Hospital

Coffey County Hospital

Coffey County Hospital in Burlington, KS publishes cash prices for 319 common procedures listed here, from its own machine-readable price file updated Nov 6, 2024. Compared with other hospitals in the state, its outpatient cash prices are below the Kansas median for 316 of 316 procedures. By typical cash price it ranks #4 of 83 Kansas hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

801 North 4TH Street, Burlington, KS 66839 Collected Sep 27, 2026 Source price file Check a bill from this hospital (620) 364-2121

Critical access hospital (rural, 25 beds or fewer) Government-owned hospital Emergency department CMS star rating 4 of 5 CCN 171385 · CMS hospital register

Financial assistance

Public hospital: ask for its charity care or sliding-scale discount

Coffey County Hospital is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Kansas	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W & W/O	$495.90	$1,653.00	$480.41–$1,570.35	63% below	70%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W & W/O	$495.90	$1,653.00	$480.41–$1,570.35	—	70%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$90.30	$301.00	$100.35–$285.95	64% below	70%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$90.30	$301.00	$100.35–$285.95	—	70%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMPLETE RT M3V	$84.30	$281.00	$103.04–$266.95	63% below	70%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMPLETE LT M3V	$84.30	$281.00	$103.04–$266.95	63% below	70%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE COMPLETE BIL M3V	$156.60	$522.00	$139.38–$495.90	32% below	70%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMPLETE RT M3V	$84.30	$281.00	$103.04–$266.95	—	70%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMPLETE LT M3V	$84.30	$281.00	$103.04–$266.95	—	70%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE COMPLETE BIL M3V	$156.60	$522.00	$139.38–$495.90	—	70%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT EXTR UPPER W/O LEFT	$344.40	$1,148.00	$420.97–$1,090.60	66% below	70%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT EXTR UPPER W/O RIGHT	$344.40	$1,148.00	$420.97–$1,090.60	66% below	70%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT EXTR UPPER W/O RIGHT	$344.40	$1,148.00	$420.97–$1,090.60	—	70%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT EXTR UPPER W/O LEFT	$344.40	$1,148.00	$420.97–$1,090.60	—	70%
Bone scan, whole body (nuclear medicine) CPT 78306 NM WHOLE BODY BONE	$213.30	$711.00	$260.72–$675.45	78% below	70%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM WHOLE BODY BONE	$213.30	$711.00	$260.72–$675.45	—	70%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST COMPLETE BI	$124.50	$415.00	$94.94–$394.25	—	70%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE RIGHT	$62.40	$208.00	$76.27–$197.60	80% below	70%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE LEFT	$62.40	$208.00	$76.27–$197.60	80% below	70%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREAST COMPLETE BI	$124.50	$415.00	$94.94–$394.25	—	70%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE LEFT	$62.40	$208.00	$76.27–$197.60	—	70%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE RIGHT	$62.40	$208.00	$76.27–$197.60	—	70%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED RIGHT	$62.40	$208.00	$76.27–$197.60	79% below	70%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED LEFT	$62.40	$208.00	$76.27–$197.60	79% below	70%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED BILTRL	$115.80	$386.00	$94.94–$366.70	61% below	70%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED LEFT	$62.40	$208.00	$76.27–$197.60	—	70%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED RIGHT	$62.40	$208.00	$76.27–$197.60	—	70%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED BILTRL	$115.80	$386.00	$94.94–$366.70	—	70%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABDMN & PELVIS	$805.50	$2,685.00	$984.59–$2,550.75	67% below	70%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABDMN & PELVIS	$805.50	$2,685.00	$984.59–$2,550.75	—	70%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD W	$616.80	$2,056.00	$753.94–$1,953.20	66% below	70%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIO HEAD W	$616.80	$2,056.00	$753.94–$1,953.20	—	70%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK W	$616.80	$2,056.00	$753.94–$1,953.20	66% below	70%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK W	$616.80	$2,056.00	$753.94–$1,953.20	—	70%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST W	$573.60	$1,912.00	$701.13–$1,816.40	68% below	70%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST W	$573.60	$1,912.00	$701.13–$1,816.40	—	70%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDMN/PELVIS WO	$732.30	$2,441.00	$480.41–$2,318.95	46% below	70%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDMN/PELVIS WO	$732.30	$2,441.00	$480.41–$2,318.95	—	70%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDMN/PELVIS W CONTR	$805.50	$2,685.00	$480.41–$2,550.75	45% below	70%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDMN/PELVIS W CONTR	$805.50	$2,685.00	$480.41–$2,550.75	—	70%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDMN/PELVIS W & WO	$896.10	$2,987.00	$480.41–$2,837.65	49% below	70%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDMN/PELVIS W & WO	$896.10	$2,987.00	$480.41–$2,837.65	—	70%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W	$413.40	$1,378.00	$480.41–$1,309.10	66% below	70%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W	$413.40	$1,378.00	$480.41–$1,309.10	—	70%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O	$320.10	$1,067.00	$391.27–$1,013.65	71% below	70%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O	$320.10	$1,067.00	$391.27–$1,013.65	—	70%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES MAXIO W/O	$444.90	$1,483.00	$480.41–$1,408.85	54% below	70%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES MAXIO W/O	$444.90	$1,483.00	$480.41–$1,408.85	—	70%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST	$535.80	$1,786.00	$480.41–$1,696.70	48% below	70%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST	$535.80	$1,786.00	$480.41–$1,696.70	—	70%
CT scan of the head with contrast CPT 70460 CT HEAD W	$589.20	$1,964.00	$480.41–$1,865.80	47% below	70%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W	$589.20	$1,964.00	$480.41–$1,865.80	—	70%
CT scan of the head without and with contrast CPT 70470 CT HEAD W & W/O	$632.10	$2,107.00	$480.41–$2,001.65	49% below	70%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W & W/O	$632.10	$2,107.00	$480.41–$2,001.65	—	70%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR W/O	$344.40	$1,148.00	$420.97–$1,090.60	69% below	70%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR W/O	$344.40	$1,148.00	$420.97–$1,090.60	—	70%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL W/O	$463.80	$1,546.00	$480.41–$1,468.70	53% below	70%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL W/O	$463.80	$1,546.00	$480.41–$1,468.70	—	70%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W	$413.40	$1,378.00	$480.41–$1,309.10	62% below	70%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W	$413.40	$1,378.00	$480.41–$1,309.10	—	70%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID	$315.30	$1,051.00	$385.40–$998.45	56% below	70%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID	$315.30	$1,051.00	$385.40–$998.45	—	70%
Chest CT scan without and with contrast CPT 71270 CT CHEST W & W/O	$495.90	$1,653.00	$480.41–$1,570.35	60% below	70%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W & W/O	$495.90	$1,653.00	$480.41–$1,570.35	—	70%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$108.00	$360.00	$132.01–$342.00	52% below	70%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$108.00	$360.00	$132.01–$342.00	—	70%
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW	$87.90	$293.00	$107.44–$278.35	55% below	70%
Chest X-ray, single view inpatient CPT 71045 CHEST SINGLE VIEW	$87.90	$293.00	$107.44–$278.35	—	70%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 CLAVICLE BILATERAL	$65.40	$218.00	$79.94–$207.10	—	70%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LEFT	$43.50	$145.00	$53.17–$137.75	78% below	70%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RIGHT	$43.50	$145.00	$53.17–$137.75	78% below	70%
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 CLAVICLE BILATERAL	$65.40	$218.00	$79.94–$207.10	—	70%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE LEFT	$43.50	$145.00	$53.17–$137.75	—	70%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE RIGHT	$43.50	$145.00	$53.17–$137.75	—	70%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMP	$99.60	$332.00	$121.74–$315.40	75% below	70%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMP	$99.60	$332.00	$121.74–$315.40	—	70%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$136.80	$456.00	$167.22–$433.20	56% below	70%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL	$136.80	$456.00	$167.22–$433.20	—	70%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY APPDCLR	$36.60	$122.00	$44.74–$115.90	73% below	70%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY APPDCLR	$36.60	$122.00	$44.74–$115.90	—	70%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O	$344.40	$1,148.00	$420.97–$1,090.60	66% below	70%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O	$344.40	$1,148.00	$420.97–$1,090.60	—	70%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W	$413.40	$1,378.00	$480.41–$1,309.10	62% below	70%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W	$413.40	$1,378.00	$480.41–$1,309.10	—	70%
Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMO BILATRL	$60.00	$200.00	$73.34–$190.00	74% below	70%
Diagnostic mammogram, both breasts inpatient CPT 77066 DIAGNOSTIC MAMMO BILATRL	$60.00	$200.00	$73.34–$190.00	—	70%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMO LEFT	$56.70	$189.00	$69.31–$179.55	72% below	70%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMO RIGHT	$56.70	$189.00	$69.31–$179.55	72% below	70%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAGNOSTIC MAMMO LEFT	$56.70	$189.00	$69.31–$179.55	—	70%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAGNOSTIC MAMMO RIGHT	$56.70	$189.00	$69.31–$179.55	—	70%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US ARTERIAL LOW EXT BIL	$293.10	$977.00	$358.27–$928.15	59% below	70%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US ARTERIAL LOW EXT BIL	$293.10	$977.00	$358.27–$928.15	—	70%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS EXTREMITY BILAT	$293.10	$977.00	$358.27–$928.15	—	70%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS EXTREMITY BILAT	$293.10	$977.00	$358.27–$928.15	—	70%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO	$672.00	$2,240.00	$821.41–$2,128.00	65% below	70%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO	$672.00	$2,240.00	$821.41–$2,128.00	—	70%
Elbow X-ray, 2 views both sides CPT 73070 ELBOW BILATERAL 2V	$70.80	$236.00	$86.54–$224.20	—	70%
Elbow X-ray, 2 views one side CPT 73070 ELBOW RIGHT 2V	$38.10	$127.00	$46.57–$120.65	81% below	70%
Elbow X-ray, 2 views one side CPT 73070 ELBOW LEFT 2V	$38.10	$127.00	$46.57–$120.65	81% below	70%
Elbow X-ray, 2 views inpatient both sides CPT 73070 ELBOW BILATERAL 2V	$70.80	$236.00	$86.54–$224.20	—	70%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW LEFT 2V	$38.10	$127.00	$46.57–$120.65	—	70%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW RIGHT 2V	$38.10	$127.00	$46.57–$120.65	—	70%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 ELBOW BILATERAL MIN 3V	$84.00	$280.00	$102.68–$266.00	—	70%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW LEFT MIN 3V	$45.60	$152.00	$55.74–$151.46	81% below	70%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW RIGHT MIN 3V	$45.60	$152.00	$55.74–$151.46	81% below	70%
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 ELBOW BILATERAL MIN 3V	$84.00	$280.00	$102.68–$266.00	—	70%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW RIGHT MIN 3V	$45.60	$152.00	$55.74–$151.46	—	70%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW LEFT MIN 3V	$45.60	$152.00	$55.74–$151.46	—	70%
Eye socket (orbit) CT scan without contrast CPT 70480 CT POST FOSSA/IAC W/O	$320.10	$1,067.00	$391.27–$1,013.65	70% below	70%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT POST FOSSA/IAC W/O	$320.10	$1,067.00	$391.27–$1,013.65	—	70%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES MIN 3V	$80.40	$268.00	$98.28–$254.60	74% below	70%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES MIN 3V	$80.40	$268.00	$98.28–$254.60	—	70%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 FOREARM BILATERAL	$84.00	$280.00	$102.68–$266.00	—	70%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LEFT 2V	$45.30	$151.00	$55.37–$143.45	78% below	70%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RIGHT 2V	$45.30	$151.00	$55.37–$143.45	78% below	70%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 FOREARM BILATERAL	$84.00	$280.00	$102.68–$266.00	—	70%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LEFT 2V	$45.30	$151.00	$55.37–$143.45	—	70%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RIGHT 2V	$45.30	$151.00	$55.37–$143.45	—	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM BILIARY	$282.00	$940.00	$344.70–$893.00	75% below	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM BILIARY	$282.00	$940.00	$344.70–$893.00	—	70%
Hand X-ray, 2 views both sides CPT 73120 HAND BILATERAL 2V	$70.80	$236.00	$86.54–$224.20	—	70%
Hand X-ray, 2 views one side CPT 73120 HAND RIGHT 2V	$38.10	$127.00	$46.57–$120.65	80% below	70%
Hand X-ray, 2 views one side CPT 73120 HAND LEFT 2V	$38.10	$127.00	$46.57–$120.65	80% below	70%
Hand X-ray, 2 views inpatient both sides CPT 73120 HAND BILATERAL 2V	$70.80	$236.00	$86.54–$224.20	—	70%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND LEFT 2V	$38.10	$127.00	$46.57–$120.65	—	70%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND RIGHT 2V	$38.10	$127.00	$46.57–$120.65	—	70%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS RIGHT M2V	$37.50	$125.00	$45.84–$118.75	81% below	70%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS LEFT M2V	$37.50	$125.00	$45.84–$118.75	81% below	70%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS BILATRAL M2V	$69.60	$232.00	$85.07–$220.40	64% below	70%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS RIGHT M2V	$37.50	$125.00	$45.84–$118.75	—	70%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS LEFT M2V	$37.50	$125.00	$45.84–$118.75	—	70%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS BILATRAL M2V	$69.60	$232.00	$85.07–$220.40	—	70%
Knee X-ray, 3 views both sides CPT 73562 KNEE BILATERAL COMPLETE 3V	$177.60	$592.00	$149.60–$562.40	—	70%
Knee X-ray, 3 views one side CPT 73562 KNEE RIGHT COMPLETE 3V	$95.70	$319.00	$116.98–$303.05	60% below	70%
Knee X-ray, 3 views one side CPT 73562 KNEE LEFT COMPLETE 3V	$95.70	$319.00	$116.98–$303.05	60% below	70%
Knee X-ray, 3 views inpatient both sides CPT 73562 KNEE BILATERAL COMPLETE 3V	$177.60	$592.00	$149.60–$562.40	—	70%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE RIGHT COMPLETE 3V	$95.70	$319.00	$116.98–$303.05	—	70%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE LEFT COMPLETE 3V	$95.70	$319.00	$116.98–$303.05	—	70%
Knee X-ray, complete, 4 or more views both sides CPT 73564 KNEE BILAT COMPLETE MINIMUM 4V	$246.00	$820.00	$216.50–$779.00	—	70%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE LEFT COMPLETE MINIMUM 4V	$123.00	$410.00	$150.35–$389.50	63% below	70%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE RIGHT COMPLETE MINIMUM 4V	$123.00	$410.00	$150.35–$389.50	63% below	70%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 KNEE BILAT COMPLETE MINIMUM 4V	$246.00	$820.00	$216.50–$779.00	—	70%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE RIGHT COMPLETE MINIMUM 4V	$123.00	$410.00	$150.35–$389.50	—	70%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE LEFT COMPLETE MINIMUM 4V	$123.00	$410.00	$150.35–$389.50	—	70%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT EXTR LOWER W/O LEFT	$344.40	$1,148.00	$420.97–$1,090.60	66% below	70%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT EXTR LOWER W/O RIGHT	$344.40	$1,148.00	$420.97–$1,090.60	66% below	70%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT EXTR LOWER W/O LEFT	$344.40	$1,148.00	$420.97–$1,090.60	—	70%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT EXTR LOWER W/O RIGHT	$344.40	$1,148.00	$420.97–$1,090.60	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$89.10	$297.00	$108.91–$282.15	73% below	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$89.10	$297.00	$108.91–$282.15	—	70%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTR/JNT LMTD NONV LT	$89.10	$297.00	$108.91–$282.15	71% below	70%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTR/JNT LMTD NONV RT	$89.10	$297.00	$108.91–$282.15	71% below	70%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTR/JNT LMTD NONV LT	$89.10	$297.00	$108.91–$282.15	—	70%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTR/JNT LMTD NONV RT	$89.10	$297.00	$108.91–$282.15	—	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG CANCER SCRNG W/O	$320.10	$1,067.00	$391.27–$1,013.65	50% below	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LUNG CANCER SCRNG W/O	$320.10	$1,067.00	$391.27–$1,013.65	—	70%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 TIBIA FIBULA BILATERAL	$99.00	$330.00	$121.01–$313.50	—	70%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBULA LEFT 2V	$53.40	$178.00	$65.27–$169.10	76% below	70%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBULA RIGHT 2V	$53.40	$178.00	$65.27–$169.10	76% below	70%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 TIBIA FIBULA BILATERAL	$99.00	$330.00	$121.01–$313.50	—	70%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA FIBULA RIGHT 2V	$53.40	$178.00	$65.27–$169.10	—	70%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA FIBULA LEFT 2V	$53.40	$178.00	$65.27–$169.10	—	70%
MR angiography (MRA) of the head without contrast CPT 70544 MRV BRAIN W/O	$345.00	$1,150.00	$421.71–$1,092.50	76% below	70%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV BRAIN W/O	$345.00	$1,150.00	$421.71–$1,092.50	—	70%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST WO W BILATERAL	$386.11	$1,287.04	$471.96–$1,222.69	—	70%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST WO W BILATERAL	$386.11	$1,287.04	$471.96–$1,222.69	—	70%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOW EXT JNT W/O RT	$403.20	$1,344.00	$492.84–$1,276.80	68% below	70%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOW EXT JNT W/O LT	$403.20	$1,344.00	$492.84–$1,276.80	68% below	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOW EXT JNT W/O RT	$403.20	$1,344.00	$492.84–$1,276.80	—	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOW EXT JNT W/O LT	$403.20	$1,344.00	$492.84–$1,276.80	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOW EXT JNT W&WO	$580.50	$1,935.00	$552.52–$1,838.25	64% below	70%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOW EXT JNT W&WO	$580.50	$1,935.00	$552.52–$1,838.25	64% below	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOW EXT JNT W&WO	$580.50	$1,935.00	$552.52–$1,838.25	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOW EXT JNT W&WO	$580.50	$1,935.00	$552.52–$1,838.25	—	70%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O	$560.40	$1,868.00	$552.52–$1,774.60	56% below	70%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O	$560.40	$1,868.00	$552.52–$1,774.60	—	70%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W & W/O	$711.60	$2,372.00	$552.52–$2,253.40	57% below	70%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W & W/O	$711.60	$2,372.00	$552.52–$2,253.40	—	70%
MRI of the brain, no contrast dye CPT 70551 MRI BRAN W IACs W/O	$298.76	$995.87	$365.19–$946.08	76% below	70%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN PITUITARY W/O	$298.76	$995.87	$365.19–$946.08	76% below	70%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O	$637.80	$2,126.00	$552.52–$2,019.70	50% below	70%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAN W IACs W/O	$298.76	$995.87	$365.19–$946.08	—	70%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN PITUITARY W/O	$298.76	$995.87	$365.19–$946.08	—	70%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O	$637.80	$2,126.00	$552.52–$2,019.70	—	70%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W & W/O	$765.30	$2,551.00	$552.52–$2,423.45	57% below	70%
MRI of the brain, with and without contrast dye CPT 70553 MRI IACs W/O W	$989.25	$3,297.50	$552.52–$3,132.63	44% below	70%
MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITARY W/O W	$989.25	$3,297.50	$552.52–$3,132.63	44% below	70%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W & W/O	$765.30	$2,551.00	$552.52–$2,423.45	—	70%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IACs W/O W	$989.25	$3,297.50	$552.52–$3,132.63	—	70%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI PITUITARY W/O W	$989.25	$3,297.50	$552.52–$3,132.63	—	70%
MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR W/O	$602.70	$2,009.00	$552.52–$1,908.55	52% below	70%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR W/O	$602.70	$2,009.00	$552.52–$1,908.55	—	70%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR W & W/O	$624.60	$2,082.00	$552.52–$1,977.90	64% below	70%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR W & W/O	$624.60	$2,082.00	$552.52–$1,977.90	—	70%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC W/O	$602.70	$2,009.00	$552.52–$1,908.55	51% below	70%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC W/O	$602.70	$2,009.00	$552.52–$1,908.55	—	70%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVIAL W & W/O	$699.60	$2,332.00	$552.52–$2,215.40	59% below	70%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVIAL W & W/O	$699.60	$2,332.00	$552.52–$2,215.40	—	70%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL W/O	$607.20	$2,024.00	$552.52–$1,922.80	49% below	70%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL W/O	$607.20	$2,024.00	$552.52–$1,922.80	—	70%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W & W/O	$566.70	$1,889.00	$552.52–$1,794.55	66% below	70%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W & W/O	$566.70	$1,889.00	$552.52–$1,794.55	—	70%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O	$366.00	$1,220.00	$447.37–$1,159.00	70% below	70%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O	$366.00	$1,220.00	$447.37–$1,159.00	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXT JNT W/O LFT	$403.20	$1,344.00	$492.84–$1,276.80	68% below	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXT JNT W/O RGH	$403.20	$1,344.00	$492.84–$1,276.80	68% below	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXT JNT W/O BIL	$750.00	$2,500.00	$552.52–$2,375.00	40% below	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXT JNT W/O LFT	$403.20	$1,344.00	$492.84–$1,276.80	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXT JNT W/O RGH	$403.20	$1,344.00	$492.84–$1,276.80	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXT JNT W/O BIL	$750.00	$2,500.00	$552.52–$2,375.00	—	70%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL MIN 4V/5V	$102.30	$341.00	$125.04–$323.95	73% below	70%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE CERVICAL MIN 4V/5V	$102.30	$341.00	$125.04–$323.95	—	70%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK SOFT TISSUE W	$413.40	$1,378.00	$480.41–$1,309.10	62% below	70%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK SOFT TISSUE W	$413.40	$1,378.00	$480.41–$1,309.10	—	70%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK SOFT TISSUE W/O	$320.10	$1,067.00	$391.27–$1,013.65	67% below	70%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK SOFT TISSUE W/O	$320.10	$1,067.00	$391.27–$1,013.65	—	70%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$39.00	$130.00	$47.67–$129.16	81% below	70%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$39.00	$130.00	$47.67–$129.16	—	70%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM STRESS CARDIO	$763.50	$2,545.00	$933.25–$2,417.75	67% below	70%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM STRESS CARDIO	$763.50	$2,545.00	$933.25–$2,417.75	—	70%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O	$320.10	$1,067.00	$391.27–$1,013.65	70% below	70%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O	$320.10	$1,067.00	$391.27–$1,013.65	—	70%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDR LIMITED	$67.80	$226.00	$82.87–$214.70	78% below	70%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BLADDR LIMITED	$67.80	$226.00	$82.87–$214.70	—	70%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$89.10	$297.00	$108.91–$282.15	75% below	70%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE	$89.10	$297.00	$108.91–$282.15	—	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANCY COMPLETE	$110.40	$368.00	$132.31–$349.60	70% below	70%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANCY COMPLETE	$110.40	$368.00	$132.31–$349.60	—	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANCY < 14 WEEKS	$76.80	$256.00	$93.88–$243.20	76% below	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREGNANCY < 14 WEEKS	$76.80	$256.00	$93.88–$243.20	—	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LIMITED TERM	$89.10	$297.00	$108.91–$282.15	65% below	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY LIMITED TERM	$89.10	$297.00	$108.91–$282.15	—	70%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS LEFT 2 VIEWS	$68.70	$229.00	$83.97–$217.55	71% below	70%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS RIGHT 2 VIEWS	$68.70	$229.00	$83.97–$217.55	71% below	70%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS RIGHT 2 VIEWS	$68.70	$229.00	$83.97–$217.55	—	70%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS LEFT 2 VIEWS	$68.70	$229.00	$83.97–$217.55	—	70%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS RIGHT WITH PA CXR	$60.60	$202.00	$74.07–$199.78	80% below	70%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS LEFT WITH PA CXR	$60.60	$202.00	$74.07–$199.78	80% below	70%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS RIGHT WITH PA CXR	$60.60	$202.00	$74.07–$199.78	—	70%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS LEFT WITH PA CXR	$60.60	$202.00	$74.07–$199.78	—	70%
Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMO 2V I CAD BI	$58.50	$195.00	$71.51–$185.25	—	70%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMO 2V I CAD BI	$58.50	$195.00	$71.51–$185.25	—	70%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT MIN 2V	$80.70	$269.00	$98.64–$255.55	64% below	70%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT MIN 2V	$80.70	$269.00	$98.64–$255.55	64% below	70%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER BILATERL MIN 2V	$150.00	$500.00	$140.31–$475.00	33% below	70%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LEFT MIN 2V	$80.70	$269.00	$98.64–$255.55	—	70%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RIGHT MIN 2V	$80.70	$269.00	$98.64–$255.55	—	70%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER BILATERL MIN 2V	$150.00	$500.00	$140.31–$475.00	—	70%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES MIN 3V	$80.40	$268.00	$98.28–$254.60	74% below	70%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES MIN 3V	$80.40	$268.00	$98.28–$254.60	—	70%
Skull X-ray, fewer than 4 views CPT 70250 SKULL < 4V	$91.50	$305.00	$111.84–$289.75	62% below	70%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL < 4V	$91.50	$305.00	$111.84–$289.75	—	70%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 FEMUR BILATERAL M2V	$213.00	$710.00	$260.36–$674.50	—	70%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR M2V LEFT	$106.50	$355.00	$130.18–$337.25	56% below	70%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR M2V RIGHT	$106.50	$355.00	$130.18–$337.25	56% below	70%
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 FEMUR BILATERAL M2V	$213.00	$710.00	$260.36–$674.50	—	70%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR M2V LEFT	$106.50	$355.00	$130.18–$337.25	—	70%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR M2V RIGHT	$106.50	$355.00	$130.18–$337.25	—	70%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC W/O	$438.60	$1,462.00	$480.41–$1,388.90	55% below	70%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC W/O	$438.60	$1,462.00	$480.41–$1,388.90	—	70%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB	$89.10	$297.00	$108.91–$282.15	71% below	70%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON OB	$89.10	$297.00	$108.91–$282.15	—	70%
Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAGINAL OB	$89.10	$297.00	$108.91–$282.15	76% below	70%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAGINAL OB	$89.10	$297.00	$108.91–$282.15	—	70%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$139.80	$466.00	$151.50–$442.70	68% below	70%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$139.80	$466.00	$151.50–$442.70	—	70%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS	$89.10	$297.00	$108.91–$282.15	74% below	70%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS	$89.10	$297.00	$108.91–$282.15	—	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD & NECK SOFT TISS	$293.10	$977.00	$358.27–$928.15	52% below	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD & NECK SOFT TISS	$293.10	$977.00	$358.27–$928.15	—	70%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 HUMERUS BILATERAL MIN 2V	$99.00	$330.00	$121.01–$313.50	—	70%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS LEFT MIN 2V	$53.40	$178.00	$65.27–$169.10	77% below	70%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS RIGHT MIN 2V	$53.40	$178.00	$65.27–$169.10	77% below	70%
Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 HUMERUS BILATERAL MIN 2V	$99.00	$330.00	$121.01–$313.50	—	70%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS LEFT MIN 2V	$53.40	$178.00	$65.27–$169.10	—	70%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS RIGHT MIN 2V	$53.40	$178.00	$65.27–$169.10	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS EXTREMITY LEFT	$293.10	$977.00	$358.27–$928.15	57% below	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS EXTREMITY RIGHT	$293.10	$977.00	$358.27–$928.15	57% below	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS EXTREMITY RIGHT	$293.10	$977.00	$358.27–$928.15	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS EXTREMITY LEFT	$293.10	$977.00	$358.27–$928.15	—	70%
Wrist X-ray, 2 views both sides CPT 73100 WRIST BILATERAL 2V	$70.80	$236.00	$86.54–$224.20	—	70%
Wrist X-ray, 2 views one side CPT 73100 WRIST LEFT 2V	$38.10	$127.00	$46.57–$120.65	79% below	70%
Wrist X-ray, 2 views one side CPT 73100 WRIST RIGHT 2V	$38.10	$127.00	$46.57–$120.65	79% below	70%
Wrist X-ray, 2 views inpatient both sides CPT 73100 WRIST BILATERAL 2V	$70.80	$236.00	$86.54–$224.20	—	70%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST LEFT 2V	$38.10	$127.00	$46.57–$120.65	—	70%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST RIGHT 2V	$38.10	$127.00	$46.57–$120.65	—	70%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 WRIST BILATERAL CMPLT M3V	$84.00	$280.00	$102.68–$266.00	—	70%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST LEFT COMPLTE M3V	$45.30	$151.00	$55.37–$143.45	80% below	70%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST RIGHT COMPLT M3V	$45.30	$151.00	$55.37–$143.45	80% below	70%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 WRIST BILATERAL CMPLT M3V	$84.00	$280.00	$102.68–$266.00	—	70%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST LEFT COMPLTE M3V	$45.30	$151.00	$55.37–$143.45	—	70%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST RIGHT COMPLT M3V	$45.30	$151.00	$55.37–$143.45	—	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMPLETE LEFT 2-3V	$80.40	$268.00	$98.28–$254.60	69% below	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMPLETE RIGHT 2-3V	$80.40	$268.00	$98.28–$254.60	69% below	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP COMPLETE LEFT 2-3V	$80.40	$268.00	$98.28–$254.60	—	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP COMPLETE RIGHT 2-3V	$80.40	$268.00	$98.28–$254.60	—	70%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1V	$71.70	$239.00	$87.64–$227.05	66% below	70%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1V	$71.70	$239.00	$87.64–$227.05	—	70%
X-ray of the ankle, 2 views both sides CPT 73600 ANKLE 2V BILATERAL	$86.70	$289.00	$104.07–$274.55	—	70%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2V RIGHT	$38.10	$127.00	$46.57–$120.65	80% below	70%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2V LEFT	$38.10	$127.00	$46.57–$120.65	80% below	70%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 ANKLE 2V BILATERAL	$86.70	$289.00	$104.07–$274.55	—	70%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2V LEFT	$38.10	$127.00	$46.57–$120.65	—	70%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2V RIGHT	$38.10	$127.00	$46.57–$120.65	—	70%
X-ray of the foot, 2 views both sides CPT 73620 FOOT 2V BILATERAL	$70.80	$236.00	$86.54–$224.20	—	70%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2V RIGHT	$38.10	$127.00	$46.57–$120.65	80% below	70%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2V LEFT	$38.10	$127.00	$46.57–$120.65	80% below	70%
X-ray of the foot, 2 views inpatient both sides CPT 73620 FOOT 2V BILATERAL	$70.80	$236.00	$86.54–$224.20	—	70%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2V LEFT	$38.10	$127.00	$46.57–$120.65	—	70%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2V RIGHT	$38.10	$127.00	$46.57–$120.65	—	70%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMPLETE RT M3V	$83.10	$277.00	$101.58–$263.15	63% below	70%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMPLETE LEFT M3V	$83.10	$277.00	$101.58–$263.15	63% below	70%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMP BILATRL M3V	$154.20	$514.00	$134.73–$488.30	32% below	70%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMPLETE LEFT M3V	$83.10	$277.00	$101.58–$263.15	—	70%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMPLETE RT M3V	$83.10	$277.00	$101.58–$263.15	—	70%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMP BILATRL M3V	$154.20	$514.00	$134.73–$488.30	—	70%
X-ray of the hand, 3 or more views both sides CPT 73130 HAND BILATERAL COMPLT M3V	$84.00	$280.00	$102.68–$266.00	—	70%
X-ray of the hand, 3 or more views one side CPT 73130 HAND RIGHT COMPLET M3V	$45.30	$151.00	$55.37–$143.45	79% below	70%
X-ray of the hand, 3 or more views one side CPT 73130 HAND LEFT COMPLET M3V	$45.30	$151.00	$55.37–$143.45	79% below	70%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HAND BILATERAL COMPLT M3V	$84.00	$280.00	$102.68–$266.00	—	70%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND RIGHT COMPLET M3V	$45.30	$151.00	$55.37–$143.45	—	70%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND LEFT COMPLET M3V	$45.30	$151.00	$55.37–$143.45	—	70%
X-ray of the knee, 1 or 2 views both sides CPT 73560 KNEE BILATERAL 1/2V	$140.40	$468.00	$107.79–$444.60	—	70%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LEFT 1/2V	$75.60	$252.00	$92.41–$239.40	60% below	70%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RIGHT 1/2V	$75.60	$252.00	$92.41–$239.40	60% below	70%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 KNEE BILATERAL 1/2V	$140.40	$468.00	$107.79–$444.60	—	70%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LEFT 1/2V	$75.60	$252.00	$92.41–$239.40	—	70%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RIGHT 1/2V	$75.60	$252.00	$92.41–$239.40	—	70%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR 2-3V	$86.70	$289.00	$105.98–$274.55	68% below	70%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBAR 2-3V	$86.70	$289.00	$105.98–$274.55	—	70%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR MIN 4V	$102.30	$341.00	$125.04–$323.95	74% below	70%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR MIN 4V	$102.30	$341.00	$125.04–$323.95	—	70%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2V	$76.50	$255.00	$93.51–$242.25	66% below	70%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC 2V	$76.50	$255.00	$93.51–$242.25	—	70%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3V	$53.10	$177.00	$64.91–$168.15	78% below	70%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3V	$53.10	$177.00	$64.91–$168.15	—	70%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 3V OR LSS	$80.40	$268.00	$98.28–$254.60	68% below	70%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 3V OR LSS	$80.40	$268.00	$98.28–$254.60	—	70%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2V	$45.60	$152.00	$55.74–$144.40	78% below	70%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2V	$45.60	$152.00	$55.74–$144.40	—	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX MIN 2V	$60.60	$202.00	$74.07–$191.90	74% below	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM/COCCYX MIN 2V	$60.60	$202.00	$74.07–$191.90	—	70%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Kansas	Off list
ACTH blood test CPT 82024 ASSAY OF ACTH	$72.30	$241.00	$88.37–$228.95	59% below	70%
ACTH blood test inpatient CPT 82024 ASSAY OF ACTH	$72.30	$241.00	$88.37–$228.95	—	70%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$7.50	$25.00	$9.17–$23.75	78% below	70%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$7.50	$25.00	$9.17–$23.75	—	70%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$6.90	$23.00	$8.43–$21.85	81% below	70%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$6.90	$23.00	$8.43–$21.85	—	70%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$90.30	$301.00	$110.38–$285.95	56% below	70%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$90.30	$301.00	$110.38–$285.95	—	70%
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$6.60	$22.00	$8.07–$20.90	79% below	70%
Albumin blood test inpatient CPT 82040 ASSAY OF SERUM ALBUMIN	$6.60	$22.00	$8.07–$20.90	—	70%
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$75.00	$250.00	$91.68–$237.50	58% below	70%
Aldosterone blood test inpatient CPT 82088 ASSAY OF ALDOSTERONE	$75.00	$250.00	$91.68–$237.50	—	70%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$6.90	$23.00	$8.43–$21.85	81% below	70%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$6.90	$23.00	$8.43–$21.85	—	70%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE ALLERGEN SPECIFIC	$15.33	$51.11	$18.74–$48.55	48% below	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE ALLERGEN SPECIFIC	$15.33	$51.11	$18.74–$48.55	—	70%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPH-FETOPROTEIN SERUM	$33.90	$113.00	$41.44–$107.35	65% below	70%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPH-FETOPROTEIN SERUM	$33.90	$113.00	$41.44–$107.35	—	70%
Ammonia blood test CPT 82140 AMMONIA	$17.70	$59.00	$21.64–$56.05	79% below	70%
Ammonia blood test inpatient CPT 82140 AMMONIA	$17.70	$59.00	$21.64–$56.05	—	70%
Amylase blood test CPT 82150 AMYLASE SERUM	$16.50	$55.00	$20.17–$52.25	70% below	70%
Amylase blood test inpatient CPT 82150 AMYLASE SERUM	$16.50	$55.00	$20.17–$52.25	—	70%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP IgG/IgA	$43.50	$145.00	$53.17–$137.75	53% below	70%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP IgG/IgA	$43.50	$145.00	$53.17–$137.75	—	70%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN	$29.10	$97.00	$35.57–$92.15	58% below	70%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN	$29.10	$97.00	$35.57–$92.15	—	70%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATURIETIC PEPTIDE	$70.80	$236.00	$86.54–$224.20	46% below	70%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATURIETIC PEPTIDE	$70.80	$236.00	$86.54–$224.20	—	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$21.00	$70.00	$25.67–$66.50	63% below	70%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$21.00	$70.00	$25.67–$66.50	—	70%
Basic metabolic panel (blood test) CPT 80048 BMP CALCIUM TOTAL	$25.50	$85.00	$31.17–$80.75	64% below	70%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP CALCIUM TOTAL	$25.50	$85.00	$31.17–$80.75	—	70%
Bilirubin blood test, total CPT 82247 BILIRUBIN	$15.60	$52.00	$19.07–$49.40	57% below	70%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN	$15.60	$52.00	$19.07–$49.40	—	70%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS & MICRO LEVEL IV	$119.10	$397.00	$145.58–$377.15	45% below	70%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS & MICRO LEVEL IV	$119.10	$397.00	$145.58–$377.15	—	70%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$49.20	$164.00	$60.14–$155.80	37% below	70%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$49.20	$164.00	$60.14–$155.80	—	70%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD VENIPUNCT	$9.90	$33.00	$12.10–$31.35	45% below	70%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD VENIPUNCT	$9.90	$33.00	$12.10–$31.35	—	70%
Blood glucose (sugar) test CPT 82947 GLUCOSE RANDOM	$11.10	$37.00	$13.57–$35.15	61% below	70%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING	$11.10	$37.00	$13.57–$35.15	61% below	70%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING	$11.10	$37.00	$13.57–$35.15	—	70%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE RANDOM	$11.10	$37.00	$13.57–$35.15	—	70%
Blood lead test CPT 83655 LEAD LEVEL	$15.90	$53.00	$19.44–$50.35	70% below	70%
Blood lead test inpatient CPT 83655 LEAD LEVEL	$15.90	$53.00	$19.44–$50.35	—	70%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM	$22.80	$76.00	$27.87–$72.20	61% below	70%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM	$22.80	$76.00	$27.87–$72.20	—	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE	$36.60	$122.00	$44.74–$115.90	62% below	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPE	$36.60	$122.00	$44.74–$115.90	—	70%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$8.70	$29.00	$10.63–$27.55	71% below	70%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$8.70	$29.00	$10.63–$27.55	—	70%
C-peptide blood test CPT 84681 C-PEPTIDE	$40.50	$135.00	$49.50–$128.25	61% below	70%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$40.50	$135.00	$49.50–$128.25	—	70%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$17.10	$57.00	$20.90–$54.15	64% below	70%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$17.10	$57.00	$20.90–$54.15	—	70%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE	$49.50	$165.00	$60.51–$156.75	56% below	70%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE	$49.50	$165.00	$60.51–$156.75	—	70%
CA 19-9 blood test (tumor marker) CPT 86301 CA-19-9	$22.80	$76.00	$27.87–$72.20	77% below	70%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA-19-9	$22.80	$76.00	$27.87–$72.20	—	70%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$33.30	$111.00	$40.70–$105.45	65% below	70%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$33.30	$111.00	$40.70–$105.45	—	70%
Calcium blood test, total CPT 82310 CALCIUM SERUM	$14.40	$48.00	$17.60–$45.60	57% below	70%
Calcium blood test, total inpatient CPT 82310 CALCIUM SERUM	$14.40	$48.00	$17.60–$45.60	—	70%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$46.50	$155.00	$56.84–$147.25	57% below	70%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$46.50	$155.00	$56.84–$147.25	—	70%
Chickenpox (varicella) immunity blood test CPT 86787 VARI-ZOSTER IGG	$40.20	$134.00	$49.14–$127.30	55% below	70%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM	$40.20	$134.00	$49.14–$127.30	55% below	70%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARI-ZOSTER IGG	$40.20	$134.00	$49.14–$127.30	—	70%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGM	$40.20	$134.00	$49.14–$127.30	—	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA GEN/PROBE	$45.90	$153.00	$56.11–$145.35	59% below	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA GEN/PROBE	$45.90	$153.00	$56.11–$145.35	—	70%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CONTRACT LIPID PANEL	$30.30	$101.00	$37.04–$95.95	66% below	70%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$32.70	$109.00	$39.97–$103.55	63% below	70%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CONTRACT LIPID PANEL	$30.30	$101.00	$37.04–$95.95	—	70%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$32.70	$109.00	$39.97–$103.55	—	70%
Complete blood count (CBC) with differential CPT 85025 CBC W AUTO DIFF	$22.50	$75.00	$27.50–$71.25	45% below	70%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W AUTO DIFF	$22.50	$75.00	$27.50–$71.25	—	70%
Complete blood count (CBC), no differential CPT 85027 CBC W MANUAL DIFF	$18.30	$61.00	$22.37–$57.95	57% below	70%
Complete blood count (CBC), no differential CPT 85027 CBC (HEMOGRAM)	$27.00	$90.00	$33.00–$85.50	37% below	70%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W MANUAL DIFF	$18.30	$61.00	$22.37–$57.95	—	70%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC (HEMOGRAM)	$27.00	$90.00	$33.00–$85.50	—	70%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$35.70	$119.00	$43.64–$113.05	64% below	70%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$35.70	$119.00	$43.64–$113.05	—	70%
Cortisol blood test, total CPT 82533 CORTISOL	$39.90	$133.00	$48.77–$126.35	59% below	70%
Cortisol blood test, total inpatient CPT 82533 CORTISOL	$39.90	$133.00	$48.77–$126.35	—	70%
Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CPK TOTAL	$21.90	$73.00	$26.77–$69.35	52% below	70%
Creatine kinase (CK) blood test, total inpatient CPT 82550 ASSAY OF CPK TOTAL	$21.90	$73.00	$26.77–$69.35	—	70%
Creatinine blood test CPT 82565 CREATININE SERUM	$8.70	$29.00	$10.63–$27.55	75% below	70%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$8.70	$29.00	$10.63–$27.55	—	70%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG	$44.10	$147.00	$53.90–$139.65	60% below	70%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG	$44.10	$147.00	$53.90–$139.65	—	70%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER	$45.00	$150.00	$55.01–$142.50	60% below	70%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER	$45.00	$150.00	$55.01–$142.50	—	70%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE	$52.80	$176.00	$64.54–$167.20	59% below	70%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE	$52.80	$176.00	$64.54–$167.20	—	70%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMVCHMISTRY ANALYZ	$57.90	$193.00	$70.77–$183.35	64% below	70%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMVCHMISTRY ANALYZ	$57.90	$193.00	$70.77–$183.35	—	70%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$17.70	$59.00	$21.64–$56.05	69% below	70%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$17.70	$59.00	$21.64–$56.05	—	70%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR CAPSID VCA	$54.60	$182.00	$66.74–$172.90	47% below	70%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR CAPSID VCA	$54.60	$182.00	$66.74–$172.90	—	70%
Estradiol blood test CPT 82670 ESTRADIOL	$76.20	$254.00	$93.14–$241.30	55% below	70%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$76.20	$254.00	$93.14–$241.30	—	70%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$46.80	$156.00	$57.21–$148.20	59% below	70%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$46.80	$156.00	$57.21–$148.20	—	70%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$71.40	$238.00	$87.27–$226.10	66% below	70%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$71.40	$238.00	$87.27–$226.10	—	70%
Ferritin blood test (iron stores) CPT 82728 FERRITIN SERUM	$35.10	$117.00	$42.90–$111.15	59% below	70%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN SERUM	$35.10	$117.00	$42.90–$111.15	—	70%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$15.60	$52.00	$19.07–$49.40	73% below	70%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$15.60	$52.00	$19.07–$49.40	—	70%
Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM	$37.80	$126.00	$46.20–$119.70	61% below	70%
Folate (folic acid) blood test inpatient CPT 82746 ASSAY OF FOLIC ACID SERUM	$37.80	$126.00	$46.20–$119.70	—	70%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3 FREE	$51.30	$171.00	$62.71–$162.45	60% below	70%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3 FREE	$51.30	$171.00	$62.71–$162.45	—	70%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$33.30	$111.00	$40.70–$105.45	47% below	70%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$33.30	$111.00	$40.70–$105.45	—	70%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$64.50	$215.00	$78.84–$204.25	55% below	70%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$64.50	$215.00	$78.84–$204.25	—	70%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT	$22.20	$74.00	$27.14–$70.30	48% below	70%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GT	$22.20	$74.00	$27.14–$70.30	—	70%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE	$12.90	$43.00	$15.77–$40.85	72% below	70%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE	$12.90	$43.00	$15.77–$40.85	—	70%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST	$32.10	$107.00	$39.24–$101.65	64% below	70%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST	$32.10	$107.00	$39.24–$101.65	—	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC GEN/PROBE	$45.90	$153.00	$56.11–$145.35	56% below	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC GEN/PROBE	$45.90	$153.00	$56.11–$145.35	—	70%
H. pylori antibody blood test CPT 86677 H PYLORI SERUM	$26.10	$87.00	$31.90–$82.65	62% below	70%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI SERUM	$26.10	$87.00	$31.90–$82.65	—	70%
H. pylori stool antigen test CPT 87338 H PYLORI STOOL	$18.90	$63.00	$23.10–$59.85	83% below	70%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL	$18.90	$63.00	$23.10–$59.85	—	70%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$111.30	$371.00	$136.05–$352.45	61% below	70%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$111.30	$371.00	$136.05–$352.45	—	70%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AG/AB	$40.50	$135.00	$49.50–$128.25	57% below	70%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 AG/AB	$40.50	$135.00	$49.50–$128.25	—	70%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DETECT AMPLI PROBE TECH	$45.90	$153.00	$56.11–$145.35	65% below	70%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DETECT AMPLI PROBE TECH	$45.90	$153.00	$56.11–$145.35	—	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$24.90	$83.00	$30.44–$78.85	60% below	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$24.90	$83.00	$30.44–$78.85	—	70%
Hemoglobin blood test CPT 85018 HGB	$6.90	$23.00	$8.43–$21.85	68% below	70%
Hemoglobin blood test inpatient CPT 85018 HGB	$6.90	$23.00	$8.43–$21.85	—	70%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL	$27.00	$90.00	$33.00–$85.50	60% below	70%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY TOTAL	$27.00	$90.00	$33.00–$85.50	—	70%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$25.20	$84.00	$30.80–$79.80	57% below	70%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$25.20	$84.00	$30.80–$79.80	—	70%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY BY EIA	$31.80	$106.00	$38.87–$100.70	60% below	70%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY BY EIA	$31.80	$106.00	$38.87–$100.70	—	70%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$65.70	$219.00	$80.31–$208.05	75% below	70%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$65.70	$219.00	$80.31–$208.05	—	70%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX	$38.40	$128.00	$46.94–$121.60	59% below	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX	$38.40	$128.00	$46.94–$121.60	—	70%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$44.10	$147.00	$53.90–$139.65	48% below	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$44.10	$147.00	$53.90–$139.65	—	70%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGHLY SENSITIVE	$37.20	$124.00	$45.47–$117.80	58% below	70%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGHLY SENSITIVE	$37.20	$124.00	$45.47–$117.80	—	70%
Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL	$107.70	$359.00	$131.65–$341.05	51% below	70%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE TOTAL	$107.70	$359.00	$131.65–$341.05	—	70%
Insulin blood test CPT 83525 INSULIN LEVEL	$33.30	$111.00	$40.70–$105.45	59% below	70%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL	$33.30	$111.00	$40.70–$105.45	—	70%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$15.60	$52.00	$19.07–$49.40	64% below	70%
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$15.60	$52.00	$19.07–$49.40	—	70%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$29.40	$98.00	$35.94–$93.10	54% below	70%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$29.40	$98.00	$35.94–$93.10	—	70%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$29.10	$97.00	$35.57–$92.15	58% below	70%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$29.10	$97.00	$35.57–$92.15	—	70%
LH (luteinizing hormone) test CPT 83002 LH	$45.60	$152.00	$55.74–$144.40	59% below	70%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$45.60	$152.00	$55.74–$144.40	—	70%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$31.20	$104.00	$38.14–$98.80	61% below	70%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$31.20	$104.00	$38.14–$98.80	—	70%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE LDH	$13.80	$46.00	$16.87–$43.70	64% below	70%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE LDH	$13.80	$46.00	$16.87–$43.70	—	70%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$18.30	$61.00	$22.37–$57.95	70% below	70%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$18.30	$61.00	$22.37–$57.95	—	70%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$24.60	$82.00	$30.07–$77.90	69% below	70%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$24.60	$82.00	$30.07–$77.90	—	70%
Lyme disease antibody test CPT 86618 LYME ANTIBODY SCREEN	$46.80	$156.00	$57.21–$148.20	62% below	70%
Lyme disease antibody test inpatient CPT 86618 LYME ANTIBODY SCREEN	$46.80	$156.00	$57.21–$148.20	—	70%
Magnesium blood test CPT 83735 MAGNESIUM	$10.20	$34.00	$12.47–$32.30	80% below	70%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$10.20	$34.00	$12.47–$32.30	—	70%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$41.70	$139.00	$50.97–$132.05	56% below	70%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$41.70	$139.00	$50.97–$132.05	—	70%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$15.60	$52.00	$19.07–$49.40	65% below	70%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$15.60	$52.00	$19.07–$49.40	—	70%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IGG IGM	$39.60	$132.00	$48.40–$125.40	55% below	70%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IGG IGM	$39.60	$132.00	$48.40–$125.40	—	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$54.00	$180.00	$66.01–$171.00	49% below	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$54.00	$180.00	$66.01–$171.00	—	70%
Pap test (liquid-based, automated screening with review) CPT 88175 THIN PREP PAP DUAL REVIEW	$22.20	$74.00	$27.14–$70.30	72% below	70%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THIN PREP PAP DUAL REVIEW	$22.20	$74.00	$27.14–$70.30	—	70%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTO THIN PREP PAP SMEAR	$39.60	$132.00	$48.40–$125.40	55% below	70%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTO THIN PREP PAP SMEAR	$39.60	$132.00	$48.40–$125.40	—	70%
Parathyroid hormone (PTH) blood test CPT 83970 PTH	$94.50	$315.00	$115.51–$299.25	52% below	70%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH	$94.50	$315.00	$115.51–$299.25	—	70%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT	$15.60	$52.00	$19.07–$49.40	66% below	70%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT	$15.60	$52.00	$19.07–$49.40	—	70%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$15.60	$52.00	$19.07–$49.40	57% below	70%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$15.60	$52.00	$19.07–$49.40	—	70%
Potassium blood test CPT 84132 POTASSIUM SERUM	$10.80	$36.00	$13.20–$34.20	67% below	70%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$10.80	$36.00	$13.20–$34.20	—	70%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MATERNITI21 PLUS CORE	$993.31	$3,311.04	$1,214.16–$3,145.49	58% below	70%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MATERNITI21 PLUS CORE	$993.31	$3,311.04	$1,214.16–$3,145.49	—	70%
Progesterone blood test CPT 84144 PROGESTERONE	$47.10	$157.00	$57.57–$149.15	57% below	70%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$47.10	$157.00	$57.57–$149.15	—	70%
Prolactin blood test CPT 84146 PROLACTIN	$48.30	$161.00	$59.04–$152.95	62% below	70%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$48.30	$161.00	$59.04–$152.95	—	70%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$20.40	$68.00	$24.94–$64.60	35% below	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$20.40	$68.00	$24.94–$64.60	—	70%
Renin blood test CPT 84244 RENIN PLASMA	$48.90	$163.00	$59.77–$154.85	62% below	70%
Renin blood test inpatient CPT 84244 RENIN PLASMA	$48.90	$163.00	$59.77–$154.85	—	70%
Rh blood typing CPT 86901 RH	$11.70	$39.00	$14.30–$37.05	82% below	70%
Rh blood typing inpatient CPT 86901 RH	$11.70	$39.00	$14.30–$37.05	—	70%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$16.80	$56.00	$20.54–$53.20	66% below	70%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$16.80	$56.00	$20.54–$53.20	—	70%
Rubella antibody test (immunity check) CPT 86762 RUBELLA SCREEN	$29.40	$98.00	$35.94–$93.10	51% below	70%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA SCREEN	$29.40	$98.00	$35.94–$93.10	—	70%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR	$13.80	$46.00	$16.87–$43.70	57% below	70%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR	$13.80	$46.00	$16.87–$43.70	—	70%
Sodium blood test CPT 84295 SODIUM SERUM	$9.60	$32.00	$11.73–$30.40	67% below	70%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$9.60	$32.00	$11.73–$30.40	—	70%
Stool ova and parasites exam CPT 87177 STOOL O AND P	$18.00	$60.00	$22.00–$57.00	68% below	70%
Stool ova and parasites exam inpatient CPT 87177 STOOL O AND P	$18.00	$60.00	$22.00–$57.00	—	70%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$13.80	$46.00	$16.87–$43.70	49% below	70%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES	$13.80	$46.00	$16.87–$43.70	—	70%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS ANTIBODY	$32.40	$108.00	$39.60–$102.60	55% below	70%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS ANTIBODY	$32.40	$108.00	$39.60–$102.60	—	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL	$13.80	$46.00	$16.87–$43.70	62% below	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL	$13.80	$46.00	$16.87–$43.70	—	70%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$51.00	$170.00	$62.34–$161.50	72% below	70%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$51.00	$170.00	$62.34–$161.50	—	70%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE	$63.90	$213.00	$78.11–$202.35	54% below	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE	$63.90	$213.00	$78.11–$202.35	—	70%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EA	$33.60	$112.00	$41.07–$106.40	57% below	70%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EA	$33.60	$112.00	$41.07–$106.40	—	70%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$39.00	$130.00	$47.67–$123.50	55% below	70%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$39.00	$130.00	$47.67–$123.50	—	70%
Total IgE blood test CPT 82785 IGE	$38.70	$129.00	$47.30–$122.55	56% below	70%
Total IgE blood test inpatient CPT 82785 IGE	$38.70	$129.00	$47.30–$122.55	—	70%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$14.40	$48.00	$17.60–$45.60	59% below	70%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$14.40	$48.00	$17.60–$45.60	—	70%
Total thyroxine (T4) blood test CPT 84436 T4 THYROXINE	$11.70	$39.00	$14.30–$37.05	71% below	70%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 THYROXINE	$11.70	$39.00	$14.30–$37.05	—	70%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$31.20	$104.00	$38.14–$98.80	60% below	70%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$31.20	$104.00	$38.14–$98.80	—	70%
Transferrin blood test CPT 84466 TRANSFERRIN	$47.40	$158.00	$57.94–$150.10	53% below	70%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$47.40	$158.00	$57.94–$150.10	—	70%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$37.22	$124.05	$45.49–$117.85	71% below	70%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$37.22	$124.05	$45.49–$117.85	—	70%
Triglycerides blood test CPT 84478 TRIGLYCERIDE	$15.60	$52.00	$19.07–$49.40	57% below	70%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE	$15.60	$52.00	$19.07–$49.40	—	70%
Troponin test, quantitative CPT 84484 TROPONIN I	$57.30	$191.00	$70.04–$181.45	50% below	70%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$57.30	$191.00	$70.04–$181.45	—	70%
Uric acid blood test CPT 84550 URIC ACID	$15.60	$52.00	$19.07–$49.40	57% below	70%
Uric acid blood test inpatient CPT 84550 URIC ACID	$15.60	$52.00	$19.07–$49.40	—	70%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W SCOPE	$22.80	$76.00	$27.87–$72.20	30% below	70%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W SCOPE	$22.80	$76.00	$27.87–$72.20	—	70%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO SCOPE	$3.60	$12.00	$4.40–$11.40	84% below	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO SCOPE	$3.60	$12.00	$4.40–$11.40	—	70%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE COLONY COUNT	$32.40	$108.00	$39.60–$102.60	39% below	70%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE COLONY COUNT	$32.40	$108.00	$39.60–$102.60	—	70%
Urine microalbumin (albumin) test CPT 82043 URINE ALBUMIN QUANTITATIVE	$23.40	$78.00	$28.60–$74.10	49% below	70%
Urine microalbumin (albumin) test inpatient CPT 82043 URINE ALBUMIN QUANTITATIVE	$23.40	$78.00	$28.60–$74.10	—	70%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$18.00	$60.00	$22.00–$57.00	60% below	70%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$18.00	$60.00	$22.00–$57.00	—	70%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$41.40	$138.00	$50.60–$131.10	54% below	70%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$41.40	$138.00	$50.60–$131.10	—	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$72.90	$243.00	$89.11–$230.85	70% below	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$72.90	$243.00	$89.11–$230.85	—	70%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25 DIHYDROXY	$54.90	$183.00	$67.11–$173.85	63% below	70%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1 25 DIHYDROXY	$54.90	$183.00	$67.11–$173.85	—	70%
Zinc blood test CPT 84630 ZINC	$36.60	$122.00	$44.74–$115.90	37% below	70%
Zinc blood test inpatient CPT 84630 ZINC	$36.60	$122.00	$44.74–$115.90	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG quantitative	$39.90	$133.00	$48.77–$126.35	57% below	70%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG quantitative	$39.90	$133.00	$48.77–$126.35	—	70%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Kansas	Off list
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$171.90	$573.00	$210.12–$544.35	51% below	70%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE	$171.90	$573.00	$210.12–$544.35	—	70%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CRDVRSN ELCTV ARRHTHM EXTRN	$271.80	$906.00	$332.23–$860.70	58% below	70%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CRDVRSN ELCTV ARRHTHM EXTRN	$271.80	$906.00	$332.23–$860.70	—	70%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIG LSN 1ST	$39.60	$132.00	$48.40–$217.71	66% below	70%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIG LSN 1ST	$39.60	$132.00	$48.40–$217.71	—	70%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED CERUMEN	$17.70	$59.00	$21.64–$586.49	82% below	70%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED CERUMEN	$17.70	$59.00	$21.64–$586.49	—	70%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTRLMNL CRV/THRC W IMAGIN	$342.60	$1,142.00	$418.77–$1,141.80	72% below	70%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTRLMNL CRV/THRC W IMAGIN	$342.60	$1,142.00	$418.77–$1,141.80	—	70%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 NJX DX/THR LMBR/SAC LEVEL 1	$260.70	$869.00	$318.66–$825.55	74% below	70%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 NJX DX/THR LMBR/SAC LEVEL 1	$260.70	$869.00	$318.66–$825.55	—	70%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR AA HERNIA 3 TO 10CM RED	$1,260.00	$4,200.00	$1,540.14–$3,990.00	77% below	70%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 REPAIR AA HERNIA 3 TO 10CM RED	$1,260.00	$4,200.00	$1,540.14–$3,990.00	—	70%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR ANT ABD HERNIA A APP <3	$512.61	$1,708.69	$626.58–$3,811.74	88% below	70%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPAIR ANT ABD HERNIA A APP <3	$512.61	$1,708.69	$626.58–$3,811.74	—	70%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY INTRN RUBBER	$752.40	$2,508.00	$919.68–$2,382.60	20% below	70%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY INTRN RUBBER	$752.40	$2,508.00	$919.68–$2,382.60	—	70%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SQ ABSCESS COMPLEX	$105.00	$350.00	$128.35–$332.50	61% below	70%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SQ ABSCESS COMPLEX	$105.00	$350.00	$128.35–$332.50	—	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRCNTSS ASPR/INJ MJR JT/BR	$226.50	$755.00	$276.86–$717.25	35% below	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRCNTSS ASPR/INJ MJR JT/BR	$226.50	$755.00	$276.86–$717.25	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHRCNTSS ASPR/INJ INTRM JT/B	$135.00	$450.00	$165.02–$427.50	51% below	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHRCNTSS ASPR/INJ INTRM JT/B	$135.00	$450.00	$165.02–$427.50	—	70%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 POST CATARACT LASER SURGERY	$555.90	$1,853.00	$679.50–$1,760.35	52% below	70%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 POST CATARACT LASER SURGERY	$555.90	$1,853.00	$679.50–$1,760.35	—	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTRM TRNK 2.5 OR LESS	$105.00	$350.00	$128.35–$451.17	74% below	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INTRM TRNK 2.5 OR LESS	$105.00	$350.00	$128.35–$451.17	—	70%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTRLMNR (CDL) LMBR/SC W I	$368.40	$1,228.00	$450.31–$1,166.60	69% below	70%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTRLMNR (CDL) LMBR/SC W I	$368.40	$1,228.00	$450.31–$1,166.60	—	70%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTRLMNR LMBR/SAC NO IMAGI	$210.00	$700.00	$256.69–$665.00	74% below	70%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTRLMNR LMBR/SAC NO IMAGI	$210.00	$700.00	$256.69–$665.00	—	70%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX ANES/STRD W IMG TFRML EDRL	$260.70	$869.00	$318.66–$825.55	75% below	70%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX ANES/STRD W IMG TFRML EDRL	$260.70	$869.00	$318.66–$825.55	—	70%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY	$1,641.60	$5,472.00	$2,006.58–$5,598.43	55% below	70%
Lumpectomy (partial mastectomy) inpatient CPT 19301 PARTIAL MASTECTOMY	$1,641.60	$5,472.00	$2,006.58–$5,598.43	—	70%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE COMPLETE	$2,196.60	$7,322.00	$2,684.98–$7,242.71	44% below	70%
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE COMPLETE	$2,196.60	$7,322.00	$2,684.98–$7,242.71	—	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LSN T/A/L 0.5CM/<	$75.00	$250.00	$91.68–$783.57	63% below	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LESION T/A/L 0.5CM/<	$75.00	$250.00	$91.68–$783.57	63% below	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LSN T/A/L 0.5CM/<	$75.00	$250.00	$91.68–$783.57	—	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LESION T/A/L 0.5CM/<	$75.00	$250.00	$91.68–$783.57	—	70%
Nail removal (partial or complete), one nail CPT 11730 REMOVE NAIL PLATE	$80.40	$268.00	$98.28–$254.60	47% below	70%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVE NAIL PLATE	$80.40	$268.00	$98.28–$254.60	—	70%
Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ OCCIPITAL	$312.60	$1,042.00	$319.16–$989.90	21% below	70%
Occipital nerve block (injection for headaches) inpatient CPT 64405 N BLOCK INJ OCCIPITAL	$312.60	$1,042.00	$319.16–$989.90	—	70%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$371.10	$1,237.00	$453.61–$1,175.15	50% below	70%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$371.10	$1,237.00	$453.61–$1,175.15	—	70%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL & MATRIX PERMANENT	$126.00	$420.00	$154.01–$451.17	69% below	70%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL & MATRIX PERMANENT	$126.00	$420.00	$154.01–$451.17	—	70%
Prostate biopsy CPT 55700 PROSTATE NEEDLE BX ANY APPROAC	$582.30	$1,941.00	$711.76–$1,843.95	56% below	70%
Prostate biopsy inpatient CPT 55700 PROSTATE NEEDLE BX ANY APPROAC	$582.30	$1,941.00	$711.76–$1,843.95	—	70%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JOINT	$354.30	$1,181.00	$433.07–$1,121.95	82% below	70%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JOINT	$354.30	$1,181.00	$433.07–$1,121.95	—	70%
Removal of a foreign object under the skin, simple CPT 10120 INCISE REMOVAL FB SQ TISS SIMP	$114.00	$380.00	$139.35–$1,075.65	70% below	70%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISE REMOVAL FB SQ TISS SIMP	$114.00	$380.00	$139.35–$1,075.65	—	70%
Short arm splint (forearm and hand) CPT 29125 SHORT ARM SPLINT	$90.30	$301.00	$110.38–$285.95	50% below	70%
Short arm splint (forearm and hand) inpatient CPT 29125 SHORT ARM SPLINT	$90.30	$301.00	$110.38–$285.95	—	70%
Short leg splint (calf to foot) CPT 29515 APPLCTN SHRT LEG SPLNT CLF FOO	$90.00	$300.00	$110.01–$285.00	56% below	70%
Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT	$96.90	$323.00	$118.44–$306.85	53% below	70%
Short leg splint (calf to foot) inpatient CPT 29515 APPLCTN SHRT LEG SPLNT CLF FOO	$90.00	$300.00	$110.01–$285.00	—	70%
Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT	$96.90	$323.00	$118.44–$306.85	—	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPL TRNK 2.5CM OR LESS	$134.10	$447.00	$163.91–$424.65	47% below	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPL TRNK 2.5CM OR LESS	$134.10	$447.00	$163.91–$424.65	—	70%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$142.50	$475.00	$174.18–$451.25	72% below	70%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$142.50	$475.00	$174.18–$451.25	—	70%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MLT FIBRCU	$35.40	$118.00	$43.27–$217.71	76% below	70%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MLT FIBRCU	$35.40	$118.00	$43.27–$217.71	—	70%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOS	$197.70	$659.00	$241.66–$626.05	65% below	70%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOS	$197.70	$659.00	$241.66–$626.05	—	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPL TRNK 2.6 - 7.5CM	$157.50	$525.00	$192.52–$498.75	51% below	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMPL TRNK 2.6 - 7.5CM	$157.50	$525.00	$192.52–$498.75	—	70%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMPL FACE 2.5 OR LESS	$150.00	$500.00	$183.35–$475.71	51% below	70%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMPL FACE 2.5 OR LESS	$150.00	$500.00	$183.35–$475.71	—	70%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BX SKIN SINGLE LSN	$150.00	$500.00	$183.35–$475.00	46% below	70%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BX SKIN SINGLE LSN	$150.00	$500.00	$183.35–$475.00	—	70%
Trigger point injections, 1 or 2 muscles CPT 20552 NJX SNGL/MLT TRGGR PNT 1/2 MSC	$52.20	$174.00	$63.81–$330.53	78% below	70%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 NJX SNGL/MLT TRGGR PNT 1/2 MSC	$52.20	$174.00	$63.81–$330.53	—	70%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30mm	$235.48	$784.94	$287.84–$1,566.51	87% below	70%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPH EGD DILATION <30mm	$235.48	$784.94	$287.84–$1,566.51	—	70%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$683.34	$2,277.80	$835.27–$2,163.91	55% below	70%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD REMOVE LESION SNARE	$683.34	$2,277.80	$835.27–$2,163.91	—	70%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION B9 LSNS U TO 14	$48.00	$160.00	$58.67–$217.71	74% below	70%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION B9 LSNS U TO 14	$48.00	$160.00	$58.67–$217.71	—	70%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN SUBQ TISSUE	$135.60	$452.00	$165.75–$451.17	61% below	70%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN SUBQ TISSUE	$135.60	$452.00	$165.75–$451.17	—	70%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Kansas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 OP BLOOD TRANSFUSION 0-2 HR	$217.80	$726.00	$266.22–$689.70	62% below	70%
Blood transfusion (giving blood or blood components) CPT 36430 OP BLOOD TRANSFUSION 2-4 HR	$300.00	$1,000.00	$366.70–$950.00	48% below	70%
Blood transfusion (giving blood or blood components) CPT 36430 OP BLOOD TRANSFUSION 4-6 HR	$397.50	$1,325.00	$485.88–$1,258.75	31% below	70%
Blood transfusion (giving blood or blood components) CPT 36430 OP BLOOD TRANSFUSION 6-8 HR	$495.00	$1,650.00	$515.69–$1,567.50	14% below	70%
Blood transfusion (giving blood or blood components) CPT 36430 OP BLOOD TRANSFUSION 8+ HR	$592.50	$1,975.00	$515.69–$1,876.25	3% above	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OP BLOOD TRANSFUSION 0-2 HR	$217.80	$726.00	$266.22–$689.70	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OP BLOOD TRANSFUSION 2-4 HR	$300.00	$1,000.00	$366.70–$950.00	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OP BLOOD TRANSFUSION 4-6 HR	$397.50	$1,325.00	$485.88–$1,258.75	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OP BLOOD TRANSFUSION 6-8 HR	$495.00	$1,650.00	$515.69–$1,567.50	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OP BLOOD TRANSFUSION 8+ HR	$592.50	$1,975.00	$515.69–$1,876.25	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TX OBS/OPS NURSE	$61.20	$204.00	$74.81–$254.03	52% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TX ED NURSE	$61.20	$204.00	$74.81–$254.03	52% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TX CARDIO STAFF	$61.20	$204.00	$74.81–$254.03	52% below	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TX ED NURSE	$61.20	$204.00	$74.81–$254.03	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TX OBS/OPS NURSE	$61.20	$204.00	$74.81–$254.03	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TX CARDIO STAFF	$61.20	$204.00	$74.81–$254.03	—	70%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74	$420.30	$1,401.00	$513.75–$1,330.95	71% below	70%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 30-74	$420.30	$1,401.00	$513.75–$1,330.95	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING	$49.50	$165.00	$60.51–$164.48	69% below	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING FAMILY PRACTC CLNC	$49.50	$165.00	$60.51–$164.48	69% below	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING	$49.50	$165.00	$60.51–$164.48	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING FAMILY PRACTC CLNC	$49.50	$165.00	$60.51–$164.48	—	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL 1	$54.90	$183.00	$67.11–$173.85	74% below	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED LEVEL 1	$54.90	$183.00	$67.11–$173.85	—	70%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL 2	$84.90	$283.00	$103.78–$268.85	74% below	70%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED LEVEL 2	$84.90	$283.00	$103.78–$268.85	—	70%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL 3	$130.80	$436.00	$159.88–$414.20	74% below	70%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED LEVEL 3	$130.80	$436.00	$159.88–$414.20	—	70%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL 4	$208.80	$696.00	$255.22–$695.24	75% below	70%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED LEVEL 4	$208.80	$696.00	$255.22–$695.24	—	70%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL 5	$324.30	$1,081.00	$396.40–$1,080.54	75% below	70%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED LEVEL 5	$324.30	$1,081.00	$396.40–$1,080.54	—	70%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TST XRCS OR PHARMCLGIC	$107.10	$357.00	$130.91–$356.37	81% below	70%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TST XRCS OR PHARMCLGIC	$107.10	$357.00	$130.91–$356.37	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 TR IV INF HYDRAT INI 31MIN-1HR	$95.10	$317.00	$116.24–$301.15	61% below	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HR	$95.10	$317.00	$116.24–$301.15	61% below	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OBS IV HYDRATION 1ST HOUR	$95.10	$317.00	$116.24–$301.15	61% below	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OBS IV HYDRATION 1ST HOUR	$95.10	$317.00	$116.24–$301.15	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1ST HR	$95.10	$317.00	$116.24–$301.15	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 TR IV INF HYDRAT INI 31MIN-1HR	$95.10	$317.00	$116.24–$301.15	—	70%
IV infusion of a medicine, first hour CPT 96365 TR IV INF THPY/PRO/DX 1ST HR	$107.10	$357.00	$130.91–$339.15	61% below	70%
IV infusion of a medicine, first hour CPT 96365 OBS IV INFUSION THPY/DX 1ST HR	$107.10	$357.00	$130.91–$339.15	61% below	70%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THPY/DX 1ST HOUR	$107.10	$357.00	$130.91–$339.15	61% below	70%
IV infusion of a medicine, first hour inpatient CPT 96365 TR IV INF THPY/PRO/DX 1ST HR	$107.10	$357.00	$130.91–$339.15	—	70%
IV infusion of a medicine, first hour inpatient CPT 96365 OBS IV INFUSION THPY/DX 1ST HR	$107.10	$357.00	$130.91–$339.15	—	70%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THPY/DX 1ST HOUR	$107.10	$357.00	$130.91–$339.15	—	70%
IV push of a medicine, first drug CPT 96374 OBS IVP INITIAL	$69.00	$230.00	$84.34–$255.27	68% below	70%
IV push of a medicine, first drug CPT 96374 TR IVP INITIAL OR SINGLE SUBST	$72.30	$241.00	$88.37–$255.27	67% below	70%
IV push of a medicine, first drug CPT 96374 IVP INITIAL	$72.30	$241.00	$88.37–$255.27	67% below	70%
IV push of a medicine, first drug inpatient CPT 96374 OBS IVP INITIAL	$69.00	$230.00	$84.34–$255.27	—	70%
IV push of a medicine, first drug inpatient CPT 96374 TR IVP INITIAL OR SINGLE SUBST	$72.30	$241.00	$88.37–$255.27	—	70%
IV push of a medicine, first drug inpatient CPT 96374 IVP INITIAL	$72.30	$241.00	$88.37–$255.27	—	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OBS IM/SUBQ INJ THPY/PRO/DX	$32.10	$107.00	$39.24–$101.65	53% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 TR SUBQ INJECTION	$32.10	$107.00	$39.24–$101.65	53% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SUBQ INJ THPY/PRO/DX	$32.10	$107.00	$39.24–$101.65	53% below	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TR SUBQ INJECTION	$32.10	$107.00	$39.24–$101.65	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OBS IM/SUBQ INJ THPY/PRO/DX	$32.10	$107.00	$39.24–$101.65	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SUBQ INJ THPY/PRO/DX	$32.10	$107.00	$39.24–$101.65	—	70%
New patient office visit, about 30 minutes CPT 99203 TC SPECIALTY CLNC OFF OP NEW 3	$54.00	$180.00	$66.01–$171.00	64% below	70%
New patient office visit, about 30 minutes inpatient CPT 99203 TC SPECIALTY CLNC OFF OP NEW 3	$54.00	$180.00	$66.01–$171.00	—	70%
New patient office visit, about 45 minutes CPT 99204 TC SPECIALTY CLNC OFF OP NEW 4	$84.00	$280.00	$101.00–$266.00	58% below	70%
New patient office visit, about 45 minutes inpatient CPT 99204 TC SPECIALTY CLNC OFF OP NEW 4	$84.00	$280.00	$101.00–$266.00	—	70%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 TC SPECIALTY CLNC OFF OP NEW 2	$42.00	$140.00	$51.34–$133.00	62% below	70%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 TC SPECIALTY CLNC OFF OP NEW 2	$42.00	$140.00	$51.34–$133.00	—	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT ASSMT/INTERV EACH 15MIN	$11.40	$38.00	$13.93–$36.10	63% below	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT ASSMT/INTERV EACH 15MIN	$11.40	$38.00	$13.93–$36.10	—	70%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 TREATMENT ROOM LEVEL 5	$105.00	$350.00	$128.35–$332.50	51% below	70%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TREATMENT ROOM LEVEL 5	$105.00	$350.00	$128.35–$332.50	—	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TC SPECIALTY CLNC OFF OP EST 3	$54.00	$180.00	$66.01–$171.00	59% below	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TREATMENT ROOM LEVEL 3	$58.20	$194.00	$71.14–$184.30	56% below	70%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TC CRNA PAIN CLNC OF OP 20MIN	$58.20	$194.00	$71.14–$184.30	56% below	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TC SPECIALTY CLNC OFF OP EST 3	$54.00	$180.00	$66.01–$171.00	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TREATMENT ROOM LEVEL 3	$58.20	$194.00	$71.14–$184.30	—	70%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TC CRNA PAIN CLNC OF OP 20MIN	$58.20	$194.00	$71.14–$184.30	—	70%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TC SPECIALTY CLNC OFF OP EST 4	$84.00	$280.00	$102.68–$266.00	48% below	70%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TC CRNA PAIN CLNC OF OP 30MIN	$90.30	$301.00	$110.38–$285.95	44% below	70%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TREATMENT ROOM LEVEL 4	$90.30	$301.00	$110.38–$285.95	44% below	70%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TC SPECIALTY CLNC OFF OP EST 4	$84.00	$280.00	$102.68–$266.00	—	70%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TC CRNA PAIN CLNC OF OP 30MIN	$90.30	$301.00	$110.38–$285.95	—	70%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TREATMENT ROOM LEVEL 4	$90.30	$301.00	$110.38–$285.95	—	70%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TC SPECIALTY CLNC OFF OP EST 2	$42.00	$140.00	$51.34–$133.00	60% below	70%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TC CRNA PAIN CLNC OF OP 10MIN	$45.30	$151.00	$55.37–$143.45	56% below	70%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TREATMENT ROOM LEVEL 2	$45.30	$151.00	$55.37–$143.45	56% below	70%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TC SPECIALTY CLNC OFF OP EST 2	$42.00	$140.00	$51.34–$133.00	—	70%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TC CRNA PAIN CLNC OF OP 10MIN	$45.30	$151.00	$55.37–$143.45	—	70%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TREATMENT ROOM LEVEL 2	$45.30	$151.00	$55.37–$143.45	—	70%
Spirometry (breathing test) CPT 94010 PFT WO BRONCHODIALATOR	$44.70	$149.00	$54.64–$300.98	85% below	70%
Spirometry (breathing test) inpatient CPT 94010 PFT WO BRONCHODIALATOR	$44.70	$149.00	$54.64–$300.98	—	70%
Spirometry before and after a bronchodilator CPT 94060 PFT W BRONCHODIALATORS	$89.40	$298.00	$109.28–$373.83	79% below	70%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT W BRONCHODIALATORS	$89.40	$298.00	$109.28–$373.83	—	70%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITY	$34.50	$115.00	$42.17–$109.25	56% below	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITY	$34.50	$115.00	$42.17–$109.25	—	70%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$49.80	$166.00	$60.87–$157.70	63% below	70%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$49.80	$166.00	$60.87–$157.70	—	70%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Kansas	Off list
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC PD #90744	$40.80	$136.00	$38.54–$129.20	11% below	70%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC PD #90744	$40.80	$136.00	$38.54–$129.20	—	70%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 VAC Pneumonia 15 0.5 ML PF Syr	$137.10	$457.00	$167.58–$434.15	65% below	70%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 VAC Pneumonia 15 0.5 ML PF Syr	$137.10	$457.00	$167.58–$434.15	—	70%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 VAC Pneumonia 20 0.5 ML PF Syr	$156.60	$522.00	$191.42–$495.90	59% below	70%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 VAC Pneumonia 20 0.5 ML PF Syr	$156.60	$522.00	$191.42–$495.90	—	70%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCN 0.5ML#90732	$70.35	$234.50	$85.99–$222.78	59% below	70%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCN 0.5ML#90732	$70.35	$234.50	$85.99–$222.78	—	70%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE HUMAN #90675	$260.85	$869.50	$318.85–$826.03	58% below	70%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE HUMAN #90675	$260.85	$869.50	$318.85–$826.03	—	70%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 VAC Tet/Diph Tox PF 0.5ML Srng	$42.75	$142.50	$38.79–$135.38	36% below	70%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 VAC Tet/Diph Tox PF 0.5ML Srng	$42.75	$142.50	$38.79–$135.38	—	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX (TDAP) 0.5ML IN#90715	$19.05	$63.50	$23.29–$67.14	77% below	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX (TDAP) 0.5ML IN#90715	$19.05	$63.50	$23.29–$67.14	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 OBS IMMUNIZATION ADMINISTRATIO	$20.40	$68.00	$8.08–$64.60	46% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION IM	$27.00	$90.00	$8.08–$85.50	29% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION	$28.50	$95.00	$8.08–$90.25	25% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 OBS IMMUNIZATION ADMINISTRATIO	$20.40	$68.00	$8.08–$64.60	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION IM	$27.00	$90.00	$8.08–$85.50	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION	$28.50	$95.00	$8.08–$90.25	—	70%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://coffeyhealth.org/Documents/480860883_Coffey_County_Hospital_Standardcharges.csv