Start-up costs are all the money a hospital pays up front to get a project going. To buy an X-ray machine for example, the hospital not only has to purchase the equipment itself, but it also has to have a room to hold the equipment, equipment to produce and read the x-ray films, and other miscellaneous office equipment like desks and chairs for people who will be operating the machine. To determine the start up costs, add up the amount paid for each thing the hospital bought or things they will need to buy to start running the project.