Home › Hospitals › Scottish Rite Hospital Posts prices for 32 of the 66 common shoppable procedures we track. Price file retrieved 2026-08-23.
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Procedure Cash price Gross charge × Medicare
Upper GI endoscopy (EGD), diagnostic (43235) $5,665
$5,665
6.2×
Upper GI endoscopy (EGD) with biopsy (43239) $5,632
$5,632
6.2×
Transforaminal epidural injection, lumbar/sacral (64483) $1,682
$1,682
1.9×
CT head/brain without contrast (70450) $2,512
$2,512
24.0×
MRI brain without contrast (70551) $3,782
$3,782
15.8×
MRI brain with contrast (70552) $5,599
$5,599
16.0×
MRI brain without and with contrast (70553) $6,374
$6,374
18.2×
X-ray lower spine, 4+ views (72110) $799
$799
7.6×
MRI lumbar spine without contrast (72148) $3,658
$3,658
15.3×
CT pelvis with contrast (72193) $6,654
$6,654
37.8×
MRI lower-extremity joint without contrast (73721) $6,181
$6,181
25.8×
CT abdomen and pelvis with contrast (74177) $8,435
$8,435
24.1×
Ultrasound, abdomen complete (76700) $1,732.50
$1,732.50
16.5×
Ultrasound, transvaginal (76830) $1,265
$1,265
12.1×
Basic metabolic panel (80048) $384
$384
45.4×
Comprehensive metabolic panel (80053) $574
$574
54.4×
Lipid panel (80061) $457
$457
34.1×
Renal function panel (80069) $392
$392
45.2×
Hepatic function panel (80076) $457
$457
55.9×
Urinalysis, non-automated, without microscopy (81002) $94
$94
27.0×
Thyroid stimulating hormone (TSH) (84443) $495
$495
29.5×
CBC with automated differential (85025) $345
$345
44.4×
CBC, automated (85027) $345
$345
53.3×
Prothrombin time (PT) (85610) $197
$197
45.9×
Partial thromboplastin time (PTT) (85730) $223
$223
37.1×
Sleep study (attended polysomnography) (95810) $5,321
$5,321
6.2×
Physical therapy, therapeutic exercise (per 15 min) (97110) $160
$160
5.5×
Office visit, new patient (low complexity, ~30 min) (99203) $491.50
$491.50
3.7×
Office visit, new patient (moderate complexity, ~45 min) (99204) $697
$697
5.2×
Office visit, new patient (high complexity, ~60 min) (99205) $1,043
$1,043
7.8×
Office consultation (low complexity, ~30 min) (99243) $558
$558
4.2×
Office consultation (moderate complexity, ~40 min) (99244) $768
$768
5.8×
Children's hospital — Medicare is an adult program, so the Medicare benchmarks on this page are a general yardstick, not rates this hospital typically bills.
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