Home › Hospitals › Ely - Bloomenson Community Hospital Posts prices for 40 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-01.
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Procedure Cash price Gross charge × Medicare
Upper GI endoscopy (EGD), diagnostic (43235) $1,678.32
$2,072
1.8×
Upper GI endoscopy (EGD) with biopsy (43239) $2,051.32
$2,532.50
2.2×
Diagnostic colonoscopy (45378) $1,057.46
$1,305.50
1.1×
Colonoscopy with biopsy (45380) $2,128.68
$2,628
1.7×
Colonoscopy with lesion removal (45385) $1,856.12
$2,291.50
1.5×
Laparoscopic gallbladder removal (47562) likely a partial charge, not the full procedure $1,044.90
$1,290
0.2×
Inguinal hernia repair (age 5+) (49505) $1,742.31
$2,151
0.5×
CT head/brain without contrast (70450) $2,345.76
$2,896
21.7×
MRI brain without contrast (70551) $2,838.24
$3,504
11.5×
MRI brain with contrast (70552) $2,243.70
$2,770
6.2×
MRI brain without and with contrast (70553) $3,013.20
$3,720
8.4×
X-ray lower spine, 4+ views (72110) $480.33
$593
4.5×
MRI lumbar spine without contrast (72148) $3,013.20
$3,720
12.2×
CT pelvis with contrast (72193) $2,833.38
$3,498
15.7×
MRI lower-extremity joint without contrast (73721) $3,013.20
$3,720
12.2×
CT abdomen and pelvis with contrast (74177) $3,649.05
$4,505
10.1×
Ultrasound, abdomen complete (76700) $498.15
$615
4.6×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $477.90
$590
4.4×
Ultrasound, transvaginal (76830) $400.95
$495
3.7×
Mammography, one breast (diagnostic) (77065) $248.67
$307
2.9×
Mammography, both breasts (diagnostic) (77066) $319.14
$394
2.9×
Mammography, screening (bilateral) (77067) $319.14
$394
3.5×
Basic metabolic panel (80048) $200.88
$248
23.7×
Comprehensive metabolic panel (80053) $336.96
$416
31.9×
Lipid panel (80061) $208.17
$257
15.5×
Renal function panel (80069) $224.37
$277
25.8×
Hepatic function panel (80076) $144.99
$179
17.7×
PSA, total (84153) $82.62
$102
4.5×
Thyroid stimulating hormone (TSH) (84443) $250.29
$309
14.9×
CBC with automated differential (85025) $142.56
$176
18.3×
CBC, automated (85027) $109.35
$135
16.9×
Prothrombin time (PT) (85610) $108.94
$134.50
25.4×
Partial thromboplastin time (PTT) (85730) $119.07
$147
19.8×
Sleep study (attended polysomnography) (95810) $3,669.30
$4,530
4.1×
Physical therapy, therapeutic exercise (per 15 min) (97110) $115.02
$142
4.0×
Office visit, new patient (low complexity, ~30 min) (99203) $207.36
$256
1.5×
Office visit, new patient (moderate complexity, ~45 min) (99204) $295.65
$365
2.2×
Office visit, new patient (high complexity, ~60 min) (99205) $375.84
$464
2.7×
Office consultation (low complexity, ~30 min) (99243) $317.52
$392
2.3×
Office consultation (moderate complexity, ~40 min) (99244) $375.03
$463
2.7×
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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