| Procedure | Gothenburg Health | Callaway District Hospital | Medicare |
|---|
| Abdominal fluid drain (paracentesis) | $1,350 | $1,041 | $284 |
| Abdominal ultrasound | $983 | $764 | $100 |
| Abdominal ultrasound (complete) | $1,255 | $850 | $114 |
| Abdominal ultrasound (limited) | $711 | $678 | $86 |
| Abscess drainage (complex or multiple) | $432 | $542 | $220 |
| Abscess drainage (simple) | $371 | $362 | $129 |
| Abscess incision and drainage | $402 | $452 | $174 |
| Albumin blood test | $59 | $53 | $5 |
| Alkaline phosphatase test | $73 | $73 | $5 |
| Allergy shots | $28 | $24 | $11 |
| ALT liver enzyme test | $81 | $73 | $5 |
| Ammonia blood test | $153 | $137 | $15 |
| Amylase test | $104 | $96 | $6 |
| AST liver enzyme test | $77 | $73 | $5 |
| Basic metabolic panel | $149 | $140 | $8 |
| Bilirubin blood test | $68 | $62 | $5 |
| Blood clotting test (PT/INR) | $68 | $62 | $4 |
| Blood glucose test | $63 | $63 | $5 |
| Blood transfusion | $1,109 | $1,044 | $47 |
| Blood type and screen | $116 | $113 | $10 |
| Blood type test | $91 | $67 | $3 |
| Blood type test (ABO group) | $116 | $65 | $3 |
| Blood type test (Rh/D antigen) | $66 | $69 | $3 |
| BNP (heart failure) test | $306 | $270 | $39 |
| Bone density scan (DEXA) | $495 | $464 | $39 |
| Breast ultrasound | $585 | $528 | $92 |
| Breast ultrasound (complete) | $585 | $528 | $100 |
| Breast ultrasound (limited) | $405 | $403 | $84 |
| Breathing tube insertion (intubation) | $601 | $447 | $133 |
| C-reactive protein (CRP) | $117 | $103 | $5 |
| Calcium blood test | $68 | $62 | $5 |
| Cardioversion | $1,360 | $360 | $155 |
| Carotid artery ultrasound | $1,575 | $1,095 | $156 |
| Celiac disease test | $56 | $130 | $12 |
| Chest X-ray | $322 | $333 | $37 |
| Chest X-ray (1 view) | $288 | $274 | $25 |
| Chest X-ray (2 views) | $356 | $344 | $33 |
| Chickenpox (varicella) vaccine | $162 | $98 | — |
| CK-MB heart enzyme test | $189 | $175 | $12 |
| Clotting time test (PTT) | $108 | $97 | $6 |
| Colonoscopy | $3,993 | $1,655 | $480 |
| Complete blood count (CBC) | $122 | $92 | $7 |
| Complete blood count (CBC) (complete) | $122 | $103 | $8 |
| Comprehensive metabolic panel | $194 | $162 | $11 |
| Creatine kinase (CK) test | $104 | $95 | $7 |
| CT angiography of the chest | $3,330 | $3,281 | $281 |
| CT angiography of the head | $3,150 | $3,010 | $274 |
| CT scan of the abdomen | $2,700 | $2,463 | $230 |
| CT scan of the abdomen and pelvis | $4,770 | $4,416 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $5,535 | $5,091 | $338 |
| CT scan of the abdomen and pelvis with contrast | $4,770 | $4,416 | $300 |
| CT scan of the abdomen and pelvis without contrast | $4,163 | $3,794 | $183 |
| CT scan of the abdomen with and without contrast | $3,060 | $2,902 | $259 |
| CT scan of the abdomen with contrast | $2,700 | $2,463 | $230 |
| CT scan of the abdomen without contrast | $2,430 | $2,234 | $136 |
| CT scan of the arm | $2,430 | $2,385 | $199 |
| CT scan of the arm without contrast | $2,160 | $2,084 | $161 |
| CT scan of the chest | $2,565 | $2,568 | $167 |
| CT scan of the chest with and without contrast | $3,128 | $2,866 | $196 |
| CT scan of the chest with contrast | $2,565 | $2,568 | $167 |
| CT scan of the chest without contrast | $2,385 | $2,309 | $133 |
| CT scan of the head | $2,340 | $2,281 | $148 |
| CT scan of the head with and without contrast | $3,150 | $2,676 | $173 |
| CT scan of the head with contrast | $2,340 | $2,281 | $148 |
| CT scan of the head without contrast | $2,070 | $2,022 | $107 |
| CT scan of the leg | $3,150 | $2,633 | $166 |
| CT scan of the leg with contrast | $2,520 | $2,166 | $166 |
| CT scan of the leg without contrast | $2,295 | $2,156 | $130 |
| CT scan of the lower back (lumbar spine) | $2,610 | $2,589 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $2,610 | $2,589 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $2,700 | $2,822 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $2,430 | $2,311 | $130 |
| CT scan of the neck | $2,475 | $2,388 | $183 |
| CT scan of the neck (cervical spine) | $2,700 | $2,480 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $2,700 | $2,480 | $196 |
| CT scan of the neck (cervical spine) with contrast | $3,038 | $2,986 | $168 |
| CT scan of the neck (cervical spine) without contrast | $2,453 | $2,320 | $131 |
| CT scan of the neck with and without contrast | $2,790 | $3,218 | $220 |
| CT scan of the neck with contrast | $2,475 | $2,388 | $183 |
| CT scan of the neck without contrast | $2,160 | $2,013 | $150 |
| CT scan of the pelvis | $2,738 | $2,534 | $226 |
| CT scan of the pelvis with and without contrast | $2,970 | $2,629 | $251 |
| CT scan of the pelvis with contrast | $2,738 | $2,534 | $226 |
| CT scan of the pelvis without contrast | $2,408 | $2,255 | $133 |
| CT scan of the sinuses | $2,340 | $2,075 | $152 |
| CT scan of the sinuses with and without contrast | $2,610 | $2,075 | $184 |
| CT scan of the sinuses with contrast | $2,340 | $2,256 | $152 |
| CT scan of the sinuses without contrast | $1,980 | $1,830 | $128 |
| D-dimer test | $180 | $165 | $10 |
| Diagnostic mammogram | $372 | $352 | $140 |
| Drug screen (urine) | $198 | $180 | $17 |
| Echocardiogram | $1,598 | $1,066 | $138 |
| Echocardiogram with and without contrast | $900 | $847 | $101 |
| EKG / ECG (tracing only) | $329 | $311 | $7 |
| Electrocardiogram (EKG) | $329 | $180 | $8 |
| Electrolyte panel | $171 | $96 | $7 |
| Emergency department visit | $585 | $533 | $69 |
| Emergency department visit (level 1) | $211 | $195 | $11 |
| Emergency department visit (level 2) | $381 | $338 | $40 |
| Emergency department visit (level 3) | $585 | $533 | $69 |
| Emergency department visit (level 4) | $878 | $750 | $118 |
| Emergency department visit (level 5) | $1,413 | $1,168 | $171 |
| Family therapy session | $761 | $761 | $110 |
| Fecal occult blood (stool) test | $48 | $59 | $10 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $50 | $59 | $16 |
| Folate (folic acid) test | $142 | $137 | $15 |
| Foreign body removal (skin) | $394 | $355 | $157 |
| Free T4 thyroid test | $122 | $103 | $9 |
| Glucose tolerance test | $90 | $123 | $8 |
| Group therapy session | $662 | $662 | $30 |
| HDL cholesterol test | $63 | $56 | $8 |
| Hematocrit test | $54 | $47 | $2 |
| Hemoglobin A1c (diabetes test) | $90 | $82 | $10 |
| Hepatitis A vaccine | $121 | $166 | — |
| Hepatitis B vaccine | $80 | $166 | — |
| Holter heart monitor | $878 | $569 | $26 |
| HPV vaccine | $255 | $156 | — |
| IV infusion therapy | $316 | $232 | $44 |
| IV infusion therapy (each additional) | $248 | $98 | $21 |
| IV infusion therapy (initial) | $383 | $365 | $67 |
| Kidney ultrasound | $603 | $686 | $84 |
| Kidney ultrasound (limited) | $603 | $590 | $61 |
| Lactate test | $144 | $135 | $12 |
| Leg vein ultrasound (Doppler) | $1,256 | $1,049 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $1,256 | $1,049 | $116 |
| Lipase test | $135 | $117 | $7 |
| Lipid (cholesterol) panel | $131 | $116 | $13 |
| Liver function panel | $149 | $137 | $8 |
| Lung function test (PFT) | $462 | $482 | $37 |
| Magnesium blood test | $95 | $86 | $7 |
| MRA of the brain | $3,690 | $3,217 | $226 |
| MRA of the neck | $3,374 | $2,736 | $245 |
| MRA of the neck without contrast | $3,870 | $3,038 | $343 |
| MRI of the abdomen | $3,510 | $3,344 | $300 |
| MRI of the abdomen with contrast | $3,510 | $3,344 | $300 |
| MRI of the abdomen without contrast | $3,083 | $3,115 | $194 |
| MRI of the ankle | $2,880 | $3,214 | $261 |
| MRI of the ankle without contrast | $2,880 | $2,863 | $222 |
| MRI of the brain | $3,825 | $3,744 | $269 |
| MRI of the brain without contrast | $3,600 | $3,433 | $195 |
| MRI of the chest | $3,600 | $3,457 | $371 |
| MRI of the chest without contrast | $3,780 | $3,407 | $466 |
| MRI of the knee | $3,375 | $3,203 | $315 |
| MRI of the knee without contrast | $2,610 | $2,570 | $204 |
| MRI of the lower back (lumbar spine) | $4,140 | $4,089 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $4,500 | $4,089 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $3,465 | $3,362 | $192 |
| MRI of the mid-back (thoracic spine) | $4,366 | $4,487 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $5,132 | $5,416 | $319 |
| MRI of the mid-back (thoracic spine) without contrast | $3,600 | $3,557 | $190 |
| MRI of the neck (cervical spine) | $4,282 | $3,686 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $4,963 | $4,016 | $318 |
| MRI of the neck (cervical spine) without contrast | $3,600 | $3,355 | $191 |
| MRI of the pelvis | $3,420 | $3,069 | $268 |
| MRI of the pelvis with contrast | $3,420 | $3,038 | $268 |
| MRI of the pelvis without contrast | $3,150 | $3,069 | $227 |
| MRI of the shoulder | $3,420 | $3,719 | $313 |
| MRI of the shoulder without contrast | $2,588 | $2,540 | $205 |
| MRI of the wrist | $3,105 | $2,921 | $330 |
| MRI of the wrist without contrast | $2,700 | $2,726 | $303 |
| Nebulizer breathing treatment | $293 | $281 | $9 |
| Occupational therapy evaluation | $199 | $223 | $101 |
| Occupational therapy evaluation (high complexity) | $203 | $294 | $101 |
| Occupational therapy evaluation (low complexity) | $191 | $197 | $101 |
| Occupational therapy evaluation (moderate complexity) | $203 | $223 | $101 |
| Office visit (established patient) | $144 | $266 | $115 |
| Office visit (new patient) | $158 | $365 | $177 |
| Office visit, established patient (level 3) | $144 | $199 | $95 |
| Office visit, established patient (level 4) | $300 | $333 | $136 |
| Office visit, new patient (level 3) | $113 | $244 | $118 |
| Office visit, new patient (level 4) | $158 | $365 | $177 |
| Office visit, new patient (level 5) | $212 | $482 | $237 |
| Pelvic ultrasound | $788 | $610 | $78 |
| Pelvic ultrasound (complete) | $788 | $792 | $105 |
| Phosphorus blood test | $72 | $66 | $5 |
| Physical therapy evaluation | $203 | $203 | $98 |
| Physical therapy evaluation (high complexity) | $234 | $257 | $98 |
| Physical therapy evaluation (moderate complexity) | $212 | $203 | $98 |
| Procalcitonin test | $243 | $212 | $27 |
| Prostate test (PSA) | $144 | $132 | $18 |
| Psychotherapy session | $270 | $687 | $140 |
| Screening mammogram | $396 | $373 | $126 |
| Scrotal ultrasound | $698 | $658 | $99 |
| Sedimentation rate (ESR) test | $63 | $48 | $3 |
| Shingles vaccine | $293 | $203 | — |
| Simple laceration repair (small, up to 2.5 cm) | $304 | $203 | $114 |
| Simple wound stitches | $323 | $224 | $127 |
| Skin biopsy | $254 | $275 | $121 |
| Skin biopsy (punch) | $254 | $275 | $121 |
| Soft tissue ultrasound | $563 | $540 | $64 |
| Speech therapy | $277 | $299 | $76 |
| Spinal tap (lumbar puncture) | $851 | $667 | $165 |
| Spirometry (lung function test) | $311 | $279 | $30 |
| Spirometry with bronchodilator | $642 | $684 | $43 |
| Strep throat test | $86 | $76 | $17 |
| Stress echocardiogram | $1,620 | $1,343 | $209 |
| Swallow study | $320 | $341 | $85 |
| Tdap (tetanus) vaccine | $41 | $155 | — |
| Thyroid test (TSH) | $140 | $114 | $17 |
| Thyroid ultrasound | $912 | $617 | $109 |
| Total protein test | $90 | $54 | $4 |
| Trigger point injection | $111 | $125 | $56 |
| Trigger point injection (1-2 muscles) | $120 | $121 | $52 |
| Triglycerides test | $70 | $59 | $6 |
| Upper GI endoscopy (EGD) | $3,779 | $2,045 | $371 |
| Urinalysis | $57 | $60 | $3 |
| Urine microalbumin test | $45 | $87 | $5 |
| Vaccine administration | $50 | $55 | $19 |
| Vaccine administration (each additional) | $39 | $32 | $16 |
| Vitamin B12 test | $140 | $147 | $15 |
| Vitamin D test | $198 | $167 | $30 |
| Wound debridement | $910 | $176 | $186 |
| X-ray of the abdomen | $410 | $345 | $36 |
| X-ray of the ankle | $342 | $327 | $37 |
| X-ray of the collarbone | $306 | $284 | $33 |
| X-ray of the elbow | $338 | $338 | $33 |
| X-ray of the facial bones | $367 | $177 | $39 |
| X-ray of the foot | $360 | $340 | $34 |
| X-ray of the forearm | $293 | $290 | $29 |
| X-ray of the hand | $374 | $328 | $38 |
| X-ray of the hip | $360 | $243 | $49 |
| X-ray of the hip (1 view) | $279 | $243 | $34 |
| X-ray of the hip (3 views) | $360 | $338 | $49 |
| X-ray of the knee | $383 | $374 | $42 |
| X-ray of the knee (2 views) | $333 | $329 | $34 |
| X-ray of the knee (3 views) | $383 | $374 | $42 |
| X-ray of the knee (4+ views) | $405 | $399 | $49 |
| X-ray of the lower back (lumbar spine) | $507 | $489 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $473 | $450 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $540 | $527 | $53 |
| X-ray of the lower leg | $320 | $300 | $31 |
| X-ray of the mid-back (thoracic spine) | $450 | $429 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $387 | $366 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $513 | $491 | $39 |
| X-ray of the neck (cervical spine) | $439 | $436 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $360 | $355 | $40 |
| X-ray of the pelvis | $376 | $345 | $36 |
| X-ray of the pelvis (1 view) | $347 | $319 | $28 |
| X-ray of the ribs | $432 | $432 | $42 |
| X-ray of the ribs (2 views) | $360 | $321 | $36 |
| X-ray of the ribs (3 views) | $432 | $432 | $42 |
| X-ray of the shoulder | $520 | $350 | $36 |
| X-ray of the skull | $414 | $317 | $40 |
| X-ray of the upper arm | $324 | $316 | $32 |
| X-ray of the wrist | $338 | $323 | $43 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
