|
Outpatient Lab,
Diagnostic and Other Ancillary Charges for
Healthcare Services
When comparing charges with
other hospitals or provider practices, it is
important to understand their charges may or may not
include both the hospital and the doctor or other
provider services. Average charges are estimates;
your out-of-pocket expense will depend on
your individual insurance coverage (such as
co-insurance or deductibles).
Click on any of the links below to view pricing information.
|
Lab |
|
Procedure |
2013 Charge |
Uninsured
Discounted Rate* |
Discounted Rate
with Prompt Pay** |
| Blood Test |
|
|
|
| Blood Collection |
$ 13.00 |
$ 10.00 |
$ 7.00 |
| Blood Test (Kidney) |
$ 20.00
|
$ 15.00
|
$ 11.00
|
| Blood (Sugar Test) |
$ 20.00 |
$ 15.00 |
$ 11.00 |
| Blood Test (Chol.) |
$ 26.00
|
$ 20.00
|
$ 15.00
|
| Blood Test
(Thyroid) |
$ 75.00 |
$ 56.00 |
$ 42.00 |
| Blood Test (Liver) |
$ 38.00 |
$ 29.00
|
$ 21.00
|
| Blood Test
(Blood Thinner) |
$ 28.00 |
$ 21.00 |
$ 16.00 |
| Blood Test (Pregnancy) |
$ 37.00
|
$ 28.00
|
$ 21.00
|
| Blood Count |
$ 34.00 |
$ 26.00 |
$ 19.00 |
| Blood Chemistries |
$ 57.00 |
$ 43.00 |
$ 32.00 |
| Blood Test
(Drugs) |
$ 168.00 |
$ 126.00 |
$ 95.00 |
| Blood Test (Heart) |
$ 33.00
|
$ 25.00
|
$ 19.00
|
| Blood Test
(Alcohol) |
$ 88.00 |
$ 66.00 |
$ 50.00 |
| |
| Urine Test
|
|
|
|
| Urinalysis W/C&S
if
Indicated |
$ 23.00 |
$ 17.00 |
$ 13.00 |
| Urinalysis,
Routine |
$ 23.00 |
$ 17.00 |
$
13.00 |
| Urine Culture |
$ 45.00 |
$ 34.00 |
$
25.00 |
| |
| Gall Bladder Test |
|
|
|
| Lipase |
$ 32.00 |
$ 24.00 |
$ 18.00 |
| Amylase |
$ 32.00 |
$ 24.00 |
$ 18.00 |
| |
|
Radiology |
|
Procedure |
2013 Charge |
Uninsured
Discounted Rate** |
Discounted Rate
with Prompt Pay*** |
| X-Ray |
|
|
|
| 2 View Chest X-Ray |
$ 309.00 |
$ 232.00 |
$ 174.00 |
| Shoulder X-Ray |
$
685.00 |
$
514.00 |
$
384.00 |
| Knee X-Ray |
$ 783.00 |
$ 587.00 |
$ 438.00 |
| Pelvis X-Ray |
$
297.00 |
$
223.00 |
$ 167.00 |
| Foot X-Ray |
$ 713.00 |
$ 535.00 |
$ 399.00 |
| Wrist X-Ray |
$ 682.00 |
$
512.00 |
$
382.00 |
| Abdomen Series
(flat, upright & upright Chest) X-Ray |
$ 503.00 |
$ 377.00 |
$ 282.00 |
| Hip X-Ray |
$
271.00 |
$
203.00 |
$ 152.00 |
| Neck (Cervical Spine) X-Ray |
$ 1,369.00 |
$ 1,037.00 |
$ 767.00 |
| Lower Back (Lumbar Spine) X-Ray |
$
1,104.00 |
$
828.00 |
$
618.00 |
| |
| Ultrasound |
|
|
|
| Abdominal Ultrasound |
$ 1,080.00 |
$ 810.00 |
$ 607.00 |
| Pelvic Ultrasound |
$
1,044.00
|
$ 783.00 |
$ 587.00 |
| Obstetrical Ultrasound, Single Fetus
(greater then 14 wks) |
$ 820.00 |
$ 615.00 |
$ 459.00 |
| Obstetric Transvaginal
Ultrasound |
$ 1,095.00 |
$ 821.00 |
$ 616.00 |
| Obstetrical Ultrasound, Single Fetus
(less then 14 wks) |
$ 721.00 |
$ 541.00 |
$ 404.00 |
| Abdominal Paracentesis |
$ 1,160.00 |
$ 870.00 |
$ 650.00 |
| |
| Cat Scan |
|
|
|
| CT Head/Brain
W/O Contrast*** |
$
2,555.00 |
$
1,916.00 |
$ 1,437.00 |
| CT Neck (Cervical) Spine W/O
Contrast |
$
3,941.00 |
$
2,956.00 |
$ 2,217.00 |
| CT Pelvis W/
Contrast* |
$
3,562.00 |
$
2,672.00 |
$ 1995.00 |
| CT Abdomen W/ Contrast* |
$ 3,266.00 |
$
2,450.00 |
$ 1,837.00 |
| CT Chest W/
Contrast* |
$ 3,444.00 |
$
2,583.00 |
$ 1,929.00 |
| CT Abdomen W/O & W/ Contrast* |
$
4,032.00 |
$
3,024.00 |
$ 2,268.00 |
| ***contrast = contrast
material, or liquids, commonly referred to as dye. |
| |
| Mammogram |
|
|
|
| Screening Mammogram with CAD |
$ 270.00 |
$ 203.00 |
$ 151.00 |
| Diagnostic Mammogram |
$ 405.00 |
$ 304.00 |
$ 227.00 |
| Ultrasound
Breast |
$ 647.00 |
$ 485.00 |
$ 362.00 |
| Bone Density |
$ 716.00 |
$ 537.00 |
$ 403.00 |
| |
|
Cardiology |
|
Procedure |
2013 Charge |
Uninsured
Discounted Rate** |
Discounted Rate
with Prompt Pay*** |
| Heart Test (EKG) |
$ 235.00 |
$ 176.00 |
$ 132.00 |
| Stress Test |
$ 859.00 |
$ 644.00 |
$ 483.00 |
| |
|
Emergency Room |
|
Procedure |
2013 Charge |
Uninsured
Discounted Rate** |
Discounted Rate
with Prompt Pay*** |
| Visit Levels |
|
|
|
| Simple Re-Check |
$ 109.00 |
$ 82.00 |
$ 61.00 |
| Level I Visit |
$ 405.00 |
$ 304.00 |
$ 228.00 |
| Level 2 Visit |
$ 787.00 |
$ 590.00 |
$ 442.00 |
| Level 3 Visit |
$ 1,191.00 |
$ 894.00 |
$ 670.00 |
| Level 4 Visit |
$ 2,252.00 |
$ 1,689.00 |
$ 1,267.00 |
| Level 5 Visit |
$ 3,312.00 |
$ 2,484.00 |
$ 1,863.00 |
| Level 1 Stat Care |
$ 304.00 |
$ 228.00 |
$ 171.00 |
| Level 2 Stat Care |
$ 534.00 |
$ 400.00 |
$ 300.00 |
| Level 3 Stat Care |
$ 1,018.00 |
$ 763.00 |
$ 572.00 |
| |
| Procedure Charges |
|
|
|
| Immobilizer Knee |
$ 426.00 |
$ 319.00 |
$ 239.00 |
| Lumbar Puncture |
$ 913.00 |
$ 685.00 |
$ 514.00 |
| Splint, Wrist |
$ 306.00 |
$ 229.00 |
$ 172.00 |
| F.B. Removal Ear |
$ 472.00 |
$ 354.00 |
$ 265.00 |
| Laceration Repair |
$ 470.00 |
$ 353.00 |
$ 265.00 |
| Incision & Drainage, Simple |
$ 854.00 |
$ 641.00 |
$ 481.00 |
| Transfusion, Blood |
$ 957.00 |
$ 718.00 |
$ 538.00 |
| IV Injection |
$ 311.00 |
$ 233.00 |
$ 175.00 |
| Intr Muscular Injection |
$ 173.00 |
$ 129.00 |
$ 97.00 |
| Administration of Tetanus |
$ 135.00 |
$ 101.00 |
$ 76.00 |
| |
|
Endoscopy |
|
Procedure |
2013 Charge |
Uninsured
Discounted Rate** |
Discounted Rate
with Prompt Pay*** |
| Colonoscopy |
$ 4,215.00 |
$ 3,161.00 |
$ 2,371.00 |
| EGD |
$ 4,958.00 |
$ 3,718.00 |
$ 2,789.00 |
| |
|
* LMHS has a new policy for
uninsured patients that do not qualify for Medicaid or Charity.
The uninsured discount is calculated at a 25% reduction of
billed charges.
** A prompt payment
discount of 25% can be applied for payments made prior to or at
the time of service for outpatient procedures, or for payments
made within an agreed upon time frame for inpatient and
non-scheduled services. This prompt pay discount can be given in
addition to the uninsured discount and will be calculated on the
uninsured balance.
The services you receive
from LMHS are based on your individual need and medical
condition as prescribed by your physician. Actual charges will
vary based on services delivered and medical condition.
Additional tests or services not listed in the estimate may be
ordered by your doctor, in order to treat, diagnose or care for
your individual needs.
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