| Procedure | Mercyone Waterloo Medical Center | Allen Hospital | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $86 | $44 | $51 |
| Abdominal fluid drain (paracentesis) | $2,599 | $2,197 | $284 |
| Abdominal ultrasound | $688 | $449 | $100 |
| Abdominal ultrasound (complete) | $688 | $918 | $114 |
| Abscess drainage (complex or multiple) | $1,981 | $407 | $220 |
| Abscess drainage (simple) | $350 | $407 | $129 |
| ACL knee reconstruction | $2,153 | $4,832 | $889 |
| Adenoid removal (adenoidectomy) | $759 | $535 | $204 |
| Aldosterone test | $335 | $109 | $41 |
| Allergy patch testing | $17 | $16 | $5 |
| Allergy shots | $40 | $29 | $11 |
| Allergy testing | $15 | $13 | $4 |
| Alpha-fetoprotein (AFP) test | $176 | $64 | $17 |
| ALT liver enzyme test | $44 | $34 | $5 |
| Ammonia blood test | $131 | $64 | $15 |
| Amylase test | $54 | $34 | $6 |
| Annual physical (established patient) | $235 | $220 | — |
| Annual physical (new patient) | $288 | $254 | — |
| Anoscopy | $176 | $122 | $129 |
| Antinuclear antibody (ANA) test | $68 | $49 | $12 |
| Arterial blood gas (ABG) | $493 | $86 | $26 |
| AST liver enzyme test | $43 | $34 | $5 |
| Barium swallow study | $484 | $192 | $107 |
| Bartholin cyst removal | $336 | $233 | $182 |
| Benign skin lesion removal | $510 | $479 | $171 |
| Bladder function test (urodynamics) | $485 | $551 | $345 |
| Bladder scope (cystoscopy) | $1,159 | $861 | $216 |
| Blood clotting test (PT/INR) | $42 | $33 | $4 |
| Blood type and screen | $163 | $57 | $10 |
| Blood type test | $94 | $57 | $3 |
| Blood type test (ABO group) | $100 | $57 | $3 |
| Blood type test (Rh/D antigen) | $87 | $57 | $3 |
| BNP (heart failure) test | $155 | $86 | $39 |
| Bone density scan (DEXA) | $357 | $452 | $39 |
| Bone marrow biopsy | $1,774 | $2,522 | $172 |
| Bone scan (nuclear) | $1,709 | $1,698 | $259 |
| Botox for migraine | $484 | $466 | $157 |
| Breast biopsy | $2,802 | $2,952 | $478 |
| Breast reconstruction | $44,432 | $5,657 | $1,227 |
| Breast reduction | $65,475 | $5,429 | $980 |
| Breast ultrasound | $1,003 | $378 | $92 |
| Breast ultrasound (complete) | $1,293 | $378 | $100 |
| Breast ultrasound (limited) | $714 | $378 | $84 |
| Breathing tube insertion (intubation) | $764 | $416 | $133 |
| Bunion surgery (bunionectomy) | $2,095 | $2,614 | $883 |
| Burn dressing and debridement (small) | $329 | $431 | $93 |
| Burn treatment | $329 | $431 | $129 |
| C-reactive protein (CRP) | $73 | $49 | $5 |
| CA 19-9 tumor marker test | $172 | $49 | $21 |
| CA-125 ovarian marker test | $190 | $49 | $21 |
| Capsule endoscopy | $2,442 | $2,457 | $802 |
| Cardiac ablation | $2,859 | $32,627 | $759 |
| Cardiac catheterization | $5,545 | $10,281 | $1,049 |
| Cardiac rehabilitation | $571 | $250 | $26 |
| Cardiac stress test | $328 | $168 | $39 |
| Cardioversion | $677 | $1,645 | $155 |
| Carotid artery ultrasound | $918 | $407 | $156 |
| Carpal tunnel release | $1,360 | $2,139 | $483 |
| Cataract surgery | $12,099 | $2,289 | $547 |
| CEA tumor marker test | $174 | $64 | $19 |
| Celiac disease test | $195 | $49 | $12 |
| Central line placement | $348 | $1,068 | $238 |
| Chemotherapy infusion | $192 | $190 | $81 |
| Chemotherapy infusion (each additional) | $90 | $130 | $28 |
| Chest fluid drain (thoracentesis) | $2,439 | $1,046 | $311 |
| Chest tube insertion | $408 | $834 | $143 |
| Chest X-ray | $161 | $145 | $37 |
| Chest X-ray (1 view) | $164 | $145 | $25 |
| Chest X-ray (2 views) | $158 | $145 | $33 |
| Chickenpox (varicella) vaccine | $242 | $363 | — |
| Chiropractic adjustment | $46 | $74 | $38 |
| Circumcision | $2,007 | $2,260 | $167 |
| CK-MB heart enzyme test | $96 | $64 | $12 |
| Colon resection (colectomy) | $529 | $3,298 | $1,238 |
| Colostomy | $2,605 | $2,954 | $1,122 |
| Colposcopy | $534 | $382 | $161 |
| Complete blood count (CBC) | $69 | $34 | $7 |
| Complete blood count (CBC) (complete) | $69 | $34 | $8 |
| Continuous glucose monitor setup | $106 | $80 | $35 |
| Contraceptive implant (Nexplanon) | $515 | $253 | $115 |
| Copper blood test | $114 | $32 | $12 |
| Coronary CT angiography | $1,914 | $1,632 | $326 |
| Cortisol test | $159 | $55 | $16 |
| COVID-19 PCR test | $153 | $67 | $51 |
| CPAP titration study | $716 | $1,035 | $69 |
| Creatine kinase (CK) test | $44 | $34 | $7 |
| CT angiography of the chest | $2,376 | $2,255 | $281 |
| CT angiography of the head | $1,914 | $1,342 | $274 |
| CT scan of the abdomen | $1,914 | $962 | $230 |
| CT scan of the abdomen and pelvis | $3,669 | $2,086 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $3,669 | $3,128 | $338 |
| CT scan of the abdomen and pelvis with contrast | $5,033 | $2,606 | $300 |
| CT scan of the abdomen and pelvis without contrast | $4,146 | $2,086 | $183 |
| CT scan of the abdomen with and without contrast | $2,165 | $1,397 | $259 |
| CT scan of the abdomen with contrast | $1,914 | $1,200 | $230 |
| CT scan of the abdomen without contrast | $866 | $962 | $136 |
| CT scan of the arm | $1,221 | $656 | $199 |
| CT scan of the arm with contrast | $1,143 | $2,296 | $199 |
| CT scan of the arm without contrast | $1,299 | $656 | $161 |
| CT scan of the chest | $2,443 | $870 | $167 |
| CT scan of the chest with and without contrast | $3,528 | $1,368 | $196 |
| CT scan of the chest with contrast | $3,293 | $1,211 | $167 |
| CT scan of the chest without contrast | $1,314 | $870 | $133 |
| CT scan of the head | $1,851 | $919 | $148 |
| CT scan of the head with and without contrast | $1,914 | $1,799 | $173 |
| CT scan of the head with contrast | $1,788 | $919 | $148 |
| CT scan of the head without contrast | $2,043 | $1,302 | $107 |
| CT scan of the leg | $1,914 | $778 | $166 |
| CT scan of the leg with contrast | $1,914 | $1,299 | $166 |
| CT scan of the leg without contrast | $2,043 | $778 | $130 |
| CT scan of the lower back (lumbar spine) | $1,766 | $842 | $169 |
| CT scan of the lower back (lumbar spine) with contrast | $1,923 | $1,215 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,609 | $842 | $130 |
| CT scan of the neck | $1,327 | $833 | $183 |
| CT scan of the neck (cervical spine) | $2,310 | $1,085 | $168 |
| CT scan of the neck (cervical spine) with contrast | $3,010 | $1,463 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,609 | $1,085 | $131 |
| CT scan of the neck with contrast | $1,788 | $1,083 | $183 |
| CT scan of the neck without contrast | $866 | $833 | $150 |
| CT scan of the pelvis | $1,914 | $947 | $226 |
| CT scan of the pelvis with and without contrast | $3,554 | $1,325 | $251 |
| CT scan of the pelvis with contrast | $1,914 | $1,159 | $226 |
| CT scan of the pelvis without contrast | $866 | $947 | $133 |
| CT scan of the sinuses | $1,609 | $719 | $152 |
| CT scan of the sinuses with and without contrast | $1,300 | $1,246 | $184 |
| CT scan of the sinuses with contrast | $1,788 | $1,111 | $152 |
| CT scan of the sinuses without contrast | $1,609 | $719 | $128 |
| D-dimer test | $85 | $33 | $10 |
| Defibrillator (ICD) implant | $2,995 | $66,238 | $798 |
| Developmental screening (child) | $53 | $57 | — |
| DHEA-sulfate test | $204 | $55 | $22 |
| Diagnostic mammogram | $347 | $212 | $140 |
| Dilation and curettage (D&C) | $874 | $695 | $298 |
| Drug screen (urine) | $114 | $72 | $17 |
| Ear pressure test (tympanometry) | $48 | $125 | $16 |
| Ear tubes (myringotomy) | $2,324 | $435 | $174 |
| Echocardiogram | $335 | $205 | $138 |
| Echocardiogram with and without contrast | $85 | $752 | $101 |
| EEG (awake and asleep) | $549 | $632 | $482 |
| EKG / ECG (tracing only) | $136 | $165 | $7 |
| Electrocardiogram (EKG) | $63 | $38 | $8 |
| Electroencephalogram (EEG) | $361 | $411 | $448 |
| Electromyography (EMG) | $542 | $92 | $141 |
| Emergency department visit (level 1) | $347 | $44 | $11 |
| Emergency department visit (level 2) | $496 | $321 | $40 |
| Emergency department visit (level 3) | $857 | $599 | $69 |
| Emergency department visit (level 4) | $1,270 | $221 | $118 |
| Emergency department visit (level 5) | $1,459 | $319 | $171 |
| Epidural steroid injection | $2,326 | $1,681 | $275 |
| Estradiol (estrogen) test | $232 | $55 | $28 |
| Facet joint injection (spine) | $2,878 | $428 | $99 |
| Fallopian tube X-ray (HSG) | $1,077 | $323 | $164 |
| Family therapy session | $254 | $173 | $110 |
| Fecal occult blood (stool) test | $161 | $37 | $10 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $47 | $64 | $16 |
| Fibrinogen test | $67 | $33 | $10 |
| Fibroid removal (myomectomy) | $1,995 | $2,606 | $914 |
| Flu test | $90 | $39 | $17 |
| Flu vaccine | $46 | $22 | — |
| Folate (folic acid) test | $70 | $64 | $15 |
| Foreign body removal (skin) | $354 | $122 | $157 |
| Free T4 thyroid test | $74 | $55 | $9 |
| FSH hormone test | $154 | $55 | $19 |
| Gallbladder scan (HIDA) | $1,057 | $1,885 | $334 |
| Ganglion cyst removal | $943 | $790 | $321 |
| Glucose tolerance test | $69 | $34 | $8 |
| Group therapy session | $548 | $190 | $30 |
| H. pylori test | $560 | $291 | $67 |
| HDL cholesterol test | $69 | $34 | $8 |
| Hearing test (audiometry) | $97 | $87 | $36 |
| Hemodialysis | $311 | $540 | $75 |
| Hemoglobin A1c (diabetes test) | $87 | $34 | $10 |
| Hepatitis B vaccine | $144 | $106 | — |
| Hepatitis C test | $119 | $49 | $14 |
| Hip fracture repair | $2,710 | $3,025 | $1,120 |
| Holter heart monitor | $643 | $193 | $26 |
| Home sleep apnea test | $1,433 | $567 | $123 |
| Hydrocele repair | $29,207 | $847 | $315 |
| IUD insertion | $154 | $331 | — |
| IV infusion therapy | $309 | $119 | $44 |
| IV infusion therapy (initial) | $309 | $396 | $67 |
| IVC filter placement | $25,530 | $5,280 | $1,885 |
| Joint aspiration or injection (mid-size joint) | $974 | $365 | $57 |
| Joint aspiration or injection (small joint) | $272 | $545 | $56 |
| Kidney biopsy | $3,115 | $2,123 | $492 |
| Kidney scan (nuclear) | $2,217 | $1,166 | $172 |
| Kidney ultrasound | $679 | $612 | $84 |
| Knee arthroscopy | $2,191 | $1,355 | $524 |
| LDH test | $32 | $34 | $6 |
| LDL cholesterol test | $79 | $34 | $11 |
| Leg artery angiogram | $5,174 | $3,459 | $149 |
| Leg artery angioplasty | $11,162 | $16,459 | — |
| Leg vein ultrasound (Doppler) | $879 | $615 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $841 | $615 | $116 |
| LH hormone test | $153 | $55 | $19 |
| Lipase test | $65 | $34 | $7 |
| Liver biopsy | $3,107 | $2,123 | $288 |
| Liver function panel | $72 | $69 | $8 |
| Lung scan (V/Q) | $1,446 | $384 | $291 |
| MMR vaccine | $156 | $222 | — |
| MRA of the brain | $7,144 | $1,377 | $226 |
| MRA of the brain without contrast | $8,026 | $2,174 | $328 |
| MRA of the neck | $3,216 | $1,413 | $245 |
| MRA of the neck without contrast | $3,307 | $2,389 | $343 |
| MRI of the abdomen | $2,051 | $1,310 | $300 |
| MRI of the abdomen with contrast | $2,051 | $1,484 | $300 |
| MRI of the abdomen without contrast | $1,683 | $1,310 | $194 |
| MRI of the ankle | $3,351 | $1,063 | $261 |
| MRI of the ankle without contrast | $3,125 | $1,063 | $222 |
| MRI of the brain | $2,068 | $1,480 | $269 |
| MRI of the brain with contrast | $1,683 | $1,531 | $269 |
| MRI of the brain without contrast | $2,068 | $1,480 | $195 |
| MRI of the chest | $2,510 | $1,396 | $371 |
| MRI of the chest without contrast | $3,400 | $2,346 | $466 |
| MRI of the knee | $5,929 | $3,312 | $315 |
| MRI of the knee with contrast | $5,929 | $3,518 | $315 |
| MRI of the knee without contrast | $4,688 | $3,312 | $204 |
| MRI of the lower back (lumbar spine) | $3,152 | $1,184 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $3,152 | $1,693 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $3,125 | $1,184 | $192 |
| MRI of the mid-back (thoracic spine) | $3,150 | $1,480 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $6,139 | $2,532 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $3,150 | $1,665 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $3,125 | $1,480 | $190 |
| MRI of the neck (cervical spine) | $3,307 | $1,184 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $3,416 | $2,668 | $318 |
| MRI of the neck (cervical spine) with contrast | $3,307 | $1,579 | $274 |
| MRI of the neck (cervical spine) without contrast | $3,125 | $1,184 | $191 |
| MRI of the pelvis | $2,608 | $1,295 | $268 |
| MRI of the pelvis without contrast | $1,799 | $1,295 | $227 |
| MRI of the shoulder | $4,842 | $1,300 | $313 |
| MRI of the shoulder with contrast | $4,876 | $1,635 | $313 |
| MRI of the shoulder without contrast | $3,967 | $1,300 | $205 |
| MRI of the wrist | $4,238 | $1,364 | $330 |
| MRI of the wrist without contrast | $4,688 | $1,364 | $303 |
| Nebulizer breathing treatment | $175 | $188 | $9 |
| Nerve conduction study | $479 | $225 | $118 |
| Newborn hospital care | $148 | $124 | $58 |
| Nuclear cardiac stress test | $3,736 | $2,801 | $428 |
| Occupational therapy evaluation | $229 | $191 | $101 |
| Occupational therapy evaluation (high complexity) | $205 | $221 | $101 |
| Occupational therapy evaluation (low complexity) | $229 | $173 | $101 |
| Occupational therapy evaluation (moderate complexity) | $229 | $197 | $101 |
| Office visit (established patient) | $209 | $176 | $115 |
| Office visit (new patient) | $307 | $290 | $177 |
| Office visit, established patient (level 4) | $209 | $192 | $136 |
| Office visit, new patient (level 3) | $180 | $190 | $118 |
| Office visit, new patient (level 4) | $307 | $290 | $177 |
| Office visit, new patient (level 5) | $402 | $367 | $237 |
| Orthopedic hardware removal | $1,446 | $1,506 | $632 |
| Pap smear (cervical screening) | $170 | $55 | $20 |
| Parathyroid hormone (PTH) test | $185 | $109 | $41 |
| Pelvic ultrasound | $875 | $177 | $78 |
| Pelvic ultrasound (complete) | $875 | $747 | $105 |
| PET scan | $2,721 | $4,020 | — |
| Physical therapy evaluation | $395 | $234 | $98 |
| Physical therapy evaluation (high complexity) | $426 | $281 | $98 |
| Physical therapy evaluation (moderate complexity) | $395 | $257 | $98 |
| Pneumonia vaccine | $272 | $129 | — |
| Pregnancy blood test (hCG) | $103 | $34 | $8 |
| Pregnancy ultrasound | $875 | $441 | $126 |
| Pregnancy ultrasound (first trimester) | $875 | $441 | $117 |
| Pregnancy ultrasound (second or third trimester) | $875 | $794 | $136 |
| Procalcitonin test | $120 | $55 | $27 |
| Prolactin test | $161 | $55 | $19 |
| Prostate biopsy | $3,589 | $2,768 | — |
| Prostate surgery (TURP) | $2,089 | $1,842 | $526 |
| Psychiatric evaluation | $418 | $290 | $188 |
| Psychotherapy session | $251 | $261 | $140 |
| Radiofrequency nerve ablation | $2,257 | $3,091 | $462 |
| Retinal (fundus) photography | $67 | $97 | $37 |
| Rheumatoid factor test | $26 | $49 | $6 |
| RSV vaccine | $658 | $403 | — |
| Scoliosis spine X-ray | $176 | $128 | $58 |
| Scoliosis spine X-ray (1 view) | $163 | $128 | $44 |
| Scoliosis spine X-ray (3 views) | $188 | $224 | $72 |
| Screening colonoscopy | $705 | $814 | $378 |
| Screening mammogram | $213 | $245 | $126 |
| Scrotal ultrasound | $875 | $600 | $99 |
| Sedimentation rate (ESR) test | $31 | $34 | $3 |
| Semen analysis | $42 | $56 | $12 |
| Sex hormone binding globulin test | $201 | $64 | $22 |
| Shoulder arthroscopy | $3,554 | $2,575 | $962 |
| Simple laceration repair (small, up to 2.5 cm) | $489 | $212 | $114 |
| Simple wound stitches | $510 | $212 | $127 |
| Skin cancer lesion removal | $783 | $607 | $240 |
| Skin graft | $1,975 | $2,106 | $898 |
| Skin lesion freezing (cryotherapy) | $51 | $88 | $36 |
| Skin tag removal | $231 | $127 | $92 |
| Sleep study (polysomnography) | $2,220 | $2,879 | $691 |
| Small bowel resection | $2,648 | $3,002 | $1,136 |
| Soft tissue ultrasound | $875 | $56 | $64 |
| Speech therapy | $663 | $263 | $76 |
| Spinal cord stimulator | $3,901 | $12,285 | $2,388 |
| Spinal tap (lumbar puncture) | $192 | $444 | $165 |
| Spine fracture repair (kyphoplasty) | $14,040 | $13,303 | $5,803 |
| Spirometry with bronchodilator | $491 | $543 | $43 |
| Spleen removal (splenectomy) | $409 | $2,705 | $1,036 |
| Strabismus (eye muscle) surgery | $28,352 | $1,632 | $475 |
| Strep throat test | $118 | $39 | $17 |
| Stress echocardiogram | $971 | $921 | $209 |
| Stress echocardiogram (complete) | $1,199 | $1,609 | $233 |
| Swallow study | $217 | $283 | $85 |
| T3 thyroid test | $118 | $55 | $14 |
| Tdap (tetanus) vaccine | $85 | $28 | — |
| Testosterone test | $215 | $55 | $26 |
| Thyroid removal (thyroidectomy) | $2,000 | $2,758 | $1,004 |
| Thyroid ultrasound | $471 | $547 | $109 |
| Thyroid uptake scan | $1,090 | $381 | $145 |
| Tilt table test | $586 | $3,176 | $168 |
| Tracheostomy | $670 | $6,558 | $273 |
| Transesophageal echocardiogram (TEE) | $642 | $1,530 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $642 | $1,960 | $239 |
| Transvaginal ultrasound | $1,189 | $646 | $118 |
| Trigger finger release | $679 | $1,334 | $630 |
| Trigger point injection | $852 | $596 | $56 |
| Trigger point injection (1-2 muscles) | $532 | $596 | $52 |
| Triglycerides test | $31 | $34 | $6 |
| Turning a breech baby (version) | $329 | $1,492 | $94 |
| Ulnar nerve surgery (elbow) | $2,738 | $2,922 | $575 |
| Upper GI endoscopy (EGD) | $503 | $1,333 | $371 |
| Upper GI series (barium) | $880 | $225 | $128 |
| Ureteral stent placement | $33,780 | $2,229 | $373 |
| Ureteroscopy (stone removal) | $34,204 | $1,050 | $365 |
| Uric acid (gout) test | $29 | $34 | $5 |
| Urinalysis | $82 | $26 | $3 |
| Urine microalbumin test | $43 | $26 | $5 |
| Urine pregnancy test | $79 | $26 | $9 |
| Vaccine administration | $33 | $55 | $19 |
| Vaccine administration (each additional) | $28 | $55 | $16 |
| Vasectomy | $4,225 | $892 | $347 |
| Vitamin B12 test | $73 | $55 | $15 |
| Vitamin D test | $245 | $86 | $30 |
| Wart removal | $270 | $297 | $121 |
| Well-child visit | $136 | $189 | — |
| Wound debridement | $701 | $782 | $186 |
| X-ray of the abdomen | $144 | $145 | $36 |
| X-ray of the ankle | $333 | $262 | $37 |
| X-ray of the collarbone | $276 | $253 | $33 |
| X-ray of the elbow | $262 | $282 | $33 |
| X-ray of the foot | $571 | $259 | $34 |
| X-ray of the forearm | $539 | $244 | $29 |
| X-ray of the hand | $335 | $109 | $38 |
| X-ray of the hip | $94 | $128 | $49 |
| X-ray of the hip (1 view) | $32 | $128 | $34 |
| X-ray of the hip (4 views) | $81 | $224 | $63 |
| X-ray of the knee | $339 | $190 | $42 |
| X-ray of the knee (2 views) | $339 | $190 | $34 |
| X-ray of the knee (3 views) | $257 | $289 | $42 |
| X-ray of the lower back (lumbar spine) | $443 | $111 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $657 | $111 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $443 | $416 | $53 |
| X-ray of the lower leg | $250 | $89 | $31 |
| X-ray of the mid-back (thoracic spine) (2 views) | $93 | $97 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $456 | $131 | $39 |
| X-ray of the neck (cervical spine) | $59 | $94 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $37 | $94 | $40 |
| X-ray of the pelvis | $319 | $97 | $36 |
| X-ray of the ribs | $203 | $184 | $42 |
| X-ray of the ribs (2 views) | $103 | $184 | $36 |
| X-ray of the ribs (3 views) | $487 | $239 | $42 |
| X-ray of the shoulder | $386 | $236 | $36 |
| X-ray of the skull | $178 | $123 | $40 |
| X-ray of the upper arm | $90 | $98 | $32 |
| Zinc blood test | $76 | $32 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
