Saline Memorial Hospital
AR 72015
Prices last published by the hospital: —
What these numbers mean.
Cash price is what the hospital lists for patients paying out of pocket.
Negotiated median is the middle of what insurance companies actually agreed to pay.
Gross charge is the sticker price — almost nobody pays it.
What you will actually pay is usually different from both numbers:
with insurance, your deductible, copay, or coinsurance decides what you owe —
the negotiated rate is what the insurer pays, not your bill.
A single line item may not be the whole cost: physician, anesthesia, pathology,
and facility fees can be billed separately.
Prices vary by hospital and change over time; always confirm with the hospital before you go.
Can't afford a bill from Saline Memorial Hospital?
This hospital has a financial assistance program that may reduce or erase it.
Financial assistance: see income limits & how to applyPrices at this hospital (368 procedures)
| Procedure | Cash price | Where it sits | Insurance pays (typical) | Gross charge |
|---|---|---|---|---|
| Abdominal ultrasound | —Insurance typically pays —Sticker price $1,502 | — | — | $1,502 |
| Ablation for supraventricular tachycardia | —Insurance typically pays —Sticker price $89,003 | — | — | $89,003 |
| Achilles tendon repair, primary | —Insurance typically pays —Sticker price $49,254 | — | — | $49,254 |
| Amino acid analysis, quantitative, each specimen | —Insurance typically pays —Sticker price $28 | — | — | $28 |
| Analysis for antibody to Herpes simplex virus | —Insurance typically pays —Sticker price $236 | — | — | $236 |
| Ankle-brachial index (ABI), complete | —Insurance typically pays —Sticker price $798 | — | — | $798 |
| Ankle-brachial index (ABI), limited | —Insurance typically pays —Sticker price $607 | — | — | $607 |
| Ankle fracture repair, open | —Insurance typically pays —Sticker price $41,309 | — | — | $41,309 |
| Appendix removal, laparoscopic | —Insurance typically pays —Sticker price $45,954 | — | — | $45,954 |
| Application of short arm cast | —Insurance typically pays —Sticker price $1,091 | — | — | $1,091 |
| Application of short leg cast | —Insurance typically pays —Sticker price $1,091 | — | — | $1,091 |
| Application of short leg splint | —Insurance typically pays —Sticker price $54,455 | — | — | $54,455 |
| Arterial line placement | —Insurance typically pays —Sticker price $2,109 | — | — | $2,109 |
| Arterial puncture for blood draw | —Insurance typically pays —Sticker price $492 | — | — | $492 |
| Arthroscopic ACL reconstruction | —Insurance typically pays —Sticker price $50,099 | — | — | $50,099 |
| Arthroscopic rotator cuff repair | —Insurance typically pays —Sticker price $44,802 | — | — | $44,802 |
| Aspiration of fluid from chest cavity | —Insurance typically pays —Sticker price $2,874 | — | — | $2,874 |
| Aspiration or injection of ganglion cyst | —Insurance typically pays —Sticker price $1,146 | — | — | $1,146 |
| Basic metabolic blood panel | —Insurance typically pays —Sticker price $455 | — | — | $455 |
| Benign skin growth removal | —Insurance typically pays —Sticker price $35,637 | — | — | $35,637 |
| Biceps tenodesis (tendon repair) | —Insurance typically pays —Sticker price $52,453 | — | — | $52,453 |
| Bladder catheter placement | —Insurance typically pays —Sticker price $492 | — | — | $492 |
| Blood count (CBC) | —Insurance typically pays —Sticker price $100 | — | — | $100 |
| Blood count with differential | —Insurance typically pays —Sticker price $126 | — | — | $126 |
| Blood draw | —Insurance typically pays —Sticker price $23 | — | — | $23 |
| Blood sugar test | —Insurance typically pays —Sticker price $86 | — | — | $86 |
| Bone biopsy, deep | —Insurance typically pays —Sticker price $6,372 | — | — | $6,372 |
| Bone biopsy, superficial | —Insurance typically pays —Sticker price $6,372 | — | — | $6,372 |
| Bowel adhesion removal, laparoscopic | —Insurance typically pays —Sticker price $71,019 | — | — | $71,019 |
| Breast biopsy, open | —Insurance typically pays —Sticker price $15,715 | — | — | $15,715 |
| Bunionectomy | —Insurance typically pays —Sticker price $30,167 | — | — | $30,167 |
| BUN kidney test | —Insurance typically pays —Sticker price $78 | — | — | $78 |
| Capillary blood draw (finger stick) | —Insurance typically pays —Sticker price $20,559 | — | — | $20,559 |
| Carpal tunnel release | —Insurance typically pays —Sticker price $15,126 | — | — | $15,126 |
| Cesarean delivery only | —Insurance typically pays —Sticker price $27,589 | — | — | $27,589 |
| Cesarean delivery with routine obstetric care | —Insurance typically pays —Sticker price $27,589 | — | — | $27,589 |
| Chemotherapy infusion, additional hour | —Insurance typically pays —Sticker price $227 | — | — | $227 |
| Chemotherapy infusion, first hour | —Insurance typically pays —Sticker price $1,335 | — | — | $1,335 |
| Cholesterol panel | —Insurance typically pays —Sticker price $295 | — | — | $295 |
| Closed treatment of broken middle or upper end of outside lower leg bone | —Insurance typically pays —Sticker price $1,043 | — | — | $1,043 |
| Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation | —Insurance typically pays —Sticker price $6,084 | — | — | $6,084 |
| Clotting factor VII (proconvertin, stable factor) | —Insurance typically pays —Sticker price $338 | — | — | $338 |
| Cold knife conization of cervix | —Insurance typically pays —Sticker price $19,419 | — | — | $19,419 |
| Colectomy with colostomy | —Insurance typically pays —Sticker price $85,243 | — | — | $85,243 |
| Colonoscopy | —Insurance typically pays —Sticker price $30,403 | — | — | $30,403 |
| Colonoscopy with biopsy | —Insurance typically pays —Sticker price $7,202 | — | — | $7,202 |
| Colonoscopy with polyp removal | —Insurance typically pays —Sticker price $6,169 | — | — | $6,169 |
| Colonoscopy with submucosal injection | —Insurance typically pays —Sticker price $4,768 | — | — | $4,768 |
| Coronary angiography | —Insurance typically pays —Sticker price $23,960 | — | — | $23,960 |
| Coronary angioplasty (balloon), single vessel | —Insurance typically pays —Sticker price $51,011 | — | — | $51,011 |
| Creatinine test | —Insurance typically pays —Sticker price $88 | — | — | $88 |
| Critical care, additional 30 minutes | —Insurance typically pays —Sticker price $290 | — | — | $290 |
| Critical care, first hour | —Insurance typically pays —Sticker price $3,960 | — | — | $3,960 |
| C-section delivery | —Insurance typically pays —Sticker price $28,074 | — | — | $28,074 |
| CT abdomen and pelvis with contrast | —Insurance typically pays —Sticker price $6,203 | — | — | $6,203 |
| CT head without contrast | —Insurance typically pays —Sticker price $2,256 | — | — | $2,256 |
| Debridement of skin, muscle or fascia | —Insurance typically pays —Sticker price $27,317 | — | — | $27,317 |
| DEPRESSIVE NEUROSES | —Insurance typically pays —Sticker price $85,568 | — | — | $85,568 |
| Detailed obstetric ultrasound | —Insurance typically pays —Sticker price $1,068 | — | — | $1,068 |
| Detection test by immunoassay technique for rotavirus | —Insurance typically pays —Sticker price $136 | — | — | $136 |
| Diagnostic exam of bladder and urethra using an endoscope | —Insurance typically pays —Sticker price $40,809 | — | — | $40,809 |
| Diagnostic exam of lower portion of large bowel using a flexible endoscope | —Insurance typically pays —Sticker price $30,479 | — | — | $30,479 |
| Dilation and curettage (D&C), diagnostic | —Insurance typically pays —Sticker price $18,886 | — | — | $18,886 |
| Distal radius fracture repair, open | —Insurance typically pays —Sticker price $47,553 | — | — | $47,553 |
| Doctor office visit (established patient) | —Insurance typically pays —Sticker price $544 | — | — | $544 |
| Doctor visit, established patient | —Insurance typically pays —Sticker price $580 | — | — | $580 |
| Doctor visit, established patient, complex | —Insurance typically pays —Sticker price $718 | — | — | $718 |
| Doctor visit, established patient, quick | —Insurance typically pays —Sticker price $456 | — | — | $456 |
| Doctor visit, new patient | —Insurance typically pays —Sticker price $549 | — | — | $549 |
| Doctor visit, new patient | —Insurance typically pays —Sticker price $438 | — | — | $438 |
| Doctor visit, new patient, complex | —Insurance typically pays —Sticker price $705 | — | — | $705 |
| Doctor visit, new patient, quick | —Insurance typically pays —Sticker price $310 | — | — | $310 |
| Duplex ultrasound of aorta and iliac arteries | —Insurance typically pays —Sticker price $1,068 | — | — | $1,068 |
| Duplex ultrasound of lower extremity arteries, bilateral | —Insurance typically pays —Sticker price $1,146 | — | — | $1,146 |
| Ear wax removal | —Insurance typically pays —Sticker price $10,471 | — | — | $10,471 |
| EEG, awake and asleep | —Insurance typically pays —Sticker price $1,701 | — | — | $1,701 |
| Electrophysiology study, comprehensive | —Insurance typically pays —Sticker price $23,613 | — | — | $23,613 |
| Emergency room visit, high complexity | —Insurance typically pays —Sticker price $2,946 | — | — | $2,946 |
| Emergency room visit (high severity) | —Insurance typically pays —Sticker price $2,476 | — | — | $2,476 |
| Emergency room visit, low complexity | —Insurance typically pays —Sticker price $1,179 | — | — | $1,179 |
| Emergency room visit, minor | —Insurance typically pays —Sticker price $725 | — | — | $725 |
| Emergency room visit, moderate | —Insurance typically pays —Sticker price $1,767 | — | — | $1,767 |
| Epidural injection, cervical or thoracic | —Insurance typically pays —Sticker price $2,774 | — | — | $2,774 |
| Epidural steroid shot, lower back | —Insurance typically pays —Sticker price $2,774 | — | — | $2,774 |
| Esophagus stretching | —Insurance typically pays —Sticker price $28,307 | — | — | $28,307 |
| Facet joint injection, lumbar or sacral | —Insurance typically pays —Sticker price $4,242 | — | — | $4,242 |
| Femur shaft fracture repair with plate or screws | —Insurance typically pays —Sticker price $74,617 | — | — | $74,617 |
| Ferritin test | —Insurance typically pays —Sticker price $179 | — | — | $179 |
| Fetal non-stress test | —Insurance typically pays —Sticker price $768 | — | — | $768 |
| Gallbladder removal (laparoscopic) | —Insurance typically pays —Sticker price $43,018 | — | — | $43,018 |
| Hammertoe correction | —Insurance typically pays —Sticker price $27,178 | — | — | $27,178 |
| HCHG ACTH PLASMA LC | —Insurance typically pays —Sticker price $363 | — | — | $363 |
| HCHG AFB CONCENTRATION | —Insurance typically pays —Sticker price $78 | — | — | $78 |
| HCHG ALDOLASE LC | —Insurance typically pays —Sticker price $106 | — | — | $106 |
| HCHG ALK PHOSPHATASE | —Insurance typically pays —Sticker price $119 | — | — | $119 |
| HCHG ALPHA-1-ANTITRYPSIN SERUM LC | —Insurance typically pays —Sticker price $339 | — | — | $339 |
| HCHG AMINO ACIDEMIAS (PKU) | —Insurance typically pays —Sticker price $254 | — | — | $254 |
| HCHG AMPA RECEPTOR ABY TITER SPINAL FLUID | —Insurance typically pays —Sticker price $316 | — | — | $316 |
| HCHG ANA | —Insurance typically pays —Sticker price $131 | — | — | $131 |
| HCHG ANAEROBIC CULTURE | —Insurance typically pays —Sticker price $219 | — | — | $219 |
| HCHG ANTI-DNASE B STREP ANTIBODIES LC | —Insurance typically pays —Sticker price $78 | — | — | $78 |
| HCHG ANTISTREPTOLYSIN O AB LC | —Insurance typically pays —Sticker price $73 | — | — | $73 |
| HCHG ANTITHROMBIN III | —Insurance typically pays —Sticker price $302 | — | — | $302 |
| HCHG ARC-ABY ID EACH SELECTED REAGENT CELL | —Insurance typically pays —Sticker price $221 | — | — | $221 |
| HCHG ARTHROCENT/ASPIR/INJ SMALL JOINT/BURSA WO US | —Insurance typically pays —Sticker price $20,639 | — | — | $20,639 |
| HCHG BLOOD/BLOOD PRODUCT ADMIN PER UNIT | —Insurance typically pays —Sticker price $1,774 | — | — | $1,774 |
| HCHG CA15.3 | —Insurance typically pays —Sticker price $176 | — | — | $176 |
| HCHG CARBAMAZEPINE | —Insurance typically pays —Sticker price $239 | — | — | $239 |
| HCHG CATECHOLAMINESURFREE24 HR LC | —Insurance typically pays —Sticker price $348 | — | — | $348 |
| HCHG CF SCREEN | —Insurance typically pays —Sticker price $1,113 | — | — | $1,113 |
| HCHG CHROMIUM BLOOD | —Insurance typically pays —Sticker price $164 | — | — | $164 |
| HCHG CHROMOGRANIN A | —Insurance typically pays —Sticker price $174 | — | — | $174 |
| HCHG CMV IGM ABY | —Insurance typically pays —Sticker price $123 | — | — | $123 |
| HCHG CMV QUANT DNA PCR (PLASMA) LC | —Insurance typically pays —Sticker price $307 | — | — | $307 |
| HCHG COMPREHENSIVE METABOLIC PANE | —Insurance typically pays —Sticker price $513 | — | — | $513 |
| HCHG COVID 19 NAA LC | —Insurance typically pays —Sticker price $522 | — | — | $522 |
| HCHG C-PEPTIDE SERUM | —Insurance typically pays —Sticker price $161 | — | — | $161 |
| HCHG CREATININE URINE | —Insurance typically pays —Sticker price $88 | — | — | $88 |
| HCHG CROSSMATCH IS | —Insurance typically pays —Sticker price $221 | — | — | $221 |
| HCHG CRYOGLOBULIN QUAL WITH REFLEX | —Insurance typically pays —Sticker price $179 | — | — | $179 |
| HCHG CRYPTOCOCCAL AG LATEX SCREEN W/REFL TITER QUE | —Insurance typically pays —Sticker price $194 | — | — | $194 |
| HCHG CT CHEST TUBE PLACEMENT AND PLEURAL DRAINAGE | —Insurance typically pays —Sticker price $5,067 | — | — | $5,067 |
| HCHG CT SOFT TISSUE NECK W CONTRAST | —Insurance typically pays —Sticker price $2,840 | — | — | $2,840 |
| HCHG CT THORACENTESIS PLEURAL ASPIRATION | —Insurance typically pays —Sticker price $32,501 | — | — | $32,501 |
| HCHG DEBRIDE SQ TISSUE FIRST 20 SQ CM | —Insurance typically pays —Sticker price $1,448 | — | — | $1,448 |
| HCHG DHEA SERUM LC | —Insurance typically pays —Sticker price $156 | — | — | $156 |
| HCHG DIPTHERIA TOXOID IGG ABY | —Insurance typically pays —Sticker price $270 | — | — | $270 |
| HCHG DIRECT ANTIGLOBULIN TEST | —Insurance typically pays —Sticker price $118 | — | — | $118 |
| HCHG EBV NA | —Insurance typically pays —Sticker price $111 | — | — | $111 |
| HCHG EBV VCA IGG | —Insurance typically pays —Sticker price $143 | — | — | $143 |
| HCHG ECHO 2D F-U OR LTD STUDY W BUBBLE | —Insurance typically pays —Sticker price $13,707 | — | — | $13,707 |
| HCHG FACTOR 2 GENE MUTATION | —Insurance typically pays —Sticker price $307 | — | — | $307 |
| HCHG FACTOR 8 ASSAY | —Insurance typically pays —Sticker price $174 | — | — | $174 |
| HCHG FACTOR IX ACTIVITY LC | —Insurance typically pays —Sticker price $315 | — | — | $315 |
| HCHG FLUORO < 1 HOUR | —Insurance typically pays —Sticker price $1,068 | — | — | $1,068 |
| HCHG FOLIC ACID | —Insurance typically pays —Sticker price $209 | — | — | $209 |
| HCHG FSH-SERUM | —Insurance typically pays —Sticker price $136 | — | — | $136 |
| HCHG GENERAL LAB 8007400 | —Insurance typically pays —Sticker price $814 | — | — | $814 |
| HCHG GENERAL LAB 8663103 LC | —Insurance typically pays —Sticker price $76 | — | — | $76 |
| HCHG GENERAL LAB 8670600 | —Insurance typically pays —Sticker price $21 | — | — | $21 |
| HCHG GENERAL LAB 8680300 | —Insurance typically pays —Sticker price $204 | — | — | $204 |
| HCHG GENERAL LAB 8738900 | —Insurance typically pays —Sticker price $214 | — | — | $214 |
| HCHG GENERAL LAB 8749100 | —Insurance typically pays —Sticker price $255 | — | — | $255 |
| HCHG GENERAL LAB 87522 LCC | —Insurance typically pays —Sticker price $463 | — | — | $463 |
| HCHG GENTAMICIN KINETICS | —Insurance typically pays —Sticker price $138 | — | — | $138 |
| HCHG GRAM STAIN | —Insurance typically pays —Sticker price $73 | — | — | $73 |
| HCHG HEMOGLOBINOPATHIES | —Insurance typically pays —Sticker price $64 | — | — | $64 |
| HCHG H HEMACHROMATOSIS | —Insurance typically pays —Sticker price $436 | — | — | $436 |
| HCHG H. PYLORI ANTIGEN STOOL | —Insurance typically pays —Sticker price $174 | — | — | $174 |
| HCHG ICU MD RETROPERITONEAL LIMITED | —Insurance typically pays —Sticker price $871 | — | — | $871 |
| HCHG I D ABSCESS/CARB/CYST SINGLE SIMPLE | —Insurance typically pays —Sticker price $15,235 | — | — | $15,235 |
| HCHG I D HEMATOMA/SEROMA FLUID COLL | —Insurance typically pays —Sticker price $19,081 | — | — | $19,081 |
| HCHG IHC STAIN ADDL | —Insurance typically pays —Sticker price $149 | — | — | $149 |
| HCHG IHC STAIN FIRST | —Insurance typically pays —Sticker price $149 | — | — | $149 |
| HCHG INJ EPIDURAL BLOOD/CLOT PATCH TX | —Insurance typically pays —Sticker price $3,980 | — | — | $3,980 |
| HCHG INSERT PICC WO SUBQ PORT/PUMP WO GUIDANCE >5 | —Insurance typically pays —Sticker price $18,465 | — | — | $18,465 |
| HCHG INTRINSIC FACTOR ABS SERUM LC | —Insurance typically pays —Sticker price $136 | — | — | $136 |
| HCHG INTUBATION ENDOTRACHEAL EMERGENCY | —Insurance typically pays —Sticker price $1,332 | — | — | $1,332 |
| HCHG IR INJ CHOLANGIOGRAPHY PERC W GUIDE EXISTING | —Insurance typically pays —Sticker price $4,832 | — | — | $4,832 |
| HCHG IRON | —Insurance typically pays —Sticker price $131 | — | — | $131 |
| HCHG JAK2 MUTATION DETECTION | —Insurance typically pays —Sticker price $750 | — | — | $750 |
| HCHG LEAD FILTER PAPER | —Insurance typically pays —Sticker price $98 | — | — | $98 |
| HCHG LUTEINIZING HORMONE | —Insurance typically pays —Sticker price $156 | — | — | $156 |
| HCHG MEAS POST VOID RES US NON-IMAGING | —Insurance typically pays —Sticker price $259 | — | — | $259 |
| HCHG N METHYLHISTAMINE URINE | —Insurance typically pays —Sticker price $1,895 | — | — | $1,895 |
| HCHG OT APPLICATION LONG ARM CAST | —Insurance typically pays —Sticker price $1,091 | — | — | $1,091 |
| HCHG OT EVAL HIGH COMPLEXITY | —Insurance typically pays —Sticker price $368 | — | — | $368 |
| HCHG OT EVAL LOW COMPLEXITY | —Insurance typically pays —Sticker price $368 | — | — | $368 |
| HCHG OT EVAL MOD COMPLEXITY | —Insurance typically pays —Sticker price $368 | — | — | $368 |
| HCHG OT RE-EVALUATION | —Insurance typically pays —Sticker price $249 | — | — | $249 |
| HCHG OT THER INTERVENT COGNITIVE FUNCT 1 1 EA ADDL | —Insurance typically pays —Sticker price $114 | — | — | $114 |
| HCHG OT THER INTERVENT COGNITIVE FUNCT 1 1 INIT 15 | —Insurance typically pays —Sticker price $119 | — | — | $119 |
| HCHG PFT C0 MEMBRANE DIFFUSE CAPACITY | —Insurance typically pays —Sticker price $368 | — | — | $368 |
| HCHG PHENOBARBITAL | —Insurance typically pays —Sticker price $177 | — | — | $177 |
| HCHG PLCMT NEPHROSTOMY CATHETER WWO NEPHRO/URETERO | —Insurance typically pays —Sticker price $8,059 | — | — | $8,059 |
| HCHG POTASSIUM | —Insurance typically pays —Sticker price $76 | — | — | $76 |
| HCHG PROCALCITONIN | —Insurance typically pays —Sticker price $161 | — | — | $161 |
| HCHG PROTEIN TOTAL | —Insurance typically pays —Sticker price $60 | — | — | $60 |
| HCHG PROTHOMBIN TIME | —Insurance typically pays —Sticker price $81 | — | — | $81 |
| HCHG PSA-SCREEN | —Insurance typically pays —Sticker price $214 | — | — | $214 |
| HCHG PT APPLICATION LONG ARM SPLINT | —Insurance typically pays —Sticker price $623 | — | — | $623 |
| HCHG PT E-STIM-ATTENDED 15MIN | —Insurance typically pays —Sticker price $78 | — | — | $78 |
| HCHG PT EVAL HIGH COMPLEXITY | —Insurance typically pays —Sticker price $342 | — | — | $342 |
| HCHG PT EVAL LOW COMPLEXITY | —Insurance typically pays —Sticker price $342 | — | — | $342 |
| HCHG PT EVAL MOD COMPLEXITY | —Insurance typically pays —Sticker price $342 | — | — | $342 |
| HCHG PT FLUIDOTHERAPY | —Insurance typically pays —Sticker price $95 | — | — | $95 |
| HCHG PT GAIT TRAINING 15MIN | —Insurance typically pays —Sticker price $124 | — | — | $124 |
| HCHG PT GROUP THERAPY | —Insurance typically pays —Sticker price $75 | — | — | $75 |
| HCHG PT IONTOPHORESIS 15MIN | —Insurance typically pays —Sticker price $128 | — | — | $128 |
| HCHG PT MANUAL THERAPY 15MIN | —Insurance typically pays —Sticker price $123 | — | — | $123 |
| HCHG PT MASSAGE 15 MIN | —Insurance typically pays —Sticker price $124 | — | — | $124 |
| HCHG PT MECHANICAL TRACTION | —Insurance typically pays —Sticker price $66 | — | — | $66 |
| HCHG PT NEUROMUSCULAR RE-ED 15MIN | —Insurance typically pays —Sticker price $143 | — | — | $143 |
| HCHG PT ORTHO/PROSTHETIC TRAIN UPR/LWR EXT TRUNK S | —Insurance typically pays —Sticker price $194 | — | — | $194 |
| HCHG PT ORTHOTIC FIT/TRAIN UPR/LWR EXT TRUNK INITI | —Insurance typically pays —Sticker price $189 | — | — | $189 |
| HCHG PT PHONOPHORESIS 15MIN | —Insurance typically pays —Sticker price $53 | — | — | $53 |
| HCHG PT PROSTHETIC TRAIN UPR/LWR EXT INITIAL ENC E | —Insurance typically pays —Sticker price $164 | — | — | $164 |
| HCHG PT RE-EVALUATION | —Insurance typically pays —Sticker price $222 | — | — | $222 |
| HCHG PT SELFCARE/HOME MNGMNT 15MIN | —Insurance typically pays —Sticker price $169 | — | — | $169 |
| HCHG PT STRAPPING ANKLE | —Insurance typically pays —Sticker price $623 | — | — | $623 |
| HCHG PT THERAPEUTIC ACTIVITY 15MIN | —Insurance typically pays —Sticker price $163 | — | — | $163 |
| HCHG PT THERAPEUTIC EXERCISE 15MIN | —Insurance typically pays —Sticker price $133 | — | — | $133 |
| HCHG RAD CT ANGIO CHEST | —Insurance typically pays —Sticker price $3,464 | — | — | $3,464 |
| HCHG RAD CT ANGIO LOWER EXTREMITY | —Insurance typically pays —Sticker price $5,057 | — | — | $5,057 |
| HCHG RAD CT ANGIO NECK W CONTRAST | —Insurance typically pays —Sticker price $3,287 | — | — | $3,287 |
| HCHG RAD CT GUIDED NEEDLE PLACEMENT | —Insurance typically pays —Sticker price $2,466 | — | — | $2,466 |
| HCHG RAD CT HEAD BRAIN WWO | —Insurance typically pays —Sticker price $3,469 | — | — | $3,469 |
| HCHG RAD CT LIMITED OR LOCALIZED FOLLOW UP | —Insurance typically pays —Sticker price $1,524 | — | — | $1,524 |
| HCHG RAD CT LOWER EXTREMITY WO | —Insurance typically pays —Sticker price $3,620 | — | — | $3,620 |
| HCHG RAD ECHO STRESS TRANSTHORACIC 2D EXERCISE OR | —Insurance typically pays —Sticker price $2,305 | — | — | $2,305 |
| HCHG RAD MRI ANGIO HEAD WO | —Insurance typically pays —Sticker price $5,140 | — | — | $5,140 |
| HCHG RAD MRI ANGIO NECK WO | —Insurance typically pays —Sticker price $2,756 | — | — | $2,756 |
| HCHG RAD MRI ANGIO NECK WWO | —Insurance typically pays —Sticker price $4,470 | — | — | $4,470 |
| HCHG RAD MRI JOINT LOWER EXTREMITY WO | —Insurance typically pays —Sticker price $6,046 | — | — | $6,046 |
| HCHG RAD MRI SPINE CERVICAL WO | —Insurance typically pays —Sticker price $5,106 | — | — | $5,106 |
| HCHG RAD MRI SPINE THORACIC WO | —Insurance typically pays —Sticker price $4,592 | — | — | $4,592 |
| HCHG RAD NM BONE SCAN WHOLE BODY | —Insurance typically pays —Sticker price $2,272 | — | — | $2,272 |
| HCHG RAD NM LUNG PERFUSION SCAN | —Insurance typically pays —Sticker price $1,637 | — | — | $1,637 |
| HCHG RAD US ARTERIAL UPPER EXTREMITY BILATERAL COM | —Insurance typically pays —Sticker price $1,068 | — | — | $1,068 |
| HCHG RAD XRAY ABDOMEN ACUTE W CHEST 1 VIEW | —Insurance typically pays —Sticker price $746 | — | — | $746 |
| HCHG RAD XRAY CHEST FRONTAL 1 VIEW | —Insurance typically pays —Sticker price $265 | — | — | $265 |
| HCHG RAD XRAY FEMUR 1 VIEW UNILATERAL | —Insurance typically pays —Sticker price $476 | — | — | $476 |
| HCHG RAD XRAY FOOT 2 VIEWS | —Insurance typically pays —Sticker price $579 | — | — | $579 |
| HCHG RAD XRAY KNEE 3 VIEWS | —Insurance typically pays —Sticker price $1,109 | — | — | $1,109 |
| HCHG RAD XRAY MANDIBLE MINIMUM OF FOUR VIEWS | —Insurance typically pays —Sticker price $552 | — | — | $552 |
| HCHG REPLACE CATH ONLY CVAD W SQ PORT/PUMP | —Insurance typically pays —Sticker price $73,955 | — | — | $73,955 |
| HCHG REPOSITIONING PREV PLC CV CATH FLUOR GUID | —Insurance typically pays —Sticker price $5,067 | — | — | $5,067 |
| HCHG REVERSE T3 SERUM LC | —Insurance typically pays —Sticker price $96 | — | — | $96 |
| HCHG RN APPL MULTLAY COMPRS LWR LEG UNILATERAL | —Insurance typically pays —Sticker price $744 | — | — | $744 |
| HCHG SCHISTOSOMA IGG ABY | —Insurance typically pays —Sticker price $761 | — | — | $761 |
| HCHG SELENIUM SERUM/PLASMA LC | —Insurance typically pays —Sticker price $287 | — | — | $287 |
| HCHG SLP EVAL ORAL/PHAR SWALLOWING | —Insurance typically pays —Sticker price $353 | — | — | $353 |
| HCHG SLP EVAL SPEECH SOUND W LANGUAGE COMP | —Insurance typically pays —Sticker price $809 | — | — | $809 |
| HCHG SLP INDIV TX COMMUNICATION | —Insurance typically pays —Sticker price $327 | — | — | $327 |
| HCHG SODIUM URINE | —Insurance typically pays —Sticker price $63 | — | — | $63 |
| HCHG SP STAIN 1 ORG | —Insurance typically pays —Sticker price $70 | — | — | $70 |
| HCHG STONE ANALYSIS LC | —Insurance typically pays —Sticker price $60 | — | — | $60 |
| HCHG STOOL CULTURE AEROBIC BACTERIA LC | —Insurance typically pays —Sticker price $153 | — | — | $153 |
| HCHG T3 FREE | —Insurance typically pays —Sticker price $124 | — | — | $124 |
| HCHG T4 FREE | —Insurance typically pays —Sticker price $166 | — | — | $166 |
| HCHG TACROLIMUS AHL | —Insurance typically pays —Sticker price $192 | — | — | $192 |
| HCHG TESTOSTERONE FREE EQUILIBRIUM ULTRAFILTRATION | —Insurance typically pays —Sticker price $444 | — | — | $444 |
| HCHG THY PEROXIDASE ABY | —Insurance typically pays —Sticker price $279 | — | — | $279 |
| HCHG THYROGLOBULIN ABY LC | —Insurance typically pays —Sticker price $116 | — | — | $116 |
| HCHG THYROGLOBULIN TUMOR MARKER FNA ASP BX NEEDLE | —Insurance typically pays —Sticker price $118 | — | — | $118 |
| HCHG TISSUE LEVEL 2 | —Insurance typically pays —Sticker price $70 | — | — | $70 |
| HCHG TOTAL T CELLS | —Insurance typically pays —Sticker price $130 | — | — | $130 |
| HCHG URIC ACID URINE | —Insurance typically pays —Sticker price $45 | — | — | $45 |
| HCHG US ABDOMEN LIMITED | —Insurance typically pays —Sticker price $1,202 | — | — | $1,202 |
| HCHG VALPROIC ACID | —Insurance typically pays —Sticker price $226 | — | — | $226 |
| HCHG VANILLYLMANDELIC ACID 24-HR U LC | —Insurance typically pays —Sticker price $138 | — | — | $138 |
| HCHG VEDOLIZUMAB QUANT LC | —Insurance typically pays —Sticker price $811 | — | — | $811 |
| HCHG VENOUS MECH THROMBECTOMY | —Insurance typically pays —Sticker price $21,671 | — | — | $21,671 |
| HCHG VITAMIN A SERUM LC | —Insurance typically pays —Sticker price $78 | — | — | $78 |
| HCHG VITAMIN B6 PLASMA LC | —Insurance typically pays —Sticker price $428 | — | — | $428 |
| Heart catheterization with bypass graft angiography | —Insurance typically pays —Sticker price $31,761 | — | — | $31,761 |
| Heart stent placement | —Insurance typically pays —Sticker price $58,386 | — | — | $58,386 |
| Heart ultrasound | —Insurance typically pays —Sticker price $3,013 | — | — | $3,013 |
| Hemorrhoid removal | —Insurance typically pays —Sticker price $18,559 | — | — | $18,559 |
| Hernia repair (inguinal) | —Insurance typically pays —Sticker price $24,229 | — | — | $24,229 |
| Hernia repair, laparoscopic | —Insurance typically pays —Sticker price $35,326 | — | — | $35,326 |
| Hip fracture repair with pins or screws | —Insurance typically pays —Sticker price $73,025 | — | — | $73,025 |
| Hip fracture repair with plate and screws | —Insurance typically pays —Sticker price $73,025 | — | — | $73,025 |
| Hip replacement (total) | —Insurance typically pays —Sticker price $90,439 | — | — | $90,439 |
| Hysterectomy (laparoscopic) | —Insurance typically pays —Sticker price $40,727 | — | — | $40,727 |
| Hysteroscopy with biopsy | —Insurance typically pays —Sticker price $16,333 | — | — | $16,333 |
| Hysteroscopy with endometrial ablation | —Insurance typically pays —Sticker price $20,879 | — | — | $20,879 |
| Insertion of tube in bypass graft for diagnosis with review by radiologist | —Insurance typically pays —Sticker price $18,003 | — | — | $18,003 |
| Insertion of tube in right heart chambers for measurement | —Insurance typically pays —Sticker price $16,146 | — | — | $16,146 |
| Iron test | —Insurance typically pays —Sticker price $113 | — | — | $113 |
| Irrigation of implanted venous access (port flush) | —Insurance typically pays —Sticker price $322 | — | — | $322 |
| IV hydration infusion, additional hour | —Insurance typically pays —Sticker price $227 | — | — | $227 |
| IV hydration infusion, first hour | —Insurance typically pays —Sticker price $867 | — | — | $867 |
| IV infusion, additional drug or sequence | —Insurance typically pays —Sticker price $483 | — | — | $483 |
| IV infusion, additional hour | —Insurance typically pays —Sticker price $308 | — | — | $308 |
| IV infusion, first hour | —Insurance typically pays —Sticker price $945 | — | — | $945 |
| IV placement (needle into vein) | —Insurance typically pays —Sticker price $594 | — | — | $594 |
| IV push injection | —Insurance typically pays —Sticker price $798 | — | — | $798 |
| Joint injection, large joint | —Insurance typically pays —Sticker price $9,880 | — | — | $9,880 |
| Joint injection, medium joint | —Insurance typically pays —Sticker price $14,003 | — | — | $14,003 |
| Joint injection with ultrasound | —Insurance typically pays —Sticker price $1,146 | — | — | $1,146 |
| Kidney function panel | —Insurance typically pays —Sticker price $491 | — | — | $491 |
| Knee arthroscopy | —Insurance typically pays —Sticker price $22,993 | — | — | $22,993 |
| Knee arthroscopy, meniscectomy medial and lateral | —Insurance typically pays —Sticker price $20,918 | — | — | $20,918 |
| Knee arthroscopy with debridement | —Insurance typically pays —Sticker price $26,599 | — | — | $26,599 |
| Knee arthroscopy with meniscus repair | —Insurance typically pays —Sticker price $42,119 | — | — | $42,119 |
| Knee replacement (total) | —Insurance typically pays —Sticker price $76,960 | — | — | $76,960 |
| Kyphoplasty (vertebral augmentation) | —Insurance typically pays —Sticker price $27,597 | — | — | $27,597 |
| Laparoscopic colectomy with anastomosis | —Insurance typically pays —Sticker price $61,968 | — | — | $61,968 |
| Laparoscopic gastric bypass | —Insurance typically pays —Sticker price $61,469 | — | — | $61,469 |
| Laparoscopic removal of ovary | —Insurance typically pays —Sticker price $24,204 | — | — | $24,204 |
| Laparoscopic sleeve gastrectomy | —Insurance typically pays —Sticker price $55,973 | — | — | $55,973 |
| LDH test | —Insurance typically pays —Sticker price $116 | — | — | $116 |
| LEEP conization of cervix | —Insurance typically pays —Sticker price $13,168 | — | — | $13,168 |
| Left heart catheterization with coronary angiography | —Insurance typically pays —Sticker price $20,059 | — | — | $20,059 |
| Leg vein ultrasound | —Insurance typically pays —Sticker price $1,401 | — | — | $1,401 |
| Liver biopsy | —Insurance typically pays —Sticker price $28,087 | — | — | $28,087 |
| Liver function panel | —Insurance typically pays —Sticker price $469 | — | — | $469 |
| Lumpectomy (partial mastectomy) | —Insurance typically pays —Sticker price $16,200 | — | — | $16,200 |
| Lysis of bowel adhesions, open | —Insurance typically pays —Sticker price $72,952 | — | — | $72,952 |
| Manipulation of knee under anesthesia | —Insurance typically pays —Sticker price $11,394 | — | — | $11,394 |
| Mastectomy, modified radical | —Insurance typically pays —Sticker price $44,899 | — | — | $44,899 |
| Mastectomy, simple | —Insurance typically pays —Sticker price $66,266 | — | — | $66,266 |
| Mohs skin cancer surgery | —Insurance typically pays —Sticker price $47,882 | — | — | $47,882 |
| Molecular pathology procedure level 6 genetic analysis | —Insurance typically pays —Sticker price $1,275 | — | — | $1,275 |
| MRI brain with and without contrast | —Insurance typically pays —Sticker price $7,435 | — | — | $7,435 |
| MRI brain without contrast | —Insurance typically pays —Sticker price $4,552 | — | — | $4,552 |
| MRI lower back with and without contrast | —Insurance typically pays —Sticker price $7,334 | — | — | $7,334 |
| MRI lower back without contrast | —Insurance typically pays —Sticker price $5,314 | — | — | $5,314 |
| Nail avulsion, additional nail | —Insurance typically pays —Sticker price $158 | — | — | $158 |
| Nail avulsion (ingrown nail removal) | —Insurance typically pays —Sticker price $22,092 | — | — | $22,092 |
| Nail bed removal | —Insurance typically pays —Sticker price $13,172 | — | — | $13,172 |
| Nebulizer treatment | —Insurance typically pays —Sticker price $292 | — | — | $292 |
| Neck artery ultrasound | —Insurance typically pays —Sticker price $1,602 | — | — | $1,602 |
| Needle EMG, two extremities | —Insurance typically pays —Sticker price $623 | — | — | $623 |
| Nuclear heart stress test | —Insurance typically pays —Sticker price $5,696 | — | — | $5,696 |
| Obstetric ultrasound | —Insurance typically pays —Sticker price $801 | — | — | $801 |
| OTHER HEART ASSIST SYSTEM IMPLANT | —Insurance typically pays —Sticker price $310,417 | — | — | $310,417 |
| Pacemaker insertion, single chamber | —Insurance typically pays —Sticker price $45,763 | — | — | $45,763 |
| Panniculectomy (excess abdominal skin removal) | —Insurance typically pays —Sticker price $99,260 | — | — | $99,260 |
| Partial excision of foot bone | —Insurance typically pays —Sticker price $21,127 | — | — | $21,127 |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC | —Insurance typically pays —Sticker price $90,399 | — | — | $90,399 |
| Sacroiliac joint injection | —Insurance typically pays —Sticker price $2,275 | — | — | $2,275 |
| Screening colonoscopy | —Insurance typically pays —Sticker price $4,812 | — | — | $4,812 |
| Screening mammogram (3D) | —Insurance typically pays —Sticker price $385 | — | — | $385 |
| Shot in muscle or under skin | —Insurance typically pays —Sticker price $3,875 | — | — | $3,875 |
| Shoulder arthroscopy with distal clavicle excision | —Insurance typically pays —Sticker price $39,835 | — | — | $39,835 |
| Shoulder arthroscopy with subacromial decompression | —Insurance typically pays —Sticker price $36,572 | — | — | $36,572 |
| Sigmoidoscopy | —Insurance typically pays —Sticker price $5,160 | — | — | $5,160 |
| Simple drainage of abscess of finger | —Insurance typically pays —Sticker price $20,993 | — | — | $20,993 |
| Skin biopsy, shave | —Insurance typically pays —Sticker price $52,922 | — | — | $52,922 |
| Skin cancer removal | —Insurance typically pays —Sticker price $55,520 | — | — | $55,520 |
| Skin substitute graft | —Insurance typically pays —Sticker price $16,679 | — | — | $16,679 |
| Sleep study (polysomnography) | —Insurance typically pays —Sticker price $4,227 | — | — | $4,227 |
| Sleep study with CPAP initiation | —Insurance typically pays —Sticker price $4,227 | — | — | $4,227 |
| Small bowel resection | —Insurance typically pays —Sticker price $127,244 | — | — | $127,244 |
| Spirometry before and after bronchodilator | —Insurance typically pays —Sticker price $1,169 | — | — | $1,169 |
| Spirometry (lung function test) | —Insurance typically pays —Sticker price $630 | — | — | $630 |
| Stool blood test | —Insurance typically pays —Sticker price $65 | — | — | $65 |
| Tdap vaccine | —Insurance typically pays —Sticker price $132 | — | — | $132 |
| Tendon insertion injection | —Insurance typically pays —Sticker price $16,841 | — | — | $16,841 |
| Tendon sheath injection | —Insurance typically pays —Sticker price $19,056 | — | — | $19,056 |
| Thyroid biopsy, open | —Insurance typically pays —Sticker price $2,683 | — | — | $2,683 |
| Thyroid (TSH) test | —Insurance typically pays —Sticker price $260 | — | — | $260 |
| Tilt table test | —Insurance typically pays —Sticker price $2,109 | — | — | $2,109 |
| Tissue lab exam (pathology) | —Insurance typically pays —Sticker price $149 | — | — | $149 |
| Tonsillectomy | —Insurance typically pays —Sticker price $13,061 | — | — | $13,061 |
| Total abdominal hysterectomy | —Insurance typically pays —Sticker price $47,868 | — | — | $47,868 |
| Total shoulder replacement (arthroplasty) | —Insurance typically pays —Sticker price $91,766 | — | — | $91,766 |
| Trigger finger release | —Insurance typically pays —Sticker price $14,267 | — | — | $14,267 |
| Trigger point injection | —Insurance typically pays —Sticker price $1,043 | — | — | $1,043 |
| Unattended home sleep study | —Insurance typically pays —Sticker price $3,290 | — | — | $3,290 |
| Upper endoscopy | —Insurance typically pays —Sticker price $20,852 | — | — | $20,852 |
| Upper endoscopy (EGD) | —Insurance typically pays —Sticker price $8,656 | — | — | $8,656 |
| Upper endoscopy with ablation | —Insurance typically pays —Sticker price $28,136 | — | — | $28,136 |
| Upper endoscopy with control of bleeding | —Insurance typically pays —Sticker price $48,504 | — | — | $48,504 |
| Upper endoscopy with fine needle biopsy | —Insurance typically pays —Sticker price $36,766 | — | — | $36,766 |
| Upper endoscopy with guide wire placement | —Insurance typically pays —Sticker price $30,462 | — | — | $30,462 |
| Upper endoscopy with limited ultrasound | —Insurance typically pays —Sticker price $48,504 | — | — | $48,504 |
| Upper endoscopy with submucosal injection | —Insurance typically pays —Sticker price $36,766 | — | — | $36,766 |
| Upper endoscopy with ultrasound | —Insurance typically pays —Sticker price $36,766 | — | — | $36,766 |
| Urinalysis | —Insurance typically pays —Sticker price $73 | — | — | $73 |
| Vaginal delivery only | —Insurance typically pays —Sticker price $10,937 | — | — | $10,937 |
| VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC | —Insurance typically pays —Sticker price $16,143 | — | — | $16,143 |
| Vaginal delivery with routine obstetric care | —Insurance typically pays —Sticker price $15,779 | — | — | $15,779 |
| Vertebroplasty | —Insurance typically pays —Sticker price $12,151 | — | — | $12,151 |
| Voice box scope | —Insurance typically pays —Sticker price $6,352 | — | — | $6,352 |
| Wound repair, layered stitches | —Insurance typically pays —Sticker price $15,453 | — | — | $15,453 |
Source: this hospital's own published price file. Original file · Methodology