| Procedure | Poudre Valley Hospital | Longs Peak Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $60 | $34 | $51 |
| Abdominal fluid drain (paracentesis) | $1,914 | $839 | $284 |
| Abdominal ultrasound | $720 | $654 | $100 |
| Abdominal ultrasound (complete) | $823 | $759 | $114 |
| Abdominal ultrasound (limited) | $617 | $550 | $86 |
| Abscess drainage (complex or multiple) | $886 | $613 | $220 |
| Abscess drainage (simple) | $463 | $448 | $129 |
| Abscess incision and drainage | $886 | $530 | $174 |
| Acupuncture | $37 | $16 | $38 |
| Acupuncture (each additional) | $32 | $12 | $28 |
| Albumin blood test | $67 | $44 | $5 |
| Aldosterone test | $40 | $34 | $41 |
| Alkaline phosphatase test | $22 | $64 | $5 |
| Alpha-fetoprotein (AFP) test | $79 | $108 | $17 |
| ALT liver enzyme test | $56 | $56 | $5 |
| Ammonia blood test | $162 | $89 | $15 |
| Amniocentesis | $982 | $771 | $120 |
| Amylase test | $241 | $96 | $6 |
| Ankle fracture repair | $6,902 | $5,257 | $608 |
| Anoscopy | $238 | $261 | $129 |
| Antinuclear antibody (ANA) test | $58 | $62 | $12 |
| Arterial blood gas (ABG) | $343 | $211 | $26 |
| AST liver enzyme test | $112 | $65 | $5 |
| Barium swallow study | $561 | $492 | $107 |
| Bartholin cyst removal | $631 | $533 | $182 |
| Basic metabolic panel | $183 | $111 | $8 |
| Benign skin lesion removal | $781 | $430 | $171 |
| Bilirubin blood test | $22 | $107 | $5 |
| Bladder scope (cystoscopy) | $1,462 | $731 | $216 |
| Blood clotting test (PT/INR) | $87 | $54 | $4 |
| Blood crossmatch | $186 | $120 | — |
| Blood glucose test | $133 | $51 | $5 |
| Blood transfusion | $805 | $935 | $47 |
| Blood type and screen | $124 | $90 | $10 |
| Blood type test | $58 | $49 | $3 |
| Blood type test (ABO group) | $67 | $50 | $3 |
| Blood type test (Rh/D antigen) | $31 | $48 | $3 |
| BNP (heart failure) test | $211 | $211 | $39 |
| Bone density scan (DEXA) | $608 | $329 | $39 |
| Bone marrow biopsy | $2,248 | $1,386 | $172 |
| Bone scan (nuclear) | $2,019 | $1,191 | $259 |
| Botox for migraine | $678 | $146 | $157 |
| Breast biopsy | $5,635 | $2,299 | $478 |
| Breast MRI | $953 | $625 | $216 |
| Breast MRI without contrast | $1,390 | $634 | $216 |
| Breast ultrasound | $478 | $142 | $92 |
| Breast ultrasound (complete) | $502 | $143 | $100 |
| Breast ultrasound (limited) | $454 | $141 | $84 |
| Breathing tube insertion (intubation) | $860 | $638 | $133 |
| Bronchoscopy | $2,413 | $1,205 | $303 |
| Burn dressing and debridement (medium) | $363 | $195 | $166 |
| Burn dressing and debridement (small) | $321 | $373 | $93 |
| Burn treatment | $363 | $373 | $129 |
| C-reactive protein (CRP) | $203 | $51 | $5 |
| CA 19-9 tumor marker test | $70 | $118 | $21 |
| CA-125 ovarian marker test | $225 | $72 | $21 |
| Calcium blood test | $53 | $58 | $5 |
| Cardiac ablation | $54,218 | $12,117 | $759 |
| Cardiac catheterization | $12,153 | $9,662 | $1,049 |
| Cardiac MRI | $1,712 | $1,556 | $322 |
| Cardiac MRI without contrast | $1,353 | $1,374 | $280 |
| Cardiac rehabilitation | $339 | $140 | $26 |
| Cardiac stress test | $702 | $962 | $39 |
| Cardioversion | $988 | $1,684 | $155 |
| Carotid artery ultrasound | $826 | $663 | $156 |
| CEA tumor marker test | $366 | $212 | $19 |
| Celiac disease test | $52 | $18 | $12 |
| Central line placement | $3,562 | $1,885 | $238 |
| Cervical LEEP procedure | $5,352 | $2,176 | $325 |
| Chemotherapy infusion | $530 | $456 | $81 |
| Chemotherapy infusion (each additional) | $221 | $308 | $28 |
| Chemotherapy infusion (first hour) | $839 | $603 | $133 |
| Chest fluid drain (thoracentesis) | $1,871 | $1,321 | $311 |
| Chest tube insertion | $1,877 | $880 | $143 |
| Chest X-ray | $423 | $261 | $37 |
| Chest X-ray (1 view) | $379 | $245 | $25 |
| Chest X-ray (2 views) | $404 | $256 | $33 |
| Chickenpox (varicella) vaccine | $396 | $198 | — |
| Circumcision | $2,039 | $992 | $167 |
| CK-MB heart enzyme test | $128 | $77 | $12 |
| Clotting time test (PTT) | $27 | $54 | $6 |
| Colonoscopy | $3,347 | $2,014 | $480 |
| Complete blood count (CBC) | $153 | $78 | $7 |
| Complete blood count (CBC) (complete) | $199 | $83 | $8 |
| Complex wound repair | $1,410 | $857 | $390 |
| Comprehensive metabolic panel | $230 | $213 | $11 |
| Contraceptive implant (Nexplanon) | $295 | $496 | $115 |
| Copper blood test | $163 | $79 | $12 |
| Coronary CT angiography | $1,420 | $1,109 | $326 |
| Cortisol test | $250 | $92 | $16 |
| COVID-19 PCR test | $70 | $37 | $51 |
| CPAP titration study | $657 | $198 | $69 |
| Creatine kinase (CK) test | $130 | $20 | $7 |
| CT angiography of the chest | $3,142 | $2,697 | $281 |
| CT angiography of the head | $2,151 | $2,710 | $274 |
| CT scan of the abdomen | $1,853 | $2,620 | $230 |
| CT scan of the abdomen and pelvis | $4,654 | $4,948 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $4,942 | $5,155 | $338 |
| CT scan of the abdomen and pelvis with contrast | $4,654 | $4,948 | $300 |
| CT scan of the abdomen and pelvis without contrast | $3,175 | $3,890 | $183 |
| CT scan of the abdomen with and without contrast | $2,221 | $2,845 | $259 |
| CT scan of the abdomen with contrast | $1,853 | $2,620 | $230 |
| CT scan of the abdomen without contrast | $1,600 | $1,822 | $136 |
| CT scan of the arm | $1,644 | $1,130 | $199 |
| CT scan of the arm with contrast | $1,644 | $1,130 | $199 |
| CT scan of the arm without contrast | $1,431 | $1,002 | $161 |
| CT scan of the chest | $2,153 | $1,471 | $167 |
| CT scan of the chest with and without contrast | $2,634 | $1,886 | $196 |
| CT scan of the chest with contrast | $2,153 | $1,471 | $167 |
| CT scan of the chest without contrast | $1,229 | $1,254 | $133 |
| CT scan of the head | $2,129 | $2,065 | $148 |
| CT scan of the head with and without contrast | $2,686 | $2,359 | $173 |
| CT scan of the head with contrast | $2,283 | $2,065 | $148 |
| CT scan of the head without contrast | $1,975 | $1,758 | $107 |
| CT scan of the leg | $1,653 | $1,192 | $166 |
| CT scan of the leg with contrast | $1,653 | $1,192 | $166 |
| CT scan of the leg without contrast | $1,226 | $947 | $130 |
| CT scan of the lower back (lumbar spine) | $1,709 | $1,770 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $2,050 | $2,114 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,709 | $1,770 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,580 | $1,307 | $130 |
| CT scan of the neck | $1,644 | $1,075 | $183 |
| CT scan of the neck (cervical spine) | $2,333 | $2,236 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $2,615 | $2,441 | $196 |
| CT scan of the neck (cervical spine) with contrast | $2,333 | $2,236 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,747 | $1,996 | $131 |
| CT scan of the neck with and without contrast | $1,941 | $1,525 | $220 |
| CT scan of the neck with contrast | $1,644 | $1,075 | $183 |
| CT scan of the neck without contrast | $1,580 | $669 | $150 |
| CT scan of the pelvis | $1,691 | $1,670 | $226 |
| CT scan of the pelvis with and without contrast | $1,896 | $1,872 | $251 |
| CT scan of the pelvis with contrast | $1,691 | $1,670 | $226 |
| CT scan of the pelvis without contrast | $1,665 | $1,139 | $133 |
| CT scan of the sinuses | $1,733 | $1,536 | $152 |
| CT scan of the sinuses with and without contrast | $2,178 | $1,931 | $184 |
| CT scan of the sinuses with contrast | $1,733 | $1,536 | $152 |
| CT scan of the sinuses without contrast | $1,225 | $1,359 | $128 |
| D-dimer test | $145 | $58 | $10 |
| Defibrillator (ICD) implant | $48,924 | $25,819 | $798 |
| DHEA-sulfate test | $115 | $131 | $22 |
| Diagnostic mammogram | $450 | $128 | $140 |
| Dilation and curettage (D&C) | $4,693 | $2,176 | $298 |
| Drug screen (urine) | $186 | $73 | $17 |
| Echocardiogram | $912 | $1,176 | $138 |
| Echocardiogram with and without contrast | $721 | $897 | $101 |
| Echocardiogram without contrast | $912 | $1,176 | $138 |
| EEG (awake and asleep) | $1,992 | $748 | $482 |
| EKG / ECG (tracing only) | $234 | $319 | $7 |
| Electrocardiogram (EKG) | $234 | $319 | $8 |
| Electroencephalogram (EEG) | $1,976 | $741 | $448 |
| Electrolyte panel | $167 | $70 | $7 |
| Electromyography (EMG) | $329 | $168 | $141 |
| Emergency department visit | $883 | $863 | $69 |
| Emergency department visit (level 1) | $299 | $234 | $11 |
| Emergency department visit (level 2) | $516 | $442 | $40 |
| Emergency department visit (level 3) | $883 | $863 | $69 |
| Emergency department visit (level 4) | $1,273 | $1,991 | $118 |
| Emergency department visit (level 5) | $2,487 | $3,052 | $171 |
| Endometrial biopsy | $277 | $242 | $98 |
| Epidural steroid injection | $1,803 | $720 | $275 |
| ERCP (bile duct endoscopy) | $4,639 | $2,514 | $311 |
| Estradiol (estrogen) test | $260 | $27 | $28 |
| Facet joint injection (spine) | $2,106 | $1,055 | $99 |
| Fallopian tube X-ray (HSG) | $1,495 | $620 | $164 |
| Fecal occult blood (stool) test | $21 | $72 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $21 | $82 | $4 |
| Feeding tube (PEG) placement | $3,301 | $1,677 | $178 |
| Ferritin (iron) test | $201 | $80 | $14 |
| Fibrinogen test | $246 | $107 | $10 |
| Flexible sigmoidoscopy | $1,628 | $933 | $323 |
| Flu test | $57 | $58 | $17 |
| Folate (folic acid) test | $341 | $137 | $15 |
| Foreign body removal (skin) | $614 | $440 | $157 |
| Free T4 thyroid test | $209 | $51 | $9 |
| FSH hormone test | $131 | $22 | $19 |
| Gallbladder scan (HIDA) | $2,331 | $1,996 | $334 |
| GGT liver test | $67 | $67 | $7 |
| Glucose tolerance test | $145 | $69 | $8 |
| H. pylori test | $218 | $128 | $67 |
| HDL cholesterol test | $199 | $56 | $8 |
| Hematocrit test | $108 | $24 | $2 |
| Hemodialysis | $1,166 | $2,048 | $75 |
| Hemoglobin A1c (diabetes test) | $203 | $78 | $10 |
| Hemorrhoid removal | $1,987 | $1,196 | $338 |
| Hepatitis A vaccine | $148 | $74 | — |
| Hepatitis B test | $99 | $79 | $10 |
| Hepatitis B vaccine | $99 | $50 | — |
| Hepatitis C test | $60 | $125 | $14 |
| HIV test | $33 | $91 | $19 |
| HIV test (antibody) | $33 | $97 | $14 |
| Holter heart monitor | $516 | $610 | $26 |
| Home sleep apnea test | $578 | $189 | $123 |
| Iron blood test | $210 | $66 | $6 |
| IUD removal | $363 | $276 | $112 |
| IV infusion therapy | $301 | $164 | $44 |
| IV infusion therapy (each additional) | $161 | $91 | $21 |
| IV infusion therapy (initial) | $442 | $236 | $67 |
| IVC filter placement | $23,017 | $5,653 | $1,885 |
| Joint aspiration (small/intermediate) | $537 | $563 | $57 |
| Joint aspiration or injection (mid-size joint) | $532 | $646 | $57 |
| Joint aspiration or injection (small joint) | $543 | $480 | $56 |
| Kidney biopsy | $2,348 | $1,340 | $492 |
| Kidney scan (nuclear) | $2,368 | $1,813 | $172 |
| Kidney ultrasound | $658 | $613 | $84 |
| Kidney ultrasound (limited) | $620 | $489 | $61 |
| Knee joint injection | $620 | $646 | $69 |
| Lactate test | $15 | $45 | $12 |
| Laryngoscopy | $1,518 | $739 | $189 |
| LDH test | $46 | $61 | $6 |
| LDL cholesterol test | $109 | $53 | $11 |
| Leg artery angiogram | $3,686 | $2,447 | $149 |
| Leg artery angioplasty | $16,090 | $7,588 | — |
| Leg vein ultrasound (Doppler) | $1,529 | $970 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $1,397 | $719 | $116 |
| LH hormone test | $190 | $215 | $19 |
| Lipase test | $148 | $104 | $7 |
| Lipid (cholesterol) panel | $196 | $104 | $13 |
| Liver biopsy | $3,434 | $1,448 | $288 |
| Liver function panel | $190 | $96 | $8 |
| Lung function test (PFT) | $474 | $306 | $37 |
| Lung scan (V/Q) | $2,806 | $1,308 | $291 |
| Magnesium blood test | $149 | $53 | $7 |
| MMR vaccine | $186 | $94 | — |
| MRA of the brain | $3,249 | $2,488 | $226 |
| MRA of the brain with contrast | $3,249 | $2,488 | $226 |
| MRA of the brain without contrast | $3,492 | $3,470 | $328 |
| MRA of the neck | $3,492 | $1,708 | $245 |
| MRA of the neck with contrast | $3,492 | $1,708 | $245 |
| MRA of the neck without contrast | $4,029 | $1,923 | $343 |
| MRI of the abdomen | $2,774 | $2,518 | $300 |
| MRI of the abdomen with contrast | $2,774 | $2,518 | $300 |
| MRI of the abdomen without contrast | $2,155 | $2,301 | $194 |
| MRI of the ankle | $2,496 | $2,324 | $261 |
| MRI of the ankle with contrast | $2,496 | $2,324 | $261 |
| MRI of the ankle without contrast | $1,607 | $2,214 | $222 |
| MRI of the brain | $2,597 | $2,215 | $269 |
| MRI of the brain with contrast | $2,597 | $2,215 | $269 |
| MRI of the brain without contrast | $2,169 | $1,486 | $195 |
| MRI of the chest | $2,794 | $1,773 | $371 |
| MRI of the chest without contrast | $3,291 | $2,010 | $466 |
| MRI of the knee | $1,924 | $2,532 | $315 |
| MRI of the knee with contrast | $1,924 | $2,532 | $315 |
| MRI of the knee without contrast | $1,841 | $2,238 | $204 |
| MRI of the lower back (lumbar spine) | $2,741 | $2,497 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $2,741 | $2,497 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $2,157 | $2,272 | $192 |
| MRI of the mid-back (thoracic spine) | $2,741 | $2,480 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $2,878 | $3,365 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $2,741 | $2,480 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $2,232 | $2,147 | $190 |
| MRI of the neck (cervical spine) | $2,741 | $2,609 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $2,878 | $3,031 | $318 |
| MRI of the neck (cervical spine) with contrast | $2,741 | $2,609 | $274 |
| MRI of the neck (cervical spine) without contrast | $2,110 | $2,319 | $191 |
| MRI of the pelvis | $2,869 | $2,709 | $268 |
| MRI of the pelvis with contrast | $2,869 | $2,709 | $268 |
| MRI of the pelvis without contrast | $2,440 | $2,392 | $227 |
| MRI of the shoulder | $2,353 | $2,291 | $313 |
| MRI of the shoulder with contrast | $2,353 | $2,291 | $313 |
| MRI of the shoulder without contrast | $1,837 | $1,981 | $205 |
| MRI of the wrist | $1,677 | $1,536 | $330 |
| MRI of the wrist with contrast | $1,677 | $1,536 | $330 |
| MRI of the wrist without contrast | $1,568 | $1,437 | $303 |
| Nebulizer breathing treatment | $153 | $211 | $9 |
| Nerve conduction study | $383 | $137 | $118 |
| Nuchal translucency ultrasound | $762 | $298 | $116 |
| Nuclear cardiac stress test | $5,352 | $4,151 | $428 |
| Occupational therapy evaluation | $263 | $216 | $101 |
| Occupational therapy evaluation (high complexity) | $271 | $239 | $101 |
| Occupational therapy evaluation (low complexity) | $257 | $153 | $101 |
| Occupational therapy evaluation (moderate complexity) | $263 | $216 | $101 |
| Pap smear (cervical screening) | $115 | $54 | $20 |
| Parathyroid hormone (PTH) test | $77 | $116 | $41 |
| Pelvic ultrasound | $622 | $530 | $78 |
| Pelvic ultrasound (complete) | $715 | $646 | $105 |
| Pelvic ultrasound (limited) | $529 | $413 | $51 |
| PET scan | $5,576 | $3,973 | — |
| Phosphorus blood test | $134 | $43 | $5 |
| Physical therapy evaluation | $263 | $216 | $98 |
| Physical therapy evaluation (high complexity) | $271 | $239 | $98 |
| Physical therapy evaluation (moderate complexity) | $263 | $216 | $98 |
| Platelet count | $70 | $43 | $4 |
| Pneumonia vaccine | $236 | $118 | — |
| Pregnancy blood test (hCG) | $116 | $95 | $8 |
| Pregnancy ultrasound | $823 | $527 | $126 |
| Pregnancy ultrasound (first trimester) | $823 | $510 | $117 |
| Pregnancy ultrasound (second or third trimester) | $823 | $543 | $136 |
| Procalcitonin test | $152 | $122 | $27 |
| Prolactin test | $244 | $103 | $19 |
| Prostate biopsy | $2,951 | $371 | — |
| Prostate test (PSA) | $177 | $127 | $18 |
| Psychiatric evaluation | $331 | $241 | $188 |
| Pulmonary rehabilitation | $230 | $175 | $87 |
| Radiofrequency nerve ablation | $2,721 | $1,414 | $462 |
| RSV vaccine | $558 | $279 | — |
| Scoliosis spine X-ray | $219 | $345 | $58 |
| Scoliosis spine X-ray (1 view) | $204 | $242 | $44 |
| Scoliosis spine X-ray (3 views) | $233 | $449 | $72 |
| Screening colonoscopy | $1,763 | $1,852 | $378 |
| Scrotal ultrasound | $823 | $461 | $99 |
| Sedimentation rate (ESR) test | $134 | $76 | $3 |
| Semen analysis | $126 | $46 | $12 |
| Sex hormone binding globulin test | $118 | $138 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $334 | $488 | $114 |
| Simple wound stitches | $334 | $584 | $127 |
| Skin biopsy | $529 | $345 | $121 |
| Skin biopsy (punch) | $529 | $345 | $121 |
| Skin cancer lesion removal | $919 | $771 | $240 |
| Skin lesion freezing (cryotherapy) | $200 | $158 | $36 |
| Skin tag removal | $363 | $215 | $92 |
| Sleep study (polysomnography) | $5,966 | $4,088 | $691 |
| Soft tissue ultrasound | $643 | $392 | $64 |
| Speech therapy | $238 | $211 | $76 |
| Spinal tap (lumbar puncture) | $974 | $870 | $165 |
| Spine fracture repair (kyphoplasty) | $10,124 | $8,041 | $5,803 |
| Spirometry (lung function test) | $259 | $232 | $30 |
| Spirometry with bronchodilator | $690 | $381 | $43 |
| Strep throat test | $67 | $41 | $17 |
| Stress echocardiogram | $1,115 | $1,824 | $209 |
| Stress echocardiogram (complete) | $1,245 | $2,057 | $233 |
| Swallow study | $237 | $328 | $85 |
| T3 thyroid test | $30 | $10 | $14 |
| Tdap (tetanus) vaccine | $81 | $41 | — |
| Testosterone test | $189 | $173 | $26 |
| Thyroid test (TSH) | $326 | $170 | $17 |
| Thyroid ultrasound | $834 | $461 | $109 |
| Thyroid uptake scan | $1,121 | $977 | $145 |
| Tilt table test | $1,182 | $1,212 | $168 |
| Total IgE allergy test | $67 | $49 | $16 |
| Total protein test | $22 | $36 | $4 |
| Tracheostomy | $2,396 | $2,048 | $273 |
| Transesophageal echocardiogram (TEE) | $2,209 | $1,905 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $2,538 | $2,423 | $239 |
| Transvaginal ultrasound | $823 | $392 | $118 |
| Trigger point injection | $445 | $226 | $56 |
| Trigger point injection (1-2 muscles) | $416 | $211 | $52 |
| Triglycerides test | $130 | $63 | $6 |
| Troponin (heart) test | $107 | $99 | $12 |
| Turning a breech baby (version) | $2,594 | $1,155 | $94 |
| Upper GI endoscopy (EGD) | $2,153 | $1,094 | $371 |
| Upper GI series (barium) | $791 | $490 | $128 |
| Ureteral stent placement | $5,195 | $2,696 | $373 |
| Ureteroscopy (stone removal) | $8,176 | $4,269 | $365 |
| Uric acid (gout) test | $134 | $75 | $5 |
| Urinalysis | $47 | $65 | $3 |
| Urine microalbumin test | $143 | $55 | $5 |
| Urine pregnancy test | $109 | $74 | $9 |
| Vaccine administration | $87 | $43 | $19 |
| Vaccine administration (each additional) | $72 | $36 | $16 |
| Varicose vein ablation | $5,545 | $2,844 | $1,018 |
| Vitamin B12 test | $197 | $117 | $15 |
| Vitamin D test | $160 | $182 | $30 |
| Wart removal | $279 | $140 | $121 |
| Wound debridement | $1,133 | $720 | $186 |
| X-ray of the abdomen | $401 | $302 | $36 |
| X-ray of the ankle | $305 | $390 | $37 |
| X-ray of the collarbone | $308 | $225 | $33 |
| X-ray of the elbow | $311 | $381 | $33 |
| X-ray of the facial bones | $277 | $320 | $39 |
| X-ray of the foot | $323 | $385 | $34 |
| X-ray of the forearm | $254 | $257 | $29 |
| X-ray of the hand | $404 | $377 | $38 |
| X-ray of the hip | $468 | $330 | $49 |
| X-ray of the hip (1 view) | $308 | $181 | $34 |
| X-ray of the hip (3 views) | $468 | $330 | $49 |
| X-ray of the hip (4 views) | $599 | $347 | $63 |
| X-ray of the knee | $323 | $385 | $42 |
| X-ray of the knee (2 views) | $276 | $277 | $34 |
| X-ray of the knee (3 views) | $323 | $385 | $42 |
| X-ray of the knee (4+ views) | $404 | $445 | $49 |
| X-ray of the lower back (lumbar spine) | $495 | $485 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $375 | $464 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $614 | $505 | $53 |
| X-ray of the lower leg | $254 | $262 | $31 |
| X-ray of the mid-back (thoracic spine) | $382 | $255 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $362 | $246 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $401 | $265 | $39 |
| X-ray of the neck (cervical spine) | $509 | $398 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $404 | $331 | $40 |
| X-ray of the pelvis | $344 | $278 | $36 |
| X-ray of the pelvis (1 view) | $339 | $184 | $28 |
| X-ray of the ribs | $401 | $345 | $42 |
| X-ray of the ribs (2 views) | $351 | $269 | $36 |
| X-ray of the ribs (3 views) | $401 | $345 | $42 |
| X-ray of the shoulder | $254 | $323 | $36 |
| X-ray of the skull | $445 | $463 | $40 |
| X-ray of the upper arm | $254 | $269 | $32 |
| X-ray of the wrist | $311 | $382 | $43 |
| Zinc blood test | $120 | $76 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
