Indiana University Health White Memorial Hospital
Monticello, IN · Critical Access Hospital
Posts prices for 49 of the 66 common shoppable procedures we track. Price file retrieved 2026-10-01.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Breast lesion removal (open) (19120) | $1,977.12 | $6,341 | 0.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) range across 3 matching MRF lines |
$492.02–$2,305.14 | $1,578–$7,393 | varies |
| Upper GI endoscopy (EGD) with biopsy (43239) | $1,845.23 | $5,918 | 1.9× |
| Diagnostic colonoscopy (45378) range across 2 matching MRF lines |
$400.97–$2,305.14 | $1,286–$7,393 | varies |
| Colonoscopy with lesion removal (45385) range across 2 matching MRF lines |
$577.14–$665.69 | $1,851–$2,135 | varies |
| Epidural injection, lumbar/sacral (with imaging) (62322) | $717.45 | $2,301 | 0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) | $931.97 | $2,989 | 1.0× |
| CT head/brain without contrast (70450) | $277.19 | $889 | 2.5× |
| MRI brain without contrast (70551) | $404.09 | $1,296 | 1.6× |
| MRI brain with contrast (70552) | $675.98 | $2,168 | 1.8× |
| MRI brain without and with contrast (70553) | $675.98 | $2,168 | 1.8× |
| X-ray lower spine, 4+ views (72110) | $232.29 | $745 | 2.1× |
| MRI lumbar spine without contrast (72148) | $404.09 | $1,296 | 1.6× |
| CT pelvis with contrast (72193) | $353.89 | $1,135 | 1.9× |
| MRI lower-extremity joint without contrast (73721) range across 3 matching MRF lines |
$404.09–$605.83 | $1,296–$1,943 | varies |
| CT abdomen and pelvis with contrast (74177) | $675.98 | $2,168 | 1.8× |
| Ultrasound, abdomen complete (76700) | $133.76 | $429 | 1.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $133.76 | $429 | 1.2× |
| Ultrasound, transvaginal (76830) | $133.76 | $429 | 1.2× |
| Mammography, one breast (diagnostic) (77065) | $179.60 | $576 | 2.1× |
| Mammography, both breasts (diagnostic) (77066) | $226.99 | $728 | 2.1× |
| Mammography, screening (bilateral) (77067) range across 3 matching MRF lines |
$182.40–$273.76 | $585–$878 | varies |
| Basic metabolic panel (80048) | $15.59 | $50 | 1.8× |
| Comprehensive metabolic panel (80053) | $18.71 | $60 | 1.8× |
| Obstetric panel (80055) | $84.81 | $272 | 1.8× |
| Lipid panel (80061) | $24.01 | $77 | 1.8× |
| Renal function panel (80069) | $15.90 | $51 | 1.8× |
| Hepatic function panel (80076) | $15.28 | $49 | 1.9× |
| Urinalysis, non-automated, without microscopy (81002) | $5.92 | $19 | 1.7× |
| PSA, total (84153) range across 4 matching MRF lines |
$7.80–$33.05 | $25–$106 | varies |
| Thyroid stimulating hormone (TSH) (84443) range across 2 matching MRF lines |
$7.80–$29.93 | $25–$96 | varies |
| CBC with automated differential (85025) | $14.65 | $47 | 1.9× |
| CBC, automated (85027) | $12.16 | $39 | 1.9× |
| Prothrombin time (PT) (85610) | $7.80 | $25 | 1.8× |
| Partial thromboplastin time (PTT) (85730) | $11.22 | $36 | 1.9× |
| Psychotherapy, 30 minutes (90832) | $58.31 | $187 | 0.3× |
| Psychotherapy, 45 minutes (90834) | $106.64 | $342 | 0.6× |
| Psychotherapy, 60 minutes (90837) | $226.68 | $727 | 1.2× |
| Family psychotherapy, without patient (50 min) (90846) | $138.75 | $445 | 0.7× |
| Family psychotherapy, with patient (50 min) (90847) | $140.62 | $451 | 0.7× |
| Group psychotherapy (90853) | $81.07 | $260 | 0.8× |
| Left heart catheterization (93452) range across 2 matching MRF lines |
$8,682.69–$15,270.41 | $27,847–$48,975 | varies |
| Sleep study (attended polysomnography) (95810) range across 3 matching MRF lines |
$1,571.16–$2,237.79 | $5,039–$7,177 | varies |
| Physical therapy, therapeutic exercise (per 15 min) (97110) | $40.85 | $131 | 1.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) range across 3 matching MRF lines |
$53.94–$62.36 | $173–$200 | varies |
| Office visit, new patient (moderate complexity, ~45 min) (99204) range across 3 matching MRF lines |
$73.90–$85.43 | $237–$274 | varies |
| Office visit, new patient (high complexity, ~60 min) (99205) range across 3 matching MRF lines |
$100.09–$115.68 | $321–$371 | varies |
| Preventive visit, new patient (age 18–39) (99385) range across 4 matching MRF lines |
$46.15–$97.28 | $148–$312 | varies |
| Preventive visit, new patient (age 40–64) (99386) range across 3 matching MRF lines |
$46.15–$97.28 | $148–$312 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.
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.
More prices at this hospital
- Imaging: 479 codes with posted prices and Medicare benchmarks
- Lab & pathology: 1136 codes with posted prices and Medicare benchmarks
- Visits & medical services: 505 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 1222 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 245 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (ZIP, 63.1 MB) ↓ — captured 2026-10-01
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.