Mercy Hospital Southeast
Mercy Hospital Southeast in Cape Girardeau, MO publishes cash prices for 40 common procedures listed here, from its own machine-readable price file updated Jun 12, 2026. Click a procedure to compare it with other hospitals nearby.
25 Doctors Park Cape Girardeau Missouri 63703-4927 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation | $214.50 | $286.00 | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation | $214.50 | $286.00 | 25% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation | $214.50 | $286.00 | 25% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation | $214.50 | $286.00 | 25% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $1,203.75 | $1,605.00 | 25% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $1,203.75 | $1,605.00 | 25% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $1,203.75 | $1,605.00 | 25% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $1,203.75 | $1,605.00 | 25% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal | $165.00 | $220.00 | 25% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal | $165.00 | $220.00 | 25% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal | $165.00 | $220.00 | 25% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal | $165.00 | $220.00 | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 Radex Spine Lumbosacral Minimum 4 Views | $82.50 | $110.00 | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 Radex Spine Lumbosacral Minimum 4 Views | $82.50 | $110.00 | 25% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Radex Spine Lumbosacral Minimum 4 Views | $82.50 | $110.00 | 25% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Radex Spine Lumbosacral Minimum 4 Views | $82.50 | $110.00 | 25% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Complete blood count (CBC), no differential CPT 85027 Cbc Automated WO Diff | $16.50 | $22.00 | 25% |
| Complete blood count (CBC), no differential CPT 85027 Blood Count Complete Automated | $16.50 | $22.00 | 25% |
| Complete blood count (CBC), no differential CPT 85027 Cbc Automated WO Diff | $16.50 | $22.00 | 25% |
| Complete blood count (CBC), no differential CPT 85027 Blood Count Complete Automated | $16.50 | $22.00 | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Cbc Automated WO Diff | $16.50 | $22.00 | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Cbc Automated WO Diff | $16.50 | $22.00 | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Blood Count Complete Automated | $16.50 | $22.00 | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Blood Count Complete Automated | $16.50 | $22.00 | 25% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $22.50 | $30.00 | 25% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $22.50 | $30.00 | 25% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $22.50 | $30.00 | 25% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $22.50 | $30.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total Diagnostic | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Assay of Prostate Specific Antigen Total | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Ultrasensitive | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Assay of Prostate Specific Antigen Total | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total Diagnostic | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Ultrasensitive | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 POC Psa Total Diagnostic | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 POC Psa Total Diagnostic | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Assay of Prostate Specific Antigen Total | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 POC Psa Total Diagnostic | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Assay of Prostate Specific Antigen Total | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 POC Psa Total Diagnostic | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total Diagnostic | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Ultrasensitive | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total Diagnostic | $18.75 | $25.00 | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Ultrasensitive | $18.75 | $25.00 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Mixing | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Tfh So Ptt Partial Thromboplastin Time | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Partial Thromboplastin Time | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Mixing | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time Partial Plasma/Whole Blood | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Partial Thromboplastin Time | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Tfh So Ptt Partial Thromboplastin Time | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time Partial Plasma/Whole Blood | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Partial Thromboplastin Time | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Mixing | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Tfh So Ptt Partial Thromboplastin Time | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time Partial Plasma/Whole Blood | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Mixing | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time Partial Plasma/Whole Blood | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Tfh So Ptt Partial Thromboplastin Time | $121.28 | $161.70 | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Partial Thromboplastin Time | $121.28 | $161.70 | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $8.25 | $11.00 | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $8.25 | $11.00 | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 POC Prothrombin Time | $8.25 | $11.00 | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 POC Prothrombin Time | $8.25 | $11.00 | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC Prothrombin Time | $8.25 | $11.00 | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $8.25 | $11.00 | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC Prothrombin Time | $8.25 | $11.00 | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $8.25 | $11.00 | 25% |
| Urinalysis with microscope exam, automated CPT 81001 Urnls Dip Stick/Tablet Reagent Auto Microscopy | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Automated W Micro | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Automated W Micro | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated CPT 81001 POC Urinalysis Automated W Micro | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated CPT 81001 Urnls Dip Stick/Tablet Reagent Auto Microscopy | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated CPT 81001 POC Urinalysis Automated W Micro | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 POC Urinalysis Automated W Micro | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urnls Dip Stick/Tablet Reagent Auto Microscopy | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 POC Urinalysis Automated W Micro | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Automated W Micro | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urnls Dip Stick/Tablet Reagent Auto Microscopy | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Automated W Micro | $11.25 | $15.00 | 25% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Non Automated W Micro | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual CPT 81000 POC Urinalysis Non Automated W Micro | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual CPT 81000 Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual CPT 81000 Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Non Automated W Micro | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual CPT 81000 POC Urinalysis Non Automated W Micro | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 POC Urinalysis Non Automated W Micro | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Non Automated W Micro | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Non Automated W Micro | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 POC Urinalysis Non Automated W Micro | $3.75 | $5.00 | 25% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy | $3.75 | $5.00 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 POC Urinalysis Automated W/O Micro | $4.50 | $6.00 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy | $4.50 | $6.00 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy | $4.50 | $6.00 | 25% |
| Urinalysis without microscope exam, automated CPT 81003 POC Urinalysis Automated W/O Micro | $4.50 | $6.00 | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy | $4.50 | $6.00 | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 POC Urinalysis Automated W/O Micro | $4.50 | $6.00 | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy | $4.50 | $6.00 | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 POC Urinalysis Automated W/O Micro | $4.50 | $6.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Non Automated WO Micro | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 POC Urinalysis Non-Auto | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Ketones Nonautomated | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Ph Nonautomated | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Ph Nonautomated | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Ketones Nonautomated | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Non Automated WO Micro | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual CPT 81002 POC Urinalysis Non-Auto | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 POC Urinalysis Non-Auto | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Ketones Nonautomated | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Ph Nonautomated | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Ph Nonautomated | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Ketones Nonautomated | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Non Automated WO Micro | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 POC Urinalysis Non-Auto | $5.25 | $7.00 | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Non Automated WO Micro | $5.25 | $7.00 | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care CPT 59510 OB Antepartum Care Cesarean Dlvr & Postpartum | $2,539.50 | $3,386.00 | 25% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 OB Antepartum Care Cesarean Dlvr & Postpartum | $2,539.50 | $3,386.00 | 25% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 OB Antepartum Care Cesarean Dlvr & Postpartum | $2,539.50 | $3,386.00 | 25% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 OB Antepartum Care Cesarean Dlvr & Postpartum | $2,539.50 | $3,386.00 | 25% |
| Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $1,088.25 | $1,451.00 | 25% |
| Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $1,088.25 | $1,451.00 | 25% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $1,088.25 | $1,451.00 | 25% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $1,088.25 | $1,451.00 | 25% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple | $960.75 | $1,281.00 | 25% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple | $960.75 | $1,281.00 | 25% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy W/Biopsy Single/Multiple | $960.75 | $1,281.00 | 25% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy W/Biopsy Single/Multiple | $960.75 | $1,281.00 | 25% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $813.75 | $1,085.00 | 25% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $813.75 | $1,085.00 | 25% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $813.75 | $1,085.00 | 25% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $813.75 | $1,085.00 | 25% |
| Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surg Cholecystectomy | $1,791.75 | $2,389.00 | 25% |
| Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surg Cholecystectomy | $1,791.75 | $2,389.00 | 25% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 Laparoscopy Surg Cholecystectomy | $1,791.75 | $2,389.00 | 25% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 Laparoscopy Surg Cholecystectomy | $1,791.75 | $2,389.00 | 25% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible | $1,010.25 | $1,347.00 | 25% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible | $1,010.25 | $1,347.00 | 25% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible | $1,010.25 | $1,347.00 | 25% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible | $1,010.25 | $1,347.00 | 25% |
| Knee arthroscopy with meniscus trim CPT 29881 Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg | $1,399.50 | $1,866.00 | 25% |
| Knee arthroscopy with meniscus trim CPT 29881 Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg | $1,399.50 | $1,866.00 | 25% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg | $1,399.50 | $1,866.00 | 25% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg | $1,399.50 | $1,866.00 | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Anes Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $141.75 | $189.00 | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Anes Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $141.75 | $189.00 | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $216.00 | $288.00 | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $216.00 | $288.00 | 25% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Anes Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $141.75 | $189.00 | 25% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Anes Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $141.75 | $189.00 | 25% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $216.00 | $288.00 | 25% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $216.00 | $288.00 | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $636.75 | $849.00 | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $636.75 | $849.00 | 25% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $636.75 | $849.00 | 25% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $636.75 | $849.00 | 25% |
| Removal of a breast lump, open surgery CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion | $726.00 | $968.00 | 25% |
| Removal of a breast lump, open surgery CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion | $726.00 | $968.00 | 25% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion | $726.00 | $968.00 | 25% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion | $726.00 | $968.00 | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls | $379.50 | $506.00 | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls | $379.50 | $506.00 | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls | $379.50 | $506.00 | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls | $379.50 | $506.00 | 25% |
| Tonsil and adenoid removal, child under 12 CPT 42820 Tonsillectomy & Adenoidectomy <Age 12 | $936.00 | $1,248.00 | 25% |
| Tonsil and adenoid removal, child under 12 CPT 42820 Tonsillectomy & Adenoidectomy <Age 12 | $936.00 | $1,248.00 | 25% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 Tonsillectomy & Adenoidectomy <Age 12 | $936.00 | $1,248.00 | 25% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 Tonsillectomy & Adenoidectomy <Age 12 | $936.00 | $1,248.00 | 25% |
| Total hip replacement CPT 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft | $2,938.50 | $3,918.00 | 25% |
| Total hip replacement CPT 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft | $2,938.50 | $3,918.00 | 25% |
| Total hip replacement inpatient CPT 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft | $2,938.50 | $3,918.00 | 25% |
| Total hip replacement inpatient CPT 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft | $2,938.50 | $3,918.00 | 25% |
| Total knee replacement CPT 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments | $2,934.75 | $3,913.00 | 25% |
| Total knee replacement CPT 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments | $2,934.75 | $3,913.00 | 25% |
| Total knee replacement inpatient CPT 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments | $2,934.75 | $3,913.00 | 25% |
| Total knee replacement inpatient CPT 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments | $2,934.75 | $3,913.00 | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple | $495.00 | $660.00 | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple | $495.00 | $660.00 | 25% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd Transoral Biopsy Single/Multiple | $495.00 | $660.00 | 25% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd Transoral Biopsy Single/Multiple | $495.00 | $660.00 | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic | $374.25 | $499.00 | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic | $374.25 | $499.00 | 25% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic | $374.25 | $499.00 | 25% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic | $374.25 | $499.00 | 25% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 Routine OB Care Vag Dlvry & Postpartum Care Vb | $2,737.50 | $3,650.00 | 25% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 Routine OB Care Vag Dlvry & Postpartum Care Vb | $2,737.50 | $3,650.00 | 25% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 Routine OB Care Vag Dlvry & Postpartum Care Vb | $2,737.50 | $3,650.00 | 25% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 Routine OB Care Vag Dlvry & Postpartum Care Vb | $2,737.50 | $3,650.00 | 25% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 OB Care Antepartum Vag Dlvr & Postpartum | $2,640.00 | $3,520.00 | 25% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 OB Care Antepartum Vag Dlvr & Postpartum | $2,640.00 | $3,520.00 | 25% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 OB Care Antepartum Vag Dlvr & Postpartum | $2,640.00 | $3,520.00 | 25% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 OB Care Antepartum Vag Dlvr & Postpartum | $2,640.00 | $3,520.00 | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Ecg Routine Ecg W/Least 12 Lds W/I&R | $31.50 | $42.00 | 25% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Ecg Routine Ecg W/Least 12 Lds W/I&R | $31.50 | $42.00 | 25% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Ecg Routine Ecg W/Least 12 Lds W/I&R | $31.50 | $42.00 | 25% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Ecg Routine Ecg W/Least 12 Lds W/I&R | $31.50 | $42.00 | 25% |
| New patient office visit, about 30 minutes CPT 99203 Office/Outpatient New Low Mdm 30 Minutes | $132.00 | $176.00 | 25% |
| New patient office visit, about 30 minutes CPT 99203 Office/Outpatient New Low Mdm 30 Minutes | $132.00 | $176.00 | 25% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office/Outpatient New Low Mdm 30 Minutes | $132.00 | $176.00 | 25% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office/Outpatient New Low Mdm 30 Minutes | $132.00 | $176.00 | 25% |
| New patient office visit, about 45 minutes CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes | $183.00 | $244.00 | 25% |
| New patient office visit, about 45 minutes CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes | $183.00 | $244.00 | 25% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes | $183.00 | $244.00 | 25% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes | $183.00 | $244.00 | 25% |
| New patient office visit, about 60 minutes CPT 99205 Office/Outpatient New High Mdm 60 Minutes | $241.50 | $322.00 | 25% |
| New patient office visit, about 60 minutes CPT 99205 Office/Outpatient New High Mdm 60 Minutes | $241.50 | $322.00 | 25% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office/Outpatient New High Mdm 60 Minutes | $241.50 | $322.00 | 25% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office/Outpatient New High Mdm 60 Minutes | $241.50 | $322.00 | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs | $181.50 | $242.00 | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs | $181.50 | $242.00 | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Well Woman Exam New 18-39 | $181.50 | $242.00 | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Well Woman Exam New 18-39 | $181.50 | $242.00 | 25% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs | $181.50 | $242.00 | 25% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Well Woman Exam New 18-39 | $181.50 | $242.00 | 25% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs | $181.50 | $242.00 | 25% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Well Woman Exam New 18-39 | $181.50 | $242.00 | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Well Woman Exam New 40-64 | $177.00 | $236.00 | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial Preventive Medicine New Patient 40-64yrs | $177.00 | $236.00 | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Well Woman Exam New 40-64 | $177.00 | $236.00 | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial Preventive Medicine New Patient 40-64yrs | $177.00 | $236.00 | 25% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Preventive Medicine New Patient 40-64yrs | $177.00 | $236.00 | 25% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Well Woman Exam New 40-64 | $177.00 | $236.00 | 25% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Preventive Medicine New Patient 40-64yrs | $177.00 | $236.00 | 25% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Well Woman Exam New 40-64 | $177.00 | $236.00 | 25% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy W/Patient 60 Minutes | $199.50 | $266.00 | 25% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy W/Patient 60 Minutes | $199.50 | $266.00 | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy W/Patient 60 Minutes | $199.50 | $266.00 | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy W/Patient 60 Minutes | $199.50 | $266.00 | 25% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes | $164.25 | $219.00 | 25% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes | $164.25 | $219.00 | 25% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes | $164.25 | $219.00 | 25% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes | $164.25 | $219.00 | 25% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes | $234.00 | $312.00 | 25% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes | $234.00 | $312.00 | 25% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes | $234.00 | $312.00 | 25% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes | $234.00 | $312.00 | 25% |