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Gundersen Moundview Hospital and Clinics

402 W Lake St, Friendship, WI 53934 · (608) 339-3331

Critical Access HospitalsVoluntary non-profit - Private

Price file

Prices published

File dated 2026-06-27

2,408 price rows for 63 procedures

Published prices

cash · negotiated range · list
Basic metabolic panel (blood test)

CPT 80048 · lowest of 2 lines

$48
cash
$2,033
cash
CT scan of the head, no contrast

CPT 70450 · lowest of 2 lines

$858
cash
CT scan of the pelvis, with contrast

CPT 72193 · lowest of 2 lines

$1,590
cash
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cash
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cash
Chlamydia test (DNA)

CPT 87491 · lowest of 4 lines

$201
cash
Colonoscopy (diagnostic)

CPT 45378 · lowest of 2 lines

$2,113
cash
Colonoscopy with biopsy

CPT 45380 · lowest of 2 lines

$2,113
cash
Colonoscopy with polyp removal

CPT 45385 · lowest of 2 lines

$2,113
cash
Complete blood count (CBC) with differential

CPT 85025 · lowest of 2 lines

$44
cash
Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 2 lines

$60
cash
Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 2 lines

$342
cash
—
cash
$134
cash
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cash
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cash
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cash
Gonorrhea test (DNA)

CPT 87591 · lowest of 4 lines

$201
cash
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cash
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Lipid panel (cholesterol test)

CPT 80061 · lowest of 4 lines

$77
cash
Liver function panel

CPT 80076 · lowest of 2 lines

$47
cash
MRI of the brain, with and without contrast

CPT 70553 · lowest of 2 lines

$2,127
cash
$1,494
cash
$2,033
cash
MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 2 lines

$2,117
cash
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cash
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cash
PSA test (prostate)

CPT 84153 · lowest of 2 lines

$105
cash
$35
cash
$74
cash
Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 2 lines

$458
cash
—
cash
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cash
Prothrombin time (blood clotting test)

CPT 85610 · lowest of 2 lines

$24
cash
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cash
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Screening mammogram (both breasts)

CPT 77067 · lowest of 2 lines

$179
cash
—
cash
Sleep study (overnight, attended)

CPT 95810 · lowest of 2 lines

$3,483
cash
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cash
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cash
TSH test (thyroid)

CPT 84443 · lowest of 2 lines

$96
cash
—
cash
Transvaginal ultrasound

CPT 76830 · lowest of 2 lines

$499
cash
Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 2 lines

$696
cash
Upper endoscopy (EGD)

CPT 43235 · lowest of 2 lines

$1,774
cash
Upper endoscopy with biopsy

CPT 43239 · lowest of 2 lines

$1,774
cash
Urinalysis with microscope

CPT 81001 · lowest of 2 lines

$18
cash
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X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 2 lines

$314
cash

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.