| Procedure | Mon Health Medical Center | Mon Health Marion | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $104 | $104 | $51 |
| Abdominal fluid drain (paracentesis) | $3,549 | $3,549 | $284 |
| Abdominal ultrasound | $403 | $403 | $100 |
| Abdominal ultrasound (complete) | $403 | $403 | $114 |
| Abdominal ultrasound (limited) | $403 | $403 | $86 |
| Abscess drainage (complex or multiple) | $1,512 | $1,512 | $220 |
| Abscess drainage (simple) | $752 | $752 | $129 |
| Abscess incision and drainage | $752 | $752 | $174 |
| Achilles tendon repair | $691 | $691 | $624 |
| Albumin blood test | $15 | $15 | $5 |
| Alkaline phosphatase test | $15 | $15 | $5 |
| Allergy shots | $11 | $11 | $11 |
| Alpha-fetoprotein (AFP) test | $50 | $50 | $17 |
| ALT liver enzyme test | $16 | $16 | $5 |
| Ammonia blood test | $33 | $33 | $15 |
| Amylase test | $19 | $19 | $6 |
| Anal fistula repair | $5,442 | $5,442 | $541 |
| Ankle fracture repair | $682 | $682 | $608 |
| Anoscopy | $488 | $488 | $129 |
| Antinuclear antibody (ANA) test | $36 | $36 | $12 |
| Aortic aneurysm repair (AAA) | $12,028 | $12,028 | $1,345 |
| Aortic valve replacement | $38,923 | $38,923 | $1,603 |
| Arterial blood gas (ABG) | $77 | $77 | $26 |
| AST liver enzyme test | $15 | $15 | $5 |
| Barium swallow study | $674 | $674 | $107 |
| Bartholin cyst removal | $438 | $438 | $182 |
| Basic metabolic panel | $25 | $25 | $8 |
| Benign skin lesion removal | $2,142 | $2,142 | $171 |
| Bilirubin blood test | $15 | $15 | $5 |
| Bladder function test (urodynamics) | $132 | $132 | $345 |
| Bladder scope (cystoscopy) | $1,167 | $1,167 | $216 |
| Blood clotting test (PT/INR) | $13 | $13 | $4 |
| Blood crossmatch | $424 | $424 | — |
| Blood glucose test | $12 | $12 | $5 |
| Blood transfusion | $1,655 | $1,655 | $47 |
| Blood type and screen | $135 | $135 | $10 |
| Blood type test | $46 | $46 | $3 |
| Blood type test (ABO group) | $46 | $46 | $3 |
| Blood type test (Rh/D antigen) | $12 | $12 | $3 |
| BNP (heart failure) test | $117 | $117 | $39 |
| Bone density scan (DEXA) | $403 | $403 | $39 |
| Bone marrow biopsy | $6,133 | $6,133 | $172 |
| Bone scan (nuclear) | $1,521 | $1,521 | $259 |
| Botox for migraine | $1,117 | $1,117 | $157 |
| Breast biopsy | $6,133 | $6,133 | $478 |
| Breast MRI | $915 | $915 | $216 |
| Breast MRI without contrast | $915 | $915 | $216 |
| Breast ultrasound | $333 | $333 | $92 |
| Breast ultrasound (complete) | $403 | $403 | $100 |
| Breast ultrasound (limited) | $333 | $333 | $84 |
| Breathing tube insertion (intubation) | $879 | $879 | $133 |
| Bunion surgery (bunionectomy) | $585 | $585 | $883 |
| Burn dressing and debridement (medium) | $752 | $752 | $166 |
| Burn dressing and debridement (small) | $752 | $752 | $93 |
| Burn treatment | $752 | $752 | $129 |
| C-reactive protein (CRP) | $15 | $15 | $5 |
| CA 19-9 tumor marker test | $62 | $62 | $21 |
| CA-125 ovarian marker test | $62 | $62 | $21 |
| Calcium blood test | $15 | $15 | $5 |
| Capsule endoscopy | $3,252 | $3,252 | $802 |
| Cardiac ablation | $92,854 | $92,854 | $759 |
| Cardiac catheterization | $12,174 | $12,174 | $1,049 |
| Cardiac event monitor | $255 | $255 | $170 |
| Cardiac MRI | $915 | $915 | $322 |
| Cardiac MRI without contrast | $915 | $915 | $280 |
| Cardiac rehabilitation | $484 | $484 | $26 |
| Cardiac stress test | $1,179 | $1,179 | $39 |
| Cardioversion | $2,477 | $2,477 | $155 |
| Carotid artery surgery | $1,227 | $1,227 | $1,026 |
| Carotid artery ultrasound | $915 | $915 | $156 |
| Cataract surgery | $8,907 | $8,907 | $547 |
| CEA tumor marker test | $56 | $56 | $19 |
| Celiac disease test | $34 | $34 | $12 |
| Cervical LEEP procedure | $12,133 | $12,133 | $325 |
| Chalazion (eyelid cyst) removal | $1,131 | $1,131 | $131 |
| Chemotherapy infusion | $297 | $297 | $81 |
| Chemotherapy infusion (each additional) | $269 | $269 | $28 |
| Chemotherapy infusion (first hour) | $1,255 | $1,255 | $133 |
| Chest fluid drain (thoracentesis) | $2,340 | $2,340 | $311 |
| Chest tube insertion | $167 | $167 | $143 |
| Chest X-ray | $333 | $333 | $37 |
| Chest X-ray (1 view) | $333 | $333 | $25 |
| Chest X-ray (2 views) | $333 | $333 | $33 |
| Chickenpox (varicella) vaccine | $216 | $216 | — |
| Circumcision | $7,754 | $7,754 | $167 |
| CK-MB heart enzyme test | $34 | $34 | $12 |
| Clotting time test (PTT) | $18 | $18 | $6 |
| Colon resection (colectomy) | $1,444 | $1,444 | $1,238 |
| Colonoscopy | $265 | $265 | $480 |
| Colostomy | $1,295 | $1,295 | $1,122 |
| Colposcopy | $1,206 | $1,206 | $161 |
| Complete blood count (CBC) | $21 | $21 | $7 |
| Complete blood count (CBC) (complete) | $23 | $23 | $8 |
| Complex wound repair | $2,317 | $2,317 | $390 |
| Comprehensive eye exam | $488 | $488 | $138 |
| Comprehensive metabolic panel | $31 | $31 | $11 |
| Continuous glucose monitor setup | $36 | $36 | $35 |
| Contraceptive implant (Nexplanon) | $1,510 | $1,510 | $115 |
| Copper blood test | $37 | $37 | $12 |
| Coronary CT angiography | $1,352 | $1,352 | $326 |
| Cortisol test | $46 | $46 | $16 |
| COVID-19 PCR test | $136 | $136 | $51 |
| CPAP titration study | $789 | $789 | $69 |
| Creatine kinase (CK) test | $19 | $19 | $7 |
| CT angiography of the chest | $674 | $674 | $281 |
| CT angiography of the head | $674 | $674 | $274 |
| CT scan of the abdomen | $674 | $674 | $230 |
| CT scan of the abdomen and pelvis | $1,352 | $1,352 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $1,352 | $1,352 | $338 |
| CT scan of the abdomen and pelvis with contrast | $1,352 | $1,352 | $300 |
| CT scan of the abdomen and pelvis without contrast | $915 | $915 | $183 |
| CT scan of the abdomen with and without contrast | $674 | $674 | $259 |
| CT scan of the abdomen with contrast | $674 | $674 | $230 |
| CT scan of the abdomen without contrast | $403 | $403 | $136 |
| CT scan of the arm | $674 | $674 | $199 |
| CT scan of the arm with contrast | $1,352 | $1,352 | $199 |
| CT scan of the arm without contrast | $403 | $403 | $161 |
| CT scan of the chest | $674 | $674 | $167 |
| CT scan of the chest with and without contrast | $674 | $674 | $196 |
| CT scan of the chest with contrast | $674 | $674 | $167 |
| CT scan of the chest without contrast | $403 | $403 | $133 |
| CT scan of the head | $674 | $674 | $148 |
| CT scan of the head with and without contrast | $674 | $674 | $173 |
| CT scan of the head with contrast | $674 | $674 | $148 |
| CT scan of the head without contrast | $403 | $403 | $107 |
| CT scan of the leg | $674 | $674 | $166 |
| CT scan of the leg with contrast | $674 | $674 | $166 |
| CT scan of the leg without contrast | $403 | $403 | $130 |
| CT scan of the lower back (lumbar spine) | $674 | $674 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $674 | $674 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,352 | $1,352 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $403 | $403 | $130 |
| CT scan of the neck | $674 | $674 | $183 |
| CT scan of the neck (cervical spine) | $674 | $674 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $674 | $674 | $196 |
| CT scan of the neck (cervical spine) with contrast | $1,352 | $1,352 | $168 |
| CT scan of the neck (cervical spine) without contrast | $403 | $403 | $131 |
| CT scan of the neck with and without contrast | $674 | $674 | $220 |
| CT scan of the neck with contrast | $674 | $674 | $183 |
| CT scan of the neck without contrast | $403 | $403 | $150 |
| CT scan of the pelvis | $674 | $674 | $226 |
| CT scan of the pelvis with and without contrast | $674 | $674 | $251 |
| CT scan of the pelvis with contrast | $674 | $674 | $226 |
| CT scan of the pelvis without contrast | $403 | $403 | $133 |
| CT scan of the sinuses | $674 | $674 | $152 |
| CT scan of the sinuses with and without contrast | $674 | $674 | $184 |
| CT scan of the sinuses with contrast | $674 | $674 | $152 |
| CT scan of the sinuses without contrast | $403 | $403 | $128 |
| D-dimer test | $30 | $30 | $10 |
| Defibrillator (ICD) implant | $121,352 | $121,352 | $798 |
| Developmental screening (child) | $237 | $237 | — |
| DHEA-sulfate test | $66 | $66 | $22 |
| Diagnostic mammogram | $494 | $494 | $140 |
| Dilation and curettage (D&C) | $12,158 | $12,158 | $298 |
| Droopy eyelid repair (ptosis) | $602 | $602 | $745 |
| Drug screen (urine) | $184 | $184 | $17 |
| Echocardiogram | $941 | $941 | $138 |
| Echocardiogram with and without contrast | $915 | $915 | $101 |
| Echocardiogram without contrast | $937 | $937 | $138 |
| EKG / ECG (tracing only) | $225 | $225 | $7 |
| Elbow replacement | $705 | $705 | $1,301 |
| Electrocardiogram (EKG) | $225 | $225 | $8 |
| Electrolyte panel | $21 | $21 | $7 |
| Electromyography (EMG) | $488 | $488 | $141 |
| Emergency department visit | $599 | $599 | $69 |
| Emergency department visit (level 1) | $333 | $333 | $11 |
| Emergency department visit (level 2) | $599 | $599 | $40 |
| Emergency department visit (level 3) | $1,048 | $1,048 | $69 |
| Emergency department visit (level 4) | $1,612 | $1,612 | $118 |
| Emergency department visit (level 5) | $2,321 | $2,321 | $171 |
| Endometrial biopsy | $761 | $761 | $98 |
| ERCP (bile duct endoscopy) | $372 | $372 | $311 |
| Esophageal dilation | $3,549 | $3,549 | $522 |
| Estradiol (estrogen) test | $83 | $83 | $28 |
| Facet joint injection (spine) | $3,370 | $3,370 | $99 |
| Fallopian tube X-ray (HSG) | $915 | $915 | $164 |
| Fecal occult blood (stool) test | $54 | $54 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $13 | $13 | $4 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $54 | $54 | $16 |
| Feeding tube (PEG) placement | $211 | $211 | $178 |
| Femoral hernia repair | $627 | $627 | $584 |
| Ferritin (iron) test | $40 | $40 | $14 |
| Fibrinogen test | $29 | $29 | $10 |
| Fibroid removal (myomectomy) | $1,116 | $1,116 | $914 |
| Flu test | $49 | $49 | $17 |
| Flu vaccine | $89 | $89 | — |
| Folate (folic acid) test | $26 | $26 | $15 |
| Foreign body removal (skin) | $810 | $810 | $157 |
| Free T4 thyroid test | $26 | $26 | $9 |
| FSH hormone test | $51 | $51 | $19 |
| Gallbladder removal (laparoscopic) | $749 | $749 | $658 |
| Gallbladder scan (HIDA) | $1,779 | $1,779 | $334 |
| GGT liver test | $21 | $21 | $7 |
| Glucose tolerance test | $25 | $25 | $8 |
| Hammertoe repair | $403 | $403 | $548 |
| HDL cholesterol test | $24 | $24 | $8 |
| Hematocrit test | $7 | $7 | $2 |
| Hemodialysis | $2,686 | $2,686 | $75 |
| Hemoglobin A1c (diabetes test) | $12 | $12 | $10 |
| Hemorrhoid removal | $3,451 | $3,451 | $338 |
| Hepatitis A vaccine | $103 | $103 | — |
| Hepatitis B test | $31 | $31 | $10 |
| Hepatitis B vaccine | $198 | $198 | — |
| Hepatitis C test | $42 | $42 | $14 |
| Hip fracture repair | $1,304 | $1,304 | $1,120 |
| Hip replacement | $1,369 | $1,369 | $1,162 |
| HIV test | $71 | $71 | $19 |
| HIV test (antibody) | $41 | $41 | $14 |
| HIV test (antigen/antibody combo) | $71 | $71 | $24 |
| Holter heart monitor | $497 | $497 | $26 |
| Home sleep apnea test | $225 | $225 | $123 |
| HPV vaccine | $363 | $363 | — |
| Hysterectomy | $1,031 | $1,031 | $933 |
| Hysteroscopy | $12,034 | $12,034 | $1,270 |
| Inguinal hernia repair | $602 | $602 | $538 |
| Iron blood test | $19 | $19 | $6 |
| IUD insertion | $1,128 | $1,128 | — |
| IUD removal | $1,151 | $1,151 | $112 |
| IV infusion therapy | $797 | $797 | $44 |
| IV infusion therapy (each additional) | $175 | $175 | $21 |
| IV infusion therapy (initial) | $797 | $797 | $67 |
| IVC filter placement | $20,460 | $20,460 | $1,885 |
| Joint aspiration (small/intermediate) | $1,117 | $1,117 | $57 |
| Joint aspiration or injection (mid-size joint) | $1,117 | $1,117 | $57 |
| Joint aspiration or injection (small joint) | $1,117 | $1,117 | $56 |
| Kidney biopsy | $6,133 | $6,133 | $492 |
| Kidney removal (nephrectomy) | $1,384 | $1,384 | $1,164 |
| Kidney scan (nuclear) | $2,066 | $2,066 | $172 |
| Kidney ultrasound | $403 | $403 | $84 |
| Kidney ultrasound (limited) | $403 | $403 | $61 |
| Knee joint injection | $1,142 | $1,142 | $69 |
| Lactate test | $34 | $34 | $12 |
| Laminectomy (spine) | $1,313 | $1,313 | $1,157 |
| Laryngoscopy | $735 | $735 | $189 |
| LDH test | $18 | $18 | $6 |
| LDL cholesterol test | $31 | $31 | $11 |
| Leg artery angiogram | $11,913 | $11,913 | $149 |
| Leg artery angioplasty | $32,468 | $32,468 | — |
| Leg vein ultrasound (Doppler) | $425 | $425 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $403 | $403 | $116 |
| LH hormone test | $55 | $55 | $19 |
| Lipase test | $20 | $20 | $7 |
| Lipid (cholesterol) panel | $40 | $40 | $13 |
| Liver biopsy | $3,112 | $3,112 | $288 |
| Liver function panel | $24 | $24 | $8 |
| Lumpectomy (breast) | $882 | $882 | $750 |
| Lung function test (PFT) | $596 | $596 | $37 |
| Lung scan (V/Q) | $2,037 | $2,037 | $291 |
| Magnesium blood test | $20 | $20 | $7 |
| MMR vaccine | $262 | $262 | — |
| MRA of the brain | $1,352 | $1,352 | $226 |
| MRA of the brain with contrast | $1,352 | $1,352 | $226 |
| MRA of the brain without contrast | $1,352 | $1,352 | $328 |
| MRA of the neck | $1,352 | $1,352 | $245 |
| MRA of the neck with contrast | $1,352 | $1,352 | $245 |
| MRA of the neck without contrast | $1,352 | $1,352 | $343 |
| MRI of the abdomen | $1,352 | $1,352 | $300 |
| MRI of the abdomen with contrast | $1,352 | $1,352 | $300 |
| MRI of the abdomen without contrast | $915 | $915 | $194 |
| MRI of the ankle | $1,352 | $1,352 | $261 |
| MRI of the ankle with contrast | $1,352 | $1,352 | $261 |
| MRI of the ankle without contrast | $915 | $915 | $222 |
| MRI of the brain | $1,352 | $1,352 | $269 |
| MRI of the brain with contrast | $1,352 | $1,352 | $269 |
| MRI of the brain without contrast | $915 | $915 | $195 |
| MRI of the chest | $1,352 | $1,352 | $371 |
| MRI of the chest with contrast | $2,990 | $2,990 | $371 |
| MRI of the chest without contrast | $1,352 | $1,352 | $466 |
| MRI of the knee | $1,352 | $1,352 | $315 |
| MRI of the knee with contrast | $2,990 | $2,990 | $315 |
| MRI of the knee without contrast | $915 | $915 | $204 |
| MRI of the lower back (lumbar spine) | $1,352 | $1,352 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $1,352 | $1,352 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $915 | $915 | $192 |
| MRI of the mid-back (thoracic spine) | $1,352 | $1,352 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $1,352 | $1,352 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $1,352 | $1,352 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $915 | $915 | $190 |
| MRI of the neck (cervical spine) | $1,352 | $1,352 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $1,352 | $1,352 | $318 |
| MRI of the neck (cervical spine) with contrast | $1,352 | $1,352 | $274 |
| MRI of the neck (cervical spine) without contrast | $915 | $915 | $191 |
| MRI of the pelvis | $1,352 | $1,352 | $268 |
| MRI of the pelvis with contrast | $1,352 | $1,352 | $268 |
| MRI of the pelvis without contrast | $915 | $915 | $227 |
| MRI of the shoulder | $1,352 | $1,352 | $313 |
| MRI of the shoulder with contrast | $2,990 | $2,990 | $313 |
| MRI of the shoulder without contrast | $915 | $915 | $205 |
| MRI of the wrist | $1,352 | $1,352 | $330 |
| MRI of the wrist with contrast | $1,352 | $1,352 | $330 |
| MRI of the wrist without contrast | $915 | $915 | $303 |
| Nebulizer breathing treatment | $770 | $770 | $9 |
| Neck (cervical) spinal fusion | $1,870 | $1,870 | $1,410 |
| Nerve conduction study | $1,179 | $1,179 | $118 |
| Nuchal translucency ultrasound | $230 | $230 | $116 |
| Nuclear cardiac stress test | $5,020 | $5,020 | $428 |
| Occupational therapy evaluation | $212 | $212 | $101 |
| Occupational therapy evaluation (high complexity) | $317 | $317 | $101 |
| Occupational therapy evaluation (low complexity) | $212 | $212 | $101 |
| Occupational therapy evaluation (moderate complexity) | $188 | $188 | $101 |
| Office visit (established patient) | $152 | $152 | $115 |
| Office visit (new patient) | $152 | $152 | $177 |
| Office visit, established patient (level 3) | $152 | $152 | $95 |
| Office visit, established patient (level 4) | $152 | $152 | $136 |
| Office visit, new patient (level 3) | $152 | $152 | $118 |
| Office visit, new patient (level 4) | $152 | $152 | $177 |
| Office visit, new patient (level 5) | $152 | $152 | $237 |
| Orthopedic hardware removal | $443 | $443 | $632 |
| Ovarian cyst removal | $823 | $823 | $698 |
| Ovary removal (oophorectomy) | $936 | $936 | $822 |
| Pap smear (cervical screening) | $60 | $60 | $20 |
| Parathyroid hormone (PTH) test | $123 | $123 | $41 |
| Parathyroid removal | $1,045 | $1,045 | $891 |
| Pelvic ultrasound | $403 | $403 | $78 |
| Pelvic ultrasound (complete) | $403 | $403 | $105 |
| Pelvic ultrasound (limited) | $403 | $403 | $51 |
| PET scan | $5,521 | $5,521 | — |
| Phosphorus blood test | $14 | $14 | $5 |
| Physical therapy evaluation | $266 | $266 | $98 |
| Physical therapy evaluation (high complexity) | $266 | $266 | $98 |
| Physical therapy evaluation (moderate complexity) | $235 | $235 | $98 |
| Pilonidal cyst removal | $10,833 | $10,833 | $541 |
| Platelet count | $13 | $13 | $4 |
| Pneumonia vaccine | $342 | $342 | — |
| Pregnancy blood test (hCG) | $22 | $22 | $8 |
| Pregnancy ultrasound | $403 | $403 | $126 |
| Pregnancy ultrasound (first trimester) | $403 | $403 | $117 |
| Pregnancy ultrasound (second or third trimester) | $403 | $403 | $136 |
| Procalcitonin test | $81 | $81 | $27 |
| Prolactin test | $58 | $58 | $19 |
| Prostate removal (prostatectomy) | $1,522 | $1,522 | $1,063 |
| Prostate surgery (TURP) | $770 | $770 | $526 |
| Prostate test (PSA) | $55 | $55 | $18 |
| Pulmonary rehabilitation | $244 | $244 | $87 |
| Rheumatoid factor test | $18 | $18 | $6 |
| Rotator cuff repair | $887 | $887 | $792 |
| RSV vaccine | $885 | $885 | — |
| Sacroiliac joint injection | $87 | $87 | $176 |
| Scoliosis spine X-ray | $340 | $340 | $58 |
| Scoliosis spine X-ray (1 view) | $340 | $340 | $44 |
| Screening colonoscopy | $193 | $193 | $378 |
| Screening mammogram | $501 | $501 | $126 |
| Scrotal ultrasound | $403 | $403 | $99 |
| Sedimentation rate (ESR) test | $9 | $9 | $3 |
| Semen analysis | $36 | $36 | $12 |
| Sex hormone binding globulin test | $65 | $65 | $22 |
| Shingles vaccine | $232 | $232 | — |
| Shoulder replacement | $1,537 | $1,537 | $1,300 |
| Simple laceration repair (small, up to 2.5 cm) | $752 | $752 | $114 |
| Simple wound stitches | $752 | $752 | $127 |
| Skin biopsy | $1,512 | $1,512 | $121 |
| Skin biopsy (punch) | $1,537 | $1,537 | $121 |
| Skin cancer lesion removal | $2,663 | $2,663 | $240 |
| Skin graft | $7,304 | $7,304 | $898 |
| Skin lesion freezing (cryotherapy) | $752 | $752 | $36 |
| Skin tag removal | $752 | $752 | $92 |
| Sleep study (polysomnography) | $3,851 | $3,851 | $691 |
| Small bowel resection | $1,329 | $1,329 | $1,136 |
| Soft tissue ultrasound | $403 | $403 | $64 |
| Speech therapy | $213 | $213 | $76 |
| Spinal tap (lumbar puncture) | $2,621 | $2,621 | $165 |
| Spirometry (lung function test) | $592 | $592 | $30 |
| Spirometry with bronchodilator | $1,179 | $1,179 | $43 |
| Spleen removal (splenectomy) | $1,200 | $1,200 | $1,036 |
| Stomach removal (gastrectomy) | $1,579 | $1,579 | $1,595 |
| Strep throat test | $49 | $49 | $17 |
| Stress echocardiogram | $2,075 | $2,075 | $209 |
| Stress echocardiogram (complete) | $2,075 | $2,075 | $233 |
| Swallow study | $230 | $230 | $85 |
| T3 thyroid test | $42 | $42 | $14 |
| Tdap (tetanus) vaccine | $151 | $151 | — |
| Testicle removal (orchiectomy) | $347 | $347 | $306 |
| Testosterone test | $77 | $77 | $26 |
| Thyroid test (TSH) | $50 | $50 | $17 |
| Thyroid ultrasound | $403 | $403 | $109 |
| Thyroid uptake scan | $1,521 | $1,521 | $145 |
| Tilt table test | $2,055 | $2,055 | $168 |
| Total IgE allergy test | $49 | $49 | $16 |
| Total protein test | $11 | $11 | $4 |
| Tracheostomy | $328 | $328 | $273 |
| Transesophageal echocardiogram (TEE) | $2,075 | $2,075 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $2,075 | $2,075 | $239 |
| Transvaginal ultrasound | $403 | $403 | $118 |
| Trigger point injection | $1,117 | $1,117 | $56 |
| Trigger point injection (1-2 muscles) | $1,117 | $1,117 | $52 |
| Triglycerides test | $17 | $17 | $6 |
| Troponin (heart) test | $37 | $37 | $12 |
| Tubal ligation | $22,281 | $22,281 | $333 |
| Upper GI series (barium) | $674 | $674 | $128 |
| Uric acid (gout) test | $13 | $13 | $5 |
| Urinalysis | $7 | $7 | $3 |
| Urine microalbumin test | $16 | $16 | $5 |
| Urine pregnancy test | $22 | $22 | $9 |
| Vaccine administration | $60 | $60 | $19 |
| Vaccine administration (each additional) | $46 | $46 | $16 |
| Varicocele repair | $13,054 | $13,054 | $327 |
| Varicose vein ablation | $11,913 | $11,913 | $1,018 |
| Vasectomy | $3,996 | $3,996 | $347 |
| Vitamin B12 test | $42 | $42 | $15 |
| Vitamin D test | $49 | $49 | $30 |
| Wart removal | $752 | $752 | $121 |
| Wound debridement | $1,512 | $1,512 | $186 |
| Wrist fracture repair | $783 | $783 | $735 |
| X-ray of the abdomen | $333 | $333 | $36 |
| X-ray of the ankle | $333 | $333 | $37 |
| X-ray of the collarbone | $333 | $333 | $33 |
| X-ray of the elbow | $333 | $333 | $33 |
| X-ray of the facial bones | $409 | $409 | $39 |
| X-ray of the foot | $333 | $333 | $34 |
| X-ray of the forearm | $333 | $333 | $29 |
| X-ray of the hand | $333 | $333 | $38 |
| X-ray of the hip | $333 | $333 | $49 |
| X-ray of the hip (1 view) | $333 | $333 | $34 |
| X-ray of the hip (3 views) | $333 | $333 | $49 |
| X-ray of the knee | $333 | $333 | $42 |
| X-ray of the knee (2 views) | $333 | $333 | $34 |
| X-ray of the knee (3 views) | $333 | $333 | $42 |
| X-ray of the knee (4+ views) | $403 | $403 | $49 |
| X-ray of the lower back (lumbar spine) | $403 | $403 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $403 | $403 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $403 | $403 | $53 |
| X-ray of the lower leg | $333 | $333 | $31 |
| X-ray of the mid-back (thoracic spine) | $408 | $408 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $408 | $408 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $408 | $408 | $39 |
| X-ray of the neck (cervical spine) | $403 | $403 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $339 | $339 | $40 |
| X-ray of the pelvis | $403 | $403 | $36 |
| X-ray of the pelvis (1 view) | $403 | $403 | $28 |
| X-ray of the ribs | $403 | $403 | $42 |
| X-ray of the ribs (2 views) | $333 | $333 | $36 |
| X-ray of the ribs (3 views) | $403 | $403 | $42 |
| X-ray of the shoulder | $333 | $333 | $36 |
| X-ray of the skull | $407 | $407 | $40 |
| X-ray of the upper arm | $333 | $333 | $32 |
| X-ray of the wrist | $333 | $333 | $43 |
| YAG laser capsulotomy (eye) | $2,232 | $2,232 | $335 |
| Zinc blood test | $34 | $34 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
