| Procedure | Maple Grove Hospital | Buffalo Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $51 | $29 | $51 |
| Abdominal fluid drain (paracentesis) | $1,026 | $785 | $284 |
| Abdominal ultrasound | $277 | $406 | $100 |
| Abdominal ultrasound (complete) | $328 | $407 | $114 |
| Abdominal ultrasound (limited) | $225 | $305 | $86 |
| Abscess drainage (complex or multiple) | $465 | $351 | $220 |
| Abscess drainage (simple) | $261 | $464 | $129 |
| Abscess incision and drainage | $363 | $411 | $174 |
| Albumin blood test | $19 | $24 | $5 |
| Aldosterone test | $39 | $47 | $41 |
| Alkaline phosphatase test | $12 | $23 | $5 |
| Alpha-fetoprotein (AFP) test | $43 | $31 | $17 |
| ALT liver enzyme test | $12 | $16 | $5 |
| Ammonia blood test | $34 | $28 | $15 |
| Amylase test | $18 | $25 | $6 |
| Anoscopy | $121 | $91 | $129 |
| Antinuclear antibody (ANA) test | $22 | $61 | $12 |
| Arterial blood gas (ABG) | $25 | $65 | $26 |
| AST liver enzyme test | $12 | $16 | $5 |
| Barium swallow study | $251 | $209 | $107 |
| Basic metabolic panel | $25 | $112 | $8 |
| Bilirubin blood test | $12 | $20 | $5 |
| Blood clotting test (PT/INR) | $25 | $43 | $4 |
| Blood crossmatch | $135 | $47 | — |
| Blood glucose test | $15 | $21 | $5 |
| Blood transfusion | $635 | $705 | $47 |
| Blood type and screen | $50 | $109 | $10 |
| Blood type test | $31 | $29 | $3 |
| Blood type test (ABO group) | $31 | $34 | $3 |
| Blood type test (Rh/D antigen) | $31 | $29 | $3 |
| BNP (heart failure) test | $95 | $75 | $39 |
| Bone marrow biopsy | $2,038 | $609 | $172 |
| Bone scan (nuclear) | $583 | $1,035 | $259 |
| Breast biopsy | $1,778 | $1,618 | $478 |
| Breast MRI | $515 | $1,155 | $216 |
| Breast MRI without contrast | $720 | $1,155 | $216 |
| Breast ultrasound | $213 | $268 | $92 |
| Breast ultrasound (complete) | $244 | $358 | $100 |
| Breast ultrasound (limited) | $181 | $268 | $84 |
| Breathing tube insertion (intubation) | $398 | $987 | $133 |
| C-reactive protein (CRP) | $14 | $29 | $5 |
| CA 19-9 tumor marker test | $20 | $46 | $21 |
| CA-125 ovarian marker test | $42 | $32 | $21 |
| Calcium blood test | $11 | $23 | $5 |
| Cardiac MRI | $720 | $1,848 | $322 |
| Cardiac MRI without contrast | $720 | $1,386 | $280 |
| Cardiac rehabilitation | $169 | $193 | $26 |
| Cardiac stress test | $462 | $831 | $39 |
| Cardioversion | $926 | $1,808 | $155 |
| Carotid artery ultrasound | $345 | $795 | $156 |
| CEA tumor marker test | $38 | $34 | $19 |
| Celiac disease test | $15 | $37 | $12 |
| Central line placement | $2,344 | $764 | $238 |
| Chemotherapy infusion | $306 | $177 | $81 |
| Chemotherapy infusion (each additional) | $179 | $177 | $28 |
| Chemotherapy infusion (first hour) | $434 | $220 | $133 |
| Chest fluid drain (thoracentesis) | $894 | $1,046 | $311 |
| Chest tube insertion | $1,507 | $774 | $143 |
| Chest X-ray | $143 | $139 | $37 |
| Chest X-ray (1 view) | $149 | $174 | $25 |
| Chest X-ray (2 views) | $143 | $174 | $33 |
| Clotting time test (PTT) | $35 | $43 | $6 |
| Complete blood count (CBC) | $21 | $77 | $7 |
| Complete blood count (CBC) (complete) | $22 | $43 | $8 |
| Comprehensive metabolic panel | $31 | $203 | $11 |
| Copper blood test | $12 | $26 | $12 |
| Coronary CT angiography | $656 | $4,563 | $326 |
| Cortisol test | $44 | $40 | $16 |
| COVID-19 PCR test | $105 | $138 | $51 |
| CPAP titration study | $249 | $297 | $69 |
| Creatine kinase (CK) test | $14 | $20 | $7 |
| CT angiography of the chest | $727 | $912 | $281 |
| CT angiography of the head | $669 | $1,825 | $274 |
| CT scan of the abdomen | $649 | $1,141 | $230 |
| CT scan of the abdomen and pelvis | $649 | $1,825 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $649 | $2,281 | $338 |
| CT scan of the abdomen and pelvis with contrast | $707 | $1,825 | $300 |
| CT scan of the abdomen and pelvis without contrast | $489 | $1,369 | $183 |
| CT scan of the abdomen with and without contrast | $649 | $1,825 | $259 |
| CT scan of the abdomen with contrast | $681 | $1,369 | $230 |
| CT scan of the abdomen without contrast | $483 | $911 | $136 |
| CT scan of the arm | $598 | $1,825 | $199 |
| CT scan of the arm with contrast | $598 | $1,825 | $199 |
| CT scan of the arm without contrast | $556 | $1,369 | $161 |
| CT scan of the chest | $598 | $798 | $167 |
| CT scan of the chest with and without contrast | $727 | $913 | $196 |
| CT scan of the chest with contrast | $598 | $912 | $167 |
| CT scan of the chest without contrast | $489 | $684 | $133 |
| CT scan of the head | $656 | $1,369 | $148 |
| CT scan of the head with and without contrast | $656 | $1,825 | $173 |
| CT scan of the head with contrast | $663 | $1,369 | $148 |
| CT scan of the head without contrast | $549 | $912 | $107 |
| CT scan of the leg | $645 | $1,977 | $166 |
| CT scan of the leg with contrast | $645 | $1,977 | $166 |
| CT scan of the leg without contrast | $556 | $1,521 | $130 |
| CT scan of the lower back (lumbar spine) | $592 | $1,369 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $649 | $1,822 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $592 | $1,369 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $498 | $912 | $130 |
| CT scan of the neck | $616 | $912 | $183 |
| CT scan of the neck (cervical spine) | $592 | $1,083 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $649 | $1,083 | $196 |
| CT scan of the neck (cervical spine) with contrast | $592 | $1,369 | $168 |
| CT scan of the neck (cervical spine) without contrast | $556 | $912 | $131 |
| CT scan of the neck with and without contrast | $649 | $1,369 | $220 |
| CT scan of the neck with contrast | $616 | $912 | $183 |
| CT scan of the neck without contrast | $549 | $608 | $150 |
| CT scan of the pelvis | $498 | $1,369 | $226 |
| CT scan of the pelvis with and without contrast | $211 | $1,825 | $251 |
| CT scan of the pelvis with contrast | $681 | $1,369 | $226 |
| CT scan of the pelvis without contrast | $498 | $1,369 | $133 |
| CT scan of the sinuses | $616 | $1,825 | $152 |
| CT scan of the sinuses with and without contrast | $649 | $1,825 | $184 |
| CT scan of the sinuses with contrast | $616 | $1,369 | $152 |
| CT scan of the sinuses without contrast | $565 | $1,825 | $128 |
| D-dimer test | $59 | $57 | $10 |
| DHEA-sulfate test | $26 | $28 | $22 |
| Drug screen (urine) | $121 | $92 | $17 |
| Echocardiogram | $583 | $729 | $138 |
| Echocardiogram with and without contrast | $382 | $444 | $101 |
| EEG (awake and asleep) | $430 | $528 | $482 |
| EKG / ECG (tracing only) | $98 | $172 | $7 |
| Electrocardiogram (EKG) | $98 | $172 | $8 |
| Electroencephalogram (EEG) | $437 | $528 | $448 |
| Electrolyte panel | $13 | $33 | $7 |
| Emergency department visit | $338 | $449 | $69 |
| Emergency department visit (level 1) | $128 | $145 | $11 |
| Emergency department visit (level 2) | $206 | $248 | $40 |
| Emergency department visit (level 3) | $338 | $449 | $69 |
| Emergency department visit (level 4) | $558 | $737 | $118 |
| Emergency department visit (level 5) | $741 | $1,018 | $171 |
| Estradiol (estrogen) test | $45 | $28 | $28 |
| Facet joint injection (spine) | $1,185 | $702 | $99 |
| Fallopian tube X-ray (HSG) | $409 | $565 | $164 |
| Ferritin (iron) test | $28 | $23 | $14 |
| Fibrinogen test | $56 | $35 | $10 |
| Folate (folic acid) test | $24 | $21 | $15 |
| Free T4 thyroid test | $18 | $25 | $9 |
| FSH hormone test | $36 | $24 | $19 |
| Gallbladder scan (HIDA) | $907 | $1,941 | $334 |
| GGT liver test | $7 | $24 | $7 |
| Glucose tolerance test | $17 | $29 | $8 |
| HDL cholesterol test | $13 | $25 | $8 |
| Hematocrit test | $3 | $28 | $2 |
| Hemoglobin A1c (diabetes test) | $18 | $25 | $10 |
| Hepatitis B test | $11 | $25 | $10 |
| Hepatitis C test | $28 | $29 | $14 |
| HIV test | $37 | $39 | $19 |
| HIV test (antigen/antibody combo) | $37 | $28 | $24 |
| Iron blood test | $13 | $21 | $6 |
| IV infusion therapy | $207 | $293 | $44 |
| IV infusion therapy (each additional) | $121 | $171 | $21 |
| IV infusion therapy (initial) | $294 | $399 | $67 |
| IVC filter placement | $6,071 | $3,480 | $1,885 |
| Joint aspiration (small/intermediate) | $394 | $580 | $57 |
| Joint aspiration or injection (mid-size joint) | $421 | $578 | $57 |
| Joint aspiration or injection (small joint) | $368 | $722 | $56 |
| Kidney biopsy | $1,507 | $848 | $492 |
| Kidney scan (nuclear) | $709 | $1,553 | $172 |
| Kidney ultrasound | $253 | $457 | $84 |
| Kidney ultrasound (limited) | $280 | $457 | $61 |
| Knee joint injection | $436 | $581 | $69 |
| Lactate test | $35 | $32 | $12 |
| Laryngoscopy | $1,051 | $144 | $189 |
| LDH test | $15 | $21 | $6 |
| LDL cholesterol test | $16 | $20 | $11 |
| Leg vein ultrasound (Doppler) | $340 | $955 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $245 | $541 | $116 |
| LH hormone test | $32 | $27 | $19 |
| Lipase test | $20 | $23 | $7 |
| Lipid (cholesterol) panel | $18 | $19 | $13 |
| Liver biopsy | $1,389 | $917 | $288 |
| Liver function panel | $24 | $62 | $8 |
| Lung function test (PFT) | $266 | $220 | $37 |
| Lung scan (V/Q) | $702 | $1,035 | $291 |
| Magnesium blood test | $16 | $21 | $7 |
| MRA of the brain | $727 | $2,310 | $226 |
| MRA of the brain with contrast | $934 | $2,310 | $226 |
| MRA of the brain without contrast | $352 | $2,772 | $328 |
| MRA of the neck | $934 | $1,849 | $245 |
| MRA of the neck with contrast | $934 | $1,849 | $245 |
| MRA of the neck without contrast | $1,041 | $2,310 | $343 |
| MRI of the abdomen | $891 | $3,119 | $300 |
| MRI of the abdomen without contrast | $741 | $2,772 | $194 |
| MRI of the ankle | $886 | $2,772 | $261 |
| MRI of the ankle without contrast | $741 | $2,772 | $222 |
| MRI of the brain | $962 | $1,386 | $269 |
| MRI of the brain with contrast | $962 | $1,848 | $269 |
| MRI of the brain without contrast | $727 | $1,386 | $195 |
| MRI of the chest | $875 | $2,541 | $371 |
| MRI of the chest without contrast | $1,030 | $3,003 | $466 |
| MRI of the knee | $1,074 | $2,657 | $315 |
| MRI of the knee with contrast | $1,074 | $4,158 | $315 |
| MRI of the knee without contrast | $806 | $1,819 | $204 |
| MRI of the lower back (lumbar spine) | $934 | $1,648 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $934 | $1,648 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $741 | $1,313 | $192 |
| MRI of the mid-back (thoracic spine) | $934 | $1,648 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $1,041 | $2,086 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $934 | $1,648 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $741 | $1,313 | $190 |
| MRI of the neck (cervical spine) | $934 | $1,652 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $1,030 | $2,086 | $318 |
| MRI of the neck (cervical spine) with contrast | $934 | $1,682 | $274 |
| MRI of the neck (cervical spine) without contrast | $828 | $1,386 | $191 |
| MRI of the pelvis | $934 | $2,310 | $268 |
| MRI of the pelvis with contrast | $934 | $2,205 | $268 |
| MRI of the pelvis without contrast | $727 | $2,310 | $227 |
| MRI of the shoulder | $934 | $3,234 | $313 |
| MRI of the shoulder with contrast | $934 | $3,234 | $313 |
| MRI of the shoulder without contrast | $741 | $2,310 | $205 |
| MRI of the wrist | $875 | $3,234 | $330 |
| MRI of the wrist without contrast | $720 | $2,772 | $303 |
| Nebulizer breathing treatment | $182 | $117 | $9 |
| Nuchal translucency ultrasound | $183 | $305 | $116 |
| Nuclear cardiac stress test | $1,846 | $3,106 | $428 |
| Occupational therapy evaluation | $155 | $240 | $101 |
| Occupational therapy evaluation (high complexity) | $199 | $240 | $101 |
| Occupational therapy evaluation (low complexity) | $146 | $240 | $101 |
| Occupational therapy evaluation (moderate complexity) | $155 | $240 | $101 |
| Pap smear (cervical screening) | $28 | $129 | $20 |
| Parathyroid hormone (PTH) test | $59 | $55 | $41 |
| Pelvic ultrasound | $242 | $306 | $78 |
| Pelvic ultrasound (complete) | $235 | $407 | $105 |
| Pelvic ultrasound (limited) | $250 | $306 | $51 |
| PET scan | $2,470 | $2,555 | — |
| Phosphorus blood test | $12 | $20 | $5 |
| Physical therapy evaluation | $155 | $240 | $98 |
| Physical therapy evaluation (high complexity) | $194 | $240 | $98 |
| Physical therapy evaluation (moderate complexity) | $155 | $240 | $98 |
| Platelet count | $15 | $36 | $4 |
| Pregnancy ultrasound | $304 | $458 | $126 |
| Pregnancy ultrasound (first trimester) | $288 | $458 | $117 |
| Pregnancy ultrasound (second or third trimester) | $320 | $458 | $136 |
| Procalcitonin test | $62 | $138 | $27 |
| Prolactin test | $18 | $26 | $19 |
| Prostate test (PSA) | $17 | $26 | $18 |
| Pulmonary rehabilitation | $135 | $258 | $87 |
| Radiofrequency nerve ablation | $2,026 | $1,521 | $462 |
| Scoliosis spine X-ray | $132 | $253 | $58 |
| Scoliosis spine X-ray (1 view) | $118 | $261 | $44 |
| Scoliosis spine X-ray (3 views) | $147 | $253 | $72 |
| Screening mammogram | $243 | $256 | $126 |
| Scrotal ultrasound | $254 | $625 | $99 |
| Sedimentation rate (ESR) test | $8 | $32 | $3 |
| Skin biopsy | $569 | $225 | $121 |
| Skin biopsy (punch) | $322 | $225 | $121 |
| Soft tissue ultrasound | $340 | $301 | $64 |
| Speech therapy | $173 | $240 | $76 |
| Spinal tap (lumbar puncture) | $759 | $694 | $165 |
| Spirometry (lung function test) | $169 | $220 | $30 |
| Spirometry with bronchodilator | $363 | $420 | $43 |
| Stress echocardiogram | $706 | $2,811 | $209 |
| Stress echocardiogram (complete) | $706 | $2,879 | $233 |
| Swallow study | $177 | $240 | $85 |
| T3 thyroid test | $14 | $25 | $14 |
| Testosterone test | $24 | $22 | $26 |
| Thyroid test (TSH) | $16 | $22 | $17 |
| Thyroid ultrasound | $259 | $457 | $109 |
| Thyroid uptake scan | $593 | $1,294 | $145 |
| Total IgE allergy test | $16 | $22 | $16 |
| Total protein test | $11 | $16 | $4 |
| Transesophageal echocardiogram (TEE) | $832 | $2,887 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $964 | $2,887 | $239 |
| Transvaginal ultrasound | $195 | $305 | $118 |
| Trigger point injection | $479 | $434 | $56 |
| Trigger point injection (1-2 muscles) | $476 | $434 | $52 |
| Triglycerides test | $8 | $16 | $6 |
| Troponin (heart) test | $13 | $30 | $12 |
| Turning a breech baby (version) | $2,695 | $964 | $94 |
| Upper GI series (barium) | $247 | $209 | $128 |
| Uric acid (gout) test | $12 | $21 | $5 |
| Urinalysis | $11 | $32 | $3 |
| Urine microalbumin test | $6 | $22 | $5 |
| Urine pregnancy test | $25 | $50 | $9 |
| Vaccine administration | $37 | $31 | $19 |
| Vaccine administration (each additional) | $19 | $21 | $16 |
| Varicose vein ablation | $3,295 | $1,929 | $1,018 |
| Vitamin B12 test | $27 | $21 | $15 |
| Vitamin D test | $40 | $43 | $30 |
| Wound debridement | $663 | $272 | $186 |
| X-ray of the abdomen | $139 | $174 | $36 |
| X-ray of the ankle | $155 | $174 | $37 |
| X-ray of the collarbone | $178 | $174 | $33 |
| X-ray of the elbow | $167 | $139 | $33 |
| X-ray of the facial bones | $161 | $139 | $39 |
| X-ray of the foot | $154 | $174 | $34 |
| X-ray of the forearm | $146 | $139 | $29 |
| X-ray of the hand | $152 | $139 | $38 |
| X-ray of the hip | $133 | $318 | $49 |
| X-ray of the hip (1 view) | $97 | $348 | $34 |
| X-ray of the hip (3 views) | $173 | $279 | $49 |
| X-ray of the hip (4 views) | $133 | $357 | $63 |
| X-ray of the knee | $199 | $139 | $42 |
| X-ray of the knee (2 views) | $188 | $174 | $34 |
| X-ray of the knee (3 views) | $211 | $174 | $42 |
| X-ray of the lower back (lumbar spine) | $206 | $139 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $191 | $174 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $222 | $139 | $53 |
| X-ray of the lower leg | $150 | $139 | $31 |
| X-ray of the mid-back (thoracic spine) | $189 | $139 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $189 | $176 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $189 | $139 | $39 |
| X-ray of the neck (cervical spine) | $199 | $139 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $191 | $174 | $40 |
| X-ray of the pelvis | $173 | $139 | $36 |
| X-ray of the pelvis (1 view) | $153 | $174 | $28 |
| X-ray of the ribs | $174 | $139 | $42 |
| X-ray of the ribs (2 views) | $169 | $139 | $36 |
| X-ray of the ribs (3 views) | $180 | $139 | $42 |
| X-ray of the shoulder | $176 | $174 | $36 |
| X-ray of the skull | $205 | $139 | $40 |
| X-ray of the upper arm | $163 | $139 | $32 |
| X-ray of the wrist | $167 | $174 | $43 |
| Zinc blood test | $18 | $19 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
