| Procedure | Athol Memorial Hospital | Cheshire Medical Center | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $79 | $51 | $51 |
| Abdominal fluid drain (paracentesis) | $1,379 | $669 | $284 |
| Abdominal ultrasound | $1,659 | $225 | $100 |
| Abdominal ultrasound (complete) | $1,659 | $242 | $114 |
| Abdominal ultrasound (limited) | $1,659 | $225 | $86 |
| Abscess drainage (complex or multiple) | $518 | $441 | $220 |
| Abscess drainage (simple) | $426 | $319 | $129 |
| Abscess incision and drainage | $475 | $392 | $174 |
| Achilles tendon repair | $2,654 | $1,642 | $624 |
| Albumin blood test | $85 | $28 | $5 |
| Aldosterone test | $616 | $26 | $41 |
| Alkaline phosphatase test | $137 | $10 | $5 |
| Allergy shots | $58 | $31 | $11 |
| Alpha-fetoprotein (AFP) test | $259 | $35 | $17 |
| ALT liver enzyme test | $137 | $24 | $5 |
| Ammonia blood test | $200 | $30 | $15 |
| Amylase test | $162 | $66 | $6 |
| Annual physical (established patient) | $137 | $162 | — |
| Annual physical (new patient) | $249 | $200 | — |
| Anoscopy | $107 | $202 | $129 |
| Antinuclear antibody (ANA) test | $182 | $16 | $12 |
| Arterial blood gas (ABG) | $231 | $59 | $26 |
| AST liver enzyme test | $137 | $31 | $5 |
| Barium swallow study | $666 | $194 | $107 |
| Bartholin cyst removal | $442 | $309 | $182 |
| Basic metabolic panel | $133 | $23 | $8 |
| Benign skin lesion removal | $683 | $393 | $171 |
| Bilirubin blood test | $137 | $20 | $5 |
| Bladder function test (urodynamics) | $744 | $668 | $345 |
| Blood clotting test (PT/INR) | $66 | $13 | $4 |
| Blood crossmatch | $322 | $242 | — |
| Blood glucose test | $103 | $14 | $5 |
| Blood transfusion | $1,751 | $491 | $47 |
| Blood type and screen | $239 | $49 | $10 |
| Blood type test | $110 | $31 | $3 |
| Blood type test (ABO group) | $162 | $39 | $3 |
| Blood type test (Rh/D antigen) | $58 | $24 | $3 |
| BNP (heart failure) test | $168 | $65 | $39 |
| Bone density scan (DEXA) | $1,222 | $153 | $39 |
| Bone marrow biopsy | $357 | $837 | $172 |
| Botox for migraine | $390 | $460 | $157 |
| Breast biopsy | $2,737 | $2,239 | $478 |
| Breast ultrasound | $1,659 | $102 | $92 |
| Breast ultrasound (complete) | $1,659 | $127 | $100 |
| Breast ultrasound (limited) | $1,659 | $102 | $84 |
| Breathing tube insertion (intubation) | $855 | $179 | $133 |
| Bronchoscopy | $2,784 | $888 | $303 |
| Burn dressing and debridement (medium) | $539 | $286 | $166 |
| Burn treatment | $420 | $286 | $129 |
| C-reactive protein (CRP) | $81 | $39 | $5 |
| CA 19-9 tumor marker test | $447 | $64 | $21 |
| CA-125 ovarian marker test | $571 | $64 | $21 |
| Calcium blood test | $137 | $31 | $5 |
| Cardiac stress test | $797 | $307 | $39 |
| Cardioversion | $676 | $639 | $155 |
| Carotid artery ultrasound | $1,597 | $408 | $156 |
| CEA tumor marker test | $420 | $42 | $19 |
| Celiac disease test | $42 | $6 | $12 |
| Central line placement | $464 | $878 | $238 |
| Cervical LEEP procedure | $472 | $1,090 | $325 |
| Chemotherapy infusion | $672 | $225 | $81 |
| Chemotherapy infusion (each additional) | $655 | $119 | $28 |
| Chemotherapy infusion (first hour) | $689 | $346 | $133 |
| Chest fluid drain (thoracentesis) | $1,379 | $644 | $311 |
| Chest tube insertion | $862 | $674 | $143 |
| Chest X-ray | $287 | $148 | $37 |
| Chest X-ray (1 view) | $411 | $87 | $25 |
| Chest X-ray (2 views) | $163 | $91 | $33 |
| Chickenpox (varicella) vaccine | $104 | $168 | — |
| Clotting time test (PTT) | $124 | $33 | $6 |
| Colposcopy | $307 | $395 | $161 |
| Complete blood count (CBC) | $116 | $24 | $7 |
| Complete blood count (CBC) (complete) | $170 | $12 | $8 |
| Complex wound repair | $879 | $786 | $390 |
| Comprehensive metabolic panel | $143 | $103 | $11 |
| Continuous glucose monitor setup | $137 | $67 | $35 |
| Contraceptive implant (Nexplanon) | $418 | $302 | $115 |
| Copper blood test | $247 | $24 | $12 |
| Cortisol test | $370 | $19 | $16 |
| COVID-19 PCR test | $148 | $241 | $51 |
| CPAP titration study | $291 | $168 | $69 |
| Creatine kinase (CK) test | $110 | $31 | $7 |
| CT angiography of the chest | $1,044 | $658 | $281 |
| CT angiography of the head | $1,395 | $685 | $274 |
| CT scan of the abdomen | $1,447 | $429 | $230 |
| CT scan of the abdomen and pelvis | $2,771 | $778 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $4,121 | $941 | $338 |
| CT scan of the abdomen and pelvis with contrast | $2,771 | $778 | $300 |
| CT scan of the abdomen and pelvis without contrast | $2,432 | $601 | $183 |
| CT scan of the abdomen with and without contrast | $2,104 | $713 | $259 |
| CT scan of the abdomen with contrast | $1,447 | $587 | $230 |
| CT scan of the abdomen without contrast | $1,209 | $427 | $136 |
| CT scan of the arm | $1,416 | $738 | $199 |
| CT scan of the arm with contrast | $1,908 | $621 | $199 |
| CT scan of the arm without contrast | $1,406 | $436 | $161 |
| CT scan of the chest | $1,845 | $706 | $167 |
| CT scan of the chest with and without contrast | $2,011 | $660 | $196 |
| CT scan of the chest with contrast | $1,845 | $706 | $167 |
| CT scan of the chest without contrast | $1,330 | $454 | $133 |
| CT scan of the head | $1,552 | $599 | $148 |
| CT scan of the head with and without contrast | $1,642 | $1,032 | $173 |
| CT scan of the head with contrast | $1,552 | $553 | $148 |
| CT scan of the head without contrast | $1,251 | $433 | $107 |
| CT scan of the leg | $1,416 | $792 | $166 |
| CT scan of the leg with contrast | $1,908 | $532 | $166 |
| CT scan of the leg without contrast | $1,406 | $463 | $130 |
| CT scan of the lower back (lumbar spine) | $1,980 | $582 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $2,277 | $727 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,980 | $589 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,980 | $479 | $130 |
| CT scan of the neck | $1,362 | $515 | $183 |
| CT scan of the neck (cervical spine) | $2,277 | $902 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $2,277 | $1,070 | $196 |
| CT scan of the neck (cervical spine) with contrast | $2,277 | $1,000 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,980 | $476 | $131 |
| CT scan of the neck with and without contrast | $1,793 | $768 | $220 |
| CT scan of the neck with contrast | $1,362 | $590 | $183 |
| CT scan of the neck without contrast | $947 | $425 | $150 |
| CT scan of the pelvis | $1,325 | $705 | $226 |
| CT scan of the pelvis with and without contrast | $2,017 | $963 | $251 |
| CT scan of the pelvis with contrast | $1,325 | $515 | $226 |
| CT scan of the pelvis without contrast | $1,223 | $426 | $133 |
| CT scan of the sinuses | $1,325 | $739 | $152 |
| CT scan of the sinuses with and without contrast | $1,886 | $842 | $184 |
| CT scan of the sinuses with contrast | $1,325 | $548 | $152 |
| CT scan of the sinuses without contrast | $880 | $502 | $128 |
| D-dimer test | $113 | $25 | $10 |
| DHEA-sulfate test | $247 | $45 | $22 |
| Diagnostic mammogram | $364 | $114 | $140 |
| Drug screen (urine) | $209 | $57 | $17 |
| Ear pressure test (tympanometry) | $135 | $44 | $16 |
| Echocardiogram | $665 | $367 | $138 |
| Echocardiogram with and without contrast | $665 | $285 | $101 |
| EEG (awake and asleep) | $111 | $320 | $482 |
| EKG / ECG (tracing only) | $186 | $94 | $7 |
| Electrocardiogram (EKG) | $93 | $94 | $8 |
| Electroencephalogram (EEG) | $111 | $279 | $448 |
| Electrolyte panel | $119 | $33 | $7 |
| Emergency department visit | $412 | $182 | $69 |
| Emergency department visit (level 1) | $177 | $79 | $11 |
| Emergency department visit (level 2) | $335 | $128 | $40 |
| Emergency department visit (level 3) | $470 | $207 | $69 |
| Emergency department visit (level 4) | $667 | $331 | $118 |
| Emergency department visit (level 5) | $1,079 | $456 | $171 |
| Endometrial biopsy | $280 | $251 | $98 |
| Esophageal dilation | $924 | $677 | $522 |
| Estradiol (estrogen) test | $906 | $19 | $28 |
| Fallopian tube X-ray (HSG) | $588 | $377 | $164 |
| Family therapy session | $920 | $142 | $110 |
| Fecal occult blood (stool) test | $59 | $38 | $10 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $79 | $38 | $16 |
| Ferritin (iron) test | $214 | $76 | $14 |
| Fibrinogen test | $74 | $66 | $10 |
| Flexible sigmoidoscopy | $1,751 | $677 | $323 |
| Folate (folic acid) test | $292 | $69 | $15 |
| Foreign body removal (skin) | $459 | $274 | $157 |
| Free T4 thyroid test | $387 | $28 | $9 |
| FSH hormone test | $442 | $31 | $19 |
| Gallbladder scan (HIDA) | $1,561 | $512 | $334 |
| GGT liver test | $177 | $29 | $7 |
| Glucose tolerance test | $181 | $52 | $8 |
| Group therapy session | $122 | $53 | $30 |
| HDL cholesterol test | $210 | $60 | $8 |
| Hearing test (audiometry) | $685 | $131 | $36 |
| Hematocrit test | $42 | $7 | $2 |
| Hemoglobin A1c (diabetes test) | $247 | $25 | $10 |
| Hemorrhoid removal | $606 | $593 | $338 |
| Hepatitis A vaccine | $81 | $38 | — |
| Hepatitis B test | $177 | $22 | $10 |
| Hepatitis B vaccine | $171 | $25 | — |
| Hepatitis C test | $340 | $41 | $14 |
| HIV test | $85 | $33 | $19 |
| HIV test (antigen/antibody combo) | $85 | $41 | $24 |
| Holter heart monitor | $338 | $269 | $26 |
| HPV vaccine | $283 | $284 | — |
| Hysteroscopy | $2,770 | $942 | $1,270 |
| Iron blood test | $137 | $28 | $6 |
| IUD insertion | $260 | $190 | — |
| IUD removal | $290 | $219 | $112 |
| IV infusion therapy | $372 | $161 | $44 |
| IV infusion therapy (each additional) | $281 | $69 | $21 |
| IV infusion therapy (initial) | $463 | $258 | $67 |
| Joint aspiration (small/intermediate) | $344 | $185 | $57 |
| Joint aspiration or injection (mid-size joint) | $371 | $185 | $57 |
| Joint aspiration or injection (small joint) | $319 | $193 | $56 |
| Kidney ultrasound | $1,659 | $189 | $84 |
| Kidney ultrasound (limited) | $1,659 | $179 | $61 |
| Knee joint injection | $397 | $226 | $69 |
| Lactate test | $162 | $32 | $12 |
| Laryngoscopy | $421 | $363 | $189 |
| LDH test | $137 | $19 | $6 |
| LDL cholesterol test | $83 | $23 | $11 |
| Leg vein ultrasound (Doppler) | $1,275 | $150 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $1,275 | $127 | $116 |
| LH hormone test | $442 | $35 | $19 |
| Lipase test | $162 | $62 | $7 |
| Lipid (cholesterol) panel | $212 | $36 | $13 |
| Liver biopsy | $314 | $631 | $288 |
| Liver function panel | $128 | $56 | $8 |
| Lung function test (PFT) | $131 | $100 | $37 |
| Magnesium blood test | $177 | $43 | $7 |
| Nebulizer breathing treatment | $291 | $74 | $9 |
| Nerve conduction study | $127 | $343 | $118 |
| Occupational therapy evaluation | $435 | $206 | $101 |
| Occupational therapy evaluation (high complexity) | $435 | $206 | $101 |
| Occupational therapy evaluation (low complexity) | $435 | $206 | $101 |
| Occupational therapy evaluation (moderate complexity) | $435 | $206 | $101 |
| Office visit (established patient) | $333 | $78 | $115 |
| Office visit (new patient) | $305 | $220 | $177 |
| Office visit, established patient (level 3) | $248 | $52 | $95 |
| Office visit, established patient (level 4) | $343 | $78 | $136 |
| Office visit, new patient (level 3) | $305 | $149 | $118 |
| Office visit, new patient (level 4) | $437 | $220 | $177 |
| Office visit, new patient (level 5) | $571 | $276 | $237 |
| Pap smear (cervical screening) | $265 | $54 | $20 |
| Parathyroid hormone (PTH) test | $620 | $27 | $41 |
| Pelvic ultrasound | $897 | $121 | $78 |
| Pelvic ultrasound (complete) | $897 | $233 | $105 |
| Pelvic ultrasound (limited) | $897 | $90 | $51 |
| Phosphorus blood test | $110 | $35 | $5 |
| Physical therapy evaluation | $384 | $206 | $98 |
| Physical therapy evaluation (high complexity) | $384 | $206 | $98 |
| Physical therapy evaluation (moderate complexity) | $384 | $206 | $98 |
| Pilonidal cyst removal | $475 | $863 | $541 |
| Platelet count | $91 | $30 | $4 |
| Pregnancy ultrasound | $1,311 | $228 | $126 |
| Pregnancy ultrasound (first trimester) | $1,311 | $278 | $117 |
| Pregnancy ultrasound (second or third trimester) | $1,311 | $193 | $136 |
| Procalcitonin test | $133 | $59 | $27 |
| Prolactin test | $469 | $32 | $19 |
| Prostate test (PSA) | $305 | $60 | $18 |
| Psychiatric evaluation | $818 | $160 | $188 |
| Psychotherapy session | $818 | $146 | $140 |
| Sacroiliac joint injection | $1,993 | $759 | $176 |
| Scoliosis spine X-ray | $478 | $107 | $58 |
| Scoliosis spine X-ray (1 view) | $384 | $104 | $44 |
| Scoliosis spine X-ray (3 views) | $572 | $108 | $72 |
| Screening mammogram | $767 | $136 | $126 |
| Scrotal ultrasound | $814 | $237 | $99 |
| Sedimentation rate (ESR) test | $45 | $25 | $3 |
| Semen analysis | $137 | $42 | $12 |
| Sex hormone binding globulin test | $331 | $19 | $22 |
| Shingles vaccine | $236 | $102 | — |
| Simple laceration repair (small, up to 2.5 cm) | $462 | $302 | $114 |
| Simple wound stitches | $477 | $302 | $127 |
| Skin biopsy | $426 | $220 | $121 |
| Skin biopsy (punch) | $426 | $220 | $121 |
| Skin cancer lesion removal | $537 | $429 | $240 |
| Skin lesion freezing (cryotherapy) | $206 | $82 | $36 |
| Skin tag removal | $259 | $289 | $92 |
| Soft tissue ultrasound | $271 | $92 | $64 |
| Speech therapy | $411 | $90 | $76 |
| Spinal tap (lumbar puncture) | $563 | $563 | $165 |
| Spirometry (lung function test) | $119 | $100 | $30 |
| Spirometry with bronchodilator | $219 | $184 | $43 |
| Strep throat test | $57 | $39 | $17 |
| Stress echocardiogram | $1,254 | $738 | $209 |
| Stress echocardiogram (complete) | $1,751 | $521 | $233 |
| Swallow study | $926 | $206 | $85 |
| T3 thyroid test | $442 | $51 | $14 |
| Tdap (tetanus) vaccine | $60 | $21 | — |
| Testosterone test | $193 | $23 | $26 |
| Thyroid test (TSH) | $160 | $34 | $17 |
| Thyroid ultrasound | $604 | $179 | $109 |
| Total IgE allergy test | $289 | $51 | $16 |
| Total protein test | $66 | $31 | $4 |
| Transesophageal echocardiogram (TEE) | $894 | $626 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $894 | $603 | $239 |
| Transvaginal ultrasound | $1,659 | $207 | $118 |
| Trigger point injection | $210 | $194 | $56 |
| Trigger point injection (1-2 muscles) | $303 | $226 | $52 |
| Triglycerides test | $214 | $39 | $6 |
| Troponin (heart) test | $49 | $92 | $12 |
| Tubal ligation | $3,232 | $1,111 | $333 |
| Upper GI series (barium) | $649 | $237 | $128 |
| Uric acid (gout) test | $75 | $35 | $5 |
| Urinalysis | $23 | $10 | $3 |
| Urine microalbumin test | $105 | $20 | $5 |
| Urine pregnancy test | $127 | $32 | $9 |
| Vaccine administration | $154 | $23 | $19 |
| Vaccine administration (each additional) | $154 | $15 | $16 |
| Vasectomy | $1,287 | $950 | $347 |
| Vitamin B12 test | $292 | $69 | $15 |
| Vitamin D test | $491 | $78 | $30 |
| Wart removal | $353 | $195 | $121 |
| Well-child visit | $118 | $143 | — |
| Wound debridement | $468 | $429 | $186 |
| X-ray of the abdomen | $249 | $148 | $36 |
| X-ray of the ankle | $163 | $93 | $37 |
| X-ray of the collarbone | $292 | $89 | $33 |
| X-ray of the elbow | $395 | $87 | $33 |
| X-ray of the facial bones | $405 | $103 | $39 |
| X-ray of the foot | $163 | $97 | $34 |
| X-ray of the forearm | $95 | $81 | $29 |
| X-ray of the hand | $163 | $86 | $38 |
| X-ray of the hip | $340 | $105 | $49 |
| X-ray of the hip (1 view) | $311 | $66 | $34 |
| X-ray of the hip (3 views) | $151 | $108 | $49 |
| X-ray of the hip (4 views) | $383 | $144 | $63 |
| X-ray of the knee | $292 | $91 | $42 |
| X-ray of the knee (2 views) | $292 | $89 | $34 |
| X-ray of the knee (3 views) | $163 | $101 | $42 |
| X-ray of the knee (4+ views) | $491 | $113 | $49 |
| X-ray of the lower back (lumbar spine) | $163 | $122 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $163 | $118 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $258 | $138 | $53 |
| X-ray of the lower leg | $163 | $90 | $31 |
| X-ray of the mid-back (thoracic spine) | $171 | $104 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $150 | $104 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $412 | $122 | $39 |
| X-ray of the neck (cervical spine) | $151 | $110 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $148 | $110 | $40 |
| X-ray of the pelvis | $386 | $113 | $36 |
| X-ray of the pelvis (1 view) | $292 | $113 | $28 |
| X-ray of the ribs | $258 | $152 | $42 |
| X-ray of the ribs (2 views) | $163 | $90 | $36 |
| X-ray of the ribs (3 views) | $258 | $143 | $42 |
| X-ray of the shoulder | $163 | $113 | $36 |
| X-ray of the skull | $465 | $120 | $40 |
| X-ray of the upper arm | $292 | $81 | $32 |
| X-ray of the wrist | $163 | $75 | $43 |
| Zinc blood test | $322 | $18 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
