Hospital

Edwards County Hospital and Healthcare Center

Edwards County Hospital and Healthcare Center in Kinsley, KS publishes cash prices for 257 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Kansas median for 173 of 250 procedures and below it for 75. By typical cash price it ranks #44 of 55 Kansas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

620 West Eighth Street, PO Box 99, Kinsley, KS, 67547 Collected Sep 27, 2026 Source price file (620) 659-3621

Critical access hospital (rural, 25 beds or fewer) No emergency department CCN 171317 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Kansas	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US ANKLE/BRACHIAL BILATERAL	$536.80	$671.00	$335.37–$630.28	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US ANKLE/BRACHIAL BILATERAL	$536.80	$671.00	$335.37–$630.28	—	20%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN COMPLETE	$1,580.80	$1,976.00	$658.50–$987.60	21% above	20%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN COMPLETE	$1,580.80	$1,976.00	$658.50–$987.60	—	20%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED	$459.20	$574.00	$144.29–$286.89	84% above	20%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED	$459.20	$574.00	$144.29–$286.89	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$5,115.20	$6,394.00	$1,499.58–$3,195.72	190% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST	$5,115.20	$6,394.00	$1,499.58–$3,195.72	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS WO	$3,199.20	$3,999.00	$629.82–$1,998.70	148% above	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS WO	$3,199.20	$3,999.00	$629.82–$1,998.70	—	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W/ CONTRAST	$3,879.20	$4,849.00	$629.82–$2,423.53	188% above	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS W/ CONTRAST	$3,879.20	$4,849.00	$629.82–$2,423.53	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS W/WO CONTRAST	$4,339.20	$5,424.00	$629.82–$2,710.92	134% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS W/WO CONTRAST	$4,339.20	$5,424.00	$629.82–$2,710.92	—	20%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ CONTRAST	$2,280.00	$2,850.00	$629.82–$1,424.43	64% above	20%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ CONTRAST	$2,280.00	$2,850.00	$629.82–$1,424.43	—	20%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO	$1,861.60	$2,327.00	$629.82–$1,163.03	55% above	20%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO	$1,861.60	$2,327.00	$629.82–$1,163.03	—	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO	$1,684.00	$2,105.00	$629.82–$1,052.08	72% above	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO	$1,684.00	$2,105.00	$629.82–$1,052.08	—	20%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO	$1,725.60	$2,157.00	$629.82–$1,078.07	68% above	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO	$1,725.60	$2,157.00	$629.82–$1,078.07	—	20%
CT scan of the head with contrast CPT 70460 CT HEAD W/ CONTRAST	$2,002.40	$2,503.00	$629.82–$1,251.00	75% above	20%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/ CONTRAST	$2,002.40	$2,503.00	$629.82–$1,251.00	—	20%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTRAST	$2,391.20	$2,989.00	$629.82–$1,493.90	91% above	20%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CONTRAST	$2,391.20	$2,989.00	$629.82–$1,493.90	—	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR WO	$1,982.40	$2,478.00	$629.82–$1,238.50	74% above	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTRAST	$1,982.40	$2,478.00	$629.82–$1,238.50	74% above	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONTRAST	$1,982.40	$2,478.00	$629.82–$1,238.50	—	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO	$1,982.40	$2,478.00	$629.82–$1,238.50	—	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL WO	$2,008.00	$2,510.00	$629.82–$1,254.50	102% above	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO	$2,008.00	$2,510.00	$629.82–$1,254.50	—	20%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/ CONTRAST	$2,167.20	$2,709.00	$629.82–$1,353.96	89% above	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ CONTRAST	$2,167.20	$2,709.00	$629.82–$1,353.96	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID DOPPLER BILATERAL	$1,192.80	$1,491.00	$630.28–$745.20	—	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID DOPPLER BILATERAL	$1,192.80	$1,491.00	$630.28–$745.20	—	20%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEW	$339.20	$424.00	$197.66–$211.92	47% above	20%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEW	$339.20	$424.00	$197.66–$211.92	—	20%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW	$248.00	$310.00	$154.94–$162.01	28% above	20%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW	$248.00	$310.00	$154.94–$162.01	—	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR BONE DENSITY/DEXA	$540.80	$676.00	$259.52–$337.86	72% above	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR BONE DENSITY/DEXA	$540.80	$676.00	$259.52–$337.86	—	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO	$1,798.40	$2,248.00	$629.82–$1,123.55	89% above	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO	$1,798.40	$2,248.00	$629.82–$1,123.55	—	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/ CONTRAST	$2,232.00	$2,790.00	$629.82–$1,394.44	104% above	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/ CONTRAST	$2,232.00	$2,790.00	$629.82–$1,394.44	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 MM 3D DX MAMMO WITH CAD BILATERAL	$360.80	$451.00	$161.54–$225.41	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM 3D DX MAMMO WITH CAD BILATERAL	$360.80	$451.00	$161.54–$225.41	—	20%
Diagnostic mammogram, one breast one side CPT 77065 MM 3D DX MAMMO WITH CAD UNILATERAL	$291.60	$364.50	$161.54–$182.18	49% above	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM 3D DX MAMMO WITH CAD UNILATERAL	$291.60	$364.50	$161.54–$182.18	—	20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US DUPLEX LOWER EXT ARTERY BILATERAL	$1,166.40	$1,458.00	$630.28–$728.71	—	20%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US DUPLEX LOWER EXT ARTERY BILATERAL	$1,166.40	$1,458.00	$630.28–$728.71	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUPLEX LOWER EXT VEINS BILATERAL	$933.29	$1,166.61	$583.07–$630.28	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUPLEX UPPER EXT VEINS BILATERAL	$1,284.80	$1,606.00	$630.28–$802.68	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUPLEX LOWER EXT VEINS BILATERAL	$933.29	$1,166.61	$583.07–$630.28	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUPLEX UPPER EXT VEINS BILATERAL	$1,284.80	$1,606.00	$630.28–$802.68	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO 2D W/ SPEC/COLOR M-MODE	$2,240.80	$2,801.00	$1,399.94–$2,008.67	18% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL LIMITED	$816.80	$1,021.00	$174.27–$510.30	135% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL LIMITED	$816.80	$1,021.00	$174.27–$510.30	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER EXT JOINT RT W/ & W/O	$2,400.00	$3,000.00	$724.36–$1,499.40	43% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER EXT JOINT LT W/ & W/O	$2,400.00	$3,000.00	$724.36–$1,499.40	43% above	20%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$2,658.40	$3,323.00	$724.36–$1,660.84	109% above	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONTRAST	$3,727.20	$4,659.00	$724.36–$2,328.57	123% above	20%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST	$2,700.00	$3,375.00	$724.36–$1,686.82	110% above	20%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTRAST	$3,859.20	$4,824.00	$724.36–$2,411.04	125% above	20%
MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE WO CONTRAST	$2,784.00	$3,480.00	$724.36–$1,739.30	127% above	20%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE W/WO CONTRAST	$4,084.80	$5,106.00	$724.36–$2,551.98	130% above	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE WO CONTRAST	$2,751.20	$3,439.00	$724.36–$1,718.81	145% above	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C SPINE W & WO CONTRAST	$3,921.60	$4,902.00	$724.36–$2,450.02	131% above	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C SPINE WO CONTRAST	$2,788.00	$3,485.00	$724.36–$1,741.80	145% above	20%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/W CONTRAST	$3,713.60	$4,642.00	$724.36–$2,320.07	121% above	20%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$760.00	$950.00	$474.81–$724.36	33% below	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL SPECT MULT IMAGING	$3,668.80	$4,586.00	$1,924.65–$2,292.08	36% above	20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL SPECT MULT IMAGING	$3,668.80	$4,586.00	$1,924.65–$2,292.08	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED	$459.20	$574.00	$174.27–$286.89	36% above	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED	$459.20	$574.00	$174.27–$286.89	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE NON OB	$917.60	$1,147.00	$174.27–$573.27	164% above	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE NON OB	$917.60	$1,147.00	$174.27–$573.27	—	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB OVER 14 WEEKS	$820.00	$1,025.00	$174.27–$512.30	116% above	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB OVER 14 WEEKS	$820.00	$1,025.00	$174.27–$512.30	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB LESS THAN 14 WEEKS	$417.60	$522.00	$174.27–$260.90	20% above	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB LESS THAN 14 WEEKS	$417.60	$522.00	$174.27–$260.90	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED	$607.20	$759.00	$185.51–$379.35	92% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED	$607.20	$759.00	$185.51–$379.35	—	20%
Screening mammogram, both breasts both sides CPT 77067 MM 3D SCREENING MAMMO BILATERAL WITH CAD	$304.00	$380.00	$80.65–$211.07	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM 3D SCREENING MAMMO BILATERAL WITH CAD	$304.00	$380.00	$80.65–$211.07	—	20%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB	$755.20	$944.00	$174.27–$471.81	136% above	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON OB	$755.20	$944.00	$174.27–$471.81	—	20%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$665.60	$832.00	$185.51–$415.83	86% above	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$665.60	$832.00	$185.51–$415.83	—	20%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE	$1,008.80	$1,261.00	$198.62–$630.25	134% above	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE	$1,008.80	$1,261.00	$198.62–$630.25	—	20%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM W/ CONTENTS	$722.40	$903.00	$174.27–$451.32	86% above	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM W/ CONTENTS	$722.40	$903.00	$174.27–$451.32	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$600.80	$751.00	$375.35–$630.28	at median	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$600.80	$751.00	$375.35–$630.28	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX LOWER EXT VEINS RIGHT	$933.29	$1,166.61	$583.07–$630.28	44% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX UPPER EXT VEINS LEFT	$933.29	$1,166.61	$583.07–$630.28	44% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX UPPER EXT VEINS RIGHT	$933.29	$1,166.61	$583.07–$630.28	44% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX LOWER EXT VEINS LEFT	$933.29	$1,166.61	$583.07–$630.28	44% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX LOWER EXT VEINS RIGHT	$933.29	$1,166.61	$583.07–$630.28	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX LOWER EXT VEINS LEFT	$933.29	$1,166.61	$583.07–$630.28	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX UPPER EXT VEINS RIGHT	$933.29	$1,166.61	$583.07–$630.28	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX UPPER EXT VEINS LEFT	$933.29	$1,166.61	$583.07–$630.28	—	20%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW	$277.60	$347.00	$173.43–$176.63	32% above	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW	$277.60	$347.00	$173.43–$176.63	—	20%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEW RIGHT	$323.20	$404.00	$144.29–$201.92	72% above	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEW RIGHT	$323.20	$404.00	$144.29–$201.92	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBAR 2 OR 3 VIEWS	$440.00	$550.00	$229.02–$274.89	61% above	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBAR 2 OR 3 VIEWS	$440.00	$550.00	$229.02–$274.89	—	20%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBAR 4 VIEWS	$620.80	$776.00	$325.26–$387.84	56% above	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBAR 4 VIEWS	$620.80	$776.00	$325.26–$387.84	—	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEW	$393.60	$492.00	$175.41–$245.90	77% above	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEW	$393.60	$492.00	$175.41–$245.90	—	20%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMPLETE	$373.60	$467.00	$193.69–$233.41	61% above	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES COMPLETE	$373.60	$467.00	$193.69–$233.41	—	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEW	$412.00	$515.00	$209.52–$257.40	65% above	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEW	$412.00	$515.00	$209.52–$257.40	—	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS	$336.00	$420.00	$174.27–$209.92	63% above	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS	$336.00	$420.00	$174.27–$209.92	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM COCCYX MIN 2 VIEW	$375.20	$469.00	$187.61–$234.41	66% above	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM COCCYX MIN 2 VIEW	$375.20	$469.00	$187.61–$234.41	—	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Kansas	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT	$72.00	$90.00	$14.90–$44.98	93% above	20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT	$72.00	$90.00	$14.90–$44.98	—	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 ASPARTATE AMINOTRANSFERASE (AST/SGOT) RL	$72.00	$90.00	$14.56–$44.98	93% above	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT	$72.00	$90.00	$14.56–$44.98	93% above	20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 ASPARTATE AMINOTRANSFERASE (AST/SGOT) RL	$72.00	$90.00	$14.56–$44.98	—	20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT	$72.00	$90.00	$14.56–$44.98	—	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE VIRAL HEPATITIS (HAV, HBV,HCV) RL	$431.17	$538.96	$180.91–$269.37	108% above	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE VIRAL HEPATITIS (HAV, HBV,HCV) RL	$431.17	$538.96	$180.91–$269.37	—	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE MOLD RL	$34.40	$43.00	$20.33–$21.49	11% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE VEGETABLE II	$136.80	$171.00	$20.33–$85.47	343% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ALMOND	$140.00	$175.00	$20.33–$87.46	353% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEANUT RL	$140.00	$175.00	$20.33–$87.46	353% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PECAN NUT RL	$140.00	$175.00	$20.33–$87.46	353% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN Cat Hair/Dander RL	$140.00	$175.00	$20.33–$87.46	353% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE Food-Fruit	$140.00	$175.00	$20.33–$87.46	353% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE FOOD-CITRUS	$140.00	$175.00	$20.33–$87.46	353% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WALNUT RL	$140.00	$175.00	$20.33–$87.46	353% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHOCOLATE CACAO RL	$140.00	$175.00	$20.33–$87.46	353% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HYPERSENSITIVITY PNEUMONITIS PROFILE RL	$180.00	$225.00	$20.33–$112.46	483% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN LATEX IGE RL	$216.80	$271.00	$20.33–$135.45	602% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE RAGWEED RELATED	$216.80	$271.00	$20.33–$135.45	602% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile Food-Berry	$216.80	$271.00	$20.33–$135.45	602% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE FOOD-NUTS	$216.80	$271.00	$20.33–$135.45	602% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE FOOD SHELLFISH	$264.00	$330.00	$20.33–$164.93	755% above	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE MOLD RL	$34.40	$43.00	$20.33–$21.49	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE VEGETABLE II	$136.80	$171.00	$20.33–$85.47	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALMOND	$140.00	$175.00	$20.33–$87.46	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PECAN NUT RL	$140.00	$175.00	$20.33–$87.46	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT RL	$140.00	$175.00	$20.33–$87.46	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHOCOLATE CACAO RL	$140.00	$175.00	$20.33–$87.46	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE FOOD-CITRUS	$140.00	$175.00	$20.33–$87.46	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE Food-Fruit	$140.00	$175.00	$20.33–$87.46	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN Cat Hair/Dander RL	$140.00	$175.00	$20.33–$87.46	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WALNUT RL	$140.00	$175.00	$20.33–$87.46	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HYPERSENSITIVITY PNEUMONITIS PROFILE RL	$180.00	$225.00	$20.33–$112.46	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE FOOD-NUTS	$216.80	$271.00	$20.33–$135.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE RAGWEED RELATED	$216.80	$271.00	$20.33–$135.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LATEX IGE RL	$216.80	$271.00	$20.33–$135.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile Food-Berry	$216.80	$271.00	$20.33–$135.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE FOOD SHELLFISH	$264.00	$330.00	$20.33–$164.93	—	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI CCP ABS (IGG, IGA) ELISA RL	$120.62	$150.78	$36.43–$75.36	12% above	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Anti CCP (IGG, IGA)	$120.62	$150.78	$36.43–$75.36	12% above	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Anti CCP (IGG, IGA)	$120.62	$150.78	$36.43–$75.36	—	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI CCP ABS (IGG, IGA) ELISA RL	$120.62	$150.78	$36.43–$75.36	—	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA by IFA Reflex to 9-biomarker profile	$222.40	$278.00	$58.07–$138.94	217% above	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA by IFA Reflex to 9-biomarker profile	$222.40	$278.00	$58.07–$138.94	—	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$254.63	$318.29	$95.49–$159.08	98% above	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$254.63	$318.29	$95.49–$159.08	—	20%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$173.00	$216.25	$25.76–$108.08	112% above	20%
Basic metabolic panel (blood test) CPT 80048 RL BMP (BASIC METABOLIC PANEL)	$173.00	$216.25	$25.76–$108.08	112% above	20%
Basic metabolic panel (blood test) inpatient CPT 80048 RL BMP (BASIC METABOLIC PANEL)	$173.00	$216.25	$25.76–$108.08	—	20%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$173.00	$216.25	$25.76–$108.08	—	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY SPECIMEN LEVEL IV	$142.38	$177.98	$64.17–$177.98	35% below	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV	$324.00	$405.00	$64.17–$256.44	47% above	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATHOLOGY SPECIMEN LEVEL IV	$142.38	$177.98	$64.17–$177.98	—	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH LEVEL IV	$324.00	$405.00	$64.17–$256.44	—	20%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$207.20	$259.00	$50.36–$129.45	176% above	20%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$207.20	$259.00	$50.36–$129.45	—	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 SP RHC VENIPUNCTURE	$14.40	$18.00	$9.00–$15.80	21% below	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 MV RHC VENIPUNCTURE	$15.20	$19.00	$9.50–$15.80	17% below	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE-VENOUS SPEC	$27.48	$34.35	$15.80–$17.17	51% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 GENERAL LAB (ROUTINE VENIPUNCTURE)	$27.48	$34.35	$15.80–$17.17	51% above	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE-VENOUS SPEC	$27.48	$34.35	$15.80–$17.17	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 GENERAL LAB (ROUTINE VENIPUNCTURE)	$27.48	$34.35	$15.80–$17.17	—	20%
Blood glucose (sugar) test CPT 82947 GLUCOSE TOLERANCE TEST POSTPRANDIAL	$60.82	$76.02	$11.32–$37.99	88% above	20%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE	$60.82	$76.02	$11.32–$37.99	88% above	20%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE	$60.82	$76.02	$11.32–$37.99	—	20%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE TOLERANCE TEST POSTPRANDIAL	$60.82	$76.02	$11.32–$37.99	—	20%
Blood lead test CPT 83655 LEAD WHOLE BLOOD ADULT	$33.91	$42.39	$21.19–$31.94	35% below	20%
Blood lead test CPT 83655 LEAD PEDIATRIC WB	$90.82	$113.52	$31.94–$56.74	74% above	20%
Blood lead test inpatient CPT 83655 LEAD WHOLE BLOOD ADULT	$33.91	$42.39	$21.19–$31.94	—	20%
Blood lead test inpatient CPT 83655 LEAD PEDIATRIC WB	$90.82	$113.52	$31.94–$56.74	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL SERUM PREG TEST	$139.00	$173.75	$44.99–$86.84	143% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL SERUM PREG TEST	$139.00	$173.75	$44.99–$86.84	—	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO GROUPING AND RH TYPING (LABCORP)	$72.80	$91.00	$45.48–$91.00	17% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB BLOOD TYPE ABO (GREAT BEND)	$304.80	$381.00	$190.42–$276.30	248% above	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO GROUPING AND RH TYPING (LABCORP)	$72.80	$91.00	$45.48–$91.00	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB BLOOD TYPE ABO (GREAT BEND)	$304.80	$381.00	$190.42–$276.30	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 RL CRP	$95.91	$119.89	$34.27–$59.92	100% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$95.91	$119.89	$34.27–$59.92	100% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$95.91	$119.89	$34.27–$59.92	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 RL CRP	$95.91	$119.89	$34.27–$59.92	—	20%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF Toxin Gene, PCR RL	$147.20	$184.00	$91.96–$98.74	36% above	20%
C. difficile toxin gene test (stool PCR) CPT 87493 RL C DIFFICILE TOXIN GENE (UNFORMED)	$154.00	$192.50	$96.22–$98.74	42% above	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF Toxin Gene, PCR RL	$147.20	$184.00	$91.96–$98.74	—	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 RL C DIFFICILE TOXIN GENE (UNFORMED)	$154.00	$192.50	$96.22–$98.74	—	20%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 RL	$171.02	$213.78	$71.46–$106.85	99% above	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 RL	$171.02	$213.78	$71.46–$106.85	—	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$195.16	$243.95	$71.80–$121.92	113% above	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$195.16	$243.95	$71.80–$121.92	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Novel Coronavirus (COVID-19) RL	$123.20	$154.00	$76.97–$149.69	10% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 2019 Novel Coronavirus (COVID-19) RL	$123.20	$154.00	$76.97–$149.69	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia/Gonococcus, NAA (UA/Aptima)	$98.26	$122.82	$61.39–$98.74	13% below	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS NAA, APTIMA	$180.04	$225.05	$98.74–$112.48	59% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia/Gonococcus, NAA (UA/Aptima)	$98.26	$122.82	$61.39–$98.74	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS NAA, APTIMA	$180.04	$225.05	$98.74–$112.48	—	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 RL LIPID	$170.00	$212.50	$56.61–$106.21	96% above	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$170.00	$212.50	$56.61–$106.21	96% above	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 RL LIPID	$170.00	$212.50	$56.61–$106.21	—	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$170.00	$212.50	$56.61–$106.21	—	20%
Comprehensive metabolic panel (blood test) CPT 80053 RL CMP	$238.00	$297.50	$29.74–$148.70	127% above	20%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$238.00	$297.50	$29.74–$148.70	127% above	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 RL CMP	$238.00	$297.50	$29.74–$148.70	—	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$238.00	$297.50	$29.74–$148.70	—	20%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$180.35	$225.44	$96.52–$112.67	55% above	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$180.35	$225.44	$96.52–$112.67	—	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA) SULFATE	$179.20	$224.00	$105.42–$111.96	40% above	20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE (DHEA) SULFATE	$179.20	$224.00	$105.42–$111.96	—	20%
Estradiol blood test CPT 82670 ESTRADIOL	$213.00	$266.25	$133.07–$164.12	26% above	20%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$213.00	$266.25	$133.07–$164.12	—	20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH (FOLLICLE STIMULATING HORMONE) RL	$180.80	$226.00	$93.46–$112.95	58% above	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH (FOLLICLE STIMULATING HORMONE) RL	$180.80	$226.00	$93.46–$112.95	—	20%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$284.40	$355.50	$32.20–$177.68	30% above	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$284.40	$355.50	$32.20–$177.68	—	20%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$146.40	$183.00	$69.79–$91.46	65% above	20%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$146.40	$183.00	$69.79–$91.46	—	20%
Folate (folic acid) blood test CPT 82746 FOLATE (FOLIC ACID) RL	$140.80	$176.00	$81.04–$87.96	43% above	20%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE (FOLIC ACID) RL	$140.80	$176.00	$81.04–$87.96	—	20%
Free T3 thyroid hormone test CPT 84481 FREE T3	$174.00	$217.50	$108.71–$110.46	36% above	20%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$174.00	$217.50	$108.71–$110.46	—	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$132.00	$165.00	$40.34–$82.47	117% above	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 RL FREE T4 (THYROXINE FREE)	$132.00	$165.00	$40.34–$82.47	117% above	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$132.00	$165.00	$40.34–$82.47	—	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 RL FREE T4 (THYROXINE FREE)	$132.00	$165.00	$40.34–$82.47	—	20%
Free testosterone test CPT 84402 TESTOSTERONE FREE DIRECT RL	$194.40	$243.00	$121.45–$142.44	37% above	20%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE DIRECT RL	$194.40	$243.00	$121.45–$142.44	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE TEST 1 HOUR	$70.00	$87.50	$26.32–$43.74	46% above	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE TEST 1 HOUR	$70.00	$87.50	$26.32–$43.74	—	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 4 HOUR	$48.00	$60.00	$29.99–$60.00	48% below	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 2 HOUR	$105.00	$131.25	$63.87–$65.60	14% above	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 3 HOUR	$140.00	$175.00	$63.87–$87.46	52% above	20%
Glucose tolerance test, 3 samples CPT 82951 GTT 4 HOUR	$175.00	$218.75	$63.87–$109.33	90% above	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 4 HOUR	$48.00	$60.00	$29.99–$60.00	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 2 HOUR	$105.00	$131.25	$63.87–$65.60	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3 HOUR	$140.00	$175.00	$63.87–$87.46	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 4 HOUR	$175.00	$218.75	$63.87–$109.33	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae, NAA (UA/APTIMA)	$175.34	$219.17	$98.74–$109.54	72% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae, NAA (UA/APTIMA)	$175.34	$219.17	$98.74–$109.54	—	20%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY IGG RL	$145.80	$182.25	$52.12–$91.09	142% above	20%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODIES IGA IGG IGM RL	$145.80	$182.25	$52.12–$91.09	142% above	20%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY IGM RL	$145.80	$182.25	$52.12–$91.09	142% above	20%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODIES IGA IGG IGM RL	$145.80	$182.25	$52.12–$91.09	—	20%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODY IGG RL	$145.80	$182.25	$52.12–$91.09	—	20%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODY IGM RL	$145.80	$182.25	$52.12–$91.09	—	20%
H. pylori stool antigen test CPT 87338 H PYLORI ANTIGEN STOOL RL	$162.80	$203.50	$40.88–$101.71	43% above	20%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI ANTIGEN STOOL RL	$162.80	$203.50	$40.88–$101.71	—	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 QUANTITAITVE RNA RL	$482.40	$603.00	$239.37–$301.38	42% above	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 QUANTITAITVE RNA RL	$482.40	$603.00	$239.37–$301.38	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV P24 AG/AB W/REFLEX TO CONFIRMATIN RL	$141.00	$176.25	$78.69–$88.09	53% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV p24 Antigen/Antibody With Reflex	$163.20	$204.00	$78.69–$101.96	77% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV P24 AG/AB W/REFLEX TO CONFIRMATIN RL	$141.00	$176.25	$78.69–$88.09	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV p24 Antigen/Antibody With Reflex	$163.20	$204.00	$78.69–$101.96	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 RL A1C	$114.40	$143.00	$47.12–$71.47	65% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCATED (A1C)	$114.40	$143.00	$47.12–$71.47	65% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCATED (A1C)	$114.40	$143.00	$47.12–$71.47	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 RL A1C	$114.40	$143.00	$47.12–$71.47	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB QUALITATIVE RL	$123.00	$153.75	$60.78–$76.84	69% above	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB QUALITATIVE RL	$123.00	$153.75	$60.78–$76.84	—	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG QUAL SCREEN RL	$118.00	$147.50	$32.28–$73.73	99% above	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN RL	$118.00	$147.50	$32.28–$73.73	99% above	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG QUALITATIVE RL	$118.00	$147.50	$32.28–$73.73	99% above	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN RL	$118.00	$147.50	$32.28–$73.73	—	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG QUAL SCREEN RL	$118.00	$147.50	$32.28–$73.73	—	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG QUALITATIVE RL	$118.00	$147.50	$32.28–$73.73	—	20%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Antibody w/Reflex	$155.20	$194.00	$59.11–$96.96	105% above	20%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS(HCV)QUANT PCR GRAPH RL	$155.20	$194.00	$59.11–$96.96	105% above	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS(HCV)QUANT PCR GRAPH RL	$155.20	$194.00	$59.11–$96.96	—	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Antibody w/Reflex	$155.20	$194.00	$59.11–$96.96	—	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS RNA QUANTI PCR-HS	$422.00	$527.50	$120.50–$263.65	39% above	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS (HCV) GENOYTPING RL	$422.00	$527.50	$120.50–$263.65	39% above	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS (HCV) GENOYTPING RL	$422.00	$527.50	$120.50–$263.65	—	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS RNA QUANTI PCR-HS	$422.00	$527.50	$120.50–$263.65	—	20%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLX VIRUS TYP 1(HSV1)AB IGG RL	$95.20	$119.00	$59.48–$83.29	1% above	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLX VIRUS TYP 1(HSV1)AB IGG RL	$95.20	$119.00	$59.48–$83.29	—	20%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX VIRUS 2(HSV2) AB IGG RL	$98.28	$122.85	$61.40–$87.90	12% above	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX VIRUS 2(HSV2) AB IGG RL	$98.28	$122.85	$61.40–$87.90	—	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP RL	$123.20	$154.00	$76.97–$80.32	36% above	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 High Sensitivity CRP	$123.20	$154.00	$76.97–$80.32	36% above	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVITY CRP RL	$123.20	$154.00	$76.97–$80.32	—	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 High Sensitivity CRP	$123.20	$154.00	$76.97–$80.32	—	20%
Homocysteine blood test CPT 83090 HOMOCYSTEINE RL	$162.40	$203.00	$101.46–$203.00	29% below	20%
Homocysteine blood test CPT 83090 HOMOCYST(E)INE LEVEL RL	$197.00	$246.25	$123.08–$231.50	14% below	20%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE RL	$162.40	$203.00	$101.46–$203.00	—	20%
Homocysteine blood test inpatient CPT 83090 HOMOCYST(E)INE LEVEL RL	$197.00	$246.25	$123.08–$231.50	—	20%
Insulin blood test CPT 83525 INSULIN	$111.20	$139.00	$66.49–$69.47	38% above	20%
Insulin blood test inpatient CPT 83525 INSULIN	$111.20	$139.00	$66.49–$69.47	—	20%
Iron blood test (serum iron) CPT 83540 IRON RL	$84.00	$105.00	$33.59–$52.48	96% above	20%
Iron blood test (serum iron) inpatient CPT 83540 IRON RL	$84.00	$105.00	$33.59–$52.48	—	20%
Iron-binding capacity (TIBC) test CPT 83550 TIBC FEE	$97.00	$121.25	$54.06–$60.60	54% above	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC FEE	$97.00	$121.25	$54.06–$60.60	—	20%
Kidney function blood test panel CPT 80069 RL RENAL (KIDNEY) PANEL	$182.00	$227.50	$26.64–$113.71	156% above	20%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$182.00	$227.50	$26.64–$113.71	156% above	20%
Kidney function blood test panel inpatient CPT 80069 RL RENAL (KIDNEY) PANEL	$182.00	$227.50	$26.64–$113.71	—	20%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$182.00	$227.50	$26.64–$113.71	—	20%
LH (luteinizing hormone) test CPT 83002 LH - LUTEINIZING HORMONE	$182.40	$228.00	$91.19–$113.95	65% above	20%
LH (luteinizing hormone) test inpatient CPT 83002 LH - LUTEINIZING HORMONE	$182.40	$228.00	$91.19–$113.95	—	20%
Lipase blood test (pancreas enzyme) CPT 83690 RL LIPASE	$125.60	$157.00	$36.42–$78.47	101% above	20%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$126.00	$157.50	$36.42–$78.72	102% above	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 RL LIPASE	$125.60	$157.00	$36.42–$78.47	—	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$126.00	$157.50	$36.42–$78.72	—	20%
Liver function blood test panel CPT 80076 LIVER PANEL	$173.00	$216.25	$41.79–$108.08	87% above	20%
Liver function blood test panel CPT 80076 RL LIVER (HEPATIC) PANEL	$173.00	$216.25	$41.79–$108.08	87% above	20%
Liver function blood test panel inpatient CPT 80076 LIVER PANEL	$173.00	$216.25	$41.79–$108.08	—	20%
Liver function blood test panel inpatient CPT 80076 RL LIVER (HEPATIC) PANEL	$173.00	$216.25	$41.79–$108.08	—	20%
Lyme disease antibody test CPT 86618 LYME DISEASE (B.BURGD RL	$158.35	$197.94	$98.93–$100.53	30% above	20%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE (B.BURGD RL	$158.35	$197.94	$98.93–$100.53	—	20%
Magnesium blood test CPT 83735 MAGNESIUM 24 HR URINE RL	$56.00	$70.00	$33.89–$34.99	4% above	20%
Magnesium blood test CPT 83735 MAGNESIUM	$96.31	$120.39	$33.89–$60.17	78% above	20%
Magnesium blood test CPT 83735 RL MAGNESIUM	$96.31	$120.39	$33.89–$60.17	78% above	20%
Magnesium blood test inpatient CPT 83735 MAGNESIUM 24 HR URINE RL	$56.00	$70.00	$33.89–$34.99	—	20%
Magnesium blood test inpatient CPT 83735 RL MAGNESIUM	$96.31	$120.39	$33.89–$60.17	—	20%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$96.31	$120.39	$33.89–$60.17	—	20%
Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) ANTIBODIES IGM RL	$104.00	$130.00	$64.97–$89.50	11% above	20%
Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) ANTIBODYIES IGG RL	$104.00	$130.00	$64.97–$89.50	11% above	20%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) ANTIBODIES IGM RL	$104.00	$130.00	$64.97–$89.50	—	20%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) ANTIBODYIES IGG RL	$104.00	$130.00	$64.97–$89.50	—	20%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$105.00	$131.25	$25.56–$65.60	127% above	20%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$105.00	$131.25	$25.56–$65.60	—	20%
Obstetric blood test panel CPT 80055 PREGNANCY INITIAL SCREEN (OB PANEL) RL	$110.82	$138.52	$69.24–$117.19	37% below	20%
Obstetric blood test panel inpatient CPT 80055 PREGNANCY INITIAL SCREEN (OB PANEL) RL	$110.82	$138.52	$69.24–$117.19	—	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE (TOTAL RATIO REFLEX) RL	$151.20	$189.00	$69.35–$94.46	64% above	20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE (TOTAL RATIO REFLEX) RL	$151.20	$189.00	$69.35–$94.46	—	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL RL	$151.20	$189.00	$89.08–$94.46	46% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL DIAGNOSTIC RL	$151.20	$189.00	$89.08–$94.46	46% above	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL RL	$151.20	$189.00	$89.08–$94.46	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL DIAGNOSTIC RL	$151.20	$189.00	$89.08–$94.46	—	20%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE (PTH) RL	$286.40	$358.00	$178.93–$203.21	43% above	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE (PTH) RL	$286.40	$358.00	$178.93–$203.21	—	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL RL	$48.00	$60.00	$29.54–$29.99	8% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 RL aPTT (PARTIAL THROMBOPLASTIN TIME)	$103.00	$128.75	$29.54–$64.35	132% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 DO NOTPARTIAL THROMBOPLASTIN TIME (APTT)	$103.00	$128.75	$29.54–$64.35	132% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME	$103.71	$129.64	$29.54–$64.80	134% above	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL RL	$48.00	$60.00	$29.54–$29.99	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 RL aPTT (PARTIAL THROMBOPLASTIN TIME)	$103.00	$128.75	$29.54–$64.35	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 DO NOTPARTIAL THROMBOPLASTIN TIME (APTT)	$103.00	$128.75	$29.54–$64.35	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME	$103.71	$129.64	$29.54–$64.80	—	20%
Progesterone blood test CPT 84144 PROGESTERONE RL	$168.00	$210.00	$94.02–$104.96	53% above	20%
Progesterone blood test inpatient CPT 84144 PROGESTERONE RL	$168.00	$210.00	$94.02–$104.96	—	20%
Prolactin blood test CPT 84146 PROLACTIN, PITUITARY MACRODENOMA, SERUM	$170.00	$212.50	$104.11–$106.21	32% above	20%
Prolactin blood test CPT 84146 PROLACTIN RL	$170.00	$212.50	$104.11–$106.21	32% above	20%
Prolactin blood test CPT 84146 MACROPROLACTIN RL	$170.00	$212.50	$104.11–$106.21	32% above	20%
Prolactin blood test inpatient CPT 84146 MACROPROLACTIN RL	$170.00	$212.50	$104.11–$106.21	—	20%
Prolactin blood test inpatient CPT 84146 PROLACTIN, PITUITARY MACRODENOMA, SERUM	$170.00	$212.50	$104.11–$106.21	—	20%
Prolactin blood test inpatient CPT 84146 PROLACTIN RL	$170.00	$212.50	$104.11–$106.21	—	20%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$72.00	$90.00	$21.08–$44.98	133% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 RL PT/INR	$72.00	$90.00	$21.08–$44.98	133% above	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$72.00	$90.00	$21.08–$44.98	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 RL PT/INR	$72.00	$90.00	$21.08–$44.98	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 UDS MEDICAL	$103.00	$128.75	$36.91–$64.35	86% above	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 UDS MEDICAL	$103.00	$128.75	$36.91–$64.35	—	20%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B ANTIGEN DETECTION	$117.00	$146.25	$71.90–$73.10	72% above	20%
Rapid flu test (influenza antigen) CPT 87804 MV RHC INFLUENZA ASSAY W/OPTIC 521	$117.00	$146.25	$71.90–$73.10	72% above	20%
Rapid flu test (influenza antigen) CPT 87804 SP RHC INFLUENZA ASSAY W/OPTIC	$117.00	$146.25	$71.90–$73.10	72% above	20%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A ANTIGEN DETECTION	$117.00	$146.25	$71.90–$73.10	72% above	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B ANTIGEN DETECTION	$117.00	$146.25	$71.90–$73.10	—	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A ANTIGEN DETECTION	$117.00	$146.25	$71.90–$73.10	—	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 SP RHC INFLUENZA ASSAY W/OPTIC	$117.00	$146.25	$71.90–$73.10	—	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 MV RHC INFLUENZA ASSAY W/OPTIC 521	$117.00	$146.25	$71.90–$73.10	—	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 MV STREP A ASSAY W/OPTIC	$100.80	$126.00	$62.97–$71.90	46% above	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 SP STREP A ASSAY W/OPTIC	$100.80	$126.00	$62.97–$71.90	46% above	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP A Ag	$100.80	$126.00	$62.97–$71.90	46% above	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP A Ag	$100.80	$126.00	$62.97–$71.90	—	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 SP STREP A ASSAY W/OPTIC	$100.80	$126.00	$62.97–$71.90	—	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 MV STREP A ASSAY W/OPTIC	$100.80	$126.00	$62.97–$71.90	—	20%
Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUAL RL	$93.00	$116.25	$33.74–$58.10	95% above	20%
Rheumatoid factor (RF) test inpatient CPT 86431 RA FACTOR QUAL RL	$93.00	$116.25	$33.74–$58.10	—	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGG RL	$103.20	$129.00	$40.51–$64.47	78% above	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGM RL	$103.20	$129.00	$40.51–$64.47	78% above	20%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IGM RL	$103.20	$129.00	$40.51–$64.47	—	20%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IGG RL	$103.20	$129.00	$40.51–$64.47	—	20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RL SED RATE (ESR)	$66.40	$83.00	$16.81–$41.48	106% above	20%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RL SED RATE (ESR)	$66.40	$83.00	$16.81–$41.48	—	20%
Stool ova and parasites exam CPT 87177 O&P DIRECT SMEAR	$112.00	$140.00	$41.18–$69.97	84% above	20%
Stool ova and parasites exam inpatient CPT 87177 O&P DIRECT SMEAR	$112.00	$140.00	$41.18–$69.97	—	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 SP RHC OCCULT BLOOD FECAL 521	$14.80	$18.50	$9.25–$16.27	45% below	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 MV RHC OCCULT BLOOD FECAL 521	$14.80	$18.50	$9.25–$16.27	45% below	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 FECAL OCCULT BLOOD (3)	$51.46	$64.33	$16.27–$32.15	91% above	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 SP RHC OCCULT BLOOD FECAL 521	$14.80	$18.50	$9.25–$16.27	—	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 MV RHC OCCULT BLOOD FECAL 521	$14.80	$18.50	$9.25–$16.27	—	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 FECAL OCCULT BLOOD (3)	$51.46	$64.33	$16.27–$32.15	—	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD #1 IMMUNO 1-3	$80.80	$101.00	$44.75–$50.48	58% above	20%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD #1 IMMUNO 1-3	$80.80	$101.00	$44.75–$50.48	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS-RPR WITH REFLEX TO RPR TITER RL	$39.20	$49.00	$21.32–$24.49	9% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RAPID PLASMA REAGIN RELFEX	$71.00	$88.75	$21.32–$44.35	98% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILLIS- RPR W/REFLEX TO RPR TITER RL	$71.00	$88.75	$21.32–$44.35	98% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS-RPR WITH REFLEX TO RPR TITER RL	$39.20	$49.00	$21.32–$24.49	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RAPID PLASMA REAGIN RELFEX	$71.00	$88.75	$21.32–$44.35	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILLIS- RPR W/REFLEX TO RPR TITER RL	$71.00	$88.75	$21.32–$44.35	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB (Not Incubated) RL	$286.44	$358.05	$174.36–$178.96	51% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB (Client Incubated) RL	$286.44	$358.05	$174.36–$178.96	51% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB (Not Incubated) RL	$286.44	$358.05	$174.36–$178.96	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB (Client Incubated) RL	$286.44	$358.05	$174.36–$178.96	—	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL (LC/MS, WOMEN)	$194.40	$243.00	$121.45–$137.47	36% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL RL	$194.40	$243.00	$121.45–$137.47	36% above	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL (LC/MS, WOMEN)	$194.40	$243.00	$121.45–$137.47	—	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL RL	$194.40	$243.00	$121.45–$137.47	—	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE (TPO) ANTIBODIES	$123.00	$153.75	$66.80–$76.84	57% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL (LKM) AB RL	$164.00	$205.00	$66.80–$102.46	110% above	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE (TPO) ANTIBODIES	$123.00	$153.75	$66.80–$76.84	—	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL (LKM) AB RL	$164.00	$205.00	$66.80–$102.46	—	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$176.24	$220.30	$57.65–$110.10	97% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 RL TSH THYROID STIMULATING HORMONE	$176.24	$220.30	$57.65–$110.10	97% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 RL THYROID STIM HORM	$176.24	$220.30	$57.65–$110.10	97% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 RL THYROID STIM HORM ST	$176.24	$220.30	$57.65–$110.10	97% above	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 RL TSH THYROID STIMULATING HORMONE	$176.24	$220.30	$57.65–$110.10	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$176.24	$220.30	$57.65–$110.10	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 RL THYROID STIM HORM ST	$176.24	$220.30	$57.65–$110.10	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 RL THYROID STIM HORM	$176.24	$220.30	$57.65–$110.10	—	20%
Uric acid blood test CPT 84550 RL URIC ACID	$72.00	$90.00	$19.29–$44.98	92% above	20%
Uric acid blood test CPT 84550 URIC ACID SERUM	$72.00	$90.00	$19.29–$44.98	92% above	20%
Uric acid blood test inpatient CPT 84550 URIC ACID SERUM	$72.00	$90.00	$19.29–$44.98	—	20%
Uric acid blood test inpatient CPT 84550 RL URIC ACID	$72.00	$90.00	$19.29–$44.98	—	20%
Urinalysis with microscope exam, automated CPT 81001 UA MICROSCOPIC	$43.20	$54.00	$12.74–$26.99	25% above	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA MICROSCOPIC	$43.20	$54.00	$12.74–$26.99	—	20%
Urinalysis without microscope exam, automated CPT 81003 UA DIP STICK MANUAL CHG	$54.00	$67.50	$12.06–$33.74	139% above	20%
Urinalysis without microscope exam, automated CPT 81003 UA AUTO CHG	$54.00	$67.50	$12.06–$33.74	139% above	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA AUTO CHG	$54.00	$67.50	$12.06–$33.74	—	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA DIP STICK MANUAL CHG	$54.00	$67.50	$12.06–$33.74	—	20%
Urinalysis without microscope exam, manual CPT 81002 SP RHC UA NONAUTO W/O SCOPE - DIPSTICK 5	$54.00	$67.50	$13.58–$33.74	207% above	20%
Urinalysis without microscope exam, manual CPT 81002 MV RHC UA NONAUTO W/O SCOPE - DIPSTICK 5	$54.00	$67.50	$13.58–$33.74	207% above	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 SP RHC UA NONAUTO W/O SCOPE - DIPSTICK 5	$54.00	$67.50	$13.58–$33.74	—	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 MV RHC UA NONAUTO W/O SCOPE - DIPSTICK 5	$54.00	$67.50	$13.58–$33.74	—	20%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE ROUTINE	$125.60	$157.00	$39.82–$78.47	136% above	20%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE ROUTINE	$125.60	$157.00	$39.82–$78.47	—	20%
Urine pregnancy test, read by color change CPT 81025 HCG QUAL URINE PREG TEST	$40.00	$50.00	$24.99–$35.58	13% below	20%
Urine pregnancy test, read by color change CPT 81025 MV RHC URINE PREGNANCY TEST 521	$57.60	$72.00	$35.58–$35.99	25% above	20%
Urine pregnancy test, read by color change CPT 81025 SP RHC URINE PREGNANCY TEST 521	$57.60	$72.00	$35.58–$35.99	25% above	20%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG QUAL URINE PREG TEST	$40.00	$50.00	$24.99–$35.58	—	20%
Urine pregnancy test, read by color change inpatient CPT 81025 MV RHC URINE PREGNANCY TEST 521	$57.60	$72.00	$35.58–$35.99	—	20%
Urine pregnancy test, read by color change inpatient CPT 81025 SP RHC URINE PREGNANCY TEST 521	$57.60	$72.00	$35.58–$35.99	—	20%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$88.00	$110.00	$54.98–$75.27	at median	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$88.00	$110.00	$54.98–$75.27	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-Hydroxy Vitamin D D2+D3 Fractionated	$225.60	$282.00	$140.94–$282.00	8% below	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY RL	$225.60	$282.00	$140.94–$282.00	8% below	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY RL	$225.60	$282.00	$140.94–$282.00	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-Hydroxy Vitamin D D2+D3 Fractionated	$225.60	$282.00	$140.94–$282.00	—	20%
Zinc blood test CPT 84630 ZINC WHOLE BLOOD RL	$31.90	$39.87	$19.92–$37.82	45% below	20%
Zinc blood test CPT 84630 ZINC, RBC	$102.00	$127.50	$37.82–$63.73	76% above	20%
Zinc blood test inpatient CPT 84630 ZINC WHOLE BLOOD RL	$31.90	$39.87	$19.92–$37.82	—	20%
Zinc blood test inpatient CPT 84630 ZINC, RBC	$102.00	$127.50	$37.82–$63.73	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG, B-SUBUNIT, QUANTITATIVE RL	$76.00	$95.00	$47.48–$79.14	20% below	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG, B-SUBUNIT, QUANTITATIVE RL	$76.00	$95.00	$47.48–$79.14	—	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Kansas	Off list
Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC 983	$340.00	$425.00	$108.44–$384.95	6% below	20%
Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC 964	$340.00	$425.00	$212.42–$384.95	6% below	20%
Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC 510	$960.00	$1,200.00	$50.31–$599.76	165% above	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 MV RHC CLSD TX METATARSAL FX W/O MAN EA	$540.88	$676.10	$337.91–$676.10	64% above	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC CONVERSION OF ARR	$126.40	$158.00	$101.43–$158.00	77% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRICTRONIC CONVERSION	$1,680.00	$2,100.00	$631.81–$1,049.58	199% above	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 SP FRX RADIAL DISTAL	$261.60	$327.00	$163.43–$327.00	43% below	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 MV FRX RADIAL DISTAL	$275.20	$344.00	$171.93–$344.00	40% below	20%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/BX REM BY SNARE	$2,100.80	$2,626.00	$1,312.47–$1,932.21	53% above	20%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$1,883.20	$2,354.00	$1,176.53–$1,932.21	24% above	20%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAGNOSTIC	$1,808.00	$2,260.00	$1,129.55–$1,731.94	69% above	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 SP RHC DEST 1ST LESION	$79.20	$99.00	$49.48–$99.00	26% below	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 MV RHC DEST 1ST LESION	$83.20	$104.00	$51.98–$104.00	22% below	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 MV RHC REMOVE IMPACTED EAR WAX WASH 521	$38.60	$48.25	$24.12–$48.25	53% below	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 SP RHC REMOVE IMPACTED EAR WAX WASH 521	$38.60	$48.25	$24.12–$48.25	53% below	20%
Earwax removal with instruments, one ear CPT 69210 SP RHC REM IMPACTED CERUMEN 521	$128.80	$161.00	$80.47–$161.00	55% above	20%
Earwax removal with instruments, one ear CPT 69210 MV RHC REM IMPACTED CERUMEN 521	$128.80	$161.00	$80.47–$161.00	55% above	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ INTERLAMINAR CER/THOR 964	$621.60	$777.00	$388.34–$777.00	49% below	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ INTERLAMINAR CER/THOR	$808.45	$1,010.56	$101.48–$1,010.56	33% below	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Inj interlaminar crv/thr 510	$1,584.00	$1,980.00	$989.60–$1,496.90	30% above	20%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 INTRAART JNT OR MBB L/S 1 LVL-BILAT 983	$497.20	$621.50	$86.27–$621.50	—	20%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 INTRAART JNT OR MBB L/S 1 LVL-BILAT 964	$497.20	$621.50	$310.63–$621.50	—	20%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INTRAART JNT OR MBB LUM/SAC 1ST LEVEL964	$497.20	$621.50	$310.63–$621.50	49% below	20%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INTRAART JNT OR MBB LUM/SAC 1ST LVL 983	$497.20	$621.50	$86.27–$621.50	49% below	20%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Intraart jnt or mbb lum/sac 1st levl 510	$2,053.60	$2,567.00	$1,282.99–$1,458.96	109% above	20%
IUD insertion (the device itself billed separately) CPT 58300 MV INSERTION OF INTRAUTERINE DEV (IUD)	$160.00	$200.00	$99.96–$175.05	20% below	20%
IUD insertion (the device itself billed separately) CPT 58300 SP INSERTION INTRAUTERINE DEVICE 521	$160.00	$200.00	$99.96–$175.05	20% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 INCIS & DRAIN ABSCESS SI	$108.80	$136.00	$104.76–$136.00	48% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMP/SINGLE	$113.60	$142.00	$104.76–$142.00	45% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 SP RHC I&D SKIN ABSCESS SIM 521	$304.80	$381.00	$190.42–$325.62	47% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 MV RHC I&D SKIN ABSCESS SIM 521	$304.80	$381.00	$190.42–$325.62	47% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 DRN & INSC SKIN ABSC SIM	$471.98	$589.97	$294.86–$325.62	127% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE SINGL	$748.00	$935.00	$325.62–$467.31	260% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT 964	$123.20	$154.00	$76.97–$154.00	15% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 SP SINGLE TENDON SHEATH INJ	$240.00	$300.00	$149.94–$186.70	66% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 MV SINGLE TENDON SHEATH INJ	$252.00	$315.00	$157.44–$186.70	74% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$306.56	$383.20	$35.31–$186.70	112% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj tendon sheath/ligament 510	$627.20	$784.00	$186.70–$391.84	333% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JNT	$67.20	$84.00	$41.32–$84.00	69% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/inj major joint/bursa w/o us 964	$160.80	$201.00	$100.46–$201.00	27% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MAJOR JOINT W/O US 983	$160.80	$201.00	$41.32–$201.00	27% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 SP RHC ASP/INJ JOINT MAJOR	$440.80	$551.00	$275.39–$483.75	100% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MV RHC ASP/INJ JOINT MAJOR	$463.20	$579.00	$289.38–$483.75	111% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT MAJOR	$472.15	$590.19	$294.98–$483.75	115% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/inj major joint/bursa w/o us 510	$652.00	$815.00	$407.34–$483.75	196% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT MAJOR (SHLDR, HIP, KNEE)	$705.60	$882.00	$440.82–$483.75	221% above	20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 MV INSERTION IMPLANTABLE CONTRAC CAP	$160.00	$200.00	$99.96–$200.00	at median	20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 SP INSERTION IMPLANTABLE CONTRACE CAP	$160.00	$200.00	$99.96–$200.00	at median	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US981	$84.00	$105.00	$33.84–$105.00	63% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XIPHOID JOINT INJECTION 964	$123.60	$154.50	$77.22–$154.50	45% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XIPHOID JOINT INJECTION 983	$123.60	$154.50	$33.84–$154.50	45% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 SP RHC ASP/INJ JOINT INTMED	$253.60	$317.00	$158.44–$317.00	12% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 MV RHC ASP/INJ JOINT INTMED	$266.40	$333.00	$166.43–$333.00	17% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US450	$880.00	$1,100.00	$483.75–$549.78	288% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BU964	$94.40	$118.00	$58.98–$118.00	56% below	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ SM JOINT/BURSA W/O US BILAT964	$121.60	$152.00	$75.97–$152.00	43% below	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ SM JOINT/BURSA W/O US BILAT983	$121.60	$152.00	$33.10–$152.00	43% below	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 SP RHC ASP/INJECT SM JOINT	$230.40	$288.00	$143.94–$288.00	8% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 MV RHC ASP/INJECT SM JOINT	$242.40	$303.00	$151.44–$303.00	14% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ SM JOINT/BURSA W/O US	$416.92	$521.15	$260.47–$483.75	96% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/inj joint/bursa w/o us 510	$627.20	$784.00	$391.84–$483.75	195% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ SM JOINT/BURSA W/O US BILAT510	$960.00	$1,200.00	$483.75–$599.76	352% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 MV RHC RPR INT WND S/A/T/EXT <2.5CM 521	$400.00	$500.00	$249.90–$500.00	16% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 SP RHC RPR INT WND S/A/T/EXT <2.5CM 521	$400.00	$500.00	$249.90–$500.00	16% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 MV RPR INT S/A/T/EXT 2.5 CM OR LESS 981	$698.04	$872.55	$139.37–$591.48	102% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RPR INTM S/T/A/EXT 2.5 CM OR LESS	$765.35	$956.69	$478.15–$591.48	121% above	20%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ INTERLAMINAR LUM/SAC (CAUDAL) 964	$623.20	$779.00	$389.34–$779.00	48% below	20%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ INTERLAMINAR LUM/SAC (CAUDAL)	$892.74	$1,115.92	$94.66–$1,115.92	25% below	20%
Lower-back epidural injection, with imaging guidance CPT 62323 Inj interlaminar lum/sac (caudal) 510	$1,584.00	$1,980.00	$989.60–$1,496.90	32% above	20%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Transforaminal l/s (tfesi)-bilat 983	$697.60	$872.00	$105.54–$872.00	—	20%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Transforaminal l/s (tfesi)-bilat 964	$697.60	$872.00	$435.83–$872.00	—	20%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 TRANSFORAMINAL-L/S(tfesi)-BILAT 964	$697.60	$872.00	$435.83–$872.00	—	20%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 TRANSFORAMINAL-L/S(tfesi)-BILAT 983	$1,490.12	$1,862.65	$105.54–$1,458.96	—	20%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 Transforaminal l/s (tfesi)-bilat 510	$2,960.80	$3,701.00	$1,458.96–$1,849.76	—	20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAMINAL-LUM OR SACRAL 1ST LEV 964	$697.60	$872.00	$435.83–$872.00	33% below	20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAMINAL-LUM OR SACRAL 1ST LVL 983	$697.60	$872.00	$105.54–$872.00	33% below	20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Transforaminal lum or sac (1st levl) 510	$1,973.60	$2,467.00	$1,233.01–$1,458.96	90% above	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 MV RHC EXCSN BENGN LESN LESS 0.5 CM 521	$190.80	$238.50	$119.21–$238.50	3% above	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 SP RHC EXCSN BENGN LESN LESS 0.5 CM 521	$190.80	$238.50	$119.21–$238.50	3% above	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCSN BENGN LESN LESS 0.5 CM 761	$774.40	$968.00	$483.81–$968.00	317% above	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 SP RHC EXCSN BENGN LESN FACE LESS 0.5CM	$217.20	$271.50	$135.70–$271.50	16% above	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 MV RHC EXCSN BENGN LESN FACE LESS 0.5CM	$217.20	$271.50	$135.70–$271.50	16% above	20%
Nail removal (partial or complete), one nail CPT 11730 MV RHC AVULS NAIL PLATE SIMPLE 521	$192.80	$241.00	$120.45–$241.00	38% above	20%
Nail removal (partial or complete), one nail CPT 11730 SP RHC AVULS NAIL PLATE SIMPLE 521	$192.80	$241.00	$120.45–$241.00	38% above	20%
Nail removal (partial or complete), one nail CPT 11730 AVULSION/NAIL PAR COMPLE 450	$192.80	$241.00	$120.45–$241.00	38% above	20%
Occipital nerve block (injection for headaches) both sides CPT 64405 GREATER OCCIPITAL NERVE BLOCK-BILAT 964	$246.80	$308.50	$154.19–$308.50	—	20%
Occipital nerve block (injection for headaches) both sides CPT 64405 Greater occipital nerve block- bilat 964	$246.80	$308.50	$154.19–$308.50	—	20%
Occipital nerve block (injection for headaches) both sides CPT 64405 Greater occipital nerve block- bilat 983	$246.80	$308.50	$47.12–$308.50	—	20%
Occipital nerve block (injection for headaches) both sides CPT 64405 Greater occipital nerve block- bilat 510	$940.00	$1,175.00	$418.42–$587.26	—	20%
Occipital nerve block (injection for headaches) CPT 64405 GREATER OCCIPITAL NERVE BLOCK PER SID964	$246.80	$308.50	$154.19–$308.50	34% below	20%
Occipital nerve block (injection for headaches) CPT 64405 GREATER OCCIPITAL NERVE BLOCK-BILAT983	$246.80	$308.50	$47.12–$308.50	34% below	20%
Occipital nerve block (injection for headaches) CPT 64405 GREATER OCCIPITAL NERVE BLOCK (PER SIDE)	$624.30	$780.38	$47.12–$418.42	67% above	20%
Occipital nerve block (injection for headaches) CPT 64405 Greatr ocipital nerve block per side 510	$627.20	$784.00	$391.84–$418.42	68% above	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 MV RHC EXC NAIL & MATRIX 521	$360.00	$450.00	$224.91–$450.00	6% below	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 SP RHC EXC NAIL & MATRIX 521	$360.00	$450.00	$224.91–$450.00	6% below	20%
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 RFA DESTROY L/S FAC-1ST JNT-BILAT 964	$975.60	$1,219.50	$609.51–$1,219.50	—	20%
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 RFA DESTROY L/S FAC-1ST JNT-BILAT 983	$2,388.48	$2,985.60	$183.61–$2,985.60	—	20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RFA destroy l/s fct 1st jnt-BILATERL 983	$975.60	$1,219.50	$183.61–$1,219.50	47% below	20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RFA DESTROY L/S FACET 1ST JNT 964	$975.60	$1,219.50	$609.51–$1,219.50	47% below	20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RFA destroy l/s fct 1st jnt-BILATERL 964	$975.60	$1,219.50	$609.51–$1,219.50	47% below	20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RFA DESTROY L/S FACET 1ST JNT 983	$2,388.48	$2,985.60	$183.61–$2,985.60	29% above	20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RFA destroy l/s fct 1st jnt-BILATERL 510	$2,936.00	$3,670.00	$1,834.27–$3,200.09	58% above	20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RFA destroy lum/sac facet 1st jnt 510	$2,936.00	$3,670.00	$1,834.27–$3,200.09	58% above	20%
Removal of a foreign object under the skin, simple CPT 10120 ERD REMOVAL FOR BOD SIMP	$100.00	$125.00	$106.32–$125.00	58% below	20%
Removal of a foreign object under the skin, simple CPT 10120 MV RHC INC&REM FB SUBQ SIMP 521	$408.00	$510.00	$254.90–$510.00	73% above	20%
Removal of a foreign object under the skin, simple CPT 10120 SP RHC INC&REM FB SUBQ SIMP 521	$408.00	$510.00	$254.90–$510.00	73% above	20%
Removal of a foreign object under the skin, simple CPT 10120 FOR BODY REMOV SUBQ TIS	$1,015.93	$1,269.91	$634.70–$1,269.91	332% above	20%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCREENING NOT HIGH RISK IND.	$1,800.00	$2,250.00	$1,124.55–$1,494.06	77% above	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCREENING HIGH RISK IND.	$1,756.80	$2,196.00	$1,097.56–$1,494.06	67% above	20%
Short arm cast (elbow to hand) CPT 29075 CAST APPL ELBOW TO FINGE	$85.60	$107.00	$60.50–$107.00	60% below	20%
Short arm cast (elbow to hand) CPT 29075 MV CASTING ARM ELBOW TO FINGERS (SHORT A	$272.00	$340.00	$169.93–$340.00	26% above	20%
Short arm splint (forearm and hand) CPT 29125 SP APPLICATION O FSHORT ARM SPLINT (FORE	$220.80	$276.00	$137.94–$276.00	27% above	20%
Short arm splint (forearm and hand) CPT 29125 SPLINT APPLY SHORT ARM	$223.20	$279.00	$42.28–$279.00	28% above	20%
Short arm splint (forearm and hand) CPT 29125 MV APPLICATION O FSHORT ARM SPLINT (FORE	$232.00	$290.00	$144.94–$290.00	34% above	20%
Short arm splint (forearm and hand) CPT 29125 ER SPLNT APPL FOREARM HN	$396.80	$496.00	$247.90–$301.90	128% above	20%
Short leg cast (below the knee) CPT 29405 CAST APPL SHORT LEG	$310.75	$388.44	$194.14–$364.14	67% above	20%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$344.00	$430.00	$214.91–$364.14	85% above	20%
Short leg splint (calf to foot) CPT 29515 SPLINT APPL CALF-FOOT	$71.20	$89.00	$51.46–$89.00	55% below	20%
Short leg splint (calf to foot) CPT 29515 SP APPLICATION OF SHORT LEG SPLINT (CALF	$224.00	$280.00	$139.94–$280.00	41% above	20%
Short leg splint (calf to foot) CPT 29515 MV APPLICATION OF SHORT LEG SPLINT (CALF	$235.20	$294.00	$146.94–$294.00	48% above	20%
Short leg splint (calf to foot) CPT 29515 ER SPLINT APPL CALF-FOOT	$281.91	$352.39	$176.13–$301.90	77% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ERD SIMPLE REP <2.5CM OR 981	$244.00	$305.00	$45.17–$305.00	at median	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 MV RHC SIMPLE REP <2.5CM 521	$285.20	$356.50	$178.18–$356.50	17% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SP RHC SIMPLE REP <2.5CM 521	$285.20	$356.50	$178.18–$356.50	17% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SIMP 2.5/LESS HEA 450	$443.26	$554.08	$276.93–$501.84	82% above	20%
Skin biopsy, punch, one lesion CPT 11104 MV RHC PUNCH BX SKIN SINGLE LESION 521	$200.00	$250.00	$124.95–$250.00	60% below	20%
Skin biopsy, punch, one lesion CPT 11104 SP RHC PUNCH BX SKIN SINGLE LESION 521	$200.00	$250.00	$124.95–$250.00	60% below	20%
Skin tag removal, up to 15 tags CPT 11200 MV RHC REM MULT SKIN TAGS<1 521	$137.60	$172.00	$85.97–$172.00	3% above	20%
Skin tag removal, up to 15 tags CPT 11200 SP RHC REM MULT SKIN TAGS<1 521	$137.60	$172.00	$85.97–$172.00	3% above	20%
Skin tag removal, up to 15 tags CPT 11200 RMVL OF SKIN TAGS, MULTPL UP & INCL 15 L	$198.40	$248.00	$72.13–$248.00	48% above	20%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SK TGS MLT FIBRQ 450	$431.14	$538.93	$269.35–$285.42	221% above	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LUMBAR SPINAL PNXR 964	$326.40	$408.00	$203.92–$408.00	38% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LUMBAR SPINAL PNXR	$642.87	$803.59	$59.82–$568.04	23% above	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Dx lumbar spinal pnxr 510	$1,523.20	$1,904.00	$568.04–$951.62	191% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 MV RHC REP SIMP 2.6-7.5CM 521	$340.80	$426.00	$212.91–$426.00	22% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SP RHC REP SIMP 2.6-7.5CM 521	$340.80	$426.00	$212.91–$426.00	22% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SIMP 2.6-7.5 HEAD	$422.40	$528.00	$263.89–$528.00	52% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SIMP 2.6-7.5	$484.80	$606.00	$302.88–$599.82	74% above	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP REP FACE 2.5 OR LES	$128.80	$161.00	$55.76–$161.00	52% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 MV RHC REP SIMP FACE <2.5CM 521	$340.80	$426.00	$212.91–$426.00	27% above	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SP RHC REP SIMP FACE <2.5CM 521	$340.80	$426.00	$212.91–$426.00	27% above	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SIMP 2.5/LESS FRO	$704.52	$880.65	$440.15–$623.66	162% above	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 MV TANGENTIAL BIOPSY SKIN SINGLE LESION	$156.00	$195.00	$97.46–$195.00	40% below	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 SP RHC TANGNTL BX SKIN SINGLE LESION 521	$156.00	$195.00	$97.46–$195.00	40% below	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIO/LES SIMPLE CLOSING	$484.00	$605.00	$302.38–$325.62	86% above	20%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION 983	$340.00	$425.00	$295.21–$425.00	76% below	20%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION 510	$1,280.00	$1,600.00	$799.68–$1,600.00	11% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECT TRIGGER POINTS 1-	$55.20	$69.00	$37.66–$69.00	63% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ BILA (1-2 MUSCLES)983	$129.20	$161.50	$37.66–$161.50	14% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger point inj (1-2 muscles) 964	$129.20	$161.50	$80.72–$161.50	14% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ BILA (1-2 MUSCLES)964	$129.20	$161.50	$80.72–$161.50	14% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 SP RHC TRIGGER POINT INJ	$290.40	$363.00	$181.43–$363.00	94% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 MV RHC TRIGGER POINT INJ	$305.60	$382.00	$190.92–$382.00	104% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger point inj (1-2 muscles) 983	$417.60	$522.00	$260.90–$433.32	178% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ (1-2 MUSCLES)	$420.98	$526.22	$263.00–$433.32	181% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger point inj (1-2 muscles) 510	$627.20	$784.00	$391.84–$433.32	318% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ BILA (1-2 MUSCLES)510	$960.00	$1,200.00	$433.32–$599.76	540% above	20%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGE/MUTIPLE	$1,756.80	$2,196.00	$1,097.56–$1,536.43	30% above	20%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$1,878.40	$2,348.00	$1,173.53–$1,536.43	47% above	20%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14 982	$100.80	$126.00	$65.04–$126.00	38% below	20%
Wart removal, up to 14 warts CPT 17110 SP DEST UP TO 14 LESIONS	$166.40	$208.00	$103.96–$208.00	2% above	20%
Wart removal, up to 14 warts CPT 17110 MV DEST UP TO 14 LESIONS	$175.20	$219.00	$109.46–$219.00	7% above	20%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14 761	$240.00	$300.00	$149.94–$300.00	47% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 SP RHC DEBRIDE SKIN & SUBQ 20CM OR LESS	$320.00	$400.00	$199.92–$400.00	1% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 MV RHC DEBRIDE SKIN & SUBQ 20CM OR LESS	$320.00	$400.00	$199.92–$400.00	1% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBQ TISSUE 20 SQ CM OR LESS	$848.80	$1,061.00	$530.29–$591.48	163% above	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Kansas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 ER BLOOD ADMINISTRATION	$578.40	$723.00	$361.36–$676.07	at median	20%
Blood transfusion (giving blood or blood components) CPT 36430 ER BLOOD ADMIN 0 TO 4HRS	$693.60	$867.00	$433.33–$676.07	20% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TR BLOOD ADMINISTRATION 4-6 HOURS	$832.00	$1,040.00	$519.79–$676.07	44% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 0 TO 2 HOURS	$998.40	$1,248.00	$623.75–$676.07	73% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 2-4 HOURS	$1,072.80	$1,341.00	$670.23–$676.07	86% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 4-6 HOURS	$1,120.00	$1,400.00	$676.07–$699.72	94% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 6+ HOURS	$1,280.00	$1,600.00	$676.07–$799.68	122% above	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ER BLOOD ADMINISTRATION	$578.40	$723.00	$361.36–$676.07	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ER BLOOD ADMIN 0 TO 4HRS	$693.60	$867.00	$433.33–$676.07	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TR BLOOD ADMINISTRATION 4-6 HOURS	$832.00	$1,040.00	$519.79–$676.07	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 0 TO 2 HOURS	$998.40	$1,248.00	$623.75–$676.07	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 2-4 HOURS	$1,072.80	$1,341.00	$670.23–$676.07	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 6+ HOURS	$1,280.00	$1,600.00	$676.07–$799.68	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SP RHC AEROSOL TREATMENT	$71.20	$89.00	$44.48–$89.00	38% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MV RHC AEROSOL TREATMENT	$71.20	$89.00	$44.48–$89.00	38% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TX - AIRWAY INHALATION TX	$176.00	$220.00	$109.96–$220.00	53% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ER AIRWAY INHALATION TREATMENT	$184.80	$231.00	$115.45–$231.00	61% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$201.60	$252.00	$125.95–$252.00	76% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$209.60	$262.00	$130.95–$262.00	83% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$209.60	$262.00	$130.95–$262.00	—	20%
Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION CHEMO AND OTHER HIGHLY CO	$598.95	$748.69	$374.19–$469.60	51% above	20%
Chemotherapy IV infusion, first hour CPT 96413 IV INFUSION CHEMO INITIAL UP TO 1 HOUR	$789.60	$987.00	$469.60–$493.30	99% above	20%
Critical care, first 30 to 74 minutes CPT 99291 ERD1 CRITICAL CARE 30-75	$258.40	$323.00	$212.15–$323.00	61% below	20%
Critical care, first 30 to 74 minutes CPT 99291 ER CRITICAL 1ST 60 MIN	$1,685.60	$2,107.00	$1,053.08–$1,339.57	154% above	20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 MV ELECTROCARDIOGRAM	$52.00	$65.00	$32.49–$41.27	42% below	20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 SP ELECTROCARDIOGRAM	$52.00	$65.00	$32.49–$41.27	42% below	20%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 MV ELECTROCARDIOGRAM	$52.00	$65.00	$32.49–$41.27	—	20%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 SP ELECTROCARDIOGRAM	$52.00	$65.00	$32.49–$41.27	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 OR MORE LEADS	$279.20	$349.00	$174.43–$215.63	52% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 OR MORE LEADS	$279.20	$349.00	$174.43–$215.63	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ERD1 EMERGENCY DEPT VISIT	$24.80	$31.00	$11.67–$31.00	82% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER CARE LEVEL 1	$276.00	$345.00	$172.43–$223.28	97% above	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ERD2 EMERGENCY DEPT VISI	$49.60	$62.00	$42.88–$62.00	74% below	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER CARE LEVEL 2	$315.20	$394.00	$196.92–$347.82	64% above	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ERD3 EMERGENCY DEPT VISI 981	$87.20	$109.00	$73.55–$109.00	68% below	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER CARE LEVEL 3 450	$520.80	$651.00	$325.37–$534.61	90% above	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ERD4 EMERGENCY DEPT VISI 981	$173.60	$217.00	$125.10–$217.00	56% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER CARE LEVEL 4 450	$835.20	$1,044.00	$521.79–$911.46	113% above	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ERD5 EMERGENCY DEPT VISI 981	$192.00	$240.00	$181.80–$240.00	70% below	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER CARE LEVEL 5 450	$1,335.20	$1,669.00	$834.17–$1,416.59	108% above	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIO STRESS TEST TECH COMP	$1,004.00	$1,255.00	$467.20–$627.25	76% above	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM CARDIOVASCULAR STRESS TEST TRACE ONLY	$1,188.90	$1,486.13	$467.20–$742.77	108% above	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM CARDIOVASCULAR STRESS TEST TRACE ONLY	$1,188.90	$1,486.13	$467.20–$742.77	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION TO 1 HOUR	$290.40	$363.00	$181.43–$334.68	19% above	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUS HYDRATION 1ST H	$304.80	$381.00	$190.42–$334.68	25% above	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION UP TO 1 HOUR	$395.20	$494.00	$246.90–$334.68	62% above	20%
IV infusion of a medicine, first hour CPT 96365 THERAPEUT IV INFUSION 1H	$331.20	$414.00	$206.92–$334.68	25% above	20%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION 1ST HR	$360.80	$451.00	$225.41–$334.68	36% above	20%
IV infusion of a medicine, first hour CPT 96365 IV INF THR PRP DX TO 1H	$449.60	$562.00	$280.89–$334.68	70% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SP RHC INJECTION ADMIN FEE	$72.80	$91.00	$45.48–$91.00	9% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 MV RHC INJECTION ADMIN FEE	$76.80	$96.00	$47.98–$96.00	15% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 MV RHC INJECTION ADMIN FEE - ALLERGY TES	$76.80	$96.00	$47.98–$96.00	15% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SP RHC INJECTION ADMIN FEE - ALLERGY TES	$76.80	$96.00	$47.98–$96.00	15% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER ADMIN INJ SUBQ/IM	$86.40	$108.00	$53.98–$108.00	29% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ADMIN INJECTION	$102.58	$128.23	$64.09–$109.99	53% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ADMIN INJ SUBQ/IM /STK	$148.80	$186.00	$92.96–$109.99	123% above	20%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR RE-ED 97112	$108.00	$135.00	$66.21–$67.47	40% above	20%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-ED 15 MIN 97112	$108.00	$135.00	$66.21–$67.47	40% above	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-ED 97112	$108.00	$135.00	$66.21–$67.47	—	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE-ED 15 MIN 97112	$108.00	$135.00	$66.21–$67.47	—	20%
New patient office visit, about 30 minutes CPT 99203 SP 99203 RHC OFFICE VISIT NEW INT 521	$150.40	$188.00	$93.96–$132.41	1% below	20%
New patient office visit, about 30 minutes CPT 99203 MV 99203 RHC OFFICE VISIT NEW INT 521	$150.40	$188.00	$93.96–$132.41	1% below	20%
New patient office visit, about 30 minutes CPT 99203 HPM OV NEW LOW MDM 30-44 983	$190.40	$238.00	$76.20–$132.41	26% above	20%
New patient office visit, about 30 minutes CPT 99203 HPM OV NEW LOW LEV 510	$284.80	$356.00	$132.41–$177.93	88% above	20%
New patient office visit, about 45 minutes CPT 99204 MV 99204 RHC OFFICE VISIT NEW EXT 521	$184.00	$230.00	$114.95–$132.41	8% below	20%
New patient office visit, about 45 minutes CPT 99204 SP 99204 RHC OFFICE VISIT NEW EXT 521	$184.00	$230.00	$114.95–$132.41	8% below	20%
New patient office visit, about 45 minutes CPT 99204 HPM OV NEW MODERATE LEVEL 510	$284.80	$356.00	$132.41–$177.93	42% above	20%
New patient office visit, about 45 minutes CPT 99204 HPM OV NEW MODERATE LEVEL 983	$311.20	$389.00	$124.88–$132.41	55% above	20%
New patient office visit, about 60 minutes CPT 99205 SP 99205 RHC OFF NEW HIGH MDM 60 M 521	$128.80	$161.00	$80.47–$161.00	53% below	20%
New patient office visit, about 60 minutes CPT 99205 MV 99205 RHC OFFICE NEW HIGH MDM 60M 521	$240.00	$300.00	$149.94–$221.12	13% below	20%
New patient office visit, about 60 minutes CPT 99205 HPM OV NEW HIGH LEVEL 510	$284.80	$356.00	$177.93–$221.12	3% above	20%
New patient office visit, about 60 minutes CPT 99205 HPM OV NEW HIGH LEVEL 983	$400.00	$500.00	$170.57–$221.12	45% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SP 99202 RHC OFFICE VISIT NEW BRF 521	$118.40	$148.00	$73.97–$88.71	2% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 MV 99202 RHC OFFICE VISIT NEW BRF 521	$118.40	$148.00	$73.97–$88.71	2% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HPM OV NEW STRAIGHTFWD 510	$284.80	$356.00	$88.71–$177.93	146% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HPM OV NEW STRAIGHTFWD 983	$311.20	$389.00	$44.17–$88.71	168% above	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 DIETARY CONSULT INITIAL EACH 15 MINUTES	$63.20	$79.00	$19.28–$39.48	112% above	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 DIETARY CONSULT INITIAL EACH 15 MINUTES	$63.20	$79.00	$19.28–$39.48	—	20%
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW COMPLEXITY 97165	$205.60	$257.00	$128.45–$153.70	23% above	20%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW COMPLEXITY 97165	$205.60	$257.00	$128.45–$153.70	—	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH COMPLEXITY 97163	$248.00	$310.00	$154.94–$158.11	19% above	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION HIGH COMPLEXITY 97163	$248.00	$310.00	$154.94–$158.11	—	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT DRY NEEDLE EVALUATION	$140.00	$175.00	$87.46–$175.00	14% below	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW COMPLEXITY 97161	$198.40	$248.00	$123.95–$181.82	22% above	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT DRY NEEDLE EVALUATION	$140.00	$175.00	$87.46–$175.00	—	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW COMPLEXITY 97161	$198.40	$248.00	$123.95–$181.82	—	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MODERATE COMPLEXITY 97162	$223.20	$279.00	$139.44–$158.11	21% above	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MODERATE COMPLEXITY 97162	$223.20	$279.00	$139.44–$158.11	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MYOFASCIAL RELEASE SOFT TISSUE 97140	$108.80	$136.00	$67.97–$76.14	43% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY TECH 15 MIN 97140	$112.80	$141.00	$70.47–$76.14	49% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 15 MIN 97140	$116.80	$146.00	$72.97–$76.14	54% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MYOFASCIAL RELEASE SOFT TISSUE 97140	$108.80	$136.00	$67.97–$76.14	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECH 15 MIN 97140	$112.80	$141.00	$70.47–$76.14	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 15 MIN 97140	$116.80	$146.00	$72.97–$76.14	—	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THER EX 15 MIN 97110	$113.60	$142.00	$70.97–$74.61	45% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THER EX 15 MIN 97110	$113.60	$142.00	$70.97–$74.61	45% above	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THER EX 15 MIN 97110	$113.60	$142.00	$70.97–$74.61	—	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THER EX 15 MIN 97110	$113.60	$142.00	$70.97–$74.61	—	20%
Preventive checkup, new patient aged 18–39 CPT 99385 MV 99385 INITIAL PREV MED AGE 18-39 521	$112.00	$140.00	$69.97–$140.00	40% below	20%
Preventive checkup, new patient aged 18–39 CPT 99385 SP 99385 INITIAL PREV MED AGE 18-39 521	$112.00	$140.00	$69.97–$140.00	40% below	20%
Preventive checkup, new patient aged 40–64 CPT 99386 MV 99386 INITIAL PREV MED AGE 40-64 521	$112.00	$140.00	$69.97–$140.00	40% below	20%
Preventive checkup, new patient aged 40–64 CPT 99386 SP 99386 INITIAL PREV MED AGE 40-64 521	$112.00	$140.00	$69.97–$140.00	40% below	20%
Preventive checkup, new patient aged 65 or older CPT 99387 MV 99387 INITIAL PREVENT MED AGE 65+ 521	$112.00	$140.00	$69.97–$119.00	47% below	20%
Preventive checkup, new patient aged 65 or older CPT 99387 SP 99387 INITIAL PREVENT MED AGE 65+ 521	$112.00	$140.00	$69.97–$119.00	47% below	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 SP 99395PERIODIC COMP PREV MED REEVAL 18	$89.60	$112.00	$50.31–$55.98	48% below	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 SP 99395 PREVENT MED EST AGE 18-39	$92.00	$115.00	$57.48–$115.00	47% below	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 MV 99395PERIODIC COMP PREV MED REEVAL 18	$94.40	$118.00	$50.31–$58.98	46% below	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 MV 99395 PREVENT MED EST AGE 18-39	$96.80	$121.00	$60.48–$121.00	44% below	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 SP 99395 DOT PHYSICAL AGE 18-39	$111.20	$139.00	$69.47–$139.00	36% below	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 MV 99395 DOT PHYSICAL AGE 18-39	$116.80	$146.00	$72.97–$146.00	33% below	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 SP 99395 EST PREV VISIT 18-39 521	$184.00	$230.00	$114.95–$168.57	6% above	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 MV 99395 EST PREV VISIT 18-39 521	$184.00	$230.00	$114.95–$168.57	6% above	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 SP 99396 PREVENT MED EST AGE 40-6	$95.20	$119.00	$59.48–$119.00	50% below	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 MV 99396 PREVENT MED EST AGE 40-6	$100.00	$125.00	$62.48–$125.00	47% below	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 SP 99396 DOT PHYSICAL ADULT 40-64	$114.40	$143.00	$71.47–$143.00	39% below	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 MV 99396 DOT PHYSICAL ADULT 40-64	$120.80	$151.00	$75.47–$151.00	36% below	20%
Preventive checkup, returning patient aged 65 or older CPT 99397 SP 99397 PREVENT MED EST AGE 65+	$72.00	$90.00	$44.98–$76.50	64% below	20%
Preventive checkup, returning patient aged 65 or older CPT 99397 MV 99307 PREVENT MED EST AGE 65+	$76.00	$95.00	$47.48–$80.75	62% below	20%
Preventive checkup, returning patient aged 65 or older CPT 99397 SP 99397 DOT PHYSICAL 65 AND OLDER	$114.40	$143.00	$71.47–$121.55	42% below	20%
Preventive checkup, returning patient aged 65 or older CPT 99397 MV 99397 DOT PHYSICAL 65 AND OLDER	$120.80	$151.00	$75.47–$128.35	39% below	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 MV 99406 SMKG&TOB CESS CNSLG 3-10MIN 521	$45.60	$57.00	$28.49–$48.82	64% above	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SP 99406 SMKG&TOB CESS CNSLG 3-10MIN 521	$45.60	$57.00	$28.49–$48.82	64% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OUTPATIENT ESTABLISHED HIGH MDM 982	$202.40	$253.00	$134.91–$253.00	3% below	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SP 99215 RHC PHYSICAL COMPLETE	$202.40	$253.00	$126.45–$253.00	3% below	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 MV 99215 RHC PHYSICAL COMPLETE	$212.80	$266.00	$132.95–$266.00	2% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HPM OV EST PT HIGH LEVEL 510	$284.80	$356.00	$177.93–$349.04	37% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HPM OV EST PT HIGH LEVEL 983	$380.00	$475.00	$134.91–$349.04	83% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SP 99213 RHC PHYSICAL CAMP/SPORTS/DAY	$46.40	$58.00	$28.99–$58.00	66% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 MV 99213 RHC PHYSICAL/SPORTS/DAY CARE	$48.80	$61.00	$30.49–$61.00	64% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OUTPATIENT ESTABLISHED LOW MDM 982	$83.20	$104.00	$61.88–$104.00	38% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 MV 99213 RHC OFFICE VISIT EST INT 521	$108.00	$135.00	$67.47–$135.00	20% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SP 99213 RHC OFFICE VISIT EST INT 521	$108.00	$135.00	$67.47–$135.00	20% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SP 99213 RHC PHYSICAL EMPLOYEE/COLLEGE	$124.80	$156.00	$77.97–$156.00	8% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 MV 99213 RHC PHYSICAL EMPLOYEE/COLLEGE	$131.20	$164.00	$81.97–$164.00	3% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HPM OV EST PT LOW LEVEL 983	$154.40	$193.00	$61.88–$175.01	14% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC 26-50 SQ CM	$170.40	$213.00	$106.46–$175.01	26% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HPM OV EST PT LOW LEVEL 510	$284.80	$356.00	$175.01–$177.93	111% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OUTPATIENT ESTABLISHED MOD MDM 982	$110.40	$138.00	$90.92–$138.00	36% below	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 MV 99214 RHC OFFICE VISIT EST EXT 521	$144.00	$180.00	$89.96–$180.00	17% below	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SP 99214 RHC OFFICE VISIT EST EXT 521	$144.00	$180.00	$89.96–$180.00	17% below	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC 51-75 SQ CM	$227.20	$284.00	$141.94–$247.22	31% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HPM OV EST PT MODERATE LEVEL 983	$228.80	$286.00	$90.92–$247.22	32% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HPM OV EST PT MODERATE LEVEL 510	$284.80	$356.00	$177.93–$247.22	65% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OUTPATIENT ESTABLISHED SF MDM 982	$70.40	$88.00	$33.27–$88.00	33% below	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SP 99212 RHC OFFICE VST EST BRIEF 521	$74.40	$93.00	$46.48–$93.00	29% below	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 MV 99212 RHC OFFICE VST EST BRIEF 521	$74.40	$93.00	$46.48–$93.00	29% below	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC 11-25 SQ CM	$132.00	$165.00	$82.47–$111.93	27% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HPM OV EST PT STRAIGHTFORWARD LEV 983	$154.40	$193.00	$33.27–$111.93	48% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HPM OV EST PT STRAIGHTFORWARD LEV 510	$284.80	$356.00	$111.93–$177.93	173% above	20%
Specialist consultation, low complexity or 30+ minutes CPT 99243 MV 99243 RHC OFFICE CONSULTATION 521	$236.40	$295.50	$147.70–$251.18	23% above	20%
Specialist consultation, low complexity or 30+ minutes CPT 99243 SP 99243 RHC OFFICE CONSULTATION 521	$236.40	$295.50	$147.70–$251.18	23% above	20%
Speech and language evaluation CPT 92523 ST EVAL SPEECH SOUND PROD WITH EVA 92523	$421.60	$527.00	$152.28–$263.39	79% above	20%
Speech and language evaluation inpatient CPT 92523 ST EVAL SPEECH SOUND PROD WITH EVA 92523	$421.60	$527.00	$152.28–$263.39	—	20%
Speech therapy session, individual CPT 92507 ST TX OF SPEECH LANG VOICE COMM 92507	$259.20	$324.00	$101.95–$161.94	90% above	20%
Speech therapy session, individual inpatient CPT 92507 ST TX OF SPEECH LANG VOICE COMM 92507	$259.20	$324.00	$101.95–$161.94	—	20%
Spirometry (breathing test) CPT 94010 SP SPIROMETRY GRAPHIC RECOR	$32.00	$40.00	$19.99–$40.00	89% below	20%
Spirometry (breathing test) CPT 94010 MV SPIROMETRY GRAPHIC RECOR	$33.60	$42.00	$20.99–$42.00	89% below	20%
Spirometry (breathing test) CPT 94010 SPIROMETRY TEST	$320.00	$400.00	$199.92–$394.58	9% above	20%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY TEST	$320.00	$400.00	$199.92–$394.58	—	20%
Spirometry before and after a bronchodilator CPT 94060 SP PRE & POST BROCHODILATOR	$287.20	$359.00	$179.43–$359.00	35% below	20%
Spirometry before and after a bronchodilator CPT 94060 MV PRE & POST BROCHODILATOR	$301.60	$377.00	$188.42–$377.00	32% below	20%
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION RESPONSIVENESS TEST	$383.20	$479.00	$239.40–$479.00	14% below	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATION RESPONSIVENESS TEST	$383.20	$479.00	$239.40–$479.00	—	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THER ACT 15 MIN 97530	$109.60	$137.00	$68.47–$74.61	40% above	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THER ACT 15 MIN 97530	$109.60	$137.00	$68.47–$74.61	40% above	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THER ACT 15 MIN 97530	$109.60	$137.00	$68.47–$74.61	—	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THER ACT 15 MIN 97530	$109.60	$137.00	$68.47–$74.61	—	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 BB THERAPEUTIC PHLEBOTOMY	$251.00	$313.75	$86.34–$90.47	112% above	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 BB THERAPEUTIC PHLEBOTOMY	$251.00	$313.75	$86.34–$90.47	—	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Kansas	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 MV INFLUENZA 65+ YRS NON-ED CO RESIDENT	$24.00	$30.00	$14.99–$30.00	92% below	20%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 SP INFLUENZA 65+ YRS NON-ED CO RESIDENT	$24.00	$30.00	$14.99–$30.00	92% below	20%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 MV INFLUENZA 65+ YRS NON-ED CO RESIDENT	$24.00	$30.00	$14.99–$30.00	—	20%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 SP INFLUENZA 65+ YRS NON-ED CO RESIDENT	$24.00	$30.00	$14.99–$30.00	—	20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Vacc HIGH DOSE	$40.80	$51.00	$25.49–$51.00	52% below	20%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Vacc HIGH DOSE	$40.80	$51.00	$25.49–$51.00	—	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 SP PH PNEUMONIA VAC	$166.40	$208.00	$103.96–$158.84	1% below	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococol Polyvalent 23 Inj	$204.56	$255.70	$127.80–$158.84	22% above	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 MV PH PNEUMONIA VAC 23	$211.59	$264.49	$132.19–$158.84	26% above	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococol Polyvalent 23 Inj	$204.56	$255.70	$127.80–$158.84	—	20%
Rabies vaccine, one dose CPT 90675 Rabies Vaccine-Rabavert 2.5 UN/1 ML Inj	$840.56	$1,050.70	$525.14–$561.51	46% above	20%
Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine-Rabavert 2.5 UN/1 ML Inj	$840.56	$1,050.70	$525.14–$561.51	—	20%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 MV PH SHINGRIX VACCINE	$304.55	$380.69	$190.27–$292.36	8% above	20%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Varicella-Zoster GE 50mcg/0.5ml	$345.76	$432.20	$216.01–$292.36	23% above	20%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Varicella-Zoster GE 50mcg/0.5ml	$345.76	$432.20	$216.01–$292.36	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 MV PH TETANUS & DIPHTHERIA TOX ABSORBED	$53.06	$66.32	$33.14–$54.34	14% below	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus Diptheria Inj	$54.65	$68.31	$34.14–$54.34	11% below	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and Diphtheria Toxoids Adsorbed	$77.84	$97.30	$48.63–$54.34	26% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 SP PH TETANUS & DIPHTHERIA TOX ABSORBED	$108.80	$136.00	$54.34–$67.97	76% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 MV PH TETANUS & DIPHTHERIA TOX ABSORBED	$53.06	$66.32	$33.14–$54.34	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus Diptheria Inj	$54.65	$68.31	$34.14–$54.34	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus and Diphtheria Toxoids Adsorbed	$77.84	$97.30	$48.63–$54.34	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 SP PH TETANUS & DIPHTHERIA TOX ABSORBED	$108.80	$136.00	$54.34–$67.97	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 SP RHC C1 TDAP > 7YRS	$78.40	$98.00	$48.98–$63.78	10% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 MV RHC C1 TDAP > 7YRS	$95.30	$119.13	$59.54–$63.78	34% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel 0.5 ML Inj (T-Dap Inj)	$98.05	$122.56	$61.26–$63.78	38% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Adacel 0.5 ML Inj (T-Dap Inj)	$98.05	$122.56	$61.26–$63.78	—	20%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 SP RHC TYPHIM VACCINE	$140.00	$175.00	$87.46–$137.45	—	20%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 MV RHC TYPHIM VACCINE	$147.20	$184.00	$91.96–$137.45	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 SP IMMUNIZATION ADM VACC >1	$25.60	$32.00	$10.59–$15.99	33% below	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 MV ADMIN VACC <19 YRS	$27.20	$34.00	$10.59–$16.99	28% below	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION	$75.20	$94.00	$10.59–$46.98	98% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VAC	$95.20	$119.00	$10.59–$59.48	151% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION	$75.20	$94.00	$10.59–$46.98	—	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 SP IMMUNIZATION ADMIN ADDITIONAL 521	$23.60	$29.50	$10.59–$14.75	1% below	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 MV ADMINISTRATION VACCINE OR TOXOID COMP	$40.80	$51.00	$10.59–$25.49	71% above	20%

Source file: https://edcomed.com/assets/site/documents/price-transparency/481082458_edwards-county-medical-center_standardcharges.csv