| Procedure | Poplar Community Hospital | Sidney Health Center | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $75 | $109 | $51 |
| Abdominal ultrasound | $426 | $218 | $100 |
| Abdominal ultrasound (complete) | $465 | $266 | $114 |
| Abdominal ultrasound (limited) | $388 | $218 | $86 |
| Abscess drainage (complex or multiple) | $561 | $406 | $220 |
| Abscess drainage (simple) | $118 | $209 | $129 |
| Abscess incision and drainage | $437 | $307 | $174 |
| Albumin blood test | $31 | $31 | $5 |
| Aldosterone test | $341 | $184 | $41 |
| Alkaline phosphatase test | $59 | $27 | $5 |
| Alpha-fetoprotein (AFP) test | $164 | $59 | $17 |
| ALT liver enzyme test | $65 | $30 | $5 |
| Ammonia blood test | $125 | $88 | $15 |
| Amylase test | $45 | $41 | $6 |
| Anoscopy | $709 | $137 | $129 |
| Antinuclear antibody (ANA) test | $135 | $74 | $12 |
| Arterial blood gas (ABG) | $62 | $33 | $26 |
| AST liver enzyme test | $64 | $40 | $5 |
| Barium swallow study | $336 | $111 | $107 |
| Basic metabolic panel | $138 | $72 | $8 |
| Bilirubin blood test | $58 | $43 | $5 |
| Blood clotting test (PT/INR) | $79 | $14 | $4 |
| Blood crossmatch | $203 | $74 | — |
| Blood glucose test | $46 | $35 | $5 |
| Blood transfusion | $336 | $193 | $47 |
| Blood type and screen | $113 | $76 | $10 |
| Blood type test | $60 | $72 | $3 |
| Blood type test (ABO group) | $60 | $84 | $3 |
| Blood type test (Rh/D antigen) | $60 | $59 | $3 |
| BNP (heart failure) test | $309 | $124 | $39 |
| Breast ultrasound | $247 | $175 | $92 |
| Breast ultrasound (complete) | $242 | $201 | $100 |
| Breast ultrasound (limited) | $252 | $175 | $84 |
| Breathing tube insertion (intubation) | $259 | $272 | $133 |
| C-reactive protein (CRP) | $66 | $49 | $5 |
| CA 19-9 tumor marker test | $212 | $145 | $21 |
| CA-125 ovarian marker test | $220 | $155 | $21 |
| Calcium blood test | $67 | $25 | $5 |
| Cardioversion | $939 | $396 | $155 |
| Carotid artery ultrasound | $784 | $212 | $156 |
| CEA tumor marker test | $172 | $100 | $19 |
| Central line placement | $471 | $513 | $238 |
| Chemotherapy infusion | $322 | $290 | $81 |
| Chemotherapy infusion (each additional) | $65 | $110 | $28 |
| Chemotherapy infusion (first hour) | $579 | $470 | $133 |
| Chest tube insertion | $738 | $534 | $143 |
| Chest X-ray | $221 | $111 | $37 |
| Chest X-ray (1 view) | $210 | $100 | $25 |
| Chest X-ray (2 views) | $262 | $144 | $33 |
| CK-MB heart enzyme test | $146 | $56 | $12 |
| Clotting time test (PTT) | $133 | $56 | $6 |
| Colposcopy | $448 | $286 | $161 |
| Complete blood count (CBC) | $87 | $45 | $7 |
| Complete blood count (CBC) (complete) | $91 | $61 | $8 |
| Comprehensive metabolic panel | $207 | $93 | $11 |
| Contraceptive implant (Nexplanon) | $438 | $328 | $115 |
| Copper blood test | $114 | $76 | $12 |
| Cortisol test | $153 | $112 | $16 |
| COVID-19 PCR test | $121 | $132 | $51 |
| CPAP titration study | $165 | $80 | $69 |
| Creatine kinase (CK) test | $86 | $41 | $7 |
| CT angiography of the chest | $2,432 | $1,427 | $281 |
| CT angiography of the head | $2,421 | $1,287 | $274 |
| CT scan of the abdomen | $1,811 | $739 | $230 |
| CT scan of the abdomen and pelvis | $1,969 | $752 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $2,054 | $1,293 | $338 |
| CT scan of the abdomen and pelvis with contrast | $1,969 | $1,219 | $300 |
| CT scan of the abdomen and pelvis without contrast | $1,253 | $752 | $183 |
| CT scan of the abdomen with and without contrast | $2,114 | $1,317 | $259 |
| CT scan of the abdomen with contrast | $1,811 | $926 | $230 |
| CT scan of the abdomen without contrast | $1,438 | $739 | $136 |
| CT scan of the arm | $2,118 | $760 | $199 |
| CT scan of the arm with contrast | $2,118 | $879 | $199 |
| CT scan of the arm without contrast | $1,835 | $760 | $161 |
| CT scan of the chest | $1,614 | $789 | $167 |
| CT scan of the chest with and without contrast | $1,975 | $1,097 | $196 |
| CT scan of the chest with contrast | $1,614 | $934 | $167 |
| CT scan of the chest without contrast | $1,391 | $789 | $133 |
| CT scan of the head | $1,452 | $500 | $148 |
| CT scan of the head with and without contrast | $1,709 | $898 | $173 |
| CT scan of the head with contrast | $1,452 | $500 | $148 |
| CT scan of the head without contrast | $1,180 | $743 | $107 |
| CT scan of the leg | $2,983 | $778 | $166 |
| CT scan of the leg with contrast | $2,983 | $805 | $166 |
| CT scan of the leg without contrast | $2,635 | $778 | $130 |
| CT scan of the lower back (lumbar spine) | $1,573 | $765 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $1,903 | $1,507 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $1,573 | $778 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,423 | $765 | $130 |
| CT scan of the neck | $1,511 | $701 | $183 |
| CT scan of the neck (cervical spine) | $1,685 | $752 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $1,995 | $877 | $196 |
| CT scan of the neck (cervical spine) with contrast | $1,685 | $801 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,414 | $752 | $131 |
| CT scan of the neck with and without contrast | $1,792 | $981 | $220 |
| CT scan of the neck with contrast | $1,511 | $916 | $183 |
| CT scan of the neck without contrast | $1,309 | $701 | $150 |
| CT scan of the pelvis | $1,674 | $647 | $226 |
| CT scan of the pelvis with and without contrast | $1,959 | $1,113 | $251 |
| CT scan of the pelvis with contrast | $1,674 | $708 | $226 |
| CT scan of the pelvis without contrast | $1,362 | $647 | $133 |
| CT scan of the sinuses | $1,418 | $616 | $152 |
| CT scan of the sinuses with and without contrast | $1,674 | $726 | $184 |
| CT scan of the sinuses with contrast | $1,418 | $616 | $152 |
| CT scan of the sinuses without contrast | $1,196 | $657 | $128 |
| D-dimer test | $113 | $32 | $10 |
| DHEA-sulfate test | $218 | $145 | $22 |
| Diagnostic mammogram | $292 | $285 | $140 |
| Drug screen (urine) | $348 | $141 | $17 |
| Echocardiogram | $1,053 | $162 | $138 |
| Echocardiogram with and without contrast | $621 | $157 | $101 |
| Echocardiogram without contrast | $1,053 | $167 | $138 |
| EKG / ECG (tracing only) | $193 | $68 | $7 |
| Electrocardiogram (EKG) | $135 | $37 | $8 |
| Electrolyte panel | $93 | $25 | $7 |
| Emergency department visit | $520 | $285 | $69 |
| Emergency department visit (level 1) | $201 | $134 | $11 |
| Emergency department visit (level 2) | $419 | $172 | $40 |
| Emergency department visit (level 3) | $520 | $323 | $69 |
| Emergency department visit (level 4) | $776 | $409 | $118 |
| Emergency department visit (level 5) | $1,220 | $619 | $171 |
| Endometrial biopsy | $438 | $230 | $98 |
| Epidural steroid injection | $612 | $436 | $275 |
| Estradiol (estrogen) test | $240 | $147 | $28 |
| Facet joint injection (spine) | $479 | $198 | $99 |
| Fecal occult blood (stool) test | $32 | $19 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $32 | $6 | $4 |
| Ferritin (iron) test | $141 | $62 | $14 |
| Fibrinogen test | $102 | $58 | $10 |
| Folate (folic acid) test | $129 | $52 | $15 |
| Foreign body removal (skin) | $563 | $317 | $157 |
| Free T4 thyroid test | $107 | $32 | $9 |
| FSH hormone test | $184 | $158 | $19 |
| GGT liver test | $76 | $30 | $7 |
| Glucose tolerance test | $99 | $65 | $8 |
| H. pylori test | $268 | $210 | $67 |
| HDL cholesterol test | $85 | $43 | $8 |
| Hematocrit test | $30 | $14 | $2 |
| Hemoglobin A1c (diabetes test) | $134 | $33 | $10 |
| Hepatitis B test | $91 | $56 | $10 |
| HIV test | $140 | $77 | $19 |
| HIV test (antibody) | $139 | $58 | $14 |
| HIV test (antigen/antibody combo) | $142 | $97 | $24 |
| Iron blood test | $77 | $37 | $6 |
| IUD insertion | $313 | $196 | — |
| IUD removal | $156 | $202 | $112 |
| IV infusion therapy | $218 | $155 | $44 |
| IV infusion therapy (each additional) | $218 | $82 | $21 |
| IV infusion therapy (initial) | $269 | $228 | $67 |
| Joint aspiration (small/intermediate) | $483 | $127 | $57 |
| Joint aspiration or injection (mid-size joint) | $527 | $127 | $57 |
| Joint aspiration or injection (small joint) | $439 | $98 | $56 |
| Kidney ultrasound | $394 | $150 | $84 |
| Kidney ultrasound (limited) | $330 | $150 | $61 |
| Knee joint injection | $451 | $118 | $69 |
| Lactate test | $173 | $75 | $12 |
| LDH test | $71 | $48 | $6 |
| LDL cholesterol test | $103 | $72 | $11 |
| Leg vein ultrasound (Doppler) | $1,158 | $92 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $942 | $77 | $116 |
| LH hormone test | $181 | $158 | $19 |
| Lipase test | $102 | $46 | $7 |
| Lipid (cholesterol) panel | $153 | $74 | $13 |
| Liver function panel | $112 | $70 | $8 |
| Lung function test (PFT) | $297 | $153 | $37 |
| Magnesium blood test | $80 | $46 | $7 |
| MMR vaccine | $166 | $141 | — |
| MRA of the brain | $836 | $1,029 | $226 |
| MRA of the brain with contrast | $1,957 | $1,029 | $226 |
| MRA of the brain without contrast | $836 | $1,753 | $328 |
| MRA of the neck | $840 | $892 | $245 |
| MRA of the neck with contrast | $1,998 | $944 | $245 |
| MRA of the neck without contrast | $840 | $1,581 | $343 |
| MRI of the abdomen | $713 | $1,124 | $300 |
| MRI of the abdomen with contrast | $713 | $1,869 | $300 |
| MRI of the abdomen without contrast | $412 | $1,124 | $194 |
| MRI of the ankle | $762 | $1,159 | $261 |
| MRI of the ankle with contrast | $1,812 | $1,646 | $261 |
| MRI of the ankle without contrast | $516 | $1,159 | $222 |
| MRI of the brain | $2,270 | $1,013 | $269 |
| MRI of the brain with contrast | $2,270 | $1,848 | $269 |
| MRI of the brain without contrast | $1,734 | $1,013 | $195 |
| MRI of the chest | $1,564 | $1,104 | $371 |
| MRI of the chest without contrast | $1,173 | $1,645 | $466 |
| MRI of the knee | $1,844 | $877 | $315 |
| MRI of the knee with contrast | $1,844 | $1,849 | $315 |
| MRI of the knee without contrast | $1,720 | $877 | $204 |
| MRI of the lower back (lumbar spine) | $2,087 | $877 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $2,087 | $1,048 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $1,662 | $877 | $192 |
| MRI of the mid-back (thoracic spine) | $1,974 | $958 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $2,544 | $1,990 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $1,974 | $988 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $1,592 | $958 | $190 |
| MRI of the neck (cervical spine) | $686 | $889 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $686 | $1,966 | $318 |
| MRI of the neck (cervical spine) with contrast | $2,010 | $1,008 | $274 |
| MRI of the neck (cervical spine) without contrast | $392 | $889 | $191 |
| MRI of the pelvis | $1,835 | $1,050 | $268 |
| MRI of the pelvis with contrast | $1,835 | $1,050 | $268 |
| MRI of the pelvis without contrast | $1,692 | $1,181 | $227 |
| MRI of the shoulder | $920 | $994 | $313 |
| MRI of the shoulder with contrast | $1,856 | $1,406 | $313 |
| MRI of the shoulder without contrast | $449 | $994 | $205 |
| MRI of the wrist | $1,776 | $928 | $330 |
| MRI of the wrist with contrast | $1,707 | $1,069 | $330 |
| MRI of the wrist without contrast | $1,776 | $928 | $303 |
| Nebulizer breathing treatment | $240 | $40 | $9 |
| Occupational therapy evaluation | $220 | $106 | $101 |
| Occupational therapy evaluation (high complexity) | $261 | $101 | $101 |
| Occupational therapy evaluation (low complexity) | $171 | $108 | $101 |
| Occupational therapy evaluation (moderate complexity) | $220 | $106 | $101 |
| Office visit (new patient) | $193 | $258 | $177 |
| Office visit, new patient (level 3) | $165 | $187 | $118 |
| Office visit, new patient (level 4) | $220 | $258 | $177 |
| Pap smear (cervical screening) | $75 | $74 | $20 |
| Parathyroid hormone (PTH) test | $207 | $146 | $41 |
| Pelvic ultrasound | $463 | $220 | $78 |
| Pelvic ultrasound (complete) | $552 | $317 | $105 |
| Pelvic ultrasound (limited) | $373 | $220 | $51 |
| Phosphorus blood test | $60 | $32 | $5 |
| Physical therapy evaluation | $210 | $111 | $98 |
| Physical therapy evaluation (high complexity) | $244 | $111 | $98 |
| Physical therapy evaluation (moderate complexity) | $210 | $111 | $98 |
| Platelet count | $54 | $31 | $4 |
| Pneumonia vaccine | $142 | $191 | — |
| Pregnancy blood test (hCG) | $71 | $38 | $8 |
| Pregnancy ultrasound | $473 | $190 | $126 |
| Pregnancy ultrasound (first trimester) | $450 | $160 | $117 |
| Pregnancy ultrasound (second or third trimester) | $496 | $223 | $136 |
| Procalcitonin test | $221 | $125 | $27 |
| Prolactin test | $189 | $145 | $19 |
| Prostate test (PSA) | $140 | $58 | $18 |
| Sacroiliac joint injection | $653 | $284 | $176 |
| Scoliosis spine X-ray | $263 | $113 | $58 |
| Scoliosis spine X-ray (1 view) | $180 | $113 | $44 |
| Scoliosis spine X-ray (3 views) | $347 | $144 | $72 |
| Screening mammogram | $290 | $305 | $126 |
| Scrotal ultrasound | $508 | $298 | $99 |
| Sedimentation rate (ESR) test | $42 | $21 | $3 |
| Semen analysis | $29 | $85 | $12 |
| Simple laceration repair (small, up to 2.5 cm) | $105 | $183 | $114 |
| Simple wound stitches | $122 | $232 | $127 |
| Skin biopsy | $645 | $300 | $121 |
| Skin biopsy (punch) | $645 | $331 | $121 |
| Skin cancer lesion removal | $445 | $305 | $240 |
| Skin lesion freezing (cryotherapy) | $460 | $93 | $36 |
| Skin tag removal | $182 | $185 | $92 |
| Sleep study (polysomnography) | $2,882 | $334 | $691 |
| Soft tissue ultrasound | $264 | $129 | $64 |
| Spinal tap (lumbar puncture) | $505 | $257 | $165 |
| Spirometry (lung function test) | $141 | $97 | $30 |
| Spirometry with bronchodilator | $453 | $210 | $43 |
| Strep throat test | $39 | $37 | $17 |
| T3 thyroid test | $151 | $52 | $14 |
| Tdap (tetanus) vaccine | $129 | $82 | — |
| Testosterone test | $206 | $139 | $26 |
| Thyroid test (TSH) | $151 | $60 | $17 |
| Thyroid ultrasound | $428 | $251 | $109 |
| Total IgE allergy test | $138 | $85 | $16 |
| Total protein test | $54 | $24 | $4 |
| Transvaginal ultrasound | $420 | $283 | $118 |
| Trigger point injection | $209 | $105 | $56 |
| Trigger point injection (1-2 muscles) | $317 | $79 | $52 |
| Triglycerides test | $59 | $28 | $6 |
| Troponin (heart) test | $30 | $74 | $12 |
| Uric acid (gout) test | $62 | $18 | $5 |
| Urinalysis | $28 | $15 | $3 |
| Urine microalbumin test | $72 | $24 | $5 |
| Vaccine administration | $54 | $30 | $19 |
| Vaccine administration (each additional) | $31 | $24 | $16 |
| Vitamin B12 test | $162 | $81 | $15 |
| Vitamin D test | $242 | $87 | $30 |
| Wart removal | $262 | $259 | $121 |
| X-ray of the abdomen | $240 | $59 | $36 |
| X-ray of the ankle | $507 | $150 | $37 |
| X-ray of the collarbone | $420 | $137 | $33 |
| X-ray of the elbow | $420 | $154 | $33 |
| X-ray of the facial bones | $270 | $89 | $39 |
| X-ray of the foot | $485 | $137 | $34 |
| X-ray of the forearm | $420 | $202 | $29 |
| X-ray of the hand | $562 | $139 | $38 |
| X-ray of the hip | $210 | $115 | $49 |
| X-ray of the hip (1 view) | $210 | $152 | $34 |
| X-ray of the hip (3 views) | $210 | $115 | $49 |
| X-ray of the hip (4 views) | $262 | $149 | $63 |
| X-ray of the knee | $580 | $118 | $42 |
| X-ray of the knee (2 views) | $420 | $118 | $34 |
| X-ray of the knee (3 views) | $580 | $150 | $42 |
| X-ray of the knee (4+ views) | $660 | $145 | $49 |
| X-ray of the lower back (lumbar spine) | $305 | $150 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $276 | $150 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $335 | $294 | $53 |
| X-ray of the lower leg | $420 | $115 | $31 |
| X-ray of the mid-back (thoracic spine) | $296 | $146 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $276 | $146 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $316 | $169 | $39 |
| X-ray of the neck (cervical spine) | $270 | $135 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $210 | $135 | $40 |
| X-ray of the pelvis | $282 | $66 | $36 |
| X-ray of the pelvis (1 view) | $275 | $126 | $28 |
| X-ray of the ribs | $279 | $140 | $42 |
| X-ray of the ribs (2 views) | $210 | $165 | $36 |
| X-ray of the ribs (3 views) | $279 | $140 | $42 |
| X-ray of the shoulder | $432 | $139 | $36 |
| X-ray of the skull | $303 | $170 | $40 |
| X-ray of the upper arm | $562 | $113 | $32 |
| X-ray of the wrist | $436 | $143 | $43 |
| Zinc blood test | $135 | $67 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
