Mercy Hospital KS
Mercy Hospital KS in Moundridge, KS publishes cash prices for 263 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 below the Kansas median for 218 of 260 procedures and above it for 42. Click a procedure to compare it with other hospitals nearby.
218 E Pack St, Moundridge, KS 67107 Collected Sep 27, 2026 Source price file (620) 345-6391
Rural emergency hospital Emergency department CCN 170780 · CMS hospital register NPI 1083628911
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w wo Contrast | $956.25 | $1,125.00 | — | 32% below | 15% |
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w wo Contrast ChestPelvis w Contrast | $956.25 | $1,125.00 | — | 32% below | 15% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete Bilateral | $140.25 | $165.00 | $29.22–$165.00 | — | 15% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Right | $140.25 | $165.00 | $29.22–$165.00 | 40% below | 15% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Left | $140.25 | $165.00 | $29.22–$165.00 | 40% below | 15% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow wo Contrast Right | $722.50 | $850.00 | — | 31% below | 15% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity wo Contrast Left | $722.50 | $850.00 | — | 31% below | 15% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity wo Contrast Right | $722.50 | $850.00 | — | 31% below | 15% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow wo Contrast Left | $722.50 | $850.00 | — | 31% below | 15% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist wo Contrast Left | $722.50 | $850.00 | — | 31% below | 15% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder wo Contrast Right | $722.50 | $850.00 | — | 31% below | 15% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist wo Contrast Right | $722.50 | $850.00 | — | 31% below | 15% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder wo Contrast Left | $722.50 | $850.00 | — | 31% below | 15% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body | $616.25 | $725.00 | $181.25–$725.00 | 42% below | 15% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angiography Abdomen Pelvis | $1,530.00 | $1,800.00 | — | 38% below | 15% |
| CT angiography (CTA) of the head CPT 70496 CT Angiography Head w wo Contrast | $892.50 | $1,050.00 | — | 51% below | 15% |
| CT angiography (CTA) of the neck CPT 70498 CT Angiography Neck w | $807.50 | $950.00 | — | 55% below | 15% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest w | $892.50 | $1,050.00 | — | 50% below | 15% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest for PE | $892.50 | $1,050.00 | — | 50% below | 15% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest w wo Contrast | $892.50 | $1,050.00 | — | 50% below | 15% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis wo Contrast | $1,530.00 | $1,800.00 | — | 14% above | 15% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis wo Contrast Stone Protocol | $1,530.00 | $1,800.00 | — | 14% above | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ChestAbdomenPelvis wo Contrast | $1,534.25 | $1,805.00 | — | 1% above | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis w Contrast | $1,572.50 | $1,850.00 | — | 4% above | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ChestAbdomenPelvis w Contrast | $1,585.25 | $1,865.00 | — | 5% above | 15% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ChestAbdomenPelvis w wo Contrast | $2,095.25 | $2,465.00 | — | 38% above | 15% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis w wo Contrast | $1,742.50 | $2,050.00 | — | 9% below | 15% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w Contrast | $973.25 | $1,145.00 | — | 29% below | 15% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen wo Contrast | $765.00 | $900.00 | — | 34% below | 15% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial wo Contrast | $722.50 | $850.00 | — | 29% below | 15% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus wo Contrast | $722.50 | $850.00 | — | 29% below | 15% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain wo Contrast | $637.50 | $750.00 | — | 41% below | 15% |
| CT scan of the head with contrast CPT 70460 CT Head or Brain w Contrast | $637.50 | $750.00 | — | 48% below | 15% |
| CT scan of the head without and with contrast CPT 70470 CT Head or Brain w wo Contrast | $637.50 | $750.00 | — | 51% below | 15% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar wo Contrast | $735.25 | $865.00 | — | 35% below | 15% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical wo Contrast | $765.00 | $900.00 | — | 28% below | 15% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w Contrast | $892.50 | $1,050.00 | — | 27% below | 15% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral | $552.50 | $650.00 | $162.50–$650.00 | — | 15% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Doppler Bilateral | $552.50 | $650.00 | $162.50–$650.00 | — | 15% |
| Chest CT scan without and with contrast CPT 71270 CT Chest w wo Contrast | $1,236.75 | $1,455.00 | — | 1% below | 15% |
| Chest CT scan without and with contrast CPT 71270 CT Thorax w wo Contrast | $1,236.75 | $1,455.00 | — | 1% below | 15% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $127.50 | $150.00 | $26.74–$158.31 | 45% below | 15% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View | $114.75 | $135.00 | $20.62–$135.00 | 41% below | 15% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left | $199.75 | $235.00 | $25.53–$235.00 | at median | 15% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right | $199.75 | $235.00 | $25.53–$235.00 | at median | 15% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $149.52 | $175.90 | $43.97–$187.46 | 64% below | 15% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest wo Contrast | $765.00 | $900.00 | — | 27% below | 15% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax wo Contrast | $765.00 | $900.00 | — | 27% below | 15% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w Contrast | $1,020.00 | $1,200.00 | — | 12% below | 15% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w Contrast | $1,020.00 | $1,200.00 | — | 12% below | 15% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral | $552.50 | $650.00 | $162.50–$650.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral | $552.50 | $650.00 | $162.50–$650.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Duplex Bilateral | $552.50 | $650.00 | $162.50–$650.00 | — | 15% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Doppler Bilateral | $552.50 | $650.00 | $162.50–$650.00 | — | 15% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo 2D Comp w Color Flow Doppler | $1,292.00 | $1,520.00 | $178.27–$1,608.78 | 32% below | 15% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO Rad | $1,292.00 | $1,520.00 | $178.27–$1,608.78 | 32% below | 15% |
| Elbow X-ray, 2 views both sides CPT 73070 XR Elbow 2 Views Bilateral | $148.75 | $175.00 | $23.19–$175.00 | — | 15% |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Left | $114.75 | $135.00 | $23.19–$135.00 | 42% below | 15% |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Right | $114.75 | $135.00 | $23.19–$135.00 | 42% below | 15% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR Elbow Complete Bilateral | $178.50 | $210.00 | $25.82–$210.00 | — | 15% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Left | $157.25 | $185.00 | $25.82–$185.00 | 35% below | 15% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Right | $157.25 | $185.00 | $25.82–$185.00 | 35% below | 15% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC wo Contrast | $616.25 | $725.00 | — | 43% below | 15% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit Sella etc wo Contrast | $616.25 | $725.00 | — | 43% below | 15% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Zygomatic Arches | $140.25 | $165.00 | $37.30–$199.04 | 56% below | 15% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Minimum 3 Views | $140.25 | $165.00 | $37.30–$199.04 | 56% below | 15% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR Forearm 2 Views Bilateral | $114.75 | $135.00 | $23.19–$135.00 | — | 15% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left | $114.75 | $135.00 | $23.19–$135.00 | 46% below | 15% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right | $114.75 | $135.00 | $23.19–$135.00 | 46% below | 15% |
| Hand X-ray, 2 views both sides CPT 73120 XR Hand 2 Views Bilateral | $119.00 | $140.00 | $24.75–$159.51 | — | 15% |
| Hand X-ray, 2 views one side CPT 73120 XR Finger Thumb 1 View Left | $97.75 | $115.00 | $24.75–$159.51 | 49% below | 15% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Right | $119.00 | $140.00 | $24.75–$159.51 | 38% below | 15% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Left | $119.00 | $140.00 | $24.75–$159.51 | 38% below | 15% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR Calcaneus Bilateral | $119.00 | $140.00 | $22.66–$140.00 | — | 15% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Right | $119.00 | $140.00 | $22.66–$140.00 | 40% below | 15% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Left | $119.00 | $140.00 | $22.66–$140.00 | 40% below | 15% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right | $140.25 | $165.00 | $32.12–$165.00 | 43% below | 15% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left | $140.25 | $165.00 | $32.12–$165.00 | 43% below | 15% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Lower Extremity wo Contrast Bilat | $786.25 | $925.00 | — | — | 15% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip wo Contrast Right | $216.75 | $255.00 | — | 80% below | 15% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee wo Contrast Left | $722.50 | $850.00 | — | 34% below | 15% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity wo Contrast Left | $722.50 | $850.00 | — | 34% below | 15% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee wo Contrast Right | $722.50 | $850.00 | — | 34% below | 15% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle wo Contrast Right | $722.50 | $850.00 | — | 34% below | 15% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity wo Contrast Right | $722.50 | $850.00 | — | 34% below | 15% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle wo Contrast Left | $722.50 | $850.00 | — | 34% below | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $133.37 | $156.90 | $39.22–$159.51 | 62% below | 15% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder | $133.37 | $156.90 | $39.22–$159.51 | 62% below | 15% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TibiaFibula Right | $119.00 | $140.00 | $25.02–$149.28 | 47% below | 15% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TibiaFibula Left | $119.00 | $140.00 | $25.02–$149.28 | 47% below | 15% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical Minimum 4 Views | $148.75 | $175.00 | $42.29–$241.96 | 61% below | 15% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck w Contrast | $807.50 | $950.00 | — | 31% below | 15% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck wo Contrast | $680.00 | $800.00 | — | 32% below | 15% |
| Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue | $93.50 | $110.00 | $25.07–$135.62 | 55% below | 15% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis wo Contrast | $743.75 | $875.00 | — | 32% below | 15% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB Limited | $133.37 | $156.90 | $39.13–$162.27 | 59% below | 15% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non OB Complete | $140.25 | $165.00 | $41.25–$173.73 | 63% below | 15% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester | $149.52 | $175.90 | $43.97–$194.35 | 61% below | 15% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited | $117.30 | $138.00 | $34.50–$159.51 | 59% below | 15% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Right | $114.75 | $135.00 | $29.35–$140.49 | 51% below | 15% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Left | $114.75 | $135.00 | $29.35–$140.49 | 51% below | 15% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs Min 3 Views Left w PA Chest | $276.25 | $325.00 | $33.67–$325.00 | 10% below | 15% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs Min 3 Views Right w PA Chest | $276.25 | $325.00 | $33.67–$325.00 | 10% below | 15% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Right | $114.75 | $135.00 | $27.42–$147.33 | 50% below | 15% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Left | $114.75 | $135.00 | $27.42–$147.33 | 50% below | 15% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete | $140.25 | $165.00 | $29.88–$203.91 | 55% below | 15% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Skull 4 Views | $157.25 | $185.00 | $28.47–$185.00 | 37% below | 15% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Min 2 Views Rt | $119.00 | $140.00 | $28.20–$140.00 | 52% below | 15% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Min 2 Views Lt | $119.00 | $140.00 | $28.20–$140.00 | 52% below | 15% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic wo Contrast | $709.75 | $835.00 | — | 31% below | 15% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Left | $93.50 | $110.00 | $23.10–$132.08 | 49% below | 15% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Right | $93.50 | $110.00 | $23.10–$132.08 | 49% below | 15% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Left | $93.50 | $110.00 | $23.10–$132.08 | 49% below | 15% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Left | $93.50 | $110.00 | $23.10–$132.08 | 49% below | 15% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Right | $93.50 | $110.00 | $23.10–$132.08 | 49% below | 15% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Left | $93.50 | $110.00 | $23.10–$132.08 | 49% below | 15% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Right | $93.50 | $110.00 | $23.10–$132.08 | 49% below | 15% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Right | $93.50 | $110.00 | $23.10–$132.08 | 49% below | 15% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Right | $93.50 | $110.00 | $23.10–$132.08 | 49% below | 15% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Left | $93.50 | $110.00 | $23.10–$132.08 | 49% below | 15% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB | $203.41 | $239.30 | $59.82–$239.30 | 37% below | 15% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $263.50 | $310.00 | $77.50–$310.00 | 43% below | 15% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum Contents | $133.37 | $156.90 | $39.22–$176.02 | 66% below | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HeadNeck Soft Tissue | $408.00 | $480.00 | $88.43–$504.80 | 35% below | 15% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid | $408.00 | $480.00 | $88.43–$504.80 | 35% below | 15% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left | $93.50 | $110.00 | $25.53–$144.40 | 60% below | 15% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Right | $93.50 | $110.00 | $25.53–$144.40 | 60% below | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left | $552.50 | $650.00 | $124.06–$650.00 | 18% below | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right | $552.50 | $650.00 | $124.06–$650.00 | 18% below | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Left | $552.50 | $650.00 | $124.06–$650.00 | 18% below | 15% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right | $552.50 | $650.00 | $124.06–$650.00 | 18% below | 15% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Right | $114.75 | $135.00 | $26.84–$135.00 | 39% below | 15% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Left | $114.75 | $135.00 | $26.84–$135.00 | 39% below | 15% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Left | $140.25 | $165.00 | $32.35–$165.00 | 41% below | 15% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Right | $140.25 | $165.00 | $32.35–$165.00 | 41% below | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Complete Right | $140.25 | $165.00 | $37.19–$181.91 | 47% below | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 23 Views Lt w Pelvis | $140.25 | $165.00 | $37.19–$181.91 | 47% below | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 23 View Right | $140.25 | $165.00 | $37.19–$181.91 | 47% below | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 23 View Left | $140.25 | $165.00 | $37.19–$181.91 | 47% below | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Complete Left | $140.25 | $165.00 | $37.19–$181.91 | 47% below | 15% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 23 Views Rt w Pelvis | $140.25 | $165.00 | $37.19–$181.91 | 47% below | 15% |
| X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 Views Bilateral | $23.80 | $28.00 | $7.00–$132.08 | — | 15% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left | $119.00 | $140.00 | $25.80–$140.00 | 37% below | 15% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right | $119.00 | $140.00 | $25.80–$140.00 | 37% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Right | $93.50 | $110.00 | $27.50–$132.08 | 48% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Right | $93.50 | $110.00 | $27.50–$132.08 | 48% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Left | $93.50 | $110.00 | $27.50–$132.08 | 48% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Right | $93.50 | $110.00 | $27.50–$132.08 | 48% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Left | $93.50 | $110.00 | $27.50–$132.08 | 48% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Right | $93.50 | $110.00 | $27.50–$132.08 | 48% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Left | $93.50 | $110.00 | $27.50–$132.08 | 48% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Left | $93.50 | $110.00 | $27.50–$132.08 | 48% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Right | $93.50 | $110.00 | $27.50–$132.08 | 48% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Left | $93.50 | $110.00 | $27.50–$132.08 | 48% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Rt | $119.00 | $140.00 | $29.89–$140.00 | 33% below | 15% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Left | $119.00 | $140.00 | $29.89–$140.00 | 33% below | 15% |
| X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 Views Bilateral | $119.00 | $140.00 | $22.40–$140.00 | — | 15% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left | $119.00 | $140.00 | $22.40–$140.00 | 39% below | 15% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right | $119.00 | $140.00 | $22.40–$140.00 | 39% below | 15% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete Bilateral | $140.25 | $165.00 | $27.13–$165.00 | — | 15% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Left | $140.25 | $165.00 | $27.13–$165.00 | 39% below | 15% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Right | $140.25 | $165.00 | $27.13–$165.00 | 39% below | 15% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Right | $119.00 | $140.00 | $29.22–$143.42 | 48% below | 15% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Left | $119.00 | $140.00 | $29.22–$143.42 | 48% below | 15% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 Views Bilateral | $119.00 | $140.00 | $27.11–$140.00 | — | 15% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right | $119.00 | $140.00 | $27.11–$140.00 | 40% below | 15% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left | $119.00 | $140.00 | $27.11–$140.00 | 40% below | 15% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $114.75 | $135.00 | $31.71–$183.42 | 59% below | 15% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 Views | $148.75 | $175.00 | $40.70–$260.51 | 63% below | 15% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views | $119.00 | $140.00 | $26.16–$159.51 | 49% below | 15% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Minimum 3 Views | $140.25 | $165.00 | $30.27–$165.00 | 43% below | 15% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views | $114.75 | $135.00 | $31.44–$167.81 | 56% below | 15% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $106.25 | $125.00 | $22.17–$159.51 | 50% below | 15% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SacrumCoccyx Minimum 2 Views | $114.75 | $135.00 | $25.82–$150.26 | 52% below | 15% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH AMS | $130.77 | $153.85 | $32.83–$146.15 | 28% below | 15% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $27.63 | $32.50 | $5.14–$30.87 | 25% below | 15% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $27.63 | $32.50 | $5.02–$30.87 | 26% below | 15% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel AMS | $170.43 | $200.50 | $40.49–$190.47 | 20% below | 15% |
| Albumin blood test CPT 82040 Albumin Level | $28.73 | $33.80 | $4.80–$32.11 | 11% below | 15% |
| Aldosterone blood test CPT 82088 Aldosterone Serum AMS | $136.13 | $160.15 | $34.64–$152.14 | 28% below | 15% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $27.63 | $32.50 | $5.02–$30.87 | 25% below | 15% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP | $93.50 | $110.00 | $14.25–$104.50 | 6% below | 15% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein AMS | $93.50 | $110.00 | $14.25–$104.50 | 6% below | 15% |
| Ammonia blood test CPT 82140 Ammonia AMS | $128.18 | $150.80 | $12.38–$143.26 | 48% above | 15% |
| Ammonia blood test CPT 82140 Ammonia Level | $128.18 | $150.80 | $12.38–$143.26 | 48% above | 15% |
| Amylase blood test CPT 82150 Amylase Level | $31.62 | $37.20 | $6.29–$35.34 | 44% below | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 ANA Quant Add On AMS | $55.85 | $65.70 | $11.73–$62.41 | 20% below | 15% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Screen AMS | $55.85 | $65.70 | $11.73–$62.41 | 20% below | 15% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BType Natriuretic Peptide | $192.91 | $226.95 | $33.37–$215.60 | 48% above | 15% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ProBNP | $192.91 | $226.95 | $33.37–$215.60 | 48% above | 15% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NTPro BNP AMS | $192.91 | $226.95 | $33.37–$215.60 | 48% above | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture AMS | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture Aerobic and Anaerobic AMS | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BPen Oral | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Wound Culture AMS | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Body Fluid Culture AMS | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 87070 Wound Culture AMS | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 87070 Sputum Culture with Gram Stain AMS | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture Aerobic w Gram Stain AMS | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Upper Respiratory Culture AMS | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasal Culture | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Flagellar stain | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture AMS | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture | $29.75 | $35.00 | $7.35–$33.47 | 50% below | 15% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $23.55 | $27.70 | $8.21–$26.31 | 71% below | 15% |
| Bilirubin blood test, total CPT 82247 Neonatal Bilirubin | $24.48 | $28.80 | $4.87–$27.36 | 33% below | 15% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $24.48 | $28.80 | $4.87–$27.36 | 33% below | 15% |
| Blood culture for bacteria CPT 87040 Blood Culture 2 AMS | $48.45 | $57.00 | $9.45–$54.15 | 45% below | 15% |
| Blood culture for bacteria CPT 87040 Blood Culture | $48.45 | $57.00 | $9.45–$54.15 | 45% below | 15% |
| Blood culture for bacteria CPT 87040 Blood Culture AMS | $48.45 | $57.00 | $9.45–$54.15 | 45% below | 15% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 Venipuncture | $14.45 | $17.00 | $8.57–$16.15 | 20% below | 15% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION Venous Draw | $14.45 | $17.00 | $8.57–$16.15 | 20% below | 15% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $18.02 | $21.20 | $3.81–$20.14 | 40% below | 15% |
| Blood lead test CPT 83655 Lead Blood AMS | $26.48 | $31.15 | $11.70–$29.59 | 50% below | 15% |
| Blood lead test CPT 83655 Lead Level 83655 | $89.80 | $105.65 | $11.70–$100.36 | 70% above | 15% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Rapid Pregnancy Test with QC | $45.73 | $53.80 | $7.29–$51.11 | 23% below | 15% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Rapid Pregnancy Test | $45.73 | $53.80 | $7.29–$51.11 | 23% below | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Type and Cross GL | $168.94 | $198.75 | $2.90–$221.29 | 61% above | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Type and Screen GL | $168.94 | $198.75 | $2.90–$221.29 | 61% above | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh GL | $168.94 | $198.75 | $2.90–$221.29 | 61% above | 15% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ARC ABO 86900 | $168.94 | $198.75 | $2.90–$221.29 | 61% above | 15% |
| Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen | $18.62 | $21.90 | $3.83–$20.80 | 40% below | 15% |
| C-peptide blood test CPT 84681 CPeptide AMS | $116.71 | $137.30 | $17.69–$130.43 | 11% above | 15% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CReactive Protein | $34.85 | $41.00 | $5.02–$38.95 | 28% below | 15% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CReactive Protein AMS | $34.85 | $41.00 | $5.02–$38.95 | 28% below | 15% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C difficile toxin B gene by PCR AMS | $73.02 | $85.90 | $34.26–$81.60 | 40% below | 15% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Rapid Clostridium Difficile Toxin | $73.02 | $85.90 | $34.26–$81.60 | 40% below | 15% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C Diff | $73.02 | $85.90 | $34.26–$81.60 | 40% below | 15% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 199 AMS | $46.75 | $55.00 | $20.19–$57.24 | 57% below | 15% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA199 | $63.75 | $75.00 | $20.19–$71.25 | 41% below | 15% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA125 AMS | $55.25 | $65.00 | $20.19–$61.75 | 43% below | 15% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 GL | $106.25 | $125.00 | $43.61–$119.89 | 23% below | 15% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Novel Coronavirus CoVID19 NAA LC | $123.25 | $145.00 | $43.61–$137.75 | 11% below | 15% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Coronavirus SARSCoV2 AMS | $123.25 | $145.00 | $43.61–$137.75 | 11% below | 15% |
| Calcium blood test, total CPT 82310 Calcium Level Total | $58.65 | $69.00 | $5.01–$65.55 | 74% above | 15% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen | $94.35 | $111.00 | $18.39–$105.45 | 15% below | 15% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA AMS | $94.35 | $111.00 | $18.39–$105.45 | 15% below | 15% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster IgG AMS | $72.97 | $85.85 | $10.95–$81.55 | 22% below | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GCChlamydia RML | $63.75 | $75.00 | $34.04–$79.09 | 45% below | 15% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlam GC Nucleic Acid Screen AMS | $63.75 | $75.00 | $34.04–$79.09 | 45% below | 15% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $32.13 | $37.80 | $12.99–$45.34 | 65% below | 15% |
| Complete blood count (CBC) with differential CPT 85025 85025 CBC wAuto Diff | $24.40 | $28.70 | $6.60–$27.26 | 42% below | 15% |
| Complete blood count (CBC) with differential CPT 85025 No Manual Differential | $24.40 | $28.70 | $6.60–$27.26 | 42% below | 15% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count with Manual Differential | $24.40 | $28.70 | $6.28–$27.26 | 46% below | 15% |
| Complete blood count (CBC), no differential CPT 85027 85027 CBC | $24.40 | $28.70 | $6.28–$27.26 | 46% below | 15% |
| Complete blood count (CBC), no differential CPT 85027 Yes Manual Differential | $24.40 | $28.70 | $6.28–$27.26 | 46% below | 15% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count wo Diff | $24.40 | $28.70 | $6.28–$27.26 | 46% below | 15% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $26.52 | $31.20 | $10.24–$29.64 | 75% below | 15% |
| Cortisol blood test, total CPT 82533 Cortisol PM AMS | $80.67 | $94.90 | $15.81–$90.15 | 18% below | 15% |
| Cortisol blood test, total CPT 82533 Cortisol Stimulation | $80.67 | $94.90 | $15.81–$90.15 | 18% below | 15% |
| Cortisol blood test, total CPT 82533 Cortisol AM AMS | $80.67 | $94.90 | $15.81–$90.15 | 18% below | 15% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase | $29.16 | $34.30 | $6.31–$32.58 | 38% below | 15% |
| Creatinine blood test CPT 82565 Creatinine with eGFR | $24.48 | $28.80 | $4.97–$27.36 | 33% below | 15% |
| Creatinine blood test CPT 82565 Creatinine | $24.48 | $28.80 | $4.97–$27.36 | 33% below | 15% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CytomegalovirusCMV Ab IgG AMS | $66.89 | $78.69 | $12.23–$75.72 | 39% below | 15% |
| D-dimer blood test (blood clot marker) CPT 85379 DDimer | $102.00 | $120.00 | $9.87–$114.00 | 14% below | 15% |
| D-dimer blood test (blood clot marker) CPT 85379 DDimer AMS | $102.00 | $120.00 | $9.87–$114.00 | 14% below | 15% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate AMS | $90.45 | $106.41 | $21.56–$101.08 | 30% below | 15% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 80307 Urine AMS | $106.25 | $125.00 | $60.28–$157.58 | 35% below | 15% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 80307 Urine wAlcohol AMS | $114.75 | $135.00 | $60.28–$157.58 | 29% below | 15% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel | $23.55 | $27.70 | $6.00–$26.31 | 61% below | 15% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 86665 EpsteinBarr Virus Serology AMS | $81.86 | $96.30 | $15.42–$91.48 | 21% below | 15% |
| Estradiol blood test CPT 82670 Estrogen Fractionated AMS | $173.40 | $204.00 | $27.10–$193.80 | 2% above | 15% |
| Estradiol blood test CPT 82670 Estradiol AMS | $173.40 | $204.00 | $27.10–$193.80 | 2% above | 15% |
| Estradiol blood test CPT 82670 Estradiol Level | $173.40 | $204.00 | $27.10–$193.80 | 2% above | 15% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone | $94.95 | $111.70 | $18.02–$106.11 | 18% below | 15% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH AMS | $94.95 | $111.70 | $18.02–$106.11 | 18% below | 15% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal AMS | $27.97 | $32.90 | $19.04–$31.25 | 87% below | 15% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin AMS | $70.89 | $83.40 | $13.22–$79.23 | 20% below | 15% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $70.89 | $83.40 | $13.22–$79.23 | 20% below | 15% |
| Folate (folic acid) blood test CPT 82746 Folate AMS | $82.37 | $96.90 | $14.26–$92.05 | 17% below | 15% |
| Folate (folic acid) blood test CPT 82746 82746 B12 and Folate AMS | $82.37 | $96.90 | $14.26–$92.05 | 17% below | 15% |
| Folate (folic acid) blood test CPT 82746 Folate Level | $82.37 | $96.90 | $14.26–$92.05 | 17% below | 15% |
| Free T3 thyroid hormone test CPT 84481 T3 Free AMS | $112.20 | $132.00 | $16.43–$125.40 | 13% below | 15% |
| Free T3 thyroid hormone test CPT 84481 Triiodothyronine Free | $112.20 | $132.00 | $16.43–$125.40 | 13% below | 15% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free | $38.85 | $45.70 | $8.75–$43.41 | 42% below | 15% |
| Free testosterone test CPT 84402 84402 Testosterone Free AMS | $55.08 | $64.80 | $24.71–$114.08 | 61% below | 15% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase | $52.70 | $62.00 | $6.98–$58.90 | 20% above | 15% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Gluc 1 Hr Post | $26.78 | $31.50 | $4.61–$29.92 | 44% below | 15% |
| Glucose tolerance test, 3 samples CPT 82951 Gluc Fasting | $61.46 | $72.30 | $12.48–$68.68 | 33% below | 15% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 2hr F12 | $61.46 | $72.30 | $12.48–$68.68 | 33% below | 15% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 2hr F30 min12 | $61.46 | $72.30 | $12.48–$68.68 | 33% below | 15% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose 2 Hour Postprandial | $61.46 | $72.30 | $12.48–$68.68 | 33% below | 15% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 GC Nucleic Acid Screen | $63.75 | $75.00 | $34.04–$79.09 | 41% below | 15% |
| H. pylori stool antigen test CPT 87338 Rapid Helicobacter Pylori Antigen Stool with QC | $140.80 | $165.65 | $13.95–$157.36 | 26% above | 15% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV AntigenAntibody Combo AMS | $88.32 | $103.90 | $11.65–$98.70 | 7% above | 15% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV Screen | $88.32 | $103.90 | $11.65–$98.70 | 7% above | 15% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1c | $47.86 | $56.30 | $9.42–$53.48 | 26% below | 15% |
| Hemoglobin blood test CPT 85018 Hemoglobin | $13.01 | $15.30 | $2.01–$14.53 | 39% below | 15% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Antibody AMS | $61.80 | $72.70 | $10.42–$69.06 | 21% below | 15% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 87340 Hepatitis Panel AMS | $56.70 | $66.70 | $10.02–$63.36 | 8% below | 15% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen | $56.70 | $66.70 | $10.02–$63.36 | 8% below | 15% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen AMS | $56.70 | $66.70 | $10.02–$63.36 | 8% below | 15% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Total Ab AMS | $112.29 | $132.10 | $13.84–$125.49 | 42% above | 15% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP High Sensitivity AMS | $81.60 | $96.00 | $11.01–$91.20 | 9% below | 15% |
| Homocysteine blood test CPT 83090 Homocysteine AMS | $50.07 | $58.90 | $17.38–$185.41 | 78% below | 15% |
| Insulin blood test CPT 83525 Insulin AMS | $67.58 | $79.50 | $11.09–$75.52 | 17% below | 15% |
| Iron blood test (serum iron) CPT 83540 Iron AMS | $34.09 | $40.10 | $5.50–$38.09 | 23% below | 15% |
| Iron blood test (serum iron) CPT 83540 Iron Level | $34.09 | $40.10 | $5.50–$38.09 | 23% below | 15% |
| Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity | $54.91 | $64.60 | $8.48–$61.37 | 15% below | 15% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $40.46 | $47.60 | $8.42–$45.22 | 45% below | 15% |
| Kidney function blood test panel CPT 80069 Renal Function Panel 1 | $40.46 | $47.60 | $8.42–$45.22 | 45% below | 15% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone AMS | $92.65 | $109.00 | $17.96–$103.55 | 17% below | 15% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone | $92.65 | $109.00 | $17.96–$103.55 | 17% below | 15% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid | $63.07 | $74.20 | $10.08–$70.49 | 21% below | 15% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH | $28.73 | $33.80 | $5.86–$32.11 | 30% below | 15% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $36.98 | $43.50 | $6.68–$41.32 | 41% below | 15% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $42.42 | $49.90 | $7.92–$47.40 | 49% below | 15% |
| Lyme disease antibody test CPT 86618 Lyme Disease EIA AMS | $93.50 | $110.00 | $14.48–$104.50 | 23% below | 15% |
| Magnesium blood test CPT 83735 Magnesium Level AMS | $34.43 | $40.50 | $6.50–$38.47 | 34% below | 15% |
| Magnesium blood test CPT 83735 Magnesium Level | $34.43 | $40.50 | $6.50–$38.47 | 34% below | 15% |
| Measles (rubeola) antibody test CPT 86765 86765 Rubeola Abs IgG IgM | $40.25 | $47.35 | $10.95–$71.68 | 61% below | 15% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies IgG LC | $76.63 | $90.15 | $10.95–$85.64 | 26% below | 15% |
| Measles (rubeola) antibody test CPT 86765 Mumps Measles Rubella Varicella Zoster Ig AMS | $90.95 | $107.00 | $10.95–$101.65 | 13% below | 15% |
| Measles (rubeola) antibody test CPT 86765 Measles IgG Quantitative AMS | $90.95 | $107.00 | $10.95–$101.65 | 13% below | 15% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Rapid Mono Screen | $26.01 | $30.60 | $5.02–$29.07 | 42% below | 15% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Rapid Mono Screen with QC | $26.01 | $30.60 | $5.02–$29.07 | 42% below | 15% |
| Mumps immunity blood test CPT 86735 Mumps Ab IgGIgM AMS | $86.45 | $101.70 | $11.09–$96.61 | 2% below | 15% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate Specific Antigen Free | $63.41 | $74.60 | $17.84–$70.87 | 31% below | 15% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SI | $90.53 | $106.50 | $17.84–$101.17 | 15% below | 15% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH | $159.97 | $188.20 | $35.09–$178.79 | 20% below | 15% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $48.28 | $56.80 | $5.25–$53.96 | 3% above | 15% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level | $24.48 | $28.80 | $4.60–$27.36 | 36% below | 15% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level AMS | $24.48 | $28.80 | $4.60–$27.36 | 36% below | 15% |
| Potassium blood test CPT 84132 Potassium Level | $19.13 | $22.50 | $4.20–$21.37 | 42% below | 15% |
| Progesterone blood test CPT 84144 Progesterone Level | $67.15 | $79.00 | $20.23–$75.31 | 40% below | 15% |
| Progesterone blood test CPT 84144 Progesterone AMS | $67.15 | $79.00 | $20.23–$75.31 | 40% below | 15% |
| Prolactin blood test CPT 84146 Prolactin AMS | $105.74 | $124.40 | $18.80–$118.18 | 17% below | 15% |
| Prolactin blood test CPT 84146 Prolactin Level | $105.74 | $124.40 | $18.80–$118.18 | 17% below | 15% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $21.42 | $25.20 | $4.16–$23.94 | 35% below | 15% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 80305 Drug Screen Collection Only | $21.25 | $25.00 | $11.49–$29.56 | 61% below | 15% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 U Drug Scrn | $97.75 | $115.00 | $11.49–$109.25 | 80% above | 15% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 U Drug Scrn w QC | $97.75 | $115.00 | $11.49–$109.25 | 80% above | 15% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep A Screen | $73.02 | $85.90 | $14.05–$81.60 | 3% above | 15% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep A Screen with QC | $73.02 | $85.90 | $14.05–$81.60 | 3% above | 15% |
| Renin blood test CPT 84244 Plasma Renin Activity LCMSMS QST | $84.62 | $99.55 | $21.33–$94.57 | 34% below | 15% |
| Rh blood typing CPT 86901 Rhogam Workup GL | $33.79 | $39.75 | $2.90–$64.72 | 47% below | 15% |
| Rh blood typing CPT 86901 ARC RH 86901 | $33.79 | $39.75 | $2.90–$64.72 | 47% below | 15% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor AMS | $45.90 | $54.00 | $5.50–$51.30 | 7% below | 15% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor | $45.90 | $54.00 | $5.50–$51.30 | 7% below | 15% |
| Rubella antibody test (immunity check) CPT 86762 Rubella IgG AMS | $70.64 | $83.10 | $12.23–$78.94 | 18% above | 15% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate | $16.75 | $19.70 | $2.62–$18.71 | 49% below | 15% |
| Sodium blood test CPT 84295 Sodium Level | $23.12 | $27.20 | $4.20–$25.84 | 24% below | 15% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Rapid Occult Blood Diagnostic Stool | $31.88 | $37.50 | $13.53–$35.85 | 38% below | 15% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Blood Diagnostic IA | $31.88 | $37.50 | $13.53–$35.85 | 38% below | 15% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Blood Diagnostic x3 | $31.88 | $37.50 | $13.53–$35.85 | 38% below | 15% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 FTAAbs QST | $94.55 | $111.24 | $12.84–$105.67 | 32% above | 15% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Ab Screen w Reflex AMS | $26.35 | $31.00 | $4.14–$29.45 | 30% below | 15% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon TB Test AMS | $146.63 | $172.50 | $60.12–$163.87 | 21% below | 15% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Free and Total w SHBG Adult Male AMS | $134.39 | $158.10 | $25.04–$150.19 | 3% below | 15% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Level Total | $134.39 | $158.10 | $25.04–$150.19 | 3% below | 15% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total AMS | $134.39 | $158.10 | $25.04–$150.19 | 3% below | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Autoantibodies AMS | $55.97 | $65.85 | $14.11–$62.55 | 29% below | 15% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroperoxidase Ab TPO AMS | $141.99 | $167.05 | $14.11–$158.69 | 80% above | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $74.21 | $87.30 | $15.75–$82.93 | 18% below | 15% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w Reflex to Free T4 | $81.05 | $95.35 | $15.75–$90.58 | 10% below | 15% |
| Total cholesterol blood test CPT 82465 Cholesterol | $16.07 | $18.90 | $4.22–$17.95 | 57% below | 15% |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine T4 AMS | $21.51 | $25.30 | $6.66–$24.03 | 52% below | 15% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 Total AMS | $59.59 | $70.10 | $13.75–$66.59 | 25% below | 15% |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine | $59.59 | $70.10 | $13.75–$66.59 | 25% below | 15% |
| Transferrin blood test CPT 84466 Percent Saturation AMS | $70.89 | $83.40 | $12.38–$81.83 | 33% below | 15% |
| Transferrin blood test CPT 84466 Transferrin | $103.79 | $122.10 | $12.38–$115.99 | 1% below | 15% |
| Transferrin blood test CPT 84466 Transferrin AMS | $103.79 | $122.10 | $12.38–$115.99 | 1% below | 15% |
| Triglycerides blood test CPT 84478 Triglycerides | $19.98 | $23.50 | $5.57–$22.32 | 47% below | 15% |
| Troponin test, quantitative CPT 84484 TroponinI | $91.38 | $107.50 | $12.10–$102.12 | 23% below | 15% |
| Uric acid blood test CPT 84550 Uric Acid | $18.62 | $21.90 | $4.38–$20.80 | 50% below | 15% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis | $16.96 | $19.95 | $3.07–$18.95 | 49% below | 15% |
| Urinalysis with microscope exam, automated CPT 81001 81001 UA AUTOMATED W MICRO | $16.96 | $19.95 | $3.07–$18.95 | 49% below | 15% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Dipstick with ProteinCreatinine Ratio | $16.96 | $19.95 | $3.07–$18.95 | 49% below | 15% |
| Urinalysis without microscope exam, automated CPT 81003 81003 UA wo Micro POC Lab | $12.92 | $15.20 | $1.91–$14.44 | 41% below | 15% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis with Microscopic if indicated | $12.92 | $15.20 | $1.91–$14.44 | 41% below | 15% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick | $12.92 | $15.20 | $1.91–$14.44 | 41% below | 15% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC | $8.50 | $10.00 | $3.01–$10.88 | 55% below | 15% |
| Urinalysis without microscope exam, manual CPT 81002 UA Dipstick POC Glucose and Protein | $8.50 | $10.00 | $3.01–$10.88 | 55% below | 15% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture AMS | $38.34 | $45.10 | $7.83–$42.84 | 31% below | 15% |
| Urine culture for bacteria, with colony count CPT 87086 Tease mount | $38.34 | $45.10 | $7.83–$42.84 | 31% below | 15% |
| Urine microalbumin (albumin) test CPT 82043 Albumin Random Urine Microalbumin AMS | $106.08 | $124.80 | $5.25–$118.56 | 131% above | 15% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Level Urine | $106.08 | $124.80 | $5.25–$118.56 | 131% above | 15% |
| Urine microalbumin (albumin) test CPT 82043 Albumin Random Urine Microalbumin AM | $106.08 | $124.80 | $5.25–$118.56 | 131% above | 15% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Level 24 Hour Urine | $106.08 | $124.80 | $5.25–$118.56 | 131% above | 15% |
| Urine pregnancy test, read by color change CPT 81025 Rapid Pregnancy Test Urine | $36.13 | $42.50 | $7.43–$40.37 | 22% below | 15% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 and Folate AMS | $72.42 | $85.20 | $14.63–$80.94 | 21% below | 15% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $72.42 | $85.20 | $14.63–$80.94 | 21% below | 15% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 AMS | $72.42 | $85.20 | $14.63–$80.94 | 21% below | 15% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25Hydroxy AMS | $80.75 | $95.00 | $25.16–$229.35 | 67% below | 15% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 zzVit D25 OH | $199.88 | $235.15 | $25.16–$229.35 | 19% below | 15% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 125Dihydroxy AMS | $141.95 | $167.00 | $37.35–$158.65 | 6% below | 15% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BhCG Quant | $80.41 | $94.60 | $12.79–$89.87 | 18% below | 15% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Quantitative AMS | $80.41 | $94.60 | $12.79–$89.87 | 18% below | 15% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Cardioversion, elective (restoring heart rhythm) CPT 92960 ER 92960 CARDIOVERSION ELECTIVE | $560.15 | $659.00 | $164.75–$981.57 | 10% below | 15% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ER 25600 CLSD TX DSTL RADULN WO MAN | $297.50 | $350.00 | $87.50–$548.22 | 41% below | 15% |
| Colonoscopy with polyp removal CPT 45385 OR 45385 COLONOSCOPY WREM SNARE Charge | $1,921.00 | $2,260.00 | $420.88–$2,260.00 | 47% above | 15% |
| Colonoscopy with tissue sample CPT 45380 OR 45380 COLONOSCOPY WBIOPSY SINGLEMULT Charge | $1,623.50 | $1,910.00 | $335.10–$1,910.00 | 7% above | 15% |
| Colonoscopy, diagnostic CPT 45378 OR 45378 COLONOSCOPY DX WWO SPECIMEN | $1,258.00 | $1,480.00 | $307.30–$1,480.00 | 23% above | 15% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 ER 69209 REMOVE IMPACTED EAR WAX UNI | $692.75 | $815.00 | $9.18–$815.00 | 696% above | 15% |
| Earwax removal with instruments, one ear CPT 69210 CL 69210 REMOVAL IMPACTED CERUMEN | $22.10 | $26.00 | $6.50–$570.48 | 78% below | 15% |
| Earwax removal with instruments, one ear CPT 69210 ER 69210 REMOVE IMPACT EAR WAX W INSTRMT | $641.75 | $755.00 | $42.37–$755.00 | 542% above | 15% |
| Earwax removal with instruments, one ear one side CPT 69210 69210 Removal impacted cerumen requiring instrumentation unilateral | $560.15 | $659.00 | $42.37–$659.00 | 460% above | 15% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 TR 45330 SIGMOIDOSCOPY FLEXIBLE DIAG | $736.95 | $867.00 | $93.62–$1,367.57 | 16% below | 15% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 OR 46221 HEMORRHOIDECTOMY BY BANDING | $1,713.60 | $2,016.00 | $166.48–$2,016.00 | 96% above | 15% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ER 10060 ID ABSCESS SIMPLESINGLE | $259.25 | $305.00 | $76.25–$305.00 | 6% above | 15% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 OR 49505 REP INGUINAL HERNIA OVER 5YR | $6,187.15 | $7,279.00 | $410.79–$7,279.00 | 63% above | 15% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505 Repair initial inguinal hernia age 5 years or older | $6,187.15 | $7,279.00 | $410.79–$7,279.00 | 63% above | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis aspiration andor injection major joint or bursa without ultrasound guidance | $348.50 | $410.00 | $59.02–$442.79 | 12% above | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER 4504247 DRNINJ MAJOR JOINTBURSA WO US | $391.00 | $460.00 | $59.02–$460.00 | 25% above | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER 20610 DRNINJ MAJOR JOINTBURSA WO US | $391.00 | $460.00 | $59.02–$460.00 | 25% above | 15% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER 20610 DRNINJ MAJ JNTBURSA BIL WO US | $391.00 | $460.00 | $59.02–$460.00 | 25% above | 15% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ER 12031 INTRMD RPR SATE 25CM OR LESS | $535.50 | $630.00 | $154.58–$630.00 | 42% above | 15% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Repair intermediate wounds of scalp axillae trunk andor extremities excluding hands and f | $845.75 | $995.00 | $154.58–$995.00 | 125% above | 15% |
| Lower-back epidural injection, without imaging guidance CPT 62322 TR 62322 INJECT SPINE LUMBARSACRAL Charge | $693.30 | $815.65 | $80.07–$1,335.44 | 13% below | 15% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 OR 11400 EXCIS BENIGN LES TAL 05CM OR Charge | $638.35 | $751.00 | $93.61–$1,055.39 | 235% above | 15% |
| Nail removal (partial or complete), one nail CPT 11730 CL 11730 AVLSN NAIL PLATE SIMPLE 1 | $25.50 | $30.00 | $7.50–$298.05 | 83% below | 15% |
| Nail removal (partial or complete), one nail CPT 11730 ER 11730 AVULSN NAIL PLATE PARTCOM SIMP | $259.25 | $305.00 | $75.46–$305.00 | 75% above | 15% |
| Removal of a foreign object under the skin, simple CPT 10120 ER 10120 IR FRGN BODY SUBCU TISS SIMPLE | $1,275.00 | $1,500.00 | $113.80–$1,500.00 | 344% above | 15% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 OR G0121 SCREEN COLONOSCOPY NOT HIGH RISK | $978.35 | $1,151.00 | $152.39–$1,367.57 | 3% above | 15% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 OR G0105 SCREEN COLONOSCOPY HIGH RISK | $978.35 | $1,151.00 | $152.24–$1,367.57 | 4% below | 15% |
| Short arm cast (elbow to hand) CPT 29075 ER 29075 APPLICATION OF FOREARM CAST | $510.00 | $600.00 | $69.61–$600.00 | 123% above | 15% |
| Short arm splint (forearm and hand) CPT 29125 29125 Application of short arm splint static | $195.50 | $230.00 | $54.28–$241.79 | 10% above | 15% |
| Short arm splint (forearm and hand) CPT 29125 ER 29125 APPLY FOREARM SPLINT | $272.00 | $320.00 | $54.28–$320.00 | 54% above | 15% |
| Short leg splint (calf to foot) CPT 29515 ER 29515 APPLICATION LOWER LEG SPLINT | $272.00 | $320.00 | $55.08–$320.00 | 60% above | 15% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Simple repair of superficial wounds of scalp neck axillae external genitalia trunk andor | $318.75 | $375.00 | $60.15–$401.93 | 33% above | 15% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ER 12001 SIMPLE RPR STHF 25CM OR LESS | $454.75 | $535.00 | $60.15–$535.00 | 90% above | 15% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 TR 62270 SPINAL PUNCTURE DIAGNOSTIC Charge | $540.18 | $635.50 | $101.21–$1,038.78 | 2% below | 15% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 ER 62270 SPINAL PUNCTURE LUMBAR DIAG | $540.18 | $635.50 | $101.21–$1,038.78 | 2% below | 15% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Simple repair of superficial wounds of scalp neck axillae external genitalia trunk andor | $382.50 | $450.00 | $78.79–$480.41 | 37% above | 15% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ER 12002 SIMPLE RPR STHF 26CM75CM | $539.75 | $635.00 | $78.79–$635.00 | 94% above | 15% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple repair of superficial wounds of face ears eyelids nose lips andor mucous membranes | $344.25 | $405.00 | $73.97–$499.50 | 25% above | 15% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER 12011 SIMPLE RPR FACE 25CM OR LESS | $561.00 | $660.00 | $73.97–$660.00 | 103% above | 15% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 OR 43249 EGD ESOPH DILATE 30MM | $1,492.60 | $1,756.00 | $256.20–$2,845.49 | 17% below | 15% |
| Upper endoscopy (EGD) with biopsy CPT 43239 OR 43239 EGD BX SINGLEMULTI Charge | $1,092.25 | $1,285.00 | $230.96–$1,406.34 | 17% below | 15% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 OR 43251 EGD REMOVE LESION SNARE | $1,442.45 | $1,697.00 | $288.87–$2,845.49 | 5% below | 15% |
| Upper endoscopy (EGD), diagnostic CPT 43235 OR 43235 EGD DX BRUSH WASH | $865.30 | $1,018.00 | $204.55–$1,406.34 | 30% below | 15% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TR 36430 BLOOD ADMIN 04HRS PER DAY | $387.60 | $456.00 | $30.75–$655.77 | 35% below | 15% |
| Blood transfusion (giving blood or blood components) CPT 36430 TR 36430 BLOOD ADMIN 08HRS PER DAY | $479.40 | $564.00 | $30.75–$655.77 | 20% below | 15% |
| Blood transfusion (giving blood or blood components) CPT 36430 TR 36430 BLOOD ADMIN 012HRS PER DAY | $582.25 | $685.00 | $30.75–$685.00 | 3% below | 15% |
| Blood transfusion (giving blood or blood components) CPT 36430 TR 36430 BLOOD ADMIN 016 HRS PER DAY | $611.15 | $719.00 | $30.75–$719.00 | 2% above | 15% |
| Blood transfusion (giving blood or blood components) CPT 36430 ER 36430 BLOOD ADMIN 024HRS PER DAY | $612.00 | $720.00 | $30.75–$720.00 | 2% above | 15% |
| Blood transfusion (giving blood or blood components) CPT 36430 ER 36430 BLOOD ADMIN 04HRS PER DAY | $612.00 | $720.00 | $30.75–$720.00 | 2% above | 15% |
| Blood transfusion (giving blood or blood components) CPT 36430 ER 36430 BLOOD ADMIN 08HRS PER DAY | $612.00 | $720.00 | $30.75–$720.00 | 2% above | 15% |
| Blood transfusion (giving blood or blood components) CPT 36430 ER 36430 BLOOD ADMIN 012HRS PER DAY | $612.00 | $720.00 | $30.75–$720.00 | 2% above | 15% |
| Blood transfusion (giving blood or blood components) CPT 36430 ER 36430 BLOOD ADMIN 016HRS PER DAY | $612.00 | $720.00 | $30.75–$720.00 | 2% above | 15% |
| Blood transfusion (giving blood or blood components) CPT 36430 TR 36430 BLOOD ADMIN 024HRS PER DAY | $723.35 | $851.00 | $30.75–$851.00 | 21% above | 15% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZEDNOPRESS INHALATION TRMT | $142.59 | $167.75 | $9.87–$305.09 | 14% above | 15% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PressurizedNopress Inhalation TRMT | $142.59 | $167.75 | $9.87–$305.09 | 14% above | 15% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 TR 94640 INHALATION TRMT AEROSOLNEB Charge | $152.58 | $179.50 | $9.87–$305.09 | 22% above | 15% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 OBS INHALATION TRMT AEROSOLNEB Charge | $222.28 | $261.50 | $9.87–$305.09 | 77% above | 15% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 Critical care critically ill or critically injured pt first 3074 mins | $760.75 | $895.00 | $185.69–$1,263.92 | 18% below | 15% |
| Critical care, first 30 to 74 minutes CPT 99291 ER 99291 CRITICAL 3075 MIN Charge | $1,211.25 | $1,425.00 | $185.69–$1,425.00 | 30% above | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram Tracing Only | $60.10 | $70.70 | $10.15–$172.70 | 63% below | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Lab | $60.10 | $70.70 | $10.15–$172.70 | 63% below | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG OP Lab | $60.10 | $70.70 | $10.15–$172.70 | 63% below | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Radiology | $60.10 | $70.70 | $10.15–$172.70 | 63% below | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 Electrocardiogram routine ECG with at least 12 leads tracing only without interpretation an | $148.75 | $175.00 | $10.15–$175.00 | 9% below | 15% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG Completed By | $148.75 | $175.00 | $10.15–$175.00 | 9% below | 15% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL 1 99281 | $199.75 | $235.00 | $11.54–$235.00 | 11% above | 15% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEVEL 2 99282 | $314.50 | $370.00 | $38.45–$370.00 | 9% above | 15% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEVEL 3 99283 | $484.50 | $570.00 | $40.48–$570.00 | 5% above | 15% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEVEL 4 99284 | $824.50 | $970.00 | $98.48–$970.00 | 7% above | 15% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEVEL 5 99285 | $1,279.25 | $1,505.00 | $98.48–$1,505.00 | 2% above | 15% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST TRACE ONLY WO INT RPT | $276.25 | $325.00 | $50.39–$467.10 | 51% below | 15% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CR Cardiac Stress Test treadmill 93017 | $276.25 | $325.00 | $50.39–$467.10 | 51% below | 15% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Intravenous infusion hydration initial 31 minutes to 1 hour | $114.75 | $135.00 | $33.75–$316.04 | 56% below | 15% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 TR 96360 IV HYDRA INITIAL 3190 MIN Charge | $202.73 | $238.50 | $35.87–$316.04 | 22% below | 15% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OBS IV INFUS HYDRAT INIT 31 MIN1HR Charge | $213.35 | $251.00 | $35.87–$316.04 | 18% below | 15% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Hydration first hour | $272.00 | $320.00 | $35.87–$320.00 | 4% above | 15% |
| IV infusion of a medicine, first hour CPT 96365 TR IV INFUSION INITIAL NONCVRD Charge 1690 MIN | $214.20 | $252.00 | $47.52–$316.04 | 22% below | 15% |
| IV infusion of a medicine, first hour CPT 96365 OBS IV INFU THER INITIAL 1690 MIN Charge | $233.75 | $275.00 | $47.52–$316.04 | 15% below | 15% |
| IV infusion of a medicine, first hour CPT 96365 TR IV INF THERP 1ST HR REPEAT VISIT Charge 1690 MIN | $233.75 | $275.00 | $47.52–$316.04 | 15% below | 15% |
| IV infusion of a medicine, first hour CPT 96365 TR 96365 IV THER INITIAL 1690 MIN Charge | $233.75 | $275.00 | $47.52–$316.04 | 15% below | 15% |
| IV infusion of a medicine, first hour CPT 96365 96365 IV Therapy Initial 1690 MIN | $272.00 | $320.00 | $47.52–$320.00 | 1% below | 15% |
| IV push of a medicine, first drug CPT 96374 CL 96374 IV PUSH SINGLE OR INITIAL | $45.90 | $54.00 | $13.50–$316.04 | 81% below | 15% |
| IV push of a medicine, first drug CPT 96374 OBS IV PUSH SINGLE OR INITIAL Charge | $148.75 | $175.00 | $35.17–$316.04 | 37% below | 15% |
| IV push of a medicine, first drug CPT 96374 TR IV PUSH NONCVRD Charge | $148.75 | $175.00 | $35.17–$316.04 | 37% below | 15% |
| IV push of a medicine, first drug CPT 96374 TR 96374 IV PUSH SINGLE OR INITIAL | $148.75 | $175.00 | $35.17–$316.04 | 37% below | 15% |
| IV push of a medicine, first drug CPT 96374 96374 IV Injection singleinitial | $272.00 | $320.00 | $35.17–$320.00 | 15% above | 15% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 CL 96372 IM OR SQ INJECTION PER STICK | $24.48 | $28.80 | $7.20–$106.76 | 64% below | 15% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OBS IM OR SQ INJ WITH IV Charge | $78.20 | $92.00 | $14.30–$106.76 | 15% above | 15% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 TR 96372 IM OR SQ INJECTION PER STICK | $78.20 | $92.00 | $14.30–$106.76 | 15% above | 15% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OBS IM OR SQ INJECTION PER STICK Charge | $78.20 | $92.00 | $14.30–$106.76 | 15% above | 15% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 DNU96372 SubqIM Injection | $78.20 | $92.00 | $14.30–$106.76 | 15% above | 15% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER IM OR SQ INJECTION PER STICK 96372 | $78.20 | $92.00 | $14.30–$106.76 | 15% above | 15% |
| New patient office visit, about 30 minutes CPT 99203 99203 Level 3 Expanded 30min | $34.00 | $40.00 | $10.00–$106.05 | 78% below | 15% |
| New patient office visit, about 30 minutes CPT 99203 99203 Other Outpatient Visit Expanded 30min | $44.20 | $52.00 | $13.00–$106.05 | 71% below | 15% |
| New patient office visit, about 45 minutes CPT 99204 99204 Level 4 Comprehensive 45min | $45.90 | $54.00 | $13.50–$120.26 | 77% below | 15% |
| New patient office visit, about 45 minutes CPT 99204 99204 Other Outpatient Visit Comprehensive 45min | $51.00 | $60.00 | $15.00–$120.26 | 74% below | 15% |
| New patient office visit, about 60 minutes CPT 99205 99205 Level 5 Comprehensive 60min | $62.90 | $74.00 | $18.50–$177.10 | 78% below | 15% |
| New patient office visit, about 60 minutes CPT 99205 99205 Other Outpatient Visit Comprehensive 60min | $64.60 | $76.00 | $19.00–$177.10 | 77% below | 15% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Level 2 Limited 20min | $28.90 | $34.00 | $20.40–$71.05 | 75% below | 15% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Other Outpatient Visit Limited 20min | $42.50 | $50.00 | $30.00–$71.05 | 63% below | 15% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges 97110 | $58.65 | $69.00 | $17.25–$69.00 | 26% below | 15% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Level 5 Comprehensive 40min | $85.00 | $100.00 | $60.00–$279.55 | 61% below | 15% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Other Outpatient Visit Comprehensive 40min | $90.10 | $106.00 | $63.60–$279.55 | 59% below | 15% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Level 3 Expanded 15min | $45.90 | $54.00 | $32.40–$140.16 | 66% below | 15% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Other Outpatient Visit Expanded 15min | $51.00 | $60.00 | $36.00–$140.16 | 62% below | 15% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Level 4 Comprehensive 25min | $68.00 | $80.00 | $48.00–$198.00 | 61% below | 15% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Other Outpatient Visit Comprehensive 25min | $73.10 | $86.00 | $51.60–$198.00 | 58% below | 15% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Level 2 Limited 10min | $30.60 | $36.00 | $21.60–$89.65 | 71% below | 15% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Other Outpatient Visit Limited 10min | $42.50 | $50.00 | $30.00–$89.65 | 59% below | 15% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy | $115.08 | $135.39 | $33.84–$210.16 | 16% below | 15% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 49281042450 influenza virus vaccine inactivated PF trivalent Fluzone PF 2425 Susp 05 mL MR | $10.20 | $12.00 | $7.20–$24.76 | 70% below | 15% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 00006498100 hepatitis B pediatric vaccine Susp | $28.14 | $33.11 | $19.86–$38.77 | 44% below | 15% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160082052 hepatitis B pediatric vaccine 10 mcg05 mL Sus MRKS | $54.95 | $64.65 | $30.72–$61.41 | 9% above | 15% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160082011 hepatitis B pediatric vaccine Susp MRKS | $54.95 | $64.65 | $30.72–$61.41 | 9% above | 15% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 00006468100 measlesmumpsrubella virus live vaccine 05 mL MRKS | $115.46 | $135.83 | $70.92–$131.54 | 8% below | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 14362011103 tetanusdiphth toxoids Td adultadol 2 units2 units05 mL Sus MRKS | $10.20 | $12.00 | $7.20–$40.00 | 85% below | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 58160084211 tetanusdiphthpertuss Tdap adultadol 5 units25 units185 mcg05 mL SusMRKS | $41.61 | $48.95 | $23.72–$46.50 | 39% below | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281021515 tetanusdiphtheria toxoids adult IM Susp 05 mL Vial MRKS | $53.39 | $62.81 | $23.72–$59.66 | 21% below | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 13533013101 tetanusdiphth toxoids Td adultadol 2 units2 units05 mL Sus MRKS | $54.21 | $63.78 | $23.72–$60.59 | 20% below | 15% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 58160084252 tetanusdiphtheriapertussis acel Tdap Susp | $115.14 | $135.46 | $23.72–$128.68 | 69% above | 15% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281040015 tetanusdiphtheriapertussis acel Tdap Susp | $87.21 | $102.60 | $38.52–$97.47 | 6% above | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 CL 90471 IMMUNIZATION ADMIN ONE VACCINE | $8.84 | $10.40 | $2.60–$106.76 | 77% below | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TR ADMIN INFLUENZA VACCINE Charge | $56.53 | $66.50 | $8.48–$106.76 | 45% above | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TR 90471 ADMIN IMMUNIZATION ONE VACCINE | $56.53 | $66.50 | $8.48–$106.76 | 45% above | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 ER IMMUNIZATION ADMIN ONE VACCINE | $56.53 | $66.50 | $8.48–$106.76 | 45% above | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 G0008 Admin Influenza Admin Charge Influenza Vaccine | $56.53 | $66.50 | $8.48–$106.76 | 45% above | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER ADMIN INFLUENZA VACCINE | $56.53 | $66.50 | $8.48–$106.76 | 45% above | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Admin IMSQ Admin Charge Vaccine | $56.53 | $66.50 | $8.48–$106.76 | 45% above | 15% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER 90471 IMMUNIZATION ADMIN ONE VACCINE | $56.53 | $66.50 | $8.48–$106.76 | 45% above | 15% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Admin IM addl Admin Charge Vaccine | $22.10 | $26.00 | $6.50–$26.00 | 10% below | 15% |
Source file: https://mrfs.hyvehealthcare.com/GreatPlainsHealthAlliance/480663711_mercy-hospital-ks_standardcharges.csv