Home › Hospitals › Memorial Hospital Posts prices for 35 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-20.
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Procedure Cash price Gross charge × Medicare
Breast lesion removal (open) (19120) $576
$600
0.1×
Transforaminal epidural injection, lumbar/sacral (64483) $2,208
$2,300
2.4×
After-cataract laser surgery (YAG capsulotomy) (66821) $960
$1,000
1.7×
CT head/brain without contrast (70450) $2,193.60
$2,285
20.2×
MRI brain without contrast (70551) $3,624
$3,775
14.6×
MRI brain with contrast (70552) $4,022.40
$4,190
11.1×
MRI brain without and with contrast (70553) $4,176
$4,350
11.5×
X-ray lower spine, 4+ views (72110) $571.20
$595
5.3×
MRI lumbar spine without contrast (72148) $2,880
$3,000
11.6×
CT pelvis with contrast (72193) $2,822.40
$2,940
15.5×
MRI lower-extremity joint without contrast (73721) $2,496
$2,600
10.1×
CT abdomen and pelvis with contrast (74177) $4,800
$5,000
13.2×
Ultrasound, abdomen complete (76700) $926.40
$965
8.5×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $768
$800
7.1×
Ultrasound, transvaginal (76830) $715.20
$745
6.6×
Mammography, one breast (diagnostic) (77065) $379.20
$395
4.4×
Mammography, both breasts (diagnostic) (77066) $460.80
$480
4.2×
Mammography, screening (bilateral) (77067) $307.20
$320
3.4×
Basic metabolic panel (80048) $165.12
$172
19.5×
Comprehensive metabolic panel (80053) $201.60
$210
19.1×
Obstetric panel (80055) $411.84
$429
8.6×
Lipid panel (80061) $153.60
$160
11.5×
Renal function panel (80069) $179.04
$186.50
20.6×
Hepatic function panel (80076) $154.56
$161
18.9×
Urinalysis, non-automated, without microscopy (81002) $31.20
$32.50
9.0×
PSA, total (84153) $158.40
$165
8.6×
Thyroid stimulating hormone (TSH) (84443) $139.20
$145
8.3×
CBC with automated differential (85025) $126.72
$132
16.3×
CBC, automated (85027) $91.20
$95
14.1×
Prothrombin time (PT) (85610) $109.92
$114.50
25.6×
Partial thromboplastin time (PTT) (85730) $140.16
$146
23.3×
Sleep study (attended polysomnography) (95810) $3,744
$3,900
4.2×
Physical therapy, therapeutic exercise (per 15 min) (97110) $101.76
$106
3.5×
Preventive visit, new patient (age 18–39) (99385) $225.60
$235
—
Preventive visit, new patient (age 40–64) (99386) $264
$275
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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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