Memorial Hospital Of South Bend — procedure prices

Published prices for 390 procedures at Memorial Hospital Of South Bend (South Bend, IN), from its machine-readable file.

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ProcedureCashChargemasterInsurerMedicare
3D mammogram (tomosynthesis) $44 $67 $50 $51
Abdominal fluid drain (paracentesis) $1,596 $2,455 $1,719 $284
Abdominal ultrasound $417 $642 $464 $100
Abscess incision and drainage $382 $587 $420 $174
Achilles tendon repair $2,757 $4,241 $3,121 $624
ACL knee reconstruction $3,338 $889
Acupuncture $27 $38
Adenoid removal (adenoidectomy) $2,274 $204
Albumin blood test $55 $84 $55 $5
Aldosterone test $558 $858 $558 $41
Alkaline phosphatase test $71 $109 $16 $5
Allergy patch testing $1,066 $5
Allergy shots $48 $11
Allergy testing $1,066 $4
Alpha-fetoprotein (AFP) test $222 $342 $222 $17
ALT liver enzyme test $72 $110 $16 $5
Ammonia blood test $177 $272 $177 $15
Amniocentesis $627 $965 $701 $120
Amylase test $94 $144 $104 $6
Anal fistula repair $1,780 $2,739 $2,191 $541
Ankle fracture repair $4,316 $608
Ankle replacement $26,103 $885
Annual physical (established patient) $37
Annual physical (new patient) $37
Anoscopy $125 $192 $154 $129
Antinuclear antibody (ANA) test $99 $152 $106 $12
Aortic aneurysm repair (AAA) $14,156 $1,345
Aortic valve replacement $14,156 $1,603
Arterial blood gas (ABG) $225 $346 $250 $26
AST liver enzyme test $71 $109 $16 $5
Barium swallow study $297 $457 $271 $107
Bartholin cyst removal $241 $370 $296 $182
Basic metabolic panel $79 $122 $20 $8
Benign skin lesion removal $841 $1,294 $737 $171
Bilirubin blood test $70 $107 $70 $5
Bladder function test (urodynamics) $1,045 $345
Bladder scope (cystoscopy) $536 $825 $668 $216
Bladder tumor removal (TURBT) $1,921 $236
Blood clotting test (PT/INR) $50 $77 $56 $4
Blood crossmatch $169 $260 $180
Blood glucose test $64 $99 $32 $5
Blood transfusion $742 $1,142 $789 $47
Blood type and screen $135 $207 $149 $10
Blood type test $74 $115 $72 $3
BNP (heart failure) test $361 $556 $361 $39
Bone density scan (DEXA) $217 $334 $173 $39
Bone marrow biopsy $1,341 $2,063 $1,650 $172
Bone scan (nuclear) $1,273 $1,958 $716 $259
Botox for migraine $648 $157
Brain shunt (VP shunt) $14,156 $1,023
Breast biopsy $4,066 $6,255 $2,738 $478
Breast MRI $1,366 $2,101 $1,019 $216
Breast reconstruction $14,156 $1,227
Breast reduction $3,212 $980
Breast ultrasound $196 $302 $192 $92
Breathing tube insertion (intubation) $455 $700 $465 $133
Bronchoscopy $922 $1,419 $3,432 $303
Bunion surgery (bunionectomy) $6,288 $883
Burn treatment $302 $465 $286 $129
C-reactive protein (CRP) $71 $109 $16 $5
CA 19-9 tumor marker test $285 $438 $64 $21
CA-125 ovarian marker test $257 $395 $59 $21
Calcium blood test $71 $109 $16 $5
Capsule endoscopy $1,007 $802
Cardiac ablation $26,366 $40,563 $28,976 $759
Cardiac catheterization $7,769 $11,953 $8,684 $1,049
Cardiac event monitor $396 $170
Cardiac MRI $1,486 $2,287 $828 $322
Cardiac rehabilitation $236 $363 $262 $26
Cardiac stress test $653 $1,004 $725 $39
Cardioversion $1,107 $1,703 $1,253 $155
Carotid artery surgery $14,156 $1,026
Carotid artery ultrasound $594 $914 $660 $156
Carpal tunnel release $1,729 $483
Cataract surgery $4,316 $547
CEA tumor marker test $192 $296 $48 $19
Celiac disease test $159 $244 $159 $12
Central line placement $2,535 $3,900 $2,870 $238
Cervical cerclage $1,415 $137
Cervical LEEP procedure $1,757 $325
Chalazion (eyelid cyst) removal $381 $131
Chemotherapy infusion $480 $738 $325 $81
Chest fluid drain (thoracentesis) $1,601 $2,463 $1,835 $311
Chest tube insertion $1,451 $2,233 $1,747 $143
Chest X-ray $220 $339 $242 $37
Chickenpox (varicella) vaccine $201
Chiropractic adjustment $27 $38
Circumcision $683 $1,050 $1,242 $167
CK-MB heart enzyme test $96 $148 $26 $12
Clotting time test (PTT) $74 $114 $80 $6
Colon resection (colectomy) $14,156 $1,238
Colonoscopy $2,274 $480
Colostomy $14,156 $1,122
Colposcopy $648 $161
Complete blood count (CBC) $78 $120 $17 $7
Complex wound repair $425 $654 $536 $390
Comprehensive eye exam $135 $138
Comprehensive metabolic panel $68 $104 $20 $11
Contact lens fitting $137
Continuous glucose monitor setup $54 $35
Contraceptive implant (Nexplanon) $411 $633 $333 $115
Copper blood test $170 $262 $170 $12
Corneal transplant $3,958 $1,066
Coronary CT angiography $788 $1,212 $821 $326
Cortisol test $196 $301 $196 $16
COVID-19 PCR test $77 $118 $53 $51
COVID-19 vaccine $0
CPAP titration study $1,011 $1,555 $1,129 $69
Craniotomy (brain surgery) $14,156 $2,161
Creatine kinase (CK) test $93 $143 $100 $7
CT angiography of the chest $1,696 $2,609 $1,884 $281
CT angiography of the head $1,780 $2,739 $1,780 $274
CT colonography (virtual colonoscopy) $260 $835
CT scan of the abdomen $1,512 $2,327 $1,248 $230
CT scan of the abdomen and pelvis $2,730 $4,200 $2,532 $300
CT scan of the arm $1,277 $1,964 $1,393 $199
CT scan of the chest $1,659 $2,553 $1,356 $167
CT scan of the head $1,220 $1,877 $1,011 $148
CT scan of the leg $1,518 $2,335 $1,486 $166
CT scan of the lower back (lumbar spine) $1,408 $2,166 $1,120 $169
CT scan of the neck $1,592 $2,449 $1,341 $183
CT scan of the neck (cervical spine) $2,094 $3,222 $1,790 $168
CT scan of the pelvis $1,333 $2,050 $1,221 $226
CT scan of the sinuses $1,337 $2,057 $1,090 $152
D-dimer test $129 $198 $29 $10
Defibrillator (ICD) implant $15,527 $798
Developmental screening (child) $98 $150 $110
DHEA-sulfate test $304 $468 $304 $22
Diagnostic mammogram $364 $560 $404 $140
Dialysis fistula creation $1,905 $601
Dilation and curettage (D&C) $2,274 $298
Droopy eyelid repair (ptosis) $2,274 $745
Drug screen (urine) $192 $296 $214 $17
Ear pressure test (tympanometry) $68 $105 $74 $16
Ear tubes (myringotomy) $1,045 $174
Eardrum repair (tympanoplasty) $3,222 $799
Echocardiogram $719 $1,106 $814 $138
Elbow replacement $7,142 $1,301
Electrocardiogram (EKG) $183 $281 $205 $8
Electroencephalogram (EEG) $485 $746 $519 $448
Electrolyte panel $86 $133 $86 $7
Electromyography (EMG) $289 $444 $267 $141
Emergency department visit $537 $826 $407 $69
Endometrial biopsy $170 $261 $211 $98
Epidural steroid injection $1,362 $2,096 $1,547 $275
ERCP (bile duct endoscopy) $4,316 $311
Esophageal dilation $1,128 $1,736 $1,302 $522
Esophageal variceal banding $4,316 $126
Estradiol (estrogen) test $359 $553 $82 $28
Eye refraction (glasses prescription) $29
Eyelid surgery (blepharoplasty) $1,916 $552
Facet joint injection (spine) $774 $1,192 $1,174 $99
Fallopian tube X-ray (HSG) $324 $499 $253 $164
Family therapy session $173 $110
Fecal occult blood (stool) test $115 $177 $15 $10
Feeding tube (PEG) placement $1,010 $1,554 $1,259 $178
Femoral hernia repair $3,122 $584
Ferritin (iron) test $161 $247 $38 $14
Fibrinogen test $111 $171 $111 $10
Fibroid removal (myomectomy) $14,156 $914
Flexible sigmoidoscopy $1,242 $323
Flu test $164 $252 $41 $17
Flu vaccine $24
Folate (folic acid) test $202 $311 $202 $15
Foreign body removal (skin) $706 $1,087 $557 $157
Free T4 thyroid test $118 $181 $27 $9
FSH hormone test $254 $390 $57 $19
Gallbladder removal (laparoscopic) $4,211 $658
Gallbladder scan (HIDA) $917 $1,412 $942 $334
Ganglion cyst removal $1,905 $321
GGT liver test $106 $163 $23 $7
Glaucoma surgery $2,274 $984
Glucose tolerance test $177 $272 $62 $8
Group therapy session $97 $30
H. pylori test $920 $1,416 $206 $67
Hammertoe repair $1,905 $548
HDL cholesterol test $112 $172 $25 $8
Hearing test (audiometry) $164 $36
Hematocrit test $38 $59 $41 $2
Hemodialysis $2,976 $4,578 $3,205 $75
Hemoglobin A1c (diabetes test) $132 $203 $30 $10
Hemorrhoid removal $648 $338
Hepatitis A vaccine $104
Hepatitis B test $89 $137 $24 $10
Hepatitis B vaccine $87
Hepatitis C test $194 $299 $43 $14
Hip arthroscopy $8,684 $931
Hip fracture repair $13,052 $1,120
Hip replacement $26,103 $1,162
HIV test $321 $494 $24 $19
Holter heart monitor $115 $26
Home sleep apnea test $371 $123
HPV vaccine $345
Hydrocele repair $1,944 $315
Hysterectomy $10,907 $933
Hysteroscopy $1,905 $1,270
Ileostomy $14,156 $968
Incisional hernia repair $1,635
Inguinal hernia repair $3,122 $538
Iron blood test $89 $137 $89 $6
IUD insertion $648
IUD removal $268 $412 $299 $112
IV infusion therapy $263 $404 $283 $44
IVC filter placement $14,905 $22,930 $16,051 $1,885
Joint aspiration (small/intermediate) $344 $529 $343 $57
Kidney biopsy $2,083 $3,204 $2,371 $492
Kidney removal (nephrectomy) $14,156 $1,164
Kidney scan (nuclear) $948 $1,459 $861 $172
Kidney stone shock-wave (lithotripsy) $8,684 $760
Kidney ultrasound $478 $736 $402 $84
Knee arthroscopy $2,274 $524
Knee joint injection $458 $704 $508 $69
Lactate test $155 $238 $155 $12
Laminectomy (spine) $4,316 $1,157
Laryngoscopy $657 $1,010 $1,045 $189
LDH test $81 $125 $81 $6
LDL cholesterol test $131 $201 $30 $11
Leg artery angiogram $5,212 $8,018 $5,853 $149
Leg artery angioplasty $30,871 $47,495 $25,791
Leg vein ultrasound (Doppler) $389 $599 $470 $150
LH hormone test $254 $390 $57 $19
Lipase test $34 $52 $10 $7
Lipid (cholesterol) panel $192 $296 $192 $13
Liver biopsy $2,083 $3,204 $2,371 $288
Liver function panel $86 $133 $21 $8
Lumbar discectomy $4,316 $898
Lumpectomy (breast) $3,958 $750
Lung function test (PFT) $445 $684 $402 $37
Lung scan (V/Q) $809 $1,244 $780 $291
Magnesium blood test $96 $148 $107 $7
Mastectomy $4,316 $1,021
Mastoidectomy $3,958 $840
Meniscus repair (knee) $1,905 $714
MMR vaccine $325 $500 $368
Mohs skin cancer surgery $1,284 $535
MRA of the brain $1,321 $2,032 $1,163 $226
MRA of the neck $1,486 $2,287 $996 $245
MRI of the abdomen $1,652 $2,541 $1,106 $300
MRI of the ankle $1,486 $2,287 $1,143 $261
MRI of the brain $1,652 $2,541 $1,321 $269
MRI of the chest $1,486 $2,287 $1,044 $371
MRI of the knee $1,652 $2,541 $1,496 $315
MRI of the lower back (lumbar spine) $1,486 $2,287 $1,143 $270
MRI of the mid-back (thoracic spine) $1,486 $2,287 $1,143 $271
MRI of the neck (cervical spine) $1,486 $2,287 $1,143 $274
MRI of the pelvis $1,321 $2,032 $1,101 $268
MRI of the shoulder $1,652 $2,541 $1,493 $313
MRI of the wrist $1,321 $2,032 $1,219 $330
Nebulizer breathing treatment $246 $379 $284 $9
Neck (cervical) spinal fusion $13,052 $1,410
Nerve conduction study $521 $801 $216 $118
Newborn hospital care $388 $58
Nuchal translucency ultrasound $153 $236 $168 $116
Nuclear cardiac stress test $2,491 $3,832 $2,545 $428
Occupational therapy evaluation $288 $443 $310 $101
Office visit (established patient) $150 $231 $167 $115
Office visit (new patient) $207 $318 $226 $177
Orthopedic hardware removal $1,905 $632
Ovarian cyst removal $3,122 $698
Ovary removal (oophorectomy) $14,156 $822
Pap smear (cervical screening) $332 $511 $27 $20
Parathyroid hormone (PTH) test $482 $741 $113 $41
Parathyroid removal $4,316 $891
Pelvic ultrasound $350 $539 $245 $78
PET scan $4,245 $6,531 $4,572
Phosphorus blood test $83 $128 $17 $5
Physical therapy evaluation $187 $288 $215 $98
Pilonidal cyst removal $1,905 $541
Platelet count $60 $93 $14 $4
Pneumonia vaccine $123
Pregnancy blood test (hCG) $68 $104 $68 $8
Pregnancy ultrasound $430 $661 $263 $126
Procalcitonin test $385 $593 $85 $27
Prolactin test $266 $409 $59 $19
Prostate biopsy $2,470 $3,800 $2,280
Prostate removal (prostatectomy) $20,177 $1,063
Prostate surgery (TURP) $2,564 $526
Prostate test (PSA) $231 $355 $249 $18
Psychiatric evaluation $304 $467 $303 $188
Psychotherapy session $313 $482 $343 $140
Pterygium removal (eye) $1,729 $540
Pulmonary rehabilitation $105 $162 $117 $87
Radiofrequency nerve ablation $2,506 $3,855 $2,799 $462
Retina scan (OCT) $164 $33
Retinal (fundus) photography $135 $37
Retinal detachment repair $3,958 $966
Rheumatoid factor test $6 $6
Rotator cuff repair $3,984 $792
Routine eye exam $135 $88
RSV vaccine $168
Sacroiliac joint injection $1,289 $1,983 $1,289 $176
Scoliosis spine X-ray $233 $359 $171 $58
Screening mammogram $322 $496 $347 $126
Scrotal ultrasound $568 $874 $568 $99
Sedimentation rate (ESR) test $45 $69 $4 $3
Semen analysis $122 $187 $16 $12
Septoplasty (deviated septum) $2,274 $613
Sex hormone binding globulin test $298 $458 $66 $22
Shingles vaccine $226
Shoulder arthroscopy $3,260 $962
Shoulder replacement $26,103 $1,300
Simple wound stitches $334 $514 $362 $127
Sinus surgery (endoscopic) $2,274 $224
Skin biopsy $391 $601 $521 $121
Skin cancer lesion removal $1,045 $240
Skin graft $4,893 $7,528 $3,178 $898
Skin lesion freezing (cryotherapy) $286 $36
Skin tag removal $148 $227 $184 $92
Sleep study (polysomnography) $3,118 $4,797 $3,560 $691
Small bowel resection $14,156 $1,136
Soft tissue ultrasound $388 $597 $431 $64
Speech therapy $288 $443 $266 $76
Spinal cord stimulator $3,056 $2,388
Spinal tap (lumbar puncture) $753 $1,158 $851 $165
Spine fracture repair (kyphoplasty) $15,471 $23,801 $13,261 $5,803
Spleen removal (splenectomy) $10,907 $1,036
Stomach removal (gastrectomy) $14,156 $1,595
Strabismus (eye muscle) surgery $2,274 $475
Strep throat test $164 $252 $41 $17
Stress echocardiogram $1,204 $1,853 $1,248 $209
Swallow study $424 $653 $428 $85
T3 thyroid test $142 $218 $35 $14
Tdap (tetanus) vaccine $167 $257 $189
Testicle removal (orchiectomy) $1,921 $306
Testosterone test $333 $513 $333 $26
Thyroid removal (thyroidectomy) $4,316 $1,004
Thyroid test (TSH) $231 $355 $231 $17
Thyroid ultrasound $353 $543 $256 $109
Thyroid uptake scan $653 $1,005 $520 $145
Tilt table test $1,632 $2,510 $1,632 $168
Tonsillectomy $3,122 $252
Total IgE allergy test $226 $347 $50 $16
Total protein test $51 $79 $51 $4
Tracheostomy $1,775 $273
Transesophageal echocardiogram (TEE) $1,617 $2,487 $1,729 $239
Transvaginal ultrasound $407 $626 $250 $118
Trigger finger release $1,729 $630
Trigger point injection $248 $382 $286 $56
Triglycerides test $86 $133 $93 $6
Troponin (heart) test $118 $182 $118 $12
Tubal ligation $2,591 $333
Turbinate reduction $1,821 $294
Turning a breech baby (version) $3,250 $5,000 $3,331 $94
Ulnar nerve surgery (elbow) $1,729 $575
Umbilical hernia repair $987
Upper GI endoscopy (EGD) $871 $1,340 $1,072 $371
Upper GI series (barium) $512 $788 $300 $128
Ureteral stent placement $1,833 $373
Ureteroscopy (stone removal) $8,684 $365
Uric acid (gout) test $60 $93 $14 $5
Urinalysis $34 $52 $26 $3
Urine microalbumin test $71 $109 $76 $5
Urine pregnancy test $90 $139 $56 $9
UV light therapy (skin) $179 $106
Vaccine administration $67 $103 $67 $19
Varicocele repair $2,274 $327
Varicose vein ablation $4,422 $6,803 $4,912 $1,018
Vasectomy $1,284 $347
Visual field test $138 $64
Vitamin B12 test $212 $326 $212 $15
Vitamin D test $414 $637 $414 $30
Vitrectomy (eye) $3,958 $814
Vocal cord injection $1,900 $211
Wart removal $286 $121
Well-child visit $37
Whipple procedure (pancreas) $14,156 $2,871
Wound debridement $920 $1,416 $1,048 $186
Wrist fracture repair $3,566 $735
X-ray of the abdomen $242 $372 $242 $36
X-ray of the ankle $190 $293 $215 $37
X-ray of the collarbone $188 $289 $212 $33
X-ray of the elbow $210 $323 $237 $33
X-ray of the facial bones $231 $356 $167 $39
X-ray of the foot $190 $293 $215 $34
X-ray of the forearm $189 $290 $213 $29
X-ray of the hand $203 $313 $229 $38
X-ray of the hip $168 $258 $159 $49
X-ray of the knee $243 $374 $224 $42
X-ray of the lower back (lumbar spine) $309 $476 $307 $47
X-ray of the lower leg $193 $297 $218 $31
X-ray of the mid-back (thoracic spine) $186 $286 $193 $36
X-ray of the neck (cervical spine) $264 $406 $225 $47
X-ray of the pelvis $164 $252 $176 $36
X-ray of the ribs $260 $400 $215 $42
X-ray of the shoulder $198 $304 $223 $36
X-ray of the skull $235 $362 $168 $40
X-ray of the upper arm $187 $287 $210 $32
X-ray of the wrist $203 $313 $229 $43
YAG laser capsulotomy (eye) $1,623 $335
Zinc blood test $65 $100 $20 $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.