| Procedure | Community Hospital of Staunton | Alton Memorial Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $106 | $30 | $51 |
| Abdominal fluid drain (paracentesis) | $313 | $2,189 | $284 |
| Abdominal ultrasound | $581 | $510 | $100 |
| Abdominal ultrasound (complete) | $630 | $573 | $114 |
| Abdominal ultrasound (limited) | $581 | $448 | $86 |
| Abscess drainage (complex or multiple) | $352 | $3,022 | $220 |
| Abscess drainage (simple) | $251 | $1,558 | $129 |
| Abscess incision and drainage | $251 | $1,558 | $174 |
| Albumin blood test | $44 | $20 | $5 |
| Aldosterone test | $197 | $118 | $41 |
| Alkaline phosphatase test | $67 | $32 | $5 |
| Alpha-fetoprotein (AFP) test | $106 | $71 | $17 |
| ALT liver enzyme test | $58 | $16 | $5 |
| Ammonia blood test | $111 | $62 | $15 |
| Amylase test | $67 | $29 | $6 |
| Antinuclear antibody (ANA) test | $88 | $52 | $12 |
| Arterial blood gas (ABG) | $176 | $135 | $26 |
| AST liver enzyme test | $63 | $26 | $5 |
| Barium swallow study | $341 | $279 | $107 |
| Bartholin cyst removal | $186 | $758 | $182 |
| Basic metabolic panel | $127 | $157 | $8 |
| Bilirubin blood test | $56 | $22 | $5 |
| Blood clotting test (PT/INR) | $54 | $17 | $4 |
| Blood crossmatch | $99 | $128 | — |
| Blood glucose test | $33 | $34 | $5 |
| Blood transfusion | $528 | $1,993 | $47 |
| Blood type and screen | $68 | $46 | $10 |
| Blood type test | $35 | $68 | $3 |
| Blood type test (ABO group) | $35 | $95 | $3 |
| Blood type test (Rh/D antigen) | $35 | $40 | $3 |
| BNP (heart failure) test | $166 | $116 | $39 |
| Bone density scan (DEXA) | $292 | $229 | $39 |
| Bone scan (nuclear) | $966 | $1,138 | $259 |
| Breast biopsy | $844 | $6,875 | $478 |
| Breast MRI | $1,407 | $1,133 | $216 |
| Breast MRI without contrast | $1,933 | $1,133 | $216 |
| Breast ultrasound | $207 | $454 | $92 |
| Breast ultrasound (complete) | $248 | $454 | $100 |
| Breast ultrasound (limited) | $169 | $438 | $84 |
| Burn dressing and debridement (medium) | $106 | $388 | $166 |
| Burn dressing and debridement (small) | $106 | $592 | $93 |
| Burn treatment | $106 | $519 | $129 |
| C-reactive protein (CRP) | $58 | $28 | $5 |
| CA 19-9 tumor marker test | $123 | $59 | $21 |
| CA-125 ovarian marker test | $129 | $65 | $21 |
| Calcium blood test | $56 | $19 | $5 |
| Cardiac stress test | $598 | $921 | $39 |
| Cardioversion | $480 | $2,932 | $155 |
| Carotid artery ultrasound | $422 | $1,417 | $156 |
| CEA tumor marker test | $123 | $77 | $19 |
| Celiac disease test | $145 | $61 | $12 |
| Central line placement | $1,041 | $5,047 | $238 |
| Chemotherapy infusion | $243 | $617 | $81 |
| Chemotherapy infusion (each additional) | $106 | $435 | $28 |
| Chemotherapy infusion (first hour) | $381 | $799 | $133 |
| Chest fluid drain (thoracentesis) | $519 | $4,118 | $311 |
| Chest X-ray | $237 | $268 | $37 |
| Chest X-ray (1 view) | $219 | $261 | $25 |
| Chest X-ray (2 views) | $253 | $274 | $33 |
| CK-MB heart enzyme test | $103 | $76 | $12 |
| Clotting time test (PTT) | $59 | $79 | $6 |
| Complete blood count (CBC) | $74 | $92 | $7 |
| Complete blood count (CBC) (complete) | $85 | $92 | $8 |
| Comprehensive metabolic panel | $155 | $215 | $11 |
| Copper blood test | $88 | $53 | $12 |
| Cortisol test | $106 | $70 | $16 |
| COVID-19 PCR test | $168 | $77 | $51 |
| CPAP titration study | $259 | $677 | $69 |
| Creatine kinase (CK) test | $74 | $28 | $7 |
| CT angiography of the chest | $1,710 | $1,071 | $281 |
| CT angiography of the head | $1,548 | $1,341 | $274 |
| CT scan of the abdomen | $1,513 | $974 | $230 |
| CT scan of the abdomen and pelvis | $2,533 | $2,292 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $2,757 | $2,981 | $338 |
| CT scan of the abdomen and pelvis with contrast | $2,533 | $2,839 | $300 |
| CT scan of the abdomen and pelvis without contrast | $1,969 | $1,744 | $183 |
| CT scan of the abdomen with and without contrast | $1,759 | $1,063 | $259 |
| CT scan of the abdomen with contrast | $1,513 | $886 | $230 |
| CT scan of the abdomen without contrast | $1,171 | $812 | $136 |
| CT scan of the arm | $1,442 | $913 | $199 |
| CT scan of the arm with contrast | $1,442 | $913 | $199 |
| CT scan of the arm without contrast | $1,273 | $701 | $161 |
| CT scan of the chest | $1,196 | $817 | $167 |
| CT scan of the chest with and without contrast | $1,442 | $974 | $196 |
| CT scan of the chest with contrast | $1,196 | $926 | $167 |
| CT scan of the chest without contrast | $1,020 | $709 | $133 |
| CT scan of the head | $1,196 | $860 | $148 |
| CT scan of the head with and without contrast | $1,515 | $1,219 | $173 |
| CT scan of the head with contrast | $1,196 | $1,023 | $148 |
| CT scan of the head without contrast | $1,072 | $860 | $107 |
| CT scan of the leg | $1,256 | $1,049 | $166 |
| CT scan of the leg with contrast | $1,256 | $1,049 | $166 |
| CT scan of the leg without contrast | $1,072 | $1,358 | $130 |
| CT scan of the lower back (lumbar spine) | $1,196 | $912 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $1,442 | $1,122 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,196 | $912 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,118 | $691 | $130 |
| CT scan of the neck | $1,412 | $857 | $183 |
| CT scan of the neck (cervical spine) | $1,273 | $1,030 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $1,442 | $1,766 | $196 |
| CT scan of the neck (cervical spine) with contrast | $320 | $1,030 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,273 | $907 | $131 |
| CT scan of the neck with and without contrast | $1,515 | $973 | $220 |
| CT scan of the neck with contrast | $1,412 | $857 | $183 |
| CT scan of the neck without contrast | $1,161 | $758 | $150 |
| CT scan of the pelvis | $1,319 | $924 | $226 |
| CT scan of the pelvis with and without contrast | $1,442 | $1,494 | $251 |
| CT scan of the pelvis with contrast | $1,319 | $924 | $226 |
| CT scan of the pelvis without contrast | $1,134 | $705 | $133 |
| CT scan of the sinuses | $1,196 | $916 | $152 |
| CT scan of the sinuses with and without contrast | $1,442 | $1,145 | $184 |
| CT scan of the sinuses with contrast | $1,196 | $916 | $152 |
| CT scan of the sinuses without contrast | $1,072 | $793 | $128 |
| DHEA-sulfate test | $145 | $170 | $22 |
| Diagnostic mammogram | $274 | $198 | $140 |
| Drug screen (urine) | $235 | $118 | $17 |
| Echocardiogram | $704 | $1,483 | $138 |
| Echocardiogram with and without contrast | $633 | $424 | $101 |
| EKG / ECG (tracing only) | $177 | $318 | $7 |
| Electrocardiogram (EKG) | $177 | $318 | $8 |
| Electrolyte panel | $80 | $50 | $7 |
| Emergency department visit | $267 | $1,604 | $69 |
| Emergency department visit (level 1) | $169 | $569 | $11 |
| Emergency department visit (level 2) | $218 | $1,010 | $40 |
| Emergency department visit (level 3) | $267 | $1,604 | $69 |
| Emergency department visit (level 4) | $419 | $2,259 | $118 |
| Emergency department visit (level 5) | $563 | $3,331 | $171 |
| Estradiol (estrogen) test | $113 | $79 | $28 |
| Fallopian tube X-ray (HSG) | $211 | $1,372 | $164 |
| Fecal occult blood (stool) test | $62 | $33 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $35 | $18 | $4 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $88 | $47 | $16 |
| Ferritin (iron) test | $89 | $58 | $14 |
| Fibrinogen test | $123 | $62 | $10 |
| Flu test | $92 | $46 | $17 |
| Folate (folic acid) test | $89 | $62 | $15 |
| Foreign body removal (skin) | $185 | $3,562 | $157 |
| Free T4 thyroid test | $80 | $44 | $9 |
| FSH hormone test | $180 | $151 | $19 |
| Gallbladder scan (HIDA) | $1,476 | $820 | $334 |
| GGT liver test | $57 | $31 | $7 |
| Glucose tolerance test | $86 | $84 | $8 |
| Group therapy session | $134 | $317 | $30 |
| H. pylori test | $211 | $169 | $67 |
| HDL cholesterol test | $70 | $35 | $8 |
| Hematocrit test | $24 | $18 | $2 |
| Hemoglobin A1c (diabetes test) | $88 | $34 | $10 |
| Hepatitis B test | $75 | $43 | $10 |
| Hepatitis C test | $92 | $61 | $14 |
| HIV test | $125 | $60 | $19 |
| HIV test (antigen/antibody combo) | $91 | $60 | $24 |
| Holter heart monitor | $343 | $775 | $26 |
| Home sleep apnea test | $736 | $870 | $123 |
| Iron blood test | $65 | $25 | $6 |
| IV infusion therapy | $125 | $547 | $44 |
| IV infusion therapy (each additional) | $56 | $132 | $21 |
| IV infusion therapy (initial) | $194 | $547 | $67 |
| Joint aspiration (small/intermediate) | $207 | $2,045 | $57 |
| Joint aspiration or injection (mid-size joint) | $168 | $2,058 | $57 |
| Joint aspiration or injection (small joint) | $246 | $2,031 | $56 |
| Kidney scan (nuclear) | $1,230 | $1,060 | $172 |
| Kidney ultrasound | $503 | $526 | $84 |
| Kidney ultrasound (limited) | $425 | $395 | $61 |
| Knee joint injection | $187 | $2,808 | $69 |
| Lactate test | $88 | $165 | $12 |
| LDH test | $63 | $26 | $6 |
| LDL cholesterol test | $70 | $32 | $11 |
| Leg vein ultrasound (Doppler) | $675 | $1,191 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $507 | $1,021 | $116 |
| LH hormone test | $129 | $105 | $19 |
| Lipase test | $70 | $75 | $7 |
| Lipid (cholesterol) panel | $148 | $57 | $13 |
| Liver function panel | $144 | $53 | $8 |
| Lung function test (PFT) | $286 | $687 | $37 |
| Lung scan (V/Q) | $1,329 | $757 | $291 |
| Magnesium blood test | $63 | $94 | $7 |
| MRA of the brain | $1,515 | $1,887 | $226 |
| MRA of the neck | $1,688 | $2,140 | $245 |
| MRA of the neck without contrast | $1,933 | $2,452 | $343 |
| MRI of the abdomen | $2,033 | $1,584 | $300 |
| MRI of the abdomen with contrast | $2,033 | $1,725 | $300 |
| MRI of the abdomen without contrast | $1,759 | $1,442 | $194 |
| MRI of the ankle | $1,970 | $1,170 | $261 |
| MRI of the ankle without contrast | $1,829 | $1,170 | $222 |
| MRI of the brain | $1,679 | $1,382 | $269 |
| MRI of the brain with contrast | $1,679 | $1,680 | $269 |
| MRI of the brain without contrast | $1,659 | $1,382 | $195 |
| MRI of the chest | $1,599 | $1,579 | $371 |
| MRI of the chest without contrast | $1,933 | $2,149 | $466 |
| MRI of the knee | $1,679 | $1,434 | $315 |
| MRI of the knee with contrast | $1,679 | $1,748 | $315 |
| MRI of the knee without contrast | $1,671 | $1,434 | $204 |
| MRI of the lower back (lumbar spine) | $1,970 | $1,446 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $1,970 | $1,470 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,759 | $1,423 | $192 |
| MRI of the mid-back (thoracic spine) | $1,679 | $1,636 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $1,857 | $1,910 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $1,679 | $1,636 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $1,528 | $1,153 | $190 |
| MRI of the neck (cervical spine) | $1,933 | $1,697 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $1,933 | $1,907 | $318 |
| MRI of the neck (cervical spine) with contrast | $1,970 | $1,697 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,712 | $1,381 | $191 |
| MRI of the pelvis | $1,679 | $1,446 | $268 |
| MRI of the pelvis without contrast | $1,154 | $1,446 | $227 |
| MRI of the shoulder | $1,644 | $2,202 | $313 |
| MRI of the shoulder with contrast | $503 | $3,138 | $313 |
| MRI of the shoulder without contrast | $1,644 | $1,266 | $205 |
| MRI of the wrist | $1,515 | $1,484 | $330 |
| MRI of the wrist without contrast | $1,515 | $1,296 | $303 |
| Nebulizer breathing treatment | $88 | $240 | $9 |
| Nuclear cardiac stress test | $2,935 | $2,061 | $428 |
| Occupational therapy evaluation | $141 | $197 | $101 |
| Occupational therapy evaluation (high complexity) | $141 | $233 | $101 |
| Occupational therapy evaluation (low complexity) | $163 | $192 | $101 |
| Occupational therapy evaluation (moderate complexity) | $141 | $197 | $101 |
| Pap smear (cervical screening) | $126 | $73 | $20 |
| Parathyroid hormone (PTH) test | $88 | $138 | $41 |
| Pelvic ultrasound | $413 | $614 | $78 |
| Pelvic ultrasound (complete) | $545 | $614 | $105 |
| Pelvic ultrasound (limited) | $281 | $274 | $51 |
| PET scan | $1,913 | $3,397 | — |
| Phosphorus blood test | $56 | $59 | $5 |
| Physical therapy evaluation | $343 | $142 | $98 |
| Physical therapy evaluation (high complexity) | $343 | $184 | $98 |
| Physical therapy evaluation (moderate complexity) | $343 | $163 | $98 |
| Platelet count | $53 | $19 | $4 |
| Pregnancy blood test (hCG) | $61 | $52 | $8 |
| Pregnancy ultrasound | $481 | $554 | $126 |
| Pregnancy ultrasound (first trimester) | $434 | $474 | $117 |
| Pregnancy ultrasound (second or third trimester) | $528 | $634 | $136 |
| Procalcitonin test | $229 | $101 | $27 |
| Prolactin test | $99 | $89 | $19 |
| Prostate test (PSA) | $123 | $77 | $18 |
| Psychiatric evaluation | $222 | $259 | $188 |
| Psychotherapy session | $137 | $239 | $140 |
| Rheumatoid factor test | $59 | $22 | $6 |
| Sacroiliac joint injection | $334 | $4,061 | $176 |
| Scoliosis spine X-ray | $85 | $187 | $58 |
| Scoliosis spine X-ray (1 view) | $65 | $182 | $44 |
| Scoliosis spine X-ray (3 views) | $106 | $192 | $72 |
| Screening mammogram | $333 | $209 | $126 |
| Scrotal ultrasound | $581 | $820 | $99 |
| Sedimentation rate (ESR) test | $27 | $23 | $3 |
| Semen analysis | $107 | $52 | $12 |
| Sex hormone binding globulin test | $123 | $68 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $195 | $2,000 | $114 |
| Skin biopsy | $667 | $2,421 | $121 |
| Skin biopsy (punch) | $667 | $2,433 | $121 |
| Sleep study (polysomnography) | $3,497 | $4,633 | $691 |
| Soft tissue ultrasound | $367 | $157 | $64 |
| Speech therapy | $130 | $284 | $76 |
| Spinal tap (lumbar puncture) | $211 | $5,206 | $165 |
| Spirometry (lung function test) | $168 | $331 | $30 |
| Spirometry with bronchodilator | $405 | $1,042 | $43 |
| Strep throat test | $70 | $31 | $17 |
| Stress echocardiogram | $1,328 | $4,006 | $209 |
| Swallow study | $167 | $162 | $85 |
| T3 thyroid test | $92 | $51 | $14 |
| Tdap (tetanus) vaccine | $51 | $89 | — |
| Testosterone test | $127 | $144 | $26 |
| Thyroid test (TSH) | $97 | $66 | $17 |
| Thyroid ultrasound | $452 | $411 | $109 |
| Thyroid uptake scan | $586 | $580 | $145 |
| Total IgE allergy test | $86 | $100 | $16 |
| Total protein test | $53 | $16 | $4 |
| Transvaginal ultrasound | $443 | $385 | $118 |
| Trigger point injection | $84 | $1,138 | $56 |
| Trigger point injection (1-2 muscles) | $84 | $1,489 | $52 |
| Triglycerides test | $53 | $30 | $6 |
| Troponin (heart) test | $115 | $86 | $12 |
| Upper GI series (barium) | $527 | $412 | $128 |
| Uric acid (gout) test | $56 | $23 | $5 |
| Urinalysis | $38 | $20 | $3 |
| Urine microalbumin test | $94 | $22 | $5 |
| Urine pregnancy test | $70 | $76 | $9 |
| Vaccine administration | $68 | $66 | $19 |
| Vaccine administration (each additional) | $64 | $49 | $16 |
| Vitamin B12 test | $84 | $64 | $15 |
| Vitamin D test | $144 | $115 | $30 |
| Wound debridement | $861 | $3,361 | $186 |
| X-ray of the abdomen | $253 | $208 | $36 |
| X-ray of the ankle | $222 | $166 | $37 |
| X-ray of the collarbone | $222 | $151 | $33 |
| X-ray of the elbow | $246 | $179 | $33 |
| X-ray of the facial bones | $310 | $222 | $39 |
| X-ray of the foot | $222 | $173 | $34 |
| X-ray of the forearm | $215 | $162 | $29 |
| X-ray of the hand | $222 | $178 | $38 |
| X-ray of the hip | $223 | $115 | $49 |
| X-ray of the hip (1 view) | $132 | $91 | $34 |
| X-ray of the hip (3 views) | $236 | $115 | $49 |
| X-ray of the knee | $222 | $171 | $42 |
| X-ray of the knee (2 views) | $205 | $157 | $34 |
| X-ray of the knee (3 views) | $222 | $184 | $42 |
| X-ray of the knee (4+ views) | $229 | $233 | $49 |
| X-ray of the lower back (lumbar spine) | $299 | $251 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $228 | $185 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $369 | $316 | $53 |
| X-ray of the lower leg | $222 | $209 | $31 |
| X-ray of the mid-back (thoracic spine) | $184 | $275 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $90 | $181 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $277 | $275 | $39 |
| X-ray of the neck (cervical spine) | $255 | $293 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $211 | $236 | $40 |
| X-ray of the pelvis | $144 | $170 | $36 |
| X-ray of the pelvis (1 view) | $222 | $170 | $28 |
| X-ray of the ribs | $71 | $212 | $42 |
| X-ray of the ribs (2 views) | $60 | $257 | $36 |
| X-ray of the ribs (3 views) | $281 | $185 | $42 |
| X-ray of the shoulder | $222 | $199 | $36 |
| X-ray of the skull | $237 | $239 | $40 |
| X-ray of the upper arm | $222 | $168 | $32 |
| X-ray of the wrist | $261 | $171 | $43 |
| Zinc blood test | $88 | $32 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
