| Procedure | Sgmc Berrien Campus | Sgmc Health Lanier | Medicare |
|---|
| Abdominal ultrasound | $1,110 | $1,110 | $100 |
| Abdominal ultrasound (complete) | $1,373 | $1,373 | $114 |
| Abdominal ultrasound (limited) | $847 | $847 | $86 |
| Abscess drainage (complex or multiple) | $416 | $275 | $220 |
| Abscess drainage (simple) | $419 | $602 | $129 |
| Abscess incision and drainage | $419 | $438 | $174 |
| Albumin blood test | $16 | $16 | $5 |
| Aldosterone test | $414 | $414 | $41 |
| Alkaline phosphatase test | $61 | $61 | $5 |
| Alpha-fetoprotein (AFP) test | $191 | $191 | $17 |
| ALT liver enzyme test | $51 | $51 | $5 |
| Ammonia blood test | $48 | $48 | $15 |
| Amylase test | $73 | $73 | $6 |
| Arterial blood gas (ABG) | $64 | $64 | $26 |
| AST liver enzyme test | $43 | $43 | $5 |
| Basic metabolic panel | $42 | $47 | $8 |
| Bilirubin blood test | $76 | $76 | $5 |
| Blood clotting test (PT/INR) | $29 | $29 | $4 |
| Blood crossmatch | $235 | $235 | — |
| Blood glucose test | $13 | $13 | $5 |
| Blood type and screen | $199 | $199 | $10 |
| Blood type test | $152 | $152 | $3 |
| Blood type test (ABO group) | $206 | $206 | $3 |
| Blood type test (Rh/D antigen) | $99 | $99 | $3 |
| BNP (heart failure) test | $49 | $53 | $39 |
| Breathing tube insertion (intubation) | $383 | $508 | $133 |
| Burn dressing and debridement (small) | $549 | $281 | $93 |
| Burn treatment | $403 | $281 | $129 |
| C-reactive protein (CRP) | $155 | $155 | $5 |
| CA 19-9 tumor marker test | $32 | $32 | $21 |
| CA-125 ovarian marker test | $248 | $248 | $21 |
| Calcium blood test | $8 | $10 | $5 |
| Carotid artery ultrasound | $296 | $242 | $156 |
| CEA tumor marker test | $98 | $98 | $19 |
| Central line placement | $1,462 | $1,462 | $238 |
| Chest tube insertion | $1,140 | $430 | $143 |
| Chest X-ray | $158 | $151 | $37 |
| Chest X-ray (1 view) | $167 | $179 | $25 |
| Chest X-ray (2 views) | $115 | $123 | $33 |
| CK-MB heart enzyme test | $122 | $129 | $12 |
| Clotting time test (PTT) | $41 | $41 | $6 |
| Complete blood count (CBC) | $6 | $24 | $7 |
| Complex wound repair | $1,146 | $1,146 | $390 |
| Comprehensive metabolic panel | $59 | $65 | $11 |
| Copper blood test | $107 | $104 | $12 |
| Cortisol test | $186 | $194 | $16 |
| COVID-19 PCR test | $192 | $192 | $51 |
| Creatine kinase (CK) test | $68 | $68 | $7 |
| CT angiography of the chest | $4,388 | $4,388 | $281 |
| CT scan of the abdomen | $3,534 | $3,320 | $230 |
| CT scan of the abdomen and pelvis | $6,566 | $6,566 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $7,065 | $7,065 | $338 |
| CT scan of the abdomen and pelvis with contrast | $6,566 | $6,566 | $300 |
| CT scan of the abdomen and pelvis without contrast | $4,153 | $4,153 | $183 |
| CT scan of the abdomen with and without contrast | $3,750 | $3,749 | $259 |
| CT scan of the abdomen with contrast | $3,320 | $3,320 | $230 |
| CT scan of the abdomen without contrast | $1,006 | $1,006 | $136 |
| CT scan of the arm | $1,161 | $1,161 | $199 |
| CT scan of the arm without contrast | $935 | $1,000 | $161 |
| CT scan of the chest | $1,139 | $1,848 | $167 |
| CT scan of the chest with and without contrast | $2,372 | $2,074 | $196 |
| CT scan of the chest with contrast | $1,848 | $1,848 | $167 |
| CT scan of the chest without contrast | $402 | $430 | $133 |
| CT scan of the head | $1,558 | $1,201 | $148 |
| CT scan of the head with and without contrast | $2,816 | $2,816 | $173 |
| CT scan of the head without contrast | $1,122 | $1,122 | $107 |
| CT scan of the leg | $889 | $1,022 | $166 |
| CT scan of the leg with contrast | $375 | $401 | $166 |
| CT scan of the leg without contrast | $956 | $1,022 | $130 |
| CT scan of the lower back (lumbar spine) | $1,187 | $1,868 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $1,975 | $1,975 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,868 | $1,868 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $473 | $506 | $130 |
| CT scan of the neck | $1,712 | $1,648 | $183 |
| CT scan of the neck (cervical spine) | $1,931 | $563 | $168 |
| CT scan of the neck (cervical spine) with contrast | $2,286 | $2,286 | $168 |
| CT scan of the neck (cervical spine) without contrast | $563 | $526 | $131 |
| CT scan of the neck with contrast | $1,712 | $1,712 | $183 |
| CT scan of the neck without contrast | $1,583 | $1,583 | $150 |
| CT scan of the pelvis | $2,575 | $2,575 | $226 |
| CT scan of the pelvis with and without contrast | $2,575 | $2,575 | $251 |
| CT scan of the pelvis with contrast | $3,461 | $3,461 | $226 |
| CT scan of the pelvis without contrast | $597 | $597 | $133 |
| CT scan of the sinuses | $1,493 | $1,421 | $152 |
| CT scan of the sinuses with contrast | $2,055 | $1,846 | $152 |
| CT scan of the sinuses without contrast | $996 | $996 | $128 |
| D-dimer test | $102 | $102 | $10 |
| DHEA-sulfate test | $284 | $284 | $22 |
| Drug screen (urine) | $489 | $489 | $17 |
| Echocardiogram | $1,142 | $1,143 | $138 |
| Electrolyte panel | $28 | $27 | $7 |
| Emergency department visit | $1,058 | $1,058 | $69 |
| Emergency department visit (level 2) | $329 | $379 | $40 |
| Emergency department visit (level 3) | $672 | $672 | $69 |
| Emergency department visit (level 4) | $2,767 | $1,058 | $118 |
| Emergency department visit (level 5) | $5,858 | $1,187 | $171 |
| Estradiol (estrogen) test | $232 | $232 | $28 |
| Fecal occult blood (stool) test | $16 | $16 | $10 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $16 | $16 | $16 |
| Ferritin (iron) test | $125 | $125 | $14 |
| Fibrinogen test | $170 | $170 | $10 |
| Flu test | $56 | $56 | $17 |
| Folate (folic acid) test | $168 | $168 | $15 |
| Foreign body removal (skin) | $968 | $968 | $157 |
| Free T4 thyroid test | $173 | $173 | $9 |
| FSH hormone test | $154 | $154 | $19 |
| GGT liver test | $75 | $75 | $7 |
| Glucose tolerance test | $257 | $257 | $8 |
| H. pylori test | $226 | $226 | $67 |
| HDL cholesterol test | $79 | $80 | $8 |
| Hematocrit test | $16 | $16 | $2 |
| Hemoglobin A1c (diabetes test) | $35 | $35 | $10 |
| Hepatitis A vaccine | $180 | $180 | — |
| Hepatitis B test | $99 | $99 | $10 |
| Hepatitis B vaccine | $153 | $153 | — |
| Hepatitis C test | $225 | $225 | $14 |
| HIV test | $68 | $68 | $19 |
| HIV test (antibody) | $68 | $68 | $14 |
| HIV test (antigen/antibody combo) | $64 | $64 | $24 |
| Holter heart monitor | $398 | $540 | $26 |
| Iron blood test | $64 | $64 | $6 |
| Joint aspiration (small/intermediate) | $551 | $558 | $57 |
| Joint aspiration or injection (mid-size joint) | $551 | $559 | $57 |
| Joint aspiration or injection (small joint) | $510 | $558 | $56 |
| Kidney ultrasound | $517 | $517 | $84 |
| Knee joint injection | $637 | $743 | $69 |
| Lactate test | $60 | $60 | $12 |
| LDH test | $90 | $90 | $6 |
| LDL cholesterol test | $72 | $72 | $11 |
| Leg vein ultrasound (Doppler) | $765 | $840 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $765 | $719 | $116 |
| LH hormone test | $192 | $192 | $19 |
| Lipase test | $104 | $104 | $7 |
| Lipid (cholesterol) panel | $61 | $61 | $13 |
| Liver function panel | $127 | $126 | $8 |
| Magnesium blood test | $47 | $50 | $7 |
| Pap smear (cervical screening) | $155 | $155 | $20 |
| Parathyroid hormone (PTH) test | $67 | $71 | $41 |
| Pelvic ultrasound | $744 | $859 | $78 |
| Pelvic ultrasound (complete) | $974 | $974 | $105 |
| Pelvic ultrasound (limited) | $550 | $744 | $51 |
| Phosphorus blood test | $10 | $10 | $5 |
| Platelet count | $30 | $30 | $4 |
| Pneumonia vaccine | $253 | $253 | — |
| Pregnancy blood test (hCG) | $122 | $122 | $8 |
| Pregnancy ultrasound | $1,001 | $1,001 | $126 |
| Pregnancy ultrasound (first trimester) | $854 | $854 | $117 |
| Pregnancy ultrasound (second or third trimester) | $1,148 | $1,148 | $136 |
| Procalcitonin test | $197 | $197 | $27 |
| Prolactin test | $190 | $190 | $19 |
| Prostate test (PSA) | $171 | $171 | $18 |
| Rheumatoid factor test | $66 | $66 | $6 |
| Scrotal ultrasound | $977 | $977 | $99 |
| Sedimentation rate (ESR) test | $54 | $54 | $3 |
| Sex hormone binding globulin test | $181 | $181 | $22 |
| Shingles vaccine | $351 | $351 | — |
| Simple laceration repair (small, up to 2.5 cm) | $402 | $466 | $114 |
| Simple wound stitches | $408 | $475 | $127 |
| Strep throat test | $124 | $124 | $17 |
| T3 thyroid test | $121 | $121 | $14 |
| Tdap (tetanus) vaccine | $108 | $166 | — |
| Testosterone test | $239 | $239 | $26 |
| Thyroid test (TSH) | $157 | $157 | $17 |
| Thyroid ultrasound | $971 | $971 | $109 |
| Total IgE allergy test | $172 | $172 | $16 |
| Total protein test | $75 | $75 | $4 |
| Transvaginal ultrasound | $981 | $980 | $118 |
| Triglycerides test | $95 | $95 | $6 |
| Troponin (heart) test | $114 | $114 | $12 |
| Uric acid (gout) test | $64 | $64 | $5 |
| Urinalysis | $81 | $81 | $3 |
| Urine microalbumin test | $17 | $56 | $5 |
| Vaccine administration | $59 | $47 | $19 |
| Vaccine administration (each additional) | $56 | $56 | $16 |
| Vitamin B12 test | $64 | $63 | $15 |
| Vitamin D test | $91 | $167 | $30 |
| X-ray of the abdomen | $403 | $337 | $36 |
| X-ray of the ankle | $405 | $405 | $37 |
| X-ray of the collarbone | $195 | $209 | $33 |
| X-ray of the elbow | $405 | $405 | $33 |
| X-ray of the facial bones | $371 | $491 | $39 |
| X-ray of the foot | $508 | $508 | $34 |
| X-ray of the forearm | $217 | $241 | $29 |
| X-ray of the hand | $374 | $374 | $38 |
| X-ray of the knee | $225 | $230 | $42 |
| X-ray of the knee (2 views) | $185 | $197 | $34 |
| X-ray of the knee (3 views) | $239 | $275 | $42 |
| X-ray of the knee (4+ views) | $210 | $230 | $49 |
| X-ray of the lower back (lumbar spine) | $308 | $308 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $288 | $288 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $744 | $744 | $53 |
| X-ray of the lower leg | $182 | $194 | $31 |
| X-ray of the neck (cervical spine) | $552 | $552 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $508 | $508 | $40 |
| X-ray of the pelvis | $144 | $82 | $36 |
| X-ray of the pelvis (1 view) | $82 | $82 | $28 |
| X-ray of the ribs | $248 | $176 | $42 |
| X-ray of the ribs (2 views) | $104 | $104 | $36 |
| X-ray of the ribs (3 views) | $248 | $248 | $42 |
| X-ray of the shoulder | $207 | $222 | $36 |
| X-ray of the skull | $393 | $373 | $40 |
| X-ray of the upper arm | $152 | $162 | $32 |
| X-ray of the wrist | $373 | $373 | $43 |
| Zinc blood test | $175 | $175 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
