Home › Hospitals › Gundersen St. Elizabeth's Hospital Posts prices for 35 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) $1,404.35
$2,306
1.4×
Upper GI endoscopy (EGD) with biopsy (43239) $1,404.35
$2,306
1.4×
Diagnostic colonoscopy (45378) $1,631.51
$2,679
1.6×
Colonoscopy with biopsy (45380) $1,631.51
$2,679
1.3×
Colonoscopy with lesion removal (45385) $1,631.51
$2,679
1.3×
Epidural injection, lumbar/sacral (with imaging) (62322) $887.92
$1,458
0.9×
Transforaminal epidural injection, lumbar/sacral (64483) $887.92
$1,458
0.9×
CT head/brain without contrast (70450) $1,186.33
$1,948
10.5×
MRI brain without contrast (70551) $2,140.03
$3,514
8.3×
MRI brain with contrast (70552) $2,140.03
$3,514
5.7×
MRI brain without and with contrast (70553) $2,971.31
$4,879
7.9×
X-ray lower spine, 4+ views (72110) $499.99
$821
4.4×
MRI lumbar spine without contrast (72148) $2,140.03
$3,514
8.3×
CT pelvis with contrast (72193) $1,562.09
$2,565
8.3×
MRI lower-extremity joint without contrast (73721) $1,668.66
$2,740
6.5×
CT abdomen and pelvis with contrast (74177) $1,895.21
$3,112
5.0×
Ultrasound, abdomen complete (76700) $744.81
$1,223
6.6×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $718.01
$1,179
6.4×
Ultrasound, transvaginal (76830) $311.20
$511
2.8×
Mammography, one breast (diagnostic) (77065) $233.86
$384
2.7×
Mammography, both breasts (diagnostic) (77066) $293.54
$482
2.7×
Mammography, screening (bilateral) (77067) $236.29
$388
2.6×
Basic metabolic panel (80048) $59.07
$97
7.0×
Comprehensive metabolic panel (80053) $87.09
$143
8.2×
Lipid panel (80061) $110.23
$181
8.2×
Renal function panel (80069) $60.90
$100
7.0×
Hepatic function panel (80076) $57.25
$94
7.0×
PSA, total (84153) $128.50
$211
7.0×
Thyroid stimulating hormone (TSH) (84443) $117.54
$193
7.0×
CBC with automated differential (85025) $63.95
$105
8.2×
CBC, automated (85027) $45.07
$74
7.0×
Prothrombin time (PT) (85610) $29.84
$49
7.0×
Partial thromboplastin time (PTT) (85730) $42.02
$69
7.0×
Sleep study (attended polysomnography) (95810) $2,770.34
$4,549
3.0×
Physical therapy, therapeutic exercise (per 15 min) (97110) $91.96
$151
3.2×
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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