| Procedure | St Andrew's Hospital | Presentation Medical Center | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $148 | $134 | $51 |
| Abdominal ultrasound | $438 | $428 | $100 |
| Abdominal ultrasound (complete) | $499 | $484 | $114 |
| Abdominal ultrasound (limited) | $377 | $371 | $86 |
| Abscess drainage (complex or multiple) | $687 | $614 | $220 |
| Abscess drainage (simple) | $379 | $319 | $129 |
| Abscess incision and drainage | $517 | $552 | $174 |
| Albumin blood test | $39 | $41 | $5 |
| Aldosterone test | $316 | $74 | $41 |
| Alkaline phosphatase test | $41 | $41 | $5 |
| Allergy shots | $31 | $41 | $11 |
| Alpha-fetoprotein (AFP) test | $130 | $131 | $17 |
| ALT liver enzyme test | $41 | $43 | $5 |
| Ammonia blood test | $113 | $31 | $15 |
| Amylase test | $50 | $65 | $6 |
| Annual physical (established patient) | $372 | $327 | — |
| Annual physical (new patient) | $432 | $378 | — |
| Antinuclear antibody (ANA) test | $95 | $61 | $12 |
| AST liver enzyme test | $41 | $41 | $5 |
| Basic metabolic panel | $65 | $65 | $8 |
| Benign skin lesion removal | $535 | $449 | $171 |
| Bilirubin blood test | $39 | $39 | $5 |
| Blood clotting test (PT/INR) | $32 | $69 | $4 |
| Blood glucose test | $35 | $33 | $5 |
| Blood transfusion | $944 | $927 | $47 |
| Blood type and screen | $154 | $101 | $10 |
| Blood type test | $23 | $22 | $3 |
| Blood type test (ABO group) | $46 | $22 | $3 |
| Blood type test (Rh/D antigen) | $23 | $42 | $3 |
| BNP (heart failure) test | $271 | $257 | $39 |
| Bone density scan (DEXA) | $431 | $108 | $39 |
| Bone scan (nuclear) | $1,495 | $1,393 | $259 |
| Breast ultrasound | $431 | $392 | $92 |
| Breast ultrasound (complete) | $431 | $392 | $100 |
| Breast ultrasound (limited) | $329 | $327 | $84 |
| Breathing tube insertion (intubation) | $431 | $411 | $133 |
| Burn dressing and debridement (medium) | $378 | $353 | $166 |
| Burn dressing and debridement (small) | $321 | $260 | $93 |
| Burn treatment | $378 | $343 | $129 |
| C-reactive protein (CRP) | $41 | $42 | $5 |
| CA 19-9 tumor marker test | $162 | $50 | $21 |
| CA-125 ovarian marker test | $162 | $48 | $21 |
| Calcium blood test | $45 | $41 | $5 |
| Cardiac rehabilitation | $136 | $209 | $26 |
| Carotid artery ultrasound | $742 | $684 | $156 |
| CEA tumor marker test | $147 | $27 | $19 |
| Chest tube insertion | $2,858 | $1,608 | $143 |
| Chest X-ray | $148 | $213 | $37 |
| Chest X-ray (1 view) | $95 | $185 | $25 |
| Chest X-ray (2 views) | $131 | $241 | $33 |
| CK-MB heart enzyme test | $91 | $89 | $12 |
| Clotting time test (PTT) | $45 | $48 | $6 |
| Colonoscopy | $2,337 | $2,785 | $480 |
| Complete blood count (CBC) | $56 | $61 | $7 |
| Complete blood count (CBC) (complete) | $61 | $61 | $8 |
| Complex wound repair | $1,092 | $1,049 | $390 |
| Comprehensive metabolic panel | $82 | $96 | $11 |
| Copper blood test | $97 | $43 | $12 |
| Cortisol test | $126 | $26 | $16 |
| Creatine kinase (CK) test | $50 | $70 | $7 |
| CT angiography of the chest | $2,298 | $2,195 | $281 |
| CT scan of the abdomen | $2,057 | $1,509 | $230 |
| CT scan of the abdomen and pelvis | $2,616 | $2,481 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $2,957 | $3,157 | $338 |
| CT scan of the abdomen and pelvis with contrast | $2,616 | $2,481 | $300 |
| CT scan of the abdomen and pelvis without contrast | $1,205 | $1,715 | $183 |
| CT scan of the abdomen with and without contrast | $2,330 | $2,210 | $259 |
| CT scan of the abdomen with contrast | $2,057 | $1,509 | $230 |
| CT scan of the abdomen without contrast | $963 | $1,246 | $136 |
| CT scan of the arm | $1,771 | $1,577 | $199 |
| CT scan of the arm with contrast | $1,771 | $1,577 | $199 |
| CT scan of the arm without contrast | $1,387 | $1,316 | $161 |
| CT scan of the chest | $1,685 | $1,557 | $167 |
| CT scan of the chest with and without contrast | $2,076 | $2,060 | $196 |
| CT scan of the chest with contrast | $1,685 | $1,557 | $167 |
| CT scan of the chest without contrast | $1,305 | $1,302 | $133 |
| CT scan of the head | $1,130 | $1,244 | $148 |
| CT scan of the head with and without contrast | $1,361 | $1,557 | $173 |
| CT scan of the head with contrast | $1,130 | $1,244 | $148 |
| CT scan of the head without contrast | $779 | $1,185 | $107 |
| CT scan of the leg | $1,737 | $1,418 | $166 |
| CT scan of the leg with contrast | $1,737 | $1,418 | $166 |
| CT scan of the leg without contrast | $1,342 | $1,247 | $130 |
| CT scan of the lower back (lumbar spine) | $1,534 | $1,467 | $169 |
| CT scan of the lower back (lumbar spine) with contrast | $1,725 | $1,557 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,342 | $1,377 | $130 |
| CT scan of the neck | $1,674 | $1,568 | $183 |
| CT scan of the neck (cervical spine) | $1,538 | $1,467 | $168 |
| CT scan of the neck (cervical spine) with contrast | $1,722 | $1,557 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,353 | $1,377 | $131 |
| CT scan of the neck with and without contrast | $2,067 | $1,733 | $220 |
| CT scan of the neck with contrast | $1,674 | $1,402 | $183 |
| CT scan of the neck without contrast | $1,297 | $1,237 | $150 |
| CT scan of the pelvis | $2,064 | $1,509 | $226 |
| CT scan of the pelvis with and without contrast | $2,338 | $1,869 | $251 |
| CT scan of the pelvis with contrast | $2,064 | $1,509 | $226 |
| CT scan of the pelvis without contrast | $974 | $1,377 | $133 |
| CT scan of the sinuses | $1,183 | $1,253 | $152 |
| CT scan of the sinuses with and without contrast | $1,504 | $1,645 | $184 |
| CT scan of the sinuses with contrast | $1,183 | $1,253 | $152 |
| CT scan of the sinuses without contrast | $1,036 | $1,185 | $128 |
| D-dimer test | $97 | $73 | $10 |
| DHEA-sulfate test | $172 | $48 | $22 |
| Diagnostic mammogram | $543 | $517 | $140 |
| Drug screen (urine) | $86 | $384 | $17 |
| Echocardiogram | $752 | $627 | $138 |
| EKG / ECG (tracing only) | $97 | $144 | $7 |
| Electrocardiogram (EKG) | $97 | $144 | $8 |
| Electrolyte panel | $56 | $58 | $7 |
| Emergency department visit | $344 | $333 | $69 |
| Emergency department visit (level 1) | $130 | $204 | $11 |
| Emergency department visit (level 2) | $223 | $289 | $40 |
| Emergency department visit (level 3) | $388 | $526 | $69 |
| Emergency department visit (level 4) | $626 | $825 | $118 |
| Emergency department visit (level 5) | $913 | $1,288 | $171 |
| Estradiol (estrogen) test | $215 | $96 | $28 |
| Ferritin (iron) test | $117 | $22 | $14 |
| Fibrinogen test | $79 | $65 | $10 |
| Flu test | $113 | $108 | $17 |
| Folate (folic acid) test | $113 | $96 | $15 |
| Foreign body removal (skin) | $597 | $407 | $157 |
| Free T4 thyroid test | $64 | $73 | $9 |
| FSH hormone test | $144 | $66 | $19 |
| Gallbladder scan (HIDA) | $2,205 | $1,861 | $334 |
| GGT liver test | $57 | $19 | $7 |
| Glucose tolerance test | $32 | $32 | $8 |
| HDL cholesterol test | $59 | $64 | $8 |
| Hematocrit test | $19 | $20 | $2 |
| Hemoglobin A1c (diabetes test) | $76 | $78 | $10 |
| Hepatitis B test | $76 | $88 | $10 |
| Hepatitis C test | $111 | $112 | $14 |
| HIV test | $173 | $90 | $19 |
| HIV test (antigen/antibody combo) | $173 | $84 | $24 |
| Holter heart monitor | $118 | $289 | $26 |
| Iron blood test | $50 | $11 | $6 |
| IV infusion therapy | $517 | $307 | $44 |
| IV infusion therapy (each additional) | $102 | $120 | $21 |
| IV infusion therapy (initial) | $517 | $500 | $67 |
| Joint aspiration (small/intermediate) | $367 | $517 | $57 |
| Joint aspiration or injection (mid-size joint) | $367 | $517 | $57 |
| Joint aspiration or injection (small joint) | $363 | $324 | $56 |
| Kidney ultrasound | $321 | $443 | $84 |
| Kidney ultrasound (limited) | $176 | $412 | $61 |
| Knee joint injection | $481 | $161 | $69 |
| Lactate test | $82 | $77 | $12 |
| LDH test | $44 | $48 | $6 |
| Leg vein ultrasound (Doppler) | $464 | $520 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $464 | $520 | $116 |
| LH hormone test | $144 | $145 | $19 |
| Lipase test | $55 | $56 | $7 |
| Lipid (cholesterol) panel | $127 | $110 | $13 |
| Liver function panel | $63 | $64 | $8 |
| Lung function test (PFT) | $107 | $136 | $37 |
| Magnesium blood test | $59 | $64 | $7 |
| MRA of the brain | $3,351 | $2,809 | $226 |
| MRA of the neck | $3,563 | $2,985 | $245 |
| MRA of the neck with contrast | $3,563 | $2,985 | $245 |
| MRI of the abdomen | $3,709 | $2,808 | $300 |
| MRI of the abdomen without contrast | $2,620 | $2,195 | $194 |
| MRI of the ankle | $3,265 | $2,971 | $261 |
| MRI of the ankle without contrast | $2,997 | $2,510 | $222 |
| MRI of the brain | $2,341 | $2,451 | $269 |
| MRI of the brain with contrast | $2,341 | $2,451 | $269 |
| MRI of the brain without contrast | $1,586 | $2,229 | $195 |
| MRI of the chest | $3,785 | $3,405 | $371 |
| MRI of the chest without contrast | $4,724 | $3,914 | $466 |
| MRI of the knee | $3,043 | $2,147 | $315 |
| MRI of the knee without contrast | $1,715 | $2,147 | $204 |
| MRI of the lower back (lumbar spine) | $2,356 | $2,563 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $2,356 | $2,563 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,523 | $2,074 | $192 |
| MRI of the mid-back (thoracic spine) | $2,380 | $2,074 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $2,699 | $3,031 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $2,380 | $1,975 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $1,526 | $2,074 | $190 |
| MRI of the neck (cervical spine) | $2,399 | $2,462 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $2,691 | $3,246 | $318 |
| MRI of the neck (cervical spine) with contrast | $2,399 | $2,462 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,523 | $1,953 | $191 |
| MRI of the pelvis | $3,265 | $2,552 | $268 |
| MRI of the pelvis with contrast | $3,265 | $2,210 | $268 |
| MRI of the pelvis without contrast | $3,047 | $2,552 | $227 |
| MRI of the shoulder | $3,018 | $2,765 | $313 |
| MRI of the shoulder without contrast | $1,715 | $2,094 | $205 |
| MRI of the wrist | $3,262 | $3,047 | $330 |
| MRI of the wrist with contrast | $3,262 | $3,047 | $330 |
| MRI of the wrist without contrast | $3,025 | $2,859 | $303 |
| Nuclear cardiac stress test | $2,481 | $3,512 | $428 |
| Occupational therapy evaluation | $421 | $419 | $101 |
| Occupational therapy evaluation (high complexity) | $455 | $383 | $101 |
| Occupational therapy evaluation (low complexity) | $419 | $419 | $101 |
| Occupational therapy evaluation (moderate complexity) | $421 | $419 | $101 |
| Office visit (established patient) | $283 | $242 | $115 |
| Office visit (new patient) | $496 | $435 | $177 |
| Office visit, established patient (level 3) | $234 | $196 | $95 |
| Office visit, established patient (level 4) | $332 | $288 | $136 |
| Office visit, new patient (level 3) | $326 | $286 | $118 |
| Office visit, new patient (level 4) | $496 | $435 | $177 |
| Office visit, new patient (level 5) | $623 | $547 | $237 |
| Pap smear (cervical screening) | $157 | $169 | $20 |
| Parathyroid hormone (PTH) test | $319 | $62 | $41 |
| Pelvic ultrasound | $299 | $316 | $78 |
| Pelvic ultrasound (complete) | $458 | $433 | $105 |
| Pelvic ultrasound (limited) | $139 | $199 | $51 |
| Phosphorus blood test | $37 | $38 | $5 |
| Physical therapy evaluation | $455 | $432 | $98 |
| Physical therapy evaluation (high complexity) | $455 | $420 | $98 |
| Physical therapy evaluation (moderate complexity) | $455 | $432 | $98 |
| Platelet count | $36 | $36 | $4 |
| Pneumonia vaccine | $194 | $407 | — |
| Pregnancy blood test (hCG) | $59 | $59 | $8 |
| Pregnancy ultrasound | $500 | $423 | $126 |
| Pregnancy ultrasound (first trimester) | $442 | $423 | $117 |
| Procalcitonin test | $187 | $229 | $27 |
| Prolactin test | $150 | $69 | $19 |
| Prostate test (PSA) | $143 | $142 | $18 |
| Pulmonary rehabilitation | $140 | $128 | $87 |
| Screening mammogram | $573 | $524 | $126 |
| Scrotal ultrasound | $419 | $441 | $99 |
| Sedimentation rate (ESR) test | $29 | $30 | $3 |
| Sex hormone binding globulin test | $169 | $63 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $334 | $297 | $114 |
| Simple wound stitches | $365 | $323 | $127 |
| Skin biopsy | $361 | $335 | $121 |
| Skin biopsy (punch) | $401 | $335 | $121 |
| Skin cancer lesion removal | $868 | $711 | $240 |
| Skin lesion freezing (cryotherapy) | $112 | $141 | $36 |
| Skin tag removal | $327 | $236 | $92 |
| Soft tissue ultrasound | $187 | $178 | $64 |
| Speech therapy | $362 | $332 | $76 |
| Spirometry (lung function test) | $107 | $114 | $30 |
| Strep throat test | $113 | $106 | $17 |
| Swallow study | $398 | $422 | $85 |
| T3 thyroid test | $110 | $110 | $14 |
| Testosterone test | $201 | $90 | $26 |
| Thyroid test (TSH) | $131 | $131 | $17 |
| Thyroid ultrasound | $536 | $491 | $109 |
| Total IgE allergy test | $36 | $129 | $16 |
| Total protein test | $29 | $31 | $4 |
| Transvaginal ultrasound | $533 | $488 | $118 |
| Trigger point injection | $558 | $148 | $56 |
| Trigger point injection (1-2 muscles) | $566 | $148 | $52 |
| Triglycerides test | $44 | $47 | $6 |
| Troponin (heart) test | $86 | $133 | $12 |
| Upper GI endoscopy (EGD) | $1,825 | $2,489 | $371 |
| Uric acid (gout) test | $36 | $38 | $5 |
| Urinalysis | $20 | $62 | $3 |
| Urine microalbumin test | $43 | $38 | $5 |
| Urine pregnancy test | $59 | $57 | $9 |
| Vaccine administration | $62 | $70 | $19 |
| Vaccine administration (each additional) | $45 | $29 | $16 |
| Vitamin B12 test | $116 | $99 | $15 |
| Vitamin D test | $224 | $221 | $30 |
| Wart removal | $381 | $345 | $121 |
| Well-child visit | $323 | $282 | — |
| X-ray of the abdomen | $132 | $223 | $36 |
| X-ray of the ankle | $158 | $208 | $37 |
| X-ray of the collarbone | $136 | $204 | $33 |
| X-ray of the elbow | $133 | $225 | $33 |
| X-ray of the facial bones | $194 | $273 | $39 |
| X-ray of the foot | $147 | $208 | $34 |
| X-ray of the forearm | $120 | $204 | $29 |
| X-ray of the hand | $157 | $208 | $38 |
| X-ray of the hip | $167 | $209 | $49 |
| X-ray of the hip (1 view) | $131 | $178 | $34 |
| X-ray of the hip (3 views) | $202 | $240 | $49 |
| X-ray of the knee | $176 | $225 | $42 |
| X-ray of the knee (2 views) | $147 | $204 | $34 |
| X-ray of the knee (3 views) | $176 | $225 | $42 |
| X-ray of the knee (4+ views) | $199 | $269 | $49 |
| X-ray of the lower back (lumbar spine) | $189 | $313 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $163 | $260 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $214 | $366 | $53 |
| X-ray of the lower leg | $133 | $204 | $31 |
| X-ray of the mid-back (thoracic spine) | $147 | $271 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $136 | $253 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $158 | $289 | $39 |
| X-ray of the neck (cervical spine) | $191 | $289 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $159 | $233 | $40 |
| X-ray of the pelvis | $153 | $232 | $36 |
| X-ray of the pelvis (1 view) | $139 | $204 | $28 |
| X-ray of the ribs | $165 | $352 | $42 |
| X-ray of the ribs (2 views) | $145 | $277 | $36 |
| X-ray of the ribs (3 views) | $165 | $374 | $42 |
| X-ray of the shoulder | $140 | $225 | $36 |
| X-ray of the skull | $163 | $312 | $40 |
| X-ray of the upper arm | $136 | $225 | $32 |
| X-ray of the wrist | $180 | $208 | $43 |
| Zinc blood test | $87 | $41 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
