F. F. Thompson Hospital Hospital Charges (Price Line Common Requested)
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1 F. F. Thompson Hospital Hospital s (Price Line Common Requested) Contact the Price Line for Verification and Tests/Procedures Not Listed (585) Lab Tests Venipuncture $8.00 Lipid Panel $60.00 BMP (Basic Metabolic Panel) $34.00 CMP (Comprehensive Metabolic Panel $46.00 TSH $73.00 T4 $31.00 T4 Free $40.00 T3 Total $64.00 T3 Free $75.00 Iron $29.00 Iron Binding (TIBC) $39.00 Ferritin $62.00 CBC $29.00 CBC w/ Diff $34.00 Hemoglobin A1C $43.00 Blood Typing $84.00 Semen Analysis $51.00 Urine Culture (Negative) $35.00 Urine Culture (Positive) $ MMR Titer $ Vitamin D $61.00 Vitamin B12 $66.00 Pap Smear $81.00-$97.00 Stool Culture $ Strep (Throat Culture) $30.00 Rapid Strep $51.00 PSA Screening $81.00 Protime (INR) $18.00 PPD $22.00 ESR Sed Rate $10.00 HPV $ Pregnancy Tests: Quantitative (Blood) $67.00 Qualitative $33.00 Urine $28.00
2 Diagnostic Imaging All diagnostic imaging services will receive a separate bill from URMC Radiology for Professional Reading of the image Mammo Digital Screening (Bilateral) $493 Mammo Digital Screening (Bilateral) with 3D Tomo $575 Mammo Digital Diagnostic (Bilateral) $563 Mammo Digital Diagnostic (Bilateral) with 3D Tomo $645 Mammo Digital (Unilateral) $461 Mammo Digital (Unilateral) with 3D Tomo $543 Dexascan $362 Chest Xray $264 Abdominal Xray $264 Hysterosalpinography (HSG) $914 Hysterosalpinography (Total Procedure) $1,517-$1562 Ultrasound, Breast Limited (Unilateral) $289 Ultrasound, Breast Limited (Bilateral) $337 Ultrasound, Breast Complete (Unilateral) $289 Ultrasound, Breast Complete (Bilateral) $337 Ultrasound, Pelvic Complete $499 Ultrasound, Pelvic Complete with Transvaginal $998 CT Scan, Head/Brain without Dye $935 CT Scan, Head/Brain with Dye $1368-$1385 CT Scan, Abdomen and Pelvis without Dye $1,424 CT Scan, Abdomen and Pelvis with Dye $ $2094 MRI Scan, Any (Unilateral) without Contrast $1,934 MRI Scan, Any (Bilateral) without Contrast $2,514 MRI Scan, Any (Unilateral) with Contrast $ $2558 MRI Scan, Any (Bilateral) with Contrast $ $3275 MRI Scan, Any (Unilateral) with and without Contrast $ $3163 MRI Scan, Any (Bilateral) with and without Contrast $ $4070 Cardiology For charges not including Professional - Professional billed by Finger Lakes Cardiology EKG (includes Professional ) $206 Stress Test (does NOT include Professional ) $719 Stress Echo (does NOT include Professional ) $ $2506 Cardiac Rehab $175 Sleep Clinic
3 Sleep Study - Normal (includes Professional ) $3,727 Sleep Study - CPAP (includes Professional ) $3,776 Home Sleep Test $1,423 Sleep Consult - Level 3 $426 Sleep Consult - Level 4 $596 Sleep Follow-up Visit $271 Ambulatory Procedures All ambulatory procedures will receive a separate bill from the physician providing the service - contact your physician for pricing. Separate charges for anesthesia also may apply - contact the anesthesia group Cataract $ $3790 Colonoscopy (Screening) $ $2300 Colonoscopy (Diagnostic) $ $3700 Note: Colonoscopies can range from $ $3700 or higher depending on what the procedure finds during the scope (ex: polyps and biopsy) EGD $ $2654 Inguinal Hernia $ $9879 Inguinal Hernia Laparoscopic $ $13100 Carpal Tunnel $ $2757 Gallbladder (Lap Chole) $ $12943 PPV Vitrectomy (Eye Surgery) $ $11900 Tonsils and Adenoids $ $5733 Myringotomy (Ear Tubes) $ $2120 Blepharoplasty (Eyelid Surgery) $ $7425 Septoplasty $ $5748 Knee Arthroscopy $ $7200 ACL Repair $ $26883 Image Guided FESS $ $21500 F. F. Thompson Family/Specialty Practices - Office Visits Office Visit - New Patient - Level 1 $72.00 Office Visit - New Patient - Level 2 $ Office Visit - New Patient - Level 3 $ Office Visit - New Patient - Level 4 $ Office Visit - New Patient - Level 5 $ Office Visit - Established Patient - Level 1 $33.00 Office Visit - Established Patient - Level 2 $72.00
4 Office Visit - Established Patient - Level 3 $ Office Visit - Established Patient - Level 4 $ Office Visit - Established Patient - Level 5 $ Preventive Visit - New Patient - Under 1 YR $ Preventive Visit - New Patient YRS $ Preventive Visit - New Patient YRS $ Preventive Visit - New Patient YRS $ Preventive Visit - New Patient YRS $ Preventive Visit - New Patient YRS $ Preventive Visit - New Patient - 65 YRS and Over $ Preventive Visit - Established Patient - Under 1 YR $ Preventive Visit - Established Patient YRS $ Preventive Visit - Established Patient YRS $ Preventive Visit - Established Patient YRS $ Preventive Visit - Established Patient YRS $ Preventive Visit - Established Patient YRS $ Preventive Visit - Established Patient - 65 YRS and Over $ Facility Office Outpatient Visit $ Case Management - Rheumatology $35.00 Hospitalist - Hospital Visits Hospitalist Inpatient Care Visits Inpatient - Initial Care - Low $ Inpatient - Initial Care - Moderate $ Inpatient - Initial Care - High $ Inpatient - Subsequent Care - Low $66.00 Inpatient - Subsequent Care - Moderate $ Inpatient - Subsequent Care - High $ Inpatient - Admit/Discharge Same Day - Low $ Inpatient - Admit/Discharge Same Day - Moderate $ Inpatient - Admit/Discharge Same Day - High $ Inpatient - Discharge - Low $ Inpatient - Discharge - Moderate $ Hospitalist Observation Care Visits
5 Observation - Initial Care - Low $ Observation - Initial Care - Moderate $ Observation - Initial Care - High $ Observation - Subsequent Care - Low $66.00 Observation - Subsequent Care - Moderate $ Observation - Subsequent Care - High $ Observation - Admit/Discharge Same Day - Low $ Observation - Admit/Discharge Same Day - Moderate $ Observation - Admit/Discharge Same Day - High $ Observation - Discharge $122.00
Contact the Price Line for Verification and Tests/Procedures Not Listed (585)
F. F. Thompson Hospital Hospital s (Price Line Common Requested) Contact the Price Line for Verification and Tests/Procedures Not Listed (585)396-6194 Lab Tests Venipuncture $8.00 Lipid Panel $55.00 BMP
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