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Saint Alphonsus Medical Center Ontario

Ontario, OR · 49 beds · 66 procedures priced

Sourced from this hospital's machine-readable file, posted Fri Jun 05 2026 00:00:00 GMT+0000 (Coordinated Universal Time) · data quality 100/100 · source file ↗

Category

Procedure ▲	Negotiated i	Cash i	Gross i
ACL Reconstruction (Arthroscopic)	$210$26$2.1k	$530	$1,249
Basic Metabolic Panel	$21$6$68	$46	$70
Breast Biopsy (Ultrasound-guided)	$1,373$654$9.1k	$3,125	$4,807
Carpal Tunnel Release Surgery	$359$122$1.2k	$1,840	$1,840
Chemotherapy Infusion (First Hour)	$314$178$1.3k	$680	$1,046
Chest X-ray (2 Views)	$89$26$287	$192	$296
Colonoscopy with Biopsy	$233$57$693	$803	$804
Complete Abdominal Ultrasound	$189$89$610	$409	$629
Complete Blood Count (CBC) with Differential	$18$5$58	$39	$60
Comprehensive Metabolic Panel	$21$7$67	$45	$69
Critical Care, First Hour	$2,680$919$9.6k	$5,806	$8,933
CT Abdomen and Pelvis with Contrast	$1,298$236$4.2k	$2,813	$4,328
CT Cardiac Calcium Scoring	$24$21$282	$51	$79
CT Chest without Contrast	$524$105$1.7k	$1,134	$1,745
CT Head without Contrast	$501$52$1.6k	$1,085	$1,669
DEXA Bone Density Scan	$128$23$414	$278	$427
Diagnostic Colonoscopy	$187$53$571	$655	$739
Diagnostic Mammogram (Both Breasts)	$161$108$520	$348	$536
Ear Tube Placement (Tympanostomy)	$127$46$579	$1,056	$1,158
Echocardiogram (Complete with Doppler)	$839$475$2.7k	$1,817	$2,796
EKG (Electrocardiogram, 12-lead)	$24$9$51	$70	$32
Emergency Room Visit (Level 3)	$386$219$1.2k	$837	$1,288
Hemoglobin A1c (Diabetes Test)	$22$7$71	$41	$63
HIV Antibody Test	$32$6$103	$69	$106
Home Sleep Study	$233$132$753	$504	$776
Inguinal Hernia Repair (Open)	$136$14$1.5k	$477	$764
Initial Hospital Admission (Level 1)	$71$48$228	$220	$228
Initial Psychiatric Diagnostic Evaluation	$80$72$597	$172	$265
Initial Psychiatric Evaluation with Medication Management	$87$49$597	$189	$291
IUD Removal	$91$11$225	$239	$347
Knee Arthroscopy with Meniscectomy	$368$15$1.9k	$1,334	$1,220
Laparoscopic Appendectomy	$212$16$1.2k	$319	$1,324
Laparoscopic Gallbladder Removal	$252$18$1.5k	$351	$1,451
Lipid Panel (Cholesterol Test)	$22$9$168	$48	$74
Lumbar Puncture (Spinal Tap)	$466$264$2.2k	$1,009	$1,552
Lumpectomy (Partial Mastectomy)	$257$18$1.8k	$520	$1,451
MRI Abdomen with and without Contrast	$1,117$265$3.6k	$2,420	$3,723
MRI Brain with and without Contrast	$1,157$250$3.7k	$2,508	$3,858
MRI Brain with Contrast	$946$212$3.1k	$2,049	$3,152
MRI Brain without Contrast	$736$154$2.4k	$1,594	$2,452
MRI Cervical Spine (Neck) without Contrast	$735$150$2.4k	$1,593	$2,451
MRI Knee without Contrast	$1,034$159$3.3k	$1,867	$2,873
MRI Lower Back (Lumbar Spine) without Contrast	$708$150$2.3k	$1,535	$2,361
MRI Thoracic Spine (Mid-back) without Contrast	$708$150$2.3k	$1,535	$2,361
Nuclear Cardiac Stress Test	$1,668$323$5.4k	$3,613	$5,559
Office Visit, Established Patient (Level 3)	$48$37$143	$146	$146
Office Visit, New Patient (Level 3)	$66$46$178	$181	$181
Pregnancy Ultrasound (Second or Third Trimester)	$148$104$477	$320	$492
PSA Prostate Cancer Screening	$28$13$89	$53	$82
Pulmonary Function Test with Bronchodilator	$264$150$1.2k	$572	$880
Rotator Cuff Repair (Arthroscopic)	$180$14$2.3k	$625	$653
Screening Mammogram	$100$85$323	$211	$325
Septoplasty (Deviated Septum Repair)	$533$196$1.2k	$2,027	$2,269
Skin Biopsy (Tangential)	$76$43$1.3k	$164	$253
Sleep Study (In-lab Polysomnography)	$1,398$792$4.5k	$3,029	$4,660
Spinal Cord Stimulator Trial	$1,534$869$20k	$3,323	$5,112
Spirometry (Breathing Test)	$193$109$679	$419	$644
Tonsillectomy and Adenoidectomy (Age 12 and Over)	$243$87$624	$1,080	$1,215
Tonsillectomy and Adenoidectomy (Under Age 12)	$233$83$598	$1,007	$1,163
Total Hip Replacement	$499$34$4.4k	$977	$2,825
Total Knee Replacement	$332$34$4.8k	$1,628	$903
Total Mastectomy	$372$26$2.8k	$865	$1,389
TSH Thyroid Function Test	$35$12$113	$69	$107
Upper GI Endoscopy (EGD)	$95$3$401	$377	$491
Urinalysis with Microscopy	$8$2$24	$16	$25
Vitamin D Blood Test	$46$21$148	$92	$141

Median facility price per procedure. Negotiated shows the median across payers with the full range. Figures as reported in the hospital's file — not a quote.