| Procedure | Slhs Massena, Inc | Clifton-Fine Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $55 | $269 | $51 |
| Abdominal fluid drain (paracentesis) | $1,858 | $1,919 | $284 |
| Abdominal ultrasound | $572 | $797 | $100 |
| Abdominal ultrasound (complete) | $653 | $1,128 | $114 |
| Abdominal ultrasound (limited) | $490 | $797 | $86 |
| Abscess drainage (complex or multiple) | $340 | $607 | $220 |
| Abscess incision and drainage | $340 | $607 | $174 |
| Albumin blood test | $42 | $114 | $5 |
| Aldosterone test | $324 | $773 | $41 |
| Alkaline phosphatase test | $38 | $52 | $5 |
| Allergy shots | $36 | $53 | $11 |
| Alpha-fetoprotein (AFP) test | $318 | $381 | $17 |
| ALT liver enzyme test | $55 | $114 | $5 |
| Ammonia blood test | $116 | $111 | $15 |
| Amylase test | $55 | $567 | $6 |
| Annual physical (established patient) | $132 | $179 | — |
| Annual physical (new patient) | $137 | $234 | — |
| Anoscopy | $809 | $280 | $129 |
| Antinuclear antibody (ANA) test | $87 | $246 | $12 |
| Arterial blood gas (ABG) | $103 | $224 | $26 |
| AST liver enzyme test | $55 | $114 | $5 |
| Barium swallow study | $203 | $452 | $107 |
| Bartholin cyst removal | $353 | $584 | $182 |
| Basic metabolic panel | $75 | $124 | $8 |
| Benign skin lesion removal | $743 | $865 | $171 |
| Bilirubin blood test | $70 | $65 | $5 |
| Blood clotting test (PT/INR) | $26 | $78 | $4 |
| Blood crossmatch | $267 | $469 | — |
| Blood glucose test | $48 | $65 | $5 |
| Blood transfusion | $651 | $1,010 | $47 |
| Blood type and screen | $50 | $222 | $10 |
| Blood type test | $34 | $103 | $3 |
| Blood type test (ABO group) | $34 | $103 | $3 |
| Blood type test (Rh/D antigen) | $34 | $103 | $3 |
| BNP (heart failure) test | $133 | $262 | $39 |
| Bone density scan (DEXA) | $511 | $1,095 | $39 |
| Bone scan (nuclear) | $1,077 | $2,120 | $259 |
| Breast biopsy | $1,626 | $3,337 | $478 |
| Breast MRI | $3,307 | $1,213 | $216 |
| Breast MRI without contrast | $3,307 | $1,190 | $216 |
| Breast ultrasound | $616 | $486 | $92 |
| Breast ultrasound (complete) | $669 | $486 | $100 |
| Breast ultrasound (limited) | $616 | $477 | $84 |
| Breathing tube insertion (intubation) | $460 | $931 | $133 |
| Burn dressing and debridement (medium) | $373 | $748 | $166 |
| Burn dressing and debridement (small) | $257 | $630 | $93 |
| Burn treatment | $373 | $689 | $129 |
| C-reactive protein (CRP) | $75 | $102 | $5 |
| CA 19-9 tumor marker test | $100 | $426 | $21 |
| CA-125 ovarian marker test | $151 | $461 | $21 |
| Calcium blood test | $51 | $114 | $5 |
| Cardiac stress test | $260 | $648 | $39 |
| Cardioversion | $937 | $2,349 | $155 |
| Carotid artery ultrasound | $390 | $796 | $156 |
| CEA tumor marker test | $148 | $405 | $19 |
| Central line placement | $376 | $4,701 | $238 |
| Cervical LEEP procedure | $3,002 | $6,226 | $325 |
| Chemotherapy infusion | $209 | $599 | $81 |
| Chemotherapy infusion (each additional) | $163 | $192 | $28 |
| Chemotherapy infusion (first hour) | $256 | $975 | $133 |
| Chest fluid drain (thoracentesis) | $541 | $1,704 | $311 |
| Chest tube insertion | $1,631 | $2,242 | $143 |
| Chest X-ray | $259 | $346 | $37 |
| Chest X-ray (1 view) | $204 | $282 | $25 |
| Chest X-ray (2 views) | $296 | $328 | $33 |
| Circumcision | $192 | $2,513 | $167 |
| CK-MB heart enzyme test | $60 | $168 | $12 |
| Clotting time test (PTT) | $59 | $98 | $6 |
| Colonoscopy | $858 | $1,072 | $480 |
| Colposcopy | $177 | $721 | $161 |
| Complete blood count (CBC) | $45 | $119 | $7 |
| Complete blood count (CBC) (complete) | $52 | $134 | $8 |
| Comprehensive eye exam | $129 | $262 | $138 |
| Comprehensive metabolic panel | $124 | $293 | $11 |
| Contraceptive implant (Nexplanon) | $210 | $593 | $115 |
| Copper blood test | $129 | $209 | $12 |
| Cortisol test | $134 | $281 | $16 |
| CPAP titration study | $173 | $272 | $69 |
| Creatine kinase (CK) test | $43 | $114 | $7 |
| CT angiography of the chest | $1,989 | $4,899 | $281 |
| CT angiography of the head | $1,766 | $4,502 | $274 |
| CT scan of the abdomen | $1,592 | $3,548 | $230 |
| CT scan of the abdomen and pelvis | $3,013 | $3,548 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $3,765 | $4,190 | $338 |
| CT scan of the abdomen and pelvis with contrast | $3,013 | $3,548 | $300 |
| CT scan of the abdomen and pelvis without contrast | $2,546 | $3,100 | $183 |
| CT scan of the abdomen with and without contrast | $2,105 | $4,190 | $259 |
| CT scan of the abdomen with contrast | $1,592 | $3,548 | $230 |
| CT scan of the abdomen without contrast | $1,284 | $3,100 | $136 |
| CT scan of the arm | $1,181 | $3,248 | $199 |
| CT scan of the arm with contrast | $1,489 | $3,248 | $199 |
| CT scan of the arm without contrast | $1,181 | $2,923 | $161 |
| CT scan of the chest | $1,695 | $3,525 | $167 |
| CT scan of the chest with and without contrast | $2,207 | $1,694 | $196 |
| CT scan of the chest with contrast | $1,695 | $3,866 | $167 |
| CT scan of the chest without contrast | $1,386 | $3,525 | $133 |
| CT scan of the head | $1,386 | $3,320 | $148 |
| CT scan of the head with and without contrast | $1,900 | $4,432 | $173 |
| CT scan of the head with contrast | $1,386 | $1,317 | $148 |
| CT scan of the head without contrast | $1,079 | $3,320 | $107 |
| CT scan of the leg | $1,335 | $2,161 | $166 |
| CT scan of the leg with contrast | $1,489 | $3,004 | $166 |
| CT scan of the leg without contrast | $1,772 | $1,317 | $130 |
| CT scan of the lower back (lumbar spine) | $1,537 | $2,689 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $1,537 | $4,605 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,695 | $2,689 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,386 | $1,004 | $130 |
| CT scan of the neck | $1,386 | $3,870 | $183 |
| CT scan of the neck (cervical spine) | $1,695 | $3,502 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $2,207 | $4,768 | $196 |
| CT scan of the neck (cervical spine) with contrast | $1,695 | $2,936 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,386 | $3,502 | $131 |
| CT scan of the neck with and without contrast | $1,900 | $4,548 | $220 |
| CT scan of the neck with contrast | $1,386 | $3,870 | $183 |
| CT scan of the neck without contrast | $1,079 | $1,004 | $150 |
| CT scan of the pelvis | $1,418 | $1,317 | $226 |
| CT scan of the pelvis with and without contrast | $1,418 | $4,074 | $251 |
| CT scan of the pelvis with contrast | $1,695 | $1,317 | $226 |
| CT scan of the pelvis without contrast | $1,386 | $1,004 | $133 |
| CT scan of the sinuses | $1,386 | $1,694 | $152 |
| CT scan of the sinuses with and without contrast | $1,615 | $1,694 | $184 |
| CT scan of the sinuses with contrast | $1,386 | $1,317 | $152 |
| CT scan of the sinuses without contrast | $1,079 | $3,502 | $128 |
| D-dimer test | $218 | $246 | $10 |
| Developmental screening (child) | $123 | $16 | — |
| DHEA-sulfate test | $248 | $480 | $22 |
| Diagnostic mammogram | $421 | $676 | $140 |
| Drug screen (urine) | $53 | $541 | $17 |
| Ear tubes (myringotomy) | $967 | $1,021 | $174 |
| Echocardiogram | $361 | $1,488 | $138 |
| Echocardiogram with and without contrast | $361 | $617 | $101 |
| EEG (awake and asleep) | $564 | $1,439 | $482 |
| EKG / ECG (tracing only) | $217 | $159 | $7 |
| Electrocardiogram (EKG) | $53 | $255 | $8 |
| Electroencephalogram (EEG) | $603 | $961 | $448 |
| Electrolyte panel | $71 | $54 | $7 |
| Emergency department visit | $324 | $895 | $69 |
| Emergency department visit (level 1) | $183 | $344 | $11 |
| Emergency department visit (level 2) | $209 | $567 | $40 |
| Emergency department visit (level 3) | $291 | $895 | $69 |
| Emergency department visit (level 4) | $667 | $1,439 | $118 |
| Emergency department visit (level 5) | $666 | $2,135 | $171 |
| Endometrial biopsy | $136 | $425 | $98 |
| Epidural steroid injection | $2,016 | $1,591 | $275 |
| Estradiol (estrogen) test | $152 | $464 | $28 |
| Facet joint injection (spine) | $209 | $589 | $99 |
| Fallopian tube X-ray (HSG) | $323 | $812 | $164 |
| Family therapy session | $267 | $329 | $110 |
| Fecal occult blood (stool) test | $40 | $60 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $29 | $60 | $4 |
| Ferritin (iron) test | $123 | $259 | $14 |
| Fibrinogen test | $83 | $115 | $10 |
| Flexible sigmoidoscopy | $397 | $710 | $323 |
| Flu test | $41 | $139 | $17 |
| Folate (folic acid) test | $96 | $302 | $15 |
| Foreign body removal (skin) | $242 | $607 | $157 |
| Free T4 thyroid test | $136 | $288 | $9 |
| FSH hormone test | $152 | $309 | $19 |
| Gallbladder removal (laparoscopic) | $8,734 | $1,160 | $658 |
| Gallbladder scan (HIDA) | $951 | $1,910 | $334 |
| GGT liver test | $71 | $212 | $7 |
| Glucose tolerance test | $51 | $149 | $8 |
| Hematocrit test | $38 | $37 | $2 |
| Hemodialysis | $144 | $1,770 | $75 |
| Hemoglobin A1c (diabetes test) | $110 | $194 | $10 |
| Hepatitis B test | $33 | $171 | $10 |
| Hepatitis B vaccine | $104 | $143 | — |
| Hepatitis C test | $45 | $256 | $14 |
| HIV test | $159 | $130 | $19 |
| HIV test (antigen/antibody combo) | $77 | $130 | $24 |
| Holter heart monitor | $69 | $307 | $26 |
| Hysterectomy | $939 | $3,609 | $933 |
| Hysteroscopy | $1,438 | $6,226 | $1,270 |
| Inguinal hernia repair | $6,715 | $3,634 | $538 |
| Iron blood test | $62 | $201 | $6 |
| IUD insertion | $125 | $439 | — |
| IUD removal | $137 | $439 | $112 |
| IV infusion therapy | $181 | $351 | $44 |
| IV infusion therapy (each additional) | $181 | $123 | $21 |
| Kidney biopsy | $943 | $1,318 | $492 |
| Kidney scan (nuclear) | $678 | $1,721 | $172 |
| Kidney stone shock-wave (lithotripsy) | $5,660 | $6,940 | $760 |
| Kidney ultrasound | $749 | $958 | $84 |
| Kidney ultrasound (limited) | $637 | $774 | $61 |
| Lactate test | $123 | $113 | $12 |
| Laryngoscopy | $244 | $621 | $189 |
| LDH test | $38 | $114 | $6 |
| LDL cholesterol test | $106 | $155 | $11 |
| Leg vein ultrasound (Doppler) | $322 | $696 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $319 | $535 | $116 |
| LH hormone test | $180 | $309 | $19 |
| Lipase test | $71 | $139 | $7 |
| Lipid (cholesterol) panel | $116 | $259 | $13 |
| Liver biopsy | $943 | $3,510 | $288 |
| Liver function panel | $105 | $135 | $8 |
| Lung function test (PFT) | $50 | $315 | $37 |
| Lung scan (V/Q) | $934 | $1,750 | $291 |
| Magnesium blood test | $67 | $146 | $7 |
| MMR vaccine | $177 | $134 | — |
| MRA of the brain | $2,435 | $5,131 | $226 |
| MRA of the brain with contrast | $2,185 | $5,131 | $226 |
| MRA of the brain without contrast | $3,131 | $2,689 | $328 |
| MRA of the neck | $2,721 | $5,131 | $245 |
| MRA of the neck with contrast | $2,721 | $5,131 | $245 |
| MRA of the neck without contrast | $3,131 | $5,131 | $343 |
| MRI of the abdomen | $2,773 | $4,751 | $300 |
| MRI of the abdomen with contrast | $2,773 | $2,689 | $300 |
| MRI of the abdomen without contrast | $2,428 | $4,751 | $194 |
| MRI of the ankle | $2,773 | $3,808 | $261 |
| MRI of the ankle with contrast | $2,773 | $2,689 | $261 |
| MRI of the ankle without contrast | $2,428 | $3,808 | $222 |
| MRI of the brain | $2,782 | $6,108 | $269 |
| MRI of the brain with contrast | $2,782 | $2,689 | $269 |
| MRI of the brain without contrast | $2,435 | $6,108 | $195 |
| MRI of the chest | $1,516 | $7,145 | $371 |
| MRI of the chest without contrast | $1,964 | $8,578 | $466 |
| MRI of the knee | $2,708 | $4,970 | $315 |
| MRI of the knee with contrast | $2,294 | $4,270 | $315 |
| MRI of the knee without contrast | $3,123 | $5,131 | $204 |
| MRI of the lower back (lumbar spine) | $2,773 | $2,689 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $2,773 | $2,689 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $2,428 | $6,078 | $192 |
| MRI of the mid-back (thoracic spine) | $2,428 | $2,689 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $3,122 | $7,936 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $2,294 | $2,689 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $2,428 | $1,706 | $190 |
| MRI of the neck (cervical spine) | $2,428 | $5,867 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $3,715 | $7,440 | $318 |
| MRI of the neck (cervical spine) with contrast | $2,294 | $2,689 | $274 |
| MRI of the neck (cervical spine) without contrast | $2,428 | $5,867 | $191 |
| MRI of the pelvis | $2,428 | $5,749 | $268 |
| MRI of the pelvis with contrast | $2,388 | $5,749 | $268 |
| MRI of the pelvis without contrast | $2,428 | $1,706 | $227 |
| MRI of the shoulder | $3,993 | $4,751 | $313 |
| MRI of the shoulder without contrast | $4,855 | $4,751 | $205 |
| MRI of the wrist | $2,574 | $3,817 | $330 |
| MRI of the wrist without contrast | $2,428 | $1,706 | $303 |
| Nebulizer breathing treatment | $406 | $249 | $9 |
| Nuchal translucency ultrasound | $201 | $418 | $116 |
| Nuclear cardiac stress test | $1,738 | $2,928 | $428 |
| Occupational therapy evaluation | $189 | $224 | $101 |
| Occupational therapy evaluation (high complexity) | $214 | $224 | $101 |
| Occupational therapy evaluation (low complexity) | $109 | $162 | $101 |
| Occupational therapy evaluation (moderate complexity) | $189 | $224 | $101 |
| Office visit (new patient) | $211 | $282 | $177 |
| Office visit, new patient (level 3) | $188 | $282 | $118 |
| Office visit, new patient (level 4) | $99 | $189 | $177 |
| Office visit, new patient (level 5) | $344 | $282 | $237 |
| Pap smear (cervical screening) | $97 | $219 | $20 |
| Parathyroid hormone (PTH) test | $80 | $125 | $41 |
| Pelvic ultrasound | $449 | $742 | $78 |
| Pelvic ultrasound (complete) | $573 | $987 | $105 |
| Pelvic ultrasound (limited) | $324 | $488 | $51 |
| PET scan | $4,168 | $7,627 | — |
| Phosphorus blood test | $32 | $114 | $5 |
| Physical therapy evaluation | $135 | $230 | $98 |
| Physical therapy evaluation (high complexity) | $159 | $230 | $98 |
| Physical therapy evaluation (moderate complexity) | $135 | $230 | $98 |
| Pilonidal cyst removal | $4,734 | $6,192 | $541 |
| Platelet count | $43 | $49 | $4 |
| Pneumonia vaccine | $183 | $179 | — |
| Pregnancy blood test (hCG) | $68 | $160 | $8 |
| Pregnancy ultrasound | $281 | $496 | $126 |
| Pregnancy ultrasound (first trimester) | $297 | $496 | $117 |
| Pregnancy ultrasound (second or third trimester) | $264 | $645 | $136 |
| Procalcitonin test | $395 | $309 | $27 |
| Prolactin test | $184 | $380 | $19 |
| Prostate biopsy | $3,935 | $397 | — |
| Prostate test (PSA) | $59 | $383 | $18 |
| Psychiatric evaluation | $231 | $329 | $188 |
| Psychotherapy session | $188 | $329 | $140 |
| Radiofrequency nerve ablation | $3,864 | $6,377 | $462 |
| Rheumatoid factor test | $38 | $124 | $6 |
| RSV vaccine | $391 | $594 | — |
| Sacroiliac joint injection | $518 | $1,499 | $176 |
| Scoliosis spine X-ray | $291 | $826 | $58 |
| Scoliosis spine X-ray (1 view) | $233 | $822 | $44 |
| Scoliosis spine X-ray (3 views) | $349 | $847 | $72 |
| Screening mammogram | $355 | $418 | $126 |
| Scrotal ultrasound | $510 | $901 | $99 |
| Sedimentation rate (ESR) test | $32 | $78 | $3 |
| Semen analysis | $63 | $250 | $12 |
| Sex hormone binding globulin test | $149 | $343 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $85 | $262 | $114 |
| Simple wound stitches | $157 | $344 | $127 |
| Skin biopsy | $1,012 | $413 | $121 |
| Skin biopsy (punch) | $497 | $466 | $121 |
| Skin cancer lesion removal | $1,255 | $865 | $240 |
| Skin tag removal | $271 | $431 | $92 |
| Sleep study (polysomnography) | $1,982 | $5,710 | $691 |
| Soft tissue ultrasound | $483 | $1,218 | $64 |
| Speech therapy | $95 | $312 | $76 |
| Spinal tap (lumbar puncture) | $1,336 | $1,766 | $165 |
| Spirometry with bronchodilator | $237 | $574 | $43 |
| Strep throat test | $39 | $78 | $17 |
| Stress echocardiogram | $1,401 | $1,138 | $209 |
| Stress echocardiogram (complete) | $1,401 | $1,138 | $233 |
| Swallow study | $336 | $731 | $85 |
| T3 thyroid test | $139 | $389 | $14 |
| Tdap (tetanus) vaccine | $57 | $98 | — |
| Testosterone test | $84 | $494 | $26 |
| Thyroid test (TSH) | $114 | $398 | $17 |
| Thyroid ultrasound | $471 | $1,008 | $109 |
| Thyroid uptake scan | $652 | $965 | $145 |
| Total IgE allergy test | $120 | $322 | $16 |
| Total protein test | $29 | $114 | $4 |
| Transesophageal echocardiogram (TEE) | $1,710 | $1,810 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $1,710 | $1,810 | $239 |
| Transvaginal ultrasound | $637 | $1,161 | $118 |
| Triglycerides test | $55 | $230 | $6 |
| Troponin (heart) test | $156 | $514 | $12 |
| Upper GI endoscopy (EGD) | $960 | $826 | $371 |
| Upper GI series (barium) | $573 | $733 | $128 |
| Ureteral stent placement | $5,666 | $1,623 | $373 |
| Uric acid (gout) test | $42 | $65 | $5 |
| Urinalysis | $26 | $64 | $3 |
| Urine microalbumin test | $63 | $169 | $5 |
| Urine pregnancy test | $23 | $68 | $9 |
| Varicose vein ablation | $4,238 | $1,539 | $1,018 |
| Vitamin B12 test | $123 | $298 | $15 |
| Vitamin D test | $123 | $68 | $30 |
| Wart removal | $165 | $413 | $121 |
| Well-child visit | $107 | $160 | — |
| Wound debridement | $1,012 | $1,138 | $186 |
| X-ray of the abdomen | $199 | $328 | $36 |
| X-ray of the ankle | $283 | $328 | $37 |
| X-ray of the collarbone | $173 | $230 | $33 |
| X-ray of the elbow | $189 | $316 | $33 |
| X-ray of the facial bones | $240 | $438 | $39 |
| X-ray of the forearm | $200 | $272 | $29 |
| X-ray of the hand | $283 | $297 | $38 |
| X-ray of the hip | $232 | $350 | $49 |
| X-ray of the hip (1 view) | $173 | $334 | $34 |
| X-ray of the hip (3 views) | $307 | $350 | $49 |
| X-ray of the hip (4 views) | $232 | $369 | $63 |
| X-ray of the knee | $378 | $318 | $42 |
| X-ray of the knee (2 views) | $415 | $312 | $34 |
| X-ray of the knee (4+ views) | $225 | $324 | $49 |
| X-ray of the lower back (lumbar spine) | $299 | $530 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $232 | $413 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $366 | $659 | $53 |
| X-ray of the lower leg | $247 | $338 | $31 |
| X-ray of the mid-back (thoracic spine) | $259 | $356 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $248 | $190 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $271 | $522 | $39 |
| X-ray of the neck (cervical spine) | $315 | $364 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $271 | $427 | $40 |
| X-ray of the pelvis | $258 | $349 | $36 |
| X-ray of the pelvis (1 view) | $253 | $323 | $28 |
| X-ray of the ribs | $262 | $383 | $42 |
| X-ray of the ribs (2 views) | $262 | $328 | $36 |
| X-ray of the ribs (3 views) | $256 | $391 | $42 |
| X-ray of the shoulder | $323 | $310 | $36 |
| X-ray of the skull | $283 | $444 | $40 |
| X-ray of the upper arm | $214 | $276 | $32 |
| X-ray of the wrist | $186 | $297 | $43 |
| Zinc blood test | $72 | $211 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
