Memorial Hospital of South Bend
Memorial Hospital of South Bend in South Bend, IN publishes cash prices for 38 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Click a procedure to compare it with other hospitals nearby.
615 N MICHIGAN ST, SOUTH BEND, IN 46601 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ROM Abdomen and Pelvis W-Contr | $3,235.70 | $4,978.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography W-Contrast | $3,235.70 | $4,978.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis W-Contrast | $3,235.70 | $4,978.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis W-Contrast | $3,235.70 | $4,978.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ROM Abdomen and Pelvis W-Contr | $3,235.70 | $4,978.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography W-Contrast | $3,235.70 | $4,978.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT ROM Brain W-O Contrast | $892.45 | $1,373.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 IR 70450 CT Head | $892.45 | $1,373.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain W-O Contrast | $892.45 | $1,373.00 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT ROM Brain W-O Contrast | $892.45 | $1,373.00 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 IR 70450 CT Head | $892.45 | $1,373.00 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain W-O Contrast | $892.45 | $1,373.00 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT ROM Pelvis W-O Contrast | $1,764.10 | $2,714.00 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W-Contrast | $1,764.10 | $2,714.00 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W-Contrast | $1,764.10 | $2,714.00 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT ROM Pelvis W-O Contrast | $1,764.10 | $2,714.00 | 35% |
| Diagnostic mammogram, both breasts CPT 77066 MA Digital Diagnostic Mammo | $473.85 | $729.00 | 35% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MA Digital Diagnostic Mammo | $473.85 | $729.00 | 35% |
| MRI of the brain, no contrast dye CPT 70551 MR Brain W-O Contrast | $1,320.80 | $2,032.00 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR Brain W-O Contrast | $1,320.80 | $2,032.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Brain W W-O Contrast | $1,651.65 | $2,541.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Brain Perfusion W W/O Contrast | $1,651.65 | $2,541.00 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Brain Perfusion W W/O Contrast | $1,651.65 | $2,541.00 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Brain W W-O Contrast | $1,651.65 | $2,541.00 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 MR Lumbar Spine W-O Contrast | $1,320.80 | $2,032.00 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR Lumbar Spine W-O Contrast | $1,320.80 | $2,032.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Wks | $401.05 | $617.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Wks | $401.05 | $617.00 | 35% |
| Screening mammogram, both breasts CPT 77067 MA Digital Screening Mammo | $322.40 | $496.00 | 35% |
| Screening mammogram, both breasts inpatient CPT 77067 MA Digital Screening Mammo | $322.40 | $496.00 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 DIAGNOSTIC SLEEP STUDY | $2,987.40 | $4,596.00 | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 DIAGNOSTIC SLEEP STUDY | $2,987.40 | $4,596.00 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB | $406.90 | $626.00 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB | $406.90 | $626.00 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 VL Abdomen Complete | $666.90 | $1,026.00 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $666.90 | $1,026.00 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $666.90 | $1,026.00 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 VL Abdomen Complete | $666.90 | $1,026.00 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 DX Spine Lumbar 4 Views | $337.35 | $519.00 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 DX EOS Lumbar Spine AP/Lat/Flx/Ext 72110 | $337.35 | $519.00 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 DX EOS Lumbar Spine AP/Lat/Flx/Ext 72110 | $337.35 | $519.00 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 DX Spine Lumbar 4 Views | $337.35 | $519.00 | 35% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BMP Basic Metabolic Panel | $79.30 | $122.00 | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BMP Basic Metabolic Panel | $79.30 | $122.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 LIPID PANEL | $192.40 | $296.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $192.40 | $296.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 LIPID PANEL | $192.40 | $296.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $192.40 | $296.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 CBC wDiff | $64.35 | $99.00 | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC wDiff | $64.35 | $99.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 CBC | $91.65 | $141.00 | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC | $91.65 | $141.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 Metabolic PanelComprehensive | $67.60 | $104.00 | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Metabolic PanelComprehensive | $67.60 | $104.00 | 35% |
| Kidney function blood test panel CPT 80069 Renal | $128.70 | $198.00 | 35% |
| Kidney function blood test panel inpatient CPT 80069 Renal | $128.70 | $198.00 | 35% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $86.45 | $133.00 | 35% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $86.45 | $133.00 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 ASSAY OF PSA FREE | $251.55 | $387.00 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 ASSAY OF PSA FREE | $251.55 | $387.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Prostate Specific Antigen Total Screening | $230.75 | $355.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Prostate Specific Antigen Total Diagnostic | $230.75 | $355.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate-specific Antigen (PSA), Free:Total Ratio Reflex | $230.75 | $355.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Prostate Specific Antigen Total Screening | $230.75 | $355.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Prostate Specific Antigen Total Diagnostic | $230.75 | $355.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate-specific Antigen (PSA), Free:Total Ratio Reflex | $230.75 | $355.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $74.10 | $114.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 THROMBOPLASTIN TIME PARTIAL | $74.10 | $114.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT with Mixing Studies if Indicated | $74.10 | $114.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 THROMBOPLASTIN TIME PARTIAL | $74.10 | $114.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $74.10 | $114.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT with Mixing Studies if Indicated | $74.10 | $114.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $50.05 | $77.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT Prothrombin Time with Mixing Studies if Indicated | $50.05 | $77.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 Prothrombin Time POC PT | $50.05 | $77.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 PROTHROMBIN TIME | $50.05 | $77.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT | $50.05 | $77.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 Prothrombin Time POC PT | $50.05 | $77.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 PROTHROMBIN TIME | $50.05 | $77.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT Prothrombin Time with Mixing Studies if Indicated | $50.05 | $77.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone Sensitive | $230.75 | $355.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (Thyroid Stimulating Hormone) Sensitive w/Rflx to Free T4 | $230.75 | $355.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (Thyroid Stimulating Hormone) Sensitive w/Rflx to Free T4 | $230.75 | $355.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone Sensitive | $230.75 | $355.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 UA Urinalysis Complete | $33.80 | $52.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 UA Scrn w/Micro + Cult if Ind | $33.80 | $52.00 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA Urinalysis Complete | $33.80 | $52.00 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA Scrn w/Micro + Cult if Ind | $33.80 | $52.00 | 35% |
| Urinalysis with microscope exam, manual CPT 81000 Done | $7.15 | $11.00 | 35% |
| Urinalysis with microscope exam, manual CPT 81000 N-Autom Urine Dip W Micro | $7.15 | $11.00 | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 N-Autom Urine Dip W Micro | $7.15 | $11.00 | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Done | $7.15 | $11.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 UA Urinalysis Macroscopic Only | $30.55 | $47.00 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA Urinalysis Macroscopic Only | $30.55 | $47.00 | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Left heart catheterization, diagnostic one side CPT 93452 Left Heart Cath w/o Coronaries | $7,794.80 | $11,992.00 | 35% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 Left Heart Cath w/o Coronaries | $7,794.80 | $11,992.00 | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR 62323 INJ L Spine Imag | $1,362.40 | $2,096.00 | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR 62323 INJ L Spine Imag | $1,362.40 | $2,096.00 | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 IR 62322 INJ L Spine No Imaging | $1,362.40 | $2,096.00 | 35% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 IR 62322 INJ L Spine No Imaging | $1,362.40 | $2,096.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 IR 64483 Nerve Root Inj Lumbar | $1,791.40 | $2,756.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT Inj Anes Ster-Lumbar | $1,791.40 | $2,756.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 IR 64483 Nerve Root Inj Lumbar | $1,791.40 | $2,756.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CT Inj Anes Ster-Lumbar | $1,791.40 | $2,756.00 | 35% |
| Prostate biopsy CPT 55700 IR 55700 Biopsy Prostate | $2,470.00 | $3,800.00 | 35% |
| Prostate biopsy inpatient CPT 55700 IR 55700 Biopsy Prostate | $2,470.00 | $3,800.00 | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHGASTRODSCPY DIAG BRUSH WASH | $871.00 | $1,340.00 | 35% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHGASTRODSCPY DIAG BRUSH WASH | $871.00 | $1,340.00 | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 E&M New Pt Level 3 (FAC) | $68.90 | $106.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 O/P Visit - Brief (New) | $82.55 | $127.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 Wound Clinic Level 3-New | $198.90 | $306.00 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 E&M New Pt Level 3 (FAC) | $68.90 | $106.00 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 O/P Visit - Brief (New) | $82.55 | $127.00 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Wound Clinic Level 3-New | $198.90 | $306.00 | 35% |
| New patient office visit, about 45 minutes CPT 99204 E&M New Pt Level 4 (FAC) | $115.05 | $177.00 | 35% |
| New patient office visit, about 45 minutes CPT 99204 WOUND CLINIC LEVEL 4 - NEW | $300.95 | $463.00 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 E&M New Pt Level 4 (FAC) | $115.05 | $177.00 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WOUND CLINIC LEVEL 4 - NEW | $300.95 | $463.00 | 35% |
| New patient office visit, about 60 minutes CPT 99205 E&M New Pt Level 5 (FAC) | $214.50 | $330.00 | 35% |
| New patient office visit, about 60 minutes CPT 99205 WOUND CLINIC LEVEL 5 - NEW | $387.40 | $596.00 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 E&M New Pt Level 5 (FAC) | $214.50 | $330.00 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WOUND CLINIC LEVEL 5 - NEW | $387.40 | $596.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL PSYCHOTHERAPY (MCARE) | $313.30 | $482.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL PSYCHOTHERAPY (MCAID) | $313.30 | $482.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL PSYCHOTHERAPY | $313.30 | $482.00 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL PSYCHOTHERAPY (MCAID) | $313.30 | $482.00 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL PSYCHOTHERAPY (MCARE) | $313.30 | $482.00 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL PSYCHOTHERAPY | $313.30 | $482.00 | 35% |