| Procedure | Arbuckle Memorial Hospital | Mercy Hospital Ada | Medicare |
|---|
| Abdominal fluid drain (paracentesis) | $254 | $1,292 | $284 |
| Abdominal ultrasound | $352 | $624 | $100 |
| Abdominal ultrasound (complete) | $448 | $673 | $114 |
| Abdominal ultrasound (limited) | $352 | $574 | $86 |
| Abscess drainage (complex or multiple) | $343 | $1,405 | $220 |
| Abscess drainage (simple) | $201 | $1,084 | $129 |
| Abscess incision and drainage | $278 | $1,245 | $174 |
| Albumin blood test | $15 | $18 | $5 |
| Aldosterone test | $82 | $109 | $41 |
| Alkaline phosphatase test | $28 | $14 | $5 |
| Alpha-fetoprotein (AFP) test | $58 | $53 | $17 |
| ALT liver enzyme test | $17 | $14 | $5 |
| Ammonia blood test | $44 | $39 | $15 |
| Amylase test | $44 | $65 | $6 |
| Antinuclear antibody (ANA) test | $40 | $43 | $12 |
| Arterial blood gas (ABG) | $88 | $287 | $26 |
| AST liver enzyme test | $15 | $14 | $5 |
| Barium swallow study | $169 | $325 | $107 |
| Basic metabolic panel | $55 | $19 | $8 |
| Bilirubin blood test | $19 | $18 | $5 |
| Blood clotting test (PT/INR) | $28 | $47 | $4 |
| Blood crossmatch | $36 | $45 | — |
| Blood glucose test | $20 | $14 | $5 |
| Blood transfusion | $776 | $2,543 | $47 |
| Blood type and screen | $42 | $150 | $10 |
| Blood type test | $12 | $10 | $3 |
| Blood type test (ABO group) | $12 | $10 | $3 |
| Blood type test (Rh/D antigen) | $12 | $10 | $3 |
| BNP (heart failure) test | $162 | $83 | $39 |
| Bone scan (nuclear) | $687 | $1,188 | $259 |
| Breast ultrasound | $126 | $613 | $92 |
| Breast ultrasound (complete) | $170 | $1,034 | $100 |
| Breast ultrasound (limited) | $96 | $193 | $84 |
| Breathing tube insertion (intubation) | $182 | $423 | $133 |
| Burn dressing and debridement (medium) | $156 | $374 | $166 |
| Burn dressing and debridement (small) | $124 | $259 | $93 |
| Burn treatment | $124 | $316 | $129 |
| C-reactive protein (CRP) | $14 | $25 | $5 |
| CA 19-9 tumor marker test | $58 | $35 | $21 |
| CA-125 ovarian marker test | $58 | $35 | $21 |
| Calcium blood test | $18 | $14 | $5 |
| Cardiac stress test | $541 | $1,134 | $39 |
| Cardioversion | $200 | $1,517 | $155 |
| Carotid artery ultrasound | $318 | $814 | $156 |
| CEA tumor marker test | $53 | $163 | $19 |
| Celiac disease test | $59 | $41 | $12 |
| Central line placement | $640 | $1,073 | $238 |
| Chest fluid drain (thoracentesis) | $273 | $675 | $311 |
| Chest tube insertion | $480 | $1,048 | $143 |
| Chest X-ray | $143 | $411 | $37 |
| Chest X-ray (1 view) | $143 | $237 | $25 |
| Chest X-ray (2 views) | $197 | $359 | $33 |
| CK-MB heart enzyme test | $42 | $111 | $12 |
| Clotting time test (PTT) | $28 | $80 | $6 |
| Colonoscopy | $744 | $3,169 | $480 |
| Complete blood count (CBC) | $47 | $16 | $7 |
| Complete blood count (CBC) (complete) | $50 | $18 | $8 |
| Comprehensive metabolic panel | $83 | $23 | $11 |
| Contraceptive implant (Nexplanon) | $281 | $2,956 | $115 |
| Copper blood test | $31 | $64 | $12 |
| Cortisol test | $45 | $112 | $16 |
| COVID-19 PCR test | $120 | $154 | $51 |
| CPAP titration study | $327 | $397 | $69 |
| Creatine kinase (CK) test | $30 | $23 | $7 |
| CT angiography of the chest | $1,284 | $1,128 | $281 |
| CT scan of the abdomen | $670 | $2,039 | $230 |
| CT scan of the abdomen and pelvis | $2,114 | $3,546 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $2,932 | $5,225 | $338 |
| CT scan of the abdomen and pelvis with contrast | $2,267 | $3,546 | $300 |
| CT scan of the abdomen and pelvis without contrast | $1,369 | $3,292 | $183 |
| CT scan of the abdomen with and without contrast | $973 | $2,328 | $259 |
| CT scan of the abdomen with contrast | $776 | $2,039 | $230 |
| CT scan of the abdomen without contrast | $346 | $1,741 | $136 |
| CT scan of the arm | $1,067 | $1,341 | $199 |
| CT scan of the arm with contrast | $1,067 | $1,341 | $199 |
| CT scan of the arm without contrast | $920 | $1,106 | $161 |
| CT scan of the chest | $1,225 | $1,795 | $167 |
| CT scan of the chest with and without contrast | $1,274 | $2,763 | $196 |
| CT scan of the chest with contrast | $1,225 | $1,795 | $167 |
| CT scan of the chest without contrast | $1,067 | $1,040 | $133 |
| CT scan of the head | $1,082 | $1,689 | $148 |
| CT scan of the head with and without contrast | $1,314 | $1,967 | $173 |
| CT scan of the head with contrast | $1,082 | $1,689 | $148 |
| CT scan of the head without contrast | $1,008 | $1,210 | $107 |
| CT scan of the leg | $1,106 | $2,404 | $166 |
| CT scan of the leg with contrast | $1,067 | $1,608 | $166 |
| CT scan of the leg without contrast | $1,106 | $2,581 | $130 |
| CT scan of the lower back (lumbar spine) | $1,106 | $2,036 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $1,198 | $2,670 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,008 | $2,036 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,106 | $1,851 | $130 |
| CT scan of the neck | $1,106 | $1,275 | $183 |
| CT scan of the neck (cervical spine) | $1,225 | $2,505 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $1,274 | $2,777 | $196 |
| CT scan of the neck (cervical spine) with contrast | $1,225 | $2,505 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,106 | $1,676 | $131 |
| CT scan of the neck with and without contrast | $1,198 | $1,662 | $220 |
| CT scan of the neck with contrast | $1,067 | $1,275 | $183 |
| CT scan of the neck without contrast | $1,106 | $1,006 | $150 |
| CT scan of the pelvis | $1,159 | $1,904 | $226 |
| CT scan of the pelvis with and without contrast | $1,466 | $2,032 | $251 |
| CT scan of the pelvis with contrast | $1,159 | $1,904 | $226 |
| CT scan of the pelvis without contrast | $1,067 | $1,671 | $133 |
| CT scan of the sinuses | $1,149 | $1,308 | $152 |
| CT scan of the sinuses with and without contrast | $1,198 | $2,148 | $184 |
| CT scan of the sinuses with contrast | $920 | $1,275 | $152 |
| CT scan of the sinuses without contrast | $1,149 | $1,308 | $128 |
| D-dimer test | $21 | $36 | $10 |
| DHEA-sulfate test | $62 | $79 | $22 |
| Drug screen (urine) | $56 | $119 | $17 |
| Echocardiogram | $438 | $1,587 | $138 |
| Echocardiogram without contrast | $834 | $1,587 | $138 |
| EEG (awake and asleep) | $163 | $1,458 | $482 |
| EKG / ECG (tracing only) | $87 | $209 | $7 |
| Electrocardiogram (EKG) | $81 | $209 | $8 |
| Electroencephalogram (EEG) | $163 | $1,458 | $448 |
| Electrolyte panel | $42 | $17 | $7 |
| Emergency department visit | $460 | $781 | $69 |
| Emergency department visit (level 1) | $34 | $210 | $11 |
| Emergency department visit (level 2) | $319 | $339 | $40 |
| Emergency department visit (level 3) | $700 | $781 | $69 |
| Emergency department visit (level 4) | $575 | $1,910 | $118 |
| Emergency department visit (level 5) | $1,360 | $1,694 | $171 |
| Estradiol (estrogen) test | $180 | $75 | $28 |
| Family therapy session | $132 | $317 | $110 |
| Fecal occult blood (stool) test | $13 | $40 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $13 | $40 | $4 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $14 | $39 | $16 |
| Feeding tube (PEG) placement | $763 | $5,915 | $178 |
| Ferritin (iron) test | $38 | $49 | $14 |
| Fibrinogen test | $24 | $23 | $10 |
| Flexible sigmoidoscopy | $384 | $3,090 | $323 |
| Flu test | $34 | $106 | $17 |
| Folate (folic acid) test | $50 | $53 | $15 |
| Foreign body removal (skin) | $206 | $1,294 | $157 |
| Free T4 thyroid test | $35 | $48 | $9 |
| FSH hormone test | $51 | $66 | $19 |
| GGT liver test | $23 | $20 | $7 |
| Glucose tolerance test | $37 | $79 | $8 |
| Group therapy session | $35 | $553 | $30 |
| HDL cholesterol test | $23 | $66 | $8 |
| Hematocrit test | $8 | $10 | $2 |
| Hemoglobin A1c (diabetes test) | $32 | $34 | $10 |
| Hepatitis B test | $29 | $37 | $10 |
| Hepatitis C test | $39 | $51 | $14 |
| HIV test | $49 | $49 | $19 |
| HIV test (antibody) | $27 | $49 | $14 |
| HIV test (antigen/antibody combo) | $60 | $49 | $24 |
| Iron blood test | $34 | $18 | $6 |
| IV infusion therapy | $231 | $195 | $44 |
| IV infusion therapy (each additional) | $54 | $214 | $21 |
| IV infusion therapy (initial) | $407 | $177 | $67 |
| Joint aspiration (small/intermediate) | $86 | $373 | $57 |
| Joint aspiration or injection (mid-size joint) | $86 | $371 | $57 |
| Joint aspiration or injection (small joint) | $122 | $375 | $56 |
| Kidney ultrasound | $307 | $845 | $84 |
| Kidney ultrasound (limited) | $307 | $517 | $61 |
| Knee joint injection | $102 | $2,976 | $69 |
| Lactate test | $30 | $135 | $12 |
| Laryngoscopy | $227 | $294 | $189 |
| LDH test | $23 | $21 | $6 |
| LDL cholesterol test | $26 | $21 | $11 |
| Leg vein ultrasound (Doppler) | $380 | $1,108 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $380 | $1,087 | $116 |
| LH hormone test | $52 | $66 | $19 |
| Lipase test | $19 | $17 | $7 |
| Lipid (cholesterol) panel | $45 | $48 | $13 |
| Liver function panel | $43 | $22 | $8 |
| Lung function test (PFT) | $68 | $474 | $37 |
| Magnesium blood test | $18 | $95 | $7 |
| MRI of the abdomen | $1,793 | $2,862 | $300 |
| MRI of the abdomen without contrast | $1,550 | $2,028 | $194 |
| MRI of the brain | $1,902 | $2,268 | $269 |
| MRI of the brain with contrast | $2,113 | $2,268 | $269 |
| MRI of the brain without contrast | $1,691 | $2,113 | $195 |
| MRI of the lower back (lumbar spine) | $1,793 | $2,943 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $1,793 | $2,943 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,550 | $2,640 | $192 |
| MRI of the mid-back (thoracic spine) | $1,793 | $2,804 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $1,793 | $3,216 | $319 |
| MRI of the mid-back (thoracic spine) without contrast | $1,550 | $2,391 | $190 |
| MRI of the neck (cervical spine) | $1,793 | $3,022 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $1,793 | $3,967 | $318 |
| MRI of the neck (cervical spine) with contrast | $1,793 | $3,022 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,550 | $2,692 | $191 |
| Nebulizer breathing treatment | $240 | $113 | $9 |
| Office visit (established patient) | $176 | $1,009 | $115 |
| Office visit (new patient) | $316 | $293 | $177 |
| Office visit, established patient (level 4) | $208 | $163 | $136 |
| Office visit, new patient (level 3) | $206 | $221 | $118 |
| Office visit, new patient (level 4) | $316 | $293 | $177 |
| Office visit, new patient (level 5) | $400 | $518 | $237 |
| Pap smear (cervical screening) | $112 | $92 | $20 |
| Parathyroid hormone (PTH) test | $114 | $111 | $41 |
| Pelvic ultrasound | $364 | $473 | $78 |
| Pelvic ultrasound (complete) | $534 | $611 | $105 |
| Pelvic ultrasound (limited) | $194 | $335 | $51 |
| Phosphorus blood test | $23 | $62 | $5 |
| Physical therapy evaluation | $128 | $253 | $98 |
| Physical therapy evaluation (high complexity) | $128 | $307 | $98 |
| Physical therapy evaluation (moderate complexity) | $128 | $157 | $98 |
| Platelet count | $21 | $16 | $4 |
| Pregnancy blood test (hCG) | $32 | $116 | $8 |
| Pregnancy ultrasound | $250 | $327 | $126 |
| Pregnancy ultrasound (first trimester) | $231 | $310 | $117 |
| Pregnancy ultrasound (second or third trimester) | $250 | $345 | $136 |
| Procalcitonin test | $172 | $117 | $27 |
| Prolactin test | $54 | $70 | $19 |
| Prostate test (PSA) | $51 | $66 | $18 |
| Rheumatoid factor test | $16 | $53 | $6 |
| Scoliosis spine X-ray | $139 | $435 | $58 |
| Scoliosis spine X-ray (1 view) | $183 | $402 | $44 |
| Scoliosis spine X-ray (3 views) | $94 | $468 | $72 |
| Scrotal ultrasound | $592 | $517 | $99 |
| Sedimentation rate (ESR) test | $18 | $38 | $3 |
| Sex hormone binding globulin test | $66 | $62 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $232 | $525 | $114 |
| Simple wound stitches | $249 | $525 | $127 |
| Skin biopsy | $350 | $1,105 | $121 |
| Skin biopsy (punch) | $408 | $1,105 | $121 |
| Sleep study (polysomnography) | $2,040 | $6,250 | $691 |
| Soft tissue ultrasound | $60 | $753 | $64 |
| Speech therapy | $152 | $625 | $76 |
| Spinal tap (lumbar puncture) | $214 | $2,510 | $165 |
| Spirometry (lung function test) | $62 | $350 | $30 |
| Spirometry with bronchodilator | $74 | $598 | $43 |
| Strep throat test | $52 | $93 | $17 |
| Stress echocardiogram | $222 | $1,347 | $209 |
| Swallow study | $149 | $369 | $85 |
| T3 thyroid test | $40 | $44 | $14 |
| Testosterone test | $71 | $92 | $26 |
| Thyroid test (TSH) | $50 | $11 | $17 |
| Thyroid ultrasound | $474 | $508 | $109 |
| Total IgE allergy test | $46 | $107 | $16 |
| Total protein test | $23 | $13 | $4 |
| Transvaginal ultrasound | $534 | $710 | $118 |
| Trigger point injection | $258 | $237 | $56 |
| Trigger point injection (1-2 muscles) | $212 | $303 | $52 |
| Triglycerides test | $23 | $23 | $6 |
| Troponin (heart) test | $65 | $167 | $12 |
| Upper GI endoscopy (EGD) | $659 | $3,614 | $371 |
| Uric acid (gout) test | $23 | $16 | $5 |
| Urinalysis | $28 | $42 | $3 |
| Urine microalbumin test | $14 | $40 | $5 |
| Urine pregnancy test | $18 | $111 | $9 |
| Vaccine administration (each additional) | $6 | $49 | $16 |
| Vitamin B12 test | $42 | $54 | $15 |
| Vitamin D test | $109 | $106 | $30 |
| Wound debridement | $244 | $1,886 | $186 |
| X-ray of the abdomen | $258 | $338 | $36 |
| X-ray of the ankle | $276 | $495 | $37 |
| X-ray of the collarbone | $258 | $211 | $33 |
| X-ray of the elbow | $760 | $287 | $33 |
| X-ray of the facial bones | $114 | $154 | $39 |
| X-ray of the foot | $286 | $192 | $34 |
| X-ray of the forearm | $183 | $154 | $29 |
| X-ray of the hand | $350 | $333 | $38 |
| X-ray of the hip | $174 | $286 | $49 |
| X-ray of the hip (1 view) | $104 | $146 | $34 |
| X-ray of the hip (3 views) | $183 | $286 | $49 |
| X-ray of the knee | $131 | $397 | $42 |
| X-ray of the knee (2 views) | $106 | $194 | $34 |
| X-ray of the knee (3 views) | $276 | $397 | $42 |
| X-ray of the knee (4+ views) | $262 | $519 | $49 |
| X-ray of the lower back (lumbar spine) | $336 | $432 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $290 | $368 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $382 | $497 | $53 |
| X-ray of the lower leg | $239 | $187 | $31 |
| X-ray of the mid-back (thoracic spine) | $438 | $299 | $36 |
| X-ray of the mid-back (thoracic spine) (3 views) | $438 | $330 | $39 |
| X-ray of the neck (cervical spine) | $370 | $335 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $370 | $278 | $40 |
| X-ray of the pelvis | $183 | $248 | $36 |
| X-ray of the pelvis (1 view) | $183 | $138 | $28 |
| X-ray of the ribs | $118 | $254 | $42 |
| X-ray of the ribs (2 views) | $222 | $254 | $36 |
| X-ray of the shoulder | $235 | $473 | $36 |
| X-ray of the skull | $122 | $257 | $40 |
| X-ray of the upper arm | $202 | $196 | $32 |
| X-ray of the wrist | $350 | $295 | $43 |
| Zinc blood test | $31 | $81 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
