| Procedure | Stillwater Medical Center | Stillwater Medical-Perry | Medicare |
|---|
| 3D mammogram (tomosynthesis) | $681 | $681 | $51 |
| Abdominal fluid drain (paracentesis) | $3,167 | $3,167 | $284 |
| Abdominal ultrasound | $1,362 | $1,362 | $100 |
| Abdominal ultrasound (complete) | $1,689 | $1,689 | $114 |
| Abdominal ultrasound (limited) | $1,034 | $1,034 | $86 |
| Abscess drainage (complex or multiple) | $1,666 | $1,666 | $220 |
| Abscess drainage (simple) | $1,296 | $1,296 | $129 |
| Abscess incision and drainage | $1,481 | $1,481 | $174 |
| Albumin blood test | $66 | $66 | $5 |
| Aldosterone test | $411 | $411 | $41 |
| Alkaline phosphatase test | $141 | $141 | $5 |
| Allergy shots | $80 | $80 | $11 |
| Alpha-fetoprotein (AFP) test | $184 | $184 | $17 |
| ALT liver enzyme test | $97 | $97 | $5 |
| Ammonia blood test | $118 | $118 | $15 |
| Amniocentesis | $1,774 | $1,774 | $120 |
| Amylase test | $122 | $122 | $6 |
| Anoscopy | $129 | $129 | $129 |
| Antinuclear antibody (ANA) test | $193 | $193 | $12 |
| Arterial blood gas (ABG) | $310 | $310 | $26 |
| AST liver enzyme test | $100 | $100 | $5 |
| Barium swallow study | $1,016 | $1,016 | $107 |
| Bartholin cyst removal | $762 | $762 | $182 |
| Basic metabolic panel | $263 | $263 | $8 |
| Benign skin lesion removal | $3,646 | $3,646 | $171 |
| Bilirubin blood test | $106 | $106 | $5 |
| Bladder scope (cystoscopy) | $5,794 | $5,794 | $216 |
| Blood clotting test (PT/INR) | $140 | $140 | $4 |
| Blood crossmatch | $364 | $364 | — |
| Blood glucose test | $69 | $69 | $5 |
| Blood transfusion | $2,845 | $2,845 | $47 |
| Blood type and screen | $247 | $247 | $10 |
| Blood type test | $200 | $200 | $3 |
| Blood type test (ABO group) | $206 | $206 | $3 |
| Blood type test (Rh/D antigen) | $200 | $200 | $3 |
| BNP (heart failure) test | $248 | $248 | $39 |
| Bone density scan (DEXA) | $698 | $698 | $39 |
| Bone marrow biopsy | $4,346 | $4,346 | $172 |
| Bone scan (nuclear) | $2,666 | $2,666 | $259 |
| Botox for migraine | $2,094 | $2,094 | $157 |
| Breast biopsy | $5,298 | $5,298 | $478 |
| Breast MRI | $3,194 | $3,194 | $216 |
| Breast ultrasound | $638 | $638 | $92 |
| Breast ultrasound (complete) | $674 | $674 | $100 |
| Breast ultrasound (limited) | $602 | $602 | $84 |
| Breathing tube insertion (intubation) | $2,645 | $2,645 | $133 |
| Burn dressing and debridement (medium) | $546 | $546 | $166 |
| Burn dressing and debridement (small) | $563 | $563 | $93 |
| Burn treatment | $555 | $555 | $129 |
| C-reactive protein (CRP) | $116 | $116 | $5 |
| CA 19-9 tumor marker test | $166 | $166 | $21 |
| CA-125 ovarian marker test | $168 | $168 | $21 |
| Calcium blood test | $69 | $69 | $5 |
| Cardiac ablation | $54,291 | $54,291 | $759 |
| Cardiac catheterization | $15,624 | $15,624 | $1,049 |
| Cardiac MRI | $1,318 | $1,318 | $322 |
| Cardiac MRI without contrast | $1,318 | $1,318 | $280 |
| Cardiac rehabilitation | $330 | $330 | $26 |
| Cardiac stress test | $1,299 | $1,299 | $39 |
| Cardioversion | $2,714 | $2,714 | $155 |
| Carotid artery ultrasound | $1,614 | $1,614 | $156 |
| CEA tumor marker test | $214 | $214 | $19 |
| Celiac disease test | $237 | $237 | $12 |
| Central line placement | $6,888 | $6,888 | $238 |
| Chemotherapy infusion | $810 | $810 | $81 |
| Chemotherapy infusion (each additional) | $283 | $283 | $28 |
| Chemotherapy infusion (first hour) | $810 | $810 | $133 |
| Chest fluid drain (thoracentesis) | $2,389 | $2,389 | $311 |
| Chest tube insertion | $3,440 | $3,440 | $143 |
| Chest X-ray | $486 | $486 | $37 |
| Chest X-ray (1 view) | $486 | $486 | $25 |
| Chest X-ray (2 views) | $347 | $347 | $33 |
| Circumcision | $5,104 | $5,104 | $167 |
| CK-MB heart enzyme test | $208 | $208 | $12 |
| Clotting time test (PTT) | $155 | $155 | $6 |
| Colposcopy | $1,696 | $1,696 | $161 |
| Complete blood count (CBC) | $118 | $118 | $7 |
| Complete blood count (CBC) (complete) | $118 | $118 | $8 |
| Complex wound repair | $2,220 | $2,220 | $390 |
| Comprehensive metabolic panel | $251 | $251 | $11 |
| Contraceptive implant (Nexplanon) | $739 | $739 | $115 |
| Copper blood test | $187 | $187 | $12 |
| Coronary CT angiography | $3,584 | $3,584 | $326 |
| Cortisol test | $262 | $262 | $16 |
| COVID-19 PCR test | $141 | $141 | $51 |
| CPAP titration study | $746 | $746 | $69 |
| Creatine kinase (CK) test | $90 | $90 | $7 |
| CT angiography of the chest | $3,772 | $3,772 | $281 |
| CT angiography of the head | $2,841 | $2,841 | $274 |
| CT scan of the abdomen | $3,393 | $3,393 | $230 |
| CT scan of the abdomen and pelvis | $5,839 | $5,839 | $300 |
| CT scan of the abdomen and pelvis with and without contrast | $7,183 | $7,183 | $338 |
| CT scan of the abdomen and pelvis with contrast | $5,839 | $5,839 | $300 |
| CT scan of the abdomen and pelvis without contrast | $4,910 | $4,910 | $183 |
| CT scan of the abdomen with and without contrast | $4,542 | $4,542 | $259 |
| CT scan of the abdomen with contrast | $3,393 | $3,393 | $230 |
| CT scan of the abdomen without contrast | $3,371 | $3,371 | $136 |
| CT scan of the arm | $2,759 | $2,759 | $199 |
| CT scan of the arm with contrast | $2,759 | $2,759 | $199 |
| CT scan of the arm without contrast | $2,583 | $2,583 | $161 |
| CT scan of the chest | $3,214 | $3,214 | $167 |
| CT scan of the chest with and without contrast | $4,357 | $4,357 | $196 |
| CT scan of the chest with contrast | $3,214 | $3,214 | $167 |
| CT scan of the chest without contrast | $2,890 | $2,890 | $133 |
| CT scan of the head | $2,798 | $2,798 | $148 |
| CT scan of the head with and without contrast | $4,084 | $4,084 | $173 |
| CT scan of the head with contrast | $2,647 | $2,647 | $148 |
| CT scan of the head without contrast | $2,798 | $2,798 | $107 |
| CT scan of the leg | $3,145 | $3,145 | $166 |
| CT scan of the leg with contrast | $3,145 | $3,145 | $166 |
| CT scan of the leg without contrast | $2,837 | $2,837 | $130 |
| CT scan of the lower back (lumbar spine) | $3,826 | $3,826 | $169 |
| CT scan of the lower back (lumbar spine) with and without contrast | $3,966 | $3,966 | $197 |
| CT scan of the lower back (lumbar spine) with contrast | $3,826 | $3,826 | $169 |
| CT scan of the lower back (lumbar spine) without contrast | $3,282 | $3,282 | $130 |
| CT scan of the neck | $3,179 | $3,179 | $183 |
| CT scan of the neck (cervical spine) | $3,530 | $3,530 | $168 |
| CT scan of the neck (cervical spine) with and without contrast | $4,135 | $4,135 | $196 |
| CT scan of the neck (cervical spine) with contrast | $3,530 | $3,530 | $168 |
| CT scan of the neck (cervical spine) without contrast | $3,291 | $3,291 | $131 |
| CT scan of the neck with and without contrast | $3,828 | $3,828 | $220 |
| CT scan of the neck with contrast | $3,179 | $3,179 | $183 |
| CT scan of the neck without contrast | $2,033 | $2,033 | $150 |
| CT scan of the pelvis | $3,208 | $3,208 | $226 |
| CT scan of the pelvis with and without contrast | $3,607 | $3,607 | $251 |
| CT scan of the pelvis with contrast | $3,208 | $3,208 | $226 |
| CT scan of the pelvis without contrast | $2,495 | $2,495 | $133 |
| CT scan of the sinuses | $3,583 | $3,583 | $152 |
| CT scan of the sinuses with and without contrast | $4,085 | $4,085 | $184 |
| CT scan of the sinuses with contrast | $3,583 | $3,583 | $152 |
| CT scan of the sinuses without contrast | $2,776 | $2,776 | $128 |
| D-dimer test | $147 | $147 | $10 |
| Defibrillator (ICD) implant | $74,164 | $74,164 | $798 |
| Developmental screening (child) | $141 | $141 | — |
| DHEA-sulfate test | $117 | $117 | $22 |
| Diagnostic mammogram | $681 | $681 | $140 |
| Drug screen (urine) | $391 | $391 | $17 |
| Ear pressure test (tympanometry) | $279 | $279 | $16 |
| Echocardiogram | $2,858 | $2,858 | $138 |
| Echocardiogram with and without contrast | $1,239 | $1,239 | $101 |
| EEG (awake and asleep) | $2,268 | $2,268 | $482 |
| EKG / ECG (tracing only) | $440 | $440 | $7 |
| Electrocardiogram (EKG) | $440 | $440 | $8 |
| Electroencephalogram (EEG) | $2,132 | $2,132 | $448 |
| Electrolyte panel | $122 | $122 | $7 |
| Emergency department visit | $449 | $449 | $69 |
| Emergency department visit (level 1) | $286 | $286 | $11 |
| Emergency department visit (level 2) | $479 | $479 | $40 |
| Emergency department visit (level 3) | $795 | $795 | $69 |
| Emergency department visit (level 4) | $1,320 | $1,320 | $118 |
| Emergency department visit (level 5) | $1,662 | $1,662 | $171 |
| Endometrial biopsy | $560 | $560 | $98 |
| Epidural steroid injection | $2,094 | $2,094 | $275 |
| Estradiol (estrogen) test | $190 | $190 | $28 |
| Facet joint injection (spine) | $3,418 | $3,418 | $99 |
| Fallopian tube X-ray (HSG) | $666 | $666 | $164 |
| Fecal occult blood (stool) test | $72 | $72 | $10 |
| Fecal occult blood (stool) test (guaiac, gFOBT) | $50 | $50 | $4 |
| Fecal occult blood (stool) test (immunochemical, FIT) | $94 | $94 | $16 |
| Ferritin (iron) test | $142 | $142 | $14 |
| Fibrinogen test | $157 | $157 | $10 |
| Flu test | $72 | $72 | $17 |
| Flu vaccine | $59 | $59 | — |
| Folate (folic acid) test | $54 | $54 | $15 |
| Foreign body removal (skin) | $1,408 | $1,408 | $157 |
| Free T4 thyroid test | $166 | $166 | $9 |
| FSH hormone test | $115 | $115 | $19 |
| Gallbladder scan (HIDA) | $2,648 | $2,648 | $334 |
| GGT liver test | $87 | $87 | $7 |
| Glucose tolerance test | $94 | $94 | $8 |
| H. pylori test | $341 | $341 | $67 |
| HDL cholesterol test | $81 | $81 | $8 |
| Hematocrit test | $64 | $64 | $2 |
| Hemoglobin A1c (diabetes test) | $134 | $134 | $10 |
| Hemorrhoid removal | $3,472 | $3,472 | $338 |
| Hepatitis A vaccine | $270 | $270 | — |
| Hepatitis B test | $182 | $182 | $10 |
| Hepatitis B vaccine | $156 | $156 | — |
| Hepatitis C test | $170 | $170 | $14 |
| HIV test | $112 | $112 | $19 |
| HIV test (antibody) | $194 | $194 | $14 |
| HIV test (antigen/antibody combo) | $95 | $95 | $24 |
| Holter heart monitor | $902 | $902 | $26 |
| Home sleep apnea test | $494 | $494 | $123 |
| Iron blood test | $98 | $98 | $6 |
| IUD removal | $1,371 | $1,371 | $112 |
| IV infusion therapy | $690 | $690 | $44 |
| IV infusion therapy (each additional) | $359 | $359 | $21 |
| IV infusion therapy (initial) | $690 | $690 | $67 |
| IVC filter placement | $11,884 | $11,884 | $1,885 |
| Joint aspiration (small/intermediate) | $1,212 | $1,212 | $57 |
| Joint aspiration or injection (mid-size joint) | $1,251 | $1,251 | $57 |
| Joint aspiration or injection (small joint) | $1,212 | $1,212 | $56 |
| Kidney biopsy | $3,468 | $3,468 | $492 |
| Kidney scan (nuclear) | $2,198 | $2,198 | $172 |
| Kidney ultrasound | $651 | $651 | $84 |
| Kidney ultrasound (limited) | $651 | $651 | $61 |
| Knee joint injection | $1,504 | $1,504 | $69 |
| Lactate test | $192 | $192 | $12 |
| Laryngoscopy | $2,053 | $2,053 | $189 |
| LDH test | $77 | $77 | $6 |
| LDL cholesterol test | $130 | $130 | $11 |
| Leg artery angiogram | $6,888 | $6,888 | $149 |
| Leg artery angioplasty | $22,279 | $22,279 | — |
| Leg vein ultrasound (Doppler) | $1,551 | $1,551 | $150 |
| Leg vein ultrasound (Doppler) (limited) | $1,358 | $1,358 | $116 |
| LH hormone test | $126 | $126 | $19 |
| Lipase test | $124 | $124 | $7 |
| Lipid (cholesterol) panel | $172 | $172 | $13 |
| Liver biopsy | $3,468 | $3,468 | $288 |
| Liver function panel | $172 | $172 | $8 |
| Lung function test (PFT) | $336 | $336 | $37 |
| Lung scan (V/Q) | $1,924 | $1,924 | $291 |
| Magnesium blood test | $98 | $98 | $7 |
| MMR vaccine | $298 | $298 | — |
| MRA of the brain | $3,379 | $3,379 | $226 |
| MRA of the brain without contrast | $3,790 | $3,790 | $328 |
| MRA of the neck | $3,153 | $3,153 | $245 |
| MRA of the neck with contrast | $3,232 | $3,232 | $245 |
| MRA of the neck without contrast | $3,153 | $3,153 | $343 |
| MRI of the abdomen | $3,835 | $3,835 | $300 |
| MRI of the abdomen with contrast | $3,835 | $3,835 | $300 |
| MRI of the abdomen without contrast | $3,329 | $3,329 | $194 |
| MRI of the ankle | $3,297 | $3,297 | $261 |
| MRI of the ankle with contrast | $3,237 | $3,237 | $261 |
| MRI of the ankle without contrast | $3,297 | $3,297 | $222 |
| MRI of the brain | $3,679 | $3,679 | $269 |
| MRI of the brain with contrast | $3,679 | $3,679 | $269 |
| MRI of the brain without contrast | $3,631 | $3,631 | $195 |
| MRI of the chest | $3,136 | $3,136 | $371 |
| MRI of the chest with contrast | $3,136 | $3,136 | $371 |
| MRI of the chest without contrast | $3,534 | $3,534 | $466 |
| MRI of the knee | $3,902 | $3,902 | $315 |
| MRI of the knee with contrast | $3,902 | $3,902 | $315 |
| MRI of the knee without contrast | $3,552 | $3,552 | $204 |
| MRI of the lower back (lumbar spine) | $4,404 | $4,404 | $270 |
| MRI of the lower back (lumbar spine) with contrast | $4,404 | $4,404 | $270 |
| MRI of the lower back (lumbar spine) without contrast | $4,020 | $4,020 | $192 |
| MRI of the mid-back (thoracic spine) | $4,744 | $4,744 | $271 |
| MRI of the mid-back (thoracic spine) with and without contrast | $5,585 | $5,585 | $319 |
| MRI of the mid-back (thoracic spine) without contrast | $3,904 | $3,904 | $190 |
| MRI of the neck (cervical spine) | $4,560 | $4,560 | $274 |
| MRI of the neck (cervical spine) with and without contrast | $5,170 | $5,170 | $318 |
| MRI of the neck (cervical spine) without contrast | $3,950 | $3,950 | $191 |
| MRI of the pelvis | $3,337 | $3,337 | $268 |
| MRI of the pelvis with contrast | $3,337 | $3,337 | $268 |
| MRI of the pelvis without contrast | $2,932 | $2,932 | $227 |
| MRI of the shoulder | $3,774 | $3,774 | $313 |
| MRI of the shoulder with contrast | $3,656 | $3,656 | $313 |
| MRI of the shoulder without contrast | $3,774 | $3,774 | $205 |
| MRI of the wrist | $3,245 | $3,245 | $330 |
| MRI of the wrist with contrast | $3,014 | $3,014 | $330 |
| MRI of the wrist without contrast | $3,245 | $3,245 | $303 |
| Nebulizer breathing treatment | $443 | $443 | $9 |
| Nuchal translucency ultrasound | $397 | $397 | $116 |
| Nuclear cardiac stress test | $4,931 | $4,931 | $428 |
| Occupational therapy evaluation | $327 | $327 | $101 |
| Occupational therapy evaluation (high complexity) | $334 | $334 | $101 |
| Occupational therapy evaluation (low complexity) | $294 | $294 | $101 |
| Occupational therapy evaluation (moderate complexity) | $327 | $327 | $101 |
| Office visit (established patient) | $308 | $308 | $115 |
| Office visit (new patient) | $348 | $348 | $177 |
| Office visit, established patient (level 3) | $308 | $308 | $95 |
| Office visit, established patient (level 4) | $339 | $339 | $136 |
| Office visit, new patient (level 3) | $323 | $323 | $118 |
| Office visit, new patient (level 4) | $356 | $356 | $177 |
| Office visit, new patient (level 5) | $392 | $392 | $237 |
| Parathyroid hormone (PTH) test | $268 | $268 | $41 |
| Pelvic ultrasound | $638 | $638 | $78 |
| Pelvic ultrasound (complete) | $1,149 | $1,149 | $105 |
| Pelvic ultrasound (limited) | $638 | $638 | $51 |
| PET scan | $6,814 | $6,814 | — |
| Phosphorus blood test | $70 | $70 | $5 |
| Physical therapy evaluation | $326 | $326 | $98 |
| Physical therapy evaluation (high complexity) | $338 | $338 | $98 |
| Physical therapy evaluation (moderate complexity) | $326 | $326 | $98 |
| Pilonidal cyst removal | $4,679 | $4,679 | $541 |
| Platelet count | $107 | $107 | $4 |
| Pneumonia vaccine | $293 | $293 | — |
| Pregnancy blood test (hCG) | $239 | $239 | $8 |
| Pregnancy ultrasound | $718 | $718 | $126 |
| Pregnancy ultrasound (first trimester) | $921 | $921 | $117 |
| Pregnancy ultrasound (second or third trimester) | $514 | $514 | $136 |
| Procalcitonin test | $202 | $202 | $27 |
| Prolactin test | $239 | $239 | $19 |
| Prostate biopsy | $5,362 | $5,362 | — |
| Prostate test (PSA) | $162 | $162 | $18 |
| Pulmonary rehabilitation | $218 | $218 | $87 |
| Radiofrequency nerve ablation | $6,160 | $6,160 | $462 |
| Rheumatoid factor test | $86 | $86 | $6 |
| Sacroiliac joint injection | $1,520 | $1,520 | $176 |
| Scoliosis spine X-ray | $368 | $368 | $58 |
| Scoliosis spine X-ray (1 view) | $172 | $172 | $44 |
| Scoliosis spine X-ray (3 views) | $565 | $565 | $72 |
| Screening mammogram | $514 | $514 | $126 |
| Scrotal ultrasound | $1,130 | $1,130 | $99 |
| Sedimentation rate (ESR) test | $78 | $78 | $3 |
| Semen analysis | $144 | $144 | $12 |
| Sex hormone binding globulin test | $131 | $131 | $22 |
| Simple laceration repair (small, up to 2.5 cm) | $799 | $799 | $114 |
| Simple wound stitches | $799 | $799 | $127 |
| Skin biopsy | $3,646 | $3,646 | $121 |
| Skin biopsy (punch) | $2,404 | $2,404 | $121 |
| Skin cancer lesion removal | $3,472 | $3,472 | $240 |
| Skin graft | $7,052 | $7,052 | $898 |
| Skin lesion freezing (cryotherapy) | $750 | $750 | $36 |
| Skin tag removal | $1,050 | $1,050 | $92 |
| Sleep study (polysomnography) | $4,796 | $4,796 | $691 |
| Soft tissue ultrasound | $599 | $599 | $64 |
| Speech therapy | $267 | $267 | $76 |
| Spinal cord stimulator | $15,880 | $15,880 | $2,388 |
| Spinal tap (lumbar puncture) | $1,836 | $1,836 | $165 |
| Spirometry (lung function test) | $268 | $268 | $30 |
| Spirometry with bronchodilator | $815 | $815 | $43 |
| Strep throat test | $137 | $137 | $17 |
| Stress echocardiogram | $2,210 | $2,210 | $209 |
| Swallow study | $385 | $385 | $85 |
| T3 thyroid test | $190 | $190 | $14 |
| Tdap (tetanus) vaccine | $158 | $158 | — |
| Testosterone test | $189 | $189 | $26 |
| Thyroid test (TSH) | $156 | $156 | $17 |
| Thyroid ultrasound | $1,075 | $1,075 | $109 |
| Thyroid uptake scan | $1,371 | $1,371 | $145 |
| Tilt table test | $2,502 | $2,502 | $168 |
| Total IgE allergy test | $126 | $126 | $16 |
| Total protein test | $83 | $83 | $4 |
| Tracheostomy | $7,404 | $7,404 | $273 |
| Transesophageal echocardiogram (TEE) | $2,914 | $2,914 | $239 |
| Transesophageal echocardiogram (TEE) with and without contrast | $2,914 | $2,914 | $239 |
| Transvaginal ultrasound | $377 | $377 | $118 |
| Trigger point injection | $1,019 | $1,019 | $56 |
| Trigger point injection (1-2 muscles) | $1,355 | $1,355 | $52 |
| Triglycerides test | $94 | $94 | $6 |
| Troponin (heart) test | $332 | $332 | $12 |
| Turning a breech baby (version) | $5,243 | $5,243 | $94 |
| Upper GI series (barium) | $1,006 | $1,006 | $128 |
| Uric acid (gout) test | $87 | $87 | $5 |
| Urinalysis | $70 | $70 | $3 |
| Urine microalbumin test | $98 | $98 | $5 |
| Urine pregnancy test | $155 | $155 | $9 |
| Vaccine administration | $157 | $157 | $19 |
| Vaccine administration (each additional) | $67 | $67 | $16 |
| Varicose vein ablation | $8,588 | $8,588 | $1,018 |
| Vitamin B12 test | $76 | $76 | $15 |
| Vitamin D test | $282 | $282 | $30 |
| Wart removal | $1,050 | $1,050 | $121 |
| Wound debridement | $863 | $863 | $186 |
| X-ray of the abdomen | $540 | $540 | $36 |
| X-ray of the ankle | $610 | $610 | $37 |
| X-ray of the collarbone | $524 | $524 | $33 |
| X-ray of the elbow | $546 | $546 | $33 |
| X-ray of the facial bones | $544 | $544 | $39 |
| X-ray of the foot | $649 | $649 | $34 |
| X-ray of the forearm | $524 | $524 | $29 |
| X-ray of the hand | $575 | $575 | $38 |
| X-ray of the hip | $437 | $437 | $49 |
| X-ray of the hip (1 view) | $381 | $381 | $34 |
| X-ray of the hip (3 views) | $493 | $493 | $49 |
| X-ray of the hip (4 views) | $231 | $231 | $63 |
| X-ray of the knee | $817 | $817 | $42 |
| X-ray of the knee (2 views) | $494 | $494 | $34 |
| X-ray of the knee (3 views) | $668 | $668 | $42 |
| X-ray of the knee (4+ views) | $817 | $817 | $49 |
| X-ray of the lower back (lumbar spine) | $585 | $585 | $47 |
| X-ray of the lower back (lumbar spine) (2 views) | $585 | $585 | $40 |
| X-ray of the lower back (lumbar spine) (4+ views) | $966 | $966 | $53 |
| X-ray of the lower leg | $580 | $580 | $31 |
| X-ray of the mid-back (thoracic spine) | $645 | $645 | $36 |
| X-ray of the mid-back (thoracic spine) (2 views) | $635 | $635 | $33 |
| X-ray of the mid-back (thoracic spine) (3 views) | $655 | $655 | $39 |
| X-ray of the neck (cervical spine) | $560 | $560 | $47 |
| X-ray of the neck (cervical spine) (3 views) | $560 | $560 | $40 |
| X-ray of the pelvis | $545 | $545 | $36 |
| X-ray of the pelvis (1 view) | $545 | $545 | $28 |
| X-ray of the ribs | $688 | $688 | $42 |
| X-ray of the ribs (2 views) | $550 | $550 | $36 |
| X-ray of the ribs (3 views) | $694 | $694 | $42 |
| X-ray of the shoulder | $659 | $659 | $36 |
| X-ray of the skull | $399 | $399 | $40 |
| X-ray of the upper arm | $542 | $542 | $32 |
| X-ray of the wrist | $574 | $574 | $43 |
| Zinc blood test | $136 | $136 | $11 |
Green = lower cash price. Source: hospitals' machine-readable files (45 CFR §180). Estimates — confirm with the hospital.
