Home › Hospitals › Prague Regional Memorial Hospital Posts prices for 38 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-29.
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Procedure Cash price Gross charge × Medicare
Upper GI endoscopy (EGD), diagnostic (43235) $105.09
$268
0.1×
Upper GI endoscopy (EGD) with biopsy (43239) $117.64
$300
0.1×
Diagnostic colonoscopy (45378) $156.82
$437
0.2×
Colonoscopy with biopsy (45380) $169.45
$522
0.1×
Colonoscopy with lesion removal (45385) $213.51
$621
0.2×
CT head/brain without contrast (70450) $1,844
$1,844
18.3×
MRI brain without contrast (70551) $1,877
$1,877
8.2×
MRI brain with contrast (70552) $3,524
$3,524
10.5×
MRI brain without and with contrast (70553) $2,693
$2,693
8.0×
X-ray lower spine, 4+ views (72110) $304
$304
3.0×
MRI lumbar spine without contrast (72148) $2,237
$2,237
9.7×
CT pelvis with contrast (72193) $2,390
$2,390
14.2×
MRI lower-extremity joint without contrast (73721) $1,712
$1,712
7.5×
CT abdomen and pelvis with contrast (74177) $2,553
$2,553
7.6×
Ultrasound, abdomen complete (76700) $540
$540
5.4×
Ultrasound, pregnant uterus (≥14 weeks) (76805) $630
$630
6.3×
Ultrasound, transvaginal (76830) $598
$598
5.9×
Basic metabolic panel (80048) $205
$205
24.2×
Comprehensive metabolic panel (80053) $308
$308
29.2×
Lipid panel (80061) $174
$174
13.0×
Renal function panel (80069) $202
$202
23.3×
Hepatic function panel (80076) $258.50
$258.50
31.6×
Urinalysis, non-automated, with microscopy (81000) $25
$25
6.2×
Urinalysis, non-automated, without microscopy (81002) $25
$25
7.2×
PSA, total (84153) $233.50
$233.50
12.7×
Thyroid stimulating hormone (TSH) (84443) $232
$232
13.8×
CBC with automated differential (85025) $109
$109
14.0×
CBC, automated (85027) $30
$30
4.6×
Prothrombin time (PT) (85610) $80
$80
18.6×
Partial thromboplastin time (PTT) (85730) $86
$86
14.3×
Psychotherapy, 30 minutes (90832) $503.71
$503.71
3.0×
Psychotherapy, 45 minutes (90834) $508.04
$508.04
3.0×
Psychotherapy, 60 minutes (90837) $513.63
$513.63
3.0×
Group psychotherapy (90853) $424.65
$424.65
4.3×
Physical therapy, therapeutic exercise (per 15 min) (97110) $112.50
$112.50
3.9×
Office visit, new patient (low complexity, ~30 min) (99203) $68.93
$240
0.5×
Office visit, new patient (moderate complexity, ~45 min) (99204) $112.76
$349
0.9×
Office visit, new patient (high complexity, ~60 min) (99205) $154.28
$445
1.2×
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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