Home › Hospitals › Jay Hospital Posts prices for 26 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-13.
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Procedure Cash price Gross charge × Medicare
CT head/brain without contrast (70450) $230.85
$1,539
2.1×
MRI brain without contrast (70551) $319.65
$2,131
1.3×
MRI brain without and with contrast (70553) $319.65
$2,131
0.9×
X-ray lower spine, 4+ views (72110) $77.70
$518
0.7×
MRI lumbar spine without contrast (72148) $319.65
$2,131
1.3×
CT pelvis with contrast (72193) $230.85
$1,539
1.3×
MRI lower-extremity joint without contrast (73721) $319.65
$2,131
1.3×
CT abdomen and pelvis with contrast (74177) $255
$1,700
0.7×
Ultrasound, abdomen complete (76700) $105
$700
1.0×
Ultrasound, transvaginal (76830) $105
$700
1.0×
Mammography, screening (bilateral) (77067) $52.50
$350
0.6×
Basic metabolic panel (80048) $20.85
$139
2.5×
Comprehensive metabolic panel (80053) $25.80
$172
2.4×
Lipid panel (80061) $4.78
$31.84
0.4×
Renal function panel (80069) $33.60
$224
3.9×
Hepatic function panel (80076) $17.25
$115
2.1×
PSA, total (84153) $16.42
$109.50
0.9×
Thyroid stimulating hormone (TSH) (84443) $6.46
$43.09
0.4×
CBC with automated differential (85025) $15
$100
1.9×
CBC, automated (85027) $18.60
$124
2.9×
Prothrombin time (PT) (85610) $14.10
$94
3.3×
Partial thromboplastin time (PTT) (85730) $10.88
$72.50
1.8×
Physical therapy, therapeutic exercise (per 15 min) (97110) $16.50
$110
0.6×
Office visit, new patient (low complexity, ~30 min) (99203) $44.55
$297
0.3×
Office visit, new patient (moderate complexity, ~45 min) (99204) $48.15
$321
0.3×
Office visit, new patient (high complexity, ~60 min) (99205) $51.75
$345
0.4×
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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