| Procedure | Garrison Memorial Hospital | CHI St Alexius Health | Medicare |
|---|
| Abdominal ultrasound | $299 | $299 | $100 |
| Abdominal ultrasound (complete) | $376 | $376 | $114 |
| Abdominal ultrasound (limited) | $221 | $221 | $86 |
| Abscess drainage (complex or multiple) | $338 | $338 | $220 |
| Abscess drainage (simple) | $191 | $191 | $129 |
| Abscess incision and drainage | $209 | $209 | $174 |
| Aldosterone test | $205 | $205 | $41 |
| Alpha-fetoprotein (AFP) test | $109 | $109 | $17 |
| Arterial blood gas (ABG) | $111 | $111 | $26 |
| Barium swallow study | $164 | $164 | $107 |
| Bartholin cyst removal | $177 | $177 | $182 |
| Benign skin lesion removal | $615 | $615 | $171 |
| Blood clotting test (PT/INR) | $29 | $29 | $4 |
| Blood glucose test | $36 | $36 | $5 |
| Blood transfusion | $418 | $418 | $47 |
| Blood type and screen | $119 | $119 | $10 |
| Blood type test | $68 | $68 | $3 |
| Blood type test (ABO group) | $99 | $99 | $3 |
| Blood type test (Rh/D antigen) | $37 | $37 | $3 |
| Bone density scan (DEXA) | $197 | $197 | $39 |
| Breast MRI | $2,559 | $2,559 | $216 |
| Breast MRI without contrast | $2,559 | $2,559 | $216 |
| Breast ultrasound | $206 | $206 | $92 |
| Breast ultrasound (complete) | $214 | $214 | $100 |
| Breast ultrasound (limited) | $198 | $198 | $84 |
| Breathing tube insertion (intubation) | $182 | $182 | $133 |
| Burn dressing and debridement (medium) | $160 | $160 | $166 |
| Burn dressing and debridement (small) | $199 | $199 | $93 |
| Burn treatment | $160 | $160 | $129 |
| Cardiac rehabilitation | $94 | $94 | $26 |
| Cardioversion | $513 | $513 | $155 |
| Carotid artery ultrasound | $605 | $605 | $156 |
| Chest tube insertion | $436 | $436 | $143 |
| Chest X-ray | $86 | $86 | $37 |
| Chest X-ray (1 view) | $73 | $73 | $25 |
| Chest X-ray (2 views) | $90 | $90 | $33 |
| Chickenpox (varicella) vaccine | $116 | $116 | — |
| Clotting time test (PTT) | $46 | $46 | $6 |
| Copper blood test | $63 | $63 | $12 |
| COVID-19 PCR test | $140 | $140 | $51 |
| CT angiography of the chest | $1,469 | $1,469 | $281 |
| CT angiography of the head | $1,427 | $1,427 | $274 |
| CT scan of the abdomen | $707 | $707 | $230 |
| CT scan of the abdomen and pelvis | $1,605 | $1,605 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $1,842 | $1,842 | $338 |
| CT scan of the abdomen and pelvis with contrast | $1,605 | $1,605 | $300 |
| CT scan of the abdomen and pelvis without contrast | $950 | $950 | $183 |
| CT scan of the abdomen with and without contrast | $959 | $959 | $259 |
| CT scan of the abdomen with contrast | $707 | $707 | $230 |
| CT scan of the abdomen without contrast | $480 | $480 | $136 |
| CT scan of the arm | $694 | $694 | $199 |
| CT scan of the arm without contrast | $694 | $694 | $161 |
| CT scan of the chest | $981 | $981 | $167 |
| CT scan of the chest with and without contrast | $1,231 | $1,231 | $196 |
| CT scan of the chest with contrast | $981 | $981 | $167 |
| CT scan of the chest without contrast | $785 | $785 | $133 |
| CT scan of the head | $624 | $624 | $148 |
| CT scan of the head without contrast | $624 | $624 | $107 |
| CT scan of the leg | $817 | $817 | $166 |
| CT scan of the leg without contrast | $817 | $817 | $130 |
| CT scan of the lower back (lumbar spine) | $804 | $804 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $804 | $804 | $130 |
| CT scan of the neck | $903 | $903 | $183 |
| CT scan of the neck (cervical spine) | $844 | $844 | $168 |
| CT scan of the neck (cervical spine) with contrast | $827 | $827 | $168 |
| CT scan of the neck (cervical spine) without contrast | $861 | $861 | $131 |
| CT scan of the neck with and without contrast | $1,007 | $1,007 | $220 |
| CT scan of the neck with contrast | $799 | $799 | $183 |
| CT scan of the pelvis | $923 | $923 | $226 |
| CT scan of the pelvis with contrast | $1,289 | $1,289 | $226 |
| CT scan of the pelvis without contrast | $557 | $557 | $133 |
| CT scan of the sinuses | $796 | $796 | $152 |
| CT scan of the sinuses without contrast | $796 | $796 | $128 |
| D-dimer test | $77 | $77 | $10 |
| Diagnostic mammogram | $307 | $307 | $140 |
| Drug screen (urine) | $123 | $123 | $17 |
| Echocardiogram | $328 | $328 | $138 |
| Echocardiogram without contrast | $190 | $190 | $138 |
| EKG / ECG (tracing only) | $90 | $90 | $7 |
| Electrocardiogram (EKG) | $54 | $54 | $8 |
| Electrolyte panel | $52 | $52 | $7 |
| Emergency department visit | $213 | $213 | $69 |
| Emergency department visit (level 1) | $94 | $94 | $11 |
| Emergency department visit (level 2) | $148 | $148 | $40 |
| Emergency department visit (level 3) | $225 | $225 | $69 |
| Emergency department visit (level 4) | $406 | $406 | $118 |
| Emergency department visit (level 5) | $646 | $646 | $171 |
| Fecal occult blood (stool) test | $30 | $30 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $30 | $30 | $4 |
| Fibrinogen test | $66 | $66 | $10 |
| Flu vaccine | $19 | $19 | — |
| Foreign body removal (skin) | $344 | $344 | $157 |
| Gallbladder scan (HIDA) | $772 | $772 | $334 |
| GGT liver test | $48 | $48 | $7 |
| Glucose tolerance test | $59 | $59 | $8 |
| HDL cholesterol test | $51 | $51 | $8 |
| Hematocrit test | $10 | $10 | $2 |
| Hepatitis A vaccine | $42 | $42 | — |
| Hepatitis B test | $67 | $67 | $10 |
| Hepatitis B vaccine | $27 | $27 | — |
| Holter heart monitor | $122 | $122 | $26 |
| HPV vaccine | $187 | $187 | — |
| IV infusion therapy | $224 | $224 | $44 |
| IV infusion therapy (each additional) | $75 | $75 | $21 |
| IV infusion therapy (initial) | $373 | $373 | $67 |
| Joint aspiration (small/intermediate) | $85 | $85 | $57 |
| Joint aspiration or injection (mid-size joint) | $78 | $78 | $57 |
| Joint aspiration or injection (small joint) | $92 | $92 | $56 |
| Kidney ultrasound | $342 | $342 | $84 |
| Knee joint injection | $226 | $226 | $69 |
| Lactate test | $55 | $55 | $12 |
| LDH test | $50 | $50 | $6 |
| Leg vein ultrasound (Doppler) | $557 | $557 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $500 | $500 | $116 |
| MMR vaccine | $66 | $66 | — |
| MRA of the brain | $1,089 | $1,089 | $226 |
| MRA of the neck | $1,325 | $1,325 | $245 |
| MRA of the neck with contrast | $1,325 | $1,325 | $245 |
| MRA of the neck without contrast | $2,126 | $2,126 | $343 |
| MRI of the abdomen | $1,569 | $1,569 | $300 |
| MRI of the ankle | $1,528 | $1,528 | $261 |
| MRI of the ankle without contrast | $1,483 | $1,483 | $222 |
| MRI of the brain | $1,517 | $1,517 | $269 |
| MRI of the brain without contrast | $1,150 | $1,150 | $195 |
| MRI of the chest | $1,335 | $1,335 | $371 |
| MRI of the knee | $1,667 | $1,667 | $315 |
| MRI of the knee without contrast | $1,667 | $1,667 | $204 |
| MRI of the lower back (lumbar spine) | $1,599 | $1,599 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,474 | $1,474 | $192 |
| MRI of the mid-back (thoracic spine) | $1,299 | $1,299 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $1,501 | $1,501 | $319 |
| MRI of the mid-back (thoracic spine) without contrast | $1,096 | $1,096 | $190 |
| MRI of the neck (cervical spine) | $1,573 | $1,573 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $1,716 | $1,716 | $318 |
| MRI of the neck (cervical spine) without contrast | $1,429 | $1,429 | $191 |
| MRI of the pelvis | $1,311 | $1,311 | $268 |
| MRI of the pelvis without contrast | $1,056 | $1,056 | $227 |
| MRI of the shoulder | $1,732 | $1,732 | $313 |
| MRI of the shoulder without contrast | $1,618 | $1,618 | $205 |
| MRI of the wrist | $1,175 | $1,175 | $330 |
| MRI of the wrist without contrast | $1,175 | $1,175 | $303 |
| Nebulizer breathing treatment | $184 | $184 | $9 |
| Occupational therapy evaluation | $195 | $195 | $101 |
| Occupational therapy evaluation (high complexity) | $195 | $195 | $101 |
| Occupational therapy evaluation (low complexity) | $235 | $235 | $101 |
| Occupational therapy evaluation (moderate complexity) | $195 | $195 | $101 |
| Pap smear (cervical screening) | $113 | $113 | $20 |
| Pelvic ultrasound | $315 | $315 | $78 |
| Pelvic ultrasound (complete) | $315 | $315 | $105 |
| Physical therapy evaluation | $252 | $252 | $98 |
| Physical therapy evaluation (high complexity) | $227 | $227 | $98 |
| Physical therapy evaluation (moderate complexity) | $268 | $268 | $98 |
| Platelet count | $33 | $33 | $4 |
| Pneumonia vaccine | $124 | $124 | — |
| Screening mammogram | $356 | $356 | $126 |
| Scrotal ultrasound | $269 | $269 | $99 |
| Shingles vaccine | $124 | $124 | — |
| Simple laceration repair (small, up to 2.5 cm) | $192 | $192 | $114 |
| Simple wound stitches | $206 | $206 | $127 |
| Skin biopsy | $155 | $155 | $121 |
| Skin biopsy (punch) | $111 | $111 | $121 |
| Skin lesion freezing (cryotherapy) | $20 | $20 | $36 |
| Skin tag removal | $170 | $170 | $92 |
| Soft tissue ultrasound | $239 | $239 | $64 |
| Speech therapy | $158 | $158 | $76 |
| Spinal tap (lumbar puncture) | $872 | $872 | $165 |
| Swallow study | $180 | $180 | $85 |
| T3 thyroid test | $92 | $92 | $14 |
| Tdap (tetanus) vaccine | $57 | $57 | — |
| Thyroid ultrasound | $331 | $331 | $109 |
| Transvaginal ultrasound | $223 | $223 | $118 |
| Triglycerides test | $43 | $43 | $6 |
| Vaccine administration | $64 | $64 | $19 |
| Wart removal | $228 | $228 | $121 |
| X-ray of the abdomen | $98 | $98 | $36 |
| X-ray of the ankle | $101 | $101 | $37 |
| X-ray of the collarbone | $50 | $50 | $33 |
| X-ray of the elbow | $103 | $103 | $33 |
| X-ray of the facial bones | $184 | $184 | $39 |
| X-ray of the foot | $95 | $95 | $34 |
| X-ray of the forearm | $80 | $80 | $29 |
| X-ray of the hand | $99 | $99 | $38 |
| X-ray of the hip | $67 | $67 | $49 |
| X-ray of the hip (1 view) | $67 | $67 | $34 |
| X-ray of the knee | $105 | $105 | $42 |
| X-ray of the knee (2 views) | $92 | $92 | $34 |
| X-ray of the knee (3 views) | $118 | $118 | $42 |
| X-ray of the knee (4+ views) | $105 | $105 | $49 |
| X-ray of the lower back (lumbar spine) | $109 | $109 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $105 | $105 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $114 | $114 | $53 |
| X-ray of the lower leg | $85 | $85 | $31 |
| X-ray of the mid-back (thoracic spine) | $102 | $102 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $92 | $92 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $111 | $111 | $39 |
| X-ray of the neck (cervical spine) | $115 | $115 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $112 | $112 | $40 |
| X-ray of the pelvis | $94 | $94 | $36 |
| X-ray of the pelvis (1 view) | $81 | $81 | $28 |
| X-ray of the ribs | $91 | $91 | $42 |
| X-ray of the ribs (2 views) | $91 | $91 | $36 |
| X-ray of the ribs (3 views) | $110 | $110 | $42 |
| X-ray of the shoulder | $89 | $89 | $36 |
| X-ray of the skull | $61 | $61 | $40 |
| X-ray of the thigh bone | $49 | $49 | — |
| X-ray of the upper arm | $81 | $81 | $32 |
| X-ray of the wrist | $119 | $119 | $43 |
| Zinc blood test | $85 | $85 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.