| Procedure | Aspirus Merrill Hospital | Marshfield Medical Center-Weston | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $120 | $33 | $51 |
| Abdominal fluid drain (paracentesis) | $1,307 | $1,430 | $284 |
| Abdominal ultrasound | $339 | $520 | $100 |
| Abdominal ultrasound (complete) | $339 | $473 | $114 |
| Abdominal ultrasound (limited) | $342 | $566 | $86 |
| Abscess drainage (complex or multiple) | $774 | $367 | $220 |
| Abscess drainage (simple) | $346 | $432 | $129 |
| Abscess incision and drainage | $470 | $399 | $174 |
| Albumin blood test | $40 | $50 | $5 |
| Aldosterone test | $237 | $369 | $41 |
| Alkaline phosphatase test | $47 | $48 | $5 |
| Allergy shots | $89 | $48 | $11 |
| Alpha-fetoprotein (AFP) test | $124 | $256 | $17 |
| ALT liver enzyme test | $41 | $67 | $5 |
| Ammonia blood test | $88 | $127 | $15 |
| Amylase test | $60 | $79 | $6 |
| Anal fistula repair | $2,199 | $884 | $541 |
| Annual physical (established patient) | $200 | $121 | — |
| Annual physical (new patient) | $320 | $145 | — |
| Anoscopy | $457 | $155 | $129 |
| Antinuclear antibody (ANA) test | $68 | $195 | $12 |
| Arterial blood gas (ABG) | $148 | $203 | $26 |
| AST liver enzyme test | $46 | $53 | $5 |
| Barium swallow study | $354 | $629 | $107 |
| Bartholin cyst removal | $544 | $234 | $182 |
| Basic metabolic panel | $90 | $137 | $8 |
| Benign skin lesion removal | $466 | $338 | $171 |
| Bilirubin blood test | $46 | $56 | $5 |
| Bladder scope (cystoscopy) | $951 | $531 | $216 |
| Bladder tumor removal (TURBT) | $1,295 | $705 | $236 |
| Blood clotting test (PT/INR) | $45 | $53 | $4 |
| Blood crossmatch | $198 | $217 | — |
| Blood glucose test | $42 | $39 | $5 |
| Blood transfusion | $551 | $1,868 | $47 |
| Blood type and screen | $92 | $209 | $10 |
| Blood type test | $38 | $68 | $3 |
| Blood type test (ABO group) | $38 | $104 | $3 |
| Blood type test (Rh/D antigen) | $38 | $33 | $3 |
| BNP (heart failure) test | $196 | $169 | $39 |
| Bone density scan (DEXA) | $508 | $141 | $39 |
| Bone marrow biopsy | $876 | $2,358 | $172 |
| Bone scan (nuclear) | $999 | $1,378 | $259 |
| Botox for migraine | $777 | $397 | $157 |
| Breast biopsy | $3,702 | $2,911 | $478 |
| Breast MRI | $3,113 | $2,348 | $216 |
| Breast MRI without contrast | $1,843 | $2,343 | $216 |
| Breast ultrasound | $419 | $331 | $92 |
| Breast ultrasound (complete) | $493 | $445 | $100 |
| Breast ultrasound (limited) | $309 | $217 | $84 |
| Bronchoscopy | $2,149 | $1,408 | $303 |
| Burn dressing and debridement (medium) | $452 | $261 | $166 |
| Burn dressing and debridement (small) | $258 | $144 | $93 |
| Burn treatment | $331 | $203 | $129 |
| C-reactive protein (CRP) | $53 | $103 | $5 |
| CA 19-9 tumor marker test | $144 | $238 | $21 |
| CA-125 ovarian marker test | $154 | $266 | $21 |
| Calcium blood test | $52 | $54 | $5 |
| Capsule endoscopy | $3,037 | $3,384 | $802 |
| Cardiac catheterization | $9,691 | $11,118 | $1,049 |
| Cardiac MRI | $3,954 | $3,315 | $322 |
| Cardiac MRI without contrast | $3,311 | $2,701 | $280 |
| Cardiac rehabilitation | $202 | $206 | $26 |
| Cardiac stress test | $454 | $540 | $39 |
| Cardioversion | $853 | $1,428 | $155 |
| Carotid artery ultrasound | $276 | $948 | $156 |
| Carpal tunnel release | $1,804 | $1,212 | $483 |
| CEA tumor marker test | $132 | $238 | $19 |
| Celiac disease test | $88 | $341 | $12 |
| Central line placement | $1,245 | $2,373 | $238 |
| Chalazion (eyelid cyst) removal | $525 | $348 | $131 |
| Chemotherapy infusion | $335 | $507 | $81 |
| Chemotherapy infusion (each additional) | $108 | $178 | $28 |
| Chemotherapy infusion (first hour) | $562 | $837 | $133 |
| Chest fluid drain (thoracentesis) | $2,373 | $1,277 | $311 |
| Chest tube insertion | $1,202 | $1,362 | $143 |
| Chest X-ray | $107 | $491 | $37 |
| Chest X-ray (1 view) | $78 | $420 | $25 |
| Chest X-ray (2 views) | $96 | $561 | $33 |
| Chickenpox (varicella) vaccine | $164 | $143 | — |
| Circumcision | $556 | $615 | $167 |
| Clotting time test (PTT) | $63 | $66 | $6 |
| Colonoscopy | $2,030 | $1,359 | $480 |
| Colposcopy | $453 | $274 | $161 |
| Complete blood count (CBC) | $68 | $123 | $7 |
| Complete blood count (CBC) (complete) | $77 | $136 | $8 |
| Complex wound repair | $829 | $701 | $390 |
| Comprehensive eye exam | $220 | $106 | $138 |
| Comprehensive metabolic panel | $111 | $191 | $11 |
| Contraceptive implant (Nexplanon) | $393 | $281 | $115 |
| Copper blood test | $81 | $213 | $12 |
| Coronary CT angiography | $3,506 | $2,723 | $326 |
| Cortisol test | $131 | $140 | $16 |
| COVID-19 PCR test | $175 | $126 | $51 |
| CPAP titration study | $534 | $148 | $69 |
| Creatine kinase (CK) test | $62 | $73 | $7 |
| CT angiography of the chest | $1,401 | $2,316 | $281 |
| CT angiography of the head | $1,691 | $2,307 | $274 |
| CT colonography (virtual colonoscopy) | $8,276 | $2,223 | $835 |
| CT scan of the abdomen | $852 | $1,931 | $230 |
| CT scan of the abdomen and pelvis | $1,528 | $2,533 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $2,086 | $2,915 | $338 |
| CT scan of the abdomen and pelvis with contrast | $1,835 | $2,533 | $300 |
| CT scan of the abdomen and pelvis without contrast | $1,487 | $1,286 | $183 |
| CT scan of the abdomen with and without contrast | $1,544 | $2,227 | $259 |
| CT scan of the abdomen with contrast | $1,384 | $1,931 | $230 |
| CT scan of the abdomen without contrast | $837 | $1,030 | $136 |
| CT scan of the arm | $879 | $1,892 | $199 |
| CT scan of the arm with contrast | $1,344 | $1,892 | $199 |
| CT scan of the arm without contrast | $992 | $1,285 | $161 |
| CT scan of the chest | $943 | $1,919 | $167 |
| CT scan of the chest with and without contrast | $1,357 | $2,366 | $196 |
| CT scan of the chest with contrast | $1,103 | $1,919 | $167 |
| CT scan of the chest without contrast | $896 | $1,292 | $133 |
| CT scan of the head | $879 | $1,393 | $148 |
| CT scan of the head with and without contrast | $1,129 | $1,703 | $173 |
| CT scan of the head with contrast | $939 | $1,393 | $148 |
| CT scan of the head without contrast | $756 | $969 | $107 |
| CT scan of the leg | $1,155 | $2,245 | $166 |
| CT scan of the leg with contrast | $1,314 | $2,245 | $166 |
| CT scan of the leg without contrast | $1,007 | $1,484 | $130 |
| CT scan of the lower back (lumbar spine) | $1,123 | $1,941 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $1,614 | $2,388 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,319 | $1,941 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,038 | $1,285 | $130 |
| CT scan of the neck | $1,014 | $2,217 | $183 |
| CT scan of the neck (cervical spine) | $1,520 | $2,245 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $2,723 | $2,765 | $196 |
| CT scan of the neck (cervical spine) with contrast | $1,342 | $2,245 | $168 |
| CT scan of the neck (cervical spine) without contrast | $966 | $1,496 | $131 |
| CT scan of the neck with and without contrast | $1,506 | $2,727 | $220 |
| CT scan of the neck with contrast | $1,187 | $2,217 | $183 |
| CT scan of the neck without contrast | $946 | $1,496 | $150 |
| CT scan of the pelvis | $899 | $1,943 | $226 |
| CT scan of the pelvis with and without contrast | $1,601 | $2,301 | $251 |
| CT scan of the pelvis with contrast | $1,368 | $1,943 | $226 |
| CT scan of the pelvis without contrast | $753 | $1,055 | $133 |
| CT scan of the sinuses | $915 | $1,493 | $152 |
| CT scan of the sinuses with and without contrast | $1,190 | $1,877 | $184 |
| CT scan of the sinuses with contrast | $998 | $1,493 | $152 |
| CT scan of the sinuses without contrast | $833 | $1,298 | $128 |
| D-dimer test | $131 | $157 | $10 |
| DHEA-sulfate test | $144 | $238 | $22 |
| Diagnostic mammogram | $286 | $675 | $140 |
| Drug screen (urine) | $185 | $176 | $17 |
| Ear tubes (myringotomy) | $744 | $321 | $174 |
| Echocardiogram | $584 | $1,210 | $138 |
| Echocardiogram with and without contrast | $385 | $356 | $101 |
| Echocardiogram without contrast | $201 | $1,210 | $138 |
| EEG (awake and asleep) | $688 | $1,536 | $482 |
| EKG / ECG (tracing only) | $124 | $171 | $7 |
| Electrocardiogram (EKG) | $69 | $171 | $8 |
| Electroencephalogram (EEG) | $637 | $1,518 | $448 |
| Electrolyte panel | $101 | $144 | $7 |
| Electromyography (EMG) | $618 | $1,093 | $141 |
| Emergency department visit | $606 | $791 | $69 |
| Emergency department visit (level 1) | $107 | $476 | $11 |
| Emergency department visit (level 2) | $166 | $630 | $40 |
| Emergency department visit (level 3) | $433 | $791 | $69 |
| Emergency department visit (level 4) | $715 | $1,667 | $118 |
| Emergency department visit (level 5) | $3,409 | $2,553 | $171 |
| Endometrial biopsy | $355 | $209 | $98 |
| Epidural steroid injection | $912 | $1,062 | $275 |
| ERCP (bile duct endoscopy) | $3,270 | $4,548 | $311 |
| Estradiol (estrogen) test | $168 | $245 | $28 |
| Eye refraction (glasses prescription) | $42 | $20 | — |
| Facet joint injection (spine) | $817 | $2,846 | $99 |
| Fallopian tube X-ray (HSG) | $406 | $865 | $164 |
| Family therapy session | $243 | $178 | $110 |
| Fecal occult blood (stool) test | $61 | $41 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $26 | $29 | $4 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $96 | $54 | $16 |
| Ferritin (iron) test | $88 | $135 | $14 |
| Fibrinogen test | $77 | $99 | $10 |
| Folate (folic acid) test | $96 | $141 | $15 |
| Foreign body removal (skin) | $389 | $271 | $157 |
| Free T4 thyroid test | $69 | $147 | $9 |
| FSH hormone test | $112 | $246 | $19 |
| Gallbladder scan (HIDA) | $1,190 | $2,830 | $334 |
| Ganglion cyst removal | $1,571 | $865 | $321 |
| GGT liver test | $52 | $64 | $7 |
| Glucose tolerance test | $58 | $102 | $8 |
| Group therapy session | $29 | $50 | $30 |
| H. pylori test | $271 | $594 | $67 |
| HDL cholesterol test | $57 | $60 | $8 |
| Hematocrit test | $38 | $54 | $2 |
| Hemoglobin A1c (diabetes test) | $67 | $139 | $10 |
| Hemorrhoid removal | $1,847 | $468 | $338 |
| Hepatitis A vaccine | $138 | $132 | — |
| Hepatitis B test | $63 | $247 | $10 |
| Hepatitis B vaccine | $213 | $139 | — |
| Hepatitis C test | $112 | $315 | $14 |
| HIV test | $112 | $292 | $19 |
| HIV test (antigen/antibody combo) | $144 | $292 | $24 |
| Holter heart monitor | $470 | $502 | $26 |
| Home sleep apnea test | $1,040 | $1,152 | $123 |
| HPV vaccine | $142 | $485 | — |
| Iron blood test | $52 | $48 | $6 |
| IUD insertion | $319 | $176 | — |
| IUD removal | $290 | $181 | $112 |
| IV infusion therapy | $195 | $421 | $44 |
| IV infusion therapy (each additional) | $90 | $120 | $21 |
| IV infusion therapy (initial) | $299 | $722 | $67 |
| Joint aspiration (small/intermediate) | $368 | $411 | $57 |
| Joint aspiration or injection (mid-size joint) | $345 | $136 | $57 |
| Joint aspiration or injection (small joint) | $368 | $687 | $56 |
| Kidney biopsy | $1,951 | $4,226 | $492 |
| Kidney scan (nuclear) | $600 | $1,349 | $172 |
| Kidney ultrasound | $272 | $387 | $84 |
| Kidney ultrasound (limited) | $243 | $310 | $61 |
| Knee joint injection | $439 | $814 | $69 |
| Lactate test | $91 | $123 | $12 |
| Laryngoscopy | $590 | $200 | $189 |
| LDH test | $51 | $57 | $6 |
| LDL cholesterol test | $98 | $80 | $11 |
| Leg artery angiogram | $814 | $4,049 | $149 |
| Leg vein ultrasound (Doppler) | $444 | $1,058 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $444 | $745 | $116 |
| LH hormone test | $112 | $203 | $19 |
| Lipase test | $66 | $77 | $7 |
| Lipid (cholesterol) panel | $104 | $214 | $13 |
| Liver biopsy | $883 | $1,667 | $288 |
| Liver function panel | $99 | $154 | $8 |
| Lung function test (PFT) | $263 | $515 | $37 |
| Lung scan (V/Q) | $1,099 | $808 | $291 |
| Magnesium blood test | $52 | $51 | $7 |
| MMR vaccine | $268 | $153 | — |
| Mohs skin cancer surgery | $996 | $929 | $535 |
| MRA of the brain | $2,114 | $4,355 | $226 |
| MRA of the brain without contrast | $2,787 | $6,022 | $328 |
| MRA of the neck | $2,134 | $4,702 | $245 |
| MRA of the neck with contrast | $2,123 | $4,702 | $245 |
| MRA of the neck without contrast | $3,101 | $6,022 | $343 |
| MRI of the abdomen | $1,928 | $3,800 | $300 |
| MRI of the abdomen with contrast | $2,503 | $3,800 | $300 |
| MRI of the abdomen without contrast | $1,795 | $3,441 | $194 |
| MRI of the ankle | $1,878 | $4,280 | $261 |
| MRI of the ankle with contrast | $2,256 | $4,280 | $261 |
| MRI of the ankle without contrast | $1,738 | $2,882 | $222 |
| MRI of the brain | $1,873 | $3,048 | $269 |
| MRI of the brain with contrast | $2,678 | $3,048 | $269 |
| MRI of the brain without contrast | $1,709 | $2,074 | $195 |
| MRI of the chest | $3,048 | $4,974 | $371 |
| MRI of the chest without contrast | $3,946 | $5,982 | $466 |
| MRI of the knee | $1,645 | $3,993 | $315 |
| MRI of the knee with contrast | $2,568 | $3,993 | $315 |
| MRI of the knee without contrast | $1,537 | $2,222 | $204 |
| MRI of the lower back (lumbar spine) | $1,895 | $2,375 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $2,246 | $2,375 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,731 | $1,978 | $192 |
| MRI of the mid-back (thoracic spine) | $2,029 | $3,109 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $2,696 | $3,523 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $2,252 | $3,109 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $1,888 | $1,987 | $190 |
| MRI of the neck (cervical spine) | $2,159 | $2,785 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $2,579 | $2,785 | $318 |
| MRI of the neck (cervical spine) with contrast | $2,558 | $3,141 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,792 | $1,987 | $191 |
| MRI of the pelvis | $1,944 | $3,800 | $268 |
| MRI of the pelvis with contrast | $2,296 | $3,800 | $268 |
| MRI of the pelvis without contrast | $1,768 | $3,613 | $227 |
| MRI of the shoulder | $1,645 | $3,955 | $313 |
| MRI of the shoulder with contrast | $2,531 | $3,955 | $313 |
| MRI of the shoulder without contrast | $1,539 | $2,217 | $205 |
| MRI of the wrist | $3,085 | $4,285 | $330 |
| MRI of the wrist with contrast | $2,864 | $4,285 | $330 |
| MRI of the wrist without contrast | $3,085 | $3,641 | $303 |
| Nebulizer breathing treatment | $73 | $120 | $9 |
| Nerve conduction study | $654 | $711 | $118 |
| Nuchal translucency ultrasound | $279 | $806 | $116 |
| Nuclear cardiac stress test | $1,801 | $4,058 | $428 |
| Occupational therapy evaluation | $245 | $333 | $101 |
| Occupational therapy evaluation (high complexity) | $280 | $657 | $101 |
| Occupational therapy evaluation (low complexity) | $185 | $328 | $101 |
| Occupational therapy evaluation (moderate complexity) | $245 | $333 | $101 |
| Office visit (established patient) | $189 | $158 | $115 |
| Office visit (new patient) | $334 | $296 | $177 |
| Office visit, established patient (level 3) | $155 | $125 | $95 |
| Office visit, established patient (level 4) | $230 | $190 | $136 |
| Office visit, new patient (level 3) | $220 | $201 | $118 |
| Office visit, new patient (level 4) | $334 | $296 | $177 |
| Office visit, new patient (level 5) | $450 | $389 | $237 |
| Orthopedic hardware removal | $3,452 | $1,095 | $632 |
| Pap smear (cervical screening) | $148 | $156 | $20 |
| Parathyroid hormone (PTH) test | $248 | $277 | $41 |
| Pelvic ultrasound | $213 | $302 | $78 |
| Pelvic ultrasound (complete) | $213 | $399 | $105 |
| Pelvic ultrasound (limited) | $124 | $205 | $51 |
| PET scan | $3,242 | $11,557 | — |
| Phosphorus blood test | $40 | $45 | $5 |
| Physical therapy evaluation | $220 | $413 | $98 |
| Physical therapy evaluation (high complexity) | $269 | $504 | $98 |
| Physical therapy evaluation (moderate complexity) | $220 | $322 | $98 |
| Pilonidal cyst removal | $1,775 | $749 | $541 |
| Platelet count | $33 | $63 | $4 |
| Pneumonia vaccine | $172 | $251 | — |
| Pregnancy blood test (hCG) | $78 | $103 | $8 |
| Pregnancy ultrasound | $276 | $493 | $126 |
| Pregnancy ultrasound (first trimester) | $280 | $554 | $117 |
| Pregnancy ultrasound (second or third trimester) | $272 | $432 | $136 |
| Procalcitonin test | $157 | $90 | $27 |
| Prolactin test | $118 | $257 | $19 |
| Prostate biopsy | $963 | $382 | — |
| Prostate test (PSA) | $115 | $180 | $18 |
| Psychiatric evaluation | $215 | $230 | $188 |
| Psychotherapy session | $192 | $177 | $140 |
| Pulmonary rehabilitation | $183 | $198 | $87 |
| Retina scan (OCT) | $46 | $52 | $33 |
| Retinal (fundus) photography | $168 | $141 | $37 |
| Routine eye exam | $141 | $65 | $88 |
| RSV vaccine | $567 | $555 | — |
| Sacroiliac joint injection | $903 | $1,075 | $176 |
| Scoliosis spine X-ray | $164 | $462 | $58 |
| Scoliosis spine X-ray (1 view) | $164 | $225 | $44 |
| Scoliosis spine X-ray (3 views) | $257 | $699 | $72 |
| Screening mammogram | $119 | $617 | $126 |
| Scrotal ultrasound | $289 | $256 | $99 |
| Sedimentation rate (ESR) test | $40 | $140 | $3 |
| Semen analysis | $137 | $296 | $12 |
| Sex hormone binding globulin test | $137 | $60 | $22 |
| Shingles vaccine | $506 | $335 | — |
| Simple laceration repair (small, up to 2.5 cm) | $389 | $159 | $114 |
| Simple wound stitches | $389 | $176 | $127 |
| Skin biopsy | $182 | $222 | $121 |
| Skin biopsy (punch) | $249 | $222 | $121 |
| Skin cancer lesion removal | $701 | $439 | $240 |
| Skin graft | $3,248 | $1,510 | $898 |
| Skin lesion freezing (cryotherapy) | $137 | $64 | $36 |
| Skin tag removal | $170 | $156 | $92 |
| Sleep study (polysomnography) | $3,729 | $4,704 | $691 |
| Soft tissue ultrasound | $194 | $112 | $64 |
| Speech therapy | $248 | $138 | $76 |
| Spinal tap (lumbar puncture) | $708 | $452 | $165 |
| Spirometry (lung function test) | $156 | $377 | $30 |
| Spirometry with bronchodilator | $263 | $654 | $43 |
| Strep throat test | $75 | $131 | $17 |
| Stress echocardiogram | $1,490 | $3,030 | $209 |
| Swallow study | $414 | $425 | $85 |
| T3 thyroid test | $104 | $97 | $14 |
| Tdap (tetanus) vaccine | $136 | $73 | — |
| Testosterone test | $151 | $321 | $26 |
| Thyroid test (TSH) | $109 | $162 | $17 |
| Thyroid ultrasound | $246 | $485 | $109 |
| Thyroid uptake scan | $334 | $1,064 | $145 |
| Tilt table test | $783 | $700 | $168 |
| Total IgE allergy test | $99 | $213 | $16 |
| Total protein test | $60 | $60 | $4 |
| Transesophageal echocardiogram (TEE) | $1,703 | $3,289 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $1,703 | $2,430 | $239 |
| Transvaginal ultrasound | $227 | $1,176 | $118 |
| Trigger finger release | $2,526 | $1,506 | $630 |
| Trigger point injection | $374 | $562 | $56 |
| Trigger point injection (1-2 muscles) | $350 | $562 | $52 |
| Triglycerides test | $53 | $64 | $6 |
| Troponin (heart) test | $96 | $133 | $12 |
| Turning a breech baby (version) | $1,259 | $3,939 | $94 |
| Upper GI series (barium) | $728 | $1,150 | $128 |
| Ureteral stent placement | $3,773 | $1,264 | $373 |
| Uric acid (gout) test | $49 | $61 | $5 |
| Urinalysis | $34 | $60 | $3 |
| Urine microalbumin test | $41 | $85 | $5 |
| Urine pregnancy test | $63 | $115 | $9 |
| Vaccine administration | $38 | $45 | $19 |
| Vaccine administration (each additional) | $31 | $29 | $16 |
| Varicose vein ablation | $5,901 | $825 | $1,018 |
| Vasectomy | $1,303 | $704 | $347 |
| Visual field test | $127 | $94 | $64 |
| Vitamin B12 test | $107 | $107 | $15 |
| Vitamin D test | $173 | $169 | $30 |
| Wart removal | $275 | $215 | $121 |
| Wound debridement | $780 | $306 | $186 |
| X-ray of the abdomen | $105 | $447 | $36 |
| X-ray of the ankle | $70 | $423 | $37 |
| X-ray of the collarbone | $66 | $371 | $33 |
| X-ray of the elbow | $93 | $390 | $33 |
| X-ray of the facial bones | $82 | $342 | $39 |
| X-ray of the foot | $70 | $404 | $34 |
| X-ray of the forearm | $132 | $418 | $29 |
| X-ray of the hand | $139 | $351 | $38 |
| X-ray of the hip | $120 | $321 | $49 |
| X-ray of the hip (1 view) | $132 | $278 | $34 |
| X-ray of the hip (3 views) | $90 | $321 | $49 |
| X-ray of the hip (4 views) | $236 | $328 | $63 |
| X-ray of the knee | $88 | $391 | $42 |
| X-ray of the knee (2 views) | $66 | $391 | $34 |
| X-ray of the knee (3 views) | $73 | $483 | $42 |
| X-ray of the knee (4+ views) | $88 | $246 | $49 |
| X-ray of the lower back (lumbar spine) | $107 | $578 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $90 | $452 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $211 | $703 | $53 |
| X-ray of the lower leg | $66 | $423 | $31 |
| X-ray of the mid-back (thoracic spine) | $90 | $305 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $90 | $97 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $90 | $513 | $39 |
| X-ray of the neck (cervical spine) | $111 | $524 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $90 | $450 | $40 |
| X-ray of the pelvis | $73 | $562 | $36 |
| X-ray of the pelvis (1 view) | $66 | $354 | $28 |
| X-ray of the ribs | $111 | $312 | $42 |
| X-ray of the ribs (2 views) | $96 | $312 | $36 |
| X-ray of the ribs (3 views) | $111 | $325 | $42 |
| X-ray of the shoulder | $62 | $437 | $36 |
| X-ray of the skull | $148 | $295 | $40 |
| X-ray of the upper arm | $90 | $424 | $32 |
| X-ray of the wrist | $99 | $351 | $43 |
| YAG laser capsulotomy (eye) | $1,449 | $902 | $335 |
| Zinc blood test | $101 | $182 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
