Home › Hospitals › Gundersen Tri-county Hospital and Clinics Posts prices for 40 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-08.
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Procedure Posted cash Posted gross × Medicare
Upper GI endoscopy (EGD), diagnostic (43235) $1,538.08
$2,426
1.7×
Upper GI endoscopy (EGD) with biopsy (43239) $1,708
$2,694
1.9×
Diagnostic colonoscopy (45378) $1,990.76
$3,140
2.2×
Colonoscopy with biopsy (45380) $2,248.16
$3,546
1.9×
Colonoscopy with lesion removal (45385) $2,630.47
$4,149
2.3×
CT head/brain without contrast (70450) $876.19
$1,382
8.6×
MRI brain without contrast (70551) $1,983.79
$3,129
8.6×
MRI brain with contrast (70552) $2,812.42
$4,436
8.3×
MRI brain without and with contrast (70553) $3,387.46
$5,343
10.0×
X-ray lower spine, 4+ views (72110) $319.54
$504
3.1×
MRI lumbar spine without contrast (72148) $1,983.79
$3,129
8.6×
CT pelvis with contrast (72193) $1,481.02
$2,336
8.7×
MRI lower-extremity joint without contrast (73721) $1,983.15
$3,128
8.6×
CT abdomen and pelvis with contrast (74177) $1,739.06
$2,743
5.1×
Ultrasound, abdomen complete (76700) $511.64
$807
5.0×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $606.74
$957
6.0×
Ultrasound, transvaginal (76830) $519.25
$819
5.1×
Mammography, screening (bilateral) (77067) $263.74
$416
2.9×
Basic metabolic panel (80048) $43.75
$69
5.2×
Comprehensive metabolic panel (80053) $54.52
$86
5.2×
Obstetric panel (80055) $247.26
$390
5.2×
Lipid panel (80061) $69.11
$109
5.2×
Renal function panel (80069) $45.01
$71
5.2×
Hepatic function panel (80076) $42.48
$67
5.2×
Urinalysis, non-automated, with microscopy (81000) $20.92
$33
5.2×
Urinalysis, non-automated, without microscopy (81002) $17.75
$28
5.1×
PSA, total (84153) $95.10
$150
5.2×
Thyroid stimulating hormone (TSH) (84443) $86.86
$137
5.2×
CBC with automated differential (85025) $39.94
$63
5.1×
CBC, automated (85027) $33.60
$53
5.2×
Prothrombin time (PT) (85610) $22.19
$35
5.2×
Partial thromboplastin time (PTT) (85730) $31.07
$49
5.2×
Psychotherapy, 30 minutes (90832) $96.37
$152
0.6×
Psychotherapy, 45 minutes (90834) $146.45
$231
0.8×
Psychotherapy, 60 minutes (90837) $170.55
$269
1.0×
Family psychotherapy, without patient (50 min) (90846) $170.55
$269
1.0×
Family psychotherapy, with patient (50 min) (90847) $170.55
$269
1.0×
Group psychotherapy (90853) $88.76
$140
0.9×
Sleep study (attended polysomnography) (95810) $2,440.90
$3,850
2.9×
Physical therapy, therapeutic exercise (per 15 min) (97110) $93.20
$147
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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