| Procedure | Bsa Hospital | Memorial Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $50 | $154 | $51 |
| Abdominal fluid drain (paracentesis) | $322 | $884 | $284 |
| Abdominal ultrasound | $266 | $592 | $100 |
| Abdominal ultrasound (complete) | $274 | $751 | $114 |
| Abdominal ultrasound (limited) | $259 | $592 | $86 |
| Abscess drainage (complex or multiple) | $118 | $441 | $220 |
| Abscess drainage (simple) | $61 | $422 | $129 |
| Abscess incision and drainage | $90 | $441 | $174 |
| Albumin blood test | $22 | $70 | $5 |
| Aldosterone test | $68 | $162 | $41 |
| Alkaline phosphatase test | $13 | $91 | $5 |
| Alpha-fetoprotein (AFP) test | $41 | $194 | $17 |
| ALT liver enzyme test | $12 | $25 | $5 |
| Ammonia blood test | $11 | $155 | $15 |
| Amylase test | $31 | $172 | $6 |
| Anoscopy | $37 | $146 | $129 |
| Antinuclear antibody (ANA) test | $42 | $62 | $12 |
| Arterial blood gas (ABG) | $52 | $230 | $26 |
| AST liver enzyme test | $12 | $25 | $5 |
| Barium swallow study | $128 | $473 | $107 |
| Bartholin cyst removal | $54 | $236 | $182 |
| Basic metabolic panel | $19 | $181 | $8 |
| Benign skin lesion removal | $217 | $1,970 | $171 |
| Bilirubin blood test | $33 | $63 | $5 |
| Blood clotting test (PT/INR) | $5 | $91 | $4 |
| Blood glucose test | $5 | $78 | $5 |
| Blood type and screen | $31 | $98 | $10 |
| Blood type test | $50 | $86 | $3 |
| Blood type test (ABO group) | $68 | $116 | $3 |
| Blood type test (Rh/D antigen) | $33 | $57 | $3 |
| BNP (heart failure) test | $22 | $145 | $39 |
| Bone density scan (DEXA) | $58 | $107 | $39 |
| Bone marrow biopsy | $397 | $444 | $172 |
| Bone scan (nuclear) | $407 | $153 | $259 |
| Breast biopsy | $564 | $3,209 | $478 |
| Breast ultrasound | $121 | $423 | $92 |
| Breast ultrasound (complete) | $129 | $453 | $100 |
| Breast ultrasound (limited) | $112 | $277 | $84 |
| Breathing tube insertion (intubation) | $81 | $785 | $133 |
| Bronchoscopy | $548 | $379 | $303 |
| Burn dressing and debridement (medium) | $75 | $300 | $166 |
| Burn dressing and debridement (small) | $69 | $310 | $93 |
| Burn treatment | $72 | $310 | $129 |
| C-reactive protein (CRP) | $16 | $191 | $5 |
| CA 19-9 tumor marker test | $49 | $237 | $21 |
| CA-125 ovarian marker test | $36 | $223 | $21 |
| Calcium blood test | $5 | $91 | $5 |
| Cardiac rehabilitation | $62 | $211 | $26 |
| Cardiac stress test | $145 | $827 | $39 |
| CEA tumor marker test | $31 | $200 | $19 |
| Central line placement | $1,419 | $1,010 | $238 |
| Chest fluid drain (thoracentesis) | $203 | $1,931 | $311 |
| Chest tube insertion | $170 | $1,154 | $143 |
| Chest X-ray | $79 | $333 | $37 |
| Chest X-ray (1 view) | $60 | $266 | $25 |
| Chest X-ray (2 views) | $66 | $310 | $33 |
| Circumcision | $732 | $1,831 | $167 |
| Clotting time test (PTT) | $11 | $91 | $6 |
| Colonoscopy | $682 | $2,357 | $480 |
| Complete blood count (CBC) | $11 | $103 | $7 |
| Complete blood count (CBC) (complete) | $13 | $108 | $8 |
| Complex wound repair | $124 | $653 | $390 |
| Comprehensive metabolic panel | $28 | $270 | $11 |
| Copper blood test | $9 | $122 | $12 |
| Cortisol test | $41 | $186 | $16 |
| COVID-19 PCR test | $20 | $109 | $51 |
| CPAP titration study | $126 | $1,014 | $69 |
| Creatine kinase (CK) test | $7 | $22 | $7 |
| CT angiography of the chest | $690 | $1,636 | $281 |
| CT angiography of the head | $359 | $2,755 | $274 |
| CT scan of the abdomen | $713 | $279 | $230 |
| CT scan of the abdomen and pelvis | $893 | $3,229 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $1,266 | $4,064 | $338 |
| CT scan of the abdomen and pelvis with contrast | $893 | $3,029 | $300 |
| CT scan of the abdomen and pelvis without contrast | $564 | $2,651 | $183 |
| CT scan of the abdomen with and without contrast | $1,066 | $372 | $259 |
| CT scan of the abdomen with contrast | $713 | $279 | $230 |
| CT scan of the abdomen without contrast | $388 | $270 | $136 |
| CT scan of the arm | $458 | $1,569 | $199 |
| CT scan of the arm with contrast | $499 | $1,569 | $199 |
| CT scan of the arm without contrast | $239 | $1,434 | $161 |
| CT scan of the chest | $543 | $279 | $167 |
| CT scan of the chest with and without contrast | $500 | $372 | $196 |
| CT scan of the chest with contrast | $621 | $279 | $167 |
| CT scan of the chest without contrast | $543 | $270 | $133 |
| CT scan of the head | $242 | $255 | $148 |
| CT scan of the head with and without contrast | $292 | $372 | $173 |
| CT scan of the head with contrast | $191 | $265 | $148 |
| CT scan of the head without contrast | $242 | $213 | $107 |
| CT scan of the leg | $344 | $1,569 | $166 |
| CT scan of the leg with contrast | $344 | $1,569 | $166 |
| CT scan of the leg without contrast | $204 | $1,434 | $130 |
| CT scan of the lower back (lumbar spine) | $431 | $1,136 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $400 | $1,400 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $507 | $2,278 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $431 | $262 | $130 |
| CT scan of the neck | $189 | $1,048 | $183 |
| CT scan of the neck (cervical spine) | $340 | $1,969 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $304 | $2,497 | $196 |
| CT scan of the neck (cervical spine) with contrast | $367 | $2,278 | $168 |
| CT scan of the neck (cervical spine) without contrast | $340 | $262 | $131 |
| CT scan of the neck with and without contrast | $217 | $1,466 | $220 |
| CT scan of the neck with contrast | $189 | $1,062 | $183 |
| CT scan of the neck without contrast | $170 | $985 | $150 |
| CT scan of the pelvis | $189 | $309 | $226 |
| CT scan of the pelvis with and without contrast | $680 | $1,579 | $251 |
| CT scan of the pelvis with contrast | $189 | $1,196 | $226 |
| CT scan of the pelvis without contrast | $163 | $234 | $133 |
| CT scan of the sinuses | $170 | $1,725 | $152 |
| CT scan of the sinuses with contrast | $187 | $1,793 | $152 |
| CT scan of the sinuses without contrast | $170 | $246 | $128 |
| D-dimer test | $14 | $210 | $10 |
| DHEA-sulfate test | $41 | $210 | $22 |
| Diagnostic mammogram | $114 | $360 | $140 |
| Drug screen (urine) | $28 | $91 | $17 |
| EKG / ECG (tracing only) | $57 | $255 | $7 |
| Electrocardiogram (EKG) | $30 | $47 | $8 |
| Electrolyte panel | $27 | $100 | $7 |
| Emergency department visit | $218 | $258 | $69 |
| Emergency department visit (level 1) | $74 | $101 | $11 |
| Emergency department visit (level 2) | $88 | $161 | $40 |
| Emergency department visit (level 3) | $218 | $265 | $69 |
| Emergency department visit (level 4) | $304 | $462 | $118 |
| Emergency department visit (level 5) | $365 | $671 | $171 |
| Endometrial biopsy | $56 | $261 | $98 |
| Esophageal dilation | $268 | $1,650 | $522 |
| Estradiol (estrogen) test | $58 | $130 | $28 |
| Fallopian tube X-ray (HSG) | $193 | $401 | $164 |
| Feeding tube (PEG) placement | $520 | $2,832 | $178 |
| Ferritin (iron) test | $10 | $155 | $14 |
| Fibrinogen test | $28 | $124 | $10 |
| Flexible sigmoidoscopy | $377 | $1,435 | $323 |
| Flu test | $18 | $91 | $17 |
| Foreign body removal (skin) | $97 | $450 | $157 |
| Free T4 thyroid test | $31 | $166 | $9 |
| FSH hormone test | $32 | $146 | $19 |
| Gallbladder scan (HIDA) | $658 | $1,510 | $334 |
| GGT liver test | $26 | $94 | $7 |
| Glucose tolerance test | $22 | $82 | $8 |
| H. pylori test | $36 | $198 | $67 |
| HDL cholesterol test | $29 | $40 | $8 |
| Hematocrit test | $6 | $46 | $2 |
| Hemodialysis | $154 | $1,120 | $75 |
| Hemoglobin A1c (diabetes test) | $7 | $118 | $10 |
| Hemorrhoid removal | $458 | $1,034 | $338 |
| Hepatitis B test | $14 | $169 | $10 |
| Hepatitis C test | $11 | $90 | $14 |
| HIV test | $14 | $239 | $19 |
| HIV test (antigen/antibody combo) | $19 | $239 | $24 |
| Holter heart monitor | $64 | $315 | $26 |
| Iron blood test | $5 | $100 | $6 |
| IUD removal | $771 | $399 | $112 |
| IV infusion therapy | $71 | $179 | $44 |
| IV infusion therapy (each additional) | $44 | $130 | $21 |
| IV infusion therapy (initial) | $97 | $556 | $67 |
| Joint aspiration (small/intermediate) | $92 | $500 | $57 |
| Joint aspiration or injection (mid-size joint) | $96 | $581 | $57 |
| Joint aspiration or injection (small joint) | $88 | $419 | $56 |
| Kidney biopsy | $465 | $2,120 | $492 |
| Kidney scan (nuclear) | $776 | $1,831 | $172 |
| Kidney ultrasound | $242 | $306 | $84 |
| Knee joint injection | $96 | $418 | $69 |
| Lactate test | $31 | $271 | $12 |
| LDH test | $13 | $97 | $6 |
| LDL cholesterol test | $8 | $82 | $11 |
| Leg vein ultrasound (Doppler) | $259 | $546 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $227 | $546 | $116 |
| LH hormone test | $32 | $146 | $19 |
| Lipase test | $29 | $154 | $7 |
| Lipid (cholesterol) panel | $16 | $96 | $13 |
| Liver biopsy | $213 | $2,120 | $288 |
| Liver function panel | $19 | $181 | $8 |
| Lung function test (PFT) | $113 | $206 | $37 |
| Lung scan (V/Q) | $842 | $1,870 | $291 |
| Magnesium blood test | $26 | $77 | $7 |
| MRA of the brain | $346 | $2,246 | $226 |
| MRA of the brain with contrast | $346 | $2,353 | $226 |
| MRA of the brain without contrast | $427 | $3,227 | $328 |
| MRA of the neck | $346 | $2,353 | $245 |
| MRA of the neck with contrast | $346 | $2,353 | $245 |
| MRA of the neck without contrast | $427 | $3,227 | $343 |
| MRI of the abdomen | $616 | $2,353 | $300 |
| MRI of the abdomen with contrast | $616 | $2,353 | $300 |
| MRI of the abdomen without contrast | $369 | $2,139 | $194 |
| MRI of the ankle | $734 | $2,213 | $261 |
| MRI of the ankle with contrast | $734 | $2,071 | $261 |
| MRI of the ankle without contrast | $638 | $2,213 | $222 |
| MRI of the brain | $730 | $2,353 | $269 |
| MRI of the brain with contrast | $730 | $2,353 | $269 |
| MRI of the brain without contrast | $634 | $2,579 | $195 |
| MRI of the chest | $743 | $2,499 | $371 |
| MRI of the chest without contrast | $720 | $3,227 | $466 |
| MRI of the knee | $994 | $2,213 | $315 |
| MRI of the knee with contrast | $1,486 | $2,071 | $315 |
| MRI of the knee without contrast | $994 | $2,213 | $204 |
| MRI of the lower back (lumbar spine) | $881 | $2,226 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $881 | $2,226 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $767 | $1,451 | $192 |
| MRI of the mid-back (thoracic spine) | $767 | $2,529 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $894 | $3,242 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $617 | $2,353 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $767 | $1,445 | $190 |
| MRI of the neck (cervical spine) | $798 | $2,353 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $809 | $3,242 | $318 |
| MRI of the neck (cervical spine) with contrast | $798 | $2,353 | $274 |
| MRI of the neck (cervical spine) without contrast | $694 | $198 | $191 |
| MRI of the pelvis | $440 | $2,353 | $268 |
| MRI of the pelvis with contrast | $440 | $2,353 | $268 |
| MRI of the pelvis without contrast | $369 | $2,139 | $227 |
| MRI of the shoulder | $1,139 | $2,213 | $313 |
| MRI of the shoulder with contrast | $1,486 | $2,071 | $313 |
| MRI of the shoulder without contrast | $994 | $2,213 | $205 |
| MRI of the wrist | $613 | $2,071 | $330 |
| MRI of the wrist with contrast | $762 | $2,071 | $330 |
| MRI of the wrist without contrast | $464 | $1,873 | $303 |
| Nebulizer breathing treatment | $64 | $104 | $9 |
| Nuclear cardiac stress test | $678 | $2,778 | $428 |
| Occupational therapy evaluation | $38 | $210 | $101 |
| Occupational therapy evaluation (high complexity) | $38 | $210 | $101 |
| Occupational therapy evaluation (low complexity) | $45 | $210 | $101 |
| Occupational therapy evaluation (moderate complexity) | $37 | $210 | $101 |
| Parathyroid hormone (PTH) test | $29 | $235 | $41 |
| Pelvic ultrasound | $308 | $251 | $78 |
| Pelvic ultrasound (complete) | $331 | $369 | $105 |
| Pelvic ultrasound (limited) | $286 | $251 | $51 |
| Phosphorus blood test | $23 | $22 | $5 |
| Physical therapy evaluation | $50 | $210 | $98 |
| Physical therapy evaluation (high complexity) | $55 | $210 | $98 |
| Physical therapy evaluation (moderate complexity) | $50 | $210 | $98 |
| Platelet count | $19 | $73 | $4 |
| Pregnancy ultrasound | $184 | $144 | $126 |
| Pregnancy ultrasound (first trimester) | $236 | $124 | $117 |
| Pregnancy ultrasound (second or third trimester) | $133 | $163 | $136 |
| Prolactin test | $43 | $172 | $19 |
| Prostate test (PSA) | $20 | $185 | $18 |
| Rheumatoid factor test | $6 | $91 | $6 |
| Scoliosis spine X-ray | $46 | $338 | $58 |
| Scoliosis spine X-ray (3 views) | $48 | $338 | $72 |
| Screening mammogram | $87 | $277 | $126 |
| Scrotal ultrasound | $306 | $107 | $99 |
| Sedimentation rate (ESR) test | $18 | $77 | $3 |
| Semen analysis | $11 | $53 | $12 |
| Sex hormone binding globulin test | $15 | $58 | $22 |
| Skin biopsy | $118 | $268 | $121 |
| Skin biopsy (punch) | $118 | $298 | $121 |
| Skin cancer lesion removal | $126 | $1,752 | $240 |
| Soft tissue ultrasound | $264 | $342 | $64 |
| Speech therapy | $45 | $158 | $76 |
| Spinal tap (lumbar puncture) | $213 | $581 | $165 |
| Spirometry (lung function test) | $91 | $181 | $30 |
| Spirometry with bronchodilator | $136 | $333 | $43 |
| Strep throat test | $18 | $94 | $17 |
| Swallow study | $77 | $542 | $85 |
| T3 thyroid test | $10 | $150 | $14 |
| Testosterone test | $60 | $105 | $26 |
| Thyroid test (TSH) | $35 | $127 | $17 |
| Thyroid ultrasound | $291 | $370 | $109 |
| Thyroid uptake scan | $464 | $700 | $145 |
| Tilt table test | $166 | $1,333 | $168 |
| Total IgE allergy test | $24 | $66 | $16 |
| Total protein test | $10 | $102 | $4 |
| Transvaginal ultrasound | $224 | $107 | $118 |
| Trigger point injection | $75 | $266 | $56 |
| Trigger point injection (1-2 muscles) | $75 | $266 | $52 |
| Triglycerides test | $18 | $54 | $6 |
| Troponin (heart) test | $35 | $169 | $12 |
| Upper GI endoscopy (EGD) | $398 | $2,138 | $371 |
| Upper GI series (barium) | $213 | $502 | $128 |
| Uric acid (gout) test | $22 | $22 | $5 |
| Urinalysis | $8 | $46 | $3 |
| Urine microalbumin test | $12 | $65 | $5 |
| Urine pregnancy test | $56 | $102 | $9 |
| Vaccine administration | $27 | $85 | $19 |
| Vaccine administration (each additional) | $32 | $85 | $16 |
| Wart removal | $58 | $202 | $121 |
| Wound debridement | $178 | $754 | $186 |
| X-ray of the abdomen | $111 | $317 | $36 |
| X-ray of the ankle | $101 | $288 | $37 |
| X-ray of the collarbone | $90 | $158 | $33 |
| X-ray of the elbow | $102 | $156 | $33 |
| X-ray of the facial bones | $359 | $71 | $39 |
| X-ray of the foot | $104 | $190 | $34 |
| X-ray of the forearm | $144 | $46 | $29 |
| X-ray of the hand | $88 | $163 | $38 |
| X-ray of the hip | $31 | $280 | $49 |
| X-ray of the hip (3 views) | $31 | $309 | $49 |
| X-ray of the knee | $186 | $334 | $42 |
| X-ray of the knee (2 views) | $104 | $334 | $34 |
| X-ray of the knee (3 views) | $186 | $212 | $42 |
| X-ray of the knee (4+ views) | $205 | $388 | $49 |
| X-ray of the lower back (lumbar spine) | $136 | $71 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $134 | $52 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $138 | $95 | $53 |
| X-ray of the lower leg | $71 | $51 | $31 |
| X-ray of the mid-back (thoracic spine) | $134 | $45 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $129 | $171 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $138 | $45 | $39 |
| X-ray of the neck (cervical spine) | $128 | $75 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $117 | $54 | $40 |
| X-ray of the pelvis | $33 | $58 | $36 |
| X-ray of the pelvis (1 view) | $24 | $52 | $28 |
| X-ray of the ribs | $103 | $54 | $42 |
| X-ray of the ribs (2 views) | $94 | $54 | $36 |
| X-ray of the ribs (3 views) | $103 | $45 | $42 |
| X-ray of the shoulder | $87 | $50 | $36 |
| X-ray of the skull | $69 | $45 | $40 |
| X-ray of the upper arm | $141 | $52 | $32 |
| X-ray of the wrist | $139 | $274 | $43 |
| Zinc blood test | $8 | $104 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
