Hospital Joplin, MO-KS

Mercy Specialty Hospital Southeast Kansas

Mercy Specialty Hospital Southeast Kansas in Galena, KS publishes cash prices for 254 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 Kansas median for 210 of 249 procedures and below it for 36. By typical cash price it ranks #69 of 85 Kansas hospitals and #7 of 7 hospitals in the Joplin, MO area, cheapest first. Select a procedure to compare it with other hospitals nearby.

198 Four States Dr STE 10 Galena KS 66739 Collected Sep 23, 2026 Source price file Check a bill from this hospital (620) 783-1732

Acute care hospital Nonprofit hospital No emergency department CCN 170203 · CMS hospital register NPI 1992341473

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Mercy Specialty Hospital Southeast Kansas 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.

Scans and imaging

ProcedureCash priceList priceInsurers payvs KansasOff list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen W/WO Cont $2,297.75 $3,535.00 $101.17–$1,675.40 73% above 35%
Abdominal X-ray, 2 views CPT 74019 Xr Abdomen 2 Views $316.55 $487.00 $21.64–$119.93 27% above 35%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 Xr Ankle Complete Min 3v Bi $414.70 $638.00 $18.00–$247.85 — 35%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete Min 3v Lt $279.50 $430.00 $18.00–$247.85 21% above 35%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete Min 3v Rt $279.50 $430.00 $18.00–$247.85 21% above 35%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Art Non Invas Extr Bi Sngl Level $358.15 $551.00 $27.30–$414.11 — 35%
Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Extremity Upper WO Cont Bi $2,022.80 $3,112.00 $59.96–$1,077.47 — 35%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Extremity Upper WO Cont Rt $1,038.05 $1,597.00 $59.96–$1,077.47 at median 35%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Extremity Upper WO Cont Lt $1,038.05 $1,597.00 $59.96–$1,077.47 at median 35%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Xr Esophagus/Barium Swallow $449.80 $692.00 $36.00–$466.75 6% above 35%
Breast ultrasound, complete, one breast both sides CPT 76641 Breast Ultrasound Complete Bilat $207.35 $319.00 $50.39–$466.75 — 35%
Breast ultrasound, complete, one breast one side CPT 76641 Breast Ultrasound Complete Lt $147.55 $227.00 $50.39–$466.75 53% below 35%
Breast ultrasound, complete, one breast one side CPT 76641 Breast Ultrasound Complete Rt $147.55 $227.00 $50.39–$466.75 53% below 35%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Breast Ultrasound Limited Rt $320.45 $493.00 $44.13–$276.54 9% above 35%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Cta Abd Pelvis Wwo Contrast $3,917.55 $6,027.00 $206.69–$2,398.75 63% above 35%
CT angiography (CTA) of the head CPT 70496 Cta Head W/WO Cont $2,193.75 $3,375.00 $101.17–$1,732.43 22% above 35%
CT angiography (CTA) of the neck CPT 70498 Cta Neck W and/or WO Contrast $2,193.75 $3,375.00 $101.17–$1,726.40 22% above 35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Chest W and/or WO Cont $2,253.55 $3,467.00 $101.17–$1,759.20 27% above 35%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd Pelvis Without Contrast $3,120.00 $4,800.00 $88.54–$943.56 139% above 35%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis With Contrast $3,543.15 $5,451.00 $188.51–$1,901.55 151% above 35%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd Pelvis WO Cont Then W Cont $4,251.65 $6,541.00 $206.69–$2,172.72 144% above 35%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W Cont $2,055.95 $3,163.00 $101.17–$1,461.23 69% above 35%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen WO Cont $1,753.05 $2,697.00 $59.96–$750.14 63% above 35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial WO Cont Limited $1,021.15 $1,571.00 $59.96–$803.69 7% above 35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial Area WO Cont $1,634.75 $2,515.00 $59.96–$803.69 72% above 35%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain WO Cont $1,660.10 $2,554.00 $57.46–$610.37 62% above 35%
CT scan of the head with contrast CPT 70460 CT Head/Brain W Cont $1,712.75 $2,635.00 $82.45–$1,097.26 57% above 35%
CT scan of the head without and with contrast CPT 70470 CT Head/Brain W/WO Cont $2,133.30 $3,282.00 $98.54–$1,097.26 72% above 35%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine WO Cont $1,133.60 $1,744.00 $59.96–$1,080.44 2% above 35%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cervical Spine WO Cont $1,133.60 $1,744.00 $59.96–$1,089.34 17% above 35%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W Cont $1,778.40 $2,736.00 $101.17–$1,467.17 65% above 35%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Carotid Duplex Scan Bilat $907.40 $1,396.00 $70.00–$935.33 — 35%
Chest CT scan without and with contrast CPT 71270 CT Chest Diag W/WO Cont $2,166.45 $3,333.00 $101.17–$1,365.96 75% above 35%
Chest X-ray, 2 views CPT 71046 Xr Chest 2 Views $285.35 $439.00 $19.41–$122.40 29% above 35%
Chest X-ray, single view CPT 71045 Xr Chest 1 View $217.10 $334.00 $14.42–$100.33 13% above 35%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 Xr Clavicle Complete Bi $398.45 $613.00 $15.00–$247.85 — 35%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle Complete Rt $258.05 $397.00 $15.00–$247.85 29% above 35%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle Complete Lt $258.05 $397.00 $15.00–$247.85 29% above 35%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneum Complete $438.10 $674.00 $44.00–$466.75 10% above 35%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest Diag WO Cont $1,771.90 $2,726.00 $59.96–$836.42 81% above 35%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest Diag W Cont $1,941.55 $2,987.00 $101.17–$1,119.09 81% above 35%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Art Lwr Extr Duplex Graft Comp Bi $742.95 $1,143.00 $73.00–$935.33 — 35%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Duplex Lower Ext Comp Bi $1,077.05 $1,657.00 $42.00–$935.33 — 35%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Duplex Upper Ext Comp Bi $1,079.00 $1,660.00 $42.00–$935.33 — 35%
Elbow X-ray, 2 views both sides CPT 73070 Xr Elbow 2 Views Bi $317.85 $489.00 $17.75–$247.85 — 35%
Elbow X-ray, 2 views both sides CPT 73070 Xr Elbow 1 View Bilat $335.40 $516.00 $17.75–$247.85 — 35%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 1 View Lt $195.65 $301.00 $17.75–$247.85 at median 35%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 1 View Rt $195.65 $301.00 $17.75–$247.85 at median 35%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 Views Rt $207.35 $319.00 $17.75–$247.85 6% above 35%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 Views Lt $207.35 $319.00 $17.75–$247.85 6% above 35%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 Xr Elbow Complete Min 3 Views Bi $417.30 $642.00 $19.00–$247.85 — 35%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete Min 3 Views Rt $280.15 $431.00 $19.00–$247.85 17% above 35%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete Min 3 Views Lt $280.15 $431.00 $19.00–$247.85 17% above 35%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit/Sella/Iac/Fossa WO Cont $1,668.55 $2,567.00 $59.96–$1,407.66 58% above 35%
Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Facial Bones Comp Min 3 Views $338.65 $521.00 $18.00–$466.75 11% above 35%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 Xr Forearm 2 Views Bi $345.15 $531.00 $18.03–$247.85 — 35%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 1 View Rt $213.85 $329.00 $18.03–$247.85 3% above 35%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 1 View Lt $213.85 $329.00 $18.03–$247.85 3% above 35%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 2 Views Lt $231.40 $356.00 $18.03–$247.85 11% above 35%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 2 Views Rt $231.40 $356.00 $18.03–$247.85 11% above 35%
Hand X-ray, 2 views both sides CPT 73120 Xr Hand 2 Views Bilateral $305.50 $470.00 $17.00–$466.75 — 35%
Hand X-ray, 2 views one side CPT 73120 Xr Hand 1 View Lt $171.60 $264.00 $17.00–$466.75 10% below 35%
Hand X-ray, 2 views one side CPT 73120 Xr Hand 1 View Rt $171.60 $264.00 $17.00–$466.75 10% below 35%
Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 Views Right $189.80 $292.00 $17.00–$466.75 at median 35%
Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 Views Left $189.80 $292.00 $17.00–$466.75 at median 35%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 Xr Calcaneus Min 2v Bi $318.50 $490.00 $13.00–$247.85 — 35%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneus Min 2v Rt $212.55 $327.00 $13.00–$247.85 9% above 35%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneus Min 2v Lt $212.55 $327.00 $13.00–$247.85 9% above 35%
Knee X-ray, 3 views both sides CPT 73562 Xr Knee 3 Views Bilateral $429.65 $661.00 $26.63–$247.85 — 35%
Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Right $290.55 $447.00 $26.63–$247.85 21% above 35%
Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 Views Left $290.55 $447.00 $26.63–$247.85 21% above 35%
Knee X-ray, complete, 4 or more views both sides CPT 73564 Xr Knee Complete Min 4v Bi $559.65 $861.00 $30.25–$466.75 — 35%
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee Complete Min 4v Rt $377.00 $580.00 $30.25–$466.75 14% above 35%
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee Complete Min 4v Lt $377.00 $580.00 $30.25–$466.75 14% above 35%
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Extremity Lower WO Cont Bi $2,170.35 $3,339.00 $59.96–$1,080.44 — 35%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Extremity Lower WO Cont Rt $1,417.00 $2,180.00 $59.96–$1,080.44 38% above 35%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Extremity Lower WO Cont Lt $1,417.00 $2,180.00 $59.96–$1,080.44 38% above 35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited $551.85 $849.00 $20.00–$623.16 74% above 35%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Extrem Nonvascular Limited Bil $536.90 $826.00 $8.76–$247.85 78% above 35%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extrem Nonvascular Limited Lt $378.30 $582.00 $8.76–$247.85 25% above 35%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extrem Nonvascular Limited Rt $378.30 $582.00 $8.76–$247.85 25% above 35%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 Xr Tibia and Fibula 2v Bi $352.30 $542.00 $19.97–$247.85 — 35%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia and Fibula 1 View Rt $209.30 $322.00 $19.97–$247.85 7% below 35%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia and Fibula 2v Lt $248.95 $383.00 $19.97–$247.85 11% above 35%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia and Fibula 2v Rt $248.95 $383.00 $19.97–$247.85 11% above 35%
MR angiography (MRA) of the head without contrast CPT 70544 Mra Head WO Cont $1,710.80 $2,632.00 $131.00–$1,303.32 23% above 35%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Extr Lwr Jt WO Cont Bi $2,168.40 $3,336.00 $120.47–$1,312.68 — 35%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Extr Lwr Jt WO Cont Rt $1,275.30 $1,962.00 $120.47–$1,312.68 at median 35%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Extr Lwr Jt WO Cont Lt $1,275.30 $1,962.00 $120.47–$1,312.68 at median 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 $2,643.55 $4,067.00 $206.69–$2,808.72 61% 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 $2,643.55 $4,067.00 $206.69–$2,808.72 61% above 35%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen WO Cont $2,189.20 $3,368.00 $110.75–$1,360.50 75% above 35%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen W/WO Cont $3,107.00 $4,780.00 $204.04–$2,301.57 87% above 35%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO Cont $2,341.30 $3,602.00 $110.20–$1,210.27 87% above 35%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain W/WO Cont $3,125.85 $4,809.00 $183.49–$2,040.94 80% above 35%
MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar Spine WO Cont $1,279.20 $1,968.00 $105.76–$1,165.00 3% above 35%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Lumbar Spine W/WO Cont $3,053.70 $4,698.00 $184.04–$2,055.06 76% above 35%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Thoracic Spine WO Cont $1,311.05 $2,017.00 $105.20–$1,165.00 10% above 35%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Cervical Spine W/WO Cont $3,090.75 $4,755.00 $184.60–$2,060.71 83% above 35%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Cervical Spine WO Cont $1,292.20 $1,988.00 $105.48–$1,162.08 10% above 35%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis W/WO Cont $3,108.95 $4,783.00 $202.93–$2,298.75 88% above 35%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis WO Cont $2,262.00 $3,480.00 $131.00–$1,570.13 90% above 35%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Extr Uppr Jt WO Cont Bi $2,065.05 $3,177.00 $120.75–$1,312.68 — 35%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Extr Uppr Jt WO Cont Rt $1,244.75 $1,915.00 $120.75–$1,312.68 1% above 35%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Extr Uppr Jt WO Cont Lt $1,244.75 $1,915.00 $120.75–$1,312.68 1% above 35%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Xr Spine Cervical 4 or 5 Views $524.55 $807.00 $32.00–$466.75 41% above 35%
Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck W Cont $1,972.75 $3,035.00 $101.17–$1,113.15 83% above 35%
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck WO Cont $1,537.90 $2,366.00 $59.96–$836.42 63% above 35%
Neck soft tissue X-ray CPT 70360 Xr Soft Tissue Neck $252.85 $389.00 $10.00–$247.85 26% above 35%
Pelvic CT scan without contrast CPT 72192 CT Pelvis WO Cont $1,691.95 $2,603.00 $59.96–$759.12 60% above 35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Non OB Limited F/U $423.15 $651.00 $21.91–$466.75 43% above 35%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Non OB Complete $553.80 $852.00 $40.00–$466.75 56% above 35%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uter 14 Wks Or> $370.50 $570.00 $56.00–$468.10 at median 35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg Uter <14 Weeks Gest $590.85 $909.00 $42.75–$466.75 91% above 35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Uter Ltd 1 or More Fetus $367.25 $565.00 $26.00–$466.75 45% above 35%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2 Views Rt $273.00 $420.00 $17.00–$247.85 19% above 35%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2 Views Lt $273.00 $420.00 $17.00–$247.85 19% above 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 $335.40 $516.00 $17.00–$466.75 13% above 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 $335.40 $516.00 $17.00–$466.75 13% above 35%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Xr Shoulder Complete Min 2v Bi $436.15 $671.00 $20.00–$247.85 — 35%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete Min 2v Rt $267.15 $411.00 $20.00–$247.85 19% above 35%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete Min 2v Lt $267.15 $411.00 $20.00–$247.85 19% above 35%
Sinus X-ray, complete, 3 or more views CPT 70220 Xr Sinuses Paranasal Comp Min 3v $347.10 $534.00 $22.75–$247.85 16% above 35%
Skull X-ray, fewer than 4 views CPT 70250 Xr Skull <4 Views $267.15 $411.00 $22.00–$466.75 12% above 35%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 Xr Femur 2 Vw Bilat $412.10 $634.00 $21.18–$247.85 — 35%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur 2 Vw Right $295.75 $455.00 $21.18–$247.85 21% above 35%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur 2 Vw Left $295.75 $455.00 $21.18–$247.85 21% above 35%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Thoracic Spine WO Cont $1,780.35 $2,739.00 $59.96–$1,086.35 82% above 35%
Toe X-ray, 2 or more views both sides CPT 73660 Xr Toe/S Min 2v Bi $323.05 $497.00 $13.00–$247.85 — 35%
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe/S Min 2v Lt $224.25 $345.00 $13.00–$247.85 24% above 35%
Toe X-ray, 2 or more views one side CPT 73660 Xr Toe/S Min 2v Rt $224.25 $345.00 $13.00–$247.85 24% above 35%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB $475.15 $731.00 $59.96–$466.75 58% above 35%
Transvaginal ultrasound during pregnancy CPT 76817 US Preg Uter Transvaginal $382.20 $588.00 $47.74–$466.75 9% above 35%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete $934.70 $1,438.00 $56.00–$466.75 117% above 35%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum and Contents $594.75 $915.00 $31.00–$466.75 75% above 35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue $599.95 $923.00 $54.00–$466.75 2% below 35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Xr Upper GI Single Contrast $430.95 $663.00 $30.00–$597.82 21% below 35%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 Xr Humerus Min 2 Views Bi $377.00 $580.00 $20.25–$247.85 — 35%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus Min 2 Views Lt $246.35 $379.00 $20.25–$247.85 8% above 35%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus Min 2 Views Rt $246.35 $379.00 $20.25–$247.85 8% above 35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Lower Ext Ltd Lt $615.55 $947.00 $73.00–$466.75 8% below 35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Lower Ext Ltd Rt $615.55 $947.00 $73.00–$466.75 8% below 35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Upper Ext Ltd Rt $615.55 $947.00 $73.00–$466.75 8% below 35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Upper Ext Ltd Lt $615.55 $947.00 $73.00–$466.75 8% below 35%
Wrist X-ray, 2 views both sides CPT 73100 Xr Wrist 2 Views Bilateral $333.45 $513.00 $19.00–$247.85 — 35%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 1 View Lt $217.10 $334.00 $19.00–$247.85 18% above 35%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 1 View Rt $217.10 $334.00 $19.00–$247.85 18% above 35%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 Views Left $224.25 $345.00 $19.00–$247.85 22% above 35%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 Views Right $224.25 $345.00 $19.00–$247.85 22% above 35%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 Xr Wrist Complete Min 3v Bi $393.25 $605.00 $23.00–$247.85 — 35%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete Min 3v Rt $257.40 $396.00 $23.00–$247.85 11% above 35%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete Min 3v Lt $257.40 $396.00 $23.00–$247.85 11% above 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 $279.50 $430.00 $27.84–$247.85 10% above 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 $279.50 $430.00 $27.84–$247.85 10% above 35%
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen 1 View $265.20 $408.00 $18.03–$109.38 28% above 35%
X-ray of the ankle, 2 views both sides CPT 73600 Xr Ankle 2 Views Bilateral $367.25 $565.00 $20.53–$247.85 — 35%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 1 View Lt $211.90 $326.00 $20.53–$247.85 12% above 35%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 1 View Rt $211.90 $326.00 $20.53–$247.85 12% above 35%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Right $255.45 $393.00 $20.53–$247.85 34% above 35%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Left $255.45 $393.00 $20.53–$247.85 34% above 35%
X-ray of the finger(s), 2 or more views both sides CPT 73140 Xr Finger/S Min 2 Views Bi $332.80 $512.00 $16.00–$247.85 — 35%
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger/S Min 2 Views Lt $202.15 $311.00 $16.00–$247.85 16% above 35%
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger/S Min 2 Views Rt $202.15 $311.00 $16.00–$247.85 16% above 35%
X-ray of the foot, 2 views both sides CPT 73620 Xr Foot 1 View Bilateral $297.70 $458.00 $17.75–$247.85 — 35%
X-ray of the foot, 2 views both sides CPT 73620 Xr Foot 2 Views Bilateral $329.55 $507.00 $17.75–$247.85 — 35%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 1 View Rt $199.55 $307.00 $17.75–$247.85 5% above 35%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 1 View Lt $199.55 $307.00 $17.75–$247.85 5% above 35%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Right $222.95 $343.00 $17.75–$247.85 17% above 35%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Left $222.95 $343.00 $17.75–$247.85 17% above 35%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 Xr Foot Complete Min 3v Bi $404.30 $622.00 $21.91–$247.85 — 35%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete Min 3v Rt $272.35 $419.00 $21.91–$247.85 20% above 35%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete Min 3v Lt $272.35 $419.00 $21.91–$247.85 20% above 35%
X-ray of the hand, 3 or more views both sides CPT 73130 Xr Hand Complete Min 3v Bi $396.50 $610.00 $24.14–$247.85 — 35%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete Min 3v Lt $220.35 $339.00 $24.14–$247.85 at median 35%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete Min 3v Rt $220.35 $339.00 $24.14–$247.85 at median 35%
X-ray of the knee, 1 or 2 views both sides CPT 73560 Xr Knee 1 or 2 Views Bilateral $423.80 $652.00 $21.91–$247.85 — 35%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 or 2 Views Left $254.80 $392.00 $21.91–$247.85 34% above 35%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 1 or 2 Views Right $254.80 $392.00 $21.91–$247.85 34% above 35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Spine Lumbar 2 or 3 Views $276.90 $426.00 $24.41–$466.75 2% above 35%
X-ray of the lower back, 4 or more views CPT 72110 Xr Spine Lumbar Min 4 Views $464.10 $714.00 $33.02–$466.75 19% above 35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr Spine Thoracic 2 Views $196.30 $302.00 $19.41–$466.75 12% below 35%
X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones Comp Min 3 Views $257.40 $396.00 $23.00–$247.85 7% above 35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 3 Views or Less $283.40 $436.00 $24.14–$247.85 15% above 35%
X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1 or 2 Views $236.60 $364.00 $16.36–$466.75 18% above 35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum and Coccyx Min 2 Views $316.55 $487.00 $17.00–$247.85 40% above 35%

Lab tests

ProcedureCash priceList priceInsurers payvs KansasOff list
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute $505.05 $777.00 $38.93–$321.62 143% above 35%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase $70.85 $109.00 $4.23–$31.82 98% above 35%
Ammonia blood test CPT 82140 Ammonia $137.15 $211.00 $11.91–$89.59 61% above 35%
Amylase blood test CPT 82150 Amylase Pancreatic $102.70 $158.00 $5.30–$39.84 87% above 35%
Amylase blood test CPT 82150 Amylase Serum $109.85 $169.00 $5.30–$39.84 100% above 35%
Amylase blood test CPT 82150 Amylase Fluid $111.80 $172.00 $5.30–$39.84 104% above 35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide, Antibody $133.90 $206.00 $10.58–$79.63 43% above 35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen $128.05 $197.00 $9.88–$74.32 88% above 35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Brain Natriuretic Peptide $163.80 $252.00 $27.74–$217.24 27% above 35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Wound Aerobic $98.80 $152.00 $7.04–$52.95 77% above 35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Spinal Fluid $128.70 $198.00 $7.04–$52.95 131% above 35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Sputum $152.10 $234.00 $7.04–$52.95 173% above 35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Aerobic Only $153.40 $236.00 $7.04–$52.95 175% above 35%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Pnl Calcium Total $140.40 $216.00 $6.91–$52.01 110% above 35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Prostate Needle Bx Gross and Micro $200.20 $308.00 $28.00–$1,270.44 8% below 35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Path Exam-Cell Block $212.55 $327.00 $28.00–$139.76 3% below 35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path Lev IV Gross and Micro $5,141.02 $7,909.26 $60.72–$2,767.83 2256% above 35%
Blood culture for bacteria CPT 87040 Culture Blood Bacterial $182.65 $281.00 $8.44–$63.46 133% above 35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Ref Lab Venipuncture Blood Collect $7.80 $12.00 $1.80–$17.75 57% below 35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture $2,774.85 $4,269.00 $1.80–$465.85 15367% above 35%
Blood glucose (sugar) test CPT 82947 Glucose Quant Blood $49.40 $76.00 $3.21–$24.19 90% above 35%
Blood glucose (sugar) test CPT 82947 POC Glucose Quant Blood $49.40 $76.00 $3.21–$24.19 90% above 35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg Qual Pregnancy Screen $83.85 $129.00 $6.14–$46.26 44% above 35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Blood Typing $74.10 $114.00 $2.44–$109.89 23% below 35%
Blood urea nitrogen (BUN) test CPT 84520 POC Bun Blood Urea Nitrogen $50.05 $77.00 $3.23–$24.29 72% above 35%
Blood urea nitrogen (BUN) test CPT 84520 Bun Blood Urea Nitrogen $53.30 $82.00 $3.23–$24.29 83% above 35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein $44.85 $69.00 $4.23–$31.82 7% below 35%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Difficile Amp Probe $154.05 $237.00 $28.68–$215.75 38% above 35%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 Covid-19, Rt-Pcr $135.20 $208.00 $30.79–$141.10 at median 35%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Ag Cea Fluid $148.85 $229.00 $15.50–$116.58 37% above 35%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen Cea $156.65 $241.00 $15.50–$116.58 44% above 35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel $139.75 $215.00 $10.94–$113.68 59% above 35%
Complete blood count (CBC) with differential CPT 85025 Cbc W Auto Diff $94.25 $145.00 $6.35–$47.76 132% above 35%
Complete blood count (CBC), no differential CPT 85027 Cbc Automated WO Diff $84.50 $130.00 $5.29–$39.72 97% above 35%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel $189.15 $291.00 $8.63–$64.96 99% above 35%
Cortisol blood test, total CPT 82533 Cortisol $156.00 $240.00 $13.33–$100.21 59% above 35%
Creatine kinase (CK) blood test, total CPT 82550 Cpk Creatine Kinase Total $89.05 $137.00 $5.32–$40.01 94% above 35%
Creatinine blood test CPT 82565 POC Creatinine $72.80 $112.00 $4.19–$31.49 119% above 35%
Creatinine blood test CPT 82565 Creatinine Blood $72.80 $112.00 $4.19–$31.49 119% above 35%
D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quantitative $152.10 $234.00 $8.32–$62.58 34% above 35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Cotinine Screen Urine $58.50 $90.00 $47.89–$357.73 60% below 35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Presumptive per Dos $174.20 $268.00 $47.89–$357.73 19% above 35%
FSH (follicle-stimulating hormone) test CPT 83001 Fsh Follicle Stimulating Hormone $165.75 $255.00 $15.19–$114.26 44% above 35%
Ferritin blood test (iron stores) CPT 82728 Ferritin $138.45 $213.00 $11.14–$83.83 62% above 35%
Fibrinogen blood test CPT 85384 Fibrinogen Activity $114.40 $176.00 $6.94–$53.78 99% above 35%
Folate (folic acid) blood test CPT 82746 Folic Acid Serum $121.55 $187.00 $12.02–$90.42 24% above 35%
Free T3 thyroid hormone test CPT 84481 T3 Free $154.05 $237.00 $13.84–$104.13 20% above 35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Thyroxine Free $126.10 $194.00 $7.37–$55.44 102% above 35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Ggt Glutamyltransferase Gamma $83.85 $129.00 $5.89–$44.27 97% above 35%
HIV-1 and HIV-2 antibody test CPT 86703 Hiv 1-2 Rapid Screen $99.45 $153.00 $7.91–$84.28 20% above 35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 Ag W Hiv-1 & 2 Ab Ia $102.05 $157.00 $19.68–$148.02 9% above 35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c Glycated $95.55 $147.00 $7.93–$59.71 63% above 35%
Hemoglobin blood test CPT 85018 POC Hemoglobin $21.45 $33.00 $1.94–$14.56 at median 35%
Hemoglobin blood test CPT 85018 Hemoglobin $27.95 $43.00 $1.94–$14.56 30% above 35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen Eia $141.05 $217.00 $8.44–$63.53 139% above 35%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody $139.10 $214.00 $11.66–$87.70 83% above 35%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus Quantification $430.30 $662.00 $35.01–$263.39 64% above 35%
Homocysteine blood test CPT 83090 Homocysteine $237.25 $365.00 $13.79–$126.17 5% above 35%
Insulin blood test CPT 83525 Insulin Total $74.75 $115.00 $9.34–$70.27 8% below 35%
Iron blood test (serum iron) CPT 83540 Iron Serum $89.70 $138.00 $5.29–$39.79 110% above 35%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity $83.85 $129.00 $7.15–$53.73 31% above 35%
Kidney function blood test panel CPT 80069 Renal Function Panel $240.50 $370.00 $7.10–$53.40 243% above 35%
LH (luteinizing hormone) test CPT 83002 Lh Luteinizing Hormone $165.75 $255.00 $15.13–$113.83 50% above 35%
Lactate (lactic acid) blood test CPT 83605 POC Lactic Acid $97.50 $150.00 $8.73–$65.69 23% above 35%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid $144.95 $223.00 $8.73–$65.69 83% above 35%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Lactate Dehydrogenase Fluid $74.75 $115.00 $4.93–$37.13 95% above 35%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Lactate Dehydrogenase $74.75 $115.00 $4.93–$37.13 95% above 35%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase $120.90 $186.00 $5.63–$42.33 95% above 35%
Liver function blood test panel CPT 80076 Hepatic Function Panel $183.30 $282.00 $6.68–$50.25 140% above 35%
Lyme disease antibody test CPT 86618 Lyme Disease Antibody $170.30 $262.00 $13.92–$104.70 41% above 35%
Magnesium blood test CPT 83735 Magnesium $103.35 $159.00 $5.47–$41.17 100% above 35%
Mono test (heterophile antibody, Monospot) CPT 86308 Monotest Heterophile Ab Screen $70.85 $109.00 $4.23–$31.82 60% above 35%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total Diagnostic $138.45 $213.00 $15.04–$113.10 29% above 35%
Parathyroid hormone (PTH) blood test CPT 83970 Pth Intact $204.75 $315.00 $33.74–$253.76 2% above 35%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Partial Thromboplastin Time $87.10 $134.00 $4.91–$36.90 92% above 35%
Potassium blood test CPT 84132 POC Potassium Ser Plasma Wb $54.60 $84.00 $3.76–$28.27 71% above 35%
Prothrombin time (PT/INR) clotting test CPT 85610 POC Prothrombin Time $59.15 $91.00 $3.22–$24.19 88% above 35%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time $65.65 $101.00 $3.22–$24.19 108% above 35%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 POC Nicotine/Cotinine Dir Opt Observ $18.20 $28.00 $8.98–$69.72 64% below 35%
Rapid flu test (influenza antigen) CPT 87804 Influenza B Ag Oia $63.05 $97.00 $9.80–$91.58 8% below 35%
Rapid flu test (influenza antigen) CPT 87804 Influenza a Ag Oia $63.05 $97.00 $9.80–$91.58 8% below 35%
Rh blood typing CPT 86901 Rh (D) Blood Typing $64.35 $99.00 $2.44–$35.00 1% above 35%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quantitative $69.55 $107.00 $4.64–$34.86 42% above 35%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate Automated $48.75 $75.00 $2.21–$16.60 50% above 35%
Sodium blood test CPT 84295 POC Sodium Plasma/Wb $58.50 $90.00 $3.94–$29.60 98% above 35%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Bld Screen Feces Qual 1 to 3 Det $44.85 $69.00 $2.66–$24.24 66% above 35%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Ab Each $124.80 $192.00 $11.89–$89.47 59% above 35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Newborn $17.55 $27.00 $13.73–$103.30 80% below 35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Thyroid Stimulating Hormone $146.25 $225.00 $13.73–$103.30 70% above 35%
Total thyroxine (T4) blood test CPT 84436 T4 Thyroxine Total $89.05 $137.00 $5.61–$42.21 122% above 35%
Total triiodothyronine (T3) blood test CPT 84480 T3 Total $122.20 $188.00 $11.59–$87.15 56% above 35%
Troponin test, quantitative CPT 84484 Troponin Quantitative $125.45 $193.00 $8.04–$69.01 10% above 35%
Troponin test, quantitative CPT 84484 POC Troponin Quantitative $140.40 $216.00 $8.04–$69.01 23% above 35%
Uric acid blood test CPT 84550 Uric Acid Blood $87.75 $135.00 $3.70–$27.77 144% above 35%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Automated W Micro $71.50 $110.00 $2.59–$19.47 120% above 35%
Urinalysis without microscope exam, automated CPT 81003 POC Urinalysis Automated W/O Micro $36.40 $56.00 $1.84–$13.78 65% above 35%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Automated W/O Micro $36.40 $56.00 $1.84–$13.78 65% above 35%
Urinalysis without microscope exam, manual CPT 81002 POC Urinalysis Non-Auto $28.60 $44.00 $2.09–$19.26 53% above 35%
Urine culture for bacteria, with colony count CPT 87086 Culture Urine Bacterial Quant Cnt $103.35 $159.00 $6.60–$49.63 94% above 35%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine Quant $112.45 $173.00 $4.72–$35.52 145% above 35%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test $109.20 $168.00 $5.17–$47.64 141% above 35%
Urine pregnancy test, read by color change CPT 81025 POC Urine Pregnancy Test $109.20 $168.00 $5.17–$47.64 141% above 35%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 $122.20 $188.00 $12.32–$92.68 35% above 35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy $232.05 $357.00 $24.20–$181.99 4% below 35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Quant $116.35 $179.00 $11.54–$92.58 26% above 35%

Surgery and procedures

ProcedureCash priceList priceInsurers payvs KansasOff list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 Adenoidectomy Primary <Age 12 $12,825.19 $19,731.06 $180.73–$5,758.36 234% above 35%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Arthrs Aided Ant Cruciate Ligm Rpr/Agmntj/Rcnstj $25,881.88 $39,818.27 $297.00–$16,168.05 163% above 35%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Surgical Arthroscopy Shoulder W/Rotator Cuff Rpr $19,602.34 $30,157.45 $363.00–$15,970.21 163% above 35%
Colonoscopy with endoscopic ultrasound CPT 45391 Colsc Flx W/Ndsc US Xm Rctm Et Al Lmtd&Adj Strux $4,404.76 $6,776.56 $213.42–$2,078.35 — 35%
Colonoscopy, diagnostic CPT 45378 GI Colonoscopy $4,057.79 $6,242.76 $154.34–$1,615.17 223% above 35%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Tympanostomy With Tube Placement $9,457.54 $14,550.06 $133.95–$2,694.82 547% above 35%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Inject Interlaminar Cerv or Thoracic W Imag $1,702.71 $2,619.56 $297.00 42% above 35%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paravert F Jnt L/S 1st Lev $816.40 $1,256.00 $297.00 19% below 35%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paravert F Jnt L/S 1st Lev Bil $3,005.56 $4,623.94 $76.93–$1,712.80 197% above 35%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 GI Sigmoidiscope Flexible $3,761.63 $5,787.12 $49.89–$1,615.17 329% above 35%
Injection into a tendon sheath or ligament (for example trigger finger) both sides CPT 20550 Bilat Inj Sgl Ten Sheath/Lig/Apo $615.55 $947.00 $297.00 — 35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Sgl Ten Sheath/Lig/Apo $385.45 $593.00 $297.00 107% above 35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Asp/Inj Major Jt WO US Guid $398.45 $613.00 $297.00 16% 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 $726.70 $1,118.00 $297.00 112% above 35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Asp/Inj Intermed Jt WO US Guid $339.95 $523.00 $297.00 24% above 35%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/Inj Small Jt WO US Guid $301.60 $464.00 $297.00 28% above 35%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Arthroscopy Kne Surg Meniscus Rpr Medial/Lateral $22,153.72 $34,082.65 $250.00–$5,682.88 405% above 35%
Knee arthroscopy with meniscus trim CPT 29881 Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg $10,649.83 $16,384.35 $297.00–$5,682.88 155% above 35%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Arthrs Knee Surg Meniscectomy Med&Lat W/Shaving $10,281.41 $15,817.55 $297.00–$5,682.88 149% above 35%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Arthrs Knee Surg Debridement/Shvg Artclr Crtlg $10,442.65 $16,065.62 $297.00–$5,682.88 138% above 35%
Lower-back epidural injection, with imaging guidance CPT 62323 Inject Interlaminar Lumbar or Sacral W Imag $1,757.48 $2,703.82 $297.00 47% above 35%
Lower-back epidural injection, without imaging guidance CPT 62322 Inj Dx/Tx Epid/Subaracr Lmbr/Sac WO Imag $33,083.70 $50,898.00 $297.00–$21,270.00 3949% above 35%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Bilat Inj Epi/Lumb/Sacral Sngl Level $2,530.45 $3,893.00 $297.00 — 35%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Transforminal Epi/Lumb/Sacral Sngl Level $2,866.49 $4,409.98 $94.11–$1,712.80 180% above 35%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Laminotomy Dcmprn Nrv Root 1 Ntrspc Lumbar $33,045.43 $50,839.12 $131.86–$12,602.75 244% above 35%
Lumbar laminectomy (spinal decompression), one level CPT 63047 Lam Facetectomy & Foramotomy 1 Vrt Sgm Lumbar $29,722.82 $45,727.42 $131.86–$12,602.75 200% above 35%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Single $256.75 $395.00 $297.00 58% above 35%
Occipital nerve block (injection for headaches) both sides CPT 64405 Bilat Inj Anes Gtr Occiptal Nerve $791.05 $1,217.00 $297.00 — 35%
Occipital nerve block (injection for headaches) CPT 64405 Inj Anes Gtr Occiptal Nerve $443.30 $682.00 $297.00 11% above 35%
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis With Imag Guidance $534.95 $823.00 $297.00 28% below 35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Exc Nail/Matrix Perm Rem $633.75 $975.00 $297.00 50% above 35%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruct Neu Facet W Imag Guid L/S Sngl $1,669.85 $2,569.00 $297.00 15% below 35%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Bil Destruct Neu Facet W Imag Guid L/S Sngl $3,144.05 $4,837.00 $163.73–$3,391.53 59% above 35%
Septoplasty to straighten the nasal septum CPT 30520 Septoplasty/Submucous Resecj W/WO Cartilage Grf $22,565.98 $34,716.89 $363.00–$5,758.36 407% above 35%
Short arm splint (forearm and hand) CPT 29125 Pt Appl Splint Short Arm $238.55 $367.00 $37.69–$208.00 33% above 35%
Short arm splint (forearm and hand) CPT 29125 Ot Appl Splint Short Arm $238.55 $367.00 $37.69–$208.00 33% above 35%
Short leg splint (calf to foot) CPT 29515 Ot Application Splint Short Leg $187.20 $288.00 $45.89–$208.00 5% below 35%
Short leg splint (calf to foot) CPT 29515 Pt Application Splint Short Leg $187.20 $288.00 $45.89–$208.00 5% below 35%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Surgical Arthroscopy Shoulder Dstl Claviculc $17,378.81 $26,736.63 $297.00–$15,970.21 283% above 35%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls $19,602.34 $30,157.45 $135.78–$15,970.21 325% above 35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Puncture Spinal/Lumbar Dx $760.50 $1,170.00 $297.00 37% above 35%
Tonsil and adenoid removal, child under 12 CPT 42820 Tonsillectomy & Adenoidectomy <Age 12 $12,552.73 $19,311.89 $242.32–$10,281.69 125% above 35%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Tonsillectomy Primary/Secondary Age 12/> $9,246.65 $14,225.61 $214.67–$5,758.36 202% above 35%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Tonsillectomy Primary/Secondary <Age 12 $9,123.66 $14,036.40 $225.79–$10,281.69 258% above 35%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Pt 1 or 2 Musc $302.25 $465.00 $297.00 44% above 35%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Esophagogastroduodenoscopy Submucosal Injection $5,675.15 $8,731.00 $116.16–$1,657.70 534% above 35%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Egd Insert Guide Wire Dilator Passage Esophagus $3,885.64 $5,977.91 $139.02–$2,767.83 235% above 35%
Upper endoscopy (EGD), diagnostic CPT 43235 GI Upper Endoscopy Complex $5,716.59 $8,794.75 $6.50–$3,332.80 346% above 35%

Doctor visits and therapy

ProcedureCash priceList priceInsurers payvs KansasOff list
Blood transfusion (giving blood or blood components) CPT 36430 Blood / Products Transfusion per Hour $552.50 $850.00 $574.00 4% below 35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation/Nebulizer Treatment Initial $179.40 $276.00 $6.00–$173.39 40% above 35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation/Nebulizer Treatment Repeat $179.40 $276.00 $6.00–$173.39 40% above 35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler $180.05 $277.00 $6.00–$173.39 41% above 35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Obstruction Sputum Induct $180.05 $277.00 $6.00–$173.39 41% above 35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Repeat $180.05 $277.00 $6.00–$173.39 41% above 35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg 12 Lead Tracing Only $219.05 $337.00 $5.25–$123.36 37% above 35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Infusion, Hydration Init Up to 1hr $217.10 $334.00 $30.76–$187.62 12% below 35%
IV infusion of a medicine, first hour CPT 96365 IV Infusion,Tx,Proph,Dx Init Up to 1 Hr $260.65 $401.00 $64.08–$187.62 4% below 35%
IV push of a medicine, first drug CPT 96374 Inj Ivp,Initial Drugs/Sub $168.35 $259.00 $24.42–$208.93 22% below 35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Sq/Im $122.85 $189.00 $15.29–$63.38 82% above 35%
Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuro Re ED 1 or > Area Ea 15m $74.75 $115.00 $24.04–$57.78 3% below 35%
Neuromuscular re-education, 15 minutes CPT 97112 Pt Neuro Re ED 1 or > Area Ea 15m $74.75 $115.00 $24.04–$57.78 3% below 35%
New patient office visit, about 30 minutes CPT 99203 OP Visit Level III New Pt $165.10 $254.00 $63.26–$129.11 9% above 35%
New patient office visit, about 45 minutes CPT 99204 OP Visit Level IV New Pt $209.30 $322.00 $67.45–$211.58 14% above 35%
New patient office visit, about 60 minutes CPT 99205 OP Visit Level V New Pt $287.30 $442.00 $12.00–$288.99 2% above 35%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP Visit Level II New Pt $124.80 $192.00 $36.66–$74.82 19% above 35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med Nutrition Therapy Ea 15m $45.50 $70.00 $10.91–$48.55 50% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 15 Min $95.55 $147.00 $55.76–$181.17 42% below 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 30 Min $124.15 $191.00 $55.76–$181.17 25% below 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 45 Min $152.10 $234.00 $55.76–$181.17 8% below 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 60 Min $180.05 $277.00 $55.76–$181.17 9% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 75 Min $208.65 $321.00 $55.76–$181.17 26% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 90 Min $236.60 $364.00 $55.76–$181.17 43% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 105 Min $265.20 $408.00 $55.76–$181.17 60% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 120 Min $293.15 $451.00 $55.76–$181.17 77% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 135 Min $321.10 $494.00 $55.76–$181.17 94% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 150 Min $349.70 $538.00 $55.76–$181.17 111% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 165 Min $377.65 $581.00 $55.76–$181.17 128% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 180 Min $405.60 $624.00 $55.76–$181.17 145% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 195 Min $434.20 $668.00 $55.76–$181.17 162% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 210 Min $462.15 $711.00 $55.76–$181.17 179% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 225 Min $490.75 $755.00 $55.76–$181.17 196% above 35%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Level I 240 Min $518.05 $797.00 $55.76–$181.17 213% above 35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 15 Min $148.20 $228.00 $57.45–$176.72 29% below 35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 30 Min $176.80 $272.00 $57.45–$176.72 15% below 35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 45 Min $204.75 $315.00 $57.45–$176.72 2% below 35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 60 Min $233.35 $359.00 $57.45–$176.72 12% above 35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 75 Min $261.30 $402.00 $57.45–$176.72 25% above 35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 90 Min $289.25 $445.00 $57.45–$176.72 38% above 35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 105 Min $317.85 $489.00 $57.45–$176.72 52% above 35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 120 Min $346.45 $533.00 $57.45–$176.72 66% above 35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 135 Min $373.75 $575.00 $57.45–$176.72 79% above 35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Level III 150 Min $402.35 $619.00 $57.45–$176.72 92% above 35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 15 Min $95.55 $147.00 $71.48–$176.72 42% below 35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 30 Min $124.15 $191.00 $71.48–$176.72 25% below 35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 45 Min $152.10 $234.00 $71.48–$176.72 8% below 35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 60 Min $180.05 $277.00 $71.48–$176.72 9% above 35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 75 Min $208.65 $321.00 $71.48–$176.72 26% above 35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 90 Min $236.60 $364.00 $71.48–$176.72 43% above 35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 105 Min $265.20 $408.00 $71.48–$176.72 60% above 35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 120 Min $293.15 $451.00 $71.48–$176.72 77% above 35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 135 Min $321.10 $494.00 $71.48–$176.72 94% above 35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Level I 150 Min $349.70 $538.00 $71.48–$176.72 111% above 35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 15 Min $124.15 $191.00 $71.48–$176.72 34% below 35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 30 Min $152.10 $234.00 $71.48–$176.72 20% below 35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 45 Min $180.05 $277.00 $71.48–$176.72 5% below 35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 60 Min $208.00 $320.00 $71.48–$176.72 10% above 35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 75 Min $236.60 $364.00 $71.48–$176.72 25% above 35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 90 Min $265.20 $408.00 $71.48–$176.72 40% above 35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 105 Min $293.15 $451.00 $71.48–$176.72 55% above 35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 120 Min $321.10 $494.00 $71.48–$176.72 70% above 35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 135 Min $349.70 $538.00 $71.48–$176.72 85% above 35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Level II 150 Min $377.65 $581.00 $71.48–$176.72 100% above 35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Ther 1 or > Reg Ea 15m $72.80 $112.00 $19.32–$49.04 4% below 35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Manual Ther 1 or > Reg Ea 15m $72.80 $112.00 $19.32–$49.04 4% below 35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ot Ther Exer 1 or > Area Ea 15m $78.00 $120.00 $20.96–$51.93 at median 35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pt Ther Exer 1 or > Area Ea 15m $78.00 $120.00 $20.96–$51.93 at median 35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP Visit Level V Est Pt $254.80 $392.00 $67.45–$228.57 16% above 35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP Visit Level III Est Pt $131.30 $202.00 $46.55–$104.82 3% below 35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP Visit Level IV Est Pt $156.00 $240.00 $56.05–$154.05 5% below 35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP Visit Level II Est Pt $104.00 $160.00 $27.62–$56.37 at median 35%
Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Therapeutic Activ Pat Ea 15m $91.00 $140.00 $21.76–$61.90 16% above 35%
Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Therapeutic Activ Pat Ea 15m $91.00 $140.00 $21.76–$61.90 16% above 35%

Vaccines

ProcedureCash priceList priceInsurers payvs KansasOff list
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Imm Admin Vac/Toxoid X1 $55.25 $85.00 $6.06–$63.38 45% above 35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imm Admin Vac/Toxoid Ea Addl $45.50 $70.00 $6.00–$15.80 76% above 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.

Source file: https://www.mercy.net/content/dam/mercy/en/web-assets/charge-files/843730625_mercy-hospital-southeast-kansas-specialty-hospital_standardcharges.zip