Tomah Memorial Hospital
Tomah, WI · Critical Access Hospital
Posts prices for 46 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-08.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Breast lesion removal (open) (19120) range across 2 matching MRF lines |
$630.06–$892.69 | $1,095.75–$1,552.50 | varies |
| Shoulder arthroscopy with decompression (29826) | $3,468.69 | $6,032.50 | — |
| Knee arthroscopy with meniscectomy (29881) | $3,259.82 | $5,669.25 | 1.0× |
| Upper GI endoscopy (EGD), diagnostic (43235) | $303.31 | $527.50 | 0.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) | $364.41 | $633.75 | 0.4× |
| Diagnostic colonoscopy (45378) | $468.48 | $814.75 | 0.5× |
| Colonoscopy with biopsy (45380) | $1,020.63 | $1,775 | 0.9× |
| Colonoscopy with lesion removal (45385) | $506.86 | $881.50 | 0.4× |
| Laparoscopic gallbladder removal (47562) likely a partial charge, not the full procedure |
$1,477.03 | $2,568.75 | 0.3× |
| Inguinal hernia repair (age 5+) (49505) | $1,000.64 | $1,740.25 | 0.3× |
| Obstetric care, cesarean delivery (global) (59510) | $3,852.36 | $6,699.75 | — |
| Epidural injection, lumbar/sacral (with imaging) (62322) range across 2 matching MRF lines |
$952.49–$1,270.18 | $1,656.50–$2,209 | varies |
| Transforaminal epidural injection, lumbar/sacral (64483) range across 2 matching MRF lines |
$637.39–$925.75 | $1,108.50–$1,610 | varies |
| Cataract removal with lens insertion (66984) | $1,686.91 | $2,933.75 | 0.8× |
| CT head/brain without contrast (70450) range across 2 matching MRF lines |
$454.54–$1,144.39 | $790.50–$1,990.25 | varies |
| MRI brain without contrast (70551) range across 2 matching MRF lines |
$804.28–$2,131.24 | $1,398.75–$3,706.50 | varies |
| MRI brain with contrast (70552) range across 2 matching MRF lines |
$883.34–$2,349.16 | $1,536.25–$4,085.50 | varies |
| MRI brain without and with contrast (70553) range across 2 matching MRF lines |
$977.64–$3,233.80 | $1,700.25–$5,624 | varies |
| X-ray lower spine, 4+ views (72110) range across 2 matching MRF lines |
$187.59–$269.82 | $326.25–$469.25 | varies |
| MRI lumbar spine without contrast (72148) range across 2 matching MRF lines |
$766.33–$2,076.76 | $1,332.75–$3,611.75 | varies |
| CT pelvis with contrast (72193) range across 2 matching MRF lines |
$590.81–$1,545.03 | $1,027.50–$2,687 | varies |
| MRI lower-extremity joint without contrast (73721) range across 2 matching MRF lines |
$840.51–$2,443.75 | $1,461.75–$4,250 | varies |
| CT abdomen and pelvis with contrast (74177) range across 2 matching MRF lines |
$431.54–$2,905.04 | $750.50–$5,052.25 | varies |
| Ultrasound, abdomen complete (76700) range across 2 matching MRF lines |
$385.97–$626.32 | $671.25–$1,089.25 | varies |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) range across 2 matching MRF lines |
$268.24–$638.11 | $466.50–$1,109.75 | varies |
| Ultrasound, transvaginal (76830) range across 2 matching MRF lines |
$121.90–$382.81 | $212–$665.75 | varies |
| Basic metabolic panel (80048) | $153.38 | $266.75 | 18.1× |
| Comprehensive metabolic panel (80053) | $196.36 | $341.50 | 18.6× |
| Obstetric panel (80055) | $188.31 | $327.50 | 3.9× |
| Lipid panel (80061) | $130.96 | $227.75 | 9.8× |
| Renal function panel (80069) | $171.93 | $299 | 19.8× |
| Hepatic function panel (80076) | $153.96 | $267.75 | 18.8× |
| Urinalysis, non-automated, with microscopy (81000) | $15.53 | $27 | 3.9× |
| PSA, total (84153) | $104.94 | $182.50 | 5.7× |
| Thyroid stimulating hormone (TSH) (84443) | $69.14 | $120.25 | 4.1× |
| CBC with automated differential (85025) | $112.84 | $196.25 | 14.5× |
| CBC, automated (85027) | $90.71 | $157.75 | 14.0× |
| Prothrombin time (PT) (85610) | $70.29 | $122.25 | 16.4× |
| Partial thromboplastin time (PTT) (85730) | $92.14 | $160.25 | 15.3× |
| Sleep study (attended polysomnography) (95810) range across 2 matching MRF lines |
$435.99–$1,458.78 | $758.25–$2,537 | varies |
| Physical therapy, therapeutic exercise (per 15 min) (97110) range across 2 matching MRF lines |
$80.64–$84.53 | $140.25–$147 | varies |
| Office visit, new patient (low complexity, ~30 min) (99203) range across 3 matching MRF lines |
$81.94–$517.21 | $142.50–$899.50 | varies |
| Office visit, new patient (moderate complexity, ~45 min) (99204) range across 3 matching MRF lines |
$89.41–$736.72 | $155.50–$1,281.25 | varies |
| Office visit, new patient (high complexity, ~60 min) (99205) range across 2 matching MRF lines |
$97.18–$253.43 | $169–$440.75 | varies |
| Office consultation (low complexity, ~30 min) (99243) | $224.39 | $390.25 | 1.7× |
| Office consultation (moderate complexity, ~40 min) (99244) | $241.93 | $420.75 | 1.9× |
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: 228 codes with posted prices and Medicare benchmarks
- Lab & pathology: 599 codes with posted prices and Medicare benchmarks
- Visits & medical services: 149 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 887 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 11 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (CSV, 30.9 MB) ↓ — captured 2026-09-08
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.