Benefis Teton Medical Center — procedure prices

Published prices for 127 procedures at Benefis Teton Medical Center (Choteau, MT), from its machine-readable file.

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ProcedureCashChargemasterInsurerMedicare
3D mammogram (tomosynthesis) $74 $123 $80 $51
Abscess incision and drainage $361 $601 $417 $174
Albumin blood test $38 $64 $61 $5
Alkaline phosphatase test $44 $74 $70 $5
Allergy shots $16 $27 $25 $11
Alpha-fetoprotein (AFP) test $80 $134 $127 $17
ALT liver enzyme test $39 $65 $62 $5
Amylase test $73 $121 $115 $6
Arterial blood gas (ABG) $32 $53 $50 $26
AST liver enzyme test $49 $82 $78 $5
Basic metabolic panel $83 $138 $131 $8
Benign skin lesion removal $340 $567 $539 $171
Bilirubin blood test $42 $70 $44 $5
Blood clotting test (PT/INR) $44 $74 $70 $4
Blood crossmatch $122 $203 $193 —
Blood glucose test $32 $54 $51 $5
Blood transfusion $601 $1,001 $1,080 $47
Blood type and screen $101 $169 $161 $10
Blood type test $77 $128 $96 $3
BNP (heart failure) test $191 $319 $303 $39
Bone density scan (DEXA) $295 $492 $467 $39
Breathing tube insertion (intubation) $458 $763 $414 $133
Burn treatment $223 $372 $238 $129
C-reactive protein (CRP) $82 $137 $130 $5
CA 19-9 tumor marker test $97 $161 $153 $21
Calcium blood test $56 $93 $88 $5
Cardiac stress test $179 $299 $284 $39
Carotid artery ultrasound $785 $1,309 $1,244 $156
Chest tube insertion $1,478 $2,464 $2,341 $143
Chest X-ray $216 $360 $301 $37
Clotting time test (PTT) $49 $81 $77 $6
Colonoscopy $214 $357 $339 $480
Complete blood count (CBC) $52 $87 $70 $7
Comprehensive metabolic panel $104 $173 $164 $11
COVID-19 PCR test $94 $157 $146 $51
CPAP titration study $106 $177 $168 $69
Creatine kinase (CK) test $54 $90 $86 $7
CT angiography of the chest $1,544 $2,574 $2,445 $281
CT scan of the abdomen $1,399 $2,332 $1,807 $230
CT scan of the abdomen and pelvis $2,242 $3,737 $2,898 $300
CT scan of the arm $963 $1,605 $1,464 $199
CT scan of the chest $1,221 $2,035 $1,869 $167
CT scan of the head $990 $1,650 $1,493 $148
CT scan of the leg $1,117 $1,861 $1,637 $166
CT scan of the lower back (lumbar spine) $1,161 $1,935 $1,778 $169
CT scan of the neck $1,132 $1,887 $1,687 $183
CT scan of the neck (cervical spine) $1,141 $1,902 $1,754 $168
CT scan of the pelvis $1,181 $1,969 $1,655 $226
CT scan of the sinuses $964 $1,606 $1,515 $152
D-dimer test $77 $128 $122 $10
Developmental screening (child) $14 $24 $23 —
Diagnostic mammogram $206 $344 $280 $140
Drug screen (urine) $59 $99 $107 $17
Echocardiogram $1,106 $1,844 $1,752 $138
Electrocardiogram (EKG) $178 $297 $133 $8
Electrolyte panel $63 $105 $100 $7
Emergency department visit $453 $755 $435 $69
Fecal occult blood (stool) test $37 $61 $58 $10
Ferritin (iron) test $87 $145 $138 $14
Foreign body removal (skin) $485 $809 $475 $157
Free T4 thyroid test $68 $113 $107 $9
FSH hormone test $87 $145 $138 $19
Glucose tolerance test $68 $113 $66 $8
HDL cholesterol test $58 $96 $91 $8
Hematocrit test $33 $55 $52 $2
Hemoglobin A1c (diabetes test) $67 $112 $106 $10
Holter heart monitor $193 $322 $306 $26
IV infusion therapy $200 $333 $116 $44
Joint aspiration (small/intermediate) $677 $1,129 $425 $57
Knee joint injection $592 $987 $435 $69
Lactate test $84 $140 $28 $12
LDL cholesterol test $14 $23 $22 $11
Lipase test $62 $103 $98 $7
Lipid (cholesterol) panel $88 $147 $140 $13
Liver function panel $88 $146 $139 $8
Lung function test (PFT) $254 $423 $312 $37
Magnesium blood test $49 $82 $78 $7
Nebulizer breathing treatment $176 $294 $120 $9
Occupational therapy evaluation $202 $337 $280 $101
Phosphorus blood test $67 $111 $105 $5
Physical therapy evaluation $194 $323 $252 $98
Platelet count $29 $48 $46 $4
Pregnancy blood test (hCG) $57 $95 $90 $8
Prostate test (PSA) $74 $124 $118 $18
Scoliosis spine X-ray $188 $313 $297 $58
Screening mammogram $196 $327 $311 $126
Sedimentation rate (ESR) test $41 $68 $65 $3
Shingles vaccine $450 $751 $713 —
Simple wound stitches $295 $492 $487 $127
Skin biopsy $202 $337 $320 $121
Skin lesion freezing (cryotherapy) $84 $140 $133 $36
Speech therapy $184 $307 $292 $76
Strep throat test $60 $100 $95 $17
Swallow study $317 $528 $502 $85
Tdap (tetanus) vaccine $108 $180 $171 —
Thyroid test (TSH) $67 $112 $106 $17
Total protein test $35 $59 $56 $4
Trigger finger release $692 $1,154 $1,096 $630
Trigger point injection $504 $840 $290 $56
Triglycerides test $48 $80 $76 $6
Troponin (heart) test $109 $182 $173 $12
Uric acid (gout) test $46 $77 $73 $5
Urinalysis $32 $53 $38 $3
Vaccine administration $29 $48 $38 $19
Vitamin B12 test $86 $143 $136 $15
Vitamin D test $121 $201 $191 $30
Wound debridement $701 $1,168 $508 $186
X-ray of the abdomen $248 $413 $285 $36
X-ray of the ankle $208 $346 $332 $37
X-ray of the collarbone $172 $287 $273 $33
X-ray of the elbow $209 $349 $332 $33
X-ray of the facial bones $193 $322 $257 $39
X-ray of the foot $210 $350 $336 $34
X-ray of the forearm $172 $286 $272 $29
X-ray of the hand $204 $340 $326 $38
X-ray of the hip $164 $274 $199 $49
X-ray of the knee $223 $372 $365 $42
X-ray of the lower back (lumbar spine) $283 $472 $355 $47
X-ray of the lower leg $188 $314 $298 $31
X-ray of the mid-back (thoracic spine) $238 $397 $336 $36
X-ray of the neck (cervical spine) $263 $439 $345 $47
X-ray of the pelvis $178 $297 $253 $36
X-ray of the ribs $224 $374 $337 $42
X-ray of the shoulder $190 $316 $303 $36
X-ray of the skull $195 $325 $275 $40
X-ray of the upper arm $169 $281 $267 $32
X-ray of the wrist $193 $322 $309 $43

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.