Home › Hospitals › Jefferson Medical Center Posts prices for 37 of the 66 common shoppable procedures we track. Price file retrieved 2026-08-28.
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Procedure Cash price Gross charge × Medicare
Epidural injection, lumbar/sacral (with imaging) (62322) $866
$1,732
0.9×
Transforaminal epidural injection, lumbar/sacral (64483) $885
$1,770
1.0×
Cataract removal with lens insertion (66984) $2,266.50
$4,533
0.9×
CT head/brain without contrast (70450) $670
$1,340
6.2×
MRI brain without contrast (70551) $1,205.50
$2,411
4.9×
MRI brain without and with contrast (70553) $1,883.50
$3,767
5.2×
X-ray lower spine, 4+ views (72110) $299.50
$599
2.8×
MRI lumbar spine without contrast (72148) $1,205.50
$2,411
4.9×
CT pelvis with contrast (72193) $850.50
$1,701
4.7×
MRI lower-extremity joint without contrast (73721) $1,206.50
$2,413
4.9×
CT abdomen and pelvis with contrast (74177) $1,737
$3,474
4.8×
Ultrasound, abdomen complete (76700) $440.50
$881
4.1×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $447.50
$895
4.1×
Ultrasound, transvaginal (76830) $440.50
$881
4.1×
Mammography, one breast (diagnostic) (77065) $212
$424
2.5×
Mammography, both breasts (diagnostic) (77066) $343.50
$687
3.1×
Mammography, screening (bilateral) (77067) $343.50
$687
3.8×
Basic metabolic panel (80048) $39
$78
4.6×
Comprehensive metabolic panel (80053) $49
$98
4.6×
Lipid panel (80061) $62.50
$125
4.7×
Renal function panel (80069) $40
$80
4.6×
Hepatic function panel (80076) $38
$76
4.7×
Urinalysis, non-automated, with microscopy (81000) $17
$34
4.2×
Urinalysis, non-automated, without microscopy (81002) $13.50
$27
3.9×
PSA, total (84153) $111.50
$223
6.1×
Thyroid stimulating hormone (TSH) (84443) $43.50
$87
2.6×
CBC with automated differential (85025) $49.50
$99
6.4×
CBC, automated (85027) $63.50
$127
9.8×
Prothrombin time (PT) (85610) $42.50
$85
9.9×
Partial thromboplastin time (PTT) (85730) $54
$108
9.0×
Family psychotherapy, without patient (50 min) (90846) $91
$182
0.5×
Family psychotherapy, with patient (50 min) (90847) $91
$182
0.5×
Physical therapy, therapeutic exercise (per 15 min) (97110) $67.50
$135
2.3×
Office consultation (low complexity, ~30 min) (99243) $98.50
$197
0.7×
Office consultation (moderate complexity, ~40 min) (99244) $98.50
$197
0.7×
Preventive visit, new patient (age 18–39) (99385) $60
$120
—
Preventive visit, new patient (age 40–64) (99386) $70
$140
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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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