Hospital

Mercy Hospital Carthage

Mercy Hospital Carthage publishes cash prices for 57 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.

1615 Hazel Avenue Carthage Missouri 64836-3020 Collected Sep 23, 2026 Source price file

Scans and imaging

ProcedureCash price List priceOff list
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen & Pelvis W/Contrast Material $455.25 $607.00 25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen & Pelvis W/Contrast Material $455.25 $607.00 25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen & Pelvis W/Contrast Material $455.25 $607.00 25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen & Pelvis W/Contrast Material $455.25 $607.00 25%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain W/O Contrast Material $208.50 $278.00 25%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain W/O Contrast Material $208.50 $278.00 25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain W/O Contrast Material $208.50 $278.00 25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain W/O Contrast Material $208.50 $278.00 25%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Contrast Material $391.50 $522.00 25%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Contrast Material $391.50 $522.00 25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/Contrast Material $391.50 $522.00 25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/Contrast Material $391.50 $522.00 25%
Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic Mammography Computer-Aided Detcj Bi $267.00 $356.00 25%
Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic Mammography Computer-Aided Detcj Bi $267.00 $356.00 25%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Diagnostic Mammography Computer-Aided Detcj Bi $267.00 $356.00 25%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Diagnostic Mammography Computer-Aided Detcj Bi $267.00 $356.00 25%
Diagnostic mammogram, one breast CPT 77065 Diagnostic Mammography Computer-Aided Detcj Uni $191.25 $255.00 25%
Diagnostic mammogram, one breast CPT 77065 Diagnostic Mammography Computer-Aided Detcj Uni $191.25 $255.00 25%
Diagnostic mammogram, one breast inpatient CPT 77065 Diagnostic Mammography Computer-Aided Detcj Uni $191.25 $255.00 25%
Diagnostic mammogram, one breast inpatient CPT 77065 Diagnostic Mammography Computer-Aided Detcj Uni $191.25 $255.00 25%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Any Jt Lower Extrem W/O Contrast Matrl $541.50 $722.00 25%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Any Jt Lower Extrem W/O Contrast Matrl $541.50 $722.00 25%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Any Jt Lower Extrem W/O Contrast Matrl $541.50 $722.00 25%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Any Jt Lower Extrem W/O Contrast Matrl $541.50 $722.00 25%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Any Jt Lower Extrem W/O & W/Contrast Matrl $896.25 $1,195.00 25%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Any Jt Lower Extrem W/O & W/Contrast Matrl $896.25 $1,195.00 25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Any Jt Lower Extrem W/O & W/Contrast Matrl $896.25 $1,195.00 25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Any Jt Lower Extrem W/O & W/Contrast Matrl $896.25 $1,195.00 25%
MRI of the brain, no contrast dye CPT 70551 MRI Brain Brain Stem W/O Contrast Material $570.00 $760.00 25%
MRI of the brain, no contrast dye CPT 70551 MRI Brain Brain Stem W/O Contrast Material $570.00 $760.00 25%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain Brain Stem W/O Contrast Material $570.00 $760.00 25%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain Brain Stem W/O Contrast Material $570.00 $760.00 25%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Brain Stem W/O W/Contrast Material $855.75 $1,141.00 25%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Brain Stem W/O W/Contrast Material $855.75 $1,141.00 25%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain W/WO Cont $855.75 $1,141.00 25%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain W/WO Cont $855.75 $1,141.00 25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Brain Stem W/O W/Contrast Material $855.75 $1,141.00 25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain W/WO Cont $855.75 $1,141.00 25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Brain Stem W/O W/Contrast Material $855.75 $1,141.00 25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain W/WO Cont $855.75 $1,141.00 25%
MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar Spine WO Cont $501.00 $668.00 25%
MRI of the lower back, no contrast dye CPT 72148 MRI Spinal Canal Lumbar W/O Contrast Material $501.00 $668.00 25%
MRI of the lower back, no contrast dye CPT 72148 MRI Spinal Canal Lumbar W/O Contrast Material $501.00 $668.00 25%
MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar Spine WO Cont $501.00 $668.00 25%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar Spine WO Cont $501.00 $668.00 25%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar Spine WO Cont $501.00 $668.00 25%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spinal Canal Lumbar W/O Contrast Material $501.00 $668.00 25%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spinal Canal Lumbar W/O Contrast Material $501.00 $668.00 25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uter 14 Wks Or> $249.75 $333.00 25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation $249.75 $333.00 25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation $249.75 $333.00 25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uter 14 Wks Or> $249.75 $333.00 25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation $249.75 $333.00 25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uter 14 Wks Or> $249.75 $333.00 25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation $249.75 $333.00 25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uter 14 Wks Or> $249.75 $333.00 25%
Screening mammogram, both breasts both sides CPT 77067 Screening Mammography Bi 2-View Breast Inc Cad $220.50 $294.00 25%
Screening mammogram, both breasts both sides CPT 77067 Screening Mammography Bi 2-View Breast Inc Cad $220.50 $294.00 25%
Screening mammogram, both breasts inpatient both sides CPT 77067 Screening Mammography Bi 2-View Breast Inc Cad $220.50 $294.00 25%
Screening mammogram, both breasts inpatient both sides CPT 77067 Screening Mammography Bi 2-View Breast Inc Cad $220.50 $294.00 25%
Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd $1,284.75 $1,713.00 25%
Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd $1,284.75 $1,713.00 25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd $1,284.75 $1,713.00 25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd $1,284.75 $1,713.00 25%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB Pf $212.25 $283.00 25%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal $212.25 $283.00 25%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB $212.25 $283.00 25%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB $212.25 $283.00 25%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal $212.25 $283.00 25%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB Pf $212.25 $283.00 25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB Pf $212.25 $283.00 25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal $212.25 $283.00 25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB $212.25 $283.00 25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB $212.25 $283.00 25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal $212.25 $283.00 25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB Pf $212.25 $283.00 25%
Ultrasound of the abdomen, complete CPT 76700 US Abdominal Real Time W/Image Documentation $206.25 $275.00 25%
Ultrasound of the abdomen, complete CPT 76700 US Abdominal Real Time W/Image Documentation $206.25 $275.00 25%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete $206.25 $275.00 25%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete $206.25 $275.00 25%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete $206.25 $275.00 25%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdominal Real Time W/Image Documentation $206.25 $275.00 25%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete $206.25 $275.00 25%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdominal Real Time W/Image Documentation $206.25 $275.00 25%
X-ray of the lower back, 4 or more views CPT 72110 Radex Spine Lumbosacral Minimum 4 Views $85.50 $114.00 25%
X-ray of the lower back, 4 or more views CPT 72110 Radex Spine Lumbosacral Minimum 4 Views $85.50 $114.00 25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Radex Spine Lumbosacral Minimum 4 Views $85.50 $114.00 25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Radex Spine Lumbosacral Minimum 4 Views $85.50 $114.00 25%

Lab tests

ProcedureCash price List priceOff list
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Pnl Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) CPT 80048 POC Bmp W Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) CPT 80048 POC Bmp W Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Pnl Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) inpatient CPT 80048 POC Bmp W Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Pnl Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) inpatient CPT 80048 POC Bmp W Calcium Total $24.75 $33.00 25%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Pnl Calcium Total $24.75 $33.00 25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 POC Lipid Panel $35.25 $47.00 25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel $35.25 $47.00 25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 POC Lipid Panel $35.25 $47.00 25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel $35.25 $47.00 25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 POC Lipid Panel $35.25 $47.00 25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel $35.25 $47.00 25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel $35.25 $47.00 25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 POC Lipid Panel $35.25 $47.00 25%
Complete blood count (CBC) with differential CPT 85025 Blood Count Complete Auto&Auto Difrntl Wbc $23.25 $31.00 25%
Complete blood count (CBC) with differential CPT 85025 Cbc W Auto Diff $23.25 $31.00 25%
Complete blood count (CBC) with differential CPT 85025 POC Cbc W Auto Diff $23.25 $31.00 25%
Complete blood count (CBC) with differential CPT 85025 Blood Count Complete Auto&Auto Difrntl Wbc $23.25 $31.00 25%
Complete blood count (CBC) with differential CPT 85025 Cbc W Auto Diff $23.25 $31.00 25%
Complete blood count (CBC) with differential CPT 85025 POC Cbc W Auto Diff $23.25 $31.00 25%
Complete blood count (CBC) with differential inpatient CPT 85025 Blood Count Complete Auto&Auto Difrntl Wbc $23.25 $31.00 25%
Complete blood count (CBC) with differential inpatient CPT 85025 POC Cbc W Auto Diff $23.25 $31.00 25%
Complete blood count (CBC) with differential inpatient CPT 85025 Cbc W Auto Diff $23.25 $31.00 25%
Complete blood count (CBC) with differential inpatient CPT 85025 Blood Count Complete Auto&Auto Difrntl Wbc $23.25 $31.00 25%
Complete blood count (CBC) with differential inpatient CPT 85025 POC Cbc W Auto Diff $23.25 $31.00 25%
Complete blood count (CBC) with differential inpatient CPT 85025 Cbc W Auto Diff $23.25 $31.00 25%
Complete blood count (CBC), no differential CPT 85027 Blood Count Complete Automated $19.50 $26.00 25%
Complete blood count (CBC), no differential CPT 85027 Cbc Automated WO Diff $19.50 $26.00 25%
Complete blood count (CBC), no differential CPT 85027 Blood Count Complete Automated $19.50 $26.00 25%
Complete blood count (CBC), no differential CPT 85027 Cbc Automated WO Diff $19.50 $26.00 25%
Complete blood count (CBC), no differential inpatient CPT 85027 Cbc Automated WO Diff $19.50 $26.00 25%
Complete blood count (CBC), no differential inpatient CPT 85027 Cbc Automated WO Diff $19.50 $26.00 25%
Complete blood count (CBC), no differential inpatient CPT 85027 Blood Count Complete Automated $19.50 $26.00 25%
Complete blood count (CBC), no differential inpatient CPT 85027 Blood Count Complete Automated $19.50 $26.00 25%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel $30.75 $41.00 25%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel $30.75 $41.00 25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel $30.75 $41.00 25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel $30.75 $41.00 25%
Kidney function blood test panel CPT 80069 Renal Function Panel $25.50 $34.00 25%
Kidney function blood test panel CPT 80069 Renal Function Panel $25.50 $34.00 25%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel $25.50 $34.00 25%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel $25.50 $34.00 25%
Liver function blood test panel CPT 80076 Hepatic Function Panel $24.00 $32.00 25%
Liver function blood test panel CPT 80076 Hepatic Function Panel $24.00 $32.00 25%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel $24.00 $32.00 25%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel $24.00 $32.00 25%
PSA (prostate-specific antigen) blood test, free CPT 84154 Assay of Prostate Specific Antigen Free $54.00 $72.00 25%
PSA (prostate-specific antigen) blood test, free CPT 84154 Psa Free $54.00 $72.00 25%
PSA (prostate-specific antigen) blood test, free CPT 84154 Assay of Prostate Specific Antigen Free $54.00 $72.00 25%
PSA (prostate-specific antigen) blood test, free CPT 84154 Psa Free $54.00 $72.00 25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Assay of Prostate Specific Antigen Free $54.00 $72.00 25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa Free $54.00 $72.00 25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa Free $54.00 $72.00 25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Assay of Prostate Specific Antigen Free $54.00 $72.00 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 POC Psa Total Diagnostic $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total Diagnostic $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total Diagnostic $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 Assay of Prostate Specific Antigen Total $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 Assay of Prostate Specific Antigen Total $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 POC Psa Total Diagnostic $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 POC Psa Total Diagnostic $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total Diagnostic $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 POC Psa Total Diagnostic $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Assay of Prostate Specific Antigen Total $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Assay of Prostate Specific Antigen Total $48.75 $65.00 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total Diagnostic $48.75 $65.00 25%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time Partial Plasma/Whole Blood $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Partial Thromboplastin Time $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Mixing $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Partial Thromboplastin Time $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Mixing $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time Partial Plasma/Whole Blood $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Mixing $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time Partial Plasma/Whole Blood $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Partial Thromboplastin Time $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time Partial Plasma/Whole Blood $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Partial Thromboplastin Time $18.00 $24.00 25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Mixing $18.00 $24.00 25%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time Mixing Test $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test CPT 85610 POC Prothrombin Time $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time Mixing Test $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test CPT 85610 POC Prothrombin Time $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time Mixing Test $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC Prothrombin Time $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC Prothrombin Time $13.50 $18.00 25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time Mixing Test $13.50 $18.00 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Newborn $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay of Thyroid Stimulating Hormone Tsh $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Thyroid Stimulating Hormone $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Newborn $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay of Thyroid Stimulating Hormone Tsh $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Thyroid Stimulating Hormone $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh Thyroid Stimulating Hormone $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh Newborn $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Assay of Thyroid Stimulating Hormone Tsh $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh Newborn $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Assay of Thyroid Stimulating Hormone Tsh $49.50 $66.00 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh Thyroid Stimulating Hormone $49.50 $66.00 25%
Urinalysis with microscope exam, automated CPT 81001 Urnls Dip Stick/Tablet Reagent Auto Microscopy $9.75 $13.00 25%
Urinalysis with microscope exam, automated CPT 81001 Urnls Dip Stick/Tablet Reagent Auto Microscopy $9.75 $13.00 25%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Automated W Micro $9.75 $13.00 25%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Automated W Micro $9.75 $13.00 25%
Urinalysis with microscope exam, automated CPT 81001 POC Urinalysis Automated W Micro $9.75 $13.00 25%
Urinalysis with microscope exam, automated CPT 81001 POC Urinalysis Automated W Micro $9.75 $13.00 25%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urnls Dip Stick/Tablet Reagent Auto Microscopy $9.75 $13.00 25%
Urinalysis with microscope exam, automated inpatient CPT 81001 POC Urinalysis Automated W Micro $9.75 $13.00 25%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urnls Dip Stick/Tablet Reagent Auto Microscopy $9.75 $13.00 25%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Automated W Micro $9.75 $13.00 25%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Automated W Micro $9.75 $13.00 25%
Urinalysis with microscope exam, automated inpatient CPT 81001 POC Urinalysis Automated W Micro $9.75 $13.00 25%
Urinalysis with microscope exam, manual CPT 81000 Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy $8.25 $11.00 25%
Urinalysis with microscope exam, manual CPT 81000 POC Urinalysis Non Automated W Micro $8.25 $11.00 25%
Urinalysis with microscope exam, manual CPT 81000 POC Urinalysis Non Automated W Micro $8.25 $11.00 25%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis Non Automated W Micro $8.25 $11.00 25%
Urinalysis with microscope exam, manual CPT 81000 Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy $8.25 $11.00 25%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis Non Automated W Micro $8.25 $11.00 25%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Non Automated W Micro $8.25 $11.00 25%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Non Automated W Micro $8.25 $11.00 25%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy $8.25 $11.00 25%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy $8.25 $11.00 25%
Urinalysis with microscope exam, manual inpatient CPT 81000 POC Urinalysis Non Automated W Micro $8.25 $11.00 25%
Urinalysis with microscope exam, manual inpatient CPT 81000 POC Urinalysis Non Automated W Micro $8.25 $11.00 25%
Urinalysis without microscope exam, automated CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 Urine Ph Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 Urine Ketones Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Automated W/O Micro $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 POC Urinalysis Automated W/O Micro $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 POC Urinalysis Automated W/O Micro $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Automated W/O Micro $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 Urine Ketones Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 Urine Ph Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Ph Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC Urinalysis Automated W/O Micro $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Automated W/O Micro $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Ketones Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC Urinalysis Automated W/O Micro $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Automated W/O Micro $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Ketones Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Ph Automated $12.00 $16.00 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy $12.00 $16.00 25%
Urinalysis without microscope exam, manual CPT 81002 Urine Ph Nonautomated $10.50 $14.00 25%
Urinalysis without microscope exam, manual CPT 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp $10.50 $14.00 25%
Urinalysis without microscope exam, manual CPT 81002 POC Urinalysis Non-Auto $10.50 $14.00 25%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Non Automated WO Micro $10.50 $14.00 25%
Urinalysis without microscope exam, manual CPT 81002 Urine Ketones Nonautomated $10.50 $14.00 25%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Non Automated WO Micro $10.50 $14.00 25%
Urinalysis without microscope exam, manual CPT 81002 POC Urinalysis Non-Auto $10.50 $14.00 25%
Urinalysis without microscope exam, manual CPT 81002 Urine Ketones Nonautomated $10.50 $14.00 25%
Urinalysis without microscope exam, manual CPT 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp $10.50 $14.00 25%
Urinalysis without microscope exam, manual CPT 81002 Urine Ph Nonautomated $10.50 $14.00 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 POC Urinalysis Non-Auto $10.50 $14.00 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Non Automated WO Micro $10.50 $14.00 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Ketones Nonautomated $10.50 $14.00 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp $10.50 $14.00 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Ph Nonautomated $10.50 $14.00 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Ketones Nonautomated $10.50 $14.00 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Non Automated WO Micro $10.50 $14.00 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 POC Urinalysis Non-Auto $10.50 $14.00 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp $10.50 $14.00 25%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Ph Nonautomated $10.50 $14.00 25%

Surgery and procedures

ProcedureCash price List priceOff list
Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq $907.50 $1,210.00 25%
Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq $907.50 $1,210.00 25%
Colonoscopy with polyp removal inpatient CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq $907.50 $1,210.00 25%
Colonoscopy with polyp removal inpatient CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq $907.50 $1,210.00 25%
Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple $859.50 $1,146.00 25%
Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple $859.50 $1,146.00 25%
Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy W/Biopsy Single/Multiple $859.50 $1,146.00 25%
Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy W/Biopsy Single/Multiple $859.50 $1,146.00 25%
Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd $827.25 $1,103.00 25%
Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd $827.25 $1,103.00 25%
Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd $827.25 $1,103.00 25%
Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd $827.25 $1,103.00 25%
Left heart catheterization, diagnostic CPT 93452 L Hrt Cath W/Njx L Ventriculography Img S&I $1,957.50 $2,610.00 25%
Left heart catheterization, diagnostic CPT 93452 L Hrt Cath W/Njx L Ventriculography Img S&I $1,957.50 $2,610.00 25%
Left heart catheterization, diagnostic one side CPT 93452 Lt Heart Cath Including Inj Lt Ventriculography, S/I $1,957.50 $2,610.00 25%
Left heart catheterization, diagnostic one side CPT 93452 Lt Heart Cath Including Inj Lt Ventriculography, S/I $1,957.50 $2,610.00 25%
Left heart catheterization, diagnostic inpatient CPT 93452 L Hrt Cath W/Njx L Ventriculography Img S&I $1,957.50 $2,610.00 25%
Left heart catheterization, diagnostic inpatient CPT 93452 L Hrt Cath W/Njx L Ventriculography Img S&I $1,957.50 $2,610.00 25%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Lt Heart Cath Including Inj Lt Ventriculography, S/I $1,957.50 $2,610.00 25%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Lt Heart Cath Including Inj Lt Ventriculography, S/I $1,957.50 $2,610.00 25%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn $481.50 $642.00 25%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn $481.50 $642.00 25%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn $481.50 $642.00 25%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn $481.50 $642.00 25%
Lower-back epidural injection, without imaging guidance CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn $274.50 $366.00 25%
Lower-back epidural injection, without imaging guidance CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn $274.50 $366.00 25%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn $274.50 $366.00 25%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn $274.50 $366.00 25%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level $597.75 $797.00 25%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level $597.75 $797.00 25%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level $597.75 $797.00 25%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level $597.75 $797.00 25%
Prostate biopsy CPT 55700 Prostate Needle Biopsy Any Approach $528.00 $704.00 25%
Prostate biopsy CPT 55700 Prostate Needle Biopsy Any Approach $528.00 $704.00 25%
Prostate biopsy inpatient CPT 55700 Prostate Needle Biopsy Any Approach $528.00 $704.00 25%
Prostate biopsy inpatient CPT 55700 Prostate Needle Biopsy Any Approach $528.00 $704.00 25%
Removal of a breast lump, open surgery CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion $813.00 $1,084.00 25%
Removal of a breast lump, open surgery CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion $813.00 $1,084.00 25%
Removal of a breast lump, open surgery inpatient CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion $813.00 $1,084.00 25%
Removal of a breast lump, open surgery inpatient CPT 19120 Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion $813.00 $1,084.00 25%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple $763.50 $1,018.00 25%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple $763.50 $1,018.00 25%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd Transoral Biopsy Single/Multiple $763.50 $1,018.00 25%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd Transoral Biopsy Single/Multiple $763.50 $1,018.00 25%
Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic $757.50 $1,010.00 25%
Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic $757.50 $1,010.00 25%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic $757.50 $1,010.00 25%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic $757.50 $1,010.00 25%

Doctor visits and therapy

ProcedureCash price List priceOff list
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Ekg for Initial Prevent Exam $40.50 $54.00 25%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Ecg Routine Ecg W/Least 12 Lds W/I&R $40.50 $54.00 25%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Ecg Routine Ecg W/Least 12 Lds W/I&R $40.50 $54.00 25%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Ekg for Initial Prevent Exam $40.50 $54.00 25%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Ekg for Initial Prevent Exam $40.50 $54.00 25%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Ecg Routine Ecg W/Least 12 Lds W/I&R $40.50 $54.00 25%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Ecg Routine Ecg W/Least 12 Lds W/I&R $40.50 $54.00 25%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Ekg for Initial Prevent Exam $40.50 $54.00 25%
Family therapy with the patient, 50 minutes CPT 90847 Family Psychotherapy W/Patient Present 50 Mins $197.25 $263.00 25%
Family therapy with the patient, 50 minutes CPT 90847 Family Psychotherapy W/Patient Present 50 Mins $197.25 $263.00 25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Psychotherapy W/Patient Present 50 Mins $197.25 $263.00 25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Psychotherapy W/Patient Present 50 Mins $197.25 $263.00 25%
Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy W/O Patient Present 50 Mins $191.25 $255.00 25%
Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy W/O Patient Present 50 Mins $191.25 $255.00 25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy W/O Patient Present 50 Mins $191.25 $255.00 25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy W/O Patient Present 50 Mins $191.25 $255.00 25%
Group psychotherapy session CPT 90853 Group Psychotherapy $45.00 $60.00 25%
Group psychotherapy session CPT 90853 Group Psychotherapy $45.00 $60.00 25%
Group psychotherapy session inpatient CPT 90853 Group Psychotherapy $45.00 $60.00 25%
Group psychotherapy session inpatient CPT 90853 Group Psychotherapy $45.00 $60.00 25%
New patient office visit, about 30 minutes CPT 99203 Office/Outpatient New Low Mdm 30 Minutes $138.00 $184.00 25%
New patient office visit, about 30 minutes CPT 99203 Office/Outpatient New Low Mdm 30 Minutes $138.00 $184.00 25%
New patient office visit, about 30 minutes inpatient CPT 99203 Office/Outpatient New Low Mdm 30 Minutes $138.00 $184.00 25%
New patient office visit, about 30 minutes inpatient CPT 99203 Office/Outpatient New Low Mdm 30 Minutes $138.00 $184.00 25%
New patient office visit, about 45 minutes CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes $207.75 $277.00 25%
New patient office visit, about 45 minutes CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes $207.75 $277.00 25%
New patient office visit, about 45 minutes inpatient CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes $207.75 $277.00 25%
New patient office visit, about 45 minutes inpatient CPT 99204 Office/Outpatient New Moderate Mdm 45 Minutes $207.75 $277.00 25%
New patient office visit, about 60 minutes CPT 99205 Office/Outpatient New High Mdm 60 Minutes $259.50 $346.00 25%
New patient office visit, about 60 minutes CPT 99205 Office/Outpatient New High Mdm 60 Minutes $259.50 $346.00 25%
New patient office visit, about 60 minutes inpatient CPT 99205 Office/Outpatient New High Mdm 60 Minutes $259.50 $346.00 25%
New patient office visit, about 60 minutes inpatient CPT 99205 Office/Outpatient New High Mdm 60 Minutes $259.50 $346.00 25%
Preventive checkup, new patient aged 18–39 CPT 99385 Well Woman Exam New 18-39 $56.25 $75.00 25%
Preventive checkup, new patient aged 18–39 CPT 99385 Well Woman Exam New 18-39 $56.25 $75.00 25%
Preventive checkup, new patient aged 18–39 CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 CPT 99385 Full Hcy Screen, New 18-20 Yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 CPT 99385 Partial Hcy Screen, New 18-20 Yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 CPT 99385 Partial Hcy Screen, New 18-20 Yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 CPT 99385 Full Hcy Screen, New 18-20 Yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Well Woman Exam New 18-39 $56.25 $75.00 25%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Well Woman Exam New 18-39 $56.25 $75.00 25%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Full Hcy Screen, New 18-20 Yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Full Hcy Screen, New 18-20 Yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Partial Hcy Screen, New 18-20 Yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Preventive Medicine New Pt Age 18-39yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Partial Hcy Screen, New 18-20 Yrs $154.50 $206.00 25%
Preventive checkup, new patient aged 40–64 CPT 99386 School Sports Physical New Patient Ages 40 - 64 $45.00 $45.00
Preventive checkup, new patient aged 40–64 CPT 99386 School Sports Physical New Patient Ages 40 - 64 $45.00 $45.00
Preventive checkup, new patient aged 40–64 CPT 99386 Well Woman Exam New 40-64 $182.25 $243.00 25%
Preventive checkup, new patient aged 40–64 CPT 99386 Initial Preventive Medicine New Patient 40-64yrs $182.25 $243.00 25%
Preventive checkup, new patient aged 40–64 CPT 99386 Initial Preventive Medicine New Patient 40-64yrs $182.25 $243.00 25%
Preventive checkup, new patient aged 40–64 CPT 99386 Well Woman Exam New 40-64 $182.25 $243.00 25%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 School Sports Physical New Patient Ages 40 - 64 $45.00 $45.00
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 School Sports Physical New Patient Ages 40 - 64 $45.00 $45.00
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Well Woman Exam New 40-64 $182.25 $243.00 25%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Preventive Medicine New Patient 40-64yrs $182.25 $243.00 25%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Preventive Medicine New Patient 40-64yrs $182.25 $243.00 25%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Well Woman Exam New 40-64 $182.25 $243.00 25%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy W/Patient 30 Minutes $116.25 $155.00 25%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy W/Patient 30 Minutes $116.25 $155.00 25%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy W/Patient 30 Minutes $116.25 $155.00 25%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy W/Patient 30 Minutes $116.25 $155.00 25%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy W/Patient 45 Minutes $150.75 $201.00 25%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy W/Patient 45 Minutes $150.75 $201.00 25%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy W/Patient 45 Minutes $150.75 $201.00 25%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy W/Patient 45 Minutes $150.75 $201.00 25%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy W/Patient 60 Minutes $220.50 $294.00 25%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy W/Patient 60 Minutes $220.50 $294.00 25%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy W/Patient 60 Minutes $220.50 $294.00 25%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy W/Patient 60 Minutes $220.50 $294.00 25%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes $192.75 $257.00 25%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes $192.75 $257.00 25%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes $192.75 $257.00 25%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes $192.75 $257.00 25%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes $284.25 $379.00 25%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes $284.25 $379.00 25%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes $284.25 $379.00 25%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes $284.25 $379.00 25%

Source file: https://www.mercy.net/content/dam/mercy/en/web-assets/charge-files/453808607_mercy-hospital-carthage-WomensHealth_RHC_standardcharges.zip