Salem Memorial District Hospital
Salem, MO · Critical Access Hospital
Posts prices for 37 of the 66 common shoppable procedures we track. Price file retrieved 2026-08-15.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Upper GI endoscopy (EGD), diagnostic (43235) | $1,943.25 | $2,591 | 2.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) | $1,943.25 | $2,591 | 2.1× |
| Diagnostic colonoscopy (45378) | $1,959 | $2,612 | 2.1× |
| Colonoscopy with biopsy (45380) | $2,529.75 | $3,373 | 2.1× |
| Colonoscopy with lesion removal (45385) | $2,529.75 | $3,373 | 2.1× |
| Obstetric care, vaginal delivery (global) (59400) range across 2 matching MRF lines |
$68.44–$754.50 | $91.25–$1,006 | varies |
| After-cataract laser surgery (YAG capsulotomy) (66821) | $1,433.25 | $1,911 | 2.6× |
| CT head/brain without contrast (70450) | $1,515.94 | $2,021.25 | 14.5× |
| MRI brain without contrast (70551) | $2,476.69 | $3,302.25 | 10.4× |
| MRI brain with contrast (70552) | $2,744.44 | $3,659.25 | 7.9× |
| MRI brain without and with contrast (70553) | $3,130.31 | $4,173.75 | 9.0× |
| X-ray lower spine, 4+ views (72110) range across 2 matching MRF lines |
$166.50–$444.94 | $222–$593.25 | varies |
| MRI lumbar spine without contrast (72148) | $2,476.69 | $3,302.25 | 10.4× |
| CT pelvis with contrast (72193) | $1,941.19 | $2,588.25 | 11.0× |
| MRI lower-extremity joint without contrast (73721) | $2,476.69 | $3,302.25 | 10.4× |
| CT abdomen and pelvis with contrast (74177) | $3,606.75 | $4,809 | 10.3× |
| Ultrasound, abdomen complete (76700) range across 2 matching MRF lines |
$232.31–$547.31 | $309.75–$729.75 | varies |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $547.31 | $729.75 | 5.2× |
| Ultrasound, transvaginal (76830) | $547.31 | $729.75 | 5.2× |
| Mammography, one breast (diagnostic) (77065) range across 4 matching MRF lines |
$216.56–$318.94 | $288.75–$425.25 | varies |
| Mammography, both breasts (diagnostic) (77066) range across 4 matching MRF lines |
$275.63–$378 | $367.50–$504 | varies |
| Mammography, screening (bilateral) (77067) range across 6 matching MRF lines |
$118.13–$255.94 | $157.50–$341.25 | varies |
| Basic metabolic panel (80048) range across 3 matching MRF lines |
$98.44–$141.75 | $131.25–$189 | varies |
| Comprehensive metabolic panel (80053) range across 4 matching MRF lines |
$6.38–$114.19 | $8.50–$152.25 | varies |
| Obstetric panel (80055) range across 2 matching MRF lines |
$141.75–$196.88 | $189–$262.50 | varies |
| Lipid panel (80061) range across 4 matching MRF lines |
$6.38–$165.38 | $8.50–$220.50 | varies |
| Renal function panel (80069) | $102.38 | $136.50 | 11.8× |
| Hepatic function panel (80076) | $114.19 | $152.25 | 14.0× |
| Urinalysis, non-automated, with microscopy (81000) range across 2 matching MRF lines |
$23.63–$38.63 | $31.50–$51.50 | varies |
| PSA, total (84153) range across 3 matching MRF lines |
$11.25–$145.69 | $15–$194.25 | varies |
| Thyroid stimulating hormone (TSH) (84443) range across 4 matching MRF lines |
$6.38–$114.19 | $8.50–$152.25 | varies |
| CBC with automated differential (85025) range across 5 matching MRF lines |
$6.38–$86.63 | $8.50–$115.50 | varies |
| CBC, automated (85027) range across 3 matching MRF lines |
$14.25–$70.88 | $19–$94.50 | varies |
| Prothrombin time (PT) (85610) range across 5 matching MRF lines |
$13.88–$113.25 | $18.50–$151 | varies |
| Partial thromboplastin time (PTT) (85730) range across 2 matching MRF lines |
$149.63–$175.50 | $199.50–$234 | varies |
| Sleep study (attended polysomnography) (95810) range across 2 matching MRF lines |
$854.25–$2,949.19 | $1,139–$3,932.25 | varies |
| Physical therapy, therapeutic exercise (per 15 min) (97110) range across 6 matching MRF lines |
$102.38–$173.25 | $136.50–$231 | 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: 219 codes with posted prices and Medicare benchmarks
- Lab & pathology: 599 codes with posted prices and Medicare benchmarks
- Visits & medical services: 107 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 279 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 9 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (CSV, 82.3 MB) ↓ — captured 2026-08-15
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.