Home › Hospitals › Archbold Mitchell Posts prices for 35 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) $1,177.20
$1,962
12.8×
MRI brain without contrast (70551) $1,979.40
$3,299
9.5×
MRI brain with contrast (70552) $219.60
$366
0.7×
MRI brain without and with contrast (70553) $1,257.90
$2,096.50
4.1×
X-ray lower spine, 4+ views (72110) $265.80
$443
2.9×
MRI lumbar spine without contrast (72148) $849
$1,415
4.1×
CT pelvis with contrast (72193) $990.30
$1,650.50
6.4×
MRI lower-extremity joint without contrast (73721) $1,490.40
$2,484
7.1×
CT abdomen and pelvis with contrast (74177) $1,354.80
$2,258
4.4×
Ultrasound, abdomen complete (76700) $410.70
$684.50
4.5×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $216.90
$361.50
2.4×
Ultrasound, transvaginal (76830) $255.60
$426
2.8×
Mammography, one breast (diagnostic) (77065) $181.80
$303
2.1×
Mammography, both breasts (diagnostic) (77066) $235.80
$393
2.1×
Mammography, screening (bilateral) (77067) $114
$190
1.3×
Basic metabolic panel (80048) $127.20
$212
15.0×
Comprehensive metabolic panel (80053) $138
$230
13.1×
Obstetric panel (80055) $173.40
$289
3.6×
Lipid panel (80061) $99.60
$166
7.4×
Renal function panel (80069) $63.60
$106
7.3×
Hepatic function panel (80076) $92.40
$154
11.3×
Urinalysis, non-automated, without microscopy (81002) $45.60
$76
13.1×
PSA, total (84153) $134.70
$224.50
7.3×
Thyroid stimulating hormone (TSH) (84443) $96.60
$161
5.7×
CBC with automated differential (85025) $92.40
$154
11.9×
CBC, automated (85027) $81
$135
12.5×
Prothrombin time (PT) (85610) $54.30
$90.50
12.7×
Partial thromboplastin time (PTT) (85730) $61.80
$103
10.3×
Electrocardiogram (ECG), complete (93000) $27
$45
0.5×
Physical therapy, therapeutic exercise (per 15 min) (97110) $47.10
$78.50
1.6×
Office visit, new patient (low complexity, ~30 min) (99203) $98.40
$164
0.8×
Office visit, new patient (moderate complexity, ~45 min) (99204) $149.40
$249
1.3×
Office visit, new patient (high complexity, ~60 min) (99205) $195.60
$326
1.7×
Office consultation (low complexity, ~30 min) (99243) $139.80
$233
1.2×
Office consultation (moderate complexity, ~40 min) (99244) $198
$330
1.7×
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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