| Procedure | Gifford Medical Center | Copley Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $80 | $72 | $51 |
| Abdominal fluid drain (paracentesis) | $920 | $459 | $284 |
| Abdominal ultrasound | $359 | $742 | $100 |
| Abdominal ultrasound (complete) | $450 | $802 | $114 |
| Abdominal ultrasound (limited) | $359 | $682 | $86 |
| Abscess drainage (complex or multiple) | $226 | $310 | $220 |
| Abscess drainage (simple) | $132 | $182 | $129 |
| Abscess incision and drainage | $179 | $182 | $174 |
| Achilles tendon repair | $1,141 | $987 | $624 |
| ACL knee reconstruction | $1,185 | $2,179 | $889 |
| Albumin blood test | $37 | $35 | $5 |
| Aldosterone test | $219 | $212 | $41 |
| Alkaline phosphatase test | $37 | $42 | $5 |
| Alpha-fetoprotein (AFP) test | $115 | $94 | $17 |
| ALT liver enzyme test | $33 | $39 | $5 |
| Ammonia blood test | $116 | $113 | $15 |
| Amylase test | $50 | $48 | $6 |
| Ankle fracture repair | $781 | $1,581 | $608 |
| Annual physical (established patient) | $79 | $171 | — |
| Annual physical (new patient) | $66 | $192 | — |
| Anoscopy | $58 | $186 | $129 |
| Antinuclear antibody (ANA) test | $50 | $108 | $12 |
| AST liver enzyme test | $30 | $42 | $5 |
| Barium swallow study | $428 | $1,226 | $107 |
| Bartholin cyst removal | $72 | $261 | $182 |
| Basic metabolic panel | $44 | $80 | $8 |
| Benign skin lesion removal | $187 | $264 | $171 |
| Bilirubin blood test | $33 | $42 | $5 |
| Bladder scope (cystoscopy) | $370 | $338 | $216 |
| Blood clotting test (PT/INR) | $27 | $38 | $4 |
| Blood crossmatch | $115 | $302 | — |
| Blood glucose test | $21 | $27 | $5 |
| Blood transfusion | $593 | $739 | $47 |
| Blood type and screen | $81 | $146 | $10 |
| Blood type test | $57 | $82 | $3 |
| Blood type test (ABO group) | $72 | $98 | $3 |
| Blood type test (Rh/D antigen) | $41 | $66 | $3 |
| BNP (heart failure) test | $161 | $263 | $39 |
| Bone density scan (DEXA) | $369 | $682 | $39 |
| Bone scan (nuclear) | $975 | $1,812 | $259 |
| Breast biopsy | $1,188 | $1,293 | $478 |
| Breast reduction | $2,033 | $1,707 | $980 |
| Breast ultrasound | $343 | $448 | $92 |
| Breast ultrasound (limited) | $343 | $448 | $84 |
| Breathing tube insertion (intubation) | $237 | $209 | $133 |
| Bunion surgery (bunionectomy) | $887 | $1,578 | $883 |
| Burn dressing and debridement (medium) | $144 | $216 | $166 |
| Burn dressing and debridement (small) | $174 | $126 | $93 |
| Burn treatment | $168 | $126 | $129 |
| C-reactive protein (CRP) | $36 | $62 | $5 |
| CA 19-9 tumor marker test | $133 | $110 | $21 |
| CA-125 ovarian marker test | $111 | $96 | $21 |
| Calcium blood test | $34 | $34 | $5 |
| Cardiac rehabilitation | $135 | $150 | $26 |
| Cardioversion | $831 | $672 | $155 |
| Carotid artery ultrasound | $307 | $975 | $156 |
| Carpal tunnel release | $1,700 | $1,506 | $483 |
| CEA tumor marker test | $121 | $70 | $19 |
| Central line placement | $828 | $659 | $238 |
| Cervical LEEP procedure | $1,706 | $559 | $325 |
| Chemotherapy infusion | $241 | $498 | $81 |
| Chemotherapy infusion (each additional) | $112 | $197 | $28 |
| Chemotherapy infusion (first hour) | $369 | $800 | $133 |
| Chest fluid drain (thoracentesis) | $682 | $1,129 | $311 |
| Chest tube insertion | $436 | $278 | $143 |
| Chest X-ray | $212 | $365 | $37 |
| Chest X-ray (1 view) | $171 | $365 | $25 |
| Chest X-ray (2 views) | $227 | $365 | $33 |
| Circumcision | $1,979 | $2,425 | $167 |
| Clotting time test (PTT) | $45 | $50 | $6 |
| Colon resection (colectomy) | $1,784 | $2,487 | $1,238 |
| Colonoscopy | $479 | $1,023 | $480 |
| Colposcopy | $123 | $222 | $161 |
| Complete blood count (CBC) | $42 | $55 | $7 |
| Complete blood count (CBC) (complete) | $42 | $57 | $8 |
| Complex wound repair | $227 | $557 | $390 |
| Comprehensive metabolic panel | $58 | $107 | $11 |
| Contraceptive implant (Nexplanon) | $88 | $182 | $115 |
| Copper blood test | $80 | $131 | $12 |
| Cortisol test | $59 | $66 | $16 |
| COVID-19 PCR test | $65 | $105 | $51 |
| CPAP titration study | $324 | $482 | $69 |
| Creatine kinase (CK) test | $50 | $55 | $7 |
| CT angiography of the chest | $1,278 | $1,864 | $281 |
| CT angiography of the head | $1,569 | $1,226 | $274 |
| CT scan of the abdomen | $1,049 | $1,226 | $230 |
| CT scan of the abdomen and pelvis | $1,578 | $2,133 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $2,464 | $2,133 | $338 |
| CT scan of the abdomen and pelvis with contrast | $1,948 | $2,133 | $300 |
| CT scan of the abdomen and pelvis without contrast | $1,578 | $1,544 | $183 |
| CT scan of the abdomen with and without contrast | $1,692 | $1,226 | $259 |
| CT scan of the abdomen with contrast | $1,269 | $1,527 | $230 |
| CT scan of the abdomen without contrast | $1,049 | $670 | $136 |
| CT scan of the arm | $862 | $1,692 | $199 |
| CT scan of the arm with contrast | $1,432 | $2,133 | $199 |
| CT scan of the arm without contrast | $862 | $1,251 | $161 |
| CT scan of the chest | $993 | $1,309 | $167 |
| CT scan of the chest with and without contrast | $1,537 | $1,199 | $196 |
| CT scan of the chest with contrast | $1,231 | $1,527 | $167 |
| CT scan of the chest without contrast | $993 | $1,309 | $133 |
| CT scan of the head | $849 | $1,251 | $148 |
| CT scan of the head with and without contrast | $1,268 | $1,545 | $173 |
| CT scan of the head with contrast | $1,107 | $1,206 | $148 |
| CT scan of the head without contrast | $849 | $1,251 | $107 |
| CT scan of the leg | $928 | $1,226 | $166 |
| CT scan of the leg with contrast | $1,327 | $1,226 | $166 |
| CT scan of the leg without contrast | $928 | $1,251 | $130 |
| CT scan of the lower back (lumbar spine) | $1,028 | $1,407 | $169 |
| CT scan of the lower back (lumbar spine) with contrast | $1,292 | $2,133 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,028 | $682 | $130 |
| CT scan of the neck | $924 | $1,225 | $183 |
| CT scan of the neck (cervical spine) | $1,078 | $1,670 | $168 |
| CT scan of the neck (cervical spine) with contrast | $1,368 | $2,089 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,078 | $1,251 | $131 |
| CT scan of the neck with and without contrast | $1,395 | $1,225 | $220 |
| CT scan of the neck with contrast | $1,130 | $1,527 | $183 |
| CT scan of the neck without contrast | $924 | $682 | $150 |
| CT scan of the pelvis | $1,020 | $1,226 | $226 |
| CT scan of the pelvis with and without contrast | $1,674 | $1,491 | $251 |
| CT scan of the pelvis with contrast | $1,195 | $1,226 | $226 |
| CT scan of the pelvis without contrast | $1,020 | $682 | $133 |
| CT scan of the sinuses | $1,010 | $1,226 | $152 |
| CT scan of the sinuses with and without contrast | $1,392 | $1,205 | $184 |
| CT scan of the sinuses with contrast | $1,233 | $1,226 | $152 |
| CT scan of the sinuses without contrast | $1,010 | $1,251 | $128 |
| D-dimer test | $76 | $107 | $10 |
| DHEA-sulfate test | $142 | $107 | $22 |
| Diagnostic mammogram | $285 | $613 | $140 |
| Drug screen (urine) | $70 | $160 | $17 |
| Echocardiogram | $436 | $138 | $138 |
| Echocardiogram with and without contrast | $333 | $71 | $101 |
| EKG / ECG (tracing only) | $100 | $126 | $7 |
| Electrocardiogram (EKG) | $100 | $68 | $8 |
| Electroencephalogram (EEG) | $389 | $84 | $448 |
| Electrolyte panel | $42 | $58 | $7 |
| Electromyography (EMG) | $112 | $170 | $141 |
| Emergency department visit | $213 | $175 | $69 |
| Emergency department visit (level 1) | $141 | $32 | $11 |
| Emergency department visit (level 2) | $163 | $62 | $40 |
| Emergency department visit (level 3) | $313 | $103 | $69 |
| Emergency department visit (level 4) | $488 | $175 | $118 |
| Emergency department visit (level 5) | $646 | $255 | $171 |
| Endometrial biopsy | $80 | $176 | $98 |
| Estradiol (estrogen) test | $87 | $111 | $28 |
| Fallopian tube X-ray (HSG) | $514 | $572 | $164 |
| Fecal occult blood (stool) test | $43 | $50 | $10 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $43 | $79 | $16 |
| Feeding tube (PEG) placement | $436 | $363 | $178 |
| Femoral hernia repair | $893 | $1,116 | $584 |
| Ferritin (iron) test | $61 | $70 | $14 |
| Fibrinogen test | $76 | $47 | $10 |
| Flexible sigmoidoscopy | $704 | $334 | $323 |
| Flu vaccine | $66 | $55 | — |
| Folate (folic acid) test | $71 | $75 | $15 |
| Foreign body removal (skin) | $147 | $227 | $157 |
| Free T4 thyroid test | $67 | $106 | $9 |
| FSH hormone test | $71 | $78 | $19 |
| Gallbladder removal (laparoscopic) | $910 | $1,552 | $658 |
| Gallbladder scan (HIDA) | $865 | $2,018 | $334 |
| Ganglion cyst removal | $561 | $794 | $321 |
| GGT liver test | $51 | $60 | $7 |
| Glucose tolerance test | $90 | $64 | $8 |
| H. pylori test | $144 | $346 | $67 |
| Hammertoe repair | $1,063 | $862 | $548 |
| HDL cholesterol test | $50 | $43 | $8 |
| Hematocrit test | $18 | $23 | $2 |
| Hemoglobin A1c (diabetes test) | $52 | $78 | $10 |
| Hemorrhoid removal | $301 | $497 | $338 |
| Hepatitis B test | $74 | $94 | $10 |
| Hepatitis C test | $78 | $100 | $14 |
| Hip fracture repair | $612 | $1,817 | $1,120 |
| Hip replacement | $1,705 | $3,904 | $1,162 |
| HIV test | $41 | $101 | $19 |
| HIV test (antigen/antibody combo) | $41 | $112 | $24 |
| Holter heart monitor | $294 | $248 | $26 |
| Hysterectomy | $1,372 | $1,495 | $933 |
| Hysteroscopy | $2,663 | $1,902 | $1,270 |
| Incisional hernia repair | $1,196 | $1,635 | — |
| Inguinal hernia repair | $798 | $1,065 | $538 |
| Iron blood test | $32 | $55 | $6 |
| IUD insertion | $76 | $140 | — |
| IUD removal | $97 | $158 | $112 |
| IV infusion therapy | $112 | $226 | $44 |
| IV infusion therapy (each additional) | $112 | $155 | $21 |
| IV infusion therapy (initial) | $325 | $298 | $67 |
| Joint aspiration (small/intermediate) | $107 | $78 | $57 |
| Joint aspiration or injection (mid-size joint) | $164 | $87 | $57 |
| Joint aspiration or injection (small joint) | $51 | $78 | $56 |
| Kidney scan (nuclear) | $1,273 | $2,188 | $172 |
| Kidney ultrasound | $321 | $682 | $84 |
| Kidney ultrasound (limited) | $311 | $682 | $61 |
| Knee arthroscopy | $693 | $1,394 | $524 |
| Knee joint injection | $50 | $114 | $69 |
| Lactate test | $71 | $86 | $12 |
| LDH test | $54 | $48 | $6 |
| LDL cholesterol test | $58 | $53 | $11 |
| Leg vein ultrasound (Doppler) | $356 | $1,193 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $356 | $842 | $116 |
| LH hormone test | $88 | $75 | $19 |
| Lipase test | $41 | $42 | $7 |
| Lipid (cholesterol) panel | $57 | $98 | $13 |
| Liver function panel | $60 | $66 | $8 |
| Lumpectomy (breast) | $2,331 | $1,216 | $750 |
| Lung scan (V/Q) | $1,163 | $2,176 | $291 |
| Magnesium blood test | $49 | $58 | $7 |
| Mastectomy | $1,712 | $1,382 | $1,021 |
| Meniscus repair (knee) | $1,628 | $1,441 | $714 |
| MRA of the brain | $1,656 | $1,544 | $226 |
| MRA of the neck | $1,716 | $3,130 | $245 |
| MRA of the neck with contrast | $2,301 | $3,130 | $245 |
| MRA of the neck without contrast | $2,360 | $3,130 | $343 |
| MRI of the abdomen | $1,410 | $1,838 | $300 |
| MRI of the abdomen without contrast | $1,410 | $1,544 | $194 |
| MRI of the ankle | $1,581 | $2,176 | $261 |
| MRI of the ankle without contrast | $1,581 | $2,218 | $222 |
| MRI of the brain | $1,645 | $2,218 | $269 |
| MRI of the brain with contrast | $1,645 | $2,122 | $269 |
| MRI of the brain without contrast | $1,623 | $2,218 | $195 |
| MRI of the chest | $1,790 | $1,804 | $371 |
| MRI of the chest without contrast | $2,114 | $2,097 | $466 |
| MRI of the knee | $1,908 | $2,218 | $315 |
| MRI of the knee with contrast | $1,908 | $3,280 | $315 |
| MRI of the knee without contrast | $1,595 | $2,218 | $204 |
| MRI of the lower back (lumbar spine) | $1,642 | $2,133 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $1,713 | $2,097 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,642 | $2,460 | $192 |
| MRI of the mid-back (thoracic spine) | $1,611 | $1,678 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $2,340 | $2,133 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $1,853 | $1,678 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $1,611 | $1,544 | $190 |
| MRI of the neck (cervical spine) | $1,597 | $2,133 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $2,293 | $2,133 | $318 |
| MRI of the neck (cervical spine) with contrast | $1,984 | $2,133 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,597 | $2,218 | $191 |
| MRI of the pelvis | $1,542 | $2,133 | $268 |
| MRI of the pelvis with contrast | $1,715 | $2,371 | $268 |
| MRI of the pelvis without contrast | $1,542 | $1,519 | $227 |
| MRI of the shoulder | $1,569 | $2,218 | $313 |
| MRI of the shoulder with contrast | $1,678 | $3,349 | $313 |
| MRI of the shoulder without contrast | $1,569 | $2,218 | $205 |
| MRI of the wrist | $1,371 | $1,544 | $330 |
| MRI of the wrist with contrast | $2,140 | $1,544 | $330 |
| MRI of the wrist without contrast | $1,371 | $1,544 | $303 |
| Nebulizer breathing treatment | $98 | $270 | $9 |
| Nerve conduction study | $111 | $173 | $118 |
| Newborn hospital care | $125 | $77 | $58 |
| Occupational therapy evaluation | $173 | $338 | $101 |
| Occupational therapy evaluation (high complexity) | $179 | $338 | $101 |
| Occupational therapy evaluation (low complexity) | $173 | $376 | $101 |
| Occupational therapy evaluation (moderate complexity) | $168 | $290 | $101 |
| Office visit (established patient) | $50 | $109 | $115 |
| Office visit (new patient) | $105 | $157 | $177 |
| Office visit, established patient (level 3) | $43 | $94 | $95 |
| Office visit, established patient (level 4) | $57 | $137 | $136 |
| Office visit, new patient (level 3) | $73 | $116 | $118 |
| Office visit, new patient (level 4) | $105 | $178 | $177 |
| Office visit, new patient (level 5) | $111 | $236 | $237 |
| Orthopedic hardware removal | $2,663 | $907 | $632 |
| Ovarian cyst removal | $939 | $1,008 | $698 |
| Pap smear (cervical screening) | $47 | $122 | $20 |
| Parathyroid hormone (PTH) test | $146 | $166 | $41 |
| Pelvic ultrasound | $354 | $546 | $78 |
| Pelvic ultrasound (complete) | $390 | $411 | $105 |
| Pelvic ultrasound (limited) | $319 | $682 | $51 |
| Phosphorus blood test | $35 | $36 | $5 |
| Physical therapy evaluation | $158 | $376 | $98 |
| Physical therapy evaluation (high complexity) | $158 | $333 | $98 |
| Physical therapy evaluation (moderate complexity) | $158 | $388 | $98 |
| Pilonidal cyst removal | $768 | $686 | $541 |
| Platelet count | $41 | $26 | $4 |
| Pregnancy ultrasound | $431 | $671 | $126 |
| Pregnancy ultrasound (first trimester) | $446 | $682 | $117 |
| Pregnancy ultrasound (second or third trimester) | $415 | $660 | $136 |
| Procalcitonin test | $104 | $123 | $27 |
| Prolactin test | $74 | $81 | $19 |
| Prostate biopsy | $548 | $4,535 | — |
| Prostate test (PSA) | $80 | $145 | $18 |
| Pulmonary rehabilitation | $34 | $130 | $87 |
| Rotator cuff repair | $1,361 | $1,350 | $792 |
| Sacroiliac joint injection | $443 | $450 | $176 |
| Scoliosis spine X-ray | $255 | $682 | $58 |
| Scoliosis spine X-ray (3 views) | $255 | $682 | $72 |
| Screening colonoscopy | $517 | $718 | $378 |
| Screening mammogram | $262 | $598 | $126 |
| Scrotal ultrasound | $505 | $682 | $99 |
| Sedimentation rate (ESR) test | $21 | $16 | $3 |
| Semen analysis | $89 | $64 | $12 |
| Sex hormone binding globulin test | $41 | $98 | $22 |
| Shoulder arthroscopy | $1,856 | $1,520 | $962 |
| Shoulder replacement | $2,647 | $2,289 | $1,300 |
| Simple laceration repair (small, up to 2.5 cm) | $145 | $200 | $114 |
| Simple wound stitches | $178 | $200 | $127 |
| Skin biopsy | $93 | $171 | $121 |
| Skin biopsy (punch) | $137 | $239 | $121 |
| Skin cancer lesion removal | $187 | $342 | $240 |
| Skin tag removal | $52 | $132 | $92 |
| Small bowel resection | $1,636 | $2,254 | $1,136 |
| Soft tissue ultrasound | $324 | $86 | $64 |
| Speech therapy | $174 | $222 | $76 |
| Spinal tap (lumbar puncture) | $191 | $208 | $165 |
| Swallow study | $224 | $319 | $85 |
| T3 thyroid test | $86 | $68 | $14 |
| Tdap (tetanus) vaccine | $127 | $136 | — |
| Testosterone test | $110 | $116 | $26 |
| Thyroid test (TSH) | $97 | $116 | $17 |
| Thyroid ultrasound | $440 | $682 | $109 |
| Total IgE allergy test | $58 | $87 | $16 |
| Total protein test | $22 | $34 | $4 |
| Transesophageal echocardiogram (TEE) | $1,244 | $282 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $1,244 | $410 | $239 |
| Transvaginal ultrasound | $450 | $162 | $118 |
| Trigger finger release | $931 | $1,439 | $630 |
| Trigger point injection | $108 | $79 | $56 |
| Triglycerides test | $40 | $50 | $6 |
| Troponin (heart) test | $87 | $79 | $12 |
| Tubal ligation | $644 | $1,087 | $333 |
| Ulnar nerve surgery (elbow) | $2,555 | $1,156 | $575 |
| Umbilical hernia repair | $560 | $815 | — |
| Upper GI endoscopy (EGD) | $373 | $664 | $371 |
| Upper GI series (barium) | $474 | $1,204 | $128 |
| Uric acid (gout) test | $31 | $38 | $5 |
| Urinalysis | $28 | $48 | $3 |
| Urine microalbumin test | $39 | $54 | $5 |
| Urine pregnancy test | $25 | $36 | $9 |
| Vaccine administration | $11 | $20 | $19 |
| Vaccine administration (each additional) | $11 | $20 | $16 |
| Vasectomy | $715 | $801 | $347 |
| Vitamin B12 test | $56 | $70 | $15 |
| Vitamin D test | $110 | $120 | $30 |
| Wart removal | $60 | $166 | $121 |
| Wound debridement | $239 | $193 | $186 |
| Wrist fracture repair | $1,019 | $1,271 | $735 |
| X-ray of the abdomen | $216 | $666 | $36 |
| X-ray of the ankle | $278 | $365 | $37 |
| X-ray of the collarbone | $220 | $365 | $33 |
| X-ray of the elbow | $220 | $365 | $33 |
| X-ray of the facial bones | $236 | $513 | $39 |
| X-ray of the foot | $257 | $365 | $34 |
| X-ray of the forearm | $220 | $365 | $29 |
| X-ray of the hand | $265 | $365 | $38 |
| X-ray of the hip | $196 | $440 | $49 |
| X-ray of the hip (1 view) | $196 | $365 | $34 |
| X-ray of the hip (3 views) | $243 | $516 | $49 |
| X-ray of the knee | $249 | $472 | $42 |
| X-ray of the knee (2 views) | $249 | $365 | $34 |
| X-ray of the knee (3 views) | $299 | $472 | $42 |
| X-ray of the knee (4+ views) | $347 | $682 | $49 |
| X-ray of the lower back (lumbar spine) | $299 | $682 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $299 | $682 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $382 | $682 | $53 |
| X-ray of the lower leg | $213 | $365 | $31 |
| X-ray of the mid-back (thoracic spine) | $247 | $682 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $247 | $682 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $311 | $682 | $39 |
| X-ray of the neck (cervical spine) | $207 | $523 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $207 | $365 | $40 |
| X-ray of the pelvis | $206 | $682 | $36 |
| X-ray of the pelvis (1 view) | $206 | $682 | $28 |
| X-ray of the ribs | $220 | $667 | $42 |
| X-ray of the ribs (2 views) | $220 | $365 | $36 |
| X-ray of the ribs (3 views) | $298 | $682 | $42 |
| X-ray of the shoulder | $257 | $365 | $36 |
| X-ray of the skull | $259 | $676 | $40 |
| X-ray of the upper arm | $220 | $365 | $32 |
| X-ray of the wrist | $279 | $365 | $43 |
| Zinc blood test | $72 | $106 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
