Home › Hospitals › Bacon County Hospital and Health System 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
Upper GI endoscopy (EGD), diagnostic (43235) $1,534.40
$1,918
1.9×
Upper GI endoscopy (EGD) with biopsy (43239) $2,432
$3,040
3.1×
Epidural injection, lumbar/sacral (with imaging) (62322) $1,080
$702
1.4×
Transforaminal epidural injection, lumbar/sacral (64483) $2,264
$2,830
2.9×
CT head/brain without contrast (70450) $1,914.80
$2,393.50
20.9×
MRI brain without contrast (70551) $2,824
$3,530
13.5×
MRI brain with contrast (70552) $3,489.60
$4,362
11.4×
MRI brain without and with contrast (70553) $4,038.80
$5,048.50
13.2×
X-ray lower spine, 4+ views (72110) $552
$690
6.0×
MRI lumbar spine without contrast (72148) $2,572.80
$3,216
12.3×
CT pelvis with contrast (72193) $2,349.60
$2,937
15.3×
MRI lower-extremity joint without contrast (73721) $2,660.80
$3,326
12.7×
CT abdomen and pelvis with contrast (74177) $1,943.20
$2,429
6.4×
Ultrasound, abdomen complete (76700) $887.20
$1,109
9.7×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $727.20
$909
7.9×
Ultrasound, transvaginal (76830) $550.40
$688
6.0×
Mammography, one breast (diagnostic) (77065) $215.20
$269
2.5×
Mammography, both breasts (diagnostic) (77066) $329.60
$412
3.0×
Mammography, screening (bilateral) (77067) $344
$430
3.8×
Basic metabolic panel (80048) $253.60
$317
30.0×
Comprehensive metabolic panel (80053) $295.20
$369
28.0×
Obstetric panel (80055) $335.20
$419
7.0×
Lipid panel (80061) $128.80
$161
9.6×
Renal function panel (80069) $268.80
$336
31.0×
Hepatic function panel (80076) $253.60
$317
31.0×
PSA, total (84153) $114
$142.50
6.2×
Thyroid stimulating hormone (TSH) (84443) $123.60
$154.50
7.4×
CBC with automated differential (85025) $100.80
$126
13.0×
Prothrombin time (PT) (85610) $68.80
$86
16.0×
Partial thromboplastin time (PTT) (85730) $87.20
$109
14.5×
Sleep study (attended polysomnography) (95810) $3,403.20
$4,254
4.5×
Physical therapy, therapeutic exercise (per 15 min) (97110) $100
$125
3.4×
Office visit, new patient (low complexity, ~30 min) (99203) $210.40
$263
1.8×
Office visit, new patient (moderate complexity, ~45 min) (99204) $310.40
$388
2.7×
Office visit, new patient (high complexity, ~60 min) (99205) $413.60
$517
3.5×
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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