Home › Hospitals › Dosher Memorial Hospital Posts prices for 39 of the 66 common shoppable procedures we track. Price file retrieved 2026-08-17.
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Procedure Cash price Gross charge × Medicare
Breast lesion removal (open) (19120) $374
$748
0.1×
Inguinal hernia repair (age 5+) (49505) $1,000
$2,000
0.3×
Transforaminal epidural injection, lumbar/sacral (64483) $162.74
$325.48
0.2×
CT head/brain without contrast (70450) $912.50
$1,825
8.7×
MRI brain without contrast (70551) $877.50
$1,755
3.7×
MRI brain with contrast (70552) $1,569.50
$3,139
4.5×
MRI brain without and with contrast (70553) $1,300
$2,600
3.7×
X-ray lower spine, 4+ views (72110) $283
$566
2.7×
MRI lumbar spine without contrast (72148) $1,500
$3,000
6.3×
CT pelvis with contrast (72193) $948
$1,896
5.4×
MRI lower-extremity joint without contrast (73721) $1,333.50
$2,667
5.6×
CT abdomen and pelvis with contrast (74177) $1,986.50
$3,973
5.7×
Ultrasound, abdomen complete (76700) $481.50
$963
4.6×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $582.50
$1,165
5.6×
Ultrasound, transvaginal (76830) $315.75
$631.50
3.0×
Mammography, one breast (diagnostic) (77065) $92.50
$185
1.1×
Mammography, both breasts (diagnostic) (77066) $231.50
$463
2.1×
Mammography, screening (bilateral) (77067) $94
$188
1.0×
Basic metabolic panel (80048) $74.50
$149
8.8×
Comprehensive metabolic panel (80053) $99.50
$199
9.4×
Lipid panel (80061) $33.75
$67.50
2.5×
Renal function panel (80069) $44.50
$89
5.1×
Hepatic function panel (80076) $32.25
$64.50
3.9×
Urinalysis, non-automated, with microscopy (81000) $3.61
$7.21
0.9×
Urinalysis, non-automated, without microscopy (81002) $3
$6
0.9×
PSA, total (84153) $94
$188
5.1×
Thyroid stimulating hormone (TSH) (84443) $85.50
$171
5.1×
CBC with automated differential (85025) $70
$140
9.0×
CBC, automated (85027) $59
$118
9.1×
Prothrombin time (PT) (85610) $26.25
$52.50
6.1×
Partial thromboplastin time (PTT) (85730) $29.25
$58.50
4.9×
Electrocardiogram (ECG), complete (93000) $14
$28
0.2×
Physical therapy, therapeutic exercise (per 15 min) (97110) $86.50
$173
3.0×
Office visit, new patient (low complexity, ~30 min) (99203) $84
$168
0.6×
Office visit, new patient (moderate complexity, ~45 min) (99204) $142
$284
1.1×
Office visit, new patient (high complexity, ~60 min) (99205) $182.12
$364.25
1.4×
Office consultation (low complexity, ~30 min) (99243) $123.50
$247
0.9×
Preventive visit, new patient (age 18–39) (99385) $112.12
$224.24
—
Preventive visit, new patient (age 40–64) (99386) $113.50
$227
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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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