| Procedure | Delta County Memorial Hospital | Community Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $52 | $182 | $51 |
| Abdominal fluid drain (paracentesis) | $968 | $1,436 | $284 |
| Abdominal ultrasound | $323 | $536 | $100 |
| Abdominal ultrasound (complete) | $363 | $370 | $114 |
| Abdominal ultrasound (limited) | $283 | $536 | $86 |
| Abscess drainage (complex or multiple) | $464 | $1,400 | $220 |
| Abscess drainage (simple) | $321 | $1,209 | $129 |
| Abscess incision and drainage | $392 | $1,400 | $174 |
| Albumin blood test | $24 | $30 | $5 |
| Aldosterone test | $153 | $44 | $41 |
| Alkaline phosphatase test | $29 | $31 | $5 |
| Alpha-fetoprotein (AFP) test | $100 | $105 | $17 |
| ALT liver enzyme test | $31 | $37 | $5 |
| Ammonia blood test | $184 | $157 | $15 |
| Amniocentesis | $757 | $1,289 | $120 |
| Amylase test | $74 | $74 | $6 |
| Antinuclear antibody (ANA) test | $76 | $74 | $12 |
| Arterial blood gas (ABG) | $203 | $146 | $26 |
| AST liver enzyme test | $54 | $35 | $5 |
| Barium swallow study | $258 | $621 | $107 |
| Bartholin cyst removal | $321 | $387 | $182 |
| Basic metabolic panel | $58 | $36 | $8 |
| Benign skin lesion removal | $414 | $560 | $171 |
| Bilirubin blood test | $42 | $17 | $5 |
| Blood clotting test (PT/INR) | $28 | $18 | $4 |
| Blood crossmatch | $178 | $209 | — |
| Blood glucose test | $26 | $39 | $5 |
| Blood transfusion | $630 | $1,090 | $47 |
| Blood type and screen | $60 | $77 | $10 |
| Blood type test | $95 | $88 | $3 |
| Blood type test (ABO group) | $134 | $102 | $3 |
| Blood type test (Rh/D antigen) | $57 | $82 | $3 |
| BNP (heart failure) test | $285 | $138 | $39 |
| Bone density scan (DEXA) | $257 | $72 | $39 |
| Bone marrow biopsy | $1,284 | $1,963 | $172 |
| Bone scan (nuclear) | $1,089 | $1,677 | $259 |
| Botox for migraine | $317 | $940 | $157 |
| Breast biopsy | $3,083 | $4,429 | $478 |
| Breast MRI | $2,172 | $2,183 | $216 |
| Breast MRI without contrast | $1,908 | $2,667 | $216 |
| Breast ultrasound | $294 | $374 | $92 |
| Breast ultrasound (complete) | $352 | $374 | $100 |
| Breast ultrasound (limited) | $235 | $324 | $84 |
| Breathing tube insertion (intubation) | $474 | $819 | $133 |
| Burn dressing and debridement (medium) | $297 | $314 | $166 |
| Burn dressing and debridement (small) | $217 | $258 | $93 |
| Burn treatment | $257 | $294 | $129 |
| C-reactive protein (CRP) | $54 | $67 | $5 |
| CA 19-9 tumor marker test | $48 | $153 | $21 |
| CA-125 ovarian marker test | $59 | $207 | $21 |
| Calcium blood test | $26 | $36 | $5 |
| Cardiac rehabilitation | $139 | $342 | $26 |
| Cardiac stress test | $697 | $788 | $39 |
| Cardioversion | $889 | $1,566 | $155 |
| Carotid artery ultrasound | $810 | $854 | $156 |
| CEA tumor marker test | $254 | $157 | $19 |
| Celiac disease test | $80 | $28 | $12 |
| Central line placement | $1,221 | $2,073 | $238 |
| Chemotherapy infusion | $283 | $972 | $81 |
| Chemotherapy infusion (each additional) | $89 | $608 | $28 |
| Chemotherapy infusion (first hour) | $476 | $1,032 | $133 |
| Chest fluid drain (thoracentesis) | $1,179 | $1,430 | $311 |
| Chest tube insertion | $687 | $1,223 | $143 |
| Chest X-ray | $200 | $258 | $37 |
| Chest X-ray (1 view) | $194 | $258 | $25 |
| Chest X-ray (2 views) | $200 | $267 | $33 |
| Circumcision | $783 | $6,103 | $167 |
| CK-MB heart enzyme test | $169 | $47 | $12 |
| Clotting time test (PTT) | $32 | $47 | $6 |
| Complete blood count (CBC) | $38 | $31 | $7 |
| Complete blood count (CBC) (complete) | $41 | $31 | $8 |
| Complex wound repair | $627 | $3,570 | $390 |
| Comprehensive metabolic panel | $80 | $47 | $11 |
| Copper blood test | $58 | $17 | $12 |
| Coronary CT angiography | $899 | $2,578 | $326 |
| Cortisol test | $36 | $129 | $16 |
| COVID-19 PCR test | $45 | $146 | $51 |
| CPAP titration study | $395 | $731 | $69 |
| Creatine kinase (CK) test | $59 | $32 | $7 |
| CT angiography of the chest | $1,210 | $1,298 | $281 |
| CT angiography of the head | $1,365 | $2,063 | $274 |
| CT scan of the abdomen | $1,198 | $861 | $230 |
| CT scan of the abdomen and pelvis | $2,239 | $2,166 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $2,558 | $2,064 | $338 |
| CT scan of the abdomen and pelvis with contrast | $2,239 | $2,166 | $300 |
| CT scan of the abdomen and pelvis without contrast | $1,848 | $2,139 | $183 |
| CT scan of the abdomen with and without contrast | $1,373 | $1,252 | $259 |
| CT scan of the abdomen with contrast | $1,198 | $1,100 | $230 |
| CT scan of the abdomen without contrast | $1,023 | $861 | $136 |
| CT scan of the arm | $1,362 | $1,595 | $199 |
| CT scan of the arm with contrast | $1,362 | $1,819 | $199 |
| CT scan of the arm without contrast | $1,440 | $1,595 | $161 |
| CT scan of the chest | $1,151 | $1,198 | $167 |
| CT scan of the chest with and without contrast | $1,618 | $1,302 | $196 |
| CT scan of the chest with contrast | $1,151 | $2,317 | $167 |
| CT scan of the chest without contrast | $938 | $865 | $133 |
| CT scan of the head | $1,127 | $956 | $148 |
| CT scan of the head with and without contrast | $1,268 | $1,252 | $173 |
| CT scan of the head with contrast | $1,127 | $1,103 | $148 |
| CT scan of the head without contrast | $915 | $956 | $107 |
| CT scan of the leg | $1,669 | $1,191 | $166 |
| CT scan of the leg with contrast | $1,462 | $1,819 | $166 |
| CT scan of the leg without contrast | $1,875 | $1,191 | $130 |
| CT scan of the lower back (lumbar spine) | $1,497 | $1,198 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $1,497 | $1,341 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,576 | $1,105 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,062 | $1,198 | $130 |
| CT scan of the neck | $1,011 | $1,616 | $183 |
| CT scan of the neck (cervical spine) | $1,274 | $1,198 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $1,859 | $1,341 | $196 |
| CT scan of the neck (cervical spine) with contrast | $1,274 | $1,105 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,274 | $1,198 | $131 |
| CT scan of the neck with and without contrast | $1,145 | $1,287 | $220 |
| CT scan of the neck with contrast | $1,011 | $2,317 | $183 |
| CT scan of the neck without contrast | $660 | $861 | $150 |
| CT scan of the pelvis | $1,123 | $1,198 | $226 |
| CT scan of the pelvis with and without contrast | $1,281 | $1,502 | $251 |
| CT scan of the pelvis with contrast | $1,123 | $1,698 | $226 |
| CT scan of the pelvis without contrast | $918 | $1,198 | $133 |
| CT scan of the sinuses | $750 | $1,191 | $152 |
| CT scan of the sinuses with and without contrast | $780 | $1,252 | $184 |
| CT scan of the sinuses with contrast | $750 | $1,105 | $152 |
| CT scan of the sinuses without contrast | $720 | $1,191 | $128 |
| D-dimer test | $102 | $81 | $10 |
| DHEA-sulfate test | $130 | $83 | $22 |
| Diagnostic mammogram | $131 | $217 | $140 |
| Drug screen (urine) | $101 | $94 | $17 |
| Echocardiogram | $923 | $717 | $138 |
| Echocardiogram with and without contrast | $289 | $646 | $101 |
| EKG / ECG (tracing only) | $217 | $146 | $7 |
| Electrocardiogram (EKG) | $217 | $146 | $8 |
| Electrolyte panel | $59 | $35 | $7 |
| Emergency department visit | $277 | $894 | $69 |
| Emergency department visit (level 1) | $169 | $298 | $11 |
| Emergency department visit (level 2) | $223 | $461 | $40 |
| Emergency department visit (level 3) | $277 | $894 | $69 |
| Emergency department visit (level 4) | $492 | $1,382 | $118 |
| Emergency department visit (level 5) | $869 | $1,851 | $171 |
| Epidural steroid injection | $759 | $1,949 | $275 |
| ERCP (bile duct endoscopy) | $3,973 | $2,803 | $311 |
| Estradiol (estrogen) test | $124 | $137 | $28 |
| Facet joint injection (spine) | $256 | $1,245 | $99 |
| Fallopian tube X-ray (HSG) | $294 | $1,065 | $164 |
| Fecal occult blood (stool) test | $75 | $45 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $27 | $45 | $4 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $124 | $100 | $16 |
| Ferritin (iron) test | $88 | $108 | $14 |
| Fibrinogen test | $74 | $84 | $10 |
| Folate (folic acid) test | $96 | $119 | $15 |
| Foreign body removal (skin) | $414 | $671 | $157 |
| Free T4 thyroid test | $76 | $83 | $9 |
| FSH hormone test | $44 | $113 | $19 |
| Gallbladder removal (laparoscopic) | $6,706 | $7,380 | $658 |
| Gallbladder scan (HIDA) | $802 | $1,976 | $334 |
| GGT liver test | $54 | $39 | $7 |
| Glucose tolerance test | $54 | $32 | $8 |
| H. pylori test | $168 | $314 | $67 |
| HDL cholesterol test | $78 | $54 | $8 |
| Hematocrit test | $15 | $12 | $2 |
| Hemoglobin A1c (diabetes test) | $20 | $68 | $10 |
| Hepatitis B test | $68 | $65 | $10 |
| Hepatitis C test | $98 | $88 | $14 |
| HIV test | $62 | $129 | $19 |
| HIV test (antibody) | $93 | $129 | $14 |
| HIV test (antigen/antibody combo) | $31 | $95 | $24 |
| Holter heart monitor | $197 | $690 | $26 |
| Iron blood test | $33 | $41 | $6 |
| IUD removal | $337 | $778 | $112 |
| IV infusion therapy | $198 | $545 | $44 |
| IV infusion therapy (each additional) | $59 | $169 | $21 |
| IV infusion therapy (initial) | $338 | $545 | $67 |
| Joint aspiration (small/intermediate) | $342 | $417 | $57 |
| Joint aspiration or injection (mid-size joint) | $354 | $767 | $57 |
| Joint aspiration or injection (small joint) | $330 | $193 | $56 |
| Kidney biopsy | $1,020 | $4,710 | $492 |
| Kidney scan (nuclear) | $1,003 | $2,654 | $172 |
| Kidney ultrasound | $448 | $682 | $84 |
| Kidney ultrasound (limited) | $335 | $576 | $61 |
| Knee joint injection | $780 | $967 | $69 |
| Lactate test | $78 | $71 | $12 |
| Laryngoscopy | $474 | $236 | $189 |
| LDH test | $42 | $41 | $6 |
| LDL cholesterol test | $24 | $47 | $11 |
| Leg vein ultrasound (Doppler) | $667 | $694 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $557 | $694 | $116 |
| LH hormone test | $105 | $113 | $19 |
| Lipase test | $64 | $60 | $7 |
| Lipid (cholesterol) panel | $83 | $37 | $13 |
| Liver biopsy | $916 | $4,509 | $288 |
| Liver function panel | $90 | $52 | $8 |
| Lung function test (PFT) | $277 | $409 | $37 |
| Magnesium blood test | $54 | $44 | $7 |
| MRA of the brain | $1,859 | $2,353 | $226 |
| MRA of the brain without contrast | $1,904 | $2,197 | $328 |
| MRA of the neck | $1,461 | $2,451 | $245 |
| MRA of the neck with contrast | $1,461 | $2,924 | $245 |
| MRA of the neck without contrast | $1,735 | $1,974 | $343 |
| MRI of the abdomen | $2,262 | $1,442 | $300 |
| MRI of the abdomen with contrast | $2,262 | $1,865 | $300 |
| MRI of the abdomen without contrast | $2,015 | $1,442 | $194 |
| MRI of the ankle | $2,116 | $2,353 | $261 |
| MRI of the ankle with contrast | $1,703 | $1,669 | $261 |
| MRI of the ankle without contrast | $2,116 | $2,353 | $222 |
| MRI of the brain | $1,843 | $532 | $269 |
| MRI of the brain with contrast | $1,843 | $532 | $269 |
| MRI of the brain without contrast | $1,733 | $1,174 | $195 |
| MRI of the chest | $2,262 | $1,640 | $371 |
| MRI of the chest with contrast | $2,262 | $1,955 | $371 |
| MRI of the chest without contrast | $2,382 | $532 | $466 |
| MRI of the knee | $2,585 | $1,716 | $315 |
| MRI of the knee with contrast | $1,419 | $2,573 | $315 |
| MRI of the knee without contrast | $2,585 | $1,716 | $204 |
| MRI of the lower back (lumbar spine) | $2,010 | $1,636 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $2,010 | $1,669 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,759 | $1,636 | $192 |
| MRI of the mid-back (thoracic spine) | $1,865 | $2,353 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $2,011 | $3,417 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $1,865 | $1,669 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $1,759 | $1,442 | $190 |
| MRI of the neck (cervical spine) | $1,884 | $2,045 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $2,259 | $1,682 | $318 |
| MRI of the neck (cervical spine) with contrast | $1,884 | $1,669 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,685 | $2,045 | $191 |
| MRI of the pelvis | $2,314 | $1,442 | $268 |
| MRI of the pelvis with contrast | $2,314 | $532 | $268 |
| MRI of the pelvis without contrast | $2,088 | $2,353 | $227 |
| MRI of the shoulder | $3,241 | $2,353 | $313 |
| MRI of the shoulder with contrast | $1,632 | $2,532 | $313 |
| MRI of the shoulder without contrast | $3,241 | $1,442 | $205 |
| MRI of the wrist | $1,884 | $2,353 | $330 |
| MRI of the wrist with contrast | $1,884 | $532 | $330 |
| MRI of the wrist without contrast | $1,652 | $2,353 | $303 |
| Nebulizer breathing treatment | $225 | $272 | $9 |
| Nuclear cardiac stress test | $2,388 | $3,540 | $428 |
| Occupational therapy evaluation | $121 | $175 | $101 |
| Occupational therapy evaluation (high complexity) | $121 | $178 | $101 |
| Occupational therapy evaluation (low complexity) | $121 | $175 | $101 |
| Occupational therapy evaluation (moderate complexity) | $121 | $176 | $101 |
| Office visit (established patient) | $138 | $100 | $115 |
| Office visit (new patient) | $209 | $162 | $177 |
| Office visit, established patient (level 3) | $111 | $81 | $95 |
| Office visit, established patient (level 4) | $164 | $119 | $136 |
| Office visit, new patient (level 3) | $166 | $100 | $118 |
| Office visit, new patient (level 4) | $253 | $162 | $177 |
| Pap smear (cervical screening) | $65 | $94 | $20 |
| Parathyroid hormone (PTH) test | $182 | $188 | $41 |
| Pelvic ultrasound | $321 | $475 | $78 |
| Pelvic ultrasound (complete) | $512 | $576 | $105 |
| Pelvic ultrasound (limited) | $130 | $374 | $51 |
| PET scan | $5,017 | $8,012 | — |
| Phosphorus blood test | $9 | $15 | $5 |
| Physical therapy evaluation | $209 | $176 | $98 |
| Physical therapy evaluation (high complexity) | $236 | $178 | $98 |
| Physical therapy evaluation (moderate complexity) | $209 | $176 | $98 |
| Pilonidal cyst removal | $469 | $4,972 | $541 |
| Platelet count | $15 | $35 | $4 |
| Pregnancy blood test (hCG) | $38 | $51 | $8 |
| Pregnancy ultrasound | $436 | $479 | $126 |
| Pregnancy ultrasound (first trimester) | $409 | $576 | $117 |
| Pregnancy ultrasound (second or third trimester) | $462 | $381 | $136 |
| Procalcitonin test | $128 | $175 | $27 |
| Prolactin test | $80 | $118 | $19 |
| Prostate test (PSA) | $91 | $63 | $18 |
| Pulmonary rehabilitation | $115 | $267 | $87 |
| Radiofrequency nerve ablation | $2,090 | $3,035 | $462 |
| Sacroiliac joint injection | $1,473 | $2,990 | $176 |
| Screening mammogram | $131 | $210 | $126 |
| Scrotal ultrasound | $439 | $697 | $99 |
| Sedimentation rate (ESR) test | $57 | $38 | $3 |
| Semen analysis | $80 | $50 | $12 |
| Sex hormone binding globulin test | $57 | $71 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $400 | $418 | $114 |
| Simple wound stitches | $400 | $408 | $127 |
| Skin biopsy | $627 | $475 | $121 |
| Skin tag removal | $321 | $204 | $92 |
| Sleep study (polysomnography) | $2,460 | $3,812 | $691 |
| Soft tissue ultrasound | $166 | $324 | $64 |
| Spinal tap (lumbar puncture) | $759 | $865 | $165 |
| Spirometry (lung function test) | $194 | $391 | $30 |
| Spirometry with bronchodilator | $360 | $705 | $43 |
| Stress echocardiogram | $943 | $359 | $209 |
| Swallow study | $262 | $452 | $85 |
| T3 thyroid test | $38 | $56 | $14 |
| Tdap (tetanus) vaccine | $64 | $208 | — |
| Testosterone test | $118 | $86 | $26 |
| Thyroid test (TSH) | $25 | $43 | $17 |
| Thyroid ultrasound | $477 | $628 | $109 |
| Thyroid uptake scan | $952 | $1,976 | $145 |
| Total IgE allergy test | $48 | $50 | $16 |
| Total protein test | $22 | $6 | $4 |
| Transvaginal ultrasound | $228 | $368 | $118 |
| Trigger point injection | $312 | $870 | $56 |
| Trigger point injection (1-2 muscles) | $312 | $870 | $52 |
| Triglycerides test | $196 | $38 | $6 |
| Troponin (heart) test | $102 | $62 | $12 |
| Turning a breech baby (version) | $1,438 | $2,154 | $94 |
| Upper GI series (barium) | $451 | $858 | $128 |
| Uric acid (gout) test | $54 | $41 | $5 |
| Urinalysis | $20 | $18 | $3 |
| Urine microalbumin test | $47 | $163 | $5 |
| Urine pregnancy test | $27 | $56 | $9 |
| Vaccine administration | $65 | $56 | $19 |
| Vaccine administration (each additional) | $55 | $42 | $16 |
| Vitamin B12 test | $86 | $126 | $15 |
| Vitamin D test | $62 | $208 | $30 |
| Wound debridement | $559 | $698 | $186 |
| X-ray of the abdomen | $239 | $282 | $36 |
| X-ray of the ankle | $192 | $282 | $37 |
| X-ray of the collarbone | $312 | $276 | $33 |
| X-ray of the elbow | $190 | $276 | $33 |
| X-ray of the facial bones | $321 | $362 | $39 |
| X-ray of the foot | $203 | $260 | $34 |
| X-ray of the forearm | $188 | $276 | $29 |
| X-ray of the hand | $203 | $344 | $38 |
| X-ray of the hip | $139 | $256 | $49 |
| X-ray of the hip (1 view) | $90 | $256 | $34 |
| X-ray of the hip (3 views) | $188 | $260 | $49 |
| X-ray of the knee | $225 | $276 | $42 |
| X-ray of the knee (2 views) | $147 | $276 | $34 |
| X-ray of the knee (3 views) | $225 | $260 | $42 |
| X-ray of the knee (4+ views) | $264 | $351 | $49 |
| X-ray of the lower back (lumbar spine) | $311 | $312 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $266 | $309 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $357 | $333 | $53 |
| X-ray of the lower leg | $150 | $276 | $31 |
| X-ray of the mid-back (thoracic spine) | $204 | $369 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $183 | $305 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $225 | $433 | $39 |
| X-ray of the neck (cervical spine) | $277 | $305 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $218 | $305 | $40 |
| X-ray of the pelvis | $198 | $305 | $36 |
| X-ray of the pelvis (1 view) | $150 | $305 | $28 |
| X-ray of the ribs | $259 | $305 | $42 |
| X-ray of the ribs (3 views) | $130 | $305 | $42 |
| X-ray of the shoulder | $209 | $282 | $36 |
| X-ray of the skull | $292 | $518 | $40 |
| X-ray of the upper arm | $203 | $276 | $32 |
| X-ray of the wrist | $294 | $260 | $43 |
| Zinc blood test | $58 | $58 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
