Home › Hospitals › St. Luke Hospital & Living Center Posts prices for 41 of the 66 common shoppable procedures we track. Price file retrieved 2026-07-29.
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Procedure Cash price Gross charge × Medicare
Epidural injection, lumbar/sacral (with imaging) (62322) —
$797
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Transforaminal epidural injection, lumbar/sacral (64483) —
$1,545
—
After-cataract laser surgery (YAG capsulotomy) (66821) —
$1,379
—
CT head/brain without contrast (70450) —
$1,746
—
MRI brain without contrast (70551) —
$2,799
—
MRI brain with contrast (70552) —
$3,234
—
MRI brain without and with contrast (70553) —
$3,499
—
X-ray lower spine, 4+ views (72110) —
$590
—
MRI lumbar spine without contrast (72148) —
$2,746
—
CT pelvis with contrast (72193) —
$2,019
—
MRI lower-extremity joint without contrast (73721) —
$2,547
—
CT abdomen and pelvis with contrast (74177) —
$2,650
—
Ultrasound, abdomen complete (76700) —
$656
—
Ultrasound, pregnant uterus (≥14 weeks) (76805) —
$542.50
—
Ultrasound, transvaginal (76830) —
$530
—
Mammography, one breast (diagnostic) (77065) —
$223
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Mammography, both breasts (diagnostic) (77066) —
$235
—
Mammography, screening (bilateral) (77067) —
$215
—
Basic metabolic panel (80048) —
$83
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Comprehensive metabolic panel (80053) —
$144
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Lipid panel (80061) —
$103
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Renal function panel (80069) —
$112
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Hepatic function panel (80076) —
$134
—
Urinalysis, non-automated, without microscopy (81002) —
$23
—
PSA, total (84153) —
$174
—
Thyroid stimulating hormone (TSH) (84443) —
$154
—
CBC with automated differential (85025) —
$94
—
CBC, automated (85027) —
$68
—
Prothrombin time (PT) (85610) —
$49
—
Partial thromboplastin time (PTT) (85730) —
$78
—
Psychotherapy, 30 minutes (90832) —
$475
—
Psychotherapy, 45 minutes (90834) —
$525
—
Psychotherapy, 60 minutes (90837) —
$550
—
Family psychotherapy, without patient (50 min) (90846) —
$386
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Family psychotherapy, with patient (50 min) (90847) —
$560
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Group psychotherapy (90853) —
$425
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Sleep study (attended polysomnography) (95810) —
$2,440
—
Physical therapy, therapeutic exercise (per 15 min) (97110) —
$84
—
Office visit, new patient (low complexity, ~30 min) (99203) —
$54
—
Office visit, new patient (moderate complexity, ~45 min) (99204) —
$54
—
Office visit, new patient (high complexity, ~60 min) (99205) —
$54
—
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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