Medical Procedure Cost Statistics (2026)

The price of a procedure depends on who is paying. An outpatient lower back MRI averaged $861 on large employer plans in 2018, counting the insurer's payment and the patient's share together. Medicare pays a hospital $243.77 for the same scan in 2026, plus a separate fee to the radiologist.

The same procedure can carry four different prices, and nearly every published cost figure is one of them. A charge is the provider's list price. An allowed amount is what an insurer has negotiated, split between the plan and the patient. A Medicare rate is what the federal program pays. Out-of-pocket is the patient's share of the allowed amount.

This page labels every figure as one of those four. Where a primary source gives a commercial price, it is shown. Where only the Medicare rate is published, the page gives that, because it is the lowest price the procedure is routinely paid at and the benchmark private prices are measured against.

FAIR Health's air ambulance data puts the four side by side. In 2020 the average helicopter transport was billed at $30,446, had an in-network negotiated price of $18,668, and was paid $3,739 by Medicare. A fixed-wing transport was billed at $24,507, negotiated at $15,624 and paid $3,216 by Medicare.

Prices also differ within one hospital. At University of New Mexico Hospitals, the negotiated price of a lumbar MRI ranged from $486 to $1,821 across private insurers, $221 to $331 for Medicare Advantage plans and $350 to $485 for Medicaid managed care, according to the hospital's own price transparency files.

What a patient owes depends on which of those prices applies and on their plan: whether the deductible has been met, whether the provider is in network, and whether the service counts as preventive care.

An outpatient lower back MRI cost an average of $861 on large employer plans in 2018, up from $784 in 2008. That price includes the scan and the radiologist's interpretation, and it is the combined insurer and patient payment.

Medicare pays less. In 2026 a hospital outpatient department receives $356.43 for a brain MRI with and without contrast and $243.77 for a lumbar spine or knee MRI. The radiologist's reading of a brain MRI is paid separately at about $105.21. An imaging centre or office that does both receives about $316.97 for a brain MRI and $191.72 for a lumbar MRI.

A Medicare patient with the deductible met owes 20% of the approved amount: $71.29 of the hospital's payment for a brain MRI and $48.76 for a lumbar or knee MRI, plus 20% of the radiologist's fee.

The average lower back MRI on employer plans was $1,106 in the Houston area and $404 in the Las Vegas area, nearly three times as much for the same scan.

Joint replacement shows the same spread at a larger scale: $56,739 for a knee or hip replacement in the New York City area against $25,044 in Baltimore. Meniscus repair cost $11,219 in New York and $4,655 in Detroit.

The setting changes the price too. For a brain MRI, Medicare's 2026 payments to a hospital add up to $461.64, the $356.43 facility payment plus about $105.21 for the reading, against about $316.97 to an imaging centre or office for the whole service.

No primary source publishes a current national commercial price for a CT scan. Medicare's 2026 rates give the floor: a hospital outpatient department receives $356.43 for a CT of the abdomen and pelvis with contrast and $106.81 for a CT of the head.

In an office or imaging centre, Medicare's national amount for the whole service is about $300.27 for a contrast CT of the abdomen and pelvis, $183.04 without contrast and $106.55 for a head CT.

A PET/CT is the most expensive routine scan on the list: Medicare pays a hospital $1,460.92, of which the patient's minimum copayment is $292.19. Its physician fee is priced by each regional Medicare contractor, so there is no national figure.

Medicare pays about $33.07 for a two-view chest X-ray in an office, and a hospital $88.91 for the same X-ray, of which the patient's minimum copayment is $17.79.

An abdominal ultrasound is about $114.23 in an office and $106.81 to a hospital. An obstetric ultrasound is about $135.94 in an office.

A screening mammogram is about $126.26 and a diagnostic mammogram about $156.98. Screening mammograms are preventive services, which Medicare and most private plans cover without cost sharing; a diagnostic mammogram, done because of a symptom or an earlier finding, is subject to normal cost sharing.

For a screening colonoscopy, the patient's cost is usually nothing. The US Preventive Services Task Force recommends colorectal cancer screening from age 45, and preventive services with its A or B grade must be covered without cost sharing by most private plans. Medicare.gov says screening patients pay nothing, and the Part B deductible does not apply.

Behind that $0, Medicare pays a hospital outpatient department $950.10 for a colonoscopy in 2026 and the gastroenterologist about $164.67. If a biopsy is taken or a polyp removed, the hospital payment rises to $1,222.56 and the physician fee to between $177.69 and $223.45.

No primary source publishes a current national commercial price for a colonoscopy. A diagnostic colonoscopy, done because of symptoms, is not preventive care and goes through the deductible and coinsurance like any other procedure: under Medicare, the minimum copayment on the hospital's $950.10 is $190.02.

Removing a polyp during a screening used to turn it into a diagnostic procedure with cost sharing. For Medicare patients that charge is being phased out by law: Medicare pays 85% from 2023 through 2026 and 90% from 2027 through 2029, so the patient pays 15% now, 10% from 2027 and nothing from 2030.

For private plans, the Labor Department ruled that a follow-up colonoscopy after a positive stool-based test is part of screening and must be covered without cost sharing for plan years beginning on or after May 31, 2022.

Anesthesia, the pathology lab and the facility can bill separately from the gastroenterologist, and each needs to be in network for the screening to cost nothing.

Pregnancy, childbirth and postpartum care cost $20,416 on average for women in large employer plans, using claims from 2021 to 2023 in 2023 dollars. The insurer paid $17,674 and the patient $2,743.

A vaginal delivery averaged $15,712, with $2,563 out of pocket. A C-section averaged $28,998, 85% more, with $3,071 out of pocket. 32.3% of births in 2023 were by C-section. Newborn care added $5,820, of which families paid $475.

HCCI's 2023 report measured childbirth admission prices separately: $13,257 per childbirth admission in 2023, after prices grew 17%. Our cost of raising a child page covers what comes after.

For privately insured patients, the negotiated price of an emergency advanced life support ride averaged $1,461 in California and $836 in Illinois in 2022, and a basic life support ride $1,031 and $673. Mileage is charged on top, from $5.79 a mile in Florida to $28.35 in Utah.

The base fee alone has risen fast. Between 2017 and 2020 the negotiated price of an ALS base fee rose 56%, from $486 to $758, while the billed charge rose from $1,042 to $1,277. The BLS base fee rose from $373 to $522.

Medicare sets its ground rates from a 2026 conversion factor of $284.56, multiplied by 1.90 for emergency ALS and 1.60 for emergency BLS, plus $9.15 a mile. Before geographic adjustment that works out to about $541 for an emergency ALS ride and $455 for emergency BLS, plus mileage. Medicare spent $4.7 billion on ambulance services in 2024.

Ground ambulances are often out of network. In 2018, 51% of emergency ground ambulance rides and 39% of non-emergency rides for privately insured patients included an out-of-network charge, and Peterson-KFF estimates up to 1.5 million privately insured patients a year may receive a surprise ambulance bill.

FAIR Health found the out-of-network share of ground rides fell from 63.7% in 2018 to 59.4% in 2022. The federal advisory committee on ground ambulance billing reported that as many as 85% of emergency ground ambulance claims are out of network.

The No Surprises Act, in effect since January 1, 2022, does not cover ground ambulance services. The advisory committee recommended in 2024 that patient cost sharing be limited to the lesser of $100, adjusted for inflation, or 10% of the rate.

A helicopter air ambulance had a median charge of about $36,400 in 2017 and a fixed-wing air ambulance $40,600, according to GAO. 69% of air ambulance transports for privately insured patients were out of network.

FAIR Health's 2020 figures show how far those charges sit from what is paid: $30,446 billed for a helicopter transport against $18,668 negotiated and $3,739 from Medicare. Medicare's 2026 base rate is $4,489.71 for a helicopter and $3,861.62 for a fixed-wing aircraft, before mileage.

Unlike ground ambulances, air ambulances are covered by the No Surprises Act, so an insured patient taken by an out-of-network air ambulance can be billed only their in-network cost sharing.

A full knee or hip replacement as an inpatient cost $35,263 on average on large employer plans in 2018, up 38% ($9,662) from 2008. The metro range ran from $25,044 in Baltimore to $56,739 in New York.

Many joint replacements are now done as outpatient procedures. In 2026 Medicare pays a hospital outpatient department $13,116.76 for an outpatient knee or hip replacement, of which the patient's minimum copayment is $2,623.36, and the surgeon about $1,159 for a knee or $1,162 for a hip.

Outpatient meniscus repair, a common knee surgery, averaged $7,595 on employer plans.

Medicare pays a hospital outpatient department $2,357.81 for cataract surgery in 2026, with a minimum patient copayment of $471.57, and the surgeon about $462.60 per eye.

An upper endoscopy with biopsy is paid $926.63 to the hospital and about $123.58 to the physician.

A vasectomy done in a doctor's office is paid about $346.70 by Medicare, all-in. Done in a hospital outpatient department, the facility payment is $2,135.66. Commercial prices for these three procedures are not published by a primary source.

The average office visit on employer plans cost $105 in 2018, from $46 for the simplest level to $182 for the most complex; the most common level averaged $90. HCCI's 2023 figures put the average primary care visit at $142 and a specialist visit at $162.

Medicare pays about $95.19 for a typical established-patient office visit and $117.57 for a new patient. An EKG is about $15.36, a physical therapy evaluation about $97.86 and each 15-minute unit of therapeutic exercise about $29.06.

Blood work is cheap at Medicare rates: $7.77 for a complete blood count, $10.56 for a comprehensive metabolic panel, $13.39 for a lipid panel and $9.34 for the blood draw. The most expensive common test on the list, vitamin D, is $29.60.

Medicare rates are the closest thing the US has to a national price list, and they are public. They are set by formula: a relative value for each service multiplied by a dollar conversion factor, adjusted for local costs.

Medicare pays separately for the facility and the professional. A colonoscopy in a hospital outpatient department is two payments, $950.10 to the hospital and about $164.67 to the gastroenterologist. A colonoscopy done in the physician's own office is one payment of about $378.10, because the office supplies the room and equipment.

Private plans show the same pattern by setting. RAND found they paid hospitals 254% of Medicare rates in 2022 and ambulatory surgery centres 171%.

In 2022, employers and private insurers paid hospitals 254% of what Medicare would have paid for the same services, according to RAND's fifth round of its hospital price study. The figure was 254% in 2018 and 246% in 2020. Ambulatory surgery centres averaged 171% of Medicare.

Only Arkansas had prices below 170% of Medicare, and eight states were above 300%.

For doctors' services the gap is smaller. HCCI found commercial prices for professional services averaged 122% of Medicare rates nationally in 2017. In Atlanta, a typical office visit cost $93 commercially against $74 from Medicare.

Average commercial health care prices grew 17.7% from 2019 to 2023, according to the Health Care Cost Institute's analysis of employer-sponsored insurance claims. Spending per person reached $6,743 in 2023, of which $923 was paid out of pocket.

Ambulance prices grew 17% and childbirth admission prices 17% over the same period. Outpatient prices rose 12%.

Lower back MRI prices on employer plans rose about 10% over the decade to 2018, from $784 to $861, slower than joint replacement, which rose 38%.

Since January 1, 2021, hospitals have had to publish their prices. They must post a machine-readable file of all negotiated rates and a consumer-friendly list of at least 300 shoppable services, 70 of them specified by CMS. CMS began enforcing updated requirements on April 1, 2026. A hospital that does not comply faces a daily penalty from $300 to $5,500 depending on size.

The No Surprises Act protects insured patients from surprise bills for emergency room visits and air ambulance services, and for out-of-network clinicians at in-network facilities. It does not cover ground ambulances.

Uninsured and self-pay patients are entitled to a good faith estimate before scheduled care. If the bill comes in at least $400 above the estimate, they can dispute it through a federal process within 120 days of the bill, for a $25 fee.

Emergency care has its own page. Our emergency room cost statistics page covers AHRQ's figure of $750 to deliver an average treat-and-release ER visit, and why it is not a patient's bill. Inpatient stays are covered on our hospital cost page.

For what people pay after the procedure, see our medical debt statistics; for insurance itself, health insurance statistics; and for Medicare's premiums and cost sharing, Medicare cost statistics. Drug prices are on our prescription drug cost page.

These figures describe prices. They are not medical or financial advice, and the right procedure and setting are clinical decisions.

Medicare hospital outpatient payments are quoted from CMS's October 2026 OPPS Addendum B, and lab rates from the 2026 fourth-quarter clinical laboratory fee schedule. Medicare physician fees are calculated from CMS's 2026 relative value units at the published $33.4009 conversion factor, the national amount before geographic adjustment.

Commercial prices are from the Peterson-KFF Health System Tracker (MarketScan claims), the Health Care Cost Institute, RAND and FAIR Health, with the data year given next to each. Air ambulance charges are from GAO-19-292. Coverage rules are from CMS, the Labor Department, the USPSTF and federal statute.

Several commercial price series are several years old because the most detailed public analyses were done on 2017 to 2020 claims. No current national commercial price for a CT scan, colonoscopy, cataract surgery or urgent care visit is published by a primary source, so those procedures carry Medicare rates only.