Home › Hospitals › Big South Fork Medical Center Posts prices for 34 of the 66 common shoppable procedures we track. Price file retrieved 2026-08-17.
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Procedure Cash price Gross charge × Medicare
Upper GI endoscopy (EGD), diagnostic (43235) $41.01
$137
0.0×
Upper GI endoscopy (EGD) with biopsy (43239) $125.91
$420
0.2×
Colonoscopy with lesion removal (45385) $882
$2,940
0.8×
CT head/brain without contrast (70450) $235.50
$785
2.5×
MRI brain without contrast (70551) $489.30
$1,631
2.3×
MRI brain with contrast (70552) $801.90
$2,673
2.5×
MRI brain without and with contrast (70553) $801.90
$2,673
2.5×
X-ray lower spine, 4+ views (72110) $201.60
$672
2.1×
MRI lumbar spine without contrast (72148) $489.30
$1,631
2.3×
CT pelvis with contrast (72193) $382.80
$1,276
2.4×
MRI lower-extremity joint without contrast (73721) $489.30
$1,631
2.3×
CT abdomen and pelvis with contrast (74177) $801.90
$2,673
2.5×
Ultrasound, abdomen complete (76700) $235.50
$785
2.5×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $235.50
$785
2.5×
Ultrasound, transvaginal (76830) $235.50
$785
2.5×
Mammography, one breast (diagnostic) (77065) $101.70
$339
1.2×
Mammography, both breasts (diagnostic) (77066) $129.60
$432
1.2×
Mammography, screening (bilateral) (77067) $107.40
$358
1.2×
Basic metabolic panel (80048) $15.30
$51
1.8×
Comprehensive metabolic panel (80053) $18.90
$63
1.8×
Lipid panel (80061) $24
$80
1.8×
Renal function panel (80069) $15.60
$52
1.8×
Hepatic function panel (80076) $14.70
$49
1.8×
PSA, total (84153) $33
$110
1.8×
Thyroid stimulating hormone (TSH) (84443) $30.30
$101
1.8×
CBC with automated differential (85025) $14.10
$47
1.8×
CBC, automated (85027) $11.70
$39
1.8×
Prothrombin time (PT) (85610) $7.80
$26
1.8×
Partial thromboplastin time (PTT) (85730) $10.80
$36
1.8×
Sleep study (attended polysomnography) (95810) $1,912.35
$6,374
2.5×
Physical therapy, therapeutic exercise (per 15 min) (97110) $47.94
$160
1.6×
Office visit, new patient (low complexity, ~30 min) (99203) $18.90
$63
0.2×
Office visit, new patient (moderate complexity, ~45 min) (99204) $18.90
$63
0.2×
Office visit, new patient (high complexity, ~60 min) (99205) $20.70
$69
0.2×
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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