| Procedure | St Nicholas Hospital | Holy Family Memorial | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $105 | $94 | $51 |
| Abdominal fluid drain (paracentesis) | $2,094 | $1,346 | $284 |
| Abdominal ultrasound | $674 | $420 | $100 |
| Abdominal ultrasound (complete) | $770 | $488 | $114 |
| Abdominal ultrasound (limited) | $578 | $351 | $86 |
| Abscess drainage (complex or multiple) | $1,336 | $894 | $220 |
| Abscess incision and drainage | $1,336 | $733 | $174 |
| Albumin blood test | $31 | $15 | $5 |
| Aldosterone test | $252 | $191 | $41 |
| Alkaline phosphatase test | $26 | $16 | $5 |
| Alpha-fetoprotein (AFP) test | $99 | $40 | $17 |
| ALT liver enzyme test | $32 | $21 | $5 |
| Ammonia blood test | $90 | $63 | $15 |
| Amylase test | $54 | $14 | $6 |
| Anoscopy | $160 | $736 | $129 |
| AST liver enzyme test | $32 | $23 | $5 |
| Barium swallow study | $520 | $374 | $107 |
| Bartholin cyst removal | $464 | $674 | $182 |
| Benign skin lesion removal | $3,657 | $857 | $171 |
| Bilirubin blood test | $36 | $18 | $5 |
| Blood clotting test (PT/INR) | $32 | $17 | $4 |
| Blood crossmatch | $172 | $147 | — |
| Blood glucose test | $24 | $18 | $5 |
| Blood transfusion | $884 | $330 | $47 |
| Blood type and screen | $75 | $50 | $10 |
| Blood type test | $40 | $58 | $3 |
| Blood type test (ABO group) | $129 | $74 | $3 |
| Blood type test (Rh/D antigen) | $40 | $32 | $3 |
| BNP (heart failure) test | $207 | $104 | $39 |
| Bone density scan (DEXA) | $592 | $304 | $39 |
| Bone marrow biopsy | $2,231 | $2,851 | $172 |
| Bone scan (nuclear) | $1,390 | $1,089 | $259 |
| Breast biopsy | $3,192 | $2,512 | $478 |
| Breast MRI | $2,657 | $4,269 | $216 |
| Breast MRI without contrast | $2,657 | $4,269 | $216 |
| Breast ultrasound | $470 | $402 | $92 |
| Breast ultrasound (complete) | $546 | $471 | $100 |
| Breast ultrasound (limited) | $393 | $228 | $84 |
| Breathing tube insertion (intubation) | $1,095 | $932 | $133 |
| Burn dressing and debridement (medium) | $434 | $365 | $166 |
| Burn dressing and debridement (small) | $375 | $355 | $93 |
| Burn treatment | $405 | $360 | $129 |
| C-reactive protein (CRP) | $40 | $21 | $5 |
| CA 19-9 tumor marker test | $140 | $67 | $21 |
| CA-125 ovarian marker test | $139 | $65 | $21 |
| Calcium blood test | $31 | $16 | $5 |
| Capsule endoscopy | $2,393 | $1,076 | $802 |
| Cardiac catheterization | $8,038 | $8,800 | $1,049 |
| Cardiac rehabilitation | $321 | $170 | $26 |
| Cardiac stress test | $991 | $579 | $39 |
| Cardioversion | $1,705 | $1,214 | $155 |
| Carotid artery ultrasound | $761 | $537 | $156 |
| CEA tumor marker test | $135 | $58 | $19 |
| Central line placement | $3,161 | $2,331 | $238 |
| Chemotherapy infusion | $488 | $402 | $81 |
| Chemotherapy infusion (each additional) | $203 | $138 | $28 |
| Chemotherapy infusion (first hour) | $772 | $665 | $133 |
| Chest fluid drain (thoracentesis) | $1,276 | $756 | $311 |
| Chest tube insertion | $1,701 | $1,429 | $143 |
| Chest X-ray | $276 | $184 | $37 |
| Chest X-ray (1 view) | $259 | $105 | $25 |
| Chest X-ray (2 views) | $276 | $134 | $33 |
| CK-MB heart enzyme test | $54 | $36 | $12 |
| Clotting time test (PTT) | $47 | $30 | $6 |
| Complete blood count (CBC) | $51 | $26 | $7 |
| Complete blood count (CBC) (complete) | $59 | $31 | $8 |
| Complex wound repair | $1,718 | $556 | $390 |
| Comprehensive metabolic panel | $119 | $55 | $11 |
| Contraceptive implant (Nexplanon) | $3,542 | $579 | $115 |
| Copper blood test | $73 | $39 | $12 |
| Coronary CT angiography | $1,259 | $965 | $326 |
| Cortisol test | $99 | $51 | $16 |
| COVID-19 PCR test | $119 | $100 | $51 |
| CPAP titration study | $286 | $248 | $69 |
| Creatine kinase (CK) test | $42 | $25 | $7 |
| CT angiography of the chest | $1,860 | $1,700 | $281 |
| CT angiography of the head | $2,092 | $2,153 | $274 |
| CT scan of the abdomen | $1,750 | $1,133 | $230 |
| CT scan of the abdomen and pelvis | $3,017 | $1,926 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $3,550 | $2,833 | $338 |
| CT scan of the abdomen and pelvis with contrast | $3,017 | $1,926 | $300 |
| CT scan of the abdomen and pelvis without contrast | $2,545 | $1,813 | $183 |
| CT scan of the abdomen with and without contrast | $2,092 | $1,246 | $259 |
| CT scan of the abdomen with contrast | $1,750 | $1,133 | $230 |
| CT scan of the abdomen without contrast | $1,259 | $1,020 | $136 |
| CT scan of the arm | $1,770 | $1,133 | $199 |
| CT scan of the arm with contrast | $1,770 | $1,133 | $199 |
| CT scan of the arm without contrast | $1,335 | $1,020 | $161 |
| CT scan of the chest | $1,539 | $906 | $167 |
| CT scan of the chest with and without contrast | $1,819 | $1,020 | $196 |
| CT scan of the chest with contrast | $1,539 | $906 | $167 |
| CT scan of the chest without contrast | $1,265 | $793 | $133 |
| CT scan of the head | $1,770 | $1,133 | $148 |
| CT scan of the head with and without contrast | $1,819 | $1,246 | $173 |
| CT scan of the head with contrast | $1,770 | $1,133 | $148 |
| CT scan of the head without contrast | $1,259 | $1,020 | $107 |
| CT scan of the leg | $1,575 | $1,133 | $166 |
| CT scan of the leg with contrast | $1,575 | $1,133 | $166 |
| CT scan of the leg without contrast | $1,431 | $1,020 | $130 |
| CT scan of the lower back (lumbar spine) | $1,563 | $1,275 | $169 |
| CT scan of the lower back (lumbar spine) with contrast | $1,563 | $1,416 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $1,360 | $1,133 | $130 |
| CT scan of the neck | $1,595 | $1,133 | $183 |
| CT scan of the neck (cervical spine) | $1,539 | $1,275 | $168 |
| CT scan of the neck (cervical spine) with contrast | $1,539 | $1,416 | $168 |
| CT scan of the neck (cervical spine) without contrast | $1,358 | $1,133 | $131 |
| CT scan of the neck with and without contrast | $2,092 | $1,246 | $220 |
| CT scan of the neck with contrast | $1,595 | $1,133 | $183 |
| CT scan of the neck without contrast | $1,259 | $1,020 | $150 |
| CT scan of the pelvis | $1,539 | $1,700 | $226 |
| CT scan of the pelvis with and without contrast | $1,819 | $1,813 | $251 |
| CT scan of the pelvis with contrast | $1,539 | $1,700 | $226 |
| CT scan of the pelvis without contrast | $1,259 | $1,586 | $133 |
| CT scan of the sinuses | $1,625 | $1,133 | $152 |
| CT scan of the sinuses with and without contrast | $1,679 | $1,246 | $184 |
| CT scan of the sinuses with contrast | $1,625 | $1,133 | $152 |
| CT scan of the sinuses without contrast | $1,271 | $1,020 | $128 |
| D-dimer test | $69 | $41 | $10 |
| Defibrillator (ICD) implant | $15,899 | $54,723 | $798 |
| DHEA-sulfate test | $135 | $69 | $22 |
| Diagnostic mammogram | $340 | $252 | $140 |
| Drug screen (urine) | $210 | $52 | $17 |
| Echocardiogram | $1,454 | $1,210 | $138 |
| Echocardiogram with and without contrast | $767 | $502 | $101 |
| Echocardiogram without contrast | $1,454 | $1,210 | $138 |
| EKG / ECG (tracing only) | $187 | $110 | $7 |
| Electrocardiogram (EKG) | $187 | $110 | $8 |
| Electroencephalogram (EEG) | $1,069 | $466 | $448 |
| Electrolyte panel | $49 | $25 | $7 |
| Emergency department visit | $840 | $601 | $69 |
| Emergency department visit (level 1) | $137 | $161 | $11 |
| Emergency department visit (level 2) | $273 | $289 | $40 |
| Emergency department visit (level 3) | $840 | $605 | $69 |
| Emergency department visit (level 4) | $1,259 | $601 | $118 |
| Emergency department visit (level 5) | $1,724 | $996 | $171 |
| Epidural steroid injection | $1,878 | $1,300 | $275 |
| Estradiol (estrogen) test | $171 | $87 | $28 |
| Facet joint injection (spine) | $1,112 | $352 | $99 |
| Fallopian tube X-ray (HSG) | $528 | $384 | $164 |
| Fecal occult blood (stool) test | $60 | $54 | $10 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $99 | $54 | $16 |
| Ferritin (iron) test | $81 | $39 | $14 |
| Fibrinogen test | $69 | $57 | $10 |
| Folate (folic acid) test | $90 | $46 | $15 |
| Foreign body removal (skin) | $461 | $963 | $157 |
| Free T4 thyroid test | $54 | $26 | $9 |
| FSH hormone test | $117 | $58 | $19 |
| Gallbladder scan (HIDA) | $1,626 | $1,894 | $334 |
| GGT liver test | $44 | $23 | $7 |
| Glucose tolerance test | $57 | $56 | $8 |
| H. pylori test | $220 | $173 | $67 |
| HDL cholesterol test | $54 | $58 | $8 |
| Hematocrit test | $16 | $8 | $2 |
| Hemoglobin A1c (diabetes test) | $63 | $25 | $10 |
| Hepatitis B test | $69 | $34 | $10 |
| Hepatitis C test | $99 | $70 | $14 |
| HIV test | $94 | $47 | $19 |
| HIV test (antibody) | $89 | $47 | $14 |
| HIV test (antigen/antibody combo) | $99 | $68 | $24 |
| Holter heart monitor | $475 | $358 | $26 |
| Home sleep apnea test | $321 | $726 | $123 |
| Iron blood test | $40 | $19 | $6 |
| IUD removal | $1,520 | $616 | $112 |
| IV infusion therapy | $292 | $242 | $44 |
| IV infusion therapy (each additional) | $144 | $88 | $21 |
| IV infusion therapy (initial) | $440 | $395 | $67 |
| IVC filter placement | $7,679 | $6,342 | $1,885 |
| Joint aspiration (small/intermediate) | $1,275 | $596 | $57 |
| Joint aspiration or injection (mid-size joint) | $1,354 | $287 | $57 |
| Joint aspiration or injection (small joint) | $1,156 | $906 | $56 |
| Kidney scan (nuclear) | $1,723 | $1,360 | $172 |
| Kidney ultrasound | $542 | $396 | $84 |
| Kidney ultrasound (limited) | $517 | $320 | $61 |
| Knee joint injection | $2,203 | $700 | $69 |
| Lactate test | $73 | $55 | $12 |
| Laryngoscopy | $224 | $763 | $189 |
| LDH test | $67 | $21 | $6 |
| LDL cholesterol test | $63 | $30 | $11 |
| Leg artery angiogram | $3,161 | $2,264 | $149 |
| Leg artery angioplasty | $9,842 | $9,064 | — |
| Leg vein ultrasound (Doppler) | $843 | $648 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $628 | $475 | $116 |
| LH hormone test | $117 | $58 | $19 |
| Lipase test | $144 | $40 | $7 |
| Lipid (cholesterol) panel | $89 | $74 | $13 |
| Liver biopsy | $1,613 | $2,344 | $288 |
| Liver function panel | $69 | $40 | $8 |
| Lung function test (PFT) | $509 | $437 | $37 |
| Lung scan (V/Q) | $1,170 | $1,282 | $291 |
| Magnesium blood test | $49 | $32 | $7 |
| MMR vaccine | $321 | $193 | — |
| MRA of the brain | $2,426 | $2,723 | $226 |
| MRA of the brain with contrast | $2,426 | $2,723 | $226 |
| MRA of the brain without contrast | $2,668 | $3,328 | $328 |
| MRA of the neck | $1,802 | $2,723 | $245 |
| MRA of the neck with contrast | $1,802 | $2,723 | $245 |
| MRA of the neck without contrast | $2,081 | $3,328 | $343 |
| MRI of the abdomen | $2,789 | $2,118 | $300 |
| MRI of the abdomen without contrast | $2,657 | $1,513 | $194 |
| MRI of the ankle | $2,421 | $3,025 | $261 |
| MRI of the ankle with contrast | $2,311 | $3,025 | $261 |
| MRI of the ankle without contrast | $2,421 | $2,420 | $222 |
| MRI of the brain | $2,592 | $1,925 | $269 |
| MRI of the brain with contrast | $2,592 | $1,925 | $269 |
| MRI of the brain without contrast | $2,360 | $1,375 | $195 |
| MRI of the chest | $2,846 | $2,118 | $371 |
| MRI of the chest without contrast | $3,036 | $2,723 | $466 |
| MRI of the knee | $2,542 | $3,025 | $315 |
| MRI of the knee with contrast | $2,542 | $3,025 | $315 |
| MRI of the knee without contrast | $2,421 | $2,420 | $204 |
| MRI of the lower back (lumbar spine) | $2,571 | $1,925 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $2,571 | $1,925 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $2,338 | $1,650 | $192 |
| MRI of the mid-back (thoracic spine) | $2,411 | $1,925 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $2,652 | $2,200 | $319 |
| MRI of the mid-back (thoracic spine) with contrast | $2,411 | $1,925 | $271 |
| MRI of the mid-back (thoracic spine) without contrast | $2,295 | $1,650 | $190 |
| MRI of the neck (cervical spine) | $1,906 | $1,925 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $2,001 | $2,200 | $318 |
| MRI of the neck (cervical spine) with contrast | $1,906 | $1,925 | $274 |
| MRI of the neck (cervical spine) without contrast | $1,815 | $1,650 | $191 |
| MRI of the pelvis | $2,505 | $2,118 | $268 |
| MRI of the pelvis with contrast | $2,505 | $2,118 | $268 |
| MRI of the pelvis without contrast | $2,277 | $1,513 | $227 |
| MRI of the shoulder | $2,542 | $3,025 | $313 |
| MRI of the shoulder with contrast | $2,542 | $3,025 | $313 |
| MRI of the shoulder without contrast | $2,421 | $2,420 | $205 |
| MRI of the wrist | $2,542 | $3,025 | $330 |
| MRI of the wrist with contrast | $2,542 | $3,025 | $330 |
| MRI of the wrist without contrast | $2,411 | $2,420 | $303 |
| Nebulizer breathing treatment | $205 | $105 | $9 |
| Nuclear cardiac stress test | $3,365 | $2,933 | $428 |
| Occupational therapy evaluation | $98 | $199 | $101 |
| Occupational therapy evaluation (high complexity) | $98 | $294 | $101 |
| Occupational therapy evaluation (low complexity) | $98 | $185 | $101 |
| Occupational therapy evaluation (moderate complexity) | $98 | $199 | $101 |
| Office visit (established patient) | $256 | $114 | $115 |
| Office visit (new patient) | $287 | $312 | $177 |
| Office visit, established patient (level 3) | $244 | $99 | $95 |
| Office visit, established patient (level 4) | $269 | $129 | $136 |
| Office visit, new patient (level 5) | $348 | $312 | $237 |
| Pap smear (cervical screening) | $132 | $74 | $20 |
| Parathyroid hormone (PTH) test | $252 | $122 | $41 |
| Pelvic ultrasound | $549 | $328 | $78 |
| Pelvic ultrasound (complete) | $615 | $449 | $105 |
| Pelvic ultrasound (limited) | $482 | $207 | $51 |
| PET scan | $5,122 | $4,950 | — |
| Phosphorus blood test | $29 | $74 | $5 |
| Physical therapy evaluation | $96 | $206 | $98 |
| Physical therapy evaluation (high complexity) | $96 | $265 | $98 |
| Physical therapy evaluation (moderate complexity) | $96 | $206 | $98 |
| Platelet count | $34 | $14 | $4 |
| Pregnancy blood test (hCG) | $62 | $26 | $8 |
| Pregnancy ultrasound | $514 | $600 | $126 |
| Pregnancy ultrasound (first trimester) | $455 | $533 | $117 |
| Pregnancy ultrasound (second or third trimester) | $574 | $666 | $136 |
| Procalcitonin test | $185 | $146 | $27 |
| Prolactin test | $117 | $65 | $19 |
| Prostate test (PSA) | $117 | $57 | $18 |
| Pulmonary rehabilitation | $138 | $172 | $87 |
| Radiofrequency nerve ablation | $2,974 | $2,570 | $462 |
| Sacroiliac joint injection | $1,484 | $976 | $176 |
| Scoliosis spine X-ray | $348 | $204 | $58 |
| Scoliosis spine X-ray (1 view) | $315 | $151 | $44 |
| Scoliosis spine X-ray (3 views) | $381 | $256 | $72 |
| Screening mammogram | $238 | $264 | $126 |
| Scrotal ultrasound | $578 | $394 | $99 |
| Sedimentation rate (ESR) test | $39 | $18 | $3 |
| Semen analysis | $128 | $85 | $12 |
| Sex hormone binding globulin test | $135 | $53 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $1,203 | $397 | $114 |
| Simple wound stitches | $553 | $400 | $127 |
| Skin biopsy | $401 | $382 | $121 |
| Skin biopsy (punch) | $401 | $382 | $121 |
| Skin tag removal | $1,813 | $244 | $92 |
| Sleep study (polysomnography) | $3,926 | $2,971 | $691 |
| Soft tissue ultrasound | $385 | $200 | $64 |
| Speech therapy | $224 | $283 | $76 |
| Spinal tap (lumbar puncture) | $1,019 | $587 | $165 |
| Spirometry (lung function test) | $363 | $312 | $30 |
| Spirometry with bronchodilator | $655 | $538 | $43 |
| Strep throat test | $80 | $54 | $17 |
| Stress echocardiogram | $1,829 | $1,037 | $209 |
| Swallow study | $273 | $191 | $85 |
| T3 thyroid test | $90 | $44 | $14 |
| Tdap (tetanus) vaccine | $159 | $101 | — |
| Testosterone test | $152 | $80 | $26 |
| Thyroid test (TSH) | $99 | $69 | $17 |
| Thyroid ultrasound | $552 | $359 | $109 |
| Thyroid uptake scan | $781 | $909 | $145 |
| Tilt table test | $1,745 | $1,055 | $168 |
| Total IgE allergy test | $99 | $110 | $16 |
| Total protein test | $24 | $12 | $4 |
| Transesophageal echocardiogram (TEE) | $2,114 | $1,047 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $2,114 | $1,047 | $239 |
| Transvaginal ultrasound | $531 | $545 | $118 |
| Trigger point injection | $375 | $535 | $56 |
| Trigger point injection (1-2 muscles) | $355 | $486 | $52 |
| Triglycerides test | $36 | $27 | $6 |
| Troponin (heart) test | $84 | $54 | $12 |
| Upper GI series (barium) | $656 | $424 | $128 |
| Uric acid (gout) test | $31 | $15 | $5 |
| Urinalysis | $33 | $16 | $3 |
| Urine microalbumin test | $55 | $17 | $5 |
| Urine pregnancy test | $59 | $39 | $9 |
| Vaccine administration | $58 | $34 | $19 |
| Vaccine administration (each additional) | $43 | $21 | $16 |
| Varicose vein ablation | $6,294 | $4,770 | $1,018 |
| Vitamin B12 test | $90 | $47 | $15 |
| Vitamin D test | $180 | $116 | $30 |
| Wound debridement | $2,549 | $674 | $186 |
| X-ray of the abdomen | $322 | $156 | $36 |
| X-ray of the ankle | $315 | $200 | $37 |
| X-ray of the collarbone | $334 | $144 | $33 |
| X-ray of the elbow | $338 | $207 | $33 |
| X-ray of the facial bones | $353 | $160 | $39 |
| X-ray of the foot | $336 | $190 | $34 |
| X-ray of the forearm | $315 | $98 | $29 |
| X-ray of the hand | $389 | $211 | $38 |
| X-ray of the hip | $364 | $220 | $49 |
| X-ray of the hip (1 view) | $363 | $211 | $34 |
| X-ray of the hip (3 views) | $364 | $220 | $49 |
| X-ray of the hip (4 views) | $391 | $224 | $63 |
| X-ray of the knee | $327 | $226 | $42 |
| X-ray of the knee (2 views) | $315 | $150 | $34 |
| X-ray of the knee (3 views) | $327 | $226 | $42 |
| X-ray of the knee (4+ views) | $363 | $260 | $49 |
| X-ray of the lower back (lumbar spine) | $473 | $208 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $364 | $130 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $583 | $285 | $53 |
| X-ray of the lower leg | $330 | $172 | $31 |
| X-ray of the mid-back (thoracic spine) | $355 | $138 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $329 | $111 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $381 | $166 | $39 |
| X-ray of the neck (cervical spine) | $444 | $216 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $420 | $108 | $40 |
| X-ray of the pelvis | $360 | $194 | $36 |
| X-ray of the pelvis (1 view) | $326 | $188 | $28 |
| X-ray of the ribs | $391 | $151 | $42 |
| X-ray of the ribs (2 views) | $323 | $151 | $36 |
| X-ray of the ribs (3 views) | $477 | $247 | $42 |
| X-ray of the shoulder | $315 | $122 | $36 |
| X-ray of the skull | $359 | $167 | $40 |
| X-ray of the upper arm | $315 | $146 | $32 |
| X-ray of the wrist | $319 | $197 | $43 |
| Zinc blood test | $63 | $57 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
