| Procedure | Rolling Plains Memorial Hospital | Cogdell Memorial Hospital | Medicare |
|---|
| Abdominal fluid drain (paracentesis) | $449 | $1,741 | $284 |
| Abdominal ultrasound | $411 | $333 | $100 |
| Abdominal ultrasound (complete) | $654 | $445 | $114 |
| Abdominal ultrasound (limited) | $400 | $333 | $86 |
| Abscess drainage (complex or multiple) | $193 | $506 | $220 |
| Abscess drainage (simple) | $181 | $285 | $129 |
| Abscess incision and drainage | $193 | $445 | $174 |
| Albumin blood test | $50 | $48 | $5 |
| Aldosterone test | $153 | $190 | $41 |
| Alkaline phosphatase test | $47 | $48 | $5 |
| Allergy shots | $17 | $25 | $11 |
| Alpha-fetoprotein (AFP) test | $105 | $118 | $17 |
| ALT liver enzyme test | $50 | $32 | $5 |
| Ammonia blood test | $97 | $69 | $15 |
| Amylase test | $68 | $81 | $6 |
| Annual physical (established patient) | $93 | $223 | — |
| Annual physical (new patient) | $99 | $280 | — |
| Anoscopy | $119 | $233 | $129 |
| Antinuclear antibody (ANA) test | $70 | $77 | $12 |
| Arterial blood gas (ABG) | $162 | $213 | $26 |
| AST liver enzyme test | $50 | $67 | $5 |
| Bartholin cyst removal | $204 | $327 | $182 |
| Basic metabolic panel | $125 | $70 | $8 |
| Benign skin lesion removal | $371 | $356 | $171 |
| Bilirubin blood test | $50 | $67 | $5 |
| Blood clotting test (PT/INR) | $36 | $43 | $4 |
| Blood crossmatch | $62 | $258 | — |
| Blood glucose test | $45 | $60 | $5 |
| Blood transfusion | $780 | $764 | $47 |
| Blood type and screen | $101 | $36 | $10 |
| Blood type test | $33 | $47 | $3 |
| Blood type test (ABO group) | $36 | $47 | $3 |
| Blood type test (Rh/D antigen) | $25 | $27 | $3 |
| BNP (heart failure) test | $144 | $189 | $39 |
| Bone density scan (DEXA) | $359 | $338 | $39 |
| Bone scan (nuclear) | $1,035 | $914 | $259 |
| Breast ultrasound | $354 | $182 | $92 |
| Breast ultrasound (complete) | $354 | $234 | $100 |
| Breathing tube insertion (intubation) | $291 | $433 | $133 |
| Burn dressing and debridement (medium) | $139 | $530 | $166 |
| Burn dressing and debridement (small) | $134 | $258 | $93 |
| Burn treatment | $138 | $394 | $129 |
| C-reactive protein (CRP) | $47 | $51 | $5 |
| CA 19-9 tumor marker test | $89 | $97 | $21 |
| CA-125 ovarian marker test | $125 | $99 | $21 |
| Calcium blood test | $45 | $48 | $5 |
| Cardiac rehabilitation | $163 | $269 | $26 |
| Cardiac stress test | $652 | $482 | $39 |
| Cardioversion | $629 | $1,022 | $155 |
| Carotid artery ultrasound | $611 | $364 | $156 |
| CEA tumor marker test | $82 | $97 | $19 |
| Central line placement | $976 | $1,888 | $238 |
| Chest fluid drain (thoracentesis) | $865 | $282 | $311 |
| Chest tube insertion | $511 | $725 | $143 |
| Chest X-ray | $189 | $184 | $37 |
| Chest X-ray (1 view) | $168 | $143 | $25 |
| Chest X-ray (2 views) | $207 | $235 | $33 |
| Chickenpox (varicella) vaccine | $350 | $145 | — |
| Circumcision | $952 | $683 | $167 |
| CK-MB heart enzyme test | $125 | $59 | $12 |
| Clotting time test (PTT) | $54 | $63 | $6 |
| Colonoscopy | $2,484 | $2,285 | $480 |
| Colposcopy | $243 | $393 | $161 |
| Complete blood count (CBC) | $57 | $43 | $7 |
| Complete blood count (CBC) (complete) | $57 | $57 | $8 |
| Comprehensive metabolic panel | $134 | $145 | $11 |
| Copper blood test | $72 | $58 | $12 |
| Cortisol test | $93 | $89 | $16 |
| COVID-19 PCR test | $101 | $128 | $51 |
| CPAP titration study | $397 | $327 | $69 |
| Creatine kinase (CK) test | $69 | $96 | $7 |
| CT angiography of the chest | $1,651 | $597 | $281 |
| CT angiography of the head | $1,690 | $1,820 | $274 |
| CT scan of the abdomen | $1,513 | $1,200 | $230 |
| CT scan of the abdomen and pelvis | $2,799 | $2,375 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $3,393 | $2,667 | $338 |
| CT scan of the abdomen and pelvis with contrast | $3,028 | $2,423 | $300 |
| CT scan of the abdomen and pelvis without contrast | $2,569 | $2,150 | $183 |
| CT scan of the abdomen with contrast | $1,513 | $1,835 | $230 |
| CT scan of the abdomen without contrast | $1,284 | $1,035 | $136 |
| CT scan of the arm | $1,513 | $1,067 | $199 |
| CT scan of the arm with contrast | $1,513 | $1,067 | $199 |
| CT scan of the arm without contrast | $1,284 | $937 | $161 |
| CT scan of the chest | $1,513 | $1,063 | $167 |
| CT scan of the chest with and without contrast | $1,698 | $1,277 | $196 |
| CT scan of the chest with contrast | $1,513 | $1,063 | $167 |
| CT scan of the chest without contrast | $1,377 | $914 | $133 |
| CT scan of the head | $1,482 | $1,015 | $148 |
| CT scan of the head with and without contrast | $1,698 | $1,285 | $173 |
| CT scan of the head with contrast | $1,622 | $1,082 | $148 |
| CT scan of the head without contrast | $1,342 | $947 | $107 |
| CT scan of the leg | $1,513 | $1,103 | $166 |
| CT scan of the leg with contrast | $1,513 | $1,103 | $166 |
| CT scan of the leg without contrast | $1,284 | $969 | $130 |
| CT scan of the lower back (lumbar spine) | $1,519 | $1,519 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $1,651 | $1,824 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,519 | $1,519 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,433 | $1,333 | $130 |
| CT scan of the neck | $1,491 | $1,284 | $183 |
| CT scan of the neck (cervical spine) | $1,519 | $1,579 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $1,651 | $1,824 | $196 |
| CT scan of the neck (cervical spine) without contrast | $1,433 | $1,333 | $131 |
| CT scan of the neck with and without contrast | $1,633 | $1,601 | $220 |
| CT scan of the neck with contrast | $1,491 | $1,284 | $183 |
| CT scan of the neck without contrast | $1,376 | $1,149 | $150 |
| CT scan of the pelvis | $1,513 | $1,270 | $226 |
| CT scan of the pelvis with and without contrast | $1,698 | $1,534 | $251 |
| CT scan of the pelvis with contrast | $1,513 | $1,270 | $226 |
| CT scan of the pelvis without contrast | $1,284 | $1,115 | $133 |
| CT scan of the sinuses | $1,147 | $1,224 | $152 |
| CT scan of the sinuses with and without contrast | $1,422 | $1,457 | $184 |
| CT scan of the sinuses with contrast | $1,264 | $1,224 | $152 |
| CT scan of the sinuses without contrast | $1,030 | $1,064 | $128 |
| Developmental screening (child) | $30 | $17 | — |
| DHEA-sulfate test | $96 | $153 | $22 |
| Diagnostic mammogram | $213 | $52 | $140 |
| Drug screen (urine) | $79 | $155 | $17 |
| Echocardiogram | $669 | $988 | $138 |
| Echocardiogram with and without contrast | $542 | $612 | $101 |
| EKG / ECG (tracing only) | $142 | $131 | $7 |
| Electrocardiogram (EKG) | $130 | $131 | $8 |
| Electrolyte panel | $88 | $43 | $7 |
| Emergency department visit | $416 | $1,042 | $69 |
| Emergency department visit (level 1) | $142 | $352 | $11 |
| Emergency department visit (level 2) | $302 | $608 | $40 |
| Emergency department visit (level 3) | $530 | $1,042 | $69 |
| Emergency department visit (level 4) | $676 | $1,658 | $118 |
| Emergency department visit (level 5) | $822 | $2,398 | $171 |
| Epidural steroid injection | $978 | $1,304 | $275 |
| Estradiol (estrogen) test | $120 | $130 | $28 |
| Family therapy session | $130 | $275 | $110 |
| Fecal occult blood (stool) test | $30 | $16 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $14 | $16 | $4 |
| Ferritin (iron) test | $83 | $109 | $14 |
| Fibrinogen test | $71 | $60 | $10 |
| Flu test | $31 | $56 | $17 |
| Folate (folic acid) test | $81 | $70 | $15 |
| Foreign body removal (skin) | $216 | $494 | $157 |
| Free T4 thyroid test | $67 | $43 | $9 |
| FSH hormone test | $92 | $57 | $19 |
| Gallbladder removal (laparoscopic) | $4,897 | $2,036 | $658 |
| Gallbladder scan (HIDA) | $1,197 | $938 | $334 |
| GGT liver test | $59 | $71 | $7 |
| Glucose tolerance test | $77 | $96 | $8 |
| HDL cholesterol test | $52 | $57 | $8 |
| Hematocrit test | $10 | $22 | $2 |
| Hemoglobin A1c (diabetes test) | $58 | $49 | $10 |
| Hepatitis A vaccine | $49 | $112 | — |
| Hepatitis B test | $64 | $48 | $10 |
| Hepatitis B vaccine | $174 | $109 | — |
| Hepatitis C test | $275 | $67 | $14 |
| HIV test | $72 | $255 | $19 |
| Holter heart monitor | $237 | $200 | $26 |
| HPV vaccine | $572 | $243 | — |
| Inguinal hernia repair | $4,434 | $5,972 | $538 |
| Iron blood test | $43 | $29 | $6 |
| IUD removal | $137 | $294 | $112 |
| IV infusion therapy | $107 | $208 | $44 |
| IV infusion therapy (each additional) | $69 | $91 | $21 |
| IV infusion therapy (initial) | $155 | $325 | $67 |
| Joint aspiration (small/intermediate) | $134 | $314 | $57 |
| Joint aspiration or injection (mid-size joint) | $149 | $314 | $57 |
| Joint aspiration or injection (small joint) | $118 | $312 | $56 |
| Kidney scan (nuclear) | $609 | $659 | $172 |
| Kidney ultrasound | $411 | $488 | $84 |
| Knee arthroscopy | $3,626 | $1,489 | $524 |
| Knee joint injection | $149 | $128 | $69 |
| Lactate test | $64 | $72 | $12 |
| LDH test | $52 | $79 | $6 |
| LDL cholesterol test | $41 | $45 | $11 |
| Leg vein ultrasound (Doppler) | $611 | $606 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $611 | $606 | $116 |
| LH hormone test | $97 | $91 | $19 |
| Lipase test | $86 | $34 | $7 |
| Lipid (cholesterol) panel | $88 | $46 | $13 |
| Liver function panel | $111 | $151 | $8 |
| Lung function test (PFT) | $275 | $276 | $37 |
| Lung scan (V/Q) | $1,106 | $807 | $291 |
| Magnesium blood test | $57 | $40 | $7 |
| MMR vaccine | $141 | $120 | — |
| MRA of the brain | $1,676 | $2,179 | $226 |
| MRA of the neck | $1,676 | $2,419 | $245 |
| MRI of the abdomen | $1,843 | $2,493 | $300 |
| MRI of the abdomen with contrast | $2,010 | $2,415 | $300 |
| MRI of the abdomen without contrast | $1,520 | $2,493 | $194 |
| MRI of the ankle | $2,010 | $2,712 | $261 |
| MRI of the ankle with contrast | $2,010 | $2,712 | $261 |
| MRI of the ankle without contrast | $1,676 | $2,361 | $222 |
| MRI of the brain | $2,010 | $2,179 | $269 |
| MRI of the brain with contrast | $2,010 | $2,658 | $269 |
| MRI of the brain without contrast | $1,676 | $2,179 | $195 |
| MRI of the chest | $2,010 | $2,304 | $371 |
| MRI of the chest with contrast | $2,010 | $3,494 | $371 |
| MRI of the knee | $2,010 | $1,514 | $315 |
| MRI of the knee with contrast | $2,010 | $1,514 | $315 |
| MRI of the knee without contrast | $1,676 | $1,339 | $204 |
| MRI of the lower back (lumbar spine) | $2,010 | $2,609 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $2,010 | $2,609 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,676 | $2,283 | $192 |
| MRI of the mid-back (thoracic spine) | $2,010 | $2,643 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $2,265 | $3,271 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $2,010 | $2,643 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $1,676 | $2,403 | $190 |
| MRI of the neck (cervical spine) | $2,010 | $2,726 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $2,265 | $3,177 | $318 |
| MRI of the neck (cervical spine) with contrast | $2,010 | $2,726 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,676 | $2,203 | $191 |
| MRI of the pelvis | $2,010 | $2,254 | $268 |
| MRI of the pelvis without contrast | $1,676 | $2,254 | $227 |
| MRI of the shoulder | $2,010 | $2,423 | $313 |
| MRI of the shoulder with contrast | $2,010 | $2,423 | $313 |
| MRI of the shoulder without contrast | $1,676 | $2,302 | $205 |
| MRI of the wrist | $2,010 | $2,010 | $330 |
| MRI of the wrist with contrast | $2,010 | $2,010 | $330 |
| MRI of the wrist without contrast | $1,676 | $1,883 | $303 |
| Nebulizer breathing treatment | $397 | $327 | $9 |
| Nuclear cardiac stress test | $2,633 | $2,824 | $428 |
| Occupational therapy evaluation | $186 | $236 | $101 |
| Occupational therapy evaluation (high complexity) | $207 | $236 | $101 |
| Occupational therapy evaluation (low complexity) | $164 | $236 | $101 |
| Occupational therapy evaluation (moderate complexity) | $186 | $236 | $101 |
| Office visit (established patient) | $56 | $201 | $115 |
| Office visit (new patient) | $72 | $383 | $177 |
| Office visit, established patient (level 3) | $52 | $175 | $95 |
| Office visit, established patient (level 4) | $59 | $201 | $136 |
| Office visit, new patient (level 3) | $93 | $202 | $118 |
| Office visit, new patient (level 4) | $65 | $383 | $177 |
| Office visit, new patient (level 5) | $72 | $498 | $237 |
| Parathyroid hormone (PTH) test | $176 | $171 | $41 |
| Pelvic ultrasound | $411 | $281 | $78 |
| Pelvic ultrasound (complete) | $411 | $384 | $105 |
| Phosphorus blood test | $50 | $55 | $5 |
| Physical therapy evaluation | $161 | $236 | $98 |
| Physical therapy evaluation (high complexity) | $182 | $236 | $98 |
| Physical therapy evaluation (moderate complexity) | $161 | $236 | $98 |
| Platelet count | $40 | $43 | $4 |
| Pneumonia vaccine | $171 | $170 | — |
| Pregnancy blood test (hCG) | $45 | $71 | $8 |
| Pregnancy ultrasound | $413 | $360 | $126 |
| Pregnancy ultrasound (first trimester) | $323 | $304 | $117 |
| Pregnancy ultrasound (second or third trimester) | $413 | $416 | $136 |
| Procalcitonin test | $249 | $302 | $27 |
| Prolactin test | $111 | $90 | $19 |
| Prostate test (PSA) | $88 | $87 | $18 |
| Psychotherapy session | $121 | $316 | $140 |
| Rheumatoid factor test | $69 | $54 | $6 |
| Scoliosis spine X-ray | $283 | $229 | $58 |
| Scoliosis spine X-ray (3 views) | $283 | $229 | $72 |
| Screening mammogram | $219 | $468 | $126 |
| Scrotal ultrasound | $465 | $328 | $99 |
| Sedimentation rate (ESR) test | $37 | $43 | $3 |
| Semen analysis | $66 | $56 | $12 |
| Sex hormone binding globulin test | $70 | $101 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $152 | $190 | $114 |
| Simple wound stitches | $156 | $224 | $127 |
| Skin biopsy | $157 | $410 | $121 |
| Skin biopsy (punch) | $170 | $648 | $121 |
| Skin lesion freezing (cryotherapy) | $29 | $132 | $36 |
| Skin tag removal | $63 | $276 | $92 |
| Sleep study (polysomnography) | $2,646 | $1,875 | $691 |
| Soft tissue ultrasound | $306 | $261 | $64 |
| Speech therapy | $164 | $264 | $76 |
| Spinal tap (lumbar puncture) | $410 | $341 | $165 |
| Spirometry (lung function test) | $184 | $98 | $30 |
| Spirometry with bronchodilator | $423 | $276 | $43 |
| Swallow study | $252 | $178 | $85 |
| T3 thyroid test | $93 | $105 | $14 |
| Tdap (tetanus) vaccine | $87 | $97 | — |
| Testosterone test | $135 | $120 | $26 |
| Thyroid test (TSH) | $117 | $79 | $17 |
| Thyroid ultrasound | $411 | $463 | $109 |
| Thyroid uptake scan | $767 | $1,154 | $145 |
| Total IgE allergy test | $77 | $85 | $16 |
| Total protein test | $33 | $56 | $4 |
| Transvaginal ultrasound | $393 | $439 | $118 |
| Trigger point injection | $158 | $126 | $56 |
| Trigger point injection (1-2 muscles) | $157 | $105 | $52 |
| Triglycerides test | $52 | $91 | $6 |
| Troponin (heart) test | $111 | $110 | $12 |
| Upper GI endoscopy (EGD) | $2,925 | $1,632 | $371 |
| Uric acid (gout) test | $50 | $56 | $5 |
| Urinalysis | $33 | $20 | $3 |
| Urine microalbumin test | $53 | $58 | $5 |
| Urine pregnancy test | $47 | $30 | $9 |
| Vaccine administration | $23 | $60 | $19 |
| Vaccine administration (each additional) | $10 | $55 | $16 |
| Vitamin B12 test | $86 | $70 | $15 |
| Vitamin D test | $124 | $183 | $30 |
| Wart removal | $66 | $168 | $121 |
| Well-child visit | $80 | $180 | — |
| Wound debridement | $436 | $687 | $186 |
| X-ray of the abdomen | $189 | $140 | $36 |
| X-ray of the ankle | $168 | $151 | $37 |
| X-ray of the collarbone | $171 | $167 | $33 |
| X-ray of the elbow | $168 | $223 | $33 |
| X-ray of the facial bones | $166 | $183 | $39 |
| X-ray of the foot | $180 | $158 | $34 |
| X-ray of the forearm | $154 | $125 | $29 |
| X-ray of the hand | $174 | $140 | $38 |
| X-ray of the hip | $175 | $122 | $49 |
| X-ray of the hip (1 view) | $168 | $83 | $34 |
| X-ray of the hip (3 views) | $184 | $160 | $49 |
| X-ray of the knee | $173 | $169 | $42 |
| X-ray of the knee (2 views) | $154 | $115 | $34 |
| X-ray of the knee (3 views) | $168 | $169 | $42 |
| X-ray of the knee (4+ views) | $204 | $190 | $49 |
| X-ray of the lower back (lumbar spine) | $261 | $186 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $176 | $156 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $364 | $285 | $53 |
| X-ray of the lower leg | $176 | $250 | $31 |
| X-ray of the mid-back (thoracic spine) | $146 | $170 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $176 | $164 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $128 | $176 | $39 |
| X-ray of the neck (cervical spine) | $189 | $229 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $168 | $204 | $40 |
| X-ray of the pelvis | $176 | $241 | $36 |
| X-ray of the pelvis (1 view) | $176 | $241 | $28 |
| X-ray of the ribs | $193 | $221 | $42 |
| X-ray of the ribs (2 views) | $168 | $154 | $36 |
| X-ray of the ribs (3 views) | $225 | $221 | $42 |
| X-ray of the shoulder | $205 | $262 | $36 |
| X-ray of the skull | $244 | $194 | $40 |
| X-ray of the upper arm | $168 | $146 | $32 |
| X-ray of the wrist | $168 | $138 | $43 |
| Zinc blood test | $57 | $53 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
