Lexington Regional Health Center
Lexington Regional Health Center in Lexington, NE publishes cash prices for 247 common procedures listed here, from its own machine-readable price file updated Dec 28, 2025. Compared with other hospitals in the state, its outpatient cash prices are above the Nebraska median for 150 of 246 procedures and below it for 94. By typical cash price it ranks #22 of 34 Nebraska hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
P O Box 980, 1201 North Erie St, Lexington, NE 68850 Collected Sep 27, 2026 Source price file (308) 324-5651
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 281361 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 ARTERIAL ANKLE/ARM I CHARGE | $608.64 | $634.00 | $317.00–$634.00 | 64% above | 4% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 US ABI Limited Right | $608.64 | $634.00 | $317.00–$634.00 | 64% above | 4% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 US ABI Limited Left | $608.64 | $634.00 | $317.00–$634.00 | 64% above | 4% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body | $1,965.12 | $2,047.00 | $1,023.50–$2,047.00 | 19% above | 4% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left | $466.56 | $486.00 | $243.00–$486.00 | 7% above | 4% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left | $313.92 | $327.00 | $163.50–$327.00 | 6% below | 4% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest | $3,322.56 | $3,461.00 | $1,730.50–$3,461.00 | 15% above | 4% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Pulmonary | $3,322.56 | $3,461.00 | $1,730.50–$3,461.00 | 15% above | 4% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Stone Protocol | $2,793.60 | $2,910.00 | $1,455.00–$2,910.00 | 1% below | 4% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast | $2,793.60 | $2,910.00 | $1,455.00–$2,910.00 | 1% below | 4% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Chest/Abd/Pelvis w/o Contrast | $4,540.80 | $4,730.00 | $2,365.00–$4,730.00 | 61% above | 4% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast | $3,975.36 | $4,141.00 | $2,070.50–$4,141.00 | 6% above | 4% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Chest/Abd/Pelvis w/ Contrast | $4,766.40 | $4,965.00 | $2,482.50–$4,965.00 | 27% above | 4% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $4,541.76 | $4,731.00 | $2,365.50–$4,731.00 | 8% above | 4% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Chest/Abd/Pelvis w/ + w/o Contrast | $5,448.96 | $5,676.00 | $2,838.00–$5,676.00 | 30% above | 4% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast | $2,315.52 | $2,412.00 | $1,206.00–$2,412.00 | 2% above | 4% |
| CT scan of the abdomen with contrast CPT 74160 CT Chest/Abdomen w/ Contrast | $2,451.84 | $2,554.00 | $1,277.00–$2,554.00 | 8% above | 4% |
| CT scan of the abdomen without contrast CPT 74150 74150 CT ABDOMEN-NO CONT | $2,206.08 | $2,298.00 | $1,149.00–$2,298.00 | 22% above | 4% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast | $2,206.08 | $2,298.00 | $1,149.00–$2,298.00 | 22% above | 4% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast | $1,740.48 | $1,813.00 | $906.50–$1,813.00 | 14% above | 4% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w and w/o Contrast | $1,740.48 | $1,813.00 | $906.50–$1,813.00 | 14% above | 4% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast | $2,011.20 | $2,095.00 | $1,047.50–$2,095.00 | 25% above | 4% |
| CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast | $2,112.00 | $2,200.00 | $1,100.00–$2,200.00 | 7% above | 4% |
| CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast | $2,412.48 | $2,513.00 | $1,256.50–$2,513.00 | 14% above | 4% |
| CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o and Chest w/ Cont | $2,412.48 | $2,513.00 | $1,256.50–$2,513.00 | 14% above | 4% |
| CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o and Neck ST w/Con | $2,534.40 | $2,640.00 | $1,320.00–$2,640.00 | 19% above | 4% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT 3D Recon Spine Lumbar w/o Contrast | $499.20 | $520.00 | $260.00–$520.00 | 74% below | 4% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast | $2,335.68 | $2,433.00 | $1,216.50–$2,433.00 | 23% above | 4% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast | $1,951.68 | $2,033.00 | $1,016.50–$2,033.00 | 2% above | 4% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast | $2,282.88 | $2,378.00 | $1,189.00–$2,378.00 | at median | 4% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral | $1,583.04 | $1,649.00 | $824.50–$1,649.00 | — | 4% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 93880 CAROTID DUPLEX CHARGE | $1,583.04 | $1,649.00 | $824.50–$1,649.00 | 3% above | 4% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $337.92 | $352.00 | $176.00–$352.00 | 36% above | 4% |
| Chest X-ray, single view CPT 71045 XR Chest Decubitus | $257.28 | $268.00 | $134.00–$268.00 | 34% above | 4% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal | $263.04 | $274.00 | $137.00–$274.00 | 37% above | 4% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $782.40 | $815.00 | $407.50–$815.00 | 3% above | 4% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton | $437.76 | $456.00 | $228.00–$456.00 | 16% above | 4% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DEXA App Skeleton | $178.56 | $186.00 | $93.00–$186.00 | 4% above | 4% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Detailed Complete First Gest | $609.60 | $635.00 | $317.50–$635.00 | 24% above | 4% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest/Abdomen w/o Contrast | $2,335.68 | $2,433.00 | $1,216.50–$2,433.00 | 23% above | 4% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast | $2,335.68 | $2,433.00 | $1,216.50–$2,433.00 | 23% above | 4% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest High Resolution | $2,424.00 | $2,525.00 | $1,262.50–$2,525.00 | 28% above | 4% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest/Abd/Pelvis w/o Contrast | $4,540.80 | $4,730.00 | $2,365.00–$4,730.00 | 140% above | 4% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast | $2,495.04 | $2,599.00 | $1,299.50–$2,599.00 | 8% above | 4% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 71260 CT THORAX W/CONTRAST | $2,495.04 | $2,599.00 | $1,299.50–$2,599.00 | 8% above | 4% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Implant Diag Bilateral w/ Tomo | $403.20 | $420.00 | $210.00–$420.00 | — | 4% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Digital Diagnostic Bilat | $403.20 | $420.00 | $210.00–$420.00 | — | 4% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral w/ Tomo | $403.20 | $420.00 | $210.00–$420.00 | — | 4% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Implant Digital Diag Bilateral | $403.20 | $420.00 | $210.00–$420.00 | — | 4% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Implant Diag Bilateral w/ Tomo. | $403.20 | $420.00 | $210.00–$420.00 | — | 4% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Implant Diag Right w/ Tomo. | $320.64 | $334.00 | $167.00–$334.00 | 60% above | 4% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left w/ Tomo | $320.64 | $334.00 | $167.00–$334.00 | 60% above | 4% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right w/ Tomo | $320.64 | $334.00 | $167.00–$334.00 | 60% above | 4% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Implant Diag Left w/ Tomo. | $320.64 | $334.00 | $167.00–$334.00 | 60% above | 4% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Implant Diag Left w/ Tomo | $320.64 | $334.00 | $167.00–$334.00 | 60% above | 4% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Implant Diag Right w/ Tomo | $320.64 | $334.00 | $167.00–$334.00 | 60% above | 4% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral | $1,081.92 | $1,127.00 | $563.50–$1,127.00 | — | 4% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 93925 ARTL DUP BIL LOWER CHARGE | $1,296.00 | $1,350.00 | $675.00–$1,350.00 | 25% above | 4% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $1,407.36 | $1,466.00 | $733.00–$1,466.00 | — | 4% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $1,407.36 | $1,466.00 | $733.00–$1,466.00 | — | 4% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 93970 VENOUS DUPLEX BIL CHARGE | $1,407.36 | $1,466.00 | $733.00–$1,466.00 | 2% above | 4% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 93306 ECHOCARDIOGRAM COMPLETE CHARGE | $2,160.96 | $2,251.00 | $1,125.50–$2,251.00 | 8% above | 4% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Imaging | $1,597.44 | $1,664.00 | $832.00–$1,664.00 | 10% above | 4% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 RT Home Sleep Study, Unattended CHARGE | $372.48 | $388.00 | $194.00–$388.00 | at median | 4% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 PSG CPAP/BIPAP TITRATION CHARGE | $4,779.84 | $4,979.00 | $2,489.50–$4,979.00 | 35% above | 4% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 76705 US Abdomen/Lower Back Limited | $672.96 | $701.00 | $350.50–$701.00 | 30% above | 4% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Cancer Screening | $2,352.00 | $2,450.00 | $1,225.00–$2,450.00 | 572% above | 4% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Low Dose Count Screening | $2,424.00 | $2,525.00 | $1,262.50–$2,525.00 | 592% above | 4% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast | $3,004.80 | $3,130.00 | $1,565.00–$3,130.00 | 11% above | 4% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast | $2,860.80 | $2,980.00 | $1,490.00–$2,980.00 | 22% below | 4% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $3,460.80 | $3,605.00 | $1,802.50–$3,605.00 | 45% above | 4% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast | $3,988.80 | $4,155.00 | $2,077.50–$4,155.00 | 7% above | 4% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $3,358.08 | $3,498.00 | $1,749.00–$3,498.00 | 14% above | 4% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $3,930.24 | $4,094.00 | $2,047.00–$4,094.00 | 5% above | 4% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast | $3,401.28 | $3,543.00 | $1,771.50–$3,543.00 | 16% above | 4% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $4,047.36 | $4,216.00 | $2,108.00–$4,216.00 | 9% above | 4% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast | $3,401.28 | $3,543.00 | $1,771.50–$3,543.00 | 13% above | 4% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast | $3,606.72 | $3,757.00 | $1,878.50–$3,757.00 | 16% above | 4% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast | $2,040.00 | $2,125.00 | $1,062.50–$2,125.00 | 14% below | 4% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial SPECT Rest and Stress | $4,561.92 | $4,752.00 | $2,376.00–$4,752.00 | 24% above | 4% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 78452 MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC | $4,639.68 | $4,833.00 | $2,416.50–$4,833.00 | 27% above | 4% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT Skull Base to Midthigh | $6,611.52 | $6,887.00 | $3,443.50–$6,887.00 | 23% above | 4% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Ltd | $356.16 | $371.00 | $185.50–$371.00 | 17% above | 4% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Complete | $792.00 | $825.00 | $412.50–$825.00 | 7% above | 4% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Weeks | $628.80 | $655.00 | $327.50–$655.00 | 7% below | 4% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Less Than 14 Weeks Single | $478.08 | $498.00 | $249.00–$498.00 | 19% below | 4% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited | $459.84 | $479.00 | $239.50–$479.00 | 37% above | 4% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screening Bilateral w/ Tomo | $357.12 | $372.00 | $186.00–$372.00 | — | 4% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Digital Screening Bilateral | $357.12 | $372.00 | $186.00–$372.00 | — | 4% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Implant Digital Screening Bilat | $360.00 | $375.00 | $187.50–$375.00 | — | 4% |
| Screening mammogram, both breasts CPT 77067 MG Mammo Implant Screening Bil w/ Tomo. | $360.00 | $375.00 | $187.50–$375.00 | 79% above | 4% |
| Screening mammogram, both breasts CPT 77067 MG Mammo Implant Screening Bil w/ Tomo | $360.00 | $375.00 | $187.50–$375.00 | 79% above | 4% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Implant Screening Lt w/ Tomo | $334.08 | $348.00 | $174.00–$348.00 | 66% above | 4% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Implant Screening Rt w/ Tomo | $334.08 | $348.00 | $174.00–$348.00 | 66% above | 4% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Implant Digital Screening Right | $360.00 | $375.00 | $187.50–$375.00 | 79% above | 4% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Implant Digital Screening Left | $360.00 | $375.00 | $187.50–$375.00 | 79% above | 4% |
| Sleep study in a lab (polysomnography) CPT 95810 RT Polysomnography CHARGE | $4,185.60 | $4,360.00 | $2,180.00–$4,360.00 | 34% above | 4% |
| Transvaginal pelvic ultrasound CPT 76830 LRHC US Transvaginal Non-OB | $555.84 | $579.00 | $289.50–$579.00 | 5% above | 4% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $571.20 | $595.00 | $297.50–$595.00 | 7% above | 4% |
| Transvaginal ultrasound during pregnancy CPT 76817 LRHC US Transvaginal OB | $552.96 | $576.00 | $288.00–$576.00 | 20% above | 4% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal | $568.32 | $592.00 | $296.00–$592.00 | 23% above | 4% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $828.48 | $863.00 | $431.50–$863.00 | 3% above | 4% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum Contents | $706.56 | $736.00 | $368.00–$736.00 | 17% above | 4% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid | $586.56 | $611.00 | $305.50–$611.00 | 3% above | 4% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 93971 VENOUS DUPLEX UNIL/LIMIT CHARGE | $1,027.20 | $1,070.00 | $535.00–$1,070.00 | 4% above | 4% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Left | $1,027.20 | $1,070.00 | $535.00–$1,070.00 | 4% above | 4% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Right | $1,027.20 | $1,070.00 | $535.00–$1,070.00 | 4% above | 4% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View | $287.04 | $299.00 | $149.50–$299.00 | 27% above | 4% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $449.28 | $468.00 | $234.00–$468.00 | 38% above | 4% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4plus Views | $497.28 | $518.00 | $259.00–$518.00 | 21% above | 4% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views | $329.28 | $343.00 | $171.50–$343.00 | 22% above | 4% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views | $326.40 | $340.00 | $170.00–$340.00 | 24% above | 4% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views | $346.56 | $361.00 | $180.50–$361.00 | 33% above | 4% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $288.96 | $301.00 | $150.50–$301.00 | 27% above | 4% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views | $325.44 | $339.00 | $169.50–$339.00 | 27% above | 4% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $55.49 | $57.80 | $28.90–$57.80 | 7% below | 4% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $55.49 | $57.80 | $28.90–$57.80 | 18% above | 4% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Acute Scrn w/Rflx to Hep C MHP | $321.79 | $335.20 | $167.60–$335.20 | 3% above | 4% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel w/Hep C Conf MHP | $321.79 | $335.20 | $167.60–$335.20 | 3% above | 4% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Abs IgG/IgA MHP | $137.95 | $143.70 | $71.85–$143.70 | 68% above | 4% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab MHP | $148.51 | $154.70 | $77.35–$154.70 | 81% above | 4% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti-Nuclear Ab (ANA) MHP | $127.49 | $132.80 | $66.40–$132.80 | 187% above | 4% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IgG Titer by Rflx MHP | $127.49 | $132.80 | $66.40–$132.80 | 187% above | 4% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide | $222.34 | $231.60 | $115.80–$231.60 | 17% above | 4% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ProBNP MHP | $222.34 | $231.60 | $115.80–$231.60 | 17% above | 4% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $129.98 | $135.40 | $67.70–$135.40 | 1% below | 4% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill Only Level 4 Surg Path G&MIC | $228.48 | $238.00 | $119.00–$238.00 | 19% above | 4% |
| Blood culture for bacteria CPT 87040 Blood Culture | $189.31 | $197.20 | $98.60–$197.20 | 5% above | 4% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Capillary | $23.42 | $24.40 | $12.20–$24.40 | 13% above | 4% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $23.42 | $24.40 | $12.20–$24.40 | 13% above | 4% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Only Venipuncture | $23.42 | $24.40 | $12.20–$24.40 | 13% above | 4% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 Collection of venous blood by venipuncture | $24.00 | $25.00 | $12.50–$25.00 | 16% above | 4% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $46.94 | $48.90 | $24.45–$48.90 | 13% above | 4% |
| Blood lead test CPT 83655 Lead Metal | $41.66 | $43.40 | $21.70–$43.40 | 30% below | 4% |
| Blood lead test CPT 83655 Heavy Metal U Lead | $43.49 | $45.30 | $22.65–$45.30 | 27% below | 4% |
| Blood lead test CPT 83655 Lead MHP | $69.70 | $72.60 | $36.30–$72.60 | 16% above | 4% |
| Blood lead test CPT 83655 Lead Ur Timed MHP | $69.70 | $72.60 | $36.30–$72.60 | 16% above | 4% |
| Blood lead test CPT 83655 Lead Capillary MHP | $69.70 | $72.60 | $36.30–$72.60 | 16% above | 4% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Serum Qual | $63.07 | $65.70 | $32.85–$65.70 | 41% below | 4% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 86900 - ABO | $14.88 | $15.50 | $7.75–$15.50 | 71% below | 4% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh | $51.65 | $53.80 | $26.90–$53.80 | 1% below | 4% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 REF ABO/Rh | $51.65 | $53.80 | $26.90–$53.80 | 1% below | 4% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh 2 | $51.65 | $53.80 | $26.90–$53.80 | 1% below | 4% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh Patient Type MHP | $96.86 | $100.90 | $50.45–$100.90 | 86% above | 4% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Type & Scrn MHP | $96.86 | $100.90 | $50.45–$100.90 | 86% above | 4% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $71.23 | $74.20 | $37.10–$74.20 | 24% below | 4% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 MHP | $59.14 | $61.60 | $30.80–$61.60 | 49% below | 4% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 MHP | $128.93 | $134.30 | $67.15–$134.30 | 17% above | 4% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Bill Only COVID PCR | $143.42 | $149.40 | $74.70–$149.40 | 23% above | 4% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 Testing MHP | $143.42 | $149.40 | $74.70–$149.40 | 23% above | 4% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 (COVID-19) PCR (GeneXpert) | $143.42 | $149.40 | $74.70–$149.40 | 23% above | 4% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 (COVID-19) RNA (ID Now) | $143.42 | $149.40 | $74.70–$149.40 | 23% above | 4% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/Chlamydia Ur PCR-MH/WH MHP | $122.88 | $128.00 | $64.00–$128.00 | 12% above | 4% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis and Neisseria gonorrhoeae (GeneXpert) | $122.88 | $128.00 | $64.00–$128.00 | 12% above | 4% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/Chlamydia PCR-MH/WH MHP | $122.88 | $128.00 | $64.00–$128.00 | 12% above | 4% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $50.40 | $52.50 | $26.25–$52.50 | 49% below | 4% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/ Differential | $73.15 | $76.20 | $38.10–$76.20 | 12% below | 4% |
| Complete blood count (CBC) with differential CPT 85025 CBC with Diff MHP | $84.86 | $88.40 | $44.20–$88.40 | 2% above | 4% |
| Complete blood count (CBC), no differential CPT 85027 CBC w/ Manual Differential | $68.64 | $71.50 | $35.75–$71.50 | 1% below | 4% |
| Complete blood count (CBC), no differential CPT 85027 CBC without Differential | $68.64 | $71.50 | $35.75–$71.50 | 1% below | 4% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $119.62 | $124.60 | $62.30–$124.60 | 18% below | 4% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel MHP | $138.72 | $144.50 | $72.25–$144.50 | 4% below | 4% |
| D-dimer blood test (blood clot marker) CPT 85379 D Dimer | $143.81 | $149.80 | $74.90–$149.80 | 8% above | 4% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer Qnt High Sensitivity | $143.81 | $149.80 | $74.90–$149.80 | 8% above | 4% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer MHP | $143.81 | $149.80 | $74.90–$149.80 | 8% above | 4% |
| D-dimer blood test (blood clot marker) CPT 85379 85379 D-Dimer | $143.81 | $149.80 | $74.90–$149.80 | 8% above | 4% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate (DHEA) MHP | $86.59 | $90.20 | $45.10–$90.20 | 39% below | 4% |
| Estradiol blood test CPT 82670 Estradiol Lvl MHP | $61.15 | $63.70 | $31.85–$63.70 | 46% below | 4% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone(FSH) MHP | $87.46 | $91.10 | $45.55–$91.10 | 22% below | 4% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Fecal Calprotectin MHP | $172.03 | $179.20 | $89.60–$179.20 | 51% below | 4% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal MHP | $172.03 | $179.20 | $89.60–$179.20 | 51% below | 4% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin MHP | $86.78 | $90.40 | $45.20–$90.40 | 15% below | 4% |
| Folate (folic acid) blood test CPT 82746 Folate MHP | $109.06 | $113.60 | $56.80–$113.60 | 3% above | 4% |
| Free T3 thyroid hormone test CPT 84481 T3 Free MHP | $196.22 | $204.40 | $102.20–$204.40 | 51% above | 4% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free(T4) MHP | $57.31 | $59.70 | $29.85–$59.70 | 22% below | 4% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroid Panel MHP | $57.31 | $59.70 | $29.85–$59.70 | 22% below | 4% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Total T4 Level | $57.31 | $59.70 | $29.85–$59.70 | 22% below | 4% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level | $57.31 | $59.70 | $29.85–$59.70 | 22% below | 4% |
| Free testosterone test CPT 84402 84402 Testosterone T&F Females/Children Free | $27.07 | $28.20 | $14.10–$28.20 | 74% below | 4% |
| Free testosterone test CPT 84402 84402 Testosterone Adult Male Panel Free | $53.57 | $55.80 | $27.90–$55.80 | 48% below | 4% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $236.64 | $246.50 | $123.25–$246.50 | 12% below | 4% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .GTT 2 HR OB | $54.72 | $57.00 | $28.50–$57.00 | 12% above | 4% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Gestational Diabetes Screen | $55.01 | $57.30 | $28.65–$57.30 | 12% above | 4% |
| Glucose tolerance test, 3 samples CPT 82951 .GTT 2 HR | $109.44 | $114.00 | $57.00–$114.00 | 6% below | 4% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 GONORRHEA DNA AMP PROBE MHP | $120.96 | $126.00 | $63.00–$126.00 | 29% above | 4% |
| H. pylori stool antigen test CPT 87338 Rapid Urease Test | $184.22 | $191.90 | $95.95–$191.90 | 58% above | 4% |
| H. pylori stool antigen test CPT 87338 Helicobacter pylori Stool Ag MHP | $184.22 | $191.90 | $95.95–$191.90 | 58% above | 4% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Bill Only HIV 1 by Quant NAAT MHP | $136.42 | $142.10 | $71.05–$142.10 | 77% below | 4% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 by Quant NAAT MHP | $140.54 | $146.40 | $73.20–$146.40 | 76% below | 4% |
| HIV-1 and HIV-2 antibody test CPT 86703 Rapid HIV-1/2 Antibody | $71.62 | $74.60 | $37.30–$74.60 | 61% above | 4% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 Ag/Ab Combo MHP | $37.73 | $39.30 | $19.65–$39.30 | 48% below | 4% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 HPV HIGH RISK MHP | $130.56 | $136.00 | $68.00–$136.00 | 43% above | 4% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV High Risk w/ 16/18 Genotyping MHP | $130.56 | $136.00 | $68.00–$136.00 | 43% above | 4% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 GYN Pap with HPV High Risk Co-Test MHP | $130.56 | $136.00 | $68.00–$136.00 | 43% above | 4% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1c | $61.44 | $64.00 | $32.00–$64.00 | 6% below | 4% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c | $71.23 | $74.20 | $37.10–$74.20 | 8% above | 4% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C(Hbg A1C) MHP | $71.23 | $74.20 | $37.10–$74.20 | 8% above | 4% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab(HBsAb) MHP | $40.70 | $42.40 | $21.20–$42.40 | 54% below | 4% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surface Ag(HBsAg) MHP | $104.35 | $108.70 | $54.35–$108.70 | 20% above | 4% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hep C Ab w/ Rfx to PCR Confirm MHP | $43.58 | $45.40 | $22.70–$45.40 | 49% below | 4% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Bill Only Hepatitis C Virus RNA Quant PCR with Ref | $137.57 | $143.30 | $71.65–$143.30 | 59% below | 4% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hep C Virus RNA Qnt PCR w/Rflx to Geno MHP | $189.31 | $197.20 | $98.60–$197.20 | 43% below | 4% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus 1/2 Rflx Typing (HSV) MHP | $16.03 | $16.70 | $8.35–$16.70 | 84% below | 4% |
| Herpes blood test, HSV-2 antibody CPT 86696 86696 HSV Type 2 Glycoprotein IgG | $16.03 | $16.70 | $8.35–$16.70 | 85% below | 4% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein High Sensitivity | $79.78 | $83.10 | $41.55–$83.10 | at median | 4% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 hsCRP MHP | $79.78 | $83.10 | $41.55–$83.10 | at median | 4% |
| Homocysteine blood test CPT 83090 Homocysteine Total MHP | $161.18 | $167.90 | $83.95–$167.90 | 15% above | 4% |
| Insulin blood test CPT 83525 Insulin Fasting MHP | $51.46 | $53.60 | $26.80–$53.60 | 51% below | 4% |
| Insulin blood test CPT 83525 Insulin Lvl MHP | $51.46 | $53.60 | $26.80–$53.60 | 51% below | 4% |
| Insulin blood test CPT 83525 Insulin 60 Minutes MHP | $51.46 | $53.60 | $26.80–$53.60 | 51% below | 4% |
| Insulin blood test CPT 83525 Insulin 120 Minutes MHP | $51.46 | $53.60 | $26.80–$53.60 | 51% below | 4% |
| Insulin blood test CPT 83525 Insulin 30 Minutes MHP | $51.46 | $53.60 | $26.80–$53.60 | 51% below | 4% |
| Iron blood test (serum iron) CPT 83540 83540 IRON MHP | $42.34 | $44.10 | $22.05–$44.10 | 33% below | 4% |
| Iron blood test (serum iron) CPT 83540 Iron Panel(Fe Pnl) MHP | $42.34 | $44.10 | $22.05–$44.10 | 33% below | 4% |
| Iron blood test (serum iron) CPT 83540 Iron(Fe) MHP | $42.34 | $44.10 | $22.05–$44.10 | 33% below | 4% |
| Iron-binding capacity (TIBC) test CPT 83550 83550 IRON BINDING MHP | $43.87 | $45.70 | $22.85–$45.70 | 32% below | 4% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $133.82 | $139.40 | $69.70–$139.40 | 3% above | 4% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone(LH) MHP | $57.60 | $60.00 | $30.00–$60.00 | 54% below | 4% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Lvl MHP | $52.42 | $54.60 | $27.30–$54.60 | 44% below | 4% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $52.42 | $54.60 | $27.30–$54.60 | 44% below | 4% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $116.45 | $121.30 | $60.65–$121.30 | 4% below | 4% |
| Lyme disease antibody test CPT 86618 Lyme (Late Disease) IgG/IgM Rflx IgG MHP | $74.21 | $77.30 | $38.65–$77.30 | 42% below | 4% |
| Lyme disease antibody test CPT 86618 Lyme (Early Disease) Acute Rflx IgG/IgM MHP | $74.21 | $77.30 | $38.65–$77.30 | 42% below | 4% |
| Lyme disease antibody test CPT 86618 Lyme Disease Rflx to IgM/IgG MHP | $96.96 | $101.00 | $50.50–$101.00 | 24% below | 4% |
| Lyme disease antibody test CPT 86618 Lyme EIA IgM MHP | $96.96 | $101.00 | $50.50–$101.00 | 24% below | 4% |
| Lyme disease antibody test CPT 86618 Lyme EIA IgG MHP | $96.96 | $101.00 | $50.50–$101.00 | 24% below | 4% |
| Lyme disease antibody test CPT 86618 Borrelia burgdorferi (Lyme) Abs Rflx IgM-IgG MHP | $129.12 | $134.50 | $67.25–$134.50 | 2% above | 4% |
| Magnesium blood test CPT 83735 Magnesium Urine (Timed or Random) MHP | $57.12 | $59.50 | $29.75–$59.50 | 9% below | 4% |
| Magnesium blood test CPT 83735 Magnesium(Mg) MHP | $59.33 | $61.80 | $30.90–$61.80 | 6% below | 4% |
| Magnesium blood test CPT 83735 Magnesium Ur Tmed Set (Mg UT) MHP | $59.33 | $61.80 | $30.90–$61.80 | 6% below | 4% |
| Magnesium blood test CPT 83735 Magnesium Level | $59.33 | $61.80 | $30.90–$61.80 | 6% below | 4% |
| Magnesium blood test CPT 83735 Magnesium RBC MHP | $70.56 | $73.50 | $36.75–$73.50 | 12% above | 4% |
| Measles (rubeola) antibody test CPT 86765 Measles Ab IgM MHP | $47.14 | $49.10 | $24.55–$49.10 | 39% below | 4% |
| Measles (rubeola) antibody test CPT 86765 Measles Ab IgG MHP | $113.18 | $117.90 | $58.95–$117.90 | 47% above | 4% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen | $54.24 | $56.50 | $28.25–$56.50 | at median | 4% |
| Obstetric blood test panel CPT 80055 OB Prenatal Panel LRHC | $300.96 | $313.50 | $156.75–$313.50 | 67% above | 4% |
| Obstetric blood test panel CPT 80055 TA Prenatal Panel | $300.96 | $313.50 | $156.75–$313.50 | 67% above | 4% |
| Obstetric blood test panel CPT 80055 OB Prenatal Panel LRHC (Bill Only) | $300.96 | $313.50 | $156.75–$313.50 | 67% above | 4% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 PSA FREE | $92.26 | $96.10 | $48.05–$96.10 | 28% below | 4% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic | $99.17 | $103.30 | $51.65–$103.30 | 6% above | 4% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Ultrasensitive, Post Prostatectomy MHP | $111.74 | $116.40 | $58.20–$116.40 | 20% above | 4% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total & Free MHP | $115.01 | $119.80 | $59.90–$119.80 | 23% above | 4% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag(PSA) MHP | $115.01 | $119.80 | $59.90–$119.80 | 23% above | 4% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Ultra MHP | $115.01 | $119.80 | $59.90–$119.80 | 23% above | 4% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 GYN Pap with Rflx to HPV High Risk MHP | $59.14 | $61.60 | $30.80–$61.60 | 23% above | 4% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 GYN Request (PAP) MHP | $59.14 | $61.60 | $30.80–$61.60 | 23% above | 4% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH MHP | $229.63 | $239.20 | $119.60–$239.20 | 9% above | 4% |
| Parathyroid hormone (PTH) blood test CPT 83970 zzParathyroid Horomone (PTH) MHP | $229.63 | $239.20 | $119.60–$239.20 | 9% above | 4% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $72.48 | $75.50 | $37.75–$75.50 | 8% above | 4% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 Partial Thromboplastin Time Panel | $72.48 | $75.50 | $37.75–$75.50 | 8% above | 4% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 7025730 Partial Thromboplastin Time Panel | $72.48 | $75.50 | $37.75–$75.50 | 8% above | 4% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 PTT | $72.48 | $75.50 | $37.75–$75.50 | 8% above | 4% |
| Progesterone blood test CPT 84144 Progesterone Lvl MHP | $66.14 | $68.90 | $34.45–$68.90 | 38% below | 4% |
| Prolactin blood test CPT 84146 Prolactin Level | $86.40 | $90.00 | $45.00–$90.00 | at median | 4% |
| Prolactin blood test CPT 84146 Monomeric Prolactin | $86.40 | $90.00 | $45.00–$90.00 | at median | 4% |
| Prolactin blood test CPT 84146 Prolactin Lvl MHP | $113.95 | $118.70 | $59.35–$118.70 | 32% above | 4% |
| Prothrombin time (PT/INR) clotting test CPT 85610 7025610 Prothrombin Time Panel | $34.46 | $35.90 | $17.95–$35.90 | 23% below | 4% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 Prothrombin Time Panel | $34.46 | $35.90 | $17.95–$35.90 | 23% below | 4% |
| Prothrombin time (PT/INR) clotting test CPT 85610 DIC Panel - MH/WH MHP | $34.46 | $35.90 | $17.95–$35.90 | 23% below | 4% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT(INR) | $34.46 | $35.90 | $17.95–$35.90 | 23% below | 4% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT(INR)/ PTT | $34.46 | $35.90 | $17.95–$35.90 | 23% below | 4% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time (PT) (Protime) MHP | $34.46 | $35.90 | $17.95–$35.90 | 23% below | 4% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Screen POC | $31.68 | $33.00 | $16.50–$33.00 | 63% below | 4% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Screen Urine - Employee | $43.87 | $45.70 | $22.85–$45.70 | 49% below | 4% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Screen Urine | $171.36 | $178.50 | $89.25–$178.50 | 98% above | 4% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Screen | $97.25 | $101.30 | $50.65–$101.30 | 99% above | 4% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep POC | $244.80 | $255.00 | $127.50–$255.00 | 402% above | 4% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quant (RA) MHP | $54.14 | $56.40 | $28.20–$56.40 | 20% above | 4% |
| Rubella antibody test (immunity check) CPT 86762 Rubella IgM Reference | $57.31 | $59.70 | $29.85–$59.70 | 24% below | 4% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Abs IgG & IgM MHP | $60.38 | $62.90 | $31.45–$62.90 | 19% below | 4% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Ab IgG Scrn MHP | $60.38 | $62.90 | $31.45–$62.90 | 19% below | 4% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Ab IgM MHP | $100.32 | $104.50 | $52.25–$104.50 | 34% above | 4% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate (ESR) | $38.30 | $39.90 | $19.95–$39.90 | 14% below | 4% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool for Occult Blood POC | $23.04 | $24.00 | $12.00–$24.00 | 18% above | 4% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Set | $23.90 | $24.90 | $12.45–$24.90 | 22% above | 4% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon TB Gold MHP | $159.17 | $165.80 | $82.90–$165.80 | 21% below | 4% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total Adult Male MHP | $98.98 | $103.10 | $51.55–$103.10 | 13% above | 4% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Females or Children MHP | $98.98 | $103.10 | $51.55–$103.10 | 13% above | 4% |
| Testosterone blood test, total (not free testosterone) CPT 84403 84403 TESTOSTERONE MHP | $101.95 | $106.20 | $53.10–$106.20 | 17% above | 4% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsome Ab IgG MHP | $52.03 | $54.20 | $27.10–$54.20 | 16% below | 4% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsome IgG MHP | $52.03 | $54.20 | $27.10–$54.20 | 16% below | 4% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Hemoglobin Evaluation Rflx EP/RBC Solubility | $57.50 | $59.90 | $29.95–$59.90 | 7% below | 4% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Ab (TPO) MHP | $70.37 | $73.30 | $36.65–$73.30 | 14% above | 4% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $56.35 | $58.70 | $29.35–$58.70 | 43% below | 4% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Panel | $65.38 | $68.10 | $34.05–$68.10 | 33% below | 4% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas PCR MHP | $146.21 | $152.30 | $76.15–$152.30 | 49% above | 4% |
| Uric acid blood test CPT 84550 Uric Acid | $47.81 | $49.80 | $24.90–$49.80 | 6% below | 4% |
| Urinalysis with microscope exam, automated CPT 81001 UA 81001 | $34.56 | $36.00 | $18.00–$36.00 | 24% below | 4% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick POC | $35.52 | $37.00 | $18.50–$37.00 | 48% above | 4% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis with Microscopic if Indicated | $36.86 | $38.40 | $19.20–$38.40 | 53% above | 4% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick Only | $36.86 | $38.40 | $19.20–$38.40 | 53% above | 4% |
| Urinalysis without microscope exam, automated CPT 81003 Outpt Hospital Urine Dip, Automated, POC | $37.44 | $39.00 | $19.50–$39.00 | 56% above | 4% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC | $31.68 | $33.00 | $16.50–$33.00 | 48% above | 4% |
| Urine culture for bacteria, with colony count CPT 87086 Culture Ur MHP | $86.21 | $89.80 | $44.90–$89.80 | 27% above | 4% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test POC | $58.56 | $61.00 | $30.50–$61.00 | 3% above | 4% |
| Urine pregnancy test, read by color change CPT 81025 Pregnancy Test Urine Qual | $63.07 | $65.70 | $32.85–$65.70 | 11% above | 4% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Lvl MHP | $142.37 | $148.30 | $74.15–$148.30 | 26% above | 4% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-OH Lvl (for deficiency) MHP | $70.66 | $73.60 | $36.80–$73.60 | 46% below | 4% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level | $141.02 | $146.90 | $73.45–$146.90 | 8% above | 4% |
| Zinc blood test CPT 84630 Heavy Metal U Zinc | $43.49 | $45.30 | $22.65–$45.30 | 23% above | 4% |
| Zinc blood test CPT 84630 Zinc MHP | $54.72 | $57.00 | $28.50–$57.00 | 54% above | 4% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta HCG Quant - Pregnancy MHP | $86.11 | $89.70 | $44.85–$89.70 | 3% below | 4% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta hCG Quantitative | $86.11 | $89.70 | $44.85–$89.70 | 3% below | 4% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 B-hCG Quantitative | $86.11 | $89.70 | $44.85–$89.70 | 3% below | 4% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 BETA HCG, QUANT MHP | $86.11 | $89.70 | $44.85–$89.70 | 3% below | 4% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 MG Breast Biopsy w/ Stereo Guide | $3,872.64 | $4,034.00 | $2,017.00–$4,034.00 | 71% above | 4% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right | $3,872.64 | $4,034.00 | $2,017.00–$4,034.00 | 71% above | 4% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left | $3,872.64 | $4,034.00 | $2,017.00–$4,034.00 | 71% above | 4% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ TechFee | $193.92 | $202.00 | $101.00–$202.00 | 51% below | 4% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION TechFee | $193.92 | $202.00 | $101.00–$202.00 | 47% below | 4% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 CARDIOVERSION, ELECTR CHARGE | $1,570.56 | $1,636.00 | $818.00–$1,636.00 | 27% above | 4% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ TechFee | $193.92 | $202.00 | $101.00–$202.00 | 49% below | 4% |
| Colonoscopy with polyp removal CPT 45385 COLONSCOPY W/POLYP\SNARE | $1,949.76 | $2,031.00 | $1,015.50–$2,031.00 | 92% above | 4% |
| Colonoscopy with tissue sample CPT 45380 COLONSCOPY PROC W/BIOPSY | $1,949.76 | $2,031.00 | $1,015.50–$2,031.00 | 85% above | 4% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 DESTRUCT LESION 1ST TechFee | $66.24 | $69.00 | $34.50–$69.00 | 48% below | 4% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 69209 CERUMEN REMOVAL UNI CHARGE | $116.16 | $121.00 | $60.50–$121.00 | 149% above | 4% |
| Earwax removal with instruments, one ear one side CPT 69210 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT TechFee | $70.08 | $73.00 | $36.50–$73.00 | 5% below | 4% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 45330 ED SIGMOIDOSCOPY FLEXIB CHARGE | $533.76 | $556.00 | $278.00–$556.00 | 36% above | 4% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOIDS BY RUBBER BAND | $1,448.64 | $1,509.00 | $754.50–$1,509.00 | 144% above | 4% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE TechFee | $171.84 | $179.00 | $89.50–$179.00 | 34% below | 4% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS TechFee | $254.40 | $265.00 | $132.50–$265.00 | 33% above | 4% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US TechFee | $254.40 | $265.00 | $132.50–$265.00 | 33% above | 4% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US TechFee | $254.40 | $265.00 | $132.50–$265.00 | 25% above | 4% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US TechFee | $254.40 | $265.00 | $132.50–$265.00 | 74% above | 4% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee | $381.12 | $397.00 | $198.50–$397.00 | 8% below | 4% |
| Nail removal (partial or complete), one nail CPT 11730 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 TechFee | $123.84 | $129.00 | $64.50–$129.00 | 54% below | 4% |
| Occipital nerve block (injection for headaches) CPT 64405 64405 INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV TechFee | $257.28 | $268.00 | $134.00–$268.00 | 38% below | 4% |
| Paracentesis with imaging guidance CPT 49083 49083 ED ABDOMINAL PARACENTESIS W GUIDE CHARGE | $540.48 | $563.00 | $281.50–$563.00 | 26% below | 4% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL TechFee | $471.36 | $491.00 | $245.50–$491.00 | 42% above | 4% |
| Removal of a foreign object under the skin, simple CPT 10120 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE TechFee | $171.84 | $179.00 | $89.50–$179.00 | 50% below | 4% |
| Short arm cast (elbow to hand) CPT 29075 29075 APPLICATION CAST ELBOW FINGER SHORT ARM TechFee | $253.44 | $264.00 | $132.00–$264.00 | 31% above | 4% |
| Short arm splint (forearm and hand) CPT 29125 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC TechFee | $124.80 | $130.00 | $65.00–$130.00 | 17% below | 4% |
| Short leg cast (below the knee) CPT 29405 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE TechFee | $253.44 | $264.00 | $132.00–$264.00 | 39% above | 4% |
| Short leg splint (calf to foot) CPT 29515 29515 APPLICATION SHORT LEG SPLINT CALF FOOT TechFee | $124.80 | $130.00 | $65.00–$130.00 | 20% below | 4% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee | $287.04 | $299.00 | $149.50–$299.00 | 38% above | 4% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee | $287.04 | $299.00 | $149.50–$299.00 | 23% above | 4% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee | $287.04 | $299.00 | $149.50–$299.00 | 26% above | 4% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJ TRIGGER POINT 1/2 MUSCLE CHARGE | $150.72 | $157.00 | $78.50–$157.00 | 8% above | 4% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY | $2,316.48 | $2,413.00 | $1,206.50–$2,413.00 | 78% above | 4% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee | $282.24 | $294.00 | $147.00–$294.00 | 9% below | 4% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Fresh Frozen Plasma (Bridge) | $965.76 | $1,006.00 | $503.00–$1,006.00 | 39% above | 4% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Cryoprecipitate Product (Bridge) | $965.76 | $1,006.00 | $503.00–$1,006.00 | 39% above | 4% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Red Blood Cells (Bridge) | $965.76 | $1,006.00 | $503.00–$1,006.00 | 39% above | 4% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Platelet Product (Bridge) | $965.76 | $1,006.00 | $503.00–$1,006.00 | 39% above | 4% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Aerosol Subsequent CHARGE | $111.36 | $116.00 | $58.00–$116.00 | 10% above | 4% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Meter Dose Inhaler Subsequent CHARGE | $184.32 | $192.00 | $96.00–$192.00 | 81% above | 4% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Aerosol Initial CHARGE | $184.32 | $192.00 | $96.00–$192.00 | 81% above | 4% |
| Chemotherapy IV infusion, first hour CPT 96413 96413 CHEMO ADM IV INF 1 HR, INITIAL CHARGE | $640.70 | $667.40 | $333.70–$667.40 | 31% above | 4% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 Facility Level Critical Care Ill/Injured Patient Init 30 | $1,336.32 | $1,392.00 | $696.00–$1,392.00 | 115% above | 4% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical Care, First Hour 99291 | $1,375.68 | $1,433.00 | $716.50–$1,433.00 | 121% above | 4% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 93000 EKG w/ 12+ leads; tracing/interp/report | $150.72 | $157.00 | $78.50–$157.00 | 167% above | 4% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 EKG w/ 12+ leads; Tracing Only | $125.76 | $131.00 | $65.50–$131.00 | 37% below | 4% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG POC | $136.32 | $142.00 | $71.00–$142.00 | 32% below | 4% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead | $307.20 | $320.00 | $160.00–$320.00 | 53% above | 4% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 Level 1 - ED Visit | $173.76 | $181.00 | $90.50–$181.00 | 51% above | 4% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 ED VISIT FOR E&M PATIENT, LEV 1, MAY NOT REQ PRESENCE OF P | $244.80 | $255.00 | $127.50–$255.00 | 113% above | 4% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 ED VISIT E&M PATIENT, LEV 2, REQ MED APPROP HSTRY/EXAM/MDM | $346.56 | $361.00 | $180.50–$361.00 | 96% above | 4% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 ED VISIT E&M PATIENT, LEV 3, REQ MED APPROP HSTRY/EXAM/LOW | $435.84 | $454.00 | $227.00–$454.00 | 81% above | 4% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 ED VISIT E&M PATIENT, LEV 4, REQ MED APPROP HSTRY/EXAM/MOD | $948.48 | $988.00 | $494.00–$988.00 | 127% above | 4% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 ED VISIT E M PATIENT, LEV 5, REQ MED APPROP HSTRY/EXAM/HIG | $1,092.48 | $1,138.00 | $569.00–$1,138.00 | 87% above | 4% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TS/10 ELECTRO CHARGE | $1,184.64 | $1,234.00 | $617.00–$1,234.00 | 13% above | 4% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 93017 Non LRHC Provider Treadmill Stress Test | $1,298.88 | $1,353.00 | $676.50–$1,353.00 | 23% above | 4% |
| Family therapy with the patient, 50 minutes CPT 90847 90847 Family psychotherapy, psychotherapy with patient present C | $244.80 | $255.00 | $127.50–$255.00 | 19% above | 4% |
| Family therapy with the patient, 50 minutes CPT 90847 90847 Family psychotherapy, conjoint psychotherapy, with patient | $247.68 | $258.00 | $129.00–$258.00 | 20% above | 4% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR | $499.20 | $520.00 | $260.00–$520.00 | 51% above | 4% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - ED Hydration, first hour | $610.56 | $636.00 | $318.00–$636.00 | 85% above | 4% |
| IV infusion of a medicine, first hour CPT 96365 96365 INFUSION THER DRUG/1 HR CHARGE | $499.20 | $520.00 | $260.00–$520.00 | 59% above | 4% |
| IV infusion of a medicine, first hour CPT 96365 96365- ED IV tx, first hour | $610.56 | $636.00 | $318.00–$636.00 | 95% above | 4% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJ/IM/DIAG OR THERA OV CHARGE | $109.63 | $114.20 | $57.10–$114.20 | 10% above | 4% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJ/IM/DIAG/OR THERA CHARGE | $109.63 | $114.20 | $57.10–$114.20 | 10% above | 4% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 ED Subq/IM Injection | $133.44 | $139.00 | $69.50–$139.00 | 33% above | 4% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 Psychiatric diagnostic evaluation | $311.04 | $324.00 | $162.00–$324.00 | 49% above | 4% |
| New patient office visit, about 30 minutes CPT 99203 99203 Nurse Fee | $24.00 | $25.00 | $12.50–$25.00 | 88% below | 4% |
| New patient office visit, about 45 minutes CPT 99204 99204 Nurse Fee | $24.00 | $25.00 | $12.50–$25.00 | 92% below | 4% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Nurse Fee | $24.00 | $25.00 | $12.50–$25.00 | 82% below | 4% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 MEDICAL NUTRITION THERAPY INITIAL 15 MIN CHARGE | $42.24 | $44.00 | $22.00–$44.00 | 7% below | 4% |
| Psychotherapy session, 30 minutes CPT 90832 90832 Psychotherapy, 30 minutes with patient and/or family membe | $151.68 | $158.00 | $79.00–$158.00 | 4% below | 4% |
| Psychotherapy session, 45 minutes CPT 90834 90834 Psychotherapy, 45 minutes with patient and/or family membe | $221.76 | $231.00 | $115.50–$231.00 | 20% above | 4% |
| Psychotherapy session, 60 minutes CPT 90837 90837 Psychotherapy, 60 minutes with patient and/or family membe | $298.56 | $311.00 | $155.50–$311.00 | 37% above | 4% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Interventions Willing to Quit Smoking -> Counseling provided | $36.48 | $38.00 | $19.00–$38.00 | 32% above | 4% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 SMOKING CESSATION COUNSELING 3 - 10 MIN CHARGE | $37.44 | $39.00 | $19.50–$39.00 | 35% above | 4% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Nurse Fee | $24.00 | $25.00 | $12.50–$25.00 | 89% below | 4% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Nurse Office/Outpatient Visit - Established Patient, Level | $24.00 | $25.00 | $12.50–$25.00 | 81% below | 4% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Nurse Fee | $24.00 | $25.00 | $12.50–$25.00 | 81% below | 4% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office/Outpatient Visit - Established Patient, Level 3 | $156.48 | $163.00 | $81.50–$163.00 | 25% above | 4% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Nurse Fee | $24.00 | $25.00 | $12.50–$25.00 | 85% below | 4% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Nurse Office/Outpatient Visit - Established Patient, Level | $24.00 | $25.00 | $12.50–$25.00 | 85% below | 4% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Nurse Fee | $24.00 | $25.00 | $12.50–$25.00 | 72% below | 4% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Nurse Office/Outpatient Visit - Established Patient, Level | $24.00 | $25.00 | $12.50–$25.00 | 72% below | 4% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Consultation | $53.76 | $56.00 | $28.00–$56.00 | 37% below | 4% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 LEVEL 2 WOUND DRESSING CHG/SESSION CHARGE | $203.52 | $212.00 | $106.00–$212.00 | 138% above | 4% |
| Spirometry (breathing test) CPT 94010 RT Incentive Spirometry Initial CHARGE | $284.16 | $296.00 | $148.00–$296.00 | 25% above | 4% |
| Spirometry (breathing test) CPT 94010 Pulmonary Function Test - Complete | $284.16 | $296.00 | $148.00–$296.00 | 25% above | 4% |
| Spirometry (breathing test) CPT 94010 RT Spirometry w/ Graphic Record CHARGE | $284.16 | $296.00 | $148.00–$296.00 | 25% above | 4% |
| Spirometry before and after a bronchodilator CPT 94060 RT Pre & Post Spiro CHARGE | $648.96 | $676.00 | $338.00–$676.00 | 49% above | 4% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195??PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE | $55.68 | $58.00 | $29.00–$58.00 | 71% below | 4% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy | $164.45 | $171.30 | $85.65–$171.30 | 14% below | 4% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 Stress Test | $1,181.76 | $1,231.00 | $615.50–$1,231.00 | 421% above | 4% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 90716 Varicella virus vaccine, live, for subcutaneous use | $196.80 | $205.00 | $102.50–$205.00 | 1% below | 4% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 90716 Varicella virus vaccine, live, for subcutaneous use | $196.80 | $205.00 | $102.50–$205.00 | 1% below | 4% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine [PRIVATE] SubQ Inj [LRHC] | $319.06 | $332.35 | $166.18–$332.35 | 61% above | 4% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine [PRIVATE] SubQ Inj [LRHC] | $319.06 | $332.35 | $166.18–$332.35 | 61% above | 4% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 90716 Varicella virus vaccine, live, for subcutaneous use | $196.80 | $205.00 | $102.50–$205.00 | — | 4% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus vaccine [PRIVATE] SubQ Inj [LRHC] | $319.06 | $332.35 | $166.18–$332.35 | — | 4% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus vaccine inactivated preservative-free trivalent Sus (Flulaval) [LRHC] | $134.16 | $139.75 | $69.88–$139.75 | 321% above | 4% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus vaccine inactivated preservative-free trivalent Sus (Flulaval) [LRHC] | $134.16 | $139.75 | $69.88–$139.75 | 321% above | 4% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza virus vaccine inactivated preservative-free trivalent Sus (Flulaval) [LRHC] | $134.16 | $139.75 | $69.88–$139.75 | — | 4% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 90651 Vaccine- Gardasil 9 | $317.76 | $331.00 | $165.50–$331.00 | 8% below | 4% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 90651 Vaccine- Gardasil 9 | $317.76 | $331.00 | $165.50–$331.00 | 8% below | 4% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 human papillomavirus vaccine 9-valent [PRIVATE] Sus [LRHC] | $541.82 | $564.40 | $282.20–$564.40 | 58% above | 4% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 human papillomavirus vaccine 9-valent [PRIVATE] Sus [LRHC] | $541.82 | $564.40 | $282.20–$564.40 | 58% above | 4% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 90651 Vaccine- Gardasil 9 | $317.76 | $331.00 | $165.50–$331.00 | — | 4% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 human papillomavirus vaccine 9-valent [PRIVATE] Sus [LRHC] | $541.82 | $564.40 | $282.20–$564.40 | — | 4% |
| Hepatitis A vaccine, adult dose CPT 90632 90632 Hepatitis A vaccine, adult dosage, for intramuscular use | $111.36 | $116.00 | $58.00–$116.00 | 64% above | 4% |
| Hepatitis A vaccine, adult dose CPT 90632 90632 Hepatitis A vaccine, adult dosage, for intramuscular use | $111.36 | $116.00 | $58.00–$116.00 | 64% above | 4% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 1440 units/mL preservative free Sus [LRHC] | $207.94 | $216.60 | $108.30–$216.60 | 206% above | 4% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 1440 units/mL preservative free Sus [LRHC] | $207.94 | $216.60 | $108.30–$216.60 | 206% above | 4% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 90632 Hepatitis A vaccine, adult dosage, for intramuscular use | $111.36 | $116.00 | $58.00–$116.00 | — | 4% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 1440 units/mL preservative free Sus [LRHC] | $207.94 | $216.60 | $108.30–$216.60 | — | 4% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 90746 Vaccine - Hepatitis B Adult Vaccine | $94.08 | $98.00 | $49.00–$98.00 | 3% above | 4% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 90746 Vaccine - Hepatitis B Adult Vaccine | $94.08 | $98.00 | $49.00–$98.00 | 3% above | 4% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 20 mcg/mL Sus [LRHC] | $161.27 | $167.99 | $84.00–$167.99 | 77% above | 4% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 20 mcg/mL Sus [LRHC] | $161.27 | $167.99 | $84.00–$167.99 | 77% above | 4% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 90746 Vaccine - Hepatitis B Adult Vaccine | $94.08 | $98.00 | $49.00–$98.00 | — | 4% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 20 mcg/mL Sus [LRHC] | $161.27 | $167.99 | $84.00–$167.99 | — | 4% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 90662 Influenza virus vaccine High Dose, Inactivated PF Trivalen | $67.20 | $70.00 | $35.00–$70.00 | 15% below | 4% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 90662 Influenza virus vaccine High Dose, Inactivated PF Trivalen | $67.20 | $70.00 | $35.00–$70.00 | 15% below | 4% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 influenza virus vaccine inactivated high-dose preservative-free trivalent Sus (FLUZONE HIGH Dose) [LRHC] | $225.32 | $234.71 | $117.36–$234.71 | 184% above | 4% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 influenza virus vaccine inactivated high-dose preservative-free trivalent Sus (FLUZONE HIGH Dose) [LRHC] | $225.32 | $234.71 | $117.36–$234.71 | 184% above | 4% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 90662 Influenza virus vaccine High Dose, Inactivated PF Trivalen | $67.20 | $70.00 | $35.00–$70.00 | — | 4% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 influenza virus vaccine inactivated high-dose preservative-free trivalent Sus (FLUZONE HIGH Dose) [LRHC] | $225.32 | $234.71 | $117.36–$234.71 | — | 4% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 90707 Measles, mumps and rubella virus vaccine (MMR), live, for | $119.04 | $124.00 | $62.00–$124.00 | 5% above | 4% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 90707 Measles, mumps and rubella virus vaccine (MMR), live, for | $119.04 | $124.00 | $62.00–$124.00 | 5% above | 4% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine (Priorix) [LRHC] | $245.07 | $255.28 | $127.64–$255.28 | 117% above | 4% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine (Priorix) [LRHC] | $245.07 | $255.28 | $127.64–$255.28 | 117% above | 4% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 90707 Measles, mumps and rubella virus vaccine (MMR), live, for | $119.04 | $124.00 | $62.00–$124.00 | — | 4% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine (Priorix) [LRHC] | $245.07 | $255.28 | $127.64–$255.28 | — | 4% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 90734 Meningococcal conjugate vaccine, quadrivalent, for intramu | $181.44 | $189.00 | $94.50–$189.00 | at median | 4% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 90734 Meningococcal conjugate vaccine, quadrivalent, for intramu | $181.44 | $189.00 | $94.50–$189.00 | at median | 4% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine (reconstituted) Menveo [LRHC] | $383.59 | $399.57 | $199.79–$399.57 | 110% above | 4% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine (reconstituted) Menveo [LRHC] | $383.59 | $399.57 | $199.79–$399.57 | 110% above | 4% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine IM Sol (Menactra) [LRHC] | $653.47 | $680.70 | $340.35–$680.70 | 258% above | 4% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine IM Sol (Menactra) [LRHC] | $653.47 | $680.70 | $340.35–$680.70 | 258% above | 4% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 90734 Meningococcal conjugate vaccine, quadrivalent, for intramu | $181.44 | $189.00 | $94.50–$189.00 | — | 4% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal conjugate vaccine (reconstituted) Menveo [LRHC] | $383.59 | $399.57 | $199.79–$399.57 | — | 4% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal conjugate vaccine IM Sol (Menactra) [LRHC] | $653.47 | $680.70 | $340.35–$680.70 | — | 4% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 90620 Meningococcal vaccine, Serogroup B, 2 dose schedule, for I | $246.72 | $257.00 | $128.50–$257.00 | 22% below | 4% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 90620 Meningococcal vaccine, Serogroup B, 2 dose schedule, for I | $246.72 | $257.00 | $128.50–$257.00 | 22% below | 4% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 meningococcal group B vaccine recombinant [PRIVATE] OMV adjuvanted Sus [LRHC] | $388.54 | $404.73 | $202.37–$404.73 | 24% above | 4% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 meningococcal group B vaccine recombinant [PRIVATE] OMV adjuvanted Sus [LRHC] | $388.54 | $404.73 | $202.37–$404.73 | 24% above | 4% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 90620 Meningococcal vaccine, Serogroup B, 2 dose schedule, for I | $246.72 | $257.00 | $128.50–$257.00 | — | 4% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 meningococcal group B vaccine recombinant [PRIVATE] OMV adjuvanted Sus [LRHC] | $388.54 | $404.73 | $202.37–$404.73 | — | 4% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine - Sus [LRHC] | $587.93 | $612.43 | $306.22–$612.43 | 20% above | 4% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine - Sus [LRHC] | $587.93 | $612.43 | $306.22–$612.43 | 20% above | 4% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine - Sus [LRHC] | $587.93 | $612.43 | $306.22–$612.43 | — | 4% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 90732 Pneumococcal polysaccharide vaccine, 23-valent, for subcut | $151.68 | $158.00 | $79.00–$158.00 | 21% below | 4% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 90732 Pneumococcal polysaccharide vaccine, 23-valent, for subcut | $151.68 | $158.00 | $79.00–$158.00 | 21% below | 4% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 90732 Pneumococcal polysaccharide vaccine, 23-valent, for subcut | $151.68 | $158.00 | $79.00–$158.00 | — | 4% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV vaccine preF A-preF B recombinant preservative-free 60 mcg-60 mcg Inj [LRHC] | $688.90 | $717.60 | $358.80–$717.60 | 82% above | 4% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV vaccine preF A-preF B recombinant preservative-free 60 mcg-60 mcg Inj [LRHC] | $688.90 | $717.60 | $358.80–$717.60 | 82% above | 4% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV vaccine preF A-preF B recombinant preservative-free 60 mcg-60 mcg Inj [LRHC] | $688.90 | $717.60 | $358.80–$717.60 | — | 4% |
| Rabies vaccine, one dose CPT 90675 90675 Rabies vaccine, for intramuscular use | $487.68 | $508.00 | $254.00–$508.00 | 11% below | 4% |
| Rabies vaccine, one dose CPT 90675 90675 Rabies vaccine, for intramuscular use | $487.68 | $508.00 | $254.00–$508.00 | 11% below | 4% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine purified chick embryo cell 2.5 intl units Pow [LRHC] | $944.40 | $983.75 | $491.88–$983.75 | 72% above | 4% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine purified chick embryo cell 2.5 intl units Pow [LRHC] | $944.40 | $983.75 | $491.88–$983.75 | 72% above | 4% |
| Rabies vaccine, one dose inpatient CPT 90675 90675 Rabies vaccine, for intramuscular use | $487.68 | $508.00 | $254.00–$508.00 | — | 4% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine purified chick embryo cell 2.5 intl units Pow [LRHC] | $944.40 | $983.75 | $491.88–$983.75 | — | 4% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 90750 Zoster (shingles) vaccine (HZV), recombinant, subunit, adj | $204.48 | $213.00 | $106.50–$213.00 | 25% below | 4% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 90750 Zoster (shingles) vaccine (HZV), recombinant, subunit, adj | $204.48 | $213.00 | $106.50–$213.00 | 25% below | 4% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster vaccine inactivated adjuvanted Pow [LRHC] | $392.04 | $408.38 | $204.19–$408.38 | 44% above | 4% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster vaccine inactivated adjuvanted Pow [LRHC] | $392.04 | $408.38 | $204.19–$408.38 | 44% above | 4% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 90750 Zoster (shingles) vaccine (HZV), recombinant, subunit, adj | $204.48 | $213.00 | $106.50–$213.00 | — | 4% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster vaccine inactivated adjuvanted Pow [LRHC] | $392.04 | $408.38 | $204.19–$408.38 | — | 4% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 90714 Tenivac - Tetanus and diphtheria toxoids (Td), over 18 | $66.24 | $69.00 | $34.50–$69.00 | 45% above | 4% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 90714 Tenivac - Tetanus and diphtheria toxoids (Td), over 18 | $66.24 | $69.00 | $34.50–$69.00 | 45% above | 4% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2 units/0.5 mL preservative-free Sus UD [LRHC] | $120.57 | $125.59 | $62.80–$125.59 | 164% above | 4% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2 units/0.5 mL preservative-free Sus UD [LRHC] | $120.57 | $125.59 | $62.80–$125.59 | 164% above | 4% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 90714 Tenivac - Tetanus and diphtheria toxoids (Td), over 18 | $66.24 | $69.00 | $34.50–$69.00 | — | 4% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphth toxoids (Td) adult/adol 5 units-2 units/0.5 mL preservative-free Sus UD [LRHC] | $120.57 | $125.59 | $62.80–$125.59 | — | 4% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 90715 Tdap, when administered to individuals 7 years or older, f | $74.88 | $78.00 | $39.00–$78.00 | 5% above | 4% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 90715 Tdap, when administered to individuals 7 years or older, f | $74.88 | $78.00 | $39.00–$78.00 | 5% above | 4% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2.5 units-18.5 mcg/0.5 mL Sus [LRHC] | $121.60 | $126.67 | $63.34–$126.67 | 70% above | 4% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2.5 units-18.5 mcg/0.5 mL Sus [LRHC] | $121.60 | $126.67 | $63.34–$126.67 | 70% above | 4% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 90715 Tdap, when administered to individuals 7 years or older, f | $74.88 | $78.00 | $39.00–$78.00 | — | 4% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2.5 units-18.5 mcg/0.5 mL Sus [LRHC] | $121.60 | $126.67 | $63.34–$126.67 | — | 4% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 90691 Typhoid vaccine, over 18 | $152.64 | $159.00 | $79.50–$159.00 | 21% below | 4% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 90691 Typhoid vaccine, over 18 | $152.64 | $159.00 | $79.50–$159.00 | 21% below | 4% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 typhoid vaccine inactivated IM Sol 0.5 mL [LRHC] | $307.37 | $320.18 | $160.09–$320.18 | 60% above | 4% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 typhoid vaccine inactivated IM Sol 0.5 mL [LRHC] | $307.37 | $320.18 | $160.09–$320.18 | 60% above | 4% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 90691 Typhoid vaccine, over 18 | $152.64 | $159.00 | $79.50–$159.00 | — | 4% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 typhoid vaccine inactivated IM Sol 0.5 mL [LRHC] | $307.37 | $320.18 | $160.09–$320.18 | — | 4% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization administration: first vaccine | $28.80 | $30.00 | $15.00–$30.00 | 16% below | 4% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 ADM VACCINE SINGLE CHARGE. | $105.60 | $110.00 | $55.00–$110.00 | 209% above | 4% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Immunization administration; each additional vaccine | $27.84 | $29.00 | $14.50–$29.00 | 33% below | 4% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IMMUNIZATION ADMIN ADDL CHARGE | $105.60 | $110.00 | $55.00–$110.00 | 154% above | 4% |
Source file: https://lexington.pt.panaceainc.com/MRFDownload/lexington/lexington