $931 | $240 |
| Skin lesion freezing (cryotherapy) | $19 | $261 | $36 |
| Skin tag removal | $80 | $260 | $92 |
| Small bowel resection | $2,011 | $3,647 | $1,136 |
| Soft tissue ultrasound | $114 | $211 | $64 |
| Speech therapy | $196 | $158 | $76 |
| Spinal tap (lumbar puncture) | $434 | $747 | $165 |
| Spirometry (lung function test) | $101 | $127 | $30 |
| Spirometry with bronchodilator | $207 | $230 | $43 |
| Strep throat test | $39 | $32 | $17 |
| Stress echocardiogram | $525 | $868 | $209 |
| Swallow study | $197 | $183 | $85 |
| T3 thyroid test | $47 | $31 | $14 |
| Tdap (tetanus) vaccine | $36 | $32 | — |
| Testosterone test | $24 | $215 | $26 |
| Thyroid test (TSH) | $52 | $36 | $17 |
| Thyroid ultrasound | $410 | $248 | $109 |
| Thyroid uptake scan | $639 | $471 | $145 |
| Tonsillectomy | $520 | $713 | $252 |
| Total IgE allergy test | $47 | $35 | $16 |
| Total protein test | $13 | $12 | $4 |
| Transvaginal ultrasound | $434 | $218 | $118 |
| Trigger finger release | $1,269 | $1,561 | $630 |
| Triglycerides test | $39 | $14 | $6 |
| Troponin (heart) test | $59 | $45 | $12 |
| Turbinate reduction | $776 | $1,153 | $294 |
| Turning a breech baby (version) | $2,463 | $3,085 | $94 |
| Upper GI endoscopy (EGD) | $1,669 | $820 | $371 |
| Upper GI series (barium) | $417 | $302 | $128 |
| Ureteral stent placement | $983 | $3,708 | $373 |
| Ureteroscopy (stone removal) | $897 | $1,011 | $365 |
| Uric acid (gout) test | $22 | $19 | $5 |
| Urinalysis | $19 | $18 | $3 |
| Urine microalbumin test | $36 | $19 | $5 |
| Urine pregnancy test | $10 | $39 | $9 |
| Vaccine administration | $31 | $16 | $19 |
| Vaccine administration (each additional) | $21 | $16 | $16 |
| Varicose vein ablation | $3,422 | $3,446 | $1,018 |
| Vasectomy | $395 | $854 | $347 |
| Visual field test | $48 | $155 | $64 |
| Vitamin B12 test | $10 | $45 | $15 |
| Vitamin D test | $26 | $67 | $30 |
| Wart removal | $85 | $230 | $121 |
| Wound debridement | $201 | $514 | $186 |
| Wrist fracture repair | $1,716 | $2,083 | $735 |
| X-ray of the abdomen | $173 | $134 | $36 |
| X-ray of the ankle | $156 | $146 | $37 |
| X-ray of the collarbone | $132 | $186 | $33 |
| X-ray of the elbow | $165 | $183 | $33 |
| X-ray of the facial bones | $162 | $140 | $39 |
| X-ray of the foot | $149 | $221 | $34 |
| X-ray of the forearm | $126 | $179 | $29 |
| X-ray of the hand | $151 | $179 | $38 |
| X-ray of the hip | $144 | $98 | $49 |
| X-ray of the hip (1 view) | $112 | $95 | $34 |
| X-ray of the hip (3 views) | $176 | $126 | $49 |
| X-ray of the knee | $170 | $155 | $42 |
| X-ray of the knee (2 views) | $127 | $151 | $34 |
| X-ray of the knee (3 views) | $170 | $155 | $42 |
| X-ray of the knee (4+ views) | $197 | $242 | $49 |
| X-ray of the lower back (lumbar spine) | $221 | $180 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $188 | $153 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $255 | $205 | $53 |
| X-ray of the lower leg | $124 | $143 | $31 |
| X-ray of the mid-back (thoracic spine) | $161 | $167 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $148 | $151 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $174 | $182 | $39 |
| X-ray of the neck (cervical spine) | $218 | $151 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $174 | $151 | $40 |
| X-ray of the pelvis | $131 | $214 | $36 |
| X-ray of the pelvis (1 view) | $126 | $145 | $28 |
| X-ray of the ribs | $170 | $138 | $42 |
| X-ray of the ribs (2 views) | $141 | $111 | $36 |
| X-ray of the ribs (3 views) | $170 | $184 | $42 |
| X-ray of the shoulder | $134 | $186 | $36 |
| X-ray of the skull | $231 | $197 | $40 |
| X-ray of the upper arm | $134 | $123 | $32 |
| X-ray of the wrist | $167 | $146 | $43 |
| YAG laser capsulotomy (eye) | $757 | $1,794 | $335 |
| Zinc blood test | $23 | $30 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
