Hospital District #1 of Rice County
Hospital District #1 of Rice County in Lyons, KS publishes cash prices for 302 common procedures listed here, from its own machine-readable price file updated Aug 14, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Kansas median for 200 of 296 procedures and above it for 94. By typical cash price it ranks #18 of 55 Kansas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
619 S Clark Ave, Lyons, KS 67554 Collected Sep 27, 2026 Source price file (620) 257-5173
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 171330 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 SMC ANKLE COMPLETE MINI (3) L | $177.71 | $236.95 | $29.22–$225.10 | 19% below | 25% |
| Ankle X-ray, complete, 3 or more views CPT 73610 SMC ANKLE COMPLETE MIN (3) R | $177.71 | $236.95 | $29.22–$225.10 | 19% below | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI'S | $612.97 | $817.29 | $88.18–$776.42 | 2% above | 25% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS | $344.76 | $459.68 | $79.14–$436.69 | 24% below | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST for PE W/WO | $1,458.41 | $1,944.55 | $209.47–$1,847.32 | 17% below | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/WO | $1,458.41 | $1,944.55 | $209.47–$1,847.32 | 17% below | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST/ABD/PEL WO/W | $1,458.41 | $1,944.55 | $209.47–$1,847.32 | 17% below | 25% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PEL WO | $1,162.50 | $1,550.00 | $151.64–$1,472.50 | 10% below | 25% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL W | $1,237.50 | $1,650.00 | $252.18–$1,567.50 | 8% below | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PEL WO/W | $1,743.75 | $2,325.00 | $282.47–$2,208.75 | 6% below | 25% |
| CT scan of the abdomen with contrast CPT 74160 CT ABD/PEL W | $1,743.75 | $2,325.00 | $188.36–$2,208.75 | 25% above | 25% |
| CT scan of the abdomen with contrast CPT 74160 CT ABD W | $1,743.75 | $2,325.00 | $188.36–$2,208.75 | 25% above | 25% |
| CT scan of the abdomen without contrast CPT 74150 CT ABD WO | $1,237.50 | $1,650.00 | $113.14–$1,567.50 | 3% above | 25% |
| CT scan of the abdomen without contrast CPT 74150 CT ABD/PEL W/O (STONE PROTOCOL) | $1,743.75 | $2,325.00 | $113.14–$2,208.75 | 45% above | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL WO | $1,162.50 | $1,550.00 | $105.67–$1,472.50 | 18% above | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS WO | $1,237.50 | $1,650.00 | $105.67–$1,567.50 | 26% above | 25% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO | $1,162.50 | $1,550.00 | $87.64–$1,472.50 | 13% above | 25% |
| CT scan of the head with contrast CPT 70460 CT HEAD W | $1,237.50 | $1,650.00 | $122.12–$1,567.50 | 8% above | 25% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WO/W | $1,240.50 | $1,654.00 | $143.42–$1,571.30 | 1% below | 25% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR WO | $1,743.75 | $2,325.00 | $106.59–$2,208.75 | 53% above | 25% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL WO | $1,743.75 | $2,325.00 | $107.12–$2,208.75 | 76% above | 25% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W | $1,199.25 | $1,599.00 | $184.00–$1,519.05 | 5% above | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 SMC US CAROTID BI | $150.00 | $200.00 | $118.00–$480.76 | — | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID BI | $612.97 | $817.29 | $187.11–$776.42 | — | 25% |
| Chest X-ray, 2 views CPT 71046 CHEST 2V | $192.23 | $256.31 | $26.74–$243.49 | 17% below | 25% |
| Chest X-ray, 2 views CPT 71046 SMC CHEST - PA & LATERAL (2) VIEWS | $192.23 | $256.31 | $26.74–$243.49 | 17% below | 25% |
| Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM, CHEST;2 VIEWS | $192.23 | $256.31 | $26.74–$243.49 | 17% below | 25% |
| Chest X-ray, single view CPT 71045 CHEST 1V | $157.57 | $210.09 | $20.62–$199.58 | 19% below | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL COMPLETE | $326.25 | $435.00 | $86.83–$413.25 | 21% below | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE | $326.25 | $435.00 | $86.83–$413.25 | 21% below | 25% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA | $252.40 | $336.53 | $30.08–$319.70 | 19% below | 25% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA WRIST | $140.33 | $187.10 | $24.86–$177.74 | 7% below | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB G14 WKS COMPLETE | $385.25 | $513.66 | $166.86–$487.97 | 12% below | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 SMC US OB G14 WKS COMPLETE | $385.25 | $513.66 | $166.86–$487.97 | 12% below | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST/ABD/PEL WITHOUT CONTRAST | $1,181.25 | $1,575.00 | $109.96–$1,496.25 | 24% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT LOW DOSE LUNG CANCER FOLLOW UP W/O CO | $1,237.50 | $1,650.00 | $109.96–$1,567.50 | 30% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO | $1,237.50 | $1,650.00 | $109.96–$1,567.50 | 30% above | 25% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W | $1,162.50 | $1,550.00 | $137.50–$1,472.50 | 6% above | 25% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST/ABD/PEL WITH CONTRAST | $1,181.25 | $1,575.00 | $137.50–$1,496.25 | 8% above | 25% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MM BI DIAG CAD | $166.50 | $222.00 | $123.22–$210.90 | — | 25% |
| Diagnostic mammogram, one breast one side CPT 77065 MM DIAG UNI LT CAD | $166.50 | $222.00 | $99.82–$210.90 | 15% below | 25% |
| Diagnostic mammogram, one breast one side CPT 77065 MM DIAG UNI RT CAD | $166.50 | $222.00 | $99.82–$210.90 | 15% below | 25% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 SMC US LEG A BILATERAL | $251.25 | $335.00 | $197.65–$480.76 | — | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 SMC US LEG V BI | $168.75 | $225.00 | $132.75–$480.76 | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO M2D | $1,953.52 | $2,604.69 | $178.27–$2,474.45 | 3% above | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LTD | $317.25 | $423.00 | $70.23–$401.85 | 9% below | 25% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG CANCER SCREEN | $1,237.50 | $1,650.00 | $113.63–$1,567.50 | 93% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXT JT WO | $1,743.75 | $2,325.00 | $196.95–$2,208.75 | 70% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXT JT WO/W | $2,613.75 | $3,485.00 | $320.90–$3,310.75 | 56% above | 25% |
| MRI of the abdomen without contrast CPT 74181 MRI ABD WO | $1,743.75 | $2,325.00 | $162.89–$2,208.75 | 37% above | 25% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD WO/W | $2,613.75 | $3,485.00 | $281.32–$3,310.75 | 57% above | 25% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO | $1,743.75 | $2,325.00 | $191.08–$2,208.75 | 35% above | 25% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/W | $2,613.75 | $3,485.00 | $311.13–$3,310.75 | 53% above | 25% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR WO | $1,743.75 | $2,325.00 | $186.47–$2,208.75 | 42% above | 25% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR WO/W | $2,613.75 | $3,485.00 | $265.24–$3,310.75 | 47% above | 25% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC WO | $1,743.75 | $2,325.00 | $157.97–$2,208.75 | 55% above | 25% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL WO/W | $2,613.75 | $3,485.00 | $265.77–$3,310.75 | 54% above | 25% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL WO | $1,743.75 | $2,325.00 | $185.85–$2,208.75 | 53% above | 25% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/W | $2,613.75 | $3,485.00 | $280.28–$3,310.75 | 56% above | 25% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO | $1,743.75 | $2,325.00 | $223.59–$2,208.75 | 55% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UP EXT JT WO | $1,743.75 | $2,325.00 | $197.26–$2,208.75 | 67% above | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC F/U | $169.49 | $225.98 | $39.13–$214.68 | 50% below | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMP | $326.25 | $435.00 | $84.34–$413.25 | 6% below | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 SMC US OB -2ND/3RD TRIM. | $169.49 | $225.98 | $127.69–$214.68 | 55% below | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB G14 WKS | $326.25 | $435.00 | $127.69–$413.25 | 14% below | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB L14 WKS | $326.25 | $435.00 | $111.23–$413.25 | 7% below | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LTD | $326.25 | $435.00 | $76.66–$413.25 | 3% above | 25% |
| Screening mammogram, both breasts CPT 77067 MM SCREEN W CAD 2V | $205.28 | $273.70 | $102.03–$260.01 | 5% above | 25% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SMC SHOULDER COMPLETE R | $178.90 | $238.53 | $27.42–$226.60 | 16% below | 25% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SMC SHOULDER COMPLETE L | $178.90 | $238.53 | $27.42–$226.60 | 16% below | 25% |
| Transvaginal pelvic ultrasound CPT 76830 US PELVIC TV | $261.00 | $348.00 | $95.57–$330.60 | 18% below | 25% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB TV | $391.50 | $522.00 | $74.31–$495.90 | 9% above | 25% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD COMP | $326.25 | $435.00 | $93.28–$413.25 | 24% below | 25% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM | $169.49 | $225.98 | $80.55–$214.68 | 56% below | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID | $612.97 | $817.29 | $88.43–$776.42 | 2% above | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US ST HEAD/NECK | $612.97 | $817.29 | $88.43–$776.42 | 2% above | 25% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI | $543.79 | $725.05 | $99.26–$688.79 | at median | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 SMC US LEG V LT | $108.75 | $145.00 | $85.55–$480.76 | 83% below | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 SMC US LEG V RT | $108.75 | $145.00 | $85.55–$480.76 | 83% below | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LT 2-3 VIEWS | $220.90 | $294.53 | $37.19–$279.80 | 14% below | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RT 2-3 VIEWS | $220.90 | $294.53 | $37.19–$279.80 | 14% below | 25% |
| X-ray of the abdomen, 1 view CPT 74018 ABD 1V | $171.78 | $229.04 | $23.76–$217.58 | 18% below | 25% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS RT 2V MIN | $140.33 | $187.10 | $29.89–$177.74 | 16% below | 25% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS LT 2V MIN | $140.33 | $187.10 | $29.89–$177.74 | 16% below | 25% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1OR2 VIEWS | $140.33 | $187.10 | $27.11–$177.74 | 26% below | 25% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LT 1/2V | $140.33 | $187.10 | $27.11–$177.74 | 26% below | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR 2/3 V | $222.73 | $296.97 | $31.71–$282.12 | 19% below | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR 4+ V | $316.33 | $421.77 | $40.70–$400.68 | 21% below | 25% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC 2V | $170.60 | $227.46 | $26.16–$216.08 | 23% below | 25% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES 3V MIN | $188.37 | $251.16 | $30.27–$238.60 | 19% below | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL 2/3 V | $224.25 | $299.00 | $31.44–$284.05 | 10% below | 25% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1/2 VIEW | $169.49 | $225.98 | $22.17–$214.68 | 18% below | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COX 2V MIN | $182.45 | $243.27 | $25.82–$231.10 | 19% below | 25% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 EMP-ALT | $14.48 | $19.31 | $5.30–$18.34 | 61% below | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALTI-(SGPT) | $44.89 | $59.85 | $5.30–$56.85 | 20% above | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 LC ALT | $51.80 | $69.07 | $5.30–$65.61 | 39% above | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST-(SGOT) | $17.33 | $23.10 | $5.18–$21.94 | 54% below | 25% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL* | $186.09 | $248.12 | $40.49–$235.71 | 10% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT TREE IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M RACEMOSUS IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 $NUT ALLERGY PANEL | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STEMPHYLIUM BOTRYOSUM | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENCILLIUM NOTATUM IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PHOMA BETAE IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 $BUFFERED LATEX FORWARD | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 $LATEX FORWARD | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ROUGH PIGWEED IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 H HALODES IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM MONILIFORME IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E PURPURASCENS IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN POLLEN IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA TENUIS IgE | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 $AMMONIATED LATEX FORWARD | $20.92 | $27.89 | $5.22–$26.49 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NUT PANEL | $20.95 | $27.93 | $5.22–$26.53 | 32% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT COMPONET IGE | $22.50 | $30.00 | $5.22–$28.50 | 27% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST PANEL SCREEN | $25.20 | $33.60 | $5.22–$31.92 | 18% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP WOOL IgE | $35.44 | $47.25 | $5.22–$44.88 | 15% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE MULBERRY IgE | $35.44 | $47.25 | $5.22–$44.88 | 15% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH IgE | $37.80 | $50.40 | $5.22–$47.88 | 22% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEAR FOOD ALLERGY | $41.25 | $55.00 | $5.22–$52.25 | 34% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BANANA FOOD ALLERGY | $41.25 | $55.00 | $5.22–$52.25 | 34% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT | $41.25 | $55.00 | $5.22–$52.25 | 34% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MILK IGE | $41.25 | $55.00 | $5.22–$52.25 | 34% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F014-IFE SOYBEAN | $41.25 | $55.00 | $5.22–$52.25 | 34% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUE GRASS IgE (JUNE) | $43.31 | $57.75 | $5.22–$54.86 | 40% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN CEDAR IgE | $43.31 | $57.75 | $5.22–$54.86 | 40% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE IgE | $43.31 | $57.75 | $5.22–$54.86 | 40% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M001-IGE CANDIDA ALBICANS | $43.31 | $57.75 | $5.22–$54.86 | 40% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MEADOW FESCUE IgE | $43.31 | $57.75 | $5.22–$54.86 | 40% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP IgE | $43.31 | $57.75 | $5.22–$54.86 | 40% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT FOOD IgE | $45.29 | $60.38 | $5.22–$57.36 | 47% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BROME GRASS IgE | $45.29 | $60.38 | $5.22–$57.36 | 47% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 A PULLULANS IgE | $45.68 | $60.90 | $5.22–$57.85 | 48% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG ALLERGY PANEL | $48.44 | $64.58 | $5.22–$61.35 | 57% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 C074-IGE GELATIN | $48.55 | $64.73 | $5.22–$61.49 | 57% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE SERUM IgE | $48.83 | $65.10 | $5.22–$61.84 | 58% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LATEX | $62.75 | $83.67 | $5.22–$79.48 | 103% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, FOOD | $86.03 | $114.71 | $5.22–$108.97 | 179% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ISLET CELL CYTOPLASMIC IgG | $104.74 | $139.65 | $5.22–$132.66 | 239% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 $NUT PANEL | $104.74 | $139.65 | $5.22–$132.66 | 239% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F340-IFE CARMINE RED DYE | $106.88 | $142.50 | $5.22–$135.37 | 246% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA-GAL PANEL | $108.68 | $144.90 | $5.22–$137.65 | 252% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE, MOLD | $170.10 | $226.80 | $5.22–$215.46 | 451% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, NONSEASONAL INHALANT PANEL | $180.34 | $240.45 | $5.22–$228.42 | 484% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS (18) | $206.33 | $275.10 | $5.22–$261.34 | 568% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 REGIONAL PANEL 9 | $483.75 | $645.00 | $5.22–$612.75 | 1467% above | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 $CONNECTIVE TISSUE CCP | $39.00 | $52.00 | $12.95–$49.40 | 64% below | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP AB, IGG/IGA | $92.14 | $122.85 | $12.95–$116.70 | 15% below | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA RFX TITER/PATTERN | $56.48 | $75.31 | $12.09–$71.54 | 19% below | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 $CONNECTIVE TISSUE ANA | $56.48 | $75.31 | $12.09–$71.54 | 19% below | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB BY MULTIPLEX (ANA SCREEN) | $59.75 | $79.66 | $12.09–$75.67 | 15% below | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP(TRIAGE) | $98.24 | $130.98 | $33.37–$124.43 | 24% below | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 LC BNP | $98.24 | $130.98 | $33.37–$124.43 | 24% below | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP (PRO) SENDOFF | $122.85 | $163.80 | $33.37–$155.61 | 4% below | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PRO BNP | $133.88 | $178.50 | $33.37–$169.57 | 4% above | 25% |
| Basic metabolic panel (blood test) CPT 80048 LC BMP | $63.00 | $84.00 | $8.46–$79.80 | 23% below | 25% |
| Basic metabolic panel (blood test) CPT 80048 BASIC PROF SEND OFF | $63.00 | $84.00 | $8.46–$79.80 | 23% below | 25% |
| Basic metabolic panel (blood test) CPT 80048 BASIC PROFILE* | $63.00 | $84.00 | $8.46–$79.80 | 23% below | 25% |
| Basic metabolic panel (blood test) CPT 80048 HUTCH-BMP | $97.65 | $130.20 | $8.46–$123.69 | 20% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH SURG LEVEL IV | $263.80 | $351.73 | $65.47–$334.14 | 20% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 BM CELL BLOCK | $263.80 | $351.73 | $65.47–$334.14 | 20% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 BM SPEC | $263.80 | $351.73 | $65.47–$334.14 | 20% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 T-CELL BLOCK | $263.80 | $351.73 | $65.47–$334.14 | 20% above | 25% |
| Blood culture for bacteria CPT 87040 HUTCH-BLOOD CULTURE | $48.98 | $65.30 | $9.45–$62.03 | 35% below | 25% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE(SECOND SET) | $51.80 | $69.07 | $9.45–$65.61 | 31% below | 25% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE(SET ONE) | $51.80 | $69.07 | $9.45–$65.61 | 31% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 CLINIC : VENIPUNCTURE | $11.25 | $15.00 | $3.75–$14.25 | 38% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 OP : VENIPUNCTURE | $11.25 | $15.00 | $3.75–$14.25 | 38% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 SMC VENIPUNCTURE | $15.37 | $20.49 | $5.12–$19.46 | 16% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 LMC VENIPUNCTURE | $15.37 | $20.49 | $5.12–$19.46 | 16% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $15.37 | $20.49 | $5.12–$19.46 | 16% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD ALCOHOL DRAW : HIWAY/POLICE | $26.25 | $35.00 | $8.75–$33.25 | 44% above | 25% |
| Blood glucose (sugar) test CPT 82947 EMPLOYEE GLUCOSE | $11.66 | $15.54 | $3.93–$14.76 | 64% below | 25% |
| Blood glucose (sugar) test CPT 82947 POC GLUCOSE | $16.50 | $22.00 | $3.93–$20.90 | 49% below | 25% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $17.33 | $23.10 | $3.93–$21.94 | 47% below | 25% |
| Blood lead test CPT 83655 LEAD, BLOOD (ADULT) | $47.25 | $63.00 | $11.70–$59.85 | 9% below | 25% |
| Blood lead test CPT 83655 LEAD RANDOM URINE | $63.00 | $84.00 | $11.70–$79.80 | 21% above | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 SMC SERUM (PREGNANCY TEST) | $16.50 | $22.00 | $7.52–$34.32 | 71% below | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 SMC SHCG | $43.76 | $58.34 | $7.52–$55.42 | 24% below | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 SERUM (PREGNANCY TEST) | $61.28 | $81.71 | $7.52–$77.62 | 7% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HUTCH-CORD ABO | $284.21 | $378.95 | $2.99–$360.00 | 224% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 LC-ABO TYPE AND RH | $284.21 | $378.95 | $2.99–$360.00 | 224% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ARC ABO | $284.21 | $378.95 | $2.99–$360.00 | 224% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB TYPE | $284.21 | $378.95 | $2.99–$360.00 | 224% above | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 LC CRP | $43.31 | $57.75 | $5.18–$54.86 | 10% below | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $43.31 | $57.75 | $5.18–$54.86 | 10% below | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HUTCH-CRP | $48.04 | $64.05 | $5.18–$60.84 | at median | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE TOXIN GENE NAA | $96.03 | $128.04 | $34.26–$121.63 | 11% below | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE TOXINS A+B, EIA | $101.57 | $135.43 | $34.26–$128.65 | 6% below | 25% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $73.52 | $98.02 | $20.81–$93.11 | 14% below | 25% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN (CA) 125 | $77.30 | $103.06 | $20.81–$97.90 | 16% below | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 QUEST | $145.58 | $194.11 | $43.61–$184.40 | 7% above | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 | $153.98 | $205.31 | $43.61–$195.04 | 13% above | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 LC COVID19 | $153.98 | $205.31 | $43.61–$195.04 | 13% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 $ CHLAMYDIA | $101.57 | $135.43 | $35.09–$128.65 | 10% below | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 $CHLAMYDIA TRACHOMATIS PROBE | $101.57 | $135.43 | $35.09–$128.65 | 10% below | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA PROBE $ONLY | $101.57 | $135.43 | $35.09–$128.65 | 10% below | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GONORRHOEAE/TRICHOMONAS | $123.57 | $164.76 | $35.09–$156.52 | 9% above | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 EMPLOYEE LIPID | $58.23 | $77.64 | $13.39–$73.75 | 33% below | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LC LIPID | $58.23 | $77.64 | $13.39–$73.75 | 33% below | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE* | $58.28 | $77.70 | $13.39–$73.81 | 33% below | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL W/APOB GLYC DRI | $141.41 | $188.55 | $13.39–$179.12 | 63% above | 25% |
| Complete blood count (CBC) with differential CPT 85025 SMC CBC | $17.03 | $22.71 | $6.60–$21.57 | 58% below | 25% |
| Complete blood count (CBC) with differential CPT 85025 EMP CBC | $25.20 | $33.60 | $6.60–$31.92 | 38% below | 25% |
| Complete blood count (CBC) with differential CPT 85025 $OBP CBC | $37.01 | $49.35 | $6.60–$46.88 | 9% below | 25% |
| Complete blood count (CBC) with differential CPT 85025 $CBC W/O MANUAL DIFF | $69.30 | $92.40 | $6.60–$87.78 | 70% above | 25% |
| Complete blood count (CBC) with differential CPT 85025 $CBC W/MORPHOLOGY | $69.30 | $92.40 | $6.60–$87.78 | 70% above | 25% |
| Complete blood count (CBC), no differential CPT 85027 CBC W/DIFFERENTIAL TO AMS | $37.01 | $49.35 | $6.47–$46.88 | 21% below | 25% |
| Complete blood count (CBC), no differential CPT 85027 $HEMOGRAM | $53.55 | $71.40 | $6.47–$67.83 | 15% above | 25% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $53.55 | $71.40 | $6.47–$67.83 | 15% above | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 LC CMP | $40.95 | $54.60 | $10.56–$51.87 | 61% below | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP PROF SENDOFF | $80.33 | $107.10 | $10.56–$101.74 | 23% below | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE PROFILE* | $88.20 | $117.60 | $10.56–$111.72 | 16% below | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 PROLIA-COMPREHENSIVE PROFILE | $88.20 | $117.60 | $10.56–$111.72 | 16% below | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 HUTCH-CMP | $185.85 | $247.80 | $10.56–$235.41 | 78% above | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 D DIMER(TRIAGE) | $99.29 | $132.38 | $10.18–$125.76 | 14% below | 25% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE | $138.48 | $184.64 | $22.23–$175.40 | 8% above | 25% |
| Estradiol blood test CPT 82670 ESTRADIOL, SENSITIVE | $168.83 | $225.11 | $27.94–$213.85 | at median | 25% |
| Estradiol blood test CPT 82670 ESTRADIOL | $168.83 | $225.11 | $27.94–$213.85 | at median | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $96.14 | $128.19 | $18.58–$121.78 | 16% below | 25% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL | $194.51 | $259.35 | $19.63–$246.38 | 11% below | 25% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $71.78 | $95.71 | $13.63–$90.92 | 19% below | 25% |
| Ferritin blood test (iron stores) CPT 82728 LC FERRITIN | $71.78 | $95.71 | $13.63–$90.92 | 19% below | 25% |
| Folate (folic acid) blood test CPT 82746 FOLATE | $83.36 | $111.14 | $14.70–$105.58 | 15% below | 25% |
| Folate (folic acid) blood test CPT 82746 LC FOLATE | $83.36 | $111.14 | $14.70–$105.58 | 15% below | 25% |
| Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE (T3), FREE | $113.62 | $151.49 | $16.94–$143.91 | 11% below | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $68.51 | $91.35 | $9.02–$86.78 | 12% above | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 LC FT4 | $68.51 | $91.35 | $9.02–$86.78 | 12% above | 25% |
| Free testosterone test CPT 84402 $TESTOSTERONE FREE | $173.78 | $231.71 | $25.47–$220.12 | 22% above | 25% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PROFILE | $149.24 | $198.98 | $49.74–$189.03 | 10% below | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT 1 HOUR NON PREGNANT | $73.24 | $97.65 | $4.75–$92.76 | 52% above | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUC 1 HR PP(GLUCOLA) PREG | $73.24 | $97.65 | $4.75–$92.76 | 52% above | 25% |
| Glucose tolerance test, 3 samples CPT 82951 GLUC TOL 4 HOUR | $65.70 | $87.60 | $12.87–$83.22 | 29% below | 25% |
| Glucose tolerance test, 3 samples CPT 82951 GTT FASTING GLUCOSE | $65.70 | $87.60 | $12.87–$83.22 | 29% below | 25% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 3 HOUR | $73.24 | $97.65 | $12.87–$92.76 | 20% below | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 $ GC | $101.57 | $135.43 | $35.09–$128.65 | at median | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 $GONOREHA PROBE$ONLY | $101.57 | $135.43 | $35.09–$128.65 | at median | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 $GONORRHOEAE AMPLIFIED DNA | $101.57 | $135.43 | $35.09–$128.65 | at median | 25% |
| H. pylori antibody blood test CPT 86677 H PYLORI AB (IGG) | $53.61 | $71.48 | $14.32–$67.90 | 11% below | 25% |
| H. pylori antibody blood test CPT 86677 H PYLORI AB (IgM) | $53.61 | $71.48 | $14.32–$67.90 | 11% below | 25% |
| H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY | $76.76 | $102.35 | $14.32–$97.23 | 27% above | 25% |
| H. pylori antibody blood test CPT 86677 HPYLORI ANTIBODY | $80.60 | $107.47 | $14.32–$102.09 | 34% above | 25% |
| H. pylori stool antigen test CPT 87338 H. PYLORI STOOL AG, EIA | $68.51 | $91.35 | $14.38–$86.78 | 40% below | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1, QUANT, REAL-TIME PCR | $232.80 | $310.40 | $85.10–$294.88 | 32% below | 25% |
| HIV-1 and HIV-2 antibody test CPT 86703 HTLV 1&HTLV 2 | $59.46 | $79.28 | $11.65–$75.31 | 25% below | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 EMP-HIV 1&2 | $76.52 | $102.03 | $24.08–$96.92 | 17% below | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV AB/P24 AG W/REFLEX | $80.94 | $107.92 | $24.08–$102.52 | 12% below | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCATED HGB | $69.30 | $92.40 | $9.71–$87.78 | at median | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 LC A1C | $69.30 | $92.40 | $9.71–$87.78 | at median | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 EMP-HEP B SAB | $59.11 | $78.81 | $10.74–$74.86 | 19% below | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB, QUAL | $62.52 | $83.36 | $10.74–$79.19 | 14% below | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 $HEPB SAb | $62.52 | $83.36 | $10.74–$79.19 | 14% below | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 $HBsAG | $31.39 | $41.85 | $10.33–$39.75 | 47% below | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 EMP-HEP B SAG | $31.39 | $41.85 | $10.33–$39.75 | 47% below | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 $OBP HEPBSAG | $35.44 | $47.25 | $10.33–$44.88 | 40% below | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG (HBsAg) SCRN, QL | $35.44 | $47.25 | $10.33–$44.88 | 40% below | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 $HEPC Ab | $57.49 | $76.65 | $14.27–$72.81 | 24% below | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 EMP-HEP C AB | $57.49 | $76.65 | $14.27–$72.81 | 24% below | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV AB | $60.81 | $81.08 | $14.27–$77.02 | 20% below | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV ANTIBODY | $60.81 | $81.08 | $14.27–$77.02 | 20% below | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA CONFIRMATION,REVERSE TRA | $123.95 | $165.27 | $36.41–$157.00 | 59% below | 25% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, QUANT(NON-GRAPH) | $189.40 | $252.53 | $36.41–$239.90 | 38% below | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 $HSV TYPE 1 IGM IFA | $85.67 | $114.23 | $11.21–$108.51 | 9% below | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 $HSV TYPE 2 IGM IFA | $90.42 | $120.56 | $19.35–$114.53 | 3% above | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 ULTRA CRP | $82.63 | $110.17 | $11.01–$104.66 | 9% below | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-HS (CARDIAC) | $91.35 | $121.80 | $11.01–$115.71 | 1% above | 25% |
| Homocysteine blood test CPT 83090 HOMOCYST(E)INE | $238.13 | $317.51 | $17.92–$301.63 | 3% above | 25% |
| Insulin blood test CPT 83525 INSULIN 3 HR | $68.40 | $91.20 | $11.43–$86.64 | 15% below | 25% |
| Insulin blood test CPT 83525 INSULIN 2 HR | $68.40 | $91.20 | $11.43–$86.64 | 15% below | 25% |
| Insulin blood test CPT 83525 INSULIN; FREE 3 HR | $68.40 | $91.20 | $11.43–$86.64 | 15% below | 25% |
| Insulin blood test CPT 83525 INSULIN | $68.40 | $91.20 | $11.43–$86.64 | 15% below | 25% |
| Iron blood test (serum iron) CPT 83540 LC IRON/TIBC | $32.66 | $43.55 | $5.50–$41.37 | 24% below | 25% |
| Iron blood test (serum iron) CPT 83540 IRON | $34.55 | $46.07 | $5.50–$43.76 | 19% below | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC | $55.61 | $74.14 | $8.74–$70.43 | 12% below | 25% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL* | $64.58 | $86.10 | $8.68–$81.79 | 9% below | 25% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH) | $93.81 | $125.08 | $18.52–$118.82 | 15% below | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 LC LIPASE | $37.46 | $49.95 | $6.89–$47.45 | 40% below | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $37.46 | $49.95 | $6.89–$47.45 | 40% below | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 HUTCH-LIPASE | $111.04 | $148.05 | $6.89–$140.64 | 78% above | 25% |
| Liver function blood test panel CPT 80076 HEPATIC PANEL* | $66.94 | $89.25 | $8.17–$84.78 | 28% below | 25% |
| Lyme disease antibody test CPT 86618 LYME DISEASE SEROLOGY W/REFLEX | $103.41 | $137.88 | $14.48–$130.98 | 15% below | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM RANDOM URINE | $34.86 | $46.48 | $6.70–$44.15 | 35% below | 25% |
| Magnesium blood test CPT 83735 LC MAG | $34.86 | $46.48 | $6.70–$44.15 | 35% below | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM | $34.86 | $46.48 | $6.70–$44.15 | 35% below | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM TIMED URINE | $34.86 | $46.48 | $6.70–$44.15 | 35% below | 25% |
| Magnesium blood test CPT 83735 HUTCH-MAGNESIUM | $97.65 | $130.20 | $6.70–$123.69 | 81% above | 25% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG | $92.07 | $122.76 | $10.95–$116.62 | 2% below | 25% |
| Measles (rubeola) antibody test CPT 86765 MEASLES Igg | $92.07 | $122.76 | $10.95–$116.62 | 2% below | 25% |
| Measles (rubeola) antibody test CPT 86765 MEASLES IGM | $92.07 | $122.76 | $10.95–$116.62 | 2% below | 25% |
| Measles (rubeola) antibody test CPT 86765 $RUBEOLA | $92.07 | $122.76 | $10.95–$116.62 | 2% below | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 LMC MONO | $7.50 | $10.00 | $5.18–$19.50 | 84% below | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 SMC MONO | $7.50 | $10.00 | $5.18–$19.50 | 84% below | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN | $24.86 | $33.15 | $5.18–$31.49 | 46% below | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 SMC HETEROPHILE | $24.86 | $33.15 | $5.18–$31.49 | 46% below | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 LMC HETEROPHILE | $24.86 | $33.15 | $5.18–$31.49 | 46% below | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 AMS HETEROPHILE ANTIBODIES | $25.20 | $33.60 | $5.18–$31.92 | 45% below | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SENDOFF | $26.30 | $35.06 | $5.18–$33.30 | 43% below | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA TOTAL+%FREE | $79.54 | $106.05 | $18.39–$100.74 | 14% below | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA MONITERING | $91.64 | $122.18 | $18.39–$116.07 | 12% below | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 LC PSA | $91.64 | $122.18 | $18.39–$116.07 | 12% below | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $91.64 | $122.18 | $18.39–$116.07 | 12% below | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRASENSITIVE W/O SERIAL | $152.78 | $203.70 | $18.39–$193.51 | 47% above | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 LIQUID THIN PREP | $87.35 | $116.46 | $17.85–$110.63 | 13% below | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP COLLECTION | $87.35 | $116.46 | $17.85–$110.63 | 13% below | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 $PARATHYROID/WCA | $209.05 | $278.73 | $35.09–$264.79 | 4% above | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $209.05 | $278.73 | $35.09–$264.79 | 4% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 $THROMBOSIS PANEL | $28.73 | $38.30 | $5.25–$36.38 | 35% below | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LC PTT | $30.38 | $40.51 | $5.25–$38.48 | 31% below | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $30.38 | $40.51 | $5.25–$38.48 | 31% below | 25% |
| Progesterone blood test CPT 84144 PROGESTERONE | $96.72 | $128.96 | $20.86–$122.51 | 12% below | 25% |
| Prolactin blood test CPT 84146 PROLACTIN | $107.09 | $142.79 | $19.38–$135.65 | 17% below | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 $THROMBOSIS PANEL | $20.51 | $27.34 | $4.29–$25.97 | 34% below | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LC PROTIME | $40.50 | $54.00 | $4.29–$51.30 | 31% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 RCH-PROTIME/INR | $42.53 | $56.70 | $4.29–$53.86 | 38% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME | $42.53 | $56.70 | $4.29–$53.86 | 38% above | 25% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 SMC MEDICAL UDS | $48.75 | $65.00 | $11.49–$61.75 | 12% below | 25% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 LMC MEDICAL UDS | $48.75 | $65.00 | $11.49–$61.75 | 12% below | 25% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN IN HOUSE URINE | $82.49 | $109.99 | $11.49–$104.49 | 49% above | 25% |
| Rapid flu test (influenza antigen) CPT 87804 $INFLUENZA B(SWAB)AG | $73.96 | $98.61 | $14.89–$93.67 | 9% above | 25% |
| Rapid flu test (influenza antigen) CPT 87804 $INFLU A(SWAB)AG | $73.96 | $98.61 | $14.89–$93.67 | 9% above | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 LMC RAPID STREP A | $69.92 | $93.23 | $14.05–$88.56 | 1% above | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 SMC RAPID STREP A | $69.92 | $93.23 | $14.05–$88.56 | 1% above | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN RAPID THROAT | $73.96 | $98.61 | $14.05–$93.67 | 7% above | 25% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR (RF) | $33.08 | $44.10 | $5.67–$41.89 | 31% below | 25% |
| Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUANTITATIVE | $33.08 | $44.10 | $5.67–$41.89 | 31% below | 25% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODIES, IGG | $41.67 | $55.56 | $12.23–$52.78 | 28% below | 25% |
| Rubella antibody test (immunity check) CPT 86762 $OBP RUBEAB | $41.67 | $55.56 | $12.23–$52.78 | 28% below | 25% |
| Rubella antibody test (immunity check) CPT 86762 $RUBELLA AB | $41.67 | $55.56 | $12.23–$52.78 | 28% below | 25% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG TITER | $41.67 | $55.56 | $12.23–$52.78 | 28% below | 25% |
| Rubella antibody test (immunity check) CPT 86762 EMP-MMRV TITER | $63.01 | $84.01 | $12.23–$79.80 | 9% above | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR | $54.34 | $72.45 | $2.70–$68.82 | 68% above | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 LC ESR | $56.70 | $75.60 | $2.70–$71.82 | 76% above | 25% |
| Stool ova and parasites exam CPT 87177 OVA + PARASITE EXAM | $50.40 | $67.20 | $8.40–$63.84 | 17% below | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 LMC OCCULT BLOOD | $18.00 | $24.00 | $3.82–$22.80 | 33% below | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 SMC OCCULT BLOOD | $18.00 | $24.00 | $3.82–$22.80 | 33% below | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 LMC OCCULT STOOL | $43.53 | $58.04 | $13.53–$55.13 | 15% below | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 SMC OCCULT BLOOD | $43.53 | $58.04 | $13.53–$55.13 | 15% below | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 *OCCULT BLOOD SCREENING | $46.04 | $61.39 | $13.53–$58.32 | 10% below | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD | $46.04 | $61.39 | $13.53–$58.32 | 10% below | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 $OBP RPR/VDRL | $21.93 | $29.24 | $4.27–$27.77 | 39% below | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $71.63 | $95.50 | $4.27–$90.72 | 100% above | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 EMP-QUANTIFERON TB TEST | $169.58 | $226.10 | $61.98–$214.79 | 10% below | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS | $179.36 | $239.15 | $61.98–$227.19 | 5% below | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TOTAL TESTOSTERONE & BIOAVAILABLE | $141.41 | $188.55 | $25.81–$179.12 | 1% below | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE | $141.41 | $188.55 | $25.81–$179.12 | 1% below | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL WOMEN, CHILDREN, HYPO | $248.06 | $330.75 | $25.81–$314.21 | 73% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE FREE, DIRECT W/TOTAL | $270.11 | $360.15 | $25.81–$342.14 | 88% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOME AB | $68.72 | $91.63 | $14.55–$87.04 | 12% below | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE(TPO) AB | $68.72 | $91.63 | $14.55–$87.04 | 12% below | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 $MICROSOMAL AB | $68.72 | $91.63 | $14.55–$87.04 | 12% below | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID ANTIBODIES | $74.81 | $99.75 | $14.55–$94.76 | 4% below | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $59.30 | $79.06 | $15.75–$75.10 | 34% below | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W/REFLEX TO FT4 | $59.30 | $79.06 | $15.75–$75.10 | 34% below | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 LC TSH | $59.30 | $79.06 | $15.75–$75.10 | 34% below | 25% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS BY PCR | $121.76 | $162.35 | $35.09–$154.23 | 12% below | 25% |
| Uric acid blood test CPT 84550 S. PNEUMONIAC URINE AG | $21.07 | $28.09 | $4.52–$26.68 | 44% below | 25% |
| Uric acid blood test CPT 84550 URIC ACID | $21.07 | $28.09 | $4.52–$26.68 | 44% below | 25% |
| Uric acid blood test CPT 84550 LC URIC ACID | $30.43 | $40.57 | $4.52–$38.54 | 19% below | 25% |
| Urinalysis with microscope exam, automated CPT 81001 $URINE W/MICRO CHARGE ONLY | $18.11 | $24.15 | $3.17–$22.94 | 47% below | 25% |
| Urinalysis with microscope exam, manual CPT 81000 SMC URINE (W/MICRO CHARGE ONLY) | $19.82 | $26.42 | $4.02–$25.09 | at median | 25% |
| Urinalysis with microscope exam, manual CPT 81000 URINE MICRO RESULTS | $20.96 | $27.94 | $4.02–$26.54 | 6% above | 25% |
| Urinalysis without microscope exam, automated CPT 81003 SMC URINALYSIS DIPSTICK | $11.73 | $15.64 | $1.91–$14.85 | 48% below | 25% |
| Urinalysis without microscope exam, automated CPT 81003 LMC URINALYSIS DIPSTICK | $11.73 | $15.64 | $1.91–$14.85 | 48% below | 25% |
| Urinalysis without microscope exam, automated CPT 81003 GLUCOSE DIPSTICK | $12.41 | $16.54 | $1.91–$15.71 | 45% below | 25% |
| Urinalysis without microscope exam, automated CPT 81003 $URINE DIPSTICK ONLY CHARGE | $17.33 | $23.10 | $1.91–$21.94 | 23% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 SMC URINALYSIS DIPSTICK (CHARGE ONLY) | $13.21 | $17.61 | $3.01–$16.72 | 25% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 $URINALYSIS DIPSTICK CHARGE ONLY | $13.97 | $18.63 | $3.01–$17.69 | 21% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 GLUCOSE DIPSTICK | $13.97 | $18.63 | $3.01–$17.69 | 21% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 BLOOD DIPSTICK | $13.97 | $18.63 | $3.01–$17.69 | 21% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 URINE SPEC GRAV | $13.97 | $18.63 | $3.01–$17.69 | 21% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 PROTEIN DIPSTICK | $13.97 | $18.63 | $3.01–$17.69 | 21% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 KETONES DIPSTICK | $13.97 | $18.63 | $3.01–$17.69 | 21% below | 25% |
| Urine culture for bacteria, with colony count CPT 87086 HUTCH-URINE CULTURE | $38.74 | $51.65 | $8.07–$49.06 | 27% below | 25% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE, ROUTINE | $40.97 | $54.63 | $8.07–$51.89 | 23% below | 25% |
| Urine pregnancy test, read by color change CPT 81025 SMC URINE PREG TEST | $16.50 | $22.00 | $7.43–$27.14 | 64% below | 25% |
| Urine pregnancy test, read by color change CPT 81025 LMC URINE PREG TEST | $16.50 | $22.00 | $7.43–$27.14 | 64% below | 25% |
| Urine pregnancy test, read by color change CPT 81025 SMC UHCG | $34.61 | $46.14 | $7.43–$43.83 | 25% below | 25% |
| Urine pregnancy test, read by color change CPT 81025 LMC UHCG | $34.61 | $46.14 | $7.43–$43.83 | 25% below | 25% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST | $36.60 | $48.80 | $7.43–$46.36 | 21% below | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $77.42 | $103.23 | $15.08–$98.06 | 12% below | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 LC VITAMIN B12 | $77.42 | $103.23 | $15.08–$98.06 | 12% below | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 $THROMBOSIS PANEL | $278.50 | $371.33 | $25.16–$352.76 | 14% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D (25-HYDROX) | $294.57 | $392.76 | $25.16–$373.12 | 20% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 LC VITAMIN D HYDROX | $294.57 | $392.76 | $25.16–$373.12 | 20% above | 25% |
| Zinc blood test CPT 84630 ZINC, PLASMA OR SERUM | $48.04 | $64.05 | $11.39–$60.84 | 17% below | 25% |
| Zinc blood test CPT 84630 ZINC RBC | $82.69 | $110.25 | $11.39–$104.73 | 43% above | 25% |
| Zinc blood test CPT 84630 ZINC URINE | $82.69 | $110.25 | $11.39–$104.73 | 43% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 QUANTITATIVE B-HCG SERUM | $81.40 | $108.53 | $12.79–$103.10 | 14% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 LC HCG | $81.40 | $108.53 | $12.79–$103.10 | 14% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 $QUANT FOR TRIPLE MARKER | $81.40 | $108.53 | $12.79–$103.10 | 14% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 $ B HCG | $81.40 | $108.53 | $12.79–$103.10 | 14% below | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY W ABCESS | $9,298.52 | $12,398.02 | $642.85–$11,778.11 | 91% above | 25% |
| Appendectomy, open surgery CPT 44950 APPENDECTOMY, OPEN | $9,944.60 | $13,259.47 | $520.42–$12,596.49 | 708% above | 25% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLINIC : FRACTURE CARE WITHOUT MANIPULAT | $1,854.36 | $2,472.48 | $175.08–$2,348.85 | 464% above | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HOSP : CARDIO CARDIOVERSION | $371.25 | $495.00 | $254.75–$1,012.89 | 34% below | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 ER : CARDIOVERSION | $614.46 | $819.28 | $254.75–$1,012.89 | 10% above | 25% |
| Carpal tunnel release, open surgery CPT 64721 CARPEL TUNNEL/MEDIAN NERVE RELEASE | $2,070.71 | $2,760.94 | $336.76–$2,992.53 | 35% above | 25% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX, SINGLE OR MULTI | $1,475.76 | $1,967.68 | $116.44–$1,869.29 | 36% above | 25% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 C-SECTION | $1,125.00 | $1,500.00 | $885.00–$1,924.96 | 69% below | 25% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 MAT. CARE : C-SECTION W/A&P | $2,298.75 | $3,065.00 | $1,808.35–$2,911.75 | 37% below | 25% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION>28 DAYS | $3,507.83 | $4,677.11 | $181.05–$4,443.25 | 66% above | 25% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 NB CIRCUMCISION | $225.00 | $300.00 | $177.00–$3,203.49 | 43% below | 25% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 OP : CIRCUMCISION | $3,264.82 | $4,353.09 | $186.51–$4,135.43 | 728% above | 25% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION NB | $3,264.82 | $4,353.09 | $186.51–$4,135.43 | 728% above | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FRACTURE CARE : ARM | $1,242.00 | $1,656.00 | $230.84–$1,573.20 | 198% above | 25% |
| Colonoscopy with polyp removal CPT 45385 PHY COLONOSCOPY W POLYPECTOMY | $641.25 | $855.00 | $420.88–$1,833.84 | 47% below | 25% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W LESION ABLA-SNARE TECH | $1,879.16 | $2,505.55 | $420.88–$2,380.27 | 54% above | 25% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W POLYPECTOMY, SNARE | $1,879.16 | $2,505.55 | $420.88–$2,380.27 | 54% above | 25% |
| Colonoscopy with tissue sample CPT 45380 PHY COLONOSCOPY W BIOPSY | $540.00 | $720.00 | $391.05–$1,833.84 | 64% below | 25% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W BIOPSY | $1,879.16 | $2,505.55 | $391.05–$2,380.27 | 24% above | 25% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W BIOPSY (SINGLE OR MULTIPLE | $1,879.16 | $2,505.55 | $391.05–$2,380.27 | 24% above | 25% |
| Colonoscopy, diagnostic CPT 45378 PHY COLONOSCOPY FLX DX C SPECIMEN | $461.25 | $615.00 | $307.30–$1,425.15 | 56% below | 25% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY | $1,725.00 | $2,300.00 | $307.30–$2,185.00 | 65% above | 25% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 OP : COLPOSCOPY UPPER ADJ W LOOP | $3,565.78 | $4,754.37 | $283.42–$4,960.86 | 379% above | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 PHY OP COLPOSCOPY OF CERVIX W/BIOP & CUR | $216.75 | $289.00 | $140.35–$467.00 | 41% below | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 OP : COLPOSCOPY CERVIX W/BIOPSY & ENDO | $1,312.50 | $1,750.00 | $140.35–$1,662.50 | 257% above | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $1,063.79 | $1,418.38 | $177.29–$1,347.46 | 1% above | 25% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 D&C, DIAG AND/OR THERAP (NONOBSTETRICAL) | $5,067.38 | $6,756.50 | $191.89–$6,418.67 | 252% above | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION BENIGN LESION X1 | $67.50 | $90.00 | $52.06–$307.47 | 37% below | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 OP : DESTRUCT LESION PREMALIG 1ST LESION | $264.75 | $353.00 | $52.06–$335.35 | 147% above | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 ER : REMOVAL IMP CERUMEN IRR/LVG UNILATE | $747.77 | $997.03 | $9.18–$947.17 | 812% above | 25% |
| Earwax removal with instruments, one ear CPT 69210 CLINIC : EAR WASH | $18.75 | $25.00 | $14.75–$543.31 | 77% below | 25% |
| Earwax removal with instruments, one ear CPT 69210 PROCEDURE : REMOVE IMPACTED CERUMEN | $37.50 | $50.00 | $29.50–$543.31 | 55% below | 25% |
| Earwax removal with instruments, one ear CPT 69210 PHY ER REM IMP CERUMEN REQ INST, UNI | $51.75 | $69.00 | $40.71–$543.31 | 38% below | 25% |
| Earwax removal with instruments, one ear CPT 69210 ER : REMOVAL IMP CERUMEN REQ INST, UNI | $692.72 | $923.63 | $42.37–$877.44 | 732% above | 25% |
| Earwax removal with instruments, one ear CPT 69210 OP : EAR WASH | $692.72 | $923.63 | $42.37–$877.44 | 732% above | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY, W/O CERVICAL DILATIO | $160.50 | $214.00 | $92.11–$309.83 | 31% below | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY W/O CERV DILATION | $160.50 | $214.00 | $92.11–$309.83 | 31% below | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY W/O DILATION | $1,312.50 | $1,750.00 | $92.11–$1,662.50 | 463% above | 25% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE | $9,944.60 | $13,259.47 | $361.61–$12,596.49 | 120% above | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HOSP FLEX SIGMOID: DIAGNOSTIC | $115.50 | $154.00 | $90.86–$1,425.15 | 86% below | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HOSP FLEX SIGMOID W/BIOPSY | $148.50 | $198.00 | $108.54–$1,425.15 | 83% below | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEXIBLE SIGMOID | $1,453.04 | $1,937.39 | $108.54–$1,840.52 | 71% above | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY, DIAG., FLEXIBLE | $1,725.00 | $2,300.00 | $108.54–$2,185.00 | 103% above | 25% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $9,298.52 | $12,398.02 | $583.17–$11,778.11 | 66% above | 25% |
| Gallbladder removal, laparoscopic CPT 47562 LAPROSCOPIC CHOLECYSTECTOMY | $9,298.52 | $12,398.02 | $583.17–$11,778.11 | 66% above | 25% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY | $9,298.52 | $12,398.02 | $626.21–$11,778.11 | 63% above | 25% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPAROSCOPIC CHOLECYSTECTOMY | $9,298.52 | $12,398.02 | $626.21–$11,778.11 | 63% above | 25% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY | $8,761.79 | $11,682.38 | $715.25–$11,098.26 | 154% above | 25% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 PHY ER: HEMORRHOIDECTOMY | $300.00 | $400.00 | $236.00–$4,253.67 | 67% below | 25% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY | $4,370.69 | $5,827.58 | $358.47–$5,536.20 | 379% above | 25% |
| Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABD HYSTERECTOMY | $3,088.05 | $4,117.40 | $817.37–$3,911.53 | 3% below | 25% |
| Hysteroscopy with endometrial ablation CPT 58563 HYSTERSCOPY, UTERINE ABLATION | $7,867.46 | $10,489.95 | $1,863.66–$9,965.45 | 120% above | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 OP : IUD PLACEMENT | $112.50 | $150.00 | $55.00–$142.50 | 44% below | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 IUD INSERTION | $170.24 | $226.98 | $55.00–$215.63 | 15% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I & D WOUND | $86.25 | $115.00 | $67.85–$307.47 | 57% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 CLINIC : I & D WOUND | $105.00 | $140.00 | $81.94–$307.47 | 48% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 PHY ER I&D OF ABSCESS SIMPLE OR SINGLE | $105.00 | $140.00 | $81.94–$307.47 | 48% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 OP : I&D ABSCESS SIMPLE | $264.75 | $353.00 | $81.94–$335.35 | 31% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE | $316.69 | $422.25 | $81.94–$401.13 | 57% above | 25% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 INGUINAL HERNIA REPAIR REDUCE | $5,624.45 | $7,499.26 | $410.79–$7,124.29 | 32% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 OP : INJ SINGLE TENDON SHEATH/LIGAMENT | $121.50 | $162.00 | $50.83–$470.40 | 16% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECTION OF MAJOR JT W/O ULTR GUIDANCE | $123.75 | $165.00 | $59.02–$470.40 | 44% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PHY: ARTHROCENTESIS (ASP/INJ LEG JT/B | $123.75 | $165.00 | $59.02–$470.40 | 44% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PHY : ER ARTHROCENTESIS (ASP/INJ LG JT/B | $123.75 | $165.00 | $59.02–$470.40 | 44% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECTION OF MAJOR JOINT SGL W/O UL GUID | $123.75 | $165.00 | $59.02–$470.40 | 44% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OP : ARTHROCENTESIS ASP/INJ MAJ JT W/O G | $264.75 | $353.00 | $59.02–$470.40 | 20% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS(ASP/INJ) MAJ JT/BUR W/O G | $264.75 | $353.00 | $59.02–$470.40 | 20% above | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 IMPLANON INSERTION | $135.00 | $180.00 | $59.07–$203.90 | 16% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PHY ER ARTHROCENTISIS W/O UL GUIDANCE | $80.25 | $107.00 | $49.65–$470.40 | 65% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ER : ARTHROCENTISIS W/O ULSD GUIDANCE | $264.75 | $353.00 | $49.65–$470.40 | 17% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 OP : ARTHROCENTESIS ASP/INJ INTERM W/O G | $266.25 | $355.00 | $49.65–$470.40 | 17% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 PHY ER ARTHROCENTISIS W/O UL GUIDANCE | $82.50 | $110.00 | $45.53–$470.40 | 61% below | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS(ASP/INJ) SM JT W/O GUIDAN | $121.50 | $162.00 | $45.53–$470.40 | 43% below | 25% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPIC APPENDECTOMY | $9,298.52 | $12,398.02 | $463.01–$11,778.11 | 99% above | 25% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 LAPAROSCOPY HYSTERECTOMY | $16,592.89 | $22,123.85 | $783.11–$21,017.65 | 39% above | 25% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 HYSTERECTOMY TOTAL ASSISTED | $16,592.89 | $22,123.85 | $783.11–$21,017.65 | 39% above | 25% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAPAROSCOPY, REPAIR INITL INGUINAL HERNI | $9,298.52 | $12,398.02 | $344.18–$11,778.11 | 129% above | 25% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP, SURGICAL; REP REC ING HERNIA | $9,298.52 | $12,398.02 | $445.50–$11,778.11 | 30% above | 25% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPROSCOPIC TUBAL W PRTL OR TOTAL OOPHOR | $9,298.52 | $12,398.02 | $583.05–$11,778.11 | 39% above | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 WOUND REPAIR | $172.50 | $230.00 | $135.70–$622.98 | 48% below | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PHY ER REPAIR INTERM STHF 2.5CM OR < | $172.50 | $230.00 | $135.70–$622.98 | 48% below | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERM SCA/TRK/EXT >2.5CM | $264.75 | $353.00 | $154.58–$622.98 | 21% below | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 EXCISION OF AXILLA MASS 2.5 CM OR LESS | $575.24 | $766.99 | $154.58–$728.64 | 72% above | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR OF HEAD LACERATION | $575.24 | $766.99 | $154.58–$728.64 | 72% above | 25% |
| Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL (LUMPECTOMY) | $7,138.00 | $9,517.33 | $442.80–$9,041.46 | 185% above | 25% |
| Miscarriage treatment with D&C, first trimester CPT 59820 OP: TRTMT OF MISSED ABORTION 1ST TRIM | $5,067.38 | $6,756.50 | $302.99–$6,418.67 | 160% above | 25% |
| Miscarriage treatment with D&C, first trimester CPT 59820 ABORTION COMPLETED SURG;1ST TRIM | $5,067.38 | $6,756.50 | $302.99–$6,418.67 | 160% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 OP : EXCISE BENIGN LESION TAL <0.5CM | $63.75 | $85.00 | $50.15–$1,085.21 | 66% below | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 OP : EXCISE BENIGN LES FEENL <0.5CM | $63.75 | $85.00 | $50.15–$1,085.21 | 66% below | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISE BENIGN LES FEENL <0.5CM | $999.05 | $1,332.07 | $108.06–$1,265.46 | 434% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 OP : TOENAIL REMOVAL | $63.75 | $85.00 | $50.15–$307.47 | 54% below | 25% |
| Nail removal (partial or complete), one nail CPT 11730 ER : REMOVAL OF TOENAIL | $173.25 | $231.00 | $75.46–$307.47 | 26% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 PHY ER: AVUL OF NAIL PLATE, PT/COMP, SIM | $175.50 | $234.00 | $75.46–$307.47 | 27% above | 25% |
| Paracentesis with imaging guidance CPT 49083 PHY : OP ABD PARACENTESIS W IMAGING GUID | $367.50 | $490.00 | $170.40–$1,389.95 | 44% below | 25% |
| Paracentesis with imaging guidance CPT 49083 OP : ABD PARACENTESIS W IMAGING GUIDANCE | $1,494.24 | $1,992.32 | $170.40–$1,892.70 | 128% above | 25% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W IMAGING GUIDANCE | $1,494.24 | $1,992.32 | $170.40–$1,892.70 | 128% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 PHY ER: EXCISION OF NAIL, PARTIAL/COMPLE | $262.50 | $350.00 | $146.89–$622.98 | 31% below | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC. NAIL & MATRIX, PERM. REMOVAL | $441.00 | $588.00 | $146.89–$622.98 | 15% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 OP : EXCISION NAIL/ MATRIX PART/COMPLETE | $441.00 | $588.00 | $146.89–$622.98 | 15% above | 25% |
| Removal of a breast lump, open surgery CPT 19120 BREAST BIOPSY | $6,102.92 | $8,137.22 | $355.87–$7,730.35 | 158% above | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 PHY ER INCISION REMOVAL FB SUB TISS SIMP | $110.25 | $147.00 | $86.73–$1,075.65 | 52% below | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 PHY: FOREIGN BODY REMOVAL SUBCUTANEOUS | $110.25 | $147.00 | $86.73–$1,075.65 | 52% below | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 OP : INCISION/REMOVAL FB SUBQ SIMPLE | $264.75 | $353.00 | $113.80–$1,075.65 | 15% above | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 ER: FOREIGN BODY REMOVAL | $1,371.46 | $1,828.61 | $113.80–$1,737.17 | 493% above | 25% |
| Removal of a foreign object under the skin, simple one side CPT 10120 PHY: FOREIGN BODY REMOVAL-LT | $110.25 | $147.00 | $86.73–$1,075.65 | 52% below | 25% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PHY COLONOSCOPY SCRN NOT HIGH RISK | $461.25 | $615.00 | $199.86–$1,425.15 | 53% below | 25% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY SCREENING NOT HIGH RISK | $1,725.00 | $2,300.00 | $199.86–$2,185.00 | 77% above | 25% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PHY COLONOSCOPY SCRN HIGH RISK IND | $461.25 | $615.00 | $199.75–$1,425.15 | 55% below | 25% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCREENING HIGH RISK | $1,725.00 | $2,300.00 | $199.75–$2,185.00 | 69% above | 25% |
| Short arm cast (elbow to hand) CPT 29075 PHY ER APPLY SHORT ARM CAST | $105.00 | $140.00 | $69.61–$432.28 | 52% below | 25% |
| Short arm cast (elbow to hand) CPT 29075 FX CARE : SHORT ARM CAST(ELB-FING) | $369.00 | $492.00 | $69.61–$467.40 | 70% above | 25% |
| Short arm cast (elbow to hand) CPT 29075 CAST APPLICATION | $369.00 | $492.00 | $69.61–$467.40 | 70% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 PHY ER APPLY SHORT ARM SPLINT STATIC | $255.00 | $340.00 | $54.28–$323.00 | 48% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 OP : APPLY SPLINT ARM SHORT STATIC | $255.00 | $340.00 | $54.28–$323.00 | 48% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 ER : APPLY SPLINT ARM SHORT STATIC | $255.00 | $340.00 | $54.28–$323.00 | 48% above | 25% |
| Short leg cast (below the knee) CPT 29405 PHY : ER SHORT LEG CAST (KNEE-TOE) | $172.50 | $230.00 | $71.81–$428.63 | 7% below | 25% |
| Short leg cast (below the knee) CPT 29405 FX CARE : SHORT LEG CAST(KNEE-TOE) | $369.00 | $492.00 | $71.81–$467.40 | 98% above | 25% |
| Short leg splint (calf to foot) CPT 29515 PHY : ER APP OF SHORT LEG SPL CALF TO FO | $106.50 | $142.00 | $55.08–$249.03 | 33% below | 25% |
| Short leg splint (calf to foot) CPT 29515 ER : APPLY SHORT LEG SPLINT CALF TO TOE | $255.00 | $340.00 | $55.08–$323.00 | 60% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE LACERATION 2.5CM < SUPER. HEAD | $146.25 | $195.00 | $115.05–$382.79 | 39% below | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PHY ER REPAIR SIMPLE SNTHF 2.5CM OR < | $153.75 | $205.00 | $115.26–$382.79 | 36% below | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 CLINIC : SUTURE 2.5CM OR LESS | $153.75 | $205.00 | $115.26–$382.79 | 36% below | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SIMPLE NEC/FT/HND/GEN <2.5CM | $264.75 | $353.00 | $115.26–$382.79 | 11% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SIMPLE SCA/TRK/EXT <2.5CM | $305.25 | $407.00 | $115.26–$386.65 | 27% above | 25% |
| Skin biopsy, punch, one lesion CPT 11104 PHY ER PUNCH BX SKIN SINGLE LESION | $173.25 | $231.00 | $73.39–$622.98 | 65% below | 25% |
| Skin biopsy, punch, one lesion CPT 11104 ER : PUNCH BX OF SKIN SINGLE LESION | $546.00 | $728.00 | $73.39–$691.60 | 9% above | 25% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 OP : EXCISE MALIG LESION TAL <0.5CM | $63.75 | $85.00 | $50.15–$1,085.21 | 73% below | 25% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISE MALIG LESION TAL =/< 0.5CM | $999.05 | $1,332.07 | $130.75–$1,265.46 | 328% above | 25% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAG | $86.25 | $115.00 | $60.50–$307.47 | 36% below | 25% |
| Skin tag removal, up to 15 tags CPT 11200 CLINIC : REMOVAL SKIN TAG | $86.25 | $115.00 | $60.50–$307.47 | 36% below | 25% |
| Skin tag removal, up to 15 tags CPT 11200 OP : REMOVE SKIN TAG UP TO 15 | $264.75 | $353.00 | $60.50–$335.35 | 97% above | 25% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS | $288.75 | $385.00 | $60.50–$365.75 | 115% above | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 MISC - LUMBAR PUNCTURE | $115.50 | $154.00 | $90.86–$1,081.76 | 78% below | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 PHY ER: LUMBAR PUNCTURE | $367.50 | $490.00 | $130.75–$1,081.76 | 30% below | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE | $370.50 | $494.00 | $130.75–$1,081.76 | 29% below | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 OP : LUMBAR PUNCTURE | $552.44 | $736.59 | $130.75–$1,081.76 | 6% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMC SUTURE 2.6CM-7.5CM | $161.25 | $215.00 | $122.62–$457.53 | 39% below | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PHY ER REPAIR SIMPLE SNTHF 2.6CM-7.5CM | $174.75 | $233.00 | $122.62–$457.53 | 34% below | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 CLINIC : SUTURE 2.6CM-7.5CM | $174.75 | $233.00 | $122.62–$457.53 | 34% below | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SIMPLE NEC/FT/HND/GEN 2.6 - 7.5CM | $264.75 | $353.00 | $122.62–$457.53 | at median | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SIMPLE SCA/TRK/EXT 2.6 - 7.5CM | $364.50 | $486.00 | $122.62–$461.70 | 38% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE LACERATION REPAIR 2.5CM < HEAD | $175.50 | $234.00 | $121.70–$475.71 | 33% below | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PHY ER REPAIR SIMPLE FEENL 2.5CM OR < | $175.50 | $234.00 | $121.70–$475.71 | 33% below | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SIMPLE FAC/EAR/MM <2.5CM | $378.75 | $505.00 | $121.70–$479.75 | 45% above | 25% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS GUIDED BY SONO | $1,099.74 | $1,466.32 | $183.12–$1,393.00 | 25% above | 25% |
| Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION-TRIGGER FINGER RE | $2,550.65 | $3,400.87 | $530.86–$3,230.82 | 78% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION TRIGGER POINT 1-2 | $84.00 | $112.00 | $46.92–$470.40 | 44% below | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 PHY : ER TRIGGER POINT INJECTION | $90.00 | $120.00 | $46.92–$470.40 | 40% below | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 OP : INJ TRIGGER PT SNGL/MULTI 1-2 MUSCL | $121.50 | $162.00 | $46.92–$470.40 | 19% below | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 ER : INJ TRIGGER PT SNGL/MULTI 1-2 MUSCL | $421.43 | $561.90 | $46.92–$533.80 | 181% above | 25% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY W REMOVAL OF TUBE CYST | $3,664.50 | $4,886.00 | $286.80–$9,264.71 | 24% below | 25% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 TUBAL LAPAROSCOPIC | $9,298.52 | $12,398.02 | $286.80–$11,778.11 | 93% above | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BRST W PLACEMENT OF DEVICE | $2,582.26 | $3,443.01 | $289.02–$3,270.85 | 31% above | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W BIOPSY AND DILATION | $3,023.33 | $4,031.11 | $620.52–$3,829.55 | 70% above | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD W BIOPSY AND POLYPECTOMY | $1,494.24 | $1,992.32 | $284.80–$1,892.70 | 12% above | 25% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD EXC POLYPS, TUMORS OR LESIONS\SNARE | $3,023.33 | $4,031.11 | $288.87–$3,829.55 | 99% above | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD W/BIOPSY | $1,494.24 | $1,992.32 | $250.00–$1,892.70 | 18% above | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD | $1,494.24 | $1,992.32 | $250.00–$1,892.70 | 18% above | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD W REMOV OF PEG TUBE AND INSERT OF GA | $1,494.24 | $1,992.32 | $250.00–$1,892.70 | 18% above | 25% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 VAGINAL BIRTH AFTER CSECTION | $1,275.00 | $1,700.00 | $1,003.00–$1,821.50 | — | 25% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 ER : EMERGENCY DELIVERY | $1,312.50 | $1,750.00 | $1,032.50–$1,751.03 | 60% below | 25% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 MAT. CARE : OB DELIVERY W/A&P | $2,341.50 | $3,122.00 | $1,751.03–$2,965.90 | 29% below | 25% |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY, UNIL OR BILAT & POST OPT | $3,264.82 | $4,353.09 | $439.82–$4,135.43 | — | 25% |
| Wart removal, up to 14 warts CPT 17110 SMC LESION DESTRUCTION <14 | $84.00 | $112.00 | $66.08–$307.47 | 49% below | 25% |
| Wart removal, up to 14 warts CPT 17110 OP : CRYO THERAPY <14 | $84.00 | $112.00 | $66.08–$307.47 | 49% below | 25% |
| Wart removal, up to 14 warts CPT 17110 CLINIC : LESION REMOVAL <14 | $96.38 | $128.50 | $74.50–$307.47 | 41% below | 25% |
| Wart removal, up to 14 warts CPT 17110 OP : DESTRUCT LESION BENIGN | $317.25 | $423.00 | $74.50–$401.85 | 94% above | 25% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF LESION BENIGN | $375.00 | $500.00 | $74.50–$475.00 | 129% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PHY :ER DEBRIDEMENT SUBCU 1ST 20 SQ CM | $417.00 | $556.00 | $76.21–$622.98 | 29% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ER : DEBRIDEMENT SUBCU 1ST 20 SQ CM | $575.24 | $766.99 | $76.21–$728.64 | 78% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 OP : DEBRIDEMENT SUBCU 1ST 20 SQ CM | $575.24 | $766.99 | $76.21–$728.64 | 78% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 OR : DEBRIDEMENT SUBCU 1ST 20 SQ CM | $575.24 | $766.99 | $76.21–$728.64 | 78% above | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 ER : BLOOD TRANSFUSION 1ST HR | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 OP : BLOOD TRANSFUSION >8- | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 ER : BLOOD TRANSFUSION 1-4 HRS | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 ER : BLOOD TRANSFUSION > 4-8 HRS | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 OBS : BLOOD TRANSFUSION 1-4HRS | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 OBS : BLOOD TRANSFUSION >16 HRS | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 OBS : BLOOD TRANSFUSION >4-<8 | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 OBS : BLOOD TRANSFUSION >8-<16 | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 OP : BLOOD TRANSFUSION 1-4 HRS | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 OP : BLOOD TRANSFUSION 16+ HRS | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 OP : BLOOD TRANSFUSION >4- | $657.50 | $876.67 | $30.75–$832.83 | 14% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PROCEDURE : INHALATION THERAPY | $23.25 | $31.00 | $9.87–$335.58 | 80% below | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL INITIAL | $323.89 | $431.85 | $9.87–$410.25 | 182% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL MED 2 | $326.27 | $435.03 | $9.87–$413.27 | 184% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL : PER HOUR | $326.27 | $435.03 | $9.87–$413.27 | 184% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL MED 1 | $326.27 | $435.03 | $9.87–$413.27 | 184% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL MED 4 | $326.27 | $435.03 | $9.87–$413.27 | 184% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT 1/3 | $326.27 | $435.03 | $9.87–$413.27 | 184% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT 4/7 | $326.27 | $435.03 | $9.87–$413.27 | 184% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB | $326.27 | $435.03 | $9.87–$413.27 | 184% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL MED 3 | $326.27 | $435.03 | $9.87–$413.27 | 184% above | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 ER : INFUSION COMPLEX INITIAL1hr | $456.71 | $608.94 | $130.49–$578.49 | 15% above | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 OBS : INFUSION COMPLEX INITIAL 1hr | $456.71 | $608.94 | $130.49–$578.49 | 15% above | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 OP : INFUSION COMPLEX INITIAL 1hr | $456.71 | $608.94 | $130.49–$578.49 | 15% above | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HR | $270.00 | $360.00 | $185.69–$1,265.88 | 59% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 PHY CRITICAL CARE 1ST HOUR | $420.00 | $560.00 | $185.69–$1,265.88 | 37% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $1,302.78 | $1,737.04 | $185.69–$1,650.18 | 96% above | 25% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 SMC CARDIAC - GLOBAL EKG | $42.75 | $57.00 | $24.16–$54.15 | 52% below | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY | $209.72 | $279.62 | $14.59–$265.63 | 14% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 SMC CARDIAC - EKG-TRACING ONLY (TC) | $209.72 | $279.62 | $14.59–$265.63 | 14% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 LMC CARDIAC - EKG-TRACING ONLY (TC) | $209.72 | $279.62 | $14.59–$265.63 | 14% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HOSP SERVICES ER DEPT SERV. LEVEL 1 | $30.00 | $40.00 | $23.60–$170.31 | 79% below | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ML ER LEVEL I | $150.00 | $200.00 | $40.48–$190.00 | 7% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER : PHY-LEV 1 | $157.50 | $210.00 | $40.48–$199.50 | 13% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PHY ER LEVEL I | $157.50 | $210.00 | $40.48–$199.50 | 13% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER ROOM : LEVEL 1 | $217.15 | $289.53 | $40.48–$275.05 | 55% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 OP : MISCELLANEOUS | $217.15 | $289.53 | $40.48–$275.05 | 55% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER ROOM : EMTALA SCREENING | $217.15 | $289.53 | $40.48–$275.05 | 55% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HOSP SERVICES ER DEPT SERV. LEVEL 2 | $41.25 | $55.00 | $32.45–$265.31 | 79% below | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ML ER LEVEL II | $168.75 | $225.00 | $38.45–$265.31 | 12% below | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PHY ER LEVEL II | $170.25 | $227.00 | $38.45–$265.31 | 12% below | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER ROOM : LEVEL II | $338.27 | $451.03 | $38.45–$428.47 | 76% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER : PHY-LEV 2 | $338.27 | $451.03 | $38.45–$428.47 | 76% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HOSP SERVICES ER DEPT SERV. LEVEL 3 | $90.00 | $120.00 | $40.48–$418.34 | 67% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ML ER LEVEL III | $198.75 | $265.00 | $40.48–$418.34 | 27% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PHY ER LEVEL III | $202.50 | $270.00 | $40.48–$418.34 | 26% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER ROOM LEVEL III | $519.93 | $693.24 | $40.48–$658.57 | 90% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER : PHY-LEV 3 | $519.93 | $693.24 | $40.48–$658.57 | 90% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HOSP SERVICES ER DEPT SERV. LEVEL 4 | $135.00 | $180.00 | $98.48–$695.24 | 66% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ML ER LEVEL IV | $255.00 | $340.00 | $98.48–$695.24 | 35% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PHY ER LEVEL IV | $258.75 | $345.00 | $98.48–$695.24 | 34% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER ROOM : LEVEL IV | $886.43 | $1,181.91 | $98.48–$1,122.81 | 126% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER : PHY-LEV 4 | $886.43 | $1,181.91 | $98.48–$1,122.81 | 126% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HOSP SERVICES ER DEPT SERV. LEVEL 5 | $198.75 | $265.00 | $98.48–$1,080.54 | 69% below | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ML ER LEVEL V | $348.75 | $465.00 | $98.48–$1,080.54 | 46% below | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PHY ER LEVEL V | $352.50 | $470.00 | $98.48–$1,080.54 | 45% below | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER ROOM : LEVEL V | $1,377.69 | $1,836.92 | $98.48–$1,745.07 | 115% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER : PHY-LEV 5 | $1,377.69 | $1,836.92 | $98.48–$1,745.07 | 115% above | 25% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS-EKG | $454.37 | $605.83 | $50.39–$575.53 | 21% below | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OP : INFUSION HYDRATION INITIAL | $325.49 | $433.98 | $35.87–$412.28 | 34% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OBS : INFUSION HYDRATION 1ST HOUR | $325.49 | $433.98 | $35.87–$412.28 | 34% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ER : IV HYDRATION INITIAL | $325.49 | $433.98 | $35.87–$412.28 | 34% above | 25% |
| IV infusion of a medicine, first hour CPT 96365 OP : IV THERAPEUTIC INITIAL | $325.49 | $433.98 | $47.52–$412.28 | 23% above | 25% |
| IV infusion of a medicine, first hour CPT 96365 OBS : INFUSION THERAPY 1st HOUR | $325.49 | $433.98 | $47.52–$412.28 | 23% above | 25% |
| IV infusion of a medicine, first hour CPT 96365 ER : IV THERAPEUTIC ADM. INITIAL | $325.49 | $433.98 | $47.52–$412.28 | 23% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 CLINIC : VFC NURSE ADMINISTRATION | $10.88 | $14.50 | $8.55–$110.34 | 84% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 CLINIC : NURSE ADMINISTRATION | $15.00 | $20.00 | $11.80–$110.34 | 78% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION ADMINISTRATION | $28.50 | $38.00 | $14.30–$110.34 | 57% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 CLINIC : PROVIDER ADMINISTRATION | $30.00 | $40.00 | $14.30–$110.34 | 55% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP : SUBQ/IM INJECTION (PER STICK) | $106.97 | $142.63 | $14.30–$135.49 | 60% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OBS : SUBQ/IM INJECTION (PER STICK) | $106.97 | $142.63 | $14.30–$135.49 | 60% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OBS : SUBQ/IM INJ | $106.97 | $142.63 | $14.30–$135.49 | 60% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER : SUBQ/IM INJECTION (PER STICK) | $106.97 | $142.63 | $14.30–$135.49 | 60% above | 25% |
| New patient office visit, about 30 minutes CPT 99203 CLINIC : NEW PT LEVEL 3 | $45.00 | $60.00 | $35.40–$101.00 | 70% below | 25% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT SERVICE - OFFICE LEVEL 3 | $93.75 | $125.00 | $73.75–$118.75 | 38% below | 25% |
| New patient office visit, about 30 minutes CPT 99203 OP : WOUND CARE (NEW PT) | $99.00 | $132.00 | $77.88–$125.40 | 35% below | 25% |
| New patient office visit, about 45 minutes CPT 99204 CLINIC : NEW PT LEVEL 4 | $45.00 | $60.00 | $35.40–$120.26 | 78% below | 25% |
| New patient office visit, about 45 minutes CPT 99204 OP : WOUND CARE (NEW PT) | $99.00 | $132.00 | $77.88–$125.40 | 51% below | 25% |
| New patient office visit, about 60 minutes CPT 99205 CLINIC : NEW PT LEVEL 5 | $45.00 | $60.00 | $35.40–$168.67 | 84% below | 25% |
| New patient office visit, about 60 minutes CPT 99205 OP : WOUND CARE (NEW PT) | $165.00 | $220.00 | $129.80–$209.00 | 40% below | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 CLINIC : NEW PT LEVEL 2 | $45.00 | $60.00 | $35.40–$67.67 | 61% below | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP : WOUND CARE (NEW PT) | $66.00 | $88.00 | $51.92–$83.60 | 43% below | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT SERVICE - OFFICE LEVEL 2 | $67.50 | $90.00 | $53.10–$85.50 | 42% below | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 CLINIC : INS PHYSICAL 18-39yr | $120.00 | $160.00 | $32.70–$152.00 | 35% below | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 NEW PT WELL CK/BY AGE LEVEL 5 | $157.50 | $210.00 | $32.70–$199.50 | 15% below | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 CLINIC : INS PHYSICAL 40-64yrs | $131.25 | $175.00 | $32.70–$176.08 | 30% below | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 CLINIC : INS PHYSICAL 65 YR &UP | $142.50 | $190.00 | $32.70–$180.50 | 24% below | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 NEW PT WELL CK/BY AGE LEVEL 6 | $157.50 | $210.00 | $32.70–$199.50 | 16% below | 25% |
| Preventive checkup, new patient aged 65 or older CPT 99387 NEW PT WELL CK/BY AGE LEVEL 7 | $165.00 | $220.00 | $32.70–$209.00 | 22% below | 25% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 CLINIC : EST PT PHYSICAL(18-39YR) | $52.50 | $70.00 | $18.53–$128.58 | 70% below | 25% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 EST PT WELL CHECK >18-39YEAR (BRIEF) | $60.00 | $80.00 | $18.53–$128.58 | 65% below | 25% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 EST PT WELL CHECK >18-39YEAR | $131.25 | $175.00 | $18.53–$166.25 | 24% below | 25% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 CLINIC : EST PT PHYSICAL(40-64YR) | $45.00 | $60.00 | $18.53–$182.01 | 76% below | 25% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 EST PT WELL CHECK >40-64YEAR | $146.25 | $195.00 | $18.53–$185.25 | 23% below | 25% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 CLINIC : EST PT PHYSICAL(65+) | $45.00 | $60.00 | $18.53–$57.00 | 77% below | 25% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 CLINIC : TOBACCO CESSATION | $39.00 | $52.00 | $9.92–$57.42 | 40% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CLINIC : EST PT LEVEL 5 | $45.00 | $60.00 | $35.40–$266.24 | 78% below | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP : WOUND CARE (EST PT) | $99.00 | $132.00 | $77.88–$266.24 | 52% below | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 CLINIC : PHYSICAL INSURANCE/DOT | $112.50 | $150.00 | $88.50–$266.24 | 46% below | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ZZZEST PT SERVICE -LEVEL 5 | $123.75 | $165.00 | $97.35–$266.24 | 41% below | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP : EST PT LEVEL 5 | $339.46 | $452.61 | $105.53–$429.97 | 63% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ZZZPHYSICAL SCHOOL/CAMP | $43.50 | $58.00 | $34.22–$133.49 | 68% below | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CLINIC : EST PT LEVEL 3 | $45.00 | $60.00 | $35.40–$133.49 | 67% below | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT SERVICE -LEVEL 3 | $60.00 | $80.00 | $45.86–$133.49 | 56% below | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP : EST PT-3 WOUND CARE 26-50 SQ CM | $66.00 | $88.00 | $45.86–$133.49 | 51% below | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP : WOUND CARE (EST PT) | $67.50 | $90.00 | $45.86–$133.49 | 50% below | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PHYS: LEVEL 3 | $80.25 | $107.00 | $45.86–$133.49 | 41% below | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PT TENS SET UP | $170.20 | $226.93 | $45.86–$215.58 | 26% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP: CV19 TR RM LEVEL 3 | $170.20 | $226.93 | $45.86–$215.58 | 26% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP : EST PT LEVEL 3 | $170.20 | $226.93 | $45.86–$215.58 | 26% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PHYS: ML CV19 TR RM LEVEL 3 | $398.25 | $531.00 | $45.86–$504.45 | 195% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CLINIC : SCHOOL ATHLETIC PHYSICAL | $24.00 | $32.00 | $18.88–$188.57 | 86% below | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CLINIC : EST PT LEVEL 4 | $45.00 | $60.00 | $35.40–$188.57 | 74% below | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP : WOUND CARE (EST PT) | $78.75 | $105.00 | $61.95–$188.57 | 54% below | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CLINIC : EMPLOYMENT PHYSICAL | $90.00 | $120.00 | $70.80–$188.57 | 48% below | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ZZZEST PT SERVICE -LEVEL 4 | $90.00 | $120.00 | $70.80–$188.57 | 48% below | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP : EST PT LEVEL 4 | $240.43 | $320.57 | $72.10–$304.54 | 39% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ZZZEST PT SERVICE -LEVEL 2 | $43.50 | $58.00 | $33.72–$85.38 | 58% below | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CLINIC : EST PT LEVEL 2 | $45.00 | $60.00 | $33.72–$85.38 | 57% below | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP : WOUND CARE (EST PT) | $51.75 | $69.00 | $33.72–$85.38 | 50% below | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP : EST PT LEVEL 2 | $108.86 | $145.15 | $33.72–$137.89 | 4% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP: CV19 TR RM LEVEL 2 | $108.86 | $145.15 | $33.72–$137.89 | 4% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ZZZPHYS: CV19 TR RM LEVEL 2 | $258.75 | $345.00 | $33.72–$327.75 | 148% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PHYS: ML CV19 TR RM LEVEL 2 | $398.25 | $531.00 | $33.72–$504.45 | 282% above | 25% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HOSP SERVICES OUTPT CONSULTATION L3 | $135.00 | $180.00 | $45.00–$171.00 | 30% below | 25% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT LEVEL 4 | $191.25 | $255.00 | $63.75–$242.25 | 22% below | 25% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HOSP SERVICES OUTPT CONSULTATION L4 | $191.25 | $255.00 | $63.75–$242.25 | 22% below | 25% |
| Spirometry (breathing test) CPT 94010 PFT (SIMPLE) | $386.57 | $515.43 | $25.12–$489.65 | 32% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 ZZZ PFT PRE & POST | $476.63 | $635.51 | $48.00–$603.73 | 9% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 PFT PRE & POST | $480.14 | $640.18 | $48.00–$608.17 | 10% above | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $93.07 | $124.09 | $69.01–$203.90 | 21% below | 25% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Kansas | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COMIRNATY 2023-2024 COV-19 VACCINE 12+ | $189.83 | $253.11 | $149.33–$240.45 | 47% above | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 12+ COVID-19 (24-25YR) 0.3ML | $196.50 | $262.00 | $154.58–$248.90 | 34% above | 25% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 INJECTION Varicella | $86.25 | $115.00 | $67.85–$248.76 | 61% below | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IM - INFLUENZA VIRUS VACCINE : 0.5ML PFS | $26.25 | $35.00 | $20.65–$33.25 | 18% below | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACCINE 0.5ML PFS | $46.50 | $62.00 | $22.35–$58.90 | 45% above | 25% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A/B (TWINRIX) | $176.96 | $235.95 | $101.00–$224.15 | 34% below | 25% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VAC | $124.18 | $165.57 | $73.54–$157.29 | 1% above | 25% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 INJECTION Hep B Adult (Engerix-B) | $66.75 | $89.00 | $52.51–$95.25 | 43% below | 25% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE ADULT 0.5ML | $89.30 | $119.06 | $70.24–$113.10 | 23% below | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE-HIGH DOSE 65+ YR 0.5ML | $98.06 | $130.74 | $77.13–$124.20 | 14% above | 25% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 INJECTION MMR | $51.00 | $68.00 | $40.12–$131.54 | 57% below | 25% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE | $124.36 | $165.81 | $70.92–$157.51 | 5% above | 25% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 INJECTION MENINGITIS (Menactra) | $101.25 | $135.00 | $79.65–$237.94 | 60% below | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 VACCINE PFS 0.5ML | $350.06 | $466.74 | $275.37–$443.40 | 7% below | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 INJECTION PNEUMOCOCCAL VACCINE | $39.00 | $52.00 | $30.68–$167.20 | 77% below | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX (PNEUMOCOCCAL) 25MCG/0.5ML VL | $210.74 | $280.99 | $133.47–$266.94 | 26% above | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 0.5ML VAC | $210.74 | $280.99 | $133.47–$266.94 | 26% above | 25% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO VACCINE 0.5ML PFS | $464.63 | $619.50 | $295.00–$588.52 | 28% above | 25% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE : INJ | $554.12 | $738.83 | $319.75–$701.88 | 4% below | 25% |
| Rabies vaccine, one dose CPT 90675 RABIES VACC (IMOVAX) | $1,210.68 | $1,614.24 | $319.75–$1,533.52 | 111% above | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX VACCINE | $288.52 | $384.69 | $162.01–$365.45 | 2% above | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 INJECTION Td 7YR+ (Decavac) | $24.00 | $32.00 | $18.88–$57.20 | 61% below | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 OT E-STIM WOUND | $53.63 | $71.50 | $38.97–$67.92 | 13% below | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 OT ESTIM | $53.63 | $71.50 | $38.97–$67.92 | 13% below | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPTH/TETANUS : PED VAC | $53.63 | $71.50 | $38.97–$67.92 | 13% below | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS TOXOID INJ | $81.00 | $108.00 | $38.97–$102.60 | 31% above | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTHERIA | $107.79 | $143.72 | $38.97–$136.53 | 75% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 INJECTION Tdap 7YR+ (Adacel) | $37.50 | $50.00 | $29.50–$67.14 | 47% below | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP : ADACEL 10-64 YR | $74.75 | $99.66 | $39.69–$94.67 | 5% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 MEDICAID INFLUENZE ADMINISTRATION | $7.50 | $10.00 | $5.90–$110.34 | 80% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER : INJ VACCINE ADMINISTRATION | $37.50 | $50.00 | $8.08–$110.34 | 1% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 OBS : INJ VACCINE ADMINISTRATION | $37.50 | $50.00 | $8.08–$110.34 | 1% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 OP : INJ VACCINE ADMINISTRATION | $37.50 | $50.00 | $8.08–$110.34 | 1% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 MEDICAID PNEUMONIA ADMINISTRATION | $7.50 | $10.00 | $5.90–$14.15 | 68% below | 25% |
Source file: https://mrfs.hyvehealthcare.com/RiceCounty/486091484_hospital-district-1-of-rice-county_standardcharges.json