Mercy Hospital Carthage
Mercy Hospital Carthage in Carthage, MO publishes cash prices for 369 common procedures listed here, from its own machine-readable price file updated Jun 9, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Missouri median for 179 of 364 procedures and below it for 175. By typical cash price it ranks #29 of 67 Missouri hospitals and #1 of 7 hospitals in the Joplin, MO area, cheapest first. Select a procedure to compare it with other hospitals nearby.
3125 Dr. Russell Smith Way Carthage MO 64836 Collected Sep 23, 2026 Source price file Check a bill from this hospital (417) 358-8121
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 261338 · CMS hospital register NPI 1003201955
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Mercy Hospital Carthage is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Mercy Hospital Carthage in Carthage, MO:
- Jun 25, 2025 Met requirements
Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen W/WO Cont | $2,009.80 | $3,092.00 | $849.37–$3,092.00 | 4% above | 35% |
| Abdominal X-ray, 2 views CPT 74019 Xr Abdomen 2 Views | $174.85 | $269.00 | $73.89–$269.00 | 41% below | 35% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 Xr Ankle Complete Min 3v Bi | $378.30 | $582.00 | $89.87 | — | 35% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete Min 3v Rt | $252.20 | $388.00 | $89.87 | 13% below | 35% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete Min 3v Lt | $252.20 | $388.00 | $23.58–$115.59 | 13% below | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Art Non Invas Extr Bi Sngl Level | $328.90 | $506.00 | $139.00–$506.00 | — | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Extremity Upper WO Cont Lt | $1,291.55 | $1,987.00 | $1,031.00 | 8% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Extremity Upper WO Cont Rt | $1,291.55 | $1,987.00 | $1,031.00 | 8% above | 35% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Xr Esophagus/Barium Swallow | $365.30 | $562.00 | $57.74–$244.94 | 16% below | 35% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone and or Jnt Imag Whol Body | $1,357.85 | $2,089.00 | $412.83 | 5% below | 35% |
| Breast ultrasound, complete, one breast both sides CPT 76641 Breast Ultrasound Complete Bilat | $139.75 | $215.00 | $56.90–$238.04 | — | 35% |
| Breast ultrasound, complete, one breast one side CPT 76641 Breast Ultrasound Complete Lt | $139.75 | $215.00 | $107.96 | 67% below | 35% |
| Breast ultrasound, complete, one breast one side CPT 76641 Breast Ultrasound Complete Rt | $139.75 | $215.00 | $56.90–$238.04 | 67% below | 35% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 Breast Ultrasound Limited Bilat | $458.25 | $705.00 | $44.13–$182.85 | — | 35% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Breast Ultrasound Limited Rt | $305.50 | $470.00 | $44.13–$182.85 | 12% below | 35% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Breast Ultrasound Limited Lt | $305.50 | $470.00 | $89.87 | 12% below | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 Cta Abd Pelvis Wwo Contrast | $4,096.30 | $6,302.00 | $206.69–$1,490.65 | 65% above | 35% |
| CT angiography (CTA) of the head CPT 70496 Cta Head W/WO Cont | $1,359.80 | $2,092.00 | $1,031.00 | 30% below | 35% |
| CT angiography (CTA) of the neck CPT 70498 Cta Neck W and/or WO Contrast | $2,180.10 | $3,354.00 | $1,031.00 | 9% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Chest W and/or WO Cont | $2,057.90 | $3,166.00 | $1,031.00 | 6% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd Pelvis Without Contrast | $1,925.95 | $2,963.00 | $1,031.00 | 10% below | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis With Contrast | $2,199.60 | $3,384.00 | $188.51–$1,179.51 | 17% below | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd Pelvis WO Cont Then W Cont | $2,674.10 | $4,114.00 | $360.27 | 16% below | 35% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen W Cont | $1,781.65 | $2,741.00 | $181.13 | 5% above | 35% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen WO Cont | $1,552.85 | $2,389.00 | $107.96 | 32% above | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial WO Cont Limited | $646.75 | $995.00 | $59.96–$470.78 | 43% below | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial Area WO Cont | $1,284.40 | $1,976.00 | $1,031.00 | 13% above | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain WO Cont | $858.65 | $1,321.00 | $57.46–$355.24 | 32% below | 35% |
| CT scan of the head with contrast CPT 70460 CT Head/Brain W Cont | $1,437.80 | $2,212.00 | $181.13 | at median | 35% |
| CT scan of the head without and with contrast CPT 70470 CT Head/Brain W/WO Cont | $1,464.45 | $2,253.00 | $181.13 | 17% below | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine WO Cont | $1,086.15 | $1,671.00 | $107.96 | 24% below | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cervical Spine WO Cont | $1,326.65 | $2,041.00 | $107.96 | 16% below | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W Cont | $2,054.65 | $3,161.00 | $101.17–$904.21 | 26% above | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Carotid Duplex Scan Bilat | $603.20 | $928.00 | $246.40 | — | 35% |
| Chest CT scan without and with contrast CPT 71270 CT Chest Diag W/WO Cont | $1,846.65 | $2,841.00 | $101.17–$801.93 | at median | 35% |
| Chest X-ray, 2 views CPT 71046 Xr Chest 2 Views | $184.60 | $284.00 | $89.87 | 25% below | 35% |
| Chest X-ray, single view CPT 71045 Xr Chest 1 View | $138.45 | $213.00 | $89.87 | 28% below | 35% |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 Xr Clavicle Complete Bi | $365.30 | $562.00 | $20.53–$115.59 | — | 35% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle Complete Lt | $243.75 | $375.00 | $89.87 | 1% above | 35% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle Complete Rt | $243.75 | $375.00 | $89.87 | 1% above | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneum Complete | $443.30 | $682.00 | $59.96–$256.45 | 29% below | 35% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Xr DXA Bone Density Axial | $255.45 | $393.00 | $107.96–$393.00 | 20% below | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Xr DXA Bone Density Appendicular | $181.35 | $279.00 | $89.87 | 3% below | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg Uter W Detl Fetl | $755.30 | $1,162.00 | $73.52–$317.33 | 14% above | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg Uter W Detl Fetl W/Counsel | $803.40 | $1,236.00 | $246.40 | 21% above | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest Diag WO Cont | $1,263.60 | $1,944.00 | $59.96–$466.70 | 2% below | 35% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest Diag W Cont | $1,250.60 | $1,924.00 | $181.13 | 24% below | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Mamm Diagnostic Bilat W Cad | $165.10 | $254.00 | $59.88–$384.06 | — | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 Mamm Diagnostic Unilat Rt W Cad | $108.55 | $167.00 | $45.87–$167.00 | 54% below | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 Mamm Diagnostic Unilat Lt W Cad | $108.55 | $167.00 | $45.87–$167.00 | 54% below | 35% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Art Lwr Extr Duplex Graft Comp Bi | $588.90 | $906.00 | $79.38–$317.33 | — | 35% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Duplex Lower Ext Comp Bi | $802.10 | $1,234.00 | $246.40 | — | 35% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Duplex Upper Ext Comp Bi | $802.10 | $1,234.00 | $246.40 | — | 35% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo 2d W/M-Mode & Dopp Comp | $2,079.35 | $3,199.00 | $878.77–$3,199.00 | 24% above | 35% |
| Elbow X-ray, 2 views both sides CPT 73070 Xr Elbow 1 View Bilat | $299.65 | $461.00 | $17.75–$115.59 | — | 35% |
| Elbow X-ray, 2 views both sides CPT 73070 Xr Elbow 2 Views Bi | $331.50 | $510.00 | $17.75–$115.59 | — | 35% |
| Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 1 View Rt | $183.95 | $283.00 | $17.75–$115.59 | 12% below | 35% |
| Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 1 View Lt | $183.95 | $283.00 | $17.75–$115.59 | 12% below | 35% |
| Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 Views Lt | $215.15 | $331.00 | $17.75–$115.59 | 3% above | 35% |
| Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 Views Rt | $215.15 | $331.00 | $90.93–$331.00 | 3% above | 35% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 Xr Elbow Complete Min 3 Views Bi | $378.95 | $583.00 | $20.53–$115.59 | — | 35% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete Min 3 Views Lt | $252.20 | $388.00 | $89.87 | 9% below | 35% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete Min 3 Views Rt | $252.20 | $388.00 | $106.58–$388.00 | 9% below | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit/Sella/Iac/Fossa WO Cont | $1,428.05 | $2,197.00 | $59.96–$526.85 | 11% above | 35% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Facial Bones Comp Min 3 Views | $297.70 | $458.00 | $29.13–$139.62 | at median | 35% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 Xr Forearm 2 Views Bi | $360.75 | $555.00 | $89.87 | — | 35% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 1 View Rt | $201.50 | $310.00 | $18.03–$115.59 | 4% below | 35% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 2 Views Rt | $240.50 | $370.00 | $89.87 | 15% above | 35% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 1 View Lt | $240.50 | $370.00 | $89.87 | 15% above | 35% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 2 Views Lt | $240.50 | $370.00 | $101.64–$370.00 | 15% above | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary System | $1,538.55 | $2,367.00 | $218.05–$924.58 | 24% above | 35% |
| Hand X-ray, 2 views both sides CPT 73120 Xr Hand 1 View Bilateral | $291.85 | $449.00 | $107.96 | — | 35% |
| Hand X-ray, 2 views both sides CPT 73120 Xr Hand 2 Views Bilateral | $318.50 | $490.00 | $19.69–$139.62 | — | 35% |
| Hand X-ray, 2 views one side CPT 73120 Xr Hand 1 View Lt | $161.85 | $249.00 | $68.40–$249.00 | 15% below | 35% |
| Hand X-ray, 2 views one side CPT 73120 Xr Hand 1 View Rt | $161.85 | $249.00 | $68.40–$249.00 | 15% below | 35% |
| Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 Views Left | $212.55 | $327.00 | $107.96 | 12% above | 35% |
| Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 Views Right | $212.55 | $327.00 | $19.69–$139.62 | 12% above | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 Xr Calcaneus Min 2v Bi | $332.15 | $511.00 | $89.87 | — | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneus Min 2v Lt | $204.10 | $314.00 | $86.26–$314.00 | 4% above | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneus Min 2v Rt | $204.10 | $314.00 | $89.87 | 4% above | 35% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysom Attended W Cpap/Bip 6/> Yrs <6hrs | $2,624.70 | $4,038.00 | $886.79 | at median | 35% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysom Attended W Cpap/Bip 6/> Yrs | $3,306.55 | $5,087.00 | $400.83–$1,335.66 | 26% above | 35% |
| Knee X-ray, 3 views both sides CPT 73562 Xr Knee 3 Views Bilateral | $405.60 | $624.00 | $26.63–$115.59 | — | 35% |
| Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Right | $270.40 | $416.00 | $26.63–$115.59 | at median | 35% |
| Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Left | $270.40 | $416.00 | $114.28–$416.00 | at median | 35% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 Xr Knee Complete Min 4v Bi | $583.70 | $898.00 | $30.25–$139.62 | — | 35% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee Complete Min 4v Rt | $349.05 | $537.00 | $107.96 | 6% above | 35% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee Complete Min 4v Lt | $349.05 | $537.00 | $30.25–$139.62 | 6% above | 35% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Extremity Lower WO Cont Bi | $1,652.30 | $2,542.00 | $1,031.00 | — | 35% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Extremity Lower WO Cont Rt | $880.10 | $1,354.00 | $59.96–$466.70 | 30% below | 35% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Extremity Lower WO Cont Lt | $880.10 | $1,354.00 | $59.96–$466.70 | 30% below | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $450.45 | $693.00 | $49.68–$208.16 | 9% below | 35% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Extrem Nonvascular Limited Bil | $484.25 | $745.00 | $23.61–$139.62 | 37% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extrem Nonvascular Limited Rt | $322.40 | $496.00 | $107.96 | 9% below | 35% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extrem Nonvascular Limited Lt | $322.40 | $496.00 | $107.96 | 9% below | 35% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 Xr Tibia and Fibula 2v Bi | $359.45 | $553.00 | $19.97–$115.59 | — | 35% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia and Fibula 1 View Rt | $239.85 | $369.00 | $19.97–$115.59 | 1% below | 35% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia and Fibula 1 View Lt | $239.85 | $369.00 | $89.87 | 1% below | 35% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia and Fibula 2v Rt | $239.85 | $369.00 | $19.97–$115.59 | 1% below | 35% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia and Fibula 2v Lt | $239.85 | $369.00 | $101.36–$369.00 | 1% below | 35% |
| MR angiography (MRA) of the head without contrast CPT 70544 Mra Head WO Cont | $1,454.05 | $2,237.00 | $1,719.00 | 5% below | 35% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Extr Lwr Jt WO Cont Bi | $2,304.90 | $3,546.00 | $1,719.00 | — | 35% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Extr Lwr Jt WO Cont Lt | $1,538.55 | $2,367.00 | $120.47–$1,192.53 | 12% below | 35% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Extr Lwr Jt WO Cont Rt | $1,538.55 | $2,367.00 | $246.40 | 12% below | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Extr Lwr Jt W/WO Cont Lt | $2,486.90 | $3,826.00 | $1,719.00 | 9% above | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Extr Lwr Jt W/WO Cont Rt | $2,486.90 | $3,826.00 | $206.69–$2,469.13 | 9% above | 35% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen WO Cont | $1,177.15 | $1,811.00 | $1,719.00 | 29% below | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen W/WO Cont | $2,225.60 | $3,424.00 | $940.57–$3,424.00 | 8% below | 35% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain WO Cont | $1,878.50 | $2,890.00 | $110.20–$1,089.33 | 21% above | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain W/WO Cont | $2,827.50 | $4,350.00 | $183.49–$1,825.49 | 14% above | 35% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar Spine WO Cont | $1,862.90 | $2,866.00 | $105.76–$1,048.56 | at median | 35% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Lumbar Spine W/WO Cont | $3,112.20 | $4,788.00 | $184.04–$1,833.64 | 26% above | 35% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Thoracic Spine WO Cont | $1,794.00 | $2,760.00 | $1,719.00 | 2% above | 35% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Cervical Spine W/WO Cont | $2,547.35 | $3,919.00 | $184.60–$1,839.08 | 3% above | 35% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Cervical Spine WO Cont | $1,794.00 | $2,760.00 | $1,719.00 | 9% below | 35% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis W/WO Cont | $3,100.50 | $4,770.00 | $1,719.00 | 25% above | 35% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis WO Cont | $1,929.85 | $2,969.00 | $131.00–$1,597.51 | 5% above | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Extr Uppr Jt WO Cont Bi | $2,117.70 | $3,258.00 | $1,719.00 | — | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Extr Uppr Jt WO Cont Rt | $1,443.00 | $2,220.00 | $609.83–$2,220.00 | 22% below | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Extr Uppr Jt WO Cont Lt | $1,443.00 | $2,220.00 | $1,719.00 | 22% below | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Xr Spine Cervical 4 or 5 Views | $410.80 | $632.00 | $34.13–$139.62 | 1% below | 35% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck W Cont | $2,007.85 | $3,089.00 | $1,031.00 | 39% above | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck WO Cont | $1,389.70 | $2,138.00 | $1,031.00 | 20% above | 35% |
| Neck soft tissue X-ray CPT 70360 Xr Soft Tissue Neck | $185.25 | $285.00 | $78.29–$285.00 | 19% below | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Mycrd Perf W Wall Mot&Ejec Frt Mult | $3,382.92 | $5,204.50 | $1,336.94 | 5% below | 35% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis WO Cont | $1,769.30 | $2,722.00 | $1,031.00 | 26% above | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Non OB Limited F/U | $359.45 | $553.00 | $107.96 | at median | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Non OB Complete | $424.45 | $653.00 | $59.96–$253.00 | 33% below | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uter 14 Wks Or> | $367.25 | $565.00 | $155.21–$565.00 | 31% below | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg Uter <14 Weeks Gest | $446.55 | $687.00 | $107.96 | 13% below | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Uter Ltd 1 or More Fetus | $265.85 | $409.00 | $42.19–$174.83 | 26% below | 35% |
| Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2 Views Lt | $194.35 | $299.00 | $82.14–$299.00 | 18% below | 35% |
| Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2 Views Rt | $194.35 | $299.00 | $89.87 | 18% below | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs Lt W Chest Pa Min 3 Vws | $274.95 | $423.00 | $107.96 | at median | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs Rt W Chest Pa Min 3 Vws | $274.95 | $423.00 | $107.96 | at median | 35% |
| Screening mammogram, both breasts both sides CPT 77067 Mamm Scrn Bilateral W Cad | $118.30 | $182.00 | $50.00–$182.00 | — | 35% |
| Screening mammogram, both breasts both sides CPT 77067 Mamm Scrn Bilat Implant W Cad | $118.30 | $182.00 | $50.00–$182.00 | — | 35% |
| Screening mammogram, both breasts one side CPT 77067 Mamm Scrn Left W Cad | $79.30 | $122.00 | $33.51–$122.00 | 55% below | 35% |
| Screening mammogram, both breasts one side CPT 77067 Mamm Scrn Right W Cad | $79.30 | $122.00 | $72.25–$318.51 | 55% below | 35% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Xr Shoulder Complete Min 2v Bi | $312.00 | $480.00 | $131.86–$480.00 | — | 35% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete Min 2v Rt | $208.00 | $320.00 | $21.64–$115.59 | 21% below | 35% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete Min 2v Lt | $208.00 | $320.00 | $21.64–$115.59 | 21% below | 35% |
| Sinus X-ray, complete, 3 or more views CPT 70220 Xr Sinuses Paranasal Comp Min 3v | $397.80 | $612.00 | $89.87 | 33% above | 35% |
| Skull X-ray, fewer than 4 views CPT 70250 Xr Skull <4 Views | $277.55 | $427.00 | $22.75–$139.62 | 8% above | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysom Attended >3 Chn 6/> Yrs <6 Hrs | $2,460.25 | $3,785.00 | $2,229.00–$3,341.00 | 5% above | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysom Attended >3 Chn 6/> Yrs | $3,161.60 | $4,864.00 | $886.79 | 35% above | 35% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Xr Swallowing Function W Video | $286.65 | $441.00 | $83.01–$351.84 | 36% below | 35% |
| Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 Xr Femur 2 Vw Bilat | $461.50 | $710.00 | $22.47–$115.59 | — | 35% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur 2 Vw Left | $307.45 | $473.00 | $89.87 | 19% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur 2 Vw Right | $307.45 | $473.00 | $22.47–$115.59 | 19% above | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Thoracic Spine WO Cont | $1,326.65 | $2,041.00 | $1,031.00 | at median | 35% |
| Toe X-ray, 2 or more views both sides CPT 73660 Xr Toe/S Min 2v Bi | $347.75 | $535.00 | $146.96–$535.00 | — | 35% |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe/S Min 2v Rt | $231.40 | $356.00 | $19.14–$115.59 | 16% above | 35% |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe/S Min 2v Lt | $231.40 | $356.00 | $19.14–$115.59 | 16% above | 35% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB | $367.25 | $565.00 | $107.96 | 29% below | 35% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Preg Uter Transvaginal | $397.15 | $611.00 | $47.74–$197.80 | 7% below | 35% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $677.95 | $1,043.00 | $59.96–$272.52 | 15% below | 35% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum and Contents | $481.00 | $740.00 | $58.57–$244.94 | 16% below | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $475.80 | $732.00 | $107.96 | 17% below | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Xr Upper GI Single Contrast | $384.80 | $592.00 | $162.62–$592.00 | 34% below | 35% |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 Xr Humerus Min 2 Views Bi | $384.15 | $591.00 | $162.35–$591.00 | — | 35% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus Min 2 Views Rt | $256.10 | $394.00 | $20.25–$115.59 | 6% above | 35% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus Min 2 Views Lt | $256.10 | $394.00 | $89.87 | 6% above | 35% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus 1 View Lt | $256.10 | $394.00 | $89.87 | 6% above | 35% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus 1 View Rt | $256.10 | $394.00 | $20.25–$115.59 | 6% above | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Lower Ext Ltd Rt | $465.40 | $716.00 | $196.69–$716.00 | 24% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Upper Ext Ltd Rt | $465.40 | $716.00 | $94.70–$139.62 | 24% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Upper Ext Ltd Lt | $465.40 | $716.00 | $196.69–$716.00 | 24% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Lower Ext Ltd Lt | $465.40 | $716.00 | $107.96 | 24% below | 35% |
| Wrist X-ray, 2 views both sides CPT 73100 Xr Wrist 2 Views Bilateral | $347.75 | $535.00 | $21.64–$115.59 | — | 35% |
| Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 Views Right | $186.55 | $287.00 | $21.64–$115.59 | 9% below | 35% |
| Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 Views Left | $186.55 | $287.00 | $78.84–$287.00 | 9% below | 35% |
| Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 1 View Lt | $200.85 | $309.00 | $21.64–$115.59 | 2% below | 35% |
| Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 1 View Rt | $200.85 | $309.00 | $89.87 | 2% below | 35% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 Xr Wrist Complete Min 3v Bi | $359.45 | $553.00 | $89.87 | — | 35% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete Min 3v Rt | $239.85 | $369.00 | $89.87 | 9% below | 35% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete Min 3v Lt | $239.85 | $369.00 | $89.87 | 9% below | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip W Pelvis 2-3 Views Lt | $213.85 | $329.00 | $89.87 | 10% below | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip W Pelvis 2-3 Views Rt | $213.85 | $329.00 | $30.80–$125.39 | 10% below | 35% |
| X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen 1 View | $158.60 | $244.00 | $89.87 | 23% below | 35% |
| X-ray of the ankle, 2 views both sides CPT 73600 Xr Ankle 2 Views Bilateral | $352.95 | $543.00 | $149.16–$543.00 | — | 35% |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 1 View Lt | $200.20 | $308.00 | $20.53–$115.59 | 1% above | 35% |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 1 View Rt | $200.20 | $308.00 | $20.53–$115.59 | 1% above | 35% |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Left | $235.30 | $362.00 | $20.53–$115.59 | 19% above | 35% |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Right | $235.30 | $362.00 | $89.87 | 19% above | 35% |
| X-ray of the finger(s), 2 or more views both sides CPT 73140 Xr Finger/S Min 2 Views Bi | $313.95 | $483.00 | $132.68–$483.00 | — | 35% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger/S Min 2 Views Rt | $192.40 | $296.00 | $89.87 | 7% below | 35% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger/S Min 2 Views Lt | $192.40 | $296.00 | $26.36–$115.59 | 7% below | 35% |
| X-ray of the foot, 2 views both sides CPT 73620 Xr Foot 2 Views Bilateral | $331.50 | $510.00 | $17.75–$115.59 | — | 35% |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 1 View Rt | $221.00 | $340.00 | $17.75–$115.59 | 6% above | 35% |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Right | $221.00 | $340.00 | $17.75–$115.59 | 6% above | 35% |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 1 View Lt | $221.00 | $340.00 | $89.87 | 6% above | 35% |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Left | $221.00 | $340.00 | $17.75–$115.59 | 6% above | 35% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 Xr Foot Complete Min 3v Bi | $365.30 | $562.00 | $89.87 | — | 35% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete Min 3v Lt | $243.75 | $375.00 | $89.87 | 10% below | 35% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete Min 3v Rt | $243.75 | $375.00 | $21.91–$115.59 | 10% below | 35% |
| X-ray of the hand, 3 or more views both sides CPT 73130 Xr Hand Complete Min 3v Bi | $350.35 | $539.00 | $89.87 | — | 35% |
| X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete Min 3v Lt | $233.35 | $359.00 | $89.87 | 10% below | 35% |
| X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete Min 3v Rt | $233.35 | $359.00 | $24.14–$115.59 | 10% below | 35% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 Xr Knee 1 or 2 Views Bilateral | $397.15 | $611.00 | $89.87 | — | 35% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 or 2 Views Left | $264.55 | $407.00 | $89.87 | 16% above | 35% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 or 2 Views Right | $264.55 | $407.00 | $21.91–$115.59 | 16% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Spine Lumbar 2 or 3 Views | $249.60 | $384.00 | $107.96 | 14% below | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 Xr Spine Lumbar Min 4 Views | $403.65 | $621.00 | $107.96 | 5% below | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr Spine Thoracic 2 Views | $140.40 | $216.00 | $107.96 | 44% below | 35% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones Comp Min 3 Views | $267.15 | $411.00 | $24.69–$115.59 | 7% above | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 3 Views or Less | $274.95 | $423.00 | $24.14–$115.59 | 6% below | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1 or 2 Views | $165.75 | $255.00 | $16.36–$139.62 | 25% below | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum and Coccyx Min 2 Views | $272.35 | $419.00 | $20.25–$115.59 | 7% above | 35% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 Acth Adrenocorticotropic Hormone | $232.70 | $358.00 | $98.34–$358.00 | 36% above | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt Sgpt | $31.85 | $49.00 | $4.71–$21.08 | 35% below | 35% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Ast Sgot | $31.85 | $49.00 | $4.61–$20.59 | 32% below | 35% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute | $274.95 | $423.00 | $116.20–$423.00 | 14% above | 35% |
| Albumin blood test CPT 82040 Albumin Serum | $29.90 | $46.00 | $4.40–$19.68 | 7% below | 35% |
| Aldosterone blood test CPT 82088 Aldosterone Serum | $228.15 | $351.00 | $96.42–$351.00 | 41% above | 35% |
| Aldosterone blood test CPT 82088 Aldosterone 24 Hr Urine | $253.50 | $390.00 | $107.13–$390.00 | 56% above | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $35.75 | $55.00 | $15.11–$55.00 | 30% below | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige Crude Extract Ea | $33.80 | $52.00 | $4.64–$20.76 | 57% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg Whole Ige | $36.40 | $56.00 | $15.38–$56.00 | 69% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Sugar Cane Ige | $36.40 | $56.00 | $4.64–$20.76 | 69% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Macadamia Nut Ige | $37.70 | $58.00 | $15.93–$58.00 | 75% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Dock Yellow Rumex Crispus Ige | $37.70 | $58.00 | $4.64–$20.76 | 75% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Galactose Alpha 1,3-Galactose Ige | $54.60 | $84.00 | $23.07–$84.00 | 153% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Feather Panel Two | $61.10 | $94.00 | $4.64–$20.76 | 184% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Latex Antigen Ige | $61.10 | $94.00 | $25.82–$94.00 | 184% above | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Maternal | $98.80 | $152.00 | $41.75–$152.00 | 3% above | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Serum | $142.35 | $219.00 | $60.16–$219.00 | 48% above | 35% |
| Ammonia blood test CPT 82140 Stone Risk Ua Ammonia | $57.85 | $89.00 | $12.38–$57.96 | 24% below | 35% |
| Ammonia blood test CPT 82140 Ammonia | $82.55 | $127.00 | $34.89–$127.00 | 8% above | 35% |
| Amylase blood test CPT 82150 Amylase Urine | $57.85 | $89.00 | $5.76–$25.78 | 1% above | 35% |
| Amylase blood test CPT 82150 Amylase Serum | $63.70 | $98.00 | $26.92–$98.00 | 11% above | 35% |
| Amylase blood test CPT 82150 Amylase Pancreatic | $93.60 | $144.00 | $5.76–$25.78 | 63% above | 35% |
| Amylase blood test CPT 82150 Amylase Fluid | $105.95 | $163.00 | $5.76–$25.78 | 85% above | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide, Antibody | $113.75 | $175.00 | $48.07–$175.00 | 42% above | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen | $56.55 | $87.00 | $23.90–$87.00 | 15% below | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Brain Natriuretic Peptide | $134.55 | $207.00 | $56.86–$207.00 | 8% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Genital | $68.90 | $106.00 | $29.12–$106.00 | 1% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Throat | $92.95 | $143.00 | $7.35–$34.28 | 36% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Spinal Fluid | $93.60 | $144.00 | $7.35–$34.28 | 37% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Ear | $109.20 | $168.00 | $7.35–$34.28 | 60% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Wound Aerobic | $114.40 | $176.00 | $7.35–$34.28 | 67% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Any Other Source | $120.90 | $186.00 | $7.35–$34.28 | 77% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Bone Marrow | $120.90 | $186.00 | $51.09–$186.00 | 77% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Eye | $120.90 | $186.00 | $7.35–$34.28 | 77% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Placenta | $120.90 | $186.00 | $51.09–$186.00 | 77% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture IV Catheter Tip | $120.90 | $186.00 | $7.35–$34.28 | 77% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Resp Cystic Fibrosis Pt | $120.90 | $186.00 | $7.35–$34.28 | 77% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Respiratory | $120.90 | $186.00 | $51.09–$186.00 | 77% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Burn Wound | $120.90 | $186.00 | $7.35–$34.28 | 77% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Nasopharyngeal | $129.35 | $199.00 | $54.67–$199.00 | 89% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Sputum | $129.35 | $199.00 | $7.35–$34.28 | 89% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Aerobic Only | $131.95 | $203.00 | $7.35–$34.28 | 93% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Bronchial Brush | $143.00 | $220.00 | $7.35–$34.28 | 109% above | 35% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Pnl Calcium Total | $61.75 | $95.00 | $26.10–$95.00 | 45% below | 35% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $72.80 | $112.00 | $4.47–$19.94 | 47% above | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path Lev IV Gross and Micro | $159.25 | $245.00 | $53.81 | 20% below | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Prostate Needle Bx Gross and Micro | $200.20 | $308.00 | $53.81 | 1% above | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Path Exam-Cell Block | $219.05 | $337.00 | $30.36–$111.65 | 11% above | 35% |
| Blood culture for bacteria CPT 87040 Culture Blood Bacterial | $110.50 | $170.00 | $9.18–$41.08 | 1% below | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Ref Lab Venipuncture Blood Collect | $16.90 | $26.00 | $6.50–$26.00 | 4% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture | $16.90 | $26.00 | $3.00–$31.73 | 4% above | 35% |
| Blood glucose (sugar) test CPT 82947 POC Glucose Quant Blood | $40.95 | $63.00 | $17.31–$63.00 | 37% above | 35% |
| Blood glucose (sugar) test CPT 82947 Glucose Quant Blood | $46.15 | $71.00 | $19.50–$71.00 | 55% above | 35% |
| Blood lead test CPT 83655 POC Lead | $89.05 | $137.00 | $10.77–$48.15 | 63% above | 35% |
| Blood lead test CPT 83655 Lead Blood | $89.05 | $137.00 | $37.63–$137.00 | 63% above | 35% |
| Blood lead test CPT 83655 Lead Urine | $89.05 | $137.00 | $37.63–$137.00 | 63% above | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 POC Hcg Qual Pregnancy Screen | $34.45 | $53.00 | $14.56–$53.00 | 35% below | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg Qual Pregnancy Screen | $52.65 | $81.00 | $22.25–$81.00 | 1% below | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Blood Typing | $44.85 | $69.00 | $137.39 | 10% below | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 Bun Blood Urea Nitrogen | $33.80 | $52.00 | $3.51–$15.71 | 9% below | 35% |
| C-peptide blood test CPT 84681 C Peptide | $126.75 | $195.00 | $53.57–$195.00 | 21% above | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein | $46.15 | $71.00 | $19.50–$71.00 | 22% below | 35% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Difficile Amp Probe | $176.80 | $272.00 | $33.15–$139.58 | 16% above | 35% |
| CA 19-9 blood test (tumor marker) CPT 86301 Ca 19 9 | $145.60 | $224.00 | $18.51–$82.78 | 38% above | 35% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Ca 125 | $78.65 | $121.00 | $33.24–$121.00 | 28% below | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 Covid-19, Rt-Pcr | $120.25 | $185.00 | $50.82–$185.00 | 24% above | 35% |
| Calcium blood test, total CPT 82310 Calcium Total Serum | $54.60 | $84.00 | $23.07–$84.00 | 18% above | 35% |
| Calcium blood test, total CPT 82310 Calcium Total Urine | $59.15 | $91.00 | $25.00–$91.00 | 28% above | 35% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen Cea | $70.20 | $108.00 | $16.86–$75.45 | 31% below | 35% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Ag Cea Fluid | $140.40 | $216.00 | $16.86–$75.45 | 38% above | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Ab Igg | $111.80 | $172.00 | $47.25–$172.00 | 51% above | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Ab Igm | $111.80 | $172.00 | $47.25–$172.00 | 51% above | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Antibody | $126.10 | $194.00 | $10.95–$51.25 | 71% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Ampl Probe Other | $73.45 | $113.00 | $31.04–$113.00 | 17% below | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Ampl Probe | $136.50 | $210.00 | $57.69–$210.00 | 55% above | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 POC Lipid Panel | $80.60 | $124.00 | $11.91–$53.26 | 21% below | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $88.40 | $136.00 | $11.91–$53.26 | 13% below | 35% |
| Complete blood count (CBC) with differential CPT 85025 Cbc W Auto Diff | $72.80 | $112.00 | $6.60–$30.92 | 44% above | 35% |
| Complete blood count (CBC), no differential CPT 85027 Cbc Automated WO Diff | $63.70 | $98.00 | $5.75–$25.73 | 20% above | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $77.35 | $119.00 | $9.39–$42.02 | 35% below | 35% |
| Cortisol blood test, total CPT 82533 Cortisol Saliva | $106.60 | $164.00 | $45.05–$164.00 | 22% above | 35% |
| Cortisol blood test, total CPT 82533 Cortisol | $117.00 | $180.00 | $49.45–$180.00 | 34% above | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 Cpk Creatine Kinase Total | $80.60 | $124.00 | $5.79–$25.90 | 28% above | 35% |
| Creatinine blood test CPT 82565 Creatinine Blood | $52.00 | $80.00 | $4.55–$20.38 | 63% above | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Igg Antibody | $87.10 | $134.00 | $36.81–$134.00 | 25% above | 35% |
| D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quantitative | $96.20 | $148.00 | $40.66–$148.00 | 23% below | 35% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea Sulfate | $169.65 | $261.00 | $71.70–$261.00 | 20% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cotinine Screen Urine | $55.25 | $85.00 | $23.35–$85.00 | 28% below | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Scn Meconium Mult Drug Non Chrom | $102.05 | $157.00 | $55.27–$230.18 | 32% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 7 Meconium | $105.95 | $163.00 | $44.78–$163.00 | 37% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 9 Meconium | $120.90 | $186.00 | $51.09–$186.00 | 57% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Ethyl Glucuronide Screen Urine | $130.65 | $201.00 | $55.27–$230.18 | 69% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Mult Drug Class Method Ea | $138.45 | $213.00 | $58.51–$213.00 | 79% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 12 Meconium | $152.10 | $234.00 | $64.28–$234.00 | 97% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Synthetic Cannabis Drug Screen Urine | $154.05 | $237.00 | $55.27–$230.18 | 99% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Presumptive per Dos | $154.05 | $237.00 | $55.27–$230.18 | 99% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Mephedrone, Mdpv, Methylone Drug Scrn Urine | $154.70 | $238.00 | $65.38–$238.00 | 100% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 13 Meconium | $157.95 | $243.00 | $66.75–$243.00 | 105% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 8 Umbilical Cord | $159.25 | $245.00 | $55.27–$230.18 | 106% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 7 Umbilical Cord | $163.15 | $251.00 | $68.95–$251.00 | 111% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 9 Umbilical Cord | $164.45 | $253.00 | $55.27–$230.18 | 113% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 12 Umbilical Cord | $181.35 | $279.00 | $55.27–$230.18 | 135% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 13 Umbilical Cord | $206.70 | $318.00 | $87.35–$318.00 | 168% above | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel | $49.40 | $76.00 | $20.88–$76.00 | 41% below | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Ebv Vca Igg | $83.20 | $128.00 | $15.42–$72.18 | 5% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Ebv Vca Igm | $83.20 | $128.00 | $35.16–$128.00 | 5% above | 35% |
| Estradiol blood test CPT 82670 Estradiol, Total | $115.05 | $177.00 | $48.62–$177.00 | 19% below | 35% |
| FSH (follicle-stimulating hormone) test CPT 83001 Fsh Follicle Stimulating Hormone | $76.05 | $117.00 | $32.14–$117.00 | 26% below | 35% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal | $170.95 | $263.00 | $17.46–$78.08 | 9% below | 35% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $117.00 | $180.00 | $12.12–$54.22 | 22% above | 35% |
| Fibrinogen blood test CPT 85384 Fibrinogen Activity | $42.90 | $66.00 | $8.65–$35.99 | 53% below | 35% |
| Folate (folic acid) blood test CPT 82746 Folic Acid Serum | $114.40 | $176.00 | $13.08–$58.49 | 39% above | 35% |
| Free T3 thyroid hormone test CPT 84481 T3 Free | $118.30 | $182.00 | $50.00–$182.00 | 19% above | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Thyroxine Free | $74.10 | $114.00 | $31.32–$114.00 | 4% below | 35% |
| Free testosterone test CPT 84402 Testosterone Free | $149.50 | $230.00 | $22.66–$101.29 | 22% above | 35% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Ggt Glutamyltransferase Gamma | $53.95 | $83.00 | $22.80–$83.00 | 6% below | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Postprandial | $44.85 | $69.00 | $4.23–$18.89 | 6% above | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Post Glucose Dose | $46.15 | $71.00 | $4.23–$18.89 | 9% above | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance 1 Hr OB | $46.15 | $71.00 | $19.50–$71.00 | 9% above | 35% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tol Test 3 Specimen | $92.30 | $142.00 | $39.01–$142.00 | 1% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae Ampl Probe Other | $70.20 | $108.00 | $31.21–$139.58 | 13% below | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae Ampl Probe | $143.65 | $221.00 | $31.21–$139.58 | 79% above | 35% |
| H. pylori antibody blood test CPT 86677 Helicobacter Pylori Antibody | $139.75 | $215.00 | $14.32–$62.40 | 75% above | 35% |
| H. pylori stool antigen test CPT 87338 Helicobacter Pylori Stool Eia | $158.60 | $244.00 | $67.03–$244.00 | 34% above | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv 1 Quantification | $395.20 | $608.00 | $167.02–$608.00 | 13% above | 35% |
| HIV-1 and HIV-2 antibody test CPT 86703 Hiv 1-2 Rapid Screen | $95.55 | $147.00 | $7.91–$54.52 | 12% below | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 Ag W Hiv-1 & 2 Ab Ia | $87.10 | $134.00 | $36.81–$134.00 | 2% below | 35% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Human Papillomavirus Ampl Probe High Risk | $115.05 | $177.00 | $31.21–$139.58 | 4% above | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 POC Hemoglobin A1c Glycated | $83.20 | $128.00 | $8.64–$38.60 | 38% above | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c Glycated | $91.00 | $140.00 | $38.46–$140.00 | 51% above | 35% |
| Hemoglobin blood test CPT 85018 Hemoglobin | $17.55 | $27.00 | $2.01–$9.43 | 37% below | 35% |
| Hemoglobin blood test CPT 85018 POC Hemoglobin | $22.10 | $34.00 | $2.01–$9.43 | 20% below | 35% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody Total | $108.55 | $167.00 | $45.87–$167.00 | 62% above | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab | $82.55 | $127.00 | $9.55–$42.72 | 23% above | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen Eia | $65.65 | $101.00 | $9.19–$40.38 | 5% above | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody | $117.65 | $181.00 | $49.72–$181.00 | 51% above | 35% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus Quantification | $365.95 | $563.00 | $154.66–$563.00 | 23% above | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Ab Type 1 | $46.80 | $72.00 | $11.21–$52.47 | 27% below | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1 Igm Ab | $90.35 | $139.00 | $38.18–$139.00 | 42% above | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1 Igm Titer | $92.30 | $142.00 | $11.21–$52.47 | 45% above | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Ab Type 2 | $63.70 | $98.00 | $17.21–$77.00 | at median | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 Igm Ab | $113.75 | $175.00 | $17.21–$77.00 | 79% above | 35% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein High Sensitive | $57.85 | $89.00 | $11.01–$51.48 | 20% below | 35% |
| Homocysteine blood test CPT 83090 Homocysteine | $156.00 | $240.00 | $15.94–$67.10 | 28% above | 35% |
| Homocysteine blood test CPT 83090 Homocysteine Urine | $173.55 | $267.00 | $15.94–$67.10 | 43% above | 35% |
| Insulin blood test CPT 83525 Insulin Total | $40.30 | $62.00 | $10.17–$45.46 | 33% below | 35% |
| Iron blood test (serum iron) CPT 83540 Iron Serum | $66.95 | $103.00 | $5.50–$25.75 | 47% above | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity | $66.30 | $102.00 | $7.77–$34.78 | 1% below | 35% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $85.80 | $132.00 | $7.72–$34.54 | 21% below | 35% |
| LH (luteinizing hormone) test CPT 83002 Lh Luteinizing Hormone | $76.05 | $117.00 | $32.14–$117.00 | 25% below | 35% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone Pediatric Lh | $106.60 | $164.00 | $45.05–$164.00 | 5% above | 35% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid | $146.25 | $225.00 | $61.81–$225.00 | 67% above | 35% |
| Lactate (lactic acid) blood test CPT 83605 D Lactate | $178.10 | $274.00 | $10.08–$42.84 | 104% above | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Lactate Dehydrogenase | $36.40 | $56.00 | $15.38–$56.00 | 29% below | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Lactate Dehydrogenase Fluid | $63.70 | $98.00 | $5.37–$24.00 | 24% above | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Fluid | $52.65 | $81.00 | $6.13–$27.39 | 30% below | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase | $55.25 | $85.00 | $6.13–$27.39 | 26% below | 35% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $63.70 | $98.00 | $26.92–$98.00 | 43% below | 35% |
| Lyme disease antibody test CPT 86618 Lyme Disease Antibody | $93.60 | $144.00 | $39.56–$144.00 | 2% above | 35% |
| Lyme disease antibody test CPT 86618 Lyme Disease Antibody CSF | $133.90 | $206.00 | $56.59–$206.00 | 46% above | 35% |
| Lyme disease antibody test CPT 86618 Lyme Disease Antibody Igg | $147.55 | $227.00 | $14.48–$67.74 | 61% above | 35% |
| Magnesium blood test CPT 83735 Stone Risk Ua Magnesium | $65.00 | $100.00 | $27.47–$100.00 | 37% above | 35% |
| Magnesium blood test CPT 83735 Magnesium Stool | $65.00 | $100.00 | $27.47–$100.00 | 37% above | 35% |
| Magnesium blood test CPT 83735 Magnesium Urine | $79.95 | $123.00 | $5.96–$26.63 | 68% above | 35% |
| Magnesium blood test CPT 83735 Magnesium 24 Hr Urine | $83.85 | $129.00 | $5.96–$26.63 | 76% above | 35% |
| Magnesium blood test CPT 83735 Magnesium RBC | $83.85 | $129.00 | $5.96–$26.63 | 76% above | 35% |
| Magnesium blood test CPT 83735 Magnesium | $87.75 | $135.00 | $5.96–$26.63 | 84% above | 35% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibody Igm | $87.10 | $134.00 | $36.81–$134.00 | 71% above | 35% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibody Igg | $94.90 | $146.00 | $10.95–$51.25 | 86% above | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 POC Monotest Heterophile Ab Screen | $53.30 | $82.00 | $22.53–$82.00 | 29% above | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Monotest Heterophile Ab Screen | $53.30 | $82.00 | $22.53–$82.00 | 29% above | 35% |
| Mumps immunity blood test CPT 86735 Mumps Igm Antibody | $74.10 | $114.00 | $11.09–$51.89 | 25% above | 35% |
| Mumps immunity blood test CPT 86735 Mumps Igg Antibody | $112.45 | $173.00 | $11.09–$51.89 | 90% above | 35% |
| Obstetric blood test panel CPT 80055 Obstetric Panel | $407.55 | $627.00 | $172.24–$627.00 | 38% above | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Psa Free | $135.85 | $209.00 | $57.41–$209.00 | 69% above | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Ultrasensitive | $129.35 | $199.00 | $54.67–$199.00 | 65% above | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total Diagnostic | $143.65 | $221.00 | $16.36–$73.18 | 83% above | 35% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Pap Smear Auto Scrn Man Rescrn | $89.70 | $138.00 | $37.91–$138.00 | 21% above | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Smear Manual Screen | $95.55 | $147.00 | $40.38–$147.00 | 31% above | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 Pth Intact | $147.55 | $227.00 | $35.09–$164.19 | 16% below | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Mixing | $39.00 | $60.00 | $5.25–$23.89 | 28% below | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Partial Thromboplastin Time | $42.90 | $66.00 | $18.13–$66.00 | 20% below | 35% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Stool | $37.70 | $58.00 | $15.93–$58.00 | 1% above | 35% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus | $41.60 | $64.00 | $4.22–$18.86 | 11% above | 35% |
| Potassium blood test CPT 84132 Potassium Plasma/Wb | $42.90 | $66.00 | $18.13–$66.00 | 9% above | 35% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Fetal Chromosomal Aneupoidy 13 18 21 Blood | $1,120.60 | $1,724.00 | $671.00–$2,810.76 | 4% below | 35% |
| Progesterone blood test CPT 84144 Progesterone | $81.25 | $125.00 | $34.34–$125.00 | 26% below | 35% |
| Prolactin blood test CPT 84146 Prolactin | $72.80 | $112.00 | $30.77–$112.00 | 38% below | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $34.45 | $53.00 | $14.56–$53.00 | 21% above | 35% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Nicotine Cotinine Dir Optical Observ | $99.45 | $153.00 | $42.03–$153.00 | 46% above | 35% |
| Rapid flu test (influenza antigen) CPT 87804 POC Influenza B Ag Oia | $53.30 | $82.00 | $14.72–$61.28 | 10% below | 35% |
| Rapid flu test (influenza antigen) CPT 87804 POC Influenza a Ag Oia | $53.30 | $82.00 | $14.72–$61.28 | 10% below | 35% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza B Ag Oia | $59.80 | $92.00 | $14.72–$61.28 | 1% above | 35% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza a Ag Oia | $59.80 | $92.00 | $25.27–$92.00 | 1% above | 35% |
| Rapid flu test (influenza antigen) CPT 87804 POC Influenza Rapid Screen Oia | $59.80 | $92.00 | $25.27–$92.00 | 1% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Dir Optical Observ | $48.75 | $75.00 | $14.05–$61.21 | 8% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 POC Rapid Strep Dir Optical Observ | $48.75 | $75.00 | $14.05–$61.21 | 8% above | 35% |
| Renin blood test CPT 84244 Renin | $145.60 | $224.00 | $61.53–$224.00 | 15% above | 35% |
| Rh blood typing CPT 86901 Rh (D) Blood Typing | $44.85 | $69.00 | $2.66–$51.53 | at median | 35% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quantitative | $24.05 | $37.00 | $5.04–$22.57 | 51% below | 35% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody Igg | $52.00 | $80.00 | $21.98–$80.00 | 1% above | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate Automated | $41.60 | $64.00 | $2.40–$10.75 | 21% above | 35% |
| Sodium blood test CPT 84295 Sodium Plasma/Wb | $50.05 | $77.00 | $4.20–$19.16 | 27% above | 35% |
| Stool ova and parasites exam CPT 87177 Ova and Parasites | $83.20 | $128.00 | $7.92–$35.39 | 41% above | 35% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Bld Screen Feces Qual 1 to 3 Det | $46.15 | $71.00 | $19.50–$71.00 | 112% above | 35% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 POC Occult Bld Screen Feces Qual 1 to 3 Det | $46.15 | $71.00 | $19.50–$71.00 | 112% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood Feces Immuno Qual 1-3 Det | $59.15 | $91.00 | $25.00–$91.00 | 16% above | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Total | $46.15 | $71.00 | $19.50–$71.00 | 10% below | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Mha Treponema Pallidum Ab by Tp-Pa | $66.95 | $103.00 | $28.29–$103.00 | 31% above | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Igg | $74.10 | $114.00 | $11.78–$52.65 | 45% above | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Fta Treponema Pallidum | $74.10 | $114.00 | $11.78–$52.65 | 45% above | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Qualitative | $35.10 | $54.00 | $3.80–$16.99 | 25% above | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl Qualitative CSF | $53.30 | $82.00 | $3.80–$16.99 | 90% above | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon R TB Gold | $195.00 | $300.00 | $55.13–$246.54 | 9% above | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total | $149.50 | $230.00 | $22.96–$102.70 | 26% above | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Kidney Microsomal Ab Each | $96.85 | $149.00 | $12.94–$57.87 | 24% above | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Ab Each | $117.65 | $181.00 | $12.94–$57.87 | 51% above | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Newborn | $16.90 | $26.00 | $14.94–$66.84 | 58% below | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Thyroid Stimulating Hormone | $74.75 | $115.00 | $31.59–$115.00 | 84% above | 35% |
| Total IgE blood test CPT 82785 Immunoglobulin E | $56.55 | $87.00 | $13.99–$65.50 | 22% below | 35% |
| Total cholesterol blood test CPT 82465 Cholesterol Serum/Whole Bld Total | $59.80 | $92.00 | $25.27–$92.00 | 80% above | 35% |
| Total thyroxine (T4) blood test CPT 84436 T4 Thyroxine Total | $67.60 | $104.00 | $28.57–$104.00 | 14% above | 35% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 Total | $65.00 | $100.00 | $12.61–$56.39 | 14% below | 35% |
| Transferrin blood test CPT 84466 Transferrin | $132.60 | $204.00 | $11.35–$50.78 | 57% above | 35% |
| Trichomonas test (NAAT) CPT 87661 Trichomonal Vaginalis Amp Probe | $136.50 | $210.00 | $31.21–$139.58 | 1% below | 35% |
| Triglycerides blood test CPT 84478 Triglycerides | $48.10 | $74.00 | $5.11–$22.86 | 7% above | 35% |
| Triglycerides blood test CPT 84478 Triglycerides Fluid | $85.15 | $131.00 | $35.99–$131.00 | 89% above | 35% |
| Troponin test, quantitative CPT 84484 Troponin Quantitative | $70.20 | $108.00 | $29.67–$108.00 | 36% below | 35% |
| Uric acid blood test CPT 84550 Uric Acid Blood | $41.60 | $64.00 | $4.02–$17.99 | at median | 35% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Automated W Micro | $53.95 | $83.00 | $22.80–$83.00 | 54% above | 35% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Non Automated W Micro | $39.65 | $61.00 | $16.76–$61.00 | 49% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Ph Automated | $31.20 | $48.00 | $1.91–$8.33 | 39% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Ketones Automated | $31.20 | $48.00 | $1.91–$8.33 | 39% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Automated | $31.20 | $48.00 | $1.91–$8.33 | 39% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Automated W/O Micro | $35.10 | $54.00 | $1.91–$8.33 | 56% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 POC Urinalysis Automated W/O Micro | $35.10 | $54.00 | $1.91–$8.33 | 56% above | 35% |
| Urinalysis without microscope exam, manual CPT 81002 POC Urinalysis Non-Auto | $21.45 | $33.00 | $9.07–$33.00 | 55% above | 35% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Ketones Nonautomated | $24.05 | $37.00 | $10.16–$37.00 | 74% above | 35% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Non Automated WO Micro | $24.05 | $37.00 | $3.01–$12.89 | 74% above | 35% |
| Urine culture for bacteria, with colony count CPT 87086 Culture Urine Bacterial Quant Cnt | $50.05 | $77.00 | $7.18–$29.88 | 25% below | 35% |
| Urine microalbumin (albumin) test CPT 82043 POC Microalbumin Urine Quant | $86.45 | $133.00 | $5.14–$22.98 | 150% above | 35% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine Quant | $95.55 | $147.00 | $5.14–$22.98 | 177% above | 35% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin 24 Hr Urine Quant | $106.60 | $164.00 | $5.14–$22.98 | 209% above | 35% |
| Urine pregnancy test, read by color change CPT 81025 POC Urine Pregnancy Test | $103.35 | $159.00 | $43.68–$159.00 | 113% above | 35% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test | $103.35 | $159.00 | $43.68–$159.00 | 113% above | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 | $52.65 | $81.00 | $22.25–$81.00 | 32% below | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy | $109.85 | $169.00 | $25.16–$117.76 | 19% below | 35% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 1 25 Dihydroxy | $250.25 | $385.00 | $96.25–$385.00 | 45% above | 35% |
| Zinc blood test CPT 84630 Zinc Serum | $62.40 | $96.00 | $10.13–$45.29 | 5% above | 35% |
| Zinc blood test CPT 84630 Zinc Urine | $68.90 | $106.00 | $10.13–$45.29 | 16% above | 35% |
| Zinc blood test CPT 84630 Zinc 24 Hr Urine | $68.90 | $106.00 | $10.13–$45.29 | 16% above | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 POC Hcg Quant | $31.85 | $49.00 | $12.79–$55.73 | 62% below | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg-Maternal Screen | $109.85 | $169.00 | $12.79–$55.73 | 31% above | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Quant | $120.25 | $185.00 | $50.82–$185.00 | 43% above | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Quant Tumor Marker | $152.10 | $234.00 | $64.28–$234.00 | 81% above | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 Surgical Arthroscopy Shoulder W/Rotator Cuff Rpr | $8,472.56 | $13,034.71 | $2,317.55–$14,826.76 | 13% below | 35% |
| Botox injections for chronic migraine CPT 64615 Chemodenerv of Musc(S) Innrv Fac Nrv Bil | $3,801.20 | $5,848.00 | $123.45–$627.20 | 914% above | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Elective Ext | $1,192.75 | $1,835.00 | $591.00–$2,224.00 | 12% above | 35% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circumcision Surg Exc > 28 Days | $215.80 | $332.00 | $83.00–$332.00 | 92% below | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Clamp Oth Dev W Block | $215.80 | $332.00 | $83.00–$332.00 | 41% below | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Clamp Oth Dev W/O Block | $215.80 | $332.00 | $83.00–$332.00 | 41% below | 35% |
| Colonoscopy, diagnostic CPT 45378 GI Colonoscopy | $2,166.45 | $3,333.00 | $960.33 | 29% above | 35% |
| Earwax removal with instruments, one ear one side CPT 69210 Rem Impact Cerumen Instrument Unilat | $272.35 | $419.00 | $104.75–$419.00 | 163% above | 35% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Inject Interlaminar Cerv or Thoracic W Imag | $2,909.32 | $4,475.87 | $728.94 | 90% above | 35% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paravert F Jnt L/S 1st Lev | $821.60 | $1,264.00 | $316.00–$1,264.00 | 24% below | 35% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paravert F Jnt L/S 1st Lev Bil | $3,954.18 | $6,083.35 | $913.36 | 265% above | 35% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 GI Sigmoidiscope Flexible | $1,204.45 | $1,853.00 | $847.00–$1,406.00 | 3% below | 35% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Inj Hysterosalpingogram | $395.85 | $609.00 | $152.25–$609.00 | 70% above | 35% |
| Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy Endometrial Ablation | $7,628.46 | $11,736.09 | $2,264.00–$5,058.00 | 12% above | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I/D Abscess Simple | $304.85 | $469.00 | $117.25–$469.00 | 8% above | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) both sides CPT 20550 Bilat Inj Sgl Ten Sheath/Lig/Apo | $609.70 | $938.00 | $234.50–$938.00 | — | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Sgl Ten Sheath/Lig/Apo | $411.45 | $633.00 | $158.25–$633.00 | 27% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Asp/Inj Major Jt WO US Guid | $423.80 | $652.00 | $163.00–$652.00 | 46% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Bil Asp/Inj Major Jt WO US Guid | $635.05 | $977.00 | $244.25–$977.00 | 118% above | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 Bilat Asp/Inj Intermed Jt WO US Guid | $497.90 | $766.00 | $191.50–$766.00 | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Asp/Inj Intermed Jt WO US Guid | $332.15 | $511.00 | $127.75–$511.00 | 2% below | 35% |
| Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 Bilat Asp/Inj Small Jt WO US Guid | $428.35 | $659.00 | $164.75–$659.00 | — | 35% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/Inj Small Jt WO US Guid | $286.00 | $440.00 | $110.00–$440.00 | 5% above | 35% |
| Knee arthroscopy with meniscus trim CPT 29881 Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg | $5,933.74 | $9,128.83 | $1,048.57–$6,685.74 | 14% below | 35% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Arthrs Knee Surg Meniscectomy Med&Lat W/Shaving | $5,912.85 | $9,096.69 | $2,264.00–$5,058.00 | 14% below | 35% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Arthrs Knee Surg Debridement/Shvg Artclr Crtlg | $5,711.26 | $8,786.55 | $3,378.88 | 18% below | 35% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 Lap Gstr Rstcv W/Byp Roux-en-Y Lmb <150 Cm | $8,328.45 | $12,813.00 | $3,203.25–$12,813.00 | 67% below | 35% |
| Laparoscopic removal of an adjustable gastric band and its port CPT 43774 Lap Gastric Restrctve Remove Device & Port | $3,204.50 | $4,930.00 | $1,232.50–$4,930.00 | 73% below | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Inject Interlaminar Lumbar or Sacral W Imag | $2,731.22 | $4,201.87 | $948.00–$1,609.00 | 91% above | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Inj Dx/Tx Epid/Subaracr Lmbr/Sac WO Imag | $1,059.50 | $1,630.00 | $407.50–$1,630.00 | 5% below | 35% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Bilat Inj Epi/Lumb/Sacral Sngl Level | $2,167.75 | $3,335.00 | $833.75–$3,335.00 | — | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Epi/Lumb/Sacral Sngl Level | $1,539.20 | $2,368.00 | $592.00–$2,368.00 | 2% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Transforminal Epi/Lumb/Sacral Sngl Level | $3,488.38 | $5,366.74 | $295.27–$1,807.26 | 131% above | 35% |
| Miscarriage treatment with D&C, first trimester CPT 59820 Tx Missed Abortion First Trimester Surgical | $5,065.79 | $7,793.53 | $1,012.78–$6,614.48 | 8% above | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Ben Les Tru <.5cm | $510.90 | $786.00 | $196.50–$786.00 | 7% below | 35% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Single | $490.10 | $754.00 | $188.50–$754.00 | 98% above | 35% |
| Occipital nerve block (injection for headaches) both sides CPT 64405 Bilat Inj Anes Gtr Occiptal Nerve | $789.75 | $1,215.00 | $303.75–$1,215.00 | — | 35% |
| Occipital nerve block (injection for headaches) CPT 64405 Inj Anes Gtr Occiptal Nerve | $1,498.68 | $2,305.66 | $948.00–$1,609.00 | 294% above | 35% |
| Paracentesis with imaging guidance CPT 49083 Abd Paracentesis With Imag Guidance | $1,008.80 | $1,552.00 | $388.00–$1,552.00 | at median | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Exc Nail/Matrix Perm Rem | $2,133.95 | $3,283.00 | $820.75–$3,283.00 | 263% above | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruct Neu Facet W Imag Guid L/S Sngl | $1,806.35 | $2,779.00 | $694.75–$2,779.00 | at median | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Bil Destruct Neu Facet W Imag Guid L/S Sngl | $7,255.19 | $11,161.83 | $948.00–$1,609.00 | 302% above | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 Rfb Subq Tissue Simple | $503.75 | $775.00 | $193.75–$775.00 | 3% above | 35% |
| Short arm cast (elbow to hand) CPT 29075 Ot Appl Cast Short Arm | $241.15 | $371.00 | $288.83 | 10% below | 35% |
| Short arm splint (forearm and hand) CPT 29125 Ot Appl Splint Short Arm | $224.90 | $346.00 | $114.00–$185.00 | 21% above | 35% |
| Short arm splint (forearm and hand) CPT 29125 Pt Appl Splint Short Arm | $224.90 | $346.00 | $58.41–$169.23 | 21% above | 35% |
| Short leg splint (calf to foot) CPT 29515 Pt Application Splint Short Leg | $247.00 | $380.00 | $167.81 | 24% above | 35% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Surgical Arthroscopy Shoulder Dstl Claviculc | $7,486.60 | $11,517.84 | $2,264.00–$5,058.00 | 39% below | 35% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls | $8,077.56 | $12,427.01 | $780.00–$14,826.76 | 41% below | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simp Rep S/Nk/Tr/Ext 2.5/< | $468.00 | $720.00 | $180.00–$720.00 | 81% above | 35% |
| Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Single Lesion | $352.30 | $542.00 | $243.90 | 6% above | 35% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc Mal Les Trnk/Ext 0.5cm Or< | $483.60 | $744.00 | $186.00–$744.00 | 24% below | 35% |
| Skin tag removal, up to 15 tags CPT 11200 Rem Skin Tags Up to 15 Lesions | $215.15 | $331.00 | $75.86–$86.39 | 28% above | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Puncture Spinal/Lumbar Dx | $594.10 | $914.00 | $228.50–$914.00 | 11% below | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simp Rep S/Nk/Tr/Ext 2.6 to 7.5cm | $338.00 | $520.00 | $130.00–$520.00 | 5% above | 35% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl Bx Skin Single Les | $327.60 | $504.00 | $85.94–$169.39 | 31% above | 35% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis Pleural Space W Guidance | $1,113.45 | $1,713.00 | $428.25–$1,713.00 | 9% above | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Pt 1 or 2 Musc | $284.05 | $437.00 | $109.25–$437.00 | 8% below | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Breast Ultrasound Percutaneous | $1,779.05 | $2,737.00 | $684.25–$2,737.00 | 1% above | 35% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 Esophagogastroduodenoscopy Submucosal Injection | $4,312.59 | $6,634.75 | $936.61 | 111% above | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 GI Upper Endoscopy Complex | $1,363.70 | $2,098.00 | $847.00–$1,406.00 | 9% below | 35% |
| Wart removal, up to 14 warts CPT 17110 Destruct Benign/ Cutaneous Vasc Lesions 1-14 | $221.65 | $341.00 | $85.25–$341.00 | 23% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debrid Subq 1st 20sqcm or Less | $468.00 | $720.00 | $180.00–$720.00 | 17% below | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Blood / Products Transfusion per Hour | $435.50 | $670.00 | $109.11–$573.94 | 34% below | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 Rapid Blood / Products Transfusion | $590.20 | $908.00 | $455.59 | 10% below | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler | $70.20 | $108.00 | $6.64–$267.02 | 50% below | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation/Nebulizer Treatment | $70.20 | $108.00 | $226.13 | 50% below | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Repeat | $70.20 | $108.00 | $6.64–$267.02 | 50% below | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation/Nebulizer Treatment Repeat | $70.20 | $108.00 | $6.64–$267.02 | 50% below | 35% |
| Chemotherapy IV infusion, first hour CPT 96413 Chemo IV Infusion Sgl/Init<1hr | $429.65 | $661.00 | $113.77–$435.45 | 1% below | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical Care First 30 - 74 Min | $1,396.85 | $2,149.00 | $853.01 | 32% below | 35% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg W Awake and Drowsy Record | $834.60 | $1,284.00 | $101.68–$408.81 | 12% above | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg 12 Lead Tracing Only | $156.65 | $241.00 | $5.25–$77.97 | 15% below | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED Visit Care Level 1 | $234.65 | $361.00 | $573.00–$2,224.00 | 2% below | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED Visit Care Level 2 | $293.15 | $451.00 | $105.00–$207.88 | 20% below | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED Visit Care Level 3 | $877.17 | $1,349.50 | $281.89 | 4% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED Visit Care Level 4 | $731.90 | $1,126.00 | $309.31–$1,126.00 | 20% below | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED Visit Care Level 5 | $4,340.51 | $6,677.71 | $591.00–$2,580.00 | 179% above | 35% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Test Tracing Only | $602.55 | $927.00 | $254.65–$927.00 | 22% below | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Infusion, Hydration Init Up to 1hr | $175.50 | $270.00 | $49.81–$276.60 | 27% below | 35% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion,Tx,Proph,Dx Init Up to 1 Hr | $222.95 | $343.00 | $94.22–$343.00 | 22% below | 35% |
| IV push of a medicine, first drug CPT 96374 Inj Ivp,Initial Drugs/Sub | $154.05 | $237.00 | $65.10–$237.00 | 14% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Sq/Im | $103.35 | $159.00 | $16.83–$93.45 | 11% above | 35% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve Conduct Studies 7-8 Studies | $815.75 | $1,255.00 | $385.35 | 27% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 Pt Neuro Re ED 1 or > Area Ea 15m | $94.25 | $145.00 | $114.00–$185.00 | 5% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuro Re ED 1 or > Area Ea 15m | $94.25 | $145.00 | $27.18–$43.35 | 5% above | 35% |
| New patient office visit, about 30 minutes CPT 99203 OP Visit Level III New Pt | $154.05 | $237.00 | $72.10–$98.08 | 2% below | 35% |
| New patient office visit, about 45 minutes CPT 99204 OP Visit Level IV New Pt | $207.35 | $319.00 | $79.75–$319.00 | 3% below | 35% |
| New patient office visit, about 60 minutes CPT 99205 OP Visit Level V New Pt | $285.35 | $439.00 | $161.31–$256.58 | 11% below | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP Visit Level II New Pt | $128.05 | $197.00 | $41.40–$63.23 | 3% above | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med Nutrition Therapy Ea 15m | $43.55 | $67.00 | $16.75–$67.00 | 8% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 15 Min | $92.30 | $142.00 | $114.00–$185.00 | 30% below | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 30 Min | $120.25 | $185.00 | $114.00–$185.00 | 9% below | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 45 Min | $148.85 | $229.00 | $55.76–$136.12 | 12% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 60 Min | $168.35 | $259.00 | $114.00–$185.00 | 27% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 75 Min | $195.00 | $300.00 | $55.76–$136.12 | 47% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 90 Min | $221.65 | $341.00 | $55.76–$136.12 | 67% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 105 Min | $248.30 | $382.00 | $55.76–$136.12 | 87% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 120 Min | $274.95 | $423.00 | $114.00–$185.00 | 107% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 135 Min | $302.25 | $465.00 | $127.74–$432.45 | 128% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 150 Min | $328.90 | $506.00 | $139.00–$470.58 | 148% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 165 Min | $355.55 | $547.00 | $55.76–$136.12 | 168% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 180 Min | $382.20 | $588.00 | $55.76–$136.12 | 188% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 195 Min | $408.85 | $629.00 | $55.76–$136.12 | 208% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 210 Min | $436.15 | $671.00 | $184.32–$624.03 | 229% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 225 Min | $462.80 | $712.00 | $195.59–$662.16 | 249% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 240 Min | $489.45 | $753.00 | $206.85–$700.29 | 269% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 15 Min | $137.80 | $212.00 | $57.45–$132.72 | 23% below | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 30 Min | $164.45 | $253.00 | $114.00–$185.00 | 8% below | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 45 Min | $200.85 | $309.00 | $57.45–$132.72 | 13% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 60 Min | $218.40 | $336.00 | $57.45–$132.72 | 23% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 75 Min | $245.05 | $377.00 | $103.56–$350.61 | 38% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 90 Min | $271.70 | $418.00 | $57.45–$132.72 | 52% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 105 Min | $298.35 | $459.00 | $57.45–$132.72 | 67% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 120 Min | $325.65 | $501.00 | $137.62–$465.93 | 83% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 135 Min | $352.30 | $542.00 | $114.00–$185.00 | 98% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 150 Min | $378.95 | $583.00 | $114.00–$185.00 | 113% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 15 Min | $92.30 | $142.00 | $71.82–$132.72 | 28% below | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 30 Min | $120.25 | $185.00 | $114.00–$185.00 | 7% below | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 45 Min | $148.85 | $229.00 | $114.00–$185.00 | 16% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 60 Min | $176.80 | $272.00 | $74.72–$252.96 | 37% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 75 Min | $184.60 | $284.00 | $71.82–$132.72 | 43% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 90 Min | $209.95 | $323.00 | $71.82–$132.72 | 63% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 105 Min | $248.30 | $382.00 | $71.82–$132.72 | 93% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 120 Min | $274.95 | $423.00 | $71.82–$132.72 | 114% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 135 Min | $302.25 | $465.00 | $71.82–$132.72 | 135% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 150 Min | $328.90 | $506.00 | $71.82–$132.72 | 156% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 15 Min | $120.25 | $185.00 | $71.82–$132.72 | 23% below | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 30 Min | $148.85 | $229.00 | $114.00–$185.00 | 5% below | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 45 Min | $176.80 | $272.00 | $74.72–$272.00 | 13% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 60 Min | $184.60 | $284.00 | $78.01–$284.00 | 18% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 75 Min | $209.95 | $323.00 | $71.82–$132.72 | 35% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 90 Min | $248.30 | $382.00 | $114.00–$185.00 | 59% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 105 Min | $274.95 | $423.00 | $71.82–$132.72 | 76% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 120 Min | $302.25 | $465.00 | $71.82–$132.72 | 94% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 135 Min | $328.90 | $506.00 | $139.00–$506.00 | 111% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 150 Min | $355.55 | $547.00 | $71.82–$132.72 | 128% above | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Ther 1 or > Reg Ea 15m | $87.10 | $134.00 | $114.00–$185.00 | 7% above | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Manual Ther 1 or > Reg Ea 15m | $87.10 | $134.00 | $22.37–$40.00 | 7% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ot Ther Exer 1 or > Area Ea 15m | $65.00 | $100.00 | $25.94–$40.00 | 17% below | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pt Ther Exer 1 or > Area Ea 15m | $65.00 | $100.00 | $25.94–$40.00 | 17% below | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pt Cpm Set Up Ea 15min | $83.20 | $128.00 | $25.94–$40.00 | 6% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pt Cpm Fitting Recovery Room Ea 15in | $83.20 | $128.00 | $114.00–$185.00 | 6% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ot Cpm Fitting Recovery Room Ea 15min | $87.10 | $134.00 | $25.94–$40.00 | 11% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ot Cpm Set Up Ea 15min | $87.10 | $134.00 | $36.81–$124.62 | 11% above | 35% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cess > 3min Up to 10 Min | $37.05 | $57.00 | $12.99–$39.12 | 39% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Est Pt-Level 5 Twoc | $213.20 | $328.00 | $108.47–$307.70 | 6% below | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP Visit Level V Est Pt | $229.45 | $353.00 | $88.25–$353.00 | 1% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP Visit Level III Est Pt | $119.60 | $184.00 | $57.87–$79.99 | 12% below | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Est Pt-Level 3 Twoc | $130.65 | $201.00 | $57.87–$79.99 | 4% below | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP Visit Level IV Est Pt | $148.85 | $229.00 | $57.25–$229.00 | 17% below | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Est Pt-Level 4 Twoc | $162.50 | $250.00 | $85.19–$113.10 | 10% below | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP Visit Level II Est Pt | $103.35 | $159.00 | $39.75–$159.00 | at median | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Est Pt-Level 2 Twoc | $111.80 | $172.00 | $31.32–$49.44 | 8% above | 35% |
| Speech and language evaluation CPT 92523 Eval Spch Sound Prod W/Lang Comp Up to 15m | $228.15 | $351.00 | $182.72–$303.36 | 11% below | 35% |
| Speech and language evaluation CPT 92523 Eval Spch Sound Prod W/Lang Comp Up to 30m | $242.45 | $373.00 | $114.00–$185.00 | 6% below | 35% |
| Speech and language evaluation CPT 92523 Eval Spch Sound Prod W/Lang Comp Up to 45m | $267.80 | $412.00 | $114.00–$185.00 | 4% above | 35% |
| Speech and language evaluation CPT 92523 Eval Spch Sound Prod W/Lang Comp Up to 60m | $324.35 | $499.00 | $114.00–$185.00 | 26% above | 35% |
| Speech and language evaluation CPT 92523 Eval Spch Sound Prod W/Lang Comp Up to 75m | $335.40 | $516.00 | $114.00–$185.00 | 31% above | 35% |
| Speech and language evaluation CPT 92523 Eval Spch Sound Prod W/Lang Comp Up to 90m | $362.05 | $557.00 | $182.72–$303.36 | 41% above | 35% |
| Speech and language evaluation CPT 92523 Eval Spch Sound Prod W/Lang Comp Up to 105m | $388.70 | $598.00 | $182.72–$303.36 | 51% above | 35% |
| Speech and language evaluation CPT 92523 Eval Spch Sound Prod W/Lang Comp Up to 120m | $416.00 | $640.00 | $175.81–$640.00 | 62% above | 35% |
| Speech therapy session, individual CPT 92507 St/Hear/Voice Tx Ind Up to 15m | $135.20 | $208.00 | $57.14–$208.00 | 20% below | 35% |
| Speech therapy session, individual CPT 92507 St/Hear/Voice Tx Ind Up to 30m | $154.05 | $237.00 | $114.00–$185.00 | 9% below | 35% |
| Speech therapy session, individual CPT 92507 St/Hear/Voice Tx Ind Up to 45m | $198.25 | $305.00 | $83.78–$305.00 | 17% above | 35% |
| Speech therapy session, individual CPT 92507 St/Hear/Voice Tx Ind Up to 60m | $226.20 | $348.00 | $67.94–$101.87 | 34% above | 35% |
| Speech therapy session, individual CPT 92507 St/Hear/Voice Tx Ind Up to 75m | $242.45 | $373.00 | $114.00–$185.00 | 43% above | 35% |
| Speech therapy session, individual CPT 92507 St/Hear/Voice Tx Ind Up to 90m | $269.10 | $414.00 | $113.73–$414.00 | 59% above | 35% |
| Speech therapy session, individual CPT 92507 St/Hear/Voice Tx Ind Up to 105m | $295.75 | $455.00 | $67.94–$101.87 | 75% above | 35% |
| Speech therapy session, individual CPT 92507 St/Hear/Voice Tx Ind Up to 120m | $322.40 | $496.00 | $67.94–$101.87 | 91% above | 35% |
| Spirometry (breathing test) CPT 94010 Spirometry W/WO Max Voluntary Vnt | $232.70 | $358.00 | $222.98 | 1% above | 35% |
| Spirometry before and after a bronchodilator CPT 94060 Bronchodial Pre and Post W Mvv | $445.25 | $685.00 | $385.35 | 1% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 St Therapeutic Activ Pat Ea 15m | $76.05 | $117.00 | $114.00–$185.00 | 5% below | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Therapeutic Activ Pat Ea 15m | $80.60 | $124.00 | $34.06–$115.32 | 1% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Therapeutic Activ Pat Ea 15m | $80.60 | $124.00 | $114.00–$185.00 | 1% above | 35% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy | $173.55 | $267.00 | $79.55–$169.23 | at median | 35% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP | $808.52 | $1,243.88 | $248.78–$1,156.81 | 387% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $123.67 | $190.26 | $38.05–$176.94 | 52% above | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TRIV 2025-26 (6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE | $83.40 | $128.31 | $25.66–$119.33 | 78% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML SUSP FOR ADULT DOSE | $314.13 | $483.28 | $65.89–$102.75 | 302% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML SYRINGE FOR PED/ADOL DOSE | $124.04 | $190.83 | $28.81–$46.24 | 65% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TRIV 2025-26 (65YR UP)(PF)180 MCG/0.5 ML IM SYRINGE | $361.15 | $555.62 | $78.17–$121.90 | 296% above | 35% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT | $404.50 | $622.31 | $70.92–$138.99 | 154% above | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE | $1,261.16 | $1,940.24 | $388.05–$1,940.24 | 152% above | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE | $494.67 | $761.03 | $124.97–$194.87 | 183% above | 35% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION | $1,067.46 | $1,642.24 | $306.90–$455.56 | 26% above | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT | $533.92 | $821.41 | $185.29–$314.64 | 122% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE | $187.65 | $288.69 | $57.74–$268.48 | 156% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $206.30 | $317.39 | $63.48–$295.17 | 109% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Imm Admin Vac/Toxoid X1 | $44.20 | $68.00 | $14.72–$93.45 | 23% below | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imm Admin Vac/Toxoid Ea Addl | $44.85 | $69.00 | $12.70–$14.72 | at median | 35% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.