Hospital

Golden Valley Memorial Hospital

Golden Valley Memorial Hospital in Clinton, MO publishes cash prices for 395 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Missouri median for 242 of 394 procedures and above it for 142. By typical cash price it ranks #23 of 60 Missouri hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1600 N 2nd St,Clinton,MO,64735 Collected Sep 27, 2026 Source price file (660) 885-5511

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 260175 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Golden Valley Memorial Hospital in Clinton, MO:

Jun 15, 2026 Warning notice

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY OF ANKLE; MINIMUM OF 3 VIEWS	$240.00	$400.00	$81.36–$157.91	20% below	40%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE	$253.99	$423.32	$81.36–$157.91	15% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ULTRASOUND STUDY OF ARM AND LEG ARTERIES	$348.00	$580.00	$114.37–$241.43	2% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$348.60	$581.00	$114.37–$241.43	2% above	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$53.89	$89.82	$164.52–$318.29	88% below	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST X-RAY OF ESOPHAGUS	$402.00	$670.00	$164.52–$318.29	7% below	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NUCLEAR MEDICINE STUDY OF BONE AND/OR JOINT WHOLE BODY	$1,320.00	$2,200.00	$369.29–$725.48	11% below	40%
Breast ultrasound, complete, one breast CPT 76641 COMPLETE ULTRASOUND SCAN OF 1 BREAST	$420.00	$700.00	$111.60–$189.72	10% above	40%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE	$478.39	$797.32	$111.60–$189.72	25% above	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 LIMITED ULTRASOUND SCAN OF 1 BREAST	$420.00	$700.00	$92.89–$157.91	42% above	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED	$474.47	$790.78	$92.89–$157.91	60% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN OF BLOOD VESSELS OF CHEST WITH CONTRAST	$1,860.00	$3,100.00	$164.52–$806.00	4% below	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCAN OF HEART WITH EVALUATION OF BLOOD VESSEL CALCIUM	$39.00	$65.00	$81.36–$806.00	54% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN OF ABDOMEN AND PELVIS WITHOUT CONTRAST	$2,700.00	$4,500.00	$219.40–$806.00	27% above	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$2,839.27	$4,732.12	$219.40–$806.00	34% above	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$3,240.00	$5,400.00	$344.34–$806.00	36% above	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$3,385.94	$5,643.24	$344.34–$806.00	43% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN OF ABDOMEN AND PELVIS BEFORE AND AFTER CONTRAST	$3,600.00	$6,000.00	$344.34–$806.00	23% above	40%
CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST	$1,800.00	$3,000.00	$164.52–$806.00	15% above	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$1,901.62	$3,169.37	$164.52–$806.00	21% above	40%
CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST	$1,620.00	$2,700.00	$98.44–$806.00	50% above	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST	$1,440.00	$2,400.00	$98.44–$806.00	34% above	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$1,380.00	$2,300.00	$98.44–$806.00	10% above	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$1,440.00	$2,400.00	$98.44–$806.00	14% above	40%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$1,380.00	$2,300.00	$164.52–$806.00	4% below	40%
CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST	$1,980.00	$3,300.00	$164.52–$806.00	11% above	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$2,081.62	$3,469.37	$164.52–$806.00	17% above	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST	$1,740.00	$2,900.00	$98.44–$806.00	26% above	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$1,820.29	$3,033.82	$98.44–$806.00	32% above	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST	$1,740.00	$2,900.00	$98.44–$806.00	7% above	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST	$1,680.00	$2,800.00	$164.52–$806.00	3% above	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$1,773.20	$2,955.34	$164.52–$806.00	8% above	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 ULTRASOUND OF BOTH SIDES OF HEAD AND NECK BLOOD FLOW	$795.00	$1,325.00	$219.40–$433.01	4% below	40%
Chest X-ray, 2 views CPT 71046 X-RAY OF CHEST; 2 VIEWS	$249.00	$415.00	$81.36–$157.91	1% below	40%
Chest X-ray, single view CPT 71045 X-RAY OF CHEST; 1 VIEW	$207.00	$345.00	$81.36–$157.91	1% below	40%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$221.58	$369.30	$81.36–$157.91	6% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 COMPLETE ULTRASOUND SCAN BEHIND ABDOMINAL CAVITY	$570.00	$950.00	$98.44–$189.72	1% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$628.97	$1,048.29	$98.44–$189.72	11% above	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY MEASUREMENT OF HIP; PELVIS; SPINE	$342.00	$570.00	$98.44–$189.72	at median	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$357.74	$596.24	$98.44–$189.72	5% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS	$155.57	$259.29	$219.40–$433.01	77% below	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 ULTRASOUND SCAN OF PREGNANT UTERUS WITH DETAILED FETAL ANATOMIC EXAMINATION; SINGLE OR FIRST FETUS	$270.00	$450.00	$219.40–$433.01	59% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST	$1,560.00	$2,600.00	$98.44–$806.00	21% above	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST	$1,860.00	$3,100.00	$164.52–$806.00	13% above	40%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$296.29	$493.82	$44.76–$148.56	—	40%
Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$216.00	$360.00	$44.76–$148.56	2% below	40%
Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI	$65.14	$108.57	$36.36–$117.37	72% below	40%
Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$210.00	$350.00	$36.36–$117.37	10% below	40%
Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY	$603.21	$1,005.35	$219.40–$433.01	14% below	40%
Duplex ultrasound of the leg arteries, both legs CPT 93925 ULTRASOUND OF LEG ARTERIES OR ARTERY GRAFTS	$750.00	$1,250.00	$219.40–$433.01	7% above	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$795.00	$1,325.00	$219.40–$433.01	1% below	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$850.30	$1,417.16	$219.40–$433.01	6% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION	$1,475.82	$2,459.70	$493.96–$991.59	2% below	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$1,728.58	$2,880.97	$493.96–$991.59	14% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NUCLEAR MEDICINE STUDY OF LIVER AND BILE DUCT SYSTEM	$1,230.00	$2,050.00	$369.29–$725.48	11% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,288.48	$2,147.46	$369.29–$725.48	6% below	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY INCLUDING HEART RATE; BREATHING; AIRFLOW; AND EFFORT	$635.24	$1,058.73	$139.86–$391.83	4% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY IN SLEEP LAB WITH CONTINUOUS AIRWAY PRESSURE (6 YEARS OR OLDER)	$3,052.20	$5,087.00	$916.68–$1,558.36	16% above	40%
Knee X-ray, 3 views CPT 73562 X-RAY OF KNEE; 3 VIEWS	$216.00	$360.00	$81.36–$157.91	20% below	40%
Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3	$231.08	$385.14	$81.36–$157.91	15% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN	$600.00	$1,000.00	$98.44–$189.72	19% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C-	$93.20	$155.34	$98.44–$806.00	79% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT SCAN OF CHEST FOR LUNG CANCER SCREENING	$1,200.00	$2,000.00	$98.44–$806.00	176% above	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$1,860.00	$3,100.00	$219.40–$1,208.00	at median	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$1,968.88	$3,281.46	$219.40–$1,208.00	6% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI SCAN OF LEG JOINT BEFORE AND AFTER CONTRAST	$2,160.00	$3,600.00	$344.34–$1,208.00	3% below	40%
MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST	$1,860.00	$3,100.00	$219.40–$1,208.00	12% above	40%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$1,976.78	$3,294.64	$219.40–$1,208.00	19% above	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST	$2,160.00	$3,600.00	$344.34–$1,208.00	11% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI SCAN OF BRAIN WITHOUT CONTRAST	$1,500.00	$2,500.00	$219.40–$1,208.00	7% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$1,618.46	$2,697.43	$219.40–$1,208.00	at median	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$2,040.00	$3,400.00	$344.34–$1,208.00	20% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$2,222.59	$3,704.32	$344.34–$1,208.00	13% below	40%
MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$1,860.00	$3,100.00	$219.40–$1,208.00	at median	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST	$2,040.00	$3,400.00	$344.34–$1,208.00	18% below	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$2,222.59	$3,704.32	$344.34–$1,208.00	11% below	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST	$1,860.00	$3,100.00	$219.40–$1,208.00	6% above	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST	$2,040.00	$3,400.00	$344.34–$1,208.00	18% below	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$2,222.59	$3,704.32	$344.34–$1,208.00	11% below	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST	$1,860.00	$3,100.00	$219.40–$1,208.00	6% below	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$1,979.02	$3,298.37	$219.40–$1,208.00	at median	40%
MRI of the pelvis without and with contrast CPT 72197 MRI SCAN OF PELVIS BEFORE AND AFTER CONTRAST	$2,040.00	$3,400.00	$344.34–$1,208.00	20% below	40%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$2,215.84	$3,693.06	$344.34–$1,208.00	14% below	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST	$1,860.00	$3,100.00	$219.40–$1,208.00	1% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI SCAN OF ARM JOINT WITHOUT CONTRAST	$1,860.00	$3,100.00	$219.40–$1,208.00	at median	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$1,968.88	$3,281.46	$219.40–$1,208.00	6% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$2,880.00	$4,800.00	$1,271.40–$2,349.40	30% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NUCLEAR MEDICINE STUDIES OF HEART MUSCLE AT REST AND WITH STRESS AND SPECT	$2,970.00	$4,950.00	$1,271.40–$2,349.40	27% below	40%
OCT scan of the retina (optical coherence tomography) CPT 92134 CPTRZ OPH DX IMG PST SGM RTA	$40.34	$67.24	$54.77–$107.05	27% above	40%
OCT scan of the retina (optical coherence tomography) CPT 92134 IMAGING OF RETINA	$50.36	$83.94	$54.77–$107.05	58% above	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NUCLEAR MEDICINE STUDY FROM SKULL BASE TO MID-THIGH WITH CT SCAN	$4,020.00	$6,700.00	$1,400.77–$2,594.93	12% below	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH	$4,210.23	$7,017.05	$1,400.77–$2,594.93	8% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 LIMITED ULTRASOUND SCAN OF PELVIS	$420.00	$700.00	$98.44–$189.72	4% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$459.89	$766.49	$98.44–$189.72	14% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$55.06	$91.76	$98.44–$189.72	92% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 COMPLETE ULTRASOUND SCAN OF PELVIS	$675.00	$1,125.00	$98.44–$189.72	4% above	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$565.85	$943.09	$98.44–$189.72	at median	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS	$567.00	$945.00	$98.44–$189.72	at median	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$79.72	$132.86	$98.44–$189.72	84% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS	$565.85	$943.09	$98.44–$189.72	11% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$52.23	$87.05	$98.44–$189.72	85% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITED ULTRASOUND OF PREGNANT UTERUS	$420.00	$700.00	$98.44–$189.72	17% above	40%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$60.64	$101.07	$33.79–$119.76	—	40%
Screening mammogram, both breasts CPT 77067 SCREENING MAMMOGRAPHY	$195.00	$325.00	$33.79–$119.76	18% above	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY OF SHOULDER; MINIMUM OF 2 VIEWS	$210.00	$350.00	$81.36–$157.91	23% below	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER	$225.08	$375.14	$81.36–$157.91	17% below	40%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$2,994.54	$4,990.90	$916.68–$1,558.36	18% above	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 IMAGING FOR EVALUATION OF SWALLOWING FUNCTION	$402.00	$670.00	$164.52–$318.29	9% below	40%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$55.55	$92.59	$98.44–$189.72	90% below	40%
Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$480.00	$800.00	$98.44–$189.72	17% below	40%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$449.70	$749.50	$98.44–$189.72	4% below	40%
Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS	$480.00	$800.00	$98.44–$189.72	3% above	40%
Ultrasound of the abdomen, complete CPT 76700 COMPLETE ULTRASOUND SCAN OF ABDOMEN	$900.00	$1,500.00	$98.44–$189.72	14% above	40%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$964.56	$1,607.60	$98.44–$189.72	23% above	40%
Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM	$570.00	$950.00	$98.44–$189.72	2% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SCAN OF HEAD AND NECK SOFT TISSUE	$600.00	$1,000.00	$98.44–$189.72	6% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$644.91	$1,074.85	$98.44–$189.72	14% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$525.00	$875.00	$164.52–$318.29	7% below	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 SINGLE CONTRAST X-RAY OF UPPER DIGESTIVE TRACT	$636.09	$1,060.15	$164.52–$318.29	12% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ULTRASOUND STUDY OF ONE ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS	$600.00	$1,000.00	$98.44–$189.72	7% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$636.05	$1,060.09	$98.44–$189.72	13% above	40%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY OF WRIST; MINIMUM OF 3 VIEWS	$210.00	$350.00	$81.36–$157.91	20% below	40%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST	$223.99	$373.32	$81.36–$157.91	15% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY OF HIP; 2-3 VIEWS	$222.00	$370.00	$81.36–$157.91	7% below	40%
X-ray of the abdomen, 1 view CPT 74018 X-RAY OF ABDOMEN; 1 VIEW	$222.00	$370.00	$81.36–$157.91	2% above	40%
X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE	$186.00	$310.00	$81.36–$157.91	2% below	40%
X-ray of the ankle, 2 views CPT 73600 X-RAY OF ANKLE; 2 VIEWS	$199.41	$332.35	$81.36–$157.91	5% above	40%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY OF FINGER; MINIMUM OF 2 VIEWS	$156.00	$260.00	$81.36–$157.91	24% below	40%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$167.16	$278.60	$81.36–$157.91	19% below	40%
X-ray of the foot, 2 views CPT 73620 X-RAY OF FOOT; 2 VIEWS	$186.00	$310.00	$81.36–$157.91	6% below	40%
X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT	$198.41	$330.68	$81.36–$157.91	at median	40%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT	$229.49	$382.49	$81.36–$157.91	16% below	40%
X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND	$239.22	$398.70	$81.36–$157.91	5% below	40%
X-ray of the hand, 3 or more views CPT 73130 X-RAY OF HAND; MINIMUM OF 3 VIEWS	$246.00	$410.00	$81.36–$157.91	2% below	40%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$198.81	$331.35	$81.36–$157.91	13% below	40%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY OF KNEE; 1-2 VIEWS	$210.00	$350.00	$81.36–$157.91	8% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS	$312.00	$520.00	$98.44–$189.72	6% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$329.93	$549.88	$98.44–$189.72	12% above	40%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$390.00	$650.00	$98.44–$189.72	9% below	40%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY OF NOSE BONES; MINIMUM OF 3 VIEWS	$228.00	$380.00	$81.36–$157.91	9% below	40%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES	$241.99	$403.32	$81.36–$157.91	3% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS	$258.00	$430.00	$81.36–$157.91	14% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$275.93	$459.88	$81.36–$157.91	8% below	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY OF PELVIS; 1-2 VIEWS	$222.00	$370.00	$98.44–$189.72	2% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY OF SACRUM AND TAILBONE; MINIMUM OF 2 VIEWS	$234.00	$390.00	$81.36–$157.91	11% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$247.99	$413.32	$81.36–$157.91	6% below	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL	$15.90	$26.50	$5.25–$9.01	67% below	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$48.00	$80.00	$5.25–$9.01	1% below	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL	$15.54	$25.90	$5.13–$8.81	67% below	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$48.00	$80.00	$5.13–$8.81	3% above	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$216.30	$360.50	$47.16–$80.97	8% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$20.56	$34.26	$5.17–$8.87	7% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH	$111.60	$186.00	$5.17–$8.87	405% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT	$14.48	$24.14	$12.83–$22.02	82% below	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$57.60	$96.00	$12.83–$22.02	28% below	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER	$14.48	$24.14	$11.97–$20.55	79% below	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$51.39	$85.65	$11.97–$20.55	25% below	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$182.31	$303.85	$38.86–$66.74	49% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL	$315.54	$525.90	$38.86–$66.74	158% above	40%
Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$111.73	$186.22	$8.37–$14.38	10% below	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY	$519.12	$865.20	$48.51–$94.57	154% above	40%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$111.24	$185.40	$10.22–$17.54	at median	40%
Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE	$222.48	$370.80	$10.22–$17.54	100% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$18.00	$30.00	$9.34–$15.88	7% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE	$21.00	$35.00	$9.34–$15.88	25% above	40%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$11.79	$19.65	$3.89–$6.68	64% below	40%
Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL	$21.32	$35.54	$3.89–$6.68	35% below	40%
Blood lead test CPT 83655 LEAD LEVEL	$55.62	$92.70	$11.99–$20.59	2% above	40%
Blood lead test CPT 83655 ASSAY OF LEAD	$212.64	$354.40	$11.99–$20.59	289% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS	$82.86	$138.10	$7.45–$12.78	55% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO)	$24.00	$40.00	$114.37–$241.43	67% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$67.98	$113.30	$114.37–$241.43	6% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION	$46.35	$77.25	$5.13–$8.81	22% below	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$114.00	$190.00	$36.89–$63.36	19% below	40%
C. difficile toxin gene test (stool PCR) CPT 87493 DETECTION TEST BY NUCLEIC ACID FOR CLOSTRIDIUM DIFFICILE; AMPLIFIED PROBE TECHNIQUE	$115.16	$191.94	$36.89–$63.36	18% below	40%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9	$105.06	$175.10	$20.60–$35.38	4% below	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125	$98.88	$164.80	$20.60–$35.38	9% below	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125	$208.38	$347.30	$20.60–$35.38	91% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 AMPLIFED DNA OR RNA PROBE DETECTION OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (COVID-19) ANTIGEN	$60.00	$100.00	$50.80–$87.23	40% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$857.70	$1,429.50	$50.80–$87.23	758% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE	$105.00	$175.00	$34.74–$59.65	17% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE	$105.27	$175.45	$34.74–$59.65	17% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$167.81	$279.69	$13.26–$22.76	63% above	40%
Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$84.00	$140.00	$7.69–$13.21	58% above	40%
Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$58.51	$97.51	$6.40–$11.00	19% above	40%
Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$144.00	$240.00	$10.45–$17.95	14% above	40%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT	$149.93	$249.88	$10.08–$17.31	20% above	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL	$222.38	$370.64	$22.01–$37.79	63% above	40%
Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE)	$185.40	$309.00	$27.66–$47.50	29% above	40%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL	$123.60	$206.00	$18.39–$31.59	21% above	40%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$351.07	$585.12	$19.44–$33.37	89% above	40%
Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL	$360.00	$600.00	$19.44–$33.37	94% above	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL	$74.16	$123.60	$13.50–$23.17	12% below	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM	$80.34	$133.90	$14.55–$24.99	6% above	40%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$56.46	$94.10	$16.77–$28.80	43% below	40%
Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE	$81.00	$135.00	$16.77–$28.80	18% below	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$54.60	$91.00	$8.93–$15.33	26% below	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE	$72.00	$120.00	$8.93–$15.33	3% below	40%
Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE	$126.00	$210.00	$25.21–$43.30	at median	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$272.91	$454.85	—	1% below	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE	$67.98	$113.30	$4.71–$8.07	60% above	40%
Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS	$20.70	$34.50	$12.74–$21.88	77% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE	$105.00	$175.00	$34.74–$59.65	29% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$154.80	$258.00	$34.74–$59.65	91% above	40%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY	$55.78	$92.96	$16.69–$28.65	26% below	40%
H. pylori stool antigen test CPT 87338 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HELICOBACTER PYLORI (GI TRACT BACTERIA) IN STOOL	$143.74	$239.57	$14.23–$24.45	20% above	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DETECTION TEST BY NUCLEIC ACID FOR HIV-1 VIRUS; QUANTIFICATION	$463.50	$772.50	$84.25–$144.67	33% above	40%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY	$263.57	$439.28	$13.57–$23.31	130% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HIV-1 ANTIGEN AND HIV-1 AND HIV-2 ANTIBODIES	$120.00	$200.00	$23.84–$40.94	48% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 DETECTION TEST BY NUCLEIC ACID FOR HUMAN PAPILLOMAVIRUS (HPV); HIGH-RISK TYPES	$114.33	$190.55	$34.74–$59.65	3% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$35.97	$59.95	$9.61–$16.51	41% below	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL	$43.20	$72.00	$9.61–$16.51	30% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT	$35.79	$59.65	$10.64–$18.26	48% below	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN	$60.00	$100.00	$10.23–$17.56	7% below	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$263.57	$439.28	$10.23–$17.56	307% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT	$92.70	$154.50	$14.12–$24.26	9% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST	$263.57	$439.28	$14.12–$24.26	211% above	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$219.68	$366.14	$42.42–$72.83	26% below	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION	$309.00	$515.00	$42.42–$72.83	4% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$48.84	$81.40	$13.06–$22.42	26% below	40%
Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1	$123.60	$206.00	$13.06–$22.42	88% above	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$37.15	$61.92	$19.16–$32.90	39% below	40%
Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2	$123.60	$206.00	$19.16–$32.90	104% above	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY	$61.80	$103.00	$12.83–$22.02	13% below	40%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE	$148.38	$247.30	$17.74–$30.46	36% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL	$162.00	$270.00	$17.74–$30.46	48% above	40%
Insulin blood test CPT 83525 ASSAY OF INSULIN	$45.00	$75.00	$11.32–$19.43	24% below	40%
Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL	$60.00	$100.00	$11.32–$19.43	1% above	40%
Iron blood test (serum iron) CPT 83540 IRON LEVEL	$46.35	$77.25	$6.40–$11.00	at median	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$74.16	$123.60	$8.66–$14.86	10% above	40%
Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL	$123.60	$206.00	$8.59–$14.76	16% above	40%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL	$111.24	$185.40	$18.34–$31.48	9% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL	$64.89	$108.15	$6.82–$11.71	3% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$67.76	$112.93	$6.82–$11.71	8% above	40%
Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL	$126.69	$211.15	$8.09–$13.89	5% below	40%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$30.65	$51.09	$16.86–$28.95	67% below	40%
Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA)	$51.09	$85.15	$16.86–$28.95	44% below	40%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$49.12	$81.86	$6.63–$11.39	5% above	40%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL	$120.00	$200.00	$6.63–$11.39	155% above	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$47.70	$79.50	$12.75–$21.90	19% below	40%
Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS)	$74.16	$123.60	$12.75–$21.90	25% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN	$24.49	$40.81	$5.13–$8.81	40% below	40%
Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO)	$63.00	$105.00	$5.13–$8.81	54% above	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE	$74.40	$124.00	$18.20–$31.26	3% below	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$45.41	$75.69	$18.20–$31.26	41% below	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$78.00	$130.00	$18.20–$31.26	1% above	40%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP TEST; AUTOMATED THIN LAYER PREPARATION; AUTOMATED SYSTEM AND MANUAL RESCREENING	$80.34	$133.90	$26.34–$45.24	8% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$31.68	$52.80	$20.05–$34.44	57% below	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL	$154.50	$257.50	$40.86–$70.18	10% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$48.76	$81.27	$5.95–$10.22	7% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$67.98	$113.30	$5.95–$10.22	29% above	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY	$3,591.00	$5,985.00	$751.46–$1,290.38	208% above	40%
Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL	$185.40	$309.00	$20.65–$35.46	68% above	40%
Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL	$123.60	$206.00	$19.18–$32.95	1% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME	$42.02	$70.04	$4.25–$7.29	50% above	40%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$58.71	$97.85	$16.39–$28.14	2% below	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$49.44	$82.40	$16.37–$28.10	24% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL	$62.60	$104.34	$5.61–$9.64	40% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$153.83	$256.38	$5.61–$9.64	245% above	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$53.46	$89.10	$14.24–$24.46	1% above	40%
Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS)	$61.80	$103.00	$14.24–$24.46	17% above	40%
Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES	$78.12	$130.20	$8.81–$15.13	36% above	40%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$125.39	$208.98	$8.81–$15.13	118% above	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL ANALYSIS FOR BLOOD TO SCREEN FOR COLON TUMORS	$27.84	$46.40	$4.33–$7.45	30% above	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 STOOL ANALYSIS FOR BLOOD; BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY	$74.16	$123.60	$15.76–$27.06	45% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST	$48.47	$80.79	$4.22–$7.26	64% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON	$216.30	$360.50	$61.36–$105.37	14% above	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL	$46.46	$77.43	$25.55–$43.88	61% below	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT	$14.48	$24.14	$14.41–$24.73	81% below	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$69.17	$115.28	$14.41–$24.74	10% below	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$35.10	$58.50	$16.63–$28.56	23% below	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$75.00	$125.00	$16.63–$28.56	64% above	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$58.20	$97.00	$34.74–$59.65	58% below	40%
Trichomonas test (NAAT) CPT 87661 DETECTION TEST BY NUCLEIC ACID FOR TRICHOMONAS VAGINALIS (GENITAL PARASITE); AMPLIFIED PROBE TECHNIQUE	$120.00	$200.00	$34.74–$59.65	13% below	40%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$13.56	$22.60	$4.48–$7.68	68% below	40%
Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD	$45.13	$75.22	$4.48–$7.68	7% above	40%
Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$52.53	$87.55	$3.14–$5.39	40% above	40%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE	$4.87	$8.11	$3.98–$6.83	85% below	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$18.42	$30.70	$2.23–$3.82	8% below	40%
Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST	$33.99	$56.65	$2.23–$3.82	69% above	40%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$34.98	$58.30	$7.99–$13.72	46% below	40%
Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE	$83.18	$138.63	$7.99–$13.72	29% above	40%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$64.80	$108.00	$8.52–$14.64	30% above	40%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL	$74.16	$123.60	$14.93–$25.64	4% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL	$135.96	$226.60	$29.30–$50.32	at median	40%
Zinc blood test CPT 84630 ASSAY OF ZINC	$65.77	$109.61	$11.28–$19.36	8% above	40%
Zinc blood test CPT 84630 ZINC LEVEL	$74.16	$123.60	$11.28–$19.36	21% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL	$123.60	$206.00	$14.90–$25.58	45% above	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS)	$1,177.96	$1,963.27	$2,882.77–$6,016.57	63% below	40%
Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS	$1,979.15	$3,298.59	$2,882.77–$6,016.57	38% below	40%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY	$1,474.80	$2,458.00	$790.09–$1,343.15	at median	40%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$2,620.04	$4,366.74	$6,774.05–$11,748.07	110% above	40%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY/SURGERY	$5,045.78	$8,409.63	$7,745.81–$13,167.88	74% below	40%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 SHO ARTHRS SRG RT8TR CUF RPR	$5,045.78	$8,409.63	$7,745.81–$13,167.88	58% below	40%
Botox injections for chronic migraine CPT 64615 INJECTION OF CHEMICAL FOR PARALYSIS OF FACIAL AND NECK NERVE MUSCLES ON BOTH SIDES OF FACE	$374.82	$624.70	$265.20–$557.04	44% above	40%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$375.00	$625.00	$265.20–$557.04	44% above	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC	$1,213.23	$2,022.05	$1,763.03–$2,997.15	52% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH	$2,430.00	$4,050.00	$1,763.03–$2,997.15	4% below	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT OF BROKEN OUTSIDE LOWER LEG BONE AT ANKLE	$202.58	$337.64	$263.30–$447.61	59% below	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE	$208.66	$347.77	$263.30–$447.61	57% below	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TREATMENT OF BROKEN BONE IN FOREFOOT OR MIDFOOT	$202.58	$337.64	$211.14–$447.61	48% below	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE	$301.20	$502.00	$211.14–$447.61	23% below	40%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 COR HLX VLGS DSTL MTAR OSTEO	$2,380.71	$3,967.85	$3,492.77–$5,937.71	31% above	40%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION OF BUNION	$1,295.98	$2,159.97	$3,492.77–$5,937.71	10% above	40%
Bunion correction with removal of part of the big toe joint CPT 28292 COR HLX VLGS RSC PRX PHLX BS	$2,380.71	$3,967.85	$3,492.77–$5,937.71	102% above	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$900.00	$1,500.00	$582.74–$1,199.42	9% above	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT	$1,020.00	$1,700.00	$582.74–$1,199.42	24% above	40%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$1,449.45	$2,415.75	$2,084.49–$3,543.63	52% below	40%
Cataract surgery with lens implant CPT 66984 XCAPSL CTRC RMVL W/O ECP	$1,728.98	$2,881.64	$2,463.54–$4,188.02	67% below	40%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$518.04	$863.40	$719.81–$1,671.44	51% below	40%
Cesarean delivery, including prenatal and postpartum care CPT 59510 CESAREAN DELIVERY	$3,852.00	$6,420.00	$2,369.86–$4,028.76	at median	40%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER	$1,526.11	$2,543.52	$1,823.72–$3,793.41	52% below	40%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 REMOVAL OF FORESKIN (OLDER THAN 28 DAYS)	$4,241.98	$7,069.97	$1,823.72–$3,793.41	34% above	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$1,526.11	$2,543.52	$1,823.72–$3,793.41	358% above	40%
Circumcision, surgical, older than a newborn inpatient CPT 54160 REMOVAL OF FORESKIN (28 DAYS OR YOUNGER)	$86.40	$144.00	$2,909.60–$3,080.18	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREATMENT OF BROKEN FOREARM (RADIUS) BONE AT THE WRIST AREA ON THE THUMB SIDE OF THE WRIST WITHOUT MANIPULATION	$202.58	$337.64	$263.30–$447.61	66% below	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO	$651.79	$1,086.31	$263.30–$447.61	11% above	40%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL	$842.75	$1,404.59	$1,056.60–$2,171.55	50% below	40%
Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$2,233.41	$3,722.35	$1,056.60–$2,171.55	31% above	40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$842.75	$1,404.59	$1,056.60–$2,171.55	53% below	40%
Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,072.28	$3,453.80	$1,056.60–$2,171.55	16% above	40%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$638.98	$1,064.97	$818.34–$1,687.61	49% below	40%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,680.00	$2,800.00	$818.34–$1,687.61	33% above	40%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP	$2,045.50	$3,409.16	$2,799.28–$5,874.40	at median	40%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$245.70	$409.50	$287.24–$552.99	45% below	40%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BIOPSY AND SCRAPING OF CERVIX USING AN ENDOSCOPE	$3,533.89	$5,889.81	$287.24–$552.99	685% above	40%
Complex cataract surgery with lens implant CPT 66982 XCAPSL CTRC RMVL CPLX WO ECP	$1,728.98	$2,881.64	$2,463.54–$4,188.02	61% below	40%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$2,427.08	$4,045.14	$3,762.82–$6,396.79	59% below	40%
Cystoscopy with ureteral stent placement CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE	$3,533.89	$5,889.81	$3,762.82–$6,396.79	41% below	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$536.84	$894.74	$611.63–$1,265.38	50% below	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 DIAGNOSTIC EXAM OF BLADDER AND URETHRA USING AN ENDOSCOPE	$3,887.93	$6,479.89	$611.63–$1,265.38	263% above	40%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE	$2,045.50	$3,409.16	$2,799.28–$5,874.40	33% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION OF PRECANCER SKIN GROWTH; 1 GROWTH	$158.81	$264.68	$179.26–$364.09	36% above	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION	$163.57	$272.62	$179.26–$364.09	40% above	40%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING	$1,024.36	$1,707.27	$1,656.27–$2,815.66	69% below	40%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA	$2,062.49	$3,437.48	$1,656.27–$2,815.66	37% below	40%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 INCISION OF EARDRUM WITH INSERTION OF EARDRUM TUBE UNDER LOCAL OR TOPICAL ANESTHESIA	$413.89	$689.81	$575.72–$978.72	at median	40%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING	$426.30	$710.50	$575.72–$978.72	3% above	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$50.31	$83.85	$62.97–$107.05	32% below	40%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$51.82	$86.37	$54.77–$107.05	43% below	40%
Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX	$2,448.74	$4,081.23	$54.77–$107.05	2572% above	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$149.34	$248.90	$178.42–$366.89	43% below	40%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NSL/SINS NDSC W/TOT ETHMDCT	$4,377.76	$7,296.26	$7,533.64–$12,807.19	49% below	40%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NSL/SINS NDSC FRNT TISS RMVL	$4,377.76	$7,296.26	$7,533.64–$12,807.19	47% below	40%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 INCISION OF NASAL SINUS USING AN ENDOSCOPE	$1,819.95	$3,033.25	$3,979.91–$6,765.85	38% below	40%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORATION MAXILLARY SINUS	$2,354.92	$3,924.86	$3,979.91–$6,765.85	20% below	40%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS	$4,377.76	$7,296.26	$7,533.64–$12,807.19	46% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE	$538.93	$898.22	$619.19–$1,280.97	47% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$873.09	$1,455.15	$619.19–$1,280.97	14% below	40%
Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECTION EYE DRUG	$267.82	$446.36	$352.59–$599.40	19% below	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$688.36	$1,147.26	$944.15–$1,605.06	34% below	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION OF LOWER OR SACRAL SPINE FACET JOINT USING IMAGING GUIDANCE; SINGLE LEVEL	$1,740.00	$2,900.00	$944.15–$1,605.06	68% above	40%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE	$5,658.17	$9,430.29	$3,097.71–$11,748.07	12% below	40%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE	$4,241.98	$7,069.97	$3,097.71–$6,497.37	10% below	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$638.98	$1,064.97	$818.34–$1,687.61	43% below	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,680.00	$2,800.00	$818.34–$1,687.61	49% above	40%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$4,039.81	$6,733.02	$5,166.31–$10,970.83	33% below	40%
Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$5,664.70	$9,441.17	$5,166.31–$10,970.83	6% below	40%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$4,039.81	$6,733.02	$5,166.31–$10,970.83	35% below	40%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE	$6,294.23	$10,490.38	$5,166.31–$10,970.83	1% above	40%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY	$1,798.20	$2,997.00	$965.76–$1,641.79	19% below	40%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$2,380.71	$3,967.85	$3,492.77–$5,937.71	1% below	40%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$638.98	$1,064.97	$818.34–$1,687.61	53% below	40%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVE INT/EXT HEM 1 GROUP	$2,084.07	$3,473.45	$2,514.04–$5,037.00	50% below	40%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVAL OF SINGLE EXTERNAL AND INTERNAL HEMORRHOID GROUP	$2,475.04	$4,125.07	$2,514.04–$5,037.00	41% below	40%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 TOTAL HIP ARTHROPLASTY	$2,788.80	$4,648.00	$8,854.00–$16,445.94	45% below	40%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL HYSTERECTOMY	$1,683.00	$2,805.00	$895.00–$6,739.00	89% below	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$232.42	$387.37	$49.40–$83.98	19% below	40%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION	$3,700.63	$6,167.72	$4,453.54–$9,077.98	51% below	40%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY	$2,059.20	$3,432.00	$2,799.28–$5,874.40	50% below	40%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$3,887.93	$6,479.89	$2,799.28–$5,874.40	6% below	40%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$128.62	$214.37	$183.42	79% below	40%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD FOR PREGNANCY PREVENTION	$1,943.96	$3,239.94	$183.42	215% above	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$216.91	$361.51	$179.26–$364.09	4% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS	$3,533.89	$5,889.81	$179.26–$364.09	1471% above	40%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR	$2,620.04	$4,366.74	$3,821.98–$6,497.37	58% below	40%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$9,351.91	$15,586.51	$3,821.98–$6,497.37	49% above	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION INTO TENDON OR LIGAMENT	$228.00	$380.00	$327.67–$557.04	15% above	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$229.42	$382.36	$327.67–$557.04	16% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT	$270.00	$450.00	$327.67–$557.04	26% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$384.67	$641.12	$327.67–$557.04	80% above	40%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT	$94.54	$157.56	$114.37–$241.43	48% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT	$222.73	$371.22	$327.67–$557.04	11% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$229.42	$382.36	$327.67–$557.04	15% above	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION AND/OR INJECTION OF FLUID FROM SMALL JOINT	$222.73	$371.22	$327.67–$557.04	11% above	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$229.42	$382.36	$327.67–$557.04	14% above	40%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHROSCOPY/SURGERY	$2,380.71	$3,967.85	$3,492.77–$5,937.71	78% below	40%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY	$2,380.71	$3,967.85	$3,492.77–$5,937.71	65% below	40%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY	$2,380.71	$3,967.85	$3,492.77–$5,937.71	66% below	40%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHROSCOPY/SURGERY	$2,380.71	$3,967.85	$3,492.77–$5,937.71	62% below	40%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$4,039.81	$6,733.02	$5,166.31–$10,970.83	49% below	40%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE	$6,578.23	$10,963.71	$5,166.31–$10,970.83	18% below	40%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPY FUNDOPLASTY	$6,835.88	$11,393.13	$9,216.77–$19,290.00	32% below	40%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 REMOVAL OF UTERUS; TUBES; AND/OR OVARIES THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS	$6,284.28	$10,473.80	$9,216.77–$19,290.00	61% below	40%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT	$4,039.81	$6,733.02	$6,453.43–$10,970.83	45% below	40%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE	$4,950.08	$8,250.13	$6,453.43–$10,970.83	33% below	40%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR	$4,039.81	$6,733.02	$6,453.43–$10,970.83	61% below	40%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA	$4,039.81	$6,733.02	$6,453.43–$10,970.83	62% below	40%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE	$4,241.98	$7,069.97	$6,453.43–$10,970.83	60% below	40%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 LAP SLEEVE GASTRECTOMY	$760.80	$1,268.00	$973.28–$7,850.00	96% below	40%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 REMOVAL OF RECURRING CATARACT IN LENS CAPSULE USING A LASER	$600.00	$1,000.00	$587.11–$998.09	16% below	40%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 AFTER CATARACT LASER SURGERY	$618.00	$1,030.00	$587.11–$998.09	13% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$379.80	$633.00	$357.03–$737.70	at median	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$2,004.07	$3,340.12	$357.03–$737.70	428% above	40%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$538.93	$898.22	$619.19–$1,280.97	44% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$1,278.60	$2,131.00	$619.19–$1,280.97	32% above	40%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$1,326.60	$2,211.00	$816.11–$1,605.06	19% above	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$688.36	$1,147.26	$944.15–$1,605.06	54% below	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$1,535.29	$2,558.81	$944.15–$1,605.06	3% above	40%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY	$2,455.06	$4,091.76	$4,179.62–$7,105.35	92% above	40%
Mastectomy (total removal of the breast) CPT 19303 MAST SIMPLE COMPLETE	$4,330.69	$7,217.82	$7,088.20–$12,049.94	193% above	40%
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$2,045.50	$3,409.16	$2,799.28–$5,874.40	58% below	40%
Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISCARRIAGE DURING FIRST TRIMESTER	$3,887.93	$6,479.89	$2,799.28–$5,874.40	20% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$521.41	$869.01	$629.97–$1,285.06	111% above	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL OF NONCANCER SKIN GROWTH OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 0.5 CM OR LESS	$521.41	$869.01	$629.97–$1,285.06	80% above	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$537.05	$895.08	$629.97–$1,285.06	86% above	40%
Nail removal (partial or complete), one nail CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL	$210.00	$350.00	$179.26–$364.09	28% above	40%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$302.94	$504.90	$179.26–$364.09	84% above	40%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$140.90	$234.84	$327.67–$557.04	54% below	40%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE	$405.00	$675.00	$327.67–$557.04	33% above	40%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT	$8,773.19	$14,621.99	$9,561.08–$18,967.27	50% below	40%
Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE	$595.32	$992.20	$811.65–$1,645.91	31% below	40%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$669.14	$1,115.24	$811.65–$1,645.91	22% below	40%
Partial knee replacement (one compartment) CPT 27446 REVISION OF KNEE JOINT	$9,110.63	$15,184.38	$13,704.95–$23,298.42	at median	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$296.76	$494.60	$357.03–$737.70	25% below	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERMANENT REMOVAL FINGERNAIL OR TOENAIL	$757.73	$1,262.88	$357.03–$737.70	91% above	40%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE GLAND	$3,179.84	$5,299.73	$1,823.72	7% above	40%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE	$3,185.86	$5,309.76	$1,823.72	7% above	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$1,468.33	$2,447.22	$2,084.49–$3,543.63	2% above	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION OF LOWER OR SACRAL SPINAL FACET JOINT NERVES USING IMAGING GUIDANCE; SINGLE FACET JOINT	$1,500.00	$2,500.00	$2,084.49–$3,543.63	4% above	40%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$2,455.06	$4,091.76	$4,179.62–$7,105.35	147% above	40%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$5,244.59	$8,740.99	$4,179.62–$7,105.35	427% above	40%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$195.13	$325.22	$357.03–$737.70	36% below	40%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE	$4,773.05	$7,955.09	$357.03–$737.70	1468% above	40%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 PARTIAL REMOVAL OF THYROID	$4,039.81	$6,733.02	$5,166.31–$10,970.83	66% below	40%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$2,475.04	$4,125.06	$992.71–$1,687.61	224% above	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK	$1,680.00	$2,800.00	$992.71–$1,687.61	123% above	40%
Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM	$1,979.15	$3,298.59	$2,882.77–$6,016.57	71% below	40%
Septoplasty to straighten the nasal septum CPT 30520 RESHAPING OF NASAL CARTILAGE	$2,298.02	$3,830.03	$2,882.77–$6,016.57	66% below	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE	$3,335.43	$5,559.05	$3,762.82–$6,396.79	65% below	40%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF ELBOW TO FINGER CAST	$212.02	$353.37	$298.57–$507.57	12% below	40%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$330.95	$551.58	$298.57–$507.57	38% above	40%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT	$95.83	$159.72	$142.02–$241.43	35% below	40%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$120.00	$200.00	$142.02–$241.43	19% below	40%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$111.35	$185.58	$298.57–$507.57	60% below	40%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$213.55	$355.92	$298.57–$507.57	24% below	40%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$121.88	$203.13	$173.47–$294.90	26% below	40%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT	$210.00	$350.00	$173.47–$294.90	27% above	40%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHO ARTHRS SRG DSTL CLAVICLC	$2,380.71	$3,967.85	$3,492.77–$5,937.71	77% below	40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHO ARTHRS SRG DECOMPRESSION	$297.00	$495.00	$142.93–$242.98	98% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$158.81	$264.68	$179.26–$364.09	28% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS	$210.00	$350.00	$179.26–$364.09	5% below	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$323.03	$538.38	$357.03–$737.70	23% above	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH	$2,434.96	$4,058.27	$357.03–$737.70	829% above	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$947.57	$1,579.28	$629.97–$1,285.06	175% above	40%
Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15	$163.57	$272.62	$179.26–$364.09	11% above	40%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAG; 1-15 SKIN TAGS	$3,887.93	$6,479.89	$179.26–$364.09	2542% above	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$489.04	$815.07	$619.19–$1,280.97	3% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST	$720.00	$1,200.00	$619.19–$1,280.97	43% above	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$310.69	$517.82	$179.26–$364.09	8% above	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM	$3,887.93	$6,479.89	$179.26–$364.09	1247% above	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$99.00	$165.00	$179.26–$364.09	63% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS	$210.00	$350.00	$179.26–$364.09	21% below	40%
TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP)	$3,335.43	$5,559.05	$4,633.00–$9,730.07	66% below	40%
TURP (transurethral resection of the prostate) CPT 52601 REMOVAL OF PROSTATE GLAND USING AN ELECTROCAUTERY KNIFE THROUGH URETHRA WITH CONTROL OF BLEEDING USING AN ENDOSCOPE	$4,241.98	$7,069.97	$4,633.00–$9,730.07	57% below	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF RELATED SKIN GROWTH; FIRST GROWTH	$134.63	$224.39	$179.26–$737.70	30% below	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$281.30	$468.84	$179.26–$737.70	47% above	40%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$551.32	$918.86	$669.62–$1,138.35	38% below	40%
Thoracentesis with imaging guidance CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE	$2,120.99	$3,534.98	$669.62–$1,138.35	137% above	40%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS	$1,979.15	$3,298.59	$2,882.77–$6,016.57	51% below	40%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVAL OF TONSILS AND ADENOID GLANDS (12 YEARS OR OLDER)	$5,355.47	$8,925.79	$2,882.77–$6,016.57	31% above	40%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$2,448.74	$4,081.23	$5,243.49–$10,742.72	35% below	40%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS	$3,904.91	$6,508.19	$5,243.49–$10,742.73	3% above	40%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS	$1,979.15	$3,298.59	$2,882.77–$6,016.57	39% below	40%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS (12 YEARS OR OLDER)	$3,179.84	$5,299.73	$2,882.77–$6,016.57	2% below	40%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS (YOUNGER THAN 12 YEARS)	$3,533.89	$5,889.81	$5,243.49–$10,742.73	21% below	40%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS	$3,904.91	$6,508.19	$5,243.49–$10,742.73	13% below	40%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY	$2,257.80	$3,763.00	$13,704.95–$23,298.42	24% below	40%
Total hip replacement CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$5,304.13	$8,840.21	$13,704.95–$23,298.42	79% above	40%
Total knee replacement CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$2,475.04	$4,125.07	$13,704.95–$23,298.42	20% below	40%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$9,110.63	$15,184.38	$13,704.95–$23,298.42	195% above	40%
Total shoulder replacement CPT 23472 RECONSTRUCT SHOULDER JOINT	$2,420.40	$4,034.00	$18,716.87–$31,818.68	82% below	40%
Total shoulder replacement CPT 23472 PROSTHETIC REPAIR OF SHOULDER JOINT; TOTAL SHOULDER	$4,596.03	$7,660.05	$18,716.87–$31,818.68	66% below	40%
Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID	$4,039.81	$6,733.02	$5,166.31–$10,970.83	70% below	40%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$1,214.95	$2,024.91	$1,439.05–$2,918.03	23% below	40%
Trigger finger release surgery CPT 26055 INCISION OF TENDON COVERING OF FINGER	$1,589.92	$2,649.87	$1,439.05–$2,918.03	at median	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$76.27	$127.12	$265.20–$557.04	63% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION OF TRIGGER POINTS; 1-2 MUSCLES	$285.00	$475.00	$265.20–$557.04	39% above	40%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY TUBAL CAUTERY	$4,039.81	$6,733.02	$5,166.31–$10,970.83	76% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$1,237.95	$2,063.25	$1,763.03–$2,997.15	30% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING ULTRASOUND; FIRST GROWTH	$1,920.00	$3,200.00	$1,763.03–$2,997.15	8% above	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM	$1,284.65	$2,141.09	$1,703.75–$3,482.23	48% below	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM	$1,589.92	$2,649.87	$1,703.75–$3,482.23	36% below	40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$669.14	$1,115.24	$811.65–$1,645.91	61% below	40%
Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$3,179.84	$5,299.73	$811.65–$1,645.91	87% above	40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$1,120.05	$1,866.75	$1,703.75–$3,482.23	43% below	40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$1,284.65	$2,141.09	$1,703.75–$3,482.23	35% below	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION	$669.14	$1,115.24	$811.65–$1,645.91	41% below	40%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$669.14	$1,115.24	$811.65–$1,645.91	39% below	40%
Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,413.99	$2,356.65	$811.65–$1,645.91	30% above	40%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CRUSHING OF STONE OF URETER USING AN ENDOSCOPE	$1,943.97	$3,239.95	$5,723.57–$9,730.07	79% below	40%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETERO W/LITHOTRIPSY	$3,335.43	$5,559.05	$5,723.57–$9,730.07	64% below	40%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$3,335.43	$5,559.05	$5,723.57–$9,730.07	73% below	40%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE	$6,012.22	$10,020.37	$5,723.57–$9,730.07	52% below	40%
Vaginal delivery, including prenatal and postpartum care CPT 59400 OBSTETRICAL CARE	$3,351.59	$5,585.98	$2,118.86–$3,602.06	19% above	40%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$1,526.11	$2,543.52	$1,823.72–$3,793.41	82% above	40%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT	$3,533.89	$5,889.81	$1,823.72–$3,793.41	320% above	40%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF SKIN GROWTH; 1-14 GROWTHS	$158.81	$264.68	$179.26–$364.09	at median	40%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$163.57	$272.62	$179.26–$364.09	3% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS	$4,241.98	$7,069.97	$357.03–$737.70	1003% above	40%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPTX DST RD XARTC FX/EPI SEP	$5,045.78	$8,409.63	$7,745.81–$13,167.88	at median	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$603.50	$1,005.84	$388.68–$800.60	8% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS	$1,122.00	$1,870.00	$388.68–$800.60	71% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$167.74	$279.57	$190.98–$397.37	6% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION	$180.00	$300.00	$2,909.60–$3,080.18	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$195.00	$325.00	$2,909.60–$3,080.18	—	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$732.00	$1,220.00	$303.24–$599.40	69% above	40%
Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS	$741.60	$1,236.00	$303.24–$599.40	71% above	40%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 NEW PATIENT COMPLETE EXAM OF VISUAL SYSTEM	$102.32	$170.54	$118.36–$241.60	9% above	40%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 COMPRE OPH EXAM NEW PT 1/>	$331.47	$552.45	$118.36–$241.60	254% above	40%
Comprehensive eye exam, returning patient CPT 92014 ESTABLISHED PATIENT COMPLETE EXAM OF VISUAL SYSTEM	$102.32	$170.54	$118.36–$241.60	34% above	40%
Comprehensive eye exam, returning patient CPT 92014 COMPRE OPH EXAM EST PT 1/>	$191.21	$318.69	$118.36–$241.60	150% above	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE HEARING TEST	$119.66	$199.44	$137.35–$233.50	30% below	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE HEARING AND SPEECH RECOGNITION TEST	$206.22	$343.70	$137.35–$233.49	21% above	40%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$660.27	$1,100.45	$794.53–$1,499.01	51% below	40%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES	$1,650.00	$2,750.00	$794.53–$1,772.00	23% above	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 MEASUREMENT OF BRAIN WAVE ACTIVITY (EEG); AWAKE AND DROWSY	$643.60	$1,072.66	$230.49–$391.83	14% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$162.00	$270.00	$54.77–$107.05	15% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING	$168.00	$280.00	$54.77–$600.00	12% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$61.79	$102.99	$79.49–$153.03	56% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY	$192.00	$320.00	$79.49–$242.00	38% above	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$112.19	$186.98	$146.44–$278.63	53% below	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY	$372.00	$620.00	$146.44–$443.00	56% above	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$197.19	$328.65	$255.48–$495.38	55% below	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$612.00	$1,020.00	$255.48–$685.00	40% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$319.98	$533.30	$396.57–$757.21	52% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$939.00	$1,565.00	$396.57–$806.00	40% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$468.77	$781.28	$575.11–$1,080.72	56% below	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$1,260.00	$2,100.00	$575.11–$1,772.00	19% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST	$613.03	$1,021.71	$230.49–$391.83	25% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG)	$709.46	$1,182.43	$230.49–$391.83	13% below	40%
Eye exam, returning patient, intermediate CPT 92012 ESTABLISHED PATIENT PROBLEM FOCUSED EXAM OF VISUAL SYSTEM	$102.32	$170.54	$118.36–$241.60	1% below	40%
Eye exam, returning patient, intermediate CPT 92012 INTRM OPH EXAM EST PATIENT	$132.77	$221.28	$118.36–$241.60	28% above	40%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 XTRNL ECG REC UP TO 48 HRS	$130.59	$217.65	—	7% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES	$300.00	$500.00	$191.92–$385.98	22% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$302.89	$504.82	$191.92–$385.98	23% above	40%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$420.00	$700.00	$191.92–$385.98	38% above	40%
IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS	$432.60	$721.00	$191.92–$385.98	43% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE	$105.00	$175.00	$63.07–$130.64	8% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$132.56	$220.93	$63.07–$130.64	36% above	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION; 7-8 STUDIES	$720.00	$1,200.00	$281.04–$677.18	55% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$95.10	$158.50	$30.56–$166.00	7% above	40%
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN	$75.00	$125.00	$69.59–$118.30	45% below	40%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$76.80	$128.00	$69.59–$118.30	43% below	40%
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN	$75.00	$125.00	$113.65–$193.21	59% below	40%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$203.60	$339.33	$113.65–$193.21	12% above	40%
New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60 MIN	$75.00	$125.00	$155.68–$264.66	71% below	40%
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES	$76.80	$128.00	$155.68–$264.66	70% below	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN	$72.00	$120.00	$39.96–$67.93	28% below	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$44.44	$74.07	$25.22–$42.87	2% above	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 THERAPY PROCEDURE FOR NUTRITION MANAGEMENT; EACH 15 MINUTES	$177.77	$296.28	$25.22–$42.87	308% above	40%
Occupational therapy evaluation, low complexity CPT 97165 EVALUATION FOR OCCUPATIONAL THERAPY; TYPICALLY 30 MINUTES	$180.00	$300.00	$93.80–$166.00	30% above	40%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$194.70	$324.50	$93.80–$166.00	40% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$254.62	$424.36	$91.50–$166.00	48% above	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$182.31	$303.85	$91.50–$166.00	44% above	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$200.54	$334.24	$91.50–$166.00	58% above	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$214.96	$358.26	$91.50–$166.00	37% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS	$81.60	$136.00	$25.68–$166.00	1% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 THERAPY PROCEDURE USING MANUAL TECHNIQUE; EACH 15 MINUTES	$244.80	$408.00	$25.68–$166.00	202% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES	$95.10	$158.50	$27.16–$166.00	23% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$190.20	$317.00	$27.16–$166.00	145% above	40%
Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39	$162.23	$270.39	$100.99	16% above	40%
Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW AGE 40-64	$191.32	$318.86	—	14% above	40%
Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT 65+ YRS	$207.47	$345.79	—	26% above	40%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST AGE 18-39	$133.15	$221.91	$100.99	7% above	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST AGE 40-64	$146.71	$244.52	—	12% above	40%
Preventive checkup, returning patient aged 65 or older CPT 99397 PER PM REEVAL EST PAT 65+ YR	$162.23	$270.39	—	11% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES	$72.00	$120.00	$121.95–$207.32	64% below	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40 MIN	$75.00	$125.00	$121.95–$207.32	63% below	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES	$75.00	$125.00	$2,909.60–$3,080.18	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN	$75.00	$125.00	$55.85–$94.94	35% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$76.80	$128.00	$55.85–$94.94	34% below	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE O/P EST LOW 20 MIN	$75.00	$125.00	$2,909.60–$3,080.18	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN	$75.00	$125.00	$82.22–$139.77	53% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$76.80	$128.00	$82.22–$139.77	52% below	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE O/P EST MOD 30 MIN	$75.00	$125.00	$2,909.60–$3,080.18	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN	$75.00	$125.00	$30.22–$51.37	9% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES	$76.80	$128.00	$30.22–$51.37	12% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE O/P EST SF 10 MIN	$75.00	$125.00	$2,909.60–$3,080.18	—	40%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF/OP CNSLTJ NEW/EST LOW 30	$136.20	$227.00	—	24% below	40%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OP CNSLTJ NEW/EST MOD 40	$158.10	$263.50	—	35% below	40%
Speech and language evaluation CPT 92523 EVALUATION OF SPEECH SOUND PRODUCTION WITH EVALUATION OF LANGUAGE COMPREHENSION AND EXPRESSION	$294.00	$490.00	$166.00–$362.00	8% above	40%
Speech therapy session, individual CPT 92507 TREATMENT OF SPEECH; LANGUAGE; VOICE; COMMUNICATION; AND/OR HEARING PROCESSING DISORDER	$180.00	$300.00	$71.67–$166.00	13% above	40%
Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME	$207.60	$346.00	$139.86–$391.83	3% below	40%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$360.00	$600.00	$281.04–$677.18	20% below	40%
Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION	$380.83	$634.72	$281.04–$677.18	16% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$95.10	$158.50	$32.30–$166.00	15% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPY PROCEDURE USING FUNCTIONAL ACTIVITIES	$285.30	$475.50	$32.30–$166.00	246% above	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM	$174.00	$290.00	$114.37–$241.43	7% below	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$180.00	$300.00	$114.37–$241.43	4% below	40%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIOVASCULAR STRESS TEST	$107.29	$178.82	—	33% below	40%
Visual field test, extended CPT 92083 EXAM OF VISUAL FIELD WITH EXTENDED TESTING	$94.54	$157.56	$114.37–$241.43	13% below	40%
Visual field test, extended CPT 92083 EXTENDED VISUAL FIELD XM	$138.31	$230.52	$114.37–$241.43	28% above	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ	$84.47	$140.79	$8.88–$140.79	54% below	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$36.65	$61.08	$8.88–$19.57	39% below	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 2/3 DOSE IM	$176.63	$294.38	$8.88–$294.38	46% below	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM	$85.75	$142.92	$135.97	22% below	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM	$66.55	$110.92	$88.45	19% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$56.30	$93.83	$74.85	28% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM	$41.72	$69.54	$69.54	59% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2025-2026 Formula	$203.10	$338.50	$72.25	100% above	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$68.42	$114.03	$26.62–$100.65	59% below	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II	$325.98	$543.30	$26.62–$100.65	96% above	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM	$99.19	$165.31	$8.88–$165.31	23% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$64.00	$106.66	$8.88–$106.66	66% below	40%
Rabies vaccine, one dose CPT 90675 RabAvert	$995.13	$1,658.55	$315.22–$535.87	14% above	40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE FOR INJECTION INTO MUSCLE	$1,134.72	$1,891.20	$315.22–$535.87	30% above	40%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM	$159.98	$266.64	$205.42	33% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$15.35	$25.59	$17.74–$25.59	78% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac PFS	$151.62	$252.70	$17.74–$31.35	112% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$63.82	$106.36	$26.62–$51.61	37% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix PFS	$180.00	$300.00	$26.62–$51.61	78% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE	$88.65	$147.75	$63.07–$130.65	50% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$96.00	$160.00	$63.07–$130.64	62% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$52.08	$86.80	—	10% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE; EACH ADDITIONAL VACCINE	$60.00	$100.00	—	26% above	40%

Dental

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION; ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORCEPS REMOVAL)	$777.08	$1,295.14	$102.92–$1,173.17	84% below	40%

Source file: https://apim.services.craneware.com/api-pricing-transparency/api/public/e541183863a90b1bd92e5225829d0ea9/charges/mrf