Beatrice Community Hospital
Beatrice Community Hospital in Beatrice, NE publishes cash prices for 332 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Nebraska median for 194 of 329 procedures and below it for 126. By typical cash price it ranks #29 of 45 Nebraska hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
P O Box 278, 4800 Hospital Parkway, Beatrice, NE 68310 Collected Sep 27, 2026 Source price file (402) 228-3344
Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 4 of 5 CCN 281364 · CMS hospital register
The price file shows no self-pay discount
For 521 of the 521 prices listed here, the cash price in Beatrice Community Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 Chg Radex Ankle Complete Minimum 3 Views | $34.00 | $34.00 | $3.00–$33.00 | 90% below | — |
| Ankle X-ray, complete, 3 or more views CPT 73610 Hc Xr Ankle 3 Views | $679.00 | $679.00 | $109.00–$652.00 | 106% above | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Hc Arterial Tcop2 Bilat Lim | $569.00 | $569.00 | $91.00–$546.00 | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Pr Non-invas Physiologic Std Extremity Art 2 Level | $218.00 | $218.00 | $30.00–$209.00 | 53% below | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Hc Xr Esophogram Barium | $711.00 | $711.00 | $114.00–$683.00 | 17% above | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 Hc Bone Imaging Whole Body | $1,903.00 | $1,903.00 | $304.00–$1,827.00 | 11% above | — |
| Breast ultrasound, complete, one breast one side CPT 76641 Hc Us Breast Unilateral Complete | $1,199.00 | $1,199.00 | $192.00–$1,151.00 | 147% above | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Hc Us Breast Unilateral Limited | $709.00 | $709.00 | $113.00–$681.00 | 84% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Hc Ct Angio Chest | $3,600.00 | $3,600.00 | $576.00–$3,456.00 | 12% above | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 Hc Ct Abdomen And Pelvis W/o Contrast | $4,200.00 | $4,200.00 | $672.00–$4,032.00 | 22% above | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $4,900.00 | $4,900.00 | $784.00–$4,704.00 | 20% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Hc Ct Abd And Pelv W/o And W/ Contrast | $5,700.00 | $5,700.00 | $912.00–$5,472.00 | 14% above | — |
| CT scan of the abdomen with contrast CPT 74160 Hc Ct Abdomen W/ Contrast | $2,786.00 | $2,786.00 | $446.00–$2,675.00 | 8% above | — |
| CT scan of the abdomen without contrast CPT 74150 Hc Ct Abdomen W/o Contrast | $2,725.00 | $2,725.00 | $436.00–$2,616.00 | 24% above | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 Hc Ct Maxillofacial W/o Contrast | $1,932.00 | $1,932.00 | $309.00–$1,855.00 | 7% above | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan | $2,244.00 | $2,244.00 | $359.00–$2,154.00 | 18% above | — |
| CT scan of the head with contrast CPT 70460 Hc Ct Head W/ Contrast | $2,612.00 | $2,612.00 | $418.00–$2,508.00 | 26% above | — |
| CT scan of the head without and with contrast CPT 70470 Hc Ct Head W/o & W/ Contrast | $2,933.00 | $2,933.00 | $469.00–$2,816.00 | 17% above | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 Hc Ct Lumbar Spine W/o Contrast | $2,635.00 | $2,635.00 | $422.00–$2,530.00 | 21% above | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 Hc Ct Cervical Spine W/o Contrast | $2,670.00 | $2,670.00 | $427.00–$2,563.00 | 19% above | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $3,160.00 | $3,160.00 | $506.00–$3,034.00 | 32% above | — |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Hc Duplex Scan Extracranial,bilat | $1,598.00 | $1,598.00 | $256.00–$1,534.00 | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Hc Duplex Scan Carotid Comp | $1,598.00 | $1,598.00 | $256.00–$1,534.00 | 1% above | — |
| Chest X-ray, 2 views CPT 71046 Chg Radiologic Exam Chest 2 Views | $66.00 | $66.00 | $4.00–$63.00 | 77% below | — |
| Chest X-ray, 2 views CPT 71046 Hc Chest Xray 2 Views | $394.00 | $394.00 | $63.00–$378.00 | 40% above | — |
| Chest X-ray, single view CPT 71045 Chg Radiologic Exam Chest Single View | $56.00 | $56.00 | $3.00–$54.00 | 76% below | — |
| Chest X-ray, single view CPT 71045 Hc Chest Xray 1 View | $333.00 | $333.00 | $53.00–$320.00 | 45% above | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Hc Us Retroperit B-scan/real Time Complete | $861.00 | $861.00 | $138.00–$827.00 | 9% above | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Chg Dxa Bone Density Study 1/> Sites Axial Skel | $125.00 | $125.00 | $3.00–$120.00 | 68% below | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Hc Xr Bone Density Dexa Central Rad | $529.00 | $529.00 | $85.00–$508.00 | 35% above | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Chg Us Preg Uterus W/detail Fetal Anat 1st Gestation | $339.00 | $339.00 | $34.00–$325.00 | 31% below | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Hc Us Preg Uterus W/detail Fetal Anatomy | $849.00 | $849.00 | $136.00–$815.00 | 73% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 Hc Ct Thorax W/o Contrast | $2,638.00 | $2,638.00 | $422.00–$2,532.00 | 22% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 Hc Ct Thorax W/ Contrast | $2,794.00 | $2,794.00 | $447.00–$2,682.00 | 12% above | — |
| Diagnostic mammogram, both breasts CPT 77066 Mammography of both breasts | $604.00 | $604.00 | $97.00–$580.00 | 34% above | — |
| Diagnostic mammogram, one breast CPT 77065 Mammography of one breast | $488.00 | $488.00 | $78.00–$468.00 | 56% above | — |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Hc Duplex Scan Lowext Art Bilat Comp | $1,350.00 | $1,350.00 | $216.00–$1,296.00 | — | — |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Hc Duplex Lo Extrem Art Bilat | $1,350.00 | $1,350.00 | $216.00–$1,296.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Hc Us Ue Or Le Veins Us Duplex Bilat Or Com | $1,505.00 | $1,505.00 | $241.00–$1,445.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Hc Duplex Extrem Venous,bilat | $1,580.00 | $1,580.00 | $253.00–$1,517.00 | — | — |
| Duplex ultrasound of the leg veins, both legs CPT 93970 Hc Duplex Scan Varicose Vein Extended Compl | $1,580.00 | $1,580.00 | $253.00–$1,517.00 | 10% above | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Hc Echo Av Opt | $2,581.00 | $2,581.00 | $413.00–$2,478.00 | 21% above | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hc Hepatobiliary System Imaging, Incl Gb | $1,282.00 | $1,282.00 | $205.00–$1,231.00 | 12% below | — |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Hc Anlys Of Home Sleep Test | $385.00 | $385.00 | $62.00–$370.00 | 16% below | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Hc Comp Sleep Disorder Study W/init Cpap/bipap | $4,643.00 | $4,643.00 | $743.00–$4,457.00 | 23% above | — |
| Knee X-ray, 3 views both sides CPT 73562 Hc Xr Knee 3views A/p Lateral Bilateral | $608.00 | $608.00 | $97.00–$584.00 | — | — |
| Knee X-ray, 3 views CPT 73562 Chg Radiologic Examination Knee 3 Views | $34.00 | $34.00 | $3.00–$33.00 | 91% below | — |
| Knee X-ray, 3 views CPT 73562 Hc Xr Knee 3views A/p Lateral | $608.00 | $608.00 | $97.00–$584.00 | 63% above | — |
| Knee X-ray, 3 views CPT 73562 Cc Knee 3 View | $608.00 | $608.00 | $97.00–$584.00 | 63% above | — |
| Knee X-ray, 3 views one side CPT 73562 Hc Xr Knee 3 Views A/p Lateral Right | $339.00 | $339.00 | $54.00–$325.00 | 9% below | — |
| Knee X-ray, 3 views one side CPT 73562 Hc Xr Knee 3views A/p Lateral Left | $339.00 | $339.00 | $54.00–$325.00 | 9% below | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Hc Us Abdomen Limited | $706.00 | $706.00 | $113.00–$678.00 | 26% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Hc Limited Us Abdomen | $706.00 | $706.00 | $113.00–$678.00 | 26% above | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Hc Ct Thorax Low Dose Lung Cancer Screen | $380.00 | $380.00 | $61.00–$365.00 | 39% below | — |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 Hc Mri Breast W&w/o Contrast W/cad Bilat | $4,734.00 | $4,734.00 | $757.00–$4,545.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint | $5,215.00 | $5,215.00 | $834.00–$5,006.00 | 102% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Cc Hc Mri Ankle W Wo Contrast | $3,731.00 | $3,731.00 | $597.00–$3,582.00 | 11% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Cc Hc Mri Knee W Wo Contrast | $3,731.00 | $3,731.00 | $597.00–$3,582.00 | 11% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Cc Hc Mri Hip W Wo Contrast | $3,731.00 | $3,731.00 | $597.00–$3,582.00 | 11% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri Lower Extremity Joint W/o & W/ Contrast | $6,716.00 | $6,716.00 | $1,074.00–$6,447.00 | 99% above | — |
| MRI of the abdomen without contrast CPT 74181 Hc Mri Abdomen W/o Contrast | $4,044.00 | $4,044.00 | $647.00–$3,882.00 | 37% above | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 Cc Mri Pancreas With Contrast | $3,626.00 | $3,626.00 | $580.00–$3,481.00 | 3% below | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 Hc Mri Abdomen W/o And W/ Contrast | $4,664.00 | $4,664.00 | $746.00–$4,477.00 | 25% above | — |
| MRI of the brain, no contrast dye CPT 70551 Hc Mri Brain Mri W/o Contrast | $3,370.00 | $3,370.00 | $539.00–$3,235.00 | 6% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Scan | $3,909.00 | $3,909.00 | $625.00–$3,753.00 | at median | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal | $3,200.00 | $3,200.00 | $512.00–$3,072.00 | 1% above | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 Hc Mri Lumbar Spine W/o & W/ Contrast | $4,420.00 | $4,420.00 | $707.00–$4,243.00 | 13% above | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Hc Mri Thoracic Spine W/o Contrast | $3,788.00 | $3,788.00 | $606.00–$3,636.00 | 16% above | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 Hc Mri Cervical Spine Mri W/o & W/ Contrast | $4,664.00 | $4,664.00 | $746.00–$4,477.00 | 19% above | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 Hc Mri Cervical Spine Mri W/o Contrast | $3,500.00 | $3,500.00 | $560.00–$3,360.00 | 10% above | — |
| MRI of the pelvis without and with contrast CPT 72197 Hc Mri Pelvis W/o & W/ Contrast | $3,716.00 | $3,716.00 | $594.00–$3,567.00 | 3% above | — |
| MRI of the pelvis, no contrast dye CPT 72195 Hc Mri Pelvis W/o Contrast | $2,954.00 | $2,954.00 | $473.00–$2,836.00 | 5% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Cc Hc Mri Elbow Wo Contrast | $2,884.00 | $2,884.00 | $461.00–$2,769.00 | 19% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Cc Hc Mri Wrist Wo Contrast | $2,884.00 | $2,884.00 | $461.00–$2,769.00 | 19% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Hc Mri Upper Extremity Joint | $5,132.00 | $5,132.00 | $821.00–$4,927.00 | 111% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Cc Hc Mri Shoulder Wo Contrast | $5,132.00 | $5,132.00 | $821.00–$4,927.00 | 111% above | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Hc Myocardial Perfusion Spect Multi W/wm&ej | $4,638.00 | $4,638.00 | $742.00–$4,452.00 | 12% above | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 Hc Pet W/diagnostic Ct Skull To Midthigh | $4,257.00 | $4,257.00 | $681.00–$4,087.00 | 21% below | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 Hc Pet W/ctskull Base To Mid Thigh | $5,750.00 | $5,750.00 | $920.00–$5,520.00 | 7% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Chg Us Pelvic Nonobstetric Image Dcmtn Limited/f/u | $155.00 | $155.00 | $9.00–$149.00 | 57% below | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Hc Us Pelvic Nonobstetric Limited Or F/u | $456.00 | $456.00 | $73.00–$438.00 | 28% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Hc Us Pelvic Nonobstetric Complete | $841.00 | $841.00 | $135.00–$807.00 | 7% above | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Abdomial ultrasound of pregnant uterus | $820.00 | $820.00 | $131.00–$787.00 | 18% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Chg Us Pregnant Uterus 14 Wk Transabdl 1/1st Gestat | $182.00 | $182.00 | $17.00–$175.00 | 70% below | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Hc Us, Ob < 14 Wks, Single Fetus | $791.00 | $791.00 | $127.00–$759.00 | 29% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Hc Us Pregnant Uterus 1st < 14wks | $791.00 | $791.00 | $127.00–$759.00 | 29% above | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Chg Us Pregnant Uterus Limited 1/> Fetuses | $354.00 | $354.00 | $30.00–$340.00 | 10% below | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Hc Us Pregnant Uterus, Limited Exam | $487.00 | $487.00 | $78.00–$468.00 | 24% above | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Hc Us Pregnant Uterus Limited | $487.00 | $487.00 | $78.00–$468.00 | 24% above | — |
| Screening mammogram, both breasts both sides CPT 77067 Mammography, screening, bilateral | $423.00 | $423.00 | $68.00–$406.00 | — | — |
| Shoulder X-ray, complete, 2 or more views CPT 73030 Chg Radex Shoulder Complete Minimum 2 Views | $32.00 | $32.00 | $3.00–$31.00 | 90% below | — |
| Shoulder X-ray, complete, 2 or more views CPT 73030 Hc Xr Shoulder Complete Min 2 Views | $679.00 | $679.00 | $109.00–$652.00 | 102% above | — |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep study | $4,388.00 | $4,388.00 | $702.00–$4,212.00 | 23% above | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Hc Xr Swallowing Function Pharynx/esophagu | $610.00 | $610.00 | $98.00–$586.00 | 7% above | — |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina | $769.00 | $769.00 | $123.00–$738.00 | 25% above | — |
| Transvaginal ultrasound during pregnancy CPT 76817 Chg Us Preg Uterus Real Time W/image Dcmtn Transvag | $144.00 | $144.00 | $13.00–$138.00 | 72% below | — |
| Transvaginal ultrasound during pregnancy CPT 76817 Hc Us Pregnant Uterus Transvaginal | $569.00 | $569.00 | $91.00–$546.00 | 13% above | — |
| Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen | $946.00 | $946.00 | $151.00–$908.00 | 14% above | — |
| Ultrasound of the scrotum and testicles CPT 76870 Hc Us Scrotum And Contents | $666.00 | $666.00 | $107.00–$639.00 | 2% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Hc Us Neck Thyroid Head Soft Tissue | $592.00 | $592.00 | $95.00–$568.00 | at median | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Hc Rad Exam Upr Gi Trc Single Contrast Study | $711.00 | $711.00 | $114.00–$683.00 | 46% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Hc Duplex Extrem Venous Uni Or Ltd | $1,220.00 | $1,220.00 | $195.00–$1,171.00 | 19% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Hc Us Ue Or Le Veins Us Duplex Uni Or Lim | $1,220.00 | $1,220.00 | $195.00–$1,171.00 | 19% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Hc Duplex Scan Ext Veins Lim | $1,281.00 | $1,281.00 | $205.00–$1,230.00 | 25% above | — |
| Wrist X-ray, complete, 3 or more views CPT 73110 Chg Radex Wrist Complete Minimum 3 Views | $31.00 | $31.00 | $3.00–$30.00 | 91% below | — |
| Wrist X-ray, complete, 3 or more views CPT 73110 Hc Xr Wrist Complete Minimum 3 Views | $492.00 | $492.00 | $79.00–$472.00 | 49% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Chg Radex Hip Unilateral With Pelvis 2-3 Views | $38.00 | $38.00 | $4.00–$36.00 | 87% below | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hc Xr Hip Unilat W/o Pelvis 2-3 Views | $339.00 | $339.00 | $54.00–$325.00 | 17% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hc Xr Hip Unilat W/pelvis 2-3 Views | $339.00 | $339.00 | $54.00–$325.00 | 17% above | — |
| X-ray of the abdomen, 1 view CPT 74018 Chg Radiologic Exam Abdomen 1 View | $63.00 | $63.00 | $3.00–$60.00 | 76% below | — |
| X-ray of the abdomen, 1 view CPT 74018 Hc Xray Abdomen 1 View | $375.00 | $375.00 | $60.00–$360.00 | 42% above | — |
| X-ray of the ankle, 2 views CPT 73600 Chg Radiologic Examination Ankle 2 Views | $28.00 | $28.00 | $3.00–$27.00 | 89% below | — |
| X-ray of the ankle, 2 views CPT 73600 Hc Xr Ankle 2 Views | $435.00 | $435.00 | $70.00–$418.00 | 74% above | — |
| X-ray of the finger(s), 2 or more views CPT 73140 Chg Radex Fingr Minimum 2 Views | $29.00 | $29.00 | $2.00–$28.00 | 87% below | — |
| X-ray of the finger(s), 2 or more views CPT 73140 Hc Xr Fingers 2 Or More Views | $426.00 | $426.00 | $68.00–$409.00 | 88% above | — |
| X-ray of the foot, 2 views both sides CPT 73620 Hc Xr Foot 2 Views Bilateral | $435.00 | $435.00 | $70.00–$418.00 | — | — |
| X-ray of the foot, 2 views CPT 73620 Chg Radiologic Examination Foot 2 Views | $28.00 | $28.00 | $3.00–$27.00 | 87% below | — |
| X-ray of the foot, 2 views CPT 73620 Hc Xr Foot 2 Views | $242.00 | $242.00 | $39.00–$232.00 | 12% above | — |
| X-ray of the foot, 2 views one side CPT 73620 Hc Xr Foot 2 Views Left | $242.00 | $242.00 | $39.00–$232.00 | 12% above | — |
| X-ray of the foot, 2 views one side CPT 73620 Hc Xr Foot 2 Views Right | $242.00 | $242.00 | $39.00–$232.00 | 12% above | — |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 Hc Xr Foot Complete 3 Views Bilateral | $685.00 | $685.00 | $110.00–$658.00 | — | — |
| X-ray of the foot, complete, 3 or more views CPT 73630 Chg Radex Foot Complete Minimum 3 Views | $34.00 | $34.00 | $3.00–$33.00 | 89% below | — |
| X-ray of the foot, complete, 3 or more views CPT 73630 Hc Xr Foot Complete 3 Views | $685.00 | $685.00 | $110.00–$658.00 | 118% above | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Hc Xr Foot Complete 3 Views Right | $685.00 | $685.00 | $110.00–$658.00 | 118% above | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Hc Xr Foot Complete 3 Views Left | $685.00 | $685.00 | $110.00–$658.00 | 118% above | — |
| X-ray of the hand, 3 or more views both sides CPT 73130 Hc Xr Hand 3 Views Bilateral | $537.00 | $537.00 | $86.00–$516.00 | — | — |
| X-ray of the hand, 3 or more views CPT 73130 Chg Radex Hand Minimum 3 Views | $31.00 | $31.00 | $3.00–$30.00 | 91% below | — |
| X-ray of the hand, 3 or more views CPT 73130 Hc Xr Hand 3 Views | $320.00 | $320.00 | $51.00–$307.00 | 6% below | — |
| X-ray of the hand, 3 or more views one side CPT 73130 Hc Xr Hand 3 Views Right | $537.00 | $537.00 | $86.00–$516.00 | 57% above | — |
| X-ray of the hand, 3 or more views one side CPT 73130 Hc Xr Hand 3 Views Left | $537.00 | $537.00 | $86.00–$516.00 | 57% above | — |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 Hc Xr Knee 1 Or 2 Views Ap & Lat Bilateral | $617.00 | $617.00 | $99.00–$592.00 | — | — |
| X-ray of the knee, 1 or 2 views CPT 73560 Chg Radiologic Examination Knee 1/2 Views | $32.00 | $32.00 | $3.00–$31.00 | 90% below | — |
| X-ray of the knee, 1 or 2 views CPT 73560 Cc Knee 1 Or 2 View | $617.00 | $617.00 | $99.00–$592.00 | 93% above | — |
| X-ray of the knee, 1 or 2 views CPT 73560 Hc Xr Knee 1 Or 2 Views Ap & Lat | $617.00 | $617.00 | $99.00–$592.00 | 93% above | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Hc Xr Knee 1 Or 2 Views Ap & Lat Left | $327.00 | $327.00 | $52.00–$314.00 | 3% above | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Hc Xr Knee 1 Or 2 Views Ap & Lat Right | $344.00 | $344.00 | $55.00–$330.00 | 8% above | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Chg Radex Spine Lumbosacral 2/3 Views | $38.00 | $38.00 | $4.00–$36.00 | 90% below | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Hc Xr Lumbar Spine 2 Or 3 Views | $520.00 | $520.00 | $83.00–$499.00 | 32% above | — |
| X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back | $611.00 | $611.00 | $98.00–$587.00 | 29% above | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Chg Radex Spine Thoracic 2 Views | $40.00 | $40.00 | $4.00–$38.00 | 87% below | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Hc Xr Thoracic Spine 2 Views | $428.00 | $428.00 | $68.00–$411.00 | 40% above | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 Chg Radex Nasal Bones Complete Minimum 3 Views | $28.00 | $28.00 | $3.00–$27.00 | 90% below | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 Hc Xr Nasal Bones Complete | $347.00 | $347.00 | $56.00–$333.00 | 19% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Chg Radex Spine Cervical 2 Or 3 Views | $32.00 | $32.00 | $4.00–$31.00 | 90% below | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Hc Xr Cervical Spine 2 Or 3 Views | $390.00 | $390.00 | $62.00–$374.00 | 23% above | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Chg Radiologic Examination Pelvis 1/2 Views | $31.00 | $31.00 | $3.00–$30.00 | 89% below | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Hc Xr Pelvis 1 Or 2 Views | $375.00 | $375.00 | $60.00–$360.00 | 39% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Chg Radex Sacrum & Coccyx Minimum 2 Views | $29.00 | $29.00 | $3.00–$28.00 | 89% below | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Hc Xr Sacrum & Coccyx | $339.00 | $339.00 | $54.00–$325.00 | 26% above | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Cc Sgpt/alt | $61.00 | $61.00 | $10.00–$59.00 | at median | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Chg Transferase Alanine Amino Alt Sgpt | $61.00 | $61.00 | $10.00–$59.00 | at median | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Chg Transferase Aspartate Amino Ast Sgot | $67.00 | $67.00 | $11.00–$64.00 | 18% above | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Cc Sgot/ast | $67.00 | $67.00 | $11.00–$64.00 | 18% above | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Cc Hepatitis Panel, Acute Cs | $337.00 | $337.00 | $54.00–$324.00 | 7% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cc Allergen Specific Ige Each Allergen | $86.00 | $86.00 | $14.00–$83.00 | 83% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cc Cat Cat Epithelium Ige | $801.00 | $801.00 | $128.00–$769.00 | 1604% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cc Cyclic Citrullinated Peptide | $196.00 | $196.00 | $31.00–$188.00 | 88% above | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Cc Ana With Pattern | $80.00 | $80.00 | $13.00–$77.00 | at median | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Chg Natriuretic Peptide | $270.00 | $270.00 | $43.00–$259.00 | 37% above | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Cc Bnp | $270.00 | $270.00 | $43.00–$259.00 | 37% above | — |
| Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel | $115.00 | $115.00 | $18.00–$110.00 | 16% below | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Hc Bone Marrow Biopsy Interpretation | $107.00 | $107.00 | $17.00–$103.00 | 44% below | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Cc Gr & Micro Exbiopsy | $148.00 | $148.00 | $24.00–$142.00 | 23% below | — |
| Blood culture for bacteria CPT 87040 Cc Culture-blood | $106.00 | $106.00 | $17.00–$102.00 | 41% below | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Pr Collection Venous Blood Venipuncture | $31.00 | $31.00 | $5.00–$30.00 | 21% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Cc Venipuncture | $31.00 | $31.00 | $5.00–$30.00 | 21% above | — |
| Blood glucose (sugar) test CPT 82947 Chg Glucose Quantitative Blood Xcpt Reagent Strip | $53.00 | $53.00 | $8.00–$51.00 | 10% above | — |
| Blood glucose (sugar) test CPT 82947 Cc Glucose | $53.00 | $53.00 | $8.00–$51.00 | 10% above | — |
| Blood lead test CPT 83655 Cc Lead, Blood | $83.00 | $83.00 | $13.00–$80.00 | 28% above | — |
| Blood lead test CPT 83655 Chg Assay Of Lead | $83.00 | $83.00 | $13.00–$80.00 | 28% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hc Hcg Qualitative | $29.00 | $29.00 | $5.00–$28.00 | 74% below | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Chg Gonadotropin Chorionic Qualitative | $56.00 | $56.00 | $9.00–$54.00 | 49% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cc Abo & Reverse | $72.00 | $72.00 | $12.00–$69.00 | 34% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Chg C-reactive Protein | $26.00 | $26.00 | $4.00–$25.00 | 71% below | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Cc C-reactive Protein | $57.00 | $57.00 | $9.00–$55.00 | 37% below | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 Cc C. Difficile, Dna | $143.00 | $143.00 | $23.00–$137.00 | 7% below | — |
| CA 19-9 blood test (tumor marker) CPT 86301 Cc Ca199 | $156.00 | $156.00 | $25.00–$150.00 | at median | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cc Ca125 | $116.00 | $116.00 | $19.00–$111.00 | 11% below | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Chg Iadna Sars-cov-2 Covid-19 Amplified Probe Tq | $115.00 | $115.00 | $18.00–$110.00 | 9% below | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Hc Sars Coronavirus 2, Rna | $115.00 | $115.00 | $18.00–$110.00 | 9% below | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Cc Ct By Amplified Probe Technique | $85.00 | $85.00 | $14.00–$82.00 | 23% below | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids | $120.00 | $120.00 | $19.00–$115.00 | 4% above | — |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated | $97.00 | $97.00 | $16.00–$93.00 | 5% above | — |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (CBC), automated | $76.00 | $76.00 | $12.00–$73.00 | 7% above | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $135.00 | $135.00 | $22.00–$130.00 | 14% below | — |
| D-dimer blood test (blood clot marker) CPT 85379 Hc D-dimer, Quantitative | $123.00 | $123.00 | $20.00–$118.00 | 8% below | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Cc Dhea-s | $142.00 | $142.00 | $23.00–$136.00 | at median | — |
| Estradiol blood test CPT 82670 Cc Estradiol | $83.00 | $83.00 | $13.00–$80.00 | 40% below | — |
| FSH (follicle-stimulating hormone) test CPT 83001 Cc Fsh | $42.00 | $42.00 | $7.00–$40.00 | 63% below | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 Hc Calprotectin | $135.00 | $135.00 | $22.00–$130.00 | 62% below | — |
| Ferritin blood test (iron stores) CPT 82728 Cc Ferritin | $74.00 | $74.00 | $12.00–$71.00 | 29% below | — |
| Ferritin blood test (iron stores) CPT 82728 Chg Assay Of Ferritin | $74.00 | $74.00 | $12.00–$71.00 | 29% below | — |
| Folate (folic acid) blood test CPT 82746 Cc Folates | $68.00 | $68.00 | $11.00–$65.00 | 35% below | — |
| Free T3 thyroid hormone test CPT 84481 Cc Triiodothyronine Free Dialysis | $155.00 | $155.00 | $25.00–$149.00 | at median | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Cc Thryoxine Free Direct Dialysis | $58.00 | $58.00 | $9.00–$56.00 | 33% below | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Chg Assay Of Free Thyroxine | $64.00 | $64.00 | $10.00–$61.00 | 26% below | — |
| Free testosterone test CPT 84402 Cc Free Testost | $80.00 | $80.00 | $13.00–$77.00 | 28% below | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Hc General Health Panel | $365.00 | $365.00 | $58.00–$350.00 | 25% above | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Chg General Health Panel | $365.00 | $365.00 | $58.00–$350.00 | 25% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Cc Hc Post Glucose Dose | $57.00 | $57.00 | $9.00–$55.00 | 3% above | — |
| Glucose tolerance test, 3 samples CPT 82951 Chg Glucose Tolerance Test Gtt 3 Specimens | $255.00 | $255.00 | $41.00–$245.00 | 95% above | — |
| Glucose tolerance test, 3 samples CPT 82951 Cc Oral Glucose Tolerance 3 Spec | $255.00 | $255.00 | $41.00–$245.00 | 95% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Cc Gc By Amplified Probe Technique | $85.00 | $85.00 | $14.00–$82.00 | 23% below | — |
| H. pylori antibody blood test CPT 86677 Cc H Pylori Ab | $222.00 | $222.00 | $36.00–$213.00 | 191% above | — |
| H. pylori stool antigen test CPT 87338 Cc Helicobacter Pylori Ant, Stool | $162.00 | $162.00 | $26.00–$156.00 | 1% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Cc Hiv Viral Load | $504.00 | $504.00 | $81.00–$484.00 | 4% below | — |
| HIV-1 and HIV-2 antibody test CPT 86703 Cc Antibody Hiv-1 And Hiv-2, Single Result | $112.00 | $112.00 | $18.00–$108.00 | 56% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hc Hiv Antigen/antibody Assay (Hivaa) | $71.00 | $71.00 | $11.00–$68.00 | 4% below | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Cc Hfp Only-hpv Reflex | $194.00 | $194.00 | $31.00–$186.00 | 76% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Chg Hemoglobin Glycosylated A1c | $82.00 | $82.00 | $13.00–$79.00 | 13% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Cc Glycohemoglob | $82.00 | $82.00 | $13.00–$79.00 | 13% above | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Cc Hep B Surf Antiby | $50.00 | $50.00 | $8.00–$48.00 | 45% below | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Cc Hep B Surface Antigen | $67.00 | $67.00 | $11.00–$64.00 | 28% below | — |
| Hepatitis C antibody blood test (screening) CPT 86803 Cc Hepatitis C Ab | $75.00 | $75.00 | $12.00–$72.00 | 18% below | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Cc Hep C Rna | $757.00 | $757.00 | $121.00–$727.00 | 124% above | — |
| Herpes blood test, HSV-1 antibody CPT 86695 Cc Herpes Simplex Ab Type 1 | $97.00 | $97.00 | $16.00–$93.00 | 5% below | — |
| Herpes blood test, HSV-2 antibody CPT 86696 Cc Herpes Simplex Ab Type 2 | $97.00 | $97.00 | $16.00–$93.00 | 9% below | — |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Cc High Sens Crp | $68.00 | $68.00 | $11.00–$65.00 | 18% below | — |
| Homocysteine blood test CPT 83090 Cc Homocystine | $63.00 | $63.00 | $10.00–$60.00 | 56% below | — |
| Insulin blood test CPT 83525 Cc Insulin, Immulite-cs | $57.00 | $57.00 | $9.00–$55.00 | 47% below | — |
| Iron blood test (serum iron) CPT 83540 Cc Iron, Serum | $82.00 | $82.00 | $13.00–$79.00 | 30% above | — |
| Iron-binding capacity (TIBC) test CPT 83550 Cc Iron Binding Capacity | $96.00 | $96.00 | $15.00–$92.00 | 35% above | — |
| Kidney function blood test panel CPT 80069 Kidney function panel test | $219.00 | $219.00 | $35.00–$210.00 | 60% above | — |
| LH (luteinizing hormone) test CPT 83002 Cc Luteinizing Hormone | $42.00 | $42.00 | $7.00–$40.00 | 66% below | — |
| Lipase blood test (pancreas enzyme) CPT 83690 Cc Lipase | $140.00 | $140.00 | $22.00–$134.00 | 46% above | — |
| Lipase blood test (pancreas enzyme) CPT 83690 Chg Assay Of Lipase | $140.00 | $140.00 | $22.00–$134.00 | 46% above | — |
| Liver function blood test panel CPT 80076 Liver function blood test | $139.00 | $139.00 | $22.00–$133.00 | 5% above | — |
| Lyme disease antibody test CPT 86618 Cc Lyme Igg Abs Csf | $261.00 | $261.00 | $42.00–$251.00 | 100% above | — |
| Magnesium blood test CPT 83735 Cc Ur Magnesium | $102.00 | $102.00 | $16.00–$98.00 | 48% above | — |
| Magnesium blood test CPT 83735 Chg Assay Of Magnesium | $102.00 | $102.00 | $16.00–$98.00 | 48% above | — |
| Measles (rubeola) antibody test CPT 86765 Cc Rubeola/measles Antibody | $131.00 | $131.00 | $21.00–$126.00 | 56% above | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 Chg Heterophile Antibodies Screen | $40.00 | $40.00 | $38.00 | 38% below | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 Cc Ec Mono Spot | $53.00 | $53.00 | $8.00–$51.00 | 18% below | — |
| Obstetric blood test panel CPT 80055 Obstetric blood test panel | $605.00 | $605.00 | $97.00–$581.00 | 206% above | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Total prostate-specific antigen (PSA) test | $151.00 | $151.00 | $24.00–$145.00 | 18% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test | $131.00 | $131.00 | $21.00–$126.00 | 24% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 Cc Hc Cytopath, Cerv/vag W/ Scrn By Auto & Man | $88.00 | $88.00 | $14.00–$84.00 | 6% above | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cc Hfp Only-pap | $117.00 | $117.00 | $19.00–$112.00 | 105% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 Cc Parathyroid Horm. | $254.00 | $254.00 | $41.00–$244.00 | 20% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test | $133.00 | $133.00 | $21.00–$128.00 | 72% above | — |
| Progesterone blood test CPT 84144 Cc Progesterone | $192.00 | $192.00 | $31.00–$184.00 | 73% above | — |
| Prolactin blood test CPT 84146 Cc Macroprolactin-prolactin | $214.00 | $214.00 | $34.00–$205.00 | 80% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $61.00 | $61.00 | $10.00–$59.00 | 21% above | — |
| Rapid flu test (influenza antigen) CPT 87804 Hc Influenza Antigen, Direct Optical | $116.00 | $116.00 | $19.00–$111.00 | 64% above | — |
| Rapid flu test (influenza antigen) CPT 87804 Chg Iaadiadoo Influenza | $116.00 | $116.00 | $19.00–$111.00 | 64% above | — |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Chg Iaadiadoo Streptococcus Group A | $86.00 | $86.00 | $14.00–$83.00 | 76% above | — |
| Rheumatoid factor (RF) test CPT 86431 Cc Rheumatoid Ab Quantitative | $44.00 | $44.00 | $7.00–$42.00 | 19% below | — |
| Rubella antibody test (immunity check) CPT 86762 Cc Rubella Titer | $113.00 | $113.00 | $18.00–$108.00 | 50% above | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Chg Sedimentation Rate Rbc Automated | $55.00 | $55.00 | $9.00–$53.00 | 17% above | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Cc Sedrate | $55.00 | $55.00 | $9.00–$53.00 | 17% above | — |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 Cc Semen Analysis | $204.00 | $204.00 | $33.00–$196.00 | 17% below | — |
| Stool ova and parasites exam CPT 87177 Hc Ova & Parasites | $59.00 | $59.00 | $9.00–$57.00 | 22% below | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Cc Occult Blood Fec | $44.00 | $44.00 | $7.00–$42.00 | 59% above | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Chg Blood Occult Peroxidase Actv Qual Feces 1 Deter | $44.00 | $44.00 | $41.00–$42.00 | 59% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Cc Blood,occult,fecal Hgb,feces,1-3 Simult | $55.00 | $55.00 | $9.00–$53.00 | 33% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Hc Hemoccult Ict Immunoassay 1-3 Det Bmc Only | $55.00 | $55.00 | $9.00–$53.00 | 33% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Chg Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 | $55.00 | $55.00 | $9.00–$53.00 | 33% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Cc Vdrl-serum | $44.00 | $44.00 | $7.00–$42.00 | 4% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Hc Tuberculosis Interferon Antigen Response | $180.00 | $180.00 | $29.00–$173.00 | 11% below | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Cc Tb Interferon Antigen Response | $288.00 | $288.00 | $46.00–$276.00 | 43% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 Cc Tgrp Testosterone, Total And | $92.00 | $92.00 | $15.00–$88.00 | 20% below | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Cc Peroxidase Ab | $163.00 | $163.00 | $26.00–$156.00 | 80% above | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $121.00 | $121.00 | $19.00–$116.00 | 12% above | — |
| Trichomonas test (NAAT) CPT 87661 Cc Hc Trichomonas Vaginalis; Amplified Probe | $85.00 | $85.00 | $14.00–$82.00 | 10% below | — |
| Uric acid blood test CPT 84550 Chg Assay Of Blood/uric Acid | $60.00 | $60.00 | $10.00–$58.00 | 14% above | — |
| Uric acid blood test CPT 84550 Cc Uric Acid | $60.00 | $60.00 | $10.00–$58.00 | 14% above | — |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis test using microscope | $58.00 | $58.00 | $9.00–$56.00 | 14% above | — |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis test using microscope | $35.00 | $35.00 | $6.00–$34.00 | at median | — |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis test | $39.00 | $39.00 | $6.00–$37.00 | 24% above | — |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis test | $24.00 | $24.00 | $4.00–$23.00 | 12% above | — |
| Urine culture for bacteria, with colony count CPT 87086 Chg Culture Bacterial Quanttative Colony Count Urine | $63.00 | $63.00 | $10.00–$60.00 | 12% below | — |
| Urine culture for bacteria, with colony count CPT 87086 Cc Culture-urine | $90.00 | $90.00 | $14.00–$86.00 | 25% above | — |
| Urine pregnancy test, read by color change CPT 81025 Cc Urine | $82.00 | $82.00 | $13.00–$79.00 | 29% above | — |
| Urine pregnancy test, read by color change CPT 81025 Chg Urine Pregnancy Test Visual Color Cmprsn Meths | $82.00 | $82.00 | $77.00–$79.00 | 29% above | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 Cc Vitamin B-12 | $68.00 | $68.00 | $11.00–$65.00 | 40% below | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Cc Vitamin D 25 Hydroxy | $99.00 | $99.00 | $16.00–$95.00 | 33% below | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Chg 25 Hydroxy Includes Fractions If Performed | $99.00 | $99.00 | $16.00–$95.00 | 33% below | — |
| Zinc blood test CPT 84630 Cc Zinc | $54.00 | $54.00 | $9.00–$52.00 | 21% below | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Cc Gonadotropin | $138.00 | $138.00 | $22.00–$132.00 | 56% above | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine both sides CPT 64615 Hc Chemodener Facial,trigeminal,cerv Spinal,bilateral | $524.00 | $524.00 | $84.00–$503.00 | — | — |
| Botox injections for chronic migraine CPT 64615 Pr Chemodervate Facial/trigem/cerv Musc Migraine | $266.00 | $266.00 | $43.00–$255.00 | 34% below | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Hc Biop Breast W/ Dvce Plcmt First Lesion Incl Stertac Guid | $2,838.00 | $2,838.00 | $454.00–$2,724.00 | 19% above | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Hc Closed Tx Distal/fib Fx W/o Manip | $435.00 | $435.00 | $70.00–$418.00 | 4% above | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Pr Cltx Dstl Fibular Fx Lat Malls W/o Manj | $763.00 | $763.00 | $105.00–$732.00 | 83% above | — |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Pr Closed Tx Metatarsal Fracture W/o Manipulation | $537.00 | $537.00 | $75.00–$516.00 | 46% above | — |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Hc Closed Tx Metatarsal Fx W/o Manip | $560.00 | $560.00 | $90.00–$538.00 | 52% above | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Pr Cardioversion Elective Arrhythmia External | $152.00 | $152.00 | $35.00–$146.00 | 89% below | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Hc Ep Cardioversion,electric,exte | $1,404.00 | $1,404.00 | $225.00–$1,348.00 | 2% below | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Hc Ep Cardioversion Electric Exte | $1,808.00 | $1,808.00 | $289.00–$1,736.00 | 26% above | — |
| Cataract surgery with lens implant CPT 66984 Removal of cataract with insertion of lens | $10,045.00 | $10,045.00 | $1,607.00–$9,643.00 | 186% above | — |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 Obstetric care, planned cesarean delivery | $27,251.00 | $27,251.00 | $4,360.00–$26,161.00 | 435% above | — |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Pr Circumcision W/clamp/oth Dev W/block | $377.00 | $377.00 | $30.00–$362.00 | 11% below | — |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Hc Circumcision Clamp Newborn | $2,896.00 | $2,896.00 | $463.00–$2,780.00 | 583% above | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Hc Closed Tx Distal Radial Fx/seperat W/o Manip | $411.00 | $411.00 | $66.00–$395.00 | 14% below | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Pr Cltx Dstl Radial Fx/epiphysl Sep W/o Mnpj | $791.00 | $791.00 | $122.00–$759.00 | 65% above | — |
| Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope | $6,101.00 | $6,101.00 | $976.00–$5,857.00 | 424% above | — |
| Colonoscopy with tissue sample CPT 45380 Biopsy exam of large bowel using an endoscope | $7,045.00 | $7,045.00 | $1,127.00–$6,763.00 | 393% above | — |
| Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using an endoscope | $5,672.00 | $5,672.00 | $907.00–$5,445.00 | 349% above | — |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Pr Cystourethroscopy | $494.00 | $494.00 | $26.00–$474.00 | 9% below | — |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Pneumococcal 20-valent Conj Vaccine-dip Crm (Pf) 0.5 Ml Im Syringe | $498.00 | $498.00 | $80.00–$478.00 | 9% below | — |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cc Cystourethroscopy,w Inj For Chemodenerv Of Bladder | $1,122.00 | $1,122.00 | $179.00–$1,077.00 | 106% above | — |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Hc Cystourethroscopy | $1,122.00 | $1,122.00 | $179.00–$1,077.00 | 106% above | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Pr Destruction Premalignant Lesion 1st | $199.00 | $199.00 | $17.00–$191.00 | 56% above | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Hc Destr Benign Or Premalig Lesion,1st Les | $385.00 | $385.00 | $62.00–$370.00 | 202% above | — |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Pr Removal Impacted Cerumen Irrigation/lvg Unilat | $28.00 | $28.00 | $6.00–$27.00 | 40% below | — |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Hc Rmvl Impact Cerumen Irrig/lvg Unilat | $117.00 | $117.00 | $19.00–$112.00 | 151% above | — |
| Earwax removal with instruments, one ear CPT 69210 Hc Remove Cerumen Impaction | $130.00 | $130.00 | $21.00–$125.00 | 46% above | — |
| Earwax removal with instruments, one ear one side CPT 69210 Pr Removal Impacted Cerumen Instrumentation Unilat | $128.00 | $128.00 | $10.00–$123.00 | 43% above | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Pr Njx Dx/ther Sbst Intrlmnr Crv/thrc W/img Gdn | $253.00 | $253.00 | $40.00–$243.00 | 76% below | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Hc Inj Cerv/ther W Img Guide | $1,633.00 | $1,633.00 | $261.00–$1,568.00 | 54% above | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Pr Njx Dx/ther Agt Pvrt Facet Jt Lmbr/sac 1 Level | $372.00 | $372.00 | $60.00–$357.00 | 71% below | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Hc Inj Paravert F Jnt L/s 1 Lvl | $3,049.00 | $3,049.00 | $488.00–$2,927.00 | 138% above | — |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Pr Rpr Aa Hernia 1st 3-10 Cm Reducible | $1,263.00 | $1,263.00 | $202.00–$1,212.00 | 2% below | — |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 Pr Rpr Aa Hernia 1st > 10 Cm Reducible | $1,698.00 | $1,698.00 | $272.00–$1,630.00 | 22% above | — |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Pr Rpr Aa Hernia 1st < 3 Cm Reducible | $754.00 | $754.00 | $121.00–$724.00 | 4% above | — |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Pr Sigmoidoscopy Flx Dx W/collj Spec Br/wa If Pfrmd | $183.00 | $183.00 | $19.00–$176.00 | 59% below | — |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Cc Flexible Sigmoidoscopy Procedure | $2,460.00 | $2,460.00 | $394.00–$2,362.00 | 455% above | — |
| Gallbladder removal, laparoscopic CPT 47562 Removal of gallbladder using an endoscope | $21,792.00 | $21,792.00 | $3,486.00–$20,920.00 | 1093% above | — |
| Hemorrhoid banding (rubber band ligation) CPT 46221 Pr Hemorrhoidectomy Internal Rubber Band Ligations | $588.00 | $588.00 | $71.00–$564.00 | 3% below | — |
| Hemorrhoid banding (rubber band ligation) CPT 46221 Hc Hemorrhoidectomy Smpl Ligature | $1,451.00 | $1,451.00 | $232.00–$1,393.00 | 139% above | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Pr Cath & Saline/contrast Sonohyster/hysterosalpi | $290.00 | $290.00 | $19.00–$278.00 | 29% below | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hc Cath/inject Hysterosalpingogram | $561.00 | $561.00 | $90.00–$539.00 | 37% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 Pr Incision & Drainage Abscess Simple/single | $441.00 | $441.00 | $36.00–$423.00 | 70% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 Hc I&d, Abscess, Simple | $467.00 | $467.00 | $75.00–$448.00 | 80% above | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Repair of groin hernia patient age 5 years or older | $11,862.00 | $11,862.00 | $1,898.00–$11,388.00 | 544% above | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Hc Inj Tendon Sheath,ligament | $119.00 | $119.00 | $19.00–$114.00 | 36% below | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Pr Injection 1 Tendon Sheath/ligament Aponeurosis | $140.00 | $140.00 | $12.00–$134.00 | 25% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Pr Arthrocentesis Aspir&/inj Major Jt/bursa W/o Us | $544.00 | $544.00 | $87.00–$522.00 | 185% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Hc Arthrocentesis/aspir/inj Major Joint | $653.00 | $653.00 | $104.00–$627.00 | 242% above | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Pr Arthrocentesis Aspir&/inj Interm Jt/burs W/o Us | $156.00 | $156.00 | $12.00–$150.00 | 12% below | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Hc Arthrocentesis/aspir/inj Intermed Joint | $1,167.00 | $1,167.00 | $187.00–$1,120.00 | 559% above | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Pr Arthrocentesis Aspir&/inj Small Jt/bursa W/o Us | $224.00 | $224.00 | $211.00–$215.00 | 57% above | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Hc Arthrocentesis/aspir/inj Small Joint | $430.00 | $430.00 | $69.00–$413.00 | 202% above | — |
| Knee arthroscopy with meniscus trim CPT 29881 Removal of one knee cartilage using an endoscope | $15,206.00 | $15,206.00 | $2,433.00–$14,598.00 | 489% above | — |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Pr Laps Total Hysterect 250 Gm/< W/rmvl Tube/ovary | $2,089.00 | $2,089.00 | $334.00–$2,005.00 | at median | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Hc Intermed Rpr,sc.ax.tr.ext <2.5cm | $339.00 | $339.00 | $54.00–$325.00 | 19% below | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Pr Repair Intermediate S/a/t/e 2.5 Cm/< | $575.00 | $575.00 | $48.00–$552.00 | 37% above | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection(s) of therapeutic substance | $2,755.00 | $2,755.00 | $441.00–$2,645.00 | 141% above | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 Injection(s) of therapeutic substance | $10,314.00 | $10,314.00 | $1,650.00–$9,901.00 | 1539% above | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection(s) of anesthetic into lower spine using imaging guidance | $3,742.00 | $3,742.00 | $599.00–$3,592.00 | 155% above | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Pr Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 0.5 Cm/< | $300.00 | $300.00 | $28.00–$288.00 | at median | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Cc Exc Skin Benig <0.5 Cm Trunk,arm,leg | $1,294.00 | $1,294.00 | $207.00–$1,242.00 | 331% above | — |
| Nail removal (partial or complete), one nail CPT 11730 Pr Avulsion Nail Plate Partial/complete Simple 1 | $239.00 | $239.00 | $18.00–$229.00 | 6% above | — |
| Nail removal (partial or complete), one nail CPT 11730 Hc Avulsion Nail Plate, Prt/comp,simple/single | $276.00 | $276.00 | $44.00–$265.00 | 23% above | — |
| Occipital nerve block (injection for headaches) CPT 64405 Pr Injection Aa&/strd Greater Occipital Nerve | $242.00 | $242.00 | $16.00–$232.00 | 42% below | — |
| Occipital nerve block (injection for headaches) CPT 64405 Hc Inj, Grtr Occipital Nerve | $426.00 | $426.00 | $68.00–$409.00 | 3% above | — |
| Paracentesis with imaging guidance CPT 49083 Pr Abdom Paracentesis Dx/ther W/imaging Guidance | $250.00 | $250.00 | $34.00–$240.00 | 70% below | — |
| Paracentesis with imaging guidance CPT 49083 Hc Abd Paracentesis W Imaging Guidance | $1,215.00 | $1,215.00 | $194.00–$1,166.00 | 45% above | — |
| Paracentesis with imaging guidance CPT 49083 Hc Abd Paracentesis W Imag Guidance | $1,366.00 | $1,366.00 | $219.00–$1,311.00 | 63% above | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Hc Excision Nail&matrix, Prt/comp | $535.00 | $535.00 | $86.00–$514.00 | 61% above | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Pr Excision Nail Matrix Permanent Removal | $544.00 | $544.00 | $34.00–$522.00 | 63% above | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Pr Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/sacral | $780.00 | $780.00 | $125.00–$749.00 | 62% below | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Hc Destr Neur Agnt,facet Jnt Lum/sac Singl | $6,907.00 | $6,907.00 | $1,105.00–$6,631.00 | 236% above | — |
| Removal of a breast lump, open surgery CPT 19120 Removal of one or more breast growth, open procedure | $10,135.00 | $10,135.00 | $1,621.00–$9,730.00 | 748% above | — |
| Removal of a foreign object under the skin, simple CPT 10120 Hc I&r Of Foreign Body, Subq, Simple | $336.00 | $336.00 | $54.00–$323.00 | 2% above | — |
| Removal of a foreign object under the skin, simple CPT 10120 Pr Incision & Removal Foreign Body Subq Tiss Simple | $369.00 | $369.00 | $37.00–$354.00 | 12% above | — |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Pr Colon Ca Scrn Not Hi Rsk Ind | $979.00 | $979.00 | $60.00–$940.00 | 24% above | — |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Cc Hc Colon Ca Scrn Not Hi Rsk Ind | $2,460.00 | $2,460.00 | $394.00–$2,362.00 | 212% above | — |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Pr Colorectal Scrn; Hi Risk Ind | $979.00 | $979.00 | $60.00–$940.00 | 19% above | — |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Cc Hc Colorectal Scrn; Hi Risk Ind | $2,460.00 | $2,460.00 | $394.00–$2,362.00 | 198% above | — |
| Short arm cast (elbow to hand) CPT 29075 Pr Application Cast Elbow Finger Short Arm | $211.00 | $211.00 | $21.00–$203.00 | 7% above | — |
| Short arm cast (elbow to hand) CPT 29075 Hc Apply Cast,short Arm | $428.00 | $428.00 | $68.00–$411.00 | 116% above | — |
| Short arm splint (forearm and hand) CPT 29125 Pr Application Short Arm Splint Forearm-hand Static | $351.00 | $351.00 | $15.00–$337.00 | 129% above | — |
| Short arm splint (forearm and hand) CPT 29125 Hc Apply Splint, Short Arm | $403.00 | $403.00 | $64.00–$387.00 | 163% above | — |
| Short leg cast (below the knee) CPT 29405 Pr Application Short Leg Cast Below Knee-toe | $473.00 | $473.00 | $20.00–$454.00 | 155% above | — |
| Short leg cast (below the knee) CPT 29405 Hc Apply Cast, Short Leg | $647.00 | $647.00 | $104.00–$621.00 | 249% above | — |
| Short leg splint (calf to foot) CPT 29515 Pr Application Short Leg Splint Calf Foot | $176.00 | $176.00 | $18.00–$169.00 | 9% above | — |
| Short leg splint (calf to foot) CPT 29515 Hc Apply Splint, Short Leg | $359.00 | $359.00 | $57.00–$345.00 | 122% above | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Shaving of shoulder bone using endoscope | $23,303.00 | $23,303.00 | $3,728.00–$22,371.00 | 1848% above | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Pr Simple Repair Scalp/neck/ax/genit/trunk 2.5cm/< | $220.00 | $220.00 | $15.00–$211.00 | 6% above | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Hc Simple Rpr,sc.nk.ext,<2.5cm | $276.00 | $276.00 | $44.00–$265.00 | 33% above | — |
| Skin biopsy, punch, one lesion CPT 11104 Pr Punch Biopsy Skin Single Lesion | $284.00 | $284.00 | $14.00–$273.00 | 12% above | — |
| Skin biopsy, punch, one lesion CPT 11104 Hc Punch Biopsy Skin Single Lesion | $385.00 | $385.00 | $62.00–$370.00 | 52% above | — |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Pr Excision Mal Lesion Trunk/arm/leg 0.5 Cm/< | $465.00 | $465.00 | $74.00–$446.00 | 15% above | — |
| Skin tag removal, up to 15 tags CPT 11200 Hc Removal Skin Tags, 1-15 Lesions | $188.00 | $188.00 | $30.00–$180.00 | 1% below | — |
| Skin tag removal, up to 15 tags CPT 11200 Pr Rmvl Skin Tags Mlt Fibrq Tags Any Up To&inc 15 | $211.00 | $211.00 | $25.00–$203.00 | 11% above | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Hc Spinal Puncture,lumbar Diag | $937.00 | $937.00 | $150.00–$900.00 | 144% above | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Pr Diagnostic Lumbar Spinal Puncture | $1,006.00 | $1,006.00 | $20.00–$966.00 | 162% above | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Pr Smpl Repair Scalp/neck/ax/genit/trunk 2.6-7.5cm | $262.00 | $262.00 | $20.00–$252.00 | 9% above | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Hc Simple Rpr,sc.nk.ext,2.6-7.5cm | $287.00 | $287.00 | $46.00–$276.00 | 20% above | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Pr Simple Repair F/e/e/n/l/m 2.5cm/< | $265.00 | $265.00 | $19.00–$254.00 | 17% above | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Hc Simple Rpr, Face, <2.5cm | $284.00 | $284.00 | $45.00–$273.00 | 25% above | — |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Pr Tangential Biopsy Skin Single Lesion | $103.00 | $103.00 | $11.00–$99.00 | 46% below | — |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Hc Tangential Biopsy Skin Single Lesion | $385.00 | $385.00 | $62.00–$370.00 | 103% above | — |
| Thoracentesis with imaging guidance CPT 32555 Pr Thoracentesis Needle/cath Pleura W/imaging | $262.00 | $262.00 | $34.00–$252.00 | 68% below | — |
| Thoracentesis with imaging guidance CPT 32555 Cc Hc Thoracentesis Needle/cath Pleura W/poc Us | $813.00 | $813.00 | $130.00–$780.00 | at median | — |
| Thoracentesis with imaging guidance CPT 32555 Hc Thoracentesis Needle/cath Pleura W/imaging | $1,189.00 | $1,189.00 | $190.00–$1,141.00 | 46% above | — |
| Tonsil and adenoid removal, child under 12 CPT 42820 Removal of tonsils and adenoid glands, patient younger than age 12 | $7,114.00 | $7,114.00 | $1,138.00–$6,829.00 | 436% above | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 Hc Inj Trigger Point, 1 Or 2 | $103.00 | $103.00 | $16.00–$99.00 | 20% below | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 Pr Injection Single/mlt Trigger Point 1/2 Muscles | $474.00 | $474.00 | $13.00–$455.00 | 270% above | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Hc Biop Breast W/ Dvce Plcmt First Lesion Incl Us Guid | $2,550.00 | $2,550.00 | $408.00–$2,448.00 | 23% above | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy exam of esophagus, stomach or small bowel using an endoscope | $6,825.00 | $6,825.00 | $1,092.00–$6,552.00 | 343% above | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach or small bowel using an endoscope | $7,269.00 | $7,269.00 | $1,163.00–$6,978.00 | 861% above | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 Obstetric care, planned vaginal delivery (post delivery by cesarean section) | $13,257.00 | $13,257.00 | $2,121.00–$12,727.00 | 173% above | — |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 Obstetric care, planned vaginal delivery | $13,791.00 | $13,791.00 | $2,206.00–$13,239.00 | 195% above | — |
| Wart removal, up to 14 warts CPT 17110 Pr Destruction Benign Lesions Up To 14 | $270.00 | $270.00 | $43.00–$259.00 | 48% above | — |
| Wart removal, up to 14 warts CPT 17110 Hc Destr Benign Lesion(up To 14) | $311.00 | $311.00 | $50.00–$299.00 | 71% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Pr Debridement Subcutaneous Tissue 1st 20 Sq Cm/< | $253.00 | $253.00 | $20.00–$243.00 | 15% below | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Hc Debride Skin, Sq, Full Thickness 1st 20 Sqcm Or Less | $717.00 | $717.00 | $115.00–$688.00 | 141% above | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Hc Blood / Plasma Administration | $856.00 | $856.00 | $137.00–$822.00 | 21% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pr Pressurized/nonpressurized Inhalation Treatment | $42.00 | $42.00 | $7.00–$40.00 | 62% below | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Intrapulmonary Percussion | $159.00 | $159.00 | $25.00–$153.00 | 45% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Aerosol Subsequent | $159.00 | $159.00 | $25.00–$153.00 | 45% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Aerosol Treatment | $169.00 | $169.00 | $27.00–$162.00 | 54% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Ippb Treatment | $176.00 | $176.00 | $28.00–$169.00 | 60% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hc Mdi Subsequent | $176.00 | $176.00 | $28.00–$169.00 | 60% above | — |
| Chemotherapy IV infusion, first hour CPT 96413 Hc Chemo Iv Infusion 1st Hour | $1,172.00 | $1,172.00 | $187.00–$1,125.00 | 109% above | — |
| Critical care, first 30 to 74 minutes CPT 99291 Pr Critical Care Ill/injured Patient Init 30-74 Min | $500.00 | $500.00 | $73.00–$480.00 | 22% below | — |
| Critical care, first 30 to 74 minutes CPT 99291 Hc Critical Care 1st Hour (30-74 Mins) | $1,212.00 | $1,212.00 | $194.00–$1,164.00 | 89% above | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 Hc Eeg Awake And Drowsy | $1,024.00 | $1,024.00 | $164.00–$983.00 | 52% above | — |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Electrocardiogram, routine, with interpretation and report | $94.00 | $94.00 | $15.00–$90.00 | 5% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Pr Ecg Routine Ecg W/least 12 Lds Trcg Only W/o I&r | $56.00 | $56.00 | $9.00–$54.00 | 76% below | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Cc Bhc Ekg | $447.00 | $447.00 | $72.00–$429.00 | 92% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Pr Emergency Department Visit May Not Req Phys/qhp | $173.00 | $173.00 | $4.00–$166.00 | 13% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Hc Er Visit Straightfwd Problem Level I | $229.00 | $229.00 | $37.00–$220.00 | 50% above | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Pr Emergency Department Visit Straightforward Mdm | $228.00 | $228.00 | $15.00–$219.00 | 24% above | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Hc Er Visit Low Complexity Level Ii | $376.00 | $376.00 | $60.00–$361.00 | 105% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Pr Emergency Department Visit Low Mdm | $350.00 | $350.00 | $25.00–$336.00 | 40% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Hc Er Visit Mod Complex Expanded Lev Iii | $499.00 | $499.00 | $80.00–$479.00 | 100% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Pr Emergency Department Visit Moderate Mdm | $575.00 | $575.00 | $43.00–$552.00 | 25% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Hc Er Visit Mod Complex Detailed Lev Iv | $725.00 | $725.00 | $116.00–$696.00 | 57% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Pr Emergency Department Visit High Mdm | $655.00 | $655.00 | $62.00–$629.00 | at median | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Hc Er Visit Hi Complex Med Emerg Lev V | $1,110.00 | $1,110.00 | $178.00–$1,066.00 | 69% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Hc Cardiovascular Stress Test Tracing Only | $1,445.00 | $1,445.00 | $231.00–$1,387.00 | 35% above | — |
| Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy, including patient, 50 min | $246.00 | $246.00 | $39.00–$236.00 | 6% above | — |
| Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy, not including patient, 50 min | $241.00 | $241.00 | $39.00–$231.00 | 18% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Pr Iv Infusion Hydration Initial 31 Min-1 Hour | $133.00 | $133.00 | $21.00–$128.00 | 65% below | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hc Hydration Iv Infusion Initial, 31min-1hr | $387.00 | $387.00 | $62.00–$372.00 | 1% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Cc Initial Iv Infuse Hydrate 31-60 Min | $387.00 | $387.00 | $62.00–$372.00 | 1% above | — |
| IV infusion of a medicine, first hour CPT 96365 Hc Iv Infusion, Therapy, Initial Up To 1 Hr | $387.00 | $387.00 | $62.00–$372.00 | 1% above | — |
| IV infusion of a medicine, first hour CPT 96365 Cc Iv Inf Thera Add New Drug Up To 1h | $387.00 | $387.00 | $62.00–$372.00 | 1% above | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Pr Therapeutic Prophylactic/dx Injection Subq/im | $60.00 | $60.00 | $6.00–$58.00 | 33% below | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Hc Im/sq Injection | $165.00 | $165.00 | $26.00–$158.00 | 83% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Pr Psychiatric Diagnostic Evaluation | $333.00 | $333.00 | $53.00–$320.00 | 56% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 Hc Neuromuscular Re-education / 15 Min Pt | $112.00 | $112.00 | $18.00–$108.00 | 21% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 Hc Neuromuscular Re-education / 15 Min Ot | $112.00 | $112.00 | $18.00–$108.00 | 21% above | — |
| New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min | $724.00 | $724.00 | $116.00–$695.00 | 251% above | — |
| New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min | $864.00 | $864.00 | $138.00–$829.00 | 184% above | — |
| New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min | $1,004.00 | $1,004.00 | $161.00–$964.00 | 171% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Hc Clinic Visit New Lvl 2 | $126.00 | $126.00 | $20.00–$121.00 | 3% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Pr Office/outpatient New Sf Mdm 15 Minutes | $228.00 | $228.00 | $15.00–$219.00 | 87% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Cc Hc New Patient Visit Level 2 | $586.00 | $586.00 | $94.00–$563.00 | 381% above | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Hc Op Nutrition Counseling -15 Min Init | $48.00 | $48.00 | $8.00–$46.00 | 1% below | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Pr Medical Nutrition Assmt&ivntj Indiv Each 15 Mi | $84.00 | $84.00 | $13.00–$81.00 | 73% above | — |
| Occupational therapy evaluation, low complexity CPT 97165 Hc Rehab Ot Low Eval | $164.00 | $164.00 | $26.00–$157.00 | 1% below | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Hc Rehab Pt High Eval | $283.00 | $283.00 | $45.00–$272.00 | 33% above | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Hc Rehab Pt Low Eval | $143.00 | $143.00 | $23.00–$137.00 | 10% below | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Hc Rehab Pt Moderate Eval | $213.00 | $213.00 | $34.00–$204.00 | 19% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Hc Manual Therapy / 15 Min | $97.00 | $97.00 | $16.00–$93.00 | 1% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Hc Manual Therapy / 15 Min Ot | $102.00 | $102.00 | $16.00–$98.00 | 6% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Hc Manual Therapy / 15 Min Pt | $102.00 | $102.00 | $16.00–$98.00 | 6% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise | $101.00 | $101.00 | $16.00–$97.00 | 6% above | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years) | $302.00 | $302.00 | $48.00–$290.00 | 22% above | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years) | $353.00 | $353.00 | $56.00–$339.00 | 25% above | — |
| Preventive checkup, new patient aged 65 or older CPT 99387 Pr Initial Preventive Medicine New Patient 65yrs&> | $383.00 | $383.00 | $61.00–$368.00 | 33% above | — |
| Preventive checkup, returning patient aged 18–39 CPT 99395 Pr Periodic Preventive Med Est Patient 18-39 Yrs | $272.00 | $272.00 | $44.00–$261.00 | 24% above | — |
| Preventive checkup, returning patient aged 40–64 CPT 99396 Pr Periodic Preventive Med Est Patient 40-64yrs | $292.00 | $292.00 | $47.00–$280.00 | 25% above | — |
| Preventive checkup, returning patient aged 65 or older CPT 99397 Pr Periodic Preventive Med Est Patient 65yrs& Older | $312.00 | $312.00 | $50.00–$300.00 | 29% above | — |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Pr Psychological Tst Eval Svc Phys/qhp First Hour | $215.00 | $215.00 | $34.00–$206.00 | 10% below | — |
| Psychotherapy for crisis, first 60 minutes CPT 90839 Pr Psychotherapy For Crisis Initial 60 Minutes | $306.00 | $306.00 | $49.00–$294.00 | 42% above | — |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 min | $144.00 | $144.00 | $23.00–$138.00 | 9% below | — |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 min | $207.00 | $207.00 | $33.00–$199.00 | at median | — |
| Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 min | $227.00 | $227.00 | $36.00–$218.00 | 10% below | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Pr Tobacco Use Cessation Intermediate 3-10 Minutes | $35.00 | $35.00 | $6.00–$34.00 | 20% above | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Hc Smoking/tobacco Counseling 3-10 Min | $44.00 | $44.00 | $7.00–$42.00 | 50% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Hc Clinic Visit Est Lvl 5 | $240.00 | $240.00 | $38.00–$230.00 | at median | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Pr Office/outpatient Established High Mdm 40 Min | $418.00 | $418.00 | $47.00–$401.00 | 74% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Cc Hc Established Patient Visit Level 5 | $793.00 | $793.00 | $127.00–$761.00 | 230% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Hc Clinic Visit Est Lvl 3 | $152.00 | $152.00 | $24.00–$146.00 | 27% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Hc Clinic Visit Lvl 3 (New, Bill Established) | $152.00 | $152.00 | $24.00–$146.00 | 27% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Pr Office/outpatient Established Low Mdm 20 Min | $210.00 | $210.00 | $21.00–$202.00 | 75% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Cc Hc Established Patient Visit Level 3 | $529.00 | $529.00 | $85.00–$508.00 | 341% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Hc Clinic Visit Est Lvl 4 | $192.00 | $192.00 | $31.00–$184.00 | 8% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Pr Office/outpatient Established Mod Mdm 30 Min | $300.00 | $300.00 | $31.00–$288.00 | 68% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Cc Hc Established Patient Visit Level 4 | $662.00 | $662.00 | $106.00–$636.00 | 271% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Hc Clinic Visit Est Lvl 2 | $112.00 | $112.00 | $18.00–$108.00 | 33% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Hc Clinic Visit Lvl 2 (New, Bill Established) | $112.00 | $112.00 | $18.00–$108.00 | 33% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Pr Office/outpatient Established Sf Mdm 10 Min | $120.00 | $120.00 | $11.00–$115.00 | 42% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Cc Hc Established Patient Visit Level 2 | $397.00 | $397.00 | $64.00–$381.00 | 371% above | — |
| Speech and language evaluation CPT 92523 Hc Eval Of Speech Sound Prod W/ Eval Of Lang Comp & Express | $316.00 | $316.00 | $51.00–$303.00 | 1% above | — |
| Speech therapy session, individual CPT 92507 Hc Speech Therapy, Extended | $314.00 | $314.00 | $50.00–$301.00 | 29% above | — |
| Speech therapy session, individual CPT 92507 Hc Speech Therapy Individual | $314.00 | $314.00 | $50.00–$301.00 | 29% above | — |
| Spirometry (breathing test) CPT 94010 Hc Pedi Pulmonary Function Test | $423.00 | $423.00 | $68.00–$406.00 | 54% above | — |
| Spirometry before and after a bronchodilator CPT 94060 Pr Brncdilat Rspse Spmtry Pre&post-brncdilat Admn | $643.00 | $643.00 | $103.00–$617.00 | 14% above | — |
| Spirometry before and after a bronchodilator CPT 94060 Hc Pedi Pre/post Brochodialator | $643.00 | $643.00 | $103.00–$617.00 | 14% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Therapeutic Activities / 15 Min | $102.00 | $102.00 | $16.00–$98.00 | 16% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Therapeutic Activities / 15 Min Ot | $102.00 | $102.00 | $16.00–$98.00 | 16% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Hc Therapeutic Activities / 15 Min Pt | $102.00 | $102.00 | $16.00–$98.00 | 16% above | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Hc Therapeutic Phlebotomy | $182.00 | $182.00 | $29.00–$175.00 | 5% below | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Pr Phlebotomy Therapeutic Separate Procedure | $227.00 | $227.00 | $35.00–$218.00 | 18% above | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Pr Sarscov2 Vacc 30mcg/0.3ml Tris-sucrose Im Use | $180.00 | $180.00 | $29.00–$173.00 | 15% below | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Pr Var Vaccine Live For Subcutaneous Use | $135.00 | $135.00 | $22.00–$130.00 | 32% below | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Pr Iiv3 Vacc Preservative Free 0.5 Ml Dosage Im Use | $36.00 | $36.00 | $6.00–$35.00 | 38% above | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Pr 9vhpv Vacc 2/3 Dose Sched Im Use | $193.00 | $193.00 | $31.00–$185.00 | 48% below | — |
| Hepatitis A vaccine, adult dose CPT 90632 Pr Hepa Vaccine Adult Dose For Intramuscular Use | $113.00 | $113.00 | $18.00–$108.00 | 31% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Pr Hepb Vaccine Adult 3 Dose Schedule For Im Use | $96.00 | $96.00 | $15.00–$92.00 | 12% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Pr Iiv Vaccine Preserv Free Increased Ag Content Im | $105.00 | $105.00 | $17.00–$101.00 | 28% above | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Pr Measles Mumps Rubella Virus Vaccine Live Subq | $100.00 | $100.00 | $16.00–$96.00 | 9% below | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Pr Menacwyd/menacwy-crm Conj Vacc Grps Acwy Im Use | $130.00 | $130.00 | $21.00–$125.00 | 29% below | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Pr Menb-4c Recombnt Prot & Outer Memb Vesic Vacc Im | $233.00 | $233.00 | $37.00–$224.00 | 16% below | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pr Pcv20 Vaccine For Intramuscular Use | $263.00 | $263.00 | $42.00–$252.00 | 39% below | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pr Ppsv23 Vaccine 2 Yrs Or Older For Subq/im Use | $112.00 | $112.00 | $18.00–$108.00 | 40% below | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Pr Rsv Monoclonal Antb Seasonal Dose 0.5ml Im Use | $638.00 | $638.00 | $102.00–$612.00 | 10% below | — |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Pr Rsv Vaccine Pref Subunit Bivalent For Im Use | $369.00 | $369.00 | $59.00–$354.00 | 2% below | — |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 Pr Rsv Vacc Pref Recombinant Adjuvanted For Im Use | $351.00 | $351.00 | $56.00–$337.00 | 9% below | — |
| Rabies vaccine, one dose CPT 90675 Hc Rabies Vaccine, Im | $120.00 | $120.00 | $19.00–$115.00 | 76% below | — |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Pr Hzv Zoster Vacc Recombinant Adjuvanted Im Use | $159.00 | $159.00 | $25.00–$153.00 | 45% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Pr Td Vaccine Prsrv Free 7 Yrs Or Older For Im Use | $52.00 | $52.00 | $8.00–$50.00 | at median | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Pr Tdap Vaccine 7 Yrs/> Im | $74.00 | $74.00 | $12.00–$71.00 | 6% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Metformin 500 Mg Tablet | $27.00 | $27.00 | $4.00–$26.00 | 21% below | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Furosemide 40 Mg Tablet | $29.00 | $29.00 | $5.00–$28.00 | 15% below | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Famotidine 20 Mg Tablet | $29.00 | $29.00 | $5.00–$28.00 | 15% below | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pr Im Adm Prq Id Subq/im Njxs 1 Vaccine | $30.00 | $30.00 | $5.00–$29.00 | 12% below | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Hc Vaccine Adm, Initial Sqim | $30.00 | $30.00 | $5.00–$29.00 | 12% below | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Diphenhydramine 25 Mg Capsule | $24.00 | $24.00 | $4.00–$23.00 | 28% below | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Sennosides 8.6 Mg Tablet | $24.00 | $24.00 | $4.00–$23.00 | 28% below | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pr Im Adm Prq Id Subq/im Njxs Ea Vaccine | $24.00 | $24.00 | $4.00–$23.00 | 28% below | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Hc Vaccine Adm, Each Addl Sqim | $30.00 | $30.00 | $5.00–$29.00 | 10% below | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Lisinopril 40 Mg Tablet | $37.00 | $37.00 | $6.00–$36.00 | 11% above | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Sodium Bicarbonate 650 Mg Tablet | $39.00 | $39.00 | $6.00–$37.00 | 17% above | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Nifedipine 10 Mg Capsule | $156.00 | $156.00 | $25.00–$150.00 | 369% above | — |