| Procedure | Bsa Hospital | Coon Memorial Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $50 | $105 | $51 |
| Abdominal fluid drain (paracentesis) | $322 | $889 | $284 |
| Abdominal ultrasound | $266 | $425 | $100 |
| Abdominal ultrasound (complete) | $274 | $450 | $114 |
| Abdominal ultrasound (limited) | $259 | $400 | $86 |
| Abscess drainage (complex or multiple) | $118 | $490 | $220 |
| Abscess drainage (simple) | $61 | $317 | $129 |
| Abscess incision and drainage | $90 | $428 | $174 |
| Albumin blood test | $22 | $35 | $5 |
| Aldosterone test | $68 | $254 | $41 |
| Alkaline phosphatase test | $13 | $21 | $5 |
| Alpha-fetoprotein (AFP) test | $41 | $193 | $17 |
| ALT liver enzyme test | $12 | $32 | $5 |
| Ammonia blood test | $11 | $127 | $15 |
| Amylase test | $31 | $67 | $6 |
| Anoscopy | $37 | $183 | $129 |
| Antinuclear antibody (ANA) test | $42 | $107 | $12 |
| Arterial blood gas (ABG) | $52 | $300 | $26 |
| AST liver enzyme test | $12 | $32 | $5 |
| Barium swallow study | $128 | $235 | $107 |
| Bartholin cyst removal | $54 | $269 | $182 |
| Basic metabolic panel | $19 | $127 | $8 |
| Benign skin lesion removal | $217 | $571 | $171 |
| Bilirubin blood test | $33 | $34 | $5 |
| Blood clotting test (PT/INR) | $5 | $70 | $4 |
| Blood crossmatch | $53 | $123 | — |
| Blood glucose test | $5 | $59 | $5 |
| Blood type and screen | $31 | $63 | $10 |
| Blood type test | $50 | $74 | $3 |
| Blood type test (ABO group) | $68 | $74 | $3 |
| Blood type test (Rh/D antigen) | $33 | $74 | $3 |
| BNP (heart failure) test | $22 | $443 | $39 |
| Bone density scan (DEXA) | $58 | $300 | $39 |
| Bone scan (nuclear) | $407 | $1,842 | $259 |
| Breathing tube insertion (intubation) | $81 | $443 | $133 |
| Bronchoscopy | $548 | $1,270 | $303 |
| Burn dressing and debridement (medium) | $75 | $169 | $166 |
| Burn dressing and debridement (small) | $69 | $166 | $93 |
| Burn treatment | $72 | $166 | $129 |
| C-reactive protein (CRP) | $16 | $57 | $5 |
| CA 19-9 tumor marker test | $49 | $156 | $21 |
| CA-125 ovarian marker test | $36 | $139 | $21 |
| Calcium blood test | $5 | $33 | $5 |
| Cardiac rehabilitation | $62 | $425 | $26 |
| Cardiac stress test | $145 | $460 | $39 |
| CEA tumor marker test | $31 | $188 | $19 |
| Central line placement | $1,419 | $2,734 | $238 |
| Chemotherapy infusion | $130 | $447 | $81 |
| Chemotherapy infusion (each additional) | $102 | $150 | $28 |
| Chemotherapy infusion (first hour) | $159 | $744 | $133 |
| Chest fluid drain (thoracentesis) | $203 | $1,023 | $311 |
| Chest tube insertion | $170 | $931 | $143 |
| Chest X-ray | $79 | $164 | $37 |
| Chest X-ray (1 view) | $60 | $147 | $25 |
| Chest X-ray (2 views) | $66 | $181 | $33 |
| Circumcision | $732 | $509 | $167 |
| Clotting time test (PTT) | $11 | $58 | $6 |
| Colonoscopy | $682 | $1,360 | $480 |
| Complete blood count (CBC) | $11 | $95 | $7 |
| Complete blood count (CBC) (complete) | $13 | $95 | $8 |
| Complex wound repair | $124 | $428 | $390 |
| Comprehensive metabolic panel | $28 | $214 | $11 |
| Copper blood test | $9 | $95 | $12 |
| Cortisol test | $41 | $127 | $16 |
| COVID-19 PCR test | $20 | $129 | $51 |
| CPAP titration study | $126 | $911 | $69 |
| Creatine kinase (CK) test | $7 | $43 | $7 |
| CT angiography of the chest | $690 | $1,500 | $281 |
| CT angiography of the head | $359 | $593 | $274 |
| CT scan of the abdomen | $713 | $1,500 | $230 |
| CT scan of the abdomen and pelvis | $893 | $2,458 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $1,266 | $3,253 | $338 |
| CT scan of the abdomen and pelvis with contrast | $893 | $2,458 | $300 |
| CT scan of the abdomen and pelvis without contrast | $564 | $2,060 | $183 |
| CT scan of the abdomen with and without contrast | $1,066 | $1,475 | $259 |
| CT scan of the abdomen with contrast | $713 | $1,600 | $230 |
| CT scan of the abdomen without contrast | $388 | $1,250 | $136 |
| CT scan of the arm | $458 | $1,300 | $199 |
| CT scan of the arm with contrast | $499 | $1,300 | $199 |
| CT scan of the arm without contrast | $239 | $1,300 | $161 |
| CT scan of the chest | $543 | $1,400 | $167 |
| CT scan of the chest with and without contrast | $500 | $1,700 | $196 |
| CT scan of the chest with contrast | $621 | $1,400 | $167 |
| CT scan of the chest without contrast | $543 | $1,300 | $133 |
| CT scan of the head | $242 | $929 | $148 |
| CT scan of the head with and without contrast | $292 | $1,233 | $173 |
| CT scan of the head with contrast | $191 | $1,000 | $148 |
| CT scan of the head without contrast | $242 | $929 | $107 |
| CT scan of the leg | $344 | $1,129 | $166 |
| CT scan of the leg with contrast | $344 | $1,129 | $166 |
| CT scan of the leg without contrast | $204 | $943 | $130 |
| CT scan of the lower back (lumbar spine) | $431 | $1,101 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $400 | $1,236 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $507 | $1,064 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $431 | $1,096 | $130 |
| CT scan of the neck | $189 | $1,012 | $183 |
| CT scan of the neck (cervical spine) | $340 | $1,101 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $304 | $1,236 | $196 |
| CT scan of the neck (cervical spine) with contrast | $367 | $1,064 | $168 |
| CT scan of the neck (cervical spine) without contrast | $340 | $1,096 | $131 |
| CT scan of the neck with and without contrast | $217 | $1,246 | $220 |
| CT scan of the neck with contrast | $189 | $1,012 | $183 |
| CT scan of the neck without contrast | $170 | $955 | $150 |
| CT scan of the pelvis | $189 | $1,203 | $226 |
| CT scan of the pelvis with and without contrast | $680 | $1,283 | $251 |
| CT scan of the pelvis with contrast | $189 | $1,203 | $226 |
| CT scan of the pelvis without contrast | $163 | $1,079 | $133 |
| CT scan of the sinuses | $170 | $924 | $152 |
| CT scan of the sinuses with contrast | $187 | $921 | $152 |
| CT scan of the sinuses without contrast | $170 | $924 | $128 |
| D-dimer test | $14 | $149 | $10 |
| DHEA-sulfate test | $41 | $356 | $22 |
| Drug screen (urine) | $28 | $250 | $17 |
| EKG / ECG (tracing only) | $57 | $228 | $7 |
| Electrocardiogram (EKG) | $30 | $228 | $8 |
| Electrolyte panel | $27 | $114 | $7 |
| Emergency department visit | $218 | $292 | $69 |
| Emergency department visit (level 1) | $74 | $75 | $11 |
| Emergency department visit (level 2) | $88 | $134 | $40 |
| Emergency department visit (level 3) | $218 | $390 | $69 |
| Emergency department visit (level 4) | $304 | $314 | $118 |
| Emergency department visit (level 5) | $365 | $463 | $171 |
| Endometrial biopsy | $56 | $344 | $98 |
| Epidural steroid injection | $388 | $313 | $275 |
| Esophageal dilation | $268 | $1,450 | $522 |
| Estradiol (estrogen) test | $58 | $132 | $28 |
| Fallopian tube X-ray (HSG) | $193 | $254 | $164 |
| Fecal occult blood (stool) test | $11 | $30 | $10 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $12 | $30 | $16 |
| Feeding tube (PEG) placement | $520 | $952 | $178 |
| Ferritin (iron) test | $10 | $119 | $14 |
| Fibrinogen test | $28 | $70 | $10 |
| Flexible sigmoidoscopy | $377 | $670 | $323 |
| Flu test | $18 | $154 | $17 |
| Foreign body removal (skin) | $97 | $129 | $157 |
| Free T4 thyroid test | $31 | $101 | $9 |
| FSH hormone test | $32 | $146 | $19 |
| Gallbladder scan (HIDA) | $658 | $1,532 | $334 |
| GGT liver test | $26 | $32 | $7 |
| Glucose tolerance test | $22 | $83 | $8 |
| HDL cholesterol test | $29 | $69 | $8 |
| Hematocrit test | $6 | $63 | $2 |
| Hemoglobin A1c (diabetes test) | $7 | $90 | $10 |
| Hemorrhoid removal | $458 | $466 | $338 |
| Hepatitis B test | $14 | $75 | $10 |
| Hepatitis C test | $11 | $78 | $14 |
| HIV test | $14 | $56 | $19 |
| HIV test (antibody) | $10 | $37 | $14 |
| HIV test (antigen/antibody combo) | $19 | $75 | $24 |
| Holter heart monitor | $64 | $267 | $26 |
| Iron blood test | $5 | $74 | $6 |
| IUD removal | $771 | $231 | $112 |
| IV infusion therapy | $71 | $468 | $44 |
| IV infusion therapy (each additional) | $44 | $100 | $21 |
| IV infusion therapy (initial) | $97 | $468 | $67 |
| Joint aspiration (small/intermediate) | $92 | $206 | $57 |
| Joint aspiration or injection (mid-size joint) | $96 | $206 | $57 |
| Joint aspiration or injection (small joint) | $88 | $206 | $56 |
| Kidney scan (nuclear) | $776 | $1,168 | $172 |
| Kidney ultrasound | $242 | $550 | $84 |
| Kidney ultrasound (limited) | $198 | $550 | $61 |
| Knee joint injection | $96 | $152 | $69 |
| Lactate test | $31 | $116 | $12 |
| LDH test | $13 | $32 | $6 |
| LDL cholesterol test | $8 | $69 | $11 |
| Leg vein ultrasound (Doppler) | $259 | $630 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $227 | $600 | $116 |
| LH hormone test | $32 | $158 | $19 |
| Lipase test | $29 | $52 | $7 |
| Lipid (cholesterol) panel | $16 | $90 | $13 |
| Liver biopsy | $213 | $2,003 | $288 |
| Liver function panel | $19 | $139 | $8 |
| Lung function test (PFT) | $113 | $447 | $37 |
| Lung scan (V/Q) | $842 | $1,208 | $291 |
| Magnesium blood test | $26 | $58 | $7 |
| MRA of the brain | $346 | $1,265 | $226 |
| MRA of the brain with contrast | $346 | $1,265 | $226 |
| MRA of the brain without contrast | $427 | $1,407 | $328 |
| MRA of the neck | $346 | $1,265 | $245 |
| MRA of the neck with contrast | $346 | $1,265 | $245 |
| MRA of the neck without contrast | $427 | $1,407 | $343 |
| MRI of the abdomen | $616 | $1,265 | $300 |
| MRI of the abdomen with contrast | $616 | $1,012 | $300 |
| MRI of the abdomen without contrast | $369 | $1,265 | $194 |
| MRI of the ankle | $734 | $1,125 | $261 |
| MRI of the ankle with contrast | $734 | $1,012 | $261 |
| MRI of the ankle without contrast | $638 | $1,141 | $222 |
| MRI of the brain | $730 | $1,519 | $269 |
| MRI of the brain with contrast | $730 | $1,328 | $269 |
| MRI of the brain without contrast | $634 | $1,519 | $195 |
| MRI of the chest | $743 | $1,012 | $371 |
| MRI of the chest without contrast | $720 | $1,125 | $466 |
| MRI of the knee | $994 | $1,125 | $315 |
| MRI of the knee with contrast | $1,486 | $1,012 | $315 |
| MRI of the knee without contrast | $994 | $1,265 | $204 |
| MRI of the lower back (lumbar spine) | $881 | $1,519 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $881 | $1,336 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $767 | $1,519 | $192 |
| MRI of the mid-back (thoracic spine) | $767 | $1,519 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $894 | $1,328 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $617 | $1,519 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $767 | $1,519 | $190 |
| MRI of the neck (cervical spine) | $798 | $1,519 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $809 | $1,659 | $318 |
| MRI of the neck (cervical spine) with contrast | $798 | $1,214 | $274 |
| MRI of the neck (cervical spine) without contrast | $694 | $1,519 | $191 |
| MRI of the pelvis | $440 | $1,519 | $268 |
| MRI of the pelvis with contrast | $440 | $1,519 | $268 |
| MRI of the pelvis without contrast | $369 | $1,519 | $227 |
| MRI of the shoulder | $1,139 | $1,407 | $313 |
| MRI of the shoulder with contrast | $1,486 | $1,919 | $313 |
| MRI of the shoulder without contrast | $994 | $1,265 | $205 |
| MRI of the wrist | $613 | $1,125 | $330 |
| MRI of the wrist with contrast | $762 | $1,012 | $330 |
| MRI of the wrist without contrast | $464 | $1,141 | $303 |
| Nebulizer breathing treatment | $64 | $245 | $9 |
| Nuclear cardiac stress test | $678 | $5,022 | $428 |
| Occupational therapy evaluation | $38 | $182 | $101 |
| Occupational therapy evaluation (high complexity) | $38 | $182 | $101 |
| Occupational therapy evaluation (low complexity) | $45 | $182 | $101 |
| Occupational therapy evaluation (moderate complexity) | $37 | $182 | $101 |
| Parathyroid hormone (PTH) test | $29 | $162 | $41 |
| Pelvic ultrasound | $308 | $291 | $78 |
| Pelvic ultrasound (complete) | $331 | $282 | $105 |
| Pelvic ultrasound (limited) | $286 | $300 | $51 |
| Phosphorus blood test | $23 | $32 | $5 |
| Physical therapy evaluation | $50 | $175 | $98 |
| Physical therapy evaluation (high complexity) | $55 | $175 | $98 |
| Physical therapy evaluation (moderate complexity) | $50 | $184 | $98 |
| Platelet count | $19 | $26 | $4 |
| Pregnancy ultrasound | $184 | $377 | $126 |
| Pregnancy ultrasound (first trimester) | $236 | $450 | $117 |
| Pregnancy ultrasound (second or third trimester) | $133 | $304 | $136 |
| Prolactin test | $43 | $149 | $19 |
| Prostate test (PSA) | $20 | $118 | $18 |
| Screening mammogram | $87 | $450 | $126 |
| Scrotal ultrasound | $306 | $450 | $99 |
| Sedimentation rate (ESR) test | $18 | $50 | $3 |
| Semen analysis | $11 | $43 | $12 |
| Sex hormone binding globulin test | $15 | $66 | $22 |
| Skin biopsy | $118 | $282 | $121 |
| Skin biopsy (punch) | $118 | $282 | $121 |
| Skin cancer lesion removal | $126 | $997 | $240 |
| Sleep study (polysomnography) | $757 | $2,282 | $691 |
| Soft tissue ultrasound | $264 | $350 | $64 |
| Speech therapy | $45 | $273 | $76 |
| Spinal tap (lumbar puncture) | $213 | $426 | $165 |
| Spirometry (lung function test) | $91 | $125 | $30 |
| Spirometry with bronchodilator | $136 | $450 | $43 |
| Strep throat test | $18 | $50 | $17 |
| Swallow study | $77 | $342 | $85 |
| T3 thyroid test | $10 | $96 | $14 |
| Testosterone test | $60 | $126 | $26 |
| Thyroid test (TSH) | $35 | $101 | $17 |
| Thyroid ultrasound | $291 | $204 | $109 |
| Thyroid uptake scan | $464 | $737 | $145 |
| Total IgE allergy test | $24 | $63 | $16 |
| Total protein test | $10 | $45 | $4 |
| Transvaginal ultrasound | $224 | $450 | $118 |
| Trigger point injection | $75 | $382 | $56 |
| Trigger point injection (1-2 muscles) | $75 | $221 | $52 |
| Triglycerides test | $18 | $32 | $6 |
| Troponin (heart) test | $35 | $198 | $12 |
| Turning a breech baby (version) | $1,302 | $1,951 | $94 |
| Upper GI endoscopy (EGD) | $398 | $1,109 | $371 |
| Upper GI series (barium) | $213 | $294 | $128 |
| Uric acid (gout) test | $22 | $32 | $5 |
| Urinalysis | $8 | $32 | $3 |
| Urine microalbumin test | $12 | $101 | $5 |
| Urine pregnancy test | $56 | $59 | $9 |
| Vaccine administration | $27 | $24 | $19 |
| Vaccine administration (each additional) | $32 | $33 | $16 |
| Wart removal | $58 | $246 | $121 |
| Wound debridement | $178 | $774 | $186 |
| X-ray of the abdomen | $111 | $225 | $36 |
| X-ray of the ankle | $101 | $200 | $37 |
| X-ray of the collarbone | $90 | $200 | $33 |
| X-ray of the elbow | $102 | $217 | $33 |
| X-ray of the facial bones | $359 | $259 | $39 |
| X-ray of the foot | $104 | $250 | $34 |
| X-ray of the forearm | $144 | $225 | $29 |
| X-ray of the hand | $88 | $200 | $38 |
| X-ray of the hip | $31 | $156 | $49 |
| X-ray of the hip (3 views) | $31 | $156 | $49 |
| X-ray of the knee | $186 | $225 | $42 |
| X-ray of the knee (2 views) | $104 | $225 | $34 |
| X-ray of the knee (3 views) | $186 | $225 | $42 |
| X-ray of the knee (4+ views) | $205 | $282 | $49 |
| X-ray of the lower back (lumbar spine) | $136 | $288 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $134 | $225 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $138 | $350 | $53 |
| X-ray of the lower leg | $71 | $200 | $31 |
| X-ray of the mid-back (thoracic spine) | $134 | $275 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $129 | $225 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $138 | $325 | $39 |
| X-ray of the neck (cervical spine) | $128 | $300 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $117 | $250 | $40 |
| X-ray of the pelvis | $33 | $141 | $36 |
| X-ray of the pelvis (1 view) | $24 | $137 | $28 |
| X-ray of the ribs | $103 | $218 | $42 |
| X-ray of the ribs (2 views) | $94 | $224 | $36 |
| X-ray of the ribs (3 views) | $103 | $213 | $42 |
| X-ray of the shoulder | $87 | $194 | $36 |
| X-ray of the skull | $69 | $300 | $40 |
| X-ray of the upper arm | $141 | $225 | $32 |
| X-ray of the wrist | $139 | $200 | $43 |
| Zinc blood test | $8 | $63 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
