Decatur County Hospital
Decatur County Hospital in Leon, IA publishes cash prices for 254 common procedures listed here, from its own machine-readable price file updated Mar 4, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Iowa median for 126 of 254 procedures and below it for 125. By typical cash price it ranks #40 of 78 Iowa hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
1405 Nw Church St Leon IA 50144 Collected Sep 27, 2026 Source price file (641) 446-4871
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 161340 · CMS hospital register
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Decatur County Hospital in Leon, IA:
- Mar 1, 2024 Warning notice
- Jun 5, 2024 Case closed
- Jul 10, 2025 Met requirements
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 X-ray of ankle, minimum of 3 views | $175.20 | $219.00 | $59.52–$229.95 | 22% below | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Ultrasound study of arm and leg arteries | $394.40 | $493.00 | $157.76–$517.65 | 26% above | 20% |
| Bone scan, whole body (nuclear medicine) CPT 78306 Nuclear medicine study of bone and/or joint whole body | $1,500.00 | $1,875.00 | $600.00–$1,968.75 | 24% above | 20% |
| Breast ultrasound, complete, one breast CPT 76641 Complete ultrasound scan of 1 breast | $262.40 | $328.00 | $104.96–$344.40 | 27% below | 20% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 Limited ultrasound scan of 1 breast | $219.20 | $274.00 | $87.68–$287.70 | 39% below | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT scan of blood vessels of chest with contrast | $2,224.80 | $2,781.00 | $709.28–$2,920.05 | 5% above | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT scan of abdomen and pelvis without contrast | $2,317.60 | $2,897.00 | $927.04–$3,041.85 | 14% below | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $2,987.20 | $3,734.00 | $1,042.22–$3,920.70 | 7% below | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT scan of abdomen and pelvis before and after contrast | $2,972.80 | $3,716.00 | $1,042.22–$3,901.80 | 14% below | 20% |
| CT scan of the abdomen with contrast CPT 74160 CT scan of abdomen with contrast | $1,600.80 | $2,001.00 | $640.32–$2,101.05 | 4% below | 20% |
| CT scan of the abdomen without contrast CPT 74150 CT scan of abdomen without contrast | $1,356.00 | $1,695.00 | $480.50–$1,779.75 | 2% above | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT scan of face without contrast | $1,136.80 | $1,421.00 | $454.72–$1,492.05 | 12% below | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan head or brain without contrast | $1,440.80 | $1,801.00 | $576.32–$1,891.05 | 6% above | 20% |
| CT scan of the head with contrast CPT 70460 CT scan head or brain with contrast | $1,398.40 | $1,748.00 | $559.36–$1,835.40 | 7% below | 20% |
| CT scan of the head without and with contrast CPT 70470 CT scan of head or brain before and after contrast | $1,556.00 | $1,945.00 | $622.40–$2,042.25 | 14% below | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT scan of lower spine without contrast | $1,390.40 | $1,738.00 | $480.50–$1,824.90 | 8% below | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT scan of upper spine without contrast | $1,540.80 | $1,926.00 | $480.50–$2,022.30 | 2% above | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $1,504.00 | $1,880.00 | $601.60–$1,974.00 | 14% below | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Ultrasound of both sides of head and neck blood flow | $984.00 | $1,230.00 | $191.58–$1,291.50 | 12% above | 20% |
| Chest X-ray, 2 views CPT 71046 X-ray of chest, 2 views | $197.60 | $247.00 | $59.52–$259.35 | 3% below | 20% |
| Chest X-ray, single view CPT 71045 X-ray of chest, 1 view | $184.80 | $231.00 | $59.52–$242.55 | 10% above | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Complete ultrasound scan behind abdominal cavity | $593.60 | $742.00 | $237.44–$779.10 | 2% below | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA bone density measurement of hip, pelvis, spine | $424.00 | $530.00 | $169.60–$556.50 | 9% above | 20% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA bone density measurement of forearm, finger, hand, or foot | $216.00 | $270.00 | $86.40–$283.50 | 13% below | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT scan of chest without contrast | $1,371.20 | $1,714.00 | $480.50–$1,799.70 | 1% below | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT scan of chest with contrast | $1,829.60 | $2,287.00 | $731.84–$2,401.35 | 2% above | 20% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 Ultrasound of leg arteries or artery grafts | $734.40 | $918.00 | $293.76–$963.90 | 1% above | 20% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 Ultrasound study of arm or leg veins with compression and maneuvers | $1,040.00 | $1,300.00 | $302.56–$1,365.00 | 16% above | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | $399.20 | $499.00 | $159.68–$523.95 | 74% below | 20% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nuclear medicine study of liver and bile duct system | $1,141.60 | $1,427.00 | $456.64–$1,498.35 | 2% below | 20% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep study including heart rate, breathing, airflow, and effort | $637.60 | $797.00 | $255.04–$1,226.92 | 16% above | 20% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep study in sleep lab with continuous airway pressure (6 years or older) | $3,112.00 | $3,890.00 | $1,115.38–$4,084.50 | 1% below | 20% |
| Knee X-ray, 3 views CPT 73562 X-ray of knee, 3 views | $197.60 | $247.00 | $59.52–$259.35 | 8% below | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Limited ultrasound scan of abdomen | $536.00 | $670.00 | $191.58–$703.50 | 9% above | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint without contrast | $1,924.00 | $2,405.00 | $769.60–$2,525.25 | 14% below | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI scan of leg joint before and after contrast | $2,736.80 | $3,421.00 | $1,094.72–$3,592.05 | 13% below | 20% |
| MRI of the abdomen without contrast CPT 74181 MRI scan of abdomen without contrast | $2,072.00 | $2,590.00 | $828.80–$2,719.50 | 1% above | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI scan of abdomen before and after contrast | $2,937.60 | $3,672.00 | $1,175.04–$3,855.60 | 12% below | 20% |
| MRI of the brain, no contrast dye CPT 70551 MRI scan of brain without contrast | $2,324.00 | $2,905.00 | $929.60–$3,050.25 | 7% above | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI scan of brain before and after contrast | $3,255.20 | $4,069.00 | $1,233.80–$4,272.45 | 8% below | 20% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal without contrast | $2,224.80 | $2,781.00 | $889.92–$2,920.05 | 7% below | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI scan of lower spinal canal before and after contrast | $2,937.60 | $3,672.00 | $1,175.04–$3,855.60 | 15% below | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI scan of middle spinal canal without contrast | $2,094.40 | $2,618.00 | $837.76–$2,748.90 | 10% below | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI scan of upper spinal canal before and after contrast | $2,946.40 | $3,683.00 | $1,178.56–$3,867.15 | 13% below | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI scan of upper spinal canal without contrast | $2,208.80 | $2,761.00 | $883.52–$2,899.05 | 3% below | 20% |
| MRI of the pelvis without and with contrast CPT 72197 MRI scan of pelvis before and after contrast | $2,618.40 | $3,273.00 | $1,047.36–$3,436.65 | 19% below | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI scan of pelvis without contrast | $1,800.80 | $2,251.00 | $720.32–$2,363.55 | 13% below | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI scan of arm joint without contrast | $1,924.00 | $2,405.00 | $769.60–$2,525.25 | 14% below | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nuclear medicine studies of heart muscle at rest and with stress and SPECT | $3,790.40 | $4,738.00 | $1,516.16–$4,974.90 | 35% above | 20% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 Nuclear medicine study from skull base to mid-thigh with CT scan | $5,356.00 | $6,695.00 | $2,142.40–$7,029.75 | 27% above | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Complete ultrasound scan of pelvis | $459.20 | $574.00 | $183.68–$602.70 | 13% below | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus | $520.00 | $650.00 | $169.88–$682.50 | 5% below | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus | $387.20 | $484.00 | $154.88–$508.20 | 13% below | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Limited ultrasound of pregnant uterus | $270.40 | $338.00 | $108.16–$354.90 | 19% below | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-ray of shoulder, minimum of 2 views | $197.60 | $247.00 | $59.52–$259.35 | 16% below | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep study in sleep lab (6 years or older) | $2,712.00 | $3,390.00 | $1,084.80–$3,559.50 | 6% below | 20% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Imaging for evaluation of swallowing function | $402.40 | $503.00 | $160.96–$528.15 | at median | 20% |
| Ultrasound of the abdomen, complete CPT 76700 Complete ultrasound scan of abdomen | $659.20 | $824.00 | $263.68–$865.20 | 5% below | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 Ultrasound scan of scrotum | $442.40 | $553.00 | $176.96–$580.65 | 18% below | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound scan of head and neck soft tissue | $411.20 | $514.00 | $164.48–$539.70 | 11% below | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Ultrasound study of one arm or leg veins with compression and maneuvers | $720.00 | $900.00 | $191.58–$945.00 | 11% above | 20% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-ray of wrist, minimum of 3 views | $179.20 | $224.00 | $59.52–$235.20 | 19% below | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-ray of hip, 2-3 views | $240.00 | $300.00 | $59.52–$315.00 | 25% above | 20% |
| X-ray of the abdomen, 1 view CPT 74018 X-ray of abdomen, 1 view | $175.20 | $219.00 | $59.52–$229.95 | 1% below | 20% |
| X-ray of the ankle, 2 views CPT 73600 X-ray of ankle, 2 views | $107.20 | $134.00 | $42.88–$140.70 | 38% below | 20% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-ray of finger, minimum of 2 views | $144.80 | $181.00 | $57.92–$190.05 | 14% below | 20% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-ray of foot, minimum of 3 views | $175.20 | $219.00 | $59.52–$229.95 | 20% below | 20% |
| X-ray of the hand, 3 or more views CPT 73130 X-ray of hand, minimum of 3 views | $183.20 | $229.00 | $59.52–$240.45 | 11% below | 20% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-ray of knee, 1-2 views | $175.20 | $219.00 | $59.52–$229.95 | 12% below | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-ray of lower and sacral spine, 2-3 views | $236.00 | $295.00 | $59.52–$309.75 | 17% below | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 X-ray of lower and sacral spine, minimum of 4 views | $307.20 | $384.00 | $59.52–$403.20 | 13% below | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-ray of nose bones, minimum of 3 views | $179.20 | $224.00 | $59.52–$235.20 | 9% below | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-ray of upper spine, 2-3 views | $214.40 | $268.00 | $59.52–$281.40 | 14% below | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-ray of pelvis, 1-2 views | $157.60 | $197.00 | $59.52–$206.85 | 20% below | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-ray of sacrum and tailbone, minimum of 2 views | $175.20 | $219.00 | $59.52–$229.95 | 20% below | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Liver enzyme (SGPT), level | $48.80 | $61.00 | $3.23–$64.05 | 16% above | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Liver enzyme (SGOT), level | $48.80 | $61.00 | $3.16–$64.05 | 26% above | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel | $265.60 | $332.00 | $52.08–$348.60 | 16% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Measurement of antibody (IgE) to allergic substance, crude allergen extract, each | $262.40 | $328.00 | $17.12–$344.40 | 573% above | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Measurement of antibody for rheumatoid arthritis assessment | $61.60 | $77.00 | $9.97–$80.85 | 11% below | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Screening test for autoimmune disorder | $72.80 | $91.00 | $11.00–$95.55 | at median | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic peptide (heart and blood vessel protein) level | $180.00 | $225.00 | $72.00–$236.25 | 15% above | 20% |
| Basic metabolic panel (blood test) CPT 80048 Blood test, basic group of blood chemicals (Calcium, total) | $109.60 | $137.00 | $11.59–$143.85 | 32% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pathology examination of tissue using a microscope, intermediate complexity | $183.20 | $229.00 | $73.28–$240.45 | 3% above | 20% |
| Blood culture for bacteria CPT 87040 Bacterial blood culture | $209.60 | $262.00 | $27.04–$275.10 | 142% above | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Insertion of needle into vein for collection of blood sample | $16.80 | $21.00 | $1.96–$45.69 | 15% below | 20% |
| Blood glucose (sugar) test CPT 82947 Blood glucose (sugar) level | $33.60 | $42.00 | $1.65–$44.10 | at median | 20% |
| Blood lead test CPT 83655 Lead level | $60.00 | $75.00 | $9.08–$78.75 | 14% above | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin (reproductive hormone) analysis | $87.20 | $109.00 | $8.20–$114.45 | 41% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood group typing (ABO) | $36.80 | $46.00 | $1.38–$107.07 | 36% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Measurement C-reactive protein for detection of infection or inflammation | $57.60 | $72.00 | $3.73–$75.60 | at median | 20% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Detection test by nucleic acid for clostridium difficile, amplified probe technique | $134.40 | $168.00 | $53.76–$176.40 | 24% above | 20% |
| CA 19-9 blood test (tumor marker) CPT 86301 Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9 | $103.20 | $129.00 | $26.84–$135.45 | 8% above | 20% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Immunologic analysis for detection of tumor antigen, quantitative; CA 125 | $114.40 | $143.00 | $29.76–$150.15 | at median | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Amplifed DNA or RNA probe detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen | $164.80 | $206.00 | $65.92–$216.30 | 44% above | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique | $110.40 | $138.00 | $44.16–$144.90 | 11% above | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids (cholesterol and triglycerides) | $93.60 | $117.00 | $15.67–$122.85 | 10% above | 20% |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $111.20 | $139.00 | $10.80–$145.95 | 80% above | 20% |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (red cells, white blood cell, platelets), automated test | $68.00 | $85.00 | $5.50–$89.25 | 52% above | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $140.80 | $176.00 | $18.59–$184.80 | 19% above | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 Coagulation function measurement, D-dimer; quantitative | $118.40 | $148.00 | $15.07–$155.40 | 40% above | 20% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone (DHEA-S) hormone level | $109.60 | $137.00 | $30.46–$143.85 | 2% below | 20% |
| Estradiol blood test CPT 82670 Measurement of total estradiol (hormone) | $132.00 | $165.00 | $46.10–$173.25 | 2% above | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin, follicle stimulating (reproductive hormone) level | $101.60 | $127.00 | $23.60–$133.35 | 10% above | 20% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Stool calprotectin (protein) level | $259.20 | $324.00 | $45.88–$340.20 | 61% above | 20% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin (blood protein) level | $89.60 | $112.00 | $15.27–$117.60 | 5% above | 20% |
| Folate (folic acid) blood test CPT 82746 Folic acid level, serum | $89.60 | $112.00 | $16.46–$117.60 | 1% above | 20% |
| Free T3 thyroid hormone test CPT 84481 Thyroid hormone, T3 measurement, free | $114.40 | $143.00 | $24.22–$150.15 | 14% above | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (thyroid chemical), free | $64.00 | $80.00 | $7.22–$84.00 | 1% below | 20% |
| Free testosterone test CPT 84402 Testosterone (hormone) level, free | $120.00 | $150.00 | $38.21–$157.50 | 13% above | 20% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General health panel | $319.20 | $399.00 | $52.08–$418.95 | 99% above | 20% |
| Glucose tolerance test, 3 samples CPT 82951 Blood glucose (sugar) tolerance test, 3 specimens | $114.40 | $143.00 | $18.40–$150.15 | 35% above | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique | $114.40 | $143.00 | $45.76–$150.15 | 26% above | 20% |
| H. pylori stool antigen test CPT 87338 Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool | $120.80 | $151.00 | $21.71–$158.55 | 8% above | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Detection test by nucleic acid for HIV-1 virus, quantification | $212.80 | $266.00 | $68.82–$279.30 | 21% below | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies | $88.00 | $110.00 | $26.49–$115.50 | 17% above | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C level | $67.20 | $84.00 | $8.16–$88.20 | 11% above | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody measurement | $69.60 | $87.00 | $9.34–$91.35 | 3% above | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Detection test by immunoassay technique for hepatitis B surface antigen | $74.40 | $93.00 | $9.61–$97.65 | 13% above | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody measurement | $92.00 | $115.00 | $16.41–$120.75 | 18% above | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Detection test by nucleic acid for Hepatitis C virus, quantification | $187.20 | $234.00 | $68.82–$245.70 | 27% below | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Measurement C-reactive protein for detection of infection or inflammation, high sensitivity | $86.40 | $108.00 | $13.99–$113.40 | 11% above | 20% |
| Homocysteine blood test CPT 83090 Homocysteine (amino acid) level | $136.00 | $170.00 | $30.46–$178.50 | 43% above | 20% |
| Insulin blood test CPT 83525 Insulin measurement, total | $68.80 | $86.00 | $9.83–$90.30 | 10% below | 20% |
| Iron blood test (serum iron) CPT 83540 Iron level | $49.60 | $62.00 | $4.01–$65.10 | 24% above | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity | $48.00 | $60.00 | $5.24–$63.00 | 1% below | 20% |
| Kidney function blood test panel CPT 80069 Kidney function blood test panel | $122.40 | $153.00 | $13.28–$160.65 | 40% above | 20% |
| LH (luteinizing hormone) test CPT 83002 Gonadotropin, luteinizing (reproductive hormone) level | $100.00 | $125.00 | $23.15–$131.25 | 8% above | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase (fat enzyme) level | $77.60 | $97.00 | $6.68–$101.85 | 22% above | 20% |
| Liver function blood test panel CPT 80076 Liver function blood test panel | $96.00 | $120.00 | $9.80–$126.00 | 14% above | 20% |
| Lyme disease antibody test CPT 86618 Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria) | $98.40 | $123.00 | $20.95–$129.15 | 11% above | 20% |
| Magnesium blood test CPT 83735 Magnesium level | $65.60 | $82.00 | $5.49–$86.10 | 35% above | 20% |
| Measles (rubeola) antibody test CPT 86765 Analysis for antibody to Rubeola (measles virus) | $80.00 | $100.00 | $12.88–$105.00 | 46% above | 20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Screening test for mononucleosis (mono) | $61.60 | $77.00 | $3.99–$80.85 | 27% above | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (prostate specific antigen) measurement, free | $105.60 | $132.00 | $24.27–$138.60 | 8% above | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (prostate specific antigen) measurement, total | $105.60 | $132.00 | $24.27–$138.60 | 10% above | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Pap test, automated thin layer preparation; automated system and manual rescreening | $77.60 | $97.00 | $25.81–$101.85 | 1% below | 20% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap test, manual screening | $91.20 | $114.00 | $23.10–$119.70 | 57% above | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (parathyroid hormone) level | $183.20 | $229.00 | $73.28–$240.45 | 4% above | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test, plasma or whole blood | $49.60 | $62.00 | $3.73–$65.10 | 10% above | 20% |
| Progesterone blood test CPT 84144 Progesterone (reproductive hormone) level | $100.00 | $125.00 | $26.08–$131.25 | 3% above | 20% |
| Prolactin blood test CPT 84146 Prolactin (milk producing hormone) level | $118.40 | $148.00 | $28.68–$155.40 | 18% above | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $40.80 | $51.00 | $2.19–$53.55 | 24% above | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Testing for presence of drug, read by direct observation | $79.20 | $99.00 | $12.47–$103.95 | 10% above | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep) | $61.60 | $77.00 | $12.73–$80.85 | 23% above | 20% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor level | $51.20 | $64.00 | $3.63–$67.20 | 5% above | 20% |
| Rubella antibody test (immunity check) CPT 86762 Analysis for antibody to Rubella (German measles virus) | $22.40 | $28.00 | $4.03–$51.83 | 62% below | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Red blood cell sedimentation rate, to detect inflammation, automated | $40.80 | $51.00 | $1.38–$53.55 | 22% above | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay | $33.60 | $42.00 | $6.69–$50.47 | 42% below | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, gamma interferon | $120.80 | $151.00 | $48.32–$158.55 | 23% below | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone (hormone) level, total | $123.20 | $154.00 | $39.75–$161.70 | 19% above | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal antibodies (autoantibody) measurement | $96.00 | $120.00 | $17.46–$126.00 | 27% above | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $100.00 | $125.00 | $21.00–$131.25 | 3% above | 20% |
| Trichomonas test (NAAT) CPT 87661 Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique | $86.40 | $108.00 | $34.56–$113.40 | 7% below | 20% |
| Uric acid blood test CPT 84550 Uric acid level, blood | $50.40 | $63.00 | $2.85–$66.15 | 44% above | 20% |
| Urinalysis with microscope exam, automated CPT 81001 Manual urinalysis test with examination using microscope, automated | $46.40 | $58.00 | $1.84–$60.90 | 12% above | 20% |
| Urinalysis without microscope exam, automated CPT 81003 Automated urinalysis test | $31.20 | $39.00 | $0.88–$40.95 | 21% above | 20% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis, manual test | $22.40 | $28.00 | $0.97–$29.40 | 3% below | 20% |
| Urine culture for bacteria, with colony count CPT 87086 Bacterial colony count, urine | $88.00 | $110.00 | $8.88–$115.50 | 50% above | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (vitamin B-12) level | $92.00 | $115.00 | $17.34–$120.75 | 10% above | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D-3 level | $132.80 | $166.00 | $49.14–$174.30 | 6% above | 20% |
| Zinc blood test CPT 84630 Zinc level | $64.00 | $80.00 | $9.11–$84.00 | 22% above | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, chorionic (reproductive hormone) level | $129.60 | $162.00 | $24.38–$170.10 | 46% above | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc | $4,120.00 | $5,150.00 | $1,395.15–$5,253.00 | 14% below | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed treatment of broken outside lower leg bone at ankle | $82.40 | $103.00 | $32.96–$3,346.57 | 81% below | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Closed treatment of broken outside lower leg bone at ankle | $82.40 | $103.00 | $32.96–$3,346.57 | — | 20% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed treatment of broken bone in forefoot or midfoot | $82.40 | $103.00 | $32.96–$3,346.57 | 78% below | 20% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed treatment of broken bone in forefoot or midfoot | $82.40 | $103.00 | $32.96–$3,346.57 | — | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 External shock to heart to regulate heart beat | $831.20 | $1,039.00 | $332.48–$1,506.54 | 4% above | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation | $82.40 | $103.00 | $32.96–$3,346.57 | 81% below | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation | $82.40 | $103.00 | $32.96–$3,346.57 | — | 20% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Diagnostic exam of bladder and urethra using an endoscope | $262.40 | $328.00 | $65.87–$334.56 | 67% below | 20% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | $328.00 | $410.00 | $131.20–$3,851.25 | 11% below | 20% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 Incision of eardrum with insertion of eardrum tube under local or topical anesthesia | $328.00 | $410.00 | $131.20–$3,851.25 | — | 20% |
| Earwax removal with instruments, one ear CPT 69210 Removal of impacted ear wax | $59.20 | $74.00 | $23.68–$362.82 | 43% below | 20% |
| Earwax removal with instruments, one ear inpatient CPT 69210 Removal of impacted ear wax | $59.20 | $74.00 | $23.68–$362.82 | — | 20% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Initial repair of sliding hernia of abdomen, 3-10 cm in length | $982.40 | $1,228.00 | $463.67–$1,252.56 | 56% below | 20% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 Initial repair of sliding hernia of abdomen, more than 10 cm in length | $1,322.40 | $1,653.00 | $623.10–$1,686.06 | 39% below | 20% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Initial repair of sliding hernia of abdomen, less than 3 cm in length | $587.20 | $734.00 | $279.52–$748.68 | 72% below | 20% |
| Hammertoe correction surgery CPT 28285 Correction of toe joint deformity | $791.20 | $989.00 | $344.07–$1,008.78 | 56% below | 20% |
| Hysteroscopy with endometrial ablation CPT 58563 Exam of uterus with destruction of lining of uterus using an endoscope | $712.80 | $891.00 | $197.53–$908.82 | 82% below | 20% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Biopsy of lining of uterus and/or removal of polyp using an endoscope | $669.60 | $837.00 | $186.14–$853.74 | 80% below | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Simple or single drainage of skin abscess | $206.40 | $258.00 | $93.12–$263.16 | 15% below | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Simple or single drainage of skin abscess | $284.80 | $356.00 | $113.92–$1,014.13 | 17% above | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Simple or single drainage of skin abscess | $284.80 | $356.00 | $113.92–$1,014.13 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection into tendon or ligament | $87.20 | $109.00 | $34.88–$705.87 | 64% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection into tendon or ligament | $87.20 | $109.00 | $34.88–$705.87 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration and/or injection of fluid from large joint | $142.40 | $178.00 | $56.96–$705.87 | 59% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration and/or injection of fluid from large joint | $142.40 | $178.00 | $56.96–$705.87 | 59% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Aspiration and/or injection of fluid from large joint | $142.40 | $178.00 | $56.96–$705.87 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspiration and/or injection of fluid from medium joint | $87.20 | $109.00 | $34.88–$705.87 | 70% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspiration and/or injection of fluid from medium joint | $92.00 | $115.00 | $36.80–$705.87 | 68% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Aspiration and/or injection of fluid from medium joint | $87.20 | $109.00 | $34.88–$705.87 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Aspiration and/or injection of fluid from small joint | $57.60 | $72.00 | $23.04–$705.87 | 79% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Aspiration and/or injection of fluid from small joint | $87.20 | $109.00 | $34.88–$705.87 | 68% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Aspiration and/or injection of fluid from small joint | $87.20 | $109.00 | $34.88–$705.87 | — | 20% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Removal or shaving of knee joint cartilage using an endoscope | $1,372.00 | $1,715.00 | $531.22–$1,749.30 | 20% below | 20% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Removal of uterus through abdomen using an endoscope, 250.0 g or less | $1,320.00 | $1,650.00 | $659.42–$1,683.00 | 40% below | 20% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, 250.0 g or less | $1,300.00 | $1,625.00 | $748.39–$1,871.60 | 52% below | 20% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Repair of groin hernia using an endoscope | $1,206.40 | $1,508.00 | $377.54–$1,538.16 | 2% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less | $56.00 | $70.00 | $22.40–$598.11 | 84% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less | $56.00 | $70.00 | $22.40–$598.11 | — | 20% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Partial removal of spine bone with release of lower spinal cord or nerves and/or removal of disc | $2,185.60 | $2,732.00 | $788.59–$2,786.64 | 3% below | 20% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | $708.80 | $886.00 | $269.49–$903.72 | 32% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail | $44.80 | $56.00 | $17.92–$598.11 | 79% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail | $163.20 | $204.00 | $46.13–$208.08 | 23% below | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail | $44.80 | $56.00 | $17.92–$598.11 | — | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve | $358.40 | $448.00 | $143.36–$703.14 | 11% below | 20% |
| Occipital nerve block (injection for headaches) CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve | $656.00 | $820.00 | $41.15–$836.40 | 62% above | 20% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve | $358.40 | $448.00 | $143.36–$703.14 | — | 20% |
| Paracentesis with imaging guidance CPT 49083 Drainage of fluid from abdominal cavity using imaging guidance | $349.60 | $437.00 | $86.86–$445.74 | 69% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Permanent removal fingernail or toenail | $147.20 | $184.00 | $58.88–$1,451.30 | 66% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Permanent removal fingernail or toenail | $147.20 | $184.00 | $58.88–$1,451.30 | — | 20% |
| Removal of a breast lump, open surgery CPT 19120 Removal of growth and tissue of breast, duct, or nipple | $680.00 | $850.00 | $364.45–$867.00 | 52% below | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 Removal of foreign body from tissue, accessed beneath the skin, simple | $394.40 | $493.00 | $157.76–$1,014.13 | 32% above | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Removal of foreign body from tissue, accessed beneath the skin, simple | $394.40 | $493.00 | $157.76–$1,014.13 | — | 20% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK | $368.00 | $460.00 | $152.74–$469.20 | 63% below | 20% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK | $394.40 | $493.00 | $152.60–$502.86 | 64% below | 20% |
| Short arm cast (elbow to hand) CPT 29075 Application of elbow to finger cast | $133.60 | $167.00 | $53.44–$445.35 | 41% below | 20% |
| Short arm cast (elbow to hand) inpatient CPT 29075 Application of elbow to finger cast | $133.60 | $167.00 | $53.44–$445.35 | — | 20% |
| Short arm splint (forearm and hand) CPT 29125 Application of nonmoveable forearm to hand splint | $148.00 | $185.00 | $59.20–$194.25 | 16% below | 20% |
| Short arm splint (forearm and hand) CPT 29125 Application of nonmoveable forearm to hand splint | $170.40 | $213.00 | $68.16–$223.65 | 3% below | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Application of nonmoveable forearm to hand splint | $170.40 | $213.00 | $68.16–$223.65 | — | 20% |
| Short leg cast (below the knee) CPT 29405 Application of short leg cast | $154.40 | $193.00 | $61.76–$445.35 | 36% below | 20% |
| Short leg cast (below the knee) inpatient CPT 29405 Application of short leg cast | $154.40 | $193.00 | $61.76–$445.35 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less | $235.20 | $294.00 | $94.08–$598.11 | 6% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less | $235.20 | $294.00 | $94.08–$598.11 | — | 20% |
| Skin biopsy, punch, one lesion CPT 11104 Punch biopsy, first skin growth | $88.00 | $110.00 | $35.58–$112.20 | 66% below | 20% |
| Skin biopsy, punch, one lesion CPT 11104 Punch biopsy, first skin growth | $260.00 | $325.00 | $104.00–$1,451.30 | 1% above | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch biopsy, first skin growth | $260.00 | $325.00 | $104.00–$1,451.30 | — | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test | $108.80 | $136.00 | $43.52–$1,487.44 | 78% below | 20% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test | $599.20 | $749.00 | $239.68–$1,487.44 | 23% above | 20% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test | $108.80 | $136.00 | $43.52–$1,487.44 | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm | $140.80 | $176.00 | $51.57–$179.52 | 42% below | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm | $254.40 | $318.00 | $101.76–$598.11 | 5% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm | $254.40 | $318.00 | $101.76–$598.11 | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less | $250.40 | $313.00 | $100.16–$598.11 | 1% above | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less | $250.40 | $313.00 | $100.16–$598.11 | — | 20% |
| Thoracentesis with imaging guidance CPT 32555 Aspiration of fluid from chest cavity using imaging guidance | $1,063.20 | $1,329.00 | $425.28–$1,703.64 | 16% above | 20% |
| Thoracentesis with imaging guidance CPT 32555 Aspiration of fluid from chest cavity using imaging guidance | $2,280.00 | $2,850.00 | $912.00–$2,992.50 | 148% above | 20% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Aspiration of fluid from chest cavity using imaging guidance | $1,063.20 | $1,329.00 | $425.28–$1,703.64 | — | 20% |
| Vein ablation, radiofrequency, first vein CPT 36475 Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance | $6,560.00 | $8,200.00 | $2,624.00–$8,610.00 | 18% above | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Removal of skin and tissue, 20.0 sq cm or less | $114.40 | $143.00 | $45.76–$634.94 | 73% below | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Removal of skin and tissue, 20.0 sq cm or less | $114.40 | $143.00 | $45.76–$634.94 | — | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion of blood or blood products | $627.20 | $784.00 | $250.88–$1,444.48 | 15% above | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation treatment for airway obstruction or sputum production | $105.60 | $132.00 | $42.24–$360.78 | 4% below | 20% |
| Chemotherapy IV infusion, first hour CPT 96413 Administration of chemotherapy into vein, 1 hour or less | $612.00 | $765.00 | $244.80–$803.25 | 13% above | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical care, first 30-74 minutes | $1,224.00 | $1,530.00 | $489.60–$1,606.50 | 40% above | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care, first 30-74 minutes | $1,224.00 | $1,530.00 | $489.60–$1,606.50 | — | 20% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 Measurement of brain wave activity (EEG), awake and drowsy | $741.60 | $927.00 | $296.64–$973.35 | 17% above | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing | $162.40 | $203.00 | $64.96–$213.15 | 2% above | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for problem that may not require health care professional | $164.80 | $206.00 | $65.92–$216.30 | 145% above | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency department visit for problem that may not require health care professional | $164.80 | $206.00 | $65.92–$216.30 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit with straightforward medical decision making | $247.20 | $309.00 | $98.88–$324.45 | 72% above | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency department visit with straightforward medical decision making | $247.20 | $309.00 | $98.88–$324.45 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit with low level of medical decision making | $515.20 | $644.00 | $206.08–$676.20 | 85% above | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency department visit with low level of medical decision making | $515.20 | $644.00 | $206.08–$676.20 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit with moderate level of medical decision making | $808.00 | $1,010.00 | $323.20–$1,060.50 | 55% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency department visit with moderate level of medical decision making | $808.00 | $1,010.00 | $323.20–$1,060.50 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit with high level of medical decision making | $1,277.60 | $1,597.00 | $511.04–$1,676.85 | 67% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency department visit with high level of medical decision making | $1,277.60 | $1,597.00 | $511.04–$1,676.85 | — | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise or drug-induced heart stress test with electrocardiogram (ECG) | $783.20 | $979.00 | $313.28–$1,027.95 | 16% above | 20% |
| Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy with patient, 50 minutes | $318.40 | $398.00 | $80.60–$417.90 | 36% above | 20% |
| Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy without patient, 50 minutes | $318.40 | $398.00 | $80.60–$417.90 | 41% above | 20% |
| Group psychotherapy session CPT 90853 Group psychotherapy | $774.40 | $968.00 | $161.82–$1,016.40 | 247% above | 20% |
| Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 Electrocardiogram (ECG) 2-day continuous with review and report by health care professional | $484.00 | $605.00 | $193.60–$635.25 | 37% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion into a vein for hydration, 31-60 minutes | $288.80 | $361.00 | $115.52–$610.39 | 3% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion into a vein for hydration, 31-60 minutes | $288.80 | $361.00 | $115.52–$610.39 | 3% above | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Infusion into a vein for hydration, 31-60 minutes | $288.80 | $361.00 | $115.52–$610.39 | — | 20% |
| IV infusion of a medicine, first hour CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | $371.20 | $464.00 | $148.48–$610.39 | 18% above | 20% |
| IV infusion of a medicine, first hour CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | $371.20 | $464.00 | $148.48–$610.39 | 18% above | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | $371.20 | $464.00 | $148.48–$610.39 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of drug or substance under skin or into muscle | $69.60 | $87.00 | $27.84–$91.35 | 19% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of drug or substance under skin or into muscle | $75.20 | $94.00 | $30.08–$98.70 | 12% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection of drug or substance under skin or into muscle | $75.20 | $94.00 | $30.08–$98.70 | — | 20% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve conduction, 7-8 studies | $394.40 | $493.00 | $101.51–$502.86 | 28% below | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $82.40 | $103.00 | $32.96–$150.04 | 10% below | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Therapy procedure for nutrition management, each 15 minutes | $41.60 | $52.00 | $16.64–$77.07 | 3% below | 20% |
| Occupational therapy evaluation, low complexity CPT 97165 Evaluation for occupational therapy, typically 30 minutes | $175.20 | $219.00 | $70.08–$229.95 | 2% below | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Evaluation for physical therapy, typically 45 minutes | $262.40 | $328.00 | $104.96–$344.40 | 22% above | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Evaluation for physical therapy, typically 20 minutes | $175.20 | $219.00 | $70.08–$229.95 | 10% below | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Evaluation for physical therapy, typically 30 minutes | $219.20 | $274.00 | $87.68–$287.70 | 10% above | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Therapy procedure using manual technique, each 15 minutes | $82.40 | $103.00 | $32.96–$150.04 | 15% below | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $82.40 | $103.00 | $32.96–$150.04 | 9% below | 20% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 minutes | $284.80 | $356.00 | $70.06–$373.80 | 67% above | 20% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 minutes | $307.20 | $384.00 | $122.88–$403.20 | 37% above | 20% |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 1 hour | $328.00 | $410.00 | $131.20–$430.50 | 15% above | 20% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking and tobacco use intermediate counseling, 3-10 minutes | $36.00 | $45.00 | $14.40–$47.25 | 2% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Established patient office or other outpatient visit with low level of decision making, if using time, 20 minutes or more | $88.00 | $110.00 | $35.20–$115.50 | 26% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $61.60 | $77.00 | $24.64–$80.85 | 23% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $206.40 | $258.00 | $82.56–$270.90 | 159% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $206.40 | $258.00 | $82.56–$270.90 | — | 20% |
| Speech and language evaluation CPT 92523 Evaluation of speech sound production with evaluation of language comprehension and expression | $320.00 | $400.00 | $128.00–$420.00 | 5% above | 20% |
| Speech therapy session, individual CPT 92507 Treatment of speech, language, voice, communication, and/or hearing processing disorder | $201.60 | $252.00 | $80.64–$264.60 | 8% below | 20% |
| Spirometry (breathing test) CPT 94010 Test to measure expiratory airflow and volume | $43.20 | $54.00 | $17.28–$282.35 | 77% below | 20% |
| Spirometry before and after a bronchodilator CPT 94060 Test to measure expiratory airflow and volume changes before and after medication administration | $328.00 | $410.00 | $131.20–$430.50 | 15% below | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapy procedure using functional activities | $152.80 | $191.00 | $61.12–$200.55 | 50% above | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Drawing of blood for a medical problem | $163.20 | $204.00 | $65.28–$387.38 | 17% below | 20% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 Exercise or drug-induced heart stress test with electrocardiogram (ECG) with supervision and review by physician | $804.00 | $1,005.00 | $321.60–$1,055.25 | 98% above | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Rabies vaccine, one dose CPT 90675 Rabies vaccine for injection into muscle | $679.20 | $849.00 | $207.70–$891.45 | 3% below | 20% |
| Rabies vaccine, one dose CPT 90675 Rabies vaccine for injection into muscle | $1,127.38 | $1,409.22 | $207.70–$1,479.68 | 62% above | 20% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies vaccine for injection into muscle | $679.20 | $849.00 | $207.70–$891.45 | — | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Diphtheria and tetanus vaccine (7 years or older) | $224.38 | $280.47 | $62.00–$294.49 | 275% above | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diphtheria, tetanus, and acellular pertussis vaccine (7 years or older) | $156.83 | $196.04 | $62.00–$205.84 | 87% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of vaccine | $51.20 | $64.00 | $20.48–$67.20 | 46% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Administration of vaccine, each additional vaccine | $51.20 | $64.00 | $20.48–$67.20 | 78% above | 20% |
Source file: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbDCHLEONIA&type=CDMWithoutLabel&fileType=CSV