Home › Hospitals › Allendale County Hospital Posts prices for 30 of the 66 common shoppable procedures we track. Price file retrieved 2026-08-22.
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Procedure Cash price Gross charge × Medicare
CT head/brain without contrast (70450) $382.50
$450
3.9×
X-ray lower spine, 4+ views (72110) $182.75
$215
1.9×
CT pelvis with contrast (72193) $393.12
$462.50
2.4×
CT abdomen and pelvis with contrast (74177) $743.75
$875
2.3×
Ultrasound, abdomen complete (76700) $178.50
$210
1.8×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $195.50
$230
2.0×
Ultrasound, transvaginal (76830) $165.75
$195
1.7×
Mammography, one breast (diagnostic) (77065) $127.50
$150
1.5×
Mammography, both breasts (diagnostic) (77066) $191.25
$225
1.7×
Mammography, screening (bilateral) (77067) $148.75
$175
1.6×
Basic metabolic panel (80048) $77.35
$91
9.1×
Comprehensive metabolic panel (80053) $161.50
$190
15.3×
Obstetric panel (80055) $181.90
$214
3.8×
Lipid panel (80061) $72.25
$85
5.4×
Renal function panel (80069) $81.60
$96
9.4×
Hepatic function panel (80076) $109.65
$129
13.4×
Urinalysis, non-automated, with microscopy (81000) $8.50
$10
2.1×
Urinalysis, non-automated, without microscopy (81002) $19.55
$23
5.6×
PSA, total (84153) $108.56
$127.72
5.9×
Thyroid stimulating hormone (TSH) (84443) $67.15
$79
4.0×
CBC with automated differential (85025) $57.80
$68
7.4×
CBC, automated (85027) $44.20
$52
6.8×
Prothrombin time (PT) (85610) $44.20
$52
10.3×
Partial thromboplastin time (PTT) (85730) $44.20
$52
7.4×
Physical therapy, therapeutic exercise (per 15 min) (97110) $75.65
$89
2.6×
Office visit, new patient (low complexity, ~30 min) (99203) $165.62
$194.84
1.3×
Office visit, new patient (moderate complexity, ~45 min) (99204) $178.37
$209.84
1.4×
Office visit, new patient (high complexity, ~60 min) (99205) $197.49
$232.34
1.6×
Preventive visit, new patient (age 18–39) (99385) $80.75
$95
—
Preventive visit, new patient (age 40–64) (99386) $89.25
$105
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As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs. The × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.
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