| Procedure | Memorial Hospital | Dublin Springs | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $36 | $50 | $51 |
| Abdominal fluid drain (paracentesis) | $1,468 | $3,369 | $284 |
| Abdominal ultrasound | $488 | $379 | $100 |
| Abdominal ultrasound (complete) | $520 | $403 | $114 |
| Abdominal ultrasound (limited) | $488 | $355 | $86 |
| Abscess drainage (complex or multiple) | $693 | $1,338 | $220 |
| Abscess drainage (simple) | $504 | $605 | $129 |
| Abscess incision and drainage | $504 | $972 | $174 |
| Albumin blood test | $7 | $7 | $5 |
| Aldosterone test | $83 | $48 | $41 |
| Alkaline phosphatase test | $10 | $7 | $5 |
| Alpha-fetoprotein (AFP) test | $47 | $46 | $17 |
| ALT liver enzyme test | $14 | $7 | $5 |
| Ammonia blood test | $52 | $133 | $15 |
| Amylase test | $47 | $54 | $6 |
| Anal fistula repair | $8,535 | $3,640 | $541 |
| Antinuclear antibody (ANA) test | $149 | $94 | $12 |
| Arterial blood gas (ABG) | $95 | $72 | $26 |
| AST liver enzyme test | $14 | $7 | $5 |
| Barium swallow study | $434 | $327 | $107 |
| Basic metabolic panel | $57 | $36 | $8 |
| Bilirubin blood test | $7 | $7 | $5 |
| Blood clotting test (PT/INR) | $27 | $23 | $4 |
| Blood glucose test | $16 | $6 | $5 |
| Blood transfusion | $918 | $1,801 | $47 |
| Blood type and screen | $66 | $38 | $10 |
| Blood type test | $59 | $26 | $3 |
| Blood type test (ABO group) | $86 | $80 | $3 |
| Blood type test (Rh/D antigen) | $31 | $26 | $3 |
| BNP (heart failure) test | $153 | $175 | $39 |
| Bone density scan (DEXA) | $341 | $291 | $39 |
| Bone marrow biopsy | $2,553 | $3,381 | $172 |
| Bone scan (nuclear) | $1,709 | $1,504 | $259 |
| Botox for migraine | $454 | $1,292 | $157 |
| Breast biopsy | $3,431 | $3,850 | $478 |
| Breast MRI | $1,713 | $1,639 | $216 |
| Breast MRI without contrast | $1,713 | $1,970 | $216 |
| Breast ultrasound | $683 | $465 | $92 |
| Breast ultrasound (complete) | $715 | $293 | $100 |
| Breast ultrasound (limited) | $561 | $695 | $84 |
| Breathing tube insertion (intubation) | $694 | $1,278 | $133 |
| Bronchoscopy | $2,606 | $3,531 | $303 |
| Burn dressing and debridement (medium) | $459 | $738 | $166 |
| Burn dressing and debridement (small) | $283 | $359 | $93 |
| Burn treatment | $371 | $549 | $129 |
| C-reactive protein (CRP) | $30 | $22 | $5 |
| CA 19-9 tumor marker test | $107 | $27 | $21 |
| CA-125 ovarian marker test | $128 | $25 | $21 |
| Calcium blood test | $36 | $6 | $5 |
| Cardiac catheterization | $9,421 | $9,624 | $1,049 |
| Cardiac rehabilitation | $294 | $296 | $26 |
| Cardiac stress test | $798 | $759 | $39 |
| Cardioversion | $2,321 | $5,136 | $155 |
| Carotid artery ultrasound | $1,010 | $695 | $156 |
| Carpal tunnel release | $10,429 | $4,185 | $483 |
| CEA tumor marker test | $129 | $183 | $19 |
| Central line placement | $2,068 | $2,203 | $238 |
| Cervical cerclage | $2,015 | $4,050 | $137 |
| Chemotherapy infusion | $755 | $841 | $81 |
| Chemotherapy infusion (each additional) | $562 | $632 | $28 |
| Chemotherapy infusion (first hour) | $917 | $1,050 | $133 |
| Chest fluid drain (thoracentesis) | $2,348 | $5,486 | $311 |
| Chest tube insertion | $1,556 | $2,668 | $143 |
| Chest X-ray | $233 | $225 | $37 |
| Chest X-ray (1 view) | $211 | $171 | $25 |
| Chest X-ray (2 views) | $260 | $200 | $33 |
| Chickenpox (varicella) vaccine | $480 | $561 | — |
| Circumcision | $6,527 | $1,615 | $167 |
| CK-MB heart enzyme test | $40 | $42 | $12 |
| Clotting time test (PTT) | $40 | $122 | $6 |
| Colonoscopy | $3,819 | $3,199 | $480 |
| Complete blood count (CBC) | $42 | $20 | $7 |
| Complete blood count (CBC) (complete) | $42 | $20 | $8 |
| Comprehensive metabolic panel | $85 | $48 | $11 |
| Copper blood test | $53 | $159 | $12 |
| Coronary CT angiography | $1,002 | $1,221 | $326 |
| Cortisol test | $70 | $67 | $16 |
| CPAP titration study | $319 | $244 | $69 |
| Creatine kinase (CK) test | $82 | $42 | $7 |
| CT angiography of the chest | $1,201 | $1,416 | $281 |
| CT angiography of the head | $1,347 | $1,302 | $274 |
| CT scan of the abdomen | $911 | $1,167 | $230 |
| CT scan of the abdomen and pelvis | $1,463 | $1,932 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $1,576 | $2,051 | $338 |
| CT scan of the abdomen and pelvis with contrast | $1,463 | $1,932 | $300 |
| CT scan of the abdomen and pelvis without contrast | $1,333 | $1,571 | $183 |
| CT scan of the abdomen with and without contrast | $926 | $1,266 | $259 |
| CT scan of the abdomen with contrast | $813 | $1,167 | $230 |
| CT scan of the abdomen without contrast | $781 | $1,069 | $136 |
| CT scan of the arm | $780 | $1,400 | $199 |
| CT scan of the arm with contrast | $780 | $1,530 | $199 |
| CT scan of the arm without contrast | $650 | $1,270 | $161 |
| CT scan of the chest | $1,224 | $1,369 | $167 |
| CT scan of the chest with and without contrast | $1,099 | $1,633 | $196 |
| CT scan of the chest with contrast | $1,300 | $1,369 | $167 |
| CT scan of the chest without contrast | $813 | $996 | $133 |
| CT scan of the head | $880 | $951 | $148 |
| CT scan of the head with and without contrast | $978 | $1,078 | $173 |
| CT scan of the head with contrast | $913 | $951 | $148 |
| CT scan of the head without contrast | $845 | $835 | $107 |
| CT scan of the leg | $813 | $1,488 | $166 |
| CT scan of the leg with contrast | $813 | $1,521 | $166 |
| CT scan of the leg without contrast | $666 | $1,308 | $130 |
| CT scan of the lower back (lumbar spine) | $970 | $951 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $1,052 | $1,128 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $970 | $951 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $929 | $868 | $130 |
| CT scan of the neck | $943 | $1,182 | $183 |
| CT scan of the neck (cervical spine) | $1,040 | $1,180 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $1,118 | $1,242 | $196 |
| CT scan of the neck (cervical spine) with contrast | $1,053 | $1,180 | $168 |
| CT scan of the neck (cervical spine) without contrast | $924 | $1,073 | $131 |
| CT scan of the neck with and without contrast | $1,059 | $1,274 | $220 |
| CT scan of the neck with contrast | $943 | $1,182 | $183 |
| CT scan of the neck without contrast | $813 | $995 | $150 |
| CT scan of the pelvis | $882 | $1,101 | $226 |
| CT scan of the pelvis with and without contrast | $1,028 | $1,182 | $251 |
| CT scan of the pelvis with contrast | $949 | $1,101 | $226 |
| CT scan of the pelvis without contrast | $748 | $1,020 | $133 |
| CT scan of the sinuses | $879 | $1,151 | $152 |
| CT scan of the sinuses with and without contrast | $1,052 | $1,260 | $184 |
| CT scan of the sinuses with contrast | $879 | $1,151 | $152 |
| CT scan of the sinuses without contrast | $749 | $876 | $128 |
| D-dimer test | $121 | $120 | $10 |
| Defibrillator (ICD) implant | $28,458 | $15,613 | $798 |
| DHEA-sulfate test | $55 | $57 | $22 |
| Diagnostic mammogram | $471 | $512 | $140 |
| Drug screen (urine) | $88 | $80 | $17 |
| Echocardiogram | $928 | $1,343 | $138 |
| Echocardiogram with and without contrast | $813 | $1,121 | $101 |
| EEG (awake and asleep) | $1,174 | $1,062 | $482 |
| EKG / ECG (tracing only) | $137 | $99 | $7 |
| Electrocardiogram (EKG) | $137 | $99 | $8 |
| Electroencephalogram (EEG) | $1,152 | $1,062 | $448 |
| Electrolyte panel | $53 | $30 | $7 |
| Emergency department visit | $876 | $1,136 | $69 |
| Emergency department visit (level 1) | $267 | $437 | $11 |
| Emergency department visit (level 2) | $553 | $718 | $40 |
| Emergency department visit (level 3) | $876 | $1,136 | $69 |
| Emergency department visit (level 4) | $1,300 | $1,879 | $118 |
| Emergency department visit (level 5) | $1,625 | $2,694 | $171 |
| ERCP (bile duct endoscopy) | $7,526 | $6,773 | $311 |
| Esophageal dilation | $341 | $4,587 | $522 |
| Esophageal variceal banding | $2,867 | $2,581 | $126 |
| Estradiol (estrogen) test | $84 | $39 | $28 |
| Facet joint injection (spine) | $2,340 | $2,535 | $99 |
| Fallopian tube X-ray (HSG) | $343 | $376 | $164 |
| Fecal occult blood (stool) test | $41 | $47 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $41 | $47 | $4 |
| Feeding tube (PEG) placement | $2,918 | $2,626 | $178 |
| Ferritin (iron) test | $42 | $100 | $14 |
| Fibrinogen test | $43 | $186 | $10 |
| Flexible sigmoidoscopy | $2,392 | $2,727 | $323 |
| Flu vaccine | $25 | $79 | — |
| Folate (folic acid) test | $39 | $40 | $15 |
| Foreign body removal (skin) | $697 | $919 | $157 |
| Free T4 thyroid test | $44 | $41 | $9 |
| FSH hormone test | $51 | $25 | $19 |
| Gallbladder scan (HIDA) | $1,953 | $2,607 | $334 |
| GGT liver test | $33 | $33 | $7 |
| Glucose tolerance test | $33 | $30 | $8 |
| HDL cholesterol test | $31 | $33 | $8 |
| Hemoglobin A1c (diabetes test) | $64 | $66 | $10 |
| Hemorrhoid removal | $2,505 | $4,279 | $338 |
| Hepatitis A vaccine | $116 | $241 | — |
| Hepatitis B test | $26 | $20 | $10 |
| Hepatitis B vaccine | $392 | $106 | — |
| Hepatitis C test | $36 | $23 | $14 |
| HIV test | $48 | $25 | $19 |
| HIV test (antibody) | $36 | $25 | $14 |
| HIV test (antigen/antibody combo) | $58 | $34 | $24 |
| Holter heart monitor | $417 | $375 | $26 |
| Iron blood test | $33 | $61 | $6 |
| IV infusion therapy | $310 | $287 | $44 |
| IV infusion therapy (each additional) | $117 | $142 | $21 |
| IV infusion therapy (initial) | $313 | $433 | $67 |
| IVC filter placement | $7,754 | $12,536 | $1,885 |
| Joint aspiration (small/intermediate) | $359 | $2,612 | $57 |
| Joint aspiration or injection (mid-size joint) | $453 | $2,780 | $57 |
| Joint aspiration or injection (small joint) | $305 | $2,528 | $56 |
| Kidney biopsy | $1,713 | $6,264 | $492 |
| Kidney scan (nuclear) | $1,354 | $881 | $172 |
| Kidney ultrasound | $533 | $380 | $84 |
| Kidney ultrasound (limited) | $547 | $321 | $61 |
| Knee joint injection | $827 | $3,031 | $69 |
| Lactate test | $50 | $51 | $12 |
| Laryngoscopy | $430 | $523 | $189 |
| LDH test | $32 | $16 | $6 |
| LDL cholesterol test | $44 | $50 | $11 |
| Leg artery angiogram | $3,502 | $3,333 | $149 |
| Leg vein ultrasound (Doppler) | $900 | $834 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $900 | $736 | $116 |
| LH hormone test | $72 | $124 | $19 |
| Lipase test | $47 | $48 | $7 |
| Lipid (cholesterol) panel | $64 | $40 | $13 |
| Liver biopsy | $1,730 | $4,028 | $288 |
| Liver function panel | $49 | $18 | $8 |
| Lung function test (PFT) | $358 | $664 | $37 |
| Lung scan (V/Q) | $1,169 | $1,091 | $291 |
| Magnesium blood test | $45 | $36 | $7 |
| MMR vaccine | $416 | $299 | — |
| MRA of the brain | $1,430 | $1,081 | $226 |
| MRA of the brain with contrast | $1,235 | $1,081 | $226 |
| MRA of the brain without contrast | $1,365 | $1,234 | $328 |
| MRA of the neck | $1,333 | $1,084 | $245 |
| MRA of the neck with contrast | $1,235 | $1,084 | $245 |
| MRA of the neck without contrast | $1,365 | $1,240 | $343 |
| MRI of the abdomen | $1,364 | $1,630 | $300 |
| MRI of the abdomen without contrast | $1,138 | $1,285 | $194 |
| MRI of the ankle | $1,433 | $2,136 | $261 |
| MRI of the ankle with contrast | $1,298 | $2,030 | $261 |
| MRI of the ankle without contrast | $1,160 | $1,928 | $222 |
| MRI of the brain | $1,430 | $1,639 | $269 |
| MRI of the brain with contrast | $1,430 | $1,639 | $269 |
| MRI of the brain without contrast | $1,300 | $1,275 | $195 |
| MRI of the chest | $1,251 | $1,586 | $371 |
| MRI of the chest without contrast | $1,504 | $1,890 | $466 |
| MRI of the knee | $1,365 | $2,068 | $315 |
| MRI of the knee with contrast | $1,170 | $2,170 | $315 |
| MRI of the knee without contrast | $1,170 | $1,836 | $204 |
| MRI of the lower back (lumbar spine) | $1,419 | $1,632 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $1,419 | $1,632 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,235 | $1,309 | $192 |
| MRI of the mid-back (thoracic spine) | $1,387 | $1,551 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $1,645 | $1,936 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $1,387 | $1,551 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $1,235 | $1,286 | $190 |
| MRI of the neck (cervical spine) | $1,300 | $1,581 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $1,645 | $1,864 | $318 |
| MRI of the neck (cervical spine) with contrast | $1,251 | $1,581 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,235 | $1,292 | $191 |
| MRI of the pelvis | $1,290 | $1,607 | $268 |
| MRI of the pelvis without contrast | $1,144 | $1,323 | $227 |
| MRI of the shoulder | $1,290 | $2,019 | $313 |
| MRI of the shoulder with contrast | $1,290 | $2,073 | $313 |
| MRI of the shoulder without contrast | $1,160 | $1,896 | $205 |
| MRI of the wrist | $1,430 | $2,008 | $330 |
| MRI of the wrist with contrast | $1,498 | $2,073 | $330 |
| MRI of the wrist without contrast | $1,116 | $1,782 | $303 |
| Nebulizer breathing treatment | $130 | $245 | $9 |
| Nerve conduction study | $464 | $1,154 | $118 |
| Nuclear cardiac stress test | $3,463 | $3,253 | $428 |
| Occupational therapy evaluation | $262 | $274 | $101 |
| Occupational therapy evaluation (high complexity) | $262 | $289 | $101 |
| Occupational therapy evaluation (low complexity) | $227 | $261 | $101 |
| Occupational therapy evaluation (moderate complexity) | $279 | $274 | $101 |
| Pap smear (cervical screening) | $77 | $48 | $20 |
| Parathyroid hormone (PTH) test | $72 | $99 | $41 |
| Pelvic ultrasound | $318 | $204 | $78 |
| Pelvic ultrasound (complete) | $345 | $226 | $105 |
| Pelvic ultrasound (limited) | $284 | $183 | $51 |
| PET scan | $6,010 | $5,489 | — |
| Phosphorus blood test | $38 | $36 | $5 |
| Physical therapy evaluation | $250 | $302 | $98 |
| Physical therapy evaluation (high complexity) | $286 | $327 | $98 |
| Physical therapy evaluation (moderate complexity) | $250 | $302 | $98 |
| Platelet count | $16 | $33 | $4 |
| Pneumonia vaccine | $498 | $379 | — |
| Pregnancy blood test (hCG) | $23 | $21 | $8 |
| Pregnancy ultrasound | $456 | $317 | $126 |
| Pregnancy ultrasound (first trimester) | $384 | $301 | $117 |
| Pregnancy ultrasound (second or third trimester) | $529 | $333 | $136 |
| Procalcitonin test | $189 | $419 | $27 |
| Prolactin test | $81 | $76 | $19 |
| Prostate biopsy | $8,534 | $1,395 | — |
| Prostate test (PSA) | $55 | $42 | $18 |
| Pulmonary rehabilitation | $364 | $116 | $87 |
| Radiofrequency nerve ablation | $3,365 | $6,807 | $462 |
| Rheumatoid factor test | $118 | $33 | $6 |
| Scoliosis spine X-ray | $255 | $184 | $58 |
| Scoliosis spine X-ray (1 view) | $209 | $130 | $44 |
| Scoliosis spine X-ray (3 views) | $255 | $237 | $72 |
| Screening colonoscopy | $3,673 | $2,443 | $378 |
| Screening mammogram | $150 | $161 | $126 |
| Scrotal ultrasound | $508 | $400 | $99 |
| Sedimentation rate (ESR) test | $32 | $50 | $3 |
| Semen analysis | $118 | $136 | $12 |
| Sex hormone binding globulin test | $88 | $100 | $22 |
| Shingles vaccine | $120 | $552 | — |
| Skin biopsy | $630 | $475 | $121 |
| Skin biopsy (punch) | $406 | $475 | $121 |
| Soft tissue ultrasound | $385 | $279 | $64 |
| Speech therapy | $218 | $244 | $76 |
| Spinal cord stimulator | $10,556 | $16,120 | $2,388 |
| Spinal tap (lumbar puncture) | $1,016 | $1,264 | $165 |
| Spine fracture repair (kyphoplasty) | $15,924 | $17,855 | $5,803 |
| Spirometry (lung function test) | $341 | $439 | $30 |
| Spirometry with bronchodilator | $922 | $888 | $43 |
| Strep throat test | $57 | $57 | $17 |
| Stress echocardiogram | $1,476 | $1,607 | $209 |
| Swallow study | $257 | $190 | $85 |
| T3 thyroid test | $48 | $34 | $14 |
| Tdap (tetanus) vaccine | $276 | $146 | — |
| Testosterone test | $90 | $52 | $26 |
| Thyroid test (TSH) | $47 | $46 | $17 |
| Thyroid ultrasound | $645 | $478 | $109 |
| Thyroid uptake scan | $1,382 | $1,146 | $145 |
| Tilt table test | $1,820 | $1,955 | $168 |
| Total IgE allergy test | $48 | $27 | $16 |
| Total protein test | $27 | $7 | $4 |
| Transesophageal echocardiogram (TEE) | $1,775 | $1,665 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $1,775 | $1,771 | $239 |
| Transvaginal ultrasound | $521 | $428 | $118 |
| Trigger point injection | $491 | $1,279 | $56 |
| Trigger point injection (1-2 muscles) | $697 | $1,096 | $52 |
| Triglycerides test | $30 | $45 | $6 |
| Troponin (heart) test | $62 | $60 | $12 |
| Turning a breech baby (version) | $2,665 | $2,883 | $94 |
| Upper GI endoscopy (EGD) | $3,429 | $2,669 | $371 |
| Upper GI series (barium) | $741 | $581 | $128 |
| Ureteral stent placement | $10,790 | $7,499 | $373 |
| Uric acid (gout) test | $20 | $11 | $5 |
| Urinalysis | $17 | $36 | $3 |
| Urine microalbumin test | $49 | $33 | $5 |
| Urine pregnancy test | $23 | $64 | $9 |
| Vaccine administration | $46 | $40 | $19 |
| Vaccine administration (each additional) | $46 | $33 | $16 |
| Varicose vein ablation | $4,263 | $9,171 | $1,018 |
| Vasectomy | $9,620 | $9,300 | $347 |
| Vitamin B12 test | $42 | $40 | $15 |
| Vitamin D test | $82 | $52 | $30 |
| Wart removal | $570 | $651 | $121 |
| Wound debridement | $1,230 | $1,081 | $186 |
| X-ray of the abdomen | $232 | $252 | $36 |
| X-ray of the ankle | $270 | $362 | $37 |
| X-ray of the collarbone | $208 | $290 | $33 |
| X-ray of the elbow | $322 | $361 | $33 |
| X-ray of the facial bones | $471 | $193 | $39 |
| X-ray of the foot | $332 | $368 | $34 |
| X-ray of the forearm | $254 | $324 | $29 |
| X-ray of the hand | $323 | $312 | $38 |
| X-ray of the hip | $385 | $235 | $49 |
| X-ray of the hip (1 view) | $242 | $207 | $34 |
| X-ray of the hip (3 views) | $385 | $235 | $49 |
| X-ray of the knee | $358 | $336 | $42 |
| X-ray of the knee (2 views) | $252 | $306 | $34 |
| X-ray of the knee (3 views) | $351 | $368 | $42 |
| X-ray of the knee (4+ views) | $364 | $396 | $49 |
| X-ray of the lower back (lumbar spine) | $355 | $247 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $355 | $207 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $395 | $287 | $53 |
| X-ray of the lower leg | $250 | $299 | $31 |
| X-ray of the mid-back (thoracic spine) | $257 | $238 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $227 | $216 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $393 | $259 | $39 |
| X-ray of the neck (cervical spine) | $364 | $268 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $340 | $236 | $40 |
| X-ray of the pelvis | $225 | $268 | $36 |
| X-ray of the pelvis (1 view) | $216 | $235 | $28 |
| X-ray of the ribs | $393 | $328 | $42 |
| X-ray of the ribs (2 views) | $258 | $209 | $36 |
| X-ray of the ribs (3 views) | $409 | $328 | $42 |
| X-ray of the shoulder | $325 | $432 | $36 |
| X-ray of the skull | $232 | $285 | $40 |
| X-ray of the upper arm | $257 | $218 | $32 |
| X-ray of the wrist | $250 | $273 | $43 |
| Zinc blood test | $36 | $19 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.