| Procedure | Ashtabula County Medical Center | UPMC Horizon | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $83 | $45 | $51 |
| Abdominal fluid drain (paracentesis) | $1,407 | $2,843 | $284 |
| Abdominal ultrasound | $865 | $1,597 | $100 |
| Abdominal ultrasound (complete) | $1,096 | $1,597 | $114 |
| Abdominal ultrasound (limited) | $339 | $1,597 | $86 |
| Abscess drainage (complex or multiple) | $329 | $1,486 | $220 |
| Abscess drainage (simple) | $316 | $496 | $129 |
| Abscess incision and drainage | $322 | $991 | $174 |
| Albumin blood test | $20 | $27 | $5 |
| Aldosterone test | $398 | $229 | $41 |
| Alkaline phosphatase test | $133 | $64 | $5 |
| Alpha-fetoprotein (AFP) test | $92 | $168 | $17 |
| ALT liver enzyme test | $39 | $85 | $5 |
| Ammonia blood test | $82 | $105 | $15 |
| Amylase test | $69 | $80 | $6 |
| Antinuclear antibody (ANA) test | $8 | $74 | $12 |
| Arterial blood gas (ABG) | $245 | $338 | $26 |
| AST liver enzyme test | $35 | $62 | $5 |
| Barium swallow study | $511 | $419 | $107 |
| Basic metabolic panel | $144 | $160 | $8 |
| Bilirubin blood test | $13 | $52 | $5 |
| Blood clotting test (PT/INR) | $45 | $29 | $4 |
| Blood crossmatch | $164 | $109 | — |
| Blood glucose test | $71 | $35 | $5 |
| Blood transfusion | $866 | $703 | $47 |
| Blood type and screen | $67 | $239 | $10 |
| Blood type test | $58 | $58 | $3 |
| Blood type test (ABO group) | $114 | $88 | $3 |
| BNP (heart failure) test | $27 | $268 | $39 |
| Bone density scan (DEXA) | $426 | $240 | $39 |
| Bone marrow biopsy | $2,775 | $1,335 | $172 |
| Bone scan (nuclear) | $820 | $1,991 | $259 |
| Botox for migraine | $391 | $595 | $157 |
| Breast biopsy | $3,140 | $3,710 | $478 |
| Breast MRI | $736 | $5,664 | $216 |
| Breast ultrasound | $190 | $652 | $92 |
| Breast ultrasound (limited) | $190 | $538 | $84 |
| Breathing tube insertion (intubation) | $701 | $1,789 | $133 |
| Burn dressing and debridement (medium) | $324 | $479 | $166 |
| Burn dressing and debridement (small) | $62 | $479 | $93 |
| Burn treatment | $193 | $479 | $129 |
| C-reactive protein (CRP) | $13 | $103 | $5 |
| CA 19-9 tumor marker test | $249 | $160 | $21 |
| CA-125 ovarian marker test | $336 | $160 | $21 |
| Calcium blood test | $101 | $32 | $5 |
| Cardiac rehabilitation | $200 | $151 | $26 |
| Cardiac stress test | $658 | $1,033 | $39 |
| Cardioversion | $1,113 | $1,170 | $155 |
| Carotid artery ultrasound | $504 | $856 | $156 |
| Carpal tunnel release | $454 | $3,256 | $483 |
| CEA tumor marker test | $218 | $130 | $19 |
| Celiac disease test | $18 | $100 | $12 |
| Central line placement | $2,430 | $1,928 | $238 |
| Chemotherapy infusion | $221 | $679 | $81 |
| Chemotherapy infusion (each additional) | $126 | $568 | $28 |
| Chemotherapy infusion (first hour) | $315 | $790 | $133 |
| Chest fluid drain (thoracentesis) | $704 | $2,270 | $311 |
| Chest X-ray | $350 | $307 | $37 |
| Chest X-ray (1 view) | $314 | $306 | $25 |
| Chest X-ray (2 views) | $385 | $426 | $33 |
| Clotting time test (PTT) | $50 | $44 | $6 |
| Colonoscopy | $456 | $2,476 | $480 |
| Complete blood count (CBC) | $35 | $44 | $7 |
| Complete blood count (CBC) (complete) | $35 | $48 | $8 |
| Comprehensive metabolic panel | $210 | $201 | $11 |
| Copper blood test | $182 | $122 | $12 |
| Cortisol test | $269 | $115 | $16 |
| CPAP titration study | $533 | $520 | $69 |
| Creatine kinase (CK) test | $81 | $39 | $7 |
| CT angiography of the chest | $384 | $2,788 | $281 |
| CT angiography of the head | $1,005 | $2,427 | $274 |
| CT scan of the abdomen | $1,731 | $2,075 | $230 |
| CT scan of the abdomen and pelvis | $778 | $4,109 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $778 | $4,953 | $338 |
| CT scan of the abdomen and pelvis with contrast | $778 | $4,109 | $300 |
| CT scan of the abdomen and pelvis without contrast | $653 | $3,559 | $183 |
| CT scan of the abdomen with and without contrast | $2,680 | $2,512 | $259 |
| CT scan of the abdomen with contrast | $384 | $2,075 | $230 |
| CT scan of the abdomen without contrast | $1,731 | $1,770 | $136 |
| CT scan of the arm | $1,757 | $1,688 | $199 |
| CT scan of the arm with contrast | $1,840 | $1,815 | $199 |
| CT scan of the arm without contrast | $1,674 | $1,562 | $161 |
| CT scan of the chest | $1,959 | $2,122 | $167 |
| CT scan of the chest with contrast | $2,190 | $2,122 | $167 |
| CT scan of the chest without contrast | $1,728 | $1,815 | $133 |
| CT scan of the head | $1,770 | $1,750 | $148 |
| CT scan of the head without contrast | $1,770 | $1,448 | $107 |
| CT scan of the leg | $1,858 | $1,815 | $166 |
| CT scan of the leg with contrast | $2,006 | $1,815 | $166 |
| CT scan of the leg without contrast | $1,711 | $1,562 | $130 |
| CT scan of the lower back (lumbar spine) | $2,526 | $2,110 | $169 |
| CT scan of the lower back (lumbar spine) with contrast | $2,645 | $2,110 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $2,406 | $1,815 | $130 |
| CT scan of the neck | $1,960 | $1,834 | $183 |
| CT scan of the neck (cervical spine) | $1,821 | $2,110 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,821 | $1,815 | $131 |
| CT scan of the neck with contrast | $2,176 | $1,834 | $183 |
| CT scan of the neck without contrast | $1,960 | $1,577 | $150 |
| CT scan of the pelvis | $1,863 | $2,034 | $226 |
| CT scan of the pelvis with contrast | $2,032 | $2,034 | $226 |
| CT scan of the pelvis without contrast | $1,693 | $1,789 | $133 |
| CT scan of the sinuses | $308 | $1,806 | $152 |
| CT scan of the sinuses with contrast | $384 | $1,806 | $152 |
| CT scan of the sinuses without contrast | $231 | $1,528 | $128 |
| D-dimer test | $85 | $59 | $10 |
| DHEA-sulfate test | $189 | $305 | $22 |
| Diagnostic mammogram | $288 | $564 | $140 |
| Drug screen (urine) | $91 | $137 | $17 |
| Echocardiogram | $515 | $958 | $138 |
| Echocardiogram with and without contrast | $764 | $538 | $101 |
| EEG (awake and asleep) | $612 | $791 | $482 |
| EKG / ECG (tracing only) | $281 | $190 | $7 |
| Electrocardiogram (EKG) | $148 | $190 | $8 |
| Electroencephalogram (EEG) | $601 | $869 | $448 |
| Emergency department visit | $564 | $386 | $69 |
| Emergency department visit (level 1) | $183 | $144 | $11 |
| Emergency department visit (level 2) | $324 | $236 | $40 |
| Emergency department visit (level 3) | $564 | $386 | $69 |
| Emergency department visit (level 4) | $874 | $570 | $118 |
| Emergency department visit (level 5) | $1,267 | $1,146 | $171 |
| Epidural steroid injection | $193 | $3,316 | $275 |
| Estradiol (estrogen) test | $193 | $266 | $28 |
| Facet joint injection (spine) | $138 | $1,898 | $99 |
| Fecal occult blood (stool) test | $21 | $21 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $17 | $20 | $4 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $26 | $22 | $16 |
| Feeding tube (PEG) placement | $379 | $2,528 | $178 |
| Ferritin (iron) test | $94 | $80 | $14 |
| Fibrinogen test | $120 | $62 | $10 |
| Flexible sigmoidoscopy | $152 | $1,235 | $323 |
| Folate (folic acid) test | $157 | $77 | $15 |
| Foreign body removal (skin) | $582 | $479 | $157 |
| FSH hormone test | $207 | $142 | $19 |
| Gallbladder scan (HIDA) | $941 | $1,991 | $334 |
| GGT liver test | $5 | $81 | $7 |
| Glucose tolerance test | $89 | $106 | $8 |
| HDL cholesterol test | $216 | $62 | $8 |
| Hematocrit test | $36 | $17 | $2 |
| Hemodialysis | $522 | $2,310 | $75 |
| Hemoglobin A1c (diabetes test) | $24 | $64 | $10 |
| Hepatitis B test | $49 | $105 | $10 |
| Hepatitis B vaccine | $96 | $65 | — |
| Hepatitis C test | $28 | $377 | $14 |
| HIV test | $60 | $146 | $19 |
| HIV test (antigen/antibody combo) | $60 | $169 | $24 |
| Holter heart monitor | $398 | $763 | $26 |
| Iron blood test | $50 | $37 | $6 |
| IV infusion therapy | $319 | $457 | $44 |
| IV infusion therapy (each additional) | $155 | $405 | $21 |
| IV infusion therapy (initial) | $483 | $509 | $67 |
| Joint aspiration (small/intermediate) | $268 | $325 | $57 |
| Joint aspiration or injection (mid-size joint) | $315 | $325 | $57 |
| Joint aspiration or injection (small joint) | $152 | $325 | $56 |
| Kidney ultrasound | $231 | $660 | $84 |
| Kidney ultrasound (limited) | $231 | $810 | $61 |
| Knee joint injection | $606 | $354 | $69 |
| Lactate test | $47 | $76 | $12 |
| Laryngoscopy | $123 | $749 | $189 |
| LDH test | $104 | $32 | $6 |
| LDL cholesterol test | $33 | $37 | $11 |
| Leg vein ultrasound (Doppler) | $437 | $767 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $378 | $611 | $116 |
| LH hormone test | $206 | $142 | $19 |
| Lipase test | $78 | $85 | $7 |
| Lipid (cholesterol) panel | $88 | $86 | $13 |
| Liver biopsy | $3,140 | $1,958 | $288 |
| Lung function test (PFT) | $51 | $300 | $37 |
| Lung scan (V/Q) | $1,062 | $1,267 | $291 |
| Magnesium blood test | $64 | $32 | $7 |
| MMR vaccine | $18 | $49 | — |
| MRA of the brain | $3,250 | $1,802 | $226 |
| MRA of the neck | $3,060 | $1,802 | $245 |
| MRI of the abdomen | $3,325 | $4,193 | $300 |
| MRI of the abdomen without contrast | $2,962 | $2,471 | $194 |
| MRI of the ankle | $3,212 | $4,051 | $261 |
| MRI of the ankle without contrast | $2,409 | $4,861 | $222 |
| MRI of the brain | $3,998 | $2,586 | $269 |
| MRI of the brain without contrast | $3,225 | $2,471 | $195 |
| MRI of the knee | $3,879 | $4,861 | $315 |
| MRI of the knee without contrast | $3,690 | $4,861 | $204 |
| MRI of the lower back (lumbar spine) | $4,496 | $3,602 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $3,828 | $4,861 | $192 |
| MRI of the mid-back (thoracic spine) | $3,780 | $3,602 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $4,421 | $3,602 | $319 |
| MRI of the mid-back (thoracic spine) without contrast | $3,139 | $4,861 | $190 |
| MRI of the neck (cervical spine) | $2,854 | $4,861 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $4,623 | $3,602 | $318 |
| MRI of the neck (cervical spine) without contrast | $1,086 | $4,861 | $191 |
| MRI of the pelvis | $3,270 | $4,193 | $268 |
| MRI of the pelvis without contrast | $2,982 | $4,861 | $227 |
| MRI of the shoulder | $4,189 | $4,193 | $313 |
| MRI of the shoulder without contrast | $3,657 | $4,193 | $205 |
| MRI of the wrist | $2,946 | $4,527 | $330 |
| MRI of the wrist without contrast | $2,409 | $4,861 | $303 |
| Nebulizer breathing treatment | $351 | $190 | $9 |
| Nuclear cardiac stress test | $2,780 | $3,739 | $428 |
| Occupational therapy evaluation | $256 | $379 | $101 |
| Occupational therapy evaluation (high complexity) | $265 | $379 | $101 |
| Occupational therapy evaluation (low complexity) | $246 | $379 | $101 |
| Occupational therapy evaluation (moderate complexity) | $256 | $379 | $101 |
| Office visit (established patient) | $119 | $233 | $115 |
| Office visit (new patient) | $238 | $434 | $177 |
| Office visit, established patient (level 3) | $92 | $216 | $95 |
| Office visit, established patient (level 4) | $146 | $251 | $136 |
| Office visit, new patient (level 3) | $137 | $338 | $118 |
| Office visit, new patient (level 4) | $238 | $434 | $177 |
| Office visit, new patient (level 5) | $301 | $526 | $237 |
| Pap smear (cervical screening) | $35 | $61 | $20 |
| Parathyroid hormone (PTH) test | $261 | $212 | $41 |
| Pelvic ultrasound | $231 | $808 | $78 |
| Pelvic ultrasound (complete) | $231 | $1,178 | $105 |
| Pelvic ultrasound (limited) | $231 | $438 | $51 |
| PET scan | $5,371 | $9,290 | — |
| Phosphorus blood test | $49 | $32 | $5 |
| Physical therapy evaluation | $195 | $340 | $98 |
| Physical therapy evaluation (high complexity) | $204 | $340 | $98 |
| Physical therapy evaluation (moderate complexity) | $195 | $340 | $98 |
| Platelet count | $88 | $39 | $4 |
| Pregnancy blood test (hCG) | $104 | $149 | $8 |
| Pregnancy ultrasound | $403 | $988 | $126 |
| Pregnancy ultrasound (first trimester) | $403 | $988 | $117 |
| Procalcitonin test | $51 | $161 | $27 |
| Prolactin test | $314 | $186 | $19 |
| Prostate test (PSA) | $13 | $115 | $18 |
| Radiofrequency nerve ablation | $456 | $2,332 | $462 |
| Retinal (fundus) photography | $83 | $133 | $37 |
| Scoliosis spine X-ray | $231 | $386 | $58 |
| Scoliosis spine X-ray (3 views) | $231 | $386 | $72 |
| Screening mammogram | $260 | $205 | $126 |
| Scrotal ultrasound | $231 | $880 | $99 |
| Sedimentation rate (ESR) test | $27 | $50 | $3 |
| Sex hormone binding globulin test | $133 | $269 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $281 | $479 | $114 |
| Simple wound stitches | $281 | $479 | $127 |
| Skin biopsy | $405 | $824 | $121 |
| Skin tag removal | $162 | $988 | $92 |
| Sleep study (polysomnography) | $2,198 | $3,646 | $691 |
| Soft tissue ultrasound | $231 | $480 | $64 |
| Speech therapy | $270 | $383 | $76 |
| Spirometry (lung function test) | $29 | $301 | $30 |
| Spirometry with bronchodilator | $380 | $299 | $43 |
| Strep throat test | $31 | $62 | $17 |
| Stress echocardiogram | $645 | $2,783 | $209 |
| Swallow study | $377 | $464 | $85 |
| T3 thyroid test | $124 | $297 | $14 |
| Tdap (tetanus) vaccine | $104 | $32 | — |
| Testosterone test | $244 | $160 | $26 |
| Thyroid test (TSH) | $91 | $100 | $17 |
| Thyroid ultrasound | $576 | $1,088 | $109 |
| Total IgE allergy test | $174 | $99 | $16 |
| Total protein test | $88 | $32 | $4 |
| Transesophageal echocardiogram (TEE) | $866 | $2,008 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $866 | $2,008 | $239 |
| Transvaginal ultrasound | $231 | $621 | $118 |
| Trigger point injection | $163 | $664 | $56 |
| Trigger point injection (1-2 muscles) | $244 | $602 | $52 |
| Triglycerides test | $81 | $32 | $6 |
| Troponin (heart) test | $186 | $113 | $12 |
| Upper GI endoscopy (EGD) | $313 | $2,174 | $371 |
| Upper GI series (barium) | $384 | $547 | $128 |
| Uric acid (gout) test | $32 | $97 | $5 |
| Urinalysis | $37 | $81 | $3 |
| Urine microalbumin test | $88 | $112 | $5 |
| Urine pregnancy test | $95 | $67 | $9 |
| Vaccine administration | $118 | $12 | $19 |
| Vaccine administration (each additional) | $81 | $12 | $16 |
| Vitamin B12 test | $169 | $77 | $15 |
| Vitamin D test | $71 | $223 | $30 |
| Wart removal | $171 | $733 | $121 |
| Wound debridement | $274 | $2,459 | $186 |
| X-ray of the abdomen | $314 | $607 | $36 |
| X-ray of the ankle | $321 | $541 | $37 |
| X-ray of the collarbone | $193 | $321 | $33 |
| X-ray of the elbow | $321 | $431 | $33 |
| X-ray of the facial bones | $231 | $406 | $39 |
| X-ray of the foot | $314 | $469 | $34 |
| X-ray of the forearm | $257 | $321 | $29 |
| X-ray of the hand | $303 | $463 | $38 |
| X-ray of the hip | $287 | $334 | $49 |
| X-ray of the hip (1 view) | $190 | $201 | $34 |
| X-ray of the hip (3 views) | $385 | $334 | $49 |
| X-ray of the knee | $358 | $626 | $42 |
| X-ray of the knee (2 views) | $321 | $360 | $34 |
| X-ray of the knee (3 views) | $385 | $626 | $42 |
| X-ray of the knee (4+ views) | $358 | $686 | $49 |
| X-ray of the lower back (lumbar spine) | $478 | $657 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $426 | $431 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $531 | $883 | $53 |
| X-ray of the lower leg | $321 | $506 | $31 |
| X-ray of the mid-back (thoracic spine) | $328 | $497 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $231 | $508 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $426 | $487 | $39 |
| X-ray of the neck (cervical spine) | $425 | $590 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $319 | $431 | $40 |
| X-ray of the pelvis | $319 | $447 | $36 |
| X-ray of the pelvis (1 view) | $319 | $431 | $28 |
| X-ray of the ribs | $308 | $557 | $42 |
| X-ray of the ribs (2 views) | $190 | $557 | $36 |
| X-ray of the ribs (3 views) | $426 | $469 | $42 |
| X-ray of the shoulder | $385 | $445 | $36 |
| X-ray of the upper arm | $190 | $243 | $32 |
| X-ray of the wrist | $321 | $463 | $43 |
| Zinc blood test | $57 | $85 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
