| Procedure | Sanford Worthington Medical Center | Spencer Municipal Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $110 | $113 | $51 |
| Abdominal fluid drain (paracentesis) | $1,390 | $891 | $284 |
| Abdominal ultrasound | $845 | $389 | $100 |
| Abdominal ultrasound (complete) | $937 | $612 | $114 |
| Abdominal ultrasound (limited) | $753 | $389 | $86 |
| Abscess drainage (complex or multiple) | $674 | $925 | $220 |
| Abscess drainage (simple) | $435 | $237 | $129 |
| Abscess incision and drainage | $555 | $581 | $174 |
| Barium swallow study | $555 | $472 | $107 |
| Blood transfusion | $1,018 | $319 | $47 |
| Bone density scan (DEXA) | $482 | $391 | $39 |
| Bone scan (nuclear) | $2,059 | $2,763 | $259 |
| Breast biopsy | $2,233 | $5,092 | $478 |
| Breast ultrasound | $610 | $294 | $92 |
| Breast ultrasound (complete) | $705 | $294 | $100 |
| Breast ultrasound (limited) | $516 | $294 | $84 |
| Breathing tube insertion (intubation) | $558 | $1,127 | $133 |
| Burn dressing and debridement (small) | $330 | $138 | $93 |
| Burn treatment | $356 | $138 | $129 |
| Cardiac rehabilitation | $218 | $210 | $26 |
| Cardiac stress test | $1,184 | $836 | $39 |
| Cardioversion | $1,062 | $1,257 | $155 |
| Carotid artery ultrasound | $953 | $612 | $156 |
| Chemotherapy infusion | $347 | $479 | $81 |
| Chemotherapy infusion (each additional) | $220 | $438 | $28 |
| Chemotherapy infusion (first hour) | $474 | $519 | $133 |
| Chest fluid drain (thoracentesis) | $1,392 | $1,199 | $311 |
| Chest X-ray | $290 | $150 | $37 |
| Chest X-ray (1 view) | $266 | $150 | $25 |
| Chest X-ray (2 views) | $300 | $150 | $33 |
| CPAP titration study | $838 | $884 | $69 |
| CT angiography of the chest | $2,790 | $1,650 | $281 |
| CT angiography of the head | $3,183 | $1,214 | $274 |
| CT scan of the abdomen | $2,987 | $1,288 | $230 |
| CT scan of the abdomen and pelvis | $4,128 | $1,635 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $4,371 | $2,225 | $338 |
| CT scan of the abdomen and pelvis with contrast | $4,128 | $1,635 | $300 |
| CT scan of the abdomen and pelvis without contrast | $3,624 | $1,635 | $183 |
| CT scan of the abdomen with and without contrast | $3,485 | $1,487 | $259 |
| CT scan of the abdomen with contrast | $2,987 | $1,288 | $230 |
| CT scan of the abdomen without contrast | $2,473 | $1,052 | $136 |
| CT scan of the arm | $2,063 | $895 | $199 |
| CT scan of the arm with contrast | $2,063 | $877 | $199 |
| CT scan of the arm without contrast | $1,750 | $913 | $161 |
| CT scan of the chest | $2,778 | $913 | $167 |
| CT scan of the chest with and without contrast | $3,056 | $913 | $196 |
| CT scan of the chest with contrast | $2,778 | $913 | $167 |
| CT scan of the chest without contrast | $2,373 | $913 | $133 |
| CT scan of the head | $1,870 | $704 | $148 |
| CT scan of the head with and without contrast | $2,057 | $704 | $173 |
| CT scan of the head with contrast | $1,870 | $931 | $148 |
| CT scan of the head without contrast | $1,795 | $628 | $107 |
| CT scan of the leg | $2,279 | $895 | $166 |
| CT scan of the leg with contrast | $2,279 | $877 | $166 |
| CT scan of the leg without contrast | $1,973 | $913 | $130 |
| CT scan of the lower back (lumbar spine) | $2,186 | $850 | $169 |
| CT scan of the lower back (lumbar spine) with contrast | $2,186 | $856 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,854 | $844 | $130 |
| CT scan of the neck | $2,282 | $913 | $183 |
| CT scan of the neck (cervical spine) | $2,288 | $844 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $2,362 | $811 | $196 |
| CT scan of the neck (cervical spine) with contrast | $2,288 | $856 | $168 |
| CT scan of the neck (cervical spine) without contrast | $2,072 | $844 | $131 |
| CT scan of the neck with and without contrast | $2,675 | $913 | $220 |
| CT scan of the neck with contrast | $2,282 | $913 | $183 |
| CT scan of the neck without contrast | $2,047 | $877 | $150 |
| CT scan of the pelvis | $2,349 | $1,145 | $226 |
| CT scan of the pelvis with contrast | $2,349 | $1,238 | $226 |
| CT scan of the pelvis without contrast | $1,993 | $1,052 | $133 |
| CT scan of the sinuses | $2,498 | $913 | $152 |
| CT scan of the sinuses with contrast | $2,498 | $913 | $152 |
| CT scan of the sinuses without contrast | $2,286 | $913 | $128 |
| Diagnostic mammogram | $403 | $235 | $140 |
| Echocardiogram | $1,673 | $1,302 | $138 |
| Echocardiogram with and without contrast | $1,071 | $781 | $101 |
| EEG (awake and asleep) | $1,162 | $682 | $482 |
| EKG / ECG (tracing only) | $123 | $207 | $7 |
| Electrocardiogram (EKG) | $123 | $126 | $8 |
| Electroencephalogram (EEG) | $929 | $682 | $448 |
| Emergency department visit | $668 | $258 | $69 |
| Emergency department visit (level 1) | $256 | $171 | $11 |
| Emergency department visit (level 2) | $433 | $211 | $40 |
| Emergency department visit (level 3) | $668 | $324 | $69 |
| Emergency department visit (level 4) | $880 | $486 | $118 |
| Emergency department visit (level 5) | $1,335 | $730 | $171 |
| Fallopian tube X-ray (HSG) | $618 | $703 | $164 |
| Foreign body removal (skin) | $619 | $206 | $157 |
| Gallbladder scan (HIDA) | $1,646 | $1,324 | $334 |
| Hepatitis A vaccine | $105 | $116 | — |
| Hepatitis B vaccine | $104 | $95 | — |
| Holter heart monitor | $626 | $317 | $26 |
| Home sleep apnea test | $608 | $1,384 | $123 |
| HPV vaccine | $470 | $389 | — |
| IUD removal | $546 | $152 | $112 |
| IV infusion therapy | $350 | $433 | $44 |
| IV infusion therapy (each additional) | $198 | $438 | $21 |
| IV infusion therapy (initial) | $502 | $428 | $67 |
| Joint aspiration (small/intermediate) | $473 | $616 | $57 |
| Joint aspiration or injection (mid-size joint) | $489 | $669 | $57 |
| Joint aspiration or injection (small joint) | $458 | $562 | $56 |
| Kidney scan (nuclear) | $1,578 | $1,303 | $172 |
| Kidney ultrasound | $762 | $464 | $84 |
| Kidney ultrasound (limited) | $618 | $464 | $61 |
| Knee joint injection | $747 | $158 | $69 |
| Leg vein ultrasound (Doppler) | $1,095 | $620 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $928 | $620 | $116 |
| Lung function test (PFT) | $268 | $285 | $37 |
| Lung scan (V/Q) | $1,950 | $1,083 | $291 |
| MRA of the brain | $2,797 | $1,503 | $226 |
| MRA of the neck | $2,886 | $1,128 | $245 |
| MRA of the neck without contrast | $3,791 | $1,503 | $343 |
| MRI of the abdomen | $3,106 | $2,269 | $300 |
| MRI of the abdomen without contrast | $2,619 | $1,759 | $194 |
| MRI of the ankle | $3,170 | $2,112 | $261 |
| MRI of the ankle without contrast | $2,798 | $1,759 | $222 |
| MRI of the brain | $3,362 | $1,702 | $269 |
| MRI of the brain without contrast | $3,093 | $1,702 | $195 |
| MRI of the knee | $3,039 | $1,386 | $315 |
| MRI of the knee with contrast | $3,039 | $1,386 | $315 |
| MRI of the knee without contrast | $2,912 | $1,386 | $204 |
| MRI of the lower back (lumbar spine) | $3,697 | $1,235 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $3,169 | $1,235 | $192 |
| MRI of the mid-back (thoracic spine) | $3,637 | $1,235 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $4,725 | $1,235 | $319 |
| MRI of the mid-back (thoracic spine) without contrast | $3,442 | $1,235 | $190 |
| MRI of the neck (cervical spine) | $3,990 | $1,211 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $4,633 | $1,188 | $318 |
| MRI of the neck (cervical spine) without contrast | $3,444 | $1,235 | $191 |
| MRI of the pelvis | $3,223 | $2,161 | $268 |
| MRI of the pelvis without contrast | $2,605 | $1,759 | $227 |
| MRI of the shoulder | $3,330 | $1,386 | $313 |
| MRI of the shoulder with contrast | $3,330 | $1,386 | $313 |
| MRI of the shoulder without contrast | $3,016 | $1,386 | $205 |
| MRI of the wrist | $3,238 | $2,112 | $330 |
| MRI of the wrist without contrast | $2,778 | $1,759 | $303 |
| Nebulizer breathing treatment | $130 | $297 | $9 |
| Nuclear cardiac stress test | $3,340 | $2,322 | $428 |
| Occupational therapy evaluation | $248 | $213 | $101 |
| Occupational therapy evaluation (high complexity) | $266 | $213 | $101 |
| Occupational therapy evaluation (low complexity) | $241 | $213 | $101 |
| Occupational therapy evaluation (moderate complexity) | $248 | $213 | $101 |
| Office visit (established patient) | $210 | $158 | $115 |
| Office visit (new patient) | $793 | $169 | $177 |
| Office visit, established patient (level 3) | $176 | $101 | $95 |
| Office visit, established patient (level 4) | $245 | $164 | $136 |
| Office visit, new patient (level 3) | $566 | $135 | $118 |
| Office visit, new patient (level 4) | $793 | $204 | $177 |
| Office visit, new patient (level 5) | $1,170 | $208 | $237 |
| Pap smear (cervical screening) | $136 | $44 | $20 |
| Pelvic ultrasound | $671 | $394 | $78 |
| Pelvic ultrasound (complete) | $767 | $493 | $105 |
| Pelvic ultrasound (limited) | $574 | $294 | $51 |
| PET scan | $6,595 | $3,548 | — |
| Physical therapy evaluation | $226 | $195 | $98 |
| Physical therapy evaluation (high complexity) | $242 | $195 | $98 |
| Physical therapy evaluation (moderate complexity) | $226 | $195 | $98 |
| Pneumonia vaccine | $216 | $72 | — |
| Pregnancy ultrasound | $839 | $535 | $126 |
| Pregnancy ultrasound (first trimester) | $748 | $535 | $117 |
| Pregnancy ultrasound (second or third trimester) | $930 | $535 | $136 |
| Scoliosis spine X-ray | $374 | $215 | $58 |
| Scoliosis spine X-ray (3 views) | $441 | $215 | $72 |
| Screening mammogram | $482 | $235 | $126 |
| Scrotal ultrasound | $734 | $362 | $99 |
| Semen analysis | $105 | $124 | $12 |
| Shingles vaccine | $301 | $263 | — |
| Simple laceration repair (small, up to 2.5 cm) | $325 | $283 | $114 |
| Simple wound stitches | $334 | $324 | $127 |
| Skin tag removal | $278 | $152 | $92 |
| Sleep study (polysomnography) | $4,372 | $2,214 | $691 |
| Soft tissue ultrasound | $578 | $308 | $64 |
| Speech therapy | $297 | $197 | $76 |
| Spinal tap (lumbar puncture) | $914 | $934 | $165 |
| Spirometry (lung function test) | $189 | $208 | $30 |
| Spirometry with bronchodilator | $347 | $362 | $43 |
| Swallow study | $305 | $274 | $85 |
| Tdap (tetanus) vaccine | $88 | $72 | — |
| Thyroid ultrasound | $701 | $418 | $109 |
| Thyroid uptake scan | $1,091 | $972 | $145 |
| Transvaginal ultrasound | $718 | $402 | $118 |
| Trigger point injection | $488 | $342 | $56 |
| Trigger point injection (1-2 muscles) | $488 | $342 | $52 |
| Upper GI series (barium) | $912 | $699 | $128 |
| Vaccine administration | $77 | $108 | $19 |
| Wound debridement | $674 | $694 | $186 |
| X-ray of the abdomen | $335 | $150 | $36 |
| X-ray of the ankle | $354 | $209 | $37 |
| X-ray of the collarbone | $329 | $150 | $33 |
| X-ray of the elbow | $369 | $212 | $33 |
| X-ray of the facial bones | $342 | $324 | $39 |
| X-ray of the foot | $346 | $185 | $34 |
| X-ray of the forearm | $323 | $150 | $29 |
| X-ray of the hand | $330 | $150 | $38 |
| X-ray of the hip | $290 | $150 | $49 |
| X-ray of the hip (1 view) | $237 | $150 | $34 |
| X-ray of the hip (3 views) | $290 | $150 | $49 |
| X-ray of the knee | $310 | $150 | $42 |
| X-ray of the knee (2 views) | $305 | $150 | $34 |
| X-ray of the knee (3 views) | $310 | $150 | $42 |
| X-ray of the knee (4+ views) | $387 | $272 | $49 |
| X-ray of the lower back (lumbar spine) | $340 | $223 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $289 | $223 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $392 | $223 | $53 |
| X-ray of the lower leg | $350 | $150 | $31 |
| X-ray of the mid-back (thoracic spine) | $308 | $255 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $350 | $287 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $266 | $223 | $39 |
| X-ray of the neck (cervical spine) | $360 | $291 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $283 | $359 | $40 |
| X-ray of the pelvis | $279 | $223 | $36 |
| X-ray of the pelvis (1 view) | $281 | $223 | $28 |
| X-ray of the ribs | $334 | $300 | $42 |
| X-ray of the ribs (2 views) | $334 | $300 | $36 |
| X-ray of the ribs (3 views) | $298 | $150 | $42 |
| X-ray of the shoulder | $283 | $150 | $36 |
| X-ray of the upper arm | $272 | $150 | $32 |
| X-ray of the wrist | $350 | $173 | $43 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.