Amery Hospital & Clinic — procedure prices

Published prices for 301 procedures at Amery Hospital & Clinic (Amery, WI), from its machine-readable file.

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ProcedureCashChargemasterInsurerMedicare
3D mammogram (tomosynthesis) $208 $398 $149 $51
Abdominal fluid drain (paracentesis) $277 $532 $208 $284
Abdominal ultrasound $462 $887 $321 $100
Abscess incision and drainage $125 $240 $204 $174
Achilles tendon repair $1,475 $2,828 $850 $624
ACL knee reconstruction $2,208 $4,235 $1,232 $889
Adenoid removal (adenoidectomy) $373 $715 $253 $204
Albumin blood test $21 $41 $17 $5
Aldosterone test $89 $170 $76 $41
Alkaline phosphatase test $15 $30 $19 $5
Allergy shots $26 $50 $26 $11
Alpha-fetoprotein (AFP) test $25 $48 $59 $17
ALT liver enzyme test $33 $64 $22 $5
Ammonia blood test $50 $96 $36 $15
Amylase test $34 $66 $27 $6
Anal fistula repair $581 $1,114 $469 $541
Ankle fracture repair $1,424 $2,731 $709 $608
Annual physical (established patient) $103 $198 $112 —
Annual physical (new patient) $119 $229 $135 —
Anoscopy $107 $205 $76 $129
Antinuclear antibody (ANA) test $63 $121 $50 $12
Arterial blood gas (ABG) $92 $176 $66 $26
AST liver enzyme test $33 $64 $24 $5
Barium swallow study $334 $640 $240 $107
Bartholin cyst removal $188 $360 $134 $182
Basic metabolic panel $56 $107 $47 $8
Bilirubin blood test $19 $36 $19 $5
Bladder scope (cystoscopy) $202 $387 $362 $216
Blood clotting test (PT/INR) $16 $31 $15 $4
Blood crossmatch $54 $103 $39 —
Blood glucose test $21 $41 $20 $5
Blood transfusion $239 $458 $328 $47
Blood type and screen $51 $98 $88 $10
Blood type test $27 $52 $19 $3
BNP (heart failure) test $94 $180 $67 $39
Bone density scan (DEXA) $479 $918 $341 $39
Bone scan (nuclear) $1,032 $1,979 $741 $259
Breast biopsy $940 $1,802 $675 $478
Breast ultrasound $364 $698 $259 $92
Breathing tube insertion (intubation) $248 $476 $177 $133
Bronchoscopy $717 $1,375 $148 $303
Bunion surgery (bunionectomy) $1,242 $2,382 $754 $883
Burn treatment $62 $120 $90 $129
C-reactive protein (CRP) $42 $81 $30 $5
CA 19-9 tumor marker test $50 $96 $36 $21
CA-125 ovarian marker test $34 $66 $25 $21
Calcium blood test $28 $54 $22 $5
Cardiac MRI $1,610 $3,087 $1,281 $322
Cardiac rehabilitation $228 $437 $164 $26
Cardiac stress test $300 $575 $217 $39
Cardioversion $183 $351 $137 $155
Carotid artery ultrasound $570 $1,094 $480 $156
Carpal tunnel release $972 $1,864 $574 $483
Cataract surgery $1,344 $2,579 $804 $547
CEA tumor marker test $23 $44 $52 $19
Celiac disease test $47 $91 $34 $12
Central line placement $2,060 $3,951 $884 $238
Cesarean section (C-section) $23,119 $44,339 $3,884 $7,552
Chalazion (eyelid cyst) removal $117 $224 $119 $131
Chemotherapy infusion $324 $621 $262 $81
Chest fluid drain (thoracentesis) $613 $1,175 $428 $311
Chest tube insertion $140 $268 $169 $143
Chest X-ray $142 $273 $115 $37
Chickenpox (varicella) vaccine $142 $273 $102 —
Circumcision $281 $540 $211 $167
Clotting time test (PTT) $39 $75 $27 $6
Colon resection (colectomy) $2,132 $4,089 $1,472 $1,238
Colonoscopy $1,951 $3,741 $1,380 $480
Colposcopy $64 $123 $136 $161
Complete blood count (CBC) $35 $67 $33 $7
Complex wound repair $625 $1,198 $447 $390
Comprehensive eye exam $97 $186 $99 $138
Comprehensive metabolic panel $106 $204 $61 $11
Continuous glucose monitor setup $82 $158 $64 $35
Contraceptive implant (Nexplanon) $83 $160 $122 $115
Copper blood test $27 $52 $19 $12
Cortisol test $45 $86 $51 $16
COVID-19 PCR test $73 $140 $66 $51
CPAP titration study $129 $247 $336 $69
Creatine kinase (CK) test $38 $72 $63 $7
CT angiography of the chest $1,524 $2,922 $1,084 $281
CT angiography of the head $1,541 $2,955 $1,096 $274
CT colonography (virtual colonoscopy) $1,690 $3,242 $1,203 $835
CT scan of the abdomen $1,343 $2,576 $965 $230
CT scan of the abdomen and pelvis $1,731 $3,320 $1,243 $300
CT scan of the arm $951 $1,824 $785 $199
CT scan of the chest $1,313 $2,519 $943 $167
CT scan of the head $1,160 $2,225 $833 $148
CT scan of the leg $1,065 $2,043 $765 $166
CT scan of the lower back (lumbar spine) $1,388 $2,663 $997 $169
CT scan of the neck $1,236 $2,370 $888 $183
CT scan of the neck (cervical spine) $1,388 $2,663 $1,019 $168
CT scan of the pelvis $1,236 $2,370 $888 $226
CT scan of the sinuses $1,217 $2,335 $874 $152
D-dimer test $108 $207 $77 $10
Developmental screening (child) $16 $30 $11 —
DHEA-sulfate test $28 $53 $20 $22
Diagnostic mammogram $242 $464 $174 $140
Drug screen (urine) $84 $161 $98 $17
Ear tubes (myringotomy) $191 $366 $330 $174
Echocardiogram $560 $1,075 $235 $138
Electrocardiogram (EKG) $26 $49 $24 $8
Electroencephalogram (EEG) $79 $152 $342 $448
Electrolyte panel $60 $115 $43 $7
Electromyography (EMG) $33 $64 $57 $141
Emergency department visit $286 $548 $251 $69
Endometrial biopsy $44 $85 $73 $98
Epidural steroid injection $399 $766 $287 $275
Estradiol (estrogen) test $119 $229 $83 $28
Eye refraction (glasses prescription) $16 $30 $27 —
Facet joint injection (spine) $731 $1,402 $986 $99
Fallopian tube X-ray (HSG) $331 $635 $278 $164
Family therapy session $166 $318 $123 $110
Feeding tube (PEG) placement $440 $843 $252 $178
Femoral hernia repair $1,288 $2,470 $737 $584
Ferritin (iron) test $69 $132 $49 $14
Fibrinogen test $50 $95 $36 $10
Flexible sigmoidoscopy $1,494 $2,865 $695 $323
Flu test $62 $119 $45 $17
Folate (folic acid) test $18 $34 $13 $15
Foreign body removal (skin) $72 $139 $124 $157
Free T4 thyroid test $115 $220 $80 $9
FSH hormone test $19 $36 $47 $19
Gallbladder removal (laparoscopic) $1,365 $2,618 $837 $658
Gallbladder scan (HIDA) $1,151 $2,208 $952 $334
Ganglion cyst removal $543 $1,041 $429 $321
GGT liver test $42 $80 $39 $7
Glucose tolerance test $30 $57 $49 $8
Group therapy session $193 $371 $138 $30
H. pylori test $166 $318 $123 $67
Hammertoe repair $808 $1,549 $548 $548
HDL cholesterol test $10 $20 $7 $8
Hematocrit test $32 $62 $15 $2
Hemoglobin A1c (diabetes test) $18 $35 $31 $10
Hemorrhoid removal $414 $794 $399 $338
Hepatitis A vaccine $66 $126 $73 —
Hepatitis B test $74 $141 $43 $10
Hepatitis B vaccine $66 $126 $84 —
Hepatitis C test $36 $69 $26 $14
Hip fracture repair $2,696 $5,170 $1,396 $1,120
Hip replacement $2,968 $5,693 $1,606 $1,162
HIV test $58 $112 $42 $19
Holter heart monitor $161 $309 $116 $26
HPV vaccine $166 $319 $287 —
Hydrocele repair $756 $1,449 $432 $315
Hysterectomy $1,708 $3,276 $1,152 $933
Hysteroscopy $1,241 $2,381 $307 $1,270
Ileostomy $2,319 $4,448 $1,149 $968
Inguinal hernia repair $978 $1,875 $656 $538
Iron blood test $26 $50 $19 $6
IUD insertion $39 $74 $138 —
IUD removal $45 $86 $75 $112
IV infusion therapy $92 $176 $70 $44
Kidney biopsy $1,239 $2,377 $890 $492
Kidney scan (nuclear) $834 $1,600 $599 $172
Kidney stone shock-wave (lithotripsy) $1,543 $2,960 $660 $760
Kidney ultrasound $436 $837 $123 $84
Knee arthroscopy $1,220 $2,339 $705 $524
Lactate test $85 $163 $59 $12
Laryngoscopy $312 $599 $209 $189
LDH test $36 $69 $26 $6
LDL cholesterol test $49 $94 $35 $11
Leg vein ultrasound (Doppler) $728 $1,396 $303 $150
LH hormone test $19 $37 $58 $19
Lipase test $47 $90 $33 $7
Lipid (cholesterol) panel $38 $74 $47 $13
Liver biopsy $1,037 $1,988 $745 $288
Liver function panel $58 $112 $34 $8
Lumpectomy (breast) $1,439 $2,760 $813 $750
Lung function test (PFT) $154 $295 $119 $37
Lung scan (V/Q) $1,280 $2,454 $919 $291
Magnesium blood test $36 $69 $27 $7
Mastectomy $1,792 $3,438 $1,309 $1,021
MMR vaccine $74 $141 $81 —
MRA of the brain $2,285 $4,383 $1,641 $226
MRA of the neck $2,295 $4,402 $1,649 $245
MRI of the abdomen $2,285 $4,383 $1,641 $300
MRI of the ankle $1,860 $3,567 $1,336 $261
MRI of the brain $2,462 $4,722 $1,768 $269
MRI of the chest $2,491 $4,778 $2,027 $371
MRI of the knee $1,860 $3,567 $1,336 $315
MRI of the lower back (lumbar spine) $2,295 $4,402 $1,649 $270
MRI of the mid-back (thoracic spine) $2,295 $4,402 $1,649 $271
MRI of the neck (cervical spine) $2,057 $3,945 $1,477 $274
MRI of the pelvis $2,295 $4,402 $1,649 $268
MRI of the shoulder $1,860 $3,567 $1,336 $313
MRI of the wrist $1,851 $3,550 $1,329 $330
Nebulizer breathing treatment $163 $313 $228 $9
Newborn hospital care $78 $151 $102 $58
Nuclear cardiac stress test $1,901 $3,645 $1,557 $428
Occupational therapy evaluation $124 $238 $100 $101
Office visit (established patient) $26 $51 $135 $115
Office visit (new patient) $39 $75 $176 $177
Orthopedic hardware removal $1,052 $2,018 $577 $632
Pap smear (cervical screening) $68 $130 $49 $20
Parathyroid hormone (PTH) test $39 $75 $72 $41
Pelvic ultrasound $307 $589 $284 $78
PET scan $3,500 $6,713 $2,535 —
Phosphorus blood test $23 $45 $17 $5
Physical therapy evaluation $107 $205 $88 $98
Pilonidal cyst removal $853 $1,636 $507 $541
Platelet count $20 $38 $34 $4
Pneumonia vaccine $125 $240 $133 —
Pregnancy blood test (hCG) $23 $45 $23 $8
Pregnancy ultrasound $484 $928 $358 $126
Procalcitonin test $51 $98 $29 $27
Prolactin test $18 $34 $13 $19
Prostate test (PSA) $25 $47 $50 $18
Psychiatric evaluation $114 $219 $174 $188
Psychotherapy session $162 $311 $142 $140
Pulmonary rehabilitation $165 $317 $119 $87
Radiofrequency nerve ablation $1,507 $2,891 $1,083 $462
Retina scan (OCT) $35 $68 $37 $33
Rotator cuff repair $1,910 $3,663 $1,078 $792
Routine eye exam $61 $117 $58 $88
RSV vaccine $257 $492 $184 —
Sacroiliac joint injection $185 $354 $132 $176
Scoliosis spine X-ray $129 $247 $105 $58
Screening colonoscopy $1,862 $3,571 $1,229 $378
Screening mammogram $244 $468 $175 $126
Scrotal ultrasound $430 $825 $306 $99
Sedimentation rate (ESR) test $23 $45 $17 $3
Semen analysis $50 $96 $36 $12
Septoplasty (deviated septum) $1,090 $2,090 $788 $613
Sex hormone binding globulin test $27 $52 $47 $22
Shingles vaccine $154 $295 $213 —
Shoulder arthroscopy $2,378 $4,560 $1,362 $962
Shoulder replacement $3,190 $6,119 $1,811 $1,300
Simple wound stitches $113 $217 $169 $127
Sinus surgery (endoscopic) $462 $887 $298 $224
Skin biopsy $94 $180 $164 $121
Skin cancer lesion removal $132 $254 $376 $240
Skin graft $1,222 $2,343 $819 $898
Skin lesion freezing (cryotherapy) $19 $37 $58 $36
Skin tag removal $80 $154 $146 $92
Sleep study (polysomnography) $2,854 $5,475 $2,149 $691
Small bowel resection $2,011 $3,857 $1,336 $1,136
Soft tissue ultrasound $114 $218 $81 $64
Speech therapy $196 $376 $141 $76
Spinal tap (lumbar puncture) $434 $833 $311 $165
Strep throat test $39 $74 $28 $17
Stress echocardiogram $525 $1,007 $527 $209
Swallow study $197 $377 $141 $85
T3 thyroid test $47 $90 $34 $14
Tdap (tetanus) vaccine $36 $69 $26 —
Testosterone test $24 $46 $47 $26
Thyroid test (TSH) $52 $99 $34 $17
Thyroid ultrasound $410 $787 $254 $109
Thyroid uptake scan $639 $1,225 $459 $145
Tonsillectomy $520 $997 $356 $252
Total IgE allergy test $47 $90 $34 $16
Total protein test $13 $26 $12 $4
Transvaginal ultrasound $434 $832 $309 $118
Trigger finger release $1,269 $2,434 $416 $630
Triglycerides test $39 $74 $27 $6
Troponin (heart) test $59 $114 $43 $12
Tubal ligation $631 $1,211 $423 $333
Turbinate reduction $776 $1,489 $202 $294
Turning a breech baby (version) $2,463 $4,724 $1,059 $94
Ulnar nerve surgery (elbow) $1,402 $2,689 $803 $575
Upper GI endoscopy (EGD) $1,669 $3,201 $1,066 $371
Upper GI series (barium) $417 $800 $300 $128
Ureteral stent placement $983 $1,885 $176 $373
Ureteroscopy (stone removal) $897 $1,721 $467 $365
Uric acid (gout) test $22 $43 $16 $5
Urinalysis $19 $37 $16 $3
Urine microalbumin test $36 $69 $24 $5
Urine pregnancy test $10 $20 $7 $9
Vaccine administration $31 $60 $21 $19
Vaginal delivery $10,618 $20,365 $3,865 $5,487
Varicose vein ablation $3,422 $6,563 $294 $1,018
Vasectomy $395 $758 $321 $347
Visual field test $48 $92 $65 $64
Vitamin B12 test $10 $20 $7 $15
Vitamin D test $26 $50 $19 $30
Wart removal $85 $164 $202 $121
Well-child visit $89 $170 $95 —
Wound debridement $201 $386 $166 $186
Wrist fracture repair $1,716 $3,292 $927 $735
X-ray of the abdomen $173 $331 $124 $36
X-ray of the ankle $156 $299 $112 $37
X-ray of the collarbone $132 $253 $95 $33
X-ray of the elbow $165 $317 $119 $33
X-ray of the facial bones $162 $312 $138 $39
X-ray of the foot $149 $286 $107 $34
X-ray of the forearm $126 $241 $90 $29
X-ray of the hand $151 $289 $108 $38
X-ray of the hip $144 $276 $126 $49
X-ray of the knee $170 $326 $139 $42
X-ray of the lower back (lumbar spine) $221 $425 $182 $47
X-ray of the lower leg $124 $237 $89 $31
X-ray of the mid-back (thoracic spine) $161 $309 $125 $36
X-ray of the neck (cervical spine) $218 $419 $188 $47
X-ray of the pelvis $131 $252 $140 $36
X-ray of the ribs $170 $326 $127 $42
X-ray of the shoulder $134 $257 $96 $36
X-ray of the skull $231 $443 $188 $40
X-ray of the upper arm $134 $257 $96 $32
X-ray of the wrist $167 $320 $120 $43
YAG laser capsulotomy (eye) $757 $1,452 $425 $335
Zinc blood test $23 $44 $43 $11

Source: this hospital’s machine-readable price file (45 CFR §180). Medicare from CMS fee schedules. Estimates — confirm with the hospital. Report an incorrect price.