| Procedure | Faulkton Area Medical Center | Community Memorial Hospital | Medicare |
|---|
| Abdominal ultrasound | $1,245 | $1,015 | $100 |
| Abdominal ultrasound (complete) | $2,031 | $1,247 | $114 |
| Abdominal ultrasound (limited) | $1,245 | $1,015 | $86 |
| Albumin blood test | $68 | $30 | $5 |
| Aldosterone test | $211 | $202 | $41 |
| Alkaline phosphatase test | $47 | $30 | $5 |
| Alpha-fetoprotein (AFP) test | $93 | $108 | $17 |
| ALT liver enzyme test | $50 | $57 | $5 |
| Ammonia blood test | $138 | $115 | $15 |
| Amylase test | $110 | $37 | $6 |
| Arterial blood gas (ABG) | $203 | $219 | $26 |
| AST liver enzyme test | $65 | $55 | $5 |
| Basic metabolic panel | $145 | $65 | $8 |
| Bilirubin blood test | $44 | $50 | $5 |
| Blood clotting test (PT/INR) | $64 | $47 | $4 |
| Blood crossmatch | $97 | $126 | — |
| Blood glucose test | $58 | $23 | $5 |
| Blood transfusion | $939 | $950 | $47 |
| Blood type and screen | $86 | $126 | $10 |
| Blood type test | $62 | $61 | $3 |
| Blood type test (ABO group) | $62 | $61 | $3 |
| Blood type test (Rh/D antigen) | $62 | $61 | $3 |
| BNP (heart failure) test | $217 | $215 | $39 |
| Bone density scan (DEXA) | $56 | $546 | $39 |
| Breathing tube insertion (intubation) | $526 | $408 | $133 |
| C-reactive protein (CRP) | $129 | $86 | $5 |
| CA 19-9 tumor marker test | $164 | $197 | $21 |
| CA-125 ovarian marker test | $259 | $117 | $21 |
| Calcium blood test | $76 | $18 | $5 |
| Cardiac rehabilitation | $159 | $218 | $26 |
| Carotid artery ultrasound | $864 | $1,225 | $156 |
| CEA tumor marker test | $175 | $98 | $19 |
| Celiac disease test | $78 | $172 | $12 |
| Chemotherapy infusion | $369 | $430 | $81 |
| Chemotherapy infusion (each additional) | $286 | $172 | $28 |
| Chemotherapy infusion (first hour) | $451 | $689 | $133 |
| Chest X-ray | $408 | $300 | $37 |
| Chest X-ray (1 view) | $334 | $291 | $25 |
| Chest X-ray (2 views) | $408 | $309 | $33 |
| CK-MB heart enzyme test | $131 | $68 | $12 |
| Clotting time test (PTT) | $30 | $86 | $6 |
| Colonoscopy | $2,142 | $525 | $480 |
| Complete blood count (CBC) | $121 | $61 | $7 |
| Complete blood count (CBC) (complete) | $128 | $71 | $8 |
| Comprehensive metabolic panel | $193 | $115 | $11 |
| Copper blood test | $78 | $43 | $12 |
| Cortisol test | $59 | $91 | $16 |
| COVID-19 PCR test | $185 | $163 | $51 |
| CPAP titration study | $688 | $877 | $69 |
| Creatine kinase (CK) test | $76 | $92 | $7 |
| CT angiography of the chest | $2,790 | $3,618 | $281 |
| CT scan of the abdomen | $3,268 | $2,295 | $230 |
| CT scan of the abdomen and pelvis | $4,867 | $4,223 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $7,389 | $4,223 | $338 |
| CT scan of the abdomen and pelvis with contrast | $4,867 | $4,628 | $300 |
| CT scan of the abdomen and pelvis without contrast | $4,047 | $3,939 | $183 |
| CT scan of the abdomen with contrast | $3,346 | $2,295 | $230 |
| CT scan of the abdomen without contrast | $1,889 | $1,969 | $136 |
| CT scan of the arm | $2,828 | $2,955 | $199 |
| CT scan of the arm without contrast | $2,739 | $2,955 | $161 |
| CT scan of the head | $2,349 | $2,600 | $148 |
| CT scan of the head with and without contrast | $3,494 | $3,073 | $173 |
| CT scan of the head without contrast | $2,210 | $2,127 | $107 |
| CT scan of the leg | $3,187 | $2,866 | $166 |
| CT scan of the leg with contrast | $2,974 | $2,897 | $166 |
| CT scan of the lower back (lumbar spine) | $2,593 | $2,122 | $169 |
| CT scan of the lower back (lumbar spine) with contrast | $2,554 | $2,117 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $2,632 | $2,127 | $130 |
| CT scan of the neck | $3,190 | $3,073 | $183 |
| CT scan of the neck (cervical spine) | $2,593 | $2,071 | $168 |
| CT scan of the neck (cervical spine) without contrast | $2,632 | $2,071 | $131 |
| CT scan of the neck with and without contrast | $3,367 | $3,129 | $220 |
| CT scan of the neck with contrast | $3,190 | $3,073 | $183 |
| CT scan of the neck without contrast | $1,839 | $2,127 | $150 |
| CT scan of the pelvis | $2,809 | $2,135 | $226 |
| CT scan of the pelvis without contrast | $2,479 | $2,135 | $133 |
| CT scan of the sinuses | $2,307 | $1,941 | $152 |
| CT scan of the sinuses with and without contrast | $3,350 | $2,127 | $184 |
| CT scan of the sinuses with contrast | $2,307 | $1,941 | $152 |
| CT scan of the sinuses without contrast | $2,263 | $1,674 | $128 |
| D-dimer test | $194 | $148 | $10 |
| DHEA-sulfate test | $116 | $157 | $22 |
| Drug screen (urine) | $191 | $116 | $17 |
| Echocardiogram | $911 | $2,202 | $138 |
| EKG / ECG (tracing only) | $184 | $163 | $7 |
| Electrocardiogram (EKG) | $184 | $163 | $8 |
| Electrolyte panel | $106 | $71 | $7 |
| Emergency department visit | $351 | $342 | $69 |
| Emergency department visit (level 1) | $178 | $342 | $11 |
| Emergency department visit (level 2) | $272 | $216 | $40 |
| Emergency department visit (level 3) | $360 | $286 | $69 |
| Emergency department visit (level 4) | $594 | $434 | $118 |
| Emergency department visit (level 5) | $1,041 | $537 | $171 |
| Estradiol (estrogen) test | $114 | $78 | $28 |
| Fecal occult blood (stool) test | $34 | $60 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $34 | $58 | $4 |
| Ferritin (iron) test | $122 | $91 | $14 |
| Fibrinogen test | $173 | $72 | $10 |
| Flu test | $68 | $72 | $17 |
| Folate (folic acid) test | $102 | $98 | $15 |
| Free T4 thyroid test | $111 | $86 | $9 |
| FSH hormone test | $86 | $97 | $19 |
| GGT liver test | $95 | $28 | $7 |
| Hematocrit test | $48 | $54 | $2 |
| Hemoglobin A1c (diabetes test) | $81 | $53 | $10 |
| Hepatitis B test | $104 | $65 | $10 |
| Hepatitis C test | $194 | $122 | $14 |
| HIV test | $113 | $173 | $19 |
| HIV test (antigen/antibody combo) | $113 | $173 | $24 |
| Holter heart monitor | $404 | $505 | $26 |
| Iron blood test | $68 | $42 | $6 |
| IV infusion therapy | $501 | $285 | $44 |
| IV infusion therapy (each additional) | $405 | $146 | $21 |
| IV infusion therapy (initial) | $501 | $423 | $67 |
| Kidney ultrasound | $1,547 | $787 | $84 |
| Kidney ultrasound (limited) | $1,040 | $787 | $61 |
| Lactate test | $107 | $79 | $12 |
| LDH test | $80 | $32 | $6 |
| LDL cholesterol test | $103 | $75 | $11 |
| Leg vein ultrasound (Doppler) | $728 | $837 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $559 | $837 | $116 |
| LH hormone test | $186 | $93 | $19 |
| Lipase test | $168 | $91 | $7 |
| Lipid (cholesterol) panel | $105 | $87 | $13 |
| Liver function panel | $93 | $98 | $8 |
| Lung function test (PFT) | $203 | $322 | $37 |
| Magnesium blood test | $49 | $52 | $7 |
| MRI of the abdomen | $2,884 | $3,910 | $300 |
| MRI of the abdomen with contrast | $2,884 | $3,910 | $300 |
| MRI of the brain | $2,637 | $5,869 | $269 |
| MRI of the brain without contrast | $2,472 | $3,522 | $195 |
| MRI of the knee | $4,285 | $3,652 | $315 |
| MRI of the knee without contrast | $2,637 | $3,652 | $204 |
| MRI of the lower back (lumbar spine) | $4,862 | $4,022 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $4,862 | $4,022 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $4,566 | $3,883 | $192 |
| MRI of the mid-back (thoracic spine) | $4,630 | $3,771 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $4,034 | $3,771 | $190 |
| MRI of the neck (cervical spine) | $4,630 | $4,248 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $5,225 | $4,613 | $318 |
| MRI of the neck (cervical spine) without contrast | $4,034 | $3,883 | $191 |
| MRI of the pelvis | $3,840 | $3,939 | $268 |
| MRI of the pelvis without contrast | $2,661 | $3,591 | $227 |
| Occupational therapy evaluation | $206 | $204 | $101 |
| Occupational therapy evaluation (high complexity) | $255 | $232 | $101 |
| Occupational therapy evaluation (low complexity) | $182 | $176 | $101 |
| Office visit (established patient) | $158 | $272 | $115 |
| Office visit, established patient (level 3) | $140 | $247 | $95 |
| Office visit, established patient (level 4) | $193 | $292 | $136 |
| Pap smear (cervical screening) | $70 | $79 | $20 |
| Parathyroid hormone (PTH) test | $221 | $183 | $41 |
| Pelvic ultrasound | $392 | $739 | $78 |
| Pelvic ultrasound (complete) | $869 | $838 | $105 |
| Pelvic ultrasound (limited) | $392 | $639 | $51 |
| Phosphorus blood test | $56 | $49 | $5 |
| Physical therapy evaluation | $206 | $204 | $98 |
| Physical therapy evaluation (high complexity) | $255 | $232 | $98 |
| Physical therapy evaluation (moderate complexity) | $206 | $204 | $98 |
| Platelet count | $69 | $54 | $4 |
| Pregnancy blood test (hCG) | $116 | $103 | $8 |
| Procalcitonin test | $140 | $196 | $27 |
| Prolactin test | $88 | $289 | $19 |
| Screening mammogram | $464 | $374 | $126 |
| Scrotal ultrasound | $1,616 | $926 | $99 |
| Sedimentation rate (ESR) test | $64 | $79 | $3 |
| Sex hormone binding globulin test | $79 | $126 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $418 | $127 | $114 |
| Simple wound stitches | $418 | $153 | $127 |
| Soft tissue ultrasound | $452 | $629 | $64 |
| Speech therapy | $224 | $264 | $76 |
| Spirometry with bronchodilator | $306 | $322 | $43 |
| Strep throat test | $78 | $76 | $17 |
| Swallow study | $269 | $335 | $85 |
| T3 thyroid test | $82 | $85 | $14 |
| Tdap (tetanus) vaccine | $153 | $140 | — |
| Testosterone test | $134 | $136 | $26 |
| Thyroid test (TSH) | $109 | $89 | $17 |
| Thyroid ultrasound | $1,096 | $835 | $109 |
| Total IgE allergy test | $163 | $24 | $16 |
| Total protein test | $78 | $16 | $4 |
| Transvaginal ultrasound | $436 | $898 | $118 |
| Troponin (heart) test | $149 | $88 | $12 |
| Upper GI endoscopy (EGD) | $2,369 | $453 | $371 |
| Uric acid (gout) test | $75 | $33 | $5 |
| Urinalysis | $68 | $25 | $3 |
| Urine microalbumin test | $68 | $69 | $5 |
| Urine pregnancy test | $112 | $52 | $9 |
| Vaccine administration | $20 | $31 | $19 |
| Vitamin B12 test | $112 | $104 | $15 |
| Vitamin D test | $153 | $121 | $30 |
| Wound debridement | $383 | $313 | $186 |
| X-ray of the abdomen | $299 | $380 | $36 |
| X-ray of the ankle | $293 | $282 | $37 |
| X-ray of the collarbone | $162 | $230 | $33 |
| X-ray of the elbow | $314 | $282 | $33 |
| X-ray of the foot | $324 | $282 | $34 |
| X-ray of the forearm | $293 | $175 | $29 |
| X-ray of the hand | $339 | $282 | $38 |
| X-ray of the hip | $222 | $503 | $49 |
| X-ray of the hip (3 views) | $232 | $503 | $49 |
| X-ray of the knee | $366 | $338 | $42 |
| X-ray of the knee (2 views) | $211 | $173 | $34 |
| X-ray of the knee (3 views) | $339 | $338 | $42 |
| X-ray of the knee (4+ views) | $366 | $372 | $49 |
| X-ray of the lower back (lumbar spine) | $488 | $255 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $401 | $220 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $575 | $290 | $53 |
| X-ray of the lower leg | $299 | $230 | $31 |
| X-ray of the mid-back (thoracic spine) | $303 | $446 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $303 | $446 | $33 |
| X-ray of the neck (cervical spine) | $521 | $276 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $424 | $230 | $40 |
| X-ray of the pelvis | $403 | $461 | $36 |
| X-ray of the pelvis (1 view) | $403 | $461 | $28 |
| X-ray of the ribs | $482 | $264 | $42 |
| X-ray of the ribs (2 views) | $415 | $264 | $36 |
| X-ray of the ribs (3 views) | $482 | $351 | $42 |
| X-ray of the shoulder | $291 | $257 | $36 |
| X-ray of the skull | $465 | $217 | $40 |
| X-ray of the upper arm | $283 | $230 | $32 |
| X-ray of the wrist | $260 | $282 | $43 |
| Zinc blood test | $124 | $85 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
