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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

2015 Charge

Uninsured
Discounted Rate*

Discounted Rate with Prompt Pay**

Blood Test         
 Blood Collection  $ 14.00 $ 10.00 $ 8.00
 Blood Test (Kidney) $ 22.00 $ 17.00 $ 12.00
 Blood (Sugar Test) $ 22.00 $ 17.00 $ 12.00
 Blood Test (Chol.) $ 28.00 $ 21.00 $ 16.00
 Blood Test (Thyroid)  $ 81.00 $ 61.00 $ 45.00
 Blood Test (Liver)  $ 41.00 $ 31.00 $ 23.00
 Blood Test (Blood Thinner) $ 29.00 $ 22.00 $ 17.00
 Blood Test (Pregnancy) $ 40.00 $ 30.00 $ 22.00
 Blood Count  $ 36.00 $ 27.00 $ 20.00
 Blood Chemistries   $ 61.00 $ 46.00 $ 34.00
 Blood Test (Drugs) $ 181.00 $ 135.00 $ 102.00
 Blood Test (Heart) $ 36.00 $ 27.00 $ 20.00
 Blood Test (Alcohol) $ 97.00  $ 72.00 $ 54.00
 
Urine Test          
 Urinalysis W/C&S if Indicated $ 26.00 $ 20.00 $ 15.00
 Urinalysis, Routine $ 26.00  $ 20.00 $ 15.00
 Urine Culture $ 49.00  $ 37.00 $ 28.00
 
Gall Bladder Test       
 Lipase $ 36.00 $ 27.00 $ 20.00
 Amylase  $ 36.00 $ 27.00 $ 20.00
 

Radiology

Procedure

2015 Charge

Uninsured
Discounted Rate**
Discounted Rate with Prompt Pay***
X-Ray      
 2 View Chest X-Ray $ 492.00 $ 369.00 $ 277.00
 Shoulder X-Ray $ 564.00 $ 423.00 $ 317.00
 Knee X-Ray $ 618.00 $ 464.00 $ 348.00
 Pelvis X-Ray $ 468.00 $ 351.00 $ 263.00
 Foot X-Ray $ 671.00 $ 503.00 $ 377.00
 Wrist X-Ray $ 621.00 $ 465.00 $ 349.00
 Abdomen Series (flat, upright & upright Chest) X-Ray $ 717.00 $ 538.00 $ 403.00
 Hip X-Ray $ 457.00 $ 343.00 $ 257.00
 Neck (Cervical Spine) X-Ray $ 842.00 $ 632.00 $ 474.00
 Lower Back (Lumbar Spine) X-Ray $ 874.00 $ 656.00 $ 492.00
 
 Ultrasound      
 Abdominal Ultrasound $ 1,137.00 $ 853.00 $ 640.00
 Pelvic Ultrasound $ 1,117.00 $ 838.00 $ 628.00
Obstetrical Ultrasound, Single Fetus (greater then 14 wks) $ 658.00 $ 494.00 $ 370.00
 Obstetric Transvaginal Ultrasound $ 1,172.00 $ 879.00 $ 659.00
Obstetrical Ultrasound, Single Fetus (less then 14 wks) $ 560.00 $ 420.00 $ 315.00
 Abdominal Paracentesis $ 1,325.00 $ 993.00 $ 745.00
 
Cat Scan      
 CT Head/Brain W/O Contrast*** $ 3,183.00 $ 2,387.00 $ 1,791.00
 CT Neck (Cervical) Spine W/O Contrast $ 4,217.00 $ 3,163.00  $ 2,372.00
 CT Pelvis W/ Contrast* $ 3,461.00 $ 2,596.00  $ 1,947.00
 CT Abdomen W/ Contrast* $ 3,963.00 $ 2,972.00  $ 2,229.00
 CT Chest W/ Contrast* $ 3,685.00 $ 2,764.00  $ 2,073.00
 CT Abdomen W/O & W/ Contrast* $ 4,954.00 $ 3,716.00 $ 2,787.00
***contrast = contrast material, or liquids, commonly referred to as dye.
 
Mammogram      
 Screening Mammogram with CAD $ 86.00 $ 65.00 $ 48.00
 Diagnostic Mammogram $ 243.00 $ 182.00 $ 137.00
 Ultrasound Breast $ 1.042.00 $ 782.00 $ 586.00
 Bone Density $ 716.00 $ 537.00 $ 403.00
 

Cardiology

Procedure

2015 Charge

Uninsured
Discounted Rate**
Discounted Rate with Prompt Pay***
Heart Test (EKG) $ 378.00 $ 283.00 $ 212.00
Stress Test $ 1,736.00 $ 1,302.00 $ 976.00
 

Emergency Room

Procedure

2015 Charge

Uninsured
Discounted Rate**
Discounted Rate with Prompt Pay***
Visit Levels      
Simple Re-Check $ 105.00 $ 79.00 $ 59.00
Level I Visit $ 427.00 $ 320.00 $ 240.00
Level 2 Visit $ 854.00 $ 640.00 $ 480.00
Level 3 Visit $ 1,281.00 $ 961.00 $ 720.00
Level 4 Visit $ 2,418.00 $ 1,814.00 $ 1,360.00
Level 5 Visit $ 3,557.00 $ 2,668.00 $ 2,001.00
Level 1 Stat Care $ 361.00 $ 270.00 $ 203.00
Level 2 Stat Care $ 600.00 $ 450.00 $ 338.00
Level 3 Stat Care $ 1,144.00 $ 858.00 $ 643.00
 
Procedure Charges      
Immobilizer Knee $ 478.00 $ 359.00 $ 269.00
Lumbar Puncture $ 977.00 $ 733.00 $ 550.00
Splint, Wrist $ 343.00 $ 258.00 $ 193.00
F.B. Removal Ear $ 531.00 $ 398.00 $ 299.00
Laceration Repair $ 459.00 $ 344.00 $ 258.00
Incision & Drainage, Simple $ 685.00 $ 514.00 $ 385.00
Transfusion, Blood $ 1,081.00 $ 811.00 $ 608.00
IV Injection $ 207.00 $ 155.00 $ 116.00
Intr Muscular Injection $ 207.00 $ 155.00 $ 116.00
Administration of Tetanus $ 151.00 $ 113.00 $ 85.00
 

Endoscopy

Procedure

2015 Charge

Uninsured
Discounted Rate**
Discounted Rate with Prompt Pay***
Colonoscopy $ 2,516.00 $ 1,887.00 $ 1,415.00
EGD $ 2,839.00 $ 2,129.00 $ 1,597.00
 

 

* 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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