Maple Grove Hospital — procedure prices

Published prices for 222 procedures at Maple Grove Hospital (Maple Grove, MN), from its machine-readable file.

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ProcedureCashChargemasterInsurerMedicare
3D mammogram (tomosynthesis) $51 $97 $35 $51
Abdominal fluid drain (paracentesis) $1,026 $1,947 $1,030 $284
Abdominal ultrasound $277 $525 $191 $100
Abscess incision and drainage $363 $690 $404 $174
Albumin blood test $19 $36 $5 $5
Aldosterone test $39 $73 $42 $41
Alkaline phosphatase test $12 $22 $6 $5
Alpha-fetoprotein (AFP) test $43 $82 $17 $17
ALT liver enzyme test $12 $22 $6 $5
Ammonia blood test $34 $65 $15 $15
Amylase test $18 $35 $7 $6
Anoscopy $121 $230 $135 $129
Antinuclear antibody (ANA) test $22 $42 $13 $12
Arterial blood gas (ABG) $25 $47 $28 $26
AST liver enzyme test $12 $22 $5 $5
Barium swallow study $251 $477 $312 $107
Bartholin cyst removal $207 $392 $211 $182
Basic metabolic panel $25 $47 $9 $8
Bilirubin blood test $12 $22 $5 $5
Blood clotting test (PT/INR) $25 $47 $4 $4
Blood crossmatch $135 $257 $179 —
Blood glucose test $15 $29 $5 $5
Blood transfusion $635 $1,204 $480 $47
Blood type and screen $50 $94 $56 $10
Blood type test $31 $59 $44 $3
BNP (heart failure) test $95 $181 $41 $39
Bone marrow biopsy $2,038 $3,868 $2,895 $172
Bone scan (nuclear) $583 $1,107 $718 $259
Botox for migraine $424 $804 $309 $157
Breast biopsy $1,778 $3,373 $1,705 $478
Breast MRI $515 $978 $412 $216
Breast ultrasound $213 $404 $120 $92
Breathing tube insertion (intubation) $398 $755 $255 $133
Bronchoscopy $1,742 $3,305 $1,797 $303
Burn treatment $223 $424 $208 $129
C-reactive protein (CRP) $14 $27 $6 $5
CA 19-9 tumor marker test $20 $37 $22 $21
CA-125 ovarian marker test $42 $79 $22 $21
Calcium blood test $11 $21 $5 $5
Cardiac ablation $24,162 $45,848 $25,561 $759
Cardiac catheterization $4,362 $8,278 $3,535 $1,049
Cardiac MRI $720 $1,366 $346 $322
Cardiac rehabilitation $169 $321 $132 $26
Cardiac stress test $462 $876 $328 $39
Cardioversion $926 $1,758 $688 $155
Carotid artery ultrasound $345 $655 $266 $156
CEA tumor marker test $38 $73 $20 $19
Celiac disease test $15 $29 $12 $12
Central line placement $2,344 $4,447 $3,279 $238
Cesarean section (C-section) $11,409 $21,648 $10,515 $7,552
Chemotherapy infusion $306 $581 $266 $81
Chest fluid drain (thoracentesis) $894 $1,696 $679 $311
Chest tube insertion $1,507 $2,859 $1,634 $143
Chest X-ray $143 $271 $161 $37
Clotting time test (PTT) $35 $66 $6 $6
Complete blood count (CBC) $21 $40 $8 $7
Comprehensive metabolic panel $31 $59 $11 $11
Contraceptive implant (Nexplanon) $364 $691 $439 $115
Copper blood test $12 $22 $13 $12
Coronary CT angiography $656 $1,245 $372 $326
Cortisol test $44 $83 $17 $16
COVID-19 PCR test $105 $200 $53 $51
CPAP titration study $249 $472 $224 $69
Creatine kinase (CK) test $14 $26 $7 $7
CT angiography of the chest $727 $1,380 $323 $281
CT angiography of the head $669 $1,269 $323 $274
CT scan of the abdomen $649 $1,232 $197 $230
CT scan of the abdomen and pelvis $649 $1,232 $450 $300
CT scan of the arm $598 $1,135 $372 $199
CT scan of the chest $598 $1,135 $203 $167
CT scan of the head $656 $1,245 $203 $148
CT scan of the leg $645 $1,223 $329 $166
CT scan of the lower back (lumbar spine) $592 $1,123 $361 $169
CT scan of the neck $616 $1,168 $197 $183
CT scan of the neck (cervical spine) $592 $1,123 $554 $168
CT scan of the pelvis $498 $945 $203 $226
CT scan of the sinuses $616 $1,168 $203 $152
D-dimer test $59 $112 $11 $10
Defibrillator (ICD) implant $28,228 $53,563 $33,406 $798
DHEA-sulfate test $26 $49 $23 $22
Drug screen (urine) $121 $229 $98 $17
Echocardiogram $583 $1,106 $566 $138
Electrocardiogram (EKG) $98 $186 $67 $8
Electroencephalogram (EEG) $437 $829 $328 $448
Electrolyte panel $13 $24 $7 $7
Emergency department visit $338 $642 $430 $69
Endometrial biopsy $248 $470 $328 $98
Estradiol (estrogen) test $45 $86 $30 $28
Facet joint injection (spine) $1,185 $2,248 $937 $99
Fallopian tube X-ray (HSG) $409 $777 $429 $164
Ferritin (iron) test $28 $54 $15 $14
Fibrinogen test $56 $107 $10 $10
Folate (folic acid) test $24 $45 $16 $15
Foreign body removal (skin) $371 $704 $418 $157
Free T4 thyroid test $18 $34 $10 $9
FSH hormone test $36 $68 $19 $19
Gallbladder scan (HIDA) $907 $1,722 $724 $334
GGT liver test $7 $13 $8 $7
Glucose tolerance test $17 $32 $13 $8
HDL cholesterol test $13 $24 $8 $8
Hematocrit test $3 $6 $2 $2
Hemodialysis $1,373 $2,605 $857 $75
Hemoglobin A1c (diabetes test) $18 $34 $10 $10
Hepatitis B test $11 $20 $11 $10
Hepatitis C test $28 $53 $15 $14
HIV test $37 $70 $25 $19
Iron blood test $13 $24 $7 $6
IUD removal $279 $529 $358 $112
IV infusion therapy $207 $393 $165 $44
IVC filter placement $6,071 $11,520 $5,815 $1,885
Joint aspiration (small/intermediate) $394 $748 $407 $57
Kidney biopsy $1,507 $2,860 $1,705 $492
Kidney scan (nuclear) $709 $1,345 $744 $172
Kidney ultrasound $253 $481 $155 $84
Knee joint injection $436 $827 $407 $69
Knee replacement $19,413 $36,837 $20,481 $18,054
Lactate test $35 $67 $12 $12
Laryngoscopy $1,051 $1,994 $372 $189
LDH test $15 $28 $6 $6
LDL cholesterol test $16 $31 $11 $11
Leg artery angiogram $3,101 $5,884 $3,279 $149
Leg artery angioplasty $9,963 $18,905 $9,926 —
Leg vein ultrasound (Doppler) $340 $645 $249 $150
LH hormone test $32 $60 $19 $19
Lipase test $20 $37 $7 $7
Lipid (cholesterol) panel $18 $35 $14 $13
Liver biopsy $1,389 $2,635 $1,705 $288
Liver function panel $24 $46 $9 $8
Lung function test (PFT) $266 $504 $267 $37
Lung scan (V/Q) $702 $1,333 $662 $291
Magnesium blood test $16 $30 $7 $7
MRA of the brain $727 $1,380 $430 $226
MRA of the neck $934 $1,772 $441 $245
MRI of the abdomen $891 $1,691 $441 $300
MRI of the ankle $886 $1,681 $441 $261
MRI of the brain $962 $1,826 $450 $269
MRI of the chest $875 $1,661 $441 $371
MRI of the knee $1,074 $2,038 $815 $315
MRI of the lower back (lumbar spine) $934 $1,772 $441 $270
MRI of the mid-back (thoracic spine) $934 $1,772 $441 $271
MRI of the neck (cervical spine) $934 $1,772 $441 $274
MRI of the pelvis $934 $1,772 $441 $268
MRI of the shoulder $934 $1,772 $804 $313
MRI of the wrist $875 $1,661 $629 $330
Nebulizer breathing treatment $182 $346 $224 $9
Nuchal translucency ultrasound $183 $347 $117 $116
Nuclear cardiac stress test $1,846 $3,502 $1,373 $428
Occupational therapy evaluation $155 $295 $127 $101
Pap smear (cervical screening) $28 $53 $28 $20
Parathyroid hormone (PTH) test $59 $112 $43 $41
Pelvic ultrasound $242 $460 $166 $78
PET scan $2,470 $4,688 $1,603 —
Phosphorus blood test $12 $22 $5 $5
Physical therapy evaluation $155 $295 $127 $98
Platelet count $15 $28 $5 $4
Pregnancy ultrasound $304 $577 $193 $126
Procalcitonin test $62 $118 $28 $27
Prolactin test $18 $35 $20 $19
Prostate test (PSA) $17 $33 $19 $18
Pulmonary rehabilitation $135 $257 $85 $87
Radiofrequency nerve ablation $2,026 $3,845 $2,146 $462
Sacroiliac joint injection $513 $973 $461 $176
Scoliosis spine X-ray $132 $251 $161 $58
Screening mammogram $243 $462 $123 $126
Scrotal ultrasound $254 $482 $166 $99
Sedimentation rate (ESR) test $8 $15 $3 $3
Simple wound stitches $202 $383 $208 $127
Skin biopsy $569 $1,080 $619 $121
Skin tag removal $196 $372 $208 $92
Soft tissue ultrasound $340 $645 $195 $64
Speech therapy $173 $329 $107 $76
Spinal tap (lumbar puncture) $759 $1,441 $761 $165
Spine fracture repair (kyphoplasty) $6,833 $12,966 $7,443 $5,803
Stress echocardiogram $706 $1,340 $628 $209
Swallow study $177 $336 $79 $85
T3 thyroid test $14 $26 $15 $14
Testosterone test $24 $46 $27 $26
Thyroid test (TSH) $16 $30 $18 $17
Thyroid ultrasound $259 $492 $177 $109
Thyroid uptake scan $593 $1,126 $718 $145
Tilt table test $832 $1,579 $569 $168
Total IgE allergy test $16 $30 $17 $16
Total protein test $11 $21 $4 $4
Tracheostomy $3,412 $6,475 $3,412 $273
Transesophageal echocardiogram (TEE) $832 $1,578 $628 $239
Transvaginal ultrasound $195 $370 $133 $118
Trigger point injection $479 $910 $317 $56
Triglycerides test $8 $16 $6 $6
Troponin (heart) test $13 $25 $13 $12
Turning a breech baby (version) $2,695 $5,113 $3,460 $94
Upper GI series (barium) $247 $469 $312 $128
Uric acid (gout) test $12 $23 $5 $5
Urinalysis $11 $21 $3 $3
Urine microalbumin test $6 $11 $6 $5
Urine pregnancy test $25 $48 $9 $9
Vaccine administration $37 $70 $72 $19
Vaginal delivery $5,921 $11,235 $8,065 $5,487
Varicose vein ablation $3,295 $6,253 $3,311 $1,018
Vitamin B12 test $27 $51 $16 $15
Vitamin D test $40 $75 $31 $30
Wound debridement $663 $1,259 $638 $186
X-ray of the abdomen $139 $265 $165 $36
X-ray of the ankle $155 $294 $163 $37
X-ray of the collarbone $178 $337 $160 $33
X-ray of the elbow $167 $317 $163 $33
X-ray of the facial bones $161 $306 $191 $39
X-ray of the foot $154 $293 $163 $34
X-ray of the forearm $146 $277 $160 $29
X-ray of the hand $152 $289 $163 $38
X-ray of the hip $133 $253 $148 $49
X-ray of the knee $199 $379 $163 $42
X-ray of the lower back (lumbar spine) $206 $392 $195 $47
X-ray of the lower leg $150 $285 $163 $31
X-ray of the mid-back (thoracic spine) $189 $358 $195 $36
X-ray of the neck (cervical spine) $199 $377 $165 $47
X-ray of the pelvis $173 $329 $195 $36
X-ray of the ribs $174 $331 $165 $42
X-ray of the shoulder $176 $334 $163 $36
X-ray of the skull $205 $389 $193 $40
X-ray of the upper arm $163 $309 $160 $32
X-ray of the wrist $167 $316 $160 $43
Zinc blood test $18 $34 $12 $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.