| Procedure | Fairview Hospital | Lutheran Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $87 | $87 | $51 |
| Abdominal fluid drain (paracentesis) | $2,803 | $2,803 | $284 |
| Abdominal ultrasound | $477 | $477 | $100 |
| Abdominal ultrasound (complete) | $477 | $477 | $114 |
| Abdominal ultrasound (limited) | $477 | $477 | $86 |
| Abscess drainage (complex or multiple) | $779 | $779 | $220 |
| Abscess drainage (simple) | $387 | $387 | $129 |
| Abscess incision and drainage | $583 | $583 | $174 |
| Acupuncture | $21 | $21 | $38 |
| Acupuncture (each additional) | $21 | $21 | $28 |
| Albumin blood test | $22 | $22 | $5 |
| Aldosterone test | $183 | $183 | $41 |
| Alkaline phosphatase test | $23 | $23 | $5 |
| Allergy shots | $109 | $109 | $11 |
| Allergy testing | $110 | $110 | $4 |
| Alpha-fetoprotein (AFP) test | $75 | $75 | $17 |
| ALT liver enzyme test | $24 | $24 | $5 |
| Ammonia blood test | $66 | $66 | $15 |
| Amniocentesis | $2,264 | $2,264 | $120 |
| Amylase test | $29 | $29 | $6 |
| Annual physical (established patient) | $176 | $176 | — |
| Annual physical (new patient) | $142 | $142 | — |
| Anoscopy | $385 | $385 | $129 |
| Antinuclear antibody (ANA) test | $54 | $54 | $12 |
| Aortic aneurysm repair (AAA) | $19,352 | $19,352 | $1,345 |
| Aortic valve replacement | $9,826 | $9,826 | $1,603 |
| Arterial blood gas (ABG) | $117 | $117 | $26 |
| AST liver enzyme test | $23 | $23 | $5 |
| Barium swallow study | $798 | $798 | $107 |
| Bartholin cyst removal | $601 | $601 | $182 |
| Basic metabolic panel | $38 | $38 | $8 |
| Benign skin lesion removal | $1,372 | $1,372 | $171 |
| Bilirubin blood test | $23 | $23 | $5 |
| Bladder function test (urodynamics) | $1,996 | $1,996 | $345 |
| Bladder scope (cystoscopy) | $1,996 | $1,996 | $216 |
| Bladder tumor removal (TURBT) | $10,312 | $10,312 | $236 |
| Blood clotting test (PT/INR) | $20 | $20 | $4 |
| Blood crossmatch | $768 | $768 | — |
| Blood glucose test | $21 | $21 | $5 |
| Blood transfusion | $1,634 | $1,634 | $47 |
| Blood type and screen | $44 | $44 | $10 |
| Blood type test | $14 | $14 | $3 |
| Blood type test (ABO group) | $14 | $14 | $3 |
| Blood type test (Rh/D antigen) | $14 | $14 | $3 |
| BNP (heart failure) test | $176 | $176 | $39 |
| Bone density scan (DEXA) | $477 | $477 | $39 |
| Bone marrow biopsy | $5,827 | $5,827 | $172 |
| Bone scan (nuclear) | $1,802 | $1,802 | $259 |
| Botox for migraine | $1,324 | $1,324 | $157 |
| Breast biopsy | $7,267 | $7,267 | $478 |
| Breast MRI | $1,084 | $1,084 | $216 |
| Breast MRI without contrast | $1,084 | $1,084 | $216 |
| Breast ultrasound | $436 | $436 | $92 |
| Breast ultrasound (complete) | $477 | $477 | $100 |
| Breast ultrasound (limited) | $395 | $395 | $84 |
| Breathing tube insertion (intubation) | $694 | $694 | $133 |
| Bronchoscopy | $5,156 | $5,156 | $303 |
| Burn dressing and debridement (medium) | $387 | $387 | $166 |
| Burn dressing and debridement (small) | $387 | $387 | $93 |
| Burn treatment | $387 | $387 | $129 |
| C-reactive protein (CRP) | $23 | $23 | $5 |
| CA 19-9 tumor marker test | $94 | $94 | $21 |
| CA-125 ovarian marker test | $94 | $94 | $21 |
| Calcium blood test | $23 | $23 | $5 |
| Capsule endoscopy | $2,803 | $2,803 | $802 |
| Cardiac ablation | $48,183 | $48,183 | $759 |
| Cardiac catheterization | $12,021 | $12,021 | $1,049 |
| Cardiac MRI | $1,343 | $1,343 | $322 |
| Cardiac MRI without contrast | $1,084 | $1,084 | $280 |
| Cardiac rehabilitation | $471 | $471 | $26 |
| Cardiac stress test | $1,164 | $1,164 | $39 |
| Cardioversion | $2,446 | $2,446 | $155 |
| Carotid artery ultrasound | $650 | $650 | $156 |
| Carpal tunnel release | $8,758 | $8,758 | $483 |
| CEA tumor marker test | $85 | $85 | $19 |
| Celiac disease test | $52 | $52 | $12 |
| Central line placement | $11,764 | $11,764 | $238 |
| Cervical cerclage | $8,267 | $8,267 | $137 |
| Cervical LEEP procedure | $9,507 | $9,507 | $325 |
| Chalazion (eyelid cyst) removal | $894 | $894 | $131 |
| Chemotherapy infusion | $904 | $904 | $81 |
| Chemotherapy infusion (each additional) | $319 | $319 | $28 |
| Chemotherapy infusion (first hour) | $1,488 | $1,488 | $133 |
| Chest fluid drain (thoracentesis) | $1,849 | $1,849 | $311 |
| Chest tube insertion | $4,645 | $4,645 | $143 |
| Chest X-ray | $395 | $395 | $37 |
| Chest X-ray (1 view) | $395 | $395 | $25 |
| Chest X-ray (2 views) | $395 | $395 | $33 |
| Chickenpox (varicella) vaccine | $427 | $427 | — |
| Chiropractic adjustment | $49 | $49 | $38 |
| Circumcision | $6,125 | $6,125 | $167 |
| CK-MB heart enzyme test | $52 | $52 | $12 |
| Clotting time test (PTT) | $27 | $27 | $6 |
| Colonoscopy | $3,526 | $3,526 | $480 |
| Colposcopy | $909 | $909 | $161 |
| Complete blood count (CBC) | $32 | $32 | $7 |
| Complete blood count (CBC) (complete) | $35 | $35 | $8 |
| Comprehensive eye exam | $385 | $385 | $138 |
| Comprehensive metabolic panel | $47 | $47 | $11 |
| Contraceptive implant (Nexplanon) | $778 | $778 | $115 |
| Copper blood test | $56 | $56 | $12 |
| Coronary CT angiography | $1,602 | $1,602 | $326 |
| Cortisol test | $73 | $73 | $16 |
| COVID-19 PCR test | $230 | $230 | $51 |
| CPAP titration study | $608 | $608 | $69 |
| Creatine kinase (CK) test | $29 | $29 | $7 |
| CT angiography of the chest | $798 | $798 | $281 |
| CT angiography of the head | $798 | $798 | $274 |
| CT colonography (virtual colonoscopy) | $1,084 | $1,084 | $835 |
| CT scan of the abdomen | $798 | $798 | $230 |
| CT scan of the abdomen and pelvis | $1,602 | $1,602 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $1,602 | $1,602 | $338 |
| CT scan of the abdomen and pelvis with contrast | $1,602 | $1,602 | $300 |
| CT scan of the abdomen and pelvis without contrast | $1,084 | $1,084 | $183 |
| CT scan of the abdomen with and without contrast | $798 | $798 | $259 |
| CT scan of the abdomen with contrast | $798 | $798 | $230 |
| CT scan of the abdomen without contrast | $477 | $477 | $136 |
| CT scan of the arm | $798 | $798 | $199 |
| CT scan of the arm with contrast | $1,602 | $1,602 | $199 |
| CT scan of the arm without contrast | $477 | $477 | $161 |
| CT scan of the chest | $798 | $798 | $167 |
| CT scan of the chest with and without contrast | $798 | $798 | $196 |
| CT scan of the chest with contrast | $798 | $798 | $167 |
| CT scan of the chest without contrast | $477 | $477 | $133 |
| CT scan of the head | $798 | $798 | $148 |
| CT scan of the head with and without contrast | $798 | $798 | $173 |
| CT scan of the head with contrast | $798 | $798 | $148 |
| CT scan of the head without contrast | $477 | $477 | $107 |
| CT scan of the leg | $798 | $798 | $166 |
| CT scan of the leg with contrast | $798 | $798 | $166 |
| CT scan of the leg without contrast | $477 | $477 | $130 |
| CT scan of the lower back (lumbar spine) | $798 | $798 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $798 | $798 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,602 | $1,602 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $477 | $477 | $130 |
| CT scan of the neck | $798 | $798 | $183 |
| CT scan of the neck (cervical spine) | $798 | $798 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $798 | $798 | $196 |
| CT scan of the neck (cervical spine) with contrast | $1,602 | $1,602 | $168 |
| CT scan of the neck (cervical spine) without contrast | $477 | $477 | $131 |
| CT scan of the neck with and without contrast | $798 | $798 | $220 |
| CT scan of the neck with contrast | $798 | $798 | $183 |
| CT scan of the neck without contrast | $477 | $477 | $150 |
| CT scan of the pelvis | $798 | $798 | $226 |
| CT scan of the pelvis with and without contrast | $798 | $798 | $251 |
| CT scan of the pelvis with contrast | $798 | $798 | $226 |
| CT scan of the pelvis without contrast | $477 | $477 | $133 |
| CT scan of the sinuses | $798 | $798 | $152 |
| CT scan of the sinuses with and without contrast | $798 | $798 | $184 |
| CT scan of the sinuses with contrast | $798 | $798 | $152 |
| CT scan of the sinuses without contrast | $477 | $477 | $128 |
| D-dimer test | $46 | $46 | $10 |
| Defibrillator (ICD) implant | $36,429 | $36,429 | $798 |
| Developmental screening (child) | $205 | $205 | — |
| DHEA-sulfate test | $99 | $99 | $22 |
| Diagnostic mammogram | $412 | $412 | $140 |
| Dilation and curettage (D&C) | $9,507 | $9,507 | $298 |
| Drug screen (urine) | $279 | $279 | $17 |
| Ear pressure test (tympanometry) | $102 | $102 | $16 |
| Ear tubes (myringotomy) | $3,851 | $3,851 | $174 |
| Echocardiogram | $904 | $904 | $138 |
| Echocardiogram with and without contrast | $904 | $904 | $101 |
| Echocardiogram without contrast | $904 | $904 | $138 |
| EEG (awake and asleep) | $1,397 | $1,397 | $482 |
| EKG / ECG (tracing only) | $222 | $222 | $7 |
| Electrocardiogram (EKG) | $246 | $246 | $8 |
| Electroencephalogram (EEG) | $1,397 | $1,397 | $448 |
| Electrolyte panel | $31 | $31 | $7 |
| Electromyography (EMG) | $578 | $578 | $141 |
| Emergency department visit | $1,242 | $1,242 | $69 |
| Emergency department visit (level 1) | $395 | $395 | $11 |
| Emergency department visit (level 2) | $710 | $710 | $40 |
| Emergency department visit (level 3) | $1,242 | $1,242 | $69 |
| Emergency department visit (level 4) | $1,910 | $1,910 | $118 |
| Emergency department visit (level 5) | $2,750 | $2,750 | $171 |
| Endometrial biopsy | $601 | $601 | $98 |
| Epidural steroid injection | $3,106 | $3,106 | $275 |
| ERCP (bile duct endoscopy) | $11,376 | $11,376 | $311 |
| Esophageal dilation | $2,803 | $2,803 | $522 |
| Estradiol (estrogen) test | $125 | $125 | $28 |
| Facet joint injection (spine) | $1,129 | $1,129 | $99 |
| Fallopian tube X-ray (HSG) | $812 | $812 | $164 |
| Family therapy session | $313 | $313 | $110 |
| Fecal occult blood (stool) test | $46 | $46 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $20 | $20 | $4 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $72 | $72 | $16 |
| Feeding tube (PEG) placement | $5,672 | $5,672 | $178 |
| Ferritin (iron) test | $61 | $61 | $14 |
| Fibrinogen test | $44 | $44 | $10 |
| Fibroid removal (myomectomy) | $2,816 | $2,816 | $914 |
| Flexible sigmoidoscopy | $2,726 | $2,726 | $323 |
| Flu test | $74 | $74 | $17 |
| Flu vaccine | $46 | $46 | — |
| Folate (folic acid) test | $66 | $66 | $15 |
| Foreign body removal (skin) | $779 | $779 | $157 |
| Free T4 thyroid test | $40 | $40 | $9 |
| FSH hormone test | $83 | $83 | $19 |
| Gallbladder removal (laparoscopic) | $17,445 | $17,445 | $658 |
| Gallbladder scan (HIDA) | $2,108 | $2,108 | $334 |
| Ganglion cyst removal | $4,785 | $4,785 | $321 |
| GGT liver test | $33 | $33 | $7 |
| Glucose tolerance test | $38 | $38 | $8 |
| Group therapy session | $542 | $542 | $30 |
| H. pylori test | $302 | $302 | $67 |
| Hammertoe repair | $9,701 | $9,701 | $548 |
| HDL cholesterol test | $37 | $37 | $8 |
| Hearing test (audiometry) | $407 | $407 | $36 |
| Hematocrit test | $10 | $10 | $2 |
| Hemodialysis | $3,138 | $3,138 | $75 |
| Hemoglobin A1c (diabetes test) | $44 | $44 | $10 |
| Hemorrhoid removal | $2,726 | $2,726 | $338 |
| Hepatitis A vaccine | $200 | $200 | — |
| Hepatitis B test | $46 | $46 | $10 |
| Hepatitis B vaccine | $168 | $168 | — |
| Hepatitis C test | $64 | $64 | $14 |
| HIV test | $85 | $85 | $19 |
| HIV test (antibody) | $62 | $62 | $14 |
| HIV test (antigen/antibody combo) | $108 | $108 | $24 |
| Holter heart monitor | $352 | $352 | $26 |
| HPV vaccine | $719 | $719 | — |
| Hydrocele repair | $10,552 | $10,552 | $315 |
| Hysterectomy | $3,002 | $3,002 | $933 |
| Hysteroscopy | $9,507 | $9,507 | $1,270 |
| Inguinal hernia repair | $10,552 | $10,552 | $538 |
| Iron blood test | $29 | $29 | $6 |
| IUD insertion | $326 | $326 | — |
| IUD removal | $909 | $909 | $112 |
| IV infusion therapy | $576 | $576 | $44 |
| IV infusion therapy (each additional) | $207 | $207 | $21 |
| IV infusion therapy (initial) | $945 | $945 | $67 |
| IVC filter placement | $11,946 | $11,946 | $1,885 |
| Joint aspiration (small/intermediate) | $883 | $883 | $57 |
| Joint aspiration or injection (mid-size joint) | $883 | $883 | $57 |
| Joint aspiration or injection (small joint) | $883 | $883 | $56 |
| Kidney biopsy | $4,844 | $4,844 | $492 |
| Kidney scan (nuclear) | $2,414 | $2,414 | $172 |
| Kidney stone shock-wave (lithotripsy) | $10,312 | $10,312 | $760 |
| Kidney ultrasound | $477 | $477 | $84 |
| Kidney ultrasound (limited) | $477 | $477 | $61 |
| Knee joint injection | $883 | $883 | $69 |
| Lactate test | $52 | $52 | $12 |
| Laryngoscopy | $2,868 | $2,868 | $189 |
| LDH test | $27 | $27 | $6 |
| LDL cholesterol test | $47 | $47 | $11 |
| Leg artery angiogram | $14,117 | $14,117 | $149 |
| Leg vein ultrasound (Doppler) | $650 | $650 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $397 | $397 | $116 |
| LH hormone test | $83 | $83 | $19 |
| Lipase test | $31 | $31 | $7 |
| Lipid (cholesterol) panel | $60 | $60 | $13 |
| Liver biopsy | $4,844 | $4,844 | $288 |
| Liver function panel | $36 | $36 | $8 |
| Lung function test (PFT) | $699 | $699 | $37 |
| Lung scan (V/Q) | $2,414 | $2,414 | $291 |
| Magnesium blood test | $30 | $30 | $7 |
| MMR vaccine | $218 | $218 | — |
| MRA of the brain | $1,602 | $1,602 | $226 |
| MRA of the brain with contrast | $1,602 | $1,602 | $226 |
| MRA of the brain without contrast | $1,602 | $1,602 | $328 |
| MRA of the neck | $1,602 | $1,602 | $245 |
| MRA of the neck with contrast | $1,602 | $1,602 | $245 |
| MRA of the neck without contrast | $1,602 | $1,602 | $343 |
| MRI of the abdomen | $1,602 | $1,602 | $300 |
| MRI of the abdomen with contrast | $1,602 | $1,602 | $300 |
| MRI of the abdomen without contrast | $1,084 | $1,084 | $194 |
| MRI of the ankle | $1,602 | $1,602 | $261 |
| MRI of the ankle with contrast | $1,602 | $1,602 | $261 |
| MRI of the ankle without contrast | $1,084 | $1,084 | $222 |
| MRI of the brain | $1,602 | $1,602 | $269 |
| MRI of the brain with contrast | $1,602 | $1,602 | $269 |
| MRI of the brain without contrast | $1,084 | $1,084 | $195 |
| MRI of the chest | $1,602 | $1,602 | $371 |
| MRI of the chest with contrast | $3,543 | $3,543 | $371 |
| MRI of the chest without contrast | $1,602 | $1,602 | $466 |
| MRI of the knee | $1,602 | $1,602 | $315 |
| MRI of the knee with contrast | $3,543 | $3,543 | $315 |
| MRI of the knee without contrast | $1,084 | $1,084 | $204 |
| MRI of the lower back (lumbar spine) | $1,602 | $1,602 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $1,602 | $1,602 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,084 | $1,084 | $192 |
| MRI of the mid-back (thoracic spine) | $1,602 | $1,602 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $1,602 | $1,602 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $1,602 | $1,602 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $1,084 | $1,084 | $190 |
| MRI of the neck (cervical spine) | $1,602 | $1,602 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $1,602 | $1,602 | $318 |
| MRI of the neck (cervical spine) with contrast | $1,602 | $1,602 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,084 | $1,084 | $191 |
| MRI of the pelvis | $1,602 | $1,602 | $268 |
| MRI of the pelvis with contrast | $1,602 | $1,602 | $268 |
| MRI of the pelvis without contrast | $1,084 | $1,084 | $227 |
| MRI of the shoulder | $1,602 | $1,602 | $313 |
| MRI of the shoulder with contrast | $3,543 | $3,543 | $313 |
| MRI of the shoulder without contrast | $1,084 | $1,084 | $205 |
| MRI of the wrist | $1,602 | $1,602 | $330 |
| MRI of the wrist with contrast | $1,602 | $1,602 | $330 |
| MRI of the wrist without contrast | $1,084 | $1,084 | $303 |
| Nebulizer breathing treatment | $608 | $608 | $9 |
| Nerve conduction study | $1,397 | $1,397 | $118 |
| Nuchal translucency ultrasound | $477 | $477 | $116 |
| Nuclear cardiac stress test | $5,855 | $5,855 | $428 |
| Occupational therapy evaluation | $438 | $438 | $101 |
| Occupational therapy evaluation (high complexity) | $438 | $438 | $101 |
| Occupational therapy evaluation (low complexity) | $438 | $438 | $101 |
| Occupational therapy evaluation (moderate complexity) | $438 | $438 | $101 |
| Office visit (established patient) | $110 | $110 | $115 |
| Office visit (new patient) | $113 | $113 | $177 |
| Office visit, established patient (level 3) | $98 | $98 | $95 |
| Office visit, established patient (level 4) | $122 | $122 | $136 |
| Office visit, new patient (level 3) | $90 | $90 | $118 |
| Office visit, new patient (level 4) | $113 | $113 | $177 |
| Office visit, new patient (level 5) | $153 | $153 | $237 |
| Orthopedic hardware removal | $8,557 | $8,557 | $632 |
| Ovarian cyst removal | $14,760 | $14,760 | $698 |
| Ovary removal (oophorectomy) | $14,760 | $14,760 | $822 |
| Pap smear (cervical screening) | $105 | $105 | $20 |
| Parathyroid hormone (PTH) test | $185 | $185 | $41 |
| Pelvic ultrasound | $477 | $477 | $78 |
| Pelvic ultrasound (complete) | $477 | $477 | $105 |
| Pelvic ultrasound (limited) | $477 | $477 | $51 |
| PET scan | $6,542 | $6,542 | — |
| Phosphorus blood test | $21 | $21 | $5 |
| Physical therapy evaluation | $393 | $393 | $98 |
| Physical therapy evaluation (high complexity) | $393 | $393 | $98 |
| Physical therapy evaluation (moderate complexity) | $393 | $393 | $98 |
| Pilonidal cyst removal | $5,581 | $5,581 | $541 |
| Platelet count | $20 | $20 | $4 |
| Pneumonia vaccine | $275 | $275 | — |
| Pregnancy blood test (hCG) | $34 | $34 | $8 |
| Pregnancy ultrasound | $477 | $477 | $126 |
| Pregnancy ultrasound (first trimester) | $477 | $477 | $117 |
| Pregnancy ultrasound (second or third trimester) | $477 | $477 | $136 |
| Procalcitonin test | $122 | $122 | $27 |
| Prolactin test | $87 | $87 | $19 |
| Prostate test (PSA) | $83 | $83 | $18 |
| Psychiatric evaluation | $313 | $313 | $188 |
| Psychotherapy session | $313 | $313 | $140 |
| Pulmonary rehabilitation | $177 | $177 | $87 |
| Radiofrequency nerve ablation | $8,758 | $8,758 | $462 |
| Retina scan (OCT) | $177 | $177 | $33 |
| Retinal (fundus) photography | $385 | $385 | $37 |
| Routine eye exam | $385 | $385 | $88 |
| RSV vaccine | $719 | $719 | — |
| Sacroiliac joint injection | $1,253 | $1,253 | $176 |
| Scoliosis spine X-ray | $436 | $436 | $58 |
| Scoliosis spine X-ray (1 view) | $395 | $395 | $44 |
| Scoliosis spine X-ray (3 views) | $477 | $477 | $72 |
| Screening colonoscopy | $2,371 | $2,371 | $378 |
| Screening mammogram | $396 | $396 | $126 |
| Scrotal ultrasound | $477 | $477 | $99 |
| Sedimentation rate (ESR) test | $12 | $12 | $3 |
| Semen analysis | $129 | $129 | $12 |
| Sex hormone binding globulin test | $98 | $98 | $22 |
| Shingles vaccine | $505 | $505 | — |
| Simple laceration repair (small, up to 2.5 cm) | $387 | $387 | $114 |
| Simple wound stitches | $387 | $387 | $127 |
| Skin biopsy | $779 | $779 | $121 |
| Skin biopsy (punch) | $779 | $779 | $121 |
| Skin cancer lesion removal | $1,372 | $1,372 | $240 |
| Skin lesion freezing (cryotherapy) | $302 | $302 | $36 |
| Skin tag removal | $387 | $387 | $92 |
| Sleep study (polysomnography) | $4,563 | $4,563 | $691 |
| Soft tissue ultrasound | $477 | $477 | $64 |
| Speech therapy | $307 | $307 | $76 |
| Spinal cord stimulator | $16,516 | $16,516 | $2,388 |
| Spinal tap (lumbar puncture) | $3,106 | $3,106 | $165 |
| Spine fracture repair (kyphoplasty) | $21,360 | $21,360 | $5,803 |
| Spirometry (lung function test) | $468 | $468 | $30 |
| Spirometry with bronchodilator | $931 | $931 | $43 |
| Strep throat test | $74 | $74 | $17 |
| Stress echocardiogram | $2,049 | $2,049 | $209 |
| Stress echocardiogram (complete) | $2,049 | $2,049 | $233 |
| Swallow study | $371 | $371 | $85 |
| T3 thyroid test | $64 | $64 | $14 |
| Tdap (tetanus) vaccine | $111 | $111 | — |
| Testosterone test | $116 | $116 | $26 |
| Thyroid test (TSH) | $75 | $75 | $17 |
| Thyroid ultrasound | $477 | $477 | $109 |
| Thyroid uptake scan | $1,802 | $1,802 | $145 |
| Tilt table test | $1,983 | $1,983 | $168 |
| Total IgE allergy test | $74 | $74 | $16 |
| Total protein test | $16 | $16 | $4 |
| Tracheostomy | $9,697 | $9,697 | $273 |
| Transesophageal echocardiogram (TEE) | $2,049 | $2,049 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $2,049 | $2,049 | $239 |
| Transvaginal ultrasound | $477 | $477 | $118 |
| Trigger finger release | $4,785 | $4,785 | $630 |
| Trigger point injection | $883 | $883 | $56 |
| Trigger point injection (1-2 muscles) | $883 | $883 | $52 |
| Triglycerides test | $26 | $26 | $6 |
| Troponin (heart) test | $56 | $56 | $12 |
| Turning a breech baby (version) | $8,267 | $8,267 | $94 |
| Upper GI endoscopy (EGD) | $2,803 | $2,803 | $371 |
| Upper GI series (barium) | $798 | $798 | $128 |
| Ureteral stent placement | $10,312 | $10,312 | $373 |
| Ureteroscopy (stone removal) | $15,200 | $15,200 | $365 |
| Uric acid (gout) test | $20 | $20 | $5 |
| Urinalysis | $12 | $12 | $3 |
| Urine microalbumin test | $25 | $25 | $5 |
| Urine pregnancy test | $38 | $38 | $9 |
| Vaccine administration | $90 | $90 | $19 |
| Vaccine administration (each additional) | $42 | $42 | $16 |
| Varicose vein ablation | $11,764 | $11,764 | $1,018 |
| Vasectomy | $6,125 | $6,125 | $347 |
| Visual field test | $385 | $385 | $64 |
| Vitamin B12 test | $68 | $68 | $15 |
| Vitamin D test | $133 | $133 | $30 |
| Wart removal | $387 | $387 | $121 |
| Well-child visit | $99 | $99 | — |
| Wound debridement | $986 | $986 | $186 |
| X-ray of the abdomen | $477 | $477 | $36 |
| X-ray of the ankle | $395 | $395 | $37 |
| X-ray of the collarbone | $395 | $395 | $33 |
| X-ray of the elbow | $395 | $395 | $33 |
| X-ray of the facial bones | $436 | $436 | $39 |
| X-ray of the foot | $395 | $395 | $34 |
| X-ray of the forearm | $395 | $395 | $29 |
| X-ray of the hand | $395 | $395 | $38 |
| X-ray of the hip | $395 | $395 | $49 |
| X-ray of the hip (1 view) | $395 | $395 | $34 |
| X-ray of the hip (3 views) | $395 | $395 | $49 |
| X-ray of the hip (4 views) | $477 | $477 | $63 |
| X-ray of the knee | $395 | $395 | $42 |
| X-ray of the knee (2 views) | $395 | $395 | $34 |
| X-ray of the knee (3 views) | $395 | $395 | $42 |
| X-ray of the knee (4+ views) | $477 | $477 | $49 |
| X-ray of the lower back (lumbar spine) | $477 | $477 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $477 | $477 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $477 | $477 | $53 |
| X-ray of the lower leg | $395 | $395 | $31 |
| X-ray of the mid-back (thoracic spine) | $477 | $477 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $477 | $477 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $477 | $477 | $39 |
| X-ray of the neck (cervical spine) | $436 | $436 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $395 | $395 | $40 |
| X-ray of the pelvis | $477 | $477 | $36 |
| X-ray of the pelvis (1 view) | $477 | $477 | $28 |
| X-ray of the ribs | $477 | $477 | $42 |
| X-ray of the ribs (2 views) | $395 | $395 | $36 |
| X-ray of the ribs (3 views) | $477 | $477 | $42 |
| X-ray of the shoulder | $395 | $395 | $36 |
| X-ray of the skull | $477 | $477 | $40 |
| X-ray of the upper arm | $395 | $395 | $32 |
| X-ray of the wrist | $395 | $395 | $43 |
| YAG laser capsulotomy (eye) | $1,641 | $1,641 | $335 |
| Zinc blood test | $51 | $51 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
