| Procedure | Sgmc Berrien Campus | Sgmc Health | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $160 | $160 | $51 |
| Abdominal fluid drain (paracentesis) | $1,425 | $1,425 | $284 |
| 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 | $416 | $220 |
| Abscess drainage (simple) | $419 | $419 | $129 |
| Abscess incision and drainage | $419 | $419 | $174 |
| Acupuncture | $48 | $48 | $38 |
| Acupuncture (each additional) | $48 | $48 | $28 |
| Albumin blood test | $16 | $16 | $5 |
| Aldosterone test | $414 | $414 | $41 |
| Alkaline phosphatase test | $61 | $61 | $5 |
| Allergy shots | $80 | $80 | $11 |
| Alpha-fetoprotein (AFP) test | $191 | $191 | $17 |
| ALT liver enzyme test | $51 | $51 | $5 |
| Ammonia blood test | $48 | $48 | $15 |
| Amniocentesis | $1,571 | $1,571 | $120 |
| Amylase test | $73 | $73 | $6 |
| Arterial blood gas (ABG) | $64 | $64 | $26 |
| AST liver enzyme test | $43 | $43 | $5 |
| Barium swallow study | $214 | $214 | $107 |
| Bartholin cyst removal | $390 | $390 | $182 |
| Basic metabolic panel | $42 | $45 | $8 |
| Benign skin lesion removal | $749 | $749 | $171 |
| Bilirubin blood test | $76 | $76 | $5 |
| Bladder scope (cystoscopy) | $4,725 | $4,725 | $216 |
| Blood clotting test (PT/INR) | $29 | $29 | $4 |
| Blood crossmatch | $235 | $235 | — |
| Blood glucose test | $13 | $13 | $5 |
| Blood transfusion | $357 | $357 | $47 |
| 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 |
| Bone density scan (DEXA) | $114 | $114 | $39 |
| Bone marrow biopsy | $3,926 | $3,926 | $172 |
| Bone scan (nuclear) | $748 | $748 | $259 |
| Botox for migraine | $666 | $666 | $157 |
| Breast biopsy | $3,737 | $3,737 | $478 |
| Breast MRI | $920 | $920 | $216 |
| Breast MRI without contrast | $544 | $544 | $216 |
| Breast ultrasound | $462 | $462 | $92 |
| Breast ultrasound (complete) | $497 | $497 | $100 |
| Breast ultrasound (limited) | $459 | $459 | $84 |
| Breathing tube insertion (intubation) | $383 | $383 | $133 |
| Bronchoscopy | $3,380 | $3,380 | $303 |
| Burn dressing and debridement (medium) | $380 | $380 | $166 |
| Burn dressing and debridement (small) | $549 | $549 | $93 |
| Burn treatment | $403 | $403 | $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 | $9 | $5 |
| Capsule endoscopy | $1,433 | $1,433 | $802 |
| Cardiac ablation | $36,761 | $36,761 | $759 |
| Cardiac catheterization | $5,777 | $5,777 | $1,049 |
| Cardiac rehabilitation | $180 | $180 | $26 |
| Cardiac stress test | $1,399 | $1,399 | $39 |
| Cardioversion | $955 | $955 | $155 |
| Carotid artery ultrasound | $296 | $296 | $156 |
| Carpal tunnel release | $5,472 | $5,472 | $483 |
| CEA tumor marker test | $98 | $98 | $19 |
| Central line placement | $1,462 | $1,462 | $238 |
| Chalazion (eyelid cyst) removal | $553 | $553 | $131 |
| Chemotherapy infusion | $447 | $447 | $81 |
| Chemotherapy infusion (each additional) | $147 | $147 | $28 |
| Chemotherapy infusion (first hour) | $747 | $747 | $133 |
| Chest fluid drain (thoracentesis) | $459 | $459 | $311 |
| Chest tube insertion | $1,140 | $1,140 | $143 |
| Chest X-ray | $158 | $168 | $37 |
| Chest X-ray (1 view) | $167 | $179 | $25 |
| Chest X-ray (2 views) | $115 | $123 | $33 |
| Circumcision | $3,974 | $3,974 | $167 |
| CK-MB heart enzyme test | $122 | $122 | $12 |
| Clotting time test (PTT) | $41 | $41 | $6 |
| Colonoscopy | $3,968 | $3,968 | $480 |
| Complete blood count (CBC) | $6 | $24 | $7 |
| Complex wound repair | $1,146 | $1,146 | $390 |
| Comprehensive metabolic panel | $59 | $62 | $11 |
| Contraceptive implant (Nexplanon) | $710 | $710 | $115 |
| Copper blood test | $107 | $107 | $12 |
| Cortisol test | $186 | $186 | $16 |
| COVID-19 PCR test | $192 | $192 | $51 |
| CPAP titration study | $173 | $173 | $69 |
| Creatine kinase (CK) test | $68 | $68 | $7 |
| CT angiography of the chest | $4,388 | $4,388 | $281 |
| CT angiography of the head | $4,493 | $4,493 | $274 |
| CT scan of the abdomen | $3,534 | $3,534 | $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 | $3,750 | $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 with contrast | $1,445 | $1,445 | $199 |
| CT scan of the arm without contrast | $935 | $935 | $161 |
| CT scan of the chest | $1,139 | $1,848 | $167 |
| CT scan of the chest with and without contrast | $2,372 | $2,372 | $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 | $1,916 | $148 |
| CT scan of the head with and without contrast | $2,816 | $2,816 | $173 |
| CT scan of the head with contrast | $1,916 | $1,916 | $148 |
| CT scan of the head without contrast | $1,122 | $1,201 | $107 |
| CT scan of the leg | $889 | $889 | $166 |
| CT scan of the leg with contrast | $375 | $375 | $166 |
| CT scan of the leg without contrast | $956 | $956 | $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 | $1,712 | $183 |
| CT scan of the neck (cervical spine) | $1,931 | $1,931 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $1,931 | $1,931 | $196 |
| CT scan of the neck (cervical spine) with contrast | $2,286 | $2,286 | $168 |
| CT scan of the neck (cervical spine) without contrast | $563 | $563 | $131 |
| CT scan of the neck with and without contrast | $2,411 | $2,411 | $220 |
| 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 | $1,493 | $152 |
| CT scan of the sinuses with and without contrast | $1,493 | $1,493 | $184 |
| CT scan of the sinuses with contrast | $2,055 | $2,055 | $152 |
| CT scan of the sinuses without contrast | $996 | $996 | $128 |
| D-dimer test | $102 | $102 | $10 |
| Defibrillator (ICD) implant | $37,015 | $37,015 | $798 |
| DHEA-sulfate test | $284 | $284 | $22 |
| Diagnostic mammogram | $613 | $613 | $140 |
| Drug screen (urine) | $489 | $489 | $17 |
| Echocardiogram | $1,142 | $1,142 | $138 |
| Echocardiogram with and without contrast | $257 | $257 | $101 |
| Echocardiogram without contrast | $1,572 | $1,572 | $138 |
| EKG / ECG (tracing only) | $153 | $164 | $7 |
| Electrocardiogram (EKG) | $153 | $164 | $8 |
| Electroencephalogram (EEG) | $514 | $514 | $448 |
| Electrolyte panel | $28 | $28 | $7 |
| Electromyography (EMG) | $442 | $442 | $141 |
| Emergency department visit | $1,058 | $2,898 | $69 |
| Emergency department visit (level 1) | $312 | $312 | $11 |
| Emergency department visit (level 2) | $329 | $379 | $40 |
| Emergency department visit (level 3) | $672 | $672 | $69 |
| Emergency department visit (level 4) | $2,767 | $4,475 | $118 |
| Emergency department visit (level 5) | $5,858 | $5,858 | $171 |
| Endometrial biopsy | $366 | $366 | $98 |
| Epidural steroid injection | $1,635 | $1,635 | $275 |
| ERCP (bile duct endoscopy) | $6,290 | $6,290 | $311 |
| Esophageal dilation | $2,060 | $2,060 | $522 |
| Estradiol (estrogen) test | $232 | $232 | $28 |
| Facet joint injection (spine) | $810 | $810 | $99 |
| Fallopian tube X-ray (HSG) | $378 | $378 | $164 |
| Fecal occult blood (stool) test | $16 | $16 | $10 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $16 | $16 | $16 |
| Feeding tube (PEG) placement | $1,925 | $1,925 | $178 |
| Ferritin (iron) test | $125 | $125 | $14 |
| Fibrinogen test | $170 | $170 | $10 |
| Flexible sigmoidoscopy | $1,801 | $1,801 | $323 |
| 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 |
| Gallbladder scan (HIDA) | $1,610 | $1,610 | $334 |
| GGT liver test | $75 | $75 | $7 |
| Glucose tolerance test | $257 | $257 | $8 |
| H. pylori test | $226 | $226 | $67 |
| HDL cholesterol test | $79 | $79 | $8 |
| Hematocrit test | $16 | $16 | $2 |
| Hemoglobin A1c (diabetes test) | $35 | $35 | $10 |
| Hemorrhoid removal | $1,740 | $1,740 | $338 |
| 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 | $398 | $26 |
| Home sleep apnea test | $953 | $953 | $123 |
| Iron blood test | $64 | $64 | $6 |
| IUD removal | $278 | $278 | $112 |
| IV infusion therapy | $360 | $360 | $44 |
| IV infusion therapy (each additional) | $236 | $236 | $21 |
| IV infusion therapy (initial) | $385 | $385 | $67 |
| IVC filter placement | $9,179 | $9,179 | $1,885 |
| Joint aspiration (small/intermediate) | $551 | $551 | $57 |
| Joint aspiration or injection (mid-size joint) | $551 | $551 | $57 |
| Joint aspiration or injection (small joint) | $510 | $510 | $56 |
| Kidney biopsy | $3,727 | $3,727 | $492 |
| Kidney scan (nuclear) | $768 | $768 | $172 |
| Kidney stone shock-wave (lithotripsy) | $19,094 | $19,094 | $760 |
| Kidney ultrasound | $517 | $724 | $84 |
| Kidney ultrasound (limited) | $932 | $932 | $61 |
| Knee joint injection | $637 | $637 | $69 |
| Lactate test | $60 | $60 | $12 |
| Laminectomy (spine) | $13,767 | $13,767 | $1,157 |
| Laryngoscopy | $314 | $314 | $189 |
| LDH test | $90 | $90 | $6 |
| LDL cholesterol test | $72 | $72 | $11 |
| Leg artery angiogram | $1,979 | $1,979 | $149 |
| Leg vein ultrasound (Doppler) | $765 | $863 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $765 | $765 | $116 |
| LH hormone test | $192 | $192 | $19 |
| Lipase test | $104 | $104 | $7 |
| Lipid (cholesterol) panel | $61 | $62 | $13 |
| Liver biopsy | $3,341 | $3,341 | $288 |
| Liver function panel | $127 | $127 | $8 |
| Lung function test (PFT) | $125 | $125 | $37 |
| Lung scan (V/Q) | $854 | $854 | $291 |
| Magnesium blood test | $47 | $50 | $7 |
| MRA of the brain | $2,057 | $2,057 | $226 |
| MRA of the brain with contrast | $2,057 | $2,057 | $226 |
| MRA of the brain without contrast | $3,268 | $3,268 | $328 |
| MRA of the neck | $2,252 | $2,252 | $245 |
| MRA of the neck with contrast | $2,252 | $2,252 | $245 |
| MRA of the neck without contrast | $2,511 | $2,511 | $343 |
| MRI of the abdomen | $4,334 | $4,334 | $300 |
| MRI of the abdomen with contrast | $2,870 | $2,870 | $300 |
| MRI of the abdomen without contrast | $4,334 | $4,334 | $194 |
| MRI of the ankle | $3,342 | $3,342 | $261 |
| MRI of the ankle with contrast | $2,081 | $2,081 | $261 |
| MRI of the ankle without contrast | $3,342 | $3,342 | $222 |
| MRI of the brain | $2,322 | $2,322 | $269 |
| MRI of the brain with contrast | $2,322 | $2,322 | $269 |
| MRI of the brain without contrast | $1,775 | $1,775 | $195 |
| MRI of the chest | $2,262 | $2,262 | $371 |
| MRI of the chest with contrast | $2,601 | $2,601 | $371 |
| MRI of the chest without contrast | $2,262 | $2,262 | $466 |
| MRI of the knee | $1,852 | $1,852 | $315 |
| MRI of the knee with contrast | $2,342 | $2,342 | $315 |
| MRI of the knee without contrast | $1,273 | $1,273 | $204 |
| MRI of the lower back (lumbar spine) | $2,507 | $2,507 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $2,507 | $2,507 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $770 | $770 | $192 |
| MRI of the mid-back (thoracic spine) | $2,480 | $2,480 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $5,241 | $5,241 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $2,480 | $2,480 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $1,781 | $1,781 | $190 |
| MRI of the neck (cervical spine) | $2,025 | $2,025 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $4,658 | $4,658 | $318 |
| MRI of the neck (cervical spine) with contrast | $2,025 | $2,025 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,622 | $1,622 | $191 |
| MRI of the pelvis | $3,881 | $3,881 | $268 |
| MRI of the pelvis with contrast | $2,594 | $2,594 | $268 |
| MRI of the pelvis without contrast | $3,881 | $3,881 | $227 |
| MRI of the shoulder | $2,672 | $2,672 | $313 |
| MRI of the shoulder with contrast | $2,672 | $2,672 | $313 |
| MRI of the shoulder without contrast | $680 | $680 | $205 |
| MRI of the wrist | $2,289 | $2,289 | $330 |
| MRI of the wrist with contrast | $2,289 | $2,289 | $330 |
| MRI of the wrist without contrast | $849 | $849 | $303 |
| Nebulizer breathing treatment | $169 | $169 | $9 |
| Nuclear cardiac stress test | $4,774 | $4,774 | $428 |
| Occupational therapy evaluation | $362 | $362 | $101 |
| Occupational therapy evaluation (high complexity) | $608 | $608 | $101 |
| Occupational therapy evaluation (low complexity) | $362 | $362 | $101 |
| Occupational therapy evaluation (moderate complexity) | $323 | $323 | $101 |
| Office visit (established patient) | $457 | $457 | $115 |
| Office visit (new patient) | $592 | $592 | $177 |
| Office visit, established patient (level 3) | $462 | $462 | $95 |
| Office visit, established patient (level 4) | $452 | $452 | $136 |
| Office visit, new patient (level 3) | $223 | $223 | $118 |
| Office visit, new patient (level 4) | $592 | $592 | $177 |
| Office visit, new patient (level 5) | $1,054 | $1,054 | $237 |
| Pap smear (cervical screening) | $155 | $155 | $20 |
| Parathyroid hormone (PTH) test | $67 | $71 | $41 |
| Pelvic ultrasound | $744 | $744 | $78 |
| Pelvic ultrasound (complete) | $974 | $974 | $105 |
| Pelvic ultrasound (limited) | $550 | $550 | $51 |
| PET scan | $2,046 | $2,046 | — |
| Phosphorus blood test | $10 | $10 | $5 |
| Physical therapy evaluation | $290 | $290 | $98 |
| Physical therapy evaluation (high complexity) | $511 | $511 | $98 |
| Physical therapy evaluation (moderate complexity) | $271 | $271 | $98 |
| 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 |
| Pulmonary rehabilitation | $113 | $113 | $87 |
| Radiofrequency nerve ablation | $2,058 | $2,058 | $462 |
| Rheumatoid factor test | $66 | $66 | $6 |
| Sacroiliac joint injection | $555 | $555 | $176 |
| Scoliosis spine X-ray | $429 | $429 | $58 |
| Scoliosis spine X-ray (1 view) | $296 | $296 | $44 |
| Scoliosis spine X-ray (3 views) | $561 | $561 | $72 |
| Screening colonoscopy | $1,731 | $1,731 | $378 |
| Screening mammogram | $487 | $487 | $126 |
| Scrotal ultrasound | $977 | $977 | $99 |
| Sedimentation rate (ESR) test | $54 | $54 | $3 |
| Semen analysis | $91 | $91 | $12 |
| Sex hormone binding globulin test | $181 | $181 | $22 |
| Shingles vaccine | $351 | $351 | — |
| Simple laceration repair (small, up to 2.5 cm) | $402 | $402 | $114 |
| Simple wound stitches | $408 | $408 | $127 |
| Skin biopsy | $666 | $666 | $121 |
| Skin biopsy (punch) | $666 | $666 | $121 |
| Skin cancer lesion removal | $1,299 | $1,299 | $240 |
| Skin tag removal | $304 | $304 | $92 |
| Sleep study (polysomnography) | $5,599 | $5,599 | $691 |
| Soft tissue ultrasound | $490 | $490 | $64 |
| Speech therapy | $262 | $262 | $76 |
| Spinal cord stimulator | $7,762 | $7,762 | $2,388 |
| Spinal tap (lumbar puncture) | $2,436 | $2,436 | $165 |
| Spine fracture repair (kyphoplasty) | $11,540 | $11,540 | $5,803 |
| Spirometry (lung function test) | $107 | $107 | $30 |
| Spirometry with bronchodilator | $522 | $522 | $43 |
| Strep throat test | $124 | $124 | $17 |
| Stress echocardiogram | $1,028 | $1,028 | $209 |
| Stress echocardiogram (complete) | $1,142 | $1,142 | $233 |
| Swallow study | $448 | $448 | $85 |
| T3 thyroid test | $121 | $121 | $14 |
| Tdap (tetanus) vaccine | $108 | $108 | — |
| Testosterone test | $239 | $239 | $26 |
| Thyroid test (TSH) | $157 | $157 | $17 |
| Thyroid ultrasound | $971 | $971 | $109 |
| Thyroid uptake scan | $1,308 | $1,308 | $145 |
| Tilt table test | $644 | $644 | $168 |
| Total IgE allergy test | $172 | $172 | $16 |
| Total protein test | $75 | $75 | $4 |
| Tracheostomy | $1,859 | $1,859 | $273 |
| Transesophageal echocardiogram (TEE) | $634 | $634 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $634 | $634 | $239 |
| Transvaginal ultrasound | $981 | $981 | $118 |
| Trigger finger release | $3,093 | $3,093 | $630 |
| Trigger point injection | $446 | $446 | $56 |
| Trigger point injection (1-2 muscles) | $426 | $426 | $52 |
| Triglycerides test | $95 | $95 | $6 |
| Troponin (heart) test | $114 | $114 | $12 |
| Turning a breech baby (version) | $3,240 | $3,240 | $94 |
| Upper GI endoscopy (EGD) | $2,745 | $2,745 | $371 |
| Upper GI series (barium) | $637 | $637 | $128 |
| Ureteral stent placement | $4,725 | $4,725 | $373 |
| Ureteroscopy (stone removal) | $16,581 | $16,581 | $365 |
| Uric acid (gout) test | $64 | $64 | $5 |
| Urinalysis | $81 | $81 | $3 |
| Urine microalbumin test | $17 | $56 | $5 |
| Vaccine administration | $59 | $59 | $19 |
| Vaccine administration (each additional) | $56 | $56 | $16 |
| Varicose vein ablation | $5,853 | $5,853 | $1,018 |
| Vitamin B12 test | $64 | $64 | $15 |
| Vitamin D test | $91 | $94 | $30 |
| Wart removal | $396 | $396 | $121 |
| Wound debridement | $472 | $472 | $186 |
| X-ray of the abdomen | $403 | $403 | $36 |
| X-ray of the ankle | $405 | $405 | $37 |
| X-ray of the collarbone | $195 | $195 | $33 |
| X-ray of the elbow | $405 | $405 | $33 |
| X-ray of the facial bones | $371 | $371 | $39 |
| X-ray of the foot | $508 | $508 | $34 |
| X-ray of the forearm | $217 | $233 | $29 |
| X-ray of the hand | $374 | $374 | $38 |
| X-ray of the hip | $137 | $137 | $49 |
| X-ray of the hip (1 view) | $137 | $137 | $34 |
| X-ray of the hip (3 views) | $80 | $80 | $49 |
| X-ray of the hip (4 views) | $280 | $280 | $63 |
| X-ray of the knee | $225 | $211 | $42 |
| X-ray of the knee (2 views) | $185 | $185 | $34 |
| X-ray of the knee (3 views) | $239 | $257 | $42 |
| X-ray of the knee (4+ views) | $210 | $210 | $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 | $182 | $31 |
| X-ray of the mid-back (thoracic spine) | $503 | $503 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $599 | $599 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $408 | $408 | $39 |
| 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 | $144 | $36 |
| X-ray of the pelvis (1 view) | $82 | $82 | $28 |
| X-ray of the ribs | $248 | $248 | $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 | $207 | $36 |
| X-ray of the skull | $393 | $393 | $40 |
| X-ray of the upper arm | $152 | $152 | $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.
