Cozad Community Hospital
Cozad Community Hospital in Cozad, NE publishes cash prices for 298 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Nebraska median for 171 of 296 procedures and above it for 116. By typical cash price it ranks #20 of 44 Nebraska hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
P O Box 108, 300 East 12TH St, Cozad, NE 69130 Collected Sep 27, 2026 Source price file (308) 784-2261
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 281327 · 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 2 actions for a hospital named Cozad Community Hospital in Cozad, NE:
- Sep 22, 2025 Warning notice
- Sep 29, 2025 Case closed
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.
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 Nebraska | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle 3v Rt | $322.00 | $358.00 | $200.00–$358.00 | 1% below | 10% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle 3v Lt | $322.00 | $358.00 | $200.00–$358.00 | 1% below | 10% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Us Abi | $644.00 | $716.00 | $401.00–$716.00 | 40% above | 10% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Ankle-brachial Index (Abi) | $644.00 | $716.00 | $401.00–$716.00 | 40% above | 10% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Rf Esophogram | $602.00 | $669.00 | $375.00–$669.00 | at median | 10% |
| Bone scan, whole body (nuclear medicine) CPT 78306 **Bone Scan Full Body | $1,510.00 | $1,678.00 | $940.00–$1,678.00 | 11% below | 10% |
| Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Lt | $500.00 | $555.00 | $311.00–$555.00 | 5% above | 10% |
| Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Complete Rt | $500.00 | $555.00 | $311.00–$555.00 | 5% above | 10% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 Us Breast Limitedbilateral | $521.00 | $579.00 | $324.00–$579.00 | 35% above | 10% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Limited Lt | $425.00 | $472.00 | $264.00–$472.00 | 10% above | 10% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Limited Rt | $425.00 | $472.00 | $264.00–$472.00 | 10% above | 10% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Pe Study Wo W | $3,008.00 | $3,342.00 | $1,872.00–$3,342.00 | 5% below | 10% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Chest Wo W | $3,008.00 | $3,342.00 | $1,872.00–$3,342.00 | 5% below | 10% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 Ct Calcium Score | $237.00 | $263.00 | $147.00–$263.00 | 79% above | 10% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Renal Stone | $3,836.00 | $4,262.00 | $2,387.00–$4,262.00 | 12% above | 10% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abdomen Pelvis Wo | $3,836.00 | $4,262.00 | $2,387.00–$4,262.00 | 12% above | 10% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast | $4,165.00 | $4,628.00 | $2,592.00–$4,628.00 | 3% above | 10% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abdomen Pelvis Wo W | $4,991.00 | $5,546.00 | $3,106.00–$5,546.00 | 2% above | 10% |
| CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W | $2,361.00 | $2,623.00 | $1,469.00–$2,623.00 | 8% below | 10% |
| CT scan of the abdomen without contrast CPT 74150 Ct Abdomen Wo | $2,177.00 | $2,419.00 | $1,355.00–$2,419.00 | 1% below | 10% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Facial Bones Wo | $1,784.00 | $1,982.00 | $1,110.00–$1,982.00 | at median | 10% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Sinus | $1,784.00 | $1,982.00 | $1,110.00–$1,982.00 | at median | 10% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan | $1,922.00 | $2,136.00 | $1,196.00–$2,136.00 | 3% above | 10% |
| CT scan of the head with contrast CPT 70460 Ct Head W | $1,935.00 | $2,150.00 | $1,204.00–$2,150.00 | 6% below | 10% |
| CT scan of the head without and with contrast CPT 70470 Ct Head Wo W | $2,995.00 | $3,328.00 | $1,864.00–$3,328.00 | 20% above | 10% |
| CT scan of the head without and with contrast CPT 70470 Ct Orbit/ear/fossa W Wo | $2,995.00 | $3,328.00 | $1,864.00–$3,328.00 | 20% above | 10% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Lumbar Spine Wo | $2,208.00 | $2,453.00 | $1,374.00–$2,453.00 | 4% above | 10% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Cervical Spine Wo | $2,206.00 | $2,451.00 | $1,373.00–$2,451.00 | 1% below | 10% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $2,206.00 | $2,451.00 | $1,373.00–$2,451.00 | 8% below | 10% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Carotid Artery Study Bilateral | $1,449.00 | $1,610.00 | $902.00–$1,610.00 | — | 10% |
| Chest X-ray, 2 views CPT 71046 **Xr Chest 2v Complete | $279.00 | $310.00 | $174.00–$310.00 | 1% below | 10% |
| Chest X-ray, 2 views CPT 71046 Xr Chest 2v | $321.00 | $357.00 | $200.00–$357.00 | 14% above | 10% |
| Chest X-ray, single view CPT 71045 Xr Chest 1v | $324.00 | $360.00 | $202.00–$360.00 | 43% above | 10% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Retroperitoneal Complete | $787.00 | $874.00 | $489.00–$874.00 | at median | 10% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dxa Bone Density Prof Fee | $52.00 | $58.00 | $37.00–$58.00 | 87% below | 10% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 **Ct Bone Density Axial | $326.00 | $362.00 | $203.00–$362.00 | 17% below | 10% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bone Density Axial | $399.00 | $443.00 | $248.00–$443.00 | 2% above | 10% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dxa Appendic Skel Prof Fee | $89.00 | $99.00 | $29.00–$99.00 | 62% below | 10% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Bone Density Appendicular | $180.00 | $200.00 | $112.00–$200.00 | 22% below | 10% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 **Ct Bone Density Appendicular | $180.00 | $200.00 | $112.00–$200.00 | 22% below | 10% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest Wo | $2,473.00 | $2,748.00 | $1,539.00–$2,748.00 | 16% above | 10% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W | $2,570.00 | $2,855.00 | $1,599.00–$2,855.00 | 4% above | 10% |
| Diagnostic mammogram, both breasts CPT 77066 Mammography of both breasts | $377.00 | $419.00 | $235.00–$419.00 | 14% below | 10% |
| Diagnostic mammogram, one breast CPT 77065 Mammography of one breast | $308.00 | $342.00 | $192.00–$342.00 | 1% below | 10% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Dup-scan Lxtr Art/artl Bpgs Com Bi Study | $1,172.00 | $1,302.00 | $729.00–$1,302.00 | — | 10% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 Art Duplex L/e Complete W/ Abi | $1,172.00 | $1,302.00 | $729.00–$1,302.00 | 10% above | 10% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 Venous Duplex | $1,429.00 | $1,588.00 | $889.00–$1,588.00 | 1% below | 10% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 Bil Ue Venous Doppler | $1,429.00 | $1,588.00 | $889.00–$1,588.00 | 1% below | 10% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Complete | $2,251.00 | $2,501.00 | $1,401.00–$2,501.00 | 7% above | 10% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 **Hep Ductal System Imaging | $1,323.00 | $1,470.00 | $823.00–$1,470.00 | 9% below | 10% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Unattended & Resp Efft | $447.00 | $497.00 | $278.00–$497.00 | 2% below | 10% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnography Split | $4,312.00 | $4,791.00 | $2,683.00–$4,791.00 | 15% above | 10% |
| Knee X-ray, 3 views one side CPT 73562 Xr Knee 3v Rt | $367.00 | $408.00 | $228.00–$408.00 | at median | 10% |
| Knee X-ray, 3 views one side CPT 73562 Xr Knee 3v Lt | $367.00 | $408.00 | $228.00–$408.00 | at median | 10% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 **Us Abdomen Ruq | $485.00 | $539.00 | $302.00–$539.00 | 13% below | 10% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Limited | $692.00 | $769.00 | $431.00–$769.00 | 24% above | 10% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Lung Screening Low Dose Ldct | $1,679.00 | $1,866.00 | $1,045.00–$1,866.00 | 171% above | 10% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint | $2,352.00 | $2,613.00 | $1,463.00–$2,613.00 | 7% below | 10% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mr Lower Extremity Joint Wo W Lt | $2,387.00 | $2,652.00 | $1,485.00–$2,652.00 | 29% below | 10% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mr Lower Extremity Joint Wo W Rt | $2,572.00 | $2,858.00 | $1,600.00–$2,858.00 | 24% below | 10% |
| MRI of the abdomen without contrast CPT 74181 Mr Abdomen Wo | $2,961.00 | $3,290.00 | $1,842.00–$3,290.00 | at median | 10% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 Mr Abdomen Wo W | $3,614.00 | $4,016.00 | $2,249.00–$4,016.00 | 2% below | 10% |
| MRI of the brain, no contrast dye CPT 70551 Mr Head Wo | $3,461.00 | $3,846.00 | $2,154.00–$3,846.00 | 12% above | 10% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Scan | $3,941.00 | $4,379.00 | $2,452.00–$4,379.00 | 1% above | 10% |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal | $3,216.00 | $3,573.00 | $2,001.00–$3,573.00 | 3% above | 10% |
| MRI of the lower back, without and then with contrast dye CPT 72158 Mr Lumbar Spine Wo W | $3,758.00 | $4,176.00 | $2,339.00–$4,176.00 | 4% below | 10% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mr Thoracic Spine Wo | $3,406.00 | $3,784.00 | $2,119.00–$3,784.00 | 6% above | 10% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 Mr Cervical Spine Wo W | $3,329.00 | $3,699.00 | $2,071.00–$3,699.00 | 15% below | 10% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 Mr Cervical Spine Wo | $3,321.00 | $3,690.00 | $2,066.00–$3,690.00 | 8% above | 10% |
| MRI of the pelvis without and with contrast CPT 72197 Mr Pelvis Wo W | $2,788.00 | $3,098.00 | $1,735.00–$3,098.00 | 21% below | 10% |
| MRI of the pelvis, no contrast dye CPT 72195 Mr Pelvis Wo | $2,660.00 | $2,955.00 | $1,655.00–$2,955.00 | at median | 10% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mr Upper Extremity Joint Wo Rt | $2,397.00 | $2,663.00 | $1,491.00–$2,663.00 | 1% below | 10% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mr Upper Extremity Joint Wo Lt | $2,397.00 | $2,663.00 | $1,491.00–$2,663.00 | 1% below | 10% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Exercise Cardiolyte Multi | $4,315.00 | $4,794.00 | $2,685.00–$4,794.00 | 8% above | 10% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Lexiscan Cardiolyte Multi | $4,315.00 | $4,794.00 | $2,685.00–$4,794.00 | 8% above | 10% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Pelvis Limited Non Ob | $443.00 | $492.00 | $276.00–$492.00 | 24% above | 10% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvis Complete Non Ob | $766.00 | $851.00 | $477.00–$851.00 | 1% below | 10% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Abdomial ultrasound of pregnant uterus | $635.00 | $705.00 | $395.00–$705.00 | 8% below | 10% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Ob Less Than 14 Weeks | $696.00 | $773.00 | $433.00–$773.00 | 13% above | 10% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Ob Limited | $414.00 | $460.00 | $258.00–$460.00 | 6% above | 10% |
| Screening mammogram, both breasts both sides CPT 77067 Mammography, screening, bilateral | $360.00 | $400.00 | $224.00–$400.00 | — | 10% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder 2v Rt | $355.00 | $394.00 | $221.00–$394.00 | 6% above | 10% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder 2v Lt | $355.00 | $394.00 | $221.00–$394.00 | 6% above | 10% |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep study | $3,791.00 | $4,212.00 | $2,359.00–$4,212.00 | 6% above | 10% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Rf Modified Barium Swallow | $599.00 | $665.00 | $372.00–$665.00 | 5% above | 10% |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina | $536.00 | $596.00 | $334.00–$596.00 | 11% below | 10% |
| Transvaginal ultrasound during pregnancy CPT 76817 Us Ob Transvaginal | $509.00 | $566.00 | $317.00–$566.00 | 1% above | 10% |
| Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen | $818.00 | $909.00 | $509.00–$909.00 | 1% below | 10% |
| Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum And Contents | $661.00 | $734.00 | $411.00–$734.00 | 2% above | 10% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Soft Tissue Head Neck Thyroid | $617.00 | $686.00 | $384.00–$686.00 | 5% above | 10% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Rf Ugi Wo Kub | $474.00 | $527.00 | $295.00–$527.00 | 3% below | 10% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Rf Ugi W Kub | $644.00 | $716.00 | $401.00–$716.00 | 32% above | 10% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Lmtd Right | $1,147.00 | $1,274.00 | $713.00–$1,274.00 | 12% above | 10% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Dup-scan Xtr Veins Unilat/limited Study | $1,147.00 | $1,274.00 | $713.00–$1,274.00 | 12% above | 10% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Lmtd Left | $1,147.00 | $1,274.00 | $713.00–$1,274.00 | 12% above | 10% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist 3v Rt | $334.00 | $371.00 | $208.00–$371.00 | 1% above | 10% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist 3v Lt | $334.00 | $371.00 | $208.00–$371.00 | 1% above | 10% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Xr Hip 2v Rtw Or Wo Pelvis | $343.00 | $381.00 | $213.00–$381.00 | 20% above | 10% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Xr Hip 2v Ltw Or Wo Pelvis | $343.00 | $381.00 | $213.00–$381.00 | 20% above | 10% |
| X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen 1 View | $264.00 | $293.00 | $164.00–$293.00 | 1% above | 10% |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2v Rt | $261.00 | $290.00 | $162.00–$290.00 | 15% above | 10% |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2v Lt | $261.00 | $290.00 | $162.00–$290.00 | 15% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger 2v Lt | $226.00 | $251.00 | $141.00–$251.00 | 1% above | 10% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger 2v Rt | $226.00 | $251.00 | $141.00–$251.00 | 1% above | 10% |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2v Lt | $239.00 | $265.00 | $148.00–$265.00 | 11% above | 10% |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2v Rt | $239.00 | $265.00 | $148.00–$265.00 | 11% above | 10% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot 3v Lt | $339.00 | $377.00 | $211.00–$377.00 | 9% above | 10% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot 3v Rt | $339.00 | $377.00 | $211.00–$377.00 | 9% above | 10% |
| X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand 3v Rt | $341.00 | $379.00 | $212.00–$379.00 | at median | 10% |
| X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand 3v Lt | $341.00 | $379.00 | $212.00–$379.00 | at median | 10% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 2v Rt | $339.00 | $377.00 | $211.00–$377.00 | 6% above | 10% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 2v Lt | $339.00 | $377.00 | $211.00–$377.00 | 6% above | 10% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Lumbar Spine 2v Ap Lat | $441.00 | $490.00 | $274.00–$490.00 | 16% above | 10% |
| X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back | $505.00 | $561.00 | $314.00–$561.00 | 8% above | 10% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr Thoracic Spine 2 Views | $358.00 | $398.00 | $223.00–$398.00 | 17% above | 10% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones 3v | $315.00 | $350.00 | $196.00–$350.00 | 9% above | 10% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Cervical Spine 3v | $340.00 | $378.00 | $212.00–$378.00 | 11% above | 10% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1v | $308.00 | $342.00 | $192.00–$342.00 | 15% above | 10% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum Coccyx 3v | $334.00 | $371.00 | $208.00–$371.00 | 25% above | 10% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 **Clinic Alt/spgt | $49.00 | $54.00 | $30.00–$54.00 | 20% below | 9% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt/sgpt | $59.00 | $65.00 | $36.00–$65.00 | 3% below | 9% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 **Clinic Ast/sgot | $57.00 | $63.00 | $35.00–$63.00 | 1% above | 10% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Ast/sgot | $67.00 | $74.00 | $41.00–$74.00 | 19% above | 9% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel,acute (Rl) | $194.00 | $216.00 | $121.00–$216.00 | 38% below | 10% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hep Prof 1 & Hep C Abs (Rl) | $262.00 | $291.00 | $163.00–$291.00 | 17% below | 10% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige P-1 (Rl) | $55.00 | $61.00 | $34.00–$61.00 | 20% above | 10% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prof Basic P-1(rl) | $73.00 | $81.00 | $45.00–$81.00 | 59% above | 10% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Peanut Component Panel Ige Arup (Rl) | $129.00 | $143.00 | $80.00–$143.00 | 180% above | 10% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Galactos Alpha 1.3 (Rl) | $165.00 | $183.00 | $102.00–$183.00 | 259% above | 10% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp Igg Antibodies (Rl) | $118.00 | $131.00 | $73.00–$131.00 | 22% above | 10% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Igg By Elisa W/reflex Ana Hep2 (Rl) | $36.00 | $40.00 | $22.00–$40.00 | 47% below | 10% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen W Reflex (Rl) | $121.00 | $134.00 | $75.00–$134.00 | 79% above | 10% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Bnp(rl) (Edta Plasma) | $168.00 | $187.00 | $105.00–$187.00 | 14% below | 10% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Probnp-nt Serum(rl) | $168.00 | $187.00 | $105.00–$187.00 | 14% below | 10% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 **Clinic Bnp | $194.00 | $215.00 | $120.00–$215.00 | 1% below | 10% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Bnp (Pro) | $209.00 | $232.00 | $130.00–$232.00 | 7% above | 10% |
| Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel | $112.00 | $124.00 | $69.00–$124.00 | 17% below | 10% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Cytology Cell Block, Tc (Rl) | $178.00 | $198.00 | $111.00–$198.00 | 7% below | 10% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Cytology Body Fluid/washi (Rl) | $178.00 | $198.00 | $111.00–$198.00 | 7% below | 10% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tissue Proc Grp 04 (Rl) | $190.00 | $211.00 | $118.00–$211.00 | 1% below | 10% |
| Blood culture for bacteria CPT 87040 Culture, Blood (Rl) | $61.00 | $68.00 | $38.00–$68.00 | 66% below | 10% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Corporate Venipuncture Wellness | $25.00 | $28.00 | $16.00–$28.00 | 5% below | 11% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 **Clinic Venipuncture | $25.00 | $28.00 | $16.00–$28.00 | 5% below | 11% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture | $28.00 | $31.00 | $17.00–$31.00 | 6% above | 10% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Of Blood | $28.00 | $31.00 | $17.00–$31.00 | 6% above | 10% |
| Blood glucose (sugar) test CPT 82947 **Clinic Glucose, Blood | $41.00 | $46.00 | $26.00–$46.00 | 13% below | 11% |
| Blood glucose (sugar) test CPT 82947 Glucose, Blood | $53.00 | $59.00 | $33.00–$59.00 | 13% above | 10% |
| Blood lead test CPT 83655 Lead,venous Only(rl) | $50.00 | $55.00 | $31.00–$55.00 | 23% below | 9% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 **Clinic Bhcg Qualitative | $69.00 | $77.00 | $43.00–$77.00 | 37% below | 10% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Qualitative | $111.00 | $123.00 | $69.00–$123.00 | 2% above | 10% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 **Clinic Blood Typing, Abo | $105.00 | $117.00 | $66.00–$117.00 | 95% above | 10% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Typing; Abo | $111.00 | $123.00 | $69.00–$123.00 | 106% above | 10% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 **Clinic Crp C-reactive Protein | $82.00 | $91.00 | $51.00–$91.00 | 9% below | 10% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive Protein (Crp) | $88.00 | $98.00 | $55.00–$98.00 | 3% below | 10% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Dontc. Diff Toxin Dna Det Conf Test (Rl) | $66.00 | $73.00 | $41.00–$73.00 | 56% below | 10% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C.diff Toxin Pcr W/refelx (Rl) | $105.00 | $117.00 | $66.00–$117.00 | 29% below | 10% |
| CA 19-9 blood test (tumor marker) CPT 86301 Ca19-9 Carbohydrate Anti (Rl) | $249.00 | $277.00 | $155.00–$277.00 | 65% above | 10% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 (Rl) | $122.00 | $135.00 | $76.00–$135.00 | 6% below | 10% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid-19 Pcr (Rl) | $79.00 | $88.00 | $49.00–$88.00 | 36% below | 10% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Gonorrhea (Rl) | $81.00 | $90.00 | $50.00–$90.00 | 26% below | 10% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids | $96.00 | $107.00 | $60.00–$107.00 | 16% below | 10% |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated | $85.00 | $94.00 | $53.00–$94.00 | 6% below | 10% |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (CBC), automated | $72.00 | $80.00 | $45.00–$80.00 | 2% above | 10% |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $140.00 | $155.00 | $87.00–$155.00 | 9% below | 10% |
| D-dimer blood test (blood clot marker) CPT 85379 **Clinic D Dimer | $118.00 | $131.00 | $73.00–$131.00 | 12% below | 10% |
| D-dimer blood test (blood clot marker) CPT 85379 Ddimer P-1(rl) | $118.00 | $131.00 | $73.00–$131.00 | 12% below | 10% |
| D-dimer blood test (blood clot marker) CPT 85379 D-dimer, Quant | $127.00 | $141.00 | $79.00–$141.00 | 5% below | 10% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea, Sulfate (Rl) | $129.00 | $143.00 | $80.00–$143.00 | 9% below | 10% |
| Estradiol blood test CPT 82670 Estradiol (Rl) | $111.00 | $123.00 | $69.00–$123.00 | 14% below | 10% |
| FSH (follicle-stimulating hormone) test CPT 83001 Fsh (Pituitary Gonadotro) (Rl) | $62.00 | $69.00 | $39.00–$69.00 | 45% below | 10% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin,fecal (Rl) | $385.00 | $428.00 | $240.00–$428.00 | 8% above | 10% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin (Rl) | $104.00 | $115.00 | $64.00–$115.00 | at median | 10% |
| Folate (folic acid) blood test CPT 82746 Folic Acid(folate) (Rl) | $97.00 | $108.00 | $60.00–$108.00 | 8% below | 10% |
| Free T3 thyroid hormone test CPT 84481 T-3 Free (Rl) | $115.00 | $128.00 | $72.00–$128.00 | 26% below | 10% |
| Free T3 thyroid hormone test CPT 84481 T3 Free | $124.00 | $138.00 | $77.00–$138.00 | 20% below | 10% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 **Clinic Free T4 | $64.00 | $71.00 | $40.00–$71.00 | 25% below | 10% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free | $69.00 | $77.00 | $43.00–$77.00 | 19% below | 10% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Equilibrium Dialysis/mass Spect( | $101.00 | $112.00 | $63.00–$112.00 | 18% above | 10% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T-4 Free, Dialysis/mass Sp (Rl) | $103.00 | $114.00 | $64.00–$114.00 | 21% above | 10% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free By Dialysis/mass Spec | $103.00 | $114.00 | $64.00–$114.00 | 21% above | 10% |
| Free testosterone test CPT 84402 Testosterone, Free (Rl) | $118.00 | $131.00 | $73.00–$131.00 | 14% above | 10% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 **Clinic General Health Panel | $162.00 | $180.00 | $101.00–$180.00 | 45% below | 10% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel (Rl) | $284.00 | $316.00 | $177.00–$316.00 | 3% below | 10% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucosepost | $18.00 | $20.00 | $11.00–$20.00 | 67% below | 10% |
| Glucose tolerance test, 3 samples CPT 82951 Gtt3 Specimen | $29.00 | $32.00 | $18.00–$32.00 | 78% below | 9% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 3 Spec | $165.00 | $183.00 | $102.00–$183.00 | 27% above | 10% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chlamydia Trachomatis (Rl) | $69.00 | $77.00 | $43.00–$77.00 | 37% below | 10% |
| H. pylori stool antigen test CPT 87338 Helicobacter Pylori Stool (Rl) | $164.00 | $182.00 | $102.00–$182.00 | 3% above | 10% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv Rna Viral Load Ultra (Rl) | $223.00 | $248.00 | $139.00–$248.00 | 57% below | 10% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 & Hiv 2 Antib (Rl) | $81.00 | $90.00 | $50.00–$90.00 | 10% above | 10% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High Risk (Rl) | $112.00 | $124.00 | $69.00–$124.00 | 3% above | 10% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Corporate Hgb A1c Wellness | $16.00 | $18.00 | $10.00–$18.00 | 78% below | 11% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Glycohemoglobin | $34.00 | $38.00 | $21.00–$38.00 | 52% below | 11% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgba1c | $34.00 | $38.00 | $21.00–$38.00 | 52% below | 11% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 **Clinic Glycohemoglobin | $67.00 | $74.00 | $41.00–$74.00 | 6% below | 9% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody (Rl) | $102.00 | $113.00 | $63.00–$113.00 | 12% above | 10% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen (Rl) | $109.00 | $121.00 | $68.00–$121.00 | 17% above | 10% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody (Rl) | $75.00 | $83.00 | $46.00–$83.00 | 18% below | 10% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Quant, Pcr W/refl Geno(rl) | $327.00 | $363.00 | $203.00–$363.00 | 2% below | 10% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus Rna & Quant (Rl) | $524.00 | $582.00 | $326.00–$582.00 | 56% above | 10% |
| Herpes blood test, HSV-1 antibody CPT 86695 Hsv 1,2 Glycoprotein G P-1(rl) | $47.00 | $52.00 | $29.00–$52.00 | 53% below | 10% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type I Ant (Rl) | $75.00 | $83.00 | $46.00–$83.00 | 25% below | 10% |
| Herpes blood test, HSV-2 antibody CPT 86696 Hsv 1,2 Glycoprotein G P-2(rl) | $47.00 | $52.00 | $29.00–$52.00 | 56% below | 10% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Crphs Cardiac(rl) | $45.00 | $50.00 | $28.00–$50.00 | 45% below | 10% |
| Homocysteine blood test CPT 83090 Homocysteine (Rl) | $221.00 | $246.00 | $138.00–$246.00 | 56% above | 10% |
| Insulin blood test CPT 83525 Insulin, Total (Rl) | $109.00 | $121.00 | $68.00–$121.00 | 1% above | 10% |
| Iron blood test (serum iron) CPT 83540 Iron Serum (Rl) | $45.00 | $50.00 | $28.00–$50.00 | 29% below | 10% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity P-1 (Rl) | $55.00 | $61.00 | $34.00–$61.00 | 20% below | 10% |
| Kidney function blood test panel CPT 80069 Kidney function panel test | $122.00 | $136.00 | $76.00–$136.00 | 10% below | 10% |
| LH (luteinizing hormone) test CPT 83002 Lutinizing Hormone (Lh) (Rl) | $62.00 | $69.00 | $39.00–$69.00 | 50% below | 10% |
| Lipase blood test (pancreas enzyme) CPT 83690 **Clinic Lipase | $75.00 | $83.00 | $46.00–$83.00 | 22% below | 10% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase | $80.00 | $89.00 | $50.00–$89.00 | 16% below | 10% |
| Liver function blood test panel CPT 80076 Liver function blood test | $113.00 | $125.00 | $70.00–$125.00 | 13% below | 10% |
| Lyme disease antibody test CPT 86618 Lyme Disease (Rl) | $58.00 | $64.00 | $36.00–$64.00 | 55% below | 9% |
| Lyme disease antibody test CPT 86618 Lyme Disease Abs W Ref Western Blot (Rl) | $138.00 | $153.00 | $86.00–$153.00 | 7% above | 10% |
| Magnesium blood test CPT 83735 Magnesium Urine, Random(rl) | $32.00 | $35.00 | $20.00–$35.00 | 53% below | 9% |
| Magnesium blood test CPT 83735 **Clinic Magnesium | $58.00 | $64.00 | $36.00–$64.00 | 15% below | 9% |
| Magnesium blood test CPT 83735 Magnesium, Serum | $62.00 | $69.00 | $39.00–$69.00 | 9% below | 10% |
| Magnesium blood test CPT 83735 Magnesium, Rbc (Rl) | $72.00 | $80.00 | $45.00–$80.00 | 6% above | 10% |
| Magnesium blood test CPT 83735 Magnesium Urine 24 Hr(rl) | $81.00 | $90.00 | $50.00–$90.00 | 19% above | 10% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Igg Antibody (Rl) | $56.00 | $62.00 | $35.00–$62.00 | 33% below | 10% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mono | $15.00 | $17.00 | $10.00–$17.00 | 77% below | 12% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mono Heterophile Antibody | $77.00 | $86.00 | $48.00–$86.00 | 19% above | 10% |
| Obstetric blood test panel CPT 80055 Obstetric blood test panel | $160.00 | $178.00 | $100.00–$178.00 | 19% below | 10% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test | $111.00 | $123.00 | $69.00–$123.00 | 7% above | 10% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Pap. Liquid Based (Rl) | $117.00 | $130.00 | $73.00–$130.00 | 41% above | 10% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Liquid Based (Rl) | $153.00 | $170.00 | $95.00–$170.00 | 179% above | 10% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone (Rl) | $185.00 | $206.00 | $115.00–$206.00 | 12% below | 10% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test | $83.00 | $92.00 | $52.00–$92.00 | 8% above | 10% |
| Progesterone blood test CPT 84144 Progesterone (Rl) | $75.00 | $83.00 | $46.00–$83.00 | 31% below | 10% |
| Prolactin blood test CPT 84146 Prolactin, Serum (Rl) | $104.00 | $116.00 | $65.00–$116.00 | 7% below | 10% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $44.00 | $49.00 | $27.00–$49.00 | 12% below | 10% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 15 Test Urine Drug Screen | $87.00 | $97.00 | $54.00–$97.00 | 8% below | 10% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Urine Drug Screen | $95.00 | $105.00 | $59.00–$105.00 | at median | 10% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 **Clinic Urine Drug Screen | $104.00 | $116.00 | $65.00–$116.00 | 9% above | 10% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza A/b | $82.00 | $91.00 | $51.00–$91.00 | 11% above | 10% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep | $29.00 | $32.00 | $18.00–$32.00 | 41% below | 9% |
| Rheumatoid factor (RF) test CPT 86431 Systemic Lupus Erythemat (Rl) | $54.00 | $60.00 | $34.00–$60.00 | at median | 10% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quan (Rl) | $62.00 | $69.00 | $39.00–$69.00 | 15% above | 10% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Igg Ab(rl) | $49.00 | $54.00 | $30.00–$54.00 | 34% below | 9% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis, Complete | $145.00 | $161.00 | $90.00–$161.00 | 41% below | 10% |
| Stool ova and parasites exam CPT 87177 Ova & Parasite Travel(rl) | $50.00 | $55.00 | $31.00–$55.00 | 33% below | 9% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood, Feces | $40.00 | $44.00 | $25.00–$44.00 | 45% above | 9% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood | $37.00 | $41.00 | $23.00–$41.00 | 11% below | 10% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Serology Sts (Rl) | $17.00 | $19.00 | $11.00–$19.00 | 60% below | 11% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tb Interferon Antigen Re (Rl) | $245.00 | $272.00 | $152.00–$272.00 | 22% above | 10% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total Serum (Rl) | $116.00 | $129.00 | $72.00–$129.00 | 8% above | 10% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Antibodies (Rl) | $68.00 | $76.00 | $43.00–$76.00 | 19% below | 11% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (Tpo)ab (Rl) | $82.00 | $91.00 | $51.00–$91.00 | 2% below | 10% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsome Ab, Igg Liv/kid (Rl) | $96.00 | $107.00 | $60.00–$107.00 | 15% above | 10% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $89.00 | $99.00 | $55.00–$99.00 | 15% below | 10% |
| Trichomonas test (NAAT) CPT 87661 Ytripcr/amplified Probe (Rl) | $89.00 | $99.00 | $55.00–$99.00 | 5% below | 10% |
| Uric acid blood test CPT 84550 **Clinic Uric Acid | $47.00 | $52.00 | $29.00–$52.00 | 11% below | 10% |
| Uric acid blood test CPT 84550 Uric Acid | $50.00 | $56.00 | $31.00–$56.00 | 5% below | 11% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis test using microscope | $49.00 | $54.00 | $30.00–$54.00 | 2% below | 9% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis test using microscope | $35.00 | $39.00 | $22.00–$39.00 | at median | 10% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis test | $10.00 | $11.00 | $6.00–$11.00 | 68% below | 9% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis test | $19.00 | $21.00 | $12.00–$21.00 | 11% below | 10% |
| Urine culture for bacteria, with colony count CPT 87086 Culture, Urine (Rl) | $59.00 | $65.00 | $36.00–$65.00 | 18% below | 9% |
| Urine pregnancy test, read by color change CPT 81025 Hcgurine | $21.00 | $23.00 | $13.00–$23.00 | 67% below | 9% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vit B12 Rl | $134.00 | $149.00 | $83.00–$149.00 | 19% above | 10% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D25 Hydroxy Rl | $148.00 | $164.00 | $92.00–$164.00 | 6% above | 10% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D2 & D3 25-hydoxy (Rl) | $153.00 | $170.00 | $95.00–$170.00 | 10% above | 10% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Pla2r Phospholipase A2 Rec Ab, Igg (Rl) | $227.00 | $252.00 | $141.00–$252.00 | 62% above | 10% |
| Zinc blood test CPT 84630 Zinc (Rl) | $83.00 | $92.00 | $52.00–$92.00 | 26% above | 10% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 **Clinic Hcg | $50.00 | $56.00 | $31.00–$56.00 | 44% below | 11% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg Quant (Rl) | $99.00 | $110.00 | $62.00–$110.00 | 12% above | 10% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 **Clinic Bhcg Quantitative | $118.00 | $131.00 | $73.00–$131.00 | 33% above | 10% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Tumor Marker | $127.00 | $141.00 | $79.00–$141.00 | 43% above | 10% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg (Quant) | $127.00 | $141.00 | $79.00–$141.00 | 43% above | 10% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 Migraine Botox | $518.00 | $575.00 | $322.00–$575.00 | 28% above | 10% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Fx Distal Fibular Closed | $497.00 | $552.00 | $269.00–$552.00 | 25% above | 10% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed Tx Of Distal Fibular Fx W/o Manip | $560.00 | $622.00 | $348.00–$622.00 | 40% above | 10% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Fx Metatarsal Foot Closed | $349.00 | $388.00 | $217.00–$388.00 | 4% below | 10% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Tx Fx Clsd Metatarsal Wo Manip | $470.00 | $522.00 | $292.00–$522.00 | 29% above | 10% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Er Fac Closed Tx Metatarsal Fx | $470.00 | $522.00 | $292.00–$522.00 | 29% above | 10% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed Tx Metatarsal Fx | $488.00 | $542.00 | $192.00–$542.00 | 34% above | 10% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Electric Ex | $2,081.00 | $2,312.00 | $1,295.00–$2,312.00 | 45% above | 10% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 Obstetric care, planned cesarean delivery | $3,586.00 | $3,984.00 | $2,231.00–$3,984.00 | 30% below | 10% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Er Fac Closed Tx Fx Radius/ulna Wo | $596.00 | $662.00 | $371.00–$662.00 | 30% above | 10% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed Tx Und Distal Radi | $606.00 | $673.00 | $313.00–$673.00 | 32% above | 10% |
| Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope | $1,100.00 | $1,222.00 | $684.00–$1,222.00 | 1% below | 10% |
| Colonoscopy with tissue sample CPT 45380 Biopsy exam of large bowel using an endoscope | $913.00 | $1,014.00 | $568.00–$1,014.00 | 30% below | 10% |
| Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using an endoscope | $777.00 | $863.00 | $483.00–$863.00 | 37% below | 10% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy | $302.00 | $336.00 | $188.00–$336.00 | at median | 10% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Actinic Keratoses (1) | $104.00 | $115.00 | $64.00–$115.00 | 19% below | 10% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Ear Lavage | $27.00 | $30.00 | $17.00–$30.00 | 42% below | 10% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal Impacted Cerumen Irrigation/lava | $103.00 | $114.00 | $64.00–$114.00 | 121% above | 10% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal Of Impacted Cerumen Using Irriga | $235.00 | $261.00 | $146.00–$261.00 | 404% above | 10% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Removal Impacted Cerumen Irrg/lav Unilat | $103.00 | $114.00 | $64.00–$114.00 | 121% above | 10% |
| Earwax removal with instruments, one ear CPT 69210 Removal Ear Wax | $93.00 | $103.00 | $58.00–$103.00 | 8% above | 10% |
| Earwax removal with instruments, one ear CPT 69210 Removal Impacted Cerument Instrumentatio | $103.00 | $114.00 | $64.00–$114.00 | 20% above | 10% |
| Earwax removal with instruments, one ear CPT 69210 Removal Impacted Ceramen | $113.00 | $125.00 | $25.00–$125.00 | 31% above | 10% |
| Earwax removal with instruments, one ear one side CPT 69210 Removal Impacted Cerumen W/instr Unilat | $103.00 | $114.00 | $64.00–$114.00 | 20% above | 10% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Biopsy Of Uterus Lining | $307.00 | $341.00 | $191.00–$341.00 | 40% above | 10% |
| Gallbladder removal, laparoscopic CPT 47562 Removal of gallbladder using an endoscope | $1,645.00 | $1,828.00 | $1,024.00–$1,828.00 | 5% below | 10% |
| IUD insertion (the device itself billed separately) CPT 58300 Iud Insertion | $153.00 | $170.00 | $95.00–$170.00 | 24% below | 10% |
| IUD insertion (the device itself billed separately) CPT 58300 Paragard Insertion | $176.00 | $196.00 | $110.00–$196.00 | 13% below | 10% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I & D Abcess | $183.00 | $203.00 | $93.00–$203.00 | 29% below | 10% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I & D Abscess | $189.00 | $210.00 | $118.00–$210.00 | 27% below | 10% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Er Fac I & D Abcess | $566.00 | $629.00 | $352.00–$629.00 | 119% above | 10% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&d Of Abscess-simple Or Single | $566.00 | $629.00 | $352.00–$629.00 | 119% above | 10% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Repair of groin hernia patient age 5 years or older | $954.00 | $1,060.00 | $594.00–$1,060.00 | 31% below | 10% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection, Tendon Sheath | $99.00 | $110.00 | $62.00–$110.00 | 42% below | 10% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection; Tendon Sheaths, Ligament | $257.00 | $285.00 | $160.00–$285.00 | 50% above | 10% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspir/inject Major Joint | $122.00 | $135.00 | $76.00–$135.00 | 36% below | 10% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Er Phys Inj Major Joint | $182.00 | $202.00 | $36.00–$202.00 | 5% below | 10% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Er Fac Er Phys Inj Major Joint | $597.00 | $663.00 | $371.00–$663.00 | 212% above | 10% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Rf Arthrocentesis, Large Joint W/o Us | $597.00 | $663.00 | $371.00–$663.00 | 212% above | 10% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion Nexplanon | $224.00 | $249.00 | $139.00–$249.00 | 2% below | 10% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspir/inject Inter Joint | $108.00 | $120.00 | $67.00–$120.00 | 41% below | 10% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspiration Of Bursa | $123.00 | $137.00 | $30.00–$137.00 | 33% below | 10% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Er Fac Aspiration Of Bursa | $257.00 | $285.00 | $160.00–$285.00 | 39% above | 10% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Rf Arthrocentesis Med Jt | $329.00 | $365.00 | $204.00–$365.00 | 78% above | 10% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Aspir/inject Small Joint | $77.00 | $86.00 | $48.00–$86.00 | 46% below | 10% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Rf Arthrocentesis, Small Joint W/o Us | $388.00 | $431.00 | $241.00–$431.00 | 170% above | 10% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Removal of recurring cataract in lens capsule using laser | $710.00 | $789.00 | $442.00–$789.00 | at median | 10% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Er Phys-int Lac 2.5cm | $334.00 | $371.00 | $124.00–$371.00 | 19% below | 10% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Inter Repair Truck< 2.5 Cm | $388.00 | $431.00 | $241.00–$431.00 | 6% below | 10% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermediate Repair2.5cm < | $463.00 | $514.00 | $288.00–$514.00 | 12% above | 10% |
| Miscarriage treatment with D&C, first trimester CPT 59820 D&c Abort Missed 1st Trim | $607.00 | $674.00 | $377.00–$674.00 | 45% below | 10% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Excsn Benign Trunk<0.5 Cm | $196.00 | $218.00 | $122.00–$218.00 | 35% below | 10% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Excsn Benign Face< 0.5 Cm | $219.00 | $243.00 | $136.00–$243.00 | 35% below | 10% |
| Nail removal (partial or complete), one nail CPT 11730 Removal Of Nail Plate | $152.00 | $169.00 | $46.00–$169.00 | 35% below | 10% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Single | $175.00 | $194.00 | $109.00–$194.00 | 26% below | 10% |
| Nail removal (partial or complete), one nail CPT 11730 Er Fac Removal Of Nail Plate | $760.00 | $844.00 | $473.00–$844.00 | 223% above | 10% |
| Paracentesis with imaging guidance CPT 49083 Us Paracentesis | $1,402.00 | $1,558.00 | $872.00–$1,558.00 | 70% above | 10% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excsn Nail & Matrix | $270.00 | $300.00 | $168.00–$300.00 | 18% below | 10% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Evacuation Nail | $317.00 | $352.00 | $88.00–$352.00 | 4% below | 10% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Er Fac Evacuation Nail | $939.00 | $1,043.00 | $584.00–$1,043.00 | 184% above | 10% |
| Prostate biopsy CPT 55700 Biopsy of prostate gland | $3,891.00 | $4,323.00 | $2,421.00–$4,323.00 | 242% above | 10% |
| Removal of a breast lump, open surgery CPT 19120 Removal of one or more breast growth, open procedure | $891.00 | $990.00 | $554.00–$990.00 | 25% below | 10% |
| Removal of a foreign object under the skin, simple CPT 10120 Rem For Body Hand/finger | $219.00 | $243.00 | $95.00–$243.00 | 33% below | 10% |
| Removal of a foreign object under the skin, simple CPT 10120 Foreign Body Removal-simple | $242.00 | $269.00 | $151.00–$269.00 | 26% below | 10% |
| Removal of a foreign object under the skin, simple CPT 10120 Inc & Removal Of Fb, Simple | $667.00 | $741.00 | $415.00–$741.00 | 105% above | 10% |
| Removal of a foreign object under the skin, simple CPT 10120 Er Fac I & R Foreign Body, Small | $667.00 | $741.00 | $415.00–$741.00 | 105% above | 10% |
| Removal of a foreign object under the skin, simple CPT 10120 Er Fac Rem For Body Hand/finger | $667.00 | $741.00 | $415.00–$741.00 | 105% above | 10% |
| Short arm cast (elbow to hand) CPT 29075 Appl Cast/elbow To Finger | $222.00 | $247.00 | $54.00–$247.00 | 12% above | 10% |
| Short arm cast (elbow to hand) CPT 29075 Er Fac Appl Cast/elbow To Finger | $317.00 | $352.00 | $197.00–$352.00 | 60% above | 10% |
| Short arm splint (forearm and hand) CPT 29125 Applic Short Arm Splint | $159.00 | $177.00 | $38.00–$177.00 | 3% above | 10% |
| Short arm splint (forearm and hand) CPT 29125 Application Short Arm Splint | $256.00 | $284.00 | $159.00–$284.00 | 65% above | 10% |
| Short arm splint (forearm and hand) CPT 29125 Er Fac Applic Short Arm Splint | $256.00 | $284.00 | $159.00–$284.00 | 65% above | 10% |
| Short leg splint (calf to foot) CPT 29515 Short Leg Spint (Apply) | $113.00 | $126.00 | $46.00–$126.00 | 29% below | 10% |
| Short leg splint (calf to foot) CPT 29515 Er Fac Applic Short Leg Splinter Fac App | $281.00 | $312.00 | $175.00–$312.00 | 77% above | 10% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Repair Trunk< 2.5 Cm | $141.00 | $157.00 | $88.00–$157.00 | 32% below | 10% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Er Phys-laceration 2.5cm | $234.00 | $260.00 | $40.00–$260.00 | 12% above | 10% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Application Short Arm Splint | $249.00 | $277.00 | $155.00–$277.00 | 20% above | 10% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Repair 2.5cm Or Less | $296.00 | $329.00 | $184.00–$329.00 | 42% above | 10% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Wound Dehiscence | $401.00 | $445.00 | $249.00–$445.00 | 93% above | 10% |
| Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy, Skin Lesion/single | $243.00 | $270.00 | $151.00–$270.00 | 4% below | 10% |
| Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Single Lesion | $271.00 | $301.00 | $36.00–$301.00 | 7% above | 10% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Excsn Malig Trunk< 0.5 Cm | $308.00 | $342.00 | $192.00–$342.00 | 24% below | 10% |
| Skin tag removal, up to 15 tags CPT 11200 Skin Tags Up To 15 | $140.00 | $156.00 | $87.00–$156.00 | 26% below | 10% |
| Skin tag removal, up to 15 tags CPT 11200 Er Fac Removal Of Skin Tag | $217.00 | $241.00 | $135.00–$241.00 | 15% above | 10% |
| Skin tag removal, up to 15 tags CPT 11200 Removal Of Skin Tage | $461.00 | $512.00 | $64.00–$512.00 | 144% above | 10% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Diag Lumbar Spinal Puncture | $599.00 | $666.00 | $373.00–$666.00 | 56% above | 10% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Fluid Tap, Diag | $785.00 | $872.00 | $488.00–$872.00 | 105% above | 10% |
| 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 Trunk 2.6-7.5 | $172.00 | $191.00 | $107.00–$191.00 | 29% below | 10% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Er Phys-lac (2.6cm-7.5cm) | $283.00 | $314.00 | $52.00–$314.00 | 17% above | 10% |
| 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 2.6cm-7.5cm | $320.00 | $355.00 | $199.00–$355.00 | 32% above | 10% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple Repair Face< 2.5 Cm | $173.00 | $192.00 | $108.00–$192.00 | 24% below | 10% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Er Phys-laceration 2.5cm | $283.00 | $314.00 | $49.00–$314.00 | 24% above | 10% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple Repair Face 2.5cm < | $314.00 | $349.00 | $195.00–$349.00 | 38% above | 10% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Biopsy Skin Tangential 1st Lesion | $129.00 | $143.00 | $28.00–$143.00 | 32% below | 10% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Biopsy, Skin Lesion/single | $144.00 | $160.00 | $90.00–$160.00 | 24% below | 10% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential Biopsy, Skin Lesion/single | $373.00 | $414.00 | $232.00–$414.00 | 96% above | 10% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis W/ Imaging Guidance | $937.00 | $1,041.00 | $583.00–$1,041.00 | 14% above | 10% |
| Thoracentesis with imaging guidance CPT 32555 Us Thoracentesis | $937.00 | $1,041.00 | $583.00–$1,041.00 | 14% above | 10% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Injection, Trigger Point | $89.00 | $99.00 | $55.00–$99.00 | 31% below | 10% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 Us Breast Biopsy Right | $2,054.00 | $2,282.00 | $1,278.00–$2,282.00 | 1% below | 10% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 Us Breast Biopsy Left | $2,054.00 | $2,282.00 | $1,278.00–$2,282.00 | 1% below | 10% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Biopsy exam of esophagus, stomach or small bowel using an endoscope | $739.00 | $821.00 | $460.00–$821.00 | 51% below | 10% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach or small bowel using an endoscope | $622.00 | $691.00 | $387.00–$691.00 | 15% below | 10% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 Obstetric care, planned vaginal delivery | $3,254.00 | $3,615.00 | $2,024.00–$3,615.00 | 31% below | 10% |
| Wart removal, up to 14 warts CPT 17110 Dest Warts Up To 14 | $175.00 | $194.00 | $109.00–$194.00 | at median | 10% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Subq Tiss =<20sq Cm | $170.00 | $189.00 | $52.00–$189.00 | 43% below | 10% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement, Subcutaneous Tissue | $216.00 | $240.00 | $134.00–$240.00 | 28% below | 10% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin 2 Units | $621.00 | $690.00 | $386.00–$690.00 | 13% below | 10% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin 3 + Units | $683.00 | $759.00 | $425.00–$759.00 | 5% below | 10% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin | $859.00 | $954.00 | $534.00–$954.00 | 20% above | 10% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin Per Day | $859.00 | $954.00 | $534.00–$954.00 | 20% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Breathing Treatment | $33.00 | $37.00 | $21.00–$37.00 | 69% below | 11% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ot Kx Airway Inhalation Treatment | $231.00 | $257.00 | $144.00–$257.00 | 118% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Init Treatment | $231.00 | $257.00 | $144.00–$257.00 | 118% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi Treatment Sub Med 3 | $231.00 | $257.00 | $144.00–$257.00 | 118% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ot Airway Inhalation Treatment | $231.00 | $257.00 | $144.00–$257.00 | 118% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Neb Rx Sub Med 1 | $249.00 | $277.00 | $155.00–$277.00 | 135% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi Treatment Initial | $249.00 | $277.00 | $155.00–$277.00 | 135% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatment Initial | $249.00 | $277.00 | $155.00–$277.00 | 135% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Neb Rx Sub Med 3 | $249.00 | $277.00 | $155.00–$277.00 | 135% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Neb Rx Sub Med 2 | $249.00 | $277.00 | $155.00–$277.00 | 135% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi Treatment Sub Med 2 | $249.00 | $277.00 | $155.00–$277.00 | 135% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi Treatment Sub Med 1 | $249.00 | $277.00 | $155.00–$277.00 | 135% above | 10% |
| Chemotherapy IV infusion, first hour CPT 96413 Chemo Iv Infusion To 1 Hr | $600.00 | $667.00 | $374.00–$667.00 | 5% above | 10% |
| Chemotherapy IV infusion, first hour CPT 96413 Chemo Iv Inf Initial Up To 1hr | $647.00 | $719.00 | $403.00–$719.00 | 13% above | 10% |
| Critical care, first 30 to 74 minutes CPT 99291 Phys Critical Care 1st Hr | $627.00 | $697.00 | $187.00–$697.00 | 4% below | 10% |
| Critical care, first 30 to 74 minutes CPT 99291 Er Room Critical Level 6 | $1,758.00 | $1,953.00 | $1,094.00–$1,953.00 | 170% above | 10% |
| Critical care, first 30 to 74 minutes CPT 99291 Er Room Comp. Level7 | $1,758.00 | $1,953.00 | $1,094.00–$1,953.00 | 170% above | 10% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg W/ Interpretation Read | $263.00 | $292.00 | $164.00–$292.00 | 11% above | 10% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg W/interpret & Report | $263.00 | $292.00 | $164.00–$292.00 | 11% above | 10% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Er Phys-focused | $79.00 | $88.00 | $10.00–$88.00 | 48% below | 10% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Er Phys-focused 25 Modifier | $79.00 | $88.00 | $80.00–$88.00 | 48% below | 10% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Rm 25 Focused | $249.00 | $277.00 | $155.00–$277.00 | 63% above | 10% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Rm Focused | $249.00 | $277.00 | $155.00–$277.00 | 63% above | 10% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Er Phys-expanded Low Comp 25 Modifier | $113.00 | $125.00 | $114.00–$125.00 | 41% below | 10% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Er Phys-expanded Low Comp | $113.00 | $125.00 | $38.00–$125.00 | 41% below | 10% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Rm Low Complex | $372.00 | $413.00 | $231.00–$413.00 | 93% above | 10% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Rm 25 Low Complex | $372.00 | $413.00 | $231.00–$413.00 | 93% above | 10% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Er Phys-expanded Mod Comp 25 Modifier | $188.00 | $209.00 | $190.00–$209.00 | 32% below | 10% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Er Phys-expanded Mod Comp | $188.00 | $209.00 | $65.00–$209.00 | 32% below | 10% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Rm Mod Complex | $642.00 | $713.00 | $399.00–$713.00 | 134% above | 10% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Rm 25 Mod Complex | $642.00 | $713.00 | $399.00–$713.00 | 134% above | 10% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Er Phys-detailed | $283.00 | $314.00 | $110.00–$314.00 | 40% below | 10% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Er Phys-detailed 25 Modifier | $283.00 | $314.00 | $286.00–$314.00 | 40% below | 10% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Rm 25 Detailed | $889.00 | $988.00 | $553.00–$988.00 | 89% above | 10% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Rm Detailed | $952.00 | $1,058.00 | $592.00–$1,058.00 | 103% above | 10% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Er Phys-comprehensive | $401.00 | $446.00 | $160.00–$446.00 | 39% below | 10% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Er Phys-comprehensive 25 Modifier | $401.00 | $446.00 | $406.00–$446.00 | 39% below | 10% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Rm 25 Comprehensiv | $1,381.00 | $1,534.00 | $859.00–$1,534.00 | 110% above | 10% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Rm Comprehensiv | $1,488.00 | $1,653.00 | $926.00–$1,653.00 | 126% above | 10% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular Stress Tes | $1,079.00 | $1,199.00 | $671.00–$1,199.00 | 1% above | 10% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Hydration Infus Initial 31min-1hr | $384.00 | $427.00 | $239.00–$427.00 | 1% above | 10% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Hydration (1st Hour) | $386.00 | $429.00 | $240.00–$429.00 | 2% above | 10% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Infsn Hydrtn Initial 31 Min To 1 Hr | $386.00 | $429.00 | $240.00–$429.00 | 2% above | 10% |
| IV infusion of a medicine, first hour CPT 96365 Op Remdesivir Infusion | $351.00 | $390.00 | $218.00–$390.00 | 8% below | 10% |
| IV infusion of a medicine, first hour CPT 96365 Iv Infusion Dx Up To 1 Hr | $416.00 | $462.00 | $259.00–$462.00 | 9% above | 10% |
| IV infusion of a medicine, first hour CPT 96365 Iv Infusion Dx (1st Hr) | $416.00 | $462.00 | $259.00–$462.00 | 9% above | 10% |
| IV infusion of a medicine, first hour CPT 96365 Iv Drug Infusion Initial Up To 1 Hr | $437.00 | $486.00 | $272.00–$486.00 | 14% above | 10% |
| IV infusion of a medicine, first hour CPT 96365 Iv Infusion Monoclonal | $495.00 | $550.00 | $308.00–$550.00 | 29% above | 10% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therapeutic Injection | $36.00 | $40.00 | $22.00–$40.00 | 60% below | 10% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Im Or Sq | $118.00 | $131.00 | $73.00–$131.00 | 30% above | 10% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Im Or Subq Injection Each | $118.00 | $131.00 | $73.00–$131.00 | 30% above | 10% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Fee (Im, Sq) | $118.00 | $131.00 | $73.00–$131.00 | 30% above | 10% |
| Neuromuscular re-education, 15 minutes CPT 97112 Transfer Training | $83.00 | $92.00 | $52.00–$92.00 | 9% below | 10% |
| Neuromuscular re-education, 15 minutes CPT 97112 Ot Kx Neuromuscular Re-education | $97.00 | $108.00 | $60.00–$108.00 | 6% above | 10% |
| Neuromuscular re-education, 15 minutes CPT 97112 Pt Kx Neuromuscular Re-educ | $97.00 | $108.00 | $60.00–$108.00 | 6% above | 10% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re-educ | $104.00 | $116.00 | $65.00–$116.00 | 14% above | 10% |
| Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuromuscular Re-educ | $104.00 | $116.00 | $65.00–$116.00 | 14% above | 10% |
| New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min | $173.00 | $192.00 | $108.00–$192.00 | 16% below | 10% |
| New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min | $279.00 | $310.00 | $174.00–$310.00 | 7% below | 10% |
| New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min | $347.00 | $385.00 | $216.00–$385.00 | 6% below | 10% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Patient--expanded | $112.00 | $124.00 | $39.00–$124.00 | 9% below | 10% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Specialty Clinic New Pt 15 Min | $116.00 | $129.00 | $72.00–$129.00 | 6% below | 10% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Pt Focused | $122.00 | $136.00 | $76.00–$136.00 | 1% below | 10% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Wcc New Patient 15 Min | $122.00 | $136.00 | $76.00–$136.00 | 1% below | 10% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Dietary Consult 1st Hour | $32.00 | $36.00 | $20.00–$36.00 | 34% below | 11% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 **Dietary Consultation | $33.00 | $37.00 | $21.00–$37.00 | 31% below | 11% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt Initial Individual Per 15 Mins | $57.00 | $63.00 | $35.00–$63.00 | 18% above | 10% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Kx Evaluation Low Complexity | $167.00 | $185.00 | $104.00–$185.00 | 2% above | 10% |
| Occupational therapy evaluation, low complexity CPT 97165 Ot Eval For Low Complexity | $188.00 | $209.00 | $117.00–$209.00 | 15% above | 10% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Kx High Complexity Eval (45 Min) | $257.00 | $286.00 | $160.00–$286.00 | 24% above | 10% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 High Complexity Eval (45 Min) | $277.00 | $308.00 | $172.00–$308.00 | 33% above | 10% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Kx Low Complexity Eval (20 Min) | $161.00 | $179.00 | $100.00–$179.00 | 2% above | 10% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Low Complexity Eval (20 Min) | $190.00 | $211.00 | $118.00–$211.00 | 20% above | 10% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Kx Moderate Complexity Eval (30 Min) | $201.00 | $223.00 | $125.00–$223.00 | 14% above | 10% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Moderate Complexity Eval (30 Min) | $216.00 | $240.00 | $134.00–$240.00 | 22% above | 10% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Kx Manual Therapy Techniques | $104.00 | $115.00 | $64.00–$115.00 | 8% above | 10% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Kx Manual Therapy | $104.00 | $115.00 | $64.00–$115.00 | 8% above | 10% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Techniques | $112.00 | $124.00 | $69.00–$124.00 | 17% above | 10% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Manual Therapy Tech | $112.00 | $124.00 | $69.00–$124.00 | 17% above | 10% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise | $110.00 | $122.00 | $68.00–$122.00 | 16% above | 10% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years) | $238.00 | $264.00 | $148.00–$264.00 | 3% below | 10% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years) | $263.00 | $292.00 | $164.00–$292.00 | 5% below | 10% |
| Preventive checkup, new patient aged 65 or older CPT 99387 New Preventive 65> | $268.00 | $298.00 | $167.00–$298.00 | 2% below | 10% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 **New Employee Visit | $193.00 | $214.00 | $120.00–$214.00 | 11% below | 10% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 **Cdl/dot 95 | $193.00 | $214.00 | $120.00–$214.00 | 11% below | 10% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 Est Preventive 18-39yrs | $214.00 | $238.00 | $133.00–$238.00 | 2% below | 10% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 **Cdl/dot 96 | $205.00 | $228.00 | $128.00–$228.00 | 12% below | 10% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 Est Preventive 40-64yrs | $224.00 | $249.00 | $139.00–$249.00 | 4% below | 10% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 **Cdl/dot 97 | $221.00 | $245.00 | $137.00–$245.00 | 7% below | 10% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 Est Preventive 65> | $231.00 | $257.00 | $144.00–$257.00 | 3% below | 10% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Counseling, Tobacco 3-10 Minutes | $24.00 | $27.00 | $15.00–$27.00 | 18% below | 11% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessatn 3-10 Min | $62.00 | $69.00 | $39.00–$69.00 | 112% above | 10% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Comprehensive Established | $216.00 | $240.00 | $119.00–$240.00 | 9% below | 10% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Wcc Established Patient 40 Min | $234.00 | $260.00 | $146.00–$260.00 | 1% below | 10% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Est Pt Comp | $237.00 | $263.00 | $147.00–$263.00 | at median | 10% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Specialty Clinic Est Pt 40 Min | $250.00 | $278.00 | $156.00–$278.00 | 6% above | 10% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Treatment Room Level T4 | $570.00 | $633.00 | $354.00–$633.00 | 141% above | 10% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Detail Established | $108.00 | $120.00 | $55.00–$120.00 | 9% below | 10% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Specialty Clinic 20 Min | $119.00 | $132.00 | $74.00–$132.00 | 1% above | 10% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Wcc Established Patient 20 Min | $119.00 | $132.00 | $74.00–$132.00 | 1% above | 10% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Est Pt Expanded | $119.00 | $132.00 | $74.00–$132.00 | 1% above | 10% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Treatment Room Level T2 | $266.00 | $296.00 | $166.00–$296.00 | 125% above | 10% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Cdl- E&m | $135.00 | $150.00 | $84.00–$150.00 | 23% below | 10% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Moderate Established | $158.00 | $175.00 | $80.00–$175.00 | 10% below | 10% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Specialty Clinic Est Pt 30 Min | $160.00 | $178.00 | $100.00–$178.00 | 8% below | 10% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Wcc Established Patient 30 Min | $175.00 | $194.00 | $109.00–$194.00 | at median | 10% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Est Pt Detailed | $175.00 | $194.00 | $109.00–$194.00 | at median | 10% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Treatment Room Level T3 | $360.00 | $400.00 | $224.00–$400.00 | 106% above | 10% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Est Pt Focused | $72.00 | $80.00 | $45.00–$80.00 | 14% below | 10% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Other Outpatient Visit-focused | $82.00 | $91.00 | $29.00–$91.00 | 2% below | 10% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Wcc Established Patient 10 Min | $104.00 | $115.00 | $64.00–$115.00 | 24% above | 10% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Specialty Clinic Pt 10 Min | $146.00 | $162.00 | $91.00–$162.00 | 74% above | 10% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Treatment Room Level T1 | $146.00 | $162.00 | $91.00–$162.00 | 74% above | 10% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Patient office consultation, 40 min | $295.00 | $328.00 | $184.00–$328.00 | 34% above | 10% |
| Speech and language evaluation CPT 92523 St Eval Sound Prod W/ Language Comp/expr | $315.00 | $350.00 | $196.00–$350.00 | 2% above | 10% |
| Speech therapy session, individual CPT 92507 **Speech Therapy | $211.00 | $234.00 | $131.00–$234.00 | 13% below | 10% |
| Speech therapy session, individual CPT 92507 St Kx Sp/lg Treatment | $277.00 | $308.00 | $172.00–$308.00 | 14% above | 10% |
| Speech therapy session, individual CPT 92507 St Sp/lg Treatment | $299.00 | $332.00 | $186.00–$332.00 | 23% above | 10% |
| Spirometry (breathing test) CPT 94010 Incentive Spirometry Subs | $270.00 | $300.00 | $168.00–$300.00 | at median | 10% |
| Spirometry (breathing test) CPT 94010 Peak Flow Inst Initial | $270.00 | $300.00 | $168.00–$300.00 | at median | 10% |
| Spirometry (breathing test) CPT 94010 Spirometry Basic | $270.00 | $300.00 | $168.00–$300.00 | at median | 10% |
| Spirometry (breathing test) CPT 94010 Peak Flow Subsequent | $270.00 | $300.00 | $168.00–$300.00 | at median | 10% |
| Spirometry (breathing test) CPT 94010 Incentive Spirometry Initial | $320.00 | $356.00 | $199.00–$356.00 | 19% above | 10% |
| Spirometry before and after a bronchodilator CPT 94060 Spirometry Pre & Post | $693.00 | $770.00 | $431.00–$770.00 | 23% above | 10% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Kx Therapeutic Activities | $92.00 | $102.00 | $57.00–$102.00 | 7% above | 10% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Kx Therapeutic Activities | $104.00 | $115.00 | $64.00–$115.00 | 21% above | 10% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Therapeutic Activities | $112.00 | $124.00 | $69.00–$124.00 | 30% above | 10% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities | $112.00 | $124.00 | $69.00–$124.00 | 30% above | 10% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, Therapeutic | $131.00 | $146.00 | $82.00–$146.00 | 32% below | 10% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Fee | $264.00 | $293.00 | $164.00–$293.00 | 37% above | 10% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Nebraska | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella (Clinic) | $311.00 | $346.00 | $194.00–$346.00 | 56% above | 10% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Hpv 9 (Clinic) | $511.00 | $568.00 | $318.00–$568.00 | 38% above | 10% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Adult >19 (Clinic) | $178.00 | $198.00 | $111.00–$198.00 | 89% above | 10% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Adult >19 (Clinic) | $157.00 | $174.00 | $97.00–$174.00 | 73% above | 10% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza High Dose Vaccine 0.5ml | $111.00 | $123.00 | $69.00–$123.00 | 35% above | 10% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu 65+ Hd | $114.00 | $127.00 | $71.00–$127.00 | 39% above | 10% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Mmr (Clinic) | $187.00 | $208.00 | $116.00–$208.00 | 67% above | 10% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcalmcv4 (Clinic) | $293.00 | $326.00 | $183.00–$326.00 | 60% above | 10% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcalmenb (Clinic) | $410.00 | $455.00 | $255.00–$455.00 | 48% above | 10% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal-pcv 20 (Clinic) | $502.00 | $558.00 | $312.00–$558.00 | 16% above | 10% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumonia- Ppsv23 (Clinic) | $246.00 | $273.00 | $153.00–$273.00 | 32% above | 10% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 Rsv Vaccine 60+yr (Clinic) | $563.00 | $625.00 | $350.00–$625.00 | 46% above | 10% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine (Special Order) | $845.00 | $939.00 | $526.00–$939.00 | 73% above | 10% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Zoster Vaccine 0.5ml | $333.00 | $370.00 | $207.00–$370.00 | 16% above | 10% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingrix (Clinic) | $352.00 | $391.00 | $219.00–$391.00 | 23% above | 10% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus/diptheria Vaccine | $99.00 | $110.00 | $62.00–$110.00 | 90% above | 10% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap Vfc (Clinic) | $18.00 | $20.00 | $11.00–$20.00 | 74% below | 10% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus/diptheria/pertussis Vaccine | $126.00 | $140.00 | $78.00–$140.00 | 79% above | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Admin | $28.00 | $31.00 | $17.00–$31.00 | 21% below | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Administration | $81.00 | $90.00 | $50.00–$90.00 | 129% above | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Covid Vaccine Admin Fee | $107.00 | $119.00 | $67.00–$119.00 | 202% above | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Admin Fee | $107.00 | $119.00 | $67.00–$119.00 | 202% above | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Administration One Vaccine | $107.00 | $119.00 | $67.00–$119.00 | 202% above | 10% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Immunization Each Addt'l | $21.00 | $23.00 | $13.00–$23.00 | 37% below | 9% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Admin Ea Add'l Vaccine | $94.00 | $104.00 | $58.00–$104.00 | 181% above | 10% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Administration Ea Add'l | $94.00 | $104.00 | $58.00–$104.00 | 181% above | 10% |