St. Mary's Community Hospital
St. Mary's Community Hospital in Nebraska City, NE publishes cash prices for 54 common procedures listed here, from its own machine-readable price file updated Feb 28, 2026. Click a procedure to compare it with other hospitals nearby.
1301 GRUNDMAN BLVD, Nebraska City, NE 68410 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 HC CT ABDOMEN PELVIS W CONTRST | $5,103.67 | $6,149.00 | 17% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN PELVIS W CONTRST | $5,103.67 | $6,149.00 | 17% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD WO CONTRAST | $1,908.17 | $2,299.00 | 17% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD WO CONTRAST | $1,908.17 | $2,299.00 | 17% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST | $2,642.72 | $3,184.00 | 17% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST | $2,642.72 | $3,184.00 | 17% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI | $357.73 | $431.00 | 17% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI | $357.73 | $431.00 | 17% |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI | $316.23 | $381.00 | 17% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI | $316.23 | $381.00 | 17% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MR JOINT LOWER EXT WO CONT | $2,490.83 | $3,001.00 | 17% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MR JOINT LOWER EXT WO CONT | $2,490.83 | $3,001.00 | 17% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MR JNT LOWER EXT W WO CONT | $3,910.96 | $4,712.00 | 17% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MR JNT LOWER EXT W WO CONT | $3,910.96 | $4,712.00 | 17% |
| MRI of the brain, no contrast dye CPT 70551 HC MR BRAIN WO CONT LTD M52 | $2,568.85 | $3,095.00 | 17% |
| MRI of the brain, no contrast dye CPT 70551 HC MR BRAIN WO CONTRAST | $3,211.27 | $3,869.00 | 17% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MR BRAIN WO CONT LTD M52 | $2,568.85 | $3,095.00 | 17% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MR BRAIN WO CONTRAST | $3,211.27 | $3,869.00 | 17% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MR BRAIN W WO CONTRAST | $4,013.88 | $4,836.00 | 17% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MR BRAIN W WO CONTRAST | $4,013.88 | $4,836.00 | 17% |
| MRI of the lower back, no contrast dye CPT 72148 HC MR LUMBAR WO CONTRAST | $3,116.65 | $3,755.00 | 17% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MR LUMBAR WO CONTRAST | $3,116.65 | $3,755.00 | 17% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC ULTRASOUND COMPLETE | $827.51 | $997.00 | 17% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGMNANCY >14 WKS | $888.10 | $1,070.00 | 17% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC ULTRASOUND COMPLETE | $827.51 | $997.00 | 17% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGMNANCY >14 WKS | $888.10 | $1,070.00 | 17% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $411.68 | $496.00 | 17% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD | $411.68 | $496.00 | 17% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGMRAPHY=> 6 YR | $3,563.19 | $4,293.00 | 17% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGMRAPHY=> 6 YR | $3,563.19 | $4,293.00 | 17% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGMINAL | $646.57 | $779.00 | 17% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGMINAL | $646.57 | $779.00 | 17% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN | $887.27 | $1,069.00 | 17% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN | $887.27 | $1,069.00 | 17% |
| X-ray of the lower back, 4 or more views CPT 72110 HC RHC LUMB SAC SPINE 4 VWS | $118.69 | $143.00 | 17% |
| X-ray of the lower back, 4 or more views CPT 72110 HC LUMBR SPINE W OBLIQUES 4OR> | $440.73 | $531.00 | 17% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC RHC LUMB SAC SPINE 4 VWS | $118.69 | $143.00 | 17% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBR SPINE W OBLIQUES 4OR> | $440.73 | $531.00 | 17% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC RHC BASIC METABOLIC PANL | $24.07 | $29.00 | 17% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $131.14 | $158.00 | 17% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC RHC BASIC METABOLIC PANL | $24.07 | $29.00 | 17% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $131.14 | $158.00 | 17% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC RHC LIPID PANEL | $38.18 | $46.00 | 17% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $113.71 | $137.00 | 17% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC RHC LIPID PANEL | $38.18 | $46.00 | 17% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $113.71 | $137.00 | 17% |
| Complete blood count (CBC) with differential CPT 85025 HC RHC CBC AUTOMATED W DIFF | $12.45 | $15.00 | 17% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC W AUTO DIFF | $116.20 | $140.00 | 17% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC RHC CBC AUTOMATED W DIFF | $12.45 | $15.00 | 17% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC W AUTO DIFF | $116.20 | $140.00 | 17% |
| Complete blood count (CBC), no differential CPT 85027 HC RHC HEMOGMRAM CBC W O DIFF | $17.43 | $21.00 | 17% |
| Complete blood count (CBC), no differential CPT 85027 HC HEMOGMRAM CBC WITHOUT DIFF | $88.81 | $107.00 | 17% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC RHC HEMOGMRAM CBC W O DIFF | $17.43 | $21.00 | 17% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC HEMOGMRAM CBC WITHOUT DIFF | $88.81 | $107.00 | 17% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC RHC COMP METABOLIC PANEL | $29.05 | $35.00 | 17% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE PANEL | $141.10 | $170.00 | 17% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC RHC COMP METABOLIC PANEL | $29.05 | $35.00 | 17% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE PANEL | $141.10 | $170.00 | 17% |
| Kidney function blood test panel CPT 80069 HC RHC RENAL FUNC PANEL | $24.90 | $30.00 | 17% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL | $121.18 | $146.00 | 17% |
| Kidney function blood test panel inpatient CPT 80069 HC RHC RENAL FUNC PANEL | $24.90 | $30.00 | 17% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL | $121.18 | $146.00 | 17% |
| Liver function blood test panel CPT 80076 HC RHC HEPAT FUNCTN PANEL | $23.24 | $28.00 | 17% |
| Liver function blood test panel CPT 80076 HC HEPATIC PROFILE | $134.46 | $162.00 | 17% |
| Liver function blood test panel inpatient CPT 80076 HC RHC HEPAT FUNCTN PANEL | $23.24 | $28.00 | 17% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC PROFILE | $134.46 | $162.00 | 17% |
| Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL | $117.03 | $141.00 | 17% |
| Obstetric blood test panel CPT 80055 HC RHC OBSTETRIC PANEL | $131.97 | $159.00 | 17% |
| Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL | $117.03 | $141.00 | 17% |
| Obstetric blood test panel inpatient CPT 80055 HC RHC OBSTETRIC PANEL | $131.97 | $159.00 | 17% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC RHC PSA FREE | $50.63 | $61.00 | 17% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE | $175.96 | $212.00 | 17% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC RHC PSA FREE | $50.63 | $61.00 | 17% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE | $175.96 | $212.00 | 17% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC RHC PROST SPEC ANTIGMN | $50.63 | $61.00 | 17% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA | $118.69 | $143.00 | 17% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC RHC PROST SPEC ANTIGMN | $50.63 | $61.00 | 17% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA | $118.69 | $143.00 | 17% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT | $78.02 | $94.00 | 17% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT | $78.02 | $94.00 | 17% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC RHC PROTIME | $9.96 | $12.00 | 17% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC POCT PT | $50.63 | $61.00 | 17% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PT | $83.00 | $100.00 | 17% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC RHC PROTIME | $9.96 | $12.00 | 17% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POCT PT | $50.63 | $61.00 | 17% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PT | $83.00 | $100.00 | 17% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC RHC TSH | $46.48 | $56.00 | 17% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH | $113.71 | $137.00 | 17% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC RHC TSH | $46.48 | $56.00 | 17% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH | $113.71 | $137.00 | 17% |
| Urinalysis with microscope exam, automated CPT 81001 HC RHC COMPL UA W MICRO | $8.30 | $10.00 | 17% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS | $18.26 | $22.00 | 17% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS AUTOMATD W MICRO | $100.43 | $121.00 | 17% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC RHC COMPL UA W MICRO | $8.30 | $10.00 | 17% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS | $18.26 | $22.00 | 17% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS AUTOMATD W MICRO | $100.43 | $121.00 | 17% |
| Urinalysis with microscope exam, manual CPT 81000 HC RHC URINALYSIS W MICRO | $8.30 | $10.00 | 17% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC RHC URINALYSIS W MICRO | $8.30 | $10.00 | 17% |
| Urinalysis without microscope exam, automated CPT 81003 HC RHC UA WO MICRO AUTO | $5.81 | $7.00 | 17% |
| Urinalysis without microscope exam, automated CPT 81003 HC POC URINE AUTO WO MICRO | $29.05 | $35.00 | 17% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO WO MICRO | $42.33 | $51.00 | 17% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC RHC UA WO MICRO AUTO | $5.81 | $7.00 | 17% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC POC URINE AUTO WO MICRO | $29.05 | $35.00 | 17% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO WO MICRO | $42.33 | $51.00 | 17% |
| Urinalysis without microscope exam, manual CPT 81002 HC RHC URINALY WO MICRO | $6.64 | $8.00 | 17% |
| Urinalysis without microscope exam, manual CPT 81002 HC POCT MANUAL URINALYSIS | $14.94 | $18.00 | 17% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS MANUAL | $37.35 | $45.00 | 17% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC RHC URINALY WO MICRO | $6.64 | $8.00 | 17% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC POCT MANUAL URINALYSIS | $14.94 | $18.00 | 17% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS MANUAL | $37.35 | $45.00 | 17% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with endoscopic ultrasound CPT 45391 PC COLONOSCOPY W ENDO US | $596.77 | $719.00 | 17% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 PC COLONOSCOPY W ENDO US | $596.77 | $719.00 | 17% |
| Colonoscopy with polyp removal CPT 45385 PC LESION REM COLONOSCPY SNARE | $1,087.30 | $1,310.00 | 17% |
| Colonoscopy with polyp removal inpatient CPT 45385 PC LESION REM COLONOSCPY SNARE | $1,087.30 | $1,310.00 | 17% |
| Colonoscopy with tissue sample CPT 45380 PC COLONOSCOPY W BX | $1,044.97 | $1,259.00 | 17% |
| Colonoscopy with tissue sample inpatient CPT 45380 PC COLONOSCOPY W BX | $1,044.97 | $1,259.00 | 17% |
| Colonoscopy, diagnostic CPT 45378 PC COLONOSCOPY DX | $622.50 | $750.00 | 17% |
| Colonoscopy, diagnostic inpatient CPT 45378 PC COLONOSCOPY DX | $622.50 | $750.00 | 17% |
| Gallbladder removal, laparoscopic CPT 47562 PC LAPAROSCOPY CHOLECYSTECTOMY | $1,477.40 | $1,780.00 | 17% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 PC LAPAROSCOPY CHOLECYSTECTOMY | $1,477.40 | $1,780.00 | 17% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PC RPR INGMUINL HERN AGME 5 OR> | $1,173.62 | $1,414.00 | 17% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PC RPR INGMUINL HERN AGME 5 OR> | $1,173.62 | $1,414.00 | 17% |
| Lower-back epidural injection, with imaging guidance CPT 62323 PC CRNA INJ LMBR SAC W IMGM GMDN | $403.38 | $486.00 | 17% |
| Lower-back epidural injection, with imaging guidance CPT 62323 PC INJ LMBR SAC W IMGM GMDN | $614.20 | $740.00 | 17% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ ANE DRGM LUM SAC W IMGM GMDN | $1,201.84 | $1,448.00 | 17% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PC CRNA INJ LMBR SAC W IMGM GMDN | $403.38 | $486.00 | 17% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 PC INJ LMBR SAC W IMGM GMDN | $614.20 | $740.00 | 17% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ ANE DRGM LUM SAC W IMGM GMDN | $1,201.84 | $1,448.00 | 17% |
| Lower-back epidural injection, without imaging guidance CPT 62322 PC CRNA INJ ANE DRGM LUM SAC W O IMGM GMDN | $289.67 | $349.00 | 17% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC INJ ANE DRGM LUM SAC W O IMGM GMDN | $826.68 | $996.00 | 17% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PC CRNA INJ ANE DRGM LUM SAC W O IMGM GMDN | $289.67 | $349.00 | 17% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJ ANE DRGM LUM SAC W O IMGM GMDN | $826.68 | $996.00 | 17% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PC CRNA INJ TRNSFRM LUM SNGML W IMGM | $585.98 | $706.00 | 17% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ TRNSFRM LUM SNGML W IMAGM | $1,108.05 | $1,335.00 | 17% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PC CRNA INJ TRNSFRM LUM SNGML W IMGM | $585.98 | $706.00 | 17% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ TRNSFRM LUM SNGML W IMAGM | $1,108.05 | $1,335.00 | 17% |
| Prostate biopsy CPT 55700 HC BIOPSY PROSTATE | $786.01 | $947.00 | 17% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY PROSTATE | $786.01 | $947.00 | 17% |
| Removal of a breast lump, open surgery CPT 19120 PC OPEN EXCISION BREAST LESION | $1,180.26 | $1,422.00 | 17% |
| Removal of a breast lump, open surgery inpatient CPT 19120 PC OPEN EXCISION BREAST LESION | $1,180.26 | $1,422.00 | 17% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PC SHOULDER ARTHROSCOP PART ACROMIOPLAS | $864.86 | $1,042.00 | 17% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 PC SHOULDER ARTHROSCOP PART ACROMIOPLAS | $864.86 | $1,042.00 | 17% |
| Total knee replacement CPT 27447 PC TOTAL KNEE ARTHROPLASTY | $2,895.04 | $3,488.00 | 17% |
| Total knee replacement inpatient CPT 27447 PC TOTAL KNEE ARTHROPLASTY | $2,895.04 | $3,488.00 | 17% |
| Upper endoscopy (EGD) with biopsy CPT 43239 PC EGMD BIOPSY SINGMLE MULTIPLE | $913.00 | $1,100.00 | 17% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC EGMD BIOPSY SINGMLE MULTIPLE | $2,244.32 | $2,704.00 | 17% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PC EGMD BIOPSY SINGMLE MULTIPLE | $913.00 | $1,100.00 | 17% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGMD BIOPSY SINGMLE MULTIPLE | $2,244.32 | $2,704.00 | 17% |
| Upper endoscopy (EGD), diagnostic CPT 43235 PC EGMD DIAGMNOSTIC BRUSH WASH | $712.97 | $859.00 | 17% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC EGMD DIAGMNOSTIC BRUSH WASH | $2,244.32 | $2,704.00 | 17% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PC EGMD DIAGMNOSTIC BRUSH WASH | $712.97 | $859.00 | 17% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGMD DIAGMNOSTIC BRUSH WASH | $2,244.32 | $2,704.00 | 17% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 PC OFFICE VISIT NEW PRO 30-44 MINS | $260.62 | $314.00 | 17% |
| New patient office visit, about 30 minutes CPT 99203 HC OFFICE OUTPATIENT NEW 30-44 MINS | $273.07 | $329.00 | 17% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PC OFFICE VISIT NEW PRO 30-44 MINS | $260.62 | $314.00 | 17% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC OFFICE OUTPATIENT NEW 30-44 MINS | $273.07 | $329.00 | 17% |
| New patient office visit, about 45 minutes CPT 99204 PC OFFICE VISIT NEW PRO 45-59 MINS | $390.10 | $470.00 | 17% |
| New patient office visit, about 45 minutes CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINS | $419.98 | $506.00 | 17% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PC OFFICE VISIT NEW PRO 45-59 MINS | $390.10 | $470.00 | 17% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC OFFICE OUTPATIENT NEW 45-59 MINS | $419.98 | $506.00 | 17% |
| New patient office visit, about 60 minutes CPT 99205 PC OFFICE VISIT NEW PRO 60-74 MINS | $516.26 | $622.00 | 17% |
| New patient office visit, about 60 minutes CPT 99205 HC OFFICE OUTPATIENT NEW 60-74 MINS | $517.09 | $623.00 | 17% |
| New patient office visit, about 60 minutes inpatient CPT 99205 PC OFFICE VISIT NEW PRO 60-74 MINS | $516.26 | $622.00 | 17% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC OFFICE OUTPATIENT NEW 60-74 MINS | $517.09 | $623.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISE 15M | $57.27 | $69.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC PROCEDURE | $75.53 | $91.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THER EXERCISE 15M M59 | $75.53 | $91.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THER EXERCISE 15M M59 | $86.32 | $104.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISE 15M | $89.64 | $108.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PC THERAPEUTIC PX 1/> AREAS EA 15 MIN EX | $129.48 | $156.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISE 15M | $57.27 | $69.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THER EXERCISE 15M M59 | $75.53 | $91.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC PROCEDURE | $75.53 | $91.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THER EXERCISE 15M M59 | $86.32 | $104.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISE 15M | $89.64 | $108.00 | 17% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PC THERAPEUTIC PX 1/> AREAS EA 15 MIN EX | $129.48 | $156.00 | 17% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PC OFFICE CONSULTATION LVL III | $218.29 | $263.00 | 17% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PC OFFICE CONSULTATION LVL III | $218.29 | $263.00 | 17% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PC OFFICE CONSULTATION LVL IV | $327.02 | $394.00 | 17% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PC OFFICE CONSULTATION LVL IV | $327.02 | $394.00 | 17% |